Sarah

Case history: Language Poor conversational skills Uses echolalia Uses poor figurative language Word finding difficulties Difficulty with initiating conversation Uses short 1-2 word phrases Inability to take turns in conversation

CASE HISTORY: birth history & milestones No complications during pregnancy or delivery Natural delivery at 9lbs 3oz Speech milestones somewhat delayed Babbled: 7mo First word: 18mo Combined words: 3 years Short sentences: 5 years Poor expressive Fairly good receptive

Case history: behaviors Separates herself from others Difficult time forming friendships Concern in turn-taking and ability to follow direction Obsessive over single topic over long period of time

Overall outcome Sarah will improve expressive language skills by increasing word finding skills so that she can interact with her peers and teachers

Short term objective Sarah will initiate conversation with the clinician upon arrival in 4 of 5 therapy sessions. Children with autism have difficulties initiating and perpetuating conversation Typical avoidances include showing no appropriate emotion in conversation or low ability to produce a narrative Children with autism typically give no response to conversation or offer new or similar information to a topic Capps,L., Kehres, J. & Sigman, M. (1998). Conversational abilities among children with autism and children with developmental dealys. Autism, 2(4), 325-344. doi: 10.1177/1362361398024002

Short term objective Sarah will successfully follow 3-step directions during a structured therapy task 4 out of 5 times. Sometimes, children on the autism spectrum have difficulty following directions. This isn’t because they don’t want to, but because they do not understand what it is that you want them to do. Following directions is an important functional lifelong skill that students should have. Vicker, B. (2004). Comprehension of the message: Important considerations for following directions. The Reporter, 9(2), 6-8, 19. Retrieved from http://www.iidc.indiana.edu/?pageId=521

Short term objective Given a verbal prompt Sarah will use 2-3 word phrases to describe her actions in 90% of her attempts. I created this goal because many people with Autism have word retrieval problems. They aren’t good with their expressive language especially when it comes to answer questions. To help them with this we could use cueing cards, multiple choice options, visual backings, etc. It also depends on the conversational situation they are in whether the person talks a lot, or if they give them time to put in a word or two. Stillman, W., Notbohm, E., Kluth, P., Hodgdon, L., Stanfield, J. (2008). General strategies for intervention. Autism Speaks. http://www.autismspeaks.org/docs/family_services_docs/sk/General_Strategies.pdf

Short term objective Goal: During a 30 minute session, Sarah will take turns (by not interrupting) in 90% of opportunities. Turn taking in young children with autism is possibly impaired before age 3 The social interactions of these children seem to be impaired Because turn taking in young children with autism can occasionally be impaired, it would be important to put an emphasis on this and other social interaction scenarios in therapy Turn taking can be emphasized through therapy activities such as: playing games, building blocks in turn, putting objects back in a bowl or bucket Chiang, C., Soong, W., Lin, T., Rogers, S. J., (2008). Nonverbal communication skills in children with autism. Journal of Autism & Developmental Disorders, 38 (10), 1898-906.DOI 10.1007/s10803-008-0586-2

Evidence based treatment strategies Use a systemic multimodal approach to treat speech and language deficits in children with Autism This means motivating people with Autism to develop their language and speech skills through contents usually present in their natural social environment Sarah likes Disney princesses, which is why we incorporated the paper dolls in dresses into her therapy Tamas, D., Markovic, S., & Milankov, V. (2013). Systemic multimodal approach to speech therapy treatment in autistic children. Medicinski Pregled, 66(5-6), 233-239. doi: 10.2298/MPNS1306233T

Materials Crayons paper dolls dry erase board/marker