Week Six

Thomas is now four years of age. Molly and Ian describe him generously as "a handful." In spite of their deep love for their son, they are worn out from his seemingly constant tantrums. While his speech has improved somewhat, he still struggles to communicate his basic needs, and much of the time he seems to prefer simply being alone. 

Thomas' tantrums made it impossible to continue in the Montessori school that he attended for a couple of months. The staff of the school made a real effort to include Thomas, but his difficulty with social relations was too much for them - and for the other kids. The final straw was Thomas biting another child, something that Molly and Ian had only seen him do at home. 

For them, in any case, Montessori seemed like years ago. Their days now are filled with trying to guess what Thomas is thinking and feeling and attempting to meet his needs before he tantrums. Sometimes they are successful, and sometimes they have to contain Thomas physically so he doesn't hurt himself or others. In these episodes, it is not uncommon for Molly to get scratched and bitten; Ian is limited in how much he can assist owing to being wheelchair-bound. Molly winds up taking the brunt of Thomas' aggression, something they both know he can't control but that nonetheless makes their life incredibly challenging. 

Sometimes Ian can soothe Thomas by having him crawl up in his lap. Ian will roll around the house with him, and, for some reason, Thomas seems to enjoy the sensation.  

When Thomas is "on," he is incredibly inquisitive and creative. His big brown eyes tell his parents that there is so much more going on in his head than he is able to tell the world - they wish so much that he could express himself better, but they know that there is much more to Thomas than most people see. And this keeps them going when he does tantrum. 

Ian and Molly are careful not to allow Thomas to see TV all that much. He can become easily fascinated to the point of tantruming when the TV is turned off or it's time to go to bed. Once in a while they will allow him to see a movie, and he even knows how to work the DVD player. He will repeatedly play the same section of 'Finding Nemo' over and over until his parents redirect him. 

[

See the following vignette (video) about a 4 year old non-verbal child who is having a tantrum (a fairly manageable one):

http://www.youtube.com/watch?v=rvC5gzmwq_8

]

* Describe the typical developmental milestones for a four-year old including physical, cognitive, emotional and social domains.

* Describe the process of transitioning from IDEA Part C to IDEA Part B. What additional services are available to him under Part B that were not under Part C?

* What is the likely classification that Thomas will fall under regarding IDEA Part B? In other words, what "label" is he likely to have within the local school district?

* Discuss the degree to which many children with Autism have sensory challenges with regard to stimulation (from lights, fabrics, sounds, etc.)

DECISION POINT ::: Do Molly and Ian take Thomas to a child psychiatrist? Why or why not? What considerations inform their (your) decision?

In addition to the questions above, please also answer the following questions posed to you by the other groups (not all questions are included from all groups) :::

From the Wendy Marianna group :::

1) Does every child with autism act in the same manner? Are there specific diagnostic criteria and/or manifestations that must be present to be diagnosed with an Autism Spectrum Disorder? Is it possible for Thomas to have a savant skill?

From the Ahmad Nassar group :::

1) At what point in a child with Autism's development is it "time" to bring in further specialists such as behaviorists? How helpful have they shown to be?

2) Since Thomas doesn't always cue his needs, what are some adaptive strategies Ian and Molly could use to allow Thomas to further express himself?

From the Lisa Yoo group :::

1) What are some ways that Molly and Ian can cope with Thomas’ diagnosis on the ASD spectrum? It has already been stated that there is a negative impact emotionally on the Molly and Ian, but what resources do they have through their community or possibly through IFSP?

Week Five

Individual Assignments

Week Four

Thomas is now 2 1/2. At 2, Molly and Ian took him to a specialist to see if he met criteria for autism. He was found to be on the spectrum and was given a diagnosis of Autism Spectrum Disorder.

For the most part, Thomas is a content child - he does not always cue his parents for his needs, however, making reading his moods difficult. Molly and Ian are deeply committed to him and have done everything   they could to make sure Thomas had all of the resources available. Thomas has been going to see a speech pathologist who has been helping with some of Thomas' language acquisition.

Molly and Ian have talked about sending Thomas to a Montessori school, but they aren't sure if he would be able to handle the peer relationships. Thus far, he has not had much exposure to other kids, and his various therapies have taken a lot of the family's time after work hours.

* What are typical developmental milestones for a 2 1/2 year old child? What would we expect to see from Thomas if he did not have autism? Be sure to include physical, cognitive and socio-emotional domains.

* What services are available for Thomas given his diagnosis? Assume the family lives in the Harrisonburg-Rockingham area. What are the considerations for insurance coverage? You previously mentioned that autism had to be covered; how so?

* What is the likely impact on Molly and Ian of Thomas' diagnosis? Be sure to utilize information from the readings to answer this question. What is the impact of Ian's disability on his ability to care for Thomas ?

* At age 2, assuming Molly and Ian utilized IDEA-C, what were some of the likely goals for his IFSP?

* What are the possibilities for a child like Thomas attending a Montessori school?

DECISION POINT ::: Does Thomas attend a Montessori school?