Autism Case Study 1

Steven: Autism, 8 year old boy

Joy Lunt
August 1997

8 year old male; Diagnosis: Autism

Steven (not his real name) started training on September 18, 1996. Sessions done at C4-SMR. Sessions #1~#28, were set at 12-15 for SMR. After that point I found that it was calming for him to work at 11.5-14.5, and did the rest of the sessions set there for the last half of the session and sometimes the whole session. (11-14 allowed him to relax to the point of sleep so we avoided that.)

Initially Mom states that he has come a long way, they work with a physical and an occupational therapist and he is currently on meds; Buspar and Prozac. However, he still has severe problems with impulse control both physical and vocal, inability to focus on any task, adverse to many textures, foods, sensations, doesn’t like to be touched, and is very hyperactive. Mom does a lot of chasing as he takes off without notice. Language is very difficult. His speech is extremely fast, difficult to understand and is basically a repetition of things he has heard. He attends a special school and works with a one-on-one aide most of the day. Mom describes him as irritable and grumpy in general.

We were not successful in getting a T.O.V.A. in the beginning due to his lack of ability to follow the directions and constant prompting was needed.

1st session….Mom was very hesitant about doing this despite seeing how it had helped her older son. She was convinced he would not sit still long enough to bother with this. He sat and did a full 30 minutes and had no problem attending. Mom was completely surprised and delighted.

2nd session…I never sat down. As soon as I put the electrodes on, he pulled them off. (We are going to need stronger electrodes if we are going to do much of this work!!) He is very sensitive and dislikes any touch, so I sent a set of old electrodes home with them so that he could get used to them.

After that we gave him small things to hold to keep his hands occupied. Mom said that there was one thing at home that kept him calm and still when he held it, a guinea pig (yes, a live one). So he brought that in for several sessions. The guinea pig sat on his chest and the two of them worked on Pac-man. After several sessions like this we were able to have the electrodes stay put for the entire session.

We were able to do 30 minute sessions with much coaching and a lot of patience. From time to time we also played classical music in the background. Sessions at this point were at three times a week.

By session #5 Mom and school noted improvement in his ability to respond to verbal cues and he was sitting still for short periods. He was also beginning to focus for short periods on school work. (The comments from school were a surprise as they had no idea he was doing the biofeedback. Mom made the choice not to tell them until she was more sure about the changes.)

After session #8, his teacher told Mom that it had been the best day he had ever had in school! School reports showed that he was much easier to direct with instructions and that he was getting better at returning to a task after being distracted.

Session #12, Teachers comments were that it was like having a different child in class. She teased him about sending his brother to school today to fool the teachers. They frequently report to Mom about how much more cheerful he is at school lately.

Between session #12 and #28, he started working on school work with Mom at home with success for the first time. Also took his first spelling and math tests and did well. Now he does consistently well in both of these subjects. He is also doing much better at listening to his parents and responding appropriately to them.

Improvements in language really became noticeable about now. His speech slowed down and he became easier to understand. He also started using original speech that he would initiate. We have discovered that he has quite a sense of humor and better yet, he understands it and uses it appropriately. (He likes to tease his mom). He also has a great sense of rhythm and plays the drums very well. He is delighted to put on a show whereas before he would avoid being any center of attention and go and hide when people came to his home. He is able to ask for help from his brother on the Nintendo games and actually waits his turn. Friends who come to the house are able to understand him for the first time.

January 27, 1997

We have done approx. 60 sessions now. We are down to 2 sessions a week. Other improvements, he is much less active at school and at home. Mom actually sits and reads while he does his sessions. His vocal volume is much better controlled, and he responds well when asked to lower his voice. He very rarely has the outbursts of noises that used to be commonplace and they are much softer now when they do happen. His physical movements are smoother and less robot-like. He dances now with some pretty fluid movements!! He is much more relaxed most of the time and he is much less sensitive to textures, touch and taste. He is actually eating a few more foods willingly. His mother beams when he asks her for a hug and kiss. She repeatedly talks about how much happier he is. There is a big impact on the function of the family. Prior to this work, they never went out as a family. He could not handle the stimulation of strange places. One of them always had to stay home with him while the other took the other kids out. Now they go out together to the malls, some simple plays and concerts, and even out to eat. This is possible because his behavior is much more controlled and his reactions are much more predictable and moderate.

On his school report form the comment was written that he is a “JOY” to have in the classroom. Mom blames me for that, what a pleasure!

March 1997

He celebrated his birthday by having a party at a video arcade! What a test! This is a place he could not tolerate for even a moment before. Mom reports that he loved it, interacted well with the other kids, waited his turn for the games and was not at all overwhelmed by all of the noise and activity.

March 27, 1997

He took the T.O.V.A.. This was the first time I could convince Mom to let me try this with him again. He was able to follow all of my directions and I did not have to prompt him at all during the test. (I have included his results.)

The next week he had a bad cold. He was pretty sick, but Mom said, “Oh, it’s nothing like it used to be. When he was sick he would totally lose it and there was no way we could control him. It was bad because when he gets sick it usually lasted a long time. Now he acts like any other sick kid and he is much easier to manage and he is only sick for a few days.” He was unable to take his meds for two days during this time and he seemed to manage fine so although they had been reluctant to make any changes in his meds, they now reduced them by half.

Starting in June we have gone to once a week sessions and he has started the “Fast Forward Program”. This is supposed to help with auditory processing problems. His language has improved tremendously. His mom is very surprised at his vocabulary and his ability to apply the correct concept to words like “nothing”. His sense of humor is growing as well and he is right on target with it! He has also started to apply the work others have done with him about relating facial expressions on others to their emotions. (At the end of one day I was very tired, he looked at me and told me I looked sad and tired and told me to go home!)

He has about three more weeks of the Fast Forward Program and I am waiting to see what kind of effect that will have. I think it will be a good mix with the biofeedback. We have done about 98 sessions to date. If I can answer any other questions just let me know. I plan to do the T.O.V.A. again at the end of the summer before he goes back to school.

Prior To Biofeedback
After Biofeedback
Speech Speech
Loud, almost constant verbal outbursts Rare “noises” that are soft.
Non-original speech, “memorized” TV and Videos Original thoughts are expressed and asks question.
Speaks too quickly to understand. Speaking more slowly and distinctly.
Perception Perception
Unable to tolerate being touched. Now asks for hugs. Will initiate touch.
Poor sensory integration. Not as sensitive to light, sound or textures, including those in food.
Didn’t relate to others. Interacts with siblings, more successful in group work at school.
No response to directions Recognizes, understands and responds appropriately to verbal and written instructions.
Jerky movements with poor control Improved balance and more fluid movement.
Severe hyperactivity Able to relax and displays energy level that is more age appropriate.
Poor understand of concepts. Improved understanding and use of humor and more awareness of others’ emotions and feelings.
Inappropriate facial expressions. Appropriate facial expressions.
Usually frustrated and grumpy Usually cheerful and cooperative
Inflexible and has poor tolerance for change. Able to respond to changes in environment and plans with no adverse behaviors.

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