Clinical Assessment of Child and Adolescent Personality and ...

chapter 19 Assessment of autism spectrum449Julie does not interact with the other children.When called on in class, she seemsembarrassed and then blurts out anyanswer. She reportedly has a very shortattention span and also sometimes leavesthe room without teacher permission. Herteacher stated that she is teased by theother children because of her behavior,which includes chewing on her mat and herclothes. According to her teacher, Julie hasnot learned many academic skills. She seemsto have learned a few basic concepts, such asshapes. She can also make a capital “A,” butit is frequently upside down. She reportedlywrites and works with other objects upsidedown frequently and does not seem to recognizethat she is doing so. She reportedlycannot complete worksheets, as she justdraws lines up and down the page or colorsthe whole page one color. According to herteacher, Julie sometimes does better withone-on-one assistance, but at other times,she will not accept help from her teacher.Julie was briefly observed at school duringlunch. She was sitting at the end of thetable by herself and did not interact withthe other children. Although she had talkedwith the observer previously, she showedlittle response to her at this time. Whenasked if she remembered the observer, shesaid that she did, but she still did not interactwith her. She just continued eating.Behavioral ObservationsJulie was tested over a 2-day period. Threeexaminers participated in her evaluation.She was brought to the first testing sessionby her mother. She seemed very uncomfortablemeeting strangers and clung toher mother. Her mother carried her to thetesting room and stayed for a while untilJulie was more comfortable. Julie did notbecome relaxed with the examiners forsome time. Adequate rapport for testingpurposes was finally established.During testing, Julie was very active anddistractible. The examiners had difficultykeeping her attention on the test materials.She required much direction and attentionfrom the examiners to stay on task. She frequentlywanted to play with the other toys.At one point, she sat on the floor, facing thewall. When asked what she was doing, shesaid she was in time-out. On further questioning,she responded that she was put therebecause she did not pay attention. Later,she again sat on the floor, this time repeating“Stephanie, it’s time to go to school.”The examiner had difficulty redirecting herfrom this behavior. This type of behaviorseemed to occur most when Julie was beingasked to perform a task that was difficult forher. After this last time, Julie could not beenticed to pay any more attention to thetest materials. She got up and left the roomwithout the examiner’s permission.Julie was more cooperative during thesecond testing session. She seemed muchmore comfortable with the examiners andaccompanied them readily to the testingroom. She was, however, still very distractibleand active, requiring much examinerattention for her to stay on task.Test Results and InterpretationsIntellectual FunctioningJulie’s intellectual functioning was far, towell below, that of her same-aged peers.This level of functioning is consistent withher teacher’s and mother’s reports of herability and with her current school performance.Her performance across subtestswas consistent, showing no relativestrengths or weaknesses.Visual Motor IntegrationOn a test of visual motor integration, Julie’sperformance was at or above that of 8%of children of her age, suggesting that hervisual motor integration and fine motorskills are well below average. Her motherand teacher also reported difficulty with finemotor tasks, such as drawing and writing.