Clinical Assessment of Child and Adolescent Personality and ...

chapter 19 Assessment of autism spectrum451that Julie displays several unusual behaviors,such as talking to herself or inanimateobjects, repeating the same phrases ormotions, panting heavily at times, chewingon clothes, preferring to stay by herself,and not interacting with other children.Most of Julie’s test results, includingintellectual, achievement, visual motor, andsome adaptive behavior areas, are in theWell Below-Average range. Other adaptivebehavior scores, however, were onlyslightly below average for her age. Informationfrom rating scales indicates that Julietends to be socially withdrawn, hyperactive,distractible, slow to learn or adapt to newsituations, and sometimes fussy too.Taking all of the assessment informationtogether, the diagnosis of PervasiveDevelopmental Disorder–Not OtherwiseSpecified seems appropriate. At this time,a diagnosis of mental retardation does notseem applicable. Although her intelligencetest scores are within the mild mentallyretarded range, her adaptive behaviorscores lie outside the mental retardationrange. Both of these areas of functioningmust be significantly below average to warranta diagnosis of Mental Retardation.RecommendationsJulie should be evaluated again at the end ofthis academic year to assess her progress. Atthis time the following recommendations aremade for Julie:1. Julie would benefit from a highly structurededucational environment whereshe can get the attention and supervision,she needs, to learn. Her parentsshould consult school personnel in orderto determine the most appropriate placementfor her2. Julie will need much individual instruction,gradually moving to small-groupinstruction3. Julie’s classroom assignments shouldbe within the range appropriate for herintellectual and academic levels4. Julie should be allowed to learn andwork at her own pace5. Instructional tasks should be organizedinto short, structured units6. Julie will need to be taught at a veryconcrete and practical level, usingmany manipulatives and teaching aids7. Skills and concepts will need to berepeated and reviewed often for Julieto master them8. Julie may be helped by being tutored bysomeone who has been trained in tutoringchildren with her set of difficulties9. Julie’s parents and teachers shouldcontinue to search for activities thatshe does well and enjoys and encourageher in these activities10. Julie should be provided withincreased opportunities to learn andpractice age-appropriate self-careand socialization skills11. Julie’s parents and teachers should continueto use behavioral managementstrategies, such as positive reinforcementand time-out, to help her learnappropriate behavior. Her parents maywish to attend sessions with a mentalhealth specialist to become more facilewith these techniques12. Inappropriate behavior should beignored as much as possible, whileappropriate behavior is rewarded withpraise and other appropriate reinforcers13. Communication between school andhome should be maintained. A homeschoolnote, in which Julie is rewardedat home and for appropriate behavior atschool, may be helpful14. Julie should be allowed as much as possibleto be around other children herown age, so that she can learn socializationand develop behavioral skills byobservation and interaction with them15. Julie’s parents should closely monitorher physical functioning and symptomsand maintain regular contact with herphysicians regarding her seizures16. Julie should be evaluated in approximately1 year to determine her level