Autism Case Study

Male, Age 10
Autism, seizure disorder

D.T. was verbal with limited language skills. He could sing in complete sentences (echolalic) but communicated using one or two word phrases. He communicated mostly by pointing. When he did speak, his enunciation was poor except when he was angry at which time the word would be clear. He displayed self-stimulatory behavior in the form of rocking, hand-turning, and hand flapping. His gross motor skills were below normal and he wore leg braces. His fine motor skills were poor and he was unable to tie his shoes. His sleep was good but he was defiant and unable to calm down at bedtime. He showed no interest in other children and his eye contact was poor. His seizures had begun at age two. He was taking medications for seizures and experienced one every ten to fourteen days.

After five weeks with REI, his mother reported that he was showing more caring towards others and his eye contact improved significantly. He began imitating other children (speech and facial expressions) and exhibited more interactive play with others. He was noticeably more calm and had fewer tantrums. His speech therapist noticed that he was able to talk clearer and that he began using 2-3 word phrases. His attention span improved and he was more able to stay with the lessons. He listened to the recording at bedtime and showed an improved ability to calm himself down and make the transition to sleep. He would often fall asleep half way through second side of tape.

After twelve weeks D.T. continued listening to the REI Program rhythms at bedtime and he would insist on listening to it while going to sleep. His school teacher and principal noticed improvements in his language skills, responsiveness, memory, and his level of understanding. They enrolled him in a regular classroom for the coming school year. He had not had any seizures for the previous four weeks. His doctor began to taking him off his medication. His language skills and vocabulary continued to improve, along with his social skills.

Female, Age 6

D.N. was verbal with limited language skills. She used simple sentences and would only speak to voice demands. She was non-aggressive and she would tantrum frequently and often demand attention. She displayed considerable self stimulatory behaviors, which included biting herself, hitting her legs, tongue-twisting, and hand-clenching. Her fine motor skills were poor--she grasped with her palm. Her gross motor skills were good, however her balance was not as good. She had good eye contact and was very affectionate towards family. Her social skills were poor--she would engage in some parallel play if directed to do so but would not seek out other children.

Ten weeks after beginning the REI Program D.N. showed considerable progress. She demonstrated more interest and awareness of her surroundings and began approaching other children and initiating interactions with them. She was much more interested in doing things and interacting, and she seemed to want to do what others were doing in school. She began speaking more--her vocabulary and enunciation both greatly improved. Her garegiver described that she would often engage in self talk while the REI rhythms were being played and it seemed that she was working on her speach skills during this time. Her balance also improved. Her mother reported that she was much more relaxed overall and was much more pleasant to be around--she was tantrumming less and was much quicker to respond to requests. Her self-stimulatory behaviors dimished significantly except for hand-clenching.

Male, Age 35

C.P. lived in a group home since age 14. He exhibited self-stimulatory vocalizations most of the time--very loud, fast and threatening. He was able to speak clearly with correct grammar, however he rarely communicated verbally with others. He was highly aggressive and violent-- generally had 3-4 incidents per week that were reported to the state. He would act out violently when asked to do anything for more than a few minutes. He was generally noncompliant, impatient, and characterized as lazy by the staff. He enjoyed riding horses but would hit them occasionally. His sleep was poor. He often woke throughout the night and tried to get out of facility. If not constantly watched, he would wander the neighborhood and enter nearby homes. He was obsessive about food and had poor table manners and he would eat as much food as he could very fast.

After one month with REI he was much less aggressive and the facility had no incident reports after the first week of the study. He would often request the tape at night. He began sleeping through the night starting second day and was no longer trying to get out. He still sometimes wandered during the day, but he stayed within the facilities boundaries. He was much more compliant and showed improved ability to listen. His self-stimulatory vocalizations continued, but he would stop when told to do so. He was starting to use conversational speech and would say 2-3 sentences when asked questions.

After eight weeks: still no incident reports, much less aggressive. He was still sleeping well and still showing improvements in compliance and listening ability. His self-stimulatory vocalizations decreased and he began initiating conversation with others.


Placebo-controlled case studies

The following case studies were conducted in a placebo-controlled format from March through May, 1995. Each of the subjects received a REI Program tape, although the subjects were unaware whether they had a real REI recording or a placebo tape containing traditional African rhythms. They were instructed to play the recording daily for the first four weeks and at least three times per week for the second four weeks. Assessments were made by the parents.

Male, age 11

After four weeks of using the recording daily S.W.'s mother reported that He seems more cooperative, calm, focused, and makes less noises. He is also showing more social interaction at school. He has talked about friends and he is initiating play with others. He seems more comfortable with himself.

At the eight week assessment his mother reported, In general he has made less repetitive noises, has been calmer and more cooperative. He has become intensely interested in his LEGOs and been very creative. He used to have to chew gum all the time, now he has not asked for any in a long time. He has a check list for his morning routine and evening routine, and I feel that he is more cooperative and independent in following the routines since he has been using the REI tape--especially this last four weeks.

J. A.
Male, age 4

After four weeks in the study his mother reported that J.A.'s eye contact has improved a lot. Overall, he was much calmer, a lot less impulsive and interacted with others much more frequently. I asked his preschool teachers if they were doing anything different. They all said that they noticed a difference in J.A. but they hadn't changed their routine any. His occupational therapist also noticed that J.A. seemed calmer.

He's really trying to talk now when before he didn't seem to have any interest. He sometimes responds verbally now. He still has some unmeaningful hand movements, but he has had no panic attacks and is much less withdrawn. His autistic behavior has lessened so much that I think his main problem now is his lack of speech.

At the eight week assessment she stated, He is calmer, more receptive. Before he was listless and unresponsive much of the time. For the first time he seems to realize he's not separate from the rest of the world. His eye contact has improved dramatically. His tantrums are fewer and when he does have a tantrum, they are more like outbursts of emotions rather than anger and defiance. He hasn't had any panic attacks in the past two months.

After twelve weeks she reported, At the beginning of the study he didnít even seem to realize that speech has a purpose. He has gone from saying only one or two words a day at the beginning to about 30 or 40 a day now. His pronunciation has also improved. He now seems to realize that speech has a purpose, and he has been putting a lot of effort into talking.


Male, Age 4

After four weeks his mother reported that He's speaking more and more. He began saying his brother's name. He also showed significant improvements in social engagement, eye contact and verbal and non-verbal communication. His mother stated that He now can let us know 98% of the time what he wants.

After eight weeks his mother reported that he interacts more with other children and has begun turn taking also. G.M's eye contact also improved and he seemed to be expressing more emotions. She reported that It is as if now that he is more tuned in, he expresses verbally what he wants. He gets mad like a two year old when he doesn't get it.

After twelve weeks, unaware of the study, his teachers reported an improvment in his attention span, and social engagement. They also reported that he began making friends at preschool. He continued to show progress in language skills--his mother stated that He is now initiating conversation and initiating social interactions. She also reported that he liked the tape and would play the tape by himself.

Case Study

Mitchell: A Boy with Autism Spectrum Disorder

Mitch was six years old when his family contacted me. He had been diagnosed as having autism spectrum disorder two years earlier by a multi-discipline clinic at a university medical school. Autism spectrum disorder (ASD) is a developmental neurological disorder characterized by atypical development in social interactions and in communication. Mitch had trouble making eye contact with listeners. His expressive language was vague: his sentences were long enough and had the right grammar and syntax (word order) but the words he chose did not quite communicate his meaning and the listener had to work extra hard at decoding the message. It was hard to have a conversation with Mitch: he tended to monopolize the taking, worked hard to steer it toward one of his favorite subjects and did not appear to be listening when it was the other person’s turn to talk. He had trouble with focus and attention: he was quite distractible. He had two favorite subject (farm tractors and the carved images at Mt. Rushmore)) and didn’t really talk much about anything else. He did not play very much with other children at school or in the neighborhood and interacted mainly with adults. Mitch periodically had bouts of anxiety and if was much harder for him to focus when that was happening. In speech therapy, among other objectives, we practiced looking at the listener and using just exactly the right word(s) to answer questions.

Children on the autism spectrum vary widely. However, we usually see some difficulty with language pragmatics, the social rules of conversation, including making eye contact, taking turns talking and listening, responding appropriately to questions, knowing how to insert oneself into a group, knowing what to talk about, and when older, knowing how to lead a conversation. There may be an intense desire to talk about one specific subject over and over. Often with children on the spectrum, we also see difficulty being specific with word use and difficulty organizing one’s thoughts into clear, concise sentences. The goals for Mitch fell into these two areas. Mitch was also receiving speech therapy at his school. His school speech language pathologist and I tried to talk by phone at least once every two or three months.

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