Secondary

 

Secondary Case Study  - Child 1
Background
Deafness
Level of Loss – Bilateral moderate to severe sensorineural loss
Diagnosis – At age 4 after investigations following poor speech development.  Born prematurely at 32 weeks by emergency section weighing 2lbs 10oz.  Spent first two months in Special Care baby unit.  Had additional oxygen but not ventilated.  Thrived upon coming home after initial period of concern regarding poor muscle tone.  This resolved with physiotherapy.
Type of equipment – BTE Oticon Synergy hearing aids, Roger Pen radio aid
Amount of use – Hearing aid use is excellent – all of waking hours.  Radio aid use less good – depends on which teacher is in charge at the time.
Autism
Diagnosed at age of 6 years with a working diagnosis of ‘Asperger’s Syndrome’.
Reason for ‘working diagnosis’ – could not be sure if language delay was due to hearing loss or Autism.  Presented as high functioning, so Asperger’s seemed the best fit.
Struggles socially but is highly intelligent and has learned how to fit in and also what is acceptable and what is not.  Struggles with personal care – knowing/feeling  when to eat and drink.  Struggles to keep track of time and be organised.  Has difficulty getting to sleep and has been prescribed Melatonin which helps with this.
Some sensory issues with food textures and clothing.

Current:
Age of student: 16 years 10 months
Communication: communicates orally but can struggle to access/process what other people say – needs additional time.  Finds written information very helpful.
Type of School Placement: Goes to a small independent, mainstream  school (paid for by Local Authority) which offers a low arousal environment and a number of staff who have specialist qualifications in Autism.  Went to local mainstream primary.  Has EHCP and had had high level of TA support throughout school career.
Typical behaviours:  Finds it very difficult to shift attention from what he is doing to another activity/communication.  Can become very defensive and distressed when he is interrupted.
Will talk at length about his special interest of computing and coding.  Has to have his screen time monitored or would stay on a screen all day, every day.
Greatest current challenge:  

1. Shifting attention.  Developing his ability to move his attention and be able to focus on what is being said to him.  He will frequently appear to have heard but then will miss important things because, although he was nodding or saying yes, he has not focussed on the communication or instruction.
2. Getting him into a routine where he will eat and drink regularly.
3. Accessing a variety of experiences/activities.
Sensory issues: Can be put off food by its appearance or because of the textures of different foods.  Struggles to cope with the touch of particular materials.
Interests: Computer science – especially coding and writing programmes.  Also playing the piano and Star Wars.
Strengths: Grade 7 (with Distinction) pianist.  Currently studying for Grade 8. Achieved Grade As at GCSE.  Excellent at computer science and programming and writing computer code.

Not so successful strategies:
Social Stories
Successful Strategies:
The Incredible Five Point Scale
The Train Track
Brain in Hand