- Clinical history
- DSM-IV-TR Diagnosis
- Case formulation using the integrative Model
- Treatment goals and planning
- Course of treatment and treatment outcome
Thomas McKean was a 15-year-old boy attending junior high school when he was diagnosed with pervasive development disorder and placed in a psychological care facility. Since he was a young boy, Thomas and his family struggled with his condition and they were all unaware of the cause behind all of his symptoms. During his childhood, his behavioral and emotional problems included random violent outbursts, resistance to change, fear of groups, frequent sensory overloads, non-existent libido, lack of appetite and a tendency to randomly retreat into solitude. Furthermore, Thomas would often engage in ritualistic behavior such as spinning objects and taking apart and reassembling electronics. Ignorant to his autism, his parents would physically punish him whenever he misbehaved in an attempt to deter the behavior (McKean, 1994).
These symptoms stayed consistent throughout his childhood and they affected his ability to perform well in school and social situations. When his parents and teachers eventually became exhausted with his behavior, he was put in a full time psychological institution. Nevertheless, after his symptoms failed to change in the psychological institution Thomas was excused after three years. Thomas then demonstrated an inability to possess full time occupation and failed out of college on two occasions. While he managed to obtain his GED, Thomas was unable to function in a normal classroom setting, as normal teaching methods did not apply to him.
[...] Since all of the diagnostic criteria for the disorder are behavioral, being able to identify autism on a biological level would allow it to be recognized from a much younger age. This would be crucial to treatment, as behavioral modification therapy has been shown to be most effective when the patient is under the age of six. Therefore understanding which biological factors cause autism could allow for a much more effective treatment regimen for young children with the disorder. The case of [...]
[...] In the final category of restricted repetitive and stereotyped patterns of behavior, individuals must demonstrate at least two of the following traits to be classified as autistic at least two of the following: encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus; apparently inflexible adherence to specific, nonfunctional routines or rituals; stereotyped and repetitive motor mannerisms; persistent preoccupation with parts of objects (Barlow & Brown, 2007). Furthermore, in order for the disorder to be considered autism, the delays or abnormal behavior should be present in at least one of the three aforementioned categories prior to the child's third birthday (Barlow & Brown, 2007). [...]
[...] directors (McKean, 1994). Clinical History Thomas reported his family was a financially stable middle class family that demonstrated little emotional support for his needs. On his fifth birthday, Thomas McKean had his first realization that he might be different from everyone else. As he followed his mother outside to cut the cake, he was stuck with immense fear about being in the presence of others. This fear then carried on into everyday life, as he would constantly run away or retreat from large groups of people. [...]