|And so we get a resolution...
||[Apr. 28th, 2005|05:51 pm]
The report has been written. All 14 pages of it. There were interviews done with myself, Max, Max's teacher, he was observed at school, he was tested and watched and blah, blah, blah....
And the official word is a diagnosis of Asperger's Disorder.
The following is an excerpt from the report.
Max reportedly does not make appropriate eye contact with others. Max was described as a "loner", even engaging in simultaneous play with peers. He does not appear to know how to have age-appropriate conversations and instead sticks to topics that interest him (e.g., reciting movie lines) when he does talk. Although Max states that he wants frienships, he does not appear to have the necessary skills to form and maintain them. Max is often rigid in terms of behavior and often does not adjust well to even small changes.
Based on the testing, interview, questionnaire, and observation data, it appears that Max meets the criteria for Asperger's Disorder. Max does have impairment in social interactions based on his impairment in the use of non-verbal behavior, failure to develop appropriate peer relationships and lack of social reciprocity with peers. In addition, Max also appears to be inflexible with nonfunctional routines and is easily upset by change. Max also has problems with inattention and overactivity that are symptomatic of ADHD; however, symptoms of inattention and overactivity are frequently found in individuals with Asperger's. At this time, Max is not being given the diagnosis of ADHD. These symptoms should be monitored and observed as Max makes progress in other areas to determine if he does meet these criteria at a later date so that the diagnosis may guide treatment.
Axis I: 299.80: Asperger's Disorder
Axis II: V71.09: None
Axis III: Defer to Physician
Axis IV: Social Problems, Educational Problems
Axis V: Current = 62
(I realize the above looks like gobbledygook to us lay folk...but apparently for the purposes of schools, IEPs and Max being given certain considerations, this is important schtuff)
1. That Max be provided with increased monitoring, feedback, and prompting to promote his attention. It is recommended that Max's teachers develop a subtle cue to let him know when he is off task. (She suggests a touch on the shoulder as opposed to calling his name out, as that can be embarassing and distracting)
2. That Max be seated at the front of the classroom near the teacher and closest to the point of instruction. This will help reduce distractions and allow his teacher to better monitor his his attention and work completion. Max may benefit from being seated near an appropriate peer model.
3. That Max be provided with repeated instructions, directions, and explanations whenever needed. His teachers may want to get his attention prior to giving instructions and have him repeat instructions back to ensure understanding. In addition, he should be given one instruction at a time.
4. That Max's teachers provide him with short breaks and allow movement when possible. For example, if Max cannot remain seated, his teachers may want to allow him to stand at his desk and complete work.
5. That a school-home note system be implemented in which Max's teachers evaluate his classroom performance daily and his mother provides consequences at home based on his school performance. Max may benefit from a note targetting on-task behavior, following directions and work completion. Rewards and praise for appropriate behavior should be emphasized.
6. That Max be allowed, when necessary, to be placed in a sperate setting free from distractions and given extended time to complete work.
7. That Max's teachers help promote positive social interactions at school by encouraging Max to play with peers at recess and by giving him feedback on appropriate and inappropriate interactions.
8. That, given his difficulty with transitions, Max's teachers provide him with information, when possible, regarding major schedule changes. Overreactions to minor changes or rigid behavior should be discouraged/ignored so that Max can learn to adapt.
9. That Max's mother provide a structured evening and homework routine for him including frequent monitoring and prompting. Max should have a quiet area, free from distractions, in which to complete homework.
10. That very colse and collaborative communication occur between Max's teachers, school administrators and mother next year in order to ensure that he experiences success and to identify and address problems as soon as possible.
11. That Max's mother participate in parent training to help her understand and better manage Max's behavior at home. For example, Mrs. Selden would likely benefit from learning how to manage Max's oppositional behavior, ways to reduce rigidity and ways to increase social skills.
12. That Max continue to participate in speech therapy.
13. That Max participate in social skills training to address his deficits. As his skills improve, Max's mother should provide him with increasing opportunities to interact positively with peers. For example, he may benefit from participating in an extracurricular activity.
14. That, if the above interventions do not bring about sufficient change in Max's behavior, that Max's mother consult with his pediatrician regarding a possible trial of medication. (She explained that this would come about if things got much worse or he started to exhibit serious signs of ADHD)