For each case study, identify what type of communication disorder the child has. You must state at least 5 characteristics from each case study to support the diagnosis you chose. Case Study #1: Danny: A seven-year-old male
For each case study, identify what type of communication disorder the child has. You must state at least 5 characteristics from each case study to support the diagnosis you chose.
Case Study #1: Danny: A seven-year-old male
Background Information: Danny was born at 35 weeks gestation. He was in the neonatal intensive care unit (NICU) for 1 week following birth for support with breathing. No major illnesses, head injuries, or seizures were reported. An audiological exam revealed hearing within normal limits bilaterally. Danny’s early motor milestones were within normal limits. However, early speech and language milestones were globally delayed. In the first two years of life, Danny did not respond to his name; he did not produce any words; he did not use gestures, such as waving hello or goodbye or pointing. He demonstrated maladaptive behaviors, including biting, hitting, and screaming, particularly when he appeared frustrated with his limited ability to communicate his wants and needs.
At the age of 2, Danny’s parents requested an evaluation through early intervention. At that time, Danny qualified for services and began receiving speech and language early intervention. Danny’s speech, language, and communication skills greatly improved. Early on in therapy, Danny began to produce echolalia, both immediately and delayed. Soon after, he began producing spontaneous words and putting two words together into phrases. He was able to communicate basic wants and needs in structured situations. He began to respond to simple questions and commands on familiar topics. Danny enrolled in an integrated public preschool at the age of 3 where he continued to receive speech and language services. He continued to make good progress. He began to produce three- and four-word sentences and understand more complex questions. Danny learned to engage in joint attention and began to use eye gaze shift to socially reference his communication partners.
Upon leaving preschool, Danny enrolled at his neighborhood public school. He was able to participate in many of his mainstream classroom activities with support from special education. In kindergarten and grade 1, Danny had a one-to-one aide with him to support his special education goals, and he continued to receive speech and language services, both in and out of the classroom. Danny is currently in second grade in a mainstream classroom. There is an aide in the classroom who is there to support Danny and another student. In addition to special education support in the classroom, Danny receives in-class and pull-out speech and language services to address language needs and social skills.
Currently, Danny uses simple and some complex language structures in structured activities and when responding during conversation. He continues to demonstrate some echolalia. His receptive and expressive vocabulary skills are in the average range; however, he has some difficulty with abstract concepts, including internal mental states and higher-level content vocabulary. In addition, he struggles with understanding connected oral and written language in unstructured activities.
Since he was very young, Danny has shown patterns of restricted interests. For example, he went through a period where he was very interested in dinosaurs and only wanted to play with dinosaurs. He was so interested in dinosaurs that his teachers needed to hide the toy dinosaurs in the classroom when it was time to focus on something else. More recently, Danny has shown an interest in keys and locks. He likes to put keys in locks over and over again and explore visitors’ keys when they come over.
In the area of reading, Danny can decode well and is quickly gaining a large sight word vocabulary. However, he is not able to comprehend what he reads. He has learned his addition and subtraction math facts with little difficulty but struggles with word problems and higher- level math concepts.
In the area social language, Danny exhibits difficulty in social reciprocity (i.e., appropriately initiating a conversation, maintaining a give and take in conversation, considering multiple viewpoints) and problematic social behaviors (i.e., making inappropriate comments, misinterpreting the intentions of others). Still, Danny demonstrates the desire to be social. He frequently invites peers to play and has success engaging with peers in one-on-one structured activities.
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