Case Study of Billy
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Billy, an eight-year-old white boy, was diagnosed with autism at the age of two. Although he emerged from a caesarean delivery with slight surgical complications, Billy failed to reach his developmental milestones early in various areas. He was only able to sit on his own at 12 months and crawled at 13 months. When he was 20 months old, he finally learned how to walk. At the same time, Billy did not have good eye contact. Moreover, he had sensory problems, being both hyposensitive and hypersensitive in certain senses. Finally, Billy exhibited delays in his expressive speech: he said his first words between 24 and 28 months and started using two-word combinations when he was already three years old. Billy's autistic symptoms are manifested in his difficulties with sustaining his interaction with his peers. Although he is beginning to initiate some interaction with them, he demonstrates a preference for solitary activities. Moreover, he continues to exhibit difficulties with maintaining sustained eye contact with others. While Billy is able to speak in phrases and sentences at times, he has the tendency to repeat words and phrases such as "excuse me" constantly. Just as significantly, Billy's level of expressive speech is not at an appropriate developmental level. Finally, Billy is also highly attached to different routines. When he is required to deviate from these routines, Billy will yell and scream in protest. Nonetheless, with therape
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kel for spontaneous acts of socially appropriate behavior. At the end of the week, Billy will be able to exchange his nickels for a selected range of favorite activities or items such as going to the park or getting a toy car. One of the key aspects of this reward system is to ensure that Billy understands how it works. During the first week, Billy's parents will most likely have to do the exchange on a daily basis in order to help Billy understand the concept of exchanging his nickels for a favorite activity. However, as Billy becomes more familiar with the system, Billy's parents will be able to lengthen the number of days in between the exchanges.
Although the reward system is an integral part of the intervention, Billy's parents will also have to implement the following measures. Before performing an activity or going out, Billy's parents should explain the rules and establish expectations that provide Billy with a general idea of appropriate behavior. For example, if the family is going out to a restaurant, Billy should be told about the restaurant and the type of food that he will enjoy. At the same time, he should be reminded that he will be expected to sit at the table and verbally express his dissatisfaction with
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Approximate Word count = 5153
Approximate Pages = 21 (250 words per page)
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