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Kyle's Story
Kyle's Story
Kyle was 7 years old when he was admitted to the Autism Services Program
at the Child Study Center. Kyle has a diagnosis of autistic disorder,
and he lives with his parents and younger sister. At the time of admission,
Kyle engaged in severe problem behavior that prevented him from learning
new skills and caused severe stress for him and his family. The most severe
problem behavior was related to clothing and food. Kyle refused to wear
anything other than a specific pair of shorts, a tank top, and flip flops.
He would stay naked in his room while these particular articles of clothing
were washed, refusing to wear anything else. In addition, he was rarely
willing to eat anything other than uncooked spaghetti. He drank only an
occasional sip of Dr. Pepper, as well as a drink of water from the faucet
every few days. When Kyle’s parents attempted to prompt him to eat more
varied food or wear different clothes, Kyle engaged in severe tantrums
which included loud screams, verbal threats, aggression, property destruction,
and banging his head against the wall. Due to the severity of Kyle’s tantrums
and his physical strength, Kyle’s parents were unable to manage and control
his behavior, resulting in severe disruption to normal family life. In
addition, Kyle was underweight as a result of his limited diet.
Kyle’s skill level made him an appropriate candidate for the Jane Justin
School, a school for children with developmental disabilities located
in the Child Study Center. However, due to the severity of Kyle’s problem
behavior, the school did not have the resources to serve him and his family,
because the school has a much higher student to teacher ratio than the
Autism Services Program. Kyle was therefore admitted to the Autism Services
Program rather than the school.
Kyle’s treatment plan had three main goals: first, to decrease Kyle’s
problem behavior such that he could benefit from the services of the Jane
Justin School; second, to help him to eat an appropriate variety and amount
of food; and third, to enable him to wear appropriate clothing. The treatment
plan consisted primarily of reinforcement of appropriate behavior and
extinction of inappropriate behavior. For instance, Kyle was allowed access
to preferred activities when he accepted food or clothing without problem
behavior (reinforcement), and food and clothing were not removed when
he engaged in tantrums (extinction).
Kyle’s problem behavior decreased dramatically as a result of the treatment.
On the first day of admission, problem behavior occurred during 88.9%
of 5 minute intervals; however, the problem behavior had decreased to
an average of 11% during the last 6 sessions of that same month. The following
month, problem behavior occurred during an average of 0.4% of 5 minute
intervals. During that time, Kyle’s parents were trained to implement
the same type of treatment in the home. The parents reported that Kyle’s
behavior improved dramatically in the home as well at that time. Kyle
started requesting a variety of food (including sushi), and wore a variety
of clothing (including self-selected Halloween costume – a space suit).
Kyle was able to start attending the Jane Justin School full time within
three months of the start of treatment. At first, Kyle was accompanied
by tutors from the Autism Services Program who provided one-on-one instruction
and shadowed him constantly. Gradually, the tutors decreased their assistance,
so Kyle could function as any other student in the classroom. Eventually,
Kyle was discharged from the Autism Services Program and admitted to the
school. His behavior is now exemplary and he is able to engage in many
learning and social activities. According to parent report, his behavior
at home is also dramatically improved.
Joyce Mauk, M.D
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