milestone 1...yet again

Sally is a 5-year old child who has been diagnosed with Autism. She arrived at the foster home showing delayed cognitive abilities and had no speech. She can produce simple unprompted vowel sounds, but was unable to make consonant sounds. She was unable to repeat any words, either prompted or not and did not seem to understand her name or any other simple commands. However, she does respond to the tone of the foster mother’s voice. She has good fine motor skills and has recently begun tearing paper independently. Sally does not show any interest in books, crayons, play dough, or any other age appropriate toys. When allowed to select an independent activity, she wanders to the indoor sensory swing and will remain there until prompted to leave.

Target Behavior

Since arriving at the foster home, Sally has been scratching other children and the foster parents. Sometimes the scratches can be deep. Sally’s scratching also prompts negative behaviors from other children in the foster home who do not enjoy being scratched. Sally also displays physical aggression (hitting, tantrums and scratching), verbal aggression (screaming and yelling), and opposition defiance (refusing to cooperate with requests). Sally’s behavior is most prominent during free-choice play when approached by other children or when the foster parents attempts to include her in a structured activity. Treatment Strategies

Sally is not only showing harm to other children, she also displays harm to herself. Immediately after these behaviors occur, Sally receives attention from the foster parents. Once Sally receives attention from the foster parents, she stops her negative behavior. Sally’s behavior is caused by a need for attention and a lack of communication skills. Sometimes, Sally does not communicate well with her peers and adults.

Providing verbal and visual positive reinforcement when Sally is approached by others can influence her behavior. The foster parents must explain to Sally that scratching others is inappropriate. They will then model how to appropriately gain the attention of an adult or peer using a hand wave. Sally will then practice this skill repeatedly. First with hand over hand reinforcement and then with gradually decreased prompts.

Sally would receive speech therapy, and occupational therapy. The foster parents will

also, be implemented an intensive home-based intervention using the foundations of Applied Behavior Analysis. This in home-based intervention with teach the foster parents developmental skills. These skills include communication, self-help, cognitive, social and motor skills. The foster parents would be advised to keep a record of Sally’s incidents and positive changes. The data will be analyzed weekly to keep track of Sally’s progress. This would be recommended continuation of services that will begin to fade to monthly visits until the behavior is eliminated or reduced. Behavioral goals should be meet weekly. Negatives behaviors should be addressed to implement the behavior. All sensory activities should be done when he is calm and asking in an appropriate manner.

Legal System Involvement

State programs serving infants, toddlers, and preschoolers under the Individuals with Disabilities Education Act (IDEA) reported a rise in the number of children that have been labeled as having autism (Mandlawitz, 1998). There has been a lot of controversy around what is considered an effective method or program for interventions. Families desire for the best outcome and strategies when it comes to properly treating their children. Service providers often find themselves in conflict with families, uncertain about their obligations, and lacking resources and expertise to implement effective programs (Feinberg & Beyer, 1998).

Foster families receive ongoing support their worker and the child’s worker. This support includes medical professionals, mental health services, school district services and etc. Children in foster care are more likely than the children to exhibit high levels of behavioral and emotional problems.

Ethical Issues

Confidentiality is one of the most vital ethical obligations a therapist working from an interdisciplinary conceptual framework is obligated to the individual with an autism spectrum disorder and their family (Cox, 2012). A positive test in a symptomatic child might falsely label the child as autistic and thereby foreshorten a more thorough evaluation (McMahon, Baty & Botkin, 2006). Clients have the right to effective treatment. Behavior analysts always have the obligation to advocate for and educate the client about scientifically, most effective procedures. Parents can have limited knowledge and understanding of research. There is a need to ensure the use of appropriate screening tools and diagnostic measures.

There are many factors that can influence the treatment for autistic children. These factors include environmental, culture and family. Environmental factors concerning the onset of autism is an essential area of study. Genetic factor has been associated with the onset of autism as well. Parents who have been exposed to teratogens have substantiated factors that stimulate the chance of autism (Castro et al., 2016). Environmental factors of autism include maternal age, multiple pregnancies in a short period, inadequate prenatal care and low birth weight. Children who are associated with autism can experience a delay in brain development. There are many risk factors that are associated with autism. They include the parents age during the time of conception, maternal nutrition, inflection during pregnancy and prematurity.

In some cases, individuals’ can be hereditarily prone to autism. Children can develop symptoms of autism based on their environment. Vaccines have been linked to the onset of autism. Also, an individual's genetic predisposition can cause autism (Reynolds & Dombeck, 2006).