Trials & Tribulations (Part 1)

I found this old paper that I did while I was taking a graduate course at Johns Hopkins in 2005. After careful thought and deliberation, I thought others would find this interesting about our battle with Asperger Syndrome (please learn from our mistakes). If anyone would like to post about their trials and tribulations, please leave a link so we can read your story. :)

This is written in the third person and was part of a project that I did.



Review of Records

M is a healthy, 14 year old, ninth grader at a public high school in southern Maryland. M is an only child and lives at home with his father (an electrical engineer) and his mother (a former special education teacher who is now a homemaker). M was born in 1991 and was the product of an uncomplicated pregnancy. Although he was a breech delivery (planned C- Section), he was a healthy baby who was even-tempered and happy and his developmental milestones were typical. M was hardly ever sick and only had a few ear infections during childhood. M continues to be extremely healthy, but tends to stay indoors most of the time.

In preschool, M reportedly had problems following directions and handling transitions; circle time was particularly difficult for him. During Kindergarten and first grade at a public elementary school in southern Maryland, he appeared happy and the teachers had no complaints about his performance.

In second grade, however, M suddenly found himself at the bottom of his class academically. His teacher and parents requested that M be tested to see if he would qualify for special education services. In February 1999, the school psychologist tested M and claimed that he had no problems significant enough to warrant special services. M’s verbal subtest scores were all solidly within average range, but he experienced significant difficulty with all of the performance tasks with the exception of visual-motor speed and accuracy. On the Beery VMI, a test of the visual-motor integration, he earned a standard score of only 77, which is well below age expectations. His scores on academic testing indicated that M is performing at grade level in reading, math, and written language. However, Speech and Language testing revealed significant verbal dysfluencies and some problems with receptive language, semantics, and formulating sentences, which were way below grade level. M qualified for Speech and Language services and received help with these difficulties.

Parents enrolled M at Sylvan Learning Center for 3 hours a week, which helped him improve his reading. However, he continued to have problems at school with attention and concentration and following directions, and both his fine and gross motor skills were poor. Sylvan Learning Center services were discontinued at the end of the summer.

During third grade, despite his grade-appropriate academic achievement scores, M’s report cards indicated that he was performing well below his potential, with most of his grades being C’s and D’s. His teacher also noted significant behavioral problems, including not following directions, not paying attention, and failure to complete his work. In addition to his academic problems, M was showing some signs of anxiety (including bedwetting at night), and his social skills appear quite immature. His parents also report that M has difficulty transitioning from one activity to another and that he is fanatical about keeping his belongings organized and in place.

Parents had a comprehensive independent evaluation done by Dr. C (clinical psychologist) in December of 1999. From several tests and observations, Dr. C diagnosed M with Asperger Syndrome. Counseling was also suggested by Dr. C for the family to alleviate anxiety that was contributing to M’s problems in the classroom and exacerbating his learning disabilities and attention problems. The therapist would work primarily with M’s parents to help them develop strategies to alleviate his anxiety and respond more effectively to his behavioral difficulties. In January 2000, the family started counseling with XX, an associate of Dr. C.

The parents met with the school and Dr. C presented her test results. The same school psychologist retested M in January 2000 and found that M had average intellectual functioning (WISC-III Verbal IQ- 110, Performance IQ- 81, Full Scale IQ- 95), however his actual potential more than likely falls within the High Average range. In addition, there were indications of significant processing deficits, which seem to be related to an autism spectrum disorder. M met the criteria for an educational disability of autism. OT and Adaptive P.E. screening was recommended and conducted. Fine and gross motor skills were in the low range and sensory reactions problems were noted in OT. For Adaptive P.E. results showed that M was way below age level in running (stride, foot placement, speed), mature form movements, throwing a ball over-handed, and rolling a ball underhanded. M received OT services and Adaptive P.E. (pull out) to combat these problems. In both speech and OT therapy, M made some progress and it was also noticed at home as well.

Organizational strategies were introduced for M such as graphic organizers, homework folder, agenda book, and a binder with dividers. M was also provided assistance in organizing his backpack and/or desk and was taught how to do it independently by his special education teacher (these organizational strategies were finally achieved and used independently by the end of fifth grade).

For help with social skills the school counselor invited M to do “Lunch Bunch” where periodically some students (a few students from M’s class) would have lunch with the counselor and play a board game. M seemed to enjoy this as well as the other students.

Parents enrolled M in various after school activities (soccer, gymnastics, and T-ball) during kindergarten through third grade. M participated and seemed to enjoy all activities, but he later discontinued due to lack of interest.

In fourth grade, despite accommodations and modifications in the IEP, no improvements were seen. His classroom teacher did not seem to be following through consistently with the accommodations and modifications that were in the IEP. Grades continued to be C’s and D’s. M started having meltdowns during class (temper tantrums, yelling, rolling on the floor, rage, shutdown, etc.). Classroom teacher would not follow the recommended behavioral procedures that were stated in his IEP. It was noted by his parents that M had some tantrums at home when he came home from school.

M was still participating with “Lunch Bunch” and seemed to enjoy it.

An Alpha Smart was introduced to M to use for extended writing when needed. M enjoyed using it and could independently download his work on a printer.

In February 2001, after 1 year of counseling from XX, it was discontinued. Family stated that they were not benefiting any more from the services.

Family then received counseling and suggestions with dealing with Asperger Syndrome at home and at the school from Dr. F (psychiatrist). Parents would follow what Dr. F suggested to calm M down (have M lay on his bed and listen to calming music). M learned this procedure and later did this all by himself with little or no prompting by his parents. Medications to combat anxiety and attention problems were then introduced by Dr. F. Some improvements at school were noted in keeping on task and medication was continued.

In May, M went back to Sylvan Learning Center for three hours a week. Progress was slow, but he was improving in reading and in math. According to their tests results, he was not up to grade level.

In Speech, M was making improvements, which parents noticed at home as well.

In OT, M was still making progress with fine motor skills, visual-spatial processing, and sensory integration (help reduce tactile and auditory sensitivity). They also worked on alleviating his stress and provided him with various strategies and stress relievers (sensory bag) which helped somewhat in the classroom.

In fifth grade, all personnel that worked with K were given an in-service by the Autism Specialist in the county about M and Asperger Syndrome (requested by parents and put in IEP). Keeping on task was still a problem for M and medications were altered. M still received C’s and D’s on his report card. There were some improvements, but parents did not receive much feedback from the classroom teacher (specified in IEP) and discontinued medication, which was also agreed by Dr. F. M’s classroom teacher did not notify parents of behavioral problems that M was having in school. M was having meltdowns during class (temper tantrums, yelling, rolling on the floor, rage, shutdown, etc.). The classroom teacher would not follow the recommended behavioral procedures that were stated in his IEP. It was also found that his classroom teacher did not seem to be following through consistently with the accommodations and modifications that were in the IEP. Only a few meltdowns were noted at home and M would proceed with his calming activity on his bed with little or no prompting by parents.

During the school year the counselor that was conducting “Lunch Bunch” was transferred to another school. The new school counselor was assigned lunch duty and could not continue with the lunch group.

M continued to make progress in Speech and OT. Parents were also noticing a difference in M understanding speech and implementing strategies to achieve fluent speech. It was noted by the parents at the IEP meeting in May of 2002 as M was getting older, he had fewer friends. As for Adaptive P.E., the regular P.E. teacher would pull M aside and help him at times (no progress was made). Parents were then informed during the IEP that for years M would mostly cover his ears and sit in the corner of the gym during P.E. Parents were never notified of this behavior.

M was still going to Sylvan Learning Center and was making slow, but steady progress. He was almost up to grade level in reading and in math.

Family stated that they are highly active in their church and M participates in Sunday School and other church activities. No problems were noted with M in any church activities.


To be continued . . .


Next: Middle School