Running head: Case Study

Case Study
Matthew Renegar
EDU 220
Professor Wyckoff
May 11, 2016

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Case Study

For my observation, I worked with and observed one of my students: GH. GH is a

nineteen-year-old female post high school student and the Variety School with a current
diagnosis of Autism Spectrum Disorder (ASD). She currently lives at home with her mother and
step-father. GH comes from an upper-middle-class home in Green Valley Ranch. She has two
older brothers who no longer live with her.
She was initially diagnosed with a developmental delay at three and reevaluated at six
with a diagnosis of Autism. Since this time, GH has been evaluated in 2009 and 2012. Her
understanding of English is very limited with little functional vocabulary. GH was observed
over a period of three non-consecutive days for 6 hours each in her classroom environment at the
Variety School. Because of her limited ability to communicate verbally, all findings are from
direct observation.
Physical
GH is a large, 19-year-old, young woman with little or no attention to personal hygiene or
style. An example of this is her hair which looks to have been quickly hacked off into a
functional cut with no regard to style. Another illustration of this lack of regard for social norms:
she wore the same clothes during all three observation sessions. GH is around 59 tall and
220lbs, putting her in the 13% of high school girls considered obese (Snowman, 2012. p. 34).
Like many in of the obese population, she has developed a resistance to insulin and has been
diagnosed with Type II diabetes.
In some regards, GH aligns with the DSHS Fosterparentscope guidelines and is
physically and sexually mature. Left unattended she will act on self-stimulating sexual desires

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during class. Snowman states that glandular activity due to puberty may be responsible for this
increase in sexual self-stimulation (p. 65).
This is where GH physically stops being in alignment with her age group and begins to
exhibit characteristics of a younger age group (DSHS Fosterparentscope, n.d.). She is able to
run, kick, throw, push and pull, but has little in the way of fine motor skills. For the most part,
she is able to control her bowels and bladder, scribble in circles and do simple puzzles. GH is
also able to feed herself and take care of her toilet needs on her own. Other than this she has
little to no energy or drive throughout the day and is fairly inactive.
GH is meeting Maslows hierarchy of needs for physiological and safety factors
(Snowman, p. 252). She has an attentive mother who cares for her basic needs such as food and
shelter. Her mother tries to nurture GH to the greatest extent possible in light of her behaviors
and almost universal desire to be left alone. GH does not lack for medical care or any other
monetary need. Her lack of variety in clothes is due to her own preference to limit changes in
her environment.
Emotional
Emotionally, according to the DSHS Fosterparentscope milestones, GH is in the 4 to 5year range. This can be seen when she is introduced to new environments or stressors. Minor
changes such as being asked to complete a new task or wait patiently may cause GH to become
very aggressive. Minimal change in her environment will usually result in GH lashing out,
initially by trying to scratch. This behavior is quickly elevated to be replaced with hitting and
spitting. If aggression is not effective in managing her environment GH becomes self-injurious,
banging her head against a wall while screaming and crying.

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In comparison to other students her age GH, as defined by DSHS Fosterparentscope, is

severely delayed in reaching common milestones. GH has no concept of failure or worry and no
drive for independence. Unlike her peers, GH has no regard for personal appearance; in three
days of observation GH wore the same loose fitting clothes. GH has no regard for grades or the
attention of other students in her age group. GH does not value privacy, constantly touching
herself inappropriately or using the bathroom without closing the door. She has no concept of
personal belonging or space and is not aggravated when others handle or open her backpack.
GH is below even the preschool and kindergarten emotional characteristics laid out by
Snowman. Her outburst of emotion, when faced with even minor difficulties, illustrates her
inability to regulate their own emotions (Snowman, p. 51). She has no need for the attention or
approval of others making jealousy a completely foreign concept to her. Emotionally GH has no
desire for Maslows concept of acceptance or affection (Snowman, p. 252). Any attempt for
human closeness, including attempts by family members, is met with violence and a wish for
isolation.

Intellectual/Cognitive
Intellectually GH is between two and three years old (DSHS Fosterparentscope). Most
noticeably GH has an extremely short attention span and must be continuously redirected
towards the task at hand. GH has a limited vocabulary and is unable to use sentences of more
than a few words. Most of GHs communication is through echolalia, the repetition of words and
phrases said in her vicinity, with a few learned phrases. GH usually repeats a standard set of
phrases such as Go to Lunch and I like pizza especially when under stress. The phrases are
usually used when GH is in a stressful situation and is looking for a way to escape. GH can
successfully ask for food, water and to go to the bathroom. GH has little mastery of symbols
and symbols systems (Snowman, p. 26). While she exhibits some of the characteristics laid out
by Piaget in defining preoperational, she is more likely to develop schemes characteristic of
the sensorimotor stage (Snowman, p. 25).

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I have been working with GH since early February. In that time, we have set up several
of Vygotskys ZPDs (Snowman, p. 36). Using these zones, we have been able to work up to a
simple 5 color sort task with minimal violent outbursts. This scaffolding has also been extremely
effective in helping GH to be calm around other students, especially during transitions or meals.
I believe GH to be below the level of Sternbergs Triarchic view or Gardners Multiple
intelligences (Snowman, p. 74-75). Intellectually GH has no desire to meet Maslows concept of
self-actualization. She prefers to sit in a dark room and does not self-initiate any behaviors other
than the desire for food or the need to use the restroom.
Social/Psychosocial
GH is severely socially delayed according to DSHS Fosterparentscope. GH rarely selfinitiates conversation unless it is for a base need like food or using the restroom. Most of GHs
vocalizations are echolalia with no meaning behind them. GH is content to be alone and does
not seek the attention of her peers or teacher. Her preferred activity is to sit outside alone while
pulling strings off of her clothes and eat them. GH exhibits most of the characteristics of a one to
two-year-old but is still lacking the need to connect with others (DSHS Fosterparentscope). GH
has exhibited a desire for no needs above Maslows Physiological and Safety levels.
Looking at GH through the lens of Eriksons epigenetic principle GH should be well into,
if not beyond, the Identity Versus Role Confusion stage (Snowman, p. 17-20). In contrast, GH
seems to be stuck somewhere between Autonomy Verses Shame and Doubt and Initiative
Versus Guilt. GH has little to no willingness to direct her own behavior and little ability for
initiation (Snowman, p. 18). According to the views of Marcia, GH may exist in a lifelong state
of Identity Diffusion. GH has little ability to relate experiences to her development of identity
and is unable to give serious thought to Occupation, gender roles, values (Snowman, p. 21).
Moral
Morally GH is able to distinguish between right and wrong in most cases although in
contrast to the milestones she is not ashamed when she does something wrong (DSHS
Fosterparentscope). GH does not value others opinions of her and has little in the way of selfcontrol. Extreme outbursts of aggression are common and she poses a danger to students and
staff. GH makes no promises in regards to her behavior but seems to want to do right and be
good in most situations. According to the criteria from DSHS Fosterparentscope GH would
place GH at about two to three years old in this category. GH has little understanding of rules
and will readily act out in negative ways when her desires override what little restraint she has.
From my observations, I believe that underlying concepts of Piaget, Kohlberg, Gilligan, and
Noddings are beyond GH. GH acts mostly on a very basic Punishment-obedience level of
Kohlbergs theory but her fear of punishment is easily overridden by her basic wants and needs
(Snowman, p. 41).

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Summary

In summary, GH is physically mature for her age in terms of height, weight, and
sexuality. She is underdeveloped or extremely delayed in other physical aspects including motor
skills and vocabulary. Additionally, she is delayed in all other areas placing her in the 4 to 5year-old range. GH has shown minimal motivation outside of the promise of food or appropriate
physical contact from staff.
Using Applied Behavioral Analysis (ABA) techniques, which build upon Skinners
concepts of operant conditioning, great strides have been made with bringing GH into the
classroom. GHs mother approached the school in January worried about the fact that GH had
little to no social interaction throughout the day and had spent most of the school year outside in
isolation. GH preferred the quiet of the outdoor calm-down area to the noise of the classroom
and reacted violent when efforts were made to bring her indoors.
In February, GH was able to be brought indoors through behavior modification using
shaping techniques. A simple and preferred task of dropping balls through a hole was selected
and a primary reinforce of food was selected. Within a week GH was able to be seated at a desk
near the door and successfully complete her task for over half of the work day. At the same time
aggression was reduced to minimal levels. Other reinforcement was introduced in the form of a
break in a dark, indoor calm down area. Food as a reinforcement was then faded into a
variable reinforcement schedule (Snowman, p. 157). GHs outbursts were ignored while
appropriate use of words was continually reinforced with preferred activities.

Recommendations
Looking ahead I recommend the continued use of ABA techniques in regard to GH. She
has just recently been introduced to eating with her classmates. This stressor has increased the
amount of outbursts exhibited by the student but through continued shaping I believe these too

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can be reduced (Snowman, p. 157). The Premack principle may also be usefully in targeting
appropriate behaviors (Snowman, p. 158). GH understands simple cause and effect and will
respond positively when an appropriate reinforcement is offered upon the successful completion
of a task. The use of tokens and earning a break is also an effective technique with GH. Past
trials have shown that she will complete a set amount of tasks for reinforcement and can
maintain appropriate responses to stressors. However, the idea of a Response-cost in
conjunction with a token economy or time-outs have been shown to be ineffective with
reducing GHs undesired behaviors (Snowman, p. 159-161). Positive and negative
reinforcement have proven to be the most effective tools in our toolbox as teachers when
working with GH (Snowman, p. 150).

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References

Snowman, J., & McCown, R. R. (2013). Ed psych. Belmont, CA: Wadsworth/Cengage Learning.
DSHS Fosterparentscope Training (n.d.). Child Development Guide. Retrieved from
http://depts.washington.edu/allcwe2/fosterparents/training/chidev/cd06.htm

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Appendix
Notes

Date 02/15 02/17 02/19

Notes

Time: 7:18am to 1:26pm

Initials: GH
Age: 19
Gender: Female
Siblings: 2
Birth Order: Youngest Child
Family Dynamics: Mother, Step Father
Culture: Filipino Immigrant Mother, White American Father
Language Spoken: Limited English
Physical: Around 59 Tall, 220 lbs
Health Issues: Type 1 Diabetes, Gross obesity
Disabilities: ASD

The first day of observation GH spent most of the day in her preferred area outside.
GH exhibited several aggressive behaviors when approached about completing
classroom tasks or when I tried to initiate communication. The Behaviors include
loud noises, scratching, hitting, spitting and head-butting walls. GH was able to
successfully finish a simple one step job 3 times under direct supervision with positive
reinforcement. The job consisted of placing soft rubber balls through a hole.
Lunch was eaten by herself and she needed help opening her milk and other
foodstuffs to avoid making a mess. She ate in about 3 minutes with little to no

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regard about the mess she was making. She was denied juice due to her diabetes but
At no point was her blood sugar checked due to her aggression. Transitions were
Especially difficult for her with outbursts of screaming, hitting, spitting and banging
Her head against the wall. The most calm she was all day was when getting ready for
Bus, she ran to grab her harness and allowed the teacher to put it on her without
Any signs of aggression.

Notes

Day 2 Gh started the day outside but was successfully able to come into the classroom
For her task. After completing one task of putting balls through the hole she ate
Breakfast and returned to the outside area. She was asked to come inside multiple
Times to no avail with outbursts of screaming. Finally around 10:00am GH came in on
Her own and began working. She successfully completed three tasks and was given
Positive reinforcement of an pretzel. throughout the day she continued to work in this
Manner earning a pretzel stick every third job. During her work GH would spout phrases
Like "I like hot tubs" and "I like Filipino food". These usually came when she was
feeling
Frustrated. at one time while I was recording behavioral and time on task data,
Without warning or an antecedent that I could determine, GH ran across the room
And punched me in the back. All in all GH spent around 3 hours on task this day.
No functional communication could be carried out, most responses were unrelated
To the questions asked or repetition of what was said. GH could follow simple
Directions when broken down step by step and stress was kept a minimum.

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Like the previous day she became excited and compliant when the time to go home
Arrived.
Guidelines

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