ABA Case Study

ABA Therapy Case Study

Jacob is a 16-year-old Caribbean-American male in Orlando, Florida who attends a small public high school and lives with his mother and 2 younger siblings. Parents are divorced but have shown a clear commitment to active co-parenting.

Major Achievements:

  • Highly verbal and speaks in sentences. 
  • Can conduct conversations with family and friends.
  • No longer requires special education. 
  • Subsequently placed in general education without any special education supports.

Onset
At age 10, parents grew increasingly concerned about his demeanor and behavior at home and in school. As his behavior worsened (exhibiting severe tantrums, unresponsive to adult instruction, increase in stimming, aggressive to peers and siblings), Jacob was placed in special ed classes to avoid expulsion and later to a private school for children with learning difficulties.

Parents placed him in psychotherapy, where he was prescribed Ritalin (methylphenidate), then Buspar (buspirone) then later Paxil (paroxetine). He also attended a speech-language therapy program 3x/week to address challenges with language and communication and group therapy 2x/week.

His behavior only improved while in his mother’s presence, leading to his mother having to end her pharmacology studies to provide round-the-clock support at home and school. An ASD diagnosis occurred when his mother changed his pediatrician, who recommended ABA therapy.

Jacob was medically recognized as high-functioning and verbal with certain struggles with language use, acquisition and social cues.  At school, education success depends on the level of engagement with the subject matter.

Challenges (@ diagnosis)
Persistent current or past behavior across a variety of settings with shortfalls in emotional and social exchanges, nonverbal communication, as well as forming, upholding and comprehending relationships. Specific, repetitive activities, hobbies, and actions include stereotyped movements, rituals or inflexibility, extreme abnormal interests, and/or problems with sensory reactions.

  • Wavering inclination between limited eye contact and intense staring at another person, familial and non-familial.
  • Lack of response to non-familial people, has shown aggression to protect his mother or his siblings misjudging typical social interactions and cues.
  • Mild sensory overload with thunderstorms
  • Disruptive behavior and unresponsiveness in classroom.
  • Engaged in repetitive behaviors like hand flapping

Treatment Plan
ABA therapy began at age 13 with a plan of 40 hours/week for 156 weeks, decreasing to 25 hours/week for 156 weeks and 10 hours/week for 52 weeks.

Positive Outlook
He is less emotional about changes in daily routines even though it still takes time for him to process. In class, Jacob recognizes his peers, responds when spoken to, and initiates contact on rare occasions.

Communication
Parents consistently support Jacob. He is more verbal with parents, siblings and close friends, reacting adequately, especially in repeated day-to-day situations. However, in unfamiliar settings, he tends to become unresponsive.

Social-Emotional Development
Jacob handles emotions relatively well, especially in social situations. His parents report the occasional meltdown during periods of high stress, i.e., exams.  When confronted with unfamiliar situations, Jacob  may exhibit fight-or-flight response becoming agitated or escaping the setting altogether.

Adaptive Development
His physical development was assessed as normal –  appropriate height and weight for his age. Initially, patient displayed slight delays in coordination and fine motoric skills, for instance, when it came to writing or drawing.

Recent Successes

Jacob has achieved a great deal of success in developing video games for a gaming company.

Jacob is well-liked with a supportive and diverse circle of friends that understand him and his needs.

Grade point average has improved from C- last year to a B-

Jacob began playing basketball with school team.

Jacob is eager to graduate and has applied to community college.