Case 1: Howard is 7 years old, and his mother is concerned about his challenging behavior in multiple settings (home, school). He is very noncompliant and has hit staff and pupils. Howard had early language delay but now uses some short sentences. His school reports indicate that he has moderately impaired intellectual ability with above average reading skills and a marked failure to develop any peer relationships. His parents report that his language is stereotyped and repetitive and that he repeats watching of videos and DVDs. He is very limited in terms initiating social communication and has a restricted pattern of interests, currently an over-focus on DVDs. He has stereotyped repetitive motor mannerisms and seeks to feel people’s clothes. When you first meet Howard, he immediately reaches out to feel your clothes.

How would you proceed?

Case 2:
John is verbal with limited language skills. He can sing in complete sentences (echolalic) but communicates using one- or two-word phrases. He communicates mostly by pointing. When he does speak, his enunciation is poor except when he is angry at which time his words are clear. He displays self-stimulatory behavior in the form of rocking, hand-turning, and hand flapping. His gross motor skills are below normal. His sleep was good, but he is defiant and unable to calm down at bedtime. He shows no interest in other children.

How would you intervene with respect to improving bedtime or improving interactions with other children?

Case 3:
Susan is a 5-year-old diagnosed with autism spectrum disorder. Your first time alone working with her, she stands and sits very close to you when she is playing. She makes some humming sounds that sound like vague human speech and she takes your hand and guides it towards her inner thigh. When you pull your hand back from her, she has a look of surprise on her face.

How would you proceed?