Case Study: Katie Peterson

Answer

Case Study: Katie Peterson

Diagnosis: Autism Spectrum Disorder (ASD)

            Katie has been diagnosed with autism spectrum disorder. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association [APA] (2013), one has to meet each of the three areas of social interaction and communication and at least 2 to 4 types of repetitive and restricted behaviors for the ASD diagnosis to be made. Social interaction and communication criteria include persistent deficits in social interaction and communication in multiple contexts including deficits social-emotional reciprocity, nonverbal communicative behaviors used for social interaction, and deficits in developing and maintaining relationships and understand relationships (APA, 2013). Consistently, Katie finds it hard to establish and maintain relationships. She is calm, self-isolating, and sometimes she makes loud spontaneous noises; thus, disturbing others.

Repetitive and restricted patterns of behavior, activities or interests may include repetitive or stereotyped motor movements, inflexibility or insistence on sameness, fixated interests, and/or hypo- or hyperactivity to sensory input or unusual interest in sensory aspects of the environment (APA, 2013). Consistently, Katie is irritable and restless, has history of seizures, she turns the lights on and off repeatedly for several minutes, other repetitive behaviors, and avoids eye contact.

Importance of the Baseline Single-Photon Emission Computed Tomography (SPECT) Scan

            Baseline SPECT scan is important for understanding brain function in autism. The scan can show decreased flow of blood in the temporal cortex, reduced glucose metabolism in the putamen, and thalamus, and elevated glucose metabolism in the parietal and occipital cortices (Sharma et al., 2018). The SPECT gives information on the regional cerebral blood flow of brain. Decrease in the flow of blood in the cerebral cortex reflects hypometabolism in positron emission tomography, which reflects neural damage in the brain. SPECT studies can demonstrate cerebral blood flow in the frontal, temporal, occipital, and parietal cortices, basal ganglia, thalamus, and the cerebellar hemisphere (Sharma et al., 2018). ASD patients can demonstrate increased blood volumes and generalized brain overgrowth (Wolff, Jacob, & Elison, 2017). In this case, baseline SPECT scan revealed overactivity in the basal ganglia as well as marked elevated patchy uptake throughout her cerebral cortex.

Recommended Resources to Help Katie Function Better

• The National Institute on Deafness and Other Communication Disorders to help Katie address the ASD-associated communication challenges (CDC, 2021).

• The National Institute of Dental and Craniofacial Research to provide resources to help caregivers and healthcare professionals with the oral healthcare needs of individuals with ASD (CDC, 2021).

• The Autism Treatment Network for creation of standards of medical treatment for the parents, physicians, researchers, policymakers, and others who want to improve the care of individuals with autism (CDC, 2021).

Medications

Currently, there is no treatment to cure ASD, however, there are several interventions used reduce symptoms, improve daily living skills, improve cognitive ability and maximize the ability of an individual to participate and function in the community (Centers for Disease Control and Prevention [CDC], 2021). Medications that can be used include atypical antipsychotics such aripiprazole and risperidone to reduce hyperactivity, stereotypy, and irritability. Newer medications including oxytocin and glutamic agents, appear promising in management of ASD, but there are mixed results (Ji & Findling, 2015).

Psychotherapy

Applied Behavior Analysis

            Applied behavior analysis (ABA) encourages positive behaviors and dampens negative behaviors so as to improve variety of skills. Discrete Trial Training is one of the ABA approaches for teaching the desired behavior or response. Incorrect behaviors are ignored while correct behaviors are rewarded (CDC, 2021). Verbal behavioral intervention is another type of ABA the emphasizes on teaching verbal skills (CDC, 2021).

Assistive Technology

            Assistive technology includes teaching the patient to use devices such as electronic tablets and communication boards to help her to communicate and interact with others. For instance, Picture Exchange Communication System utilizes picture symbols to educate and train ASD to acquire and master communication skills (CDC, 2011).