This is an exact reproduction of the psychological report. The psychologist writes :
"Mr. & Mrs. M. came for our assessment giving interview today, October 15, 1986.
I began by sharing with the (parents) our findings on Daniel this year and by comparing his performance on the tests last year. Daniel showed considerable improvement in his intellectual functioning this year. He received a mental age score of 6 years, 8 months which increased his IQ from 51 last year to 54 this year. Comparable gains Daniel also made on the Peabody picture Vocabulary Test, a test which purports to evaluate receptive language ability. Generally, Daniel showed slight but steady improvement on all other instruments that he was tested with. He clearly appeared to be more alert this year and generally to be more aware of his environment.
On the basis of parental responses related to the Alpern and Boll Developmental Profile, Daniel also showed gains in his physical development, in his academic skills and in his communication ability (more detailed data on this and previous tests are included in the psychological report).
We subsequently discussed some of the problems that Daniel appears to present at home and particularly at school. Daniel apparently would bolt from the house and climb on the roof of adjacent houses. This is a cause of considerable and understandable concern of the parents. We discussed how the bolting might indicate both a desire on Daniel's part to be independent and able to move around his neighbourhood like other children his age, and the possible attention he receives from the obviously and understandably concerned parents. Clearly, Daniel's escapades alert the parents to the point that their reaction might reinforce this behaviour in Daniel. It was therefore suggested that Daniel be taken in outings, which apparently the family currently does, but also be told that, in the event that he bolts, he will be deprived of his outing for the rest of the day. It was felt that a program which emphasizes a positive attention to Daniel and his needs for freedom and being outdoors rather than reacting to his getting away from home might be best at present. It is, of course, unfortunately, very difficult to advise the parents not to show excitement and apprehension to thereby prevent Daniel from being negatively reinforced through parental reaction to his escapades.
We subsequently discussed toileting. The parents feel that Daniel has somewhat regressed in this area, perhaps becausehe is very happy to play with hair shampoo and that necessitates the presence of others in the bathroom to supervise him. Apparently, Daniel also wants to be helped by his mother, and although he was able to manage to fully toilet himself in the past, he know (sic)(meant to say "now") appears to require some assistance. It was felt that some attempt to remove the shampoo from the bathroom, so that Daniel might not engage in bubble blowing, as well as progressively weaning him from having an adult in the bathroom with him might be the appropriate steps to take. Daniel's cognitive ability certainly is high enough to allow him to understand the consequences of his actions but also, within limits, to be possible for adults to reason with him.
The discussion then revolved around exposure to danger. Although Daniel has apparently been shown how to cross the street he would nonetheless cross against oncoming traffic just to see the reaction of his parents to this dangerous activity. This is clearly a very difficult problem and one that may require very careful one-to-one handling by adults, reducing their negative attention-giving to Daniel when he crosses the street. We offered to be available to a one-to-one worker if the need for our involvement arises. However, we understand that both Aventure Place and the Geneva Centre provide ongoing behavioural consultation to the family and school.
Daniel's potential entrance to (name of group home) was then discussed. I emphasized how strongly our team felt about Daniel entering (a place), particularly because he has many positive points that would make him a good candidate for the facility. Also, it appears that his family may benefit from a placement away from home, particularly because Daniel is an inquisitive and daring child. Having in a context where behavioural consequences are consistent and systematic might really make for a much evener day for Daniel.
Some discussion revolved around the saliva smearing which Daniel presented last year and again this year. While he was tested, he engaged in this activity this year. Yet both parents and the school apparently feel that he he's not excessively preoccupied with saliva smeared. It is possible that the considerable stress imposed on Daniel through the testing might have exacerbated the relatively low frequency of exhibiting this behaviour under normal circumstances. Nonetheless, it was felt that, were the saliva smearing to increase, there may be a need to implement another overcorrection approach very much along the lines that were suggested to the parents last year.
I closed the interview by wishing the family all the best for this year and offering to be available to them as the opportunity arises in the future.
It was signed by the head of autism clinic
