Case study 29-Initiate behavioural therapy for 5 year old child

The child aged, 5-year and 6-month-old boy, initiated behavior therapy, due to various concerns. He faces difficulties in establishing eye contact, responding to his name, and sustaining attention. Social interactions pose challenges for him, and he exhibits hyperactive behaviors along with instances of aggression and destructiveness, such as hitting others. Additionally, he struggles with inappropriate conduct, such as touching strangers, and demonstrates shyness or hesitation in engaging with others. His socialization skills are lacking, and he displays reluctance in interactions.
The child was born out of a non-consanguineous union, he was delivered by Caesarean section at full term with a birth weight of 3.45kg. While he achieved motor milestones on time, delays were observed in speech and social development. His eating and sleeping patterns are adequate. He is independent in eating, dressing, and undressing, and partially dependent on toileting.
He has been actively engaged in behavior therapy, attending 45-minute sessions six times a week to enhance communication, social skills, and address behavioral concerns. The initial month prioritized building rapport, improving eye contact, eliciting name call response, and developing waiting tolerance using a counting strategy. Subsequent months focused on increasing waiting tolerance without counting, following commands, and improving attention. In the third month, the aim was to guide him in behaving appropriately in social situations, improving socialization skills, and reducing hesitation in interactions.
Throughout the therapy, issues like restlessness, aggression and inappropriate behaviors were promptly addressed with appropriate consequences. Different strategies were used, including positive and negative reinforcement, extinction, and differential reinforcement, all aimed at encouraging positive behaviors.
Upon reaching the third month, notable improvements are evident. Initially challenging, establishing rapport has become easier and Name call response, once absent, has improved significantly as he can now responds to calls by looking and saying “entho”. Eye contact, initially difficult to establish and maintain, is now achieved for extended durations, although a tendency towards avoidance persists sometimes. His waiting tolerance has significantly increased, he can now wait without counting for a period while folding his hands. His ability to follow commands has improved significantly, responding to commands upon the first call. Additionally, his attention span has extended, allowing him to sustain focus for longer durations.
To address his struggles with inappropriate behavior, such as touching strangers and his hesitance in social interaction, therapy sessions incorporate role-playing scenarios, social interaction games, and group activities. These activities aim to guide him in behaving appropriately and improving his socialization skills.
He is smart and capable child. Throughout the intervention period, notable improvements have been observed in his developmental skills, showcasing his inherent potential. It is evident that he has the capacity to excel further with continued rehabilitation and support. His current achievements are indicative of a promising future.
I am sincerely happy to work for this lovely child. I also want to use this opportunity to thank Child’s parents who was really hard working throughout the intervention.
Shaziya Shamsudheen
Consultant Psychologist