Reference no: EM133877633

Question

What is the CANS answers to this vignette assumption?

Linda is a four-year-old girl with severe autism. She lives in a two-bedroom apartment with her mother, father, and two older sisters, aged ten and thirteen.  Her family emigrated from Vietnam ten years ago and English is their second language. Her father is a mail carrier and her mother is currently staying home with the children.

Linda is non-vocal and communicates her wants and needs by touching and/or pulling an adult - or one of her sisters - towards the desired item. Two days a week Linda attends a special education program focused on improving communication skills.  Linda understands simple directions in context (i.e. "shoes on," "outside," "open," "jump"), but has difficulty understanding directions out of context (i.e. when asked to "jump," while not on the trampoline). Linda has emerging play skills and is eager to play with cause-and-effect toys, blocks, and puzzles. She will run, jump, and skip on the playground; however, her attention to these activities is fleeting and she usually prefers to play on her own, rarely seeking out interaction with her classmates. Linda loves sensory activities like sand and water play.

Linda has difficulties with transition which manifest not as restlessness or irritation but as aggressive behaviors - kicking, screaming, hitting - when she is switching from a preferred activity to a less-preferred activity. She is also defiant towards her teachers, throwing tantrums when she does not get what she wants.  This is a frequent issue and a concern at preschool, as Linda's tantrums often impede her learning and disrupt the class.  Outside of those times where Linda is defiant and there is tension between her and the teacher, Linda gets along with her teachers.

Linda's parents have tried to stop it when she displays this defiant behavior at home but usually give in and give her what she wants. Linda's parents are committed to learning practical strategies to help their daughter even though they are having a difficult time accessing supports and services in their region: they have attended several parent workshops and support groups but difficulties with language, childcare, and financial resources often interfere with their ability to access these services. They have no family in the country and no friends who are able to provide childcare. Their oldest daughter can watch the younger children for short periods but they are uncomfortable leaving them alone for long. Linda's sisters are very fond of her and spend a lot of time playing with her.

Linda needs full assistance to dress herself but she can eat with a spoon and will remain dry on a toileting schedule where she is taken to the washroom every two hours.