Reference no: EM133307486

Question: Sam K. is a 7-year-old, African American male, who lives with his biological parents and his 11-year-old brother. Mrs. K was 42 years old at the time of Sam's birth. Sam was born 6 weeks prematurely and experienced developmental delays in reaching most milestones including, sitting, walking, and talking. He suffered from frequent respiratory infections during his first two years of life and continues to be prone to them. He is a slim, short child with a larger and elongated head. Sam's mother reported that as a baby, Sam never liked to be cuddled. She shared that her older son loved to be cuddled and to engage in games like peek-a-boo and pat-a-cake as a toddler. Mrs. K. reported that Sam did not show interest in engaging in these games and he often preferred to engage in rocking for prolonged periods of time.

Sam parents became concerned when they would talk to him, and he ignored them. The parents were concerned Sam might have hearing problems and had him evaluated; the results revealed normal hearing. Sam did not start talking until the age of 3-years and had very few words. The parents took Sam to his pediatrician who informed them that it was probable that Sam's prematurity could be responsible for his delay in speech. Sam eventually demonstrated increased speech at 3.5 years; however, he continuously repeated the same words and phrases (e.g., you ball), and these words were used to communicate all his wants and needs.

Sam's parents attempted to send him to preschool at the age of 4-years. Sam was not able to adjust to the changes and demands of a pre-school placement as the expectations and structure were significantly different from his home routine. Sam parents withdrew him from the program. When Sam attended first grade, his intelligence was evaluated and revealed a full-scale IQ of 68. His teachers reported he was socially isolating himself from peers. He exhibited limited language skills and deficits in expressive language and pragmatics. Sam did not show interest in communicating with peers. During unstructured times, Sam displayed increased anxiety and agitated behaviors. He often preferred to play on his own, often choosing to play with water in the sink. According to his teacher, Sam was fascinated with the sight and sounds the water made in the sink.

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