Case Study: 11 Year Old Male with Autism, Verbal Apraxia, and Sensory Processing Disorder

James was diagnosed with ASD (specifically, PDD NOS) with complicating diagnoses of verbal apraxia and sensory processing disorder. His most significant issues were:

  • Anxiety. Generalized anxiety as well as fear of changes in routine and unfamiliar places.
  • Sleep Problems.
  • Self-stimmulatory behaviors such as vocal noise-making, pinching, hand-flapping.
  • Poor social engagement.
  • Apraxia and lack of verbal communication.

James began listening to his custom REI recording in the evening while he engaged in quiet play. He was initially resistant to listening (sometimes he would say “no music!”) when the music was turned on. This resistance lasted less than two weeks while, during this time, he made significant gains.

During the first two weeks,  James began sleeping through the night, something that he had not been able to do for the previous few years. His anxiety also reduced profoundly, most notably he stopped compulsively asking about the the day’s schedule and worrying about his next activities.

During the third week, his mom related, “For the first time James started asking the ABA therapists to keep playing when the session was done. He also, on his own volition, chose to start playing with his trains and Rescue Heroes. Usually he only wants to draw all day.”

After four weeks on the REI Custom Program, his mom and therapists noted that James’s vocabulary was increasing, as was the length of his sentences.

After 6 weeks James was reported to show the first signs of pretend play. His mother wrote, ”The other day he said ‘elephant’ and used his arm as a trunk and stomped around the room! Also did a similar thing with ‘giant.’ Very exciting!”

At eight weeks, James’s mom reported more behavioral gains. He was doing less drawing and the drawings that he did create were of broader subjects. She noted that he was able, with prompts, to sit through his brother’s baseball game, a first. While the family was out sightseeing they got caught in the pouring rain. “James did not like it, but was okay”. To his family’s surprise he did not have the customary meltdown.

After 16 weeks of listening to his REI recordings, his mother requested a revision to his program that focused more on his issues with inflexibility and difficulty with transitions.

After 20 weeks, it was noted that James was continuing to make behavioral gains. His brother was having a bar mitzvah and the whole family was worried about how James would tolerate the very stimulating day. He handled the day surprisingly well, his mother reported, sitting through the entire religious ceremony and staying calm among all the guests. Most surprisingly, James allowed himself to be photographed. Until that day James would get very agitated when a camera was pointed at him and always refused to stand for a photograph. On this day, not only would he allow many photos to be taken, but even smiled on command!

Over the next month, his mother reported that James was using more spontaneous language and appeared “more connected” with his feelings. For instance, she related that when his teacher asked him what was wrong, James replied,  “I feel angy”. When asked why he was upset when he had to go to a mainstream class that he did not like (because the sound of the classroom music hurt his ears,) he replied “because there was music.”  On another occasion, he told his mother that he felt “nervous” when his school bus took another route home one day.

Fifteen months after completing the REI Custom Program, in an interview with his mother, James was reported to be doing well, with continued growth in his ability to verbally communicate his needs and to socialize more appropriately. He has maintained all of the gains he made while on the REI Custom program, including decreased anxiety, especially about his schedule, increased spontaneous play, and use of verbal communication to express his feelings.

Learn more about the REI Custom Program here