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12. Amelia is a 19momth old who has been monitored by a birth to Three program in her area because she was born 8 weeks prematurely and her primary care physician referred her for developmental follow up. As the SLP participating in her birth to Three follow up, you visited Amelia's home and noticed that Amelia demonstrated little eye contact, no jargoning, and a few screeching sounds when she was unhappy or wanted something. She tended to perform the same actions over and over again with her toys and preferred to play without an adult joining in. Nothing that her daughter does not seem to like her, Amelia's mother has been frustrated in her efforts to get her daughter to respond. Amelis's mother also recently lost her job and has been raising not only Amelia but also a 4year old son with little support from her family. what would be your next step in supporting this family?

a. Tell the mother that her daughter has autism.

b. Explain to the mother that the stress in her life is likely to affect her daughter's ability to connect.

c. Remind her that Amelia's was premature and is doing what might be expected of a younger toddler and that it will take sometime to adjust.

d. Acknowledge the mother's concerns and that you share those concerns, and suggest an assessment plan for addressing Amelia's needs and those of the family/

e. Acknowledge the current stresses affecting the mother's situation and offer to find personal care of respite support to alleviate some of her immediate needs.

풀이) d

It is critical to acknowledge what you hear a parent saying, identify any concerns you hare, and put a plan in place to ensure that these concerns can be addressed in a family centered and meaningful way. You may suspect the child has autism (option a); however, it would be inappropriate to make such a statement without a careful assessment of the early markers of autism. Because the child has early medical complications, ongoing involvement of a medical complications, ongoing involvement of a team is important. It is inappropriate to suggest that the mother's stress (option b) is causally related to her daughter's joint attention and social communication challenges, because there is no evidence of this. The child's failure to respond as expected probably exacerbates the stress the mother is currently experiencing; furthermore, many families experience similar stresses and do not have children who present with Aemlia's challenges. A child's Prematurity (option c) should be considered in defining expected development; however, if Aemlia's gestation age (i.e., 17 months) is taken into account, the current observations would be as concerning as they are at 19months. Providing personal care of respite support (option e) is reasonable, but it does not address a primary problem: the current social communication deficits being reported and observed for Amelia.

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