Respondent: Ms. Resinick
Talia is a 4 year, 2 month old female. She currently attends preschool 5 mornings per week and is in a class designed for children with language delays. She receives speech therapy 1 time per week for 30 minutes. Her mother takes her swimming at the YMCA or to the park each day after school, weather permitting.
Talia has difficulty communicating vocally and has only a few words that include “mom” and “no”. Because she has difficulty expressing her wants and needs, Talia’s preschool teacher recently started teaching her to use Picture Exchange Communication (PECs). Talia is not yet able to use PECs without significant help, but she will pull adults to the items she wants and will sometimes point. Talia tolerates her peers playing near her, but does not play or engage with them in any way. Talia’s teacher describes her as “being in her own world”.
Talia loves to watch Minion videos on YouTube Kids. She has specific videos that are her favorite and she will fast forward and rewind to watch specific clips over and over again. She is also very active and loves going to the park and playing outside. She will climb on the playhouse, jungle gym, and rock climbing wall. She also loves to go down the spiral tube slide and running around the play area. She is fascinated by watching things fall through the air and often tosses items up to watch them fall or drops them down the slide. In addition, she enjoys waterplay days at preschool and anything with Bluey. She likes to have music playing and gets excited during anything music-related at school, often humming along to the tune.
Talia’s dangerous behaviors include head banging against walls and windows. This has resulted in bruising and swelling. She also bites herself on the hand and arms and has bitten other people in various places at times. Sometimes she will gently place her teeth against the skin and other times she will clench down for several seconds and leave marks or break the skin. Her mom reports that she can usually tell that the head banging or biting are about to occur because Talia begins to cry, yells “No! no!”, and will fall to the ground.
When Talia is happy, she can be seen engaged in her favorite play activities such as running around or watching her YouTube Kids videos. She often has a smile or slight grin on her face and can sometimes be heard humming. The single most concerning behavior is head banging. The other concerning behaviors are biting herself and others and yelling.
Interfering behaviors are occurring in a variety of situations. If mom tells Talia she is unable to go outside for whatever reason, such as the weather, she will become very frustrated. The same behaviors are seen if her Ipad battery dies or if she is unable to find the specific video she is looking for. She also becomes very upset if she is engaged in one of her favorite activities andis asked to transition to something else. For example, if she is watching Minion videos and mom tells her it is time for lunch, she will begin to cry, yell “No! no!”, and will drop to the ground with her Ipad in hand. Sometimes mom can distract her and avoid an escalation by offering other preferred items and activities, but this does not work every time.
If the interfering behavior escalates, mom will try to calm her down by offering things that she likes or by giving her more time with the activity she is currently engaged in. If there is a problem with the Ipad mom will fix it and try to help her find the video she is looking for. Mom will often try to incorporate the activity into whatever she needs her to do, such as allowing her to continue to watch the Ipad while eating lunch.
Mom thinks that Talia engages in these behaviors to get what she wants.