Therapeutics
Dadang Kusumawardhana, MD
Physiatrist
Departemen of Physical Medicine and Rehabilitation, dr. Wahidin Sudiro Husodo Regional General Hospital, Mojokerto, Indonesia
SURABAYA, Jawa Timur, Indonesia
Hanna Dyaferi Anomsari, MD
Pediatrician
2. Department of Child Health, Faculty of Medicine Airlangga University, Indonesia
Surabaya, Jawa Barat, Indonesia
A 2-year-old boy was identified as having a high risk for Autism Spectrum Disorder (ASD) based on developmental screening and language assessment. The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) yielded a total score of 16, indicating high risk for ASD. Language evaluation using the Early Language Milestone Scale (ELMS) showed developmental skills equivalent to a 6–7-month-old child, confirming significant delays in social communication and language development.
Case Description:
The patient presented with chief complaints of inability to communicate and limited eye contact. At baseline, he was unable to imitate or initiate gesture-based games, follow one-step commands with or without gestures, point to desired objects or body parts, or use meaningful words. His vocalizations were limited to polysyllabic babbling.
A rehabilitation program was initiated consisting of sensory integration therapy twice weekly for six months. In addition, parent-implemented contingent imitation (CI) was applied in the home setting for a total of 1.5 hours daily. The parent was trained to immediately and attractively imitate the child’s actions, gestures, and vocalizations to capture his attention and increase social engagement.
Discussions:
Autism spectrum disorder (ASD) is a usually lifelong condition characterized by impairments in social communication skills as well as restricted and repetitive patterns of behavior. Emerging evidence suggests that contingent imitation (CI) may be a uniquely effective way to increase social engagement in children with ASD. CI is defined as a technique in which the therapist immediately imitates the child’s actions and vocalizations. Total score of M-CHAT-R became 10. ELMS showed patient can imitate and initiate gesture game, can do one step command without gesture, can say mama-papa (specific) and other one word.
Conclusions:
Rehabilitation program (combination of sensory integration therapy and home setting contingent imitation) can improve language skill and social engagement of this child.
