Video Cases Title

Ethan: 13 year-old patient
Ethan is a 13 year-old patient. While this patient was verbal at a young age, his mother noted that he had serious problems with interpersonal relationships, a rigid approach to routines, and restricted interests.

Even though he seems to want friendshps, she notes that he has not made many friends at all. At times, he will respond to questions in a way that he believes to be "socially acceptable" and not in a way that reflects his true situation or feelings. For instance, when asked about friends, this patient fabricated a set of friends that he does not really play with.

This video clip points out:

That history from parents can be a vital factor in the detection and diagnosis of autism.

The presentation of this patient breaks many of the stereotypes of autism.

In this patient case note:

He has a restricted affect.

At first glance, he answers questions in a way that you might expect other young teenagers to respond.

During much of the interview, this patient seemed to choose answers that were more "socially appropriate."

The mother of this patient provides a much different story and reality to the social difficulties that he faces.

Compare this patient’s limited reciprocity, limited interests, own stereotypical behavior, and conversational patterns with the older patients in this series of video cases.

Clinical suggestions:

1) Make sure you obtain history from parents. They can be very accurate reporters of developmental problems in their children.

2) The diagnosis of autism should not be dismissed by cursory clinical impressions or first impressions.

3) Even if the diagnosis of autism is uncertain, the presence of general developmental concerns should lead to early referral and intervention.

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