Case 1
Andrew’s development was normal up to the age of 3;2. At that time, he contracted encephalitis. He was in a coma for a week and subsequently was tube fed for 4 months.
He has epilepsy which is not yet fully controlled with medication, although the number of tonic-clonic seizures has decreased. Andrew seems to have a severe tonic-clonic seizure every three weeks and he has absence seizures many times per day.
Andrew is now 6 years and lives at home with his mother, Olivia, and older brother Martin (9 years). His parents are separated. While his father, Max, has Martin to stay every second weekend, he has very little to do with Andrew. There is a lot of tension between Olivia and Max.
Andrew is able to eat soft foods, and sometimes gags on lumpy foods. He needs his drinks at a nectar consistency. He has recently started using an adapted spoon to feed himself yoghurt.
Olivia is devoted to Andrew and looks for new techniques that might help him improve. She has started raising funds to take him to the Institute for the Achievement of Human Potential in the USA.
Andrew attends an early intervention program three mornings each week, and a special school on the other days. A speech pathologist visits him at school each week.
Olivia is sure that Andrew recognises her; he will turn, look at her and smile when she speaks to him. She says that he also recognises Martin and watches him whenever he is nearby. Andrew likes rough and tumble play and shows his pleasure by squealing with delight. He reaches out for things that he wants, and especially likes shiny toys and surfaces.
Olivia is sure that Andrew understands her sometimes. She knows when he likes something because of a particular noise that he makes while flapping his hands. He also rubs his nose when he doesn’t like something. He gets distressed when she or Ian have an argument in front of him. Andrew knows his bath routine and gets excited when he hears the water running.
Andrew can sit unsupported, pull himself up to stand, walk with light support from behind and can around walk indoors by steadying himself on furniture. He has a pincer grasp.