Josue Case Study

The B.A.T. clinical team met Josué’s parents and Josué on October 26, 2016. On this date the B.A.T. clinical team conducted an indirect functional assessment, which consisted of a parent interview and review of ABA services in relation to Josué. The B.A.T clinical team gathered information regarding Josué’s history (as outlined in the above section) and inquired about the challenges they encounter, including any behaviors that are of concern. Josué was also present in the home during this visit.
Josue displays a number of difficulties in regards to communication according to his parents. To illustrate, Josue has difficulty complying with one-step instructions, sitting in attending for non-preferred for more than three minutes, and sitting
in attending for preferred activities for 10 minutes. However, parents report he is able to look when his name is called, he can say three words in both English and Spanish (ma, pa, and bye). Mom reports, when he is hungry he pulls her to the fridge. In regards to socialization, parents report that Josue has issues with waiting, playing with peers, and he has difficulty playing with his toys appropriately.
In regards to maladaptive behaviors, parents report that Josue displays a number of stereotypy behaviors. To illustrate Josué will bite rubber toys, such as, his rubber iPad cover and rubber book cover. Josue also engages in hand flapping, when he's excited or muscle tensing when he is excited. Parents report that these behaviors occur on a daily basis, lasting up to one minute. Parents also report that Josue engages in tantrums. During a tantrum Josue will fall backwards onto the floor hit and screen. According to parents tantrum's last 10 seconds per day. Parents report that during a tantrum, they redirect him to do something else and they talk to him. Reportedly, Josue engages in tantrum behavior when he cannot have access to tangibles. Third, parents report that Josue engages in elopement or wonders off in public. According to dad, Josue wants his attention. Dad reports that he will usually follow Josue or go after him, call his name, and in return, Josue will smile and laugh . Finally, Parents report Josue will become aggressive for attention. To illustrate, Josue will gently slap people and make a "Aa" sound to get peoples attention so he can have access to a tangible item.

In regards to self-help skills, Josue displays difficulty.
According to parents Josue is not potty trained. However, they report they are working on potty training in home. Mom reports that Josue will sit on the potty with his iPad and he is also able to gesture when he needs to be changed. To illustrate, Josue will say mama and get in the position (i.e. lay down on his back) to be changed. Parents also report, that Josue still drinks from a bottle, parents report he enjoys biting or chewing on the rubber nipple of the bottle. Josue also has difficulty with undressing, washing his hands, brushing his teeth, spitting out the water when brushing his teeth, and cleaning up. In addition, Josue has difficulty with wiping his nose, buttoning buttons, snapping snaps, and zipping zippers.Overall, parents want Josue’s communication to improve and they want to learn how to control his maladaptive behaviors.
The B.A.T. evaluator conducted a reinforcement assessment (RAISD) and the Adaptive Behavior Assessment System Third Edition (ABAS-3) assessment with Josué’s parents, as well as reviewed some anticipated goals for Josué and his parents. Parents stated they were in agreement. The B.A.T. evaluator then concluded the observation. The duration of this assessment was approximately one hour and 30
minutes.