978-1572305441

Zachary 51
silent. He was never interested in reading picture books with his mother
but became fascinated with the phone book and loved to watch the
credits at the end of TV shows. His favorite show was the Business Report
because letters and numbers from the stock market were constantly
being flashed across the screen.
Zachary was first seen by his family doctor because he was considered
a difficult child and a bit of a loner in day care. However, as his language
and motor skills were quite good, the family doctor did not feel
there was a significant developmental problem requiring intervention.
He was not assessed again until kindergarten, when his teacher noted
that he was having difficulty paying attention in class; he seemed absorbed
in letters and numbers and spoke little to her or to the other
children.
As a six-year-old, he had a few friends but would play alongside
them rather than together with them. If his friends were not interested
in Thomas the Tank Engine or watching the Business Report, Zachary
would play by himself. Adults found him entertaining as he could talk
to them on a surprisingly sophisticated level. He was especially fond of
asking adults what kind of car they drove. He would proudly bring out
this information at family gatherings and amaze everybody there with
his memory. Zachary liked to be the center of attention as long as people
focused on his interests. He always had a very close relationship
with his mother; he was quite affectionate with her and would spontaneously
give her a hug and come for comfort if hurt. He would sit beside
her while watching TV and nestle up to her. But Angela could not
get him to look her directly in the eye during a conversation, and they
could not play cars together in a truly reciprocal way. Zachary tended to
tell her what to do and would resist her attempts to modify the play.
Unlike many children with ASD, specific phobias or resistance to
change had not been a prominent feature of Zachary’s early development.
But there were slight hints of things to come. For example, he
would become very upset (possibly anxious?) at the sound of the vacuum
cleaner, the blender, or anything else that made a loud noise. But
that was it. There was no evidence of difficulty in changing from summer
clothes to winter clothes, no problem in changing brand names of
food, no difficulty in having his bedroom furniture moved around.
Very little had changed in the last three years. Zachary’s language
skills continued to improve slowly; he learned more sophisticated rules
of grammar, and his vocabulary expanded appropriately. But he retained
the same interests and the same fearfulness about loud noises. He mem-