CASE | Autism

Case study #1: Marc (Child)

Marc is an eleven year old boy who has been diagnosed with autism. In school he doesn’t have many friends, and would rather not be in contact with other kids. This is because Marc cannot always understand what they are doing. Ever since he was little, Marc has been fascinated by clocks, and this is something that he involves in his daily life. 

Day routine: 
07:00 AM Marc wakes up 
07:05 AM brushing his teeth and getting dressed 
07:15 AM breakfast
07:50 AM going to school by car (mom takes him) 
08:15 AM – 03:00 PM March will be in school 
03:00 PM Mom picks up Marc and they go home 
03:30 PM arrival at home and Marc plays with his clocks 
06:00 PM Supper 
06:30 PM playing with the clocks 
08:30 PM off to bed 

When there is a change in Marc’s routine, his parents say that he will get angry and hysterical. It takes a while for him to calm down. Getting Marc to understand is also difficult. When something is explained, it needs to be concrete and explained exactly as it needs doing step by step. 
Marc is not able to understand and process double messages, this confuses him. At school, they try to support Marc but the teachers don’t know what the best method is for this. They would like to see Marc interacting more with other children. 


  • What OT interventions would apply for Marc? 
  • Teachers would like to see Marc interacting more with others, but he doesn’t because he doesn’t understand them. Where lies your duty as an OT? 
  • How would you ‘teach’ Marc to handle sudden changes in his daily life?


Case study #2: Roxanne (Adult)

Roxanne got married recently, and has two kids with autism. Ever since the age of 16, Roxanne has experienced periods of gloom.
She likes to workout, especially running. However, when doing this; Roxanne forgets about physical boundaries which result in permanent damage. 

Roxanne studies chemistry at university, but can’t seem to find a job which fits her academic knowledge. She now has a job below her abilities and works three days a week. This job feels like a stressor for Roxanne.
In the last couple of years, Roxanne experienced multiple burn-outs. A major factor for this is the high expectations Roxanne sets for herself. This is not only at work, as Roxanne tends to do this at home as well. Her husband works full time, therefore Roxanne believes she has to do everything in the household. Yet, this is hard for her and she cries often. When something is not working out, Roxanne panics. She gets overstrung by the kids easily, and can barely find a moment of rest. The only thing Roxanne believes that helps, is running. Endless running.

Roxanne has two friends; a vacation friend she sees every summer and a childhood friend. Furthermore, Roxanne doesn’t have many contacts. She limits the contact with her collageuas and barely sees her family. She rejects invitations for family parties as she would rather take some rest. 

Lately, Roxanne recognizes herself in the behaviour of her children; easily getting overstrung and having difficulties with changes. She now wonders if they may also have autism?

  • Do you think Roxanne has autisme? Please enlighten your answer. 
  • Which autistic related behaviour do you recognise in Roxanne?
  • What is your role as an OT? Would you focus on her suspected autism or on her multiple burn-outs?

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