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Case Study on Autism Spectrum Disorder (ASD) in a Child – DSM-5 Diagnostic Approach, Study Guides, Projects, Research of Clinical Psychology

This document is a detailed case study on a child diagnosed with Autism Spectrum Disorder (ASD), based on DSM-5 diagnostic criteria. It explores developmental delays, sensory sensitivities, behavioral observations, family history, and psychosocial background. The report includes observations from clinical interviews, developmental milestone charts, and mental status examination. Ideal for psychology students, clinical interns, or professionals studying neurodevelopmental disorders, this case helps readers understand how early signs of ASD present and how diagnosis and intervention planning is carried out. Includes reflective notes, assignment prompts, and educational value for child psychology, clinical psychology, and mental health courses.

Typology: Study Guides, Projects, Research

2023/2024

Available from 06/21/2025

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The Child Who Didn't Like Hugs: A Story of Sensory Sensitivity and
Silent Struggles
In a quiet neighborhood, a mother brought her 12-year-old child to a mental health center. The mother,
gentle but visibly anxious, had carried the weight of unanswered questions for years. "My child doesn't
like being touched," she said. "Even as a baby—she would cry if anyone tried to hug her too long. She
prefers to play alone and doesn’t respond when spoken to. And now… school has become a daily
challenge."
The journey to that clinic had been a long one—starting not with school troubles, but far earlier, right
from birth.
A Beginning Marked by Delays
The child was born full-term in a hospital, but the delivery wasn’t smooth. The umbilical cord had been
tangled around her leg—an early sign that this child’s journey might not be an easy one. She weighed a
healthy 3 kilograms at birth, but developmental milestones began to drift off track as the months
passed.
She didn’t walk until after age two. While other children were scribbling with crayons and pointing at
body parts in books, she was still watching silently from the sidelines. Her fine motor skills were slow
to develop. Her mother remembers vividly how she would line up toys rather than play with them.
There was no pretend tea party, no shared giggles with friends.
Social milestones were delayed too. The early smiles, the recognition of her mother's face, the clinging
to her when strangers approached—all those milestones came late or, at times, never came at all.
The School Years: Isolation in a Crowd
When she started school, her teachers noticed that she often drifted off mid-task. Her attention would
flicker away like a candle in the wind. She didn’t raise her hand in class. She didn’t play during recess.
Other children reached out—some curious, some kind—but she avoided them. It wasn’t shyness; it was
something deeper.
She couldn’t keep up with her peers in reading or writing. Letters didn’t stay straight on the page.
Words seemed to float away. Special education services were eventually provided, but her progress
remained slow. Not because she wasn’t intelligent, but because her mind processed the world
differently.
At home, she would only eat very specific types of food—soft, pulpy textures. Anything crunchy or
mixed-texture was met with refusal or distress. Haircuts were traumatic. Even her mother’s affectionate
touch was sometimes too much.
A Family’s Quiet Struggles
The mother’s own journey had not been easy. She had struggled with anxiety and depression, and her
own father had lived with mental illness, though no formal diagnosis was ever made. These emotional
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The Child Who Didn't Like Hugs: A Story of Sensory Sensitivity and

Silent Struggles

In a quiet neighborhood, a mother brought her 12-year-old child to a mental health center. The mother, gentle but visibly anxious, had carried the weight of unanswered questions for years. "My child doesn't like being touched," she said. "Even as a baby—she would cry if anyone tried to hug her too long. She prefers to play alone and doesn’t respond when spoken to. And now… school has become a daily challenge." The journey to that clinic had been a long one—starting not with school troubles, but far earlier, right from birth.

A Beginning Marked by Delays

The child was born full-term in a hospital, but the delivery wasn’t smooth. The umbilical cord had been tangled around her leg—an early sign that this child’s journey might not be an easy one. She weighed a healthy 3 kilograms at birth, but developmental milestones began to drift off track as the months passed. She didn’t walk until after age two. While other children were scribbling with crayons and pointing at body parts in books, she was still watching silently from the sidelines. Her fine motor skills were slow to develop. Her mother remembers vividly how she would line up toys rather than play with them. There was no pretend tea party, no shared giggles with friends. Social milestones were delayed too. The early smiles, the recognition of her mother's face, the clinging to her when strangers approached—all those milestones came late or, at times, never came at all.

The School Years: Isolation in a Crowd

When she started school, her teachers noticed that she often drifted off mid-task. Her attention would flicker away like a candle in the wind. She didn’t raise her hand in class. She didn’t play during recess. Other children reached out—some curious, some kind—but she avoided them. It wasn’t shyness; it was something deeper. She couldn’t keep up with her peers in reading or writing. Letters didn’t stay straight on the page. Words seemed to float away. Special education services were eventually provided, but her progress remained slow. Not because she wasn’t intelligent, but because her mind processed the world differently. At home, she would only eat very specific types of food—soft, pulpy textures. Anything crunchy or mixed-texture was met with refusal or distress. Haircuts were traumatic. Even her mother’s affectionate touch was sometimes too much.

A Family’s Quiet Struggles

The mother’s own journey had not been easy. She had struggled with anxiety and depression, and her own father had lived with mental illness, though no formal diagnosis was ever made. These emotional

undercurrents ran quietly through the family, making the child’s emotional needs even more urgent— and at times, more confusing. Despite these hardships, her family remained supportive. They weren't sure what was wrong, but they were determined to help her find her place in the world.

The Mental Health Visit: Clarity Amidst Complexity

At the mental health institute, the child was observed closely. Her posture was guarded. Eye contact was fleeting. She answered questions slowly, sometimes not at all, often spacing out mid-sentence. Her speech lacked emotional inflection—flat, almost rehearsed. The examiners noted that her mood was anxious, and her insight into her own feelings was limited. She didn’t understand why her parents were concerned. She didn’t see a problem with avoiding touch or preferring solitude. She wasn't upset—just distant. Her attention and concentration were severely impaired. Abstract thinking was intact but slow. She had difficulty engaging in meaningful conversation. Even simple social questions—like where she saw herself in five years—were met with silence or vague confusion.

The Diagnosis: Understanding the Inner World

After thorough evaluation, the clinical team diagnosed her with Autism Spectrum Disorder (ASD), Level 1, as defined by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). This diagnosis was based on:

  1. Deficits in social-emotional reciprocity and non-verbal communication.
  2. Difficulties in developing and maintaining peer relationships.
  3. Restricted and repetitive patterns of behavior and interests.
  4. Sensory sensitivities—especially tactile defensiveness.
  5. Early developmental delays across multiple domains. There were also signs of co-occurring anxiety features and specific learning difficulties.

Hope, Not Labels

A diagnosis is not a label—it is a map. It gives direction to wandering questions. For this child, it opened the doors to early intervention, occupational therapy for her sensory needs, behavior therapy for her routine management, and specialized education support. It helped her family understand that she wasn't being stubborn or aloof. She wasn't distant because she didn’t care—she was simply experiencing the world through a different lens.