Kasus Autis 2:
Richard, age 3 1/2, a firstborn child, was referred at the request of his parents because of his uneven development and abnormal behavior. Delivery had been difficult, and he had needed oxygen at birth. His physical appearance, motor development, and self-help skills were all age appropriate, but his parents had been uneasy about him from the first few months of life because of his lack of response to social contact and the usual baby games. Comparison with their second child, who, unlike Richard, enjoyed social communication from early infancy, confirmed their fears.
Richard appeared to be self-sufficient and aloof from others. He did not greet his mother in the mornings or his father when he returned from work, though, if left with a baby-sitter, he tended to scream much of the time. He had no interest in other children and ignored his younger brother. His babbling had no conversational intonation. At age 3 he could understand simple practical instructions. His speech consisted of echoing some words and phrases he had heard in the past, with the original speaker’s accent and intonation; he could use one or two such phrases to indicate his simple needs. For example, if he said, “Do you want a drink? He meant he was thirsty. He did not communicate by facial expression or use gesture or mime, except for pulling someone along and placing his or her hand on an object he wanted.
He was fascinated by bright lights and spinning objects, and would stare at them while laughing, flapping his hands, and dancing on tiptoe. He also displayed the same movements while listening to music, which he had liked from infancy. He was intensely attached to a miniature car, which he held in his hand, day and night, but he never played imaginatively with this or any other toy. He could assemble jigsaw puzzles rapidly (with one hand because of the car held in the other), whether the picture side was exposed or hidden. From age 2 he had collected kitchen utensils and arranged them in repetitive patterns all over the floors of the house. These pursuits, together with occasional periods of aimless running around, constituted his whole repertoire of spontaneous activities.
The major management problem was Richard’s intense resistance to any attempt to change or extend his interests. Removing his toy car, disturbing his puzzles or patterns, even retrieving, for example, an egg whisk or a spoon for its legitimate use in cooking, or trying to make him look at a picture book precipitated temper tantrums that could last an hour or more, with screaming, kicking, and the biting of himself or others. These tantrums could be cut short by restoring the status quo. Otherwise, playing his favorite music or a long car ride was sometimes effective.
His parents had wondered if Richard might be deaf, but his love of music, his accurate echoing, and his sensitivity to some very soft sounds, such as those made by unwrapping a chocolate in the next room, convinced them that this was not the cause of his abnormal behavior. Psychological testing gave him a mental age of 3 years in non-language-dependent skills (fitting and assembly tasks), but only 18 months in language comprehension.
Perilaku Richard menunjukkan hambatan dalam interaksi sosial dan berbahasa termasuk bahasa non-verbal serta keterbatasan dalam aktivitas. Semua gejala tersebut mulai muncul sejak beberapa bulan kehidupan. Dia sama sekali tidak tertarik dengan anak lain dan tidak pernah bermain-main dengan orangtuanya. Bahasanya terbatas dan mengulangi kata-kata orang lain. Anak tersebut tidak pernah bermain permainan imaginasi. Kesukaannya terbatas pada aktivitas stereotipik seperti bermain puzzle dan flapping his hands. Perilaku ini dimulai sejak sebelum usia 3 tahun yang merupakan tanda-tanda spesifik Gangguan Autistik, suatu Pervasive Developmental Disorder.