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Original Question
what are this childs self care needs Jasmeet is a 4-year-old girl who is now staying with her grandparents but lives with her parents in a small Sikh community. English is the family’s second language, and it is not spoken at home. Jasmeet’s parents are concerned for her well-being and attentive to her needs, but they are reluctant to take her to community events. Jasmeet was diagnosed with Autism at age 3 years. Her IQ was assessed at 52. Jasmeet was delayed in her walking, toileting, and language development. She has poor vision and must wear glasses to see. She now noticeably “toe” walks around her house and in her community. Jasmeet is verbal, but rarely uses language in a meaningful way. Instead, she will repeat words and phrases she has heard recently or a while ago (echolalia). Most of her communication consists of repeating phrases she hears from songs in children’s TV shows. Jasmeet’s parents have difficulty communicating with their daughter, as her use of stereotyped language is rarely appropriate to the situation and they do not always understand what the English phrases from television shows mean. Jasmeet’s speech is not clear and her parents really are the only ones who can understand some of what she says. Jasmeet also actively avoids eye contact. Jasmeet does not use sign language or any supplemental communication system for communication, but can make use of hand and body gestures. Jasmeet’s mother, Badriya, has chosen to stay at home and care for Jasmeet and her father, Zain, teaches at a private school in the Sikh community. Badriya says that she experienced postpartum depression following Jasmeet’s birth, and comments that she has recently been feeling sad, hopeless, restless, and distractible – symptoms that remind her of how she felt following when she had postpartum depression. Badriya sent Jasmeet to stay with her mother and father a few blocks away because she feels so down that she is unable to care for her daughter; she still sees Jasmeet every day. Badriya’s physician has prescribed her an anti-depressant for her symptoms. She says that her case worker has suggested she reach out to other members of the community for help and support and that this advice is frustrating to Badriya. She says that her case worker does not understand that friends and neighbors in Badriya’s community probably blame her for Jasmeet’s problems and will not be supportive to her. She says that the only person she can turn to for support is her husband, but Zain is busy at work all day and cannot be disturbed. Jasmeet attends a preschool where she has an opportunity to interact with other children. Jasmeet spends most of her time sitting in the same place engaged in solitary play (e.g., shifting sand in the sand box, playing with toy cars and trains). She will sit on the carpet for the duration of group circle games, but will not participate in group activities with her peers. She has a very limited set of activities with which she expresses any interest. She is a very picky eater and will sometimes refuse to eat at all if she does not like the food being served. If the parents try to feed her she will cry and arch her back. She will feed herself finger foods. She has difficulties grasping and manipulating a spoon. At preschool and at home, Jasmeet requires adult assistance with buttons and zippers, personal grooming, and washing her hands. Jasmeet will sometimes avoid having to go to the washroom at preschool. When she is asked to try toileting against her will, Jasmeet will resist by becoming physically rigid and start crying. Badriya says that she finds it challenging to handle Jasmeet’s behaviors at these times.
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