Case Study

Alyson & Joseph, North London


O n his 1st birthday when we lit the candles on Joseph's cake and sang, he cried and cried. We thought this was because he was so young, but year after year he never wanted a cake or for anyone to sing to him. During the numerous birthday parties he was invited to, he would not join in and we would spend the time in a quiet place away from the action. Joseph would finally come in for tea, looking nervously round for the cake and as soon as it appeared he would run out and hide again. He was also worried about party guests in fancy dress.

When Joseph started nursery, things continued in the same vein. He had a huge fear of loud and sudden noises and would run out of class and hide in the bathrooms whenever he heard one. He would never dare stay in the room for class shows, as he was too scared. As he entered kindergarten this behaviour continued, even though we thought he would grow out of it as he got older. We went to see our paediatrician who recommended Ann.

Ann worked very closely with Joseph's Reception teacher to set in place things that could be done at school to help him integrate and tolerate the loud noises

After explaining the issues to Ann. my husband and I took Joseph to see her and she observed him and spoke to him. He took to her straight away and was always excited for their sessions. Ann also came to our house, where she watched Joseph and talked to him in his own environment. Ann noticed that his fine motor skills were not as they should be for his age and his coordination needed improving. He also liked to play on his own, reading in the corner, and did not integrate with other children.

Ann worked very closely with Joseph's Reception teacher to set in place things that could be done at school to help him integrate and tolerate the loud noises. Ann worked with Joseph to tighten his understanding of group instructions in the classroom. Joseph’s teacher adapted to Ann’s style of speaking to him directly and discussing his feelings in certain situations. We used these techniques at home with Joseph to provide consistency and continuum.

His progress has been unbelievable! At his Grandma's 70th birthday, he stood up with his sister and sang Happy Birthday into a microphone to over 80 people

Ann told us not to pressure Joseph to stay at parties and to let him wander in and out at his own accord. We bought him books about birthday parties and looked on-line at cakes and party decorations. Ann also recommended some family films with animals, which helped him to distinguish between real life and the fantasy of children’s cartoons.

To help with Joseph’s coordination, Ann put us in touch with an Occupational Therapist, who helped with strengthening Joseph’s upper body, showing us exercises that we could do at home. Joseph also saw an OT for his fine motor skills, as well as receiving help at school. His progress has been unbelievable!

Joseph enjoyed his first birthday cake with candles in May for his 5th birthday party and everyone sang Happy Birthday - he loved it. For family birthdays, he is always the one who wants to carry in the cake. At his Grandma's 70th birthday, he stood up with his sister and sang Happy Birthday into a microphone to over 80 people.

In July, Joseph participated in his graduation show from Reception - singing, dancing and dressing up. He was so excited and we were so proud. He is now in Year One and doing really well and enjoying learning. He joins in at assembly and we no longer have to worry about him being anxious. He has lots of friends and is "one of the boys,"

Joseph no longer has to have OT or see Ann, although we still keep in contact and Joseph loves to see her when she comes for tea and to catch up with all his news.