Case Studies

The Frozen Child – Wai Chi (1)

Looking back at the summer in 2013, at the times we spent hours with Wai Chi (a boy who was tormented by autistic symptoms), those encouraging and surprising moments that was brought by him was still crystal clear on our minds.


Wai Chi was a twenty years old boy, who was diagnosed with autism at primary school age. In Grade 10, Wai Chi’s mom decided Wai Chi would continue with his education in the United States to minimize pressure from schoolwork. With full support and help from his mother, he was successfully accepted into a local institute. Wai Chi was always determined to complete his university education despite the unforeseeable difficulties he might come across with, meeting and retaking uncountable failures in exams, or retaining in the same grade. In spite of these, he has never thought of giving up in any occasions, but to confront and work extra hard to compensate with his faults. Apart from his academics, Wai Chi also held the same persisting attitude towards his struggles in social interactions. In view of this aspiring teenager’s perseverance towards overcoming life challenges, even we, the trainers feel deeply inspired and humbled.   


On the first day at PDA, Wai Chi said in his definite tone, ‘I want to improve my autism!’ He stated that he wanted to improve his interpersonal and communication skills so he could have less error in communication. After further questioning, he described that his mind was constantly filled with bits and pieces of scenarios that happened in the past, which led him to unconsciously think aloud or laugh in public. If you could imagine, those scenarios would pop up and ‘broadcast’ at random times, in which he was not able to stop. With a sense that this was inappropriate, he had no clue in stopping them. Often in a conversation, it took him a massive amount of effort to retrieve an answer to a question. Wai Chi did not only feel that he thinks too slowly, but also struggled with giving an appropriate answer.


And what did Wai Chi’s mom say about him? Wai Chi is a good boy, who is diligent and strives for his best in his every day study. However, ‘slowness’ is Wai Chi’s Achilles’ heel. This includes him being slow in all motions, thinking and speaking. Communicating with Wai Chi was never an easy task, not only because he was slow, but he would also pick up wrong information from a dialogue. However, the biggest difficulty was Wai Chi’s anxiety. The more anxious he is , the slower he could generate a response, and thus more autistic behaviors would arise. There was no way that he could be told to relax. His mother expressed with concern that she was getting old and was no longer able to take full care of him like before, and wishes to see Wai Chi to be able to gain independence as soon as he could. This perhaps is the dream of every parent on earth indeed!


So how was Wai Chi in the eyes of the trainers? He was 5 feet 8 and weighed 180 pounds. He walked with eyes looking down, shrugged shoulders, and only had limited natural movements with his hands. His walking pace was twice as slow as peer his age. For example walking posture, Wai Chi sat with head pointing down and shrinking body, a posture that did not allow him to have eye contact with others.


During conversions, despite how much we believed Wai chi tried to engage in the course of communication; his stiff facial expressions; lack of body language and eye contact have stopped him from convincing others of his engagement; it was most dejecting to see his confusions towards our questions, or the unexpectedly long duration that took him to respond. Once, when he was asked about his house in the United States, it took him around 7 to 8 seconds to respond ‘I drive in Canada.’ There was also once we asked how he got to PDA, it also took him 7 to 8 seconds to respond ‘I have been to this room before. I have played on the swing.’ It was clear that he had slow and nonsensical responses. Also, he at times produced passage length answers that tended to wander and not get to the point.


To help Wai Chi, we first observed his communication behaviors, emotions and sensations. The first thing we realized was Wai Chi’s anxiety. It was seen to be his major during a conversation; the level of self-protection was constantly high throughout. It could be seen that Wai Chi grew up with his anxiety; it has been shadowing him since his childhood.


For Wai Chi’s body, it was ‘frozen’!The body was stiff and movements were clumsy from head to toe, especially in his neck, chest, face and jaw. His body tended to shrink as if an infant was protecting himself. His sensations towards touches in the body, as well as distance with others were weak. Moreover, the control over his body was not strong either: he tended to move from shoulder down to his hand when he was only requested to move his wrist; he performed morning exercises when he was asked to create postures with his body. With undeveloped body sensation, there is no way that one can develop his body language; and thus, not even to mention about noticing and understanding others through non- spoken language!


For vision, Wai Chi showed a tendency to avoid looking; his eye movements were also limited.  Wai Chi had narrow vision and mainly focused on objects at 30 centimeters down front (consistent with his head and body position), and rarely look afar in his surroundings. The ability to integrate vision with language was still underdevelopment. During the assessment, he was only able to verbalize objects within 90 degrees at his front; and naming objects on both sides with prompts; however, he was responding with three times slower than peer his age. Also, Wai Chi was not able to control his eyeball movement to observe the surroundings; movements in his eyes were mostly reflex and habits instead of conscious control movements. 


Similar to vision, Wai Chi’s sense of hearing was also underdeveloped. He was most responsive to sounds at the front, and was however insensitive or slow in responding to sounds from all other directions. For example, while we rang the bell above Wai Chi, he first responded to the wrong direction in the first two trials, and then used almost ten seconds to point to the correct direction in the later trials. At times, he did not hear or turn around when the trainer spoke behind him. Moreover, Wai Chi associates sounds with things, which made him think whether he heard it with or without consciousness. As Wai Chi had difficulty with multi-tasking, he was not able to control and draw back his own attention to listening and looking for message reception while he was thinking.


With a high nervous status, coupling with the dilemma in his body, vision and hearing, having eye contact, consistent looking and hearing to others; observing body language, information integration and processing was seen to be such an unreachable goal for him!


Seeing this, in the first half of the month, we mainly focused on four trainings areas with Wai Chi. We first applied “Mindful Healing Touch” on Wai Chi, and coached his mother to apply this gentle touching massage technique on Wai Chi on her own times or even when after they return to the United States. The aim of “Mindful Healing Touch” is to release their myofascial energy to relax their body, so as to release stiffness and nervousness generated in their body cells. In this way, their body can be relaxed and reset to a relaxed body posture. This will subsequently allow Wai Chi to rediscover his body language, and open his ears and eyes to notice things and people around him.


In the next two training areas, we used “Self-Consciousness Awakening Therapy” as the blueprint to train Wai Chi to use his eyes and ears with consciousness. The aim of the training goal was for Wai Chi to learn to observe and listen continuously to the surrounding information with consciousness in a relaxing status, in which he will also be able to observe and listen to information at the same time. After this, we taught him to increase self- awareness of whether he was both listening and observing or sunk in thoughts. 


In the end, we made use of “Cognitive Behavioral Therapy” to work on Wai Chi’s communication skills. For example, looking at his communication partner calmly; head nodes in response to show understanding and smile in response to messages he finds interest in; and also maintain attentive listening until the communication partner has finished his dialogue, but not to indulge in his own fantasy after the conversation started for a few seconds. 


Wai Chi attended individual therapy twice a week, with back-to-back  lessons each time for six weeks. What was the outcome? One of our trainers wrote this in her reflection, ‘From the first training until Wai Chi left for the United States, I seemed to have seen a new Wai Chi.’ From my point of view, it might seem slightly exaggerated; however, from all Wai Chi’s self description, the report from his mother and our observations, we all found changes in Wai Chi’s body, general maturity and communication behaviors.  So, what were his changes and how we did that? Stay tune for our next issue!



PDA Newsletter 2014 Feb (9 Edition)