Brian Smith is a 4-year-old who resides with his mother, father, and younger brother Luke in a four-bedroom home in a comfortable suburban neighborhood. Brian’s father is a civil engineer and his mother is a dietitian. As a newborn, Brian was described as a “fussy” baby who did not enjoy being held by others, including his parents. As he grew, Brian’s parents coped by minimizing their interactions with him, often encouraging him to play by himself. Although he is able to talk, he prefers to express his needs by grunting and mumbling. His pediatrician has recommended speech therapy to encourage him to use a greater vocabulary on a regular basis, Brian’s parents are hesitant to “label him” as a “special needs child” at this young age and have declined any intervention at this time.
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