Thomas: Thomas was five years old when he first came to occupational therapy. His parents described him as being a ‘good child’. He had never gotten into any trouble. Thomas had never gotten out of his bed by himself. If he was put in his room, he stayed there. Thomas tended to be quiet and although he had an extensive vocabulary, was slow to respond to questions or efforts to engage him in conversation. He was inconsistent in responding to his name and had a flat affect. At school he seemed lost, disengaged. Thomas often sought out extra physical support from his environment by leaning against furniture, hanging his legs over the arms of a chair, or lying down on the floor.

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