Do Not Jump To Conclusions — A Story Of A Child With Autism

I was performing a mental status examination or mental state examination (MSE) on a 9-year-old male patient with a history of Autism Disorder. The kid was doing phenomenal in this examination until I asked him to subtract 7 from 100 (this is called serial sevens, it assesses the mental state and possibly cognition), he couldn’t do it at all. I gave him around 3 minutes and he just gave up. He was giving me different answers: 107, 117 and so on. This was definitely not normal for his age.

After discussing the results with my attending, he instructed me to ask it in a different way. The next day, I decided to interview the patient again and ask him about his day and what things that are bothering him possibly. After some times passes by during the interview:

I asked him: “What is your favorite fruit?”

The kid replied: “Apples!”

Even cats love apples!

Then I said: “Imagine you are an apple dealer and now I am willing to pay you $1/apple.” The kid was super excited as I can see his smile and he was concentrating a lot more.

I told him: “Would you like to sell me some?”

He answered: “Yes.”

I said: “Alright. Well you have 100 apples now.” He replied: “Wow, I have so many apples!”

I said: “I want 7 apples, please. How much would that be and how many do you have left?”

He replied: “$7 and I will have 93 apples.”

I was shocked. He was able to give me the answer every time I asked to buy 7 more apples!



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