Josh is a 9 year – old autistic boy with Cerebral Palsy and Craniosynostosis. Josh recently returned to school having had craniofacial surgery. This was his second surgery related to his craniosynostosis, which involved the remodeling of his cranium. For Josh, this was a difficult experience, and his distress post-surgery was really intensified, as all his hair, medium-length curly hair was shaven during the surgery. He was not fully prepared for this, and Josh intensely dislikes anyone touching his head or hair.

Josh is a wheelchair user as a result of his Cerebral Palsy. He has relatively good upper body strength however he has reduced tone in his lower limbs. Before his recent surgery, Josh had frequent headaches. When he had headaches at school he was very irritable and sometimes got angry with others around him. Since his surgery, he gets much fewer headaches and he tends to be calmer and appears happier at school.

Although Josh has a high average level of intellectual ability and is very verbally able, he finds it difficult to speak about pain, discomfort, or his hospital experience. Josh also relies on structure and routine to help him feel regulated at school. Josh has a great interest in music and Roblox computer games. Music really supports Josh to regulation. It can calm him if upset and it can help him to be more alert if he is feeling tired.