Karon is 12 years old and has a diagnosis of Down syndrome. He attends a school for children with additional needs and his father reports that he had been very happy there until recently, when his classroom teacher left to go to another school. She had been Karon’s teacher for some years and since her departure he has been showing signs of depression and stress. Karon’s father reports that Karon likes things to follow set routines and becomes very anxious if there is any change. His previous teacher understood this and adapted her classroom so Karon could follow his routines undisturbed. Karon dislikes his classmates as they tend to be loud and unpredictable and Karon hates noisy environments. At school, his teacher has always been his sole focus for all interactions.