Roseann C. Schaaf, Joanne Hunt, Teal Benevides; Occupational Therapy Using Sensory Integration to Improve Participation of a Child With Autism: A Case Report. Am J Occup Ther 2012;66(5):547-555. doi: 10.5014/ajot.2012.004473.
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© 2017 American Occupational Therapy Association
In this case report, we describe the changes in adaptive behaviors and participation of 1 child with autism during a 10-wk program of intensive occupational therapy using a sensory integrative approach (OT–SI) following a manualized protocol. This case is part of a larger study examining the efficacy of the OT–SI approach. We found improvement in sensory processing, as measured by the Sensory Integration and Praxis Tests, as well as enhanced participation in home, school, and family activities, as indicated on parent-rated goal attainment scales.
D.Y.’s records and evaluation findings were reviewed before meeting with the parent.
A semistructured interview with the parent was conducted to ascertain parent goals.
Five goals were established.
The goals were reviewed with the parent to validate the expected level of performance and ensure they captured the parent’s concerns.
The goals were then scaled with equal intervals.2
A semistructured postintervention interview was conducted with the parent to determine D.Y.’s rating for each goal.
An overall goal attainment T score was calculated following the methodology outlined by Kiresuk et al. (1994) . The goals established for D.Y. are displayed in Table 1, and proximal and distal (functional) outcomes are identified. A unique feature of each goal was that it identified the underlying sensory deficits hypothesized to be affecting participation on the basis of the formalized assessment data.
Ensure physical safety.
Present sensory opportunities.
Facilitate the child’s self-regulation of arousal level, attention, and emotion.
Challenge postural, ocular, and bilateral motor development.
Promote praxis and organization of behavior.
Tailor activities to provide the just-right challenge.
Collaborate with the child on activity choices.
Create a context of play.
Foster a therapeutic alliance with the child.
D.Y. started to play trucks and cars with the other kids at school and could focus long enough to play a board game with the family. . . . He can sit and play for up to 30 minutes. . . . D.Y. goes bowling every week, for 1 hour a week. . . . Two other children are with him. . . . He will give verbal encouragement to another child who is upset.
An intensive program of occupational therapy using sensory integration (30 sessions over 10 wk) may be useful for children with autism whose participation challenges are related to difficulty processing and integrating sensory information.
Following a systematic intervention protocol of OT–SI and its accompanying Ayres Sensory Integration® Fidelity Measure may be an important strategy for children with autism whose participation challenges are related to difficulty processing and integrating sensory information.
This case provides a model for treatment for children with autism and difficulty processing and integrating sensory information.
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