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Case studies 3 different profiles
Do not use or distribute without written permission.
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Colin (Mathew K) Initial Concerns: (May 16, 2011 / 3 years, 3 months)
Sensory Processing Feeding difficulties Speech Language Skills Behaviors Retained reflexes Postural control fine motor skills Sensory modulation Praxis / motor planning Visual efficiency Oral motor planning Feeding Speech / language skills Play and social skills Do not use or distribute without written permission.
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Intensive May 2011 – Consultation June 2011
No changes in feeding – picky eater Decreased mouthing of fingers Not bladder or bowel trained Improved balance / postural control, threw ball for first time Poured water in little cup independently Putting 2 to 4 words together (no sentence), more verbal overall Remained even tempered Increased interaction with family Grand parents reported increased engagement Do not use or distribute without written permission.
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Intensive June 2011. Consultation July 2011
No napping, falling and staying asleep Chewing more on back molars, still picky eater Sitting on potty now Increased functional motor planning at home, problem solving “how” No FM, not interested Consistent 3 word utterances Increased imitation of short phrases, increased non-verbal communication, increased intentionality, more interaction with sister More affectionate, initiating with mom and dad Few increases in temper tantrums Playing for 30 minutes at a time now, expanding into painting and doing puzzles, still obsessed with cars Trying to put his own shoes on Still fairly active All reflexes integrated except for Babinski and Spinal Galant Do not use or distribute without written permission.
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Intensive August 2011 – Consultation September 2011
3 years, 6 months Increased antigravity control Climbing over obstacles now Improved sustained balance on vestibular equipment Increased endurance Expanded play skills such as increased initiation, increased verbal, increased eye contact, moving beyond car play Improved oral motor control: producing more sounds, imitating more sounds, producing more words spontaneously Do not use or distribute without written permission.
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Re-evaluation November 2011
Sensory modulation from max to mod /min DeGangi Berk: improved postural control, bilateral integration, reflex integration BRIEF-P decrease shifting (transitions) Emotional control slight improvement Working memory substantial improvement Planning and organizing in typical range now Improved speech and communication Improved response timing More able to follow assessment, but still great ocular motor concerns Improved oral motor planning (Sara Rosenveldt Johnson) Continues to be tube fed Gag reflex much improved No more mouthing Improved dissociation of trunk / limbs Continued need for reflex integration Movements less clumsy overall No changes on laterality and directionality More interest, but continued fine motor delay Improved social skill, turn taking Less cautious overall Increased flexibility Do not use or distribute without written permission.
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Intensive January 2012 / Consultation February 2012
3 years, 11 months Chewing well, still does not swallow Started potty training Pedalling tricycle in slow motion Scooter independently for short distances Galloping now Initiating conversational turntakes more Improved articulation Language continues to improve Pull zipper down, undo velcro of his shoes Attempting fine motor Focus varies School reported increased verbal, listening and engagement Do not use or distribute without written permission.
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Intensive March 2012 / Consultation April 2012
4 years, 1 month Autism support clasroom Looks back to see if someone is looking Early morning waking – does go back to sleep Feeding difficulties remain Can use utensil to feed self Draw a circle Answering open ended questions Up to 5 word sentences Increased two way communication More connected, more eye contact Showing his sense of humor Very emotional periods Using words and gestures during interaction in play Play still needs more complexity and expansion Recognition of 25 words Do not use or distribute without written permission.
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Intensive August 2016 / Consultation September 2012
Likes routines Still tube fed, will chew not swallow, improved self feeding Still wearing diaper, verbalized that he was having a bowel movement Mastered riding a tricycle Will scribble on paper Exploding verbally (commenting, telling, complete sentences, accurate use of pronouns Increased time concepts, asks about daddy when he is not there. Mostly happy and silly Emerging pretend play now; role play Recognizes all letters and numbers, counting now, more interested to attend and look at books Hyperactive most of the time, though calmer Do not use or distribute without written permission.
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Intensive December 2012 – Consultation January 2013
4 years, 8 months Increased engagement in gross and fine motor skills Improved control over crayon Improved sequencing from 1 step with max assist to 2 to 3 steps with mod assist From 3 back and forth interactions to 7. Broadening play themes: animals, characters, zoo. From wearing diaper full time to being bladder trained with minimal assistance Attempting to feed self with spoon Now independent donning and doffing clothing. Do not use or distribute without written permission.
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December 3 to 14, 2012 intensive Consultation January 16, 2013
5 years old Communication improved Language improved Autism support classroom Still feeding difficulties Playing with cars and trucks at home Very sensitive emotionally, clench fists and growls Testing boundaries Parallel play with peers at school Do not use or distribute without written permission.
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Intensive June 2013 – Consultation July 2013
5 years, 4 months Improved fine motor – rolling clay Light grip on marker / right dominant Improved attention to FM Skills Scribbling, coloring now Speaking full sentences now – significant improvement, asking more questions Sustaining back and forth communication with less support Improved engagement in play and social Improved overall body control Do not use or distribute without written permission.
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OT Evaluation February 16, 2015 Phase 1
Sensory Modulation difficulties more related to performance anxiety at this time Auditory improved greatly, still Auditory filtering difficulties and atypical ear advantage Postural control improved, though still needed work Still difficulty with Graphethesia (SIPT) Visual perceptual skills improved, still difficulty with visual closure and visual spatial relations. Do not use or distribute without written permission.
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OT Evaluation February 16, 2015 Phase 2
No more generalized dyspraxia, now bilateral integration and sequencing dyspraxia (BIS) Difficulties with sequencing and timing Postural Praxis (SIPT) still showed deficiency Ocular motor difficulties milder, but persists No more reversals Do not use or distribute without written permission.
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OT Evaluation February 16, 2015 Phase 3
Continued executive functioning difficulties Visual and Auditory attention difficulties Fine motor skills delayed Reading decoding difficulties Difficulties with basic math facts Spacing and sizing of letters in writing is compromised Difficulties with working memory, organizational and thinking skills, and time management Do not use or distribute without written permission.
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OT Evaluation February 16, 2015 Social-Emotional Processing
Was able to comply in relational way to all activities required in evaluation Would ask for breaks when he needed them Less interested in friends – difficulty keeping up with them Acts younger than children his age Difficulty managing changes in his routines Can express thoughts, but not in social realm Do not use or distribute without written permission.
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Reading intensive summer 2015 – Consultation September 2015
7 years, 7 months Adjusting well to second grade, regular ed. Classroom Performance anxiety prevalent Increased self awareness / down on himself Little outbursts of frustration Still struggling with reading, but reading more, increased attention to detail, change is definite, decoding better than comprehension Does not want to be pulled from classroom by specialists Writing sentences, no paragraphs Struggling socially at school with making friends, but more included in group activity now, uses sense of humor to cope Do not use or distribute without written permission.
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Timing intensive December 2015 – consultation February 2016
7 years, 11 months “I just did not want to do my homework”, but can do the work now No eating issues Enjoys socializing at church, wanting to go to boy scouts Enjoys gym class now, though still some coordination Fine motor improving, writes 30 spelling words each night Quite verbose now, seeking engagement, wants to tell stories More self aware, not wanting to be “different” Anxious about what would happen “next” Not playing commensurate with peers More will to help and organize at home Homework is no issue with regards to schedule Requires learning support for math and reading, though more math at this time. Loves music Do not use or distribute without written permission.
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OT and Timing Intensive June 2017 Consultation July 24, 2017
9 years, 5 months Some Stratera for attention Sleep normal Interested in trying new foods Jumping off diving board, swimming good now Still riding bike with training wheels Becoming quite “chatty” with mom Always asking what is coming ahead More capable, though still wants to do what he wants to do Showing frustration and anger (not in a bad way) Becoming more autonomous, perhaps not always sure how to respond to this change Fascination with vehicles still there, but can play with other games / toys. More social at school, but still not easy for him to initiate participation during school recess. Independent in ADL’s Going really well at school, now sharing his aide with others Reading at age level now, no more learning support Still requires support for math and writing Do not use or distribute without written permission.
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Maude Le Roux, OTR/L, SIPT, IMC
9 Lacrue Avenue, Suite 103 Glen Mills, PA 19342 Maude Le Roux, OTR/L, SIPT, IMC Website Facebook LinkedIn Blog Do not use or distribute without written permission.
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