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Learning to be Creative with Autism - August 2008

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Learning to be Creative with Autism

By: Alison M. Bodor, MS OTR/L

Establishing Credibility with Families:
Children who have Autism is one of the most talked about diagnoses today. As an Occupational Therapy clinician you are greeted with concerned parents, evaluating and treating children with an array of sensitivities, and the challenging task of honing in on your clinical observation skills. Where do you begin in the clinical world of Occupational Therapy and the fundamentals of development and success with children who have Autism?

Be prepared: If you are an Occupational Therapy clinician who has met with a concerned family, you must be prepared. Providing resources, relating your professional practice and experience, and being knowledgeable about Autism will help you gain the respect and trust of the client and family. On the day of evaluation:
  • Explain your clinical background and your experience with Autism;
  • Provide brochures or handouts on what Occupational Therapy can do for a child with Autism;
  • Provide information on community resources, support groups, or websites that families can visit ;
  • Educate the family on reimbursement for Occupational Therapy services (e.g., private practice);
  • Upon completion of your evaluation, explain areas of your evaluation that you noticed (i.e., dyspraxia) and what your plan is; and
  • Offer information on what the family can do at home.

Are you wanting to present yourself in an even more dedicated, trusting manner? Completing educational courses that will list you on websites as certified (e.g., sensory integration certification), such as http://www.autism.com or http://www.spdfoundation.net/ may help.

Interventions: Whatever the setting you are working in, the primary goal of Occupational Therapy is to increase a child's function with a variety of daily living skills. Whether it is handwriting for a school assignment, eating lunch, or feeling comfortable to walk up steps to ride the school bus, OT clinicians are challenged to incorporate structured play to meet these goals.

Action Based Learning: According to Melissa Wampler, OTR/L, if working in a school setting, ABL may be helpful. Sometimes it is difficult to gain or keep a child's attention, when addressing pre-handwriting skills, because they may have energy to expend. Initiating your treatment with the Infinity Walk may help as a modulation technique. An upgrade of the Infinity Walk may be to have the child flip through flash cards with shapes or letters and have them say what they see. A downgrade may be to assist the child through the walk and then direct them to a station where they can trace shapes, letters, or numbers while utilizing different textures. If you do not have an Infinity Walk mat, tape down two hula-hoops and have the kids walk in an infinity/figure 8 pattern (Wampler, M 2008). This is also a good intervention if you are addressing auditory processing, vestibular dysfunction, or motor planning.

Obstacle Course: Per Britt Collins, M.S. OTR/L, if you are addressing motor planning, balance, sequencing, or memory an obstacle course may be a fun activity. This can be in a group or individual format. Utilizing the course in a circle may be best to assist the child in sequencing their path. Moving over or through items, such as the barrel, body rocker, or trampoline may add to the adventure for the child. An upgrade to this treatment can be to have the child bear crawl or crab crawl through part of the course. A downgrade may be to provide manual cues or guidance to help the individual with possible gravitational insecurities, motor planning, or visual-motor deficits (Olson, B. et al 2007).

Oral-Motor: If your client is having trouble with closing their mouth to eat or drink, or drooling, opening their mouth to brush their teeth, or planning the process of opening/closing the mouth during such tasks oral-motor intervention can be addressed. Some neat products to look at: water flutes, chewy tubes, or a vibrating toothbrush. If you are able to do pet therapy, activities such as giving a dog a treat may help with the visual process for the child. The water flutes or whistles are good for feedback as well. The child is able to see how their movements influence a response. According to Collins, some oral-motor interventions, such as using the vibrating toothbrush or chewy tube, may be a calming activity as well (Olson, B. et al 2007).

Tips:
  • Remain patient: As OT clinicians we know success does not happen overnight. When it comes to Autism, clients may not reach their goals for a lengthy period of time (e.g., 12 months or longer). Keep in mind, your interventions are having an effect on neural plasticity.
  • Per Collins, structure your intervention and therapy style to make the child feel successful . This may become a trial and error process (Olson, B. et al 2007).
  • Establishing trust and rapport with your client and family will increase carryover outside the therapy environment.
  • Have Occupational Therapy treatments be enjoyable. Designing interventions using structured play, not laborious, will attract your client to OT.
  • Decrease stimuli, if necessary. Gradually increasing other children or stimuli may be an upgrade to your OT intervention.
Resources:
Olson, Bryce et al (Producer) & Caudillo, Alan (Director). (2007). OT For Children with Autism, Special Needs, & Typical (Britt Collins, M.S. OTR/L) [DVD]. United States.
Wexler Video.

Wampler, Melissa (2008, August 14). Autism [MSG 2].



This Month's Featured Vendor: OT Advantage.com

Special Thanks to Alison Bodor, MS OT, for contributing this month's article. Alison is the owner and developer of OT-ADVANTAGE.COM, a social networking and resource site for Occupational Therapy. Designed as a place for Occupational Therapy clinicians, students, and educators to communicate, share ideas and find helpful resources. The website has over 1500 members and is growing everyday!

Please visit OT-Advantage at http://www.ot-advantage.com/ota/


Tags: August 2008 Newsletter OT Autism Sensory Processing Disorder Article