Tag Archives: Educational psychologist

Why your child with Aspergers Syndrome May need an OT Assessment

24 May

Does your child with Aspergers Syndrome have difficulties with their fine and gross motor skills as well as that of their sensory processing.

If the answer is yes, you should consider getting an assessment from an occupational therapist (OT).

In Little mans case, this was highly recommended by an independent educational psychologist during an assessment in preparation for our pending tribunal hearing early last year. I’d always had concerns regarding some of his motor skills especially that of fine motor skills, handwriting mainly. I guess i wasn’t fully prepared for the final report, which admittedly came as somewhat of a shock!

However, knowing the true extent of these difficulties has allowed me understand why little man struggles within certain areas, plus since getting the statement amended he now has regular OT sessions within his special school.

The final report which was written by an independent OT based in Harley street London was a real eye opener, not only highlighting his motor difficulties but that of his poor sensory processing too.

It’s extremely important to think along the lines of OT when applying for a statuary assessment and beginning the process of requesting a statement of SEN. Once you have that statement and it’s all agreed, it will be a good year before the annual review, your next opportunity to request amendments!

Below I’m sharing some of the findings from Little mans OT report.

The report is sadly far to large to include everything so I’ve chosen some important factors that may affect others like little man.

Many see Aspergers as just a social communication and behavioural condition. This is simply not always the case!

Note I have Removed my sons real name and replaced this with the name you all know… Little man.

Behaviour during Testing
Little Man presented as a friendly young boy and was generally co-operative whilst completing table top activities during the first half of the assessment was and able to complete the assessment tasks with prompting and encouragement. However, Little man found the gross motor tasks during the second part of the assessment more challenging and needed constant prompting to complete the assessment.

Strength
Little man showed some difficulty with completing the given tasks of maintaining postures against gravity and practicing push-ups and sit ups. While practicing push-ups, shoulder abduction and pelvic tilt were noticed. It has to be noted that such activities apart from the strength, require a good level of motor planning sequencing of movements, and overall body awareness. Little man’s performance points to a mild difficulty in this area that is related to sensory input processing from joints and muscles.

Running Speed and Agility
Little Man scored below the average expected for his age group when tested on the subtest for Running Speed and Agility, showing some difficulty in this area. Items included a shuttle run and hopping activities. Little man managed appropriately with the shuttle run but showed some difficulty with hopping on one leg whilst stationary. He also struggled with items such as stepping sideways over a balance beam, and doing a two-legged side hop, which requires a high level of motor planning.

Results following a number of different tests

Little man presents with difficulty coordinating complex motor movements and higher level motor planning due to reduced vestibular-proprioceptive processing. These systems work closely together to give us a sense of where we are in space and of how our body works (strength, muscles, balance). He does not always rely on autonomic control and this means it will take him longer to complete tasks and need additional time to acquire new skills. His movements are not always refined and timed.This will directly impact upon his ability to produce handwriting at an age appropriate speed and develop more complex gross and fine motor skills that involve higher level motor planning and overall body configuration.

HANDWRITING

Little man held the pencil in his right hand with his thumb overlapping his index finger. He applied increased grip and writing pressure. He needed prompting to use his left hand as a stabilizer whilst writing. Little man sat on the edge of his seat with his trunk in flexion, leaning forward a lot.
Little man presented with some difficulty with handwriting, in particular letter formation and the spacing of his letters. His handwriting speed was also slow and appeared laborious. His increased writing pressure, poor knowledge of mechanical elements of handwriting and decreased planning suggests Little man must work extra hard to complete handwriting tasks, which involve fine motor control. It also indicates difficulties with sequencing and planning.This will impact significantly on Little man’s ability to complete written work in an expected time frame and to complete written tests on time.

Results of Little Mans sensory profile indicated difficulties with sensory processing and sensory modulation.
In addition the factor summary of the questionnaire indicated that Little man shows a Definite Difference with sensory seeking, emotional reactivity, low endurance/tone, oral sensitivity, inattention/distractibility, poor registration and sensory sensitivity.

Sensory Processing
Sensory processing refers to how we process sensory information from our environment and our bodies. We receive information from the following senses: touch (tactile); hearing (auditory); taste (gustatory); smell (olfactory); sight (visual); proprioception and vestibular. Little man has difficulty with sensory processing in all the above areas.

The auditory processing differences for Little man are apparent in the fact that he is distracted or has trouble functioning if there is a lot of noise around. It is reported that Little man appears to not hear what people say at times and that he enjoys strange noises.

The visual processing differences for Little man are apparent in the fact that he occasionally expresses discomfort with or avoids bright lights and becomes frustrated when trying to find objects in competing backgrounds. It is reported that he frequently has a hard time finding objects in competing backgrounds.

The vestibular sense allows a person to sense body movement, direction, and acceleration, and to attain and maintain postural equilibrium and balance. This then impacts on all areas of the person’s development and in particular, motor-co ordination. Little man’s difficulties in this area of processing are apparent in that he constantly seeks movement to the point where this interferes with his daily routine. It is reported that he spins or twirls himself occasionally throughout the day.

The touch processing differences for Little man are apparent in that he is sensitive to certain fabrics. It is reported that he expresses distress during grooming. Little man also has difficulty with standing in line or standing close to other people.

The multisensory processing differences for Little man are apparent in that he has difficulty paying attention and looks away from tasks to notice all actions in the room.

The oral sensory processing differences for Little man are apparent and that he will only eat certain tastes and prefers sweet food. It is reported that he is a picky eater and that he craves certain foods such as sugar drinks and coffee.

Sensory Modulation
Modulation is the ability to regulate/maintain arousal so that you can orient, focus attention on meaningful sensory events, and maintain an alert but relaxed state. It is this optimum level of arousal which allows us to function meaningfully within our environment. Some people have difficulty modulating sensory information. This can result in being over or under stimulated. We all have thresholds that need to be met by incoming sensory input. Without adequate sensory input we are unable to maintain an organised calm state. If an individual’s thresholds are too high they will need more intense input to meet their needs. If their thresholds are too low they will be easily overwhelmed. Little man is easily overwhelmed and becomes emotionally over reactive. It is reported that he easily becomes distressed at home and school when he finds situations difficult and overwhelming.

Conclusion
These clinical observations as well as the standardised assessments indicate that reduced sensory processing and modulation, and low muscle tone may be impacting on Little man’s ability to perform gross and fine motor tasks successfully.

Vestibular processing is our sense of movement and is closely related to the proprioceptive system. It tells us what direction we are moving, where we are in space and what speed we are moving at. Vestibular input can help to organise and refocus the body. Little man has some difficulty with registering and processing vestibular information, which is impacting on his co-ordination skills and ability to sit still for extended periods of time.

Proprioception is the understanding of where our limbs are in relation to ourselves. This information is provided by the stimulation of receptors in our muscles and joints. Proprioceptive feedback informs us where our arms and legs are without looking (e.g. being able to unfasten an apron that ties at the back).

When our proprioceptive sense works well, we make continual and automatic adjustments in our position. This sense helps us to stay in an optimal position in a chair; to hold utensils such as a pencil or fork in the right way; to judge how to manoeuvre through space so that we do not bump into things; to know how far to stand away from people so we are not too close or too far; to plan how much pressure to exert so we do not break a pencil lead or a toy; and to change actions that we are not successful with, such as the throwing of a ball that was off target.

Since proprioception helps us with such basic functions, difficulties in this system can cause many challenges for a child. Little man has difficulty with this and this is impacting on gross motor and fine motor tasks in all areas of daily living such as school work and play.

Low muscle tone relates to the tension of the muscles. A certain amount of tension is required to maintain positions and to allow co-ordinated controlled movements. For some children, the level of tension in the muscles is lower than other children of the same age, and so they require more effort to maintain the same positions/postures. Little man’s low muscle tone means that he would find it difficult to maintain a good seated posture for lengthy periods in the classroom setting.

APRIL IS AUTISM MADNESS

8 Apr

So Autism Awareness month is here. April is said to be the month to best get heard when reaching out to society when trying to raise awareness for Autism. I consider every month to be awareness month! I blog, talk, share, link, tweet and more It seems to happen naturally now and it just comes easy to me. I am proud to say im passionate about autism. I love autism solely because its part of my son.  Aspergers don’t make little man! Little man makes Aspergers. So for this reason I’m going to blog like mad this April! I’m looking to do at least one interview this April. I really enjoyed them last year and I’m considering bringing back the feature permanently. Guest post will also feature on the blog this April and throughout the rest of the year. The first Guest post is in relation to my day in Court on the 30th March 2010. A friend who attended Court with me has written an interesting  post. She makes fantastic points and has strong opinions it’s in my view a wonderful read.

Over these past few months I have discovered some great links and excellently good blogs that I’m keen to share with readers. Some have been added to the links already.  Pass through regularly?  Then maybe you noticed and gave them a preview. You will also see that a few more blog buttons have been added to the sidebar. If  displayed then in my opinion they are worth a look. With it being April I will be highlighting some fantastic campaigns and non-profit charity’s So if you’re looking for an Autism  charity to fundraise for this April then please I urge you to check these out. The last few months it’s been nothing but doom and gloom within these blog walls. That’s not what I want the blog to be focussed on. I don’t want new visitors, parents of  a newly diagnosed child to look and feel that life is set to be a never-ending challenge. I wont lie when I say with every closing door another seems to open and behind it is a new battle. It seems to be that way  for me right now! But ASD or not! We will always as parents try to gain the best in everything we aim for when it’s for our children. No day is the same! As is no child on the spectrum.  We need less negativity and more positive Input. As little man don’t return to school in till 21st April that gives me plenty of time to spread a little sunshine over the blog.  And lets hope that some day soon school will bring more positive days for little man clearly resulting in a few more uplifting post.

Well in my quest to create a totally  jam-packed Awareness month and not being able to take on the challenge single-handed, I’m gonna need readers help. This is what I’m looking for.

  • A Father of a child on the autism spectrum. I want to hear from the dads who would be interested in sharing their story in an interview with me. Covering diagnosis its impact and what everyday life is like. Check out some of the interviews from 2009. John Kirton from the documentary Autism x6 on Discovery Health was interviewed on the blog last April. Did it raise awareness? Hell yes and it still continues too giving that it’s still one of our most popular post on this blog to date. John a father to not one but six children all placed along the spectrum of autism made for a truly inspirational interview. I’m not requesting you need six children in order to participate in an interview I’m just requesting you’re a father to a child on the Autism spectrum. Email me or comment if interested.
  • Mums tell it how it is. This was a feature due to start last month. However this never happened with the craziness of whats been my life lately. So any spectrum mums who wish to voice important opinions or advise other parents and caregivers on ASD related issues then let me know. I am hoping that the lovely Rachel author of the blog Strange and beautiful would still be happy to share her insights in a talk relating to Sensory sensitivities 🙂
  • Kids art to be put up on the Autism and Art page. Please refer to the page for details.
  • help in our ever-growing Autism Love list. All it takes is for you to visit the page and state your reason for loving Autism. After all it’s within somebody we love. For this reason I say we embrace it. Thank you for the recent comments on the page. If you were one of them commentors then I’m pleased to inform you that your comments have been transformed into something beautiful and are now ready to view as part of the Autism Love List.
  • Now for my big ask!  Are there any autism professionals willing to be interviewed? By professionals I mean specialist teachers, Dr, Educational psychologist, speech and language therapist, behavioural therapist, child psychologist, mental health practitioner or other. There would be no payment for the interview. It would be done by yourself solely for the purpose of helping raise awareness for autism. And for that I would be truly greatful.

Anybody who participates on any part of this blog are very welcome to have a link back to their blog or website.

Autor Clairelouise82 parkinson.claire@yahoo.com

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