Tag Archives: occupational therapist

How My Son With Aspergers Has Changed Since Attending A Special School

10 Dec

So, little man has been in his independent special school for children on the autism spectrum for some 18 months now! With this, I’ve decided to write a post concentrating on all the positive changes I have noticed in this time.

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1 – Improved confidence: This is one of the most apparent changes in my child. He is more confident in his own skin. Special interests are celebrated and his not afraid to share his likes and dislikes with peers. His no longer ashamed of his differences and is more able to see them as positives rather than negatives.

2 – Moods: Little mans moods are less impulsive than before which is because he feels much happier than he did when he was in a mainstream school. Ok, he can still become angry and agitated at the flick of a switch but I can defiantly see a reduction in this type of behaviour.

3 – Attitude to learning: Its very apparent that Little man is more willing and excited to learn. I love it when he comes home raving about the stuff his has learnt. His enjoying his lessons and finishes his day with a head full of new knowledge that he just can’t wait to share.

4 – Improved social skills: Yes, we still have a long way to go but his learning new skills daily. The fact that he actually has a whole school period every day dedicated to social skills training means the improvements are really starting to show. He tends to be less impulsive with the things he says to others. Overall he has a better idea when it comes to behaviours that are socially acceptable.

5 – Willingness to attend school: Little man actually looks forward to school now! The only issues we still have is with his sleeping leading to some issues with attendance. However, the fact he likes his school and wants to attend is just amazing!

6 – Better Understanding of Aspergers: He has a knowledgable understanding of Aspergers Syndrome and feels Better able to talk about how the condition applies to him.

7 – Independence: Since attending his new school little man has noticeably become much more independent. He still requires lots of visual clues but is more independent when it comes to creating and following a routine that his independently applied to a visual schedule. This is a really big achievement for Little man and is a huge step in the right direction therefore giving me more confidence that he will cope OK, when it comes to his life as an independent adult. His even cooking on a weekly basis. He brings home some amazing dishes that put my own to shame.

8 – Better reactions to sensory stimuli: He is still very sensitive in many ways and to a certain extent probably always will be. We have noticed some slight improvements in this area though, which is mainly down to the work he does with the occupational therapist while at school.

9 – Engagement & concentration: Although his attention span remains pretty short he is slowly showing some improvements in concentration levels. Good relationships with teachers and a high teacher to pupil ratio means he is engaging in tasks and able to complete work projects more so than he was before.

10 – Willingness to try: This is a change on a huge scale. Little man is more willing to give things a go in all areas of life. His added confidence is a big contributing factor. The fact he is less scared of failing means his less scared of trying. Little man was sadly discriminated against while in mainstream school and this lead to problems both at home and in his learning environment. The fact he is finally moving on from this, making friends and enjoy his school life is simply awesome to witness.

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.

Tactile defensiveness

16 Sep

This past week has been so horrid for the whole of the family. We really thought we had got past the school uniform battle. Things are never as they seem, far from it in fact. We have a very angry boy coming home from school on a daily basis. Last week was bad enough with supermarket meltdowns and sleepless nights! Just when things all go quite something else happens.

Little man has always had sensory sensitivity some days worse then others. When in his favourite tracksuit bottoms we don’t have to worry about it as much… That was up in till the school introduced the new school uniform policy. We spent the best part of reception class and year one constantly battling to get Little man into school. He would scream, quite literally hang on to the banister as I dragged him out of the house I knew there was something a little different about Little man. What was different became clearer as he grew older. He had no diagnosis but he sure did do some “Odd” things. Why on earth has he hide his clothing I would think , as I pulled a bundle of jeans out from under his bed. Then there was the “I’m not wearing that coat! No, no, no!” I didn’t have a clue and we must off brought him five or more coats in till I started to “get it!” He used to always try and lose his coats in school, and still does. I remember at the end of the school year when they lay out or the last property. What isn’t claimed ends up outside the charity shop. I must have looked like I was going in for the kill and getting what I could for free. I’m not kidding when I say we came out with six coats, four jumpers, two packed lunch boxes, and a ton of jumpers. I was so …. embarrassed

Discovering that Little man could be on the autistic spectrum (Our second CAMHS visit with Tony, back when little man was seven) was a real turning point. It was hard and oh my it was a lot to take in, but going home and reading about ASD and Aspergers I finally knew why he did such things. Sensory sensitivity is something we all have just those on the spectrum have this problem to a greater degree. I know that a certain background nosie like the washing machine spinning while I’m reading or watching TV drives me bonkers, but I can deal with it. My little man like many others can be driven bonkers. Certain sounds, smells and textures can get to Little man and really upset him to the point of meltdown.

It’s his tactile defensiveness that is now causing him more problems at school. Yes, his wearing the correct uniform he is just having trouble with the tucking in your shirt rule. Sadly it seems others are having problems “getting it” It got to the point where little man become so upset yesterday, I kept him home the afternoon when he came home for lunch. I’ve written a letter to school and hope that maybe from now on the situation can be dealt with in a sensitive way.

Maybe it’s hard for some people to take a child’s problem with sensory sensitivity seriously. To many not being able to tuck your shirt in because it makes you feel fuzzy is silly. You often get comments like “What do you mean he can’t” Or “Just give it a go” Would we say to someone.. “Go on stick your head in the oven and see how it feels?” Many may think it’s not the same, but it is! Somebody said to me its like making a child in a wheel chair climb stairs! It was kinda cute, as when repeating this to little mans father, Little man over heard and told me that would just be an outrage, as he would fall and smash his face. Of course I explained it was just an expression. My point is I just find it very frustrating so I can only imagine what it does to Little man.

Lately I’ve been thinking that maybe we should consider an occupational therapist, I hear they are good at helping with sensory issues. A while back I contacted Brainwave and they did agree to help. Brainwave is a two day programme, that involves you and the child meeting a number of professionals and they devise a programme for the child. The parent learns the programme and carries it on at home. The child has a review every few months. It’s a programme that cost a few thousand but the best part comes from charitable funds, the parent is only asked to pay £500 toward this. It’s a brilliant opportunity  and once I have the Money I think it will be something we will seriously consider.

Well, I took Little man in to school today with his shirt un-tucked but I had come up with a plan. He had left his over sized school jumper in school. My plan was for him to wear this and hide his shirt underneath. Good job it was cold today as Little man would be more willing to wear it (I hoped) The lovely receptionist in the school (Always polite and none judgemental) took little man off to find this over sized jumper as he left it on his peg. I was worried she may have a problem with him refusing to put it on. When I got him for lunch I was so please to see him wearing it. His TA did report there had been a few issues (Non uniform related) But it was a joy not to have him moaning all the way up the road about being made to tuck his shirt in. He even went back to school after lunch with zero fuss.

Sadly at 6pm this evening I was called by the head teacher who informs me little man is excluded tomorrow and Monday. I was so upset as I had already told him on collection from school that he would be treated to something of his choice (Of course it was a bus ride with dad) Reason for the treat was because I finally received some fantastic news (For a change) The progress Little man had made in his support group for reading, writing and spelling was fantastic. The letter stated that what he had achieved in six month was what most achieve in ten month. This meant his progress was much better then expected of him. Sadly I had no time to enjoy my Little mans good news and smile at the fact we were receiving good news instead of bad, and for once no after school drama. Two and a half hours later the bubble got popped by the telephone call informing me off his two day exclusion. I cried in putting down the phone. I was told it was for a whole range of issues, mainly name calling. It just never ends EVER! Ironic as tomorrow I planed to go swimming with him and the school and then head out to get food shopping as our cupboards are bare. Most mother do all their bits and pieces when the children are in school. Hell no not me! I should be so lucky. I’m down the school three times a day and do trips were I can I just can’t do it. So…. Now his shopping along side me…

.. WILL WE GET OUT THE SUPERMARKET ALIVE? That is the question.

The Sen (Special educational needs) panel wont meet till the 30th of September due to the fact the Senco put in the assess one form to late. It’s a bit of a pain as it would of been heard today. All the time his in this school nothing will get better. I just hope that this time the LEA do the right thing.

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