1 st September 2014 ASD Team: Rachael-Anne Scott Alanna Reid Denise Gough Lisa Wallace Sharron Kane

Role of paediatric OT with ASD

 Activities of Daily Living (ADL)  Fine Motor  Gross Motor  Visual Perception  Planning and Organisation  Sensory Processing

Sensory Processing

Studies indicating prevalence of sensory processing difficulties within ASD

National study with sample group of 44: Adamson O Hare and Graham

(2006

) 70% (modulation difficulties) Larger sample group of 208 (age group 20 to 54 mths) :Klintwall et al

(2011)

78% (sensory differences)

What is Sensory Processing?

Our interpretation of the information which we receive from our environment.

How is the information received?

 Sight  Sound  Touch  Taste  Smell  Vestibular  Proprioception

Common difficulties

Sight  Sensitivity to light  Hyper-attention to detail

(Hyper

-

systemising)

Sound  Hypersensitive to noise  Difficulty responding when addressed  Easily distracted with different noises  Difficulty filtering relevant sounds

Common difficulties

Touch  Impact on ADL  Sensitivity to clothing textures  Reduced tolerance of touch  Difficulty with hair washing/ hair cutting  Difficulty tolerating showers  Dislike of teeth brushing

Common difficulties

Taste

Hypersensitive  Sensitive to texture  Gagging or vomiting Hyposensitive  Likes spicy food  Eats/mouths non food objects Is it specifically sensory? (other points to consider)  Systemising/ child attempting to be in control  Emotional response

Common difficulties

Smell Hypersensitive (impact on ADL)  Vomiting with smell of certain food types and/or household smells  Issues with toileting  Avoidance of places or people Hyposensitive (impact on ADL)  Smearing of faeces  Smelling objects and people inappropriately

Common difficulties

Vestibular (Impact on ADL)  Hyper responsive to movement  Reluctance to engage in playground activities  Difficulty leaning back to have hair washed etc  Sitting posture may be poor  Hypo responsive to movement  Sensory seeking (i.e. Spinning)  Sitting posture may be poor

Common difficulties

Proprioception (Impact on ADL)  Difficulties with force control i.e. Excessively hugging, heavy footed, applying excessive pressure through pencil.

 Difficulties dressing due to poor awareness of body position.

 Enjoys firm pressure i.e. Firm hair brushing or firm drying with a towel

Referral process

 Who can refer?

 Health referrals  Request for assistance from education  When to refer?

 If there are motor and/or a

cluster

of sensory difficulties impacting on the childs functional abilities.

Assessment

 Clinic appointment if appropriate  Discussion with parents (completion of questionnaires as relevant)  Standardised assessments (i.e. Movement ABC, Sensory Profile, sensory processing measure)  Observation at home and/or school as appropriate  Liaison with school staff and other members of the MDT

OT Intervention

May involve combination of the following:  Evaluation of assessments  Individualised programmes i.e. Stick kids  Strategies to assist with sensitivities toward self care tasks  Predominantly advisory in consultative role  Depending on the needs of the child, treatment blocks may be recommended  Visual stories

• • • • • • •

Resources

Sensory processing pack: Advice and strategies for home and school Top tips for sensitivity A Practical Approach at home for parents and carers: Autism spectrum Disorder: Falkirk Council.

A Practical Approach at home for parents and carers:. Making sense of sensory behaviour: Falkirk Council Building bridges through sensory integration: Yack et al (2002) A Buffet of sensory Interventions: Culp S (2011) Aspergers Syndrome and sensory Issues Myles et al (2000)

Any Questions?