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What is Autism Spectrum Disorder?
- This is a neurobiology disorder.
- The DSM-IV outlines 3 categories of functioning. In order for the diagnosis of autism to be made. This disorder includes qualitative impairment in reciprocal social interactions, verbal & nonverbal communications & imaginative play, restricted repertoire of activities & interests, & onset prior to age 3.
* Disturbances in developmental rates & sequences that affect motor, cognitive, & socioemtional areas; & disturbances in response to sensory stimuli as evidenced by hyperactivity, hypo-reactivity, or extreme alternating between these 2 states.
* This disorder was described as a lack of responsiveness on the part of the child to environmental input & an inability to relate to people & situations from the beginning of life.
What frame of reference are used with Autism?
Ayres' sensory integration. This approach, developed by Dr.A. Jean Ayres.
Sensory integration is a clinical theory and frame of reference based on extensive research of normal development, experimental neuroscience, studies with children diagnosed with learning disabilities, concepts on mind-brain-body, and open systems theory.
Ayres' sensory integration theory for learning within all developmental sequences.
What test are used for Autism?
The Southern California Sensory Integration Test (SCSIT).
- The Sensory Integration & Praxis Tests(SIPT).
- *Only the OTR are allowed to administer and interpretation of these tests.
The OTA could benefit from the courses offered through a collaborative effort of the University of Southern California & Western Psychological Services.
What is the OTA's role for child with autism?
The role of the OTA can be quite extensive within home, school, and clinic-based therapy & institutional environments.
The sensory integration frame of reference requires intense cooperation between the OT & the OTA. The primary emphasis of OT staff working with children on the spectrum would be to educate other team members on the utilization of sensory integrative techniques so that these strategies can be incorporated into everyday experiences.
Provide opportunities for the child to grow & develop socially & emotionally.
Capitalizing & expanding upon what the child finds intriguing is a useful technique in expanding the child's play sequences as well as motor planning opportunities.
The OTA can play an integral role in the initial phase of the process. Observations of functional performance within the classroom or home environment would be important to complete.
Additionally, conversations with the parent or teacher to determine their concerns regarding the child's performance cannot be emphasized enough.
During these observations, the OTA's knowledge of task analysis is helpful when attempting to identify areas of concern through observation of functional performance.
This initial phase of the evaluation process should also include a chart review. It is important to review the observations of other team members in order to document how areas of deficit noted within those reports impact varying domains of function. Additionally, this review would also allow the OTA to gain preliminary information as to where OT concerns might be impacting performance in other domains of functioning.
Define the evaluation and assessment process.
The eval process for a child is always complex.
The first area to be assessed should be sensory processing.
- Most children with Autism would not be able to complete a standardized assessment. This depends on the severity.
- The effects are pervasive, as noted in the diagnosis, full team evaluation & intervention planning often occurs, particularly within the educational system.
The disciplinary approach is often considered to be most appropriate for these children.
OT would assess the child & the results would be shared with the OTA for collaboration & intervention planning.
In addition to the tests of sensory processing, traditional standardized motor assessments could be helpful. These include the following:
- *Test of Visual Perceptual Skills-Revised
- *Test of Visual Motor Skills-Revised
- *The Beery Developmental Test of Visual-Motor Integration
- *The Bruininks-Oseretsky Test of Motor Proficiency (BOTMP)
- *Miller & Roid
- *Peabody Developmental Motor Scales-2
What is the Test of Visual Perceptual Skills-Revised?
This is a non-motor test assessing 7 areas of visual perceptual functioning. Test lower divisions ages 4-12. Upper ages 12-17.
What is the Test of Visual Motor Skills- Revised?
Test of categories of visual motor functioning such as intersecting lines, the ability to close or connect designs, angulation, & change of direction of the strokes.
What is the Beery Developmental Test of Visual-Motor Integration?
Is a test of visual motor functioning.
What is the Bruininks-Oseretsky Test of Motor Proficiency.
This is used for children ages 4.5 years to 14.5 years of age. This tool is useful in assessing underlying skills such as speed and dexterity, upper extremity control, & response speed.
What is the Miller & Roid evaluation tool?
Motor Evaluation tool for toddler & infants 4 months- 3.5 years of age. This tool is to identify motor delays & deviations in 8 domains related to motor abilities.
What is the Peabody Developmental Motor Scales-2?
This is for younger children who might not be able to complete other assessment tools. The PDMS is utilized for children birth to 6 years 11 months of age.
What are evident-based treatment strategies for children with autism?
Social & Peer interaction including social stories.
Functional impact of sensory experiences.
What is a sensory diet for children with Autism?
Heavy work - Pushing car door closed, carrying heavy objects such as book bag, opening doors, push/pull heavy items.
- Wear weighted vest, ankle & wrist weights
- Joint compressions
- Therapy band around legs of the chair.
- Have them use a squeeze ball.
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