fitzjohns presentation[1]
DESCRIPTION
As a pediatric occupational therapy intern at the Royal Free Hospital NHS Trust, I was allowed to meet with a primary school student with global developmental delays for OT weekly sessions. I observed sessions with him one week, and met with him by myself three more times. I was supposed to meet with him a fourth time, but he was out sick. I was responsible for the researching, planning, implementation, and review of his sessions. This presentation gives a brief overview of why OT is needed in pediatrics, OTs role in helping this student, the activities I included in the therapy sessions, and their results. I presented this PowerPoint to the Trust\'s Pediatric OT Department at monthly department meeting.TRANSCRIPT
From Beanbags to Letter Formation: The Planning,
Implementation, and Review of My First OT Sessions
Alissa BonjuklianAlissa Bonjuklian
1/4/20091/4/2009
Role of OT
In general practice:– Increase participation in ADL’s and other meaningful
occupation In community paediatrics:
– Based on an understanding of the interactions among children, their activities, and their environments
– Interventions should either: Establish a higher level of functioning Compensate for activity limitations through adaptation and/or
assistive technology Modify environments Change systems to increase participation (Case-Smith, 2001, p.3)
– Goal = help children cope with disability and master activities that have meaning to them
* denotes name change
Intro to John*
6 y.o. Globally delayed:
– Cognitive developmental delays– Physical/gross & fine motor problems– Perceptual impairments– Speech difficulties
These impairments all hinder him from keeping up with his classmates and being able to perform important daily activities
Role of OT in treating John
– Occupational performance of children = self-care, work, and play activities
Work academic tasks & functional tasks– examples– “The functional skill of handwriting supports the academic task of
writing and allows students to convey information” (Case-Smith, 2001, p.545)
– Role of OT = view the student’s handwriting performance by focusing on the interaction of the student, the school environment, and the school occupation (Case-Smith, p.546)
– John’s treatment plan falls under the first category of interventions: “Establish a higher level of functioning”
RESEARCHING
Reflected on my 1st observation
Used resources at FBS & Greenland Rd for Rx ideas, games, worksheets, props etc.
Read through HWT teacher’s manual
Used Lindsay as a resource for more in-depth info task analysis
Integrated the ideas learned through research with my observations of John and his needs
Thought about the different activity ideas from the resources I used and arranged them in a flowing order that would be most effective
Spent time creating the props I needed (laminated mazes, worksheets, games, etc…)
PLANNING
Task Analysis of Handwriting: Performance Components
Sensorimotor components Sensory
– Tactile/proprioceptive– Visual perceptual skills*– Kinesthesia– Position in space– Visual closure
Neuromuscular– Muscle tone– Strength*– Postural control
Motor– Crossing the midline*– Bilateral integration Bilateral sequencing skills– Laterality– Praxis– Fine motor coordination*– Visual motor integration*
Cognitive components Attending to a writing task independently Recalling letter formations and handwriting strategies over time* Generalising handwriting from an intervention program to real-life situations
Psychosocial components The child’s values and interests, self-regulation, self-concept, and coping skills(Case-Smith, 2001, p.553)
Week 1: Hand & Finger Strengthening
Newspaper tear & crush Thumb wrestle Elastic band activities Playdough work
– Hid toys in Playdough and ask him to find them– Rolled it out to make a “pizza”– Made a “snake”– Made the letter ‘C’ and other simple letters
Mazes HWT slate
Week 1 Results
Carried out the strengthening activities relatively well Vaguely recognized letters that were taught to him last
week indicates problems with letter recall When asked to write the letter ‘C’, he drew:
instead of
This indicated that he may have trouble crossing the midline
Week 2: Bilateral Activities
Big clapping sequences Arm circles w/ and w/o beanbags lazy 8s Reached around body to grab another beanbag Playdough work
– Made 2 “snakes” cross them over each other to make an ‘X’. Run his fingers over it.
– Drew an ‘X’ into patted-down Playdough. HWT slate Mazes Flag-making
Week 2 Results
Much improvement as a result of the bilateral activities:– Recalled letters more easily– Wrote the letter ‘C’ correctly– Receptive to learning the letter ‘X’
Continued to write very lightly indicated more need of strengthening exercises
Week 2 Results: Flag-Making
Week 3: Perceptual & VMI Activities (with a Touch of Bilateral & Strengthening!)
Bilateral Warm-Up– Beanbag activities
Arm circles figure 8’s Reached around body to grab beanbags
– Rolling object back and forth Visual Perceptual Activities
– Visual fixation/tracking activity: had him follow a moving beanbag first with his head then only with his eyes
– Visual memory exercise: started with 5 letter cards and take 2, then 3 away– Figure discrimination: overlapping worksheet– Visual discrimination matrix cards
Visual Motor Integration– Mazes (also strengthening and bilateral)– PlayDough activities
Strengthening warm-up Formed letters with “snakes” Wrote letters into patted-down PlayDough (strengthening)
– Ground discrimination worksheet
Week 3 Results
Letter formation on the ground discrimination worksheet was very wobbly indicates we should perhaps work on more strengthening
He often fails to take up the entire area designated for a letter leads me to believe there are still perceptual problems
– Performed very well on visual perceptual activities, which focused on visual fixation/tracking, visual memory, and visual, figure, & ground discrimination
Has much difficulty in completing arm circles and rolling object back and forth needs work with gross motor skills (although he gets this in a special session with Lindsay)
Continued to respond well to bilateral activities
Week 3 Results: Figure Discrimination
Week 3 Results: Visual Discrimination
Week 3 Results:Ground Discrimination
Week 3 Results: Mazes
OVERALL RESULTS:Week 1 vs. Week 3
Observation week vs. Week 3
Questions ?Comments ?Feedback?