1st 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?