The role of the Paediatric Occupational Therapist

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
 Sensitivity to light
 Hyper-attention to detail (Hyper-systemising)
 Hypersensitive to noise
 Difficulty responding when addressed
 Easily distracted with different noises
 Difficulty filtering relevant sounds
Common difficulties
 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
 Sensitive to texture
 Gagging or vomiting
 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
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
 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
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
 Predominantly advisory in consultative role
 Depending on the needs of the child, treatment
blocks may be recommended
 Visual stories
• 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
• A Buffet of sensory Interventions: Culp S (2011)
• Aspergers Syndrome and sensory Issues Myles et al
Any Questions?

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