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Case Study: ADHD and Asperger’s

🕑 4 minutes read
Posted February 25, 2016

iLs Associate:
Lynn Schoeneck, OTR/L, Porter Academy

“Paul”, male, age 9

“Paul” was diagnosed with ADHD and Asperger’s Syndrome. He started at Porter Academy during Summer Camp. Prior to coming to Porter Academy, he had been asked to leave multiple schools (both public and private) due to behaviors that interfered with the learning and safety of himself and others: climbing under the desk, running from the classroom/lunchroom/school, throwing chairs/desks, hitting, kicking, biting and verbally escalating.

Presenting Problems:
Emotional Regulation, Auditory Processing and Attention Difficulties

Therapeutic Goals:
Improve emotional regulation as evidenced by improved classroom behavior and improved interactions with peers; improve auditory processing as measured by the SCAN-3: C; improve attention as evidenced by teacher report.

iLs Program Used:
iLs Sensory Motor Program, three one-hour sessions per week, integrated with occupational therapy (OT) activities, primarily handwriting, visual perception and sensory motor activities (foam pit, rope swing, zip line, OT swings, climbing wall).

Other Interventions Used:
Paul participated in OT, speech-language therapy and music therapy within a group setting as part of the curriculum at Porter Academy. Porter Academy provided him with a small homeroom (six students) and small academic groups. He also participated in private hippotherapy and speech-language therapy once a week. He had participated in behavior therapy the six months prior to beginning iLs. He also participated in a special needs baseball league with the goal of assisting social development and to help him feel that he is participating in “typical” activities.

Summary of Changes:

  • The Student, Staff, and Academic Coordinator at Porter Academy commented that he “made incredible leaps and bounds. This was the first time in four years that he made it through a full school year without being asked to leave. He also learned how to make a mistake and move on from it. He [made] incredible strides in emotional regulation and social skills. [He went] from leaving school for days at his former school to sitting with me for a few minutes while he solved his own problem and talked himself down. His eye contact also is much improved from last September.”
  • His homeroom teacher reported that he “got straight A’s this year. He is very bright…his mood mellowed and his anger lessened significantly during the year. He was very frustrated at the beginning of writing workshop but eased up and did very nice work at the end of the year. He got straight A’s in spelling without stressing. I believe he worked hard on writing more neatly as the year progressed. He tended to be frustrated with new concepts in math but was proud of himself when he succeeded.” Note that Porter Academy teaches academics based on the student’s instructional level rather than a curriculum based on age/grade.
  • His mother commented that he “has grown tremendously. He has much greater self-esteem, control and awareness. He has the ability to focus, regroup and reassess in numerous situations more than he ever had before.”
  • His SCAN: 3-C scores, measuring auditory processing abilities, improved significantly as seen in the tables below. His composite auditory processing score improved from the 1st percentile (“disordered”) to the 73rd percentile (“normal”).
Auditory Figure Ground +8dB August April
Raw Score 38 40
Scaled Score 10 14
Percentile Rank 50 91
Descriptive Category Normal Normal
Filtered Words August April
Raw Score 4 34
Scaled Score 1 13
Percentile Rank 0.1 84
Descriptive Category Disordered Normal
Competing Sentences August April
Raw Score 54 60
Scaled Score 8 10
Percentile Rank 25 50
Descriptive Category Normal Normal
Competing Words – Directed Ear August April
Raw Score 9 36
Scaled Score 1 8
Percentile Rank 0.1 25
Descriptive Category Disordered Normal
Auditory Processing Composite August April
Raw Score 20 45
Scaled Score 67 109
Percentile Rank 1 73
Descriptive Category Disordered Normal

Conclusions and Recommendations:
The combination of the social, therapeutic and academic interventions provided at Porter Academy with the iLs Sensory Motor Program enabled this child to make huge progress with his emotional regulation, social skills, attention and auditory processing abilities. Starting out under a great deal of stress stemming from his own internal disorganization, he transformed into a child who was comfortable, well-liked by both peers and teachers, and who acted as a positive role model for his classmates. I hope his mother chooses for him to participate in another year of iLs in order to continue to assist in his development of sensory processing abilities and further stabilize his emotional regulation.

Comments from Ron Minson, MD, iLs Clinical Director:
This case presentation is a beautiful example of the deep and meaningful changes that can be obtained through the synergy of using iLs in an academic setting that is geared to meet the needs of a child at a level where they can experience success rather than continued frustration. The comment from above, “Porter Academy teaches academics based on the student’s instructional level rather than a curriculum based on age/grade” had a great deal to do with the wonderful changes obtained. It is clear iLs had an important positive impact on his auditory processing skills. These improvements likely helped him to be more available for listening and processing, not only the information from others, but also to listen to and process his own thoughts. I believe the OT activities along with the iLs further enabled integration of his sensory system and subcortical organization supporting higher learning. We have all been aware of the calming effect that iLs has on clients; this may have added even further to his availability for learning.

We have much to learn from academic institutions that incorporate such a sound, safe and student- oriented approach to working with children who have significant behavioral, emotional and learning difficulties.

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