Associate Name: Clare Lanman, Occupational Therapist
Patient: Jane (pseudonym), 11-year-old female
Jane has an ASC (Autistic Spectrum Condition) diagnosis. Area of difficulty identified prior to the SSP were auditory and tactile hypersensitivities, separation anxiety and narrow area of interest both within her physical and social environments. Jane also demonstrated poor interoceptive awareness. Jane has a diagnosis of dyslexia.
Implementation of SSP
The SSP was carried out on 5 consecutive days to address sensory sensitivities and rigidity. Jane also receives regular occupational therapy intervention which was focussing on developing interoceptive awareness and independence with self-care.
Jane presented as anxious on arrival for the first session. It was explained that we would be quietly listening to music while sitting and playing together. It was explained that the music may sound different and it will go quieter and louder when listening. I would check in with her with a thumbs up or a thumbs down to see if she liked the song or not to encourage her to listen to the music.
We started with playing a very simple turn taking card game which she enjoyed. We then did some colouring together.
She then organised some Sylvanian families into family groups and did some small world play of some of them going on a car trip.
The session started drawing on a large piece of paper together. First of all we drew our own pictures and then turn taking with lines and curves to create strange images which she enjoyed. Initially the images were joyful which then turned into more bizarre images which Jane found amusing.
We then sprayed some shaving foam on a vertical surface and drew images in the shaving foam. She enjoyed the tactile experience of this.
There was lots of eye contact within the session.
On arrival Jane stated she was keen to play the turn taking drawing activity again which we did for 40 minutes. Lots of eye contact and nonverbal communication demonstrated.
She then played with the Sylvanian families creating a family home and setting a family up in the home.
The session finished with drawing in shaving foam, turn taking creating images.
We began with playing the simple turn taking card game and moved on to creating pictures out of lines for 45 minutes. This activity involved turn taking and expanding on each other’s mark making. A longer time being spent on each activity as demonstrated within this session.
The whole session was spent creating animals out of play dough. Again lots of nonverbal communication was demonstrated and responding to each other’s models resulting in creating a farm.
Response to SSP
Observations in clinic and school;
Jane showed an increased interest in her environment and others post SSP. She would enquire as to how others felt in relation to herself i.e. if stating she was hungry would enquire if others around her were hungry, compliment her dad on his socks, notice a homeless individual outside a shop and ask if she could give the man some of her own money (reported by parents as never seen before). A fellow classmate was unsure what to do when a class teacher was absent and Jane volunteered the information and offered to help the other student which is reported to be unusual for Jane to initiate the information and offered support.
Increased interoceptive awareness was also demonstrated with Jane identifying her stomach felt full (intervention to support this was also carried out alongside SSP).
Increased independence with self-care within the sessions observed with Jane independently putting on her shoes with no help requested. This did not carry over into the home environment.
Appropriate eye contact during social interactions was identified as much improved with an example being Jane being able to talk directly to parents with good eye contact even within a busy restaurant.
Jane converses more readily with her parents when a subject of interest is introduced.
A reduced sensitivity to noise was demonstrated with Jane being able to wait in line quietly in a noisy environment and being able to access noisy environments such as the cinema.
Overall parents report the changes seen in Jane are slight but when they occur they have a big impact for Jane. The benefits seen are mainly that Jane is more aware of others and how they may feel. She pays compliments and observes details which before would have been overlooked.
Jane shows an increased ability to cope in noisy environments and remaining calm or if it is too much she is able to verbalise this before a meltdown occurs.