Case Study: Autism, Sensory Integration; Behavioral State Regulation

Name of Organization: Children’s Therapy of Woodinville, PLLC

Associate Name: Doreen Hunt

Age/Gender of Client: Six-year-old girl with autism

Previous Therapies and Programs:

• ABA and OT services on and off since the age of three
• Speech Therapy
• iLs Sensory & Motor

Presenting Problems

• Gravitationally insecure, extremely over-responsive to vestibular sensory input
• Difficulty in auditory and visual sensory processing
• Poor behavioral and state regulation (emotional outbursts, screams, hyper-silly behaviors)
• Difficulty transitioning
• Poor eye contact, poor visual tracking and hand-eye coordination
• Delayed gross motor and bilateral motor planning skills
• Reversed letters and numbers, writing is larger in size

Therapeutic Goals

• Improve vestibular-visual-auditory integration
  • Improved self-regulation, calm behavior
  • Improved attention, learning and participating
• Improve social engagement
  • Eye contact, turn-taking
  • Flexible behavior to increase friendships and overall happiness
• Improve gross motor skills and bilateral motor integration
• Improve fine motor strength and control
  • Decrease tremors
  • Increase legible, age-appropriate handwriting skills

Programs Used

• iLs Sensory & Motor program 1-20 (now the Focus System)
• SSP x 5 days
• For one month following the SSP, no sound/music intervention (to determine effects of SSP on functional changes, for research purposes)
• Resumed iLs Sensory & Motor program 20-60
• Repeated SSP x 5 days after 3 months
• Combined program: Sensory & Motor 1-20, Concentration & Attention program 12-40

Summary of Changes

• More flexible, less fear and rigid behaviors: improved vestibular processing
  • Better vestibular input: able to climb on and off moving equipment more easily and independently
  • Able to explore and play on playground equipment: climbing up ladders, slides, swings

• Improved receptive language speed of processing
  • Follows verbal directions more quickly

• Significant increases in expressive language
  • Began to use “I” statements, used new words parents had never heard her use before, longer utterances (five-to-six-word sentences with good pragmatics); had a reciprocal conversation with hairdresser during haircut
  • Improved articulation reported by Speech Therapist

Progress following Second SSP Program

• One week later, she learned to hold her breath and swim with her face in the water
• School work has improved:
  • She raised her hand and answered a question to her peers in first grade; teacher had never seen this before
  • Doing homework has improved substantially
  • Fewer reversed writing of letters or numbers
• She followed directions at the doctor’s and answered all questions appropriately. Pediatrician noticed the significant changes from her last visit.
• She can approach someone, make eye contact and ask, “Hi, what’s your name?”
• Continued improvements in all functional behaviors, listed above