Autism Spectrum Disorder, Sensory Integration Challenges and a School-Based Occupational Therapy Intervention
As diagnoses of autism spectrum disorder (ASD) increases, the waitlist to be diagnosed becomes longer, and the resources available are utilized. Soon, the percentage of school children that have ASD will continue to grow as the diagnostic criteria are expanding and the awareness of symptom behaviors develop. Additionally, the prevalence of sensory integration and sensory processing challenges diagnoses accompanying ASD diagnoses will also continue to increase. For some children, their sensory processes do not develop as efficiently, resulting in many difficulties faced, especially in educational settings, including learning, development, and behavior. Where apparent difficulties are existing in a child’s school life, there is often a response of interventions including teachers, support staff, parents, and intervention therapists.
In an evidence-based case study involving a 6-year-old boy diagnosed with Autism Spectrum disorder and sensory processing challenges, it was stated that he was demonstrating disruptive behavior that drew attention from his teacher, parents, and principal, who then decided to involve the school occupational therapist (OT). This support system discussed challenges including difficulties with social interaction with peers, following classroom rules, and self-regulatory behavior; despite the teacher’s best efforts to make positive adaptations in the classroom. The classroom struggles lead the support system to involve a school-based occupational therapist to conduct an evaluation of the child in the classroom to understand how to support him best.
An evaluation of this child’s behavior resulted in detailed explanations as to why it was appearing that he wasn’t behaving ‘properly’ in class and revealed some challenges with his sensory processes that were contributing to his ‘disruptive behavior’. For example, it was determined that this boy would engage in unsafe behaviors on the playground which was stated in the evaluation as difficulty participating appropriately and safety in gross motor activities. The evaluation revealed contributing factors to these behaviors included difficulties with balance, bilateral coordination, motor planning, and poor body awareness resulting from difficulties processing input from several sensory systems in his body. Also, there were other areas of concern including self-regulation, fine motor and social skills that warranted the school OT to complete a review of effective evidence-based strategies existing in research. Therefore, evidence-based intervention methods were selected to be implemented in this child’s classroom, playground, and lunchroom. As well, the support system for this child worked out obstacles along the way as suited best to the child, such as adding a clinically-based OT into the child’s support system. After the collaboration of teacher, parents, principal, support staff and a school and clinic-based OT, this child was able to make progress in reaching or meeting his goals.
Overall, OTs play a crucial role in facilitating assessments, team planning, evidence-based interventions and resources and encouraging environments for children with any developmental or intellectual disability, but specifically children with ASD and sensory processing challenges in a school setting. The OT’s use of a complete, extensive evaluation of the situation happening with the child in his environments provided the team with the groundwork knowledge to develop and implement evidence-based intervention strategies targeted to reduce his disruptive and unsafe behavior. This case study demonstrated the effectiveness of OT’s school support including complete evaluations and evidence-based intervention strategies in trying to reduce negative classroom behaviors while keeping the child in the class.
Matson, J., & Kozlowski, A. (2011). The increasing prevalence of autism spectrum
disorders. Research in Autism Spectrum Disorders, 5(1), 418–425.
Parham, L., Clark, G., Watling, R., & Schaaf, R. (2019). Occupational Therapy Interventions for
Children and Youth With Challenges in Sensory Integration and Sensory Processing: A Clinic-Based Practice Case Example. The American Journal of Occupational Therapy, 73(1), 7301395010p1–7301395010p9. https://doi.org/10.5014/ajot.2019.731002
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