Nine year old boy with coordination difficulties
We were asked by the Learning Support department in an independent school to assess a 9 year old pupil who was struggling with motor skills; writing, concentration in class and playing sports.
After a telephone discussion with parents and the SENCO, an OT assessment was arranged at school. The assessment consisted of clinical observations, standardised testing and discussion with learning support staff. The assessment identified specific motor issues that were causing difficulties in practical skills – most notably handwriting and balance. Parents and teachers were invited to a feedback meeting at school after the assessment.
A full report of the assessment findings was sent to parents, who then shared it with school. Recommendations were made for school to help support coordination, writing, and concentration. It had also been agreed at the feedback meeting that an individual programme of activities and exercises would be written to develop those areas identified in the assessment. This pupil followed the programme at home and school, and progress was reviewed after two terms.
He made good progress with the underlying motor issues identified, which had improved his coordination and hand skills, in particular, stamina and control for writing. The recommendations for some minor practical adaptations in class had also improved his focus in lessons.
Bright twelve year old girl with mild cerebral palsy
Lucy is a bright and friendly youngster, who has mild cerebral palsy with tremors and hemiplegia. Over the years, Hands Up OT has supported her in school by training her Teaching Assistant and SENCO in practical ways to develop handwriting control, typing skills, self-care and managing her sensory over- sensitivity.
We have solved practical equipment issues by finding stylish user-friendly items for home, so that she is now very independent.
Lucy also wanted to ride a bicycle with her family; rather than purchase a special trike, we decided to arrange an intensive course of OT sessions during the school holidays. We were all delighted when Lucy pedalled away independently at the end of the week!
Eleven year old with complex needs
Tom is educated at home as he needs a very specialist approach to education. He has OT written into his EHCP and his therapy goals are shared with the other people who deliver the curriculum. He is a very active youngster who has complex diagnoses including ASD, PDD and ADHD. He really likes practical tasks however, and therapy has been focused on him achieving therapy goals while working on activities he enjoys.
The Alert Programme for self- regulation has been adapted for Tom to understand his need for movement and how he might be able to sit for longer to carry out table-top tasks. He has developed his own personalized materials and these have been used to train his support workers and other professionals to better meet his need for sensory regulation strategies.
Gradually Tom has been able to focus to write for longer periods, without becoming too anxious and he can also recognise when he needs to use a sensory strategy to help him focus or calm down. Others working with Tom understand his reactions better and he has made good progress in all areas. Tom is currently developing a passport or business card that he can use to help explain his issues to other people he meets.
Organisational Skills for a teenager
Alex has some difficulty with developing his organizational skills. He had coordination difficulties when younger, which don’t bother him so much now but now as a teenager he is finding it much more difficult than his peers to organize his belongings, plan his homework schedule (and remembering what he has been set) and generally keep up with the pace of life. He becomes quite overwhelmed and anxious as a result.
OT has helped Alex to develop his Executive Functions, the higher thinking skills linked to memory, self-regulation and organization throughout the teenage years. It is common for students with ADHD, DCD, ASD and/or brain injury to struggle to keep pace with their peers for these skills.
OT has used Alex’s own priorities to develop simple strategies that work for him, while also developing the ability analyse a situation and decide how to tackle a difficulty so he can be more self-sufficient in the future.
OT has also discovered that Alex’s handwriting speed is too slow for his age and stage, approaching GCSEs. Using specialist assessments, OT has provided the evidence to help apply for Alex to use a laptop in school and to develop these skills so that he can sit most of his GCSEs by typing. Alex is now working with OT to help develop the systems that will keep his printed work organised.
4 year old with sensory processing difficulties
Callum was referred by his Mum when his pre-school setting picked up that he had difficulty tolerating the noise during certain sessions and avoiding getting his hands dirty or sticky.
Mum had thought Callum would grow out of it and realised that they usually avoided places with electric hand-driers or too many people around and that he could not tolerate certain fabrics or labels in clothes. He was described by everyone as being a “picky eater”.
OT carried out a sensory assessment using formal questionnaires, observations and a sensory play session to discover what helped to calm and settle Callum, rather than irritating him.
Using this information, OT helped home and pre-school to develop a “sensory diet” that would help prepare Callum for situations where he would feel uncomfortable and to de-sensitise the most problematic areas. OT trialed a specialist programme, which became part of his daily routine at home and significantly helped to improve his tolerance of loud or unexpected sounds.
However, it took time for Callum to adjust and he needed a lot of extra preparation for his transition to school, so that he did not become anxious or overwhelmed by the new environment. OT advised about using visual schedules to help make his day more predictable.
Once everyone was aware of Callum’s challenges and his environment was gently adjusted, Callum coped well with his first year in school.
Six year old with fine motor difficulties
Alexa is a 6 year old girl, who was referred to OT by her parents and school SENCO; she was struggling to keep up with her peers in class, in particular learning to write. She had a weak pencil grip and was reversing letters and numbers. She was starting to be aware of her difficulties and getting frustrated particularly at home. The OT assessment and report identified underlying delay with specific motor and co-ordination skills, which underpin writing skills. An individual programme was devised and carried out by school staff. Parents also opted for a block of direct OT sessions at school. Alexa made excellent progress in consolidating her visual-motor skills over two terms, and her confidence in her abilities improved dramatically.
