Occupational Therapy in the Schools

1. Occupational Therapy in the Schools The Autism Connection Presenters: Kristin Denault, Colleen Ungurean Sheila Bott

2. Clare Woods Academy A non-profit specialized school providing a nurturing, individualized curriculum, assisting students with special needs to maximize their full potential.

3. About the School 1. Located in Bartlett, Illinois 2. Founded in the late 60’s by the Sisters of Saint Joseph of the Third Order of St. Francis a. Converted part of their residence/community college into a school for special education of area children b. First year enrollment in 1968 was 5 students 3. A private, non-public alternative day school 4. Educating special needs children/young adults

4. Our Students Licensed for educating students ages 3 to 21 Currently the youngest student is 5 years old With special educational needs in the areas of mental or emotional impairment Clare Woods Academy is one of the only schools in Northern Illinois accepting students with such diversification of impairments in one facility.

5. Students arrive from 51 communities across Northern Illinois • From all races, ethnic groups, religious denominations and economic/social classes • Current enrollment of 120 full time students • Through the years hundreds of students have attended Clare Woods Academy

6. Curriculum Day school, not residential 9 am to 3 pm 176 days year (Illinois Law) Core curriculum: Math, science, reading, language arts and social studies Art, music, physical education, computer labs, library and health classes

7. Educational Departments 1. Primary 2. Intermediate 3. Secondary/High School 4. Vocational

8. Our Faculty 1. Currently 85 staff for 120 students One-to-one ratio often the norm instead of the exception 2. Many have advanced degrees in education 3. Many are certified in multiple areas of instruction and include specialists in reading and behavior.

9. Topics • The role of O.T at Clare Woods Academy • Special Therapeutic Interventions • Sensory Systems • Behavior = Communications • Strategy Checklist • IEP Goals and Objectives

10. Occupational Therapy • Fine Motor • Handwriting Skills • Sensory Integration • Motor Planning • Oral Motor Functioning • Self-Help skills • Adaptive Equipment Environmental Modification • Environmental Adaptations • Play/Socialization

11. Behavior = Communication • Look at all behaviors as a form of communication ! • The behavior chosen is helpful to the child, • that is why it is chosen. • Stereotyped behaviors lower cortisol (stress hormone) levels. • Behavior only reflects the amount of disorganization.

12. Special Therapeutic Interventions • Wilbarger Protocols • Listening Therapy • Brain Gym /Educational Kinesiology • Therapeutic Yoga • Handwriting without Tears Program • Mary Benbow Cursive Program

13. Wilbarger Protocol • The Wilbarger Protocol (Wilbarger, 1991) is a specific, professionally guided treatment regime designed to reduce sensory defensiveness. The Wilbarger Protocol has its origins in sensory integration theory and has evolved through clinical use. It involves deep-touch pressure throughout the day.

14. Listening Therapy • Benefits children 2 and up with Sensory Processing Difficulties • Therapeutic Listening uses special electronically altered music and sounds to impact multi-sensory processing and integration. • A typical listening program will require 2-3 modulated CD’s, a portable player and special headphones.

15. Brain Gym • Brain Gym is used by teachers and therapists in programs for children with developmental and learning difficulties. • Brain Gym is a series of activities that uses simple body movements to exercise the two sides of the brain.

16. Therapeutic Yoga • Yoga works on the whole body • All ages and physical abilities • Ideal way to enjoy movement and exercise • Promotes strength, endurance, flexibility and improves balance. • Teaches children how to relax and concentrate

17. Handwriting Without Tears • The goal of Handwriting without tears is to make legible and fluent handwriting an easy and automatic skills for all students. The curriculum uses multi-sensory techniques and consistent habits for letter formation to teach handwriting to all students.

18. Mary Benbow Kinesthetic Approach to Cursive Handwriting • Cursive handwriting is a kinesthetic skill taught by reinforcement on the “feel of the motion”. • The 26 letters of the alphabet are reduce to four main groups determined by their lead in strokes. • All activities are giving information to the skin, joints, and tendon receptors that guide correct letter formation while having FUN. • Essentially all children learn better using kinesthetic techniques.

19. Sensory Diet • A sensory diet is a planned and scheduled activity program designed to meet a child’s specific sensory needs. • Wilbarger and Wilbarger (1991) developed the approach to provide the “just right” combination of sensory input to achieve and maintain optimal levels of arousal and performance the nervous system.

20. Team Approach • Parent • Teacher • 1:1 Assistant • Speech Therapist • Occupational therapist • Social Worker • Physicians Combined Effort will Provide the Greatest Advantage

21. The important thing in science is not so much to obtain new facts as to discover new ways of thinking about them. • Sir William Lawrence Bragg

22. Sensory Integration • The process of organizing and interpreting information for use. • Most learning occurs first through the sensory system then the cerebral cortex • Neurons must be stimulated to form connections making pathways.

23. Sensory Systems • Tactile • Vestibular • Proprioceptive • Visual • Auditory • Olfactory

24. Just a Thought • Do what you can with what you have where you are.

25. Tactile system • The tactile system receives information from receptor cells in the skin:

26. Tactile Dysfunction • Characteristics: • Hypo sensitivity to touch • Exhibits delayed or no response to input • Craves input/ touches everything • Poor body awareness • Messy eater

27. Tactile Dysfunction • Characteristics: • Over sensitivity to unexpected or light touch • Exhibits fight or flight response • Dislikes messy activities • Picky eater • Dislikes bathing, teeth brushing or hair cuts.

28. Vestibular System • Definition: • Vestibular system is responsible for integrating information relating to movement , gravity, balance and space. • Provides information about movement, gravity, and the changing head position. • Tells us where we are moving and how fast.

29. Vestibular Dysfunction • Hypo sensitivity Characteristics: • Craves input bump and crash • Thrill seeker • Constant motion • Enjoys inversion

30. Vestibular Dysfunction • Hypersensitivity: • Intolerant of movement • Over reactive to slight changes in position • and feet leaving the ground. • Dislikes physical activities • Motion sickness • Fails to protect self from falling

31. Proprioceptive System • Definition: • The unconscious awareness of your body position giving us information necessary to coordinate movement. • Information from muscles, joints, tendons and ligaments about movement and body position. • Receptors communicate how much force is necessary

32. Proprioceptive Dysfunction • Characteristics: • Problem with gravity and movement • Poor sense of body awareness • Bump and crash against people or objects • Breaks toys or classroom supplies • Stomps while walking • Pulls or plays with clothing

33. “Childhood visions of a magic machine was my search to satisfy my damaged nervous systems craving for tactile input!” • Temple Grandin

34. Oral Motor • Hypo sensitivity characteristics: • Food stuffers • Eating non food objects • Crave spicy foods • Biters • Chew clothing

35. Oral Motor • Hypersensitivity characteristics: • Poor speech • Picky eaters • Not aware of spillage • Avoid textures • May not chew food before swallowing

36. Gustatory System/Oral Input • Suggestions: • Alerting: Cold, sour/tart, spicy, mint, crunchy foods. • Organizing: chewy foods granola, licorice cheese, suckers and gum. • Calming : suckers, hard candy, Popsicles, water bottle, vibration and any blowing toys such as bubbles, pinwheels and whistles.

37. Visual System • Definition: Visual Perception is defined as the total process responsible for the reception and cognition of visual stimuli.(Zaba, 1984)

38. Visual Dysfunction • Characteristics: • Overreact to harmless objects coming toward him • Difficulty locating objects • Hypersensitivity to light • Minimal eye contact • Squinting

39. Fine Motor Development • Foundation Skills • Development of hip trunk stability • Shoulder girdle stability • Head control • Visual tracking

40. Visual Input • Suggestions: • Printed schedules • Overlays • Solid / cool colors • Soft or Natural lighting • Highlight directions and lines • Slant Board • Increase font on worksheets • Visual timers, Schedules, PECS

41. Auditory System • Definition: The ability to perceive, process and respond to sound. • Auditory Defenensiveness has been defined by the Wilbargers (1991,p.4) as “oversensitivity to certain sounds and may involve irritable or fearful responses to noise like vacuum cleaners, motors, fire alarms, etc.” • Hypo sensitivity: Delayed auditory processing.

42. Auditory Dysfunction • Hypersensitivity characteristics: • Appears overly sensitive to sound • Difficulty understanding you • Distracted by background noises • Covers ears to shut out sound • Hums, sings or self talks through a task • Difficulty following auditory directions

43. Now what………….. • Discovering the children's sensory needs…………………..

44. TEAM