Monthly Archives: March 2017

Getting Creative with Sweatshirts and Seat Cushions!

Guest post by Barbara A. Smith.

Sensory Processing disorders (SPD) impact how children and adults respond to sensory stimulation such as sound, touch, what they see and movement. One basic principle of occupational therapy for individuals with SPD is to provide controlled, graded and individualized sensory stimulation to promote functional skills such as playing catch or writing one’s name. This means that activities such as tossing bean bags into containers while the child is suspended on a swing can be:

  • Controlled – as the therapist responds to the child’s reactions. For example, the therapist might push the swing faster, slower or in a different direction,
  • Graded- as the therapist chooses the type of swing used, how long the activity lasts, how heavy the bean bags are and how far away the container is positioned, and
  • Individualized – according to the child’s sensory, emotional and motor needs. For example, the child may wear a squeeze vest during the activity, name an animal each time the bean bag is thrown or have a special friend hold the container.

What is a Sensory Diet?

Parents can implement individualized sensory strategies at home in what is called a “Sensory Diet”. This is like a recipe book of activities and adaptations that the therapist designs for parents to carryover at home, school or in the community. It is important to frequently discuss with the therapist how these strategies are working out since children grow and change rapidly along with their sensory needs in different settings.

In my book From Flapping to Function: A Parent’s Guide to Autism and Hand Skills, I describe the 6 different subtypes of SPD and some general strategies to use with children who have each type. These strategies usually impact the following 3 sensory systems:

  1. Tactile – uses sensory receptors in the skin to interpret sensations, such as light and heavy touch.
  2. Proprioception – uses receptors in joints and muscles to tell us where the body is and how it is moving in relation to objects and space.
  3. Vestibular – tells our body how to respond to the pull of gravity and movement of the head. It is also called the balance system.

Now for the fun part…

Many children with or without SPD LOVE deep, heavy pressure experiences and movement. This includes children on the autism spectrum or those with other types of developmental disabilities. One very simple strategy is to provide some type of “dynamic seating”. This simply means that the child can bounce, wiggle, rock or move around in some other way while seated. Many teachers incorporate seat cushions and ball chairs in the classroom to help students focus. The Disco Seat is one popular product. An inexpensive alternative is to sit on a deflated ball, as I am doing in the photo. Don’t have one available while eating out or sitting in the movie theater? Consider rolling up a sweatshirt for the child to sit on or curl up inside of to get a full body squeeze.

 

Speaking of sweatshirts, I have had great success in helping a young lady named Judy to be more focused and less agitated by placing a Disco Seat cushion inside the body of a sweatshirt. The photo shows Judy sitting on the cushion, enjoying some gentle bounces with the sleeves slung over her lap.

 

The sleeves are heavy because I put bags filled with sand inside of them. Next I sewed the wrist and shoulder ends of the sleeves closed so that the bags wouldn’t fall out. This adaptation can be used in a various of ways. The sweater may be placed over the back of a chair so that the heavy sleeves are draped over the child’s shoulders and body. Placing the cushion inside the sweater is optional.

 

A young man named Eddy, craves extreme movement and is typically agitated unless in a rocking chair, bungee seat or swing. You can see in the photograph that his chair is adapted to not tip over given all of his body rocking. He LOVED when I attached the sweatshirt with enclosed seat cushion to the back of his chair so that he could slam his back into it while rocking. I know that he enjoyed the deep pressure bouncy sensation because he became calmer, quieter and smiled. The heavy sweatshirt sleeves are draped over his lap. I did my best to capture how I set this up in the following video while maintaining his privacy.

Seat cushions and lap bags that are a lot nicer than the ones I make with a deflated ball, sand and plastic bags are sold by Therapro, Inc. Whether you are reading this blog post as a caregiver, therapist or other type of professional, I hope that adding these simple sensory strategies to your tool box helps the people you love or work with improve their quality of life. This is why I love being an occupational therapist!

 
 

Barbara A. Smith has worked with children and adults with developmental disabilities for over 40 years! She is the author of the Recycling Occupational Therapist, From Rattles to Writing: A Parent’s Guide to Hand Skills and From Flapping to Function: A Parent’s Guide to Autism and Hand Skills. Learn more about her work at RecyclingOT.com.

Saturday Seminar: Post-Secondary Transition Planning

Tee Stock, MS OTR/L, MBA presented a Therapro Saturday Seminar last weekend that provided a comprehensive look at Post – Secondary Transition Planning (PSTP) for students. Her extensive experience with transition planning in public schools, a private special education school, and a local collaborative, in addition to her doctoral work in this area, offered attendees an abundance of useful and current information including a guide to the numerous resources available. An essential component of her presentation was the role of the occupational therapist on the transition team.

In her review of the PSTP process, Tee reviewed some interesting statistics, some of which were quite alarming, including: “People with disabilities are twice as likely to drop out of high school; ”Those with disabilities are three times more likely to live in poverty;” and “After high school, students with disabilities are less likely to continue their education, find employment, or live independently.”    Transition planning is federally mandated to begin at age 16, but in some states, including Massachusetts, planning begins at age 14, or even earlier with the goal of preparing the student for life after high school by teaching the student a set of skills.  These skills encompass finding and keeping employment, living independently, learning to access community resources, and learning to self-manage medical and other personal needs.

When taking a look at the skill set that PSTP addresses, it seems clear that the occupational therapist should have an important role on the transition team.  However, Tee explained that sometimes lack of understanding of what the OT can offer to the process or lack of funding to increase OT services when preparing for post-secondary transitioning could stand in the way of including this professional on the team.  AOTA supports the role of the occupational therapist in TP as stated clearly in the OT Standards of Practice Guidelines and by providing valuable resources on transition planning.

Tee highlighted a large sample of OT activities for transition services that included: performing activity analysis for job, school, and self help skills; administering assessments that support life skills and transition skills; providing consultation on assistive technology to promote a student’s access, progress, and participation. The I Can Work! curriculum was endorsed by Tee and other attendees as a valuable 5-module program for integrating communication skills with hands-on pre-vocational training for middle school, high school, and young adults with special needs. Some assessments that can be administered by OTs that Tee recommended include the Transition Planning Inventory (TP-2), the Kohlman Evaluation of Living Skills (Kels) 4th Edition, which was developed by an OT, TEACCH Transition Assessment Profile – 2nd Edition (TTAP), and the Reading-Free Vocational Interest Inventory 2 (R-FII:2).  Attendees freely shared information about assessments they used, liked, and did not like. OTs can consult on selecting Assistive Technology that may be useful for TP. Tee recommended a broad variety of Apps including: Stop, Breathe & Think, a free meditation app that we actually tried out; Visual Schedule Planner, to create a custom schedule with audio and video of events; and My Homework Student Planner, designed to help students from middle school age through college keep track of classes, projects, test, and homework.

Tee left us with a great deal of information on the whole scope of post-secondary transition planning including the importance of a full team that includes the parents and student.  We also learned the important contribution the occupational therapist can provide for the student to help ensure a successful transition from high school to the community.

Take a look at a few of the many positive remarks from those who attended Tee’s seminar:

“It was a pleasure listening to this comprehensive seminar, presented at an excellent pace with thorough notes.  Thanks so much!”  Beth B., Occupational Therapist

“Organized, lots of resources.”  Karen D., Occupational Therapist

“Informative, a lot of resources.”  Jackie P., Occupational Therapist

Thank you, Tee!

Filomena Connor, MS, OTR/L