Ben is a 10 year old boy with Aspergers. He lives at home with his parents and attends a mainstream secondary school. Ben was having difficulties at school being extremely anxious about attending, struggling with his work and being bullied. He also struggled to establish and maintain friendships at school as his difficulties with social interaction caused the other children to see him as different.
Reason For Referral
Ben was referred for occupational therapy by his parents who wanted assistance in reducing his anxiety, improving his school work and supporting the school to reduce the bullying.
Occupational Therapy Assessment
Ben underwent a period of assessment involving three sessions of working collaboratively with Ben, his parents and his school. The assessment was person centred and utilised a number of occupational therapy models and strategies including sensory integration and the Assessment of Motor and Process Skills (AMPS). The assessment involved individual time with Ben as well as informal interviews with his family and school staff.
The assessment identified a number of difficulties at school including:-
- Falling behind with his work in class which caused him distress - Ben struggled to keep up as he always needed to do his work perfectly;
- Following verbal instructions - Ben struggled with knowing what was expected of him in class;
- Social relationships with his peers - Ben had no friends at school and relied on the staff for social interaction and support;
- Route finding - Ben struggled to move from class to class and regularly became lost and late for the next lesson.
Occupational Therapy Treatment Plan
Ben was offered an occupational therapy programme consisting of 12 weekly sessions, each session lasting for 2 hours which focussed on:-
- Supporting Ben to develop his social skills by using social stories and role playing to teach him how to greet people and how to behave in different situations. He was also supported to talk about his difficulties with his parents opening the lines of communication making both him and his family feel more connected;
- Working collaboratively with school to set up structured play which Ben and other similar children could participate in - games were provided and pupils were supervised by trained members of staff. This structured play gave Ben a chance to practice the social skills he was learning with his occupational therapist;
- Visual timetables detailing where Ben was supposed to go and what classes were next;
- Visual schedules for days where the timetable was not followed such as trips out. Previously these days caused Ben a great deal of stress and he was often kept off school to avoid going;
- Supporting Ben to finish his work at appropriate times and giving him clear expectations. Ben’s teachers were told about his need to complete his work perfectly and were supported with being very clear in their expectations of Ben giving him clear time limits for his work. Ben was supported to finish his work at other times if needed. His teachers were also offered Autism training in order to support them in understanding Ben’s needs.
As a result of occupational therapy input:-
- Ben's school attendance increased significantly;
- He was less anxious about going to school;
- He was able to finish his work in class and no longer felt behind with his class activities;
- He went to structured play at break and lunch and had made some good friends;
- Occupational therapy supported Ben in having some of these friends visit him at home where he was able to play and further develop his relationships;
- The visual timetable reduced Ben’s difficulties when moving from class to class and he was allowed to listen to music when moving between classes which supported him in managing the noise levels in the corridors;
- Ben is now a much happier young man - he has friends and is able to complete his school work and learning tasks.