DOWN'S SYNDROME - CHILD
Julie is 18 years old and has Down’s syndrome. She currently lives with her mother, father and younger sister and attends a special needs Sixth Form College.
Reason For Referral
Julie’s parents referred her for occupational therapy for support in increasing her self-care skills. Julie relied heavily on her mother and father for self-care tasks such as washing and dressing. Her parents wished for Julie to become more independent as these issues were beginning to prevent her going away on trips with friends. This would be a concern when Julie wanted to move out of the family home.
Occupational Therapy Assessment
The occupational therapist assessed Julie’s environment and her abilities within that environment. The assessment used a person centred approach, combining the use of formal and informal assessments. Formal assessments included the Assessment of Motor and Process Skills (AMPS) and the Model of Human Occupation Screening Tool. Informal interviews and observations of activities were also carried out.
The assessment identified that:-
- Julie had particular problems with sequencing the actions and steps within her activities;
- She was also easily distracted by people and objects within her surroundings;
- Fine motor skills were an issue as Julie struggled to manipulate objects such as zips or co-ordinate two hands for activities such as doing up buttons.
Occupational Therapy Treatment Plan
Julie was offered an occupational therapy programme consisting of 12 weekly sessions which focused on:-
- Working with Julie, her family and school staff to implement a program of fine motor tasks and co-ordination activities to improve her skills (she completed these at school and at home for a period of three weeks). The occupational therapist then worked with her to transfer the skills she had learnt into real life situations such as doing up zips, buttons, opening containers etc;
- Adapting her home environment to remove visual distractions such as superfluous products and bottles;
- Providing visual sequences in her bedroom and bathroom to prompt her into the order in which to complete tasks;
- Being fun to ensure Julie was motivated and engaged fully with the therapist;
- Activities carefully designed to challenge Julie whilst ensuring that she succeeded (this approach developed Julie’s self confidence and willingness to persevere with tasks that she found difficult).
At the end of the programme:-
- Julie was able to dress herself and clean her own teeth;
- Julie was able to wash herself independently meaning she was able to have her first ever sleepover at a friends' house (she continued to need minimal support with showering as this was a complex task made more difficult by being unable to wear her glasses in the shower);
- Julie was able to take her visual aids to her friend’s house and was able to carry out her selfcare activities unaided (she was delighted with this result as it was one of her life goals);
- Julie was also able to go to the school swimming events and not require any support in dressing afterwards.
Julie’s family were able to see how her increased independence would enable her to leave home one day and lead a more independent life.