H.s.j. Poa (dec).docx

GOALS Partnership-Occupational Therapist and Other Health Professionals #109 Katipunan St., Bagong Barrio, Caloocan City Telephone Number: 3625981 Email address: [email protected] Occupational Therapy: Plan of Action Demographic Information Name: Herb San Jose Age: 3.7 years old/M Diagnosis: Autism Spectrum Disorder Date: November 23, 2018 OT Intern in-charge: Abby Victoria Concepcion (AUF OT Intern 2018-2019) CS In-charge: Anna Louisa Y. Tiu, OTRP I.

Occupational Therapy Diagnosis and Assessment 1. Difficulty in writing due to problems in work behavior specifically impulse control and attention and concentration, problems in fine motor skills specifically improper tool grasp and problems in sensory specifically vestibular, proprioceptive, and tactile seeking behavior secondary to Autism Spectrum Disorder.

2. Difficulty in social interaction, specifically maintaining eye contact due to problems in work behaviors specifically impulse control and attention and concentration, and problems in sensory regulation specifically vestibular and proprioceptive seeking behavior secondary to Autism Spectrum Disorder.

II.

Intervention Plan Frame of Reference: 

Behavioral FOR will be used to address the client’s maladaptive behaviors that hinder him when performing activities. BMTs such as positive social reinforcements will be given when good behavior is shown as this would increase its likelihood of occurrence. Prompts and cues can be given to address inattention and impulsiveness.

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The principles of sensory integration FOR will be used as the child shows sensory seeking behaviors. By providing activities that have high sensory input this would enable him to functionally engage in activities during table top activities.

Problem 1: Difficulty in writing due to problems in work behavior specifically impulse control and attention and concentration, problems in fine motor skills specifically improper tool grasp and problems in sensory regulation specifically vestibular and tactile seeking behavior, and difficulty with auditory attention secondary to Autism Spectrum Disorder. Occupational Therapy Plan of Action Herb San Jose 1

GOALS Partnership-Occupational Therapist and Other Health Professionals #109 Katipunan St., Bagong Barrio, Caloocan City Telephone Number: 3625981 Email address: [email protected] LTG 1: Client will be able trace vertical, horizontal, and curved thickened-lines independently within 6 months of OT sessions. STG 1: Client will be able to use pencil with dominant hand using tripod grasp when writing given physical and verbal prompts 80% OTT within 5 weeks of OT sessions. STG 2: Client will be able to use non-dominant hand to stabilize paper given 3 physical and verbal prompts within 5 weeks of OT sessions. STG 3: Client will be able to attend to task 80% OTT given 5 physical and verbal prompts within 6 weeks of OT sessions. STG 4: Client will be able to trace vertical thick lines 5/5 times with minimal deviations given physical and verbal prompts 80% OTT within 5 weeks of OT sessions. STG 5: Client will be able to trace horizontal thick lines 5/5 times with minimal deviations given physical and verbal prompts 80% OTT within 5 weeks of OT sessions. STG 6: Client will be able to trace curved thick lines 5/5 times with minimal deviations given physical and verbal prompts 80% OTT within 5 weeks of OT sessions. STG 7: Client will be able to regulate himself during activities by lessening self-stimulatory behaviors such as singing and running around 80% OTT given 4 verbal and physical prompts within 5 weeks of OT sessions. TUS: Active friendliness will be used to establish rapport and have him interested in the activity being given. Kind firmness will also be used if the child is inattentive and uncooperative during activities .

BMT: Positive reinforcement will be given verbally such as “good job”, “high five”. Free play will also be given when the set activities are accomplished successfully. Prompts and cues will be given when the child would present work behavior issues such as inattention and impulsiveness.

TUA: Preparatory: Provide activities that will help regulate his sensory seeking behaviors specifically vestibular , proprioceptive and tactile seeking in preparation for table top activities such as:  Linear movement on vestibular swing  Jump on trampoline 10x  Wheel barrel position when completing form boards  modified sit-ups when getting form board pcs  Provide different textured toys Occupational Therapy Plan of Action Herb San Jose 2

GOALS Partnership-Occupational Therapist and Other Health Professionals #109 Katipunan St., Bagong Barrio, Caloocan City Telephone Number: 3625981 Email address: [email protected] Provide activities that are structured, repetitive, and has at maximum 2 step instructions to target his work behaviors such as:i  Have him complete a form board as he gets the pieces  Obstacle course (jumping on trampoline, slide, balance board) with completion of 4-piece puzzle

Provide activities that target coordination (Asymmetrical) and isolation of finger movements such as:  Tightening of nuts and bolts  Spooling of beads Purposeful/Occupation based: 

Tracing of shapes with thick lines using a broad highlighter eventually transitioning into thin broken lines with a fine-tip marker.

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Tracing of first name in uppercase letters using highlighted thick lines eventually transitioning into thin broken lines

Problem 2: Difficulty in social interaction, specifically maintaining eye contact due to problems in work behaviors specifically impulse control and attention and concentration, and problems in sensory regulation specifically vestibular and proprioceptive seeking behavior secondary to Autism Spectrum Disorder. LTG 2: Client will be able to indicate his wants and needs through gestures with one-word phrases given verbal and physical prompts after 6 months of OT session

STG 1: Client will be able to assume eye contact with social partner when asking for wants 70% OTT given 3 verbal and physical prompts within 6 weeks of OT session. STG 2: Client will be able maintain eye contact at least 70% OTT when talking/listening to social partner given 3 verbal prompts within 6 weeks of OT session. STG 3: Client will be able to appropriately indicate his wants and needs by using gestures with one-word phrases 80% OTT given verbal prompts within 6 weeks of OT session.

TUS: Active friendliness will be used to establish rapport and get his attention and interest during conversations Kind firmness will be used if the child does not initiate eye contact with social partner and is inattentive during conversations.

Occupational Therapy Plan of Action Herb San Jose 3

GOALS Partnership-Occupational Therapist and Other Health Professionals #109 Katipunan St., Bagong Barrio, Caloocan City Telephone Number: 3625981 Email address: [email protected] BMT: Positive reinforcement will be given verbally such as “good job”, “high five”. Free play will also be given when the set activities are accomplished successfully. Prompts and cues will be given when the child would present work behavior issues such as inattention and impulsiveness.

LFT: Obstacles will be used to prompt the child to verbalize his wants and needs during activities. Expansion will also be used to introduce different and new concepts to the child to expound his vocabulary.

TUA: Preparatory Activities: 

Opening song – “Where is teacher?” to promote participation to activities.

Provide activities that will help regulate his sensory seeking behaviors specifically vestibular and proprioceptive seeking in preparation for him to engage in social participation such as:  Asking which preparatory activity he wants to do first  Linear movement on vestibular swing  Jump on trampoline 10x  Going up and down the slide Provide activities that are structured, repetitive, and has at maximum 2 step instructions that targets his work behaviors such as:  Have him complete a form board. As the therapist will ask him “What do you want?”. He should respond with “Give me __” and make eye contact with palm up gesture before giving it to him.  Incorporate obstacle course (jumping on trampoline, slide) with completion of 4-piece puzzle. Therapist will ask him “What do you want?”. He should be able to respond with “Give me __” and make eye contact and palm up gesture before giving it to him. The therapist may also ask what the child would like to do with his free time and/or indicate his needs such as to use the toilet, to drink water, to play with another toy or with another child. The therapist can also provide activities that requires turn taking for him to be able to have joint attention with social partner; “your turn teacher___”. Purposeful/Occupation Based: During table top activities the therapist will be asking questions to prompt him to verbalize what he wants to promote social interaction. Questions can be asked such as what is the color of the toy, what is the picture on Occupational Therapy Plan of Action Herb San Jose 4

GOALS Partnership-Occupational Therapist and Other Health Professionals #109 Katipunan St., Bagong Barrio, Caloocan City Telephone Number: 3625981 Email address: [email protected] the puzzle or form board, etc. to promote expansion of vocabulary and more communication between the therapist and child during the session. Using of language facilitating techniques can be used such as obstacles for the child to verbalize the correct answer or his wants and needs during the activity. Therapist can also use filling in for the child to communicate and have joint attention when communicating during activities such as “ It’s time to pack ____ (away)”, “we are ___ (finish)”. Also, using gestures when cueing the child can facilitate him to talk during activities other than verbal cueing.

III.

RECOMMENDATIONS

For the family, encourage the child to make eye contact and use gestures when indicating his wants and needs during ADLs (ex: when he is eating and asking for his food, when he needs to use the toilet, when he is gathering his bathing materials, when he wants to dress up wearing specific clothes he prefers to wear for the day) and Play (ex: when he is playing with another child or relative, when he wants to request for a toy that is out of reach). Practice writing at home and establish hand preference but not force the child to write as this would hinder him from freely wanting to hold the pencil with preferred hand. Techniques/ knowledge learned during session should be incorporated into his routine at home for him to generalize the skills being taught.

Prepared by:

Abby Victoria Concepcion AUF 2018-2019

Noted by:

Anna Louisa Y. Tiu, OTRP OT CS-in-charge

Occupational Therapy Plan of Action Herb San Jose 5