Child’s nаme & аge:KL, 7 Mаin areas оf cоncern:Selective mutism in schоol, refusal to complete work; and to participate in class and sometimes to sit in class. Sensory over responsive, particularly with tactile and auditory input. Outline of case study KL is a 7 year old girl who attends main stream elementary school. Referral to MCA was made as a result of selective mutism in school and more recently, refusal to complete work, participate in class and sometimes sit in class. These challenges emerged in school because of a change in KL’s class peer-group. When KL is calm, she has a good understanding of language, is able to follow instructions and participate in interactions in both home and school settings. When under stress her communicative abilities and behaviour deteriorate e.g. KL will sometimes ‘freeze’ or become very upset when approaching busy events in the school. Sometimes KL will engage in pacing backwards and forwards. Along with her diagnosis of autism, KL presents with a range of difficulties including deficits in Social Communication skills, Sensory Processing difficulties and challenges around rigidity of thought. Assessment and analysis Prior to conducting assessments, observations of KL were carried out at home and school. This was followed by a Sensory Profile (Dunn, 1999) assessment which was completed with KL’s parents. The Sensory Profile School Companion (Dunn, 2006) assessment was completed with school staff. The Adolescent/Adult Sensory Profile (Brown and Dunn, 2002) assessment was conducted with KL to afford her the opportunity to self-report. Analysis was combined with the assessment results from the specialist teacher, specialist speech and language therapist, specialist occupational therapist and behaviour intervention specialist. The information below focuses on KL’s sensory needs. KL presented as sensory over responsive, particularly with tactile and auditory input. Sensory over-responsive KL reported having difficulty managing with unexpected, loud and background noises and demonstrates this by appearing to be stressed or anxious. She sometimes will ‘freeze’ or become very upset in a crowded or busy environment. KL will make noise (cough) when completing tasks, which added to her sensitivity of background and loud noise, resulting in group participation being difficult. Assessment highlighted that KL may not always register auditory cues particularly at home. However, she will notice small changes within the environment and others moving about, though KL reported that this is not a source of distraction. Although KL’s attention to detail is a strength, on occasion she will add more detail than is necessary to drawings and written work and sometimes is unsure of when to stop or know when an activity is finished. KL’s handwriting ability was also noted to require a lot of effort and pressure. The Sensory Profile indicated that KL is sensitive to touch particularly within the domain of personal caring e.g. showering, cutting hair. KL has also described certain types of clothing (tights, shirts and blazer) as irritating. The Specialist Occupational Therapist observed that KL tended to slouch and prop herself up when sitting, often appearing to have difficulty maintaining various positions against gravity and generally presenting as lethargic. KL often refused to take part in PE, instead preferring more sedentary activities. It was observed that KL often avoids eye contact. Please create 3 relevant goals and 3 treatment activities with corresponding justification ( why did you choose this particular activity)
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