Running head: INTERVENTION PLAN FOR A YOUNG CHILD ASSIGNMENT 1

Intervention Plan for a Young Child Assignment

SUNY Downstate Medical Center

I. A brief description of the child and the context where intervention will be provided.
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Sailor is 3.4-year-old and lives at home with her mother, older sister and younger brother in a

private house. She has a diagnosis of autism and attends a 3-K program at a New York City public

school. Sailor exhibits deficiencies in fine motor skills, visual motor / visual perceptual abilities,

social emotional abilities, and sensory modulation which affect her ability to complete activities of

daily living (ADL). In addition, Sailor doesn’t play well by herself; she generally needs someone to

get on the floor with her and start playing with the toy. After watching, she will try to repeat the

same activity, but her efforts do not continue without prompting. She also displays poor body

awareness as she is often seen bumping into things and tripping over objects. Sailor was observed to

play well with her siblings but her mother reports that she doesn’t interact when she is around other

toddlers in the neighborhood. She generally sits near her mother and watches their play. She

becomes easily upset when children come near her and attempt to interact. After several minutes she

cries and clings to her mother. Her mother stated that she has improved since she began daycare, but

that she still would like to see further improvements with social interactions with her siblings and

peers.

Occupational therapy intervention will be provided at a sensory gym 2x/week for 30 minutes for

the next 12 months. The sensory gym is located 3 blocks from Sailor’s house which would be

included as part of her extended natural home environment. Mom’s primary goal for Sailor is for her

to be able to function at age appropriate level.

II. A list of 1 to 2 main occupations the child is having challenges performing, including the

client factors, performance skills, performance patterns and contexts and environments

contributing to the performance of each occupation noted.

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Mom completed the Toddler Sensory Profile-2: Caregiver Questionnaire to establish the

child’s sensory processing abilities and profiles the effect of sensory processing on functional

performance in daily activities. Sailor’s visual attention impacts her ability to identify and

recognize shapes, letters, objects, and colors, which negatively impacts her overall occupational

performance. To be alert to her surroundings, she needs a lot of proprioceptive, vestibular, and

tactile input. Sailor demonstrates poor attention to task as she has difficulty focusing on activities

assigned to her. Her eyes wander around the room looking at what her peers are doing.

Sailor exhibits decreased sensory-perceptual skills, cognitive skills, sustained & divided

attention, motor coordination, visual motor/ graphomotor skills, which is compromising her level

of independence with BADLs and IADLs, especially social participation, play exploration, and

school preparation, which are essential for the preparation of school. Occupational Therapy

Services are indicated 1x/week for 30 minutes for the next 12 months in order to address the

identified areas of need.

III. Two long-term goals/outcomes relevant to both the child and family and two corresponding

short-term goals which are measurable from the evaluation.

LTG 1: Within a year, Sailor will demonstrate improved sensory processing skills, motor

coordination skills, and social participation skills by 50% as evidenced by clinical

observation, and the Toddler Sensory Profile-2: Caregiver Questionnaire.

STG 1a: Sailor will perform 4-5 animal walks with minimal verbal cues for vestibular /

proprioceptive input, showing high body awareness and motor control in 3/5 trials within 3

months.

STG 1b: Sailor will maintain an upright posture while sitting at a table for 8-10 minutes

with/without cueing or physical support.

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LTG 2: Within one year, Sailor will improve her grasping and visual Motor skills to enhance her

preparation for handwriting and participation in classroom activities in school via activities

that challenge Fine Motor Skills and Visual Motor Skills as per teacher and care giver report.

STG 2a: Sailor will mold and tear Thera-putty of medium resistance (yellow) between her fingers

when completing a small craft project to increase overall hand strength with 2 verbal cues,

4/5 trials within 2-3 sessions.

STG 2b: The patient will follow a 2-step written direction to pick up toys and place them in the

appropriate storage bins with no more than 2 verbal cues for 2/3 trials.

IV. 4. A detailed summary of a treatment session targeting one of the short-term goals indicated.

Please describe the model of practice this treatment approach is based on.

Intervention Plan- Duration: 30 minutes

Preparatory activity

For a preparatory activity, Sailor will use a sensory swing for modulation in the sensory

gym. A sensory swing can be a source of intense vestibular input as a means to challenge arousal

levels. Sensory modulation is defined by Dr. A Jean Ayres as “the neurological process that

organizes sensation from one’s own body and from the environment and makes it possible to use

the body effectively within the environment. The spatial and temporal aspects of inputs from

different sensory modalities are interpreted, associated, and unified” (Ayres, 1972). Problems

with sensory modulation result in difficulty responding to and regulating sensory input. A child

with sensory modulation disorder might withdraw as a result of their responses.

Main activity – Balance on the Web

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Purpose: This activity will promote motor planning skills, as Sailor plans her route on the spider

web. In addition, she will strengthen her balance skills and her core, while walking on the web

lines and squatting down to pick up objects

Skills worked on: Balance, Body Awareness, Core Strength, Eye-Hand Coordination, Motor

Planning, Pincer Grasp, Visual Perception

Materials needed: Bean Bag, Container, Masking Tape, Ping Pong Ball, Tongs, Tweezers

The therapist would use masking tape to create a large spider web shape on the floor or

carpet. A container would be placed in the center of the web. Different objects like ping pong

balls and bean bags to be picked up will be placed inside the spider web. Sailor would then be

asked to walk and stay on the web lines while picking up all the objects along the way and

putting the objects in the container. As Sailor picks up the objects, she would be encouraged to

squat down, reach for the object while staying on the line, pick up the object, and return to a

standing position. For grading, Sailor could be asked to throw the objects into the container and

use a point system where the child gets a point for scoring and loses a point if he falls off the

spider web line. The activity could be further graded by working on pincer grasp by using small

objects, such as plastic bugs, and have the child use tongs or tweezers to pick up the items.

V. 5. A brief summary of how you would assess outcomes within a 3-month treatment period

specific to the setting.

In three months, the occupational therapist would re-administer the Toddler Sensory

Profile-2: Caregiver Questionnaire to Sailor’s mom to document whether or not change in

behavior has occurred or if in fact increased function and participation was accomplished.

Sailor’s processing patterns would not be expected to change drastically in a 3-month period.
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Parents tend to have a long view of the child, so their responses are likely to reflect their overall

knowledge of the child, not how the child is responding right now. This may result in a similar

sensory processing profile. However, it’s worth noting that the context has changed dramatically

as Sailor has been attending a 3-K program. So, there should be a focus on the context and how

home, 3-K participation and sensory gym situations are interacting with sensory processing

patterns.

It’s important to note that the Toddler Sensory Profile was not designed to measure

change in a child’s sensory processing. When Toddler Sensory Profile is readministered and

ratings move into the typical range, we can say that the child is demonstrating the behaviors with

a frequency that’s typical of children his or her chronological age. We cannot identify whether

the child’s sensory processing abilities have changed. Perhaps through intervention, we’ve

helped to create a better match between the child’s probable sensory preferences and

opportunities available within his or her daily experiences.

VI. 6. Information from an evidence-based research article supporting the effectiveness of at

least one of the intervention strategies you plan to use with this child.

Evidence- Sensory-based treatments include activities that are intended to include vestibular,

proprioceptive, auditory, and tactile inputs to coordinate the sensory system. Such inputs are

provided by brushes, swings, balls, and other specially built therapeutic or recreational

equipment. Sensory integration therapy in a clinical setting involving specialized equipment

(e.g. suspended swings) is typically delivered using a direct one-on - one intervention model.

Treatment plans are developed individually and performed approximately 1 to 3 times a

week, 1-hour sessions, by a licensed therapist (OT) (Baranek, 2002). Case-Smith & Bryan

(1999) studied five boys across a 3-week baseline phase and a 10-week intervention that
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consisted of a combination of classical sensory integration treatment and consultation with

teachers. Independent coding of videotaped observations of free play indicated that three of

the five boys demonstrated significant improvements in mastery play, and four of five

demonstrated less “nonengaged” play. Only 1 subject had significant improvements with

adult interactions, and none changed in level of peer interaction.

Reference

Ayres, J. (1972). Improving academic scores through sensory integration. Journal of Learning

Disabilities, 5, 338–343.

Baranek, G. T. (2002). Efficacy of Sensory and Motor Interventions for Children with

Autism. Journal of Autism and Developmental Disorders, 32(5), 397–422.

Case-Smith, J., & Bryan, T. (1999). The effects of occupational therapy with sensory integration

emphasis on preschool-age children with autism. American Journal of Occupational

Therapy, 53, 489–497.

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