CASE STUDY

PRESENTATION
Welcome to my Presentation!

DEPARTMENT OF OCCUPATIONAL THERAPY

BANGLADESH HEALTH PROFESSIONS INSTITUTE (BHPI)
Case study presented by_

Disha Biswas
2nd year Students of
Session- 2018-19
B.Sc in Occupational therapy
Roll:01
 Case Study Presentation on a
Child with Cerebral Palsy Named
“S”
 Case scenario

The child’s mother had first cousin marriage

and she had severe high blood pressure
during her pregnancy. At 8month of
gestation, she had caesarean section
delivery. The child needed oxygen support
for13 days due to oxygen deficiency. The
child had his first seizure at 5 months of
age and it diminished at 1 year of age.
 Occupational Therapy
Diagnosis
Spastic Diplegic CP with
Behavioral problem
 Problem List 1

The child has difficulty in eating due to

Poor attention span in feeding activity
Poor interest in feeding activity due to behavioral
problem
Un-integrated sensory skills.
Poor body co-ordination and bilateral integration in
feeding
Poor body awareness
Poor fine motor skill such as- reach, grasp, release,
in-hand manipulation, eye-hand co-ordination
Poor knowledge of the mother about child’s feeding
techniques.
 Long Term Goal

The child will be able in eating any kind of

food with minimum assistance within 6
month of therapy sessions.
 Short Term Goals

The child will be able to pay attention and

show interest in eating with verbal
instructions within 3 month of therapy
sessions.
The child will be able to control the posture
while eating with minimum assistance
within 3 month of therapy sessions.
The child will be able to mix the food with
vegetables in case of rice within 3 month of
therapy sessions.
 Cont..
The child will be able to hold food and
reach the food towards his mouth with
minimum assistance within 3 month of
therapy sessions.
The child will be able to integrate his body
with moderate assistance within 3 month of
therapy sessions.
Mother will be able to practice eating with
proper techniques independently within 14
days of therapy sessions.
 Treatment plan

 Divided the eating activity in small parts

to increase child’s attention
 Encouraged and praised the child after
finishing eating activity
 Introduced the eating activity before
practicing
 Making the food colorful, appetizing and
aromatic
 Provided vestibular stimulation by
vestibular board and bean bag
 Cont..
 Provided proprioceptive stimulation by
reaching for toys by crawling, joint
compression
 Practiced reaching and in-hand manipulation
for manipulating food
 Practiced eye-hand co-ordination with
different toys and activities
 Practiced symmetrical and bilateral use with
different toys
 Educated the mother about proper feeding
techniques.
 Problem List 2

The child has difficulty in upper and lower halves

dressing due to
 Poor attention span for dressing activity
 Poor interest in dressing activity due to behavioral
problems
 Poor body co-ordination and bilateral integration in
dressing
 Un-integrated sensory skills.
 Poor postural control in dressing
 Poor visual perception in dressing
 Poor hand skills such as- reach, grasp, release,
symmetrical use, bilateral use, eye-hand co-ordination
 Long Term Goal
The child will be able in dressing of upper
and lower halves in sitting position with
moderate assistance within 6 months of
therapy sessions.
 Short Term Goals

The child will be able to reach for shirt and

pant within 2 months of therapy session.
The child will able to put and remove one
hand to one sleeve and then another hand to
other sleeve within 3 months of therapy
session.
The child will be able to put and remove one
leg in one hole of the pant and then another
leg to other hole within 3 months of therapy
session.
 Cont..

The child will be able to adjust shirt and pant

within 2 months of therapy session.
The child will be able to button the shirt and
zipper the pant within 2 months of therapy
session.
The child will be able to control his posture
while dressing within 2 month of therapy
sessions
Mother will get proper knowledge about her
child’s dressing techniques within 14 days of
therapy sessions
 Treatment plan

 Encouraged and praised the child after

finishing the dressing activity
 Introduced the dressing activity before
practicing
 Using modified clothing such as- use
chain instead of buttons, or tip buttons,
wearing loose cloths etc.
 Introduced different body parts of the
body and their functioning
 Cont..

 Practiced reaching grasping and wearing

the shirt and pants and removing it
 Practiced putting and removing hand to
one sleeve of shirt
 Practiced putting and removing leg to
hole of the pants
 Practiced symmetrical use, eye-hand co-
ordination and bilateral use with different
toys and activity
 Theoretical Framework
Frame of Reference:
◦ Biomechanical Frame of Reference
◦ Rehabilitation Frame of Reference
Model:
◦ Occupational Performance Model
 Theoretical Framework
Approach:
Intervention Approach
Education
Compensation
Top-Down Approach
Client Centered Approach
 Assistive Device
Standing frame
AFO
 Condition at Discharge
Child could response better to visual,
vestibular, tactile and proprioceptive
stimulation.
Attention span increased to 5-6 minutes.
Shows less irritation doing an activity.
Need minimal assistance for reaching and
releasing and moderate assistance for
grasping object.
Mother has learnt about her child’s condition
& prognosis.
 Recommendation
Engage the child in ADLs.
Continue follow-up.
Engage the child in social play with
others.
Follow the advises for child’s
abnormal behavior.
Any Sharing?