Elizabeth is 7 years old and has been diagnosed with ADHD. When we met Elizabeth she would chew her uniform, bark and toys. She also seeked out to touch most things in her path. Her parents described her as “busy and impulsive”, that she would “constantly bump into things” and “couldn’t concentrate on instructions”. Through an Occupational Therapy assessment, Elizabeth was diagnosed with a Sensory Processing Disorder, with preferences to seek sensations and difficulties with spatial awareness to know where her body is in space. The assessment also revealed that Elizabeth had poor coordination and gross motor skills which were contributing to her profile.
Through Occupational Therapy, Elizabeth and her family learnt about our sensory systems, and the Sensory Integration theory. Elizabeth’s Occupational Therapist trialled different types of sensations and movements at the clinic, home and school environment, to help develop a suitable Sensory Diet for Elizabeth to meet her sensory needs. A Sensory Diet involves scheduling certain movements and opportunities to receive sensory information within her day, to help achieve a more ‘calm-alert’ state during the day.
Through this, the Occupational Therapist and Elizabeth found out that vestibular input (bouncing, jumping, crashing and rebounding) followed by deep pressure (pressure to the muscles or joints) was a good formula for Elizabeth. Each morning, at 12:00 at school and in the afternoon Elizabeth completed similar routines involving jumping on a fitball, crashing onto crash mats, hopping and skipping, followed by rolling on the fitball and using a weighted pillow/blanket.
Elizabeth was also taught the Engine Program, where she learnt about her body engines in terms of three main speeds; ‘too slow’, ‘just right’ and ‘too fast’. Elizabeth learnt the warning signs that her body was moving ‘too fast’ and what to do when this happens. She was taught deep breathing strategies, asking for a break and noticing when she was not concentrating to help her come back to the instructions/task at school and home. There was a focus on the impact that a ‘fast’ engine can have in the classroom and when playing with friends, where Elizabeth learnt through the Social Thinking ® methodology taught, the ‘expected’ and ‘unexpected’ behaviours.
The Occupational Therapist also taught Elizabeth some activities to complete that helped to integrate her reflexes. Across three terms, Elizabeth slowly integrated her reflexes into her bodily systems.
- A Sensory Diet helped Elizabeth to keep her ‘body and brain’ focused whilst at school, and in preparation for after school routines and bed routines.
- Elizabeth is now aware of when her engine is running ‘too fast’, and can use her strategies to do deep breathing, take a break and complete her Sensory Diet or use her weighted products to reach a ‘just right’ engine.
- Integrating reflexes into bodily systems to make room for new coordination and spatial awareness development.
- Elizabeth is aware of how her ‘fast engine’ can impact others, and how they perceive her.
- She has a greater awareness of her social environment and that others have thoughts and feelings about her, therefore able to respond more appropriately at school and in the classroom.
After weekly Occupational Therapy across three terms, Elizabeth gained awareness and the skills to manage her co-existing Sensory Processing Disorder and ADHD. Elizabeth can now attend in the classroom and at home to multiple-step instructions, and has learnt valuable skills in slowing her engine down. This in turn has supported her social development and help her sense of self.