Case Studies

A boy came to our Centre at age of 3 years and one month. He wouldn’t stand in a place for more than a minute and would run around and cry continuously. There was no response to name call. Any object given in his hand will be thrown right after he holds it. If he chooses a particular object, he will start arranging it i.e., visual seeking sense was also noticed. He would try to harm himself by hitting his head anywhere possible. It was clear that he required intervention.

Occupational Therapy program was planned for six months. We planned an intensive sensory integration program planned out and implemented. It included vestibular seeking activities, proprioceptive activities, tactile processing activities, joint attention activities (respond to name call and eye contact) .We focus on functional communication such as asking for desired items through pointing and saying hi and bye through gesture and in-between all the activities, make him wait for his turn.

As he lacked body awareness and environmental awareness, bumping into objects was very usual. To address all these issues, initial programme was planned through Gross motor, motor planning activities and bi-lateral coordination activities were introduced for him. As the child started to respond to motor activities, we slowly included the programme for other lacking areas. Fine motor and visual tracking activities were given for the further improvement. When the child shows good response to fine motor and visual tracking, we started to work on his attention span. In the initial stages, the attention span would be for two to three minutes through various activities with different. Now after a two month period, he can sit for half-an hour in a place. He turns when his name is called. He is able to identify colors, sings rhymes and able to identify animals.

Therapy continues with different approach with different program plan out according to the primary needs of child.

It was a pleasure to work with Gani (name changed)

A boy aged 3 years walked into the Centre with anklets in his legs and with his eyes moving here and there. As the therapist took kelvin inside he was let free to explore, he walked around the Centre bumping into objects (lack of body awareness) and his eyes didn’t look down to see what he hit (lack of environmental awareness). He moved and reached a bucket of animals and threw them down, followed by a box of colorful beads which he overturned (visual seeking sense). Therapist called out his name (no response for name call) and he didn’t turn but continued his messy playing. For kelvin, someone has to be there all the time otherwise he will make that place a mess and will be missing (parents used to find him with the help of the anklet sound). When he walked on the obstacle walking course, he carefully avoided walking over grass ( tactile issue was noticed) and therapist realizing his issue asked him to touch paint and he didn’t even come near the paint proving the presence of tactile issue.

Yes. Kelvin did have a lot of issues and was really tough child to handle. Therapist allowed kelvin to explore various activities such as ball pool, swing, colour matching, lacing, beading, vehicle sorting and a lot more with different materials and the therapist carefully gathered his likes and dislikes. Therapists with the help of his favorite materials, initially, made a program to address the primary issues such as bumping into objects through vestibular seeking activities, proprioceptive activities, tactile processing activities, joint attention activities (respond to name call and eye contact). The first session started as planned but he didn’t respond even to his favorite activity, then the therapist discovered that since he wanted to explore those new colorful materials, he liked it and moment his exploration phase is over, that same object is no more attractive for kelvin. Then the program was changed with different materials every session, so that kelvin peeps out from his world and gives his attention for those few minutes.

As the therapy session was going on, he started to do gross motor activities but when fine motor skills were given, his way to put things down still continued. Therapist then designed technique of touch (holding the child to make him aware of the presence of someone) instead of auditory which proved effective. Kelvin now is able to give fifteen minutes per activity. Able to differentiate colors and collects animals on his own. Kelvin’s next program is to look into his joint attention skills and tactile issues.

Looking forward for the next session.

Hemanth, entered the Centre when he was 3yrs. When his parents brought him for consultation, he ran from the hold of his parents and climbed the stairs to jump into the ball pool. He tried the swing, arranged the trucks (pretend play was not present) and found a toy animal which he didn’t leave (visual seeking: attracted to a particular object). Parents quoted that he wouldn’t stand in a place for more than 40 seconds. Therapist allowed Hemanth to do what he wanted and observed him carefully. He didn’t even know when his name was called (no response to name call) and his attention span was very less (maximum 2 minutes). When any question was posed, there wasn’t any response. His speech is meaningless and lacks functional skills.

Therapist planned out a program to address the primary needs of concentration through joint attention activities which would help him to respond to name call and eye contact. Hemanth wouldn’t sit and would look everywhere but not the person in front of him (co-operation was less). The therapist worked out a new technique especially for him, sit and look approach ( a technique where child is made to sit on a therapy ball and the therapist sits in front of him in a manner he cannot avoid the person’s eye for long) in 20 minutes he would meet therapist eye for 2 minutes. After a week, his attention span increased to continuous 15 minutes. As he co-operated to joint attention, program was revised and it included Gross motor activities, vestibular seeking activities, and proprioceptive activities to address the other required areas of intervention. He was given occupational therapy which included the above said activities for a period of two months.

Now, Hemanth is able to listen to one-word command and he can sit for ten minutes continuously per activity. His attention span, eye contact and his response to command has increased to half-an hour. His parents were really happy to see his progress. Next step of action is to give speech therapy to improve his communication (enhance meaningful communication and functional skills).

Riya aged 2 and half years came into the Centre without any noise. She sat quietly for an hour through the consultation with her parents. Yes, She was non-verbal and a under responsive child. Riya was allowed to explore with lot of materials but she didn’t even attempt to touch anything in front of her (no pretend play). There was no response for her name call and total lack of eye contact. It was very evident that Riya required intensive therapy which meant she had to attend therapy for six days in a week.

Riya’s program was planned out with motor planning skills and joint attention activities, in the beginning. Riya used to sit in-front of therapist with her head bend towards the ground. After a week of focused efforts through simple activities and Rhymes, Riya finally lifted her head up. The scheduled program was then implemented and after six months, there was drastic change in Riya. She started responding for her name and was able to understand one-word command. Her parents were so happy seeing Riya’s progress. Looking at the improvement, Riya’s program was revised for more advance activities to improve her gross motor and Fine motor skills. Since, Riya has developed the skill of understanding, her plan included speech therapy. Next 3 months, speech therapy and occupational therapy went hand-in hand.

Riya’s progress suddenly became slow due to her irregularity. She took lot of breaks in between each week. Riya’s mom was upset that her child didn’t show any change through speech therapy. She craved for her child to speak. Then it was informed that lack of attendance creates a problem in a developing child. Then for a complete two months, Riya attended and now, she progressed from non-verbal to alphabets, numbers, fruits , animals and a lot more. Riya’s mom understood the importance of regularity. Thus, Riya has progressed to a stage of echolalia from being totally non-verbal.

Recently, Riya was found to be avoiding art sessions in her school and it was informed here. Therapists then found out, Riya had tactile issues, her face changed when a bottle of paint was opened. Program was immediately revised to address tactile issues. She is in the step towards progress.

It is really amazing to work with Riya

A boy around the age of 3 years walked into the Centre six months back with open mouth, drooling (non-verbal) and bumping into objects (lack of body awareness). Rishab did have response to name call and he could follow one word command. Rishab required speech therapy intervention as soon as possible. Initially, his program was framed with motor planning activities, gross motor (which included jumping and obstacle walking). In a month’s time, Rishab was able to follow command told in a sentence. Seeing his fast progress, the second session of the program included speech therapy with occupational therapy. Speech therapy classes were nightmare for Rishab. That’s when Rishab started crying. Rishab was totally non-verbal and the moment he sees the therapist he used to sob. In a week of his program, Rishab started responding to the activities such as Tongue exercise and Oro-motor exercise. After a month of tremendous efforts by therapist, he started using sounds “mmm”, “ooo” and “aaa”.

Rishab is here for six months now; he has progressed to single words like “light, fan, switch etc”. Rishab’s mom is really happy when her child calls her “amma” and in tears when she sees her kid having functional speech (such as hi and bye). Currently, the session of Rishab includes two words together and visual processing skills, sensory integration activities.

Waiting for the next step

A child aged 6 years entered Chaitanya Therapy Centre with very less attention span. Visual processing ability required intervention and he was able to follow only 3 word command. His verbal ability lacked clarity in pronunciation and spelling error was also spotted in his writing skills. Even his mathematical skills were assessed and found that his counting skills were appreciable but needed advance intervention for further learning. He was found disturbed when introduced in a group.

To address these issues, He was given intensive therapy program which includes combination of occupational therapy, speech therapy and writing skills as per his needs. Child took therapy for (three months) and gradually with the help of occupational therapy his attention span increased from 10 minutes to forty minutes. As the time increased, his requirement of in- depth visual processing therapy was noticed.
With the help of occupational therapy his visual processing skills was sharpened. He can now find the hidden objects, missing pairs and differentiate between various sizes. He was able to focus on the activities given and respond correctly. This was supportive for him to enhance his writing skills from basic to framing a sentence. To improve his auditory processing the commands moved from three words to sentences. After a few sessions, he was able to receive the sentence command and act accordingly.

The improvement in the child was cherished by the parents and encouraged him at home. They were happy as his over-responsive behavior to spell few words. As the progress was seen in writing ability, therapy was continued with him so as bring a change in his handwriting. The speech therapy aimed to provide him with the skill to have meaningful and functional communication. Now, the child can frame sentences and answer for a particular question.