Think Outside the Box- Peds Edition

 

    During our pediatric interventions course, we were given a case study of children with different diagnoses. My case study was about a girl who had Developmental Dyspraxia. This was a diagnosis I was not super familiar with as we briefly went over it in class. I was given the scenario of my client being 6 years old and was referred to OT services due to difficulty with most school subjects, handwriting, participating in PE, and limited play on the playground, as well as poor dressing skills. Right off the bat, I wanted to consider the frameworks of Motor Skill Acquisition, Biomechanical, and Social Participation. However, after getting feedback from my professor, I realized there was more that I was not truly seeing with this diagnosis.

    There was a visual perception deficit as well considering her diagnosis of developmental dyspraxia. Another important factor was her sensory integration deficits as she is shown to have poor tactile defensiveness and poor tactile perception. I still wanted to consider utilizing the motor skill acquisition frame of reference since she does have some motor deficits and difficulty with in hand manipulation. To come up with an intervention I would consider using for this client, I had to consider her occupational profile, break down each domain, and understand it from her perspective. What would someone with developmental dyspraxia have trouble with? 

    I finally decided how I would address this client's deficits and came up with a goal I wanted to target.

GOAL: Client will tolerate tactile play 4 out of 5 days of the school week with minimal verbal prompts in order to participate in school-related activities such as PE within 6 months.

I wanted to use a goal that wasn't too specific but specific enough to be able to reach and have leeway with the freedom of how it was to be addressed. I decided I wanted to incorporate a game board to address some of this client's deficits. I took a twist on chutes and ladders and added a lot of sensory components on the game board for the client to explore. Along the game board path, some prompts consist of either physical activity to utilize gross motor skills, math problems, critical thinking, finger manipulation, and much more. I wanted to keep the game basic enough for her to be able to achieve mastery of some of the prompts. The beauty of this DIY game is that once she reaches mastery, you can grade up on some of the prompts/ math problems. If this was too difficult for the client, it could be just as easy to grade down some of the prompts by simply replacing them by covering them up and writing something new. 

The intervention would address:

• - Client Factors: Body functions and structures.  

• - Sequencing and planning, coordination, visual perception, educating parents 

• - Performance Patterns: Routines/ Roles.  

• - Handwriting, PE participation, playground, participation, dressing skills 

• - Performance Skills: Motor, Process, and Social Interaction Skills.  

• - Grasp, coordination, motor planning/ sequencing, social participation in PE/ playground/ classroom

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I really enjoyed completing this project as it allowed me to be creative in a freeway and think about how I would address the diagnoses. I enjoyed the process of the project and breaking it down into different steps, which helped me figure out how to break down the diagnosis and how to go about addressing different deficits. I hope to be able to use this game in the future with an actual client experiencing developmental dyspraxia!