Friday, February 10, 2017

Middle + High School Students With Significant Intellectual Disabilities


Ideas for OT Consult/Intervention
for Students with Significant Intellectual Disabilities*

Depending on the educational and related service goals and objectives of your students, this is what a school year might look like for many occupational therapists.
Month
Intellectual + Physical Disabilities
Intellectual Disability + Autism
September
Observe feeding--any adaptive equipment needed?
Take photos of each student’s feeding equipment. What equipment is on hand in classes, kitchens.
Need timer to pace intake?
Prep feeding guidelines for individual students.
Initiate or update feeding forms on annual basis, or after hospitalization affecting feeding status.

Obtain photo permission from parents, for use in therapy records and training staff.
Take photos of UE splints and other specialized equipment, for OT file.
Observe during snacks, lunch.  How wide/how narrow are their food preferences?

Note fine motor skills and grasp patterns during utensil use or finger feeding.
If needed, provide photos of typical grasps for visual models to use with students during mealtimes.

Address immediate needs for self-regulation strategies and activities. What was used in the past?  Review former therapy records in student’s school confidential file.
October
Document what assistive technology is in place.  Take photos of mounting systems for AT and mark wheelchair or other equipment for best sites to attach AT.

Visit physical education to observe students out of wheelchairs and note gross motor skills and UE skills in more dynamic environment.

Observe students in school environments (lunchroom, assemblies, transition in hallways, art class, school jobs…) and consult on adaptations for promoting fine motor skills and independence.

Observe students in school environments (lunchroom, PE, assemblies, transition in hallways, art class, school jobs…) and consult on adaptations for promoting fine motor skills and self-help skills.

Explore primary classroom environment (lights, seating, noise level, computer placement, window glare) and items in place for self regulation.
Provide written recommendations to teachers and, possibly,  additional items for trial periods (fidget mat, light diffusers, standing desk, other).
Offer team in-service for creating items that have been successful with students.  
Use therapy session to model creating simple items to use in class--have students participate (such as rice-sock fidgets).  Include precautions.


November
Assess classroom inventory of materials for sensory exploration and individual leisure skills.
Create set of materials for students on OT caseload and train teachers & classroom aides on using items for alerting/calming to aid self regulation & readiness to learn.  Include precautions and symptoms of over-stimulation.
Do students have preferred activities for self regulation?  If so, help students and staff create a personal menu of preferred activities they can select from on a regular schedule through the day.  Enlist the school SLP to use visuals in the schedule.
December
Use seasonal weather and holiday traditions to expand group activities (ice maker for snow, cinnamon-nutmeg or
peppermint to salt/flour/water
dough for olfactory & texture exploration.
Use highly-textured materials (pinecones, gumballs, holly leaves) and other natural materials to create small gifts for families and school staff.

Students can create gift tags (tracing/cutting), write greetings then deliver gifts to school personnel during group sessions.
January
Review progress in self-help skills:
  • Self feeding
  • Food prep (cutting)
  • Utensil grasp
  • Independence in lunch line
  • Self dressing
  • Managing fasteners
  • Shoe tying

Provide adapted materials, as needed, to supplement classroom items.  (shoe laces cut in half and re-tied in contrasting colors)
Same as column to left.


 

February
Schedule visit with school-based SLP for shared students using augmentative communication devices.  Observe and collaborate on best access for switches/devices.
Schedule visit to off-campus work sites or adapted sports (skating, Medford League games, Special Olympics).
Observe student’s response to environment and need for any modifications needed at site.
March
Observe students during school-based jobs (washing windows, watering plants, working in school store, stationery business, café cart).
How have their fine motor skills and self help skills increased since October?

Refresh any customized “sensory kits” for students with seasonal items.
Observe students during school-based jobs (washing windows, watering plants, working in school store).
How have their fine motor skills and independence with self help skills increased since October?

Refresh any customized “sensory kits” for students with seasonal items.
April
Update materials for practicing self-help (bubble wrap for snaps).  Send home parent handout on tips for increasing independence at home.
Update materials for practicing self-help (bubble wrap for snaps).  Send home parent handout on tips for increasing independence at home.
May
Incorporate water and other outdoor activities into group sessions (reaching into water-filled basis to grasp objects).

Send thank-you notes to donors, describing how $$$ or materials were used to help students.
Improve hand strength for greater endurance in school jobs and work settings via carrying different sizes of water for outdoor plants, bringing heavy water bottle on outside walks.

Send thank-you notes to donors, describing how $$$ or materials were used to help students.
June
Meet with teachers, SLP, PT to determine what intervention strategies  to repeat and what to change for the next school year.
What feeding precautions need to be in place on the first day of school next year?  What equipment?  What self regulation strategies?
Meet with teachers, SLP, PT to determine what intervention to repeat and what to change for the next school year.
What feeding precautions need to be in place on the first day of school next year?  What equipment?  What self regulation strategies?
*

"Intellectual disability is a below-average cognitive ability with three (3) characteristics:

  • Intelligent quotient (or I.Q.) is between 70-75 or below
  • Significant limitations in adaptive behaviors (the ability to adapt and carry on everyday life activities such as self-care, socializing, communicating, etc.)
  • The onset of the disability occurs before age 18." 

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