Module 5 CASE STUDIES The Cases Two case

Module 5 CASE STUDIES

The Cases �Two case studies in different settings One pediatric case One outpatient neuro case �Names of clients have been changed for confidentiality purposes

Case Study #1 “Tim” � 11 year old boy �Diagnosis: Autism �Has received OT using AAT for 4. 5 years � Initially terrified of animals not very verbal �Difficulty with: ADL Independence Bilateral Motor Coordination Handwriting Strength

Goals �STG #1: Complete 5 shirt buttons I in less than 2 minutes �STG #2: Complete a 3 step activity or duplicate a 3 step design after demonstration I on 80% of tx opportunities �STG #3: Write between 10 -15 words using designated adaptations in a legible format in <4 mins with < 10 verbal/physical cues �STG #4: Keyboard between 10 -15 words using hunt/peck method in > 4 mins with > 10 verbal/physical cues �STG #5: Maintain body weight on his arms for 1 minute during assisted handstands or wheelbarrow walking

Session 1 �Make a list �Type a story �Practice buttoning �Reward with seeing the goats

Session 2 �Write a story �Following 3 steps �Upper extremity strengthening Hold plank Ball launcher

Tim’s Mom Perspective �Huge motivator Always excited to go to therapy, even after 4. 5 years Talks about it constantly �Calming effect �Form connections with the animals and has helped him be able to form relationships with other people �Conquered his fear of animals

Case Study #2 “Lance” � 43 year old male �Left MCA CVA Right hemiparesis Expressive aphasia �Difficulty with: ADL Independence Fine Motor Coordination Strength ROM

Goals 1. Demonstrate improved R grip 5 -7 pounds as use in daily activities: currently 5 pounds 2. Demonstrate improve right hand coordination for daily activities as evidence by 5 -7 block improvement on box and blocks: currently 9 blocks 3. Modified independent to spontaneously use his right hand in three activities and report follow through 4. Demonstrate 10 -15 degree improvement in right shoulder active range of motion and use in positioning and assist for functional tasks 5. Modified independent to participate in 15 minutes of functional activity at walker/standing level

Session 1 �Brushing with arm weights Goals #1 & #4 �Baking task Measuring ingredients Opening containers Following directions Increase endurance Goals #2, #4, #5

Session 2 �Fine motor vest Goal #2 �Fetch ROM FMC with the treats Recall and speech with saying commands Standing tolerance Goals #1, #2, #4, #5

End of Module 5 You have now finished module 5 please proceed to simulated cases