OCCUPATIONAL THERAPY EVALUATION FOR EDUCATION PURPOSES AND IN SCHOOL SETTINGS

This confidential report contains private information and should not be shared outside of the IEP process and without specific consent.

Name: Child Parents:

Date of Birth:
Test Date:
Age: 16 years 11 months

Referral: Child was referred for an Occupational Therapy (OT) Independent Educational Evaluation (IEE)
at the request of his parents to assess his development and determine the need for OT services. His
parents describe Child as a caring, loving teenager who loves to build and create. He is rather artistic and
enjoys graphic design, drawing, painting, and sculpting. He lives with his parents and 2 younger siblings.
He is bright and capable but working below his potential at school. Child can be argumentative when
asked to do something he does not want to do. He has difficulty focusing and prefers to draw in class. He
has the diagnoses of Attention Deficit Disorder (ADD). Primary concerns relate to his reading abilities,
homework skills, task completion, handwriting, visual skills, and communication. His parents and the
district wish to determine the services necessary to support his development and academic success as a
productive and self-sufficient adult.

Medical History: While pregnant, Child’s mother experienced frequent bladder infections and borderline
gestational diabetes. Labor was induced 2 weeks past Child’s due date, requiring suctioning. During
circumcision he turned dusky and doctors discovered that Child had a small hole in his heart. He required
an apnea monitor during infancy. He currently takes 25 mg Adderall and 20 mg Celexa.

Education History: Child attends 10th grade.

During Dr. testing, Child received a Full Scale IQ score of 91 (average), Nonverbal IQ of 86 (average),
and Verbal IQ of 86 (below average). Factor index scores revealed low average quantitative reasoning
and working memory. He has difficulty planning, organizing, and problem solving resulting in below
average scores for task completion and working memory on the BRIEF-2 self-report form. Dr. stated “Per
endorsements on parent and teacher questionnaires, Child was described as having many symptoms of
impairment in executive functioning”. His fine motor skills were considered average with the exception of
timed tasks. Dr. stated in her report summary “Multiple off task behaviors Child exhibits are thought to be
due to his attempt to compensate for his disabilities in auditory and visual processing”. According to the
Functional Behavior Assessment, she noted that teacher’s written instructions on the board may be
above Child’s reading level. Child had a hard time advocating for his needs or asking for additional
instruction. He sometimes referred to his peer’s paper during independent work. Dr. noted “When
teachers make assumptions regarding his current academic abilities, believing he can rapidly access the
material being taught, Child becomes frustrated, isolated and exhibits off task behaviors including
drawing.”

Recommendations included:
 Eligibility should continue to be OHI and SLD in the area of math, phonemic processing, auditory
and visual processing.
 Positive behavior support plan in school and home environments
 Child should participate in a multisensory research-based program with 1:1 educational therapy
using Lindamood-Bell methodology
 Instruction from both teachers and classroom aides who have knowledge of Child’s academic
weaknesses
 Continued participation in SAI classes
  Twice weekly vision therapy sessions for 10 weeks
 Bi-weekly case carried meetings with Child to address planning and organization of homework
and assignments as well as social concerns
 Provision of a study period each day to receive additional individualized assistance and complete
assignments
 Use of an FM System in class
 Participation in social clubs and organizations based on similar interests
 Individual therapy outside of school to address social skills and executive functioning from a
cognitive-behavior approach
 Continued psychiatric care
 AT assessment, Central Auditory Processing Assessment

Intervention History: Child has participated in vision therapy services to address visual scanning and
ocular motor skills. He received school-based OT services to address executive functioning skills. Per his
9/2018 triennial OT evaluation, Child received school-based OT services in 2015 for 10 X 15 minute
sessions per year, totaling 150 minutes. In his 7th grade year, OT addressed Child’s ability to utilize a
monthly calendar to track assignments and turn in homework. OT continued throughout his 2016/17
school year with the following goal:
 By 9/20/17, Child will be able to successfully complete assignments for his academic classes and
turn them in by the due date to eliminate missing assignments and minimize their impact on his
overall grade when given minimal assistance (up to 24%) as measured by summary/teacher
reports.

This goal was continued as Child still had difficulty “keeping track of his papers and remembering to bring
them to school to turn in, or to complete them during class and turn in with all the required information
appropriately”. He received group OT services 60 minutes per month. During the OT evaluation, Child
received below average scores in fine motor precision and fine motor integration on the BOT-2. He
completed the Adolescent/Adult Sensory Profile revealing “lower than most people” in the sensation
seeking quadrant and “more than most people” in the sensation avoiding quadrant. The occupational
therapist recommended OT services 300 minutes per year to support Child’s organizational skills.

Developmental History (Parent Report):

State Regulation – Child was a quiet, passive, non-demanding baby. At present, Child sleeps well and
expresses he wants to sleep more. Child is mostly quiet and prefers to “hibernate” in his room in isolation.
He can be lethargic and slow moving. Child prefers calm and serene environments. His medications
influence his appetite and he eats better once they wear off. He likes to be excessively warm and will
wear a jacket in 100-degree weather. He gets depressed and can be moody. He has trouble finding
motivation to complete daily tasks and does not always respond to disciplinary actions by parents. He lied
to get out of homework or chores. Child experiences low self-esteem due to feelings of failure. He shuts
down when he feels he is not good at something. He prefers to wear his headphones in class and reports
that music helps him focus.
Motor Skills – Child’s gross and fine motor skills developed within the typical range.
Self Care – Child has delayed self-care skills. He learned to toilet independently by 4 ½ years and dress
himself independently by 5. He manipulated zippers independently by 6 and managed buttons and snaps
by 8. Child was independent in bathing and grooming by age 9, but continues to need reminders to
maintain his hygiene. Child used to be sensitive to socks, certain textures, and car seats. He does not
like to wear certain shirts with buttons and he refuses to wear shorts. He hates getting his haircut.
Communication – Child looked when called and pointed to simple pictures by 6 months. He said his first
word by 1 year, combined words at 15 months, and spoke in sentences at 2 years. Child followed one-
step instructions and looked in the direction others pointed by 2 years.
Affect, Attention, & Activity – Typically, Child is a quiet, happy teenager who is well-behaved, polite and
cooperative. Child is unrealistic in his expectations and can be immature. Child is often “quietly off-task”.
He can be impulsive, restless, stubborn, inattentive, and easily frustrated. He craves freedom and
unstructured time.

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Self-Direction – Child does best when provided with 1:1 support. He has difficulty following through with
self-care tasks without constant reminders. He lacks self-discipline and has poor responsibility for his
actions. It is difficult to find something to motivate Child with. Following daily household routines rarely
runs smoothly for Child and his family. Bathing and grooming activities, homework, completing chores,
and getting ready for bed is challenging for Child. He often forgets his binders and homework. He needs
reminders to keep his backpack and folders organized. Unexpected changes in schedule or routine are
difficult for him to tolerate. Staying involved in the community is challenging and Child always shows an
initial resistance to go anywhere. His parents have to make him go on outings and he always asks to stay
home. While running errands with his family, Child always asks to stay in the car. He often participates in
recreational activities such as bike riding and ball games. As part of his daily routine, Child typically
wakes up around 6am. He takes the dogs out, feeds them, and then takes his medication. He eats
breakfast, puts on his shoes and jacket. Child rides his bike to school. At lunch he will either sit with
friends or go to his next class and draw until class starts. After school, he bikes straight home and parks
his bike in the garage. He watches YouTube videos and gets himself a snack. He usually plays video
games but at this time he is not allowed due to “D’s” and “F’s” on his progress reports. Child’s parents
arrive home around 4pm and they sit and talk. After dinner, his parents have to strongly encourage him to
wash the dishes. They also have to make him take a shower, or else he would not do it. He has the habit
of wearing his clothes to bed for the next day. He forgets to brush his teeth at night about 1-2 times per
week. Child goes to bed anywhere between 9-10pm.
Play and Leisure – Child prefers to engage in more solitary activities and requires encouragement to
socialize with his family and friends. He has a small group of close friends. He easily makes and keeps
friends, although he prefers to play video games and enjoys engaging in artistic projects, graphic design,
painting, sculpting, and drawing. He does not participate in organized sports but plays pickleball and
pool/billiards.

Assessments: The evaluation report is based on information from the following:

1. Parent report: Developmental and Family Impact Questionnaire
2. Parent interview
3. School Observation
4. Adaptive Behavior Assessment System (ABAS-3) Parent Form and Teacher Form
5. Sensory Processing Measure – Home Form and Main Classroom Form (SPM-H; SPM-C)
6. The Sensory Integration and Praxis Tests (SIPT), a series of 17 tests designed to assess visual
and tactile perception, motor planning, visual motor skills, 2 and 3-dimensional construction and
nystagmus, a back and forth reflexive response of the eyes to rotation.
7. Beery-Buktenica Developmental Test of Visual-Motor Integration, (VMI) Full Form, Motor
Coordination Test, and Visual Perception Test
8. Behavior Rating Inventory of Executive Functioning (BRIEF-2) Parent Form and Teacher Form
9. Clinical observations of postural control, muscle tone, ocular and oral motor control and sensory
responsiveness
10. Record Review:

Assessment Results: The test results are reported in the categories below.

School Observation:

Adaptive Skills: On the ABAS-3, Child’s parents and teacher reported concerns in the area of self-
direction as part of conceptual skills. His parents reported below average functional academics, home
living, and leisure skills.

ABAS-3 Parent Report Teacher Report

Raw Scaled Standard % Raw Scaled Standard %
Score Scores Score Score Scores Score
Communication 64 8 90 25% 57 8 90 25%
Community Use 49 9 95 37% 43 11 105 63%
Functional Academics 49 7 85 16% 60 9 95 37%

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 Home (School) Living 54 7 85 16% 60 9 95 37%
Health and Safety 57 11 105 63% 45 10 100 50%
Leisure 48 7 85 16% 45 9 95 37%
Self-Care 66 8 90 25% 57 12 110 75%
Self-Direction 36 4 70 2% 48 7 85 16%
Social 65 8 90 25% 64 10 100 50%
ABAS-3 Summary
Parent Sum of Scaled Composite Percentile 95% Confidence
Composite Scores Scores Rank Interval
GAC 69 85 16% 83-87
Conceptual 19 79 8% 75-83
Social 15 88 21% 83-93
Practical 35 90 25% 86-94
Teacher Sum of Composite Percentile 95% Confidence
Composite Scaled Scores Score Rank Interval
GAC 85 94 34% 90-98
Conceptual 24 87 19% 82-92
Social 19 98 45% 93-103
Practical 42 99 47% 93-105

Performance Test Situation: Child was assessed in one, two-hour session with breaks as necessary to
sustain his attention. His mother was present throughout the evaluation. Aja Roley MA, OTR/L and Korrie
Sparks OTD, OTR/L administered the assessments. Child greeted both assessors by shaking hands and
immediately sat down to begin testing. He was personable, soft-spoken, and was wearing glasses with
shaggy hair close to his eyes. It appeared he had chewed down his finger nails. Child frequently
commented on testing procedures with clever insights. He was bright with a good sense of humor and
was determined to complete challenging test items. He joked with the assessors and commented on
things in the environment. While looking at the SIPT testing suitcases he questioned what was inside and
playfully guessed there were “portable dogs” inside. When thanked for his patience during testing, he
replied “of course”. He worked quietly and cooperatively for two hours with no more than the usual short
breaks. Child sat against the back of his chair with a flexed spine for the majority of testing. Overall, we
were able to present the tests in a standardized fashion and the results may be considered a reliable
estimate of his abilities at this time.

On the space visualization test, Child chose his answers quickly and quietly. When the assessor took
additional time to set up an item Child stated “I can see how it can be difficult to set up”. He did well on
the figure ground perception test, naming the figures as he went as well as pointing to the answers. He
sometimes explained his choices out loud. On item #10 he selected a design and said with excitement
“Oh! Primary colors triangle!” The standing and walking balance test was challenging for him, but he
persisted. He laughed frequently when closing his eyes to balance. Child stated “I never expected to
immediately feel…‘where am I?’” After being asked to balance on a wooden dowel he commented “I
found that really weird”. On the design copy test, he utilized a left-handed quadrupod grasp with a thumb
wrap. He completed the postural praxis and bilateral motor coordination tests easily. He followed
directions required for praxis on verbal command while occasionally repeating the directions out loud.
During one item requiring him to lean over, he said it looked like an “oompa loompa”. On the
constructional praxis test, he quickly and easily constructed buildings for part I and II. On the postrotary
nystagmus test, he had inconsistent reflexive eye movements. He appeared dizzy after completing the
last trial and laughed each time he engaged in rotations. On the motor accuracy test, his movements
were slow and accurate while tracing. He held tightly onto the pen and hunched his body over the paper,
leaning to his side. When asked to use his non-preferred hand he stated “this feels weird… I’m not good
with my right hand”. He successfully completed sequencing praxis, oral praxis, manual form perception,
and kinesthesia. Child was able to accurately perceive and discriminate tactile stimuli on the finger
identification test, graphesthesia, and localization of tactile stimuli test.

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When informally interviewed, Child easily shared his opinions and ideas. He shared about his interests in
improv comedy, graphic art, drawing, carving and woodshop. He often rides his bike and sometimes
plays basketball and pickle ball. He said he did gymnastics as a kid but had difficulty with cartwheels.
Child stated that schools do not teach social skills and he figured things out on his own. He said he used
to be an introvert but decided to become an extrovert because he felt he was missing out. Child stated
being more outgoing was “a great feeling” for him. He spontaneously shared how often he gets distracted
in class and chooses to draw instead. He commented “I try to keep it to a minimum”. When discussing
challenges in life, Child said it was important for him to let go of the past. He said when someone insults
him he thinks “that’s you” and moves on.

Sensory Integration, Motor Skills, and Praxis:  According to Principle 1C, The Occupational Therapy
Code of Ethics, “Occupational therapy personnel shall use, to the extent possible, evaluation, planning,
intervention techniques, assessments and therapeutic equipment that are evidenced based, current, and
within the recognized scope of occupational therapy practice”.  The SIPT is the gold standard evaluation
for assessing sensory integration and praxis. These are developmental tests measuring sensory motor
areas that are mature by approximately age 9 years.

The SIPT scores are reported in standard deviations and listed on the accompanying profile. Scores that
fall between –1.0 and +1.0 are in the typical range. The research for this test indicates that scores that
fall below –1.0 are significantly low (Ayres, 1989). Each of the 17 individual tests of the SIPT
discriminated between the typical and atypical group and can be interpreted individually. Predictive
validity is established with the SIPT predicting learning in reading and math better than the IQ measure
(Kauffman) used in this study (Parham, 1998). Additionally, numerous studies have been conducted
looking at the relationships between tests indicating patterns of sensory integration difficulties (Ayres,
1989; Mailloux, et al, 2011; Van Jaarsveld et al, 2015).

Child scored in the average or high range range on all 17 tests. Because Child is older, scores that fall in
the average or low average range are not easily interpreted however scores that fall below -1.0 are highly
significant given that he is compared to children several years younger than his chronological age. While
there is a risk of false positives, meaning that areas of difficulty might be missed by not comparing him to
his own age group, the presence of low scores would be highly significant.

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 Space Vis
Figure-Gro
Sensory Reactivity: Child’s mother reported some problems in the area of hearing and touch
responsiveness. She also indicated some problems with social participation and definite dysfunction with
planning and ideas. His teacher reported typical scores.

Man. Form P
SPM Home Form Classroom Form
Raw T- Interpretive Range Raw T- Interpretive Range
Score Score Score Score
Social Participation 23 63 Some Problems 17 52 Typical
Vision 15 59 Typical 7 40 Typical
Hearing 16 67 Some Problems 7 43 Typical
Touch 19 64 Some Problems 8 44 Typical
Body Awareness 12 52 Typical 7 42 Typical
Balance and Motion 13 51 Typical 9 40 Typical
Planning and Ideas 25 70 Definite Dysfunction 10 40 Typical
Total Sensory Score 82 61 Some Problems 42 40 Typical

Ki
Visual Perception
Reactivity: On the SPM, Child’s parents and teacher reported typical visual responsiveness.
Discrimination: Child scored in the above average range on space visualization, a mental rotation test and
on figure ground perception.
Visual motor skills: Child scored in the significantly above average range on design copying. He received an
above average score on constructional praxis, manual form perception and motor accuracy test. On the
Beery he scored in the average range on the VMI, visual perception and motor coordination subtests.

Finger Ide
BEERY Raw Standard Scaled % Age Description
score Score Score Equiv.
VMI 28 99 10 47% 16:0 Average
Visual Perception 28 94 9 34% 15:0 Average
Motor Coordination 28 93 9 32% 15:0 Average

Gra
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 Auditory-Language Processing
Reactivity: On the hearing section of the SPM, his parents reported some problems and his teacher
reported typical auditory responsiveness. Child always seems easily distracted by background noises
such as a lawn mower outside, an air conditioner, a refrigerator, or fluorescent lights. He frequently
seems disturbed or intensely interested in sounds not usually noticed by others.
Receptive: Child scored in the typical range on the praxis on verbal command test that requires following
two-step unfamiliar verbal instructions.

Tactile Perception
Reactivity: On the SPM his parents reported some problems with tactile responsiveness and his teacher
reported typical scores. Child frequently becomes distressed by the feel of new clothes and having his
nails cut. He seems bothered when someone touches his face.
Discrimination: Child scored above average on localization of tactile stimuli, finger identification and
graphesthesia which requires tactile spatial processing needed during graphomotor tasks.

Vestibular Processing
Vestibular-ocular responses: Child had a typical duration of nystagmus following rotation, although his
responses were inconsistent. After each trial he smiled and laughed. Following the 4 th trial, he stated he
was feeling dizzy and his head hurt. Child told examiners he sometimes gets car sick.
Postural Control: Child scored in the typical range on the standing and walking balance test. He was able
to assume and sustain positions of flexion and extension against gravity. He completed alternating
forearm movements (diadochokinesia), finger/thumb opposition, and the finger-to-nose test with
accuracy. On the SPM his parents and teacher reported typical balance and motion.

Proprioceptive Awareness: Child scored in the typical range on kinesthesia. On the SPM his parents and
teacher reported typical body awareness. During clinical observations, Child performed slow, graded arm
movements with good control.

Gross motor skills: Child scored in the above average range on the bilateral motor coordination and
sequencing praxis tests. He was able to disassociate head, arm and trunk movements during Schilder’s
arm extension test and completed dynamic bilateral activities with accuracy such as jumping jacks.

Praxis: Child scored in the above average range on postural praxis, oral praxis, sequencing praxis, and
constructional praxis. He received a typical score on praxis on verbal command. On the SPM his parents
reported definite dysfunction and his teacher indicated typical planning and ideas. He performs
inconsistently in daily tasks, fails to perform multi-step tasks in proper sequence, and has difficulty
imitating demonstrated actions. He tends to play the same activities over and over.

Social Skills: On the SPM his parents reported some problems with social participation and his teacher
reported typical scores. On the ABAS, his parents reported a below average social composite score.
Child is inconsistent in his ability to interact appropriately with parents and significant adults, take part in
appropriate mealtime conversation, and fully engage in family outings such as dining out or going to the
park. In the school environment, Child sometimes works as part of a team or is helpful with others.

Executive Functions: On the BRIEF-2, Child’s parents and teacher reported concerns with executive
functioning skills including shifting, initiation, working memory, planning/organizing, and organization of
materials. His parents also reported poor task-monitoring. Executive functions include judgment,
attention, organization, and problem solving, thought organization, sequencing, prioritizing, follow-
through, decision making, creativity (i.e., generating new ideas, coming up with options for life problems),
concentration, and abstract thinking. Teenagers with deficits in executive functioning often need
additional adult supervision to ensure their safety and task completion.

BRIEF -2 Parent Form Teacher

T scores greater than 65 are Raw T Score Percentile Raw T Score Percentile

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considered significant Score Score
Inhibit 12 52 74% 13 58 87%
Self-Monitor 9 63 93% 8 55 80%
Behavior Regulation Index 21 57 79% 21 57 84%
Shift 19 76 98% 20 87 99%
Emotional Control 11 49 65% 9 49 83%
Emotion Regulation Index 30 62 88% 29 69 94%
Initiate 12 67 93% 11 77 97%
Working Memory 22 77 99% 18 74 96%
Plan/Organize 24 80 >99% 22 78 98%
Task-Monitor 15 73 >99% 13 64 91%
Organization of Materials 15 67 93% 10 68 94%
Cognitive Regulation Index 88 77 99% 74 74 96%
Global Executive Composite 139 72 96% 124 70 94%

Impression: Child is an artistic, personable, and capable teenager. He is interested in graphic design,
drawing, sculpting, and comedy. He has the diagnosis of ADD and a history of depression. At school, he
has trouble keeping up with assignments and often sketches during class. His teachers consider him to
be an intelligent, polite teenager who is difficult to motivate. He requires adult support to keep his
belongings organized, record homework assignments in his planner, and turn in work on-time. At home,
Child can get absorbed in video games and needs encouragement to engage with his family and close
friends. His parents have to constantly remind him to take care of basic needs such as showering,
dressing, and grooming. Per psychological report, Child has poor visual and auditory processing skills. He
is significantly behind in math and reading.

The results of this evaluation indicate that Child has strengths in foundational sensory motor skills
including visual perception, graphomotor skills, visual motor skills, proprioceptive abilities, tactile
discrimination, praxis, movement processing and bilateral coordination. Child’s areas of weakness include
poor adaptive skills including self-direction, and poor executive functioning required for
planning/organizing, initiating tasks, and accessing working memory. Sensory sensitivity to tactile and
auditory information may also impact Child’s ability to sustain attention to tasks. These areas of deficit
directly impact his learning and behavior and his ability to access the curriculum and benefit from his
education.

Sample Goals (Present levels to be determined by the IEP team) in preparation for setting goals and
objectives include but are not limited to:
1. Cognitive Regulation – Child will demonstrate improved cognitive regulation and attention by
demonstrating active participation during 50% of a classroom lesson (e.g. contributing to class
discussions, writing notes, completing worksheets, etc.) in at least 2 classes per day, provided
training and participation in a mindfulness-based program (including yoga practices if appropriate) to
provide cognitive strategies and tools to support attention, over a 3 week period as measured by staff
observation and data collection.
2. Executive Functioning (Planning/Organization) – Child will demonstrate improved organization
and planning to write at least 1 assignment/activity into the correct location in his agenda during every
class period (e.g. language arts, math) provided no more than 1 cue per class in 4/5 school days.
3. Executive Functioning (Organization of Materials) – Child will demonstrate improved organization
of materials by submitting at least 2 homework assignments per class, per week with assistance as
needed such as creating a homework plan, establishing a color-coded binder/folder system etc,)
provided at least 2 weekly adult “check-ins” during the week as measured by staff observation.

Recommendations: Occupational therapy services are necessary:

a. 30-minutes per week collaboration (direct and consultation) with the OT, student, and IEP team
including educational staff and family
b. Engagement in a mindfulness-based program/workbook with a home program

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 c. Use the Model of Human Occupation (MOHO) theory and approach to occupational therapy
treatment https://www.moho.uic.edu/default.aspx
d. Assessment of progress towards goals is necessary in 12 months

References: The following references provide current research and standards on the use of evidence-
based methods in school-based occupational therapy practice.
1. American Occupational Therapy Association. (2015). Occupational Therapy for children and
youth using sensory integration theory and methods in school-based practice. American Journal
of Occupational Therapy, 69 (Supplement 3), 6913410040p1-19.
2. Bissel, J., Bohman, S., Mailloux, Z., Test, L. (Eds.) (2012). The Guidelines for Occupational
Therapy and Physical Therapy in California Public Schools, Second Edition. California
Department of Education Press: Sacramento, California. 
3. Bodison, S. C., & Parham, L. D. (2018). Specific sensory techniques and sensory environmental
modifications for children and youth with sensory integration difficulties: A systematic
review. American Journal of Occupational Therapy, 72,
7201190040.https://doi.org/10.5014/ajot.2018.029413
4. Miller-Kuhaneck, H., & Watling, R. (2018). Parental or teacher education and coaching to support
function and participation of children and youth with sensory processing and sensory integration
challenges: A systematic review. American Journal of Occupational Therapy, 72, 7201190030.
https://doi.org/10.5014/ajot.2018.029017
5. Pfeiffer, B., Frolek Clark, G., & Arbesman, M. (2018). Effectiveness of cognitive and occupation-
based interventions for children with challenges in sensory processing and integration: A
systematic review. American Journal of Occupational Therapy, 72,
7201190020. https://doi.org/10.5014/ajot.2018.028233
6. Schaaf, R. C., Dumont, R. L., Arbesman, M., & May-Benson, T. A. (2018). Efficacy of
occupational therapy using Ayres Sensory Integration®: A systematic review. American Journal
of Occupational Therapy, 72, 7201190010.
7. Schoen, S.A., Lane, S.J., Mailloux, A., May-Benson, T., Parham, L.D., Smith Roley, S. & Schaaf,
R.C. (2018). A Systematic Review of Ayres Sensory Integration Intervention for Children with
Autism. Autism Research, 1-14. DOI: 10.1002/aur.2046
8. Watling, R., Miller Kuhaneck, H., Parham, D., & Schaaf, R. C. (2018). Practice guidelines for
children and youth with challenges in sensory integration and sensory processing. Bethesda, MD:
AOTA Press.

Referrals:
1. Provide opportunities for Child to access creative arts classes and programs
2. Provide a study period each school day for Child to receive staff support and monitor/track his
academic assignments
3. Assistive technology evaluation

Accommodations during Learning Activities: Offer frequent opportunities to move outdoors as

needed to support his alertness and attention throughout his day.
 Ergonomically appropriate seating with good lighting when doing seat-work
 Alternative/flexible seating and option to stand rather than sit as needed
 Provide movement breaks as much as possible including whole-class dynamic exercise, walking
breaks, extra time on the outside
 Break down information into manageable chunks to help him complete assignments more
independently
 Use visual checklists when possible
 Use technology/apps to provide reminders for writing down homework, collecting books/binders,
bringing items home for homework
 Encourage engagement in (or creation of) clubs that are of interest to Child
 Use positive behavior supports such as Mindfulness training which shows excellent outcomes

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ACTIVITIES WITHIN THE HOME AND COMMUNITY

Building Skills:

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 1. Provide Child opportunities for physical activities in which he can build strength and stamina.
2. Allow Child the independence to problem solve through challenges that arise while providing
assistance when needed. This can help boost his self-esteem while improving his ability to learn
new tasks more independently.
3. Use visual supports and lists to help understand and remember the sequence of actions
expected within the daily routine.
4. Check off lists to monitor progress towards completion of necessary tasks.
5. Consider taking on one adult chore per week and mastering it by practicing every day before
moving onto the next one. These tasks such as dish washing, laundry, and trash will likely seem
boring, but building these habits allows you to increase your speed of executing them, making
them go much faster.
6. Take time to visualize what you’re going to do to help plan ahead.

Cognitive-Regulation:
7. Mindfulness activities are found to be quite helpful. See the work of Dr. Richard Davidson.
8. Increase time outdoors in nature such as hiking, walking on the beach, and gardening
9. Engage in physical activities every day and more than one time per day whenever possible,
including pacing/running which you know will make you feel better.

Building Resiliency
10. Research has shown that people who are healthy and happy develop friendships and maintain an
active life-style throughout life.
11. Build a support network of friends and colleagues who understand and accept idiosyncrasies in
others.
12. Practice flexibility. Every day doesn’t always go as planned. Make the decision to let it go and
move onto the next wonderful part of life. “Go with the flow.”
13. Challenge yourself to do things that are a bit anxiety provoking. You may discover that you like
these activities and if not, you don’t have to keep doing them. If you don’t try, you won’t know.
Also, stay open to the fact that sometimes things don’t go well and you may need to give it
another try.

Traveling in Community
14. Plan ahead when traveling with maps for knowledge of the area including the location of parks or
waterways that might be quiet, relaxing, and beautiful.
15. Prioritize what you’re most interested in when on trips with family and friends, allowing you to
have a bit more control of the events/conversation.

Healthy Habits and Routines

16. Build healthy habits and routines with the way you decide to spend your time that will sustain you
for a lifetime including eating, sleeping, friends, work, and entertainment.
17. Plan your day to include a restorative space for respite when necessary. This includes letting
people around you know that you need a quiet space to rejuvenate yourself.
18. Take time each day to listen to others. It won’t always be as interesting as what you’re learning
by yourself, but it will provide insights into people, some of whom may become your best friends.
19. Reflect on the highs and lows for the day and what might make things could go better the next
day
20. Participation in the performing arts such as music and drama classes or visual arts.
21. Develop the routine of engaging in a physical activity that makes you feel better once you’ve
done it such as yoga, hiking, kayaking, swimming or rock climbing. You won’t always feel better
starting it, look at the results.
22. Join in extra-curricular community-based activities that you enjoy such as music, dance, painting,
pottery/clay and acting.

Susanne Smith Roley OTD, OTR/L, FAOTA Aja Roley MA, OTR/L

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Licensed Occupational Therapist Licensed Occupational Therapist

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