Background Meet the Participants Special school based research - PDF document

Paper presented at WFOT 2014, Yokohama, Japan 19 June, 2014 Carolyn Mills Literature Review • Extensive reporting presence of sensory difficulties in ASD (Iarocci & McDonald, 2006; Ben-Sasson, Hen, Fluss, Cermak et al, 2009, Ashburner, Bennet, Rodger & Ziviani, 2013; Tomcheck & Dunn, 2007) • Difficulties in occupational performance resulting from sensory issues (Ashburner, Ziviani & Rodger, 2008) • Limited studies on classroom based sensory intervention (Case-Smith, Weaver & Fristad, 2014; Lang et al 2012) • Children with ASD have ID up to 70% of the time, different Classroom based sensory intervention for children with autism spectrum needs to those with ASD alone (Matson & Goldin, 2013; Matson & disorders (ASD): A pilot study using single system design Shoemaker, 2009) Caroline Mills Chris Chapparo 1 2 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) Background Meet the Participants • Special school based research Name Age Sex Diagnosis M 7 y 10 mo Male Autistic Disorder, moderate intellectual • Children with ASD, ID, autism specific special school in disability, severe language delay Sydney B 5 y 7 mo Male Autism spectrum disorder, intellectual disability Research Question: What is the impact of a Sensory Activity Schedule L 6 y 3 mo Male Autistic disorder, moderate intellectual disability (SAS) on task performance and cognitive behaviours in children with ASD in a classroom setting? C 6 y 8 mo Male Autistic disorder, moderate intellectual disability 3 4 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) Method Referral and Assessment • Single System AB design: non-concurrent, multiple baseline • Referred to School OT for reduced participation Phase A (Baseline) Phase B (Intervention) • Teacher reported: ‘Off task’ behaviour - sensory seeking Best practice teaching for ASD Best practice teaching for ASD + (Curriculum, structure, routine, Sensory Activity Schedule (SAS) or sensory avoiding function, frustrated, fixed in routine visual supports) • Short Sensory Profile (McIntosh, Miller & Shyu, 1999) findings • Teacher designed desk work tasks were rated including cutting, summary: All total scores showed definite difference sticking, put in tasks, puzzles and matching. (underresponsive/seeks sensation, auditory filtering, visual/auditory • sensitivity, tactile sensitivity) Sampling of class task performance was videotaped by school staff 5 6 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) 1

Paper presented at WFOT 2014, Yokohama, Japan 19 June, 2014 Carolyn Mills Intervention- Sensory Activity Schedule (SAS) Method • Between 11 and 18 videos were rated using Perceive, Intervention • Administered by teacher’s Recall, Plan and Perform (PRPP) Stage One and Two aide and teacher. Bouncing on a therapy ball, tight lycra, deep touch pressure Analysis for each student (Chapparo & Ranka, 2005) • Morning session- after Jumping on a mini-tramp, deep touch • Videos were randomly ordered and scored by researchers morning circle, before desk pressure work. • For each student, Phase A (Baseline) and Phase B Squashing with a bean bag • Used classroom based (Intervention) performances were compared. Rolled over a therapy ball, equipment • Students were not compared to each other. Jumping on a mini tramp and crashing • 10-15 mins into cushions, shoulder squeezing, tight lycra 7 8 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) Perceive, Recall, Plan, Perform (PRPP) Intervention- Sensory Activity Schedule (SAS) Queensland DET Guidelines (QLD DET, 2011): • Two stage standardised criterion referenced • Based on the ‘sensory diet’ (Wilbarger & Wilbarger, 1991) assessment • Activities are encouraged at specific times • Stage One uses • procedural task analysis Enable occupational performance to determine level of • expected skill Terminology should be clarified • Stage Two uses • Brushing (Deep Pressure Proprioceptive Technique) was cognitive task analysis and measures cognitive not used (Wilbarger & Wilbarger, 1991) strategy application in • the context of task Participants were not targeted for sensory performance defensiveness (Chapparo & Ranka, 2005) 9 10 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) Data Analysis- PRPP Stage One Results M Performance Mastery PRPP Stage One Errors • Outcome Measure- PRPP 100.00 Put in Task 95.00 Stage One: Procedural task Sit down 90.00 analysis for teacher 85.00 Take plastic bottle Percentage Score designated desk work tasks 80.00 Take bottle cap 75.00 in the classroom. Place in bottle X 70.00 • Steps containing errors were 65.00 Take bottle cap 60.00 recorded Place in bottle Phase A- Baseline 55.00 Phase B- SAS Intervention • Put bottle in finish tray Percentage of error free X 50.00 1 2 3 4 5 6 7 8 9 10 11 Task Performances performance was calculated ERROR FREE- 5/7 71.4% p=0.038, p<0.05 Two band standard deviation method (Ottenbacher, 1986) 11 12 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) 2

Paper presented at WFOT 2014, Yokohama, Japan 19 June, 2014 Carolyn Mills B Performance Mastery L Performance Mastery 100.00% 100.00 95.00% 95.00 90.00% 90.00 85.00% 85.00 Percentage Score Percentage Score 80.00% 80.00 75.00% 75.00 70.00% 70.00 65.00% 65.00 60.00% 60.00 Phase A Baseline Phase B SAS Intervention 55.00% Phase B SAS Intervention Phase A Baseline 55.00 50.00% 50.00 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Task Performance Task Performances p=0.01, p<0.05 p=0.502, p>0.05 13 14 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) C Performance Mastery Results Summary PRPP Stage One 100.00% Child Stage One Task Mastery Result Statistics* 95.00% 90.00% Phase A (Baseline) Phase B (Intervention) 85.00% 69.5% 82.64% p=0.038** M 80.00% Percentage Scores 75.00% 86.67% 95.88% p=0.01*** B 70.00% L 81.32% 84.39% p=0.502 65.00% 60.00% C 85.2% 98.18% p<0.001*** 55.00% Phase A Phase B 50.00% *Two tailed, Independent Samples T test (confirmed by Mann 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Whitney U statistic) Task Performances ** Significance at the 0.05 level, *** Significance at the 0.01 level p<0.001 15 16 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) Discussion Discussion • 3 out of 4 showed improved task mastery following a • Teachers can be trained to do the intervention • Intervention designed with teachers classroom based SAS as measured by Stage One PRPP • Qualitative feedback from teachers confirmed • Why was intervention effective for 3 out of 4 children? statistical results • A targeted opportunity to meet a child’s sensory needs • PRPP is a suitable tool to use to measure task contributed to better self regulation prior to completion mastery in context of work tasks in the classroom. • Ecologically suitable- teacher set tasks • L’s results were not significant - baseline not stable, • Small pilot study, many limitations trend lines showed improvements • Real life research • L needed a longer baseline 17 18 Autism Spectrum Australia (Aspect) Autism Spectrum Australia (Aspect) 3