Scenario

Associate Name: Doreen Hunt

Name of the organisation: Children Therapy Centre

Gender: Male

Age: 5 Years old with autism, developmental delays, and attachment challenges.

Background:

Thomas is 5 years old and was adopted at the age of 9 months from a developing country where he spent time in an orphanage and foster care. He suffers from attachment challenges, autism and global developmental delays, and was a very angry, inflexible detached and neurologically disorganized boy when you met him a year ago. He has done several ILS (Integrated Listening System - ILS) focus programs intensely in the clinic - combined with the home program and has made beautiful changes from them. Presenting Problem: Thomas displays behavioural dysregulation and auditory processing difficulties. Anxiety with change or unexpected transitions. He has poor social engagement with his brother or peers, obtains brief eye contact and has no two-way communication.

Therapeutic Goals:

Improve self-regulation and ability to engage in the purposeful activity (play, learning/pre-academic); Increase happiness and positive interaction with others.

• Improve Social Engagement and Communication
• Improve Fine Motor and Visual Motor development
• Improve Visual Perceptual skills
• Improve Visual tracking, eye-hand coordination

ILs Program Used:

• Safe and Sound Protocol (SSP).
• Thomas has completed the Sensory Motor, Concentration & Attention, Reading & Auditory Processing in the past.
• He seemed an ideal candidate for the SSP, so he completed the program during a break between ILs programs.

Summary of Changes: BBC Sensory Scales: Auditory Processing - Primary Caregiver Version

This tool assesses behaviours related to auditory processing. Responses are on a 4- point Likert scale (4=Almost Always; 1= Almost Never) Question Answer Pre Post

QUESTIONS	ANSWERS
Pre	Post
How often does your child hold his/her hands over or plug his/her ears?	2	1
How often does your child seem overly aware, distracted, or disturbed by continuous noise in the environment (for example, TV, stereo)?	4	1
How often does your child take a long time to respond when spoken to, even to familiar voices?	4	2
How concerned are you about the above behaviours?	Very Concerned	Moderately Concerned

Parents' Comments: Thomas' mother wrote a grateful letter describing her observations since he completed the SSP.

A few highlights are:

- Thomas is now communicating on a deeper and more emotional level

- His language, intonation and eye contact have all improved

- He can think more clearly and connections are made more quickly

Below are segments from the three-page letter:

"At times, over the last month and a half, I have asked myself if I am making this up. If somehow the changes I've observed are the result of wishful thinking. They are not. Something is changing in the connections he is making. The awareness of the world around him. The stress level of interactions with people and his environment....

The biggest change I see is that he wants to communicate. Not just ask for things, but communicate. He has always been an affectionate child. But now he seems aware that we want love from him as much as he wants it from us. It's like bits of his brain can make connections now whereas before there was only static... I believe this program allowed him to rapidly make connections that were lying dormant in his brain. That information that was stored can now be accessed easier or simply accessed. Something changed. Things we had been working and working on are suddenly there at a greater rate. That I am sure is real."

Therapist's Comments:

Thomas is more 'connected to others and teachable'. He greets familiar people unprompted; he is quiet instead of constantly talking about the information racing through his "noisy brain". He will now sing along, and count along to 20 (mostly accurately) and can name most colours correctly. His attention span has increased and he'll engage positively in activities requiring visual motor, fine motor skills and puzzles (instead of screaming "NO!"). He is happy, smiles frequently and is able to transit easily between activities.

Conclusion and Recommendations:

Thomas' response to the SSP was very positive. And the progress he has shown in the areas of physiological state, behavioural regulation and social communication has affected his engagement in the world around him, his family and his classroom community.

Thomas will continue with Occupational Therapy and ILs Focus Programs. He is currently doing the Reading and Auditory Processing Program for the 2nd time. He has very good "body organization" skills (balance, motor planning). He loves to skip, throw and catch balls (except for delayed visual fixation and tracking skills); He rides a 2-wheel bike with training wheels.

Section 3: Specific Issues

You are required to report on how you checked for and responded appropriately to specific issues.

Client
With regards to this client, were there any developmental issues that needed to be reported. If not, describe an example where this would be the case and your workplace procedures.
Were there any indicators of any other issues for this client. If so, describe them. If not, describe example indicators of other issues.
What workplace procedures relevant for reporting specific issues. This should also include mandatory reporting requirements. What are the importance of reporting accurately and with the required level of detail. Make sure that all the documents you submit (including this Portfolio) show that you can report accurately and with the level of detail required.
	Attach evidence of your work with this person here. Evidence may include: Diary entries of conversations or meetings Minutes of case conference or meetings Case management plan Correspondence Forms