Sensory Case Study

• Kylie is 4 y.o. girl in regular preschool. She has very few words and a raspy type voice. She sees
a speech therapist in an outpatient facility for her speech apraxia. She is being referred to OT
for motor apraxia. She is hesitant to step off the mats and often holds her arms in high guard
when walking. She refuses to swing or lay or roll in a barrel. For bathtime, mom has her sitting
in a laundry basket where she lays her head back on the rim to wash her hair. She scrunches up
her face and contracts her body when mom is washing her body and her hair. She does not
throw tantrums but used to when she was little. She hates tags in her shirt and prefers to wear
long sleeves and pants. She has smaller hands and poor ability to use a spoon without spilling.
She can poke food with a fork. She cannot operate scissors and shies away from anything but
coloring. She uses a static tripod grasp to color. She uses a pronated fisted grasp to eat. She
can imitate a circle but has poor closure, and every attempt looks different. Once she gets it,
she forgets it the next session. She is a very quiet, shy girl that is very sweet. She enjoys being
with people and enjoys coming to therapy. She tries very hard and wants to do all the activities
to please the adults, but she will start to cry if pushed too hard. Mom’s best way to console her
is to pick her up, cradle her and stroke her hair while Kylie sucks her thumb.

• Kylie’s short term goals are as follows:

• Kylie will demonstrate decreased gravitational insecurity as evidenced by allowing her

head out of upright for at least 30 seconds, at least twice during a session, ¾ days.

• Kylie will demonstrate increased core/trunk strength and body awareness as evidenced
by walking across an unstable surface without hands in high guard position, and no LOB,
¾ days.

• Kylie will demonstrate increased tool use as evidenced by using a tool to scoop and
dump a play material into a bucket without spilling, 75% of the time, over 2 days.

• Kylie will copy a circle with closure and no more than ¼” gap, ¾ times, over 2 days.

1) Take a look at Kylie’s PDMS-2 and SP2. Make a video of yourself describing Kylie’s results on
the SP-2 to mom. You can do this on CarmenZoom and record to the cloud.

Link to your video: Kylie Sensory Profile Explanation

2) Create one intervention activity for Kylie that would address at least 2 of the above short term
goals (yes in one activity-you can do it!)

5-10 steps:

1. At the start of the activity Kylie will go grab a toy dog (with wheels on its feet) that has a long
leash attached from the dog house. The dog will be at the back of the house and shoulder level
with Kylie so that she has to put her head down to go in, and keep it down for the duration of
the time she is inside.
 2. Kylie will grasp the leash and pull the dog behind her as she walks across to the “grocery store”
display to get a dog bone.
3. Kylie will keep ahold of the leash, pulling the dog with one hand and holding the bone in the
other as she takes the dog for a walk.
4. Kylie will start on the ground and walk on a straight line – outlined with brightly colored tape on
the ground.
5. Kylie will then step up and onto an elevated Lily-pad path that vary in height with each step.
6. Kylie will complete the path (approximately 5 different steps) without losing balance or letting
go of the dog’s leash or bone.
7. Kylie will then squat down while maintaining good trunk control to feed the dog the bone.
8. The activity may be repeated with another dog, or the same if time and supplies permit.

What 2-3 specific objectives are you watching for to determine if this is a just right challenge for Kylie?

1. Kylie will demonstrate decreased gravitational insecurity as evidenced by allowing her head out
of upright for at least 30 seconds, at least twice during a session, ¾ days.
a. Watch Kylie as she goes in the dog house to make sure she keeps her head down, but
also stays calm and unaffected by the action while doing so. If she tenses up or
becomes scared and upset, the challenge is too difficult for Kylie.
2. Kylie will demonstrate increased core/trunk strength and body awareness as evidenced by
walking across an unstable surface without hands in high guard position, and no LOB, ¾ days.
a. Watch Kylie as she walks up and down through the Lily Pads, walking close behind if she
were to fall, but wanting her to be able to maintain good posture and balance while
walking and keeping her hands down to hold the items (out of high guard). If she brings
her hands up or loses balance, the challenge is too difficult for Kylie.

How would you grade/adapt this activity to make it the just right challenge, keeping the objectives you
want in mind?

To grade the challenge up, you could add more Lily pads or increase the height of them. You could also
remove the items from her hands and ask her to hold them out as if she were a ballerina to grade the
balance objective. To grade the task down in regards to the same objective, you would only give her
one item (a lighter one like maybe two dog bones), or decrease the number and height of the Lily pads.

To grade the challenge up in regards to head position, you could put the dog farther back and put the
bone in a separate “house” where she is required to keep her head down. The Lily pads could
technically be put underneath a lower ceiling to promote this as well, but it runs the risk of interfering
with her posture this way. To grade the activity down for the same objective, you could move the dog
forward in the house, or just have her duck under a short beam to retrieve it.

Why did you choose this activity for Kylie?

I chose this activity for Kylie because she is at a stage where imaginative/role play is starting to emerge,
but also because I remembered doing activities like this around her age and enjoying them. Without
knowing many of Kylie’s interests it was sort of free-range with the activities, so when I thought of play
scenarios that promoted the objectives, the activity just came together. That being said, they are also all
common preschool objects that may already be familiar to Kylie, so she may be more willing to engage
with them/the activity. It could also be used to help with her grasp by indicating she hold the leash and
bone a particular way if we wanted to prepare for spoon use as well.