STUDENT OCCUPATIONAL THERAPY

Treatment Plan

Client’s First Name: Student OT Practitioner: Daniel Ethington

Lucas
Client Diagnoses Supervising Therapist:
ASD BJ

Safety Issues/Precautions: Date/Time of Session:

11/18/2021 @1345

Client’s Current Treatment Goals

1. Within 6 months with min VC Lucas will explore novel foods, including touching, smelling,
licking, chewing and swallowing on 4/5 opportunities
2. Within 6 months, Lucas will add 6 novel foods to his diet with no more than 2 VP for
consumption, consuming foods 4/5 opportunities

Reflect upon your last treatment session and answer the following questions:
1) What went well: Client was cooperative and engaged in therapeutic activities. He only required
minimal cueing and redirects
2) What did not go as planned: Client needed the food therapy activity to be graded down. He would not
initate handling non-preferred foods until they were placed on the cutting board for him.
3) What will you change this week, based upon what you learned last week? Next session I will give
client direct commands instead of asking him if he wants to do an activity
Areas of occupation to be addressed:
☒ ADL/Self Care
☒ IADLs and/or Graphic Communication
☐ Education
☐ Rest and Sleep
☐ Work and Employment
☒ Play & Social Participation

Client Factors to be addressed in this session:

(These should apply to your goals above and be the steps needed to reach that goal)
Attention to having his name called
Sensory tolerance to novel foods through taste and touch and addressing sensory seeking needs
through vestibular and proprioceptive input.
Responds appropriately to peers in social situations
Social interaction- using appropriate level of eye contact and composure with switching between
activities
Emotional regulation- client is able to switch from one task to another without demonstrating
maladaptive behavior
Additional comments or thoughts:

Intervention Overview
List 1 Overarching FOR or Practice Model you will PEO- This model guides therapy through the lens of
use this week and why. understanding how the client interacts with his
occupation in the context of his environment.
 STUDENT OCCUPATIONAL THERAPY
Treatment Plan

PEO addresses how the client diagnosis affects his

social interaction with his caregivers during dressing,
self-feeding within the context of his sensory seeking
behavior.

List 1-2 additional FORs you will use this week to
guide your practice and why.
1. Sensory Integration Model- This model
incorporates sensory integration into therapy.
With the client being sensory seeking, the
therapist will incorporate sensory regulation
into activities to increase the level of
participation of the client.
2. Social Participation Model- This model uses
therapeutic play to guide client to acquire age-
appropriate social participation skills into
therapy.

Intervention Plan
Materials Grade the Grade the What Describe how
Activity & and activity Up activity UNDERLYING this activity
# of Minutes Equipment down SKILLS are addresses the
Needed you addressing client’s goals
with this
activity?
Obstacle Crash Two large Increase time Decrease time Sensory seeking This addresses
Course Activity (15- Bean Bags and amount of and amount needs via sensory seeking
minutes) and 10 feet pressure of pressure proprioceptive needs of the
of runway in applied from applied from input client, and
Client will run and the main the bag the bag increases
jump into the large room emotional
bean bags. Then regulation
therapist and/or during
parent folds the bag remaining
into client, giving minutes of
him pressure to his therapy
joints and muscles

Cognitive Behavioral Book of Decrease Decrease Sensory This activity is

Food Therapy (30- stickers preferred food non-preferred tolerance to non- designed to
minutes) options and food options preferred foods present the
Preferred increase and increase client with
Using a book of Foods: non/less preferred opportunities to
stickers as a reward Pretzels preferred food food options tolerate
for eating both Goldfish options non/less
preferred, less Crackers preferred foods
preferred, and non- options in with
preferred foods. Less a cognitive
Preferred behavioral
Begin with a Foods: reward system
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Treatment Plan

preferred food item. Chicken

One at a time, and Nuggets
small portions. When
client he finishes a Non-
small portion,he gets preferred
to choose a sticker. Foods:
Scale to less and non Mashed
preferred foods. Potatoes
Reward every time he Yogurt
eats with a sticker Apple Sauce
reward system.
Food Play Activity Pureed foods Grade up Grade down Sensory The purpose of
with Animal activity by activity by tolerance to non- this activity is
crackers- (15- Vanilla touching and touching and preferred foods to decrease
minutes) Frosting smelling more smelling clients’
non-preferred more aversions to
Activity Instructions: Mashed food items preferred puree foods like
Gather preferred and potatoes than preferred food items mashed
non-preferred foods than non- potatoes,
for client to touch at a Oreos preferred yogurt, and
table. apple sauce. By
Animal exposing the
The goal here is to crackers client to the
touch. If client is texture and
willing to taste or eat, Peanut Butter smell, we can
this would be take the next
acceptable Apple sauce steps to kissing,
licking and
Create a plate of eating.
white pureed foods
like cream cheese
frosting, and vanilla
yogurt. Animal
crackers will be
placed flat into the
non-preferred pureed
food. Other crackers
will be placed on the
side for the client to
play with in the food.

This will hopefully

encourage client to
touch the food, and
possibly smell.
Mirror play with
client using the
animal crackers. At
the end of the
activity, client will
remove each animal
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Treatment Plan

crackers from the

foods and throw them
away in the trash.
Sensory Break (5- Platform Increase level Decrease Sensory This activity is
minutes) swing, Bean of sensory level of Regulation used as needed
bag, toy input sensory input to address his
Give client sensory truck. iPad sensory needs
breaks as needed to timer. Example: Push Example: in order to
emotionally regulate. a toy truck quiet time in regulate
If client is upset around the the sensory emotions and
about something, he room fast, room participate in
may need decreased jump and crash therapy
sensory input. If into bean bags
client has a lot of
energy and isn’t
attending to task, this
may require more
sensory input. The
therapist verbally cue
client as to how long
the break will be and
verbally cue him
when there is one
minute left. Have
client turn off the
timer when the alarm
goes off to have
client acknowledge
the break as over
Additional comments, ideas, thoughts:

Parent Education and/or Home Programming Recommendations

1. Make mealtime as playful as possible with preferred and non-preferred foods
2. Use iPad during mealtime and have its set-up across from client so he can see himself eating non-
preferred foods as an animal
3. During dressing, scale down the level of physical assist while maintaining verbal cueing. Be sure to
give positive affirmation when client completes a step independently

Evidence Based Practice Support: Below, list 1-2 research articles you found which support one or more of
your intervention approaches from this week. You will want to be very clear how you used this information to
support your clinical reasoning. Please use APA 7th edition reference list citations when listing your articles.

Article Reference (APA, 7th edition) How does this article support your intervention approach,
activities, and clinical reasoning for the development of this
treatment session?

Barnhill, K., Tami, A., Schutte, C., During the feeding therapy, client was not interested in eating
Hewitson, L., & Olive, M. L. (2016). the puree foods (mashed potatoes, and yogurt) or the chicken

Targeted Nutritional and Behavioral
Feeding Intervention for a Child with
Autism Spectrum Disorder. Case
reports in psychiatry, 2016, 1420549.
https://doi.org/10.1155/2016/1420549
Ausderau, K. K., St John, B.,
Kwaterski, K. N., Nieuwenhuis, B., &
Bradley, E. (2019). Parents' Strategies
to Support Mealtime Participation of
Their Children With Autism Spectrum
Disorder. The American journal of
occupational therapy : official
publication of the American
Occupational Therapy Association,
73(1), 7301205070p1–7301205070p10.
https://doi.org/10.5014/ajot.2019.024612
STUDENT OCCUPATIONAL THERAPY
Treatment Plan
nuggets. Taking the approach of making sure the child is hungry
enough to participate in therapy is important to achieving his
goals. Educating the parents on scheduling meals with an
apporpriate amount of time before therapy to facilitate his
participation, but not so hungry that client becomes grumpy or
unwilling to cooperate.
This intervention approach in the article addresses the behavioral
component of only eating at scheduled mealtimes, thereby being
able to monitor and apply therapeutic interventions addressed in
his goals.
This article supports my intervention approach of using play and
imagination via iPad filters to increase client’s participation in
eating non-preferred foods.
This article uses twelve families with children with ASD (ages
2–7 yr) who participated in videotaped mealtime observations.
Qualitative content analysis was used to identify strategies
families used to facilitate participation.
Six categories were identified: (1) parent intervening and
ignoring, (2) meal preparation and adaptability, (3) play and
imagination, (4) distractions, (5) positive reinforcements, and (6)
modeling. Props—common child objects that support the child’s
mealtime participation—were used in the context of multiple
strategies.
Families used multiple strategies within and across mealtimes,
highlighting the individualistic nature of feeding challenges.
Understanding parent mealtime strategies allows for further
investigation into the efficacy and development of intervention
strategies to promote mealtime participation of children with
ASD.