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Case Study: Aryaman. Age 12 Years. Treatment: Autism Spectrum Disorder (ASD)

 

Aryaman a 12 year boy with Autism Spectrum Disorder (ASD) was referred to Saksham for Occupational Therapy and Sensory Integration to reduce his hypersensitivity. He has been attending Day Care facility at Saksham since past 3 years.

Aryaman is a high functioning, verbal Autistic who showed to be hypersensitive to changes in schedules or newer events such as a delay of 5 minutes in pick-up time, changes in weather, a change in therapist or class, or a new student in class-room. He had problem in communicating with peers and showed aggression in response to neglect from them or to any mistake on his part as he did not understood the way to communicate sorry. Aryaman never initiated conversation and rarely made eye contact with other individuals.

With therapy Aryaman has slowly learnt to control his temper and shares his needs and concerns when asked upon. Aryaman during these years has been exposed to Social Stories to help him suit to various social situations such as classroom behavior, behavior at a mall or in a park or in school van, daily routines and pre-exposure to situations that need to occur in the near future has made him easy to cope up with changes in the schedules.

Aryaman has been exposed to sensory experiences such as Brushing on arms and legs to reduce hyperactivity, and various Brain Gym Exercises to improve his mental functioning. Also, therapy aimed at improving communication abilities to establish better relationships with his peers & feel less frustrated during daily interactions with other people. Aryaman was also trained for various Activities of Daily Living Skills such as Feeding and Toileting. Now, Aryaman has developed a tendency to sit patiently and independently performs certain tasks allotted to him in his classroom.

He has also improved upon his command following abilities. Aryaman now rarely shows aggression when notices a new face or when in a crowded place. He has as well improved upon his eating hypersensitivity and now completes his lunch or snacks offered to him. He now expresses his toileting urge. Aryaman is now trained to improve upon his communication skills, reading ability and mental functioning.

 
Case Study: Kartik, Age 11 Years. Treatment: Autism Spectrum Disorder (ASD)
 

Kartik a 11 year old boy with Autism Spectrum Disorder was referred at Saksham around 3 and a half years back for his hyperactivity, self-injurious/self hitting behavior, head banging, biting, no eye contact, social isolation and inability to sit in a place. Kartik is a nonverbal Autistic child. In his initial months at Saksham, Kartik showed hypersensitivity to light touch and favored moving or spinning objects, rotational objects and glasses to spin. Kartik used to run from a place to another and was usually Bunny-hopping, or was on toes.

Kartik was introduced to various sensory experiences of which he favoured Brushing or a towel rub, swinging in a hammock, bouncing on a therapy ball. Brushing on his feet improved Kartik’s ability to gain sensations in a better way from ground and now he places his foot properly on the ground when he walk, but now also has a tendency to remove his shoes during certain times however he doesnot remove his socks. As Kartik learned his sensory needs, he used to gain those sensory experiences on his own such as bouncing on ball for long times but these made him even more worse as he would over-stimulate himself beyond the requirements of his Sensory Diet.

Slowly, Kartik learnt to Sit and transfer objects from a container to another which would take him around half an hour earlier to transfer 4-5 blocks and now he would even pick a whole lot in 2-3 minutes. He was gradually introduced to Water Play as a medium to Sensory activities.

Kartik slowly progresses to improved seating behavior. Kartik was then trained in Activities of Daily Living skills starting with Dressing and now he is able to aid his mother in Dressing such as lifts and moves his arm into the shirt or lifts his pants up. Kartik was then trained for Eating and now is able to feed himself independently but spills his food and asks for food when hungry.

Kartik has now become potty trained and takes his parents to toilet when feels an urge, but has no control over his urination needs. Kartik now follows commands such as get your shoes or bag, go sit on your seat, wait don’t run, eat your food, etc. Kartik when on a vacation enjoys outings and has become easier to manage. He is now able to sit and watches a movie for around 2 hours.

Kartik at Saksham is currently trained for Tooth Brushing, Ball Activities, and being provided sensory experiences to improve mental functioning, reduce self hitting despite other goals.

 
Case Study: Pawan, Age 5 Years. Diagnosis: Cerebral Plasy
 

Pawan , a 4 year old boy with hypertonicity (Cerebral Plasy) came to Saksham 2 1/2years back for his lack of sitting, standing or walking, , inability to speak, inability to understand & follow commands. He was referred to Physiotherapy and Occupational Therapy Clinic at Saksham.

His therapies included slow brushing and slow bouncing over ball to inhibit hypetonic muscle fibres. Stretching exercises for improving flexibility of tight muscles and prevent contractures & deformities. Weight bearing exercises such as Squatting, Quadruped, Kneeling progressing to Half-Kneeling were initiated then Standing by holding a rod or a table. Pawan has slowly progressed to learn independent sitting without fea of fall.. Now he could stand independently ( with KAFO) but needs supervision to prevent fall.

He has been trained for balance activities in sitting and other developmental positions. He was also referred for Special Education where he has learnt the ability to recognize & recall daily use objects on command.. He has also improved in speech and now can call his family members with their respective names.

 
 
Case Study: Honey, Age 2 Years. Treatment: Cerebral Palsy with Gross Developmental Delay
 

Honey a 2 year old boy with Cerebral Palsy with Gross Developmental Delay in speech and motor milestones and a slightly increased tone in particularly right side of the body was referred to Saksham around 6 months ago with complaints of inability to sit, crawl or stand, tightness, drooling and poor speech. Honey was referred to Occupational Therapy Clinic and Physiotherapy Clinic at Saksham.

Honey was provided therapies including Weight Bearing, PNF Patterns, Developmental positioning, Therapy Ball Activities, Balancing, Oral motor activities. In a course of 6 months Honey is able to sit for around half an hour with 2 falls in between, he is able to use his right hand to reach for objects, has reduced tightness, improved ability to control saliva and frequently uses words such as ma, papa, dada, bua, aao, chachaji, etc.

Honey can imitate certain feelings and expressions. Honey is currently undergoing the above mentioned therapies at Saksham.

 
Case Study: Kopal, Age 25 Years. Treatment: Hearing impairment and behavioral concerns
 

Kopal a 25 years old girl with hearing impairment and behavioral concerns was referred to Saksham 8 months ago. Her Behavioral issues were the major concern of her parents that included hitting in the eyes of any ongoer, head-banging, self-hitting, locking doors, shouting, inability to sit on a place for minutes. Kopal was very obese and obsessed with food. She also faced gastric problems due to over-indulgence with food. She was on medications Serenace 1.5 mg 1 tab morning-evening to control her hyperactive behavior.

With Behavior Therapy and scheduling of her meals and routine Kopal has been showing great improvements. Her hitting behavior has reduced to 10% of her actual behavior that too when unable to express her needs, distressed or is having some pain. Her weight has been reduced owing to Treadmill and physical activity she is being exposed to. She has become much active and is even capable of running.

She now performs productive tasks while seated on a place. Her medications have been reduced to ½ tab Serenace morning-evening. Kopal still is undergoing Behavior Therapy for some unresolved issues and Special Education for improving communication skills.

 
Case Study: Rachit, Age 23 Years. Treatment: Infantile Hemiplegia
 

Rachit a 23 years old boy with Infantile Hemiplegia (Right Side) and Behavioral issues is attending Day Care facilities at Saksham since 3 ½ years. Rachit was obese, hyperactive child and used to make mess at public places such as throwing stalls, fighting, screaming at home, hitting parents and brother and showing other such behavioral problems. Rachit was also dependent for his ADL’s on his parents.

At Saksham Rachit’s Behavioral issues were addressed first. Then he was referred for Physiotherapy and Occupational Therapy (ADL Skills Training). Then he was referred for Special Education. Rachit has been trained in Bathing and Dressing however he still remains dependent on his parents for these needs due to Behavioral and Time issues. He does Dressing when there is need. Rachit is able to utilize his right hand in daily activities and does not neglect it now.

Rachit has even improved on Gait and its parameters. Rachit has formed basic concepts of reading, writing and calculations. Rachit is now a very quiet child and doesnot scream or fight at school, home or even in public places. Rachit is currently undergoing Physiotherapy and Special Education at Saksham.

 
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