Sensory Integration Dysfunction Case Study

Student Name: Michael

Student Age: 4

Therapist: Angelika Brocklehurst OTR/L, Achievement Therapies LLC

NeuroNet Program used: Early Learning Program

Student's background prior to NeuroNet

An August 2010 doctor’s report included history of Oromotor Dyspraxia, Auditory Sensitivity, Articulation Disorder, Developmental Language Delay, and Heavy Metal Toxicity which had improved with prior therapeutic interventions. Current diagnoses include Sensory Integration Dysfunction, Metabolic Disorder, and Developmental Coordination Disorder. Michael was receiving Speech Therapy 5 days a week and Occupational Therapy once a week. His delays first became evident at age 2 when he had not begun to talk.

Symptoms or circumstances that led the student to NeuroNet

When he began pre-school in August 2010, teachers expressed concerns to the parents regarding apparent delays in fine motor skills and pre-writing skills compared to his same age peers.

Parent Concerns

Parent concerns prior to beginning the program were related to delayed fine motor skills and decreased interest in fine motor, pre-writing, drawing and coloring skills. He resisted and was unable to participate in these types of activities for any length of time. There were also concerns regarding his ability to join peers in play at the playground. He was clumsy and would often bump into things, even the playground equipment, or trip over his own feet, because he appeared to not always be aware of his environment. He was fearful and apprehensive in new environments or on new playground structures. Ball skills, including catching and throwing were difficult.

Results of Initial NeuroNet Evaluation

NeuroNet Early Learning Motor Patterns pre-test score – 1.63.

In this NeuroNet pre-test measure, a four to four-and-half year-old is expected to achieve a criterion score of 3.0 or higher. Michael's pre-test score indicated that he was having significant difficulties performing many of the functional movement patterns required of pre-schoolers. Michael had difficulty moving separate parts of his body independently of others, especially for more complex movement patterns. Differentiation of body parts is an important school readiness skill for tasks like writing and cutting (move upper body only, while keeping lower body still on the seat), reading (only move eyes), and copying from the board (move head, but not body). He also exhibited decreased awareness of the parts of his body which he could not see, and did not have a good idea of the position of different parts of his body in relation to each other and in space.

Gains since beginning NeuroNet

After participating in the Early Learning Program, parents and teachers reported the following improvements:

All respondents reported improvements in coloring and handwriting skills. His father and teacher also reported improvements in his willingness to share, be helpful, and be kind. His mother reported improvements in number concepts and completing simple chores. Dad reported progress in understanding and following directions, taking care of personal possessions, and in fine motor skills. His teachers saw improved auditory memory and auditory analysis but a decline in how well he paid attention.

Michael’s mother reported that his teachers said his fine motor skills are now at grade level. He is more willing to color, paint, draw, and write letters. Michael shows more responsibility in completing his daily exercises and is proud of his own progress. This has also increased his confidence.

Michael’s father reported improvements in his participation in the basketball team. He is learning the basic concepts of the game, such as offense and defense, and is able to shoot the ball into the 6 foot rim. He sees an improvement in Michael’s meaningful play and interactions with his younger sibling. His father also noted a change in handwriting and an increased interest in coloring over the past 3 months.

Results of the Post Test

Michael’s Early Learning Motor Patterns post-test score was a 3.67, or a gain of 2.04. In this NeuroNet post-test measure, a four-and-half to five-year old is expected to achieve a criterion score of 3.5 or higher. Michael met the criterion cut-off indicating that his functional movement patterns may be within the average range for his age. Michael's significant gains resulted in movement patterns which appear more goal-directed and less incidental. His sense of directionality has also solidified. Michael still showed a relative weakness in performing more complex motor patterns at a functional speed.

After the program, he achieved a scaled score of 9 on the visual motor skills section and a scaled score of 7 on the fine motor skills section of the Miller Function and Participation Scales (M-Fun). Both scores are within the average range for his age.