Case Study: Ally

Therapist: Angela Kyprianou

Issues & Programs

• Developmental Delay
• Sensory Defensiveness
• Emotional Regulation
• Sensory Integration
• DIR/ Floortime

What were the problems?

Ally (not her real name) was initially seen when she was 2 and a half years old. Her parents requested an assessment as they were absolutely at their wits end. They knew that inside their daughter lived a beautiful child but had rare glimpses of that child.

Ally’s typical day was spent screaming. Screaming at people looking her, screaming when she moved, screaming when someone new came to the house, screaming when she didn’t get her own way, screaming when she was moved to a different room of the house, screaming when her hair was being washed, screaming when water hit her face, and screaming during nappy changes.

Ally’s assessment and subsequent sessions were so overwhelmingly terrifying for her that within 20 minutes of the session she would fall into a deep sleep. This was a shutting own. Her coping strategy of dealing with a very frightening world.

Ally had severe sensory defensiveness which affected almost every part of her life. She had defensiveness to touch, sounds, visual stimuli, and was terrified of any movement. Walking 5 steps from the front door into the gym would require 20 minutes, constant screaming, and eventual shutdown (ie sleep).

What did Angela do?

• Sensory integration treatment, and the Wilbarger therapressure protocol were implemented to address the sensory defensiveness.
• Parent education was vital to allow her parents to understand the causes underlying her behaviours and for the coping strategies Ally used.

What did her parents do?

• Consistent attendance to Occupational Therapy every week to fortnight
• Consistent application of the Wilbarger Protocol, sensory diet and arousal strategies
• Integration of strategies learned in therapy in everyday life.
• Environmental set-up for movement activities at home

Outcomes

Over the period of a year involving continuous treatment, Ally was able to have a bath and tolerate water hitting her face; tolerate having her hair washed with minimal complaints; she was able to accompany her mother to the shops and actually enjoy the outing; she recommenced playgroup; and most importantly she began connecting with her family. The family was able to go on outings as a family unit without fear of what might cause Ally distress and start another screaming marathon.

Ally is now able to move more confidently over different surfaces. Her mother states it is amazing to see her daughter at 3 and a half years of age wanting to climb tables. Sensory defensiveness has been significantly reduced and it is wonderful to see this vibrant and affectionate child come to life.

Where to from here?

Ally has recently recommenced OT following a 7 month rest break, to address socio-emotional issues and to prepare her for pre-prep.