Case Study: Molly

Therapist: Vivienne Williams

Issues & Programs

• DIR/ Floor-time
• Wilbarger Therapressure Protocol
• Therapeutic Listening

What were the problems?

Molly was diagnosed with optic nerve hypoplasia, which meant that she was unable to see at all. She came to Kids Matters at the age of 3 with sensory defensiveness especially to touch and sound. She has an older brother and a baby sister. The sound of her baby sister’s crying was especially difficult for her. Molly had minimal engagement with her family or other people. She also had frequent and prolonged crying episodes for hours at a time. Molly would quickly withdraw when stressed.

Molly had previously seen another OT in Sydney and had been started on the Wilbarger therapressure brushing technique and a modified version of therapeutic listening. Molly enjoyed spinning, mouthing and feeling things with her hands. She had very little interactive communication but spoke clearly and frequently about her world, to herself. There were many functional issues including self-cares, community access and frequent melt-downs.

What did Vivienne do?

• Supporting Mum in the consistent application of the Wilbarger Therapressure Protocol and Therapeutic Listening and helping to integrate this into everyday life.
• Supporting parents with setting realistic goals and problem-solving priorities (such as environmental set-up for safety, access, working with regulation).
• Training Mum in arousal theory, to be a sensory detective and in the DIR/ Floortime framework.
• Direct DIR/ Floortime clinic treatment.

What did her parents do?

• Consistent application of Wilbarger Therapressure protocol for 6 months
• Consistent use of Therapeutic listening CDs for 6 months (only with headphones for about 1 month)
• Environmental set-up/ changes
• Mother completed on-line training for DIR/ Floortime
• DIR/ Floortime for 30 minutes on most days (for past 2 months)

Outcomes

• Molly is regulated more of the time. When she is not regulated, her parents are more aware of techniques and strategies they can use to help her calm. Although she still has extensive periods of crying, these are on average less than before and she has more “good times”.
• Mum is learning to read Molly’s signals and can respond to her more of the time.
• Molly has fallen in love with her mum and actively seeks her exclusive attention.
• Molly and her mum have prolonged periods of fun play with lots of laughter and joy.
• Molly initiates meaningful communication about her needs and wants more of the time (previously never did)

Where to from here?

• We are seeking to strengthen Molly’s regulation, engagement and initiation as the foundations for normal communication and development.
• We will be starting weekly home visits.