A Case Study: Ryan

Ryan, a seven year-old first grader, was referred to me for an OT evaluation due to poor fine and gross motor skills, decreased social competency, and inconsistent performances in the classroom and school environment. His teachers found he was frequently absent on gym days. He maintained little or no peer interaction and exhibited solitary play during recess. When called on to speak out or report in front of the class, Ryan reacted by shutting down.

When I observed Ryan in the classroom, he sat in an asymmetricalposture, fidgeting and making mouth noises. While walking down the hall, Ryan kept his eyes down and his body flexed. He refused to touch many testing items, and refused to touch the floor or assume any posture other than sitting or standing. He scored with a two-year delay in the fine motor portion of the Peabody Developmental Motor Scales. It became evident to me that Ryan was sensory defensive with the resultant motor and social-emotional issues common to this type of disorder.

First, I suggested instituting the Wilbarger Pressure Touch Protocol. It was begun in school the week before Christmas and continued at home. Ryan’s parents reported limited success with maintaining the regime although they noted improvements in his response to transition times and changes in routine. He seemed less irritated overall and able to stay relaxed throughout the day.

Next, Therapeutic Listening® was added to Ryan’s program. He listened to modulated music for a half hour each day in school after the Wilbarger Protocol had been carried out. With the headphones on, he generally engaged in fine motor play using hand manipulatives. He has listened to Ease 1, Ease 2, and Mozart for Modulation.

In just three months, the changes in Ryan have been monumental. Now when he comes to OT, he gives high fives. He doesn’t miss gym anymore and has won an award for most improved performance! At his end-of-year testing, he got right on the floor and assumed full body prone-extension and supine-flexion postures. His fine motor skills have improved by one year. We’ve also seen interactions with peers and he recently presented an oral report to his class. He has become a sensory input seeker, his favorite toy being the 15-foot spandex tunnel. Ryan has begun a joyful and playful childhood!

- Jodi Taylor, OTR