Treatment strategies for OT's and SLP

What are 4 take home treatment strategies and rationale that SLP’s and OT’s can apply given the literature and discussion from the blog?  OT’s and SLP’s  can compliment each other’s therapy in many ways!  It is always nice to have an extra set of hands, ears,  as well as eyes!  Also, (as the old saying goes) “two brains are better than one”!  Our students with an ASD are complex people and never present the same.

1.       Categorization:   As we have learned and according to a study by Gastgeb (2006), person’s with autism have difficulty categorizing and this greatly impacts how information is processed. What a super way to incorporate language while sorting different items!  This adds an additional component to maintain attention while using an augmentative device or speech to communicate. 

2.       Attention: As studied in the article by Wang (2007), attention is the key factor in determining performance of tasks with individuals with ASD.  Wang suggests that while people with ASD are capable of global processing, they have a marked preference to local processing. (Wang, Mottron, Peng, Berthiaume, & Dawson, 2007).  Therefore, during co-treatment, therapists are able  to use language to encourage processing and understanding parts and the whole!  For example, while an OT works on dressing skills, a SLP may use an iPad to show and discuss ALL of the items needed to get dress for school.  This difficulty looking at the whole picture or weak central coherence results in a “disjointed internal social world” ( Miller-Kuhaneck ,3rd edition ).  A co-treatment could also include social scenarios’ to help socially while also addressing the need to process globally.   

3.       Sensory processing:  By co-treating with a SLP, you can simultaneously "attack" the sensory system to help organize and prepare a child for the components that a speech therapist is working on.  Providing appropriate oral motor stimulation helps to improve the ability to tolerate a variety of touches, textures, tastes and smells.  This can better  prepare for feeding and communication.   Appropriate sensory input also helps to increase or decrease arousal levels and puts a child in a more optimal state for learning.  This is needed to reach the goals of the OT and SLP (retrieved from: http://www.pediastaff.com/blog/tag/sensory-processing-disorder/page/3).

4.       Motor planning:  Perception is a major contributor to successful motor-planning.  Intersensory integration of visual, vestibular, and proprioception inputs guide motor execution ( Miller-Kuhaneck ,3rd edition ).  If a child has poor awareness throughout their body  they are going to have a much harder time coordinating their mouth muscles as well. To effectively communicate, a child needs to attend, maintain control of their body, and understand where their body is in space. Postural control is also regulated by the information that the vestibular and proprioceptive systems sends to our muscles. This can and does affect a child’s ability to use their breath support muscles for speech.   Providing movement can increase sound production and is frequently reported from the speech therapist I work with as a nice side effect with some children! While improving body awareness and motor planning (which includes the muscles of the face and mouth), the ability to imitate actions, sequences, and sounds will also improve. (retrieved from: http://www.pediastaff.com/blog/occupational-therapy-and-speech-therapy-why-we-need-each-other-2378).   Motor control as well as the ability to register an auditory event are affected by “the use of a feedback rather than a feed forward mode of control” (Schmitz,2005).  So by combining a motor event with auditory input may allow the child to better process the information and be able to feed forward  with the task in the future.   

Occupational and speech therapy are intimately linked as well as the  reasons for treatment strategies.  For example while bouncing on a therapy ball during a co-treatment and working on speech goals, a sensory component is being added, vestibular/proprioception input for better motor control, as well as improving attention.   Another wonderful benefit of co-treatments is the ability to incorporate the goals of the SLP as well as the OT.  This carries over into individual treatments as well!