Cognition/Action/Perception/Modulation

Module 4: Cognition/Action/Perception

Jake is a very bright individual, and functions a high level. However he struggles with abstract processes. i.e. if he is presented with pictures representing a frog or muffin and followed with the question of "what would you eat?" he freely chooses the frog. Jake does not understand that we are talking about meals, perhaps he is thinking of playtime. Miller-Kuhaneck (Chapter 5) describes occupations as a set of actions performed with intent. These occupations must be motivating to Jake, if they are going to be pursued. Our next tx session would be to find out what Jake like to eat for breakfast and present him with a picture of "breakfast food he enjoys" versus a frog and see if he makes a better choice. If we can identify and share an occupation that is meaningful to Jake, then we should be able to decrease many of ASD behaviors.

Individuals with ASD process information differently then typically developing children (Miller-Kuhaneck 2004). This difference makes us as therapists change the way we look at occupations and design tx on a more understandable level. Discrete Trial Training (Miller-Kuhaneck 2004) could prove as one intervention style. Jake struggles with dinner time and eating. This is assessed daily through mealtimes at home. His tx is to begin table setting activities during clinic. Jake also has a behavior of attachment to objects(fishing poles, candy canes, etc). We have him set the table with one plate, one cup, one napkin etc. for each person. He is making progress with this. Initially he wanted all the cups and plates for him. He will share when prompted. This behavior could also be effecting his limited social building skills. The attachment to objects could be seen as selfish and other children may not want to play with him or engage in social activities. Jake does enjoy constructional play (blocks, puzzles).

ASD individuals struggle with occupational reframing (p. 94). If Jake is better able to balance the need to have all the toys, with the social action of sharing and turn taking, then he stands a better chance at increasing his social acceptance by peers. If Jake is presented with an occupation that is more motivating to him, or we can increase his level of arousal (Lynch PPD, 2009) then there is a greater likelihood that he be able to attend to task longer. Increased attention to tasks will increase communication skills and social interactions and decrease many of the behaviors we have been describing in class.