Dynamic Seating : Improving Engagement Susan O. Rivelli, MBA, OTD, OTR/L An Evidence-Based Occupational Therapy Intervention Chatham University, Pittsburgh, PA Contact: [email protected] SETTING & BACKGROUND Living Life to Its Fullest! LITERATURE REVIEW OUTCOMES The Critically Appraised Topic Portfolio Average Time Engaged Middle School Participants Search Terms Used: ASD and Dynamic Seating Alternate Seating Sensory Modulation Stability Balls in Education (Webster Public Schools, 2013) Located in south central Massachusetts Approximately 1,800 student Elementary School: Preschool through Grade 2 Middle School: Grades 3-6 2 Classrooms for students with Autism 2 Special Education Teachers, 4 Behavioral Technicians PIO QUESTION Does the use of dynamic seating improve engagement in school-aged children diagnosed with autism? Comorbidity of sensory modulation disorder with ASD, and the high prevalence of sensory modulation disorder within this population (Ben-Sasson et al., 2008; Tomchek & Dunn, 2007) Individuals with ASD have a 40-80% chance of having a co-morbid Sensory Processing Disorder (Baranek, 2002, p. 398) DESIGN & IMPLEMENTATION Engagement was defined as “…when the student is orientated towards the appropriate classroom activity such as instructional materials, activity, or teacher and either interacting with the materials, responding to the speaker, or looking at the speaker” (Schilling & Schwartz, 2004, p.427) Average Time Engaged Post-Intervention Teacher Questionnaire Question Strongly Disagree Uncertain Agree 90% 89% 81% 65% 61% 59% 57% 55% 44% 43% Strongly 38% Disagree 37% Agree 29% Therapy balls are a safe 60% 40% accommodation to use in (3) (2) The goals of the 40% 60% intervention were clear (2) (3) 25% my classroom. Baseline Intervention Withdrawal and easily understood. Using dynamic seating as 60% 20% 20% an accommodation (3) (1) (1) Average Time Engaged Elementary School Participants presents a distraction to other students. I would recommend the 20% 80% use of this (1) (4) I plan to continue to use 80% 20% dynamic seating as an (4) (1) accommodation to other teachers. accommodation in my classroom Average Time Engaged “Every Classroom, Every Student, Every Day” 25 articles dated from 2002 – 2013 1 randomized control trial 2 meta-analysis 5 systematic reviews 16 single case studies 1 qualitative study 91% 90% 83% 85% 81% 73% 66% 48% 40% 35% SIGNIFICANCE TO OT All participants diagnosed with Autism Spectrum Disorder BRIAN Baseline Addresses the underlying sensory needs of a child diagnosed with ASD Assists the school-based occupational therapist in providing classroom strategies to enhance alertness for learning in all children Supports child in their role as student within the context of the classroom Adds to evidenced-based interventions used within the classroom for children diagnosed with ASD Completed the Sensory Processing Measure: Main Classroom Form on all participants with the assistance of classroom teachers and behavioral technicians (Kuhaneck et al., 2007) First two weeks- participants used standard classroom chairs, second two weeks- participants used therapy balls for seating Elementary School Participants: 10 minutes during 1:1 direct teaching Intervention JARED Withdrawal SUMMARY Evidence is mixed regarding the use of therapy balls to improve engagement in children diagnosed with ASD Results highlight the need for standardized assessments and protocols needed in the treatment of individuals with ASD Qualitative results demonstrated agreement with classroom personnel that therapy balls are a safe, easy to use accommodation within the classroom setting Two classrooms, eight participants six data collectors Middle School Participants: 10 minutes during morning calendar group DAMIEN Use of Dynamic Seating to Improve Engagement in School-Aged Children Diagnosed with Autism Susan O. Rivelli, OTD, MBA, OTR/L Contact: [email protected] Session: PO1059 The purpose of this Evidenced-Based Occupational Therapy Project was to determine the effectiveness of using therapy balls as chairs on engagement in eight school-aged children diagnosed with autism spectrum disorder (ASD). Each participant was also assessed using the Sensory Processing Measure to determine if patterns of sensory processing had an effect on outcomes. Baseline data were collected on engagement while sitting on a standard classroom chair. During the intervention phase, participants sat on therapy balls. Although results were mixed, use of the therapy ball appeared to have a positive effect on engagement for many participants. For others, poor postural stability seemed to impede engagement while seated on the ball. The participants’ specific pattern of sensory processing did not appear to effect engagement. The results highlight the multi-faceted diagnosis of ASD. These children have both unique and extreme reactions to sensory input, as compared to their typically developing peers. It also emphasizes the importance of using clinical judgment when recommending sensory motor accommodations for use with this population. References Bagatell, N., Mirigliani, G., Patterson, C., Reyes, Y., & Test, L. (2010). Effectiveness of therapy ball chairs on classroom participation in children diagnosed with autism spectrum disorders. American Journal of Occupational Therapy, 64(6), 895-903. doi:10.5014/ajot.2010.09149 Baranek, G. (2002). Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders, 32(5), 397-422. National Autism Center. (2009). National standards project-addressing the need for evidence-based practice guidelines for autism spectrum disorders. Randolph: National Autism Center. Pfeiffer, B. A., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Reasearch Scholars Initiative Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, 65(1), 76-85. doi:10.5014/ajot2011.09205 Schilling, D., & Schwartz, I. (2004). Alternative seating for young children with autism spectrum disorder: Effects on classroom behavior. Journal of Autism and Developmental Disorders, 34(4), 423-432.
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