Angel and Anthony are fun, energetic twins that began therapy when they were four years old. At that time, their mother was concerned with their lack of desire to play with children their own age or participate in daily activities, such as dressing, feeding, bathing, grooming, oral/hand hygiene, and toileting. They demonstrated delays with attention, impulse control, and poor sensory processing/regulation skills demonstrated by seeking out vestibular and proprioceptive input by jumping around, crashing into furniture and people, flapping their hands, and banging their head. Both boys were overresponsive with auditory stimuli, which affected their ability to tolerate sounds, as they would cover their ears at the sound of an airplane or the honk of a horn and avoided crowded rooms. They were picky eaters and were picky with food presentation and avoided trying new foods. Angel and Anthony both struggled with verbally communicating their wants and needs, which increased their level of frustration, and they exhibited frequent behavioral outbursts.
Occupational therapy focused on providing engaging and functional coordination activities as well as sensory processing and emotional regulation techniques to improve their ability to participate in daily tasks with decreased behavioral overreactions. Their therapist provided an array of food opportunities to work on utensil use and expanding their palate to new food choices as well as provide them with the opportunity to take part in making their own food choices. These strategies helped their mom incorporate techniques provided during their OT sessions into their everyday routine, which significantly impacted their level of interest in all daily activities and play.
Angel and Anthony have significantly improved their level of independence with dressing, feeding, brushing their teeth, problem solving, sensory processing, emotional regulation, and verbal communication. They now enjoy getting messy and using their hands to help their mom make food. They have improved their ability to dress themselves for school, wash their hands, feed themselves using utensils, ask for help after attempting to problem solve the task themselves, and taking turns. Both boys have explored a variety of foods and have expanded their palate. They no longer cover their ears and avoid crowds and have demonstrated an interest in playing with other children. Therapy continues to focus on their potential for greater independence.