Cole, 4-year-old boy diagnosed with Autism Spectrum Disorder. His parents report he experiences difficulties with attention and impulsivity. Cole has challenging behaviors and is severely anxious, but soothed with sensory play. He displays avoidant symptoms, has restricted interests, and self-stimulates daily. Cole also has social and communication deficits and is currently non-verbal. 
Goals
Long Term Goal
Short Term Goal
In 6 weeks, Cole will transition during daily routine activities, with verbal cueing using the first/then communication board, for 2 out of 5 daily opportunities, for seven consecutive days, as reported by caregiver/parent, for improved transition of daily routines
References
Model: SETT
Student: Deficits in Functional Communication
Environment
Task
Tools
Approaches to Intervention
Functional areas of concern: inability to functionally communicate, unable to participate in structured educational activities, difficulties participating in activities of daily living (ADLs), such as brushing teeth, brushing hair,
Interests and preferences: sensory stimulating activities, such as the chair swing, ball pit, platform swing, and squeeze balls
Current Abilities: Able to undress to prepare for bathing, participating in bathing with moderate assistance with washing hair and body
Arrangement: parents/caregiver and therapists will be responsible for the communication board folder and the first/then sheet.
Support: Cole has a therapy room in his house, specifically used for tutoring and sensory play with therapist/parent/caregiver.
Materials and Equipment: tooth brush, hair brush, chair swings, T-bar swings, medicine, tooth paste, tactile balls, sensory tables, ball pits, squeeze balls
Access Issues: Cole does not always have access to desired occupations due to lack of functional communication
Attitudes and Expectations: Family would like Cole to be able to transition from play exploration to ADLs without an outburst.
Establish
What SPECIFIC tasks occur in the student’s natural environments that enable progress
toward mastery of IEP goals and objectives? Cole has a private teacher that comes to his house three times a week along with an occupational therapist that comes once a week.
What SPECIFIC tasks are required for active involvement in identified environments? Cole needs to be able to functionally communicate his desires and preferences in order to fully participate in daily activities. Cole also needs to be able to transitions between tasks without having an outburst.
Cole currently is unable to communicate in his natural environment and is experiencing difficulties establishing a daily routine. The OT intervention will focus on establishing a routine through the use of a communication board. The communication board will also provide Cole with independence and a voice.
In 12 weeks, Cole will transition during daily routine activities, independently, with verbal time reminders, for 3 out of 5 daily opportunities, over seven consecutive days, as reported by caregiver/parent, to improve transition of daily routines.
Zabala, S. J., Ed. D., ATP (2005). Using the SETT framework to level the learning field for students with disabilities. [PDF]. Retrieved from: http://www.joyzabala.com/uploads/Zabala_SETT_Leveling_the_Learning_Field.pdf
A daily schedule will be created using a low tech communication board with representational pictures. When transitioning from one task to another, a first/then board will be used with the representational pictures used on the daily schedule.
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68 (Suppl.), S1-S48. http://dx.doi.org/10.5014/ajot.2014.682006
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Group: Valerie Sanderson, Stephanie Lundy, Soina Sandhu, Alexa Monita