with
organizational skills, poor in-class participation, and difficulty with written
expression tasks. The focus of the evaluation was the development of an
occupational profile -- what Hunter sees as meaningful tasks, what are
expected tasks, and current and historical performance of those tasks. The
occupational therapist gathered information using the Child Occupational
Self Assessment (COSA). Based on Hunters responses on the COSA, the
occupational therapist also used the Adolescent/Adult Sensory Profile, the
AIR Self-Determination Scale, and the Casey Life Skills Education High
School Self Assessment. In addition to the standardized assessments, the
occupational therapist also used skilled observation, parent and teacher
report, and a review of records to complete the evaluation.
Hunter is a 17-year-old adolescent 10th grader who enjoys thinking about
science problems, cooking meals, and taking care of members of his family.
He does not currently have any medical diagnosis but reports a suspected
traumatic brain injury as a child. Hunter lives with his grandparents and
spends the weekends with his mother. He has half-siblings whom he did
not meet until recently. Hunter and his mother report that he is
independent with all basic ADLs, he is able to cook meals independently,
and he is able to use public transportation independently to access
shopping and recreational activities in his community. Hunter attends an
alternative high school due to difficulties he experienced when he attended
his boundary school. Hunter reported that the number of people at the
comprehensive high school was overwhelming. He would get angry just
walking down the hallways and that he was suspended for going into a
rage last year. Hunter reports that he struggles to complete schoolwork
and values taking care of his grandparents and working after graduating
from high school.
His teachers report that Hunter struggles to complete work and does not
engage with peers in the classroom. For example, in cooking class,
although he enjoys cooking, Hunter was observed to disengage from
working with the other three students in his group, sit down in his assigned
seat away from the kitchen, and put his head down. When the teacher
attempted to redirect Hunter back to the kitchen, he refused to engage in
conversation with her. Hunter has not received occupational therapy
before this evaluation. He has received special education services primarily
in the areas of communication, reading, writing, math, and
social/emotional or behavior.
Hunters scores indicate that he has lower sensory registration than most
people and he rated 7 out of 15 items as frequently or almost always.
Items that Hunter rated as frequently or always less sensitive to include:
I trip or bump into things.
I miss the street, building, or room signs when trying to go
somewhere new.
I get scrapes and bruises but dont remember how I got them.
I dont seem to notice when someone touches my arm or back.
It takes me more time than other people to wake up in the morning.
I dont notice when my name is called.
Several of these opportunities naturally occur in traditional high school
classrooms, which may affect Hunters performance. When a student has
low sensory registration, he may miss important cues in the environment.
Noticing pertinent information on a chalkboard/white board, alerting to
cues to pay attention (e.g. when someone calls his name or touches his arm
to gain his attention) and concentrating for a 50-minute period without
missing important auditory or visual information are all skills affected by
Hunters self-reported lower sensory registration.
The Casey - Education High School Assessment was used to understand
Hunters perspective on those skills he does not feel he has mastered. It
also provides insight into how supportive he perceives the adults in his life
are to his educational needs. Hunter responded mostly yes and yes to
the following percentage of items in:
Goals 60%
School Environment 93%
Home/Community 100%
Study and Technology 86%
Basic Skills 66%
Motivation and Participation 66%
Relationships 85%
Hunter reports that he knows which classes he needs to take to graduate, he
can name at least one career that interests him, and he can identify an adult
who will support him in achieving his goals. He reports that his school is a
safe and friendly place, he feels treated with respect at school, and that the
counselors at his school seem to care about him. Hunter identified that he