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Ashton’s diary - September 2019

05/09/19

OCCUPATIONAL THERAPY SESSION SUMMARY

Name:

Date of Session: People Present: Location:

Ashton Groves 05/09/2019 Ashton, Viryan, Liz Home

Long Term Goals:

1. Ashton will be able to come up with ideas to initiate play with his sisters and peers, and have the confidence to interact and engage with others.

2. Ashton will achieve toileting independence. Currently he is developing the skill to identify that he needs to go to the toilet and needs adult assistance for toilet timing. This is progressing well.

3. Ashton will use strategies to regulate his emotions when engaging in challenging activities.

4. Ashton will develop his gross motor strength and coordination.

5. Ashton will be happy and comfortable in his home and preschool environment.

6. Ashton will develop his school readiness skills of tool use (drawing, scissors, glue etc) and following tasks on an adults agenda.

Session Goals:

- Facilitate engagement for whole session.

- Progress complexity of play sequences and themes.

- Extend participation in adult led table top tasks for visual motor / fine motor / early learning.

- Introduce emotions using face tokens.

Activities to Facilitate Goal Achievement:

• Predominately child led session with stations of activities set up in therapy space.

• Encouragement of FIRST and THEN to encourage activity completion. Ashton required frequent redirection to table top activity today.

• Cutting & Pasting toy story. Ashton was initially interested in this activity, replicated from dinosaur / bug cutting activity completed recently. Ashton was motivated to cut out his preferred characters and requires only occasional prompts for scissor positioning and paper stabilising. He was not motivated to complete the activity by pasting the pictures onto a background scene and needed several heavy work breaks and redirection to come back to table top.

• Money Box. Ashton was motivated to explore the money box and dinosaurs today. He was not motivated to look at the emotions cards and disengaged quickly when his focus was directed to them.

• Painting ceramics. Provided as an option however not motivating today.

• Dinosaur dot to dot. Provided as an option however not motivating today.

• Jumping Frogs. Ashton was motivated to explore the frogs however disengaged when increased structure was added (e.g. use your pointer finger to make them jump).

• Heavy work. Ashton was more disorganised in his play and activity levels than during recent sessions. He was very clearly seeking out proprioceptive feedback by climbing on couch, squeezing self between cushions, standing on head & climbing under blankets. He responded really well when firm pressure was applied to his back, and calmed - requesting ‘more squash’ several times. He also responded very well to joint compressions, requesting ‘squeeze elbows’; ‘squeeze legs’ when I stopped and waited for a response / permission to continue. This is the first time Ashton has verbally asked for this in a session - which likely means he is recognising activities that help him feel calm and organised.

• Blow toys. Ashton demonstrated some lovely back forwards blowing with lip whistles. He makes such beautiful visual engagement during simple activities like this, and was able to engage in ‘turn taking’ blowing different rhythms. His body was very relaxed during this respiration activity.

• Pretend play. A short pretend play session today. Ashton demonstrated some quality play with his train track for a short period of time.

Homework:

• Continue focus on pincer grip strengthening in play - pinching and poking with pointer finger where possible.

• Continue encouragement of supported turn taking at daycare and with siblings.

• Continue pretend play sessions, always challenging ideas and adding in themes where you can.

• Lots of heavy work over the next few days - squeezes, blowing toys, digging in the sand, running on the beach.

Plan:

Next session 8am 7th September - Temple.


















06/09/19

Speech with Tania

On the way to speech Ashton was upset and he said “How about we... How about ... “ I said how about we what Ashton, how about we...”and Ashton finished by saying “ how about we go to the animal park ?” I said “we can’t today we are going to therapy to see Tania.” Ashton got very upset by screaming no to therapy . Did not want to get out of the car... amazing he says how about when giving me a request as this is attentative (giving close and thoughtful attention) language , a polite way of asking without demanding. Ashton hasn’t been able to access this kind of language to explain what he wants to do before now.

Once we got there he was happy .

Wonderful collaborative play session today making a dragon with a head and a tail and spikes on his back. Sharing ideas and acting out the story of the angry bear.










07/09/19

O/T with Liz

OCCUPATIONAL THERAPY SESSION SUMMARY

Name:

Date of Session: People Present: Location:

Ashton Groves 07/09/2019 Ashton, Viryan, Liz Home

Long Term Goals:

1. Ashton will be able to come up with ideas to initiate play with his sisters and peers, and have the confidence to interact and engage with others.

2. Ashton will achieve toileting independence. Currently he is developing the skill to identify that he needs to go to the toilet and needs adult assistance for toilet timing. This is progressing well.

3. Ashton will use strategies to regulate his emotions when engaging in challenging activities.

4. Ashton will develop his gross motor strength and coordination.

5. Ashton will be happy and comfortable in his home and preschool environment.

6. Ashton will develop his school readiness skills of tool use (drawing, scissors, glue etc) and following tasks on an adults agenda.

Session Goals:

- Facilitate engagement for whole session.

- Progress complexity of play sequences and themes.

- Extend participation in adult led table top tasks for visual motor / fine motor / early learning.

Activities to Facilitate Goal Achievement:

• Predominately child led session with stations of activities set up in therapy space.

• Encouragement of FIRST and THEN to encourage activity completion. Ashton required some redirection to table top activity today however once engaged in each activity - he was able to stay with it for about 5 minutes.

• Lycra Tunnel. Ashton was interested to take his lego pirranah creation into the tunnel, however was hesitant to crawl through. He walked through the tunnel whilst I held it up, more like a sock.

• Bowling. Ashton was able to add pretend play into bowling task once given an idea. He used the medicine ball as an asteroid, and then meteorite to knock over the ‘alien’ bowling pins. He was able to complete this game 4 or 5 times, helping to set up the pins on the last go. He seemed to really enjoy using & benefit from the heavy ball. He enjoyed sitting on this ball at other times during the session as well.

• Bean bags & bucket. Ashton engaged briefly in this game, catching ‘sea grass’ bean bags and throwing them into a big bucket with the pirannah lego creation. He was able to throw the bean bag about 2m with his right hand (unsuccessfully getting it into the bucket). He had a good success rate of throwing bean bags into the bucket when standing about 1m away. He was able to accurately name all shapes and colours.

• Osmo Masterpiece. Ashton completed 2 x drawings using this app. He required prompting to hold his pen with his fingers rather than his whole hand. He was most interested in the sea creatures today, and was able to add claws, eyes and what looked like eyelashes to a circular crab that he drew.

• Pretend play. Pretend was incorporated into the whole session today as Ashton moved through activities. He was not interested in including farm yard props in the play, preferring to explore how they worked. He was able to follow suggestions for play scripts throughout (e.g. get in the boat (bucket)); meteorite bowling ball; beanbags as seaweed; paint and shaving foam as volcano lava.

• Shaving Foam & Paint. Ashton was very motivated to explore the shaving foam visually today. He was able to touch it a couple of times however was most interested in watching how it blended with paint colours. This activity promoted great verbal engagement and motivation to engage socially. Ashton mastered the fine motor components of this task well (opening paint tubes, squeezing paint tubes, manipulating bugs to stamp them). Wonderful to see Ashton motivated to complete a craft activity amongst this sensory experience!

Homework:

• Continue focus on pincer grip strengthening in play - pinching and poking with pointer finger where possible.

• Continue encouragement of supported turn taking at daycare and with siblings.

• Continue pretend play sessions, always challenging ideas and adding in themes where you can.

• When you are practicing pen / pencil activities with Ashton, try to encourage him to hold the pencil in a mature grasp with his fingers.

Plan:

Next session 8am 12th September - Temple.






Ashton after his session with Liz we sat and he built LEGO




09/09/19

Ashton in the morning playing with me and his sea creatures.. wonderful interaction and making up play scenarios.



12/09/19

Occupational session

OCCUPATIONAL THERAPY SESSION SUMMARY

Name:

Date of Session: People Present: Location:

Ashton Groves 12/09/2019 Ashton, Viryan, Liz Home

Long Term Goals:

1. Ashton will be able to come up with ideas to initiate play with his sisters and peers, and have the confidence to interact and engage with others.

2. Ashton will achieve toileting independence. Currently he is developing the skill to identify that he needs to go to the toilet and needs adult assistance for toilet timing. This is progressing well.

3. Ashton will use strategies to regulate his emotions when engaging in challenging activities.

4. Ashton will develop his gross motor strength and coordination.

5. Ashton will be happy and comfortable in his home and preschool environment.

6. Ashton will develop his school readiness skills of tool use (drawing, scissors, glue etc) and following tasks on an adults agenda.

Session Goals:

- Facilitate engagement for whole session.

- Progress complexity of play sequences and themes.

- Extend participation in adult led table top tasks for visual motor / fine motor / early learning.

Activities to Facilitate Goal Achievement:

• Predominately child led session with stations of activities set up in therapy space.

• Encouragement of FIRST and THEN to encourage activity completion.

• Bean bags & hula hoops. Ashton was interested in the hoops briefly, and enjoyed matching the animal shaped bean bags to each hoop by colour. Ashton initiated some pretend play with the hoops, sitting in the ‘pool’ with the animals, but was not overly motivated by this activity.

• Pretend play. Ashton initiated a wonderful pretend play session with the fire truck. He utilised the whole of the living / toy room space in this play and engaged in give and take play for the duration of the 40ish minute play scenario. Play moved between rescuing bean bag animals from the ‘pool’ or up a ‘tree on fire; to bean bag animals and then dinosaurs escaping the exploding volcano; to the dinosaurs using the toilet and bath; to the dinosaurs having something to eat. Ashton came up with some great ideas during play, and was flexible and able to follow my story line when I introduced ideas. He was able to answer ‘yes’, and initiate verbal negotiation in play ‘how bout we....’. He was able to ask for what he needed in play, and actively sought me out as a play partner. He was happy to have his sister join in play and was able to wait short periods whilst she had a turn. He was able to follow the suggestion to take food to his sisters figurine to share in play. Well done Ashton!

• Dinosaur Operation: Ashton was interested in how this game worked. The interest in making the dinosaur shake may take over the turn taking aspect I was hoping to facilitate with this activity, but we will try again next week - with all of the correct pieces.

• Dinosaur stamps: Ashton briefly engaged with the dinosaur stamps. He demonstrates adequate placement strength and control when making stamps on paper.

• Shaving Foam & Paint. This was again a very motivating activity. Ashton requested what he needed for this game and enjoyed squeezing paint on his crocodile. He is still cautious to explore paint and shaving foam with his fingers - using his hand to move my hand into to spread the paint. With encouragement he was able to carefully paint the crocodiles feet and then wash the paint off at the sink. He required prompts to ask to turn the tap on.

A great session overall Ashton, well done!

Homework:

• Continue focus on pincer grip strengthening in play - pinching and poking with pointer finger where possible.

• Continue encouragement of supported turn taking at daycare and with siblings.

• Continue pretend play sessions, always challenging ideas and adding in themes where you can.

• When you are practicing pen / pencil activities with Ashton, try to encourage him to hold the pencil in a mature grasp with his fingers.

Plan:

Next session 8am 19th September - Kanbeki







13/09/19

Tania speech therapy







18/09/19

Ashton putting on his socks in the evening after he had taken them off.

Independence skills.




Language development.

Reading a sea creatures book


Imaginary play.

Ashton acting out the animals .



Self stimulatory behaviour.

Repetition of physical movements or sounds or moving objects.

Ashton needs to release energy after an intense interaction with me where he used a lot of language, connecting socially takes a lot out of Ashton.


Interaction with sibling.

Socially connecting.

Ashton looking at his bugs and interacting with his sister.




Imaginative play.

Ashton reading dinosaur book and pretending he is a T. rex



Ashton pacing - needing to stimulate himself .

Ashton needing to release energy as he has had lots of social interaction and communication with me and with his sister . I ask him if he needs a squeeze which he has been able to ask for for a few weeks now.



19/9/19

Therapy with o/t Liz


OCCUPATIONAL THERAPY SESSION SUMMARY

Name:

Date of Session: People Present: Location:

Ashton Groves 19/09/2019 Ashton, Viryan, Liz Home

Long Term Goals:

1. Ashton will be able to come up with ideas to initiate play with his sisters and peers, and have the confidence to interact and engage with others.

2. Ashton will achieve toileting independence. Ashton has told his parents that he needs to use the toilet on a couple of occasions now.

3. Ashton will use strategies to regulate his emotions when engaging in challenging activities.

4. Ashton will develop his gross motor strength and coordination.

5. Ashton will be happy and comfortable in his home and preschool environment.

6. Ashton will develop his school readiness skills of tool use (drawing, scissors, glue etc) and following tasks on an adults agenda.

Session Goals:

- Facilitate engagement for whole session.

- Progress complexity of play sequences and themes.

- Extend participation in adult led table top tasks for visual motor / fine motor / early learning.

Activities to Facilitate Goal Achievement:

• Predominately child led session with stations of activities set up in therapy space. Ashton was exited and explorative in play today. He was keen to explore all of the toys presented for the session, and took about 10 minutes to settle into his first activity.

• Encouragement of FIRST and THEN to encourage activity completion. Ashton did really well today in finishing adult chosen activities after being re-directed, before playing his preferred activity.

• Dinosaur clay. Ashton was interested in this activity and enjoyed using the cutting tools and both hands to cover the t-rex skeleton in clay. He requested items with occasional prompting. This activity didn’t produce as much social engagement as I was hoping, however so wonderful to see Ashtons sustained interest in completing a craft activity (about 15 minutes).

• Screw Triceratops. This was Ashtons preferred activity, that he wanted to play before the Dinosaur clay. He was motivated to put together the dinosaur and was able to request parts with facilitation. He was visibly frustrated and my task manipulation to encourage social

participation, but was able to stay calm and engaged until the end of the task. Well done Ashton.

• Pretend play. Above 2 dinosaurs & T-rex mouth used in pretend play. Themes not as complex as last session however some lovely social engagement and creativity on Ashtons behalf. Ashton interested in my idea of using BBQ to cook for the dinosaurs & extended this allowing only the carnivores to eat the meat.

• Woodpecker. Set up as a turn taking game however the worms all on display limited the social engagement for this game as Ashton was very interested in putting in and putting out the worms.

• Digging bugs in putty. As always Ashton enjoyed this sensory activity to re-group. He requires prompting to use his ‘pincer grip’ instead of a lateral, or thumb and middle finger grasp.

• Balloon dinosaur / fish. Ashton demonstrated strong and sustained eye contact, spontaneous social engagement and pretending with this activity. He was motivated to initiate conversation with the dinosaur with his dinosaur / crocodile. He initiated lots of requesting to me to blow or let out air. Well done Ashton.

Homework:

• Continue focus on pincer grip strengthening in play - pinching and poking with pointer finger where possible.

• Continue encouragement of supported turn taking at daycare and with siblings.

• Continue pretend play sessions, always challenging ideas and adding in themes where you can.

• When you are practicing pen / pencil activities with Ashton, try to encourage him to hold the pencil in a mature grasp with his fingers.

Plan:

Next session 8am 21st September - Kanbeki


Keeping Ashton on track.

Developing his imagination.

Social interaction.

Language development.


Lots of encouragement needed to To keep Ashton on track. The session with Liz is very interactive and Ashton is socially connected and developing his imagination as he dresses the dinosaur or covers the dinosaur with putty.



Social - Taking turns.

How to reconnect when no interest is shown.

Important to have other interests for Ashton.



Exploring putty.

Communication. Developing his communication by asking questions, example, what is it? and waiting for a response.

Developing concentration.

Staying at a task.



Social play


Intruding on play.


Developing imaginative play.


Developing social interactions.


Initial stages of this play is intruding in Ashtons play to introduce a character to develop social interaction and imaginative play.


When Ashton is not interested in the activity and moves on to another such as a stegosaurus toy Liz takes the parts that Ashton requires to encourage Ashton to ask for the screws for the screwdriver or to ask for help thus developing interaction social connectedness and language.


Modelling play scenarios.


Liz is continually modelling play scenarios for Ashton. As she continues to interact with him with the other dinosaur.


Language development.


Ashton’s language is extended as Liz asks questions regarding the items for the barbecue set.

Introducing a new item such as the barbecue Ashton shows he is excited, first time he has said that he’s excited so great to see introduction of a new activity brings out an excitement inAshton and that he displays this emotion.


Developing imagination.


Imaginative play is developing even more as Ashton feeds the dinosaurs with the items from the barbecue even identifying that the T rex eats meat.



Introduction of new game.


Imaginative play.


Introduces captain America into play.



Blow up animals.


Social connectedness.


Making eye contact.


Ashton giving Instructions.


Asking Ashton what he wants to do and waiting for an answer.



Introducing craft items into this play.


Imaginative play.


Turning the blowup dinosaur into a blue tongue lizard.


Developing new ideas and introducing new ideas to change animals into something else.



Communication

Talking to Liz today about how Ashton doesn’t ask for something from anyone by having the name of the person or the title of the person in front of the question so the girls normally will ask and say, “ mummy can I have a drink”, “ mummy come and see this.”, but Ashton doesn’t. Reading back over the notes in November 2017 he did start to say “mummy look” , but that seems to have dropped off now so I might ask Tania what that means. I’m going to start encouraging Ashton when he has a request to say, “mummy can I have a drink.”


Speech therapy cancelled 20/9/19


Occupational therapy 21/9/19


Gross motor


Scooter board activity.


Animals pegged onto line for use with scooter board.


Develop midline


Gross motor


Extend with hoop to make pretend pond to put animals into when unpegged.



Following child’s lead.


Extend play scenarios add bbq to animals in the pond.



Child directs play.


Dinosaur skeleton with play dough ( putty).


Imaginative play.


Language development


Social connectedness


Eye contact activity ( encourage eye contact by asking questions and not giving the item until child looks at you. )


Fine motor development



Encouraging child back to play


Language


Imaginative


Cognitive


Packing away


Art and craft stamping activity


The tunnel allows Ashton to regroup after he has been involved in social interaction and imaginary play or communication exchanges.


24/09/19


Session at kindy


Packing away


Feeding the lizard


Following instructions


Communication


Engagement


Cutting activity


Fine motor skills



Dinosaur size comparison


Fine motor skills (glueing)


Fine motor skills


Cognitive


Identifying sizes


Ashton coming up with an independent thought to video sandy the lizard


Social and emotional


Feelings identifying


Two way Communication


Matching activity


Reading

Identifying pictures in the book


26/09/19


OCCUPATIONAL THERAPY SESSION SUMMARY

Name:

Date of Session: People Present: Location:

Ashton Groves 26/09/2019

Ashton, Chantelle, Liz Home

Long Term Goals:

1. Ashton will be able to come up with ideas to initiate play with his sisters and peers, and have the confidence to interact and engage with others.

2. Ashton will achieve toileting independence. Ashton has told his parents that he needs to use the toilet on a couple of occasions now.

3. Ashton will use strategies to regulate his emotions when engaging in challenging activities.

4. Ashton will develop his gross motor strength and coordination.

5. Ashton will be happy and comfortable in his home and preschool environment.

6. Ashton will develop his school readiness skills of tool use (drawing, scissors, glue etc) and following tasks on an adults agenda.

Session Goals:

- Facilitate engagement for whole session.

- Introduce obstacle course style games outdoors.

- Turn taking practice.

- Challenge themes in play to mimic peer based play.

- Engage in structured visual motor activity.

Activities to Facilitate Goal Achievement:

• Predominately child led session. Ashton is enjoying exploring the toy bucket and choosing the activities that interest him.

• Scooter board. Scooter board was set up with 2 hula hoops, insects and animals in one, none in the other. Ashton encouraged to help insects get from one ‘island’ to the other by hopping on board the scooter board boat. Ashton was briefly interested in my idea (to transport 1 lot of insects) however he had his own ideas around what the animals should be doing. Ashton initiated play with dragonfly becoming stuck in the cracks between the decking & all the other animals had a go at helping him get out. Ashton was happy to let my animals help too however was quite engrossed in his own story line.

• Ashton was very motivated to play with squeezy paints today. The task set up was to follow a dinosaur dot to dot, and a simple maze. Ashton demonstrated sound fine motor control for this task. He demonstrated he understood the task requirements by commencing the dot to dot VERY carefully however he lost interest in the ‘functional’ aspect of the activity and became

engrossed in squeezing the paint out of the tubes. We were able to turn this into more productive play by painting animals (spots and stripes for the snake); and using the animals as stamps. Ashton seemed tired during this activity, and whilst he attended for a decent amount of time, he was not always 100% engaged. Ashton was very reluctant to use his fingers to spread the finger paint, and chose to use the plastic animals, the paint lid or my hand as a tool.

• Dinosaur operation. Ashton was very interested in this activity, although the rules I set (turn taking & following the spinning board when choosing a body part) may have been too challenging for optimal engagement. Ashton operated the tweezers well, and stayed with the activity for 3 turns each before wanting to engage in more sensory style play (e.g. making the dinosaur buzz). He was able to turn take putting the pieces in by hand, and stay with the activity & help pack up with encouragement.

• Ashton had lots of energy after engaging in structure play for about 40 minutes. The green tunnel was used as a ‘sea snake’ and Ashton had to run and jump over it. He enjoyed this activity and it was a great way to structure his movement seeking. The sea snake then got hungry and ate Ashtons foot. He ran with this idea and enjoyed climbing inside the sea snake to be ‘eaten’. With a prompt, he was able to find other animals the sea snake could eat, and we repeated this activity several times. Ashton was able to follow my intentions in the game e.g. he wanted to put all of the animals in first, and I said, ‘no I like eating little boys better’, he stopped, thought about it, and then climbed in so that the sea snake could eat the little boy.

He then followed my idea that the sea snake was tired after such a big lunch and went to sleep. Well done Ashton! He also incorporated the scooterboard ‘boat’ into this activity, which was great imitation and modelling from our previous game today. He was calm and organised after this gross motor play.

• Rope snake. Varying the sea snake idea, we tied a rope to the fence and played ‘jump over the snake’. Ashton was cautious at first, but enjoyed this game until the rope came loose. This would be a great game to practice as a group activity with the girls.

• When Eddy was leaving in his car, Ashton looked up and said quietly ‘bye dad’.

Great session Ashton!

Homework:

• Continue focus on pincer grip strengthening in play - pinching and poking with pointer finger where possible.

• Continue encouragement of supported turn taking at daycare and with siblings.

• Continue pretend play sessions, always challenging ideas and adding in themes where you can.

• When you are practicing pen / pencil activities with Ashton, try to encourage him to hold the pencil in a mature grasp with his fingers.

• Try to include simple ‘obstacle course’ type play in the daily routine. Now that Ashton is interested in pretending to be animals, it would be great to encourage him to pretend to be the animals that involve upper limb weight bearing e.g. frog, snake, bunny, bear, crab.

• Try out the rope snake game turn taking with the girls.

Plan:

Next session 8am 3rd October - Kanbeki


I was away this session so it was videoed by Chantelle .








27/9/19

Speech Therapy Tania






30/09/19

Play with Ashton’s sisters before bed time . In the girls room playing with barbies and ken doll. Ashton is running around us and making noise and coming up to me a grabbing my hand and saying “ come on mummy “ I have told him I am playing with the girls why doesn’t he join us. The girls are getting some food for Ken as I have suggested he might be hungry . They bring me a small plastic fish, some bananas and a bone.. Ashton is running around us in circles and I say “ Ashton Ken is hungry can you get him something to eat?”

Ashton stops and comes over and leans into the middle where the food is and gets a fish and says “ here is some fish” he puts it in Ken’s hand. I say thank you and Ashton runs off

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