The occupational therapist has determined that the client has poor grip strength and fine motor control skills.
The occupational therapist has determined that the client has poor grip strength and fine motor control skills. The first part of today’s session is undertaking strengthening and fine motor coordination activities to improve his grip and control using feeding utensils. The session plan is as follows:
Theraputty Activity: therapy putty that promotes finger and hand strength and endurance.
Hide 8 buttons in the putty by stretching and manipulating it until they are all completely hidden. Once all buttons are hidden stretch and manipulate the putty to find and remove all of the buttons.
Padlocks Activity: Fine motor skills and coordination activity.
The box contains 6 different padlocks and keys. The client must find the correct key to unlock each padlock
Spoon and Marbles Activity: Grasp, wrist and forearm control and motor planning activity.
The client is given a bowl with 15 marbles inside and an empty bowl to be placed 30cm away. The client must use the spoon to pick up each marble and transport this to the other bowl without dropping it
3.5 Jonathan was resistant to participation in the Theraputty activity initially but became engaged when you allowed him to choose the buttons that were to be hidden in the putty. He took his time in choosing 8 different buttons and hid these as instructed. He was then able to locate and remove 4 buttons within the first minute using both hands. After the first minute however Jonathan appeared distracted and placed the putty in his lap whilst using only his left hand to search for the remaining buttons.
Provide for Jonathan and his carer:
Constructive feedback of his participation in the activity
Positive reinforcement to encourage Jonathan to complete the task
3.6 Jonathan’s treatment plan states that Jonathan may self harm when frustrated. The Treatment Plan written by the Occupational Therapist has included the following pro-active strategies prevent the occurrence of these behaviours:
Verbally asking the client if he ‘needs a break’ whilst demonstrating the Australian Sign Language sign for ‘break’
Providing appropriate prompting to help the client with the task as required
Scaffolding the task and providing positive reinforcement to allow the client to feel a sense of achievement The Treatment Plan also states that if the client shows physical signs of aggression towards himself or others then the following strategies can be used:
Redirecting the client to a more appropriate behaviour such as the use of sensory calming tools or deep pressure
When there is a risk of harm to himself or to others removing any objects that may cause harm and removing any non-essential persons from the area
Provide four (4) signs that the client might show that he is distressed during an activity?
3.7 During the padlock activity in today’s session you note that Jonathan is showing some of these signs of distress. He is having difficulty remembering which keys he has tried in each padlock, which appears to be the source of his distress. How can you respond to this in accordance with the treatment notes form the Occupational Therapist as noted in question 3.6.
3.8 You have tried to calm Jonathan during the above activity but his frustration escalates and he throws a padlock across the room, narrowly missing hitting his carer. What strategies could be used in response to this situation to minimise the chance of harm to others or to Jonathan?
3.9 When and how is it appropriate to seek advice from the Occupational Therapist for situations where the client or others may be at risk?
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