Angela Lassiter Capstone Proposal FCS 487 Spring Autism Spectrum Disorder and Developmental Disability Sensory Coping Box

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1 Angela Lassiter Capstone Proposal FCS 487 Spring 2018 Autism Spectrum Disorder and Developmental Disability Sensory Coping Box

2 Autism Spectrum Disorder and Developmental Disability Sensory Coping Box The purpose of this project is to provide effective coping tools for pediatric patients to minimize or prevent challenging and traumatic hospital experiences. In my experience, adequate resources for children with autism spectrum disorders (ASD) and developmental disabilities (DD) are few and far between when compared to resources for typically developing children. Since 2015, the CDC estimates that 1 in 6 children between the ages of three and seventeen are diagnosed with a developmental disability. Additionally, roughly 1 in 45 males and 1 in 189 females in the United States are diagnosed with an Autism Spectrum Disorder annually. Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there is not one autism but many types, caused by different combinations of genetic and environmental influences. The term spectrum reflects the wide variation in challenges and strengths possessed by each person with autism (Autism Speaks, 2012). Children diagnosed with ASD characteristically have sensory sensitivities and experience negative reactions to items and environments that provide unfamiliar sensory stimulation. Cindy Hatch-Rasmussen explains the cause of common ASD behaviors such as rocking and hand flapping may often be the result of a dysfunctional sensory system. She also explains how sensory integration relies on three basic senses: tactile, vestibular, and proprioceptive. Common reactions to having some level of tactile dysfunction presents itself in refusing to wear certain types of clothing or eating certain textured foods. Tactile defensiveness is extreme sensitivity to light touch which can overstimulate the brain and lead to negative emotional responses to touch stimulation. Dysfunction in the vestibular sense presents itself in a child having improper balance and may have fearful reactions to normal movements (Hatch-Rasmussen, 2018). In general, these children appear clumsy. On the other extreme, the child may actively seek very intense sensory experiences such as excessive body whirling, jumping, and/or spinning (Hatch- Rasmussen, 2018). Children with proprioceptive dysfunction display clumsiness, tendency to fall, and inability to manipulate small objects. A culmination of dysfunction in any combination of these sensory systems can result in gross and/or fine motor coordination problems [and] speech/language delays. Behaviorally, the

3 child may become impulsive, easily distractible, and show a general lack of planning. Some children may also have difficulty adjusting to new situations and may react with frustration, aggression, or withdrawal (Hatch-Rasmussen, 2018). When predetermining how a child with ASD or a developmental disability may respond in the healthcare setting, the most important factor as it relates to the scope of practice for a child life specialist is how the child will adjust to new situations and respond to healthcare interventions. The role of the child life specialist is to minimize traumatic experiences through promoting normal activities, providing developmentally appropriate education about procedures, and creating individualized coping plans to best meet the needs of each patient and family. Although many pediatric programs have playroom spaces for children, a child that experiences sensory dysfunctions may be unable to function effectively or independently in the playroom therefore his/her play experience possibilities are severely limited to play that can be done in a bed or at the bedside. It has also been my experience that children with Autism and certain developmental disabilities crave sensory stimulation through items that can be held, manipulated and have certain textures. Children with ASD or DD also benefit from visual stimulation and typically function best under routine and have unique needs when it comes to developmentally appropriate and non-threatening interactions with new people in the healthcare setting. By creating sensory coping boxes, it is my hope that the intervention will help ease the stress of being in the hospital by promoting effective coping strategies, play opportunities, familiarity, normalcy, and stimulation. The sensory coping boxes will have items that primarily address tactile sensory dysfunction and the overall notion that children with ASD or DD benefit from tactile and visual stimulation. Items in the coping boxes may also help strengthen the ability to manipulate smaller objects however this intervention is not meant to be a therapeutic treatment for proprioceptive sensory dysfunction. Finally, items in these boxes may also benefit children diagnosed with ADHD/ADD who need to have busy hands to remain relaxed, engaged, focused. This project will be completed by April 29, Three to five sensory coping boxes will be created initially as a foundation for this intervention with the ability for Mary Bridge Children s hospital to create more as the child life team discovers a need for more boxes. Items for the boxes will be found in the treasure chest at MBCH or purchased from a third party by myself. Supplies for the boxes will be gathered and/or purchased by March 30, 2018.

4 Each sensory coping box will contain between five and seven items that are visually and tactilely stimulating. The items in each box may be but are not limited to the following: 1. Fidget spinner 2. Fidget cube 3. Tangle Jr. 4. Tangle texture Jr. 5. Clip connect 6. Novelty puffer ball 7. Squishy stress relief ball 8. Bubble motion tumbler 9. Jacobs ladder toy 10. Spikey ball 11. Fidgipod tactile hand fidget 12. Silicone chew necklace or object Additionally, it is crucial to maintain objects that are made of plastic or silicone because each item and box must be sanitized after each use to prevent the spread of germs and illnesses. The box that holds the items should be of a size that is easy to store, transport, and can be easily opened. Each box will have a list of items that belong in it, in addition to labeling each item. Labeling will reinforce the boxes belong to the hospital and help maintain organization. The measure of success for this project will be determined by how often the coping boxes are offered by staff, how often they are utilized by patients, feedback from patients and/or families, and the patients overall experience. For every five patients with ASD or DD that would benefit from the coping box, my goal is for it to be offered to at least three patients. When promoting family-centered care in the hospital setting and creating normalized environments and opportunities for play, typically developing patients have a wide variety of play options and ways to be engaged. Common items I have seen are; coloring, puzzles, ipad games, TV shows/movies, action figures, dolls, card games and play kitchens/work stations. When patients who have limited mobility, sensory dysfunctions and sensory sensitivities come to the hospital, their options for engaging in play to promote a normalized environment are limited. Hopefully through the implementation of a sensory coping box, patients with ASD or DD can engage in play that is appropriate, stimulating, non-threatening and familiar.

5 Bibliography Hatch-Rasmussen, C. (n.d.). Sensory Integration. Retrieved February 17, 2018, from What Is Autism? (2012, May 30). Retrieved February 15, 2018, from