Child First Occupational Therapy Services

This article was published in the OT Insight Magazine. Please click on the following link to read the article HAPPY HANDS HAPPY FEET

Hi,

Thanks for sharing this interesting info on this forum. I would like to take this opportunity to throw some more light on tracking device and how they can be used for children with Autism.

I am a paediatric occupational therapist and also accredited to do Equipment and Modification  assessment . I am not sure about India but the need of a tracking device is increasingly becoming popular for some children with autism (especially those with hyperactivity, impulsivity, and escaping, wandering behaviour) in New Zealand and Australia. Here in New Zealand, government would fund for such devices provided that there is a comprehensive behavioural plan around how to manage the child’s escaping behaviour. Usually a child who needs tracking device would also need complex housing modification (like a fenced play area, safety locks on doors & windows, safety window glasses etc). The idea is to provide a safer area to live rather than applying any kind of restrain.

The hard reality is that most of the available tracking devices (at least those available in NZ) have their own advantages and disadvantages. For example-

Wandatrack- http://www.aucklandsar.org.nz/wandatrack/

http://www.gpstracking4u.com/trackingyourkids.htm

You may like to follow the links to get some ideas.

Some important features to look for in a tracking device are-

• Response time: Say if the child leaves your property (home) then after what interval of time the GPS can alarm you that he/she has escaped. Is that time small enough to keep the child safe? (E.g. the child can be out on the road putting his safety at risk).

• What surface area can be covered by the tracking device?

• How much is the ongoing cost?

• How small will be the “transmitter” so that the child can wear it? (E.g. not all children can carry an I phone in their pocket).

• Children with high intelligence may refuse to wear a bracelet or pendant.

I understand that the latest smart phones have much advanced technology and efficient GPS system. Also some companies already use efficient tracking devices for their employees.

However, I am not sure how successfully these technologies can be applied to children with autism. Currently I have 3 such children on my case load and I am trying hard to look for an appropriate tracking device for them. I wonder if there is any option available out there.

I have limited knowledge of technology as I am not an IT expert. I will be interested to know from the parents, especially the IT experts in this group on their ideas around the tracking device. I will love to touch base and offer my support to the tech experts in this group who have the enthusiasm & interest to develop such a device.

Thank You

Harsh 

Hi ABC,

You may find the following useful-

Ayres (1972) postulated that deep pressure and proprioception have a

central inhibitory effect. It activates the parasympathetic system.

Physiologically, the parasympathetic nervous system helps the body to

feed, breed, rest or repose. In other words it has calming effects on

the body (e.g. relaxed muscles, tone etc.).

Keeping this postulate in mind even if the input (deep pressure via

squeasewear) is applied to a specific area the effect may be more

generalised. In other words even a strong localised input (covering

less surface area) may be sufficient to activate the parasympathetic

system. I hope it provides a possible answer for the following part of

your query- “whether there is enough compression to be effective in a

bigger body”. Fortunately the squeasewear appear to be covering a

significant amount of the body.

Frankly speaking, I have never used the “squeasewear” with my Clients.

In fact I saw it for the first time even virtually when you posted the

link to it. However, I have been applying the above theory ( i.e. deep

pressure has a generalised effect) e.g. joint pressure on small joints

like PIP, DIP, wrist and elbow can be as effective as applying direct

pressure to the large joints like knee.

Also I know a family who used a “pressure suit” (they got it from a

sports gear shop) with their child with sensory issues. It was

reported to be successful in addressing some maladaptive behaviour.

As far as high level research evidences are concerned, I am not aware

of any such study measuring the outcome of “pressure suit/

squeasewear”. Of course, there are a few studies on “weighted vests”.

I think weighted vests provide more “proprioceptive input (gravity

dependent). However, the pressure suits provide more of sustained

uniform “deep pressure” (which is not much dependent on gravity).

Hence, we cannot rely much on the “weighted vest” research outcomes.

Based on the physiological facts and my clinical experience I would

still use it wherever indicated. However, I would keep the following

things in minds-

• Not to use it with every client. It can be trialled with those

clients who seek significant amount of deep pressure. For example, the

case you have mentioned- frequently seeking hugs.

• To use functional goals as the outcome of the success of the use of

the pressure suite.

• To ensure that the suite will not affect distal blood circulation

(e.g. doing Blanch test: pressure is applied to a fingernail or

toenail until normal color is lost. The pressure is then removed, and,

if the circulation is normal, color should return almost immediately,

within about 2 seconds)

• To monitor signs of skin inflammation (redness, swelling, warmth).

• To monitor signs of breathlessness.

• To avoid using it in case of a medical condition like epilepsy,

cardiac issues.

• Monitoring physical signs and symptoms will be more significant in

the non verbal clients.

I will look forward for the views of other group members.

Thank you

Regards,

Harsh 

Hi Everyone

FYI the UK DCD guidelines are now available to download. I have attached the link

http://www.movementmattersuk.org/content/documents/Revised%20EACD%20UK%20Recommendations%20Pocket%20Guidelines.pdf

These were revised in 2012 specifically for the UK from the European standards so to my knowledge they are the most current.

You can also view the participant list http://www.movementmattersuk.org/content/documents/DCD%20Consensus%20participants.pdf. You will see there were many different disciplines involved in creating this document.

Thanks

Harsh