OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

This assignment involves synthesizing or integrating the information from OTCH 6120 (Theory), OCTH 6140 (Skills)
and OCTH 6160 (Evaluation) on the module we completed on high-school aged youths. The format for this case
study replicates the occupational therapy process from referral through evaluation and planning intervention.
You are to complete all the questions in the order that they appear. As in the therapy process, you will gain more
information as you go through case. DO NOT change your answers to earlier questions as you gain more
information. It is important for you to reflect on your thinking processes and to identify information you need and want
to obtain as you learn more about the youth and his or her family.
You may refer to your notes, to your textbooks, or use the internet to help you to answer the questions.
Case Study #4
Jorge is a 16-year-old boy who recently moved to Salt Lake City from New Mexico. You are a member of the
IEP team who will participate in developing a transitional program with Jorge and his family. Jorge was attended a
general education class and received specialized education services for about of each school day. He was
followed by an OT in New Mexico on a consult basis. You are the occupational therapist who will do Jorges
evaluation.
1. Referral
a) What are two possible diagnoses that Jorge may have? (Include diagnostic information and support it with
evidence from the referral).
1.

Intellectual disability- The fact that Jorge spends half of the school day in specialized education
services leads me to believe that he may have moderate to severe cognitive deficits that effect his
ability to participate in general education. Additionally, intellectual disability is one of the diagnoses
that qualify for transition services under IDEA. Intellectual disability is characterized by limitations in
intellectual functioning and adaptive behavior. Source:
http://www.cdc.gov/ncbddd/developmentaldisabilities/documents/intellectualdisabilities.pdf

2.

Autism Spectrum Disorder- ASD is another diagnosis that may explain Jorges need for specialized
education and transitional programming. ASD is characterized by social, communication, and
behavior challenges.
Sources: http://www.cdc.gov/ncbddd/autism/facts.html
https://www.naset.org/disabilitypopulatio2.0.html

b) Pick one of these diagnoses. Name the diagnosis you selected and identify four specific occupational
performance tasks (areas) that may be affected. Identify three potential contextual and three potential
personal barriers that may limit Jorges participation in everyday activities.
Diagnosis: Autism Spectrum Disorder
1. Personal hygiene and grooming-ADL

2. Drving and community mobility- IADL

3. Meal Preparation and clean-up- IADL

4. Social Participation- community, family, peer

OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

List four specific occupational performance tasks (areas) that may be affected for Jorge:

Personal Weaknesses
(Client Factors,
Performance Skills,
Performance Patterns)

Contextual/Environmental
Barriers

Social Interaction SkillsASD will affect Jorges

ability to effectively
participate in social
interaction. Specific skills
that might be a challenge
are turning toward, looking,
producing speech, and
regulating behaviors.

Temporal- because Jorge is

a teenager, his behavior
might be even less
acceptable than if he were a
younger child.

Process Skills- If Jorge has

ASD, process skills such as
attending to a task,
choosing and handling
materials, and sequencing
the steps of an activity might
be difficult for him.

Cultural- Jorges culture

might have negative stigma
or non-acceptance of
individuals with disabilities.

Motor skills- Jorge might

have gross and fine motor
deficits that affect his ability
coordinate his movements
and manipulate objects

Social- Jorge might not

have friends or social
support because of his
social interaction difficulties.

2. Preparation for Evaluation

You review Jorges educational record and learn that he has received specialized services since he was 6 years of
age when he received an educational diagnosis of mental retardation. At 10 years of age, he sustained a closed head
injury after falling off the 3rd floor balcony at his apartment. He also participated in adaptive physical education.
Currently, he is with peers for homeroom, study hall, lunch, health education, art, and assemblies. He is in a
specialized education class for academics.
Jorge lives at home with his mother, father, and four siblings. His youngest brother, Julio, receives early intervention
services. His oldest sibling, Marco, dropped out of school and works at a local gas station.
a) From the information above, identify three risk factors that may influence Jorges development. (Cite your
information source, identify references from lecture notes.)

OCTH 6140 - Integrative Case Study #4

Risk Factor
1. Psychosocial problems

Name: Jennifer Farnsworth

Scientific Reasoning & Evidence

Jorges traumatic brain injury puts him at risk for problems with psychosocial
functioning, including the possibility of depression, anxiety, and aggressive
behavior. In a longitudinal study of 72 adolescents and adults with TBI, these
psychosocial conditions were commonly reported, as well as problems with
executive functioning (Finnanger et al., 2015).
Finnanger, T. G., Olsen, A., Skandsen, T., Lydersen, S., Vik, A., Evensen, K.
I., & ... Indredavik, M. S. (2015). Life after adolescent and adult moderate
and severe traumatic brain injury: Self-reported executive, emotional, and
behavioural function 25 years after injury. Behavioural Neurology, 2015
Adolescents with intellectual disability are more likely to be obese as well as
have obesity-related diagnoses. In a survey of 461 parents of adolescents
with ID and developmental disability in the U.S., adolescents with autism and
Down syndrome were two to three times more likely to be obese than
adolescents in the general population, and more likely to have high blood
pressure, high cholesterol, and diabetes (Rimmer et al., 2010).

2. Obesity

3.
Social Isolation

Rimmer, J., Yamaki, K., Lowry, B., Wang, E., & Vogel, L. (2010). Obesity and
obesity-related secondary conditions in adolescents with
intellectual/developmental disabilities. Journal Of Intellectual Disability
Research, 54(9), 787-794 8p. doi:10.1111/j.1365-2788.2010.01305.x
Social functioning, friendship, and companionship are all extremely important
factors in participation and quality of life for adolescents. Jorges intellectual
disability puts him at risk for social isolation. Tipton, Christensen, and Blacher
(2013) found that adolescents with ID spent less time with friends and had
had a lower quality of friendship than their typical peers, which was
influenced by both the presence of behavior problems and problems with
social skills.
Tipton, L. A., Christensen, L., & Blacher, J. (2013). Friendship quality in
adolescents with and without an intellectual disability. Journal Of Applied
Research In Intellectual Disabilities, 26(6), 522-532.

Pick two of the risk factors you identified above. Next to each risk factor identify
How it may affect Jorges occupational performance
How it may the affect Jorges family and school life.
Risk #1_______Social Isolation______________________________________________
1.Jorges occupational performance:
If Jorge doesnt have opportunities to interact with his peers, he will miss out on important
role modeling opportunities that may provide him with support in developing appropriate
social behaviors. He will be unable to perform age-appropriate occupations such as leisure
exploration and participation, which require performance skills such as expressing emotion,
turn taking, and transitioning.
2. Impact of occupational performance problems on family and school life

OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

Social interaction skills are also required for participation and success in family, school, and
community environments. In high school and at home, Jorge is expected to communicate
appropriately with peers, teachers, and family members. Failure to do so may result in increased
isolation, stigma, and lower overall participation and quality of life.

Risk #2 : Psychosocial problems

1. Jorges occupational performance
Depression, anxiety, and aggression could exacerbate Jorges difficulties that are already
present due to his intellectual disability. He might not be able to initiate task, express
emotion, or heed direction due to these psychosocial complications.
2. Impact of occupational performance problems on family and school life.
If Jorge has aggressive behavior, it might not be safe for him to be at school around his peers or
even in his home. His participation in family and school life could be severely limited because he
poses too much of a safety risk to himself and to others around him.
b) Domain Analysis: Based on what you know, highlight domains that you think need further investigation
during your initial evaluation to see how they might be impacting the childs occupational performance and
their school and family life.
Occupations

Client Factors

Performance
Skills

Performance
Patterns

Context & Environment

ADLs

Values
Beliefs
Spirituality

Motor Skills

Habits

Cultural

IADLs

Personal

Rest & Sleep

Education

Routines
Body Functions

Process Skills

Work

Physical
Rituals

Social

Roles

Temporal

Play
Leisure
Social
Participation

Body Structures

Social Interaction
Skills

Virtual

d) Practice Models Guiding your Evaluation & Assessment

Based on what you know so far (Age, diagnosis, concerns, setting, risk factors, etc.) and all the factors considered
above:
Choose an organizing practice model (PEO, MOHO, OA, EHP, Lifestyle Balance that will help guide you in
the overall evaluation process. Be specific Justify and provide a rationale to support your choice for this
child.

OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

Choose at least 2 (two) complimentary OT models that will help guide you in the overall evaluation process.
Be specific. List only those most pertinent. Justify and provide a rationale for each one to support your
choice for this child.
REMEMBER you want to choose a model that provides a foundation for a COMPREHENSIVE evaluation
plan.

Practice Models

Organizing: PEO

Complimentary #1: Social

Participation

Complimentary #2:
Acquisitional

Rationale:
Describe the model & Justify the relevance to this child & their family using
postulates of change.
The Person-Environment-Occupation model emphasizes that occupational
performance depends on the congruence between person, environment, and
occupation. Improved performance can be a result in changes to the person, the
environment, the occupations, or the transactions among these dimensions. This
model is relevant to Jorge because environmental supports and barriers impact his
performance as much as personal factors such as his TBI and ID do. In Jorges
evaluation, I want to look at Jorge (person), but also his school, home, and
community environment, the occupations he regularly engages in, and the way these
dimensions interact with one another to impact Jorges occupational performance.
The social participation model is based on behavior, social, and cognitive learning
theories and states that a childs success in social participation is based on their
temperament, emotional regulation, environmental supports, peer interaction, and
school supports. It postulates that positive social interactions, routines, and
emotional regulation strategies can all help a client to achieve success. Social
participation is particularly relevant for Jorge because it is a key skill component in
transitioning from school to community participation. In the evaluation, I would be
interested in the quality of Jorges social interactions and assessing which skills are
strengths and which are emerging, in order to help him to succeed in multiple
environments.
This model is based on the acquisition of specific skills necessary for occupational
functioning. It postulates that repeated, reinforced skill training can result in
generalized acquisition of skills through reinforcement and shaping. This is
appropriate for Jorge because he may have performance deficits of specific skills
necessary for school, home, and community participation. In evaluation, I would want
to see which school and community living skills he still needs to acquire in order to
prioritize goals and plan treatment.

e) Evaluation Plan
Identify at least three assessment tools or strategies (formal or informal) you would use to evaluate Jorge during this
initial one-hour session. Next to each assessment or strategy, briefly describe information you hope to obtain using
this method. Also identify the practice model that guided your choice of this tool with a brief rationale. You may
schedule a return visit to collect additional information. [Remember that, collectively, your assessments and
procedures must only take 1 hour.]
Strategy/Assessment
Tool

Information you would hope to

obtain
The COPM would give me information

Practice Model & Rationale

PEO- this is an appropriate guiding model

OCTH 6140 - Integrative Case Study #4

COPM

Vineland-II

Observation

Name: Jennifer Farnsworth

about Jorges performance in selfcare, productivity, and leisure

domains. I would find out what
occupations are most important to
him, how his environments are
impacting his success, and the
alignment of his current performance
and satisfaction with that
performance.
Through giving Jorges parent or
teacher the Vineland, I would hope to
obtain information on Jorges adaptive
skills- specifically, daily living skills
and socialization. I would want to see
how his performance in these areas
compares to a normative sample of
his peers and his age equivalence in
these domains.
I would hope to obtain more
information about Jorges specific
abilitieshis motor, process, and
social interaction skills. I would want
to see which tasks he has difficulty
with, his overall behavior, and which
aspects of his environment are
supports and barriers to his
performance.

because it is broad and encompasses all

domains of Jorges occupational
performance. By using this model, I can be
client-centered by hearing Jorges own
perspective of his performance. I can also
identify potential supports and barriers in his
physical and social environments from his
responses.
Social Participation- This is a relevant model
for evaluation because of its focus on the
social domain of adaptive behaviors.
Appropriate social skills and behaviors are
an extremely important component of
successful transition and integration in the
community, so an emphasis on social
participation is warranted.
Acquisitional- This model would guide my
observation by looking at the specific skills
that Jorge needs to acquire to succeed in
his environment. It is relevant because it his
individualized to Jorge and his specific
performance strengths and deficits.

You arrange a time to meet with Jorge at school.

3. Evaluation: Occupational Profile
a)

List three important questions you would ask Jorge. Phrase your questions as you would if you were talking
with Jorge.

1. What are you really good at?

2. What do you still need to work on?

OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

3. What do you hope to do someday?

b) What are three important questions you would ask Jorges father?
1. What are Jorges strengths?
2. What are your hopes for Jorge?
3. What are your greatest concerns for Jorge?

c) Given his age and what you know about Jorge so far, what are four occupational performance task that you would
want to observe during your evaluation?
1. His social skills and interactions with his peers during unstructured time.
2. His academic/learning skills in a typical school lesson- i.e., reading, writing, and math
3. His behavior during seated classroom activities
4.Riding the bus or transportation to/from school and around the community.

4. Evaluation: Analysis of Occupational Performance

From your evaluation, you find the following:
Jorge readily engaged in conversation with you in English. He often interrupted you and interpreted what you said
literally. On the COPM, he identified the following goals for himself: riding the bus, getting a job, and making friends.
His father identified the following goals for Jorge: getting a job, getting up on time, using public transportation, and
getting along with others at home and when working.
You observed Jorge at school during lunch and in the classroom. At lunch, Jorge joined several peers and
immediately gave them hugs. The peers responded to Jorge by moving away. Jorge sat beside a girl. When you
asked Jorge who the girl was, he said My girlfriend. The girl said that she had just met Jorge. In the classroom,
Jorge followed a schedule that he had taped to his desk. Given a pre-determined checklist of food items, he could
recognize familiar or favorite foods to purchase for a meal. He had difficulty adding sums for a practical activity on
grocery shopping. He could print his name and copied the names for common grocery items. On leaving, he sought
assistance to determine which bus to take home.

OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

a) From the evaluation information you gathered and information provided above, identify two specific areas of
occupation that are being impacted for Jorge. With these occupations in mind, identify two activity demands, two
client factors, and two possible contextual factors that may limit Jorges participation in your identified areas of
occupation.

Occupations

Activity Demands
(related to the 2
occupations stated
above Table 7 OTPF)

Potential Limitations or Barriers

Social Participation-peer
Community Mobility

Social demandsthe demands of

appropriate social behavior are too
high for Jorges abilities
Required actions and performance
skills- Jorge is lacking the performance
skills to successfully engage with his
peers

Personal factors
(Client Factors,
Performance Skills &
Patterns Table 4
OTPF)

Social interaction skills- Jorge doesnt

have the skills of taking turns and
socially appropriate touching
Global mental functions- Jorges
temperament and personality are such
that he is over-eager to hug his peers

Contextual Factors
Cultural- Cultural norms arent in line
with Jorges desire to touch/hug his
peers
Social- The high school social
environment is difficult for Jorge to
participate successfully in.

Objects used and their properties- Jorge

doesnt use tools such as signs and
schedules that would help him navigate the
bus system
Sequencing and timing- Jorge is unfamiliar
with the sequencing and timing of bus routes
Routines- Jorge doesnt have the necessary
patterns of behavior needed to independently
use the bus system
Performance Skills- Jorge is lacking process
skills such as sequencing, notice/responding,
and accommodating that are needed to use
public transportation.
Virtual- Jorge isnt familiar with online bus
schedules and supports that make public
transportation easier
Physical- The physical environment of signs,
buses, and schedules is too complicated for
Jorge to navigate independently.

From the evaluation information you gathered and information provided above, identify two specific areas of
occupation that are strengths for Jorge. With these occupations in mind, identify two activity demands, two client
factors, and two possible contextual factors that may promote Jorges participation in home, school, community,
and/or vocationally related activities.
Occupations

Potential Strengths or Supports

Formal education participation
Functional mobility

OCTH 6140 - Integrative Case Study #4

Activity Demands
(related to the 2
occupations stated
above Table 7 OTPF)

Personal factors
(Client Factors,
Performance Skills &
Patterns Table 4
OTPF)

Name: Jennifer Farnsworth

Relevance and importance to clientJorge seems to enjoy school and is

willing to participate in school tasks

Required body functions- Jorge has the

required strength and mobility to walk to
where he needs to go

Required actions and performance

skills- Jorge has many of the required
performance skills for his special ed
class, including writing and copying

Space demands- Jorges environments allow

him to move around freely

Motor skill: Jorge has the fine motor

skill to grip and manipulate writing
utensils

Motor skills: Jorge has the ability to walk

(performance skill) from place to place

Process skill: Jorge can initiate and

continue school tasks

Contextual Factors
Physical- the Special Ed classroom is
physically conducive to learning for
Jorge

Movement related functions: Jorge has the

control of voluntary movement, joint mobility,
and joint stability needed for functional
mobility
Physical- Jorges environments are set up so
that he can navigate them
Personal- Jorges physical characteristics
make it possible for effective mobility

Cultural- Jorge can abide by the

cultural norms of following directions
from a teacher

b) Projected Outcomes: Explain and detail your targeted outcomes for Jorge (Select at least 2-3 that are being the
most directly addressed in your intervention plan.)
Occupational
Performance
Jorge will
improve his
performance at
functional skills
required for
community
participation.

Prevention

Health & Wellness

Quality of Life

Participation

Well-being

Jorge will
improve his
social
participation
and acquire
appropriate
social skills
with his peers.

OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

c) Based on evaluation information, list three priority intervention/goal areas for Jorge. (Be sure the priorities
you select directly support your outcomes listed above.)
1. Social participation
2. Community mobility
3. Employment seeking and acquisition
5. Intervention Process: Develop a Plan
Practice Models need to be selected to guide intervention and activity selection and intervention priorities based on:
Client Goals, values, beliefs & occupational needs
Client health & well-being
Client performance skills & patterns
Collective influence of context/environment, activity demands & client
factors on the child
Context of service deliver in which intervention is provided
Best available evidence
a) From the evaluation information and your chosen priorities:
Review your choice of an organizing practice model (PEO, MOHO, OA, EHP, Lifestyle Balance). Is it still a
good choice to guide intervention for your client? (If not revise your choice) Justify and provide a rationale
for your choice with research/readings support your choice for this child. (see below)
Choose at least 2 (two) complimentary OT models that will help guide you in the overall intervention
process. Be specific. List only those most pertinent. Justify and provide a rationale for each one with
research/readings support your choice for this child. (See below)
REMEMBER you want to choose models that provide a foundation for a COMPREHENSIVE evaluation and
intervention plan.
Scientific Reasoning and Evidence: What researched evidence is available to help you with your evaluation
and/or treatment process? Give references to readings or research

Practice
Models

Organizing:
PEO

Rationale:
Describe the model & Justify the relevance to this
child & their family using postulates of change.

PEO is a broad model that considers not just the client or

the disability, but also the environment and the
occupations in which the person is involved. Change in
one of these dimensions or the transactions between
them can have a positive effect on performance. This
model is relevant for Jorge because for effective
intervention, we must consider the environments that
Jorge plans to engage in and the tasks that he will be
expected to do. Supportive adaptations to these
dimensions could result in a positive change in Jorges

Explain how these models address the priorities and

areas of intervention and overall outcomes you
identified for this child. **Use research articles to
support your rationale.
PEO can address Jorges occupational goals at school
and in the community by recommending possible
adaptations to the environment, such as visual schedules
and other external supports. Arvidsson, Granlund, and
Thyberg (2008) found that participation in adolescents
with intellectual disability increased with social support
and the opportunity for choice.
Arvidsson, P., Granlund, M., & Thyberg, M. (2008).
Factors related to self-rated participation in adolescents

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OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

performance.

Complimentary
#1:
Social
Participation

Complimentary
#2:
COgnitve

The social participation model addresses poor social

functioning in children by changing their habits and
routines, helping to organize their patterns of behavior,
and emotional regulation strategies. This model is a good
fit for Jorge because social participation is one of his
primary challenges and goal areas. Furthermore, social
participation is one of the most important adaptive
behaviors to consider as Jorge transitions to adulthood.

and adults with mild intellectual disability--A systematic

literature review. Journal Of Applied Research In
Intellectual Disabilities, 21(3), 277-291.
doi:10.1111/j.1468-3148.2007.00405.x
Through interventions that maximize Jorges
opportunities to interact with his peers, he will acquire the
social skills needed for friendship, leisure participation,
and employment. Carter and Hughes (2005) assert that
in the context of peer relationships, adolescents with
intellectual disabilities can practice and refine social
skills, access support systems, and learn peer norms and
values.

Cognitive frames of reference, such as CO-OP, are

rooted in educational psychology and postulate that a
client can use cognitive strategies to improve task
performance on an identified goal. This is a relevant
model to consider for Jorge because the evaluation
information indicates that he has the capacity for metacognition, and the use of cognitive strategy could
enhance his occupational performance.

Carter, E. W., & Hughes, C. (2005). Increasing Social

Interaction Among Adolescents with Intellectual
Disabilities and Their General Education Peers: Effective
Interventions. Research & Practice For Persons With
Severe Disabilities, 30(4), 179-193.
Cognitive approaches could help Jorge improve his
performance in many of the prioritized occupations and
tasks, such as riding the bus and getting up on time. By
following a specific, practiced plan that he can verbalize,
the skill can be acquired and generalized. Missiuna et. Al
found that children with ABI experiencing self-care
difficulties were able to improve on their chosen goals
using CO-OP.
Missiuna, C., DeMatteo, C., Hanna, S., Mandich, A., Law,
M., Mahoney, W., & Scott, L. (2010). Exploring the use of
cognitive intervention for children with acquired brain
injury. Physical & Occupational Therapy In Pediatrics,
30(3), 205-219 15p. doi:10.3109/01942631003761554

b) Goals
Choose one of your priority intervention/goal areas for Jorge.
Write a long-term goal and two related/supporting short-term goals for Jorge. Be sure your goals are
behavioral, measurable, and functional (SMART format).

Annual Long Term Goal 1: In 6 months, Jorge will independently engage in conversation with his peers,
following appropriate social norms, in 4/5 opportunities to do so.
o

Short Term Goal 1: In 2 months, Jorge will sit with peers in the lunchroom and maintain
appropriate physical boundaries with no more than one verbal cue, 4/5 lunch periods in one
school week.

11

OCTH 6140 - Integrative Case Study #4

o

Name: Jennifer Farnsworth

Short Term Goal 2: In 3 months, Jorge will engage in a two-minute conversation with therapist,
using appropriate conversational turn taking, with no more than one verbal cue, 4/5
opportunities to do so.

c) Service Delivery: What type(s) of services do you anticipate will best meet Jeremys needs?
(Direct/Consult/Collaboration/Co-treat, etc.)
Type(s) of service
Direct
Consult

Rationale:
Jorge will benefit from direct service to address his specific needs in a
variety of environments to prepare his transition from high school
Consult will also take place with Jorges parents and teachers to
maximize environmental supports and carry over strategies from
treatment to school and home to support generalization of learned skills.

d) What setting(s) will the services take place? Jorges school and community (bus, community center, etc.)
e) What is Frequency & Length of Services? Once a week for 45 minutes, for at least the next year.

6. Implement the Plan

Treatment Sessions: Choose at least 2 Interventions to do in a 45 minutes session that support one of your
above stated goals.
Intervention #1:
What goal does this Intervention support? STG 1
Intervention Description: Social Stories
Discuss the topic of respecting personal space with Jorge. Tell him that even though sometimes
we want to touch and hug the people we like, they dont like it and we need to respect their space.
Introduce Jorge to social stories. Tell him we are going to write a story about respecting personal
space so that we can read and remember it when we need to.
Have Jorge help write the social story, making sure that it includes descriptive, directive, and
perspective sentences. I have a lot of friends. When I see them, I can say hi! or whats up? I
do not touch or hug them because I dont want them to feel uncomfortable. Everyone is happier
when I respect their space. Have Jorge choose simple illustrations from clip-art at the computer.
Print and laminate the story. Have Jorge read the story before lunch or other social opportunities
with his peers.
Setting

Activity Demands:

Therapy room at school

Relevance: Fun, creative

Objects: Table and chairs,
computer
Space demands: quiet room
with limited distractions
Skills: Attend, initiate heed,

Anticipated outcome
Jorge will improve his social
skills by respecting personal
space.

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OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

replies,
Body functions/structures:
Attention, memory, higher-level
cognitive, orientation,

Intervention Approach: Establish/Restore

Practice Model(s): Social Participation

Intervention Type: Activity/Occupation

Rationale & evidentiary Support: Social stories can help Jorge learn, remember, and generalize specific
social skills that he needs to acquire. Social stories have shown effectiveness in improving the behavior
of adolescents with intellectual disabilities.
Kim, M., Blair, K. C., & Lim, K. (2014). Using tablet assisted Social Stories to improve classroom
behavior for adolescents with intellectual disabilities. Research In Developmental Disabilities, 35(9), 22412251. doi:10.1016/j.ridd.2014.05.011
Intervention #2:
What goal does this Intervention support? STG 2
Intervention Description: Video modeling
Discuss the importance of waiting to take your turn in talking. Tell Jorge its just like playing
catch with a ball-first its your turn to talk, then the other persons.
Practice a short (1 min) role-playing script with Jorge in which the therapist tells about her day
and Jorge tells about his. Reinforce and remind him to wait his turn to talk. Practice the script
until Jorge has mastered it.
Tell him we are so good at this, we are ready to be filmed! Film the role-play.
Watch the video with Jorge and point out his strengths.
Setting
Therapy room at school

Activity Demands:
Relevance: Fun, acting
Objects: Table and chairs, video
camera or phone camera
Space demands: quiet room
with limited distractions
Skills: Attend, initiate heed,
replies, continues, regulates,
engage
Body functions/structures:
Attention, memory, higher-level
cognitive, orientation, voice and
speech

Intervention Approach: Establish/restore

Practice Model(s): Social participation

Anticipated outcome
Jorge will improve his social
skills by practicing taking turns
in conversatopm

Intervention Type: Occupation/Activity

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OCTH 6140 - Integrative Case Study #4

Name: Jennifer Farnsworth

Rationale & evidentiary Support:

Practicing conversational turn-taking with the use of video modeling will help Jorge experience success
in learning social skills and physically see what that looks like, contributing to generalization to use with
peers. Carter and Hughes found that adults teaching social procedure s to adolescents with intellectual
disability ,with the use of a visual aid, led to increased engagement with peers.
Carter, E. W., & Hughes, C. (2005). Increasing Social Interaction Among Adolescents with Intellectual Disabilities
and Their General Education Peers: Effective Interventions. Research & Practice For Persons With Severe
Disabilities, 30(4), 179-193.

7. Review the Plan

a. Explain how & when you will
review/re-evaluate your plan.

The plan will be reviewed yearly with the IEP/transitional planning team, and
sooner than that if Jorge meets his goals or if there are specific circumstances
or concerns.

b. Modifications to plan (Are

they needed? How do you
implement them?)

Modifications to the plan will be made by the IEP/transitional planning team as

a result of assessment and evaluation information or special circumstances.

c. Continuation/DC from
Services

Jorge will be discharged from services when he exits or ages out of special
education, meets his OT goals, or is no longer benefitting from OT services.

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