Impact

Deepak (name changed) is an 8-year-old child in Mumbai, with autism. In addition to receiving autism intervention services at Ummeed, Deepak was also referred to Ummeed’s Occupational Therapy team to improve his play and engagement skills. His mother was concerned about her son's persistent mouthing behaviour, a common sensory coping mechanism for children with autism. It is important to note that even typically developing children mouth objects as a normal part of sensory exploration of taste, touch, and smell, but soon outgrow it. However, some children with sensory processing difficulties, such as children with autism, persist with this behaviour when they feel a sensory overload. This behaviour posed a health risk as Deepak would put unsanitary or unhealthy objects in his mouth, potentially leading to internal injuries.

Ummeed's Occupational Therapist, Madhura, met with Deepak's mother to develop a therapy plan focused on teaching alternative strategies to meet Deepak's oral sensory needs and improve his play skills. As first steps, Madhura suggested using a washable and clean chewy tube as an adaptive device for Deepak to fulfil his need to put something in his mouth for comfort and organization. Ummeed procured the chewy tube and Madhura worked with Deepak and his mother to implement strategies related to the oral area. The therapy sessions focused on teaching Deepak what is appropriate to put in his mouth and finding safe and suitable options that he likes to eat/chew on. His mother observed his preferences for food with a certain texture and incorporated these items into his diet (such as ragi chips over typical potato chips, amla pickles, and even healthier options like carrots, cucumbers) – and kept these items within his reach at home for easy access. This was a breakthrough as it reduced the number of inedible items he would chew on and allowed him to express his likes and dislikes. In this case, Madhura used a transdisciplinary approach and made use of some autism-intervention strategies with visual cues such as "red cross" for unsuitable items and "green tick" for suitable items to help Deepak understand what he can and cannot put in his mouth.

Deepak’s mother was very proactive and actively participated in the therapy sessions. Even before the therapy sessions at Ummeed, she would always try to keep harmful things out of Deepak’s reach, and the strategies recommended during the therapy sessions helped her achieve the goals she hoped for Deepak. The mother shared that she appreciated how Ummeed therapists use a strength-based approach and help the child/caregiver with strategies to manage difficult concerns, instead of blame, or reprimand. (She shared that in the past when Deepak had ingested something inedible accidently and she took him to a doctor, she was blamed for not taking care of her child). With the use of a chewy tube and a change in diet, Deepak's behaviour of mouthing objects decreased. The therapy sessions then focused on improving his play skills and adding variety with new play toys such as a trapeze, swings, and play-tunnels (such as put pressure on his hands). The mother also regularly took Deepak to the local park to allow him to explore movements in an open space. Deepak's ten-week therapy cycle showed positive results, with reduced mouthing behaviour and increased play skills. The mother was proactive and willing to implement the strategies recommended by the OT, which played a significant role in achieving the therapy goals.