The impact of occupational therapy using Ayres Sensory Integration® on a child with cochlear implants: a case study

Abstract

Introduction: A three-year-old child with bilateral cochlear implants (CIs) was referred to occupational therapy by the cochlear team due to suspected tactile over-reactivity.  The child's behaviour fell outside of typical expectations of young children who receive CIs and had a ripple effect on her language and developmeent, e.g. removing and hiding her CIs after 45-60 minutes of usage.

Methods: A retrospective, longitudinal experimental single-case study was conducted.  Occupational therapy, using the Ayres Sensory Integration(R) approach (OT-SI) was provided to the child for 48 months in a private practice in South Africa.  This study aimed to show that the child's sensory perception and regulation improved over time as a result of the intervention.  Results of the Sensory Integration and Praxis tests completed abnd 23 and 42 months after the onset of intervention, were compared.

Outcomes:  After OT-SI intervention, the child tolerated and enjoyed waring her CIs during waking hours every day.  Test results and her incvreased participation on occupations, confirmed that the child showed significant improvement.

Conclusion:  OT-SI made a meaningful difference for thi child and should be considered as part of intervention for children with CIs.  The parents and cochlear team were satisfied with the positive outcomes of intervention.  The study highlights the potential contribution of the occupational therapist to the cochlear team.

Implications for practice:

• This case study provides valuable insights to promote early intervention to support occupational therapists working with young children with cochlear implants.
• Clinical strategies are shared to stimulate professional reasoning and articulate goal setting for a child-directed intervention plan.
• Knowledge is shared to empower occupational therapists to make a valuable contribution to the cochlear team and to fill the gap in available literature.
• The article reflects the value of a support system for parents of children with cochlear implants.
• Fostering continuous communication between team members can create an atmosphere of empathy and recognition of each family’s unique journey.