Reflection on an occupational therapy diverse placement at Down Syndrome Development Trust Sussex

by Luke Angel, MSc Occupational Therapy (pre-registration) student

One of the placements on the occupational therapy course was a ‘diverse placement’, a setting where occupational therapists may not be traditionally employed. For this placement I had the opportunity, with a student colleague Meg Harries, to deliver occupational therapy at a vocational college for young adults with down syndrome, the Down Syndrome Development Trust. The college offers a fantastic range of occupations, including education, sports, arts, music, cooking and work experience for the young people to develop communication, social skills and independence. Our role as occupational therapy students was to explore the sensory needs of the students to support their engagement and emotional regulation. Our aims and details of the intervention are as below, followed by a personal reflection of the placement.

Our aim on the placement:

• To identify the sensory needs of the students, interviewing parents using the Sensory Profile (Brown and Dunn, 2002).
• To increase awareness of sensory needs by college staff and parents so they can better support the students.
• To Identify appropriate sensory therapy activities to support students to self-regulate and use sensory strategies to support in everyday occupations they find meaningful.

What we did on placement:

•  Assessing student emotional regulation strategies and sensory needs through observation of behaviour in and out of the class, discussing preferences with students and staff, completed the Sensory Profile (Brown and Dunn, 2002) with parents.
• Creating a box of sensory tools some alerting, calming and organising (e.g. beads, modelling clay, massage gun, yoga exercise ball, bean bags etc. Ideas were inspired by Horwood (2021) Sensory Circuits and O’Sullivan and Fitzgibbon (2018) Sensory Modulation Resource Manual.
• Creating a guide of sensory tools with activity analysis and how to grade for staff to continue.
• Supporting student sequencing in activities of daily living, such as tying shoelaces, washing hands and cooking through modelling, scaffolding, visual cues and prompts (white boards ‘now and next’, pictorial step by step instructions and singing).
• Compiling and synthesising all the information from above to create personal occupational profiles (communication passports) for the students to keep.

As this was a role emerging placement with no existing occupational therapy role, this meant as students we needed good organisational skills to plan our resources and processes. For example, planning when to do occupational therapy activities, such as emotional regulation around existing college timetable and the students’ routines, arranging an appropriate time to do sensory therapy activities in a personalised way (calming or activating), planning the steps for activities and designing resources, creating an OT equipment box and organising a room so it was accessible to carry out activities safely and effectively.

To create a sustainable intervention we compiled ‘About me’ student profiles for new staff to understand the students’ needs, their interests, stressors and coping strategies and for the students to bring these ‘passports’ to their next college or workplace. We also created a sensory activity and equipment resource book to make an accessible way for the team to see the activities and an occupational therapy perspective of their purpose, how they can be graded and the occupational capacity skills involved.

This placement has taught me a lot about adapting communication to suit needs and breaking down information e.g. supported decision making and social stories. It also increased my understanding of multiple sensory needs and sensory strategies to support regulation. Both skills will be highly transferrable to my future work settings.