Table 1.

Participant’s occupational profile.

Participant report
Parent and school professionals’ concerns related to engagement in occupations & barriers to participation	This child is an 8 y/o girl with classic Rett syndrome (RTT) who needs full assistance for postural transitions, has severe dyspraxia and hand stereotypies, poor sustained grasp and functional hand use, no spoken language, and limited active participation in classroom/school, self-help & play activities. She needs full physical assistance for holding/using classroom tools/toys/eating utensils, and for dressing, grooming, and toileting. She demonstrates high level of arousal/increased baseline body tension. She has significant gravitational insecurity walking, approaching steps/elevator, & during transitions—evidenced by distressed affect, grabbing helper, rigid posture, and/or freezing in place. She walks rigidly with irregular rhythm, stopping after every few steps. She strongly avoids trunk rotation when assisted to change body position. She needs full assistance to go from floor-sitting to standing and vice versa. She is unable to crawl or roll She relies on a total communication system based on eye-gaze. She is non-speaking. She has frequent GI discomfort. Often requires venting of her G-J tube.
Occupations in which child is successful	She uses her hands to manipulate soft gel toys—only texture she sustains She walks (dysrhythmic and stops after a few steps) She maintains sitting balance on chair, and on adapted swings when holding onto ropes and movement is gentle and predictable. She is very social and engages with others non-verbally with her quick smile and intense eye contact.
Occupational history	She lives w/ her mother and 2 siblings who lead active lives. She attends a publicly funded, private school for children with significant special needs.
Performance patterns	She requires moderate to full physical support to use her hands to participate in school, self-help & play activities, and to change body position. She expresses herself using facial expression and vocalization. GI discomfort, gravitational insecurity, dyspraxia, & hand stereotypies hinder occupational performance.
Environment and context
Physical, Social, Cultural, Personal	Her transdisciplinary school team (PT, OT, SLP, 3/6 teacher/student ratio) supports engagement at school and her loving family carries over school recommendations at home. There are no barriers to engagement in her adapted school setting.
Participant goals
Participant and Team’s priorities and desired outcomes	Summary of targeted goals: She will be able to transition and move thru her environment & on/off play equipment with less fear and assistance. She will initiate reaching to and sustaining grasp on objects (all textures), and use objects functionally to participate more actively in valued student and childhood occupations

See Supplemental B Sensory Processing Evaluation Summary.