The current interview process is in regards to a child who is four years old and was diagnosed with autism when he was two years old. Children with autism often display deficits in language, social interaction, behaviors, and sensory and perceptual processing (Case-Smith &ump; O’Brien, 2010). Therefore, the purpose of the current interview is to investigate the child’s overall needs, strengths, and weaknesses in regards to the child’s specific condition to gain an in-depth understanding of the child.
The goal of the interview is to collect thorough information about the child to allow the practitioner to gain an understanding of the child and parent’s needs for therapy. Furthermore, the interview facilitates rapport between the practitioner and the child and parent and expresses the practitioner’s desire to understand and empathize with the child. It is important to establish a relationship with the child and the parent to allow for an open discussion and a successful intervention. The practitioner should establish proper eye contact and engage with the child properly to gain the child’s trust during the interview process. Structure of interviewing
The structure of the interview is made available so there are smooth transition within the interview. The questions are phrased in an open-ended form to promote more conversation with the client and allows the practitioner to gain more information about the client. The questions in the interview are directed to the parent due to the young age of the child and the child’s diagnosis of autism. Furthermore, according to Stone and Hogan (1993) “parents offer an unique perspective on the child’s behaviors, one that is acquired over time and across different contexts and input from parents provides an invaluable supplement to clinical observations.”
The intake form is formatted in a style where the practitioner may easily ask the questions and transcribe the information from the client. The typical sections of the interview are the opening, body, and closure (Sommers-Flannagan,J. &ump; Sommers-Flannagan, R., 2003). The intake form contains information regarding demographics, medical history, treatment history, and developmental history in the opening section. In the body section of the interview, information about the occupational performance areas, performance skills, and performance patterns are addressed. Lastly, the interview concludes by requesting the personal goals and major concerns for the client and parent.
In the beginning of the session, the practitioner introduces oneself to the client by stating the practitioner’s name, qualification and role in the setting (Crepeau, Cohn, &ump; Schell, 2009). In the opening of the interview, the practitioner needs to inform the client of the purpose of the interview and the type of questions that are going to be asked (Crepeau et al., 2009) and discuss about confidentiality (Sommers-Flannagan, J. &ump; Sommers-Flannagan, R., 2003). Confidentiality is an integral aspect of the interview process and is important to the client and practitioner. Establishing confidentiality encourages the client to participate with a healthy attitude and lead to effective sessions in the future. According to Sommers-Flannagan, J. and Sommers-Flannagan, R. (2003), practitioners in the opening of the session have a duty to make a positive first impression or they will lose their client’s trust.
Practitioners need to relay that they care about their clients both with verbal and non-verbal cues (Sommers-Flannagan, J. &ump; Sommers-Flannagan, R., 2003). In the current case, the practitioner seeks information about the client’s demographics, medical history, treatment history, and developmental history. Although the goal in the beginning is to create a warm setting (Sommers-Flannagan, J. &ump; Sommers-Flannagan, R., 2003), it is important to learn about the client’s background information. In order to develop a proper treatment plan for the future, it is essential to know about the client’s history.
Demographics questions are posed to gain general information about the client’s age, contact information, and caretaker’s information. Questions regarding medical history are present to help provide information regarding any medical disability that may affect the client’s current condition. Treatment history questions provide how effective the previous interventions were for the client and a framework for future interventions. Information regarding the client’s developmental history are asked to understand the client’s milestones and areas that the child may display delays. These questions provide the practitioner with a thorough background about the client and enables the practitioner to formulate a direct and specific treatment plan for the client.
The body of the interview incorporates the development and exploration phase, which is the time when the practitioner and the client collaborate together to develop the personal story (Crepeau, et al., 2009). Moreover, during this stage of the interview process, the practitioner asks questions that are related to the client’s occupation and the factors that may hinder or promote the client’s occupations. The questions in the current interview are formatted according to the Occupational Therapy Practice Framework (OTPF) (American Occupational Therapy Association, AOTA, 2008). Within the body of the interview, the following topics are addressed: areas of occupation, performance skills, and performance patterns.
Areas of occupation
According to AOTA (2008) the areas of occupation are: activities of daily living, instrumental activities of daily living, education, work, leisure, play, social participation, and rest and sleep. In the interview, the practitioner poses questions to investigate the child’s independence regarding activities of daily living, which are bathing, eating, dressing self, and grooming. It is important to know how independent the child is in these areas to have an understanding regarding the child’s personal needs. Children with autism often are capable of learning tasks such as self-care, but it is important to know the child’s level of functioning. Due to the client’s age and diagnosis, the client is reliant on the care taker or parent to assist with instrumental activities of daily living. Education and play are the child’s primary occupations, therefore, it is important to recognize the child’s needs and capabilities in these areas.
The intake interview asks questions regarding the child’s experience in school to help describe the child’s learning abilities. Children with autism often have developmental delays which impact the child’s abilities to grasp or process information (Case-Smith &ump; O’Brien, 2010). The level of functioning vary for each child on the autism spectrum, therefore, it is essential to know the specific academic experience of the individual child. Moreover, children with autism exhibit disturbances in behavior which often impacts their progress in education (Case-Smith &ump; O’Brien, 2010), therefore it is imperative to inquire about the child’s behavior issues. It is difficult to work with individuals who display behavioral issues, and therefore, children who have autism may often be refused for services, such as education.
Other difficulties children with autism often experience are with social interaction and appropriate play. Practitioners need to inquire about the child’s interaction with other individuals their age and family members (Stone &ump; Hogan, 1993). It is important to have an idea of how the child interacts, if any, and what specific activities are motivators. Children with autism may react to strange settings and activities negatively, therefore it is essential to seek information regarding tasks that may offset these behaviors. Furthermore Lord, Rutter, and Le Couteur (1997) states that it important to ask questions regarding social interaction and avoidance to differentiate between children diagnosed with fragile X from those who are diagnosed with autism.
According to AOTA (2008), performance skills are part of the occupational therapy domain and include: sensory and perceptual skills, motor and praxis skills, emotional regulation skills, cognitive skills, and communication and social skills. These areas within the performance skills are integral information that are relevant in children diagnosed with autism. The child diagnosed with autism may display difficulties in these areas. In this section of the interview, the practitioner seeks information regarding the child’s communication skills. Children with autism may not have spoken language, but may exhibit various communicative skills with the parent. According to Lord et. al (1997), questions regarding communication, such as directing attention, expressing interest in others, social interaction and imitating responses should be asked because children with autism often display disturbances in these areas.
Also these forms of questions help differentiate between a child who has intellectual disability and autism (Lord et al., 1997). Other questions directed to children with autism are in regards to sensory processing skills. Children who are diagnosed with autism often haven an aversion to sensory stimulations and may over or under react to sensory input such as touch, sound, taste, and sight. Children with autism may display difficulty processing sensory information (Zager, 2005). Since children with autism often display issues with sensory processing and over stimulation, it is important to identify what specific form of sensory difficulties the child experiences. Difficulties in these areas may also pose problems with child’s ability to regulate their emotions, which leads to disturbing behavioral problems.
Therefore, questions regarding these issues are pertinent to identify in order to have a successful intervention. Another focus within the performance skills domain is motor skills. Children with autism have developmental delays (Stone and Hogan, 1993) and this results in the child’s difficulty with motor and motor planning skills. Children with autism often have difficulties with praxis and therefore are often unable to perform novel tasks. Questions directed towards investigation of child’s praxis is important to identify because this provides the practitioner with an understanding of what the child is capable of doing. Understanding the child’s capabilities will allow the practitioner to have a foundation to establish proper therapeutic interventions.
Within this domain of the occupational therapy practice framework (AOTA, 2008), the different areas include: routines, roles, and habits. This area is relevant to children with autism because of the child’s high tendency to engage in repetitive behaviors (Zager, 2005). Therefore, it is encouraged for practitioners to inquire about the child’s daily routines, habits, and roles. Some of the habits (or behaviors) children with autism exhibit are unhealthy and practitioners should seek information about the specific behaviors that are harmful to the child. Often, children with autism display tantrums due to change in routine. If the practitioner does not seek information regarding these types of behaviors, then it may halt progress in the intervention.
In the last section of the interview, the practitioner needs to transition smoothly to the end the session (Crepeau et al., 2009). It is important for the practitioner to identify the child and parent’s goals and clear up any questions the client may have regarding the interview and the future sessions. The practitioner and client collaborate together to establish goals that are of primary to the needs of the client. Practitioners need to clarify any questions the client may have and provide information about the future sessions.