This case study describes my work with Lucy, a 5-year-old child with working memory weaknesses, visual spatial difficulties, ADHD, and sensory processing disorder. Because Lucy struggles with attention, she finds it difficult to retain what letters and numbers look like. Before the pandemic, we had been doing a lot of multisensory work to help her retain letter and number recognition and formation, in addition to what sounds each letter makes.

In the virtual environment, her attention and sensory processing disorder made it almost impossible for us to make any progress toward those goals. Inside her house, her parents were not always available to assist due to working from home. Her sister was becoming a distraction, too. I initially proposed that she move outdoors during our Zoom sessions outside to escape those distractions, but that didn’t work much better.

With me “stuck” in the computer on our Zoom session, it was difficult to keep her attention on the lesson. She chased squirrels, ran off to pick flowers, and got distracted by just about everything in her backyard. It was incredibly disheartening: The skills we were trying to work on were ones she could do just fine two months ago. She had lost so much progress.

Her behavior at home during the quarantine also became a huge problem. She was exhibiting negative and avoidant behavior and shutting down completely. She and her sister were constantly getting into trouble on their own. In fact, the day before our first park session, she and her sister gave themselves haircuts without permission or supervision. Her parents were ready to lose it.

That’s when her parents and I decided to switch up my lessons by going to a park. We were socially distant. We wore masks, used hand sanitizer, and cleaned therapy items when necessary. I knew she would be distracted by her surroundings, so we incorporated the surroundings into the lesson. With me there in person, it was much easier to find ways to keep her attention and have a productive lesson.
​
Learning goals
Improve attention to task through multisensory learning strategies
Provide sensory input through functional proprioception and vestibular input to increase attention and meet sensory-seeking needs
Improve letter and number recognition and formation
Sequence alphabet and numbers 1–10
Follow one- and-two step directions
Improve basic executive function skills, waiting, and turn-taking