Occupational Therapy uses a family centered approach to enable children to engage in the activities they want and need to do. This is done using play as a means to assist in the treatment of motor, sensory, cognitive, social and emotional needs of the child.
So who is an Occupational Therapist?
You’ve probably heard the term used in hospitals, by specialists and even your friends when referring to treatment they or a family member may be receiving. But do you actually know what an Occupational Therapist (OT) does? There are a variety of fields you may see an OT in – Aged Care, WorkCover, Hospitals, Community Settings but here we’ll talk about what a Paediatric OT does.
An Occupational Therapist is a highly trained professional who, after attending university for many years, is skilled in helping clients improve their quality of life and skills in order to effectively function in both everyday and working life. They work with individuals who have conditions that are mentally, physically, developmentally, socially or emotionally disabling. Basically, an OT will put into place exercises or processes that will enable the client to develop what is currently missing in order to live life to the fullest.
Paediatric OT settings:
An OT may see a client in a clinic specifically set up to provide an experience for a child, for example a sensory gym. Additionally, an OT may see a client at home to view how the child performs their activities of daily living, how the child interacts with their family and any equipment that may allow the child to develop. If your child is in hospital they may see an OT there who could provide casting and splinting or skill building. OT’s in the school setting could be provided to give group therapy to children or be employed by the parent to see the child within the School environment. Additionally, you could find an OT with a child or adolescent accessing the community such as a shopping centre or on public transport.
Who sees an OT?
The sorts of diagnoses a child may have differ greatly. An OT will typically see children that have been diagnosed with conditions such as Autism Spectrum, Attention Deficit Disorders, Intellectual Disability, Dyslexia, Cerebral Palsy, Developmental Disorders, Down syndrome. Additionally, some children may not have been diagnosed with a condition but have difficulties with sensory processing, friendships and/or behavioural difficulties.
What does an OT work on with a child?
An OT assessed a child to see what areas of development they are not functioning at compared to their peers. Those areas could be:
- Gross Motor Development – for example motor planning, strength, endurance, core stability, posture.
- Fine Motor Development – such as handwriting, scissoring, shoe laces, feeding independently with utensils.
- Executive Functioning – Memory, planning and initiating tasks, organisation, shifting thinking.
- Social/Emotional – impulse control/self regulation, making and keeping friendships, turn taking, flexible thinking, theory of mind (knowing that other people have different ideas than you)
- Sensory Processing – feeding issues, clothing sensitivities, attention disorders, noise sensitivities.
- Activities of Daily Living – an OT will assist with adaption or skill building in areas such as dressing, feeding, transport, hygiene and grooming, toileting, mobility, managing money, safety and travelling.
- Equipment prescription – such as wheelchairs
- Home modifications – an OT may modify your bathroom or kitchen to be easily accessible
Why does it look like they’re just ‘playing‘?
Your OT is the unique position to use fun and meaningful activities (often games) that match the skills we are working on to build the motor and sensory foundations needed for children to function independently. For example, a game of Trouble is perfect for fine motor precision and turn taking; Monkey Bars work on a upper limb strength and coordination, intrinsic hand muscles and the proprioceptive and vestibular sensory systems.
Where do I start and who pays for the sessions?
Your GP or Paediatrician can refer your child to an OT. Your GP will let you know if your child may be eligible for a health care plan to be rebated under Medicare. Children can now be funded under the National Disability Insurance Scheme to see an OT that is registered, such as Sensory Spectrum OT.
Kris Kross must have know that Vestibular input is one of the most important foundations of our sensory system!!
Whilst not always mentioned with the ‘common’ sensory processing centres such as sight, touch, hearing, taste, smell, the vestibular sensory system is a vital component in a human’s development. It is responsible for helping us maintain balance and coordination, centering around the auditory system being the cochlea and labyrinth of the inner ear. It also assist us in developing and determining our processing of visual information and the other unknown sense of proprioception (where you are in space).
To put it simply, when you feel vertigo, lose your balance when you spin around and around, that is your vestibular system being affected. The fluids in the inner ear shiftwhen your head changes direction or tilts, sending messages to the other sensory organs that alignment is off. This allows the other senses to make the necessary adjustments to maintain balance.
A person who suffers vestibular sensory disorder does not send the right messages, therefore unbalancing their overall equilibrium. A sufferer can either be hypersensitive or hyposensitive. Meaning, they can be more over-responsive and more sensitive to movement or less sensitive and crave more movement due to an under-responsive system.
Key signs of hypersensitivity (over responsive):
- Clumsiness or loss of balance
- Avoid rapid or rotating movements e.g.- playground roundabouts
- Avoid going upside down or being tilted
- Fear of heights or falling as a result of uncertainty or even motion sickness
- Fearful of, or difficulty, riding a bike or jumping
- Dislikes lying on their stomach, especially as an infant
- Motion sickness travelling in elevators or stairs.
- Avoids playgrounds
- Fearful of leaving the ground
Key signs of hyposensitivity (under responsive):
- In constant motion i.e. can’t sit still
- Likes sudden movements and even craves them
- Likes to go upside down
- Runs, jumps, hops instead of walking
- Thrillseeker – loves fast rides at amusement parks
- Jumps on furniture, trampolines and anything else bouncy for longer period of time and more intensely than usual.
- Loves to swing as high as possible on swings.
- Never seems to get dizzy or lose balance or control.
Vestibular sensory disorder can be managed with the correct treatment. There are also steps you can take at home to help with your child’s development in between your OT sessions.
- If hypersensitive: Encourage your child to play on playground equipment with your support. Swing them gently on the swing to get them use to the movement without being too vigorous.
- Jumping rope.
- Riding a bike or trike
- Tyre swing or hammock
- Climbing frames
- All playground equipment
- Rolling down a grass hill
* Core strengthening! Look at that great posture. You can see my daughter has even widened her base of support to draw at the correct height!
* Shoulder stability and upper limb muscle strengthening. All that working against gravity is great for building up those muscles! Adding some resistance with a chalk board would be even better…
* Practice crossing the midline with large are movements and practice hand dominance
* Great for developing hand eye coordination because the hand is at or close to eye level
* Sensory – lots of movement for those kiddies that can’t sit still for long periods
On the weekend I spent a very long and exhausting but thoroughly enjoyable day with our cub scout pack. Reflecting on the day, I thought about all of the amazing things we get to do with our cubs that most kids will never get to experience these days.
Remember when we were kids and we’d just run because we loved it. We took responsibility for ourselves and our friends and learnt what was and wasn’t safe. We’d take risks and if we fell…well that’s what being a kid is all about, scrapped knees and scars that you can tell your kids and grand kids about. These days, however, kids are mostly stuck on screen, sitting at a desk or chair. They have limited opportunities to engage in activities that were natural to us parents. Unfortunately, the implications of this can be a lack of gross motor refinement, poor core stability, decreased hand dexterity and strength for fine motor activities and even their ability to be resilient.
So what does this all have to do with the kids I see for therapy?
Well scouting is very inclusive, everyone is made to feel welcome and part of the whole. Kids get the chance to interact with their peers in a non threatening, non competitive way. They get a chance to practice self regulation when on parade. Through fun and engaging games they learn how to be fair and take turns. They also learn to be part of a pack and therefore they have a responsibility not only to themselves but to the whole group. The leaders in scouting know well that children need to move first, listen/do second. So children are often running, jumping, climbing – getting lots of sensory input (which releases those happy hormones). This weekend the children practiced self care skills such as tying knots and shoelaces, basic first aid, cooking, washing up, packing away and taking turns…and that was just in one day!
Most importantly however, the activities they participate in, the skills they learn and badges they earn, all build confidence and self esteem. THIS is why I love scouting for every child….