Occupational Therapy

Occupational therapy (OT) improves the functioning of children who have mental, physical, neurological and developmental disorders.  Children with a variety of disabilities and diagnoses use OT to improve age-appropriate functioning in the activities of daily living.  Employing a wide variety of methods, OT can address multiple problems including those that involve:

• Eye-hand coordination
• Motor skills
• Concentration
• Organizational skills
• Body image and sense of space
• Sequencing of tasks
• Self-esteem 
• Problem-solving
• Attention span
• Planning
• Awareness of others and the environment
• Motivation
• Responsiveness to others and the environment

These are only some of the areas that OT can target and improve for children with disabilities. Therapists are trained to assess the individual needs of each child by evaluating skill level and functioning in various aspects.  The following are some of the areas that an OT evaluation will assess to determine how well a child has developed and is functioning:

1. Motor Planning—how well the child can coordinate both sides of the body, plan a sequence of movements, translate verbal commands into behavior and imitate movements
2. Activities of Daily Living—how well the child can perform age-appropriate tasks of daily life such as dressing, bathing, toileting, completing schoolwork and participating in play activities
3. Stability—the quality of the child’s reflexes, movement, muscle strength and coordination
4. Sensory Integration—how well the child perceives in all senses (visual, auditory, taste, smell, touch) and how well sensory information is used
5. Fine Motor Skills—how well the child can use tools and utensils and complete tasks that require eye-hand coordination
6. Social Skills—how well the child responds to others, initiates age-appropriate interactions, participates in games and other activities that require cooperation and communication

OT sessions can include a variety of methods and equipment depending upon each child’s particular needs.  Methods used include structured ‘play’ in a therapeutic environment that contains specialized materials and equipment. The OT room may have suspended equipment such as swings in which the child can sit or lie down.   The therapy room will also typically contain equipment designed for climbing (ramps, steps or slides) and other activities that require movement, balance and coordination. Many other ‘toys’ and sensory materials that appeal to sight, sound, touch, smell and taste are often included.  Some occupational therapists will use arts and crafts materials, various tools and utensils, exercise equipment and ‘computer play’.

Conditions Treated with OT

Children with various disorders and disabilities benefit from OT and are frequently referred by their physicians.  Learning Disorders (Goodman, Hurst, & Locke, 2008), Autistic Spectrum Disorders and other Pervasive Developmental Disorders are some of the most prevalent conditions that indicate a need for OT (Watling, Tomchek, & LaVesser, 2005).  Depressive Disorders and Anxiety Disorders, including Post-Traumatic Stress Disorder  (Davis, 1999), have also responded well to these techniques.   It is generally thought that most children with a psychiatric disorder can benefit from OT if such conditions have interfered with educational, social, recreational and self-care development.  Additionally, children with physical impairments due to other illnesses, injury, and congenital conditions can be helped to learn age-appropriate skills, overcome developmental delays and rehabilitate through these methods.  

Participation in OT 

Overall, the goals of OT seek to improve the child’s independent functioning at an age-appropriate and developmentally-appropriate level.  By using play and other enjoyable experiences, OT techniques target skills and abilities that are essential for growth and development in children.  Children with delays and deficits, no matter what the cause, can build and strengthen development. Furthermore, not only behaviors and skills are developed in such therapy.  Children will often improve in mood, motivation, self-confidence, and self-image.  As active participants in their own individualized treatment plans, children begin to view themselves as having abilities rather than limitations.  Additionally, children usually enjoy visits to the occupational therapist and consider their sessions to be play.  Consequently, families are often greatly relieved to find that children are enthusiastic about these sessions since many will have resisted appointments when other ‘less fun’ techniques were involved.  Tantrums and other related disruptive behaviors are greatly reduced when children prepare for and participate in OT appointments since they are viewed as ‘play’ and ‘fun’.  Additionally, children and their families will find that progress is measurable,  gratifying  and can occur rapidly.  Such progress increases motivation, hope, self-esteem and the child’s willingness to continue sessions.  As a result, a good deal of family stress can be immediately reduced as the usually resistant child first engages in therapy.  As therapy continues, and the child becomes more independent, the daily stressors of family life are again diminished.

References:

Davis, J. (1999). Effects of trauma on children: Occupational therapy to support recovery. Occupational Therapy International, 6(2), 126-142.

Goodman, J., Hurst, J., & Locke, C. (2008). Occupational Therapy for People with Learning Disabilities. Churchill Livingstone.

Watling, R., Tomchek, S., & LaVesser, P. (2005). The Scope of Occupational Therapy Services for Individuals With Autism Spectrum Disorders Across the Life Span. American Journal of Occupational Therapy, 59 , 680-683.