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for Parents of Special Needs Children

The Occupational Therapist: Your Very Own Private Detective

A Parent’s Guide to What OT Is and How it Can Help Your Child

Part 1 of 2: Understanding OT

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A plan for success 
Occupational therapy (OT) helps children with disabilities increase their independence. The occupational therapist plays the role of “sensory investigator,” working with your SPD child and you to create individualized therapy plans and strategies for success to keep in your ‘backpack.’

What will occupational therapy do for my child?
OT is interactive, child-guided therapy. The therapist uses multi-sensory activities — that is, activities that incorporate movement, touch, sight, sound and muscle input — to give your child the experiences he/she needs to master the occupations, or demands, of everyday life.

A child has a variety of “occupations,” such as playing, learning, socializing, and taking care of basic needs such as bathing, dressing, toileting, feeding. These occupations all work together to develop the ability to function independently in the world using skills such as: sensory discrimination and processing; fine and gross motor; communication; social; interaction; cognitive; self-care; self-concept; and self-esteem.

Right now, there is a separation between your child and his or her environment. OT helps bring them together to allow your child to thrive at home, in school, and in society.
 
What is the role of the occupational therapist?
As a sensory investigator, the therapist begins by observing your child in order to figure out more about what’s happening with his/her sensory-based needs. The therapist identifies the sensory and environmental obstacles that limit your child’s ability to participate successfully in everyday activities.
 
The therapist then develops a plan of action which includes:
  • Teaching your child sensory and motor strategies to handle sensory processing challenges and participate in everyday life activities and real life social interactions
  • Developing daily routines to help keep your child regulated and to increase his/her self-awareness and adaptive response to sensory input
  • Helping the entire family learn how to modify the environment and potentially stressful situations in order to build on your child’s individual strengths and accommodate his/her difficulties
  • Recommending adaptive equipment and teaching your child how to use it effectively
  • Working with other medical professionals, such as physicians, speech-language pathologists, physical therapists, etc., to determine the need for specialized evaluation and intervention
What skills does an occupational therapist help facilitate?
  • Fine motor coordination (see explanation below)
  • Gross motor coordination (see explanation below)
  • Play
  • Independence with daily living/self-care appropriate to your child’s age
  • Sensory processing
  • Self-regulation
  • Social
  • Attention
  • Behavioral
  • Visual perceptual
  • Eye-hand coordination

What is fine motor coordination?
“Fine motor skills” refers to our ability to use our arms, hands, and fingers to grasp, hold, and manipulate small objects. For most of us, it is simple to learn how to hold and use a scissors, a pencil, a spoon, a toothbrush, without realizing the control and precision necessary to manipulate them properly. But for some children, it does not come so easily. This can affect them in school and socially, since they cannot write clearly and legibly, cut out an object along the lines, tie their shoelaces, or even play successfully with many toys, such as blocks and balls.

What is gross motor coordination?
“Gross motor skills” refers to our ability to use the large muscles of our body in order to perform some main movements. These include running, skipping, jumping, hopping, riding a bicycle, and most other athletic abilities. Very importantly, gross motor coordination is often related to muscle tone. Good muscle tone is necessary for posture, balance, stamina and muscle control in positions including sitting and standing. In addition to having difficulties with gross motor skills, children with low muscle tone may tire faster than their peers, as well as appear clumsy. This can affect their self-esteem and they refuse, or are unable, to participate in many typical childhood activities. 

Occupational therapy can address and improve fine and gross motor development on many levels.

What is the evaluation process?
To determine if your child has Sensory Processing Disorder and could benefit from therapy, a qualified occupational or physical therapist will use a sensory history provided by other medical professionals and/or by parents; standardized testing; and his or her own clinical observations of your child’s posture, balance, coordination, eye movements, and responses to sensory stimulation.
 
The therapist will carefully analyze the test results and assessment data to determine which symptoms the child displays; which category or categories causes difficulty; how much it interferes with his/her daily life; and how it impacts his/her level of functioning. The therapist will then be able to make targeted recommendations about appropriate therapy and strategies.
 

Money is not a barrier to obtaining an evaluation and/or therapy
Whether your child is attending or will attend public or private school, your child from birth up to the age of 21 is covered under the “Child Find” mandate, which is included in the “Individuals with Disabilities Education Act.” Child Find requires all school districts to (find and) evaluate all children with disabilities, regardless of the severity of their disabilities. If your child is under three years, you will want to contact the “Early Intervention” program. Both Child Find and Early Intervention are run by your school district.

Don’t wait to get your child evaluated
Occupational therapy services are available in schools, hospitals, clinics and other facilities, public and private therapists and programs, Head Start programs, community centers, and through referral from a physician. Decide which is the best place for your child and family. The earlier the child receives intervention, treatment, and therapy, the better the outcome. Trust yourself — if you think there’s a problem, take your child for an evaluation as soon as you can. Be sure to bring your checklist/s, journals, notes, etc. because the more information you can provide, the more accurate the evaluation will be.

After the initial evaluation, occupational therapists work closely with your child and family to create an individualized intervention and therapy action plan to help with daily living activities and allow your child to thrive.
 

Looking ahead:
In the next post, we will finish discussing the role of the occupational therapist and the therapy program in helping your child fully integrate into his or her environment.

Where are you in the evaluation process? Please share your thoughts in the comments section below. Also, let me know there or via email what topics you would like to discuss or hear more about. 
 
Feel free to share or quote from this blog (with attribution, please, and if possible, a link), and to repost on social media.
 
I look forward to hearing from you!
 
 

All the best,
Miriam

About Miriam:
Miriam Skydell MS, OTR/L is a pediatric OT with 30 years experience and a strong commitment to empowering every child and every family with the skills, confidence and emotional stability necessary for a meaningful, independent life. In addition to her Masters degree from NYU (1986) and membership in the AOTA (American Occupational Therapy Association), Miriam is a licensed Interactive Metronome®,  HWT (Handwriting Without Tears®), and TLP (The Listening Program®) provider.

Miriam performs preschool screenings, contracts experienced OTs, PTs and STs to schools, helped implement the HWT curriculum, and lectures extensively for parent and support groups and at teacher conferences for public and private schools throughout New Jersey. Through her private practice in Fair Lawn, Miriam Skydell and Associates, established in 1995, Miriam has helped countless children with a wide range of diagnoses improve functional living skills, manage the impact of sensory processing dysfunction, and meet their individual potentials.

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