What is pediatric occupational therapy and how can it help my child?

Occupational therapy (OT) treatment focuses on helping people with a physical, sensory, or cognitive disability be as independent as possible in all areas of their lives. OT can help kids with various needs improve their cognitive, physical, sensory, and motor skills and enhance their self-esteem and sense of accomplishment.

Some people may think that occupational therapy is only for adults; kids after all, do not have occupations. Well this is not true! A child’s life is made up of “occupations,” or daily activities. These occupations include playing, learning, and socializing. Occupational therapy practitioners work with children and their families to help them succeed in these activities throughout the day.

They also help with basic challenges faced by most families, from creating morning routines to choosing appropriate toys.

According to the American Occupational Therapy Association (AOTA), in addition to dealing with someone’s physical well-being, OT practitioners address psychological, social, and environmental factors that can affect functioning in different ways. This approach makes OT a vital part of health care for some kids.

My paediatrician said my child may have sensory integration dysfunction?

Sensory integration is a specialty area of practice within the field of occupational therapy.

When we think of the senses we generally think of sight, sound, smell and taste. In addition to these senses, occupational therapists are concerned with the senses of touch, movement and postural responses to the sensation of gravity and movement. Just as the eyes detect visual information and relay it to the brain for interpretation and action, other sensory receptors pick up and relay information to the brain for interpretation and purposeful response. Many of our sensory processes take play within the nervous system at an unconscious level. Cells within the skin send information about light touch, pain, temperature and pressure to the brain. Structures in the inner ear along with our eyes detect movement and changes in position of the head. The vestibular system allows us to maintain our balance while engaged in physical activity. The proprioceptive system gives us a sense of where we are in space and allows us to move our arms and legs in a guided and controlled fashion. An adequately functioning sensory system is crucial in helping us interact with others and the environment. This interaction between the senses and higher cortical functions is complex and necessary in order for a person to interpret a situation accurately and make an appropriate response. It is this organization of the senses that is termed sensory integration. Pediatric occupational therapists work with infants and young children to facilitate this intake of information, processing and make sense of it and responding to it appropriately, to help develop a child’s organization of behavior and self regulation.

How do I know if my child needs occupational therapy services?

The decision to pursue occupational therapy services for your child is a very personal one. There are a number of reasons that a paediatrician, teacher or parent may decide that it is time to act. Usually, there are a number of concerns in one or more of the following areas:

  • Difficulty with coordination either gross motor, fine motor or visual motor (for instance difficulty holding and controlling a pencil), as with other children their age.
  • The child is overly sensitive to touch, movement, sights or sounds. Difficulty tolerating touch sensations may be exhibited in a child having difficulty sitting close to peers in circle time or standing in line at school.
  • Under reactivity to sensory stimulation, this may be exhibited by children who are constantly seeking input of various types.
  • Activity level that is unusually high or unusually low.
  • Increasing frustration or feelings of failure.
  • Difficulty with learning self-care skills: dressing, fastening clothing or independent feeding
  • Poor organization of behavior.
  • Difficulty making and keeping friends.
  • Difficulty learning new and unfamiliar tasks.
  • Difficulty with learning to write or complete school work or household chores in a timely manner.

What referral do I need to receive Occupational Therapy?

Most of the clients we see have been referred by a development pediatrician or a pediatric neurologist who may first diagnose a particular developmental disability or if the child may be at risk for the same.  However, parents, school teachers and significant other care takers or professionals working with the child may also refer the child for OT evaluation if they notice some red flags.

Why does my child need to have an OT evaluation and treatment plan?

The evaluation determines your child’s strengths and weakness in various areas of development. We use the information gathered in the evaluation to determine the nature of services needed and to write specific treatment goals, as well as, to measure your child’s progress.

If my child needs OT, how long does it last?

Each child is very different and courses of therapy can range from 6 months to more typically 2 years or more depending on the severity of issues. We have found that children who come regularly to their scheduled appointments and follow home programs make the most progress.

What areas are addressed in occupational therapy treatment?

Occupational therapy treatment encompasses several areas of performance. All treatment plans and therapy goals are created and implemented based on the child’s individual needs.

  • Fine Motor Skills: Pertaining to movement and dexterity of the small muscles in the hands and fingers.
  • Gross Motor Skills: Pertaining to movement of the large muscles in the arms, legs and trunk.
  • Visual Motor Skills: Referring to a child’s movement based on the perception of visual information.
  • Oral Motor Skills: Pertaining to movement of muscles in the mouth, lips, tongue and jaw, including sucking, biting, crunching, chewing and licking.
  • Self-Care and functional Skills: Pertaining to daily dressing, feeding and toileting tasks.
  • Sensory Integration: The ability to take in, sort out and respond to the information we receive from the world.
  • Motor Planning Skills: The ability to plan, implement and sequence motor tasks.
  • Neuromotor Skills: Pertaining to the underlying building blocks of muscle strength, muscle tonicity, postural mechanisms and reflex integration.

Who can benefit from occupational therapy?

Children who can benefit from occupational therapy include but not limited to diagnoses like:

Autism spectrum disorders
Sensory integration disorders
Difficulty with handwriting
Down syndrome
Genetic disorders
Cerebral palsy
Spina bifida
Visual deficits
Developmental delays
Seizure disorders
Brain injuries
Feeding issues
Oral motor skills
Learning disorders

Do I need to attend these sessions with my child?

We require that at least one parent or care taker attend each session. This is because a large part of the therapy service provided involves coaching the parents or carers, as well as discussion and feedback.

The exception is in group sessions – these focus on therapist-supported peer interaction, and do not involve the parent during the main body of the session.

What happens in a group session?

When your child is ready for peer group sessions, your therapist will begin looking for a suitable peer partner/group and time. We match our peer groups very carefully, and will not offer a peer group until we are confident that this will be a good match and provide the right level of challenge for each child.

In the peer session, parents are generally not included, except for a brief period at the end of the session (the last 5-10 minutes) when your therapist will discuss the session with you. Your child will come into the therapy room with their peer/peers, and the therapist will facilitate (rather than lead) a play session between these children. This is a great way to help your child develop the social skills which will support them throughout their life, in a controlled and supportive environment. Groups are held to work on social skills, self-regulation skills, handwriting, feeding, fine motor, play skills etc.

My child is being seen by another professional – will your therapist be able to communicate with other professionals to ensure consistent care for my child?

Yes. We will be more than happy to communicate with other professionals at your request, regarding your child’s care. We feel that co-ordinating care and using a holistic approach towards the overall treatment plan for the child can be of great benefit

What ages does Reach Therapy Center see?

We see children ages birth to 18 years of age. We may also continue to see them post 18 years of age if the functional goals to be worked upon are within our scope and area of practice. We also see special cases for therapy, for e.g. an adult with cerebral palsy or similar other developmental disability, within our scope and area of practice.

Are all sessions held in the therapy center? Will my therapist visit my home or my child’s school/preschool/daycare?

All of our regular sessions are held in our therapy offices. However, on request, your therapist can look into doing a visit to your child’s school/preschool/daycare, or to your home, to observe and to make recommendations.

What days and/or hours do you work?

Our center is open Monday-Friday from 10:00-7:00 and Saturdays from 9:00- 5:00 pm.

After I schedule the evaluation what should I tell my child?

If your child is old enough to have a conversation chances are he/she has already told you some things are difficult for them or they don’t like school. A conversation noting these concerns: “I know you don’t like writing, dressing or feel uncomfortable with standing in line with your friends (or whatever the presenting problem may be) etc. We are going to see a friend of mine to see if she can make some of these things easier for you. She is going to play some games with you to see what can help you and help me learn to help you too.” Most children are relieved to hear that their parents understand that some things are hard for them and that they are going to get some special help. The evaluation is done in a fun way and is like playing games at a table and playing on an indoor playground.

How many therapists do you have, and how do you decide who will take on my child?

We have a team of 7 proficient and trained Occupational therapists on our panel. There will be one therapist doing on going sessions with your child to maintain consistency for the children and families. The therapist doing on going sessions with your child will be decided based on the requirements of the child and family and also on logistic factors like the availability of time and slots for the child and the therapist.