What is Pediatric Occupational Therapy?

What is Pediatric Occupational Therapy?
Pediatric Occupational Therapists help children build the developmental motor skills necessary for the successful, independent completion of daily activities and tasks. These activities are broken down into skills and analyzed. Several aspects of motor skills determine a need for service. These include planning, strength, and the quality of the execution of a task. Assessment and Treatment utilize a variety of tools and equipment as well as toys to evaluate a child's developmental milestones . Play is the media most often used in treatment. OT's are trained to aid in the performance of functional activities. These tasks are what occupy our lives and for children, are the building blocks that are necessary to become independent adults.

What skills are targeted during an OT session?
A typical OT session focus on the countless skills a child performs without thought on a daily basis, e.g., think of the motor movements executed during play or the attention skills required for learning. Innate skills are performed as early as birth, known as reflexes. There are developmental reflexes that are important for self-care from birth. The rooting reflex, for example, is important for feeding. Activities of Daily Living (ADL's) are a requisite for growing up and becoming an independent adolescent/adult. These skills begin emerging as young as 6 months old and include dressing, feeding and hygiene. Children often have difficulty with performance of fine motor tasks such as cutting, drawing and manipulation of small objects. They may also present with an awkward grasp while holding crayons, buttons and other small objects. Delayed fine motor skills are frequently a result of decreased strength and coordination in the small muscles of the hand. Fine motor delays are also caused by a decreased ability to stabilize the trunk and shoulders, which help to control the hands for performance of tabletop tasks; these are gross motor skills which can affect the fine motor production. OT's also help children practice gross motor skills including throwing and catching a ball, negotiating playground equipment, and jumping and skipping. These skills all require balance and coordination. Puzzles, drawing and stacking blocks require strong visual, spatial, perceptual and cognitive skills and could be possible areas of concern if not mastered within a developmental framework. An OT will help your child to perceive similarities and differences between objects as well as the correct orientation of objects. In addition, OT's often provide suggestions for teachers and parents to make adaptations within the classroom setting and in the home to ensure success throughout all environments.

What is Sensory Processing?
Another area of concern for Occupational Therapists is Sensory Processing.This refers to the way in which a child registers and interprets sensory information from the environment. This information is attained through a variety of sensory systems: visual, auditory, vestibular (movement), proprioceptive (body awareness), tactile, olfactory and gustatory. Sensory input provides the child with important information about his environment. Effective use of this information is necessary for interpretation and response to stimuli. If a child has sensitivities to input and appears to overreact (e.g. covers ears to block out noises, tantrums in crowded spaces) or appears unaware of sensory information and is not responding appropriately to input (e.g. does not seem to notice or register pain, seeks out deep pressure or hugs) it could be a possible indication of a Sensory Processing Disorder (SPD).

Some examples of sensory processing difficulties:

1. Difficulty sitting still and constantly moves around or “fidgets”
2. Picky eater—preferring foods with similar textures,
3. Difficulty with change—including transitions between different activities,
4. Responding negatively to certain fabrics—preferring to wear the same clothes repeatedly because they are most comfortable in them.

Sensory Processing Disorder Information:

• Kidfoundation.org
• Sensorysmarts.com

What is a Sensory Integration (SI) Clinic?
Occupational Therapists utilize toys and equipment to achieve sensory motor goals.Many tactile items are frequently found in the gym such as vibration toys, squishy balls, sandbox, and rice and/or bean boxes. Diverse tactile media, such as finger paint, glue, glitter, and shaving cream are also common items utilized in sessions. Tabletop tasks are usually part of an OT session if the child needs to practice fine motor skills.

Below are a few pictures of some equipment typically found in a SI gym. The swings are all utilized to provide vestibular input. Each swing has unique properties and focuses on diverse skills such as muscle strength and balance, while the child perceives the activity as fun! For example, standing activities can be performed to work on balance and quadriceps strength while performing a puzzle or a game of catch. The blue swing works on shoulder and back strength, while the child is flying through the air like their favorite super hero. Endless obstacle courses can be made utilizing balance beams, scooters, ladders, therapy balls, the trapeze, ball bath, and any equipment available. There are multiple ways of utilizing each piece of equipment. A child can propel a scooter on their stomach (back and shoulder strength) or sitting (leg strength). Balance beams can be walked on or jumped over. Puzzle pieces can be hiding in the ball bath. Occupational Therapists are imaginative and constantly change the environment to suit each child's daily needs.

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