| Services - Occupational Therapy
Occupational therapy is provided for infants through adolescents to assess and treat fine motor skills, visual-perceptual skills, cognitive skills, and sensory-processing impairments. A child might benefit from one or two sessions or many sessions over months or years. The parent usually accompanies the child with the therapist on his first evaluation visit; in ensuing visits the parent usually waits in the waiting room for 45 minutes while the child works with the therapist, but sometimes parent stay with the child and therapist for part of the session. The last few minutes of a session are reserved for the therapist and parent to discuss the visit and the progress that the child is making, as well as to review home exercise and programs. During the sessions, the Occupational Therapist may work with the child on skills such dressing, tying shoes, writing, cutting with scissors, or handwriting. Sometimes the Occupational Therapists help kids create alternate ways to play popular games they might miss out on because of their impairments. Some children learn best by planning obstacle courses or a series of movements and then moving and preparing the equipment before moving through the obstacle course. Kids learn by playing and doing, so the office and gym at Milestones has interesting toys like swings, a fort, a trampoline, tires, a trapeze and lots of games and fun things to do with paper, scissors markers and pencils.
Questions About Occupational Therapy
How does the Occupational Therapist help my child?
Occupational Therapists at Milestones use a variety of techniques and methods with children to improve their skills, depending on the child’s needs and characteristics. Our clinic gym area is set up especially to provide proprioceptive input (joint movement and awareness) and vestibular input (balance via the inner ear) with equipment such as suspended swings, a trampoline, a fort to jump from into foam pads, scooters and all sizes of therapeutic balls. In this sensory based environment, our Occupational Therapists use techniques from their study and experience such Neuro-development Treatment, Sensory Integration techniques, functional training, Therapeutic Listening, as well as other functional and goal based activities. Occupational Therapists work on fine motor skills so that kids can grasp and release toys and develop good handwriting skills. Occupational therapists might also address hand-eye coordination by working on copying words off the board, assembling a puzzle or completing a maze. Some children with atypical social skills learn how to interact with others, both adults and other children. Children in therapy improve play skills, such as hitting a target, batting a ball, writing on a blackboard. The Occupational Therapist will give you home activities and will teach you what to expect and how you can help your child at home.
What are some examples of diagnosis that children may have who come to Milestones for OT?
A child with the diagnosis of autism is a good example of a child who might go to Occupational Therapy. The therapist may provide that child an initial period of gross motor activities such as swinging, crashing into mats or brushing his skin before sitting down to do handwriting or other fine motor task. The therapist could help him organize his activities by making an activity plan with him and then helping him set it up and follow it through to completion. Depending on the child’s needs and development, the therapist might work with the child on his grasp of a pencil and forming letters. The therapist might even work on upper extremity strengthening via pull ups, push ups, bear walking and wheelbarrow walking to improve his posture while writing and coloring. If the child is receiving other services, such at PT or Speech, the disciplines collaborate to work on areas of communication and motor skills at every visit with the professional.
A child with the diagnosis of hemiplegic Cerebral Palsy is another example of a child who could benefit from receiving Occupational Therapy Services. That child might not be able to use his less strong hand for writing so learning the letters with his stronger hand while stabilizing with his involved hand would likely be one activity they practice frequently. His shoulder and elbow joints could be tight from the increased muscle tone from the hemiplegia, so active and active assisted range of motion would be in their repertoire of activities, as might push ups, wheelbarrow walking and mimicking zoo animals with his body could be part of the session. If the child would benenfit from hand splinted, the OT could assist the family in obtaining a splint or make splint to make the hand more functional.
Toddlers and Preschoolers are sometimes in Occupational Therapy because they have not developed age appropriate fine motor skills for handwriting or cutting with scissors as well as being able to stay on task to practice fine motor skills. An OT might provide activities alternating large muscle and small muscle activities to increase success at letter formation and grip position. This same child might be doing a brushing program at home with his family as part of a home program to address his tactile sensitivity. Children with visual perceptual challenges might need assistance to follow a line of pictures visually or be able to jump and track objects at the same time. An OT can assist the child in skills required for kindergarten, such as shoe tying, writing his name and staying on task to complete activities. Each play scenario is tailored to the child’s strengths and weakness.
I think my child might benefit from coming to Occupational Therapy. How can we get started?
Frequently a parent and pediatrician discuss a child’s needs and the physician refers the child for therapy. Sometimes the parent has identified the need and wants as much information as possible about the child’s abilities, so self initiates a therapy evaluation. Either way, an OT can examine and evaluate you child by arranging an evaluation appointment. A Occupational Therapist can initially examine and evaluate you child without a physician’s referral, but if OT intervention is recommended, we must obtain a referral from your child’s pediatrician or other physician that is caring for your child. Not only is this part of the practice rules for OTs, it is sometimes required by insurance companies for reimbursement and most importantly to insure that your therapist is aware of any precautions or contraindications and to keep the child’s pediatrician abreast about his/her progress.
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