Every individual engages in occupations, jobs, routines and responsibilities. For children, jobs include drinking from a bottle, tolerating the fabric of clothing, sitting up in order to play, buttoning a button, participating in a game with other children, tolerating the noise of a birthday party, holding a pencil, writing legibly, playing on the playground, the list goes on and on. There are, however, numerous reasons why a child would be unable to successfully participate in his/her roles, or occupations. These can include motor difficulties, sensory processing inefficiencies, perceptual deficits, visual problems, or other interfering factors.
Occupational therapists possess a knowledge base of anatomy and physiology, neurology, sensory and motor development. We have been trained to analyze tasks or activities. This includes breaking down the activity into components, and identifying the areas of weakness. For example, if a child is struggling with handwriting, an occupational therapist assesses all components necessary for the child to be successful with this task, including sitting posture, core strength, shoulder stability, hand strength, and visual/perceptual skills.
Questions about Occupational Therapy:
Also see FAQ page for more information
My child's teacher told me that my child might benefit from occupational therapy. What is it?
Occupational Therapists who specialize in pediatrics are trained to create opportunities for children to master developmental tasks and achieve independence in their home, school, and community. A few reasons for referral for evaluation and treatment include clumsiness, difficulty with grasp or motor skills and difficulty playing or socializing effectively. Direct service or consultation may be provided by your school’s therapist if your child’s difficulties directly interfere with education. Private occupational therapists, often covered by insurance companies, focus on a greater variety of intensive treatment interventions.
Why is handwriting so difficult for my child?
The physical act of handwriting can be a very laborious process for some children. Most don’t understand the various underlying components involved with this task. Sitting in the chair, maintaining an upright posture, stabilizing the paper with the supporting hand, having efficient visual motor skills, fine motor strength and coordination are all prerequisites to the obvious skill of the child holding the pencil, formulating thoughts and then writing them in a cohesive and legible manner. It is no wonder why some children struggle! If your child is still struggling at age 12, exploring other means of written communication may be appropriate. An occupational therapist is trained to evaluate where the breakdown is that is causing your child to struggle, and can make recommendations based on your child’s current skills.
What is sensory integration? What does the term mean?
The term ‘Sensory Integration” is be used to reflect the theory developed by A. Jean Ayres, an occupational therapist, as well as for the intervention strategy that was based on that original theory.Sensory Integration is used to describe certain processes that go on in our brain, allowing us to make sense of the information we get from our environment and act on it. The term refers to the process by which the brain interprets and organizes various sensory experiences including sight, sound, smell, touch, movement, body awareness, and the pull of gravity. Sensory integration is a normal phenomenon of central nervous system functioning and provides a foundation for complex learning and behavior. For some individuals sensory integration does not develop as efficiently as it should. Sensory integration dysfunction can result in motor development difficulties, learning difficulties, or behavioral concerns.
How do I know if my child has a Sensory Processing Disorder (SPD)?
What should I do if I suspect that my child has SPD (Sensory Processing Disorder)?
If a child has SPD, it can present in various ways. Efficient processing of sensory information is an integral foundation of the development of skills. A disruption in processing sensory information can interfere with self-care skills, language skills, motor skills, academic skills, and social/emotional skills. Examples of sensory processing disorder include sensory defensiveness (an over response to various types of sensory input), problems in self-regulation (activity levels too high or too low for the task at hand), and difficulties with praxis or motor planning (the ability to conceive, organize and execute skills of all kinds). Some specific concerns might be:
- takes a long time to learn a new task/skill
- seems clumsy, has too many accidents
- not keeping up with peers
- presents as a behavior problem at school
- has difficulty with handwriting
- demonstrates unpredictable behavior in social situations, especially new or highly stimulating ones
- acts restless or fussy when held
- displays short attention span
- seems overly dependent upon routine or schedules and/or easily upset with minor changes
- acts impulsively or explosively
- angers easily or frequently accused of of fighting, acting out, or “bullying” others
- appears overly colicky or fussy
- exhibits “picky” eating behavior
If you think your child has SPD, an occupational therapy evaluation is appropriate. An evaluation usually consists of standardized testing (when possible), a structured observation of play and responses to sensory input, and an interview with the parent. If intervention is recommended it can be intensive (more than once a week), weekly, or consultative.
Can my child just practice the tasks with which he struggles?
Typically, when a child struggles with certain motor skills, repeated practice alone isnt enough. It is important to remember that not all types of learning, particularly motor learning, can be mastered by practicing. Efficient sensory processing is necessary for higher level skill attainment. When there is a dysfunction, natural skill acquisition rarely happens. Until a child has efficient processing, he wont acquire the skill effectively.
What happens during therapy?
Therapy is often fun for the child. Our clinicians use a play-based approach for all intervention plans. During occupational therapy sessions, the clinician creates an environment where your child participates in activities that develop their areas of weakness. While your child is swinging, jumping on the trampoline, and crashing into the ball pit, these activities are actually improving underlying vestibular processing, proprioceptive processing, balance, coordination, and body awareness. Functional activities are always incorporated into treatment sessions, such as drawing a picture, completing a puzzle, tying shoes, or even handwriting.
What is sensory processing, and how is it different from SI?
Sensory processing is the initial step of sensory integration. Inputs must be taken in, filtered, and organize before integration can occur. Integration is the final step of an organized response to inputs received. It includes a motor response typically called an adaptive response by followers of Ayres.
What is body awareness?
There is an internal body “map” each of us has that allows us to know where we are, what position we are in, and how we are moving at any given moment. The body map allows us to move without relying on our visual system to guide each movement. It is created over time as we develop from infancy throughout childhood. This system allows you to know where you are in space and is created by the feedback received from muscles and joints. Children with inaccurate body maps typically rely heavily on their visual systems and have significant difficulty with many aspects of motor skill, such as poor coordination, frequently bumping into people and things, and generally being clumsy.
What is the vestibular system?
The vestibular sense allows individuals to maintain balance and upright posture. It is closely connected to the visual system and allows us to judge our movement in relationship to objects around us. This sense allows us to feel secure with gravity such as being comfortable with our feet off of the ground when on a swing or climbing up high on playground equipment. It also allows us to know where we are in relation to gravity. Some children who have inefficient processing of vestibular information may spin and spin and never get dizzy, or may be extremely fearful and refuse to go on an amusement park ride.
What is proprioception?
The proprioceptive sense allows us to understand in what position are our body parts, meaning, where exactly our body is in space. For example, without looking, you can tell if your elbows or knees are bent or straight. This sense also tells us about the force of our movements, such as being able to automatically reach and grab for a cup without knocking it over. Children with inefficient proprioceptive processing may fall out of their chair for no apparent reason, or grasp the crayon so hard that it breaks. This sense is extremely important for body awareness and coordinated movements.
What is sensory defensiveness?
Sensory defensiveness is an over-sensitivity to a particular type of sensory input, such as touch, visual, auditory, movement and smell. Defensiveness suggests a cluster of aversive responses to one (or more than one) type of sensory input. For example, a child who is defensive to tactile input may only wear sweat pants or dresses regardless of the weather. A child who is defensive to auditory input may frequently cover his ears and become upset when he hears a hair dryer, vacuum cleaner, or the echo in a large classroom; he may be bothered by sounds that others tend to not notice, such as the hum of the refrigerator. A child who struggles with defensiveness may avoid social gatherings or have frequent meltdowns which impact their ability to interact in their environment.
What are my next steps?