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Pediatric Occupational Therapy

Pediatric Occupational Therapy

Typically, when people hear the term “occupational therapist,” they associate it with work or job-related tasks. When we discuss pediatric occupational therapy with someone unfamiliar with the profession they are confused as to why a child would need therapy to return-to-work. However, the term “occupational” just refers to how one occupies their time. For adults, that can be dressing themselves, cooking, driving, golfing, parenting, work, etc. For children, it might be school tasks, dressing, feeding themselves, and PLAY. One of a child’s most important “occupations” is play. Children develop strength, balance, coordination, social skills, and hand dexterity during these activities.

Who do Pediatric Occupational Therapists work with?
The American Occupational Therapy Association explains that “Occupational therapy practitioners work with children, youth, and their families, caregivers, and teachers to promote active participation in activities or occupations that are meaningful to them.” This highlights the fact that when it comes to pediatrics, the caregivers and/or the teachers are a major piece of the therapy. They provide valuable information to help individualize the treatment, and they can also perform activities at home and school that help the child meet their therapy goals. Pediatric occupational therapists work with a variety of children and diagnoses including Down’s Syndrome, Autism Spectrum Disorder/Sensory Processing Disorders, Cerebral Palsy, Brachial Plexus Injuries, general orthopedic injuries, and delayed milestones.

What does therapy look like?
I always tell people, if it looks like we are just playing, then I’m doing my job well. We try to make all our activities as engaging and fun as possible. However, every piece of that task has a purpose. For instance, it might look like we are just playing a game of “Operation”, but in that task we are working on the correct grasp to hold a pencil; we might be in tall kneeling to work on balance and core strength; and we can reach up to place the pieces on a shelf to work on strength and range of motion. Each task has a purpose, but in the end, we try to make it all play. If we are doing therapy to improve feeding abilities (motor or sensory issues), we will do a lot of play with the food and may not even do much eating until we establish a level of comfort with the therapy and with food. Commonly, true sensory and motor-based feeding issues involve a lot of anxiety, so that will always be taken into account. The caregivers can sit in on therapy or wait in the waiting room. Depending on the situation and goals for the session, it might work better to have the therapist be one-on-one with the child or for the caregiver to watch certain techniques the therapist is using with the child.

How does someone obtain occupational therapy services for their child?
To receive occupational therapy, you need a script/referral from a primary care physician, child-developmental specialist, physician’s assistant, nurse practitioner, chiropractor, or surgeon. There are several different settings and avenues where a child can receive occupational therapy depending on age, diagnosis, and other criteria. If you think your child would benefit from outpatient occupational therapy services, it would be beneficial to discuss it with your/their doctor. You can also contact us with any questions at 316-263-0003.

Final Thoughts
Even though the holidays are over, with the shopping and delivering of presents over the last several weeks, I thought it would be beneficial to talk about toys. Play and being able to use and manipulate toys is such a critical piece of development for children. They learn creativity, problem solving, and develop important motor skills during this time. Recently, children are starting to display delays in milestones as well as weakness and decreased balance compared to their counterparts in previous decades. In a study by Lin et al (2017), researchers found that preschoolers who utilized touch-screen devices for greater than 60 minutes, displayed weaker fine motor skills compared to preschools who had less screen/computer time. There are many possible contributors to this; however, one major thing we can do to help is to give them opportunities to develop and improve these skills through play and different toys. Stacking blocks, balls, shape sorters, pretend play sets, coloring books, and toys that require reach and pinch are very beneficial for developing gross and fine motor skills. Even though tablets and TV do have educational programs available, they do not provide the motor development of those basic toys. Even using a crayon for drawing instead of a stylus can provide different feedback to the child and help with handwriting as they get older. Sometimes less electronic/automatic toys and more creative/building toys can help children reach their milestones.

Finally, as I have worked with children more and more, I am better able to understand the difference between behavioral and sensory issues. As we are going through the hustle and bustle of shopping and running errands, it is important to remember that the child throwing a “temper tantrum” in the store might actually have a sensory processing disorder and is overwhelmed by the crowds and noises. A child who seems to be misbehaving may have a disability that is not visible. We are seeing a shift in society as we learn more and become more aware and understanding of these conditions. This is very promising, and I hope parents in those situations are feeling more supported and less judged.

Content provided by Angela Gerstenkorn, MOTR/L

Ling-Yi Lin, Rong-Ju Cherng & Yung-Jung Chen (2017) Effect of Touch Screen Tablet Use on Fine Motor Development of Young Children, Physical & Occupational Therapy In Pediatrics, 37:5, 457-467, DOI: 10.1080/01942638.2016.1255290
https://www.aota.org/~/media/Corporate/Files/Practice/Manage/Presentation-Resources/Brochure/What-is-OT-Peds.pdf

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