Occupational Therapy: Hands-on Help
By Randi Mazzella
When my son Jason was 4 years old, he was asked to draw a picture of his family for school. While my daughters both loved to color at that age, Jason was more likely to choose a bat and ball over a crayon. So although I wasn’t surprised by the results of his efforts, I was concerned when I compared it to the quality of the pictures his classmates had drawn. I discussed my observations with his teachers. They agreed his writing and drawing were lagging behind his peers, but that it wasn’t a major problem. They told me that all children just develop at different rates.
A few weeks later, Jason was trying to write his name when he said, “I don’t know why my Js don’t look as good as Jake’s.” Even though he was working hard, his writing wasn’t progressing typically; he seemed upset about it.
So I spoke to his teachers again and decided it would be worthwhile to have Jason evaluated by an occupational therapist.
Making life easier
The American Occupational Therapy Association (AOTA) defines occupational therapy as “a profession that enables people of all ages to live life to its fullest by helping them promote health and prevent—or live better with—illness, injury, or disability.” Sandra Schefkind, an AOTA pediatric coordinator, says, “Occupational therapy supports a child’s ability to complete his daily habits and routines (occupations), such as playing on the playground, developing friends, and building independence in self-care skills such as eating or dressing.”
Further, Schefkind says, “Activities such as buttoning a shirt, opening their lunch box, or riding a bike may be challenging for a child with physical or emotional issues. If a child has trouble performing these tasks, he may become upset and frustrated.” Occupational therapy (OT) teaches coping skills and techniques to help circumvent those negative reactions.
The need for occupational therapy may occur at any time. It can help children with significant disabilities, as well as those with less severe delays, and offers a holistic approach to helping kids in such areas as fine and gross motor coordination, motor planning, sensory integration, behavioral health, and more.
Successes and struggles
Although there are some indicators that a child might benefit from occupational therapy, Schefkind suggests parents look at their child’s overall behavior and performance and note both his successes and struggles. She says, “For some children, the need for occupational therapy is more obvious, while for others there are subtle signs.”
Parents need to use their instincts and observe trends in their child’s behavior, participation, and emotional response during a variety of situations, she said. They should ask themselves, ‘Does my child struggle with the physical or emotional components of activities, such as completing homework assignments or participating in self-care tasks? What feedback is given about my child’s performance in school, on the playground, or in playgroups?’” Parents can request a conference with their child’s teacher or a meeting with their physician to ask about their child’s development and progress, and whether the child would benefit from occupational therapy.
For my son, the developmental delay in handwriting was a red flag. But the fact that he was starting to feel bad about himself and how his skills measured up against his peers’ was what prompted me to get the evaluation.
Jane Case-Smith, editor of the book Occupational Therapy for Children (Elsevier Science, December 2004), says, “Sometimes children think they are at fault when they are having trouble in social situations or with school work. Parents and teachers can also get frustrated, believing the child isn’t trying her best or she is just behaving badly. Having somebody indentify that there is in fact a problem is the first step toward helping a child feel better about herself and getting her the assistance she needs to be able to participate fully in her life.”
An occupational therapy evaluation may include formal testing, interviews, and observation of the child to monitor the level of his performance in critical developmental areas. To find an occupational therapist who can perform an evaluation, Schefkind suggests asking your child’s school or physician, or other parents, for recommendations.
Occupational therapy is offered in schools, homes, hospitals, and clinics.
Work as play
Occupational therapists use play to enhance a child’s skills and encourage her to try new things that may be difficult. They can help to adapt or modify toys or the environment so the child can become stronger and more independent. For example, an occupational therapist may add handles to puzzle pieces so the child with coordination difficulties has greater ease of manipulation. Occupational therapists try to strike a balance of making therapy fun while making it challenging, so the child progresses without getting frustrated.
An occupational therapist will also provide the family with a home program to reinforce skills and promote carryover. She can suggest ways to modify the classroom or learning materials to best support the child’s needs. My son’s therapist, for example, suggested a slant board and fat pencils that help him with his writing at home and at school.
Jason has been going to occupational therapy for more than a year. Although sometimes he still struggles, his therapist and I help him overcome hurdles and praise his dedication and abilities as he tries to master new skills. Occupational therapy has increased his confidence and made him a happier student and child.
When to intervene
If your child displays several of the following difficulties, consider an evaluation by a licensed occupational therapist:
- Balance and coordination difficulties
- Clumsiness, frequent falls, bumping into people or objects
- Frequent fatigue or apparently weaker than his peers
- Difficulty with fine motor skills and handwriting
- Difficulty manipulating small toys
- Difficulty with dressing, using utensils, or grooming activities
- Difficulty with transitions or adjusting to changes in routine
- Limited play skills
- Limited social interaction
- Tendency to become overwhelmed easily
- Avoids playgrounds or motor activities with peers
To learn more
Randi Mazzella is a freelance writer from Short Hills, NJ. She has three children.
December 2009
