COMMON QUESTIONS ABOUT OCCUPATIONAL THERAPY

By Myania Moses
Myania Moses & Associates, Pediatric Occupational Therapy Services, Inc.
www.myaniamoses.com


What is pediatric occupational therapy and how can it help
my child
?

Occupational therapy is an allied health profession devoted to helping
individuals with motor and behavioral problems learn how to perform
purposeful activities. The purposeful activity of children includes: playing,
climbing, swinging, jumping, running, bike riding, drawing, cutting and writing
to name a few. The child’s occupation is to develop play, social, self care,
gross, fine, sensory, visual and perceptual motor skills along with pre-
academic and academic skills. Through activities the child’s response to the
environment becomes more organized and efficient.

How do I know if my child needs occupational therapy
services?

The decision to pursue occupational therapy services for your child is a very
personal one. There are a number of reasons that a pediatrician, teacher or
parent may decide that it is time to act. Usually, there are a number of
concerns in one or more of the following areas:

*Difficulty with coordination either gross motor, fine motor or visual motor (for
instance difficulty holding and controlling a pencil), as well as with other
children their age.
  
*The child is overly sensitive to touch, movement, sights or sounds. Difficulty
tolerating touch sensations may be exhibited in a child having difficulty sitting
close to peers in circle time or standing in line at school.
  
*Under reactivity to sensory stimulation, this may be exhibited by children who
are constantly seeking input of various types.
  
*Activity level that is unusually high or unusually low.
  
*Increasing frustration or feelings of failure.
  
*Difficulty with learning self care skills: dressing, fastening clothing or
independent feeding.
  
*Poor organization of behavior.
  
*Difficulty making and keeping friends.
  
*Difficulty learning new and unfamiliar tasks.
  
*Difficulty with learning to write or complete school work or household chores
in a timely manner


My child’s teacher said my child may have sensory
integration dysfunction, what does that mean?

Sensory integration is a specialty area of practice within the field of
occupational therapy. When we think of the senses we generally think of sight,
sound, smell and taste. In addition to these senses, occupational therapists
are concerned with the senses of touch, movement and postural responses
to the sensation of gravity and movement. Just as the eyes detect visual
information and relay it to the brain for interpretation and action, other sensory
receptors pick up and relay information to the brain for interpretation and
purposeful response. Many of our sensory processes take play within the
nervous system at an unconscious level. Cells within the skin send
information about light touch, pain, temperature and pressure to the brain.
Structures in the inner ear along with our eyes detect movement and changes
in position of the head. The vestibular system allows us to maintain our
balance while engaged in physical activity. The proprioceptive system gives us
a sense of where we are in apace and allows us to move our arms and legs
in a guided and controlled fashion. An adequately functioning sensory system
is crucial to helping us interact with others and the environment. This
interaction between the senses and higher cortical functions is complex and
necessary in order for a person to interpret a situation accurately and make an
appropriate response. It is this organization of the senses that is termed
sensory integration. Pediatric occupational therapists work with infants and
young children to facilitate an adequately functioning feedback loop between
the sensory systems and the brain allowing for the development of
appropriate skills and self-regulation.

Why does my child need to have an evaluation and
treatment plan?

The evaluation determines your child’s strengths and weakness in various
areas of development We use the information gathered in the evaluation to
determine the nature of services needed and to write specific treatment goals,
as well as, to measure your child’s progress. Most insurance companies
require an evaluation and treatment plan to consider reimbursement for
services rendered. Depending on the age of the child and reason for referral,
the evaluation usually takes from 1-2 hours. For families coming to pursue
work in the DIR/Floortime Model an additional session may need to be
scheduled. The recommendations for treatment and the written treatment plan
are based on the results of the evaluation and the concerns of the parents.

If my child needs occupational therapy how long does it last?

Each child is very different and courses of therapy can range from 3-6 months
to more typically 18-24 months depending on the severity of issues. We have
found that children who come regularly to their scheduled appointments and
follow home programs make the most progress.

After I schedule the evaluation what should I tell my child?

If your child is old enough to have a conversation chances are he/she has
already told you some things are difficult for them or they don’t like school. A
conversation noting these concerns: “I know you don’t like writing, dressing or
feel uncomfortable with standing in line with your friends (or whatever the
presenting problem may be) etc. We are going to see a special teacher to see
if she can make some of these things easier for you. She is going to play
some games with you to see what can help you and help me learn to help you
too.” Most children are relieved to hear that their parents understand that
some things are hard for them and that they are going to get some special
help. The evaluation is done in a fun way and is like playing games at a table
and playing on an indoor playground.
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