Occupational therapy is the use of meaningful occupation to help people who have difficulty in achieving a healthy and balanced lifestyle and to enable an inclusive society so that all people can participate to their potential in the daily occupations of life.
An occupational therapist therefore is concerned with developing and maintaining a child’s ability to carry out everyday activities to the best of his or her own ability.
The focus of a paediatric occupational therapist is to enable children to effectively participate in desired daily life occupations within family, school and community environments.
An occupational therapist could address areas such as child’s play and leisure activities (for example playing on the equipment at the park), work and productivity (for example educational activities such as writing) and self care (for example dressing and showering).
Occupational therapists are concerned with how a child functions within their natural environment.
Paediatric occupational therapy intervention is based upon an understanding of normal development and the mastery of developmental milestones. Not only are the child‘s abilities considered by the therapist (fine motor skills, sensory processing, gross motor skills etc.), but also how the child relates to their environment. In order to gain this crucial information a therapist will usually conduct discussions with the family. The therapist may also ask to chat with the school, day care, bus driver or relevant others. These discussions provide the therapist with a meaningful picture of the child and how they function in the world.
Once the therapist has gathered the information and has set goals in conjunction with the family and relevant others, the therapist will then identify problem areas that might need remediation or adaptation through an intervention programme. The intervention will aim to promote healthy development, establish needed skills, and/or modify environments all in support of participation in the child’s daily activities. This intervention could occur in three different ways (Dunn, 2000).
This involves the therapist working directly with a child to change something about the child’s performance. For example if a child has difficulty with riding a bike, the therapist may teach the child the individual steps to riding the bike. The important aspect of direct intervention is that the therapist determines how to solve a problem and how to directly deliver the service to the child. This form of intervention can be carried out in the child’s home, school or in the clinic.
This is where the occupational therapist trains teachers, parents and/or relevant others to implement a procedure typically done by the therapist. Once again the therapist will still be in charge of solving problems and modifying the procedure. An example would be the development of a sensory diet for a child to carry out at school, which the therapist reviews every 6 weeks.
This is where the therapist works with the child, teachers, other professionals and parents to solve problems. The child, teacher and parent then own the problems and the solutions. This method requires regular meetings with the parents and relevant others during the year. Because the teachers/parents come to understand the child’s needs they can generalize principles and apply them to new situations with little assistance from the therapist.
“Consultation can be extremely powerful. We believe it should be the primary type of service delivery used by practitioners working in schools. What little research there is in this area has supported the view that consultation is either as effective or more effective for meeting students’ objectives than is direct service. In fact, we have found no direct evidence to the contrary.”(Bundy 2002)
- Townsend, Elizabeth A. and Polatajko, Helene J. (2007). Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-Being & Justice Through Occupation. Ottawa: CAOT Publications ACE.
- American Occupational Therapy Association fact sheets: Occupational Therapy in Preschool Settings and Occupational Therapy for Children available from http://www.aota.org/featured/area6/index.asp
- Dunn, W. (2000). Best practice occupational therapy: In community service with children and families. Slack Inc.
- Bundy, Anita C. Lane, Shelly J. , Murray, Elizabeth A. (2002). Sensory Integration: Theory and Practice. F. A. Davis Company