Does My Child Need Occupational Therapy (OT)?

Written by Vibha Pathak, Occupational Therapist, OTD, OTR/L

Every morning Marsha, age 10, wakes up on the wrong side of the bed and it is a battle to get to school on time.

After multiple reminders to brush her teeth, change her clothes, eat her breakfast and pack her school bag, Marsha drags her feet and asks her mom if she can stay home today. She is worried about the noise in PE, the teacher calling on her in math, sitting still during Assembly and needing to write a paragraph in social studies. Marsha gets through the day, and as her mom rounds the pickup line, they both dread ‘Round II’ of the battle—homework.

The endless reminders, unfinished work and constant distractions are exasperating both Marsha and her mom. “If only Marsha tried harder and stopped being so lazy, our days would be easier,” thinks Marsha’s mom.

Having attempted the constant reminders and check-in strategies for six months to no avail, Marsha’s mom wonders if this is a routine struggle that all parents face or if there is something she can do to help support her daughter to be more functional and independent. At the recommendation of Marsha’s pediatrician, they make an appointment to see an occupational therapist, or OT.

You might have heard from your child’s pediatrician, teacher or coach that your child might benefit from a visit with an OT. But first, it’s important to understand what occupational therapy is and how it can help.

What Does an OT Do?

An OT’s goal is to enhance function and participation in daily life activities. The challenges to function could be neurological, developmental, caused by an injury or genetic in nature. An OT will explore different areas of the child’s life and determine the skills that are are impacting a child’s participation in their occupations (play, school, daily routines, sports).

The areas that an OT will address are:

• Gross motor skills
• Fine motor skills
• Visual motor skills
• Coordination of the body (eye, hand, both sides of the body)
• Motor planning
• Sensory processing
• Feeding
• Self-care skills
• Self-regulation
• Social skills

What Happens in an Occupational Therapy Session?

An occupational therapy session incorporates daily life activities and play and is interactive and functional for the child. An assessment determines which skills are impacting a child’s function, serving as a playbook for the OT to design a therapy plan. This plan will use skill-building activities and functional play with the ultimate goal of enhancing the child’s participation in daily life activities. The goals could be as varied as working on legible handwriting, processing sensory information, playing with peers on the playground, and participating in household routines.
Marsha’s OT assessment found challenges in sensory modulation, wherein her brain does not filter out the noises in a typical classroom and she needs constant movement to stay alert, shedding light on her fidgetiness and inability to sit still. An inability to regulate her arousal level made everyday routines hard for Marsha, which is why the constant prompts and reminders became a reality. Challenges with fine motor skills made handwriting a chore,explaining why Marsha dreaded (and avoided) tasks that needed writing.

The assessment helped Marsha’s mom understand that Marsha’s errant behavior was the unintended result of an unmet need, not laziness, and helped empower her to become an empathetic advocate on Marsha’s OT journey.

Treatment Plan

A treatment plan was devised for Marsha to help manage her alertness in the classroom, increase her fine motor skills and address her hyper-sensitivity to noise in the classroom.

Six months into therapy, Marsha is able to understand her body’s needs better and is empowered to ask for things like noise-canceling headphones, when working independently or a movement break to regulate her arousal level. With the addition of a sensory diet that feeds her body with myriad sensory inputs throughout the day to regulate her arousal level, Marsha is better able to follow through with her routines. Regular OT appointments are helping to improve her fine motor skills, and she is also using voice to text software and typing to collect her thoughts.

In conjunction with improvement of skills and participation in everyday routines, a subsequent goal of OT is an increased understanding of the sensory needs of the body. Knowledge is power. As the child learns more about themselves, they start to figure out what works best for them and how they can achieve their goals, leading to more independence and self-regulation: milestones for both parent and child.

About the Author

Vibha Pathak: As a child growing up, my sensory needs were very different from everyone around me and left me feeling like an outlier. I needed movement and lots of it to function in my daily life. I did not realize this until much later when sensory processing started making sense to me. Being an occupational therapist helps me empower the children with an understanding of their body and how their sensory systems affect their daily lives.

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To schedule an evaluation or to get advice about your child’s challenges, call or email a CHC Care Coordinator at 650.688.3625 or careteam@chconline.org