Occupational Therapy: Proactive Parenting Tips and An Autism Success Story!

A hot and humid “Howdy!” from KidsCare Therapy in Dallas/Fort Worth, where the temperatures are getting higher and higher! In our last post you learned all about pediatric occupational therapy—why and how an occupational therapist helps children. This week, we are going to review some of the things an occupational therapist regularly sees when treating patients.  We will also let you know about some of the most important developmental milestones your child should be reaching and at what age these milestones occur. You’ll also learn a few tips from our in-house OT clinical manager that you can use to ensure that your child continues to develop and thrive on target!  And, of course, we’ll have another inspiring success story where you can see the real-life benefits of home health services.

As you know, an occupational therapist treats a wide array of conditions—everything from sensory processing disorder to autism. As a review, below are some of the more common conditions treated by an OT:

• Developmental delays
• Cerebral Palsy and other neurologic disorders
• Autism and other spectrum disorders
• Down Syndrome and other genetic disorders
• ADD/ADHD and learning disabilities

Some cases requiring OT services may not be as severe, but the following behaviors can all be red flags indicating an issue that OT would potentially address:

• Stiff movements, keeping hands closed, difficulty reaching for toys or movements, appears very “floppy”
• Uses one arm or leg or uses one side of the body significantly more than the other
• Considered significantly behind peers in play skills and social interactions
• Attention and behavioral difficulties which interfere with the child participating in daily routines
• Unusual reactions to:
• Touch (overly sensitive or touches everything)
• Movement (on the go, can't sit still or fearful of movement/feet off the ground)
• Sound (covers ears to everyday sounds or talks loudly/makes excessive noise frequently)
• Visual inputs (covers eyes to light or significant interest in spinning objects or patterns)
• Smell (smells everything or is easily distracted by everyday smells)
• Tastes (picky eater, only eats certain textures of foods or overstuffs mouth, puts everything in mouth after 2 years of age)

While not all children exhibiting these symptoms are candidates for occupational therapy, these are some of the indicators of issues that are treatable with OT services.  To supplement, KidsCare Therapy’s clinical managers have composed a chart for parents to gauge whether their child is developing at a normal pace.  This resource is divided by ages and skills. For instance, the parent of a nine-month-old can easily see if their child has mastered feeding, self-care, speech, social, play, fine motor and gross motor skills typical of a child their age. You can access the chart here. Again, development varies tremendously with each child. These are broad guidelines for child development, but they can be helpful in understanding what to expect.

So how can you, as a parent, ensure that your child continues to develop at a reasonable rate? Here are a few activities that you can administer to promote development:

• Tummy time early with supervision to help strengthen trunk, arms, neck, and vision
• Play—provide a variety of toys to reach for, shake, bang together, pull apart, connect, put in/take out, stack or build, open/close, or otherwise manipulate
• Sensory experiences—try water or sand play, Play-Doh, finger paint, food play; play outside on a swingset, at the park or playground; use play objects with a variety of textures, sounds, lights, vibration
• Visual-motor tasks—drawing/writing using a variety of tools (crayons, markers, chalk, colored pencils, vibrating pen), a variety of puzzles (knob, peg, form-fit, jigsaw puzzles simple to hard), arts & crafts projects
• Self-care skills—play dress-up with parent or sibling clothing or costumes; practice using spoon and fork during play activities, brush teeth, hair, wash/dry hands at the mirror; allow the child to try all tasks first before doing for them and give lots of praise for all attempts at independence
• Provide structure and predictability in daily routines, build opportunities for social play through turn-taking, sharing, and modeling appropriate play through play dates and sibling interactions.

April is not only National Occupational Therapy Month, but also National Autism Awareness Month. We are excited to share a success story about one of our patients that incorporates both!

----------------------------------

Nate began home health occupational therapy services at two years of age.  He has a diagnosis of moderate autism.  At evaluation, he presented with sensory-seeking behaviors (in constant motion running back and forth, climbing on furniture, up counters and on the table, placing non-food objects in his mouth, flapping hands, humming and grinding his teeth).  He made sounds, but did not use intelligible words.  He was easily frustrated, aggressive and throwing tantrums when unable to communicate and get his wants or needs met.  He had delayed play skills—using repetitive play only, such as picking up and dropping items over and over.  He used limited eye contact, had no interest in social interaction, and appeared aloof and unaware of people and objects in his environment.

 Occupational therapy intervention has included:

• Engaging him in daily sensory activities to increase his attention, social interaction, and participation in play and self-care skills
• Practice of fine motor and visual-motor skills with a variety of play activities starting with cause and effect toys and progressing to more challenging manipulation of objects, use of play tools and drawing tasks
• Practice with self-care skills including dressing and feeding tasks with physical and verbal prompts, and modeling of how to complete tasks
• Changes in the environment and use of visual supports such as utilizing a booster seat to cue the child of where and when to sit
• Use of picture cards to provide the child with the steps to do a task and the ability to make choices

 After one year of treatment, Nate has made progress and will continue to do so with skilled occupational therapy intervention, caregiver education, home programming, and coordination of services with his speech therapist. He is now calmer and able to sit for table-top activities for up to 30 minutes, following structured movement and heavy work activities.  He can engage in a variety of play skills, point to pictures appropriately, complete puzzles, finger feed himself and drink from an open cup.  He can follow a photo card sequence, with assistance, for improved dressing skills.  He gestures and attempts to make sounds to communicate.  He uses increased eye contact, recovers more easily when frustrated, and responds positively to the use of reinforcers.  He also now attends a Preschool Program for Children with Disabilities, which provides a structured learning environment and more opportunity for social interaction with peers.  Nate will benefit from continued occupational therapy services to improve his overall functional skills and to further facilitate his progress towards goals and the achievement of age-expected developmental skills.

----------------------------------

Be sure to check back in May, when we’ll be celebrating Better Speech and Hearing Month with a feature on speech therapy!