Paediatric occupational therapy is a field of rehabilitation where professionals provide support to children in various ways. The primary occupation of a child is “play”. Playing helps a child progress in all developmental domains, like sensory, motor, cognitive, and speech. Through play, the child develops various gross and fine motor skills, is able to explore the senses in the world around him, develops imagination through pretend play, and develops fine and gross motor skills while manoeuvring toys of different shapes and sizes. Play also helps meet speech and communication milestones. Play is the most natural setting a child can be observed in.
Occupational therapists help to develop these skills in children who have different developmental delays like autism spectrum disorder, learning difficulties, attention deficit hyperactivity disorder, Down syndrome, seizure disorder, cerebral palsy, other neurological conditions, or a global developmental delay.
Through occupational therapy, a child is able to meet his motor milestones like sitting, crawling, walking, mass grasp, pincer grip, etc.These skills are crucial for him to be mobile and functional in his environment.Many times, children with these conditions often show sensory processing difficulties like hypersensitivity to touch, sounds, and movement, which interfere with their daily routine.
A child may cover his ears constantly while going out, find hair trims and nail trims extremely overwhelming, refuse to feed himself to not touch food, eat mashed food beyond the expected age, not play in the preschool with different textures like clay, sand, and slime, not chew his food properly, gag at certain foods, or have trouble eating or drinking from feeding utensils.
Sometimes a child may be hyposensitive and keep on running, spinning, jumping, crashing into walls, pushing, or pinching other kids.Using sensory integration therapy, an occupational therapist helps to reduce these issues.This therapy also helps to reduce hyperactivity, increase sitting tolerance, focus on a task, and have good postural control and shoulder stability. These are crucial skills for school readiness.
But do only children with a diagnosis see an occupational therapist? No. Even neurotypical children (children who have normal development) who struggle with paying attention to tasks, are overly sensitive, unable to regulate in a classroom, have poor handwriting, often lie down versus sitting, mouth and chew their collars or pencils, are unable to initiate and complete a task, may appear to be lazy or sleepy, appear fidgety, have difficulty grasping pencils, and organise themselves need an occupational therapist. A detailed occupational therapy assessment is followed by a few occupational therapy sessions.
Most times, parents think that their child is struggling with certain tasks because he is lazy, overtly pampered, or reluctant to do them. They think that they may just outgrow them. But instead, the gap in their skill set and expectations just goes on increasing if not intervened at the right time. Proper guidance and a home programme from the therapist will help to create new pathways in the brain to develop a particular skill. Difficulties with these skills often reflect poor performance in school, play, friendships, activities of daily living, and self-regulation (sensory and emotional).
Occupational therapy is an evidence-based practice and may appear to the parents as “play”. But there is a lot of science behind this and years of study with skilled training involved. A typical session includes playing on the gym ball, swing, trapeze, trampoline, puzzles, tunnels, and toys and involves the active participation of the child. A child often loves and looks forward to the OT sessions.
These sessions are conducted continuously for a period of at least 12 weeks, depending on the nature of the difficulty, and some even for a year. It is very rightly said that an occupational therapist adds “fun” to the function.
(The author, Dr. Isha Soni, is a Senior Occupational Therapist and Centre Head, of Lexicon Rainbow Therapy and Child Development Centre.)
