Children
Occupational therapists enable children to participate in activities at home and in school
Occupational therapists are health and social care professionals who are specifically and uniquely trained to address the relationship between occupation, physical and mental wellbeing. They help children and young people aged from 0 to 18 years of age to access education and engage in activities at home and in school. Occupational therapists are one of the few professionals to work with children across all settings - in the home, at school, and in the community - enabling children to develop their skills and increase their independence. Working with children, occupational therapists set goals to enable them to participate in activities they need or want to do, to help children get the most from life.
Occupational therapists will work with children who have additional or special education needs, co-ordination disorders, physical disabilities and autistic spectrum disorder. They are experts in understanding a child’s underlying skills, the nature of the task, and the effect the environment has on a child’s ability to carry out the activities they need to do. Occupational therapists are also specialists in altering and modifying tasks - and the environment if needed - to help children to be as independent as possible.
Participation plays a key role in the development of children and youth; through participation, children acquire skills and competencies, achieve physical and mental health, and develop a sense of meaning and purpose in life. There is evidence that participation in activities that one enjoys and that promote skill development, protect at- risk children and youth from developing mental health, academic and social problems (Law 2011).
Occupational therapists help children to achieve the early years’ curriculum
Occupational therapists can work with all children, not just those with identified needs, in response to teachers’ concerns that children are not developing the basic skills needed to manage everyday tasks. Head teachers have expressed their disquiet that children start school unable to do the basics, for example, not being able to dress themselves, not able to use the toilet, or use a pencil. Using their knowledge of children’s activities, occupational therapists can help children to resolve these issues to enable them to develop the skills needed to be able to carry out everyday tasks.
The benefits of occupational therapy intervention
A multi disciplinary team called ‘Sparkle, which included occupational therapists, worked in early years’ settings in Kent to enable all children to access the Early Years’ Foundation Stage Curriculum. The occupational therapists worked in partnership with Early Years’ practitioners providing school staff with formal training and situational learning opportunities. A recent evaluation of ‘Sparkle’ has highlighted how creating opportunities for early years’ practitioners to work closely with occupational therapists and specialist teachers resulted in many positive changes for children in the early years’ settings.
Case study evidence from the Sparkle evaluation supports the view that, following the occupational therapy intervention, teachers were able to make changes to the physical environment, including increasing the availability of activities related to early writing skills.
Occupational therapists help children with co-ordination disorders to solve problems they face every day
For many children with ‘hidden disabilities’ such as Developmental Co-ordination Disorder (often known in schools as ‘dyspraxia’) or Attention Deficit Hyperactivity Disorder, an occupational therapy assessment and intervention is key to helping children to develop their skills and allowing those around them such as parents and teachers, to understand the children’s needs.
There is evidence to show that children with co-ordination disorders, known as Developmental Co-ordination Disorder, achieve less in school and in subsequent employment, and this condition can persist into adulthood (Losse et al 1991, Geuze et al 1993). This condition is estimated to affect c. 5 – 8% of the school age population (Henderson et al 1982). There is also evidence that with the right help, children can develop the skills that are important to them (Polatajko et al 2001).
Occupational therapists use evidence based intervention to help children with Co-ordination Disorders to develop independent problem-solving skills. Occupational therapists use evidence based approaches to support children with co-ordination disorders to develop new skills, helping children to access education, and reach their full potential by developing independent problem solving skills. This relies on the occupational therapist’s unique understanding of how individuals learn to carry out every day activities, including the complex relationship between children’s skills, the environment, and the actual task.
The benefits of occupational therapy intervention
Evidence shows that task-orientated approaches such as the Cognitive Orientation Approach to Daily Occupational Performance (CO-OP), created and used by occupational therapists, helps children with Developmental Co-ordination Disorder to develop, improve and maintain everyday skills. This is a cost effective occupational therapy intervention as evidence shows that the problem-solving techniques learnt can be applied to most daily activities, with progress being sustained over time (Polatajko et al 2001, Wilson P.H. 2005). Occupational therapists also work with children to help develop their abilities such as motor and organisational skills to enable children to manage everyday tasks successfully.
Occupational therapists help children with physical disabilities to participate in daily activities to increase their independence
Children with physical disabilities often need specialist equipment to enable them to sit in an appropriate and safe position for toileting, bathing, and sometimes to be positioned for sleeping. This equipment helps children to participate more fully in everyday life and can protect them from contracture and deformities. It also helps children who need assistance to manage their personal care, providing greater safety for children and for their carers.
Occupational therapists are trained to carry out specialist assessments of posture, correct positioning and movement to ensure that specialist equipment meets children’s postural needs, leading to increased independence for children.
The benefits of occupational therapy intervention
There is evidence that children are more able and more likely to participate in everyday activities when using specialist seating and other specialist equipment. Studies demonstrate that when equipment is withdrawn, the level of participation among children was reduced (Ryan et al 2009, Rigby et al 2009).
Occupational therapists help children with Autistic Spectrum Disorder to manage every day tasks and cope with busy environments
Children with Autistic Spectrum Disorder (ASD) often have difficulty managing everyday tasks at school, in the home and in the community. Occupational therapists use a number of approaches to address these difficulties, to enable these children to reach their full potential and for families to better manage their children’s needs.
There is evidence that children with Autism process sensory information from the world around them differently from other developing children; the findings from one study reported that 95% of children diagnosed with ASD, experience sensory processing problems (Tomcheck 2007). Occupational therapists are trained to incorporate their knowledge of sensory processing into their work for children with ASD.
Occupational therapists play a vital role in the diagnostic pathway for ASD, helping parents and teachers to understand and manage the challenges faced by children with this condition. It is the holistic assessment of the child which is unique to occupational therapists. An occupational therapist will assess a child’s skills, their sensory processing, the nature of the task to be done, and the environment where the task is to be carried out. Occupational therapists will also analyse how children with ASD approach daily tasks to enable them to understand the barriers children face with, for example, teeth cleaning, toileting, eating, going to the shops, being on public transport and doing school activities such as writing and listening.
The benefits of occupational therapy intervention
Evidence shows that by working collaboratively with the child and the family, occupational therapists enable children with ASD to participate more fully in everyday life and reduce parental stress and increase feelings of confident parenting. (Dunn 2011). Use of sensory processing strategies may also be able to reduce autistic mannerisms (Pfeiffer 2011).
References
Early intervention, Eye volume 11 no 7 2009
DCD Geuze R, Borger, H (1993) Children who are clumsy: Five years later. Adaptive Physical Activity Quarterly; 10, 10-21.
Losse A, Henderson SA, Elliman D, Hall D, Knight E, Jongmans M (1991) Clumsiness in children: Do they grow out of it? A 10 year follow up study Developmental Medicine Child Neurology 33, 55–68.
Polatajko H.J, Mandich A.D, Miller L.D, Macnab JJ (2001) Cognitive Orientation Approach to Daily Occupational Performance (CO-OP) Part II - The Evidence. Physical and Occupational Therapy in Pediatrics 20 (2-3), 83–106.
Wilson PH (2005) Practitioner review: approaches to assessment and treatment of children with DCD: an evaluative review. Journal Child Psychology Psychiatry.46(8):806-23
Equipment
Ryan SE, Campbell KA, Rigby PJ, Fishbein-Germon B, Hubley D, Chan B (2009). The impact of adaptive seating devices on the lives of young children with cerebral palsy and their families. Archives of Physical Medicine & Rehabilitation 90 (1) 27-33 ISSN: 0003-9993 PMID: 19154826 CINAHL AN: 2010172659.
Rigby PJ, Ryan SE, Campbell KA (2009). Effect of Adaptive Seating Devices on the Activity Performance of Children with Cerebral Palsy Archives of Physical Medicine and Rehabilitation. Archives of Physical Medicine & Rehabilitation 90 (8): 1389-95 ISSN: 0003-9993 PMID: 19651273 CINAHL AN: 2010377617.
Autism
Dunn W, Cox J, Foster L, Mische-Lawson L, Tanquary J (2011) Impact of an integrated intervention on parental competence and children’s participation for children with autism, University of Kansas Department of Occupational Therapy Education. School of Health Professions. University of Kansas Medical Centre.
Law M (2006) Autism Spectrum Disorders and Occupational Therapy. Canadian Association of Occupational Therapists.
Pfeiffer B, Koenig K, Kinnealy M, Sheppard M, Henderson L (2011) Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy 65, 1 76-85.
Tomcheck S.D, Dunn W (2007) Sensory processing in children with and without autism: a comparative study using the short sensory profile. American Journal of Occupational Therapy 61, 190-200.
