What is Occupational Therapy?
In the late 1800s, arts and crafts therapists would regularly visit mental institutions and hospitals. It was discovered that patients who engaged in normal activities, such as crafts, were more healthy than the patients who did not. Fast forward to World War I, and the same activities were being performed with injured soldiers. The American Occupational Therapy Association was formed, and occupational therapy (OT) officially became a tool to rehabilitate the body and mind through normal, meaningful daily activities where people live, work, learn, and play.
In more simple terms, OT assists people to function well in all areas of life, and the goal of OT is to use meaningful activities to increase functioning. “Occupation” refers to how you spend your time: taking care of yourself, working, learning, resting, engaging in recreational activities, etc. And “therapy” refers to a trained professional helping the patient regain and maintain functioning, or making accommodations to help the patient adapt. Developmental delays, disabilities, or interferes with activities of daily living can be aided with OT.
Patients range from young children to the elderly, and typically have physical, mental, emotional, sensory, speech, or social issues. The elderly usually engage in OT during rehabilitation after surgery or an accident, and involve assistive equipment, such as walkers, wheelchairs, shower chairs, or grabbers. OT with children focuses on play, academic learning, self-care, fine motor skills, focus, and attention.
The occupation of children is to play and learn. OT uses activities that feel like play to promote growth. Imagine an occupational therapist and a four year old child playing with mini colorful bears in a bucket of shaving cream. It looks like playtime, yet the OT is using the combination of shaving cream and plastic bears as a sensory activity, testing the child on the colors and numbers of bears as an educational activity, and talking with the child to engage socially. OT would look different for a 14 year old struggling to hold his pencil and write legibly, or a mom who broke one hand, or an elderly veteran who is struggling to walk without falling. But, the goal remains the same: to increase the patient’s skills or to adapt the environment so that the patient may be independent and able to developmentally function well.
Therapy may take place in a clinic, hospital, long-term care faculty, school, or in a family’s home, depending on the patient’s goals. An OT in a clinic or hospital will assist patients in completing activities of daily living, like dressing or bathing; usually the patient cannot go home until he/she can successfully complete these tasks. Long-term care facilities often focus on reducing falls and improving the patient’s mobility, or helping the patient adapt to life after an injury (such as a stroke or traumatic brain injury). School and home-based OTs work with children of all ages and difficulty levels. Some students will need assistance with fine motor skills like handwriting, while others will require more intensive help.
Types of Activities Performed in OT
Reflexes are automatic movements made by the brain, nervous system, and sensory organs. Examples include blinking or how a baby knows how to suck from birth. Generally these reflexes are programmed from infancy. Some common reflexes include oral, hand and foot reflexes; spinal galant reflexes; tonic labrinthine reflex, symmetrical tonic neck reflex (STNR); and asymmetrical tonic neck reflex (ATNR), all of which cause possible long-term effects if not properly developed or addressed.
OT can assist with the delays caused by incomplete or underdeveloped reflexes but relearning the reflex movements. For example, asymmetrical tonic neck reflex (ATNR) can be relearned by teaching babies to lay on their stomach and reach for toys beside them; for young children to crawl with a bean bag between their chin and shoulder; or for older children to do one-handed push ups standing perpendicular from the wall.
Research from the past thirty years reveals that OT has positive effects for those who struggle with reflexes, such as improved reading skills and oculo-motor functioning.
In a normal functioning body, the five senses receive input from the environment and sends messages to the brain, then the brain controls the body to perform appropriate motor and behavioral responses. But research has shown that nearly 1 in 20 children feel like his/her senses are jumbled up. This is when occupational therapy with sensory integration (OT-SI) is valuable.
The aim of sensory integration is to teach the brain appropriate responses to sensory input. This may include brushing, a well-balanced sensory diet, and playful activities, such as wearing a pressure vest while completing a puzzle, or jumping on a trampoline while singing the alphabet song. Activities will always be mildly challenging and engage multiple senses simultaneously. Here is a list of tips and resources to help your child who is struggling with sensory integration.
Kinesiology is defined as the science of movement. Applied kinesiology, also known as muscle strength testing, is used to diagnose a disability related to mobility, strength, and muscles, then a trained practitioner, such as an OT, carries out treatment. Research has mixed results as to the effectiveness of the type of therapy; the International College of Applied Kinesiology has posted a list of positive results on their website, while the National Center of Biotechnology Information has published negative results from research experiments.
“Moving with intention leads to optimal learning.” Brain Gym was founded in 2000 by the Educational Kinesiology Foundation. The program includes 26 movements that are naturally learned during the first years of one’s life, like touching your toes, crossing your legs, or twisting your arms and hands together. Experimental research has shown that Brain Gym can improve reaction time, concentration, memory, physical coordination, attitude, reading, academic abilities, decreases problem behaviors, and more. Read a previous post about Brain Gym and other alternative learning programs here.
Yoga is well known as a form of exercise that promotes relaxation, focus, builds strength, enhances coordination, and reduces stress. Recently the OT field has incorporated yoga as a form of intervention, allowing the yoga to target the body while OT focuses on the environment and modifications. Children with ADHD or autism have had very successful results from participation. Often the OT will read a book about animals, then the student will perform yoga stretches that resemble the animals (think of the cat stretch or downward dog). Often the time includes guided relaxation and visualization as well. After these activities, the child is more focused and attentive to fine motor tasks. There is limited research on OT and yoga, but it appears that more studies will be performed in the future as it’s popularity expands.
Occupational therapy at it’s core focuses on the patient and aims to reach higher levels of functioning with necessary accommodations. This allows for freedom in the ways that therapy is performed, so there are many other options for the field of OT!
Share with our readers some unique ways you’ve seen OT performed with your child. If you are an OT, share your creative ideas and favorite tricks, the ones that you can’t imagine practicing without!
- The Parent’s Guide to Occupational Therapy for Autism and Other Special Needs: Practical Strategies for Motor Skills, Sensory Integration, Toilet Training, and More, by Koscinski
- Balanced and Barefoot: How Unrestricted Outdoor Play Makes for Strong, Confident, and Capable Children, by Hanscom and Louv
- The Out-of-Sync Child, by Kranowitz and Miller
- Occupational Therapy Toolkit: Treatment Guides and Handouts, by Hall
- Occupational Therapy for Children with Special Needs, by Wilson
- 1001 Pediatric Treatment Activities: Creative Ideas for Therapy Sessions, by Danto and Pruzansky