Occupational therapists

Occupational therapists (OTs) assist children to overcome challenges they may have with self-care activities such as eating, dressing, and going to the toilet, and with many other everyday activities including playing with others and participating in play-group, pre-school, or school. They also help children manage sensory sensitivities such as over-reacting to smells or noise and coordination difficulties including difficulties with running, jumping, drawing, and writing that often accompany ASD. OTs use children’s everyday activities as the focus of intervention and are expert at modifying activities and environments to better suit a child’s needs.

When should a child see an occupational therapist?
If a child has difficulties with developing motor skills, play, self-care activities, concentrating and tasks such as writing, or sensory and coordination difficulties, parents or carers should consider seeing an OT.

What roles do parents, family, and carers play in the work of an occupational therapist?
The home environment is critical to a child’s health, growth, and development. It is also a setting where parents and carers first learn about their child’s interests, needs, and capabilities. Information from parents and other carers about how a child functions and behaves is crucial for the OT to devise ways that enable the child to better manage activities, behaviours, and routines. OTs work with a child and family to explore different ways of performing tasks that may be challenging for the child, frustrating for parents and carers, or may have caused disruption in the home or community.

As part of intervention, OTs can show parents ways of:
• understanding and managing their child’s behaviour;
• playing with their child;
• teaching their child new skills;
• helping their child to understand others; and,
• modifying their child’s environment, such as changing sources of sensory stimulation, to help him or her function better.

What would an assessment involve?
The OT will talk with the parents or carers (and the child if appropriate) about the child’s strengths, weaknesses, likes, dislikes, and behaviour. OTs use their knowledge of children’s activities and typical movement, sensory, thinking, language, and social-emotional development as the basis for understanding the challenges a child faces, as well as the abilities he or she possesses. An OT will interact with a child and may also use formal assessments and specific equipment that help to identify where the child is having difficulties. In order to get a picture of how a child functions in different settings, the OT may speak with childcare workers or teachers and with other professionals, such as psychologists and speech pathologists, who are involved in a child’s assessment.

What happens next?
Occupational therapy assessment may identify problems in one or more of the activities that a child undertakes at home, at school, in the playground or in the community. The OT will work with parents and carers to develop a plan with goals and objectives for them and the child to follow. As part of this process, the OT might modify and structure the activities the child finds difficult. These activities might involve dressing, playing with other children, or coping with change. Over time, the OT will also work with the parents or carers and the child to learn new ways of doing things. On occasions, altering the environment in which a child engages in an activity can help achieve success. The OT will help parents or carers, and others in a family to implement and follow through with these changes. An OT might also work with a child’s childcare worker, teacher, psychologist, and speech pathologist to develop consistent ways of supporting that child’s learning and behaviour at school or pre-school. For example, the environment in childcare and school settings often causes too much stimulation and stress for a child diagnosed with ASD, and the advice from an OT can help a child learn and cope better in these environments. The aim of an occupational therapy session is to improve a child’s ability to perform a wide range of play, self-care, social, and child care or school related activities. Because no two children are the same, the OT considers the physical, social, and cultural circumstances of each child before developing a treatment plan that is tailored and relevant to that child’s development and needs.

An occupational therapy session for young children might involve:
• play that includes social interaction, - sharing, and taking turns;
• modelling and support for parents who are learning to interact and play with their children;
• self-care activities such as toileting, bathing, and feeding;
• activities to improve children’s use of their hands;
• behaviour management such as learning to sit and wait; and
• strategies and interventions addressing sensory difficulties.

For a school aged child, an occupational therapy session might involve additional activities such as active movement, role play, stress reduction techniques, handwriting practice, or a social skills group with other children. As a child gets older, these activities might expand to include advice about organising and managing friendships, interests, and responsibilities.

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