Occupational Therapy

A child’s “occupations” from infancy to young adulthood include growing, playing, learning, socializing, participating in school, exploring interests, and becoming independent from parents.

Our occupational therapists evaluate and treat for concerns in many areas that affect a child’s ability to do their “jobs”. These areas include:

GROSS MOTOR

Gross motor skills are the building blocks that form part of the foundation for many other higher-level activities. These underlying skills include balance and whole-body coordination, strength and endurance, postural control, body awareness, motor planning (praxis), and motor learning. Under-developed gross motor skills form a shaky, unstable foundation and must be addressed for a child to gain skill in other areas.

FINE MOTOR

We work to improve the fine motor skills a child needs to develop skill and independence with use of their hands for everyday tasks. These skills include bilateral coordination, crossing midline, hand and finger strength, hand-eye coordination, hand dominance, object manipulation, and grasp development. If prewriting skills are not well developed, a child will likely have difficulty with higher level fine motor skills like writing and tool use.

VISUAL PERCEPTION

Visual perception is the brain’s ability to make sense of what the eyes see. This is different than visual acuity (what the eye doctor looks for). A child with “20/20 vision” can still have visual perceptual processing problems. Visual perceptual processing is important for any motor activity, but especially for “school skills” like reading, writing, and math problems. It’s hard to pay attention and stay focused when a child has poor visual perceptual processing!

SENSORY PROCESSING

Learn more about how we treat sensory processing problems.

When a child has substantial sensory processing deficits, this affects one or more areas of daily life. It often impacts academic performance, makes social interactions more difficult, and cause distress or discomfort during everyday activities. It commonly affects often-overlooked sensory-based motor skills, postural functions, and praxis (motor planning). We work to decrease abnormal responses to sensory input; increase sensory-based motor skills; educate parents so they can be interpreters and guides in their child’s sensory life; and improve a child’s coping skills so they can make more adaptive, appropriate responses when they encounter sensory input that is distressing. Through therapeutic activities, children develop functional skills and self-confidence.

SELF-REGULATION AND BEHAVIOR

Self-Regulation is the ability to modulate mood, self-calm, delay gratification, and tolerate transitions in activity. The ability to self-regulate the nervous system, including sleep/wake cycles, begins in infancy and is typically refined over the first two years of life. All of the sensory systems supporting body awareness and reinforced through movement, work together to maintain self-regulation. When problems exist in any of the areas of sensory processing and impact sensory motor development or organizational processing, it can interfere with a child’s ability to manage a calm, alert, or emotionally positive state. When a child has a difficult time with self-regulation, they may have increased behavioral outbursts or inappropriate responses to the environment and sensory stimuli.

EXECUTIVE FUNCTIONING

Executive Functioning refers to a set of neurologically-based skills involving mental control and self-regulation that allow us to manage ourselves and our resources to achieve a goal. All children require practice and guidance to master executive function skills, and some executive functions do not fully develop until age 30. A child with ADHD or similar diagnosis can be 30 – 40% more delayed in executive functioning compared to typically developing peers.

SIGNS OF EXECUTIVE DYSFUNCTION

Preschool

  • Wants to answer questions but forgets answers
  • Gives vague or off topic answers
  • Easily frustrated
  • Starts a task but doesn’t finish as peers do
  • Appears lost, confused, or in a daze
  • Avoids or doesn’t follow drections/routines
  • Difficulty transitioning between activities
  • Difficulty with imaginary/pretend play
  • Difficulty with art projects

Elementary school

  • Easily distracted
  • Disorganized
  • Inflexible in thinking or expectations
  • Misses the big picture (too focused on details)

Middle school

  • Easily bored, doesn’t self-entertain
  • Has difficulty making social plans with peers
  • Doesn’t keep track of own activity schedule
  • Avoids and procrastinates, easily overwhelmed
  • Emotionally overreacts, takes things personally
  • Surprised by failure

High school

  • Poor sense of self
  • Difficulty articulating thoughts
  • Poor reasoning skills
  • Inefficient time management
  • Socially awkward or “out of sync”
SELF-CARE

Young children are dependent on parents to complete self-care tasks for them, but as children mature, they should become more skilled and independent with self-care. Problems with self-care might include:

  • Needing more help to get dressed or undressed than age-appropriate
  • Not tolerating certain items of clothing at any age
  • Being unable to use eating utensils, open containers, or prepare simple food as expected for age
  • Refusing to eat many foods. Learn more about how we treat feeding problems.
  • Inability/intolerance for tooth brushing, hand washing, bathing, hair brushing/combing, nail clipping, or hair cuts
  • Requiring more help than expected for age to fall asleep or stay asleep
  • Less independence with toileting than age-appropriate
  • Less independence with daily and nightly routines than age-appropriate (needs frequent reminders for routine tasks)
SOCIAL PARTICIPATION

Social participation requires the communication, problem-solving, decision-making, self-management, and peer-relating skills that allow a child to make and maintain positive relationships with others. Social skills are difficult to develop if motor skill, sensory processing, self-regulation, executive function, and play skills are delayed. We address social skills in the context of ongoing individual therapy, and also run periodic social skills groups.

PLAY AND LEISURE

Play is the primary occupation for children, and includes any activity that is freely chosen, intrinsically motivated, and individually directed. A playful approach is what makes an activity “play”. Play is critical to a child’s development, as it increase’s the brain’s neural connectivity; improves a child’s ability to adapt to changes in their environment; develops physical skill; and enhances a child’s ability to perceive emotion in others and to develop sharing, empathy, and compassion. Children with socio-communicative deficits often have significant difficulty engaging in imaginative and productive play. Children with sensory processing problems and anxiety often have difficulty finding fulfilling and engaging leisure activities within the community.