Nadia Cusack
Occupational Therapists
Occupational Therapy is …
Occupational Therapy involves treating a child’s physical, psychosocial, developmental, learning or related difficulties with meaningful activities aimed at promoting age appropriate development and independence. Initially individualized therapy activities target improving skill and a child’s ability to cope with the demands of their learning environments. Thereafter, therapy promotes carry-over of these skills into other settings thus enabling a child to continue to adapt their skills and meet new challenges.
Throughout the assessment and treatment process, the child is viewed holistically and no area of development is treated in isolation. This means that although initial concerns may indicate difficulties with tactile defensiveness for example, the defensiveness will be treated as part of a therapy program, which also treats any associated difficulties present in the areas of play development, interaction with others and independence in activites of daily living (For example activities such as dressing or eating). Therapists consider all areas of development as important including social interaction, play development and academic and related activities and aim to improve skill levels and ability but also to contribute to a child’s sense of self-worth through accomplishment.
Sensory Integration is …
Sensory Integration is an unconscious process of the brain by which information detected by the senses is organized. It is through these processes that meaning is attached to what is experienced. In order for this process to occur smoothly, the brain must sift through all the information it receives from the various senses and select what to focus on. For example, within a classroom a child is expected to pay attention to what is being taught by the teacher while simultaneously ignoring background noise present, in order to learn optimally. Through a process referred to as habituation, the brain filters out unimportant information and decides to no longer pay attention to it. For instance, daily our brains recognize when clothes are put on but do not constantly notice this information throughout the day unless attention is drawn to them.
The process of Sensory Integration allows us to respond to situations in a purposeful manner known as adaptive responses. Adaptive responses that are appropriate to the situation form the foundation for academic learning and social behaviour. When these processes are inefficient or overtly effortful for a child this can affect multiple areas of development such as socio-emotional development, independence and motor planning development and have grave consequences. In an attempt to minimise the effects of these difficulties, a child will often avoid, seek or ignore certain sensory inputs in an effort to cope. However, these strategies are often ineffective and negatively impact on daily function.
A Sensory Integration trained Occupational Therapist will therefore consider the child’s individual sensory profile during assessment and make careful use of sensory-based treatment activities to enhance therapy and promote adaptive behaviour resulting in learning and improved integration of sensory and associated neurological pathways.
An Occupational Therapist looks for …
A holistic and systematic assessment and treatment process will assess the following areas of development according to age appropriate norms and how a child performs in all relevant areas of their lives.
- Sensory Processing and Regulation:
This refers to the ability to perceive, interpret and respond appropriately to sensory information and impacts on the ability to cope with daily routines
- Concentration and Auditory Processing:
This relates to the ability to focus and participate in a variety of situations as well as the ability to make sense of and respond appropriately to what is heard, for example, to be able to follow instructions.
- Gross Motor Ability and Control:
Here the occupational therapist evaluates the child’s ability to smoothly coordinate, time and plan a variety of familiar and unfamiliar gross motor activities. Core stability, endurance and strength are also assessed.
- Fine Motor Ability and Control:
This includes aspects such as pencil grip and control as well as neatness and speed of cutting, writing and colouring. Tool manipulation and the coordinated use of both hands are evaluated.
- Perception:
Perceptual abilities refers to being able to visually manipulate information such as building puzzles, understanding that a circle and sphere are both round as is a tin, a ball, a fan etc. These skills form part of the foundation for learning to read and write.
- Behaviour:
This applies to various characteristics such as confidence, frustration or anxiety levels as well as participation, imaginary play and following a routine.
- Activities of Daily Living:
The child’s ability to dress or feed themselves as well as toilet routines is assessed. Sleep routines are also considered as is the child’s involvement and ability to cope at school (preschool or primary) and academics.
*Please note that this list is not exhaustive and that some signs be present in children that do not display affected development while others may be present in children who do not have a Sensory Integrative Disorder.
