by Phillip Kindschi | Apr 29, 2013 | Occupational Therapy
At TherapyWorks, we “work wonders in children’s lives” with physical therapy, speech therapy and occupational therapy, along with diet and nutrition therapy. And while most people know about physical therapy and speech therapy and nutrition, a lot of people aren’t quite sure what occupational therapy is.
So, just what is Occupational Therapy???
Occupation can be defined as the way we occupy our time. It includes the daily activities of:
Self-Care: sleeping, eating, grooming, dressing, and toileting
Work: effort that is exerted to do or make something, or perform a task
Leisure: free, unoccupied time where you choose to do something enjoyable (i.e., hobby, tv, sports, socializing, read, listen to music, travel, etc.)
Occupation is how we spend our time; whether paid or unpaid, restful or fun, obligation or choice. It is that which fulfills us, gives us purpose, and allows us to interact with, be productive, and function in the world around us to the best of our ability.
If, at any point in our lives from birth to old age, an injury or disability prevents us from effectively or independently functioning in one or more “occupational” areas, then it is the job of the Occupational Therapist to provide treatment. OT helps you learn or regain function, maintain skills, or make accommodations for deficits you may experience. In other words, so that you may live life to the fullest!
Since many people have never heard of OT, they think it is a relatively new profession. Actually it began in the late 1700’s but was not formally named occupational therapy until 1917. In the 1700’s the mentally ill were locked away in insane asylums and treated like prisoners. Phillipe Pinel, a French physician, and William Tuke, an English Quaker, started to challenge this treatment and developed new beliefs about how to improve the lives of the mentally ill. Phillipe Pinel began what he called “Moral Treatment and Occupation”, defining occupation as “man’s goal-directed use of time, energy, interests and attention”. He advocated for treatment based on purposeful daily activities. He used literature, music, physical exercise, and work as a way to “heal” emotional stress and improve the patient’s ability to perform activities of daily living (ADL’s).Tuke’s basic premise, called “moral treatment” was based on the principles of “consideration and kindness”. Tuke felt occupations, religion and purposeful activities should be used to improve function and minimize the symptoms of mental illness. He encouraged patients to participate in a variety of employment or “amusements” (leisure activities) that they enjoyed.
These ideas spread to the US and from 1840-60 many American hospitals began to use these new treatments. Arts and crafts activities were used for both relaxation and feelings of being productive. Many of these concepts were nearly lost during the upheaval of the Civil War. In the late 1890’s, nurse Susan Tracy successfully brought back the use of “occupation” with the mentally ill. She began to specialize in this field and started educating student nurses on the therapeutic use of activities as part of treatment. Tracy coined the term “Occupational Nurse” and called the training “occupation work”.
On March 15, 1917 Susan Tracy, Eleanor Clark Slagle of Johns Hopkins Psychiatric Clinic and 5 others formed the National Society for the Promotion of Occupational Therapy (NSPOT), which was later changed to the American Occupational Therapy Association (AOTA). The founders were dedicated to building a role for occupational therapy in the health care community that incorporated treating mind, body and spirit.
During and after World War I over 5,000 reconstruction aides were hired to provide occupational therapy to the war’s wounded. In the 1920-30’s training programs were established at universities and OT expanded to include health care and hospital based medical treatment. Thousands of returning soldiers with physical injuries and mental problems from WWII, Korea and Vietnam received occupational therapy as part of the “Rehabilitation Movement”. During the 1950-60”s the practice of OT expanded and therapists specialized, providing treatment for the mentally ill in institutions, physically disabled adults and children with cerebral palsy and developmental disabilities. Medicare covered OT services starting in 1965 and in 1975 The Education of the Handicapped Act was passed and Occupational Therapy was included in the public schools as a “Related Service”.
Today Occupational Therapists continue to use purposeful activities. Children occupy their time in play, learning and have a wide choice of “leisure” activities. By creating fun challenges and involving children in functional activities, arts and crafts, OTs help children gain strength, learn to problem solve, become more independent in their own care (dressing, bathing, chores), gain confidence and skills for social interactions, become more independent and ready to learn new skills and handle the challenges of the world they live in.
Suzette Werner Jones, OTR/L
President ,TherapyWorks, Inc.
Information from AOTA, Eleanor Clark Slagle lectures, Sensory Processing Disorder Website
by Phillip Kindschi | Apr 8, 2013 | Occupational Therapy
Nathan is a smart, spunky kindergartener who loves learning about animals and the environment. Nathan was getting into trouble at school for not keeping his hands to himself, interrupting the teacher and having difficulty remaining on task and staying seated. He began receiving occupational therapy about a year ago at TherapyWorks. While he had made some progress, his therapist recently implemented the How Does Your Engine Run?© Alert Program© to help improve self-regulation in order to decrease hyperactivity.
The Alert Program© was developed by occupational therapists Mary Sue Williams and Sherry Shellenberger in 1991, in order to create a shared language for students, parents, teachers, therapists and other professionals to use when improving self regulation and attention. According to their website, www.alertprogram.com, their mission is, “developing practical ways to teach people of all ages how to incorporate sensory integration theory into everyday living… and how understanding self-regulation can enrich the lives of children.”
The Alert Program© uses the analogy that your body is like a car engine; it can run too fast, too slow, or just right. For example, your engine is automatically running too fast if you are angry or are overly excited during recess.
Now that Nathan can accurately identify the engine level in himself and others, he has begun to learn different tools to use in order to change his engine speed. It is often a challenge to choose an appropriate activity to slow his engine and not simply pick a favorite activity!
Nathan is currently experimenting with changing his engine speed. He has learned body movement tools such as swinging, jumping, crashing, and climbing, used within a sensory diet for home and school, in order to calm and organize his engine to
the “just right” level. Next, he learned mouth tools such as resistive sucking through a straw (i.e. pudding or applesauce). Finally, hand tools, such as using a fidget toy or fabric fastener under the desk, keep his hands busy and his mind focused while learning.
His mother, Kimberly, has been very pleased with his progress in OT and using the Alert Program©. She explains, “In the past year, since beginning at TherapyWorks, Nathan has improved in so many areas, including self-regulation, social skills, attention and listening, behavior, coping skills, and so much more. He is now attending full days at school, whereas last year he was limited to half days. Nathan has always been an amazing, bright little boy, but he seems much happier and more confident now than when we first started at TherapyWorks. As a family we are so much better able to be successful and enjoy
each other. We are truly grateful to all of the amazing staff at TherapyWorks.”
How Does Your Engine Run?® and Alert Program® are registered trademarks of TherapyWorks, Inc.
TherapyWorks, Inc. 7200 Montgomery NE, Ste B9 Box 397, Albuquerque, NM 87109
Phone: (877) 897-3478; Fax: (505) 899-4071 Email: manager@AlertProgram.com Website: www.AlertProgram.com
by Phillip Kindschi | Feb 21, 2013 | Occupational Therapy, Physical Therapy, Speech Therapy
It’s often said it takes a village to raise children. With children with special needs, that village sometimes includes a number of therapists and specialists.
When children are brought into our clinic for their first assessment, the therapist may request additional assessments from other health care professionals. This allows therapists and parents to get a clearer picture of the child’s strengths and weaknesses and gives valuable information about how to best address the child’s individual needs.
Parents may feel overwhelmed or confused about these many specialists and may ask, “What does that person really do? Why is my child meeting with them?” Below is a basic review of some of the specialists your child may see and their unique role in your child’s treatment team.
At TherapyWorks, your child’s therapy team may include:
Speech-language pathologists give children the skills necessary for successful communication and meaningful interactions with others. Additionally, speech therapists assist children with feeding difficulties to eat and swallow safely.
Physical therapists work to improve muscle strength, range of motion, reflexes and coordination. Our physical
therapists are also trained to fit and cast custom foot orthotic devices. Orthotic supports align the foot or lower leg and improve posture, sitting, standing, walking and running.
Occupational therapists help children develop or regain skills necessary for play and work, and self and home care. Children may also need occupational therapy to help them with school and social skills. Play is important for a child’s mental, physical and emotional development. Occupational therapists also address sensory processing and integration problems which have a tremendous impact on motor skills, behavior, learning and a child’s ability to process information and respond to the demands and changes of daily living.
We also work with the following outside professionals to create a total treatment plan for your child:
Physicians emphasize the physical health of the child including height, weight gain, and absence of disease. Doctors also work closely with dieticians or nutritionists to ensure your child’s nutritional needs are being met for optimal growth and
development.
Psychologists and mental health professionals help people learn to cope with the daily stresses of life. For many of our families, psychologists provide strategies to help manage behavior issues to make children more successful at home and school. They also perform standardized assessment of developmental milestones.
Teachers and administrators address the educational/academic needs of children and work to meet educational mandates as required by state and federal laws.
Communication Intervention Birth to Three- 2nd Edition by Louis M Rossetti.
Delmar Publishing 2001 was referenced.
by Phillip Kindschi | Jan 10, 2013 | Occupational Therapy
Primitive reflex integration work is a newer technique beginning to be embraced by many different health professions. We are all born with reflexes to help us survive and learn as infants. Primitive reflexes are repetitive, automatic movements that occur in response to a stimulus, such as an infant sucking a nipple or bottle in order to eat.
Reflexes help to develop movement patterns, from involuntary (reflex pattern) to voluntary movement, and cognitive development. They are also the foundation for sensory integration as well as fine and gross motor coordination. If reflexes are not properly integrated, it could cause difficulties in daily life related to balance, coordination, gravitational insecurity, anxiety, reading and more.
Primitive reflex integration work is often called the “missing link.” It has been thought many children who have received therapy for years with minimal or no progress in a certain area, or are unable to maintain that progress, may have a reflex that has not been fully integrated. This interrupts the child’s ability to complete tasks efficiently or create a good foundation on which to build other skills. Once the reflex is integrated, gains in this area can then be seen.
In one particular case, a child, struggling with sensory integration, was highly anxious about most sensory input, refused to play on swings, was aversive to touch, had poor attention to task and was easily frustrated. The therapist began to work on some basic reflex integration exercises for gravitational insecurity and grounding the body. A little more than a month after starting the exercises, this child began to tolerate, and even initiates, playing on the swing. He is better able to self regulate and can attend to play tasks without running away for 10-15 minutes. The child also tolerates touch from the therapist with minimal resistance now, which previously, had been a struggle. Overall, this child has shown remarkable progress in the clinic, at home and school and has led to great improvements in daily living.
by Phillip Kindschi | Nov 5, 2012 | Occupational Therapy
Children are often referred for an
occupational therapy evaluation without their parents knowing what to expect. In fact, many other health care providers may not know the full extent of what occupational therapists can do to help their patients.
OTs work in many health care fields including: hospitals (acute care, inpatient and outpatient rehabilitation), skilled nursing facilities, home health, mental health, vocational rehabilitation, driver’s rehab and pediatrics (schools, early intervention, hospitals, and outpatient clinics). In general, OTs help people with their occupations – work, school or daily living.
For children, their primary “occupation” is play. Everyday activities include success at home, school and with peers. TherapyWorks helps children birth-21 years old with a wide variety of physical and neurological diagnoses including:
- Developmental delay
- Autism spectrum disorders
- Sensory processing disorder
- ADHD
- Down Syndrome
- Torticollis
- Brachial plexus injury
- Cerebral palsy
- Traumatic brain injury
- Developmental coordination disorder
- Genetic disorders
- Behavior problems/modification (reactive attachment disorder, obsessive compulsive disorder, oppositional defiant disorder)
… as well as many children who do not yet have a diagnosis.
I often explain occupational therapy as an “umbrella” covering many areas of a child’s functioning including:
- School readiness skills: visual motor skills such as handwriting or cutting and visual perceptual skills to boost reading, puzzles, etc.
- Self-care skills: dressing, brushing hair/teeth, sleeping suggestions, shower sequences
- Vocational skills: completing chores, simple meal preparation, interview skills, filling out a resume/application
- Gross and fine motor strength and coordination: Reflex Integration, jumping jacks, throw/catch, finger dexterity, pencil grasp, home exercise programs
- Physical limitations: range of motion, amputations, congenital deformities, muscle tone fluctuations, wheelchair transfers, splinting/casting, adaptive equipment
- Sensory processing and modulation: paying attention, listening and following directions (auditory processing), pain and touch (tactile processing), picky eating (oral sensory), balance and body awareness (vestibular processing)
- Social skills: deciding what to play, taking turns, sharing, joining in, inviting others, cooperation
- Emotional development: identifying and working through emotions, awareness of how our actions impact others, responding appropriately to others’ emotions
- Behavioral management: meltdowns, shutting down, aggression, positive reinforcement, natural consequences
- Executive functioning: sequencing routines or chores, ranking/grading scales, homework help, problem solving
- FloorTime™ (functional emotional developmental levels): shared attention, engagement (reciprocal interactions), purposeful communication, shared problem solving, symbolic play, emotional thinking
Occupational therapy evaluations typically last 1 hour and will include parent interview, standardized testing, clinical observations of behavior, attention, fine and gross motor functioning, and free play if time allows. Please bring a copy of your school-based Individualized Education Plan (IEP) or other therapist or psychological evaluations if your child has been evaluated elsewhere.
