Pediatric Occupational Therapy:
Transitioning Children from Being Isolated to Being Included
By Nelson Gonzalez, OTR/L / July 1, 2017
"Nobody is superior, nobody is inferior, but nobody is equal either. People are simply unique. You are you, I am I." Osho
Pediatric Occupational Therapists are life builders for children whose lives have been raided by disability, especially those with Autism and Cerebral Palsy. OTs help these individuals to be free of their isolation, and help them to share their abilities with others. OTs do not attempt to make clients like everyone else. We embrace their strengths, and work on the areas that are weakened which affect their everyday functioning. If a child has difficulty controlling his or her self-stimulating behaviors, we teach them how to satisfy that crave in supplementary ways so that it does not affect their functioning and those around them. We want them to share their uniqueness. If a child with Cerebral Palsy demonstrates impairments with his or her motor control and coordination skills which affect his or her activities of daily living including dressing, bathing, and social interaction skills, occupational therapist help remediate deficits and train clients and caregivers on compensatory techniques as needed to lead fulfilling lives.
Various children with Autism may miss sensory information from the environment that provides signals about what is going on in their surroundings and may be referred to as having poor registration. The brain may not be getting what it needs to produce appropriate responses. Other children may be referred to as having seeking behavior. These individuals are characteristically active and continuously engaged in their environments. They add sensory input to every experience in daily life. They may seem impulsive and the consideration for safety when playing may be absent. Some children with Autism may display hypersensitivity to sounds, sights, smells, tastes, and textures. These children may have sensitivity behavior. They have over-reactive neural systems that make them aware of every stimulus that becomes available, and do not have the appropriate ability to adjust to these stimuli.
Children may also present as having avoiding behavior, which represent those who may engage in disruptive behaviors especially in situations where they know they are having difficulty. They avoid circumstances by either withdrawing or participating in emotional outbursts that enable them to get out of the situation. The child may appear stubborn and controlling and prefer routines without any sudden changes. The child is creating a state to limit sensory input to those events that are known and therefore easy for the nervous system to interpret. There is not a cookie-cutter treatment plan for these exceptional children. OTs give the children and caregivers with individualized recipes (treatment plans) called a sensory diet with ingredients (tools) to help the child regulate his or her sensory system for success at home, school, and in the community.
Children with Cerebral Palsy characteristically demonstrate deficits with reflex, body movement, muscle tone, balance, posture, muscle coordination, and receiving and responding to information through the senses. These complications can considerably impair a child's ability to successfully take part in daily living activities including, dressing, feeding, sitting, standing, socializing, and more. These limitations can lead to isolation. OTs encompass the skills necessary to improve their posture, reduce muscle tone and improve their range of motion. OTs will improve a child's self-care skills, visual motor skills, handwriting skills, and the ability to navigate their environment. These skills are imperative to improve a child's functional independence to replace isolation into inclusion. But treatment does not end in the therapy clinic. A comprehensive home exercise and activities program and family education are vital to this process.
OTs are knowledgeable in many areas in pediatric care. The focus is on improving a child's functional independence. Through individualized treatment strategies and taking a family centered approach, limitations can be altered into great expectations.
Nelson Gonzalez, OTR/L, CPT, RFS, is the Lead Occupational Therapist and Director of Rehabilitation Services for Therapies4Kids.
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