Occupational ther­apy can im­prove chil­dren’s lives in a va­ri­ety of ways



Spend any time at a preschool or ele­men­tary school th­ese days, and you will no doubt hear about occupational ther­apy (OT).

“An occupational ther­a­pist works with some­one who is hav­ing dif­fi­culty suc­ceed­ing in their ‘role’ in life,” ex­plains Karen Bron­stein, an occupational ther­a­pist in pri­vate prac­tice at North­ern Val­ley Speech Lan­guage and Learn­ing Cen­ter in Cresskill. “Th­ese ar­eas en­com­pass work, self-care and leisure.”

An occupational ther­a­pist will help when a child has trou­bles in any of th­ese ar­eas, Bron­stein says, such as, “hold­ing a pen­cil or cut­ting with scis­sors, feed­ing them­selves, dress­ing them­selves, co­or­di­nat­ing their bod­ies to play on the play­ground or in­te­grat­ing their vis­ual mo­tor skills to catch a ball.”

Jean Marie Sacco, an occupational ther­a­pist at North Jer­sey Elks De­vel­op­men­tal Dis­abil­i­ties Agency, a non­profit in Clifton, says some signs that a child may need occupational ther­apy in­clude “a se­vere re­ac­tion to ev­ery­day sit­u­a­tions like tags on cloth­ing, hair­cuts or teeth brush­ing. [The child] does not seem to know how to play with toys ap­pro­pri­ately and they have trou­ble us­ing his or her hands to­gether to per­form such tasks as but­ton­ing, cut­ting with a scis­sors, dress­ing or un­dress­ing one’s self.”

She says that by age 3, a tod­dler should be able to com­pletely un­dress with­out help.

If a par­ent or care­giver has con­cerns, a child should be brought for an ini­tial screen­ing or eval­u­a­tion. Dr. Chaye Lamm War­burg, direc­tor of Pe­di­atric Occupational Ther­apy Ser­vices in Tea­neck, notes, “A lot of par­ents come with con­cerns – per­haps their baby is hy­per­sen­si­tive to cer­tain things. Par­ents have a gut feel­ing, and we re­spect that and in­ves­ti­gate the area of con­cern.”

An­drea Del­monico, an occupational ther­a­pist at the Abil­i­ties Ther­apy Net­work in Mid­land Park, ex­plains that chil­dren are eval­u­ated “in lots of dif­fer­ent ac­tiv­i­ties. This helps us look at their vis­ual-mo­tor skills, vis­ual-per­cep­tual skills, bi­lat­eral hand co­or­di­na­tion, fine mo­tor strength and co­or­di­na­tion. We are then able to see where the dys­func­tion is and we look for the un­der­ly­ing is­sue.”

Occupational ther­apy can start at birth for some ba­bies, and there are occupational ther­a­pists that go into the NICU if a baby is hav­ing trou­ble po­si­tion­ing, feed­ing or there is a lack of phys­i­o­log­i­cal flex­ion. War­burg sees ba­bies as young as 6 weeks old if they have an iden­ti­fi­able dis­abil­ity and then a lit­tle later if they are not meet­ing ma­jor de­vel­op­men­tal mile­stones, such as rolling, sit­ting or stand­ing.

“We also see ba­bies who seem aloof, over­whelmed by sights and sounds, and who are hy­per­sen­si­tive,” she says.

How do occupational ther­a­pists ac­com­plish their goals?

“A great OT should look like a play date,” War­burg says. “We use sys­tem­atic de­sen­si­ti­za­tion. Mak­ing it fun, we pre­pare all senses to ex­plore on their own terms. This may in­clude vi­bra­tion, deep brush­ing and joint com­pres­sion. We use swings, tun­nels, jump­ing and other whole body ac­tiv­i­ties. We will in­tro­duce nox­ious cloth­ing. We are al­ways go­ing to use a prac­ti­cal ac­tiv­ity. Through play, we en­tice them to use their mus­cles, and then we give the par­ent a play pro­gram that they can use and fol­low through.”

Bron­stein agrees, “For ther­apy with chil­dren, I al­ways say there is a fine line between stress and dis­tress. We need to stress the child, move them into more chal­leng­ing ac­tiv­i­ties so they can grow and achieve new skills. How­ever, we do not want to stress so much that it be­comes dis­tress.”

Del­monico ad­vises that “picky eat­ing could be a sign of prob­lem eat­ing,” and Abil­i­ties Ther­apy Net­work uti­lizes the Se­quen­tial Oral Sen­sory (S.O.S.) ap­proach to work on this with chil­dren.

War­burg says that in her prac­tice, she has had highly mo­ti­vated teens or tweens with spe­cial needs visit with a spe­cific goal in mind. One young man was a foot­ball player-turned-coach who wanted to be able to dress in a but­ton down shirt, and one girl wanted to be able to wear a spe­cial dress for her bat mitz­vah. Both were ul­ti­mately de­sen­si­tized to the of­fend­ing ma­te­rial.

Over the years, War­burg has seen a much greater aware­ness of the ben­e­fits of occupational ther­apy.

“Many laws have been passed al­low­ing occupational ther­apy as an en­ti­tle­ment,” she says. “There is recog­ni­tion of the value of OT in al­low­ing peo­ple to func­tion in ev­ery­day life.”

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