Occupational therapy involves helping children with their occupations – their activities. Children sometimes need specific strategies so that they can learn to participate in activities with other people. Occupational therapy intervention addresses key ‘doing’ SKILLS which a child is having difficulty with such as:
- Fine motor – (puzzles, construction activities, colouring, drawing, cutting, handwriting legibility and speed, typing skills) e.g. Ben learning how to write neatly so that his teacher can read his amazing stories.
- Written expression – (thinking up and organising ideas on paper with structure and coherence, essay writing) e.g. Sandra learning how to organise her essay writing so that her good ideas don’t end up going round and round in circles.
- Gross motor – (ball skills, skipping, jumping) e.g. Thomas learning how to catch a ball so that he can play cricket with the other neighbourhood kids in his backyard.
- Self care – (dressing, eating, hygiene, toileting) e.g. Jenny learning how to do up her own shoelaces so that she doesn’t need help when she goes to the school swimming carnival.
- Play – (imaginative play, purposeful, structured and sequenced play) e.g. James learning how to play imaginatively with different objects and not just lining them up in a row.
- Social – (friendship, dealing with feelings) e.g. Anna learning how to make friends and how to deal appropriately with her feelings in the playground.
Occupational therapy intervention also addresses different UNDERLYING ABILITIES which may be causing problems for these skills. Underlying abilities may be:
- Mechanical difficulties – (posture, seating, muscle tone and pencil grip) e.g. Timothy learning how to develop a pinch grip so that he can hold his pencil with control for drawing a picture of his dad.
- Sensory abilities – (coordination, sensory processing, body awareness, balance, motor planning) e.g. Matthew learning how to coordinate the left and right side of his body in a smooth and flowing way so that he can swim in his friend’s pool.
- Cognitive abilities – (attention, memory, organisation and planning) e.g. Steven learning how to problem solve – think up strategies and choose the best strategy instead of impulsively reacting to a situation.
- Personal abilities – (motivation, confidence, enjoyment and perseverance) e.g. Jonathan learning how to have the confidence to join in and have fun with the rest of the kids.
Occupational therapy at Skills for Kids uses 3 main strategies for intervention:
- Skills mastery – we teach children the step by step process for learning skills – one step at a time.
- Information processing – we teach children how to use their thinking for doing.
- Sensory processing– we teach children how to organise sensory input from their body and their environment for use.
We teach skills by using task analysis to break skills down into their small subskills so that children can learn a small part of a skill with confidence and enjoyment before moving on to learn another part of the skill. For example: handwriting legibility is a skill which is made up of a number of subskills including matching sound to written symbol, letter formation, word spacing, letter alignment, letter sizing and letter shape. For children who are experiencing a difficulty with learning we work on one subskill at a time – each subskill with its own set of strategies. Task analysis is important so that children do not get overwhelmed by difficult skills. Task analysis can be applied to lots of different skills – tying shoelaces, catching a ball, concentration, even making friends.
We teach many skills to children who have a difficulty with learning by using an information processing approach. There are numerous theories thought to be the cause for a difficulty with learning. Since the 1970’s information processing theory has been one of the major cognitive theories which explains the way individuals learn. Research has suggested that information processing strategies can make a difference for children who experience a difficulty with learning. At Skills for Kids we use an information processing model developed by Dr Christine Chapparo and Dr Judy Ranka at Sydney University. This model has 4 factors – perceive; recall; plan and perform. We assess breakdown points associated with these areas for learning and participation and then provide specific strategies at each of these breakdown points.
- Perceiving (including attention) as a child being in an alert state of focused readiness for learning.
- Recalling as the child’s ability to build a functional reference or ‘filing’ system for recognising, storing and retrieving information from memory stores. A child is then able to remember when, where and what to do for performance.
- Planning as a child’s ability to use and apply strategies in new experiences so that the child can organise how to do an activity.
- Performing (doing) as the actual physical execution or performance of an activity following attention to, recall for and planning of the activity.
Some children who have a difficulty with learning respond best to a sensory processing based approach. These children are often overwhelmed by their sensory environment. There are 5 common senses – vision, hearing, smell, taste, touch and 2 additional special senses of proprioceptive and vestibular movement (where information is received from the muscles, tendons and joints, and provides us with an awareness of the position, direction, force and speed of movement – without vision).
One of the main difficulties children with a sensory processing disorder have is with sorting and screening out the messages coming from the senses. Children can either over – react or under – react. Some examples are that children may strongly react to hair cutting or brushing; be irritated by certain clothing fabrics; become distressed in high noise or movement areas such as shopping centres or playgrounds.
Children in the Autism Spectrum Disorder continuum have been commonly found to have difficulty processing and responding appropriately to sensory information. The use of sensory processing therapy has been successful in reducing anxiety and behavioural difficulties, and in increasing children’s positive interaction with others.