Occupational Therapy Intervention in Pediatric

Introduction[edit | edit source]

Montessori toy

This page provides a concise overview of the pediatric occupational therapy process. The goal of pediatric occupational therapy is to increase kids' participation and engagement in daily activities. There are many different kinds of intervention strategies. To help families and therapists make informed decisions about the best possible care for children with impairments. [1]

In pediatrics, occupational therapy focuses on how illnesses and environmental factors affect a child's capacity to perform well in everyday situations (such as the home, school, and playground) and roles (such as family members, students, etc.). [2]

Indication[edit | edit source]

For children with delayed motor abilities, sensory processing difficulties, or coordination problems, occupational therapy is crucial. To determine whether your child requires assistance in this area, observe them over the day and note how they engage with their surroundings. You may notice that these children aren't able to feed themselves or do some activities like writing. [2]

Assessment[edit | edit source]

The occupational therapist will evaluate fine motor, visual motor, and gross motor skills. A standardized assessment might also be completed which can involve the occupational therapist performing tasks with the child or having parents fill out a questionnaire.[2]

Common Assessment Tools in OT:[3]

  • Adolescent/Adult Sensory Profile
  • Assessment of Motor and Process Skills (AMPS) [4]
  • Back on Track
  • Bayley Scales of Infant Development (BSID)
  • Berry-Buktenica Developmental Test of Visual-Motor Integration (BEERY VMI)
  • Developmental Test of Visual Perception (DTVP-2) [5]
  • Evaluation Tool of Children's Handwriting
  • Hawaii Early Learning Profile (HELP)
  • Infant-Toddler Sensory Profile (Sensory Profile 2)
  • Miller Assessment of Preschoolers (MAP)
  • Motor-Free Visual Perception Test (MVPT) [6]
  • Peabody Developmental Motor Scale (PDMS-2)
  • Pediatric Evaluation of Disability Inventory (PEDI)
  • School Functional Assessment (FSA)
  • Sensory Integration and PRAXIS Tests (SIPT) [7]
  • Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
  • Vineland Adaptive Behavior Scales (Vineland-II or VABS)

An occupational therapy evaluation will determine if a kid can execute any or all of the following tasks at an age-appropriate level[8]:

  • Motor function
  • Hand abilities
  • Integration and processing of senses
  • Perception of vision
  • Psychosocial problems influencing social engagement
  • Conduct Feeding abilities
  • Self-soothing
  • Engagement of the Community
  • Have fun
  • Handwriting and prewriting abilities
  • Mobility
  • Requirement for assistive devices/technology

Intervention techniques[edit | edit source]

With children and their families, occupational therapists are taught to employ a comprehensive strategy that prioritizes functional and developmentally appropriate techniques. Occupational therapy's guiding principles are well embodied in early intervention programs. Occupational therapists will assist children who need services after the age of three in creating a plan of care that will fulfill their needs and transition them into the next phase of their lives. [2]

Occupational therapy assistants (OTAs) employ tactics and procedures known as occupational therapy interventions to assist their clients in reaching their objectives. They are predicated on a thorough assessment of an individual's capacities, constraints, and objectives. Throughout the examination process, an OTA collaborates closely with an occupational therapist and may even take part in some aspects of it. Together with their clients, the OT and OTA choose the best interventions to apply during treatment sessions.[8]

The following six occupational therapy interventions are typical: [9]

  1. Examination of Activities
    • OTAs dissect an activity's components, considering the mental, physical, and emotional demands, and then devise a plan of action to modify the activity to the individual's capabilities and objectives. For instance, they might search for methods to increase or decrease the difficulty of a task[9].
  2. Modifiable Tools
    • Equipment that has been modified and tailored to meet the needs of specific clients is frequently advised. Walkers, canes, and crutches are examples of mobility aids that fall under the category of equipment. Another possibility is instruction in the use of modified cutlery with built-up or weighted handles. An individual can dress more easily with specially made garments featuring elastic waistbands or Velcro fastenings. OTAs may also assist clients who use prosthetics and orthotics. [10]
  3. Modification of the Environment
    • OTAs can collaborate with their clients to alter their surroundings so that they are secure and easily accessible. This can entail putting in grab bars, a bench, or a shower chair. An OTA may also advise making changes to the lighting or clearing out obstructions from stairs and hallways, such as furniture or clutter. [11]
  4. Helping Technology
    • OTAs may suggest assistive technology to their clients and provide training on its use. OTAs could assist users with voice-activated typing, speech recognition, or task simplification through the use of specialized software. They might assist clients in utilizing communication boards, augmented communication devices, or modified keyboards in their day-to-day activities.[12]
  5. Rehabilitation Training
    • Exercise is a tool used by OTAs to help people develop their physical skills, such as balance, strength, flexibility, and coordination. These workouts are only one way to assist a client in acquiring the motor skills required to meet their objectives. [13]
  6. Instruction and Guidance
    • OTAs frequently instruct and train patients, their families, or caregivers on how to use adaptive equipment, manage symptoms, and carry out activities safely and effectively.[13]

References[edit | edit source]

  1. 1.Brown GT, Rodger S, Brown A, Roever C. A Profile of Canadian Pediatric Occupational Therapy Practice. Occupational Therapy In Health Care. 2007 Jan;21(4):39–69.
  2. 2.0 2.1 2.2 2.3 Pediatric occupational therapy handbook : a guide to diagnoses and evidence-based interventions By Patricia Bowyer, Susan M Cahill Year: 2009 Publisher: Elsevier/Mosby Publisher Place: St. Louis, Mo. ISBN: 9780323053419
  3. Gage M. The Appraisal Model of Coping: An Assessment and Intervention Model for Occupational Therapy. American Journal of Occupational Therapy. 1992 Apr 1;46(4):353–62.
  4. Chard G. An investigation into the use of the Assessment of Motor and Process Skills (AMPS) in clinical practice. British Journal of Occupational Therapy. 2000 Oct;63(10):481-8.
  5. Lee SC. Visual perceptual skills as predictors of handwriting skills of children grades 1-3. Journal of Occupational Therapy, Schools, & Early Intervention. 2022 Jul 3;15(3):265-73.
  6. Brown T, Peres L. A critical review of the Motor-Free Visual Perception Test—fourth edition (MVPT-4). Journal of Occupational Therapy, Schools, & Early Intervention. 2018 Apr 3;11(2):229-44.
  7. Mailloux Z, Grady-Dominguez P, Bundy A, Parham LD, Roley SS, Wieland S, Schaaf RC. Evaluation in Ayres Sensory Integration® Praxis Tests: Construct Validity and Internal Reliability. American Journal of Occupational Therapy. 2023 Jul 1;77(4).
  8. 8.0 8.1 Bowyer P, Cahill SM. Pediatric occupational therapy handbook : a guide to diagnoses and evidence-based interventions. St. Louis, Mo.: Elsevier/Mosby; 2009.
  9. 9.0 9.1 Soderback I. International handbook of occupational therapy interventions. Springer International Pu; 2016.
  10. Aoyama H, Aflatoony L. Occupational therapy meets design: An augmented reality tool for assistive home modifications. InProceedings of the 32nd Australian Conference on Human-computer Interaction 2020 Dec 2 (pp. 426-436).
  11. Bodison SC, Parham LD. Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: A systematic review. The American Journal of Occupational Therapy. 2018 Jan 1;72(1):7201190040p1-1.
  12. Domínguez-Lucio S, Compañ-Gabucio LM, Torres-Collado L, de la Hera MG. Occupational therapy interventions using new technologies in children and adolescents with autism spectrum disorder: A scoping review. Journal of Autism and Developmental Disorders. 2023 Jan;53(1):332-58.
  13. 13.0 13.1 Tanner K, Schmidt E, Martin K, Bassi M. Interventions within the scope of occupational therapy practice to improve motor performance for children ages 0–5 years: A systematic review. The American Journal of Occupational Therapy. 2020 Mar 1;74(2):7402180060p1-40.