Why Occupational Therapy Works for Kids on the Spectrum

Occupational Therapy is one of the treatments for kids on the Autism Spectrum.  The main reason for occupational therapy is that children can work on fine and gross motor skills, as well as overcome some of their sensory processing difficulties.

A developmental delay in gross motor skills might mean the child can't ride a bike, may run in an awkward manner, or may have difficulty kicking a ball.  Therapists use organized play to work on these gross motor skills.  If a child has severe delay with gross motor skills, then physical therapy would work better.

A developmental delay in fine motor skills might mean the child has trouble feeding themselves, getting dressed, or writing.

Occupational Therapy can help with self care issues and academic skills.  They may work on writing, cutting with scissors, as well as developing the muscles required for those skills by playing with play dough, stringing beads, and squeezing sponges. 

The goal of Sensory Integration Occupational Therapy is not to teach behaviors or skills, but to help with neurological processing deficits, teaching them to adapt to the environment around them. This could include teaching tolerance to different textures, loud noises, and bright lights.  It involves determining what kind of sensory issues a child has and helping him/her get the sensory input they seek in a controlled environment.

With Sensory Integration, the therapist will be helping the child manage his/her body in space.  An OT can also help the child with communication and interaction with others through therapy known as Floortime, where the therapist gets down on the floor and Plays with the child.  The therapist works on transitions from one activity to another if transitioning is an issue with the child. Determining strategies that work can help outside of the therapy session when the child is at home, at school, and in the community.

Occupational Therapy

I am often asked what Occupational Therapy is, so I thought I'd go into detail in today's blog post.

Occupational Therapy, also known as OT, (according to Wikipedia) incorporates meaningful and purposeful occupation to enable people with limitations or impairments to participate in everyday life.

According to About.com, Occupational Therapy actually deals with strengthening fine motor skills, like writing, cutting, shoe-tying and using utensils. For adults recovering from an accident or stroke, that may include work-related skills; for children, whose "occupation" is school and play, it will focus more sharply on developmental milestones and skills required for playground and academic activities. Occupational therapists working with children typically use techniques and routines that may seem like play, but are designed to target areas of delay and difficulty. Some occupational therapists are also trained in therapy with a sensory integration approach (SI), which uses play-like activities to help children better process and tolerate the information they get through their senses.

John would spend his hour of OT swinging on different types of swings, climbing, working through obstacle courses, hanging on a trapeze bar, jumping in ball pit, jumping on trampoline, walking on different textures, riding a tricycle, throwing balls, working on fine motor skills, and sometimes, working on eating issues.

Recognizing Sensory Processing Disorder

I am continuing to read the book, The Out-of-Sync Child, by Carol Stock Kranowitz and am positive that an OT evaluation will reveal that John has Sensory Processing Disorder. (SPD)

According to Carol Stock Kranowitz, SPD is the inability to use information received through the senses in order to function smoothly in daily life.

There are 3 categories within Sensory Processing Disorder and 5 sub-categories under those 3 main ones. The three Disorders are:
1. Sensory Modulation Disorder
2. Sensory Discrimination Disorder
3. Sensory Based Motor Disorder

Under the Sensory Modulation Disorder, the subgroups are :
1. Sensory Over-responsivity
2. Sensory Under-responsivity
3. Sensory Seeking

Under the Sensory-Based Motor Disorder, the subgroups are:
1. Postural Disorder
2. Dyspraxia

John falls under the Sensory Modulation Disorder as a Sensory Seeking Child, based on my own evaluation using Carol Stock Kranowitz' checklists.

This kind of child wants "more" -- wallows in mud, dumps out toys (rummaging through them for the texture), chews on objects and shirt collars, runs and 'crashes' into furniture on purpose, moves constantly, fidgets, loves being upside down, takes bold risks, craves bear hugs, loves being squeezed, seeks heavy work and vigorous playground activities.

With sound, I see John having aspects of all 3 main categories -- he covers his ears to close out normal everyday sounds (microwave and hair dryer) -- overresponsive child
He ignores ordinary sounds and 'turns on" to exagerrated sounds -- underresponsive child
He loves crowds and places with noisy action --- sensory seeking child

I also notices some motor skills issues -- low muscle tone and fine motor planning with his mouth (although with speech therapy, this is getting so much better -- this week, he can now blow bubbles consistently!)

Many issues can arise because of sensory processing issues. Such as:
Self Regulation - inability to adjust mood (calm down once aroused)
Sleep Issues - want or need to sleep with parents, difficult falling asleep, staying asleep, and waking up
Eating Issues - picky eater, texture issues, lack of coordination to chew, swallow, and breathe
High Activity Level
Inattention
Impulsivity
Poor Communication
Other issues like Autism, ADHD, Selective Mutism, Down Syndrome, etc may accompany SPD

So, to sum it up for the day, Sensory Processing Disorder is difficulty in the way the brain takes in, organizes and uses sensory information, causing a person to have problems interacting effectively in the everyday environment. Through OT/SI (Occupational Therapy Sensory Integration), children learn to develop their nervous system. A professional evaluation and diagnosis is necessary to begin OT/SI therapy. John has had a primlimary screening through Casa Colina, in which they determined he needed a full evaluation.

*This information was taken from Carol Stock Kranowitz' book, The Out-of-Sync Child.