|
OCCUPATIONAL THERAPY
Occupational Therapy (OT) is a health
profession that helps individuals develop that result in
increased independence in personal, social, academic and
vocational pursuits. These skills include:
- More effective motor performance for
school or work tasks
- Better organizational abilities for
successful completion of assignments and job
responsibilities
- Increased capacities to perform
self-care
- Improved social skills
- Coping strategies to assist children in
managing the classroom and sensory environment
- Analysis and adaptation of daily
activities
The basic philosophy of Occupational
Therapy rests on increasing quality of life and/or
functional independence through activities that are
functional and important to the individual. The role of the
Occupational Therapist is to assist clients of all ages with
debility/disability secondary to injury, trauma or
congenital (birth) deficits to increase their level of
functional independence to their maximum by using
activities. Activities are chosen on grounds of interest,
developmental level, physical ability and therapeutic goal.
Occupational Therapist
An Occupational Therapist can provide
direct treatment to the client, whether it is in a clinical
setting, home or school. He or she may also provide
consultation services to assess needs and recommend
specialized equipment, sensory activities (sensory diets),
curriculum and task modifications and caregiver education to
meet the needs of clients.
Occupational Therapists are an integral
part of the rehabilitation team and work directly with other
health care providers and educational professionals to
insure that each client receives the best care and
instruction possible. Team members include: physicians,
nurses, teachers, social workers, physical therapists,
psychologists, dentists, speech therapists, recreational
therapists, optometrists, vision specialists and
audiologists.
Occupational Therapy Assistants
Certified Occupational Therapy Assistants,
or "COTAs", are health care paraprofessionals who work under
the supervision of OTs. Their responsibilities include
assisting OTs with implementation of treatment programs,
training patients in exercise and activities of daily
living, training in the use of specialized equipment, and
reporting the patient's response to treatment.
EDUCATION
Occupational Therapists hold bachelor or
master degrees and Occupational Therapy Assistants are
trained at the associate degree level. Occupational therapy
education includes the study of human growth and
development, with specific emphasis on the social,
emotional, and physiological implications of illness and
injury. Occupational therapy practitioners must complete
supervised clinical internships in a variety of health care
settings, and are required to pass a national certification
examination.
PRACTICE SETTINGS
- Public and private schools
- Private practitioner offices
- Wellness centers
- Home health agencies
- Hospitals
- Day treatment centers
- Community mental health centers
- Clinics
THE OCCUPATIONAL THERAPY PROCESS
What happens first?
Occupational Therapy can be recommended by a
teacher/diagnostician or health care provider (MD, Dentist).
This is called a referral. If a teacher makes the referral
the process will be set in motion by the school's
diagnostician. If a doctor or other health care provider
makes the referral it will often be in the form of a
prescription. The physician will usually tell the patient or
parent whom to contact.
When the OT receives the referral from the
suggested agency, she or he will begin a screening process.
In the screening, the OT will be attempting to discover if
occupational therapy is the appropriate service to perform
an evaluation. She or he will determine this by talking with
the child's parents, caregivers, and/or teachers. This is
the best time to tell the therapist about your child. The OT
will ask questions. The OT will need to know any precautions
required to insure your child's safety and also any
information that will help your child be most comfortable
during the evaluation. If you forget to mention something in
the screening interview, you may contact the OT at a number
she/he will provide or send a letter through your child's
teacher. The therapist will also ask to review available
medical and/or school records.
What happens in the evaluation?
The evaluation is where the OT observes a child's
performance. Overall performance of self-care, daily living
skills, play, and school activities will be evaluated. The
underlying skills will be evaluated as well. Some underlying
skills are: muscle tone, muscle strength, amount of movement
that a child can achieve, posture, attention span, eye-hand
coordination, and sensory processing.
The therapist will use a variety of
activities and tests to make accurate determination of
skills. A child may be asked to attempt to undress and dress
herself, feed herself, and perform a variety of pencil and
paper tasks. The therapist may attempt to maintain the
interest of the child throughout the evaluation by quickly
changing activities, and promoting and allowing play. The
therapist will attempt to involve the child in activities
that best allow the underlying skills to be analyzed.
What happens after the evaluation?
Once the evaluation is complete, the tests graded, and the
summary written, an appointment will be made for you and the
therapist to go over the evaluation. The OT will tell you
his or her findings, and recommendations and goals for
treatment, if necessary.
What happens in treatment?
Answering this question is where a little understanding of
Occupational Therapy is most helpful.
- Occupational Therapy Definition:
Individuals experiencing limitations, use meaningful and
purposeful activity to achieve maximum independence.
- The occupational therapist's role: to
select appropriate, meaningful/purposeful activity in
order to achieve the desired goals.
- The theory behind Occupational Therapy:
an individual with a limitation will try harder to
overcome that limitation if involved in an activity that
has meaning and purpose to that individual. Basically,
this is saying that a person works harder and longer if he
or she is interested in, or believes in, what they are
doing.
For a child, play is what interests them
most. So with children, play is more often than not, the
type of treatment used. This play is not random, however. It
is the job of the therapist, to not only select activities
that are fun and meaningful, but also activities that will
help the child achieve an increase in self-care, daily
living skills, and other underlying skills.
The OT will also use specific handling
techniques (touch) to support and promote postural alignment
and control as well as apply sensory input to facilitate
more normal muscle tone, flexibility and balance.
Throughout treatment sessions the OT will
reassess skills to evaluate the child's progress toward
goals and to determine further and future goals.
Reassessment of skills is often done using some of the same
tests used in the initial evaluation.
What treatment approaches does an OT
use?
Occupational therapists use a variety of approaches to guide
their clinical practice. They include:
- NEURO-DEVELOPMENTAL APPROACH is used
for persons who have been born with a dysfunctional
central nerves system (e.g. cerebral palsy) or who have
suffered trauma or disease to the central nerves system
(e.g. stroke or traumatic brain injury).
Sensory input and developmental sequences are used to
facilitate change in the sensory-motor organization of the
central nerves system. This approach also includes
cognitive information processing strategies to promote
learning or relearning of movement control or
perceptual/cognitive functional abilities.
- BIOMECHANICAL APPROACH deals with
increasing strength, endurance and range of motion with
clients who have intact central nerves systems, but who
has dysfunction in musculo-sceletal, integument or
cardio-pulmonary systems (e.g. hip/shoulder replacements
and sport injuries, heart problems).
- REHABILITATIVE APPROACH
aims at
achieving the highest level of independence in spite of
residual disability that has resulted for any reason. Here
the Occupational Therapist will concentrate on assisting
the client and family in finding ways to compensate for
losses by adapted techniques and/or equipment e.g.
blindness, post-stroke.
- SENSORY-MOTOR APPROACHES, or "Ready
Approach". The Ready Approach was developed by Bonnie Hanschu and her associates at Developmental Concepts. It
is a sensory-based perspective for viewing the behavioral
and educational needs of children and adults with
disabilities. The ready approach was developed after
extensive exploration of the current research available in
the fields of neurology, biology, and physiology. The
ready approach advocates the use of the brainstem
sensations (vestibular, proprioception, and tactile) in
order to help the brain get into "a ready state" for
learning and for interacting appropriately within the
surrounding environment.
"Sensory Diets"
A sensory diet is a term for what we all do
everyday, all the time, to keep ourselves alert, calm, and
attentive.
For instance if your watching TV or listening to a lecture,
and you get sleepy, you get up and move, or shake your head,
or tap yourself to 'Wake up." This is giving yourself the
right stimulation to get yourself awake. Another example is
when you're very upset and you take a brisk walk. This is
what a sensory diet is. Some children are not able to detect
their needs. They may make adjustments to meet needs in a
dysfunctional way. For example, a child may need movement to
keep himself alert. A sensory diet gives these children
sensations by providing scheduled opportunities to get the
needed sensations that help them regulate their system.
Therefore, the inappropriate sensory seeking behaviors can
be diminished. A sensory diet must be done throughout the
day in all environments, making it possible for the child to
get sensation the brain needs. The sensory diet should not
be used as an occasional treatment intervention, but should
be a consequence of engaging in functional activity within
the child's normal routine.
What are consultation services? Sometimes
a child does not require direct (therapist-to-child)
intervention. Rather, the OT only needs to be a part of a
problem solving team to examine the environment and
interactions with the child to help determine why the child
may be experiencing delays or deficits and make
recommendations.
The recommendations made by the
Occupational Therapist should be tried, adjusted, and
adapted by parents, caregivers and teachers, with ongoing
evaluation by the occupational therapist consultant, the
team members involved, and the child.
Consultation services may include
recommendations for positioning equipment, sensory diets,
classroom modifications, and/or adapted equipment.
School districts are required by law to
provide Occupational Therapy services to eligible students.
This requirement may be met through either direct services
or consultation as indicated by the therapist and agreed
upon by the ARD committee.
When do OT services end? Occupational
Therapy services end when the child has reached all of
his/her goals or when the child is no longer making progress
toward the goals. The therapist often refers to this time as
plateau. A child "plateau's" when he or she has climbed many
mountains of achievement and has finally reached his or her
full potential at that time). This does not mean that the
child will be completely independent or free of limitations.
If self care and daily living skills
remain impaired, the child may be placed on consultation
services for a time so that the team can continue to problem
solve together to achieve the child's maximum independence
and to prevent further disability.
Interdisciplinary Team
Each member of the health care team provides a specific and
crucial portion of your child's rehabilitation needs. Your
child may have one or more of the following health care
professionals working on their health care team. The roles
of the team members are:
- Doctor - performs a medical evaluation,
and recommends management: i.e., therapy, braces,
traction, decreased physical activity, surgery, or
medications, and follows the overall general health of the
child
- Educational Diagnostician - determines
eligibility for special school services through
standardized testing.
Educational
- Paraprofessional - implements classroom
educational strategies under the direct supervision of the
teacher. This person is usually known as the classroom or
student's aide.
- Equipment vendor - supplies, repairs,
and orders all adaptive
equipment for the child such as wheelchairs, walkers,
canes, standing frames, tub chairs, etc.
- Occupational Therapist - assesses
self-help skills and activities of daily living, provides
direct treatment and home/school programming, assesses the
need for special equipment at home, in the classroom, or
at work.
- Orthotist
- responsible for creating
braces for the back, legs, ankles, wrists, hands, etc.;
responsible, along with the PT and OT, for maintaining the
braces in good working order
- Parents - the most important part of the team, advocates
for the child's needs, coordinates care for the child and
provides stable support system
- Physical Therapist
- assesses strength, movement patterns,
walking, joint mobility, balance and gross motor skills,
provides direct treatment and home/school programming, and
assesses the need for special equipment
- Speech Therapist
- assesses and treats oral motor
deficits, and communication disorders
- Teacher - develops and coordinates educational strategy to
promote learning and cognitive development in the school
setting. Responsible for the student's overall well being at
school
COMMONLY USED ASSISTIVE DEVICES
- Suspended Equipment Pencil Grips
- Ball Chair Touch Screen
- Slant Board Weighted Vest
IMPORTANT PHONE NUMBERS AND RESOURCE INFORMATION
- Richard L. Shorkey Education & Rehabilitation Center of
Southeast Texas
855 South 8th Street
Beaumont, Texas 77701
409-838-6568
Email:
lgillespie@shorkey.org
Provides physical therapy, occupational therapy, aquatics
classes, wheelchair clinic and equipment loan program for
children birth-21 years old, special needs daycare program,
community training for parents, schools, and daycare
personnel. Also provides education services including a
learning clinic, early childhood clinic, art for the special
needs child, diagnostic evaluations, language learning
classes, and standardized test preparation along with child
counseling and Transdisciplinary team assessment.
Non-profit, United Way agency.
- Beaumont State Center
655 South 8th Street
Beaumont, Texas 77701
409-833-1485 or 1-800-317-5809
TDD 409-784-5627
Provides physical therapy, occupational therapy, and speech
therapy, therapists/trainers can go to the child's house.
Programs include: First Steps, Community Living Skills,
Living Environment Adapted for People (L.E.A.P) Senior
Services, Transition Services, Vocational Training, Job
Quest, Home Services, In-Home & Family Support, Community
Residential Services, and Respite Care
- Texas Department of Health
Martin Blum and Judy Melling
3420 Fannin, Suite 100
Beaumont, Texas 77701
409-833-0072
Case management services, will advise family on how to apply
for Medicaid, Supplemental Security Income (SSI),
Chronically Ill and Disabled Children's Services (CIDC),
CIDC spend-down program, etc.
- Early Childhood Intervention
Beaumont State Center
655 South 8th Street
Beaumont, Texas 77701
409-833-1485 or 1-800-317-5809
TDD 409-784-5627
Federally and State funded program for children, birth to
age 3, with disabilities or delays. ECI supports families to
help their children reach their potential through
developmental services. Beaumont State Center is the local
site in Jefferson County, but it is also located in every
county in Texas.
- Texas Rehabilitation Commission
5550 Eastex Freeway, Suite D
Beaumont, Texas 77708
409-898-3988
For special needs people ages 16-adults. Wide range of
services provided to help
people become independent and employable
- Catholic Charities (CCMS)
P.O. Box 829
Beaumont, Texas 77704
409-835-1411
Helps provide daycare funding for children of low-income
parents. Can provide extra funding to the daycare center if
the child is disabled. This extra funding can help pay for
equipment, training for staff, etc.
- Partners Resource Network, Inc.
1090 Longfellow Drive
Beaumont, Texas 77706
A non-profit agency that provides training, information,
referral, resources, consultation, and emotional support to
parents of children with all types of disabilities
- Shriners Hospital for Children
6977 Main Street
Houston, Texas 77030-9817
713-797-1616
Free orthopedic care, braces, etc. for children that qualify
- Beaumont Independent School District
Special Education Department
3395 Harrison
Beaumont, Texas 77706
409-899-9972
Special ed dept can provide services for hearing and
visually impaired children from 0-21 years old, physically,
mentally, or speech impaired children from 3-21 years old.
Child can be tested on or after the 3rd birthday. The
following areas are assessed: gross motor, fine motor,
cognitive, speech, and self-help skills. Head Start program
for 4 year olds from low-income families.
- Region V Education Service Center
3545 Highway 96 Bypass
Silsbee, Texas 77656
409-386-1111
Provides services to school districts in Hardin, Jasper,
Jefferson, Orange, Newton, and Tyler counties. Includes
administrative services and training, computer services, and
special education services, assistive/adaptive device
evaluations.
- Dr. Charles Dyer, DDS
1120 Longfellow Drive
Beaumont, Texas 77706
409-898-8923
Dentist specializing in services for special needs children.
- Canine Companions for Independence
P.O. Box 4568
Oceanside, CA 92052
1-800-572-2275
National organization that provides dogs to help people
achieve independent living. Takes 1 ½ to 2 years from time
of application to receiving the dog.
REFERENCES
Sensory Integration, Toronto
|
