WHAT IS OT? Elisa Wern, OTR/L Occupational Therapy Related service under IDEA IDEA definition: OT is “ (I) improving, developing or restoring functions impaired or lost though illness, injury, or deprivation (ii) improving ability to perform tasks for independent functioning when functions are impaired or lost, and (iii) prevention, through early intervention, initial or further impairment or loss of function.” [34 C.F.R., 300.16(a) (5).] focuses on the educationally relevant areas of ADL, work, and leisure/play. Can be in typical school setting or in charter school, alternative schools, vocational schools or home-based related services when deemed to be most appropriate environment for the child’s education Where do OT’s work? Schools Rehabilitation centers Early intervention centers Hospitals Day care centers Psychosocial disorder treatment centers e.g. Shands at Vista How are OT’s trained? 4 1/2 year degree from accredited university classes in neuroanatomy, musculoskeletal anatomy, pediatrics & development (4 courses), psychosocial illnesses, elders/geriatrics, neurorehabilitation Two 3 month internships, with optional 4 week specialty state and national certification and licensure Difference between OT and PT Both are health care professionals that treat children with developmental disabilities, adults/children with injury or diseases. In general, the OT and PT provide assessment services, treatment and program suggestions. The OT assesses the areas of daily living skills, upper extremity strength/range of motion, developmental delays, cognitive functioning, visual perception, work hardening skills, sensory integration and/or adaptive behavior. Treatment includes self-help skills training, upper extremity strength/endurance training, and enhancement of developmental skills. The PT areas of focus may include joint motion, muscle strength and endurance, function of heart and lungs, and/or performance of activities required in daily living. Treatment includes therapeutic exercise, ROM, and lower extremity coordination. Reasons for Referral in School System Handwriting is a huge reason for referral- very large growing practice area. daily living skills and community living skills fine motor / upper extremity dysfunction visual / perceptual motor difficulties sensory motor integration problems self-feeding skills deficits Roles of OT Direct service: typical therapy sessions in group or individual settings Consultative: to child who does not qualify for direct service, consult may be used to monitor and assess needs of child in class Consult to teachers: often we are approached with scenarios of “I have a student who is having problems with X, what suggestions do you have? (Pre-referral checklist) Words you Might hear ADL: activities of daily living FM: fine motor skills – writing, manipulating objects, using hands to complete ADL tasks such as brushing hair, putting on earrings… GM: gross motor skills – running, jumping, skipping, walking… ROM: range of motion SI: sensory integration AT: assistive technology COTA: certified occupational therapy assistant Kinds of therapy you may see Pull out: students are taken to another part of the classroom or school campus for therapy time, often with other children who are working on similar goals Push in: move lately towards provision of services in the student’s natural setting – in this case, the classroom Developmental Delays Often used to classify children who for unknown reasons demonstrate delays in areas of fine motor, gross motor, or sensory processing skills. OT goals may include: age appropriate scissoring or pencil grasp DD is not used as a classification after age 6. Mobility/Positioning WC seating and positioning for optimum educational performance “if you are uncomfortable, do you want to do work?” Assist with ensuring child has maximum access to classroom environment – desks, playgrounds, specials… Feeding May work in classrooms at breakfast and lunch to assist students in learning ways to adapt use of utensils Help to teach teachers and aids tools to assist student to be as independent as possible in feeding AT -- Feeding Machines may co-treat with SLP to work on feeding issues Fine motor coordination Involves use of hands for purposeful movements such as writing, picking up items Dysfunction areas are in finger strength and pinch strength, finger isolation Very interwoven with handwriting difficulties manipulating small objects using scissors turning pages using clothing fasteners opening and closing containers Gross Motor Skills & Motor Planning/Coordination Dyspraxia: difficult motor planning Some kids have a hard time knowing how to get their bodies to do what they want to-- whether that’s swinging on a swing or walking to a teacher’s desk from theirs we break down the steps and teach child one at a time, or in clumps Gross Motor Skills The development and use of large muscles such as trunk and legs to perform activities. Includes balance and equilibrium sitting up straight while in chair walking on uneven and even surfaces hopping, skipping, jumping strength and endurance alternating feet when climbing stairs walking on a narrow path or balance beam Visual Perceptional Skills Visual Sequential Memory Deficits Visual Motor Coordination Deficits Assignments are forgotten Difficulty drawing geometric symbols Forgets steps that are shown in an activity Difficulty in copying Cannot remember the alphabet in correct order Decreased legibility in handwriting Difficulty with mazes and dot-to-dot Position in Space Deficits Figure-Ground Deficits Inconsistent symbol reversal Difficulty with hidden pictures Transposes number or letters Cannot focus on one word on a page Difficulty differentiating between b,d,p,q Difficulty copying from a board Trouble finding place on the page Spatial Relations Deficits Trouble with right/left Visual Closure Deficits Difficulty with spacing within and between words. Cannot complete partially drawn pictures or stencils May knock over items Trouble completing age appropriate puzzles Difficulty in spelling Visual Discrimination Deficits Leaves out parts of word or entire words Matching and sorting difficulties Size discrimination may be impaired Visual Memory Deficits Fails to recognize similarities and differences in objects Trouble remembering sight words Difficulty matching two dimension to three dimensional such Copies only one letter or number at a time from the board as alphabet letters ADD & ADHD Attention strategies Often involves behavioral plans, and consultation with parents and teachers Sensory Impairments Low vision technology : Braille, large print books assist students in being able to navigate their environment successfully and independently hearing - assist in development of programs to increase access to environment OTHER/MISCELLANEOUS Energy conservation and activity endurance especially with children who are classified as OHI Splinting of extremities to allow increased function and decreased deformities AT for children who have communication disorders such as picture schedules Sensory Processing Disorders condition in which children demonstrate problems regulating, interpreting or producing correct motor responses to sensation. In order for it to be classified as a disorder or a dysfunction, the problems must impact daily living routines. Children and/or adults must demonstrate difficulty with social participation, self-regulation, self-esteem, and/or specific sensory motor skills. (Dr. Lucy Anne Miller, 2002.) Sensory Diet Children with sensory modulation disorders can use a sensory diet sensory modulation is a continuum The ALERT program – How does your engine run? Resources www.aota.org American Occupational Therapy Association www.hp.ufl.edu/ot UF OT website My email firstname.lastname@example.org Please feel free to email me questions, at any time!