WHAT IS OT by rrboy

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									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?

Rehabilitation centers
Early intervention centers
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

Handwriting is a huge reason for referral-
 very large growing practice area.
daily living skills and community living
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,
 ROM: range of motion
 SI: sensory integration
 AT: assistive technology
 COTA: certified occupational therapy assistant
Kinds of therapy you may

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

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…

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
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

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

Attention strategies
Often involves behavioral plans, and
 consultation with parents and teachers
Sensory Impairments

Low vision technology : Braille, large print
assist students in being able to navigate
 their environment successfully and
hearing - assist in development of
 programs to increase access to

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

 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
 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?

www.aota.org American Occupational
 Therapy Association
www.hp.ufl.edu/ot UF OT website
My email ewern@fdn.com
  Please feel free to email me questions, at
   any time!

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