The Occupational Therapy Looking Glass

You drop your child off at the front office of the clinic, at the front doors of the school, or at the bus stop and say goodbye. Later, you get a note from their Occupational Therapist that says they had a good session today, but have you ever wondered what that “good session” looks like? I can give you a general idea, but keep in mind as you read through this ever-entertaining and insightful blog, that every child that receives OT is different – their goals, strengths and how the session is structured. 

Your child might tell you that they got to play in the gym, do an obstacle course, or do some exercises in OT today. As a therapist, I don’t just see your child playing on the swing, jumping on a trampoline, doing jumping jacks, or wall push-ups. I want to know if your child avoids certain movements and equipment, or if they seek that out and what that means for their sensory system. I make notations if your child is having a hard time attending to a task and if they do better after getting some movement breaks. I see if they have the motor planning to properly sequence an obstacle course and do so safely. 

Your child’s therapist may have written down or told you that they played a game. Why do we use games so much in therapy? Let’s use the game Connect 4 as an example. As a therapist, I don’t view Connect 4 as just a fun game to pass the time. I consider what skills are needed to play the game and how they are foundational to so many other skills. For this one simple game, my observations reveal how:

• the act of placing the disc into the slot is practice for managing buttons independently
• the act of using the fingers and thumbs to pick up the disc from the table is building the intrinsic muscles of the hand to foster a proper grasp on pencils 
• the ability to visually scan across the board is training the eyes to read across the whiteboard in school 
• reaching into various planes and across the body promotes motor planning and bilateral integration

To me, I am interested in what muscles, movements,  skills, and what thought processes have to go into playing that game. So, there is a good chance that your child participated in a game-like activity in therapy today!

Your child comes running out of the office or off the school bus and hands you a lovely craft that they worked so hard on in therapy for you to proudly display on the refrigerator. Crafts can be used to work on so many skills. They can involve using scissors, pencil grasp, bilateral integration and coordination, coloring, and drawing pre-writing shapes. They also provide opportunities for children to practice writing their names, writing sentences, strengthening by squeezing the glue bottle, and sequencing by following the steps to complete the task. 

Your child might tell you that they had to do some writing, or typing, or practice their zipper, or whatever their goals may be, and it wasn’t very fun. While we strive to make therapy as enjoyable as possible, there may be a time during the session that one has to practice the not-so-fun stuff. These are the activities that your child’s therapist has identified as goals to work on. That means that these tasks may be more difficult and not as preferred. Let’s be real for a moment, if I have a hard time doing something, chances are, even as an adult,  I am going to avoid having to do it and if I can’t avoid it, I’m probably not going to have a good time doing it. The same goes for the kids that I work with when it comes to addressing the goals head on. My job is to try and find ways to make those difficult tasks easier by building those foundational skills. 

Wow, that was a mouthful! Essentially, your child’s therapy sessions will typically involve various games and activities that work on developing  foundational skills needed to make  difficult tasks less challenging.  You know… that “walk before you run” saying… same concept. There will most likely be some type of strengthening activity, whether it be strengthening just the hands and fingers, the whole arm, or the trunk as well. Movement breaks and crafts are also popular while promoting improved skills. Then there will be the direct interventions on those identified and targeted goals. We have a tendency to reward hard work, so there is a good chance that the session will end with one of your child’s favorite activities, but don’t worry, it will still be therapeutic! ?

-Madonna Smith, OTR/L