OCCUPATIONAL THERAPY

M.ARUN KUMAR., B.O.T.,OCCUPATIONAL THERAPIST

MERF Institute of Speech and Hearing

Take a moment to think of some of Take a moment to think of some of the things (occupations) you have the things (occupations) you have

done todaydone today......

have you had a shower, have you had a shower, had lunch with friends, had lunch with friends, or gone to work?or gone to work?

HOW WOULD YOU…HOW WOULD YOU…

You had poor balance?You had poor balance?

You couldn’t reach your You couldn’t reach your arms up to your hair?arms up to your hair?

HAVE A SHOWER IF…

HOW WOULD YOU…HOW WOULD YOU…

You couldn’t hold a fork?You couldn’t hold a fork?

You couldn’t remember where to You couldn’t remember where to meet them?meet them?

You just couldn’t cope with You just couldn’t cope with getting out of bed?getting out of bed?

HAVE LUNCH WITH FRIENDS IF…

HOW WOULD YOU…HOW WOULD YOU…

You had pain in your back?You had pain in your back?

You heard voices in your You heard voices in your head?head?

You had arthritis in your You had arthritis in your hands?hands?

GO TO WORK IF…

OCCUPATIONAL THERAPYOCCUPATIONAL THERAPY

Is the assessment and treatment ofIs the assessment and treatment of

physical and psychiatric conditions, usingphysical and psychiatric conditions, using

specific purposeful activity to preventspecific purposeful activity to prevent

disability and promote independent functiondisability and promote independent function

in all aspect of daily life.in all aspect of daily life.

Who do Occupational Therapists Who do Occupational Therapists work with?work with?

ChildrenChildren

Adolescents

Adults

Seniors

Where do Occupational Where do Occupational Therapists work?Therapists work?

HospitalsHospitals SchoolsSchools Mental Health Mental Health

FacilitiesFacilities Home CareHome Care Personal Care Personal Care

HomesHomes Private ClinicsPrivate Clinics

Rehabilitation Rehabilitation CentersCenters

Community Health Community Health CentersCenters

Insurance Insurance CompaniesCompanies

Client HomesClient Homes Client Work PlacesClient Work Places

Occupational Therapists are Occupational Therapists are concerned with:concerned with:

Person, Person,

Environment Environment Occupation Occupation InteractionsInteractions

OP

PERSON(Intrinsic Factors)

ENVIRONMENT (Extrinsic Factors)

OCCUPATION

PERFORMANCE

HUMANS AS OCCUPATIONAL BEINGS – PEOP MODEL

Physiological

Cognitive

Spiritual

Neurobehavioral

Psychological

Social Support

Social & Economic Systems

Culture & Values

Built Environments &Technology

Natural Environments

WELL BEING QUALITY OF LIFE

OccupationalPerformance &Participation

OCCUPATIONAL THERAPY OCCUPATIONAL THERAPY SERVICES FOR INFANTS AND SERVICES FOR INFANTS AND

CHILDRENCHILDREN

Pediatric occupational therapy is Pediatric occupational therapy is

skilled treatment aimed to enable the childskilled treatment aimed to enable the child

to be as physically psychologically andto be as physically psychologically and

socially independent as possible.socially independent as possible.

HOW DO THEY WORKHOW DO THEY WORK

Occupational therapists works in close Occupational therapists works in close partnership with…. partnership with….

Medical TeamMedical Team Educational TeamEducational Team Community TeamCommunity Team Family Family

Together they have a shared responsibility for Together they have a shared responsibility for meeting children’s needs. meeting children’s needs.

MULTIPLE DISABILITYMULTIPLE DISABILITY

When child has several different When child has several different

disabilities we say, that He/She has multiple disabilities we say, that He/She has multiple

disability disability Multiplication of disability Multiplication of disability 50% cerebral palsy – visual deficit 50% cerebral palsy – visual deficit 13% cerebral palsy – auditory deficit 13% cerebral palsy – auditory deficit Mental retardation Mental retardation

SOME EXAMPLES OF MULTIPLE SOME EXAMPLES OF MULTIPLE DISABILITIES ARE:DISABILITIES ARE:

Deafblind (Visual impairment + hearing Deafblind (Visual impairment + hearing impairment)impairment)

Visual impairment + hearing impairment + Visual impairment + hearing impairment + mental retardation.mental retardation.

Visual impairment + mental retardation. Visual impairment + mental retardation.

Cerebral palsy + mental retardation / hearing / Cerebral palsy + mental retardation / hearing / speech / visual problems. speech / visual problems.

Hearing / Listening Hearing / Listening Vision / Looking Vision / Looking Touch Touch Smell Smell Taste Taste Movement Movement Sensory integration Sensory integration Cognitive Cognitive Social Social

GROSS MOTOR SKILLS:GROSS MOTOR SKILLS:

Movement of the large muscles in the arms, and legs.Movement of the large muscles in the arms, and legs.Abilities like Abilities like RollingRolling CrawlingCrawling Walking Walking Running Running JumpingJumping Hopping Hopping Skipping Skipping

FINE MOTOR SKILLS:FINE MOTOR SKILLS:

Movement and dexterity of the small muscles in Movement and dexterity of the small muscles in

the hand and fingers. Abilities likethe hand and fingers. Abilities like

In-hand manipulation In-hand manipulation Reaching Reaching Carrying Carrying Shifting small objects Shifting small objects

SENSORY INTEGRATIONSENSORY INTEGRATION

Sensory processing Ability like Sensory processing Ability like

Vestibular Vestibular ProprioceptiveProprioceptive TactileTactile Visual Visual AuditoryAuditory Gustatory Gustatory Olfactory skillsOlfactory skills

CENTRAL NERVOUS SYSTEM

COGNITIVE PERCEPTUAL COGNITIVE PERCEPTUAL SKILLS:SKILLS:

Abilities like Abilities like Attention Attention ConcentrationConcentration MemoryMemory ThinkingThinking Reasoning Reasoning Problem solving Problem solving Concept of shapeConcept of shape Size and color Size and color

VISUAL MOTOR SKILLS:VISUAL MOTOR SKILLS:

Perception of visual information Perception of visual information

Abilities like copying Abilities like copying

MOTOR PLANNING SKILLS:MOTOR PLANNING SKILLS:

Ability to Ability to

PlanPlan

Implement Implement

Sequence motor tasks. Sequence motor tasks.

ORAL MOTOR SKILLS:ORAL MOTOR SKILLS:

Movement of muscles in theMovement of muscles in the MouthMouth LipsLips TongueTongue JawJaw SuckingSucking Biting Biting ChewingChewing BlowingBlowing Licking Licking

PLAY SKILLS:PLAY SKILLS:

Age appropriate purposeful play skillsAge appropriate purposeful play skills

SOCIO-EMOTIONAL SKILLS:SOCIO-EMOTIONAL SKILLS:

Ability to interact with peers and others.Ability to interact with peers and others.

ACTIVITIES OF DAILY LIVING:ACTIVITIES OF DAILY LIVING:

Self – care skills like daily Self – care skills like daily

Dressing Dressing Feeding Feeding Bathing Bathing Grooming Grooming Toilet tasksToilet tasks

ENVIRONMENT MANIPULATIONENVIRONMENT MANIPULATION

Like handling Like handling

Switches Switches Door knobsDoor knobs PhonesPhones TV remote TV remote

CHILD(Intrinsic Factors)

ENVIRONMENT (Extrinsic Factors)

OCCUPATION

PERFORMANCE

HUMANS AS OCCUPATIONAL BEINGS – PEOP MODEL

Physiological

Cognitive

Spiritual

Neurobehavioral

Psychological

Social Support

Social & Economic Systems

Culture & Values

Built Environments &Technology

Natural Environments

WELL BEING QUALITY OF LIFE

OccupationalPerformance &Participation

Case ExampleCase Example

Profoundly deaf, identified at 11 monthsProfoundly deaf, identified at 11 months Developmental history of hypotonia, tactile Developmental history of hypotonia, tactile

defensiveness, motor overflow, poor eye defensiveness, motor overflow, poor eye contact. Slow learning rate, limited social contact. Slow learning rate, limited social interaction with peersinteraction with peers

Referred by preschool teacherReferred by preschool teacher

On observation On observation

Reduced proprioceptive perception Reduced proprioceptive perception Weak bilateral coordination and motor planning Weak bilateral coordination and motor planning Reduce proximal trunk stability Reduce proximal trunk stability Avoidance of crossing midline Avoidance of crossing midline

Therapy ImplementationTherapy Implementation

Successive approximation based on motor Successive approximation based on motor complexity complexity

Increase visual and perceptual skill Increase visual and perceptual skill Model matching side by sideModel matching side by side Facilitate midline crossing Facilitate midline crossing Guidance and support of motor planGuidance and support of motor plan

Influence of sensory integration procedures on Influence of sensory integration procedures on language development.language development.

Ayres AJAyres AJ, , Mailloux ZMailloux Z. Am J Occup Ther. 1981 . Am J Occup Ther. 1981 Jun;35(6):383-90Jun;35(6):383-90

The relationship between language development and The relationship between language development and sensory integration was explored through single case sensory integration was explored through single case experimental studies of one female and three male experimental studies of one female and three male aphasic children ranging in age from 4 years, 0 months aphasic children ranging in age from 4 years, 0 months to 5 years, 3 months. Three of the four children had to 5 years, 3 months. Three of the four children had received either speech therapy, special education received either speech therapy, special education specific to aphasia, or both, before starting occupational specific to aphasia, or both, before starting occupational therapy. Inspection of rate of language growth before therapy. Inspection of rate of language growth before and after starting occupational therapy showed a and after starting occupational therapy showed a consistent increase in rate of growth in language consistent increase in rate of growth in language comprehensive concomitant with occupational therapy comprehensive concomitant with occupational therapy compared to previous growth rate. compared to previous growth rate.

Thank youThank you

Comments and Questions?Comments and Questions?