A child's developing senses are constantly overwhelmed with new stimuli. The fire truck sirens that adults can tune out are startling to infant ears; ice cream flavors that simply taste good to us are exponentially thrilling to a toddler. In addition to taste, touch, sight, hearing, and smell, kids are developing two internal senses. Proprioception allows for motor control and posture, and the vestibular sense links balance and coordination. Children with developmental delays need a little more help in synthesizing all the stimuli coming in from their environment. The go-to specialists are pediatric occupational therapists, who are trained to address a child's physical well-being along with the psychological, social, and environmental factors that can affect functioning.
Pediatric OTs should:
Lay the groundwork from the beginning.
At the first visit, expect more questions than answers. "A parent will fill out a sensory questionnaire and provide a developmental history for the therapist," says Meghan Corridan, an occupational therapist in New York City who treats children with a variety of disabilities and delays. A child will then undergo a session where he may be observed while cutting, grasping, or playing at a table. "While working at the table, the child is also assessed for attention span, frustration tolerance, and language skills," Corridan says. Motor skills may be assessed in a therapeutic gym using swings, therapy balls, and other equipment.
Make visits consistent and address expectations.
The number and length of therapy sessions per week vary, depending on the developmental delay. "For children with isolated handwriting or fine-motor difficulties, we can work together for up to six months to a year," Corridan says. Children with more extensive developmental delays or disabilities may be treated until they outgrow a therapeutic gym, usually around age 8 or 9. Corridan sees children with mild delays once or twice a week; those with disabilities usually have three sessions per week.
Have an eagle eye for improvement.
Occupational therapists hone in on even the subtlest signs of improvement and advance activities appropriately, teaching parents what to look for and how do the same at home. "Parents notice that the kids are able to do certain activities for longer amounts of time and are having an easier time keeping up with their siblings or peers. Schools may notice that a child's attention is improving or that they have a better grasp on writing instruments," Corridan says.
"Frustration is a very important thing to keep under control; if a child gets frustrated during therapy -- which is inevitable -- he will begin to avoid activities," Corridan explains. She's always watching for signs of frustration and jumps in to provide suggestions before the child has a chance to throw in the towel. "I can tell that a child is making progress with his frustration tolerance when he begins to ask for help without my prompting it."
Make work feel like play.
Adding one extra challenge to an activity is the fundamental idea behind keeping kids motivated. "In the therapeutic gym, I am sometimes able to 'hide' the work by adding it into an obstacle course," Corridan says. She also uses technology to her advantage: "The introduction of the iPad to my therapy sessions has been a huge motivation to my kids. There are so many great apps that work on fine motor skills, handwriting, and visual perceptual skills. I find that the kids who sometimes avoid all those activities are far more likely to do them when on the iPad."
Get parents involved without overwhelming them.
"I keep parents in the loop and provide them with activities to do at home," Corridan says. "These might be strengthening activities like drawing on an easel, or doing wheelbarrow walking with their child at home." But she doesn't rely too heavily on parents, believing that it's important not to turn a parent into an occupational therapist at home: "Parents should still be the parents and not the therapist."
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