WhichSchoolAdvisor.com spoke to Michelle Choytooa, Paediatric Occupational Therapist at The Developing Child Centre, to learn how Occupational Therapy can dramatically alter the lives of children with SEN.
Tell us about the role of an occupational therapist?
As an occupational therapist (OT) I support people in improving how they manage everyday activities. I work with children to empower and promote their independence. I assist them in performing and achieving important learning and developmental tasks. These then help them achieve independence in school productivity, self-care and play and ultimately preparing them in building the skills they need for life!
I improve handwriting by teaching children to hold their pencil properly. I develop fine motor skills, which allows children to improve how they use the small muscles in their hands. Making them better able to cut and manipulate small objects as well as improving their attention, concentration and ability to follow instructions.
At home I can help children develop self-care, things like being able to get dressed, fasten buttons, zips and even shoelaces. Personal care can also be improved by working on bathing, brushing teeth and independent feeding.
Occupational Therapists also support children in developing their play skills, things like hopping, jumping, throwing and catching a ball or riding a bike.
I also have additional qualifications in a specialist area called Sensory Integration. Children with sensory integration problems are the ones who can’t sit still; they have to hold things and play with things can appear clumsy, fall over, spin and even twirl. They often choose to avoid messy play activities, struggle to eat particular textures and become upset when getting dressed, washing their hair, brushing their teeth or cutting their nails. Sensory integration work is a really effective method of helping children overcome these issues.
Which SEN do the majority of your patients constitute?
The majority of children we see don’t have a formal diagnosis therefore we assess each child to identify their areas of difficulties. However, I do also see children on the autism spectrum, those with developmental delays, and dyspraxia and others with sensory processing disorder.
What special educational needs respond best to OT?
Occupational therapy is really effective at improving handwriting difficulties, poor letter formation, reversal, poor spacing, legibility and a child’s speed of handwriting. Children with difficulties in work ‘neatness’ like copying from a whiteboard/blackboard and those unable to set out work neatly on a page benefit from OT. Occupational therapy can improve the writing of those who are more verbally able than their written work.
Any children who have poor fine motor and gross motor skills, those with difficulties in using a knife and fork, dressing, and toileting, poor co-ordination and organisational skills and difficulty organising themselves in their environment can all benefit immeasurably from OT.
OT also helps children who:
• Frequently ‘zone out’ in class and appear to be in a world of their own
• Require visual demonstrations before they can complete activities
• Have poor attention and concentration skills
• Avoid messy play activities
• Are overtly particular about clothing and textures
• Have poor attention and concentration skills and are always ‘on the go’
• Are adverse to food textures
• Respond negatively to loud noises
• Refuse to go on outdoor play equipment because they’re afraid of their feet leaving the floor
Tell us about your equipment and how it’s used?
To the outsider OT can look very much like children just ‘playing.’ But, my sessions consist of a variety of activities aimed at developing the child’s areas of difficulty through games and activities. For me a therapy ball or peanut ball is a daily essential!
The therapy ball is used by moving it back and forth to help develop core stability, balance skills and postural control. As the child progresses I then introduce aiming and catching games to increase the difficulty and challenge.
I also add in floor work, and then increase the difficulty by getting them to do an activity such as picking objects up with tweezers, throwing items at a target or playing a board game or puzzle.
What everyone loves, are our swings! We have a variety of swings: tire, platform and a net swing, like a hammock. We use these to develop co-ordination, planning, sequencing, postural control and balance.
The swings are also great for developing the child’s vestibular system. This processes information about movement and head position in space and is essential for making fine postural adjustments so crucial for balance and coordinated movements.
How does an OT treatment schedule progress?
This is the one question that we always get asked and unfortunately there’s just no set answer. Each child is an individual and therefore naturally progresses at his or her own speed. While one child might just need a little help with their handwriting and only require a term of weekly sessions, another might benefit from having longer periods of time engaged in therapy. For me a really important aspect of what I do is setting targets with the family. This helps set their expectations, and each person involved in the child’s development knows the aims and has a set review. At the review it can then be decided if additional therapy is required and if it is, we set new goals and objectives.
What is your role in the diagnosis and assessment of SEN?
When diagnosing SEN it should be part of a multidisciplinary approach. Ideally the child should complete an assessment with a variety of professionals, OT, speech and language therapist, psychologists and a paediatrician. Following this a report would be compiled to provide the parents with the outcome, strategies, recommendations and diagnosis.
What questions should parents ask when choosing an occupational therapist?
• What are the goals of therapy?
• What can I be doing at home to help develop my child’s skills?
• What strategies and/or advice can be implemented into school to help aid their learning
Michelle Choytooa works at The Developing Child Centre, Al Manara, Umm Suqueim Dubai. For more information visit: www.tdcc.ae.
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