What is Occupational Therapy?

By Dana Sciullo

Perhaps a fellow parent mentioned their child is receiving occupational therapy (OT), or maybe your own child’s pediatrician or teacher suggested pursuing an occupational therapy evaluation. Despite the ever-growing number of children receiving OT, many adults are still unfamiliar with it.

The potentially misleading name “occupational therapy” brings to mind professional adults in their workplaces. However, “occupation” refers to all activities of daily living including sleeping, dressing, feeding, bathing, playing, attending school or work, driving, ect. Pediatric occupational therapists (OTs) are healthcare professionals who use their specialized knowledge to assist children in developing the small and large muscle strength and control necessary to complete these activities as independently and successfully as possible.

Pediatric OTs also work to improve sensory processing skills in children who have sensory integration disorders. OTs facilitate natural skill development in children whenever possible. However, in instances when a child is unable to improve a skill, OTs are also experts in activity modification and assistive technology to ensure that child can still be as independent as possible.

Does my child need OT?

Occupational therapists are able to benefit children who struggle with gross motor skills and overall coordination of body movements (ie moving safely through the environment, keeping up with peers on the playground, and maintaining appropriate balance to avoid excessive falls), fine motor skills (ie self-feeding with utensils, holding a crayon/pencil/scissors, completing clothing fasteners, and cutting), visual motor skills (ie coloring, cutting with scissors, handwriting, eye/hand coordination, and catching and throwing accurately), and sensory integration disorder.

Sensory integration disorder may present as sensory sensitivities, which occur when a child is more sensitive than others their age to certain sensory input, such as tactile or auditory input. It may also present as sensory seeking behaviors, which occur when a child craves certain sensory input, such as movement, more than other children their age.

While OTs are almost always a member of treatment teams for children who have diagnosed disabilities, they also treat patients with no diagnoses who have just one or two specific skill deficits.

What should I expect?

To schedule an outpatient occupational therapy evaluation that will be billed through insurance, you will likely need a prescription from your child’s pediatrician. At the evaluation appointment, you can expect the occupational therapist to ask about what developmental milestones your child has reached and when. You may be asked to fill out a questionnaire regarding your child’s ability to complete specific activities of daily living or their response to sensory input.

The OT will test your child’s skills using a variety of tasks that will vary based on the child’s age and developmental stage. The OT may test their ability to sit upright, crawl, stand, walk, run, jump, gallop, stand on one foot, or skip. Your child may be asked to stack blocks, complete a button or zipper, use a spoon, color a shape, cut with scissors on a line, write a sentence, or catch a ball. The occupational therapist should provide you with immediate feedback based on your child’s performance including whether or not they are recommending your child begin a course of therapy sessions.

If therapy is being recommended, your input should be sought for the creation of goals. Goals are the skills your child is working toward in therapy. You should feel free to ask any questions you may have (bring a written list if you are worried about forgetting one!).  Following the evaluation, you will receive a written evaluation report that will also be sent to your child’s pediatrician.

In my current practice, our OTs typically see their clients once or twice per week for 8-12 weeks. Activities for home or “homework” should be provided to you weekly to ensure carryover of skills and continued development. At the end of 8-12 weeks, therapy is either ended (if goals have been met) or a re-evaluation is completed and goals are updated.

As your child’s guardian, you are always welcome to provide input, ideas, and feedback regarding your child’s progress! Parents are a vital partner in their child’s development. Very little change can be made during just one hour-long OT session per week. Real progress is made when you and your child are engaging in therapeutic activities daily in their natural environment.

Remember that while therapists are experts in child development,YOU are the expert about YOUR child’s development!

Dana Sciullo, MOT, OTR/L is a registered and licensed occupational therapist at the Laughlin Children’s Center in Sewickley who has spent time working in schools and pediatric outpatient clinics seeing a wide variety of clients. She holds a Master of Occupational Therapy degree from the University of Pittsburgh and has participated in numerous pediatric continuing education courses, including a week-long intensive mentorship at the highly regarded STAR Institute in Denver, Colorado.