What does an Occupational Therapist do?
The Occupational Therapist assists individuals with disabilities achieve their optimal level of independence in purposeful activity performance.
Why Occupational Therapy not Physiotherapy?
Many children with ASD present with difficulties with fine motor and/or gross motor skills and sensory issues which affect their ability to engage in daily activities and roles.
Activities could include self-help skills such as doing up buttons or the development of good pencil skills which will then effect the person’s ability to engage in an occupation or activity such as dressing or drawing.
Roles would include the role of being a student or a friend. An inability to maintain good postural control, for example, would mean that the child would find it difficult to sit at a school desk for any length of time which would affect his ability to fulfil his role as a student. Similarly, if the child has poor spatial awareness his body language towards his peers may put up barriers to developing friendships which affects his attempts to develop his role as a friend.
Thus Occupational Therapy assists the individual to develop the necessary physical skills, where needed, to make the engaging in activities or roles more accessible to them through individualised, specifically targeted programs.
What is Sensory Integration ?
Ayres (1972a) defined sensory integration as the neurological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment.
Why do Occupational Therapists use Sensory Integration programs?
Many children with ASD have sensory problems. They may be Hypersensitive (overly sensitive) and/ or Hyposensitive (unable to access the usual level of sensation when engaged in an activity). An
Occupational Therapist will use a Sensory Integration Program to promote effective integration of the senses in order to develop a child’s ability to register, process and respond to sensory information in his/her environment, thereby improving learning, behaviour and activity participation.
What questions should I ask an Occupational Therapist?
When looking for an Occupational Therapist to work with your child, you may wish to consider the following:
- Is the Therapist registered with and have they had their qualifications validated for work by theDepartment of Health and Children?
- Does he or she have Garda Clearance to work in Ireland?
- Does the Therapist have previous Paediatric experience including Autism specific experience and training?
This may include the following:
- Sensory Integration Certification (at level 1 or above)
- Other relevant training in Sensory Integration theory (this may include hands on experience, in service training days, or courses run by the Sensory Integration Network)
- Specialist training in Sensory techniques such as the Wilbarger Deep Pressure Brushing and Joint Compression Protocol; use of Sensory Diets and self-regulation programmes such as How Does Your Engine Run?
- Knowledge of neurodevelopmental approaches for increasing motor learning and control, muscle tone and trunk stability
- Knowledge and experience of Applied Behavioural Analysis (ABA) techniques and how best to implement Occupational Therapy intervention within this framework if appropriate
- Experience or specific training working and administering assessments for Dyspraxia (motor planning disorders); these may include the Movement Assessment Battery for Children or the Bruininks-Oseretsky Test of Motor Proficiency and knowledge of Programme such as â€œStretch and Growâ€
- Knowledge of handwriting assessment and intervention tools; if this is an area of difficulty for your child, can the therapist provide and support specialist programmes such as Handwriting Without Tears?
- Knowledge or training in communication methods to include Irish Sign Language, Lamh, PECS
(Picture Exchange Communication System) and use of visual schedules to aid learning for children with expressive and receptive language difficulties
Other things to consider:
- Are you required to have your child re-assessed prior to Therapy commencement? (in this instance, it is important to provide Therapists with any assessments completed within the last year as some assessments cannot be repeated in this time frame as they lose their reliability and validity due to the child’s or parents’ familiarity with test materials)
- Is the Therapist practising as a basic grade or a senior (3 years plus experience) and is this reflected in the cost of Therapy sessions?
- Where will Therapy being taking place and are parents required to purchase equipment for sessions including sensory items such as weighted vests or blankets, body sox, scrub brushes etc? How many other children will be receiving Therapy with your child i.e. are sessions group or individually based?
- Will the Therapist be delivering sessions in the child’s school or home environment? If school are involved, will consultation with teachers take place and programmes be provided for teaching staff to follow under the Therapist’s guidance? Will parents be provided with home programme activities to complete in the interim between Therapy sessions?
- How frequently will sessions be provided and what is the hourly rate being charged? (80 to 100 euro per hour is the usual rate)
- Will the Therapist participate in the child’s IEP meeting if required? Is there an additional charge for this?