Monday, October 13, 2014

But he doesn't have an occupation...

 Riley has been working with an Occupational Therapist (OT) since he was about 1 year old.  I'm sure most of you have head us talk about Robin...  Robin is Riley's OT and our friend. When Riley started at the Guild school at 10 weeks he saw a speech therapist and a physical therapist.  At about one year old he added occupational therapist and a special education teacher.  Robin was assigned to be  Riley's OT and boy are they a match made in heaven.  Robin is able to keep up with him and challenge him while making him do a ton of work.  We were really lucky that Robin has a private practice as well as her time at the Guilds School.  At 3 years old when Riley graduated from the Guilds school he started seeing Robin privately.  When Riley was at All Saints she actually came to school weekly and worked with him there.  Since Riley is able to access OT support through the public school system she no longer comes to him at school but we go to her office for an hour every other Thursday after school.  She keeps the really hard stuff at her office.  This is a weird spandex swing that sucks you in and makes you work your entire body to keep your self straight and then drag your self around while you write or do puzzles.  

Occupational Therapy seems like a funny thing for a baby to go to.  Why would you do that....he doesn't have an occupation.  Well, really every child does.  Their occupation if you will is to play.  It is amazing how much learning really goes on while a child is playing.  We typically take it for granted but with Riley we have learned about all the itty gritty details of it.  
For those of you with inquiring minds I've taken some information off the National Down Syndrome Society website about Occupational Therapy and what it might look like for a child with Down syndrome.  

Occupational therapists who work with children have education and training in child development, neurology, medical conditions, psychosocial development, and therapeutic techniques. Occupational therapists focus on the child's ability to master skills for independence.
These can include:
  • Self care skills (feeding, dressing, grooming, etc.)
  • Fine and gross motor skills
  •  Skills related to school performance (eg: printing, cutting, etc.)
  • Play and leisure skills
When your child is an infant, your immediate concerns relate to his health and growth, development of the basic motor milestones, social interaction with you and others, interest in things going on around him, and early speech sounds and responses.
At this stage an OT may become involved to:
  • Assist with oral-motor feeding problems (this can also be addressed by Speech Pathologists). Due to hypotonia and weakness of the muscles of the cheeks, tongue and lips, feeding is difficult for some infants with Down syndrome. OTs suggest positioning and feeding techniques, and can be involved in doing feeding studies, if necessary.
  • Help facilitate motor milestones, particularly for fine motor skills. Occupational therapists and Physical therapists work closely together to help the young child develop gross motor milestones (eg: sitting, crawling, standing, walking).OTs work with the child at this stage to promote arm and hand movements that lay the foundation for later developing fine motor skills. The low muscle tone and loose ligaments at the joints associated with Down syndrome are real challenges to early motor development and occupational therapy can help your child meet those challenges.
When your child is a toddler and preschooler, she will likely have some independent mobility and will be busy exploring her environment. To assist her development you will want to provide her with many opportunities for learning, you will want to encourage the beginning steps in learning to feed and dress herself, you will want her to learn how to play appropriately with toys and interact with other children, you will be encouraging speech and language skills, and you will continue to provide opportunities for refinement of gross motor skills.  
At this stage an OT may become involved to:
    Facilitate the development of fine motor skills. This is an important stage in the development of fine motor skills for children with Down syndrome. Now they will be developing the movements in their hands that will allow them to do many things as they get older, but many children need some therapy input to ensure that these movements do develop. Children do this through play; they open and close things, pick up and release toys of varying sizes and shapes, stack and build, manipulate knobs and buttons, experiment with crayons etc. Your child may face more challenges learning fine motor skills because of low muscle tone, decreased strength and joint ligament laxity.
    Help you promote the beginning steps of self help skills. An OT can help parents break down the skills so expectations are appropriate, and can suggest positioning or adaptations that might help the child be more independent. For example, a child may have more success feeding herself with a particular type of spoon and dish.
Then your child enters the school system and the focus of your energies changes somewhat again! You help your child adjust to new routines, you attend school meetings to plan your child's educational program, you focus on speech and communication, you help your child practise fine motor skills for school (such as learning to print), you expect your child to develop more independence in self help activities, and you search out extracurricular activities that will expose your child to a variety of social, physical and learning experiences.
At this stage an OT may become involved to:
    Facilitate fine motor skill development in the classroom. Many OTs work in the school system and provide programs to help children with Down syndrome learn printing, handwriting, keyboarding, cutting etc. They will also look at physical positioning for optimal performance (eg: desk size etc.) and assist with program adaptations based on the child's physical abilities.
    Facilitate self help skills at home and at school. As with all children, our kids with Down syndrome vary in personality, temperament, and motivation to be independent. Some children with Down syndrome have a desire to do things themselves, such as dress and feed themselves. These children may learn these skills by watching others and participating from a young age. Other children may be happy to let others do things for them, and may resist attempts to help them learn these skills. In these cases an OT may be able to help a parent work out these challenges, while helping the child develop better motor skills to be successful in self help skills.
    Address any sensory needs your child may have. Sometimes a parent has a concern about things their child does that may relate to the child's sensory development. For example, a child may excessively put toys in her mouth, she may have poor awareness of her body in space, she may squeeze everything too hard or drop things a lot, or she may not tolerate very well some routines like washing and brushing hair. An OT can offer suggestions to help the child and parents deal with these issues.

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