Through the OT lens, an occupation is anything you do that is meaningful or important to you. It could be your job. But it could also be your hobby- doing art, or hiking, or climbing; being independent by dressing or feeding yourself or brushing your teeth. It could be playing with your friends or learning in a classroom.
An occupational therapist will help you adapt, improve or restore your performance in your occupations by working to remove physical, emotional, sensory, or cognitive barriers. For children, occupational therapists work to remove (as much as possible) barriers to school participation and academic learning, peer and family relationships, independence with self care, play and sleep.
What’s the difference between OT and PT?
Occupational therapists and physical therapists often work closely together as they address some similar goals, but in different ways. Physical therapists look at the ways specific muscles and joints work, giving exercises, stretches, and using different pain management modalities to help with pain, mobility, strength, and range of motion. Occupational therapists look at the sensory and cognitive foundations to movement challenges and also focus more on fine motor movements, such as printing or doing buttons, visual motor and visual perceptual abilities, adaptive equipment (such as wheelchairs or assistive technology), and also cognitive (executive functioning or thought processes), environmental, sensory and social-emotional barriers to daily tasks.
Occupational therapists work one-on-one or in groups with children of all ages, but also support caregivers, families, school teams and anyone else on the child's support team. Occupational therapists also often work closely with Speech Language Pathologists, Behaviour Consultants, and Counsellors and sometimes there may be some overlap in what we do in these different roles.
Is Paediatric OT only for Autism?
Paediatric occupational therapists are often associated with autism spectrum disorders, as children with ASD have government funding to cover occupational therapy services, but we work with many other kids including those with:
Various physical disorders and conditions
Developmental coordination disorder
ADHD
Down’s syndrome
Anxiety
Challenging behaviours
Developmental delays
Complex trauma
Attachment disorders
Difficulties with emotional regulation
Sensory processing disorders
Does my child need OT?
If your child has any physical, emotional, cognitive, or sensory barriers to participating in the things they need and want to, an OT might be right for them. More specifically, an OT can help if your child:
is bothered by sensory input, such as sounds, the feel of their clothing, or eats very limited foods
is clumsy and has a hard time understanding their body in space or learning new sports and activities
struggles with fine motor or visual motor skills, such as printing, buttons, or laces
is impulsive
has frequent meltdowns, beyond what is typical for their age
could benefit from special equipment or an assistive device for learning or mobility
seeks out sensory input such as movement in disruptive ways
has challenging behavioural responses to situations
has an anxious temperament or worries that interfere with daily life
has a hard time organizing themselves and their belongings
struggles with sustained attention
struggles with making or maintaining friendships
is struggling to meet motor milestones typical for their age
struggles with skills for independence, such as using the toilet or getting dressed
OTs learn broadly in school and can work with babies to adults in nursing homes and work in many different environments and with many different modalities. Because of this, an OT has probably taken training, mentorship and professional development after grad school specifically related to the area they are currently working in, and different OTs will have different training and specialties, so find an OT that is right for you and your child by researching your options in your area and asking questions. Don't be afraid to ask questions such as: what is your experience with/ training around _______ (your child's specific need)?
What does an OT session look like?
OT sessions are play based, as that is how children learn best. “Scientists recently determined that it takes approximately 400 repetitions to create a new synapse in the brain- unless it is done with play, in which case, it takes between 10 and 20 repetitions!” (Dr. Karyn Purvis). In play, children are regulated, so their brain stems are less active, allowing for more full brain activity; they’re motivated and interested (because likely the activity is, at least in part, their idea), so their attention and more parts of their brain are more fully engaged; they’re happy, causing more dopamine, which positively affects memory, attention, creativity, and flexibility; and they’re making decisions and trying things out, rather than just being told what to do, which means more active learning.
Play based OT sessions will likely involve a variety of equipment such as swings, balance beams, various step stones to balance on, ball pits, climbing walls, crash mats and/or monkey bars in order to work on foundational sensory skills, create fun movement and motor planning challenges and create various motivating games and challenges to work on different cognitive and social-emotional skills. There may also be carefully chosen board games to work on executive functioning skills, fun table top activities and/ or crafts to work on hand skills, sensory bins to explore calming sensory experiences or work on desensitization towards certain stimuli, and likely books or visuals to learn different emotional regulation or social skills. OT sessions can also take place outside on playgrounds, in the woods, or in homes, integrating play and child- led (but OT directed) activities in natural environments.
OT sessions will likely also involve parent/ caregiver coaching and collaborative problem solving around difficulties at home and how to continue to progress towards goals in the home environment, and also at times consultation to school or other therapy teams connected to the child.
My extended health plan doesn't cover OT, how can I access services?
If you don't have autism funding and you don't have coverage for OT services under your extended health plan, you may be able to access some funding through Variety Children's Charity (https://www.variety.bc.ca/), CKNW Kid's Fund (https://www.cknwkidsfund.com/) or if you're Indigenous, through Jordan's Principle, (https://www.sac-isc.gc.ca/eng/1568396042341/1568396159824). You can also advocate for OT services as part of your workplace health benefits- the Canadian Association of Occupational Therapists has a letter template and phone scripts to help you here: https://caot.ca/site/adv-news/advocacy/askforot.