OCCUPATIONAL THERAPY

In pediatric occupational therapy (OT) there is considerable overlap with physical therapy.Many children with disabilities related to cerebral palsy or spina bifida are easily recognized to need OT.There are, in addition, many children with more subtle defects that interfere with fine motor, sensory, or cognitive development that might benefit from OT.The emphasis of the therapist is to help in the overall functional performance that is age appropriate.The two theoretical approaches to OT are sensory intergration (SI) and neurodevelopmental therapy (NDT).SI dysfunction relates to abnormal sensory function related to touch, proprioception, and kinesthetics as well as to vision, hearing, and taste.The concept relates to developmental dyspraxia, which results in poor skill in dressing and eye-hand functions.NDT relates to functional movement that results from reflex and postural responses.Neonates are evaluated using the Brazelton Neonatal Behavioral Assessment Scale.Infants are evaluated using the Bayley Scales of Infant Development and the Peabody Motor Scales.

                Positioning strategies are used in the neonatal intensive care unit to help posture and muscle tone.The therapist can help the family to become comfortable in infant feeding and handling.In the first few years of life, the problems relate to fine motor coordination skills especially of the hands.The therapist will assist by devising specific exercises that involve games and play to learn the skill to achieve the developmental milsetones.

                Preschool children benefit from interventions that ready them for school activies.Using paper and pencil and dressing and eating are skills that should be able to be learned during this time.The school-age children and adolescents who need OT will often be identified by the school.Interventions in the area of coping in activities of daily living and developing independence may be indicated.