ABOUT OCCUPATIONAL THERAPY
Yeled v’Yalda Occupational Therapists address medical and developmental delays and support academic and non-academic outcomes, including social skills, math, reading and writing (i.e., literacy), behavior management, recess, participation in sports, self-help skills. Occupational therapy services goals aim to increase participation in school routines. Yeled v’Yalda therapists conduct an ongoing activity and environmental analysis and make recommendations to improve the fit for greater access and progress. The goals address the reduction of barriers that limit participation and help plan relevant age appropriate instructional activities for ongoing implementation in the academic and social settings.
Why the child needs Occupational Therapy?
When therapy is started early and the OTs work closely with teachers to address:
- Physical limitations
- Delayed development
- Learning disorders
- Speech or language problems
- Hearing or visual problems
- Behavior or emotional problems
Fine motor skills are important for success with daily tasks such as printing, drawing, cutting with scissors and doing up buttons and zippers. When children have difficulties with these daily activities because of a motor problem, it is hard to fully participate in the things they need to do, want to do, or are expected to do at home, at school and in the community. Occupational therapists help teachers and parents better understand and help these children succeed with everyday activities.
Attention-deficit/hyperactivity disorder (ADHD) is an example of a behavior disorder that may be helped by occupational therapy. Autism is an example of a developmental disability that can be helped by occupational therapy.
Occupational therapy services for students with special needs are determined through the NYC IEP process. School-based occupational therapy is available for students who are eligible for special education.
Evaluation for students ages 3-5 are available to be conducted by Yeled v’Yalda expert multi-disciplinary evaluation team. The NYC DOE district conducts evaluations and assessments for students over the age of 5 years old. The evaluation team identifies student’s annual goals and determine the services, supports, modifications, and accommodations that are required for the student to achieve them, including addressing transition needs.
School-based occupational therapy (OT) is provided only if a medical diagnosis or fine motor delay is determined by the IEP team to have an adverse effect on the student’s performance at school.
Students who are currently receiving occupational therapy from a medical outpatient facility may continue with their medical-based occupational therapy. School-based occupational therapy is not a replacement for medical-based occupational therapy.
IEP Occupational therapy is a related service provided to any special education student who demonstrates deficits in fine motor functioning that may affect their academic performance. Occupational therapists focus on students’ fine motor skills and needs. Primary attention is given to ensuring that each student has the fine motor ability to effectively access his or her educational environment.
The IEP Team meets and determines if fine motor skills are affecting the student’s academic performance. Based on the evaluation completed by the Occupational Therapist in the areas of fine motor skills that includes identifying deficits in handwriting skills, strength, coordination, sensory regulation within the school setting, goals are created. Additional goals are created to address challenges within the school environment. The overall goal of the IEP based Occupation therapy goals is facilitating independence with learning and school-related activities.
Occupational therapists identify the etiology or underlying deficits of a problem and address those directly through frequent rehabilitative activities. Clinic based model is more of a “bottom up” approach; therapists identify the building blocks and attempt to fix or repair the deficits for improved function. A clinical therapist may see a child one-on-one several times a week to strengthen and rehabilitate deficits.
School-based therapists focus on removing barriers from students’ ability to learn, helping students develop skills which increase their independence in the school environment, and educating school personnel about the different considerations required for students with disabilities. Everything Occupational therapists do with students in school must be educationally relevant. These services are more of a “top down” approach. In the schools, therapists assess the student’s functional skills and identify areas of difficulty. The primary concern for the school therapist is enabling the student to learn and access his or her learning environment (classroom, playground and cafeteria). Besides rehabilitating a deficit, the school therapists adapt or modify the environment or offer the teacher strategies to implement on a daily basis to afford success. Occupational therapist’s knowledge and expertise assists in curriculum development for handwriting and social skills, modifications or design of classroom environments or assignments that help all students access and participate in age appropriate academic and social life.
Developmental delay means that a child is behind in developing skills that are common during a particular age or during a particular time period. A developmental delay, however, is more than being a little behind other children in a skill; it is being behind in a combination of skills or not meeting development milestones. These are examples of developmental delays:
- Not reaching developmental milestones of sitting, crawling, and walking
- Not learning at an age appropriate level
- Not developing age appropriate play and social skills
Fine motor skills are small movements made with fingers, toes, wrists, lips, and tongue, like holding a small object or picking up a spoon. If your child is struggling with fine motor skills, they may have difficulty with one of these actions:
- Manipulating toys and puzzles
- Holding a pencil
- Using silverware or straws at an age-appropriate time
- Using scissors
- Using zippers, buttons, shoelaces
- Coloring, drawing, tracing, prewriting shapes
- Poor handwriting, letter/number formation
- Not developing a hand dominance at an age-appropriate time
- Avoiding tasks and games that require fine motor skills
Gross motor skills help us move and coordinate our arms, legs, and other body parts. They involve larger muscles that help us control our body. A child who is behind in movement, strength, and/or balance may appear clumsy or uncoordinated. They may also have difficulty with these things:
- Going up and down stairs at an age appropriate time
- Coordinating both sides of the body
- Understanding the concept of right and left
- Poor ball skills
- Poor balance
Their muscle tone, or muscle tension and resistance, could be higher or lower than the appropriate developmental milestone.
They might also:
- be fearful of feet leaving the ground
- doesn’t cross midline of his or her body during play and school tasks
- avoids tasks and games that require gross motor skills
Visual processing is the process we use to make sense of what we see. It is a process in our brain that interprets visual information. If your child has difficulty with one of these things, they may have difficult with visual processing:
- Difficulty with the spacing and sizes of letters
- Difficulty with recognizing letters
- Difficulty with copying shapes or letters
- Difficulty with visual tracking and crossing midline
- Difficulty finding objects among other objects
- Difficulty with copying from the board or another paper
- Difficulty with the concept of right and left
Your child may lose his or her place when reading or copying from the board or may have poor eye contact.
Oral motor or oral sensory skills are control of muscle movements in the face and oral area, such as the lips, jaw, tongue, and soft palate. Delayed oral motor and sensory skills can show in one or more of these ways:
- Excessive drool
- Çhews food in the front of the mouth, rather than on the molars
- Difficulty using a cup at an age-appropriate time
- Difficulty with drinking from a straw at an age-appropriate time
- Lengthy bottle or breast feedings
- Tiredness after eating
- Baby loses excessive liquid from his or her lips when bottle or breast feeding
- Child loses excessive liquid or food from his or her mouth when drinking or chewing
- Child appears to be excessively picky when eating, only eating certain types or textures of food
- Child excessively mouths toys or objects beyond an age-appropriate time
Sensory processing is making sense of information that we receive through our senses, like sound and smell. Your child may be oversensitive to things around them and show the following symptoms:
- Overly sensitive or heightened reactivity to sound, touch, or movement
- Under-responsive to certain sensations (e.g., high pain tolerance, doesn’t notice cuts/bruises)
- Constantly moving, jumping, crashing, bumping
- Easily distracted by visual or auditory stimuli
- Emotionally reactive
- Difficulty coping with change
- Inability to calm self when upset
Social interaction skills are skills that help us have relationships and understand those around us. They help us bond with other people in our life. Your child may have delayed social skills if they show some of the following things:
- Difficulty interacting socially and engaging with family and peers
- Difficulty adapting to new environments
- Delayed language skills
- Overly focused on one subject (e.g., space, universe, dinosaurs, trains)
- Can’t cope in the school environment
Learning challenges, sometimes called learning disabilities, are another type of developmental delay. If your child is challenged by one of the following, you may want to consult an occupational therapist:
- Unable to concentrate and focus at school
- Easily distracted
- Difficulty following instructions and completing work
- Tires easily with schoolwork
- Poor impulse control
- Hyperactivity or low energy
- Not keeping up with workload at school
- Difficulty learning new material
- Makes letter or number reversals after age seven
Play skills are skills that can help a child make sense of the world around them. A child can gain self-confidence, learn problem solving, and develop social skills through play. Your child may be developmentally delayed if they show one of the following symptoms:
- Needs adult guidance to initiate play
- Difficulty with imitative play
- Wanders aimlessly without purposeful play
- Moves quickly from one activity to the next
- Does not explore toys appropriately
- Participates in repetitive play for hours (e.g., lining up toys)
- Does not join in with peers/siblings when playing
- Does not understand concepts of sharing and turn taking
Remember that all children are different and develop these skill sets at their own pace. However, if you think your child may be struggling with adopting some of the skill areas above, you can contact an occupational therapist.