At ENA we offer paediatric occupational therapy services to children with developmental, neurological and learning disabilities. Our mission is to provide evaluation and treatment to infants and children facing difficulties in a broad spectrum of skills with an aim to maximizing their capabilities in the school and social environment. To name a few, the following diagnostic categories require occupational therapy intervention:
- Cerebral palsy and other neuromuscular disorders
- Motor and coordination developmental disorder (dyspraxia)
- Developmental disorders (Pervasive Developmental Disorder, Attention Deficit Disorder/Hyperactivity, psychokinetic delay, behavioural problems, etc.)
- Diagnosed syndromes (e.g. Down syndrome, Rett syndrome)
- Brachial plexus paralysis
- Sensory integration disorder
- Learning difficulties, Dysgraphia
- Mental retardation
The services provided by the occupational therapist in our centre are:
- Extensive, detailed evaluation and interpretation through the use of formal and informal evaluation tools
- Specialized treatment placing emphasis on the holistic development of the child by promoting their social, cognitive, physical and emotional skills.
- Counselling and treatment at the centre, as well as at home (adaptations, modifications), so as to ensure that the child achieves the optimal level of functionality with the environment.
- Development of a schedule of activities in collaboration with the school and the family
- Parent and caregiver training so as to promote the individualized therapeutic program of their child
A detailed assessment is carried out for the detection of difficulties and the development of an individualized therapeutic program. During the evaluation process questionnaires for the parents, developmental tests, as well as formal and informal clinical tests are used. The results of the evaluation are then discussed with the parents and therapeutic goals are set in collaboration with the family. Finally, the planning and execution of the intervention is carried out. During the intervention procedure specialized equipment is used which varies according to the age of the child and the type of difficulties she encounters.
The main areas of intervention relating to occupational therapy are:
- Self-help skills: these include nutrition/feeding, personal hygiene, dressing and sleep.
- Playing and free time: these refer to skills the child picks on the basis of his internal motivation for play and self-expression.
- School: skills in this area refer to reading, writing, mathematics and the ability to solve a problem, as well as cognitive skills.
- Acquisition of self-confidence and capacity of the child for self-action
Methods of intervention at ENA:
Sensory Integration: Theory and therapeutic intervention (Dr Ayres) during which ‘the appropriate action and behaviour of children is based on the reception, processing and interpretation of information entering from the environment through sensory systems.’
ABA: (Applied Behavior analysis, Dr Ivar Lovaas). This is a structured behavior program aimed at generalizing knowledge. This intervention is used in particular on children with Pervasive Developmental Disorders.
TEACCH: ( Treatment and Education of Autistic and Communication Handicapped Children).
- Therapressure Program- Deep Tactile Pressure and Proprioception Inflow: a therapeutic program for sensory defensiveness, which was developed by Patricia Wilbarger, Ed., OTR, FAOTA
- Therapeutic Listening – Therapeutic Hearing Program: designed by the American occupational therapist Sheila Frick. The aim of the program is to enhance attention, balance, perception and body control, as well as communication, through the hearing of specially modified music and sounds.
- Write From the Start: Perceptual-kinetic Writing Program: a program designed by the educator Ion Theodorescu and the occupational therapist Lois Addy. The aim of the program is the development of visual perception and fine mobility skills, so that the pupils can develop the necessary skills for more complex writing-kinetic abilities.
Occupational Therapy and Early Intervention (0-3 years)
Infants with various developmental disorders have trouble responding appropriately to environmental stimuli. For example, the infant may face:
- Kinetic difficulties
- Difficulties in feeding and sleep
- Hypersensitivity to sounds and touch
- Emotional fluctuations
- Discomfort in changes in routine
- Limited communication and babbling
- Difficulties during play
In our daily lives we receive a multitude of information with regards to our body and the environment that surrounds us, through our senses. When the flow of this initial sensory information is carried out in a well-organized manner, it enables our brain to create the appropriate background for more complex functions, such as cognitive and perceptual, as shown in the figure below (Figure 1)
Consequently, it is essential to provide a natural and social environment with appropriate sensory experiences even from the very first months of life. The processing of these initial sensory experiences paves the ground for the development of the following skills:
- Social interaction
- Motor skills
- Attention and concentration
- Nutritional behaviour
- Sleeping behaviour (sleeping patterns)
Occupational therapy at preschool and school age
According to the American Occupational Therapy Association, a child requires occupational therapy evaluation if it consistently presents three or more difficulties:
- Has trouble making friends
- Has trouble playing
- Falls often, is awkward
- Has reduced stamina, appears weak
- Gets lost easily in new surroundings
- Gets hurt easily
- Has trouble playing and does not like playground equipment
- Struggles with fine mobility activities (painting, using scissors, etc.)
- Faces speech and language problems
- Is slow/has difficulty dressing, eating on her own
- Is hyperactive
- Is sluggish, passive
- Dislikes everyday activities (combing, bathing, tooth brushing, nail clipping)
- Avoids hugging and kissing
- Reacts badly/Overreacts to odours, flavours, noises, touching
- Has sleeping disorders
- Is selective with food, often gets soiled when eating
- Has limited attention span
- Has difficulty learning new things
- Has poor handwriting skills, presses the paper too hard or too softly
- Has poor pencil holding skills
- Does not leave spaces between words, does not copy letters and numbers correctly, cannot write on the lines
- Gets tired easily
- Finds it difficult to follow verbal instructions
- Appears to lack self-confidence
- Has difficulty mimicking
- Appears not to hear when talked to
Source: American Occupational Therapy Association (AOTA)