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1. WHAT IS OT? Elisa Wern, OTR/L
3. Where do OT’s work? Schools
Rehabilitation centers
Early intervention centers
Hospitals
Day care centers
Psychosocial disorder treatment centers e.g. Shands at Vista
4. How are OT’s trained? 4 1/2 year degree from accredited university
classes in neuroanatomy, musculoskeletal anatomy, pediatrics & development (4 courses), psychosocial illnesses, elders/geriatrics, neurorehabilitation
Two 3 month internships, with optional 4 week specialty
state and national certification and licensure
5. Difference between OT and PT Both are health care professionals that treat children with developmental disabilities, adults/children with injury or diseases.
In general, the OT and PT provide assessment services, treatment and program suggestions.
The OT assesses the areas of daily living skills, upper extremity strength/range of motion, developmental delays, cognitive functioning, visual perception, work hardening skills, sensory integration and/or adaptive behavior. Treatment includes self-help skills training, upper extremity strength/endurance training, and enhancement of developmental skills.
The PT areas of focus may include joint motion, muscle strength and endurance, function of heart and lungs, and/or performance of activities required in daily living. Treatment includes therapeutic exercise, ROM, and lower extremity coordination.
6. Reasons for Referral in School System Handwriting is a huge reason for referral- very large growing practice area.
daily living skills and community living skills
fine motor / upper extremity dysfunction
visual / perceptual motor difficulties
sensory motor integration problems
self-feeding skills deficits
7. Roles of OT Direct service: typical therapy sessions in group or individual settings
Consultative: to child who does not qualify for direct service, consult may be used to monitor and assess needs of child in class
Consult to teachers: often we are approached with scenarios of “I have a student who is having problems with X, what suggestions do you have? (Pre-referral checklist)
8. Words you Might hear ADL: activities of daily living
FM: fine motor skills – writing, manipulating objects, using hands to complete ADL tasks such as brushing hair, putting on earrings…
GM: gross motor skills – running, jumping, skipping, walking…
ROM: range of motion
SI: sensory integration
AT: assistive technology
COTA: certified occupational therapy assistant
9. Kinds of therapy you may see Pull out: students are taken to another part of the classroom or school campus for therapy time, often with other children who are working on similar goals
Push in: move lately towards provision of services in the student’s natural setting – in this case, the classroom
10. Developmental Delays Often used to classify children who for unknown reasons demonstrate delays in areas of fine motor, gross motor, or sensory processing skills.
OT goals may include: age appropriate scissoring or pencil grasp
DD is not used as a classification after age 6.
11. Mobility/Positioning WC seating and positioning for optimum educational performance
“if you are uncomfortable, do you want to do work?”
Assist with ensuring child has maximum access to classroom environment – desks, playgrounds, specials…
12. Feeding May work in classrooms at breakfast and lunch to assist students in learning ways to adapt use of utensils
Help to teach teachers and aids tools to assist student to be as independent as possible in feeding
AT -- Feeding Machines
may co-treat with SLP to work on feeding issues
13. Fine motor coordination Involves use of hands for purposeful movements such as writing, picking up items
Dysfunction areas are in finger strength and pinch strength, finger isolation
Very interwoven with handwriting difficulties
manipulating small objects
using scissors
turning pages
using clothing fasteners
opening and closing containers
14. Gross Motor Skills & Motor Planning/Coordination Dyspraxia: difficult motor planning
Some kids have a hard time knowing how to get their bodies to do what they want to-- whether that’s swinging on a swing or walking to a teacher’s desk from theirs
we break down the steps and teach child one at a time, or in clumps
15. Gross Motor Skills The development and use of large muscles such as trunk and legs to perform activities.
Includes balance and equilibrium
sitting up straight while in chair
walking on uneven and even surfaces
hopping, skipping, jumping
strength and endurance
alternating feet when climbing stairs
walking on a narrow path or balance beam
16. Visual Perceptional Skills Visual Sequential Memory Deficits
Assignments are forgotten
Forgets steps that are shown in an activity
Cannot remember the alphabet in correct order
Position in Space Deficits
Inconsistent symbol reversal
Transposes number or letters
Difficulty differentiating between b,d,p,q
Spatial Relations Deficits
Trouble with right/left
Difficulty with spacing within and between words.
May knock over items
Visual Discrimination Deficits
Matching and sorting difficulties
Size discrimination may be impaired
Fails to recognize similarities and differences in objects
Difficulty matching two dimension to three dimensional such as alphabet letters
Visual Motor Coordination Deficits
Difficulty drawing geometric symbols
Difficulty in copying
Decreased legibility in handwriting
Difficulty with mazes and dot-to-dot
Figure-Ground Deficits
Difficulty with hidden pictures
Cannot focus on one word on a page
Difficulty copying from a board
Trouble finding place on the page
Visual Closure Deficits
Cannot complete partially drawn pictures or stencils
Trouble completing age appropriate puzzles
Difficulty in spelling
Leaves out parts of word or entire words
Visual Memory Deficits
Trouble remembering sight words
Copies only one letter or number at a time from the board
17. ADD & ADHD Attention strategies
Often involves behavioral plans, and consultation with parents and teachers
18. Sensory Impairments Low vision technology : Braille, large print books
assist students in being able to navigate their environment successfully and independently
hearing - assist in development of programs to increase access to environment
19. OTHER/MISCELLANEOUS Energy conservation and activity endurance especially with children who are classified as OHI
Splinting of extremities to allow increased function and decreased deformities
AT for children who have communication disorders such as picture schedules
20. Sensory Processing Disorders condition in which children demonstrate problems regulating, interpreting or producing correct motor responses to sensation.
In order for it to be classified as a disorder or a dysfunction, the problems must impact daily living routines.
Children and/or adults must demonstrate difficulty with social participation, self-regulation, self-esteem, and/or specific sensory motor skills.
(Dr. Lucy Anne Miller, 2002.)
21. Sensory Diet Children with sensory modulation disorders can use a sensory diet
sensory modulation is a continuum
The ALERT program – How does your engine run?
22. Resources www.aota.org American Occupational Therapy Association
www.hp.ufl.edu/ot UF OT website
My email ewern@fdn.com
Please feel free to email me questions, at any time!