by Ann Stensaas, M.S., OTR/L
An occupational therapist (OT) is a highly trained medical professional who evaluates and treats children and adults who have difficulty participating in meaningful activities (or "occupations") relevant to their daily lives. Although many people often think of "occupation" as work or a job, occupation can mean any activity a person engages in. This can include self-care, play and leisure activities, and work. For a child, "work" often involves playing, learning, and going to school.
Children make up a large part of the population receiving OT services. Treatment often focuses on improving a child's development in the areas of fine motor skills (e.g., stringing beads, cutting with scissors, buttoning buttons), play skills, social skills, and self-care skills (e.g., dressing, bathing, grooming, and feeding).
Generally, occupational therapists provide treatment to clients who have been diagnosed with a specific medical condition by a physician. Diagnoses may include learning disorders, stroke, traumatic brain injury, autism spectrum disorders, sensory processing disorders, cerebral palsy, Down syndrome, attention deficit hyperactivity disorder (ADHD), genetic disorders, and developmental delays. Based on the results of an evaluation, the occupational therapist designs a treatment plan based on each client's and family's unique needs.
What Do OTs Treat?
Below is a list of common problems an occupational therapist treats.
- Decreased range of motion- limits in moving the head, neck, body, or limbs
- Decreased strength- difficulty performing age-appropriate weight bearing movements (e.g., bear walk, wheelbarrow walk) and holding body positions against gravity (e.g., superman)
- Fine-motor delays- difficulty with handwriting and cutting skills, using a pincer grasp to pick up small items, and buttoning a button on a shirt
- Self-care delays- difficulty performing dressing, grooming, toothbrushing, and feeding skills
- Bilateral coordination delays- difficulty using both hands together to perform a task (e.g., tying shoes, throwing/catching a ball)
- Visual perceptual disorders- difficulty organizing visual information from the environment in order to perform a task (e.g., putting a puzzle together)
- Sensory processing disorders- difficulty responding appropriately to different sensory experiences (i.e., touch, taste, sound, and movement) which interferes with the ability to perform daily activities
Where Do OTs Work?
Occupational therapists work in a variety of settings, including hospitals, private clinics, early intervention programs, schools, nursing homes, and at clients' homes. In addition to these more common settings, you will find OTs working at universities, health and wellness centers, research laboratories, and state and federal government agencies.
How Do I Find an OT?
Occupational therapists must complete supervised clinical internships in a variety of health care settings, and pass a national exam. Every practicing therapist must obtain licensure by the state board of occupational therapy. However, state regulations regarding the practice of occupational therapy vary from one state to another.
If you are looking for an occupational therapist for your child, it is important to locate one who specializes in working with pediatric populations—this is important because testing and treatment techniques are different for children and adults.
There are several ways to find an occupational therapist if you are concerned that your child has developmental delays. Your school district should have an occupational therapist that can observe and/or test your child for sensory and/or motor delays. Your local children's hospital will also have pediatric occupational therapists on staff. Each state also has an early intervention program that offers occupational therapy services for qualifying children, birth to age three. Your child's pediatrician can also recommend an occupational therapist or therapy clinic.
What Should I Expect at My Child's First Appointment?
Prior to scheduling an appointment within a private or hospital-based rehabilitation setting, you must first obtain an occupational therapy referral from your child's pediatrician or other medical specialist. In the school setting, consult with your child's teacher about scheduling an occupational therapy evaluation if you have concerns about his/her handwriting skills.
The first visit to an occupational therapist will include an evaluation. An initial OT evaluation involves administering a series of tests over a period of 1–2 hours. The therapist may observe your child, administer standardized tests, and conduct a parent interview to determine if your child is in need of and qualifies for services. Following the evaluation, the therapist will review the findings with you, establish treatment goals and objectives, and obtain written permission from you and your child's pediatrician to move forward with therapy.
What Questions Should I Ask the OT?
The occupational therapist will ask you questions about your child's medical and developmental history as part of your child's occupational therapy evaluation. Here are a few questions you may want to ask the OT before and/or during your child's appointment.
Prior to the Appointment
- What age group do you work with?
- What specific area (autism, sensory integration, early intervention, cerebral palsy) is your specialty?
- How quickly can you see my child and what methods of payment are required?
- After the evaluation, is there a waiting list for treatment?
- What other certifications have you obtained as an OT?
During the appointment
- How frequently will my child need therapy? How did you make that decision?
- Can I observe each therapy session?
- How will you check my child's progress?
- What types of activities will you be doing with my child during therapy?
- Where can I get resources to learn more about my child's difficulties?
- What can I do to help my child with his/her difficulties?