Pediatric Therapy Services ­

Frequently Asked Questions What is occupational therapy (OT)? Is occupational therapy similar to physical therapy? Is occupational therapy regulated and do therapists require a license? Who can benefit from occupational therapy? What is sensory integration? What is Sensory Processing Disorder (SPD)? What is sensory defensiveness? Do I need a referral from a doctor for my child to receive OT? What does an evaluation consist of? What is the Sensory Integration and Praxis Test (SIPT)? If needed, how often will my child attend occupational therapy sessions? What can I expect from a treatment session? What is a brushing program? What is a sensory diet? When will my child no longer require occupational therapy? What is occupational therapy (OT)? A health profession concerned with improving a person’s performance in their daily roles, or ‘occupations,’ through the use of purposeful and meaningful activities. For a child, this is often done through play. Back to top Is occupational therapy similar to physical therapy? While physical therapy is concerned with improving a person’s strength and movement, occupational therapy is concerned with using strength and movement and improving a person’s ‘occupations,’ which, for example, include dressing, eating and writing. Back to top Is occupational therapy regulated and do therapists require a license? Yes. Occupational therapists are required to complete a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA) and achieve an education level of at least a baccalaureate. Upon successful completion of the National Board for Certification in Occupational Therapy (NBCOT) Certification Exam, therapists will become licensed and must maintain this license in strict accordance with state regulations. Back to top Who can benefit from occupational therapy? Your child can benefit from occupational therapy if they have: A diagnosis within the Autistic spectrum: - Autistic Disorder - Asperger’s Syndrome - Retts Disorder - Childhood Disintegrative Disorder - PDD-NOS Selective Mutism or other anxiety-based disorder Fragile X Syndrome Sensory Processing Disorder (SPD) Cerebral Palsy Down Syndrome ADD or ADHD Behavioral or emotional difficulties Sensory defensiveness – over-reactivity to touch, sound, light, smell, foods Visual motor or perceptual difficulties Poor eye-hand coordination Inability to easily calm Low muscle tone Dyslexia / reversal of numbers or letters Poor handwriting Developmental delays Fine motor delays Gross motor delays Poor social skills Inattention or distractibility Back to top What is sensory integration? Sensory integration is the ability to process information received through the senses, put it all together and make meaningful responses. This typically happens on an unconscious level in the brain. Sensory Integration literature, which is based on the work of A. Jean Ayers, emphasizes three main sensory systems, the vestibular, proprioceptive and tactile systems. The vestibular system is responsible for detecting motion, gravity and vibration. It is the smallest receptor system in the body. The receptors are located in the inner ear in the utricle, sacule and semi-circular canals. These receptors tell us where we are in space in relation to everything else. The vestibular system is closely linked to both the visual and the auditory systems, as both the optic nerve and the auditory nerve run through the vestibular system. Next is the proprioceptive system, which pertains to movement and body position. The receptors for this system are in the muscles, joints and tendons. It is responsible for body awareness, or the ability to know where one’s body or body parts are. The tactile system relates to touch and its receptors are located all over the body in the skin. This system is responsible for how we perceive and interpret touch from the ability to find the correct piece of change in your pocket without looking to the inability to tolerate or ignore the tag in the back of your shirt. All these systems begin to develop before birth and must connect and communicate with other areas of the brain in order to interpret a situation and respond appropriately. Back to top What is Sensory Processing Disorder (SPD)? Also known as Dysfunction of Sensory Integration (DSI) and Sensory Integrative Dysfunction (SID), SPD is the inability to properly process environmental stimuli, resulting in difficulties in the areas of arousal, emotions, motor abilities and behavior, which can impact a person’s ability to perform optimally in their various performance environments. This inability to correctly process information creates a range of difficulties in their daily life, including motor/coordination difficulties, neuromuscular problems, sensory sensitivities, visual-motor difficulties, sensory seeking behaviors, and behavioral and emotional problems. For signs & symptoms of SPD, click here. Back to top What is sensory defensiveness? Sensory defensiveness is a pattern of avoidant/aversive behavior that develops as a reaction to non-noxious stimuli, or sensory information others would consider normal (i.e. over-reaction to touch, smells, sounds, etc.). Sensory defensiveness can manifest in many ways, with some examples being: A child that can not tolerate the tags in shirts or will not wear specific articles of clothing Simply walking through the mall makes your child cover their ears Such a limited food tolerance that their diet may literally consist of four or five items If cutting their hair or washing their face causes extreme, possibly even aggressive, protest Back to top Do I need a referral from a doctor for my child to receive OT? No, you can contact us for an appointment or evaluation at any time, but a physician's referral may be required for some insurance coverage. Back to top What does an evaluation consist of? A background questionnaire is completed by the parent or guardian and appropriate, non-invasive, standardized tests are used for evaluation. These can include: The Sensory Integration and Praxis Test (SIPT) Peabody Developmental Motor Scales Developmental Test of Visual Perception Wold Sentence Copy Test Beery-Buktenica Developmental Test of Visual-Motor Integration Bruininks-Oseretsky Test of Motor Proficiency Children often find evaluations fun, as they are evaluated in their current ‘occupations,’ which, for them, are play activities. The entire evaluation takes one to three hours to complete, depending on the age and condition of the child. All information gathered is strictly confidential. A detailed typed report is furnished and, if required, an appropriate therapy plan is formulated and recommended. This includes key goals of therapy and progress reporting. Back to top What is the Sensory Integration and Praxis Test (SIPT)? The SIPT is a highly comprehensive test that is designed for children ages 4 years to 8.11 years with learning disabilities and / or sensory issues. It contains 17 standardized subtests, takes approximately 3 to 4 hours to complete and is the only test of its kind. Tracey DeMaria of Sensagration, LLC is certified in the administration and interpretation of the SIPT. Back to top If needed, how often will my child attend occupational therapy sessions? Sessions are typically 60 minutes, one to two times per week, but this can be increased or decreased depending on necessity. Back to top What can I expect from a treatment session? This varies depending on the particular needs of each child, but activities/programs can include: Attempts to elicit adaptive and appropriate responses by providing the ‘just right’ challenge in a safe setting Child-directed and fun activities Use of suspended equipment, i.e. swings, ladders Tactile (touch) input activities, such as sand, rice, or other texture filled boxes, finger paints, and shaving cream play Heavy work activities, such as pushing, pulling, climbing and crawling Obstacle courses Fine and gross motor activities Self-help strategies Brushing programs Visual motor perceptual activities Behavioral and emotional strategies and tasks when applicable ‘Sensory diets’ and self-regulation strategies for use at home and school Back to top What is a brushing program? More accurately known as The Wilbarger Deep Pressure protocol, it is a sensory-integration intervention program developed by Patricia and Julia Leigh Wilbarger used primarily to treat sensory defensiveness. Treatment involves the use of a Deep Pressure Tool, joint compressions and a sensory diet. This program must only be administered by an individual trained in the Wilbarger protocol. Back to top What is a sensory diet? A ‘sensory diet’ is a term commonly used to describe the development and use of a systematic plan to provide an individual with appropriate sensory input throughout the day. Neurological theories of the latency effect on the brain tell us that any input into the nervous system lasts for approximately 1½ to 2 hours. Therefore, the sensory diet creates a plan that involves simple sensory activities provided approximately every 2 hours to maximize the positive and organizing components of this input to the nervous system. Back to top When will my child no longer require occupational therapy? The following are indicators that occupational therapy is no longer required: The child has met their key goals and can function independently in the areas of concern The problem has ceased to be an area of concern The parent(s) or guardian(s) have learned and can facilitate techniques necessary for independence The child has reached a functional plateau and further change is unlikely Back to top