Initial understanding of the term `occupational therapy' is
based on a limited view of the meaning of the term. Actually,
this therapy is the use of directed purposeful occupations to
influence positively a person's sense of well-being and thus
his/her state of health. Among adults, directed purposeful
occupations encourage the person to assume responsibilities
through increasing occupational performance levels and
improving adaptive behavior.
When a child is referred to an occupational therapist, the
purpose is to help the child function as a complete person,
physically, socially and emotionally. A child's first
`therapist' is usually the mother, in the home, and she is
generally an excellent therapist in the pre- school years.
The child learns to empty containers and in the next
developmental stage, to fill them again. He learns to feed
himself, undress and a little later, to dress himself. He
masters all the skills he needs to take care of himself. He
learns how to demand attention in a socially acceptable way,
and how to interact with various members of the family. In
short, a child learns a great deal in the first five years of
his life.
There has been an increase in the number of referrals to
occupational therapy. A mother may become aware that her
child is not speaking as well as his peers. A professional
looks him over and remarks that he is functioning below par
in many other spheres too, and suggests that the child be
taken to an occupational therapist. A parent will frequently
complain that "all they do there is play games."
A parent might think the child is lazy. He does not jump and
climb to dangerous heights as the others do. The doctor
decides that he is not `lazy,' he has poor muscle tone, and
refers him to a therapist. The therapist's primary
intervention strategies involve providing a play area with
equipment designed to facilitate (or inhibit) the stimulation
of muscles and joints, to stimulate touch, i.e. the tactile
skills and vestibular and spacial skills, which means how to
correctly judge gravity and movement.
The therapist will closely monitor the time spent on each
activity and may suggest new activities, making sure to
maintain the child's interest. Spinning and climbing a jungle
gym, or balancing on various objects are all part of this
therapy. Gradually, the child will gain an increase in the
range or arc of motion of individual joints, or an increase
in strength in groups of muscles. He will attain an increase
in physical endurance. Usually, children will carry out most
of these activities in the park without the need of any
therapy. But these are the children who know that their
bodies will obey them. They are not suspected of being
`lazy.'
For occupational therapy to be most effective, the approach
will be family based. Behavior of the child will be assessed
and recorded by a parent as to what the child is doing every
half hour or so, over a period of one or two days. The parent
may find that the child is spending most of his time either
talking or looking out of the window aimlessly. Parents and
child will have to learn to follow schedules. They will have
to find some motive, purpose or reason to do things. Our aim
is to get the child to think, achieve and through this, to
learn.
Parents often complain that they feel they are wasting their
money by taking the child to therapy, any therapy. Will the
child really benefit from the time, effort and expenditure
involved? As with most other forms of therapy, it is not a
magic cure. It takes time to learn new movements or concepts.
If after three months, i.e. twelve sessions, there is not the
slightest change, then perhaps a parent should think about
changing the therapist or discontinuing the therapy
altogether. It depends on the problem. Frequently, if parents
didn't feel there was a problem in the first place, if they
give the child more of their time, he will progress without
outside help. Or parents should seek another opinion.
There are constant changes in knowledge and treatment in the
field of occupational therapy. America is light years ahead
of England in the therapy it provides. Israel has some good
therapists but unfortunately, there are many who work
privately and do not have the right equipment nor advanced
technique.
Parents will do anything to advance their child's development
and potential, but they would be well advised to speak to
others whose child has been receiving occupational therapy.
As with much private practice in other fields too, whether
dentistry or ophthalmic services etc., recommendation by word
of mouth is the best advertisement. A person who charges
astronomical sums for his services may be very well
qualified, but it does not always signify that he is the most
competent therapist who gets the best results.
