Will is 17 years old. I first began seeing him when he was just a little guy of six. Will’s mother, Kathy, has always felt that her son functions better when receiving occupational therapy (OT) intervention. OT helps to improve function and increase engagement in meaningful activities of daily living. OT intervention varies based on client factors, context, and activity demands. For the pediatric population, occupations include self-care, play/leisure activities, social participation and school/vocational performance.
In Will’s case, shaving became a pertinent self-care skill to master as he began to grow an “itchy” beard around his 16th birthday. Like many children on the spectrum, Will could not learn this task through modeling or repetition. Occupational therapists use skilled observation and task analysis to look at the performance components affecting the child’s ability to functionally complete activities of daily living. Performance areas may include, but are not limited to, strength, coordination, attention, eye-hand coordination, organization, and sensory processing. Underlying areas of need have to be addressed before the end goal can be achieved. Will has always had sensory processing issues, especially in terms of auditory and tactile processing. Sensory integration is the neurological process of taking in, sorting out and using information from the environment. Typically this process occurs automatically, but when there is a malfunction we see children with hyper (over) or hypo (under) sensitive systems in one, several or all sensory systems. Besides the 5 major senses of taste, touch, smell, vision and hearing there is also the sense of movement in space (vestibular – receptors are housed in the inner ear and respond to the force of gravity, with a primary role in our balance) and body awareness (proprioceptive- receptors are in the joints, tendons and skin and give us information about where our body is in space).
Occupational therapist’s use purposeful therapeutic interventions and modalities to address areas of need. In this particular OT session with Will you see him using headphones (with an impedance of 150 Ohms and a sensitivity range to 22,000Hz) with a Therapeutic Listening CD to assist with auditory desensitization to the sound of the razor. He is sitting in a sling swing receiving structured vestibular/proprioceptive input with movement externally facilitated with a spandex sheet to help him achieve a calm and organized state of alertness. Once Will’s central nervous system was in a balanced state we moved into engagement with age-expected daily activities such as shaving and writing.
For more information on the types of therapeutic programs my practice provides please visit www.hollynelsonpediatricOT.com. For additional information on occupational therapy look at the Maryland Occupational Therapy Association website or the American Occupational Therapy Association website. For detailed information on sensory processing please see www.spdfoundation.net. For Therapeutic Listening information log on to www.vitallinks.net.
-Holly Nelson, OTR/L
Owner Holly A. Nelson Pediatric Occupational Therapy