Occupational Therapy

Occupational therapy helps children develop or improve the skills important for daily life. At CHOC, we work with patients from birth through 21 years of age to master skills including feeding and eating, basic play skills, self-care skills like brushing teeth and hair and washing and pre-academic skills like coloring and writing letters or numbers.

Therapy is offered in our state-of-the art facility and in CHOC specialty rheumatology, cancer, gastroenterology, orthopaedic and hand clinics and at the High-Risk Infant Follow-up Clinic.

Occupational therapy may be recommended if a child has:

• Delayed fine motor developmental skills.
• Abnormal muscle tone.
• Joint or muscle tightness in the arms that may limit movement.
• Difficulty producing smooth movements.
• Swallowing issues.
• Feeding issues.

Occupational therapy may also be recommended if a child is not able to do age appropriate self care activities like dressing or simple hygiene tasks.

Skills Addressed in Therapy

Once a child has been referred for occupational therapy, our specialists evaluate the child’s specific needs and put together a plan detailing the exact skills the child will work on with our therapists. Depending upon the child’s age, developmental age and needs, the therapist may address the following areas:

• Fine motor skills: Patients focusing on fine motor skills may work on grasping, reaching, and/or letting go of objects; both hands working together; coloring and writing skills; using scissors and/or the ability to perform age-appropriate play activities. Learn more about fine motor skills milestones.
• Visual motor skills: Visual motor skills refer to the ability to produce exact motor movement by correctly processing visual information. A child with visual motor difficulties may appear clumsy.
• Bilateral coordination: Bilateral coordination refers to a person’s ability to use both sides of their body together. An occupational therapist looks at the use and coordination of both hands in activities like coloring, cutting and block construction.
• Feeding skills: The goal of feeding therapy is to help the child develop normal, effective feeding patterns and behaviors after the therapist evaluates what may be causing the child’s feeding difficulties. Learn more about feeding skills therapy.
• Swallowing: The goal of swallowing therapy is to help the child develop normal, effective swallowing patterns after the therapist determines what may be causing the child’s swallowing difficulties. Learn more about therapy for swallowing.
• Self care independence: Patients focusing on self care may work on feeding themselves, being able to handle his or her own light hygiene needs like brushing teeth and washing his or her own face and hands, brushing or combing his or her own hair, getting dressed, bathing and/or using the restroom independently. Learn more about self care milestones.
• Hand therapy: Hand therapy involves the assessment and treatment of the hand and arm. Hand therapy may include strengthening the hand and arm and working with children to improve their functioning skills or teaching them to use assistive equipment. Learn more about hand therapy.
• Sensory processing and modulation: Also referred to as “sensory integration therapy,” therapists create opportunities for patients to learn senses the right way. Patients are taught how to detect information from the environment, pull together information received from our seven senses and create an appropriate response.

Therapy Techniques

The occupational therapists at CHOC carefully work with patients to ensure they use the very best treatment therapies for each child’s age, development and needs. Patients may receive therapy using one of the treatment methods below or a combination of methods.

• Neurodevelopmental techniques: Neurodevelopmental treatment (NDT) is usually used with patients with neuromotor dysfunction including difficulty with balance, gait and mobility control; involuntary movements and spasms and muscle weakness. The goal of NDT is to help patients learn more normal movements and reduce their abnormal movements by using guided exercises in a specific pattern. The more the patient practices and performs the movements, the easier and more automatic they become for the child.
• Sensory integration: In sensory integration therapy, therapists create opportunities for patients to learn how to use their senses the right way. Patients are taught how to detect information from the environment, pull together information received from our senses and create an appropriate response.
• Physical agent modality: There are three different types of physical agent modality treatment methods used at CHOC.
  —Neuromuscular Electrical Stimulation (NMES) involves the use of electrical pulses to cause muscle contraction. The electrical currents are delivered through leads and electrodes that are placed onto the patient’s skin. NMES is a noninvasive procedure (a procedure that does not require doctors to go inside the body). Learn more about NMES treatment.
  —TENS unit is similar to NMES and involves the use of electrical pulses that are delivered through leads and electrodes. The goal of utilizing a TENS unit is to reduce and/or manage pain as it stimulates at a sensory level rather than a neuromuscular level.
  —Hot packs and cold packs are used to alleviate pain, relax targeted muscles or excite specific muscles.
• Myofascial Release: Myofascial release is a hands-on technique that involves a gentle form of stretching and pressure onto the fascial tissue to eliminate pain and restore motion. The therapy, also known as soft tissue mobilization or MFR, releases the uneven tightness in injured fascia. It is different from massage, which focuses on muscles. Learn more about myofascial release.
• Guided imagery: Guided imagery is a program of directed thoughts and suggestions that guide the patient’s imagination toward a relaxed focused state. It can be used as a way of reducing pain, anxiety and discomfort. Learn more about guided imagery.
• Therapeutic listening: Therapeutic listening is a type of therapy that uses music to affect changes at all levels in children with sensory processing dysfunction, as well as those with listening, attention and communication delays or problems. Learn more about therapeutic listening.
• Splinting for hands: Splints are prescribed for many different reasons. The splints can help protect or stabilize broken bones or tissue injuries, provide support because of nerve damage and help with pain control and protection after surgery. Custom-made splints are directly formed to the patient and allow the patient to heal while maintaining mobility.