Occupational Therapy

What is pediatric occupational therapy?

occupational-therapyPediatric occupational therapists help children master daily life skills with ease and efficiency. The “job” or “occupation” of a child is to play, use tools such as crayons or utensils, and interact with their environment, adults and their peers effectively. Occupational therapists help a child navigate through these daily important tasks to accomplish them effectively. An occupational therapist works on strengthening, but particularly focuses on the trunk and upper extremities. An occupational therapist addresses more fine motor or “refined” tasks, such as using the fingers and thumb for more difficult skills like picking up a coin, feeding themselves, or using both hands together to perform a task. An occupational therapist also addresses the sensory system, or how a child perceives and processes their environment through touch, movement and experiences. Depending on a child’s needs, an occupational therapist could work with a child on anything from improving their handwriting to taking part in social activities to having the strength to hang from the monkey bars.

What specific occupational therapy interventions do we offer?

  • Strength and endurance training
  • Joint range of motion and soft tissue mobilizations
  • Musculoskeletal alignment / Postural control
  • Handwriting skills
  • Fine motor skills such as cutting, coloring, self feeding, etc.
  • Neuro-Developmental Treatment (NDT)
  • Coordination and motor planning exercises (how your child can plan and execute motor movements)
  • Proprioception and body awareness (how your child moves in space and adapts to different environments)
  • Sensory integration
  • Constraint induced therapy programs
  • Assistance with emotional development
  • Use of Kinesiotaping, Theratogs, Neuromuscular Electrical Stimulation and other modalities as appropriate for intervention
  • Adaptive and assistive technology recommendations
  • Splinting/casting

What are some typical milestones my child should be meeting for sensory and fine motor skills?

Birth to 3 months:

  • Grasps objects placed in or near palm
  • Tracks or follows an object with their eyes
  • Startles to sounds (This should end at 2 months)
  • Demonstrates opening/closing of hands (hands are not fisted)
  • Is able to be held, picked up by a variety of caregivers, laid down and moved without becoming upset
  • Tolerates tummy time for short intervals
  • Holds head up when supported at chest (chin does not rest on chest or head is not extended back)

4 Months:

  • Swipes and reaches for objects on belly, on back and in supported sitting
  • Brings hands or objects to their mouth
  • Tolerates diaper/clothing changes well
  • Can place hands to a bottle with slight support

5-6 Months:

  • Holds bottle during feeding
  • Smiles at familiar caregivers or at own image in mirror
  • Sustains hold on rattles or small toys while shaking or banging
  • Transitions easily when leaving home, moving around the home, or between caregivers
  • Grasps larger toys or early finger foods
  • Begins to sit independently

7-8 Months:

  • Easily passes toys from one hand to another
  • Frequently mouths toys for exploration, as well as turning toys in hands
  • Beginning to place toys into and out of containers
  • Claps

9-10 Months:

  • Begins to pick up small objects with finger/thumb
  • Points or pokes with index finger
  • Eating a variety of textures, solids and foods
  • Easily able to be diapered, dressed or bathed without becoming too upset
  • Able to be consoled when upset

11- 12 Months:

  • Sleeps through the night for the majority of nights
  • Begins to pick up cheerios or small objects with tip of thumb and tip of index finger
  • Accommodates easily to loud noises, such as a siren or barking dog
  • Feeds self finger foods
  • Attempts to use utensils for eating
  • Holds crayons to try to color
  • Uses ring stacker
  • Turns pages of board books

12-15 Months:

  • Can stack 2-3 blocks
  • Places large puzzle pieces in puzzle with minimal assistance
  • Can place objects into container with smaller opening
  • Can use spoon to self feed
  • Begins to identify simple body parts: belly, head, nose, etc.
  • Uses pretend play for feeding baby, eating pretend food, etc.

15-18 Months:

  • Points to multiple body parts
  • Stacks 3-4 blocks
  • Holds crayon to color for longer intervals
  • Increasing in pretend play
  • Begins to show interest in playing with peers, even if still playing side by side

18-24 Months:

  • Plays with a variety of toys appropriately
  • Can unscrew a cap from a small bottle once loosened
  • Removes socks, shoes with ease
  • Can pull on pants without help
  • Can play with one toy for extended period of time
  • Can pull up a large zipper
  • Puts shapes into a large shape shorter
  • Begins to string large beads
  • Can throw a small ball forwards
  • Increases in pretend play with dolls, food, cars, etc.
  • Turns pages of a book, may be 2-3 pages at a time

24-30 Months:

  • Can imitate drawing a line after watching this performed on paper
  • Can scribble a circular pattern after watching this performed by adult
  • Builds with blocks, stacking objects
  • Can fold paper in half
  • Can snip the edges of paper with scissors
  • Holds a crayon with thumb and fingers
  • Turns single pages in a book

30-36 Months:

  • Can remove clothing after fasteners are loosened
  • Begins to use one hand more than another for activities
  • Builds a tower of multiple, larger blocks
  • Imitates the actions of adults in the home
  • Uses a fork to eat
  • Can cut across a piece of paper
  • Can put together large linking blocks
  • Can dress with some assistance

3-4 years:

  • Uses age-appropriate scissors
  • Copies circles and squares
  • Draws a person with two to four body parts
  • Beginning to write capital letters
  • Dresses and undresses without help
  • Screws and unscrews lids
  • Turns handles on doors
  • Demonstrates very few tantrums when transitioning to new places or dropping off at school
  • Shows affection for family and friends
  • Understands “mine” or “hers”
  • Shows a wide range of emotions, such as being sad, angry, happy, or bored
  • Has an increased imagination and repertoire of pretend play
  • Enjoys doing new things
  • Plays “Mom” and “Dad”
  • Would rather play with other children than by himself
  • Talks about what she likes and what she is interested in
  • Names some colors and numbers
  • Understands the idea of counting
  • Starts to understand time
  • Remembers parts of a story
  • Understands the idea of “same” and “different”
  • Plays board or card games
  • Tells you what he thinks is going to happen next in a book

4-5 years:

  • Wants to please or be like friends
  • Likes to sing, dance, and act
  • Shows concern and sympathy for others
  • Is aware of gender
  • Can tell what’s real and what’s make-believe
  • Shows more independence
  • Is sometimes demanding or very cooperative
  • Counts 10 or more things
  • Can draw a person with at least 6 body parts
  • Can print some letters or numbers
  • Copies a triangle and other shapes
  • Knows about things used every day, like money and food