Occupational Therapy at Emerge Pediatric Therapy focuses on the whole child and their relationship with the world around them. Common reasons that our clients receive occupational therapy are for sensory processing deficits, difficulties with behavioral modulation and emotional regulation, Dyspraxia, Autism, ADHD, learning disabilities and/or delays in play, social skills, coordination, attention, handwriting and motor skills.
Our occupational therapists help children succeed in meeting the daily occupations of childhood: play, school, and self-help skills. Most of the children referred to occupational therapy at Emerge demonstrate difficulties in processing sensory input. These children misinterpret everyday sensory information, such as touch, movement and sound. They may feel bombarded by the sensory world or seek out intense sensory experiences. This can lead to difficulties with motor coordination, social/emotional challenges, school difficulties, behavioral problems, poor self-esteem and other issues. The occupational therapists at Emerge have advanced training in assessing and treating sensory processing and sensory integration disorders. They use a child centered approach, selecting activities designed to give each child the ‘just-right’ challenge to facilitate developmental and/or behavioral change and promote positive self-esteem.
Here are some signs of sensory processing difficulties:
- Overly sensitive or under reactive to touch, movement, sights, or sounds
- Difficulty with behavioral and/or emotional regulation
- Easily overwhelmed
- Difficulty with transitions, rigid
- Poor response to behavioral intervention
- Difficulty learning how to play or get along with other children
- Difficulty with everyday activities like eating, sleeping, brushing teeth or getting dressed
- Problems learning to color, cut, draw or write
- Difficulty transitioning from one activity or place to another
- Problems learning to walk, jump, skip, ride a bike or play sports
Does Your Child Have Delays in Motor Skills?
Children may be referred to occupational therapy due to concerns regarding motor skill development or sensory processing or both. Below are some general guidelines for developmental expectations in motor skill development. If your child is delayed, an occupational therapy evaluation may be indicated.
AT 9 MONTHS, DOES YOUR CHILD:
- Sit independently.
- Move about room (roll, crawl on stomach, creep on hands and knees).
- Eat mashed table food without gagging.
AT 12 MONTHS, DOES YOUR CHILD:
- Pull to stand and cruise (may walk independently).
- Pick up small objects between thumb and index finger.
- Feed self with fingers.
AT 18 MONTHS, DOES YOUR CHILD:
- Build a 3-4 block tower.
- Feed self with little help.
- Walk confidently.
- Walk up and down 3 steps.
AT 24 MONTHS, DOES YOUR CHILD:
- String large beads.
- Remove simple clothing.
- Jump with both feet clearing floor.
AT 36 MONTHS, DOES YOUR CHILD:
- Independently dress except for fasteners.
- Draw a circle and cross.
- Ride a tricycle.
- Catch an 8” ball.
AT 48 MONTHS, DOES YOUR CHILD:
- Draw simple pictures.
- Cut on a line.
AT 60 MONTHS, DOES YOUR CHILD:
- Cut out simple shapes.
- Color within the lines.
Understanding Sensory Processing Disorders
Efficient sensory processing involves the ability to appropriately register, attend to, interpret, and execute a response to sensory input from the environment and from within the body. When an individual is unable to process information from the senses efficiently, they are said to have a sensory processing impairment. Sensory processing impairments may manifest in a variety of ways and affect a child’s motor skills, learning, activity level, behavior, social, and emotional regulation.
For all of us, our mind and body are delicately connected. Every thought, feeling and action we experience occurs through complex interactions of our brain. How we process sensory information has a major impact on our behavior. The slightest change in our brain processes can influence how we cope with everyday life.
Children inherently want to play, learn, cooperate, make friends and be successful. This internal drive can become disrupted when certain areas of the brain that process sensory information do not seem to be making the connection that they should be. The behaviors that result can confuse, frustrate and sometimes anger parents, teachers, day-care providers and baby-sitters. But most importantly, they impact the child’s ability to feel comfortable in and successfully navigate their world.
Most children with sensory problems are born with these challenges. That’s why early intervention is so important for infants and toddlers. Treating ‘little’ issues early prevents them from becoming big issues later on.
Understanding how impaired sensory processing may be underlying a child’s struggle is the first step in a family’s journey toward helping the child.
Does Your Child Have a Sensory Processing Disorder?
Sensory processing disorders cover a wide range of behaviors and the impact on a child can range from very mild to severe. No child will demonstrate all of these behaviors. A child may need to be referred for an occupational therapy evaluation if difficulties are seen in several of these areas or if one area is creating significant problems.
- Was unusually fussy, difficult to console, or easily startled as an infant. Is over-sensitive to stimulation–over-reacts to touch, movement, tastes, sounds, or odors.
- Has difficulty regulating sleep/wake cycle–settling for sleep, staying asleep, and waking without irritability.
- Has difficulty with everyday activities like eating, sleeping, brushing their teeth or getting dressed.
- Is easily overwhelmed in group situations, which may result in overexcitement, meltdowns or shutting down.
- Can’t get “enough” sensory input: touching, squeezing, moving, bouncing or mouthing.
- Has poor muscle tone, fatigues easily, leans on people, or slumps in a chair. Uses an inappropriate amount of force when handling objects, coloring, writing, or interacting with siblings or pets.
- Was slow to roll over, creep, sit, stand, or walk, or to achieve other motor milestones.
- Is clumsy, falls frequently, bumps into furniture or people, and has trouble judging position of body in relation to surrounding space.
- Has difficulty learning new motor tasks; experiences frustration when attempting to follow instructions or sequence steps for an activity.
- Avoids playground activities, physical education class, and/or sports.
- Does not enjoy age-appropriate motor activities such as jumping, swinging, climbing, drawing, cutting, assembling puzzles, or writing.
- Difficulty learning how to play or get along with other children. Difficulty with or avoids drawing, cutting, writing activities.
- Challenges in school, including attention, organizational perception and listening skills.
Books About Processing/Sensory Integration
While nothing can replace the value of having an occupational therapist, skilled in sensory integration, evaluate, treat and consult with you regarding your child, the greater understanding you have of sensory processing, the more effective you will be in meeting your child’s needs and making daily life run more smoothly.
Sensory Integration and the Child: 25th Anniversary Edition (1979, revised 2005) by A. Jean Ayres. Updated classic by Dr. Jean Ayres, who developed the theory of sensory integration and many of the treatment foundations. This book offers extensive information about sensory integration with case examples.
The Sensory-Sensitive Child: Practical Solutions For Out-of-Bounds Behavior (2004) by Karen A. Smith. Written by two psychologists, who are also mothers of children with sensory processing disorders, this book is strong in addressing the behavioral impact of sensory processing disorders (not just those with hypersensitivity).
Sensational Kids: Hope and Help for Children with SPD (2006) by Lucy Jane Miller. In-depth, state of the art information of sensory processing disorder. Includes medical and scientific explanations as well as real life examples of children with Sensory Processing Disorders.
The Out-Of-Sync Child: Recognizing and Coping with Sensory Integration Dysfunction (1998; revised 2005) by Carl Kranowitz. An easy-to-read classic written by a preschool music and movement teacher. Includes detailed checklists. Carol has given one-day workshops in our areas several times.
The Out-Of-Sync Child has Fun (2003; revised 2006) by Carol Kranowitz. A collection of sensory based activities to do at home.
Building Bridges through Sensory Integration (2003) by Ellen Yack, Shirley Sutton, and Paula Aquilla. Practical book specifically oriented to children with autism and other pervasive developmental disorders. Offers specific strategies for challenging behaviors and self-help skills.
Tool Chest for Teachers, Parents and Students Handbook by Diane Henry. Easy to use reference, primarily geared to school support and adaptations. Sensational Kids by Lucy Jane Miller
Raising Your Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Integration Issues (2005) by Lindsey Biel and Nancy Peske. Written by a parent of a child with Sensory Processing Disorder and a pediatric occupational therapist, this book includes practical ideas for activities.
Sensory Secrets: How to Jump-Start Learning in Children (2001) by Catherine Schneider. Introductory book to understanding sensory systems and impact on learning.
Too Loud, Too Bright, Too Fast, Too Tight: What to Do It You Are Sensory Defensive in an Overstimulating World (2002) by Sharon Heller. An overview of sensory defensiveness and treatment options.