An occupational therapy evaluation will determine in which daily activities the child is having difficulties and why. The first step is parent/caregiver interview (and child interview if possible) to create an occupational profile consisting of the child’s medical and developmental history, current level of function, strengths, challenges, and motivations. The OT evaluation will consist of administering parent questionnaires, standardized assessments, functional task analysis, and structured and unstructured clinical observations. Depending on the child’s needs, occupational therapy evaluation may consist of assessing the following areas:
How well does the child performs specific age-appropriate gross, fine, bilateral and visual motor tasks?
How is the child’s ability to process and utilize visual information for functional tasks?
How do environmental and internal stimuli affect the child’s function?
Is the child able to sustain attention to a task and do they demonstrate the ability to functional plan, initiate, sequence, and terminate a given task?
Arm, wrist, and finger strengthening to support endurance and manipulation of commonly used items. Coordination activities may involve age-appropriate bilateral activities such as dressing, ball play, and jumping jacks.
Understanding the task at hand, planning the action, sequencing the steps to accomplish the plan, and executing the motor task are the components of praxis. Praxis is the cognitive process that allows the body to carry out movements to meet the demands of a task. Functional praxis allows for a child to complete fine motor tasks such as completing fasteners, coloring, and cutting and gross motor tasks such as climbing stairs or catching and throwing a ball.
This is the brain’s ability to process sensory information from within and outside of the body. The goal of sensory integration strategies in occupational therapy is to support the child in producing an adaptive response, which is a successful and appropriate action in response to the internal and/or external environment. Sensory integration primarily focuses on the 3 basic senses tactile (touch), vestibular (balance), and proprioceptive (body awareness) with use of certain tasks and specialty equipment when available, while sensory supports may include accommodations for those with hypo- or hyperreactivity to the 3 aforementioned senses or for sight, hearing, smell, or taste. An OT may recommend a sensory diet to support the child in self-regulation throughout their daily routine.
Play is a child’s number one occupation! Play is crucial in supporting motor, cognitive, and social skills as well as emotional regulation. Occupational therapy uses many play activities including play exploration, pretend play, games with rules, and using toys to support functional goals including social participation. Social interaction skills include approaching, starting and concluding interactions, reciprocal interaction (taking turns), expressing emotions, regulation, personal space awareness, transitions, and timing.
Promoting healthy sleep patterns that support growth and health by engaging the child in routines to prepare for comfortable rest and sleep.
In collaboration with parents/caregivers the occupational therapist helps them to support their child in meeting their maximal potential. A home exercise program or a sensory diet may be recommended that needs to be implemented by the parent, as consistency is key to successful functional outcomes. Occupational therapy also works to help the parent implement useful strategies for their child through questioning and constructive feedback.
Recommendations for changes in the environment or activity to support the child’s ability to engage in occupations. This may include low- or high-tech assistive technology.