What is Occupational Therapy?  What areas does it address?
What is Speech Therapy?  What areas does it address?
What is Sensory Modulation?

What is Occupational Therapy?  What areas does it address?

Occupational therapy focuses on children’s “occupations”, which consist of school activities, play, and self-care skills.  The following is a breakdown of tasks addressed in OT.

• Fine Motor Skills:
  • Dressing
  • Handwriting
    • Age-appropriate and functional grasp on pencils/markers
    • Number and letter formation (manuscript and cursive)
    • Near-point (from book) and far-point (from board) copying
  • Use of utensils & eating skills
  • Toileting
  • Grooming and hygiene
• Coordination (bilateral and eye/hand)
  • Dexterity
  • Manipulation (zippers, buttons, snaps, etc.)
• Strength and Endurance
  • Quality of movement
    • Functional range of motion
  • Tone
• Balance
• Motor Planning
• Independent Living Skills
  • Management of time and money
  • Safety awareness
  • Organizational skills
  • Following schedule/calendar
• Play and Leisure Skills
  • Social Interactions
• Regulation/Modulation (Sensory Integration)
  • Tactile, Vestibular, Proprioceptive, Oral, Auditory, Visual, and Olfactory sensitivities which interfere with daily function
• Visual-Perception
  • Form Constancy
  • Discrimination
  • Memory
  • Spatial Relations
  • Left/Right Orientation
• Attention to Task/Focus
  • Self initiation
• Computer and/or Assistive Technology Use
• Adaptive Equipment
• Positioning and Functional transfers
• Communication (functional)
  • Use of pictures/items/signs/computers to communicate

What does an Occupational Therapy initial evaluation consist of?

OT’s work with children primarily through play activities.  Toys, games, and movement activities may be used during the evaluation.  Additionally, standardized testing addressing motor skills are usually included in the evaluation, using reputable and well recognized tests, such as the Bruininks Oseretsky Test of Motor Proficiency, 2nd Edition (BOT-2), Peabody Developmental Motor Scales, 2nd Edition (PDMS-2), or the Miller Function and Participation Scales (M-FUN).  Evaluation of the child’s visual perceptual skills may be assessed using the Motor-Free Visual Perception Test, 3rd Edition (MVPT-3).  If applicable, handwriting skills will also be tested.  Additionally, the therapist will perform skilled observation of your child’s reactions to testing demands and the environment to determine strengths and weaknesses that may interfere with their development.  Most children really enjoy the evaluation and look forward to returning.

What does an OT treatment session consist of?

The one hour session works to facilitate improved regulation, foster occupational engagement, and develop appropriate social participation skills.  Every session focuses on functional activities such as self care skills (dressing, tying shoelaces, manipulating buttons, zippers, and utensils), fine motor skills (handwriting, scissors, visual motor skills), life skills (telling time, using money, organizational skills), visual perceptual skills and social skills.

Sessions also includes time in our sensorimotor gym which promotes motor planning, coordination, strength, balance, and endurance. It also allows your child to engage with peers and improve social interaction.

What is Speech Therapy?  What areas does it address?

Speech Therapy helps children with daily functional communication of their wants, needs, thoughts, and ideas to others who are older, the same age, and younger than they are as they go through their everyday activities.  The Speech-Language Pathologist (SLP) usually addresses how children communicate, both verbally and nonverbally.  The SLP may also work with children to facilitate development of their oral motor skills for safe management of their food (swallowing) and fine motor coordination of speech sounds (articulation), fluency of speech production, listening skills (auditory comprehension and processing), social language skills (pragmatic language), and reading skills (phonological development and processing).

What does a speech language evaluation typically consist of?

The SLP evaluates a child’s communications during structured and unstructured interactions to identify functional speech and language skills.  As needed, the SLP will complete standardized testing using well known, reputable assessments.

What is Sensory Modulation?

Understanding Sensory Modulation and How It Can Affect Learning

For all people in the course of a typical day, our nervous system (brain, spinal cord, sensory nerves) takes in and responds to a wide variety of sensory information.  The sensory nerves send messages through the spinal cord and into the brain.  The brain is in charge of organizing the information received.  It filters out what it perceives as not important and attends to information it registers as important.  For example, when one walks into a smelly room the nose sends information to the brain and the brain registers the smell.  A motor response is then made, such as fanning the air or moving to the other side of the room, etc.  However, after a few minutes the odor is hardly noticed, if at all, until one leaves the room and reenters.  Although the sensory nerves are still working, the brain stops registering the smell as important.

Although the brain usually filters out unimportant information, interprets the sensory input accurately and responds appropriately (a term called modulation), for some children and adults this is not the case.  For example, when one puts on a new shirt and initially feels the tag at the back of one’s neck but after a few minutes does not notice, this is a sign of modulation.  However, when one puts on a new shirt and continues to feel the tag at the back of one’s neck continuously, this is an example of unmodulated behavior.  The brain continues to send information disallowing one to “tune out” the feel.  Therefore, it is important to analyze what part of sensory processing is having difficulty and determine what can be done to help improve the modulation.  Another example relates to the auditory system.  When one alerts and arouses (brain tunes one into the auditory input) to the wrong inputs it may become over aroused (turning in class to hear every noise rather than maintain attention to work) or fail to alert at all (not respond when called on by teacher).

Besides everyone’s nervous system being unique, an individual’s nervous system can respond differently throughout the day.  Some days everything may be registered correctly, thereby allowing the individual to be “well regulated.”  However, on another day, the system may have increased difficulty tuning out sensory information or not registering sensory information at all, causing one to be “dysregulated”.  Unfortunately, this is why many parents and teachers get frustrated with children as they “know they can do it!”

Most of us know the five “typical” senses, such as taste, touch, smell, hearing, and seeing.  There are also two “hidden” senses.  These senses consist of vestibular and proprioceptive input.  The vestibular input is registered in our inner ear, as fluid passes through the semi-circular canals and is registered by Cranial Nerve VIII, the Vestibular Cochlear Nerve.  This helps register the sense of movement, gravitational security, muscle tone, balance, and posture.  Proprioception is registered in one’s muscles and joints.  It helps one have a sense of “body awareness” and helps one determine the amount of force needed to activate muscles (grade movements).  It also provides postural stability and the ability to motor plan.  For example, when one pushes hard on a pencil due to not receiving the correct feedback from one’s muscles and joints, whiteness at the knuckles is observable and complaints of hand fatigue when writing are common.  Children that do not process sensory input well often demonstrate outward signs or behaviors that can give clues about their internal systems.  For example, a child that frequently rocks in their chair, fidgets with anything on/near their desk, and/or turns towards even the slightest noise in the classroom (air conditioner or heater activating) could be demonstrating signs of over-responsiveness to auditory information (can not tune out) and under-responsiveness (can not get enough) to vestibular and tactile input.

The level of a child’s modulation is very important for learning.  If the child’s level of arousal is too low, the child’s overall performance will be poor due to difficulty “tuning in” to information presented.  This child’s behavior will not cause a problem in class; however, the child will appear to be “daydreaming” and learning is not happening.  The child whose level of arousal is too high is also at risk for a poor performance.  This child can not slow down enough to tune in to the teacher or complete work, as the brain and body tend to race.  The challenge is to have the child in the “just right” level; the area the child is modulated.

Ways to improve modulation, whether too high or too low, often include the same types of sensory activities.  The oral system is the fastest way to get organized, but only lasts a short while.  Tactile (squishy toys) and auditory (classical music) input can be calming for some, but others may be sensitive.  Vestibular input can be both calming and alerting.  If movements are linear, such as rocking a baby, the movements tend to be calming.  However, spinning tends to be alerting.  Heavy work activities, such as pushing, pulling, and carrying heavy objects activate proprioceptive receptors.  The sensory input that has the longest change to the nervous system relate to vestibular and proprioceptive input.  It is important to have as many opportunities throughout the day to participate in activities that affect change in the sensory systems to allow one to maintain modulation.  These activities are commonly referred to as a “sensory diet.”

See sheets located in the parent handout section for sensory strategies in the classroom and/or sensory strategies in the home for further ideas.