Written by: Dr. SangitaSarmah (BOT-KOLKATA, MOT-ORISSA, MAIOTA-MUMBAI)
(Consultant Occupational Therapist)
Occupational therapy is a health care profession, a holistic approach to a client’s physical well-being along with psychological, social and environmental factors that may affect functions. Occupational therapy is designed to help children and adults to acquire or regain the skills needed to perform the activities or occupations of daily life. When a child shows delay in mastering typical activities like achieving neck control, rolling, sitting, crawling, standing etc. or displays unusual and disruptive behaviour then occupational therapy is often the first professional to work with the child.
In today’s world there are many developmental disabilities like cerebral palsy (CP), autism, learning disability, ADHD, different genetic disorders including downs syndrome etc. This may occur during prenatal stage that means during the time of pregnancy or during perinatal stage that means during the process of child birth or due to any trauma or infection at postnatal period. Once child suffers from any central nervous system (CNS) lesion, on the developmental period they shows a lack of higher level control over movements and a release of primitive and abnormal reflexes at lower level. The lesion in CNS of patient with cerebral palsy results in a lack of inhibition of primitive total patterns and insufficiently developed postural reflex mechanism. Due to which the child becomes unable to achieve the developmental milestones on time. The child becomes delay in achieving neck control, rolling, sitting, crawling standing etc. on proper time. At this moment the child needs proper therapeutic intervention.
Occupational therapy is directed primarily towards the inhibition of abnormal movement, facilitation of automatic responses and encouragement of voluntary movements with ultimate goal is to provide children with more normal patterns of posture and movement. Occupational therapist uses developmental therapies, motor learning theories and reflex inhibition patterns to integrate abnormal reflexes and facilitate normal postural movements. Besides these Occupational therapy also focuses on improvement of fine motor functions which includes hand functions, reading and writing difficulty, feeding, toileting etc. for overall improvement of the child. On the basis of need occupational therapist fabricate splints and adaptive/assistive devices also which plays an important role during the recovery process, as these positioning & supportive devices facilitate participation in daily activities like self-feeding, grooming activities, school activities and in most important PLAY activity which is an essential part of childhood.
Another common developmental disability to be found is Autism & learning disability or sensory processing disorder. Here the child experience difficulties in organizing sensory information for use. Children with sensory processing disorder cant synthesize all the information streaming in from the traditional 5 senses – touch, hearing, taste, smell & sight, as well as 2 internal senses body awareness (proprioception) & movement (vestibular sensation).Proprioception allows for motor control and posture while vestibular receptors tell the brain where the body is in space which links directly to balance and co-ordination.
Children with sensory processing disorder who have trouble modulating sensory input experience oversensitivity or hypersensitivity and under sensitivity or hyposensitivity or both to an impairing or overwhelming degree at school, at home or outside. An extremely oversensitive child tend to be withdrawn because he/she is easily overwhelmed or excited by auditory and visual stimuli, easily distracted, make it difficult to pay attention and participate in class. While those are under sensitive crave for input. They want to keep on moving, touching everything or even tripping or crashing into other kids.
Thus for the treatment of these kind of children sensory integration therapy is widely given which is a domain of occupational therapy profession. In sensory integration therapy, children are provided with enhanced opportunities for controlled sensory input with a particular emphasis on vestibular, proprioception and tactile input by giving some meaningful and planned activities to the child. Different protocols are been used where graded stimulations are given to get a proper adaptive response. As the child starts receiving proper sensory input, he/she is put under motor learning and functional training sessions to prepare the child to attend normal schooling or social activities. Occupational therapy treatment focuses on prescription of activities with specific aim. Thus it plays an important role in treatment of children’s with developmental disabilities to make them maximally independent.
