Occupational Therapists work in a variety of settings.  We see children in their home, a clinic setting, hospital or educational settings.  We might work closely with medical staff, parents and educators.  It can be confusing for people who have never met (or even heard of occupational therapists) to understand what we actually do! How do we differ from other professionals working with your child?  You may also be wondering if an elderly relative who has had a stroke just saw an OT, how can we possibly help your child?!

To understand what we are looking for when we see your child for an assessment takes me back to university and the models of practise we studied. Depending on our training (from all over the world) we might take slightly different approaches.  Having studied at Sydney University, the main theoretical model taught was the Occupational Performance Model (Australia) [OPM(A)].  Read more about the model here or for OTs interested in publications related to this model, find them here.

But what does this mean when my child has an assessment???

This model of practice helps an OT to consider the whole child ... their roles, activities, where their performance may need help, areas of strength and the context they are in (family, cultural, social, etc).  We may not consider every area in great detail depending on the reason for contacting us, however it gives us a framework to look at your child. 

Here is a typical scenario from my current OT practise to help you see what we consider when assessing your child .

REASON FOR REFERRAL -
A six year old child has difficulty with handwriting and producing legible work.  The child is in year one at school and the teacher reports that they have difficulty paying attention in class and is constantly breaking pencils. 

ASSESSMENT PROCESS - 

Occupational Roles:
OTs consider the child's role as a student and friend in the classroom.  What is preventing them from participating fully in those roles?  We would also consider any impact this has on the child as a "player", "self-carer" or "son/daughter". 

Occupational Performance Areas:
​Then we consider the areas of self-maintenance, rest, leisure/play and productivity/school occupations. Based on the referral, emphasis would be on school tasks (ie. productivity) - What school tasks and functions are they having difficulty completing? This might include writing activities, mathematics, sitting on the floor, listening to instructions, transitioning between tasks, completing work in a timely manner, etc.

Occupational Performance Components:
What components may need to be address that may explain underlying difficulties? 

* Biomechanical - This may include muscle tone, range of motion, strength, manipulation,  joint stability, coordination, bilateral coordination, fine motor and gross motor skills.

​For this case study we may look at how the child holds the pencil, how they produce written work, how they move their hand/arm/shoulder, posture of head/body, ​what the written work looks like. 

* Sensory motor - This may include a child's under or over responsiveness to touch, movement, sight, sound, taste and smell as well as theirvisual perceptual skills and body awareness. 

For this case study we may consider how much pressure the child is applying to the pencil, do they have sensory seeking behaviour, what are they doing when they have difficulty paying attention, what is the classroom environment like ?

* Cognitive - This may include perceiving, planning, sequencing, problem solving, understanding concepts, learning, short term/long term and working memory.

For this case study we may consider the child's familiarity with the alphabet and letter formation,  We may also consider how they structure sentences.

* Intra personal - This may include self regulation, self esteem, inner drive and motivation to participate in activities.

For this case study we may consider the child's behaviour and motivation in the classroom.  Does this differ in different environments? What does the child find motivating?  Do have difficulty controlling their emotions?

* Inter personal - The ability to relate to other children and adults. This may include communication, following instructions, asking for help, taking turns and waiting.

For this case study we may consider how the child relates in a 1:1 context compared with a classroom environment? Who are they seated near and what impact does that have on the child? What is their proximity to the teacher's desk from their own desk?

OTs use a variety of standardised and non-standardised assessments as well as observations of your child in their natural environments.  OT reports can be quite daunting for parents and teachers as we are looking at such a range of things for your child.  I hope this article helps to explain the background behind your child's assessment and report.

​As OTs we may use a model like the Occupational Performance Model (Australia) with people throughout their lifespan. OTs work in aged care, mental health, rehabilitation, disability, return to work programs and increasingly diverse populations.  They may also consider some of the same things we consider in your child to help them to maximise function and independence.  

If you would like your own copy of this application of the OPM (Australia), you can download your FREE copy here! Please redirect your friends, family and colleagues to this page so they can download their own copy as well!

​Has this article helped you to understand occupational therapy assessment?
What model of practice underpins your work as an OT?
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Long before your child may be ready for potty training there are some important concepts that they should learn! These concepts include learning the difference between wet and dry, dirty and clean, front and back.  

Teaching your child to count can be a useful way to measure time for your young child (eg. let's wash our hands until we count to 5).  It is also helpful when encouraging your child to learn to sit down and you can slowly increase the number that you count to (slowly increasing their attention).  When your child is ready to use toilet paper on their own, counting is helpful so they know the number of squares they can use (and to avoid whole rolls of toilet paper in the toilet)!

It is also really  important to teach your child about their own bodies...naming each body part correctly and finding where it is on themselves.  This body schema helps with gross, fine and visual spatial awareness as well as body safety. They can learn about "private parts" that they don't show other people and be aware that others do not touch their private parts (and they don't touch others).  This does not need to be in a fearful way but should be taught naturally and may be built on as your child matures.  There are lots of great books that teach older children about  body safety including "Some Secrets Should Never Be Kept".
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​TEACHING WET AND DRY  through everyday opportunities and play situations. 

1. Washing face in the morning.
2. Having a bath and drying with a towel.
3. Going for a swim and drying with a towel.
4. Watering plants with a watering can.
5. Washing the car.
6. Washing windows with a spray bottle.
7. Washing and drying the dishes.
8. Throwing wet sponges at a target.
9. Going into the rain with an umbrella or raincoat.
10. Jumping in puddles.
11. Painting with water on objects or on paper that changes colour. 
12. Dipping feet into a bucket of water and then walking on a paved/concrete surface leaving footprints.

TEACHING DIRTY AND CLEAN through everyday opportunities and play situations.

1. Washing hands before eating.
2. Washing hands or feet after playing with paint, shaving cream, mud or dirt.
3. Washing dirty dishes.
4. Giving a doll a "bath" in a bucket of water.
5. Helping to wash a pet.
6. Collecting rocks from the garden or park and washing them in a bucket of water.
7. Chalk drawing on the driveway and washing away the drawing with water.
8. Helping to wash the car.
9. Helping to wash dirty toy.

​

TEACHING FRONT AND BACK through everyday opportunities and play situations.
Teaching front and back is important when it is time to teach your child to wipe their bottoms independently. 

Use various items you have around your home to teach front and back, such as stuffed toys, books, toy planes and cars, CDs and even tins of food! (see photo)

TEACHING TO COUNT through everyday opportunities and play situations.
​It is best to use physical objects or actions when teaching young children to count.

1. Use household items to count such as cotton wool, pegs, toilet paper, books, cutlery, etc.
2. Count the number of stairs up to the front door.
3. Jump along a rug or yoga mat and count as you go.
4. Count how many steps to climb up to the top of a slippery dip and how long it takes to slide down a slippery dip.
5. Count as you stir the bowl when making muffins together.
6. Count 10 swings before giving someone else a turn.
7. Count as you clap your hands.
8. Count out 3 books to read before bed time.
9. Count how many wooden blocks you can use to build a tower.
10. Count ten sultanas (raisins) before eating them up.
11. Sing songs and finger rhymes that involve counting fingers or actions.  Find someHERE.
12. Roll balls or sausages of play dough and count them.

TEACHING BODY AWARENESS through everyday opportunities and play situations.

1. Having a bath is a natural time to teach naming body parts.
2. "Simon Says put your hands on"....
3. Read books that have clear pictures such as DK's My first body board book.​
4. Wash a toy doll or teddy and name body parts.

This article is part of “Functional Skills for Kids: 12 month series by Paediatric Occupational and Physical Therapists”.  You can read all of the childhood functionsHERE.  Read all Your Kids OT’s monthly posts HERE.

Find more information about “Potty training”, stop by to see what other Occupational and Physical Therapists participating in the “Functional Skills for Kids series” have written: 
​

Potty Training Readiness: 10 Signs It’s Time to Ditch the Diapers  | Mama OT
Potty Training, Toileting and Fine Motor Considerations  | The Inspired Treehouse
Gross Motor Skills and Toilet Training | Your Therapy Source
Toileting and Sensory Processing   | Miss Jaime OT
Potty Training with Attention and Behavior Problems | Sugar Aunts
Modifications For Potty Training  | Therapy Fun Zone
Preparing Your Child & Environment for Potty Training | Growing Hands-On Kids
Potty Training Instruction Tips  |Kids Play Space
Teaching Concepts for Potty Training Through Play |Your Kids OT

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​We all want calm kids! Let's face it, we want calm parents, teachers and OTs too! Here are some quick ideas to help your child (or self) to calm down!

Inspired by the sea, I have called these my Sea Life Sensory Solutions! 
1. Puffer Fish Puff - Puff your cheeks like a puffer fish. Fill your cheeks with air and hold for 5 seconds.  Blow quickly or slowly with silly noises.
2. Clam Cuddle - Cuddled yourself like a clam.  Place your hands on the opposite shoulders and squeeze. Encourage deep breathing at the same time.
3. Turtle Tongue - Poke your tongue out like a turtle pokes out its neck. Stick out your tongue and quickly hide it again.
4. Starfish Stretch - Stretch out like a starfish. Place your arms up over your head and stretch out wide. Stretch your legs out wide too! Encourage deep breathing at the same time.

These sensory solutions are based on sensory processing theory.  Anxiety and stress have been linked with an amplification of tactile or sensory defensiveness as stress is a behavioural response to environmental input*. Anxiety may be both a cause and an effect of the predominance of the protective system**.  Tantrums or meltdowns are outward demonstrations of the stress and anxiety within your child.  They are responding to their "fight, flight or fright" (sympathetic nervous systems) ... their perceived reality.  Read more about tactile defensiveness and sensory processing here and here.
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These activities facilitate self regulation through breathing and proprioceptive input into muscles, skins and joints. They may be incorporated into a sensory diet. Read more about sensory diets here.

Teach these sensory solutions to your children so they have strategies in their "tool kit" to calm down when the need arises.  Teachers may implement these with a whole class.

Best of all, I have made these strategies into a FREE PRINTABLE! Simple subscribe to Your Kids OT to claim your copy of "Sea Life Sensory Solutions"!  
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Cindy is a registered Occupational Therapist practising in Sydney Australia.  She has two young children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. Cindy is the author of the Occupational Therapy blog Your Kids OT.
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The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions.

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References
​* Bundy, A, Lane, S.J., Murray, E.A. (2002) Sensory Integration Theory and Practice (2nd Edition)
** Ayers, A. J (1964). Tactile functions: their relations to hyperactive and perceptual motor behavior. american Journal of Occupational Therapy, 18, 6-11

​It was a priviledge to write a guest post for Teacher Types recently with my "Tummy Time Tips"! There are four tips to help new parents get started with tummy time!  Here is a sneak peak...

“Back to sleep, tummy to play” was coined as a response to encouraging parents to lay their babies to sleep on their back to help reduce the risk of SIDS- Sudden Infant Death Syndrome or "cot death".

Tummy time encourages a baby with the development of head, neck and upper body muscles.  This development is so important as baby learns to roll over, sit up, crawl, stand and walk.  All these activities need baby to have the strength to support themselves against gravity and develop postural tone.  Tummy time helps them to understand how to weight-shift and over time use both arms at the same time (bilateral coordination).  Weight bearing on baby’s arms and hands is an important benefit of tummy time and crawling that can be sometimes overlooked.  Tummy time also helps to prevent the development of flat areas on the back of their head.

Please head over to Teacher Types to read these tips as I encourage you to consider the time baby spends on their tummy as enjoyable and an opportunity for parent and child interaction. Read it in full here!

Looking for more information about "tummy time"?

• "Begin With a Blanket: Creative Play for infants" is a great resource written by Rachel Coley from Can Do Kiddo.  This book contains 45 super-creative, simple ways to play with your baby from a pediatric Occupational Therapist and mommy. Read more here!

     Have you read these articles from the YKOT archives?

• Terrific Tummy Time Positions
• Homemade Roller for babies
• Ask an OT: Does Crawling matter? Is it OK if my child skips crawling?

What tips do you give new parents about tummy time?
​

Cindy is a registered Occupational Therapist practising in Sydney Australia.  She has two young children who are a constant source of inspiration and learning.  Cindy loves working creatively to help children to reach their potential, finding opportunities in everyday living and making learning fun. Cindy is the author of the Occupational Therapy blog Your Kids OT.

The information on this site is general in nature. The activities are safe for most children, however, you should consult an Occupational Therapist or health professional to address specific movement, sensory or other medical conditions.