Now, after that whole explanation, I'll risk more confusion by identifying myself as a pediatric occupational therapist. I knew I wanted to be a pediatric OT from the moment I learned about occupational therapy. I was a lost 23-year-old with absolutely no clue about my career path. However, soul-searching didn't quite pay the bills so I reverted to my old standby of nannying. I always liked kids, but I didn't want to be a teacher. I also liked health topics, but I did not have the patience for med school. When I got asked to nanny for a girl with special needs, I agreed with a slight hint of anxiety. As someone who went to private school my entire life, I hadn't even been exposed to kids with special needs. (Yet another reason my kids will attend public school someday.) But, from the moment I met her, I was totally smitten. This little girl was a fighter. In her five years of life, she had already had a multitude of surgeries including the placement of a feeding tube and tracheostomy tube. Her mom was (and still is) one of the greatest moms around. They knew in utero that it was going to be a long road, and she became her daughter's greatest advocate. After I'd been nannying for a few weeks, I asked what had made the greatest difference in helping her develop into "a regular kid". Without missing a beat, she said "occupational therapy." I knew my youngest brother had some OT in grade school when he had trouble writing, but that was the extent of my knowledge. You mean this OT thing does more than teach kids how to hold a pencil? For the next 15 minutes, she explained going to an intensive sensory integration camp down in Florida where they did things like place her daughter on a board, blindfold her, and spin her to the beat of music. Uh... I'm sorry but what kind of voodoo is this? She swore that her daughter had been afraid to walk without assistance and could not read before her time in Florida. Afterwards, she was running and reading like nobody's business.
I've probably already lost some people as I understand this sounds completely nuts. If you've never heard of occupational therapy, you've definitely never heard of sensory integration or sensory processing disorder. This topic area has become my passion, and it's truly why I became an OT. The gist of it is this- every human takes in information from their senses, and it is processed by the brain. The brain interprets the sensation and generates an appropriate motor response. Sounds simple enough, right? Well, a lot can go very, very wrong. Everyone processes sensory experiences differently. For example, I have terrible eye/hand coordination. My eyes and my body just don't work well together, and this caused a lot of anxiety growing up. I really hated gym class, and I also got nervous any time we had to learn new games during Girl Scouts. I usually coped by trying to hide in the corner or pretending I was sick.
Now, imagine if, instead of living in a state of constant anxiety, there was a safe place I could go and practice these skills. That's exactly what a pediatric OT with sensory integration training can do. These OTs are trained to look at how a child processes sensory information, where the dysfunction occurs, and determine activities to help them better navigate their world, despite the challenges. Here's an example of how most people look at a child's behavior vs. how an OT views it-
Most people: Chris is a brat. Everyday at recess, he picks the same game and forces his friends to play it over and over. If they say they don't want to, he starts yelling "You're so mean! You're not my friend!" Then, he'll go sulk in the corner and refuse to do anything. During class time, he's constantly fidgeting in his seat. We tell him he has to sit still, but he just won't. He still can't write within the lines of the paper, and he doesn't know how to use scissors.
An OT: Chris has very poor postural control (core strength) which causes him to constantly wiggle in his seat. This poor postural control also interferes with his motor planning, or his body's ability to plan and execute movement. New activities are very hard for Chris to learn so once he learns a game he wants to stick with it. When his friends suggest a new game, the amount of anxiety is so overwhelming that he will yell and cry. It's not that Chris doesn't want to play- it's that he doesn't know how. All of these issues are affecting his school work as well. The ability to write and cut actually begins with good core strength. A strong core provides the base for shoulder, elbow, wrist, and, finally, finger stability. A child cannot perform small, isolated movements if their base isn't strong.
For the past two years, I worked in a therapeutic day school for kids with autism. There's an even deeper level when working with autism thanks to the delay or absence of language, lack of coping skills, and distractibility. I think autism will always be my favorite population to work with, but I'm excited to start a new job on June 8th working with a variety of diagnoses. The school system has its pluses, but I'm excited for the increased flexibility that working in an outpatient clinic will bring. I can still work with kids on school-based skills, but I can also address things like motor planning challenges, inflexibility, and even motion sickness. If you ever have the chance to see an outpatient OT clinic, do it! It's filled with slides, swings, trampolines, scooters, and a million other things to encourage movement and exploration. If we can't give these kids a safe place to explore, then they'll never have the chance.
So, think back- was there something you dealt with in childhood that really impacted your day-to-day life? I can't promise I can "fix" it at this point, but maybe I can give you a little insight! At the very least, I hope I educated a few more people on the merits of OT.
Oh! And that little girl I talked about earlier in the post? She's doing great, and I'm actually babysitting for her tomorrow! She "graduated" from OT a few years ago, and I love seeing that those foundational skills she received years ago continue to aid in her development.