Does My Child Need Occupational Therapy?

While parents often notice a speech delay or physical impairment early in a child’s development, the need for occupational therapy isn’t always obvious.

To determine whether occupational therapy services are necessary for your child, we offer free screenings. If we believe your child would benefit from therapy, we will schedule a more intensive evaluation, usually with a physician referral. This helps us gather information about your child’s unique challenges and from there, develop individualized goals.

Some areas we might red flag include:

• Developmental delays. When a child isn’t reaching certain developmental milestones such as integrating basic reflexes, crawling, walking or sitting, not learning at a level that is age-appropriate and not developing appropriate play and social skills, that’s a concern.
• Fine motor skills. We see this in areas where a child might have difficulty manipulating puzzles or toys, grasping a pencil, using feeding utensils, developing proper handwriting, using scissors or with clothing fasteners such as shoelaces/ buttons/ zippers.
• Gross motor skills. These would be things like poor balance, difficulty going up and down stairs, seemingly clumsy or uncoordinated, poor ball skills or trouble integrating use of both sides of the body.
• Bilateral integration and crossing midline. A lack of communication from each side of the brain limits the body’s ability to work as a cohesive unit. Difficulty with bringing hands together for a task, limited trunk rotation and lack of or limited reaching across the body are signs of difficulty in this area. This skill is important to establish handedness. If a child does not cross midline with a dominant hand, both hands will develop simultaneously to produce mediocre skills bilaterally, versus strong fine motor skills on the dominant side.
• Visual perceptual processing. These would include things like difficulty making eye contact, visual tracking, discriminating differences between two or more items or shapes, making sense of things that are only partly visible, visual memory and sequential memory in order to memorize a phone number or spell/ read words,  finding an object among other objects, recognizing letters/ numbers, copying letters or shapes or with the concept of left and right.
• Oral motor/ Oral sensory. What we would look for here would be issues like difficulty or inability to use a cup at the age-appropriate time, chewing food at the front rather than with molars, inability or difficulty to control tongue movement or relocate food particles, excessive drooling/ open mouth posture, trouble drinking from a straw or blowing bubbles,  excessive mouthing of toys beyond a time that is age-appropriate and excessively picky eating.
• Sensory processing. Here, we’re looking to see if a child is able to process, organize and appropriately respond to movement, touch, sights and sound as well as understand where their own body is in a space in relation to others, objects, etc. A child may be overly-sensitive or have heightened reactivity to movement, touch or sound. In other cases, they may be under-responsive to certain senses. A child with a sensory processing issue may be easily distracted, crave excessive movement/ pressure, present with low arousal and unable to alert himself, be bothered by certain textures (including clothing, baths, foods, etc.), be unable to calm himself when upset or have trouble coping with change.
• Social interaction. A child who struggles to engage socially with family or peers, adapt to new environments, has delayed language skills, is overly-focused on a single subject or is not doing well coping in school may need help with social interaction skills.
• Learning challenges. A child who is unable to concentrate, requires increased processing time/ repeated directions, has difficulty understanding/ responding to mainstream teaching styles,  has poor impulse control or struggles to follow instructions or keep up at school may have a learning challenge that could require intervention.
• Play skills. A child who struggles to initiate play on his own, wanders without purposeful play, moves quickly from one thing to the next, doesn’t engage with peers or siblings, plays with toys repetitively or in ways not age appropriate may need further assistance.
• Self regulation. A child’s ability to regulate his emotions and impulses is a vital skill needed across all environments. Without self-regulation, learning all other skills becomes harder. A child who demonstrates difficulty coping with disappointment, throws tantrums when told, “No,” has difficulty sharing or taking turns becomes distressed or anxious with change/ transitions, avoids or misses opportunities for self advocacy/ asking for help, etc. would benefit from being taught strategies and practicing those strategies in a safe, consistent place until mastered.

Child development exists on a continuum, but occupational therapy can help those with delays, disorders, injuries or isolated challenges in a number of ways.

Examples of Fort Myers occupational therapy in action:

• Helping a child who uses a wheelchair learn to play with his or her peers.
• Assisting a child with cognitive impairment learn how to use tools like crayons or toys.
• Working with a child with autism to overcome sensory aversions or social difficulties.
• Assisting a child with concentration troubles learn how to succeed in school.
• Helping a child with a traumatic brain injury learn how to once again conquer basic tasks, like teeth-brushing, dressing or writing.
• Assisting a child with low vision to safely navigate his environment and discriminate between various items.
• Helping a child with extreme sensory aversions to grow his variety of nutritional foods while learning to enjoy mealtime.
• Teaching alternative strategies to a child with limited motor control and/or strength of one or more of his extremities in order to open containers, prepare a snack or stabilize a plate while eating.