Fort Myers occupational therapy
By Rachel Revehl, FOCUS Therapy Parent
Earlier this year, prior to the pandemic, one of our son’s speech therapists from FOCUS approached me with what seemed at the time an absurd idea: Would we consider allowing him to do some of his speech therapy sessions via teletherapy? He’d be a great candidate, she said. She also thought it might help us with our busy schedule.
That last part was tempting, but…
“Um, thanks,” I replied. “But, I just don’t think that would work for him.”
Seriously, how could it? He would NEVER sit for a full session without a therapist physically in front of him, I thought.
Our Therapy Journey
Our son was diagnosed with autism spectrum disorder and ADHD at 18-months-old, beginning our journey of intensive therapy schedules, specialist appointments, IEPs and support groups. It was an overwhelming time simply because of what we didn’t know: Whether he would ever speak, have meaningful relationships or achieve the same things as other kids.
I’m a bit sheepish to admit now, but when we first started therapy, I didn’t realize parents weren’t encouraged to sit in on every therapy session. At the time, though, no one said anything. So I sat in the corner of the room, quietly watching, observing like a fly on the wall, careful not to interject. And I learned SO much about the techniques and strategies the therapists were employing to help my son talk and tackle the functions of daily life. As I absorbed all this information, I began to grow more confident in his abilities. My own too. For all the difficulties and hurdles we faced, we were also discovering all the AMAZING ways his mind works. He could do this. WE could do this.
Later, I stopped going into his sessions, but still watched as day after day, week after week, month after month and year after year – slowly (and sometimes in fits and starts), he began catching up to his peers. Therapy really does work!
Faithfully after each session, FOCUS therapists would fill me in on all the details of what they worked on, challenges they faced and ways we could practice greater consistency and carryover at home and in school. Still, I did find that I sometimes missed seeing some of the progress in action.
Then came the pandemic. School closures. Day care closures. Therapy center closures. Suddenly, the only way he was going to continue to get therapy services for a time was through teletherapy.
“Well, here goes nothing,” I thought.
Luckily, FOCUS already had a teletherapy department up and running. In fact, it had been featured in Florida Weekly just weeks before the clinic was forced to temporarily close. I considered us fortunate that we had this stop-gap, an imperfect, temporary solution to an all-around bad situation. And for some parents, it turned out to be exactly that. But for us, it turned out to be a wonderful, eye-opening learning experience.
Why Occupational, Speech Teletherapy Works for Us
Initially, I was not convinced it would go well. But to my surprise, for the most part: He loved it. Not every time, of course. I certainly can’t pretend it’s been without its challenges. But truth be told: In-person therapy has its challenges too. Some days are good, and others… well, you know.
But teletherapy gave me an opportunity to gain deeper insight into WHY some days were better than others – and how we could be active participants in improving it.
I first began studying the practice of teletherapy in general. I found ample and growing research that for many kids, teletherapy can be just as effective as in-person therapy. It depends on the child, the diagnosis, how far along they are in their treatment, etc. It’s not for everyone. But for some kids, it’s every bit as good as seeing a therapist face-to-face. It does sometimes require a little more parent involvement during sessions, but if we’re being honest: It’s not like in-person therapy works well either if parents expect the therapists and kids to do all the work.
Worth noting: Teletherapy is very different than sticking him in front of a video game or a movie (something about which I was worried). The whole session is interactive. The point is to get him engaged and talking. There are clear expectations. The therapists set up visual schedules and rewards systems. He enjoys choosing his “stickers,” picking out fun backgrounds for the therapists or checking off his achievement boxes one-by-one. In sitting nearby, clacking away on my own computer, I realized I once again had the chance to passively observe, to soak in the techniques his therapists were using – why they were using them, what worked and what didn’t.
Sometimes, I’m simply within earshot while his therapist handles the whole session, start-to-finish. Even just hearing in the background the terminology they use, seeing the way he responds, observing the importance of his visual schedules and rewards – all of that naturally finds its way more into our day-to-day vocabulary and interactions with him, resulting in better carryover of the skills they’re trying to teach him.
Other times, I need to jump in to give some physical redirection or hand-over-hand assistance. But I’ve found that these moments have meant valuable, hands-on learning for me as much as my son. The therapist guides us through the challenges in real time, and those lessons are more prone to stick.
I also began to better understand the importance of something his occupational therapists had been gently pressing me on for months prior to our switch to teletherapy: A more consistent sensory diet. They had asked a few times (ok, more than a few) if I might consider stopping at the playground with him before in-person sessions to allow him to burn off some energy so he could better focus during therapy. Time-wise, it didn’t seem realistic. But as I watched during teletherapy – I witnessed the HUGE difference it made when he spent just 10 to 15 minutes prior to a session playing guided “heavy-work” games like bear crawl races or jumping jacks contests. It wasn’t that I didn’t believe what his therapists were telling me before. I just always felt so pressed for time, and I didn’t appreciate the significance of the cost-benefit. Actually seeing it – doing those exercises with him during a session, realizing how simple it could be and what a difference it made – compelled me to make it much more of a priority.
Now, it’s something we make a point to do not just before therapy, but any brain-intensive activity. What’s more, we actually have a bit more time to devote to this because teletherapy allowed us to eliminate the back-and-forth trips to the clinic every other day. As my husband and I are both small business owners, that aspect alone has granted us a lot of relief, especially during such a stressful economic time.
To be fair: I fully recognize our positive experience isn’t shared by everyone. For some kids and families, in-person therapy services are critical. Many were desperate for them to return, and for their sake, I’m grateful that they have. I do look forward someday to our son returning to the clinic, at least part-time (if nothing else for all the great hugs I know he’s missing out on!). But for now, as our family continues to social distance and we embark on at least another year of virtual learning, FOCUS teletherapy has proven a vital lifeline for our son and our family. I expect to continue at least some of his services via teletherapy, even after the threat of the pandemic has fully passed. I can confidently say: I’m no longer a teletherapy skeptic.
FOCUS Therapy is an excellent teletherapy source if you live in Florida and are interested in giving it a try.
FOCUS Therapy offers speech, ABA, physical and occupational therapy for children in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online for more information.
More Blog Entries:
FOCUS Now Offers Online Speech Therapy for Kids in Fort Myers, Feb. 18, 2020, FOCUS Teletherapy Blog
Many of the children we treat at FOCUS have some sensory processing issues. These are difficulties organizing and responding to information that is “read” through the senses. Some kids are undersensitive (sensory seeking), some are oversensitive (sensory avoiding) – and some are both, depending on the sense and stimuli. When a child has trouble managing sensory input, it can have a significant impact on learning and everyday life. One of the things our Fort Myers occupational therapists frequently recommend to help children with sensory processing issues is called “heavy work.”
Heavy work is a strategy we use in therapy and recommend to parents to target a sense called proprioception, with the ultimate aim of:
- Improving attention and focus.
- Decreasing defensiveness.
- Helping to calm/regulate.
Heavy work can actually benefit all children, not just those with sensory processing difficulty. Our occupational therapists have found it especially helpful to have kids do heavy work just before or at the very beginning of our sessions.
There are many established benefits to giving children regular household chores. From an occupational therapy perspective, this holds especially true for children with special needs.
Some of the known upsides include:
- Establishing routine. Having chores on a set schedule can help reduce anxiety, improve focus and even avoid meltdowns. Many kids on the autism spectrum, for example, feel more secure when they know what to expect next. Chores assigned at the same time each day or day of the week or after certain activities can make for smoother transitions. Visual schedules can help with this too.
- Teaching valuable life skills. This includes learning the task itself but also responsibility. Children with developmental delays and other conditions may need more practice with certain things and sometimes modifications are necessary, but never assume they can’t just because of their diagnosis. Talk to your occupational therapist if you have questions.
- Contributing to the family. No matter what a child’s abilities, there are always ways to help out. It also gives children confidence and a sense of accomplishment.
- Development of fine and gross motor skills and sensory integration. Chores require use of either big muscle groups (gross motor skills) or careful hand-eye coordination and finger manipulation (fine motor skills). These are things our Fort Myers occupational therapy team is probably working on with your child. Chores are a good way to practice and reinforce those skills.
Happy New Year from all of us at FOCUS Therapy!
To ensure this year goes as smoothly as possible, we’re publishing the 2020 FOCUS Therapy Scheduled Office Closures list in advance.
Typically, our Fort Myers therapy clinic’s schedule mirrors that of the Lee County School District. In other words: If the schools are open, we’re open. If schools are closed, we’re closed. Keep this in mind anytime there are severe weather closures, etc. (particularly during hurricane season!). Obviously, this doesn’t apply to the summer schedule, but where there are deviations, your child’s therapists should alert you in advance. Please don’t hesitate to ask if you have any questions!
Scheduled 2020 FOCUS Therapy Office Closures
- 4/10/20 – Good Friday
- 5/25/20 – Memorial Day
- 9/7/20 – Labor Day
- 11/26-11/27 – Thanksgiving and the Friday after
- 12/21/20-12/25/20 – Christmas Week
- 1/1/21 – New Year’s Day
(Note: We will be open during spring break, March 16-20th and Friday, July 3, 2020.)
The FOCUS Fort Myers occupational therapists have years of education and experience in developing goals and a plan-of-care for our pediatric patients, with the goal of promoting the highest level of functioning in everyday life. But as parents, you don’t need a degree to carry these lessons over with at-home occupational therapy exercises. There are many ways you can help strengthen your child’s skills and development with occupational therapy exercises – most with items you probably have around the house, if you need anything at all. The idea is not just to improve your child’s development of independence and life skills, but to have fun and spend quality time doing it.
Some of the strengths and skills you can target with occupational therapy exercises at home include:
- Body awareness
- Visual perception skills
- Language skills
- Muscle strength
- Direction following
- Texture exploration
- Emotional regulation
Because every child is different, it’s important to discuss your plan for at-home occupational therapy exercises with your child’s FOCUS occupational therapist, to ensure safety and the best results.
Many times, when a child is first diagnosed with autism and referred to occupational therapy in Fort Myers, their first question is, “What the heck is that?” It’s a reasonable one. Most people hear “occupation” and think, “job.” What gets overlooked is the fact that children do have a job: Learning how to take care of themselves and function in society.
Part of that is learning to speak and walk, but it’s also learning how to draw and write, how to eat healthy, how to understand and follow directions, how to exercise proper hygiene and use the toilet, how to look people in the eye when we’re interacting and how to cope with transitioning from one thing to the next.
For a typically-developing child, these lessons will come naturally over time. For a child with autism, intervention is required to help them reach their maximum potential. Occupational therapy is a big part of that puzzle, and at FOCUS Fort Myers, it’s tailored to each child.
Power to the puppets!
For children with a range of difficulties and disabilities, our speech and occupational therapists in Fort Myers have seen striking benefits in working with puppets during our sessions with kids. Puppets, first and foremost, are fun (who doesn’t love Sesame Street?). But they can also help us engage children in ways they might otherwise struggle, namely in peer-to-peer and child-to-adult interactions. They can also help kids better understand certain functional roles and responsibilities in everyday life.
Puppets can be an entertaining yet powerful visual to help us illustrate action-word vocabulary or spatial concepts. As speech and occupational therapists, we can use puppets to help teach the rules of conversation, general social interaction and causal connections. A puppet might “forget” they shouldn’t interrupt or talk so loudly or push to the front of the line. Puppets can be frustrated, sad or angry about something, and it allows the child to explore those complicated feelings and situations without being overwhelmed – because puppets are inherently silly too. They also tend to be more effective than a two-dimensional picture because they rely on visual, audible and tactile senses.
Motor planning is the ability to plan and carry out motor tasks. As our occupational therapists in Fort Myers know, this can be especially difficult for children with cerebral palsy. Early intervention is critical because motor planning is essential for every day functioning. When one has a deficit in motor planning, it’s going to result in motor behavior that is slower, clumsier and inefficient. It can mean physical activities are tougher to learn, retain and generalize. They may end up appearing awkward when trying to carry out a specific task. Occupational therapy helps children with cerebral palsy by working on these skills day-in, day-out, using fun activities to help them master each element of the activity.
A recent longitudinal study published in the Journal of Clinical Neuropsychology explored this connection between motor planning and cerebral palsy. Researchers closely followed 22 children with cerebral palsy alongside 22 other neuro-typical children of the same age. Each child was asked to perform a task that required those involved sacrificing their initial posture comfort to achieve an end-state comfort. Researchers made repeated observations over the course of a year.
What they discovered was that children with cerebral palsy showed poorer end-state planning when achieving critical angles. Further, unlike those children in the “control group,” those with cerebral palsy did not display improved motor planning skills over the course of a year. Researchers recommended more efforts be made to intervene and enhance motor planning skills for children with cerebral palsy.
At FOCUS Therapy in Fort Myers, we can offer help from both occupational therapists and physical therapists, teaming up together simultaneously or working from the same plan of care, to help a child improve their motor planning skills.