Exploring the Process of Occupational Therapy
In our previous articles we had the privilege of meeting occupational therapists who shared their stories with us. Today, Robyn Meissner explains the process of patients requiring OT sessions and what these sessions entail.
Referrals come mainly from doctors and nurses in the clinics we currently work in (or their referring hospitals).Children are referred to us when a they are behind on or have missed developmental milestones in any developmental area, if their caregivers and teachers are worried about problems regarding writing and learning or if they have congenital or neurological disorders already diagnosed. We can see anything from sitting and walking delays, to behaviour problems, to writing backwards/upside down, to not holding their pencil correctly.
We always start with an assessment so we can try identify where the difficulties and problems are and so that we have a baseline of their abilities to use - we can use this at a later stage to compare and recognise improvements.
Therapy involves using play to practice/exercise/teach and improve their difficulties or delays. We try to involve the caregivers as much as possible within the therapy sessions and provide them with ideas and support on how to help their children at home as they are not always able to come to the clinic frequently in between their doctors’ appointments. These therapy sessions all take place at the clinic where the child is seeing their doctor, on the same day as their doctor and medication appointments. Children and caregivers will continue to see us for appointments until their difficulties are resolved and they are confident in their abilities.
Seeking early intervention (as soon as they start experiencing difficulties) is always best for the child! If there is a delay referring to therapy the difficulties are often more difficult to help resolve and could cause other problems.
One case that comes to mind:
I was referred a little girl at one of the clinics, who was 2yrs8mo old. She was born 1 month premature, weighing 1.62kg and tested positive for HIV after birth. Unfortunately, her family did not attend follow-up appointments and defaulted her medication, they were in struggling with a very poor socioeconomic situation at home. She now had pulmonary TB and malnutrition. My initial assessment placed her at a 1-year old level – she was not walking or talking yet, a delay of about 18months across all developmental areas. She was also extremely traumatised and would cry through her entire clinic visit, she would not let me come near her, even to give her a toy.
I was able to show her parents how to stimulate her development without having to buy toys. We worked slowly for her to gain my trust and eventually she stopped crying and started to play more in therapy sessions, all the while her parents were playing with her at home based on the guidance given. She started walking 4 months after I first saw them. She also started speech therapy which has helped her communication to catch up. She is now 5yrs old, I still see her for monthly sessions - she has continued to improve. Unfortunately, we think she will always be behind her age group in some developmental areas and she is being seen by specialists to help provide appropriate support. Her parents understand her health condition better and are committed to care for her.
This story highlights a couple things:
- the significant importance of home stimulation in a child’s development and the difference it makes when the caregivers are encouraged and recognise their responsibilities,
- this is also a great example of the multi-disciplinary team at work to provide holistic care to save and improve a child’s (and their family’s) life – without the counselling from HOPE’s community workers, doctor’s care, nutritional advice and support from the dietician and occupational and speech therapist intervention, she would not be where she is today.