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What is Occupational Therapy?

Occupational Therapy is a profession which focuses on helping individuals participate in meaningful occupations with maximum independence. Occupational Therapy in the area of Pediatrics, views an occupation as an activity that a child participates in everyday. This includes activities of daily living, such as getting dressed, eating, bathing, grooming, etc. A child’s occupations also include participating in school and play. The occupations of school and play are central to a child's development and are the focal points of Occupational Therapy interventions. If a child has difficulty in an area of occupation for any reasons, whether physical, mental, emotional, or social, Occupational Therapy is beneficial. Occupational Therapists focus on the process of developing a skill not the outcome. This is important as a child needs adequate processing skills to learn more complex skills later on. Occupational Therapists have a unique way of looking at the whole picture including the child, family, history, teacher, and environments. They are able to see how each of these factors impacts the child's successful performance and identify ways to maximize their development and success. The areas of intervention which this clinic addresses are sensory motor integration, fine and gross motor delays, and handwriting.

How is Sensory Integrative OT Different From Hospital- and School-Based OT?

Sensory Integrative OTs are certified therapists that see children holistically. The main goal of sensory integration therapy is to integrate a child's sensory and motor systems to promote participation in daily occupations (such as play, self-care activities, and education). We utilize various models such as motor learning, developmental, and biomechanical. Hospital-based OT focuses heavily on the medical model, which involves rehabilitation services for children who are in acute conditions. School-based therapists focus primarily on a child's independent performance in the school environment. Their scope of practice involves navigating the school environment, handwriting, and proper form when holding writing tools. These settings differ from Ridgewood Pediatrics because we are more concerned with sensory integration, motor learning, and neurodevelopmental treatment models. Our goal is to provide the best form of care for children who have trouble integrating their sensory and motor systems so that they can perform efficiently in various environments.

What is Sensory Integration?

Sensory integration involves registering and processing information received from the senses, in order to effectively interact with the environment. Sensory information is received from the basic sensory systems including vision, auditory, gustatory (taste), and olfactory (smell), as well as body centered senses which include tactile, vestibular, and proprioceptive systems. The tactile system registers information regarding the various sensations of touch for discrimination, protective, and emotional purposes (bonding, nourishment). The proprioceptive system receives information from the joints to tell one where his or her body is in space allowing for adequate body awareness. The vestibular system tells us the direction and speed in which we are moving. It is essential for balance and equilibrium, as well as body awareness. These body centered senses allow for internal awareness and control of one’s body in order to successfully interact with other people and the environment.


What is Sensory Integration Theory?

Ridgewood Pediatric Therapy Associates provides children with sensory integration therapy through the use of various modalities to increase a child's ability to process and integrate sensory information in order to successfully interact with their environment. It is a technique whereby occupational therapists use play and meaningful activities to enhance a child's sensory intake in order to lead to a more adaptive functioning within activities of daily living. Some modalities that are used include the following:


Brain Gym: Brain Gym is a program which utilizes full body movements to stimulate brain function. Brain function requires effective communication among various pathways throughout the brain. Brain gym movements are designed to stimulate the flow between these pathways, allowing for optimal function.


Bal-A-Vis-X: Bal-A-Vis-X is a program including balance, auditory, and vision exercises that are used to challenge the brain and integrate the brain and body. The program includes around 300 exercises involving beanbags and racquetballs. The exercises require children to perform thousands of mid-line crossings in various dimensions while using a steady rhythm. 


Therapeutic Listening: Therapeutic listening is a program which uses sound stimulation in combination with sensory integrative treatment techniques, emphasizing vestibular stimulation and postural movement strategies. It is beneficial for children who have difficulties with movement, auditory processing, perception, language, and learning difficulties.


Handwriting: Handwriting is a treatment focus within this center as well. However, as Occupational Therapists we look for all of the factors leading to poor handwriting. These factors may include visual perceptual/motor difficulties, poor posture, sensory issues, inconsistent hand dominance and decreased prehension skills. Each factor is worked on separately from handwriting itself. This clinic utilizes the Handwriting Without Tears Program which incorporates print and cursive handwriting.


Social Motor Groups: Social motor groups are specifically designed to enhance social interaction skills, motor skills, and sensory processing. The group setting encourages the development of various social skills such as appropriate eye contact, initiating and sustaining conversations, taking turns sharing and working towards a common goal, role playing, and ADL skills (self feeding, food prep, cleaning up). The group also incorporates various gross motor activities and games to promote development. A sensory component is also utilized involving various touching, tasting, and sound activities.


Visual/Motor Perceptual: Various modalities are utilized to help children develop and utilize visual motor and visual perceptual skills successfully while performing functional activities. 


Reflexes: This clinic also addresses reflex integration. Normal development includes the presence and maturation of various reflexes. In some cases, children show signs of immature reflexes which may impair their functional independence. Various methods including rocking and crawling techniques to improve STNR are utilized to integrate these reflexes into mature movement patterns.


What are signs my child is having difficulty with sensory integration?

Ineffective sensory integration may lead to a variety of problems ranging from mild to severe. Some of the common issues include:


Sensory Modulation: Children who have sensory modulation disorder experience difficulties regulating the nature and intensity of their responses to sensory stimuli. A child with such difficulties may display a negative response to a sensory stimulus that is not typically averse to other children. Further, the child may display over-responsiveness or under-responsiveness to stimuli such as touch, pain, tastes, smells, sights, sounds, and movements.

Sensory Motor Based: Children with sensory motor based difficulties demonstrate challenges with navigating their environments. Specifically, a child may demonstrate awkward movements, decreased motor coordination, and poor timing, organization, planning, and sequencing of his or her movements. Children with sensory motor based difficulties may also demonstrate poor postural control which can negatively impact their balance and ability to successfully use their muscles and bodies.


Sensory Discrimination/ Defensiveness: Sensory defensiveness is an oversensitivity to one or more sensory stimuli. The level of defensiveness can range from mild to severe. Children with mild sensory defensiveness may have adverse reactions and avoid certain experiences such as wearing tags in clothing, having their hair brushed, going in a store, etc. Many parents think their child is just picky or oversensitive. The situation becomes more severe when the defensiveness begins to disrupt the child's life as they become controlling, compulsive, or disorganized.

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