The Sensory Bounce Therapy Blog:
Sensory Processing, Motor and Social Skills Resources
for Parents of Special Needs Children

The Occupational Therapist: Your Very Own Private Detective

A Parent’s Guide to What OT Is and How it Can Help Your Child

Part 2 of 2: The Therapy Process


How does occupational therapy help my child? 
At the conclusion of the evaluation, the therapist made targeted recommendations about therapy and strategies for your child. Now, during the therapy phase, s/he will use clinical reasoning to figure out exactly what works best. Children process information in different ways, so they need to be taught in different ways that suit their individual sensory processing needs. The therapist builds a program customized to enhance your child’s existing skills, while learning new skills and behaviors and how to apply the old and the new skills to additional situations. 

The ultimate goal of occupational therapy is to enable SPD children to accurately perceive, regulate, and interpret sensory input, and to execute appropriate motor and behavioral responses to this input, so they are able to successfully perform everyday activities.
The therapist teaches your child these appropriate responses in an active, meaningful, and fun way so s/he is able to function well. As therapy progresses, your child learns to extend these appropriate responses to situations at home, at school and in the community, becoming able to participate in regular childhood activities, such as playdates with friends, enjoying circle time and learning at school, eating dinner at the family table, getting dressed for the day, and sleeping well. 

What can I do to support the therapy process?
The therapist involves parents, helping you recognize how your child perceives sensation, and how that perception affects your child’s attention, social and emotional abilities, motor skills and learning. Once you understand that, you are able to work with the therapist to develop the best methods for engaging your children in therapeutic activities, social interactions, and daily routines. The OT will help you acquire skills to keep in your backpack of strategies so you can give your child what s/he needs at any particular moment to achieve goals, develop life skills, and function independently.

Occupational therapy utilizes a sensory integration approach
Sensory integration therapy follows your child’s lead. The occupational therapist designs and uses activities that supply sensory input and experiences that gently challenge your child’s ability to respond appropriately. When your child engages in activities that provide the intensity, duration, and quality of sensation his/her particular central nervous system requires, s/he becomes more efficient at organizing and integrating sensory information, and adaptive behaviors follow naturally.
OT with a sensory integration approach often takes place in a sensory-rich environment often called an “OT gym.” This is usually a large therapy room filled with hanging and climbing apparatus such as nets, ropes, swings, slides, climbing structures, and other sensory equipment.
Can a therapist improve my child’s interoceptive skills too?
Yes. An OT trained in sensory processing can indeed improve your child’s ability to perceive and understand his/her body’s internal messages. The therapist develops and implements strategies directed at a child’s particular interoception subtype (is the child hypo-responsive? hyper-responsive?). Therapy focuses on increasing the child’s ability to notice internal signals, to give the correct meaning to these sensations, and to respond appropriately to them. 
Can any age child benefit from therapy?
Yes; occupational therapists work with all age groups with SPD, from infants through adults.
– Infants and toddlers:
Occupational therapists identify sensory and motor difficulties and provide interventions to facilitate effective self-regulation (wake–sleep cycles, alertness level, self-soothing), motor development, and adaptive behavior. 
– School-aged children:
A variety of sensory-based approaches can improve life skills, participation, and behaviors needed at home, school, and the community. In addition, the OT may recommend modifications to the home and/or classroom environments to make it possible for children to participate in daily routines, become independent with self-care skills, progress at school, etc.

– Adolescents and young adults:
Sensory integration problems, such as a fear of movement, sensitivity to touch, poor motor planning, or decreased awareness of body position in space, may interfere with age-appropriate life activities such as learning to drive, making vocational choices, engaging in leisure activities, developing independence, and having romantic relationships. Therapists can provide direct OT interventions and/or accommodations and education to improve daily functioning. 

– Adults:
Many adults have never been diagnosed, so they haven’t had the opportunity to develop coping skills and adaptive performance mechanisms. Often, they have difficulty with interpersonal relationships, vocational skills, leisure activities, and general quality of life. Therapists can work directly with them, as well as recommend accommodations and adaptations to their surrounding environment to minimize distractions from external sensory input and allow them to function better.  

Therapy feels like fun for your child; not like another obstacle to overcome
During OT sessions, the therapist guides your child through enjoyable activities that are subtly structured so the child is constantly challenged, but always successful. The focus is on play to make change happen; play is the vehicle for learning to share, take turns, use language, increase cognitive capacity, etc., all while strengthening physical motor skills and coordination.

The wrap-up
Occupational therapists use your child’s existing strengths and supports in a fun environment to build on what s/he needs to learn to become more independent. They work with parents to build an individualized backpack of personal strategies that help you navigate the most difficult times of the day, and recommend school accommodations to enable your child to succeed there as well. Remember, the sooner your child begins therapy to address his/her sensory issues, the better the outcome. That’s why it’s so important to start the occupational therapy process as soon as you can after becoming aware that a problem exists.

Looking ahead:
Every child is different, thus every child’s set of behavioral responses is different. There is no one single therapeutic approach that will work for every SPD child. In an upcoming post, we will discuss how different strategies will work for different children, and why.

Is your child receiving OT? What strategies are working for you? Please share your thoughts in the comments section below. Also, let me know there or via email what topics you would like to discuss or hear more about. 
Feel free to share or quote from this blog (with attribution, please, and if possible, a link), and to repost on social media.
I look forward to hearing from you!

All the best,

About Miriam:
Miriam Skydell MS, OTR/L is a pediatric OT with 30 years experience and a strong commitment to empowering every child and every family with the skills, confidence and emotional stability necessary for a meaningful, independent life. In addition to her Masters degree from NYU (1986) and membership in the AOTA (American Occupational Therapy Association), Miriam is a licensed Interactive Metronome®,  HWT (Handwriting Without Tears®), and TLP (The Listening Program®) provider.

Miriam performs preschool screenings, contracts experienced OTs, PTs and STs to schools, helped implement the HWT curriculum, and lectures extensively for parent and support groups and at teacher conferences for public and private schools throughout New Jersey. Through her private practice in Fair Lawn, Miriam Skydell and Associates, established in 1995, Miriam has helped countless children with a wide range of diagnoses improve functional living skills, manage the impact of sensory processing dysfunction, and meet their individual potentials.