What Does a Paediatric Occupational Therapist Do (and Which One is Right For You)?

So you have been told that your child needs OT. What does this mean?

If you have a child with a disability, delay, or developmental concern, you have probably have heard the words “your child needs OT”. Depending on your previous experiences, you may or may not know what OT even is. Perhaps you’ve heard of someone who has had a fall being supported by an occupational therapist. Maybe a family member needed OT support to return to work after an accident, or perhaps an elderly family member gets OT support through an aged care facility. Occupational therapists (or OTs for short) work in a huge array of settings, and support individuals to engage in a large range of occupations.

You may be feeling some confusion over why a child would need an occupational therapist, as occupations commonly refer to our primary job or societal role (eg student, parent, caregiver etc). In OT speak however, occupations are the things we do throughout our days and lives. They may be things we want to do, things we need to do, or things we are expected to do. From getting out of bed, to going to sleep, our days are filled with a variety of occupations we find purpose and meaning in.

Our children are no different. Their primary occupation is to play, as this is where they learn and develop a multitude of skills required for personal and social development and engagement. They may also engage in non-play based occupations such as eating, sleeping, toileting, dressing, reading, writing etc.

An occupational therapist is a skilled practitioner whose goal is to support occupational participation and engagement. If your child has difficulty engaging in or performing occupations appropriate (or expected) for their age, they may have been referred to an occupational therapist for support. 
Here’s where it gets even trickier though, as occupational therapists may use different approaches or settings in order to support a child’s development. It’s important you find a therapist who will work closely with your child and their social supports (ie parent, caregivers, teachers) in order to reach their goals.

At Rocket OT, we use a collaborative, coaching and strengths based approach, delivered within a child’s natural environments. Below, I’ve listed the reasons for this (in comparison to other approaches), which may help you to decide on what to look for in your occupational therapist. The approach used at Rocket OT has been thoroughly vetted and is supported by research. For a comprehensive review of effective paediatric occupational therapy approaches, please see the following systematic review: https://onlinelibrary.wiley.com/doi/full/10.1111/1440-1630.12573

Collaboration rather than “expert approach”: 

  • Working with key stakeholders in a child’s life (including the child themselves) to ensure therapy support is individualised and tailored to the child and family needs. Recognising that a child and their family know themselves best and are experts by experience. Therapists work respectfully alongside child and family, rather than seeing themselves as the expert who holds all the answers and knowledge.
  • This approach respects every individual involved within the therapy process, and helps make supports that can be applied outside of structured therapy times.

Coaching rather than direct therapy provider: 

  • Focus is on up-skilling and building capacity of family members and caregivers to promote learning and development. Key figures in a child’s life are given the knowledge, practice and skills to support a child to learn and master new skills and developmental milestones, even when the therapist is not present. While direct therapy provides opportunity for a child to develop only while the therapist is there, coaching allows therapy to be provided throughout a child’s day as it is embedded in everything a child does. A key adult figure is always present and actively involved in therapy (no dropping off or sitting on your phone!).
  • Parent involvement has been shown to be equally effective than direct therapy services alone.

Strengths based rather than deficit focused: 

  • Focuses on and acknowledges the unique strengths of an individual and their supporters. Aims to enhance and further occupational performance and engagement, instead of treating underlying “deficits”. Acknowledges and supports differences without always trying to change or fix them. Recognises and actively engages with the supports that already exist within a child’s environment (such as their parents or teachers). Matches what the child can already do with an appropriate occupation, and supports development through doing (rather than through remediation and treatment).
  • A strengths based approach supports individuals and families to recognise what they can do, what they are doing, and helps foster independence, well-being and resilience.

Natural environments rather than clinic based or withdrawal:

  • Therapist sees and supports an individual within the environments they usually spend time in (eg home, childcare, school). This allows the therapist to see supports and challenges that occur within these environments, allowing them to make necessary changes to best support development between therapy sessions. Therapist uses toys and objects that are available to the child outside of their visit, allowing caregivers the opportunity to use strategies taught within session. Child is given many opportunities to practice skills, rather than relying on therapist run sessions as their only place for skill development. Therapist gives parents and caregivers strategies that are applicable and practical for their environment.
  • Seeing a child within their natural environment means that the therapist sees the whole picture, and recognises the importance of a child’s social supports (parents, teachers, family) in therapeutic success.

For more information on how to access services at Rocket OT, please click here.

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