Not all pediatric occupational therapy is the same! At our facility, we focus on sensory integration....building connections in the brain to support the development of motor, sensory, emotional, social and play behaviors in the child. Come visit our one of a kind gym and see for yourself!
Many health professions have general practitioners as well as specialists. Occupational therapy does too. An occupational therapist may have been exposed to sensory integration principles while in school or may have taken a continuing education class; however, applying sensory integration principles in occupational therapy practice is a specialty that requires post-graduate education and training. For a pediatric occupational therapist to effectively use a sensory integration (SI) approach to assess or treat a child, she or he requires additional education to understand its theoretical underpinnings and extensive mentorship training to integrate the theory into practice.
Children with deficits in sensory integration and sensory processing require occupational therapy using sensory integration principles to facilitate the formation of efficient neural pathways and thereby support the development of skills (ex. gross motor, fine motor, self-care, play, etc.). Correct use of sensory integration strategies changes the brain and nervous system. Therapy is provided within the context of play, exploration and pure fun! Sensory integration focuses on developing and strengthening the child’s sensory processing foundations in the brain so that skills like cutting, coloring and writing, eating, etc naturally develop and generalize across settings. Social participation, emotional regulation and the development of attention are by-products of this therapy. This is very different from a skill-based approach in which the occupational therapist focuses on specific skills such as cutting, coloring or hand writing practice. Such therapy does not change the brain and does not generalize.
Beyond the therapist's additional training and certification, there are specific "tools" that the therapist needs to practice within an SI framework. The therapist needs an enriched sensory environment which provides for a variety of ways to encourage exploration with each of the senses. A first must have is a plethora of moving equipment, not just one swing, but a variety of swings that allow for movement with the head in a variety of planes, not only upright, but also upside down, side ways, and every other combination. Therefore there should be several places or hooks for suspension of swings. This means that the therapy gym should be very large to accommodate multiple suspension locations/systems. In addition to movement, opportunities for a child to engage in heavy work (proprioceptive) activities, that include pushing, pulling, lifting, carrying, climbing, jumping, building should abound. Let's consider the visual system. Activities that allow for visual perception tasks, including those in two and three dimensional space should abound. Next, a variety of tactile materials should be invitingly and readily available for the child, not only for hands but also for bodies to be buried and nestled in. These could be large bins filled with balls or beans or other media of varying textures. Games and activities that encourage the use of and exploration with the senses of hearing, smell and taste should invite children to engage and explore. The space should feel like the best play yard or a miniature Disneyland for a young child!
With sensory integration, the relationship between the therapist and the child is integral to the therapy outcomes. An occupational therapist trained in the correct use of sensory integration principles should:
- Have appropriate education, training, and credentials (ex. post-graduate training in sensory integration, clinical mentorship from an experienced occupational therapist in a sensory integration setting, SIPT certification)
- Be playful, fun, flexible, and creative
- Be warm, caring, empathetic
- Establish a good, trusting relationship with children and their families
- Guide therapy but not direct or dominate
Occupational therapy clinics which utilize a sensory integration approach have specifically designed the clinic space for practice. The clinic gym should have:
- Large space for fun and play
- Multiple suspension systems for suspending swings and other therapy equipment
- Multiple types of swings which allow varying the position of the child’s head and body (ex. sitting, kneeling, standing, lying on tummy, lying on back)
- A variety of ways to climb
- Ways to build with large and small bolsters and equipment
- Activities and games that encourage pushing, pulling, lifting, and carrying of bolsters, equipment
- Enticing tactile bins (eg. ball bin, beans, rice, macaroni, etc.) for a child to climb into and immerse their bodies in
- Various target based games like throwing and catching, fishing and ring toss
- Spaces for quiet play and calming activities