Tuesday, March 26, 2013

Returning to the Roots of OT

Deanna Macioce, MS, OTR/L

The history of treatment in the profession of occupational therapy found itself rooted in the use of crafts.   Therapists used a variety of crafts to help improve the fine motor, visual motor, coordination, and mental capabilities, as well as others of individuals.  They were a way to assist in improving an individual’s ability to perform their “daily occupations”.  However, due to the demands of insurance companies and the increased focus of “functional activities” you no longer see crafts being using in traditional therapy settings such as hospitals, clinics, and nursing homes.  Crafts were an ideal way to perform task analysis and devise a treatment activity that would address an individual’s need based on a variety of problem areas rather than just one specific activity. 

In the area of pediatrics, occupational therapists focus on the “functional” activities of children.  This includes, play, self-care, behavioral, and educational concerns.  Therefore, it can be easier to justify the use of crafts.

Just as in the ‘old’ days, crafts can cover a wide range of skills and can be adapted to address the various needs of children, while still focusing on their functional activities. The same craft can typically be graded, even if only in positioning and set up, to address most children on a therapist’s caseload.  From sensory needs, fine motor and visual motor skills to bilateral coordination, sequencing, and attention skills, crafts can do it all.

 Tactile sensory skills can be addressed with finger painting, doing hand and foot print crafts, and using glue, as well as using stickers, foam pieces or sequence. 

Both fine motor and dexterity skills can be address by gluing small objects such as marshmallows, dried pasta or pieces to complete a paper lion.  Increase the challenge by having the child use tongs to obtain the objects if grip and strength are part of the treatment plan.  Ripping small squares off a strip of paper to glue onto a template such as a heart, balloon or pumpkin helps to improve the use of the pincer grasp while encouraging bilateral hand skills needed for higher functioning activities.   In addition, the use of crayons, markers, and paint brushes for drawing and coloring help improve hand-eye coordination and visual motor skills, as wells grasp and hand endurance.

Scissor skills can be addressed initially to make snips for grass, a lion’s mane, or the petals on a flower.  Then moving to lines, shapes, and templates.  In addition, changing the type of paper used, such as construction paper versus card stock.

Attention, sequencing, and modeling skills can be addressed through the presentation of the craft and how the directions are delivered.  For some, you may provide just the model and the pieces, and have them form it, while others you may have directions just written out.  Doing the necessary sensory preparation for regulation and organization makes these activities even more fully encompassing of a treatment plan.

So, as we move into to April celebrating Occupational Therapy Month, it is a great time to go back to our roots encouraging the use of crafts in our treatments.  Not to mention it is fun, creative and they make great keepsakes.