What are occupations?
Many people think the word “occupation” is a work-related term; however, an occupation can be anything someone does to occupy his or her time in every day life. Groups of activities constitute an occupation. For example, work, leisure/play, and self-care are general occupations.
Within each of these are components of one or more activities. Self-care includes many activities of daily living such as brushing your teeth, bathing, eating, and dressing. Leisure/play can involve reading, writing, teaching, or typing. Activities are the building blocks or components of human occupation.
“Occupational therapy is a health profession concerned with improving a person’s occupational performance. In a pediatric setting, the occupational therapist deals with children whose occupations are usually players, preschoolers, or students.”A Parent’s Guide to Understanding Sensory Integration, 1986
“Occupational therapists use a knowledge base of neurology, anatomy, physiology, kinesiology, child development, psychology, psychosocial development, activity analysis, and therapeutic techniques. They are trained to treat clients holistically, addressing their cognitive, emotional, and physical needs through functional, activity-based treatment. When working in pediatrics, occupational therapists select activities that are of interest and have meaning for children, and that also meet therapeutic goals.”The Alert Program for Self Regulation, How Does Your Engine Run?, 1992
Possible reasons for referral to OT
Visual Motor Skills
Difficulty coordinating hand movements/skills using the eyes, copying shapes, connecting dots, drawing through mazes, difficulty cutting on a line, or writing and drawing.
Visual Perceptual Skills
Difficulty labeling letters/numbers/shapes, discriminating differences between forms, difficulty putting puzzles together, difficulty remembering forms, difficulty locating objects in a distracting background, matching similar objects/forms, and trouble copying when writing or drawing.
Sits in a slouched manner at a table or desk, props head up with hand while sitting, fidgets constantly in chair, falls out of chair or falls down while navigating the environment, relies on railing to climb stairs, frequently bumps into people or objects, props self up against people or objects, has poor endurance and poor balance.
Daily Living / Self-help Skills
Difficulty manipulating clothing fasteners, trouble with dressing and undressing, difficulty turning faucet or water fountain on, difficulty washing hands, and difficulty opening food packages or using utensils.
General Gross Motor Skills
Difficulty maintaining balance when standing on one foot, difficulty negotiating playground equipment, unable to hop, jump, skip, gallop, or walk on a line, appears awkward when running, avoids physical education or sports activities.
Difficulties with feeding due to underlying oral motor problems, sensory problems (taste, texture, temperature, consistency), or behavioral challenges.
In-hand Manipulation / Fine Motor Skills
Drops or has poor control of small objects (pegs, beads, coins), difficulty using both hands at the same time or always uses one hand, has hand dominance confusion, difficulty grasping pencil, marker, crayon, hand muscles appear weak and movements seem awkward.
Problems with transitions (stops and starts tasks with an adverse reaction), becomes frustrated or upset easily, has difficulty making friends, has low self-esteem.
Attention / Arousal
Doesn’t respond to his/her name, looks “spaced out”, becomes easily distracted, fidgets often, misses verbal directions or needs directions repeated, impulsive, seems lethargic or over-active and cannot adjust arousal level for a task.
Difficulty with sharing, becomes upset when losing a game, difficulty following rules, tends to play alone rather than with peers, doesn’t understand how to join peers in play or how to initiate play
Sensory Processing and/or Modulation
The child could be under/over-responsive to ordinary sensations from the body or environment (sounds feel too loud or the person cannot tune into what is said, unexpected touch might feel uncomfortable or the person touches everything/everyone constantly) or sensory information is not processing accurately causing poor coordination and/or body in space awareness.