Occupational therapy is one of those core therapies for children with autism. An at home occupational therapy program can either accentuate what you’re doing at a therapy center or allow you to do one exclusively at home. If you’re doing one at home then it’s probably due to one of three scenarios:
Scenario 1: insurance either won’t pay for more occupational therapy for your child or your child has used up all their sessions for the year.
Scenario 2: it has been deemed that the child has progressed as far as they can for the time and no more therapy is needed.
Scenario 3: You’re just tired of spending yet another hour or more sitting in a therapy office with your child and deem it necessary to take a break.
We’ve had all three scenarios happen to my family at some point. Insurance can sometimes be my nemesis. There are times when we just got burnt out of the tediousness. When that happens, it’s best for us to take a break. Unfortunately, autism doesn’t take a break . Therapy still needs to be done. We just choose to do it at home. Nothing like sitting in our pajamas at home to make the tediousness more appealing.
Therapy counts as a subject in our home school. Which therapy is being done determines what credit is issued. For speech, I give a quarter of a credit for language arts per semester. For OT and PT , I issue PE credits. If I can count dance as a PE credit then I don’t see the problem in issuing one for therapy.
What is postural control?
This is the ability to maintain your trunk position. For us , this means being able to sit at the table to eat dinner but not need to lay his head on the table halfway through. It means being able to sit on the floor without needing a back support to keep him upright. This directly translates to strengthening his core. Core work is crucial here. Logan has severe hypotonia which translates into decreased muscle tone. This is why lots of children with autism look like giant marshmallows.
Exercises to work on postural control:
- planks (front and side)
- tummy time (lay on his stomach to read, watch tv, color, etc.)
- animal walks like crab walks or wheelbarrows
- yoga poses
What is motor planning?
Motor planning are the skills needed to do normal, everyday things like washing your hands, taking a shower, or brushing your teeth. It’s the skill you need to remember the steps to an activity in the order they need to be done. This is why visual schedules with step by step instructions or games that teach hygiene are so important for boys and girls.
What are examples of fine motor skills in occupational therapy?
Fine motor work is needed if we want our kids to write more. If Logan’s hand gets fatigued easily then it is difficult for him to write. That in turns translates into bad episodic memories of writing. Hence, he doesn’t want to do it. No one wants to do something that fatigues them or makes them feel incompetent.
What are fine motor activities?
- make and play with slime
- move items around inside a sensory bag
- squeeze a tennis ball
- open and close clamps or clothespins
- lay on your back and paint on a piece of paper under the table
- paint with a q tip
- use a spray bottle to wet a fabric in the backyard
- pick up items using tweezers or tongs
Web Space Development or Open Thumb Web Space
The web space refers to the circle that forms with the tip of the index finger and and the thumb touching. It is important to maintain this space to hold the pencil or crayon correctly. Thus, you gain greater control which improves your handwriting. There are simple stretches which are easy to do anywhere.
The OT Toolbox has some great web space development activities for all ages.
What are proprioceptive activities?
Proprioceptive activities help a child learn to be aware of his body in space thus coordinating their actions. It provides info to the brain from the muscles, ligaments and joints. This can be core work too. (Have you seen the pattern yet? A strong core equals a strong child.)
These are also called heavy work activities. For heavy work activities , you use the child’s weight against him while doing gross motor activities. Looking for examples?
- Logan will do his outside chore of sweeping the carport while wearing his weighted vest.
- Carrying a bucket of water from the spigot to the flowers.
- Carrying in groceries
- push mowing a portion of the grass when we lived in Florida.
- Rake the rocks back evenly for our yard in Arizona.
- Carry the laundry basket to the washing machine.
- Take out the trash
- A bike ride.
- Horseback riding
- Making whirlpools while in the pool then going against the tide is always a fun game.
Pick something your child can or will do successfully and have him do it regularly. Supervision is as essential here as it is in everything else. The big idea here is to have some sort of weight pushing against your child or something heavy to carry or push. When all else fails, I just have him wear a backpack with books stuffed in it while he walks around.
How can bilateral coordination be improved?
Bilateral coordination is the ability to use both sides of the body at the same time. This is what a child needs in order to walk up and down stairs without putting both feet on the same step. One of the things that stood out to me when Logan was 10 was that he still put both feet on every step.
- play Simon Says, Twister, Jenga
- Bopping a ballon back and forth
- Crossing the midline activities
- Playing catch
- tug of war
- roller skates
Learning to jump rope as well as bike riding are higher level skills you can achieve by working on this ability.
What are the arches of the hand?
The hand has three arches to it. All 3 must work together in order for the hand to work properly. Mobility is also affected by the arches. We use gluten free playdough to roll it into snakes or rolls. Holding a fork when eating or using a shovel to dig is also a great idea either at home or at the beach.
Some of this is development due to age. You can continue to work on it but some things have to wait for growth.
Core work in occupational therapy
There are plenty of ways to work on core strength.
- Pool work
Our pool is also a great place to work on core strength while having fun. Swimming, doing the whirlpool thing, or playing volleyball in the pool are all therapy items. He really likes the pressure of the pool although he hates water in his face. Our rule is no splashing. We can’t work on anything if he won’t get in the blasted pool. No matter who is in the pool, the rule is no splashing. Logan’s needs outweigh the fun of splashing.
These are just a few ways we implemented an at home occupational therapy program. It doesn’t have to be fancy to be effective. It doesn’t need to be costly either. It just needs to be done continuously to get results. Slow and steady is the mantra here. It’s a marathon not a sprint. Ok, enough cheesy sayings. Remember that all your hard work will reap rewards eventually. Stay the course.
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