What is occupational therapy?
An occupational therapist (OT) works with children who have spina bifida and their families to enable children to participate in everyday activities (or occupations). Occupations for children and young people may include:
- Self-care: dressing, showering, using the toilet, brushing teeth
- Being productive: participating in preschool and school activities
- Leisure: engaging in preferred activities, play and socializing with friends
An occupational therapist will assess how your child uses motor and process skills (e.g. attention, planning, organizational skills) to carry out every day occupations. The OT will identify what your child’s strengths and areas of needs are and provide advice on how they can improve their performance in everyday activities. The OT may suggest alternative ways of doing things, providing advice on learning new approaches and techniques, or making changes to the environment, for example, through using equipment or adaptations. OTs will support you and other relevant people such as teachers, to evaluate your child’s challenges and strengths to help them to do those occupations that are important to you and your child.
Occupational therapists achieve outcomes by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement.
(World Federation of Occupational Therapists, 2010)
When do I see the spina bifida occupational therapist?
The OT will see all children with spina bifida when there is an acute need when they are an inpatient in CHI at Temple Street. The occupational therapist will also review your child as an outpatient in the spina bifida clinic if the need arises. Please refer to the role of the occupational therapist is the spina bifida clinic for further details.
Role of the occupational therapist in the spina bifida clinic
The occupational therapist receives a referral for all clients attending the clinic. The occupational therapist commences screening referrals. This begins by contacting the child’s primary occupational therapist or key worker. If the child is not linked in with a community occupational therapist or key worker on a disability team, the occupational therapist will contact the child’s parent and school. Information gathered will include how the child is participating in everyday activities in their home and school environment, and what equipment the child uses e.g. wheelchair, an activity chair, sleep system. If the occupational therapist does not receive contact from the primary occupational therapist or parents prior to clinic, screening will be completed at the clinic with the child and parents.
Based on information gathered at the screening stage the occupational therapist will determine if an occupational therapy assessment is required.
The occupational therapist will complete assessment focusing on occupational therapy concerns identified during the screening process. Occupational therapy concerns include but are not limited to:
- A child with significant difficulties participating in everyday activities in home and school who is not linked in with local services.
- Equipment not meeting child’s postural needs.
- Primary occupational therapist has requested a second opinion.
- Spina bifida team would like an occupational therapist’s opinion to make an informed decision for further interventions.
Depending on the area of concern the occupational therapist will book an assessment appointment on the morning of the clinic or jointly with another member of the team in the clinic e.g. spina bifida nurse, consultant orthopedic surgeon, consultant paediatrician. If a comprehensive occupational therapy assessment is required a child may have to attend an outpatient occupational therapy appointment.
- If immediate follow up is required e.g. high risk of pressure areas, wheelchair not supporting postural needs, the occupational therapist will contact the child’s local occupational therapist via a phone call or email as soon as possible.
- The occupational therapist will liaise with the local OT to provide an update on clinic findings which may impact on a child’s occupational performance in everyday activities.
In April 2019 the occupational therapist will commence data collection to explore children with spina bifida’s functioning and participation in everyday activities. An information leaflet and consent form will be provided to parents when they check in to the clinic. If parents would like additional information on the research the occupational therapist will be present at the clinics. Information will be gathered from parents at the clinic if they consent to participate in the study.