Occupational Therapy in Learning Disabilities Rajani Kelkar Program Ummeed Child Development Center, Mumbai

1. Occupational Therapy in Learning DisabilitiesRajani KelkarProgram Ummeed Child Development Center,Mumbai

2. Occupational Therapy • Is health profession concerned with how people function in their respective life roles and perform everyday activities • In children the life roles & activities include • Academic activities • Functional skills • Socialisation & Play

3. What do Occupational Therapists do? • Child and family centered practice • Comprehensive evaluation • Effective intervention • Through various media & modalities

4. L D - OT Perspective (1) • Group of problems affecting child’s ability to • Master school tasks • Process information • Communicate effectively

5. L D - OT Perspective (2) Often associated with other neurological problems ADHD Auditory processing difficulties Visual Perceptual impairment 5

6. L D - OT Perspective (3) • Learning disorders are caused by a difference in the brain that affects how information is received, processed, or communicated. • Children and adults with learning disabilities have trouble processing sensory information because they see, hear, and understand things differently.  

7. Behaviours Displayed by LD Child • Gross & fine motor dysfunctions • Educational Disorders • Disorders of attention & concentration • Disorders of thinking & memory • Problems with speech & communication • Auditory processing difficulties • Sensory integrative & perceptual disorders • Psychosocial problems

8. Assessment -What and How (1) • Interview • Formal assessment tools- examples • Peabody Developmental Motor scales • Tests of visual motor skills • Tests of visual-perceptual skills (non-motor) • Sensory profile • Handwriting scales • Social skills rating system • Play scales

9. Assessment -What and How (2) Observation and assessment of Behavior Occupational and other life skills Family dynamics and environment Informal assessment through the use of activities 9

10. Brain can change • Premise of OT intervention based on concept of Neuroplasiticy • Natural life long ability to form new connections • Generate new brain cells in response to experience & learning ( Doidge, Norman, 2007)

11. How does understanding brain help with learning disability? Faulty wiring in brain disrupts normal lines of communication and makes it difficult to process information easily. Under right learning conditions, brain has ability to reorganize itself by forming new neural connections. New connections facilitate skills like reading and writing that had been difficult using old connections.  11

12. Fine Motor Activities to Improve School Functions (1) Strengthening Hide & find tiny pegs, beads, marbles in putty Crumble paper to fill a bag Nuts & bolts games Use clothes pins on rope Build with magnets 12

13. Fine Motor Activities to Improve School Functions (2) Manipulation skills Place stickers on paper Use eye dropper to squirt coloured water on paper Place dried peas in small container with tweezers Use small musical keyboard Hold coins & place one at a time in slot 13

14. Preparing Children for Writing (1) Posture Adjust seat & table height, use slant boards Hand dominance E.g. Practice cutting, lacing, stringing beads Use of appropriate force   E.g. Writing on sand paper, hiding small objects in PlayDoh (Jane Case- Smith, 2008) 14

15. Preparing Children for Writing (2) Tripod grasp   E.g. Twisting on/off lids, use pencil grips Letter forms E.g. Use colour code to identify top & bottom of each line, practice dot-to-dot pictures, fill in missing parts of letters. Spacing & alignment E.g. Use popsicle stick between words, self correct, draw letters in small boxes. 15

16. Activities for Visual Motor Integration String macaroni Use toy hammer & nails Draw with templates Use tweezers to pick up small objects Lacing objects Cut shapes Make a necklace 16

17. Sensory Integration Therapy (1) Professional treatment techniques Provides carefully guided sensory stimulation Vestibular Visual Tactile Proprioceptive i.e. through muscles & joints. Purposeful activities requiring adaptive response 17

18. Sensory Integration Therapy (2) Educate teachers, parents, and older children about sensory integration and to develop strategies to adapt to and compensate for dysfunction Environmental modifications Adaptations to daily routines Changes in how people interact with the child (Wilbarger & Wilbarger, 2002) 18

19. Social Skills Training Groups conducted by interdisciplinary team Increase social awareness Encourage peer relationships E.g. asking a friend to play, sportsmanship Improve self regulatory behaviours E.g. anger management Enhance Language expression Role playing Use of “wh” questions to teach conversational skills 19

20. Life Skills Training Functional independence Daily living tasks Play & developing hobbies Prevocational Testing & training in adolescents 20

21. Integration of Interventional Strategies Student’s class room schedule School routines Curriculum At home 21

22. Where is Therapy Provided School as team member In classroom Resource room Private clinics Multidisciplinary centers Child guidance clinics Hospitals 22

23. In Conclusion • Therapy or treatment provided by an occupational therapist • Helps child's developmental & physical skills • Focuses on use of hands and fingers coordination of movement, self-help skills, such as dressing and eating, and sensory and perceptual-motor integration • Includes design and adaptation of materials, equipment, and environment.

24. Thank You