Viewing therapy through an occupational therapist’s lens
Peer into Holland Bloorview’s occupational therapists’ storage spaces and you might be surprised to find closets full of fun. While the floor to ceiling toy-filled spaces may look like a child’s dream come true, these rooms and activities are more than just fun and games.
Instead, they're filled with tools occupational therapists use to help enable children and youth to engage in their “occupations” or the activities they want, need, and love to do.
Occupations can range from activities involving self-care, participation in work or school, or activities for fun and restoration. And occupational therapists help by enabling participation, suggesting modifications or changing the environment.
“If I was an occupational therapist looking at a toy drum, for example, I see it as a way to help a baby play, explore, have fun and interact with their mum and dad,” says Laura Thompson, a Team Lead for the Transition Strategy and occupational therapist with the Child Development Program.
“Those are things that naturally happen with any baby, but they just might need a little more facilitation.”
Similarly, for Rashan Edwards, an occupational therapist working on the Specialized Orthopedic and Developmental Rehabilitation unit, building blocks, crayons, bouncy balls, board games, or dolls, are integral components to helping each child reach their individual goals—whether it’s to assist with school-related activities, improving mobility, managing sensory overload, or strength training.
“Our clients have been through a lot and hospitals aren’t normally fun places,” says Edwards.
“A lot of our in-patients are here for months at a time, and sometimes being in therapy everyday will make them feel really tired, burnt out, bored and just not want to be here. So we try to make it as fun as possible."
What you see: A makeshift beans and knick-knacks “sandbox”
What OTs see: A method to help clients with sensory processing difficulties.
“Some of our clients are hypersensitive, so they don’t like getting their hands wet or they can’t touch anything slimy, so we work on building up their tolerance level,” says Edwards.
“And one of the ways we do that is exposing them to different sensations.”
For clients just starting out, Edwards tasks them with identifying objects using a shovel or an ice cream scoop. Then depending on the client’s comfort level, she’ll slowly have them identify objects with one finger, pick up the object with their fingers, and hopefully, eventually, submerge their full hand.
What you see: Silly putty
What OTs see: Theraputty: to improve grip strength, finger strength and fine motor skills to help increase participation in daily activities.
With Theraputty, clients are able to practice finger-specific strengthening, like a pinch. Sometimes Edwards will hide objects in the putty for clients to try to find.
“Clients love it because it’s slimy, but there are also different colours and they are different resistances: blue is more firm, but yellow is softer.” says Edwards. This increased muscle strength may have the potential to translate into other daily tasks like, for example, kneading dough to make a pizza!
What you see: A felt frog friend
What OTs see: A way to help clients work towards dressing themselves.
“We help clients learn how to put their clothes on, like zipping up their jacket to go out for recess,” says Thompson.
What you see: Squigz
What OTs see: A way to entice kids to explore their environment and play.
Occupational therapists are key in enabling child participation in play activities.
Squigz stick to the walls and make a fun “pop” sound when being pulled from the walls. Thanks to their bright colours and interactive sounds, they’re a favourite amongst the younger clients.
“Babies explore their environments a lot. So toys like this encourage them to play and reach with their hands,” says Thompson. “Play is essential. It helps young children learn so much about themselves and the world.”
What you see: A kiddie pool
What OTs see: A way to help kids with sensory overload, get accustomed to water for increased ease of bath time.
“Perhaps you’re working with a child with autism and, for them, touching water is sensory overload, but the parents want them to feel better during bath time. How do we accomplish that?” asks Thompson. Her solution: an inflatable kiddie pool.
“We splash around in the pool, we play, and we try to work on that association of water to something more fun. And maybe six weeks later bath time isn’t a scary experience anymore.”
What you see: A swing
What OTs see: A sensory swing and method of helping clients develop core strength and practice reaching and grabbing.
“We use it a lot to work on a lot of different things,” says Edwards.
“Sometimes it is used from a sensory perspective where we are trying to help regulate children by either calming or exciting them through vestibular input. Or it can also be used for upper extremity and core strengthening, where we get them to swing by themselves. You can also have clients lie on it on their stomachs with their feet up, and ask them reach for things on the mat below them.”
Edwards adds that activities like this help clients pursue day-to-day activities at their own homes, whether that means helping them jump on a trampoline or with transitioning into schoolwork.
"As I mentioned, from a sensory perspective we use it to help excite a child and make them feel more energetic. This is information we can then pass along to their parents or their teachers. Maybe then their teachers will suggest the child do ten jumping jacks before they have to sit down and do a worksheet."
What you see: Scissors and crayons
What OTs see: A way to enable engagement in school.
Occupational therapy plays a key role in helping kids gain the skills they need for school, like learning to write.
“[These techniques we practice] could help them do their homework or write a birthday card to their friend, or learn how to have strength in their hands to squeeze glue out of the bottle,” says Thompson.
For some clients adaptations, such as springy scissors or assistive technology, can help enable participation in school-type activities.
And while Holland Bloorview also has therapy rooms with weights and sporting equipment, the large storage rooms of toys open up the hospital's 44 occupational therapists, 8 occupational therapist assistants, and clients to endless possibilities for lessons and games—but all with child and youth rehabilitation in mind.