Occupational therapy: One milestone at a time

Occupational therapy: One milestone at a time

 When a baby is about 3 or 4 months old, she can lie on her stomach and start to push up with her soft little arms—her own infant version of the cobra pose in yoga. It’s difficult; she’s just beginning to develop neck and arm muscles and the coordination to match. Raising up, her eyes become huge; suddenly, she has a whole new view of her world. This developmental stage is motivated by sight. But what about children who can’t see or who have visual deficits—how do they reach the necessary developmental milestones?

Remedying the problem

Occupational Therapy (OT) recently developed a program designed to help children who have low vision or visual deficits. Occupational therapists concentrate on fine motor skills—the motion, strength and coordination of small muscles and joints. As children move from babyhood to childhood, they develop myriad skills to help them navigate the world. For a child who has lost one or more eyes, or who has double vision, calcifications or problems with hand-eye coordination, skills like dressing, eating, playing with toys or writing can seem like mountains to conquer.

“Our interest is in looking at a child’s ability to do day-to-day things,” says Amanda Coffey, Rehabilitation Services. “It is important to identify areas of difficulty for children with visual impairments early on, in order to help them learn ways to compensate and successfully do everyday kid stuff.”

Along with working with the doctors and other staff who care for these patients, occupational therapists partner with the Eye Clinic and hope to bring more adaptive equipment to St. Jude. The therapists also collaborate with the vision services in a patient’s community.

“Treatment of retinoblastoma is not only centered on cancer cure, but also on functional outcome,” says Carlos Rodriguez-Galindo, MD, Oncology. “This concept has driven modern therapy, with more conservative treatments focused on eye salvage and vision preservation. Occupational therapy is an integral part of the global management. Our OTs are extraordinary professionals and are committed to the care of these children. I rely on their opinion, and I know these children’s families are appreciative.”

Starting early

“The key is always to catch problems early,” says Lisa Neumeyer, Rehabilitation Services. Sometimes parents don’t know what they don’t know. Occupational therapists can educate parents to look for particular developmental milestones while empowering them by teaching them specific activities or strategies to help their children move forward.

“I am a teacher, really, and the reason I went into occupational therapy was to help people help themselves. I am not doing for them; I am having them do as much as they possibly can through directions and specific recommendations, to maximize independence of the child as well as the family’s ability to help their child,” Neumeyer says. “Reinforcing small successes, such as placing a block atop another or cutting a straight line, can lead to a child taking healthy risks, which in turn can open up the whole world.”

Reprinted from Corridors magazine, summer 2006.

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