Your life is made up of occupations and roles; those necessary and meaningful activities you do every day whether you are a toddler, student, parent, worker or senior citizens. Many people think occupational therapists treat workplace injuries and help get people back on the job. Occupational therapy encompasses a wide variety of treatments, including low vision therapy, drive safe assessments for older adults, and addressing bad ergonomics and overuse injuries in the workplace. Some companies even have an OT on staff.
Imagine if an accident, injury, illness, or other condition made it difficult for you to participate in your daily activities:
- A wrist injury makes getting dressed in the morning difficult.
- A back injury reduces mobility to twist, reach or touch your toes.
- Arthritis or loss of vision makes driving chal¬lenging.
- A stroke impairs memory to remember medications.
- Multiple sclerosis hinders the ability to get around the house.
- Autism affects your child’s concentration and social interactions at school.
- A traumatic brain injury interferes with memory and organizational skills.
- Even a small change in your activities or the environment could prevent a future condition, such as using ergo¬nomics at work to avoid carpal tunnel or back pain.
Occupational therapists can widen their focus to groups or community transitions, such as senior driving, veterans, troubled youth, addiction recovery, and the developmentally disabled. OTs do a lot with pediatrics and children with developmental delays or autism. If your child has trouble with daily tasks such as tying shoes, getting dressed, writing, or copying things from the board, OT can help.
April is Occupational Therapy Awareness Month. Meagan Grubbs, OTR/L, occupational therapist, CCCE, works with all ages at Southeastern Physical Therapy and Southeastern Therapy for Kids in Virginia Beach, Virginia. She became interested in being an OT after seeing the benefits for her grandfather while he was in assisted living.
“He had a stroke and was having a hard time, and they were able to facilitate a lot of things for him,” she said. “I would visit and he was able to get a glass and pour me a drink.”
What is Occupational Therapy?
Occupational therapy incorporates your valued occupations and activities of daily living into the rehabilitation process. We generally don’t think about our daily occupations until we have trouble doing them. Everyone has occupations. For children, it’s being able to go to school and participate in play and learning and keep pace with peers. For older adults, occupations are driving, dressing, and managing daily tasks at home. If you are recovering from an accident or injury, your valued occupations, including your job, may be disrupted. That could be learning to reuse your wrist to type or lift 50 pounds.
“The term occupation is just things that people need or want to do to get through their day,” Grubbs said.
Both children and adults can struggle with tasks such as personal hygiene, brushing teeth, getting dressed, and eating. Grubbs works with both children and adults and said the functional deficits are often similar, but the treatment approach is very different.
The plan of care is unique based on each person and goals for independence.
“With the kids, it’s a lot of purposeful play,” Grubbs said. “We have a goal in mind of what we are trying to address, but we present it in a way that is fun and engaging and what makes them motivated.”
When do You Need Occupational Therapy?
Have you or a family member ever been diagnosed with a new health condition and found yourself asking, “now what?” OT can help a child with autism who has developmental delays, an aging parent who wants to remain at home but has difficulty making dinner or taking a shower, or those with depression who struggle to do everyday activities. OT is also recommended after an accident, injury or TBI, or stroke.
“How they get here can look very different, but the deficits are similar,” Grubbs said. “We definitely get people who are hurt on the job for sure. I don’t get that as much as I get neurological conditions.”
In the case of children, they are usually born with a disability or developmental delay. It becomes more obvious as they age and are not meeting developmental milestones as their peers.
Occupational therapy can help you answer that “now what?” question. An occupational therapy practitioner will keep the focus on the things you need and want to do — your goals, your activities, your independence.
“We write goals and set goals,” Grubbs said. “It’s very client-centered and what are they desire to get back to doing. When you really make a plan of care centered around your patient, that is where you are really able to see a lot of growth, a lot of progress; because they have the buy-in, they are motivated.”
With occupational therapy services you can:
- Achieve goals, such as helping your teenager with a developmental disability gain the skills to transition from high school to independent living as an adult.
- Stay as healthy and productive as possible, while managing a chronic medical condition.
- Maintain or rebuild your independence, such as using assistive devices so you can care for yourself after a stroke.
- Participate in the everyday activities important to you, such as driving, visiting friends, going to church, and other activities that keep you involved with your community.
What to Expect During an OT Session?
Occupational therapists are skilled health care professionals who use research and scientific evidence to ensure their interventions are effective. They often simulate real-life situations to help patients strengthen deficit areas and get back to normal functioning.
They conduct an initial assessment to gather information about a patient’s psychological, physical, emotional, and social makeup and daily routines. Occupational therapy practitioners can evaluate how your condition (or risk for one) is affecting your body and mind, using a holistic perspective.
Difference between Occupational Therapy (OT) and Physical Therapy (PT)
While PTs focus on improving strength, flexibility, or range of motion, OTs focus more on tasks, breaking them down and building independence on those tasks. For instance, an OT may help a patient relearn how to reach into a high cabinet to retrieve something to prepare a meal.
“Being able to put your sock on, I do that across generations,” Grubbs said. “People want to be able to dress and feed themselves.”
Something as simple as putting on a sock can be a challenge for patients who have had a stroke or have really bad grasp patterns due to weakness or coordination. Grubbs breaks it down:
- You have to be able to grasp that sock with a functional grasp pattern with both hands;
- You need hand-eye coordination to get your foot in the sock;
- You have to have balance and sitting tolerances and core strength;
- You have to be able to have the dexterity to pull it up all the way on your foot.
Some clinics have kitchen and laundry facilities to help patients relearn their daily living skills. Other times, patients simulate the scenario. Grubbs recently had a patient who was injured in a car accident and has to lift heavy items at his workplace.
“We really broke it down and we built towards him being able to do that,” she said. “It was more of a simulated thing for him, I relied on him to show me.”
Working with children, Grubbs helps them learn to copy things from the board, improve their handwriting, and participate in activities they can do with siblings and their same-age peers.
“If you’re not developmentally with your same-age peers, it really affects your self-esteem at a young age,” she said. “A lot of my kids really, really struggle with handwriting. You can be bright and so intelligent, but if you are not able to write it down, you are not able to demonstrate you have that knowledge.”
Where and How Can you get Occupational Therapy?
Occupational therapy practitioners work in a variety of settings, including hospitals, schools, clinics, community centers, and health care facilities. They can even come to your home, typically after a stay in the hospital.
“Each state has different rules, but in Virginia, patients are referred by a physician,” Grubbs said. “Typically, OT involves an hour session one or two times a week. A plan of care can be as short as two or three months or last for a year or indefinitely, depending on the severity of the disability or delay.”
“We are very interdisciplinary,” Grubbs said. “We are all very team-based, working with speech therapists and physical therapists in making a plan of care that supports the families the best way we can.”
Grubbs has a few families she has worked with long-term, and it is rewarding to see a child’s progress.
“We become part of the families and celebrate them meeting these milestones together, which is another really neat part of it,” she said.
For Grubbs, the most rewarding aspect is working with patients to develop a plan that allows them to get back to performing daily activities. She helps get them out of a mindset of failure by breaking it down into smaller, achievable steps. Setting and reaching goals gives them a sense of confidence and independence.
“It goes far beyond employment,” she said. “It helps you be a part of the community and really the biggest takeaway I get is being able to facilitate building people’s self-esteem and helping them believe in themselves.”
You can ask your physician about a referral for occupational therapy or find an Ivy Rehab clinic in your community.
Article Reviewed by Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA
Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA is a practicing physical therapist and a partner and Director of Clinical Services at Ivy Rehab Network. Deur is board certified as a geriatric clinical specialist and certified exercise expert for aging adults with more than 35 years of clinical experience. She is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.
