LECTURE 1 :

INTRODUCTION TO OT

DR MARIAN MAMDOUH
LECTURER OF OT & PT
 OBJECTIVES IN THIS LECTURE :
• What Is Occupational Therapy?
• Who Is An Occupational Therapist?
• History Of OT
• Occupations of children
• Goal Of Occupational Therapy Intervention
• Places Of Occupational Therapist Services
• How Received Occupational Therapy Services?
• Steps Of Occupational Therapy Work
• Rules For Applying Occupational Therapy Activities
What Is Occupational Therapy?
- Occupation: Activity in which one engages
- Therapy: Treatment of an illness or disability
- Goal: End toward which effort is directed
- Activity: State or condition of being involved
- Independence: State or condition of being self-
reliant (independent)
- Function: Action for which a person is specifically
fitted.
- Occupational therapy is a practice that uses
goal-directed activity to promote independence in
function.
Occupational therapy (OT) is the use of exercises,
activities, strategies and accommodations to help kids
develop the skills they need-to become more
independent. OT interventions are not focused on the
child's Performance but on implementing adapted
methods or applying assistive technology to
increase the child's participation despite performance
problems
WHAT ARE THE DIFFERENCES BETWEEN OT
AND PT?
• OCCUPATIONAL THERAPIST: Is a health care person
who enables people to lead a more productive, satisfying,
and independent life. He/she should a creative person.
•
PT OT
Direct treat a person`s Help a person to optimize
injury using techniques their independence and
such as manual therapy their ability to accomplish
or any modalities their daily activities
following an injury or in
situations
History of OT :
Occupational therapy which developed as a profession during
world war I (1914-1918)grew rapidly in English –speaking
countries with the recognition of the need to rehabilitate the
civilian patient as well as the disabled soldier.
In 1952 the world Federation of Occupational Therapy was
founded , this organization has done much to develop educational
programs which meet the standard of education of occupational
therapy throughout the world.
- Occupational therapy practitioner refers to two different levels of
clinicians

occupational therapist (OT) occupational therapy assistant (OTA)

Occupations of children are player or student so the main types of play according to
Piaget`s theory:
Sensorimotor play predominate in infancy as infants develop mastery over their own bodies
and learn the effect of their actions upon objects and people in the environment. Sensorimotor
play peaks in the second year of life and then declines. Children continue to use sensorimotor
play when they learn new motor skills.
Exploratory play begins in infancy, and by the end of the first year, infants actively explore
their surroundings, demonstrate a beginning understanding of cause and effect, and are
interested in how things work. In the second year, play centers on combining objects and
learning their meaning. Children begin to classify objects and develop purpose in their actions.
Exploratory play gradually declines through the preschool years, but it reappears when the child
is learning new skills
Constructive play has identifiable outcomes and predominates during the preschool years as
practice. Constructive play remains high during middle childhood and adolescence but becomes
more abstract. It may develop into arts and crafts.
Symbolic play and pretense develop at the end of the first year and through the second, peaking
at around 5 years of age and evolving into dramatic and sociodramatic play. During middle
childhood, symbolic play and fantasy play are seen in mental games, and daydreaming, and in
language play such as riddles or secret codes. Television, computer games, and movies are also
ways of indulging in fantasy play.

Social play begins very early with interaction between the infant and mother, and by age 3,
children are able to engage in complex social games. Children use role play to learn about
social systems and cultural norm. Social play combined with motor play develops into rough-
and-tumble play. Games with rules teach children to take turns and to initiate, maintain, and end
social interactions. This type of play predominates during the school-age years. Social play and
games with rules are particularly influenced by the culture
occupational therapist services may be introduced at:
 Schools/Special schools
 Hospitals
 Private Clinics
 Homes
 Community Health Centers
 Rehabilitation Centers
 Work Places
 insurance Companies
- The goal of occupational therapy intervention is to increase the
ability of the client to participate in everyday activities.
- OT practitioners serve all ages (infants to older adults) and clients
with physical, cognitive, and/or psychosocial impairments, which
may be the result of an accident or trauma, disease, conflict or stress,
social deprivation, genetics, or congenital anomalies (birth defects).
The child will be referred to O.T in the following situations:
- When has a specific diagnosis (e.g., autism or cerebral palsy)
- Exhibits a particular functional problem (e.g., poor fine motor skills
or poor attention).
OT can work with kids on many different types of activities as:
1. Self-care or activities of daily living (brushing teeth, buttoning clothes,
using eating utensils)

2. Eye-Hand coordination (writing on a classroom whiteboard, copying in

a notebook What the teacher writes on the board)
3.Fine motor skills (grasping, controlling a pencil, using scissors)

4. Gross motor skills (doing jumping jacks, working on core muscle strength
for sitting posture)
5. Sensory responses (helping kids with sensory processing issues respond to
sensory input in more comfortable ways)
OT practitioners consult with other team members, who may
include:
physicians
physical therapists,
speech therapists
social workers
Nutritionists
case managers
Nurses
Educators
and family members.
OT interventions based on
1- analysis of the child's behaviors and performance,
2- determines how performance is influenced by impairment and how
the environment supports or constrain performance.
3- the occupations in which the child engages,
4- identifies discrepancies between the child's performance and
activity demands and interprets the meaning and importance of those
discrepancies,
O.T therapist should follow the following steps:
1-Comprehensive evaluation
• Begins by an understanding of the child's level of participation in
daily occupations
• form a picture of the child that includes his or her interests and
priorities.
• assesses specific performance areas and analyzes performance to
determine the reasons for the child's limitations.
Area of OT assess:
Muscle tone and strength
Posture and Balance
motor and Sensory assessment
mobility
Oral and feeding assessment
Using assistive device
• The best strategy for gathering information about the child is to
interview using open-ended questions.
• Understanding the family context and respecting the family's
perspective
2- Ecologic Assessment:
• It is the evaluation in the child's natural environment.
• Ecologic assessment helps to determine the discrepancy between the child's
performance and expected performance. It includes:
1- The School Function Assessment
2- The Sensory Processing Measure.
3-Context Evaluating
• Evaluating the contexts in which the child learns, plays, and interacts.
• Evaluating performance in multiple contexts
1. Does the environment allow physical access?
2. Are materials to promote development available?
3. Does the environment provide an optimal amount of supervision?
4. Is the environment safe?
5. Are a variety of spaces and sensory experiences available?
6. Is the environment conducive to social interaction?
7. Are opportunities for exploration, play, and learning available?
8. Is positive adult support available and developmentally appropriate?
4- Effective intervention
Occupational therapists improve children's performance and participation by:
 adapting activities and modifying the environment
 consulting, educating, and advocating.
 implementing adapted methods or applying assistive technology to increase
the child's participation despite performance problems.
 Understanding the family context and respecting the family's perspective.

5- Providing Interventions to Enhance Performance

The occupational therapist develops Interventions that promote and reinforce the
child's participation and lead to active engagement
6- Provide a just right challenge
Therapists design and employ play activities that engage and challenge the child across
domains.
example of a child with gravitational insecurity (i.e., fear of and aversion to being on unstable
surfaces or heights with immature postural balance).
Therapy activities begin close to the ground, and the therapist provides close physical support to
help the child feel secure. Gradually, in subsequent sessions, the therapist activities that require
the child to walk on unstable and to swing with his or her whole body suspended.

7- Establish a therapeutic relationship

Establish a therapeutic relationship with the child that encourages and motivates. This
relationship enables the child to feel safe and willing to take risks.
Rules for applying occupational therapy activities
• Children experience a greater degree of sensory integration when actively

• Based on careful analysis the occupational therapist selects an activity that matches the
child's strengths and limitations across, performance domains

• The analysis allows the therapist to individualize the difficulty, the space, and the
supports needed for a child to accomplish a task

• Therapist selects highly adaptable activities that can be modified to raise or lower the
difficulty level based on the child's performance.
Environmental Modification:
A child with disabilities often benefits from modifications to the environment.
Goals include:
• enhancing a child's participation,
• increasing safety (e.g., reducing barriers on the playground),
• improving comfort (e.g., improving ease of wheelchair use by reducing the
incline of the ramp).
Thank you