OT for Special Needs

girl holding pen at table

Independence and Inclusion

What is the Focus of Occupational Therapy

At Online Children’s Therapy, goal setting is child-centred and family-driven, according to the interests, priorities and daily realities of the individual and the family. Skill building starts where the child is functioning and builds from there, with support to families for carryover into other environments.  Home programs are offered, in keeping with family time and resources.  OT is a vital member of your child’s circle of care, and our therapist coordinates with other professionals serving your child. 

Although each family’s goals are customized to them, below are some possible focus areas of treatment, organized by diagnosis:

Children’s Therapy Occupational therapy services include:

fine motor skills icon

fine motor skill development

For hand function

Sensory processing icon

sensory processing support

Across environments

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Sensory-motor skills

For leisure and occupational tasks

The following is an overview of Special Needs our therapist specializes in:

OT for Attention Deficit Disorder
(ADD and ADHD)

ADD and ADHD and Self Regulation

Self regulation is that ability to remain calm across environments and to modulate emotions even when over stimulated, hungry or tired.  To keep ourselves with just the right amount of focus and attention for the task at hand, we all use tools and strategies.  Self regulation can be especially challenging for children with Attention problems. OT helps children to develop their own personalized set of tools and strategies that work for them, for self regulation and focus.

Attention Deficit Disorder and Sensory Processing Disorder

Many children diagnosed with ADD or ADHD have challenges with taking in or screening out the sounds, sights, lights, movement, textures or touch from their environments. They may be overly sensitive and/or under responsive to sensations. Sensory overload may put them into a high alertness state or a fight or flight response, resulting in meltdowns or tantrums, angry outbursts, anxiety, or shut down and withdraw.  Occupational Therapy treats sensory processing disorder in children for fewer meltdowns, better self-regulation, improved relationships and overall a happier and more relaxed life. More About Sensory Processing Disorder

Attention Deficit Disorder and Learning Challenges

Many children diagnosed with ADD or ADHD have visual perceptual or visual-motor difficulties that make it hard to catch a ball and to write legibly.  Occupational therapy provides therapy for visual spatial skill building, handwriting (link to HW section), ball skills and other functional challenges with coordination.  Children may have difficulty with executive functioning for time management, money concepts, planning and organization, sequencing tasks, task initiation and completion and a variety of other daily life challenges that OT can address.

Attention Deficit Disorder and Social Skills

Children with ADHD may have difficulty making and keeping friends.  Occupational therapy uses Social Thinking, mindfulness, CBT and other approaches to support social communication skills in children with ADHD.

OT for Autism Spectrum Disorder (ASD)

Children’s Therapy provides Occupational Therapy assessment and treatment of sensory processing, sensory sensitivity, vestibular, balance, self-regulation,social skills and behaviour, as well as fine motor, gross motor, feeding and adaptive skills, for children with autism.

Sensory Processing Disorder and Self-Regulation challenges

Most autistic children have sensory processing challenges with taking in or screening out sounds, sights, lights, movement, textures or touch from their environments.  They may be overly sensitive and/or under responsive to sensations. Sensory overload may put them into a high alertness state or a fight or flight response, resulting in meltdowns or tantrums, angry outbursts, anxiety, or shut down and withdraw.  Occupational Therapy treats sensory processing disorder in children for fewer meltdowns, better self-regulation, improved relationships and overall a happier and more relaxed life. More about Sensory Processing Disorder

Treatment for Vestibular Dysfunction

Many children with autism have difficulties with coordination and balance, sometimes due to vestibular processing challenges.  Children’s Therapy has a multitude of therapy options, from using swings, yoga balls, and balance equipment in a therapy gym, to home movement activities such Bal-a-vis-x routines with beanbags and balls, and yoga poses for children. 

Proprioception, Coordination and Interoception Treatment in Autism

Many autistic children have poor awareness of their body position (proprioception) and may appear to be clumsy. In addition to senses from our joints and muscles, our bodies have many sensors that tell us when we are hungry or full, thirsty, hot or cold, need to use the bathroom.  These also may be under-developed or their messages may be drowned out due to hypersensitivity of other senses in autism.  Occupational therapy treatment in autism may include therapy for Interoception and Developmental Coordination Disorder, sometimes called dyspraxia.

Occupational Therapy for Social Skills, Anxiety and Autism

Our Children’s Therapy draws from the Alert program, Zones of Regulation, 5-point Incredible Scale and the Winner-Garcia Wee Thinkers, Superflex and Social Thinking series, anti-bullying programs, Friendmaker curriculum videos, Hidden Curriculum and others.  Children learn self-awareness, self-calming, perspective taking, and the impact of their choices on others.  Anxiety work with school-age children includes cognitive behavioral approaches (CBT), drawing from Tony Atwood’s workbooks, growth mindset, several mindfulness approaches, and many other programs that address fears and build social confidence and social skills.

OT for Fine Motor Skills in Autism

Occupational Therapy uses a variety of toys and games to improve finger, hand and wrist strength and coordination in therapy sessions.  Therapists also provide home ideas to incorporate just the right strengthening challenges into your child’s daily routines.

OT for Adaptive Skills and Activities of Daily Living in Autism

OT may need help preschoolers learn to dress, use utensils and potty train independently.  OT may help school-age children with autism to learning to ride a bike and to print legibly, in addition to supporting self-regulation and behavioural challenges.

OT for Handwriting in Autism

There can be many reasons why autistic children struggle with handwriting, including visual tracking, attention, visual perception, hand strength and coordination, visual-motor coordination, and postural stability.  At Children’s Therapy, our skilled therapist will tease out these variables, and choose therapies to address the root causes of difficulties from our many treatment options. More about OT for handwriting

Feeding Therapy and Autism

Children with autism may be following special diets under the guidance of a nutritional expert. In addition, children with autism may be very restricted in the tastes or textures they will eat, or refuse new foods based on how they look.  Autistic children may get stuck on one favorite food for weeks and then replace it with a new singular favorite food, rejecting the former favourite. Occupational Therapy creates a personalized feeding program for the child and family that follows a developmental sequence.  Therapy helps children with overactive gag or under sensitive oral musculature to learn to bite and chew without overstuffing or gagging.  Oral motor treatments may include progressive straws and blow toys.  The Get Permission and the SOS approach guide the feeding treatments utilized to expand children’s food choices, and to prevent food jags, in a supportive setting.

Occupational Therapy for Cerebral Palsy (CP)

OT and Home Equipment and Assistive Technology for Cerebral Palsy

Occupational Therapy for children with cerebral palsy or hemiplegia focuses on motor skills development and functional skills. When motor limitations are severe, the focus is often on equipment and assistive technology for self-care and participation in leisure skills with family and in the community. Our therapist’s knowledge of motor skill development guides the selection of equipment and technology to maximize function while minimizing the demands for muscle strength and control. 

Our Children’s Therapy may loan high and low tech adaptive equipment to families for trial before purchase, can prescribe suitable equipment for the child’s needs and the family’s home, and can help with paperwork to obtain insurance or other funding for equipment.

Feeding Therapy and CP

Many children with CP are following special diets under the guidance of a swallowing expert.  Occupational Therapy creates a personalized program for the child and family that follows a developmental sequence, once they are cleared for food intake by a swallow study.  Therapy helps children with overactive gag or under sensitive oral musculature to learn to bite and chew without overstuffing or gagging.  Oral motor strategies for straw drinking and blowing blow toys are also used.  The Get Permission and the SOS approach to feeding are utilized to expand children’s food choices in a supportive setting.

OT for Developmental Coordination Disorder (DCD)

Developmental Coordination Disorder, also known as Dyspraxia, is a difficulty in planning movements, which leads to difficulty delays and incoordination in home tasks like dressing and pouring, difficulty participating on the playground and in sports, and struggles with cutting with scissors and writing legibly.

Treatment of Vestibular Dysfunction in Developmental Coordination Disorder

Children with challenges with coordination and balance may have vestibular processing challenges.  Children’s Therapy may use therapy swings, scooter boards, rotation boards and balance equipment in treatment in a therapy gym, and a variety of other vestibular activities including beanbag and ball routines, yoga poses and other movement activities indoors or outside, depending on the home environment. 

Eye-hand Coordination in DCD

Fun games are utilized to develop visual tracking and eye-hand coordination for children with Developmental Coordination Disorder.  Bal-a-vis-x routines with beanbags and balls also improve bilateral coordination and eye-hand coordination. 

Handwriting and DCD

Handwriting may be a struggle for many different reasons, including fine motor incoordination.  Several OT treatments are available for this. More about OT for handwriting

Proprioception and Developmental Coordination Disorder

Often called the hidden sense, proprioception is what our muscles and tendons tell us about their position and tightness.  Occupational therapists understand and design activities to improve this sense for greater balance, core strength and coordination.  Therapy may include a variety of resistive movement activities, activities that build core strength and yoga poses.

Interoception and Developmental Coordination Disorder

In addition to senses from our joints and muscles, our bodies have many sensors that tell us when we are hungry or full, thirsty, hot or cold, need to use the bathroom.  These may be under-developed or their messages may be drowned out due to hypersensitivity of other senses, such as sound, light or touch sensitivity.  Anxiety can also affect interoception.  The Maher curriculum may be used in therapy if interoception difficulties are present in a child with DCD.

Occupational Therapy for Early Intervention

Early Intervention (EI) is a federally-mandated free public education program for children experiencing delays in development or is at risk of falling behind in development, from birth until school entry in kindergarten.  It often includes home-based services for those under the age of three in their natural environments by an educator and sometimes by occupational therapists, speech therapists and physiotherapists.  There is one designated agency in every local area in the USA and Canada, for the Early Intervention program for children under age 5 with developmental delays.  Anyone may refer to the program, and a screening or assessment must be completely in a timely manner for delays in development in: language, social interaction, thinking skills, motor skills and adaptive functioning.

In Oregon, start here and in BC start here to find your local programs.

Private OT Services for Developmental Delay at Children’s Therapy

For children birth to kindergarten, in addition to the public program for Early Intervention, occupational therapy is also be available to families through health insurance programs and private pay.  Our Children’s Therapy provides services to families for concerns about delays in development, whether or not they are enrolled in their local Early Intervention program. 

Occupational therapy for developmental delays addresses the early intervention areas of motor, social and adaptive skills.  OT services may include therapy for sensory processing disorder (tactile, vestibular, proprioception, interoception, picking eating), fine motor skills, muscle strength and coordination, dressing, toileting skills, play skills, social engagement and relationship building.

Occupational Therapy for Intellectual Disability (ID)

Occupational Therapy focuses on the life skills each individual needs for their life, across the environments where they spend time and for activities of daily living, leisure and vocation.   Barriers to accessing typical experiences are overcome by simplifying the methods or task, modifying the environment, and providing supports for learning new skills. The OT brings knowledge of activity analysis to break down tasks into component parts and identify underlying skills.  Our therapist has broad knowledge of adaptations that can lead to greater independence and inclusion.  

The emphasis is on life skills for greater independence, such as manipulation and orientation skills for independent dressing (buttons, snaps, laces), money management skills including coin differentiation and value, food preparation skills such as using a knife to cut or spread or using appliances safely, recognition of traffic signs and rules for navigating streets safely, use of public transportation, and other independence skills for living, when at home and in the community.  Independence, safety, physical activity and inclusion are themes of occupational therapy goals for those with intellectual disabilities. 

OT for Handwriting Challenges

Fine Motor Development Handwriting Help

Before children develop sophisticated composition skills for written communication, they learn the fundamental skills of the mechanics of handwriting.  When a child’s fine motor abilities can’t keep up with their thoughts and academic abilities, they are unable to show on paper what they know, leading to frustrating school experiences and sometimes poor grades.  As a child struggles to control the pencil, they may hear they are not trying hard enough or need to take more pride in their work, when they are doing their best.  There is effective handwriting help for children whose fine motor skills are holding them back academically and in life. 

Handwriting and Occupational Therapy

Occupational Therapy helps children have successful experiences with writing, while they learn to control the pressure, direction, size and spacing of their written work.  Fun therapy activities target the specific muscles and ligaments in the fingers, palm, wrist and forearm for strengthening.  Positioning tricks and adaptive tools, serve as a bridge to skill acquisition. Our therapist helps you choose the correct pencil grippers, slant boards and wrist holders to use as temporary aids while learning correct positioning and strengthening the muscles involved.

Handwriting Without Tears© & Printing Like a Pro

Children’s Therapy uses the Handwriting Without Tears© curriculum, the Benbow Loops and Groups curriculum and the Printing Like a Pro curriculum, in conjunction with other Occupational Therapy techniques and tools.  Our therapist has many years of experience teaching handwriting skills in schools, homes and clinics, to groups and individuals using many therapy activities, supported by the Handwriting Without Tears, Printing Like a Pro, and customized worksheets.  Whether your goal is printing or cursive, Children’s Therapy can support your child to successfully master handwriting.

Handwriting Research Study by Our Therapist

Our therapist participated as the clinical site in a research trial using a robotic device to teach handwriting, following the HWT curriculum.  The study was published in the American national OT research journal, AJOT.

OT and Sensory Processing Disorder (SPD)

Self-regulation Treatment and Sensory Processing Disorder

Occupational Therapy for Sensory Processing Disorder begins with understanding a child’s unique sensory profile of how sensory information is getting in.  OT supports children and families to recognize the effects of sensory overload and to use sensory tools and strategies to self-regulate in a wide range of environments.  OT supports children and their families to expand their personalized sensory and movement tools and strategies, to successfully prevent meltdowns and improve self- regulation. 

Sound Hypersensitivity in Sensory Processing Disorder

Occupational therapy supports tools and strategies to address sound sensitivity.

OT for Toileting, and Interoception Deficits in SPD

Occupational therapy helps children with toileting difficulties, touch hypersensitivity, aversion to clothing, and over or under reactivity to temperature changes or changes.  Treatment draws from the Maher Interoception Curriculum, treatments for tactile defensiveness, and use of social stories.

Occupational Therapy for Feeding Difficulties in SPD

OT guides families of children with sensory processing related extreme picky eating, appetite inconsistency, and other mealtime difficulties, following the SOS Feeding program and drawing from several other feeding therapies.

Movement and Play in Sensory Processing Disorder

In our therapy programs, children engage in play activities that bring together vision, movement, sound and balance for sensory integration of information that comes through different sensory channels.  Children engage in muscle work activities to self-regulate, to build core and to meet their proprioception needs and improve their body-in-space awareness.  Balance activities develop their core and vestibular senses.  Children with SPD may also have developmental coordination difficulties

Sensory Processing Disorder Resources:

Check your local library or favourite bookseller for one of these books about sensory processing:

  • Raising a Sensory Smart Child, Lindsey Biel & Nancy Peske
  • Sensational Kids, Lucy Jane Miller & Doris A Fuller
  • Too Loud, Too Bright, Too Fast, Too Tight, Sharon Heller
  • The Out of Sync Child, Carol Stock Kranowitz
  • The Sensory-Sensitive Child, Karen A Smith & Karen R Gouze