Occupational Therapy
What is Occupational Therapy?
Occupational Therapy for children focuses on the development of skills for life.
The goal of Occupational Therapy is to enable the child to perform tasks and activities in the environment where they take place, ie; in the home, the school and/or the playground. Everyday activities such as dressing, eating, hand writing and leisure pursuits – the child's achievement of these everyday tasks can enhance their self confidence and enable future participation in learning, employment, social and leisure activities.
How does the Occupational Therapist Assess?
Intervention from the Occupational Therapist starts with assessment.
Assessment can be a combination of many things;
- observing the child playing and interacting;
- asking parent's questions;
- we may use assessment tools such as the Peabody developmental motor scales.
- we look at how the child is doing everyday activities in the home or in their preschool and if they need any equipment to help them to be more independent.
- When a child has started school, we can assess the school environment and recommend adaptations.
- Assessment can include looking at any activity and breaking it down into its component parts. For example; the ability to write and all the component parts involved in this task, everything from how the child grasps the pencil, their sitting posture and muscle tone, how they write letters and numbers (pattern formation), spacing between letters and words, sizing of letters, the height of their desk, the distance they are from the black board. Adding all this information up, we can help the child with learning this skill.
What does the Occupational Therapist do?
- The Occupational Therapists will make a plan with parents, the child and the other team members and set goals with all involved.
- Everyday tasks such as dressing can be broken down into small steps for the child. Parents can be shown ways to help their child achieve these small steps.
- The child and parents may attend the clinic for weekly appointments for up to six weeks and then the Occupational Therapist can give a home programme to help encourage independence.
- The weekly Occupational Therapy appointments may be as part of a group with other children and/or with other team members.
- The Occupational Therapist can help with preparation for preschool and school and can visit and meet with teachers.
- Equipment may help with daily tasks such as bathing and eating. The Occupational Therapist may recommend equipment and/or adaptations to the environment to enable the child participate and to help parents and carers to manage their daily lives.
- The Occupational Therapist may come to visit you at home and recommend equipment which is then supplied by the local community HSE or assist with plans to adapt or extend the home to suit the needs of the child. Adaptations might mean a ramp or an accessible shower in the bathroom.
Parent participation in the process is key to our work, both in individual and
group settings.
Occupational Therapy is available through the clinics in Clontarf, Clondalkin and Waterford.
Our facilities at the clinics include adapted environments such as kitchen, bathroom and sensory rooms, splinting and casting facilities, a large range of assessments as well as many toys to play with.
Areas of Service
Early Intervention
(children from 0 – 6 years in Dublin region)
Team Assessment Clinic
- interdisciplinary team for children with complex needs: assessment for full morning
and then feedback and discussion with parents. The team involves OT, PT,
SLT and Social Worker. Following the team assessment, a plan is made, therapy
is provided jointly with PT and/or SLT, groups take place during the summer,
home visits can also be made. Individual Care plans takes place which include
the child's Paediatrician.
Or
Early intervention service
- includes; assessment of children's play, hand function, activities of daily living, interaction and learning of skills; assessment for equipment; home programmes; preparation for and liaison with preschool and school. Initial appointment at Early intervention clinic and then follow up intervention with PT or SLT, groups etc as required.
School age programme for children with physical and sensory disability
(children 4 – 18 years in Dublin Region in CRC school or out-patients)
Children attending the CRC school are allocated an Occupational Therapist at the beginning of each school year. Children attending mainstream can attend the CRC for appointments and Therapists liase with and visit schools if required. Service includes assessment and recommendations regarding daily activities: self-care, leisure and productivity; participation in activities, accessing school curriculum. The Occupational Therapist participates in the Individual Educational Plans and supports recommendations for Special Needs Assistants and assistive equipment. Clinic based interventions, home visits and school visits are part of the process of delivery of service. Planning for transition from school is also part of this programme. The service is delivered with requirements of EPSEN ACT 2004 in mind.
This service does not only focus on school participation but includes home programmes focusing on activities of daily life. The service is provided with continual liaison with other departments at the CRC including specialist areas of seating and mobility and assistive technology. The Therapists in the different departments consult each other on a regular basis regarding clients and conduct relevant joint assessments.
Children with specific Hand
Function difficulties
(children from all regions of Ireland)
The Occupational Therapist provides functional assessment, splinting and upper limb activities as part of the team which also identifies the potential improvements which Botox and/or surgery may provide for the child. The team includes OT, PT and Orthopaedic surgeon and Plastic Surgeon.
This is a breakdown of the therapeutic process for the Hand Therapy service.
Assessment:
A child's hand function is assessed in terms of his/her daily occupation,
including play, school functioning and daily living skills. Assessment
may include:CRC departmental assessment - including functional testing,
sensation), fine motor abilities, functional range of movement, grip
strength and 
functional
muscle testing,.Standardised assessments, e.g. - Melbourne - assessment
of
unilateral upper limb function.Jebsen & Taylor
PeabodyBailey scalesVideo or photo's of assessment is used where possible.
Recommendations / intervention:Following assessment recommendations/intervention may include:
- A home activity programme
- A splinting regime - either to enhance functional use of the hand/arm or, to provide a continuous stretch to muscles to prevent/reduce contracture.
- Occupational Therapy treatment to address specific identified difficulties or to develop functional abilities.
Onward referral if necessary e.g. orthopaedic opinion/botox, second skin, night positioning, seating, CTS. (Other services have similar process, this one is included as one example)
Brachial Plexus Injury Clinic
(children from all regions)
The Occupational Therapist provides functional assessment, splinting and activity programmes as part of the team service. The team includes PT, OT, Consultant Neurologist and Orthopaedic Surgeon.
Eating, Drinking and Swallowing clinic
(children from all regions)
Occupational Therapy in specialist interdisciplinary
team (SLT, OT, Paediatrician and Dietician) for children with eating
and drinking difficulties including positioning, sensory issues
and independence. The service
includes team assessments and appropriate interventions and recommendations
to other therapists involved. Once a month, Videofluroscopy assessments
take place in Temple street and the CRC Occupational Therapist
attends this clinic
to facilitate positioning and use of utensils. One team works specifically
with the CRC school children who have a meal here 
on a daily basis
and the other teams focus on out patients and regional clients.
Nationwide Consultation and Outreach service
(children from outside Dublin region)
Children and families can avail of CRC Occupational Therapy on a consultation basis when they attend for their paediatrician's appointment or at an out reach clinics, (these are currently in operation in the North west and midland HSE areas). Out reach clinics are provided in an interdisciplinary format with OT, PT, SLT, and Paediatrician.
Where there is a local paediatric OT service the CRC will liase, share reports and recommendations and if appropriate, discharge to this service.
National Muscular Dystrophy Clinic
(children from all regions)
Occupational Therapy in specialist multidisciplinary clinic for children with muscular dystrophy including assessment of daily activities, assistive equipment, (home visit, school visits if in Dublin region) and liaison with local therapists in regions.