I have worked in several different pediatric settings as an occupational therapist such as: acute mental health, long-term mental health, home health, and school systems. One thing has remained true across all of these settings; other health care professionals have very little idea what I, as an occupational therapist do and furthermore, why I do what I do. It has been necessary in my career to educate and demonstrate how occupational therapy (OT) can play a vital role on a child’s treatment team. Occupational therapy is a health science that focuses on improving a child’s ability to function is his daily life. A child’s main areas of functioning include: dressing, eating, sleeping, learning, and playing. Although I have training in assisting children in improving in these and other areas, I have often had to educate other health care professionals about my role. Among other things, I’ve had to explain that I use play in therapy because that is how children typically learn and develop. In the end, I have been fortunate enough to have the physicians and other health care professionals I work with come to understand the importance of what I do and the value that it brings to the children with which I work.
Do physicians know when it is appropriate to refer to OT?
A study published in Advance Healthcare magazine by Karen Hyche (2011) reviewed patient charts and discovered that 70% of the children who had been referred to speech or physical therapy also required OT; but were not referred. This startling statistic demonstrates that many children are not receiving all the necessary services, which likely slows down their progress. It appears from this that physicians may not understand the depth of occupational therapy’s scope of practice and when to refer to us. This article led me to do my own informal survey of a few doctors to see what they know about OT and if they refer out appropriately.
Dr. Michelle Clark, of North Carolina, reported that she would have learned very little about OT while in medical school if she had not had a roommate who was attending OT school. Dr. Tyler Haberle, of Saint George, explained to me that physicians receive very little training into the domain of other health care professionals. He said, “Even though he attended a top 10 medical school and residency, his only training about my profession was that occupational therapists are the ones who come see your inpatients who you think need skilled nursing facilities or home health.”
Hyche (2011) found that children most often referred to OT had a diagnosis of developmental delay or delayed motor skills. She discovered that the diagnosis that was referred the least often to OT was Autism spectrum disorders. This is alarming to me since I have been trained in Ayres Sensory Integration and understand the vital importance of addressing sensory deficits in children with Autism and other similar diagnoses.
What can you, as a parent do for your child?
I believe that you, the parent, know your child and your family the best and are a vital part of your child’s progress and treatment. You will be your child’s best advocate. Find reputable sources and research to justify your position. Present this information as a reason you think OT will help your child. My role is to use my expertise, get specialized training, stay up on the most recent evidence-based practice, and incorporate the specific needs of your child and your family into my plan of care resulting in faster progress.
In seeking an OT be wary of therapists that do not have specialized training, who only treat one aspect of your child’s life, use only one method, treat each child in the same manner, or if your child doesn’t appear to be interested in or engaged in therapy sessions.
At FUNctionabilities we believe in getting specialized training beyond what we learned in school to stay on the cutting edge of what treatments are most effective for the children that we treat. Beyond sensory integration, we have training in the following areas: feeding, grooming, fine motor (doing shirt buttons, handwriting), cognitive (thinking, planning), gross motor, vision training, and other areas. This allows us to be comprehensive in our assessment and treatment of the many facets of your child’s life. An administrator at a hospital where I received a commendation from the governor said that neuropsychologists know how to explain what is causing the problem and the occupational therapists know how to treat it.
Contributed By: Kaylyn Ellis, MOTR/L
Hyche, K (2011). Advance Healthcare Network online. http://occupational-therapy.advanceweb.com/Archives/Article-Archives/Are-Pediatricians-Appropriately-Referring-Children-to-OT.aspx
To read more about Dr. Tyler Haberle you can check out his blog: https://toughpills.wordpress.com/
Dr. Michelle Clark is a doctor of osteopathic medicine in North Carolina.