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Why is the Occupational Therapist Playing with my Child?

As Occupational Therapists, a question that we are often asked is, “Why do you spend your entire session simply playing with my child”?  Although it may not appear as though therapy goals are being addressed, or that functional activities are being worked on, a good therapist has the ability to mask therapeutic exercises and techniques via the use of play.  The intent is to make the session fun and exciting, while creating an environment that the child feels comfortable in and looks forward to visiting.

Play is considered to be a child’s primary occupation (AOTA, 2002), and is viewed as being need-fulfilling and essential in the development of daily competence (Rodger & Ziviani, 1999).  In addition, play can promote appropriate motor skills, stimulate the imagination, enhance social skills, and improve intellect.  Play provides the child with an opportunity to establish interests, and is something that is universally accessible.

Play can be used in Occupational Therapy in one of two ways; as the explicit goal being addressed (i.e. improving play skills), or as a modality to improve a specific skill or competency.  The latter is what is most frequently seen in treatment; this is commonly referred to as ‘play-based therapy’ (AOTA, 2002).  Using this technique, therapists provide the child with challenges, with the intent to enhance particular skills.  You may notice the Occupational Therapist modeling play activities, providing verbal and/or visual cueing, and adapting/modifying activities that prove to be difficult for your child (Couch, Deitz, & Kanny, 1998).

To provide you with some clarity, five frequently used Occupational Therapy play activities/exercises will be broken down, noting what skills they have the potential to address and giving simple recommendations for home/community use.  Please be aware that some of the skills listed below are written in technical terms; explanations can be found in the blog post entitled ‘What is my OT Talking About?’.

Activity Skills That Can Be Addressed Translating This To Home/Community
Puzzles
  • Dexterity
  • Motor planning
  • Sequencing
  • Visual perception
Begin with simple puzzles, explicitly teaching the correct strategy (i.e. start with the corners, progress to the border, match colors and patterns) and then progress to more complex ones. Present the puzzle to your child with the pieces face down, encouraging him/her to flip them over using his/her thumb and index finger (pincer fingers).
Coloring/Drawing
  • Pencil grasp
  • Hand separation
  • Motor control
Use a variety of small writing tools (see blog post entitled ‘The Smaller The Better’) and have your child color inside the lines of various pictures. Begin with pictures that have large coloring areas, but keep this image on a small piece of paper to eliminate full arm movements (the goal is to isolate hand/finger movements).
Squishy Substances (Theraputty, Play Dough, Floam)
  • Dexterity
  • Hand/finger strength
  • Bilateral coordination
  • Exposure to various sensory stimuli
Small items can be hidden inside these substances, shapes/letters/numbers can be formed using these substances, or your child can simply work these substances through his/her hands while engaging in another activity (i.e. watching television). A fun way make use of squishy substances at home is to have your child assist with baking activities, kneading dough through his/her hands or rolling small balls to make cookies.
Obstacle Courses
  • Motor planning
  • Upper extremity and core strength
  • Balance
  • Body awareness
  • Exposure to various sensory stimuli
Create an obstacle course using couch cushions, pillows, blankets, etc. Present your child with opportunities to climb over items, crawl through things, and balance on top of unstable surfaces. Include your child in the planning of obstacle courses, encouraging creativity and imagination.
Crab and Wheelbarrow Walks
  • Upper extremity and core strength
  • Endurance
Make these activities part of your child’s daily routine, with a set time and place each day. For example, have your child crab walk to the bathroom every morning or engage in wheelbarrow races with his/her sibling each day before bed.

 
Although it may appear as though your child’s therapy session is all fun and games, the Occupational Therapist likely has specific goals in mind.  Transparent communication is key, so if there is ever an activity that you would like clarity on, don’t be afraid to ask.  In an effort to engage your child and make therapy functional, play-based therapy approaches may be used.

References

American Occupational Therapy Association (2002). Occupational Therapy Practice Framework: Domain and Process. American Journal of Occupational Therapy, 56, 609-639.

Couch, K., Deitz, J, & Kanny, E. (1998). The role of play in pediatric occupational therapy. The American Journal of Occupational Therapy, 52 (2), 111-117.

Rodger, S., & Zivianti, J. (1999). Play-based occupational therapy. International Journal of Disability, Development and Education, 46, 337-363.

Jordana Schwarz, MSc.OT., OT Reg. (Ont.)

About Jordana Schwarz, MSc.OT., OT Reg. (Ont.)

Jordana is a certified Occupational Therapist who received a Master of Science degree in Occupational Science and Occupational Therapy from the University of Toronto and an Honour’s Bachelor of Arts degree in Psychology from the University of Western Ontario. Jordana is a member in good standing of the College of Occupational Therapists of Ontario (COTO) and the Ontario Society of Occupational Therapists (OSOT).

Learn more about Jordana Schwarz, MSc.OT., OT Reg. (Ont.)

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