Physical Therapy, Occupational Therapy, Speech, & Down Syndrome (original) (raw)

Occupational therapists (OTs) are health professionals who work with individuals who have Down syndrome to improve their participation in everyday activities. OTs work with individuals across the lifespan to increase their independence in these activities. These everyday activities are a person’s “occupations” and include sleep, hygiene, dressing, cooking, self-feeding, employment, transportation, attending school, and toileting. Some individuals will be learning a skill for the first time (called habilitation) while others will be re-learning skills after an illness or injury (rehabilitation). OTs are also able to recommend accommodations or modifications to activities or the environment to improve the ability to participate in an occupation.

OTs can provide support in a variety of areas including:

• Sensory processing challenges
• Feeding challenges
• Fine motor, gross motor, and coordination skills
• Activities of daily living (ADLs) such as dressing, showering, sleeping, and toileting
• School-based support
• Employment skills
• Healthy relationships and sexuality
• Social skills
• Mental Wellness support
• Assistive technology
• Adaptive equipment

Pediatric Occupational Therapy

OTs who work with children have education and training in child development, neurology, medical conditions, psychosocial development, and therapeutic techniques. Occupational therapists focus on the child’s ability to learn skills for independence.

These can include:

• Self-care skills (feeding, dressing, grooming, hygiene)
• Fine and gross motor skills
• Skills related to school performance (e.g., printing, cutting, etc.)
• Play and leisure skills

During infancy, health priorities relate to consistent growth and the development of basic motor milestones. At this stage an OT may become involved to help a child with:

• Feeding problems: Due to hypotonia (low muscle tone) as well as the weakness and lack of coordination of the muscles of the cheeks, tongue, and lips, feeding can be difficult for some infants with Down syndrome. OTs help with positioning and feeding techniques for both breast and bottle feeding.
• Reaching motor milestones: Sometimes OTs and physical therapists work together to help infants develop motor milestones (e.g., sitting, reaching, crawling, grasping, standing, walking). Other times, only one specialist will be involved.

A great amount of skill development happens when a child is a toddler and preschooler. They will likely develop the ability to move around their environment with less assistance. Children will learn how to interact with the many objects around them. An OT may become involved to:

• Encourage the development of fine motor skills: Some children will need extra help to learn the hand and finger movements needed for picking up small items, holding a crayon or spoon, and completing a button.
• Teach play skills: Children learn through play. During play, they open and close things, pick up and release toys of varying sizes and shapes, stack and build blocks, manipulate knobs and buttons, and scribble with crayons. Children who struggle with basic play skills might miss out on these important opportunities to learn.
• Promote the beginning steps of self-help skills: An OT can break down activities into simple steps and suggest positioning or adaptations that might help the child be more independent. For example, a child may have more success feeding herself with a particular type of spoon and dish.

School-age children will need to adjust to new routines, increase independence in self-help and hygiene skills, learn classroom skills, and build friendships with their peers. OTs may help children this age to:

• Improve fine motor skill development in the classroom: Many OTs work in the school system and provide interventions to help children learn handwriting, keyboarding, and cutting. They will also look at physical positioning for optimal performance (e.g., desk size) and assist with program adaptations based on the child’s physical abilities.
• Develop self-help skills: An OT may be able to help a child to be successful in self-help skills including using the restroom, washing hands, putting on a coat, and zipping or buttoning clothing.
• Address sensory needs: Sometimes a child engages in behaviors that may relate to their sensory development. For example, excessively putting non-food items in their mouth, having poor awareness of their body in space, using too much or too little force on objects, or not tolerating experiences like using glue or play dough.

An occupational therapist is one member of the team parents can rely on to provide professional assistance throughout the growth and development of their children.

In the US, OT services can be obtained through Early Childhood Intervention programs, public and private schools, and private therapists.

Adult Occupational Therapy

The need for occupational therapy doesn’t end when a child turns 21. Although it is less common for adults to receive occupational therapy, many individuals could still benefit from it.

According to Katie Frank, PhD, OTR/L at the Adult Down Syndrome Center in Illinois, you may want to consider consulting an OT for an adult with Down syndrome if:

• You notice self-stimulatory behaviors (rocking, hand flapping, etc.).
• Your loved one has strong preferences or sensitivities (to light, texture, taste, smell, sound, or movement).
• Your loved one is a picky eater.
• Your loved one has poor fine motor and coordination skills.
• Your loved one is having difficulty completing basic activities of daily living (ADLs) such as dressing, showering, and toileting.
• Your loved one is overweight.
• Your loved one needs to learn job skills.
• Your loved one has questions about healthy relationships and sexuality.
• Your loved one needs to learn or practice appropriate social skills.
• Your loved one has difficulty transitioning between activities.
• Your loved one needs assistance establishing a routine.
• Your loved one has anxiety about medical procedures, dental visits, haircuts, blood draws, or other activities that need to occur periodically.

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NDSS thanks Maryanne Bruni, BSC OT(C) for assistance with this piece.

Citation:
Frank K. What is occupational therapy? Advocate Medical Group Adult Down Syndrome Center. https://adscresources.advocatehealth.com/what-is-occupational-therapy/. Accessed June 20, 2022.