What is Occupational Therapy?

To put it simply, Occupational Therapy is a health profession that helps people to do the things that matter most to them. This looks different depending on who the Occupational Therapist is working with. For children, Occupational Therapists seek to support them with the skills they need to be a child - playing, learning, making friends, learning to look after themselves and being part of their family, school and community.

Being an Occupational Therapist comes with an awareness that what we do can be difficult to understand, and at times confusing. I recall in university having a whole subject dedicated to understanding what we do! So please never feel awkward asking your Occupational Therapist for the first, or tenth time, what it is that they do.

To illustrate what we do as Occupational Therapists, I have likened us to gardeners. Gardening is something we can all appreciate, whether it be your prowess in growing any kind of foliage you set your mind to, being a 'wannabe' or being an appreciative onlooker of that neighbour who always has an immaculate lawn. I have also accompanied my metaphor with 'composite examples' to give a real-world understanding of what a day as an OT might look like. These examples do not refer to any particular clients, but are a general reflection of my experiences as an OT.

As a 'wannabe' gardener, I think Occupational Therapy is actually quite similar to thoughtfully tending a garden. As I have tried my hand at gardening I have come to appreciate the skilful art and science that goes into having a vibrant and thriving garden. Thankfully, I consider myself a better Occupational Therapist than gardener - you only need to gander at my forest of weeds or look-upon my sorrowful Bonsai to see my shortcomings as a horticulturalist. Although my heart yearns to one day sustain my own beautiful garden, I am thankful to channel these dreams through my work. You see...

1. Occupational Therapists provide individualised care:

   Just as every plant has unique needs - water, soil types, sunlight, temperature - every person has unique needs too! As a gardener tends to each plant according to their needs, so does an Occupational Therapist.

   
   

   There are many children who came into my clinic who were eager and ready to learn in OT. Establishing trust and working and goals came easily. They listened, hanging onto each word, eager to grow. For these children, the conditions they needed to grow were to be met with the same enthusiasm that they presented with, and for myself to have a plan for each session that matched their fast-paced progress. These children need a cheerleader whooping and hollering from the side lines!

   
   

   For many other children, they were not so eager. In fact, the thought of someone else trying to work with them was enough to make them hide under desks, refuse to come out of cars, or run away all together. And so they did. For these children, the conditions they needed to grow was to be met with a steady, consistent, gentle and reassuring presence. They needed to know that they would not be pushed into overwhelm. They needed to know that when they were done with a session that this would be respected. They needed to know that regardless of what they did, that they would receive the same calm and consistent reassurance. These children needed a dance partner, perfectly in-tune to them and following them, all the while providing gentle guidance.

2. Occupational Therapists consider the environment:

   A skilful gardener knows that the environment is crucial to a plant's ability to thrive. They know how to perhaps modify aspects of the environment (providing more shade, moving the plant into more sun, building a green house or special patch with extra drainage). They know that sometimes when a plant isn't growing or flourishing as it should, that their challenges or short-comings can be attributed to an environment that simply doesn't meet their needs.

   
   

   As an OT I have seen many children be overcome by anxiety and challenges in schools. For some children, it was due to persistent bullying by peers, the overwhelm of the sensory environment of school, or the inability to demonstrate their intelligence and strengths in the way the curriculum is designed. Although it's a hard decision, I have seen children thrive and grow in their confidence with changing schools, going to Flexischools, or taking a period of homeschooling to reset. It was evident in these cases that the child needed to find their roots in a different environment that met their needs.

   
   

   For other children, instead of changing the environment altogether what they needed to better their school experience was for their environment to be modified. This included accommodations such as different seating arrangements, access to quiet spaces or staff members that felt safe to them and were excellent 'co-regulators'.

   
   

3. Occupational Therapists are problem-solvers

   Gardeners are adept at troubleshooting challenges like soil quality or disease. They know how to pick up on signs that a plant needs help and they know the resources they need to intervene. Occupational Therapists are experts at noticing even subtle barriers to a person's ability to do what they want to do. We are creative problem-solvers, even to those incredibly specific or 'out of the box' challenges.

   
   

   As an OT there are countless examples of this, it's difficult to chose just one. What comes to mind is things such as picking up on underlying and subtle difficulties such as visual perceptual, motor planning or executive functioning issues. It has been a privilege to reassurance to families, that no, your child is not being 'lazy' or 'stubborn' but has some challenges that make activities extremely difficult for them. Other examples include knowing how to redirect a child's behaviours that have the potential to harm themselves and others into something more regulating and organising (although hardly ever a straight forward process!).

   
   

4. Occupational Therapists are hands-on

   Just as a gardener gets into the 'nitty gritty' work to support their garden - digging, getting soil under their fingernails, sweating in the hot sun... so do we. We love getting into those things that matter most to people and working with them in real time and in the 'real world'. We don't shy away from topics that may be considered 'sensitive' like toileting, challenging behaviours, maintaining personal hygiene etc. it's what we are trained to do, and it does not bother us one bit!

   
   

   As an Occupational Therapist I have been in countless bathrooms, kitchens and backyards. I have been on backyard trampolines and swings to meet kids where they are at. It's in these moments that can prove the most productive and important, and we love to do it!

   
   

5. Occupational Therapists are holistic

   Gardeners see the big picture, thinking of the whole ecosystem when tending to their garden. OTs are also holistic, considering the person, 'occupations' and environments of our clients. By considering all these factors, we can truly understand how a person functions, how they use their strengths and resilience in daily life, and how to best support them.

   
   

   I can think of many times when a child has presented with a challenge, take handwriting for example, and we have found that there are so many layers and barriers to this. Things like underlying visual perceptual , executive functioning, hypermobility, fine motor control challenges, discouragement, as well as factors such as the desk being too high, and the tasks being too long for the child's capacity etc. An Occupational Therapist in this instance can work with this school to put in place accommodations to ensure the tasks and environment better suit the child, educating the child's teachers on his/her underlying challenges, and additionally addressing the child's challenges within the OT role (and referring on where needed).

   
   

6. Occupational Therapists nurture growth

   Gardeners are patient, knowing that what they want to achieve takes time. In Occupational Therapy, progress can be slow and steady (or with dramatic inclines and dips). As gardeners cannot rush a plant to grow, we appreciate that people need time to work towards what is important to them.

   
   

   As an OT, I can think of many clients where I was thinking 'are we getting anywhere with this?' , I talk to the parents about what our options are... do we take a break? Do we find someone new? Do we keep going? Sometimes these options are needed, and sometimes 'out of the blue', it clicks. Some children especially need to come to the table on their own terms, or they have been thoughtfully putting everything into place 'behind the scenes' making it appear like their progress came out of nowhere. With experience, it's easier to discern what children are likely to make everything come together in their own time and space, and what children would benefit from a pivot or change in plans.

   
   

Gardening is about nurturing life and helping something to grow - and so is OT. Both roles are deeply empowering, and both roles require specialist skills. As I recall the small and big moments of growth for children and their families, I know that this beautiful profession has a unique, needed and valuable place in our communities.

If you want to find out more about OT and useful tips that can help you as you support your child, watch this space!