OCCUPATIONAL AND PHYSICAL THERAPY

What exactly do the Occupational and Physical Therapists do in the school setting?
Sensory Motor Skill Development 
Related Websites

What exactly do the Occupational and Physical Therapists do in the school setting?

Occupational Therapist

School-based Occupational Therapists assess and work with students who qualify to enhance their ability to function and be successful in the classroom and school environment.  This can include working on underlying sensory motor foundation skills, fine motor coordination, visual motor control, visual perception, handwriting and keyboarding to facilitate completion of written work, copying, organizing work on paper, and other activities of daily living to function in the school environment.

These underlying foundation skills can be facilitated with a variety of strategies which can include:

• direct therapy with the child 

• consultation with the teacher 

• environmental modifications

• providing adaptive equipment

• training staff

For further information please go to the following websites:

http://www.aota.org/featured/area6/docs/ssfact.pdf

Physical Therapist

Physical Therapy services are provided to help students with special needs safely:

• sit and maintain proper positioning at their desks and/or on the rug on the floor

• move from one place to another in the classroom
• walk in the hallways
• step up and down the stairs
• sit at the lunch room table and get around in the lunch room itself
• get in and out of the bathroom
• participate in physical education class or any other classes that require movement activities
• get on and off the school bus
• play on the playground

To achieve these goals school-based Physical Therapists focus on strength, endurance, balance, sensory processing, adaptive equipment needs, eye hand coordination, eye foot coordination, and bilateral (using both sides of the body together) coordination.

Physical therapists also:

• help teachers and other school staff understand how motor skills affect participation in activities and find solutions to any problems that arise 
• suggest modifications
• train staff how to safely assist and/or physically handle students with special needs
• train staff how to use adaptive equipment or follow recommended plans of action
• communicate with staff on an on-going basis to see how things are working out for them and the student
• discuss upcoming extracurricular activities and events with teachers and anticipate potential challenges that may come up and suggest possible solutions

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SENSORY MOTOR SKILL DEVELOPMENT 

What does sensory motor foundation skills mean?

Sensory motor foundation skills rely on the interaction of sensation and movement.  We receive sensory information from our bodies and the environment through our sensory systems (vision, hearing, smell, taste, touch, vestibular, and proprioception).  This sensory information then needs to be organized and processed to be able to produce an appropriate motor or movement response to be successful in daily tasks at home or at school.  

What are the sensory motor foundation skills?

The following are sensory motor foundation skills that can influence learning and behavior to increase success at school:

1. Sense of Proprioception (Body Awareness)
Receiving adequate proprioceptive sensory information from your muscles and joints allows you to know where each part of your body is and grade movement to refine gross and fine motor control.  A student with poor body awareness may:

• appear clumsy

• have difficulty maintaining posture in seat at desk

• have difficulty getting dressed

• press too hard or too soft on pencil

2. Vestibular Sense (Perception of Movement)  
To perceive movement accurately you need to receive adequate information from your vestibular sense.  The vestibular system helps you to know whether you are moving or the earth is moving. It also generates the muscle tone needed to move smoothly and efficiently in the school environment.  A student who has difficulty processing movement information may:

• lose balance easily

• not be able to keep up with others in gym class or on the playground

• be fearful of or not tolerate movement 

3. Sense of Touch (Perception of Touch)  
Sense of touch involves interpreting touch information on the skin.  A child with tactile discomfort (tactile defensiveness) may have difficulty interpreting protective touch information.  For example, a student with tactile discomfort may avoid playing in sand, avoid finger painting, and /or may over or under react to painful touch experiences such as getting a paper cut.  A child with tactile discrimination difficulty may have trouble cutting with scissors or grasping a pencil. 

4. Sense of Vision (Visual Acuity and Visual Perception)  
The sense of vision includes being able to see objects clearly at a distance and near (visual acuity) and being able to interpret what the eyes see (visual perception).  It enables the student to discriminate between letters, numerals, and words that are similar in formation.  The sense of vision influences writing skills such as sizing of letters, spacing of letters and words on the writing line, organizing work on a piece of paper, and copying from the chalkboard or from a book to a piece of paper.

5. Motor Planning  
When given an unfamiliar task, motor planning is the ability to develop an idea, organize and utilize the materials needed for the task, and then sequence the steps necessary to complete the task.  A student with poor motor planning may:

• seem accident prone

• struggle to master new skills

• have difficulty sequencing steps needed to complete tasks in the classroom or gym 

6. Gross Motor Coordination  
Gross Motor Coordination is the ability to use large muscle groups for stability (maintaining positions and posture) and mobility within the school environment. Examples include sitting properly in a chair, walking in the classroom and the hallways, climbing the stairs, and running at recess or in physical education class, etc. 

7. Bilateral Motor Coordination  
Bilateral motor coordination is the ability to use both sides of the body together to produce a coordinated movement such as a student alternating his/her feet to walk upstairs or  manipulating scissors with one hand while turning the paper with the other hand to cut. 

8. Fine Motor Coordination  
Fine motor coordination is the ability to use the small muscle groups of the body for skilled work in the classroom such as grasping a pencil, handwriting, cutting with scissors, using a glue stick, coloring with crayons and colored pencils, etc. 

9. Visual Motor Control  
Visual motor control is the ability to integrate visual input with a motor output to perform eye-hand and eye-foot tasks.  Visual motor control is an underlying skill required for refined eye-hand coordination tasks such as handwriting.  It influences a child’s ability to reproduce letters and numerals, color within the lines, trace objects, keep letters/words on the writing line, organize written work on paper, and complete classroom projects and written work on time.  

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As the Physical Therapist and the Occupational Therapist working with children in the school setting we have found that strengthening underlying sensory motor foundation skills is helpful in preparing students for their academic work in the classroom and functioning in the school environment.  Many teachers feel therapy has a positive impact on the development of skills needed to complete classroom work and activities of daily living at school.   

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RELATED WEBSITES:

www.henryot.com 
-strategies for teacher and parents

www.out-of-sync-child.com 
- information, products, resources regarding sensory processing

www.sensoryresources.com 
-books, music, workshops, and links to other resources

www.sinetwork.org
-sensory disorders and related topics

http://home.earthlink.net/~lmlk/index.html
-fine motor skills from an Occupational Therapist's perspective

http://www.fiskars.com/pdfs/cut_poster.pdf
-teaching children to cut

http://www.childrentoday.com/resources/articles/handwriting.htm
-helping your child learn to write right

http://www.hummingbirded.com/fine_large_motor.html#fine
-fine motor skill activities 

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K-1ST Grade Language Arts