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Occupational Therapy Q&A

Your top questions answered by an occupational therapist

Painted hands and toes for OT.

Before our son started receiving weekly occupational therapy (OT) sessions through Early Intervention, I’ll admit that I didn’t fully understand what occupational therapists do. Over the past two years, I’ve learned so much about OT and child development from our provider, Elizabeth Harnett. I knew she was the perfect person to answer some questions that a parent would have while considering occupational therapy for their child.

1. Why did you pursue a career in occupational therapy?
Honestly, occupational therapy was a profession I never heard about. I was in college studying to be a social studies teacher and had a bad experience with one of my education theory type classes which led me to start looking into other majors and fields. Once I decided on psychology as a major, I started researching what I could do with a degree in psychology, which is not much. At the time I was an EMT, which can be considered an entry level healthcare type job. I loved being an EMT, and knew I wanted something medical/healthcare. I also knew I wanted something to do with psychology. I then took to Google and stumbled upon OT and it seemed like all my interests fit into one neat package. I then completed observation hours with an OT who worked in pediatrics and LOVED it. 

2. What is the main goal of an occupational therapist? When do you feel that a child is ready to be discharged from care?
The main goal for any individuals receiving OT is for them to be as independent as possible in their “occupations” which are whatever an individual wants or needs to do. 

A child is ready to be discharged when a team (usually a therapist and a parent) comes to a decision based on meeting goals set by the team. An important consideration is medical diagnosis and history.

RELATED: What is a sensory diet?

3. Why would someone need an occupational therapist? When should a parent seek an OT for their child?
I describe OTs as problem solvers. We look at the whole child, the environment, family dynamics, medical background, and how they all interact. If there's a concern that seems to have no clear answer or is confusing, an OT may be able to problem solve and point you in the right direction, whether that means referral to another service or recommendation of OT services. I would also say, if you're looking for the most client centered and holistic approach to your child's care, OT will provide you with the best client-centered and holistic approach compared to other disciplines. We will listen to your concerns and try to make sense of it all.

Most common skill areas OTs address are fine motor skills, sensory processing, social, community participation, play, and self-care (feeding, self-reading, dressing, toileting, etc.). 

4. What is the most common misconception about occupational therapy?
Most people think OTs help people find jobs. While we don't do that directly, we build the skills necessary to perform jobs. I also think OTs get associated a lot with specific therapeutic tools (such as weighted blanket, chewies, vests, pencil grips). A therapeutic tool may assist with meeting goals and intervention, but it is not a stand-alone intervention that OTs implement. There is a whole process to determine if certain therapeutic tools are needed and best fit for the need. It is one of many strategies, utilized by OTs to address goals.

5. What makes occupational therapy different from physical therapy?
OT is a holistic and client centered practice. For example, PT and OT overlap in upper extremity, we might both agree the child or individual needs to increase shoulder endurance and strength. For PT, the goal might be a specific motor milestone such as crawling. For OT, the goal might be to be able to use their upper extremity to participate in their self-care or feeding or prop themselves up on their arms to play peek-a-boo with a family member. 

In pediatrics, OT and PT can blend together because play is a major tool we use in order to get kids engaged in activities to help meet their goals. Sessions may look similar, but the clinical reasoning is different. There are some specific practice area differences such as PTs do a lot with gait patterns, lower extremity, balance, head/neck. OTs mainly work on upper extremity. Core strength is typically where OTs and PTs share. While seasoned PTs can incorporate a lot of sensory motor activities, they are not provided with specific education on sensory processing skills as it pertains to behavior and functional participation in daily life compared to OTs. 

6. How do sessions in a school/group setting differ from those in the home?
Sessions are different between school and home environment because there are different routines and values placed in each environment. We are creatures of habits and routines and children are no different. It's never surprising for me to hear when a child may perform a specific skill at school but not home. When considering EI verses school-based OT, therapists are looking at a child's participation in their classroom environment routines as it pertains to their education, whereas at home, therapists are looking at self-care, daily routines, play at home, social skills within the family, etc. 

7. What do you consider the most rewarding part of your job?
Overall, I'd say the flexibility as a profession. OTs can work in a variety of settings. You can always change settings to decrease your own burnout. OTs can progress to becoming business owners like myself, product makers, college professors, advocates, media platform experts, you name it. OTs can impact a lot of niche areas. OT is about living life and there are so many aspects to living life that we can impact. Even within daily practice in pediatrics, you are constantly flexible in the type of interventions you use and the diagnoses you see. Kids always do things to surprise you, too, so it's never boring!

8. What do you consider the most challenging part of your job?
Most OTs would say the paperwork; I agree and disagree with that. I tend to think it's manageable. I honestly believe its productivity requirements. While in EI and as a business owner, I determine my own productivity, many other settings have productivity standards developed by non-OTs or non-rehab related service personnel that are not conducive to providing excellent OT services. I believe productivity demands (along with paperwork combined) drives therapists to burnout and subsequently provider shortages. This is an ongoing trend with most healthcare professions. With high productivity, quality of client centered care decreases. That's what drew me to EI and becoming a business owner, I could determine my own productivity and really focus on the cases I had to provide them with the best service I could, rather than feeling rushed to squeeze in a number. 

9. What is your favorite activity to do in an OT session?
I have to say going to the playground or anything outside. The world is so big, especially in the eyes of children, it should be explored and it's fun to participate and share in that occupation together (therapist, child and parent) to best meet goals.

10. What is the best way a parent can be involved in the occupational therapy process?
I think it's a mix of asking questions both by the parent and the therapist. Often times, parents don't understand what OT is and what services look like. We are often misunderstood or compared to other disciplines. I think it's always important to get a dialogue going. If there's something that looks odd or if I bring a specific therapy tool, I always have parents try things out on themselves, or I might challenge them to reflect on their own childhood to relate. I also think being able to communicate to your provider what's important to your values, your routines, and your experiences will only better serve that individual child and family. 

You can find Lizzy on Facebook business here and on Instagram here.


Underestimated Strength is a collection of posts all about our journey through life as we navigate preemie parenting after the NICU. You can read my posts here every Tuesday! Also, feel free to follow me on Instagram, where I speak freely about our story and advocacy.
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