• Our family has members who are immune-compromised and as a result we will not be sending our child back to school for the rest of the year. Is it still possible to receive guidance from an Occupational Therapist?

Yes, as an alternative to face-to-face appointments, Occupational Therapists at this practice make use of video conferencing to offer assessments, therapy sessions and parent consultations through online platforms that are deemed safe and secure by South African health industry norms. We also make use of other platforms, such as WhatsApp (text messages, voice-notes, video calls, photo and video sharing), emails, home programmes and telephone calls, in order to provide therapeutic services.

Telehealth services are typically provided in situations where you or your child cannot attend face-to-face appointments. Your therapist will discuss your child’s current functioning with you and will offer you support which is most suited to your child and family’s individual differences. Telehealth services, as with face-to-face consultations, are time-based billing codes and therefore billed at usual therapy tariffs, unless special billing arrangements have been agreed upon between the therapist and client.

  • My child has been referred for an Occupational Therapy (OT) assessment. What does this entail?

Occupational Therapists are trained to assist children with a broad spectrum of developmental-, learning- and behaviour-related challenges. Your child’s assessment may therefore differ from another child’s assessment. Please refer to the Services page on this website for further information regarding what type of paediatric Occupational Therapy services we offer. Assessment procedures may differ slightly from one Occupational Therapy practice to another. The process described below refers to what you can expect should you make contact with us.

Once you have made contact with us, we will provide you with a Background Information Questionnaire and arrange a meeting time so that the Occupational Therapist can discuss the content of the Questionnaire and the relevant details pertaining to your child’s referral to OT. With your permission, the Occupational Therapist will observe your child in their classroom setting and meet with their teacher to gain further insight into the challenges they experience within their learning environment. This information is necessary for the Occupational Therapist to decide which standardized- and non-standardized assessments to administer in order to gain a comprehensive understanding of your child’s difficulties. You will be provided with a breakdown and costing of the recommended assessment procedures. Please note that this practice endeavours to adhere to copyright laws and therefore makes use of original assessment materials. This also ensures that your child’s performance during the assessment is not affected by inferior copies and assessment materials.

An assessment appointment will be scheduled once you have confirmed that you wish to go ahead. Some children may require more than one appointment to complete the required assessment procedures. Once the assessment procedures have been completed, the Occupational Therapist will process the results and compile a written report of the findings. You will be required to attend a feedback meeting in which the assessment findings and the recommendations (including suggested therapy goals) will be discussed with you.

  • My child was referred for fine motor difficulties only. Why do you need to do a full/comprehensive assessment?
There are many factors which could contribute to difficulties with fine motor development, for example, deficits in: postural control and proximal joint stability; wrist and fine motor control; touch discrimination; and motor planning. In order to provide your child with goal-directed intervention, it is therefore necessary to gain a comprehensive understanding of the factors that are contributing to your child’s functional challenges.
  • My child was referred to Occupational Therapy (OT) following comprehensive psychometric testing by an Educational Psychologist. Why does my child require another assessment?
Although the Educational Psychologist’s assessment would provide a wealth of information which would aid the Occupational Therapist’s understanding of your child’s learning profile, the information from this assessment would likely not be able to provide some of the underlying reasons for certain challenges your child may be experiencing. For example, the Educational Psychologist may have observed that your child struggles with pencil skills and copying of shapes, numbers and letters (i.e. visual-motor integration). The OT assessment aims to provide a more in-depth explanation of these difficulties in order to establish the most effective treatment method. As per the previous question regarding an assessment for fine motor difficulties, there are many factors which could contribute to difficulties with visual-motor integration, for example: fine motor skills, visual-perceptual skills, eye movements, sensory processing and praxis. In order to provide your child with goal-directed intervention, it is therefore necessary to gain a comprehensive understanding of both their strengths and difficulties.
  • My child was referred to OT; I am a stay at home mom and would be able to do the exercises myself. Why is it necessary for an OT assessment and treatment if I could "work" with my child at home?
As discussed in previous questions relating to the OT assessment process, the Occupational Therapist will take time to ensure that the underlying difficulties leading to your child’s functional concerns are identified and subsequently addressed. Parents, who are actively involved in their children’s therapy programmes by participating in sessions and guiding their child through the recommended home programmes, benefit the therapy process and their child’s progress in therapy greatly. A parent, who has a child with learning difficulties or Sensory Processing Disorder, would benefit tremendously from the guidance that an OT can provide in order for their home-based activities to be more goal-directed and effective.
  • For how long will my child need Occupational Therapy (OT)?
The duration of therapy may differ significantly from one child to the next, as each child’s therapy programme, personality and personal circumstances are unique. OT is not generally regarded a “quick fix” and most children making use of our services require therapy for 6 months or longer. Please caution against accepting a teacher or friend’s opinion of your child only needing “a few sessions of OT”, rather discuss the anticipated duration of therapy with the Occupational Therapist. Although many teachers are experienced and regularly attend workshops presented by professionals such as OT’s, they too will admit that they do not have the clinical insight into the underlying reasons for your child’s difficulties. Therefore it should rather be the responsibility of the Occupational Therapist, who completed the comprehensive assessment, to provide you with guidance regarding the duration of therapy.
The therapy goals set out in your child’s initial OT assessment report are used as measures of progress in therapy. Typically, although not invariably the case, a formal re-assessment would be required following 24 – 30 therapy sessions (or weeks of therapy) in order to formally measure progress with standardized assessment procedures. The results of this re-assessment would aid to determine whether your child is ready to discontinue their therapy or whether they would benefit from further intervention.
  • What is Sensory Processing Disorder (SPD)?
Sensory Processing Disorder (SPD) refers to a complex disorder of how the brain processes sensation. Individuals with disordered sensory processing misinterpret everyday sensory experiences, such as touch, movement, sight and sound, which consequently manifest in challenges with motor, behaviour, emotional, arousal and attention responses. Intact sensory processing allows individuals to make meaning of and organize the sensations they experience within their body and from their environment, which in turn allows them to respond meaningfully and adaptively. There are several subtypes of SPD; each one has a distinctly different manifestation of symptoms. Some individuals with SPD may feel overwhelmed by sensory experiences, while others may crave or seek out intense sensory input. Other individuals experience challenges related to posture and motor coordination. Although there is a broad spectrum of symptoms and severity, SPD can be pervasive in its disruption of everyday life.
  • Is Sensory Processing Disorder different from “Sensory Integration Dysfunction”?
No. Sensory Processing Disorder is a relatively new term that health care providers and researchers are using to describe the dysfunction (i.e. impairment in daily routines and roles) that manifests as a result of sensory integration challenges. It is an umbrella term which encompasses several distinct subtypes of sensory-based processing concerns. The term Sensory Integration is still used to describe the theory and treatment, i.e. your child may attend Occupational Therapy using a Sensory Integration approach to treat their Sensory Processing Disorder.
  • Why are so many children being referred to Occupational Therapy (OT)?

There are so many factors to consider when answering this question. For one, modern life continues to evolve and as part of this process there has been a significant change in the way children play and experience the world around them. For example, in this age of TV, computers, tablets, and play stations, children are far more sedentary. In urban dense areas, more people with families are living in apartments and smaller houses without freely accessible space for children to run, play with a ball, ride their bikes and climb trees. Within the South African context there is also a safety factor to take into consideration, which closely resembles a form of environmental deprivation for many, as not many children can safely be allowed to play unsupervised in parks or ride their bikes in their neighbourhood. In an attempt to combat the sedentary lifestyle associated with this age, many well-meaning parents enrol their children into multiple structured extra-mural activities from a very young age. Although structured extra-murals are beneficial for exposing children to a variety of different sports or skills, many children are enrolled in far too many structured sessions per week. As a result, these children have limited time and opportunities to freely explore, play and make up their own games. The developmental benefits of unstructured play are well documented in literature.

Not only postural and gross motor skills have been affected by modern lifestyle, but also fine motor skills. In this era of Velcro and T-shirts, many children are not exposed to the fine motor development that occurs with the mastering of buttoning, fasting of buckles and tying of shoelaces. Even the packaging of food, treats, and cool drinks are continuously being redesigned to allow for easier opening; thereby reducing the demands on fine motor skills.

Modern lifestyle has also been accompanied by increased competitiveness and academic expectations. In many preschool environments “academic programmes” are introduced earlier as a result of pressure to have children school-ready by Grade 1. This reduces the time children spend engaging in sensory-motor play activities. Advances in medical science have also resulted in far greater survival rates of premature births, and these numbers are continuously on the rise. Research demonstrates that many of these children present with developmental-, learning-, and sensory processing challenges.

On the positive side, increased awareness and knowledge of developmental-, learning-, and sensory processing challenges have also led to more children being referred for assistance to overcome their difficulties. Some years ago, many of these children would have been labelled naughty, lazy, aggressive or unintelligent, rather than being given therapeutic support. Popular psychology and the media have also influenced society’s tendency to want to preserve a child’s self-esteem and therefore teachers and parents are often eager to provide a child with assistance, rather than leaving them to struggle.