When OT Interventions Become Mainstream
This is something that has bothered me for awhile but I’ve been unable to put my concerns into words. I decided today to attempt to tackle the topic.
It worries me when a long used occupational therapy tool becomes so mainstream that every child in the country seems to have one. Take the fidget spinner for example. Fidgets are meant to be used by children who require movement for learning. There is scientific evidence that shows that moving the hands activates learning centers in the brain. Children on the spectrum and those with ADHD often benefit from these tools. When implemented by an OT, there are “rules” that surround the use of these tools. Students are told that they can use it so long as it doesn’t get thrown and it is used with respect. As the fidget spinner became trendy, these rules were not implemented, leading to many classrooms and schools banning them entirely. This is fine for children who do not require movement for learning. They accept the ban and get on with their day. Children who fall into the other category; however, now have one less tool in their toolbox.
Another occupational therapy intervention that has become popular is the weighted blanket, and rightfully so. They can have a powerful effect when used properly. The deep pressure input provided to the proprioceptive system has a calming effect that is believed to be most beneficial at bedtime. The thing is, most people don’t know how heavy the blanket should be, how long it should be used for or when it should be used. When prescribed by an occupational therapist, these instructions are catered for your child based on age, weight and need. Weighted blanket use in teens and adults is relatively harmless; however, there have been deaths related to improper use of a weighted blanket with infants and children. A nine-year-old boy in Quebec passed away after being rolled up in a weighted blanket - an activity I do frequently, but never with a weighted blanket. I recommend to parents that a weighted blanket never exceed 10% plus one pound of a child’s body weight and that they ensure the child can lift it independently prior to any use. Another recommendation I use frequently is to use the weighted blanket during bedtime routine to calm the child, but to remove the blanket either before the child falls asleep or just after they fall asleep. The risk of suffocation isn’t worth using the blanket all night. If you find your child requires deep pressure input all night long, there are other tools that can be introduced, but this is where an OT comes in.
Recently, I’ve seen unqualified individuals providing families with recommendations for self-regulation and sensory diets. This concerns me as they do not have the educational background and understanding required to make sound therapeutic judgements. Occupational therapists have an undergraduate degree followed by a masters degree, for a minimum of six years of post-secondary education as a new grad. I myself completed an undergraduate degree with a double major in biology and psychology (five years) plus a two year master of science in occupational therapy. At this point, occupational therapists in Ontario are not required to have a certain number of CEUs (Continuing Education Units), but a good OT will always be completing continuing education courses. In the last year alone, I have taken three days of training in Rhythmic Movement Therapy for primitive reflex integration, a day of forest and nature school training, I’ve attended four days of training in Toronto with OT gurus Tina Champagne and Kim Barthel, I started working towards my certification in Sensory Processing through the University of Southern California (30 hours), I completed a two day course on vision assessment and rehabilitation and I attended a one day course on oppositional defiant disorder. And that’s just off the top of my head. Continuing education is neither easy nor cheap (the first course in my sensory certification was over $1000 and there are five more courses), but I do it to provide my clients with the most up to date evidence based practice. I say this to ensure that you consider where you are getting your information from. Other parents may have the best intentions by sharing what worked for their child, but not all children are alike. When receiving advice from others, whether it be a teacher, an EA, a doctor, a daycare provider, or other community service provider, question what their background is and if they have a deep understanding of the nervous system and how their recommendations may affect it.
In a world of Dr. Google, it’s easy to become an armchair expert. Just as you wouldn’t go to your neighbour to cure your diabetes, please don’t go to an untrained individual for sensory processing or self-regulation advice. Keep in mind that many of the suggestions out there are band-aid solutions, only someone who really knows what they’re doing can provide you with the proper recommendations to rewire the nervous system for long lasting effects.