Occupational therapy can help children with special needs in their activities of daily living (ADL)
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Key takeaways from workshop on Activities of Daily Living

Every parent wishes for their child to be independent so they can maintain a quality of life even when the parents are not around to help them. Independence is a lofty target with many steps starting with independence in living to the final step of achieving financial independence. In this article we will focus on the first crucial step; achieving independence in performing Activities of Daily Living (ADL). Although we might not give this step a second thought for a child without disability it is crucial we are conscious of it for our special child. Learning how to do simple daily living tasks, like brushing, bathing, eating, dressing and others; independently, is a key milestone for the child and parents need to actively participate in the process.

While Physiotherapy deals largely with range of movements of different body parts; Occupational therapy goes beyond fine motor movements to developing functional skills using multidisciplinary approach (visual, sensory, motor, etc.). Here are a few key takeaways from a workshop conducted by Snehal Vaidya at Greens Special School as part of the Nayi Disha parent empowerment initiative.

1. Always keep in mind that what might be acceptable behavior for a younger child will not be acceptable as the child grows into an adult. Hence start the child’s independence journey as early as possible.

2. Use a visual schedule that breaks a major task (for example brushing) into smaller steps. These charts are easily available online; Google “visual schedule”. Print it and post it where the child can see it while performing the task.

3. Give very simple instructions to the child. Repeat any instruction only after 30 seconds. Avoid nagging!

4. The sequence of monitoring a task should go from physically assisting the child to visual instructions to verbal instructions and finally minimal supervision. As the child becomes familiar with following a particular task list, begin to fade directions until the child is able to follow the schedule on his or her own without any prompting.

5. Learn to differentiate between behavioral issues versus sensory issues.

6. Various games and fun activities can be used to increase finger dexterity and strength. Clothes pegs, walking fingers using a specific color sequence, playing tug of war, use play dough to make objects, hide coins in play dough, stretch rubber band across two pegs. Draw different objects on the palm and back of hand, and ask child to show each object. Helps in wrist movement and strengthening. Crawling, walking on hands, garlanding, beading etc. are good

7. While brushing some of the common issues parents face are: crying, not spitting, not holding brush or eating toothpaste. Massage the cheeks and mouth to reduce sensitivity to touch before brushing. Hold the bristles, facing out, go to the side and turn it inside the mouth if child is sensitive.

8. While eating some of the issues faced are: picking up food, chewing, eating too fast, not using spoon, pocketing food and picky eater. Use finger foods, eat at the same time and same things as the child, let the child try to feed the parent, and most important don’t overfeed, let the child get hungry. Ensure thumb is pointing up when picking up food to reduce food dropping on the floor.

9. For children who do not chew, use crunchy texture like chips, boondi, or roll chappati and give it to the side of their mouth. To break pattern of eating same thing, pair things the child normally eats with new food items one at a time.

10. Drooling is generally caused by low tone. Massage of chin, lower lip and above upper lip is recommended.

11. Bathing is one of the easiest activities as kids enjoy playing with water and taking a bath. If the child is not interested, it means the parent is not doing it right. Using liquid soap and loofa for washing are two alternatives to soap.

12. For dressing, use clothes with design on front or back so the child can distinguish between the two. Always try to do the dressing and undressing in front of the mirror. Use Velcro and big buttons for children with fine motor skills issue.

13. For toilet training keep a minute by minute schedule. At the most frequent times, remind the child if they want to go to the washroom.

14. Last but not the least, do not stress the child or yourself. Remember the more relaxed and calm you are, the more your child will enjoy the activity. A follow-on workshop was done a month after the first workshop. It was very heartening to hear parents feedback that they found the above tips to be very helpful and were able to work with their children to make a positive difference in their lives.

To get more details on the tips mentioned above do watch the workshop videos posted below.

DISCLAIMER: Please note that this guide is for information purposes only. Please consult a qualified health practitioner for safe management.

Also consult this presentation about tips from Occupational therapist, Ms.Snehal Vaidya about how to handle menstruation of your girl child to understand her unique sensory needs.

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