“Occupational Therapy & Down Syndrome”
by Maryanne Bruni, BSC OT
Occupational therapists (OT) who work with children have education and training in child development, neurology, medical conditions, psychosocial development, and therapeutic techniques. Occupational therapists focus on the child’s ability to master skills for independence.
Skills for independence may include:
- Self-care skills (feeding, dressing, grooming, etc.)
- Fine and gross motor skills
- Skills related to school performance (eg: printing, cutting, etc.)
- Play and leisure skills
OT for Infants
When your child is an infant, your immediate concerns relate to health and growth, development of the basic motor milestones, social interaction with you and others, interest in things going on around them, and early speech sounds and responses.
For infants, an OT may be involved to:
- Assist with oral-motor feeding problems (this can also be addressed by Speech Pathologists). Feeding is difficult for some infants with Down syndrome. This is due to hypotonia and weakness of the muscles of the cheeks, tongue and lips. OTs suggest positioning and feeding techniques, and can be involved in doing feeding studies, if necessary.
- Help facilitate motor milestones, particularly for fine motor skills. Occupational therapists and Physical therapists work closely together to help the young child develop gross motor milestones (e.g., sitting, crawling, standing, walking). OTs work with your child at this stage to promote arm and hand movements that lay the foundation for later developing fine motor skills. The low muscle tone and loose ligaments at the joints associated with Down syndrome are real challenges to early motor development. Occupational therapy can help your child meet those challenges.
OT for Toddlers and Preschoolers
When your child is a toddler and preschooler, they will likely have some independent mobility and will be busy exploring their environment. To assist their development, provide them with many opportunities for learning. Encourage the beginning steps in learning to feed and dress themselves. Help them learn how to play appropriately with toys and interact with other children. You will be encouraging speech and language skills. Continue to provide opportunities for them to refine their gross motor skills.
For toddlers and preschoolers, an OT may become involved to:
- Facilitate the development of fine motor skills. This is an important stage in the development of fine motor skills for children with Down syndrome. They will be developing the movements in their hands that will allow them to do many things as they get older. However, many children need some therapy input to ensure that these movements do develop. Children do this through play. They open and close things, pick up and release toys of varying sizes and shapes, stack and build, manipulate knobs and buttons, experiment with crayons etc. Your child may face more challenges learning fine motor skills because of low muscle tome, decreased strength and joint ligament laxity.
- Help parents break down the skills so expectations are appropriate. They can suggest positioning or adaptations that might help the child be more independent. For example, a child may have more success feeding herself with a particular type of spoon and dish.
OT for School Age Children
When your child enters the school system the focus of your energies changes somewhat again! You can help your child adjust to new routines. Attend school meetings to plan your child’s educational program. Focus on speech and communication. Help your child practice fine motor skills for school, such as learning to print. Expect your child to develop more independence in self-help activities. Search out extracurricular activities that will expose your child to a variety of social, physical and learning experiences.
For school age children, an OT may become involved to:
- Facilitate fine motor skill development in the classroom. Many OTs work in the school system and provide programs to help children with Down syndrome learn printing, handwriting, keyboarding, cutting, etc. They will also look at physical positioning for optimal performance (eg: desk size etc.) and assist with program adaptations based on the child’s physical abilities.
- Facilitate self-help skills at home and at school. As with all children, kids with Down syndrome vary in personality, temperament, and motivation to be independent. Some children with Down syndrome have a desire to do things themselves, such as dress and feed themselves. These children may learn these skills by watching others and participate from a young age. Other children may be happy to let others do things for them and may resist attempts to help them learn these skills. In these cases, an OT may be able to help a parent work out these challenges while helping the child develop better motor and self-help skills.
- Address any sensory needs your child may have. Sometimes a parent has a concern about things their child does that may relate to the child’s sensory development. For example, a child may excessively put toys in their mouth, have poor awareness of their body in space, squeeze everything too hard or drop things a lot, or not tolerate very well some routines like washing and brushing hair. An OT can offer suggestions to help the child and parents deal with these issues.
Ask for Help
As parents we must be concerned with the well-being of our child in all respects. We have so many things to think about and keep track of: medical and dental needs, motor and communication needs, educational needs, advocacy, and social and behavioral needs. The list seems to go on and on! We need the help of trained professionals to guide us and to work with our children to help them achieve their potential in life. An occupational therapist is one member of the team that we can rely on. They provide professional assistance throughout the growth and development of our children.
Further information about fine motor development can be found in the book Fine Motor Skills in Children with Down Syndrome, published by Woodbine House.