What is Occupational Therapy (OT)?

Lisa: Hi everyone. Welcome to AutismBC Talks about Occupational Therapy today with Jen Taubensee of Breaking Trail OT. We’re lucky to have her today to explain and describe what an Occupational Therapist does and how they can help support your child, your loved one, or yourself. Thank you, Jen, for being with us here today.   

Jen: Thanks so much for having me, Lisa. This is really exciting! I love talking about OT so anytime anyone wants to hear about it, just give me a shout. Occupational Therapists look at occupations, which really means how we occupy our time. So, all those activities we do during the day. The cool thing about occupations is that it affects our health and our well-being, so what we do every day that makes us happy, makes us healthy, what doesn’t or maybe it’s neutral. Most people you know, we have some in both categories. So, OTs are healthcare professionals looking to help you figure out what’s meaningful, what are those helpful activities, which ones maybe aren’t so helpful, but we still want to do and that’s totally okay. We’re not here to judge, just letting you know your balance. When we’re working with kids, like we do at Breaking Trail, development is a big part of kids’ health. That’s where a lot of our skill-building comes in as well. So, we’ll look at the environment and how it interacts. That’s our sensory systems, using visuals, all those kinds of things. The activity itself- can we make it harder; can we make it easier? Can we add dinosaurs so it’s super fun, and then the actual skills and strategies to help kids and their families kind of learn different ways of approaching something so that it uses their strengths instead of the things that are super hard so they can do more and what they want.

Lisa: Can an Occupational Therapist help with fine motor skills such as we hear often families or parents or loved ones are struggling with dressing or using utensils. How can you support learning and are those skill sets you can work on?  
 
Jen: Yes, OTs are usually called in for fine motor and a lot of the time it’s more than just how these work. So, it’s our thinking around things, it’s our planning, it’s maybe the fear of trying it. Especially with tying shoes. We’ll go in to work on the fine motor of tying shoes and it’s that motor planning piece because before we tried shoes, we built the most intricate LEGO kit ever, so we know there’s great strength in the fingers. But there’s just something maybe it was a fear, maybe it was uncertainty. Or maybe it was just tying shoes. Just like the 10 steps where there’s a lot of looping, bunny rabbits and pulling and switching hands. So, it’s trying to figure out what the piece is that is actually the hindrance and sometimes it is fine-motor. Then we get to do cool activities like LEGO building and playing with Playdoh and clay to build up that hand strength. But usually, if a parent hasn’t been able to figure out how to boost those fine motor skills, there’s more pieces to it   

Lisa: What about gross motor skills? Sometimes parents ask us “my child doesn’t know how to ride a bike. what can you do?”   

Jen: So, we will break down any kind of tasks. So, in this case, a gross motor task in biking- there’s community safety pieces, the actual coordinating your leg movements and the balance component. We’ll work on that, but another piece is the family readiness for their kid to be able to ride a bike. Because as soon as they’re on that, they’re gone! Do we have a bike for the adults or a scooter? How are we going to stay together as a group? That community safety mindset in all those pieces. So, when OTs support with gross motor, we’re looking at the whole activity. When we’re at the playground not only are we working on going up the stairs and going down the slide, but we’re also going to look at our ability to navigate when there’s another kid on the stairs. How do we go around them or do we ask them to move? What’s our skill level and how can we advocate for ourselves to get where we need to go? Or do we say oh, I can wait and that’s okay. It depends on the kid. So, playgrounds are a great place for OTs and stairs in the house is always a thing that some kids struggle with. We really want to because of the health mindset OTs bring we really want to make sure kids are aware of how to move their body physically because we need that for our baseline regulation and for physical health. Everyone knows exercise is good for us but if we don’t have the skills to do it, for instance, I wouldn’t want to go play hockey if I didn’t know how to skate, right? Even though I love hockey, I’m not going to go twice a week and get my cardio in. if I don’t know how to skate. So, that’s how OTs helps. It’s more than just learning left leg, right leg, left leg, right leg. it’s about the whole picture so that they can engage in those occupations   

Lisa: Can you help someone with selective eating? 

Jen: Yes, and maybe. When you’re choosing an OT, the first thing we’re going to do is figure out how selective the eating is. Because sometimes there are pieces that we need to get cleared by medical or real specialists in feeding. As OT’s at Breaking Trail, we are generalists, but we do have extra training in feeding sections. So, we have to make sure that we’re the right fit for you and then it’s totally customized.    

Lisa: Can you tell me what executive functioning is? We hear that term a lot, but what exactly is executive functioning?  

Jen: Executive functioning is our ability to juggle. It’s juggling our thinking, our feeling and our actions. So, there’s a lot of skills incorporated into that and concepts like planning regulation, starting a task, sustaining our attention in a task and knowing when it’s done. It’s pretty complicated but if we can think about it as executing the thinking portions, the feeling portions, and the actions of a task all at the same time. That’s where executive functioning comes in.   

Lisa: How can an OT help with executive functioning?  

Jen: What we do is whatever the challenge area is something like getting ready in the morning, we want to break it down into those pieces, so the thinking tasks. Well, they’ve been working on this for a long time so maybe the thinking’s only a little bit because they know how to brush their teeth, they know the order and we’ve been practicing that a lot. But maybe it’s a pretty stressful time for them because they’ve been getting in trouble for being late or they’re really susceptible to time pressures.  Maybe that one’s really high on school days and really low on weekends. So, we’ll say it’s a school day and then the actions- maybe we’re still working on getting dressed or maybe we’re working on teeth brushing and this is where sensory can kind of come into it. Maybe it’s a really uncomfortable feeling to wash our face in the morning, so that can add to the feelings pile or the actions pile, depending on the kid. What we do is we look and say, “oh, that task is a little bit too hard for first thing in the morning because that’s not the best time of day for this person.” So, what we do is we try and figure out where can we make the test easier. Maybe laying the clothes out the night before, a super basic starter one, right? But now we don’t have to open that drawer and sort through all the stuff. It’s already there right, we know what we’re wearing and we’re kind of excited about those clothes, which maybe brings that feeling down or that sensory component. “That’s my comfiest shirt.” Because we know Mondays are the hardest going from weekend to school days, so let’s go with the comfy socks too. So, what we do is we try to lower demands where we can and realized that “nope, this is always going to be a hard one, so we only have space to juggle these two.” How can we most support? Then it goes into picking our battles because we can’t make every task super easy and healing. Also, when we’re working on a “tough feelings one,” let’s not make it a “tough actions one” as well. Let’s make that one easier.  

Lisa: I love that response because as a mom myself i know how hard it is to get out of the house in the morning sometimes and we hear that all the time from families that the mornings and the bedtime routines are often the toughest so thanks for that explanation. The term I’ve heard a lot lately is ‘Resiliency Building’. What is that?

Jen: Great question – so resilience is our ability to bounce back when we face an obstacle, and these obstacles are sometimes expected like maybe changing from your primary school to your high school or something you know is coming like a job change or a move. It’s also those unexpected things that come in kind of out of nowhere. So, it’s our ability to navigate that obstacle or that challenge. How do we after it happens? Are we learning from it and moving on? Are we able to go back to our life or are we kind of stuck in that “oh man I’m overwhelmed” mode? How we build resiliency is what we do every day so it’s a lot of the things that we heard of- are you getting enough sleep? Are you getting your basic needs met? Are you having food? Are you doing those things that make you feel like you? So, what we like to focus on is how do you find meaning in your everyday activities? How do you prioritize what you value and what is good for you when you have way too many things to do in a day? How do we either add meaning to things that you’re already doing or extra like relaxation or extra energy boosting or whatever it may be? What you’re already doing or how do we take the schedule or your approach to your day so that you make time and space for the things you need?  
 
Lisa: Can you tell me about your caregiver resiliency group that you’re running right now?   

Jen: Yeah, so we’ve run it in person and with all the difficulties with that right now, we are doing it virtually. It’s super exciting because it’s more accessible to as many people that need it right now and it really focuses on not only activities. We get to try out a bunch of stuff to see what actually works for you because sometimes, when we’re in a slump, we don’t even know how to make ourselves feel better because we haven’t thought about that in a really long time. We just know that we don’t feel good.  So, what might work for you- but then actually how are you going to do it? Because not much of this is rocket science, right? You know eating’s important; sleeping is important. But how do we do those things? That’s really what we look at. What do we need to do now? How do we do it? Why are we doing it? That’s why this group dynamic is awesome and we’re just so excited about it! We’ve got some great feedback about the first round.  

Lisa: This is super exciting and sounds really cool. This is for any caregiver, not just moms, right? 

Jen: Oh yeah, caregivers as well. This could be grandma, this could be an auntie, this could be dad, or it could be siblings.  

Lisa: Can an adult benefit from the services of an occupational therapist?  

Jen: Yes, and many do. So, a lot of times your adults see OTs after an accident or something like an incident or a moment in, whether it’s a health crisis or something like that. But now more and more adults are seeking out for executive functioning support, which is really interesting because they’re noticing a late diagnosis of ADHD or things that we’re working on. There’s just too many demands in the world right now so we need better systems and that’s something that I think is so cool in our profession. Breaking Trail OT has really noticed a gap in our clients that kind of had funding up until they’re 18 to 19 and then services really work well for them when they’re 25 to 30. So kind of that gap in that transition time, which is when we need the most supports, when things are changing and there’s a huge piece of development there in our young adult life. We are working on a group to try to support those occupations of being a young adult, of growing up, so hopefully, that will be coming out this spring. But right now, we do take a case-by-case approach with young adults. So, if anyone’s looking for support with their like 18- to 25-year-old, feel free to let us know. Then if you are an adult that’s looking for some OT support you can always reach out and we can refer you to a clinic or a provider that would be able to meet your needs or what you’re looking for to get you started.  

Lisa: Thanks Jen, for all the information today about occupational therapy. It’s been super helpful and I’m wondering how can people reach out to you if they have more questions, if they want to learn more about the virtual caregiver resiliency group or if they just want to explore more about occupational therapy  
 
Jen: Thanks Lisa they can reach out to us by checking out our website www.breakingtrailot.ca or you can email me or give our office a call and I think our number’s going to pop up on the screen.