Occupational Therapy: From Tactile to Digital

Holly D. Elmore
Holly D. Elmore
Elementary school principal; M.A.Ed. in Educational Leadership, M.A. in Special Education
Young boy using a computer and painting a picture.

Imagine sitting in a classroom and, all of a sudden, you realize your teacher is ten steps ahead of you and the idea of determining what to do next overwhelms you in a way that you feel paralyzed. You could be the student who struggles with ADHD, and the only barrier standing in your way is access to a therapist that helps you to strengthen your core, minimizing the challenges you face as a learner. Occupational therapists open a world of possibilities for our children who are not processing information in a developmentally normative approach.

What is Occupational Therapy?

When individuals find normal tasks daunting or a skill set lacking strategies to cope with a current situation, occupational therapy adds tools to the box, providing an opportunity for a person to self-advocate and become independent. An occupational therapist assists those who struggle with fine and gross motor skills, developmental delays, visual, oral, and sensory processing, social interactions, learning challenges, balance, coordination, and play. Many students with Individualized Education Plans will have an allied service plan including OT for a set number of days and minutes, defined goals on which they will work, and the therapist will serve as an active member of the Admissions and Release Committee (ARC), providing input on what are the best next steps for the student.

In the midst of a pandemic, everything was required to pivot, including therapeutic services for students. Occupational therapy was no exception to the rule. As with many things over the past year, there has been a shift in delivery of services with OT, transitioning from in-person, tactile therapy to a virtual platform, providing flexibility and commitment from therapists and clients.

Traditional Occupational Therapy

Occupational therapy has traditionally been very tactile in nature. Some examples of therapy tasks include:

  • Tactile containers – objects are placed in a bin and a student can manipulate the objects in order to build fine motor skills or to satisfy a sensory urge. Objects may include but are not limited to sand, rice, macaroni, beads, or bird seeds. Hiding an object within the container and asking a child to find it helps build the tiny muscle groups in the hand.
  • Playdough – allow students to make letters, numbers, or shapes.
  • Shaving cream – spread shaving cream over the table top and allow students to practice writing in the cream, creating a multi-sensory approach.
  • Necklaces – giving students the opportunity to create necklaces from macaroni or cereal, utilizing thread or, to make it completely edible, use licorice, and improve fine motor skills at the same time.
  • Pinchers – use a spring-loaded clothes pin to pick up small objects and move from one place to another, capturing and releasing one color or shape at a time.
  • Deep pressure – utilizing tools to provide deep pressure when a child is experiencing sensory overload, which can result in a meltdown. The pressure helps the child to release the tension.
  • Push and pull heavy objects to engage gross motor muscle groups.
  • Walk through the grass with bare feet.
  • Roll down a hill to increase self-regulation.

There are many other occupational therapy strategies that meet the needs of an individual. Therapists are trained to determine the best regime to meet the goals initiated by the ARC.

Transitioning to Digital Occupational Therapy

When the norm no longer looks normal or is acceptable, evolution occurs and that is exactly what OT’s are encountering right now. The tactile strategies that have defined the therapeutic practices are no longer meeting the guidelines and, once a digital option is offered, some will never want to transition back, so changes must be made.

When work is tactile, how do you evolve work to a digital platform? Therapists are providing resources for families and moving forward with therapies that are over a video screen like much of the rest of the workforce. OTs have Zoom, FaceTime, or other digital solutions where they provide a box of supplies to the client and then the therapies are guided through the computer screen. For some, this works wonderfully; however, there is a population where this proves difficult. Students who already experience developmental delays and learning disabilities have demonstrated significant distraction and lack of cooperation through virtual delivery.

While in a school setting, an occupational therapist pulls a student for their service minutes and provides reports and data to the parents to communicate progress. The parent or an assistant never really have to be involved in the therapy, itself, other than to reinforce strategies at home. In a virtual environment, there typically needs to be an adult present to assist the therapist with supervision and cooperation. If the student is completing the therapy alone, then communication with the parent is essential to the success of the student.

One consistent thread of occupational therapy that remains is assistive technology. Whether a student is in person in a facility or learning institution or receiving their services digitally, individuals who can receive assistance through technological devices are able to do so regardless of the environment. There is an increase in the use of assistive technology since the pandemic. Product developers are researching ways to make assistive devices more discreet and accessible to those with language processing disabilities. While there have been many unfair experiences through these uncharted times, assistive technology has closed gaps and given opportunities those preceding the pandemic have not had.

While navigating through therapy, traditionally or digitally, it is significant that students have the resources and strategies in place to impart independence and self-advocacy for our students. As educators, we want our students to be successful. When a child needs supports to complete daily tasks, we depend on occupational therapists to link arms with the student, family, and school to make success tangible.

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