Friday, 9 November 2018

Special Needs Exercise Prescription for older children and Adults

Our older teen and adult special needs children benefit from exercise and motor skill development programs, just like the younger ones.

There are two key differences in the approach however;

1. Identifying the developing health and mental changes

2. Educating on lifestyle habits and body awareness

The developing health challenges can include such things as being overweight, joint problems, high blood pressure, hormone issues, posture and muscle imbalances, low tone or strength and poor endurance.  Mental changes can include misunderstanding the above, poor self care, sexuality, social connectedness, depression and opposition.

Lifestyle habits can be educated regarding self-care, leisure, sexuality, social graces and activity.  Body awareness is an ongoing educational process. Teaching about the muscles, bones, proper activity, eating/food/nutrition, posture and exercise for their particular needs.  Something as simple as how strong are you, can lead to a conversation about how to feel stronger.

For parents, its having access to appropriate programs and professionals that is a challenge for this age group.  In our opinion, the one on one approach has always been the best way to address the above elements.  The importance of the relationship between the individual and the Instructor cannot be understated.  This is the social connectedness for many - especially those out of high school as the pool of others around them diminishes and their adult sense increases.

Keeping active frees the mind and provides self-esteem increases. Especially one on one exercise prescription - where an individual's needs are specifically addressed and a relationship developed.  Something to think about!

Thursday, 1 November 2018

Leisure - easy to cast aside but Important for Development


This group of occupations is the one that is most universally understood:
Leisure includes any activities that you might do in your free time and that you enjoy.

This can include more active recreation such as playing sports or going to the beach or can be quieter in nature such as gardening, listening to music or reading a book. Leisure can also encompass activities involving groups of people like attending a party or ones that are more individual-based.

Compared to self-care or productivity, leisure is often cast aside as ‘not that important’. While it is vital to address our basic care needs (eating, toileting, dressing), the importance of engaging in activities that we enjoy and that have a positive influence on our mental health should not be ignored. 
A fundamental tenet of Occupational Therapy is that every person, no matter their age, diagnosis, or any other factor has the right to and will benefit from having ‘occupational balance’: a balance in their daily life activities of self-care, work, rest and play.

Example: Going to the movies

Your 15-year old child expresses both a desire and an apprehension to wanting to go to the movie theatre to watch a movie with their friends. They have tried to do so once before in the past but experienced various difficulties in the process. The end result was that your child did not want to go back to the movie theatre for some time and the group of friends that they went with did not want to go see another movie with your child, who was left feeling hurt and  confused. 

In this instance, an OT would use their skills in activity analysis to gather information from the parent, child and observing the child in the relevant environments 
to identify the specific issue(s):

·       Transportation: Was the route to the theatre planned out in advance? Was the child familiar with the route? Have they been to this particular theatre before? Do they know the layout/how to navigate the signs? Do they have any physical limitations?

·       Money Management: Does the child have experience handling money? Do they normally use cash or a card? Do they have any cognitive delays which would hamper this aspect of the activity?

·       Environment: Are they able to scan information on screens to identify the theatre and starting time? Did they look up this information prior to arrival? How do they perform in other high traffic environments? Are there sensory challenges?

·       Do they understand the relevant Social Cues: standing in line to wait their turn, leaving enough personal space for others, not talking during movie, etc?

·       Emotions: How did their first experience affect their self esteem, sense of well being? What emotional barriers may be getting in the way?

Once the OT has a clear understanding of the issues, some relevant recommendations and strategies might include:

·       Transportation training: learning to navigate the bus system independently

·       Practice and strategies for managing money appropriately

·       Practice and strategies for dealing with busy environments, adaptations if possible

·       Social skills training to learn to understand and react to social situations

·       Supportive counselling to address the initial adverse experience and mapping out a new plan to ensure a future successful experience

This is just one example of what seeing an OT for a leisure concern might look like. If you or a loved one is experiencing challenges with any sort of LEISURE activities, please contact your Occupational Therapist today for more information.

Thank you for reading this blog series in support of Occupational Therapy Month. I hope it helped deepen your understanding of the value and benefits that OT can bring to life. I will leave you with a final quote, representative of the OT process:

“You need to be content with small steps. That’s all life is. Small steps that you take every day so when you look back down the road it all adds up and you know you covered some distance.”
—Katie Kacvinsky

Please feel free to leave comments below. We welcome all your input.

Written by:
Rachel Tavares, OT (Reg.) Ont., Registered Occupational Therapist, Bodiworks Institute