Vol. 20 •Issue 4 • Page 12
Maintaining Authenticity in New Peds Arenas
OT articles regarding non-traditional approaches to intervention covering the last decade indicate practitioners feel these modalities are beneficial and are using them in practice.
Consequently, pediatric OTs need to be more knowledgeable about modalities such as hippotherapy, aquatic therapy, animal-assisted therapy, music therapy, storytelling, infant massage, and even spiritual agent modalities for pain. If we continue to use these modalities, we also need to develop a keener concept of reimbursement issues; educate families, educators and other professionals about our rationales for using them; and increase our research efforts.
Not just the inherent therapeutic properties of these activities should drive our choices of them, but sensitivity to cultural, social and economic contexts as well. And we need to present carefully to families and caregivers the rationale behind the modality choice to maintain the integrity of OT’s’ identity in pediatric practice.
Because many alternative modalities are now recognized as legitimate therapeutic interventions in and of themselves, it is easy for parents, caregivers and even practitioners to slide into the mindset that the activity has an identity of its own. That’s all well and good when the activity is the ultimate goal, but when it is used within the context of occupational therapy intervention, it must fit into an overall therapeutic treatment plan.
Goals may include postural alignment and sensory integration when using hippotherapy as the modality of choice for children with cerebral palsy; for children with musculoskeletal or neuromuscular disorders, aquatic therapy can increase unrestricted movement. Music or animal-assisted therapy promotes relaxation and motivation for all children.
These postural, neuromuscular and sensory outcomes are most viable when the results not only allow the child to enjoy participating, but promote self-care, increased participation in educational settings or alternate sport/leisure activities. Included in the overall advantages of such treatment choices are psychological and cognitive effects: increased self-esteem, personal identity, social confidence and caring for others. These prepare children for successful participation in varied age-appropriate activities.
Treatment goals that are carefully designed and supported by selected, analyzed and graded activities remain the essential process of OT practice in any venue.
Carolyn Cantu, MS, OTR, is currently a consultant and trainer for Austin Families Inc. of Austin, Texas, and a curriculum writer for the OTA program at Austin Community College.