Recently I had a client who wanted to get a discharge from the OT services by saying the child is going to school and then, has 4 hrs of Behavior therapy and so, we feel that adding OT -which is NOT every-day-but, only once a week-NOT for 4-5 hrs a day, but  for 1 hr only – will be “too much”. 

Disclaimer: This Blog is NOT about STOPPING YOU FROM GETTING BEHVAIOR THERAPY, BUT, creating an awareness on how to stop yourself from being trapped by those “salesy hours” in oppose to 1 hour of quality services. 

Really? IS OT REALLY TOO MUCH?

Choosing between Occupational Therapy (OT) and Behavior Technician therapy is a significant decision for individuals and families navigating therapeutic options.

Both approaches are fundamental in rehabilitation but differ in their philosophies, methods, and target populations.

It is always a big deal when we have to choose between two. If we can cut-off school timing, if we can cut-off family gathering, we can definitely cut off 40 hrs long therapy just to get 1 hr of quality evidence-based professional Occupational Therapy services.

Here are some details to understand both professional services:

Occupational Therapy (OT)

Occupational therapy focuses on helping individuals of all ages engage in meaningful activities to enhance their independence and quality of life. OT addresses physical, cognitive, and emotional challenges, aiming to improve daily functioning in self-care, work, and leisure.

It employs a client-centered approach, tailoring interventions to meet the specific needs and goals of each person. OT is beneficial for a wide range of conditions, including developmental delays, physical disabilities, mental health issues, and neurodevelopmental disorders.

Behavior Therapy

Behavior Therapy which is provided by BT/Behavior Therapist or by using Applied  Behavior Approach –  is the ONLY behavior-focused approach primarily used to address behavioral challenges, especially in individuals with autism spectrum disorder (ASD). Rooted in behaviorism, it aims to modify behaviors by analyzing and altering the relationship between actions and the environment.

It uses systematic, data-driven techniques to reinforce positive behaviors and reduce undesirable ones. While commonly associated with autism, this therapy also addresses behavioral issues in other conditions like ADHD and conduct disorders.

Comparison and Integration

Philosophies: 

• OT takes a holistic, client-centered approach, focusing on the overall well-being of the individual. 

• BT  is grounded in behaviorism, emphasizing observable behaviors and systematic modification through reinforcement.

• Target Populations: OT serves a broad spectrum of individuals across all ages and conditions. 

• Behavior Therapy primarily targets individuals with ASD, though it can be applied to other behavioral challenges.

Methods: 

• OT uses hands-on activities, adaptive equipment, and therapeutic exercises to enhance functional skills. 

• Behavior Technician relies on behavior modification techniques, reinforcement strategies, and rigorous data collection to track progress.

OT Can provide services to enhance behaviors using effective and harmless Evidence based therapeutic approaches and a couple examples of such evidence based scientific approaches that OTs are, ALERT Program or Zones of Regulation. 

On the other hand- Behavioral Technician CANNOT work as OT. 

Education:

• Occupational Therapists go for extensive Masters or Doctorate degrees after completing 3-4 years of bachelors in medical science based subjects. The intensive Masters and doctorate are scientific evidence based education degree programs which prepare them to understand and provide treatment to their expertise area of client care effectively. After completing degree- they have to PASS national board certification to prove their capabilities and then, only OT can treat clients. 

• BCBA/RBT etc. are “certification” courses that can be accomplished by any one within 40 hrs of “in person” or “online” training. 

MY QUESTION IS: would you TRUST your Child’s therapy FOR 40 HRS with someone WITH ABOVE MENTIONED education or TO SOMEONE WHO IS WELL TRAINED, AND KNOWS DIAGNOSIS AND PLANNINGS INSIDE AND OUT, WITH EVIDENCE BASED PRACTICES? 

Why would you leave your child in the hands of someone for 40 hrs and say NO to someone qualified for just 1 hr !!

Choosing Between OT and Behavior Technician Therapy

For those with challenging behaviors, especially related to ASD, Behavior Technician therapy may be more suitable due to its focus on behavior modification. This therapy is effective for developing communication, socialization, and daily living skills through structured teaching methods. OT, however, is more versatile, addressing a wider range of conditions and focusing on holistic improvement in daily functioning.

Ask yourself and write YES and NO next to each:

• Do I want to raise my “Autistic” child as an individual who is confident the way he/she “sees” and “understands” the world? ________
• Do I want to raise my child as “FIXED” just to please societal norms? _________
• Do I want to raise my child who “has to follow adult lead instructions” to FIT into the BOX OF Well BEHAVED CHILD? ________
• Do I not want to teach my child to be independent the way he/she wants to “do” the tasks by making decisions by themselves, and finding solutions to potential problems arising in completing the tasks by themselves? __________
• Do I want my child to FEEL TRAUMATIZED in the future when they grow up like other Autistic kids are feeling who are grown-ups right now, who went for more than 30-40 hrs of therapy and were constantly “corrected”? ________

[1 hr per week – OT is really  too much for your child if you answered “yes” to all questions above] 

Now Ask yourself these questions:

• Do I LIKE SOMEONE CORRECTING ME all the time 5 hrs / day whatever I do in the comfort of my own home? ______
• Do I get irritated when someone is always “judging” me and ready to ‘fix’ my way of eating, biting, sitting, playing, and bathing? ______
• Do I love someone “new” or “not so familiar” or “professional” always come to my home 5 days a week for 4-5 hrs to teach my child how to behave – even after I HAVE COMPLETED 5-6 hrs of school already and followed school-rules already in the day – to “FIX” my “home-based behavior”? ______
• Do I not like to just be myself in my own home? ____
• After my long workday DO I NOT NEED MYSELF BEING MYSELF? _____
• Do I get irritated when SOMEONE, even my husband/wife, tells me “how to make my bed” or “how to put laundry” or “how to put dishes into the dishwasher” correctly all the time? _____
• Do I NOT throw tantrums because I AM OVERWHELMED WITH CONSTANT “DO THIS” AND “DO THAT” from others? In the workplace and now at home too? ____
• Can I work with 100% focus if you are overwhelmed? ____

[1 hr per week – OT is really  too much for your child if you – well, I am leaving this decision up to YOU to decide for every question above] 

I am not sure about YOU, but, as 12 years in practice, and a mom, I would definitely love my “me time” at home after a long day at work. I need some sensory strategies to calm myself down such as a work-out (for my vestibular and proprioception needs) and candles for my emotional regulation as good smells make me feel ‘happy’, a warm water bath to relax, and before work or during the work sipping strong coffee or crunchy foods.

It’s time for YOU to speak up for yourself and your community. This is about uplifting the ASD community and supporting raising ABUSED AND TRAUMATIC AUTISTIC ADULTS.

We all have sensory needs and so do OUR KIDS. They don’t need to be fixed. We don’t fix our behaviors of sensory needs, we REGULATE them using strategies such as going out for a run, going on a hike, taking showers, cooking favorite food, eating pistachios or pretzels, or just watching TV or reading books.

We don’t put ‘data’ next to it such as “how many times I refused to sit today or put my finger in my mouth out of anxiety as I had a big presentation at work”. WHY OUR KIDS?

ONLY a LICENSED OT, who are professionals to understand children in such a better way, can use strategies to help you understand the child to “regulate” their needs and explain how they see the world and make sure to support them the way they love to grasp the information.

It is important to advocate for our one child and choose what is best. 40 hrs of the same routines, or 1 hour of quality time with professional guidance.

It is sad when parents just think “more therapy more results” mindset or just because the child is “taken care of” and we are off duty.

It is sad when we just trust individuals who “see” observable behaviors only but do not find any depth behind those behaviors. Any human being does not LOVE to act out or LOVE to throw tantrums or LOVE to run on the streets. THERE ARE PURPOSES AND BODY NEEDS AND LACK OF REGULATION. WHICH ONLY trained and licensed OT can GUIDE YOU WELL and NOT Behavior Technician.

It is also sad that you cannot see how much a child can get overwhelmed with 40 hrs BUT, DOING 1 HR OF OT makes them overwhelmed where they are actually having fun and function.

It’s upsetting that denying services for OT is EASY for the majority of parents but, requesting REDUCED HOURS FOR Behavior Technician therapy is not.

It is sad that even if you recognize 40 hrs are a lot, you cannot advocate for your child’s needs and understand the value of OT services and end up deciding ‘not doing OT’ just cuz it’s too much!!

The question is – IS Occupational Therapy – REALLY TOO MUCH?

Or are you misguided?

I read this somewhere and I am sure you believe that too, “I don’t want to” is an Extremely VALID reason to NOT do any task.” and I would add – no one should be counting as “child says no” to do the task and label it as “bad behavior”. PERIOD.

MOST IMP References PLEASE READ THEM: (DO NOT AVOID READING THESE ARTICLES)

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ARTICLES 

Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis | Emerald Insight

https://stopabasupportautistics.home.blog/2019/08/11/the-great-big-aba-opposition-resource-list/?fbclid=IwZXh0bgNhZW0CMTAAAR3HefjCTbpl3xPT3KMrTtjOsa9iTM-EDiIMWcpZS96WD7wK9z_MTqMAR0U_aem_ATXtBgsouH8HFXqfYqmcc4LD6K83TWj3a0rIUkBpTYtr01O-dAW9pFXkpip-SxOz2IxdslE3A4ioK5TCuhuctEAz

https://therapistndc.org/aba-is-not-effective-so-says-the-latest-report-from-the-department-of-defense/?fbclid=IwZXh0bgNhZW0CMTAAAR1pXx6GJov2kD2-j714SvgLsiMTIUWC2ocyJp-nyh5PzNr9F576v51h85g_aem_ATXh3CWxl4TKxERJeA6DV7hD6TQm_YxNrsuxlDJuy32nHSfJnVhWiHlnwQ4SLwl6nXozRA8be3zkj83XtUKsm7FD

https://www.sciencedirect.com/science/article/abs/pii/S0883941716300061?fbclid=IwZXh0bgNhZW0CMTAAAR2RulKxh5oDuag7UmsgPQiVm2CtZhbOZQFHk5cq7zuzIEOvlYEUEpFi_qw_aem_ATUr5bViewWFIT0VHMYYHqh_Hj2leb3VA3Iw6U6N6Y6RoMasrtulKlCiVIqEbFu9TvKXTOgONocjXtX1Zfp8mggn

NOTE:

THE DECISION TO CONTINUE/DISCONTINUE ANY THERAPY OT/ABA IS SOLE DECISION OF PARENTS/CAREGIVERS OF CHILDREN who are OT Park client or potential clients. ABOVE INFORMATION IS ONLY CREATED TO CREATE AWARENESS ABOUT HOW PROFESSIONAL SERVICES WORK. It does NOT guarantee any success of therapy one over another. THE REFERENCES ARE ATTACHED FOR PARENTS/CAREGIVERS TO LOOK, READ, AND SUPPORT THEIR DECISION MAKING JOURNEY. We aim to advocate for getting services in an appropriate manner, and NOT choosing between two. WE support balance between all and not AVOID ONE OVER OTHER. THANK YOU. 

As an occupational therapist, I often emphasize the importance of engaging children in household chores as a means of developing their skills and enhancing their overall well-being. While some may view these tasks as mundane and unimportant, they can play a significant role in promoting the physical, cognitive, and emotional development of children. In this blog post, I will explore the reasons why teaching household chores to kids is essential from an occupational therapy perspective.

1. Developing motor skills

Household chores require children to engage in a range of fine and gross motor activities, such as sweeping, mopping, washing dishes, and folding laundry. These activities help to strengthen the muscles in their hands and arms, improve hand-eye coordination, and develop their balance and coordination. Through repeated practice of these tasks, children can refine their motor skills and gain greater control over their movements.

2. Building independence and self-esteem

When children learn to perform household tasks independently, they develop a sense of mastery and achievement. This, in turn, can enhance their self-esteem and confidence. As they take on more responsibility around the house, they also develop a greater sense of independence and self-sufficiency, which can be valuable skills for their future success.

3. Promoting executive functioning

Household chores require children to plan and sequence tasks, organize materials, and manage their time effectively. These skills are essential components of executive functioning, which refers to the cognitive processes that enable individuals to set goals, prioritize tasks, and regulate their behavior. By engaging in household chores, children can improve their executive functioning skills, which can help them succeed in school, work, and life.

4. Fostering social skills

Household chores also provide opportunities for children to practice social skills, such as communication, cooperation, and teamwork. When children work together to complete a task, they learn to negotiate and compromise, share responsibilities, and support each other. These skills can help them form positive relationships with others and navigate social situations effectively.

5. Teaching life skills

Finally, household chores teach children important life skills that they will need as adults, such as cooking, cleaning, and budgeting. By mastering these skills early on, children can develop a sense of competence and preparedness for their future roles as caregivers, partners, and parents.

In conclusion, teaching household chores to kids is important from an occupational therapy perspective because it supports their physical, cognitive, and emotional development, fosters independence and self-esteem, promotes executive functioning and social skills, and teaches valuable life skills. As parents, caregivers, and educators, we can help children develop these skills by involving them in age-appropriate household tasks and providing them with the support and guidance they need to succeed.

“There is nothing in the intellect that was not first in the senses,” – Aristotle

Did you know that when your baby crawls around a room touching objects, playing with toys, listening to you singing songs, or putting things in his mouth, he’s doing a lot more than just playing? Toddlers use their senses to learn about and explore their environment. As a parent, you can enhance this learning by providing a positive sensory experience.

Sensory play or experience would then allow your child to interact with his surroundings and learn about his world. 

Once your child is born, his brain is ready to gain knowledge about the world. They’re actually learning long before they walk and talk. This learning takes place through hearing, touch, taste, sight, smell, and movement. They hear our voices, enjoy bouncing, chew toys, and touch everything they can.

The more positive sensory experiences your baby has, the stronger newly built brain connections become. Sensory play not only has a positive effect on your child now, but also helps to promote learning and development even in adulthood.

Researchers have found that a baby who is not given an appropriate set of opportunities and is kept in a swing most of the day or is kept in a dark, quiet environment for long periods can have his learning and brain development stunted by lack of exposure to sensory stimuli. 

These sensory systems don’t develop simultaneously, but rather in a specific order that does not vary.

This is tactile > vestibular > chemical > audio > visual. The infant has five senses functioning at different levels at the time of birth. 

Building blocks essential to an efficient sensory system

• For effective sensory processing, all sensory systems need to work together. It should be recognized that the sensory system is indeed composed of seven senses; these sensory systems process information as the building blocks to most of the individual skills.
• Visual Sense: This is the ability to understand and interpret what is seen. The visual system uses the eyes to collect information about the contrast between light and dark, color, and movement. It receives sensory information from the environment by light waves that stimulate the retina then by the optic nerve to the visual cortex on the back of the brain.
• Auditory Sense: is the ability to interpret information that is heard. The auditory system uses the external and middle ear to obtain sound information. They collect information about volume, pitch, and rhythm to the brain’s side parts by the 8th nerve.
• Olfactory Sense is the ability to interpret smells by Receiving the chemical makeup of particles in the air to determine if the smell.
• Gustatory Sense: it is the ability to interpret information regarding taste in the mouth using specialized buds on the tongue’s upper surface.
• Tactile Sense: It uses skin receptors to receive sensations of touch, such as fine touch, pressure, vibration, temperature, and pain. This is the first Sense to develop (in the womb), and, as such, it is vital for the overall neural network.
• Proprioceptive Sense is the ability to interpret where your body parts are in relation to each other. It uses information from the nerves and sheaths of the muscles and bones to inform about body posture and movement by muscle contraction, stretching, bending, straightening, pulling, and compression.
• Vestibular Sense: is the ability to interpret information relating to movement and balance. The vestibular system uses specialized channels in the inner ear to transmit information on movement, change of direction, change of position of the head, and gravitational pull.

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Most human critical periods exist within the early years postnatal, which is why sensory play is especially important for young children​.

A critical period is a phase in which brain cell connections are more plastic and receptive to the influence of a certain type of life experience. These connections, called synapses, can be formed or strengthened more easily during this period.

A recent study has linked the lack of sensory play and negative home environments, especially during children’s first three years with several developmental problems, including:

• Poorer language development by age three.
• Later behavior issues.
• Deficits in school readiness.
• Anxiety, Aggression, and depression.
• Impaired cognitive development at age three.

The Importance of Sensory Play

Building Nerve Connections

Research indicates that sensory play builds nerve connections (synapses) in the brain pathways that contribute to a child’s ability to perform more complex learning tasks.

Cognitive Development

Children first learn to understand new things through their senses. Every time they encounter something that is sticky, cold, or wet, for example, they gain a better understanding of which types of objects have these characteristics. Your child will then begin to make connections between things that have similar properties.

Strengthening Fine Motor Skills

Sensory play often involves touching, pouring, pinching, sorting, and moving actions. Toddlers primarily use their hands to explore, building on their fine motor skills, which will later be used for writing, zipping jackets, buttoning clothes, and tying shoes.

Enhancing Language Skills

By exploring new smells, tastes, and textures through sensory play, children can learn new ways to describe things found in the world around them. For example, a rock will be more than a rock when they feel it – it’s either smooth or rough or cool to the touch.  Also, your kids begin to describe food as sweet, salty, spicy, or crunchy.

Sensory Play Is Calming

You may have noticed that your kid is calmer after bath time or after a particularly rough session of jumping around the room, crashing onto his bed, banging into furniture, or pillows. This type of sensory activity calms children as it helps them manage their internal discomfort, whether it is boredom or restlessness.

 Early taste experiences 

 Early life nutrition is an important factor affecting later health. Your child’s food habits are shaped in infancy and are tracked back to adolescence and beyond, meaning that supportive eating activities are important to prevent eating disorders later in life.

Italian researchers from the Department of Pediatrics at the University of Milan have shown that early repeated experiences with different tastes and supportive feeding increase the children’s desire to try new foods and greatly decrease the risk of having a picky-eater kid in a healthy social environment. In other words, you, as a parent, can modify the innate food preferences of your child! 

By paying attention to these things, your baby will gain a lot of benefits and get exposed to various wonderful activities that will really help him develop properly! 

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Until Next blog,

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References:

 Blair C, Granger DA, Willoughby M, et al. Salivary cortisol mediates effects of poverty and parenting on executive functions in early childhood. Child Development. 2011; 82(6):1970-8.

Son S, Morrison F. The nature and impact of changes in home learning environment on development of language and academic skills in preschool children. Developmental Psychology. 2010; 46(5):1103–1118.

De Cosmi V, Scaglioni S, Agostoni C. Early Taste Experiences and Later Food Choices. Nutrients. 2017;9(2):107. Published 2017 Feb 4. doi:10.3390/nu9020107

Howard-Jones P, Taylor J, Sutton L. The Effect of Play on the Creativity of Young Children During Subsequent Activity. Early Child Development and Care. August 2002:323-328. doi:10.1080/03004430212722

Rosenzweig MR, Bennett EL. Psychobiology of plasticity: effects of training and experience on brain and behavior. Behavioural Brain Research. June 1996:57-65. doi:10.1016/0166-4328(95)00216-2