QRG • JUNE 2021

PEDIATRICS
MAYA JOHNSON, OTS

THE ROLE OF OT
OT’S ADVOCATE FOR AND HELP
KIDS ENGAGE IN DAY-TO-DAY Variables that influence practice
ACTIVITIES THAT MAY BE Healthcare- Within the scope of OT practice is the maintenance and/or
CHALLENGING IN THE FACE OF improvement of health through treatment, prevention, and recovery from
illness, injury, disability, or other qualifying conditions. This is considered
PHYSIOLOGICAL, MENTAL, OR
health care. Healthcare systems impact financial coverage for a child to
NEUROLOGICAL CONDITIONS. OT’S
receive OT services.
EMPHASIZE OCCUPATIONS SUCH AS Education- The grade level of the child can help shape OT goals related
PLAY AND EDUCATION TO PROMOTE to education using a “just right challenge” that fits their academic needs
DEVELOPMENTAL SKILLS THAT appropriately.
SHAPE THE GROWTH AND LEVEL OF Community- The physical & social environment surrounding the child
INDEPENDENCE THE CHILD may influence their personal values and perspectives which can affect
ACQUIRES INTO ADULTHOOD. the ways that they participate in OT.
Political- Public affairs that involve policies and laws which may impact
the OTs role of advocating for a child must be well known.
Social Systems- One key aspect of pediatric OT is encouraging social
Educate & Advocate engagement to prepare children for adulthood. Different kinds of social
systems require many different social and communication skills which
The OT’s role is to increase the child’s independence can be developed under the intervention of OT.
and participation in their valued activities. A child’s
activities of daily living may include play, education,
social participation, and rest. Pediatric OTs work on
Models & Frame of Reference
any skill that is a barrier to participating in these Behavioral Cognitive Continuum- An approach that focuses
activities and their tasks. This includes fine, visual & on how a child’s behaviors and mental state are influenced by
gross motor skills, as well as processing sensory their environment and external stimuli. It emphasizes the use of
input. behavioral therapy to shape and manage feelings and actions,
To work successfully with a child, the OT which increases the probability of positive behaviors and
collaborates effectively with other professionals decreases negative behaviors.
such as the child’s teachers and primary physician. Developmental Frame of Reference- A guide to measuring
The family’s input and feedback are valued and the effects of illness, disorder, or disability on all-around
considered for shaping the goals of treatment growth and progression in children. It does not assume that a
plans. By taking a holistic approach through looking child’s age and stage of development should correlate, but
at the child’s strengths & limitations, environments, taking it into consideration is helpful in understanding the
and occupations, the OT determines how to help impact of these things on a child’s life.
the child become happy, healthy, and successful.
 Interprofessional Team
Educators | Primary Caregivers | Pediatricians | Physical Therapists | Neonatologists

It does take a village to raise a child, so there are many professionals who play important roles in the pediatric years
(birth-21). Parents, school teachers, Pediatricians, Neonatologists, Physical Therapists, and Occupational Therapists
are just a few people who make collaborative efforts in order to care for, educate, and protect a child. These
occupations exist on the basis of a child’s physical, mental, and social needs. As developmental changes take place,
the child must be equipped with the skills and tools necessary to grow into a wholesome adult. The significance of the
OT is that they take a holistic approach to encouraging a healthy and independent lifestyle.

Case Coordination & Management

To facilitate an appropriate and successful delivery of health care service, OTs often have to work with family and
education providers in order to ensure that the child’s needs are being met, even outside of the OT setting. If the
treatment sessions take place at home, the OT will include the parent in the intervention process so that they can
practice reaching goals with the child on their own. In the school, the OT must help the child become more engaged in
their academic responsibilities by learning what those responsibilities are in communication with teachers.
OTs that practice in Neonatal settings are in charge of encouraging healthy development in a safe environment for
babies in need of special care. They do this by focusing on the occupations of early development which include care-
giver bonding, feeding, resting, exploring and playing. In a NICU, babies are nurtured and protected by controlled
sensory stimulation environments, allowing them the opportunity to thrive and grow.

Referral Process
Internal [OT refers a child for specialized OT services outside of their own practice]
If an outpatient entry-level OT gives services to a child who is in need of specialized hand therapy, the entry-level OT can refer
the child to a hand therapist OT.

External [OT refers a child for services outside of OT]

If an OT gives services to a child that may also benefit from physical therapy treatment, they are able to refer that child out to
a good PT who will meet their needs.

Community [OT refers child to a program or service offered in the community]

An OT can refer a child to services offered in their community. For example, in many inner city low income neighborhoods,
there are programs such as “Big Brothers & Big Sisters of America” which benefits youth through academic and social support
and one-on-one mentorship relationships with qualified adult volunteers.

References
American Occupational Therapy Association. (2014). Occupational Therapy Practice Framework: Domain and Process (3rd ed.). Bethesda, MD: AOTA
Press.
Cole, M. (2012). Group Dynamics in Occupational Therapy: The Theoretical Basis and Practice Application of Group Dynamics. Thorofare, NJ: SLACK
Inc.
Schell, B., Gillen, G., & Scaffa, M. (2014). Willard & Spackman's occupational therapy (12 ed.). Baltimore: Lippincott Williams & Wilkins.

Kramer, P. (2018). Frames of reference for pediatric occupational therapy. Lippincott Williams & Wilkins.