Friday, April 9, 2010

It's So Simple

A visit to a sensory gym during treatment hours looks like an indoor playground, with children climbing, swinging, jumping, navigating obstacle courses, throwing stuff at targets, yelling and laughing, getting messy, and, if they are working with me, making craft projects. I'm sure that it seems as if the children are just playing. How could it possibly be therapeutic? Isn't therapy supposed to be all complicated and scientific?

I'll never forget the comment of a mother whose son was graduating after coming once a week for the duration of the school year. His issues had largely cleared up, he was confident and happy, had great handwriting, and was easily keeping up with all of the academic demands of second grade. She said it seemed unbelievable that OT could make such a difference, because everything I had done for him all year was so simple. We played in the gym, we worked on handwriting, and we did craft projects. It was simple, and it was just what he needed.

A skilled therapist working in a sensory setting can determine what activities a child needs to do to in order to improve, among other things, visual motor coordination, motor planning, trunk strength, and balance, and make it fun and rewarding in the process by turning it all into a game. These skills are the underpinnings of the ability to sit for long periods, to sustain attention, and to support and power the hands and eyes for reading and writing.

My personal bias is to throw some craft into the mix. Over the years, I've seen magic happen when the right craft is put into someone's hands. Working on crafts teaches patience, sequencing, problem solving, visual motor coordination, and the ability to handle frustration. It builds sitting tolerance, improves attention, sharpens and develops visual perception, and develops fine motor control.

The occupational therapists who graduated from OT programs before I joined the profession {I began school in the mid 80's} were rigorously trained to be competent at a wide range of craft activities. They could throw pots, make furniture, knit, crochet, quilt, tat, and weave, make baskets, bind books, crack and grout tiles for mosaics, and do leather, bead and metal work. I remember someone telling me that when he was a child in the early 50's and had to be hospitalized for a long time due to a bone infection, the occupational therapists there taught him how to work leather -- how to cut it, dye it, tool it, turn it into useful things. He got so skilled that he went on to earn his living making and selling belts and purses at craft fairs, and put himself through college with the money.

Unfortunately today's OT curriculum does not have the same emphasis on craft and working with the hands. I think this is a real loss to the profession. Up until very recently, people were required to do all kinds of crafts for survival. We had to make pots, and quilts, and clothes, and canoes, and baskets, and furniture. Humans have an inherent need to engage in purposeful activity, and we also have the need to feel competent, which making things provides in abundance.

One summer I spent three weeks with a friend and four of her children up in the mountains, without a television or computer. We brought lots of craft activities and we spent the afternoons sitting on the porch making projects together and chatting. It was a wonderful time.

I suggest having a stash of craft projects and materials handy for your child. If, like me, you're not a natural at making things, you can buy some wonderful structured craft projects, all materials included, in many toy stores. If you're lucky enough to live near an Amazing Savings or Family Dollar, they often have a fun selection of little kits to choose from. Just examine them carefully and make sure that whatever strikes your fancy that day doesn't look too cheap or cheesy, or you'll have frustration instead of success. I've had good luck with little felt and foam sewing projects and wooden models to paint and put together from those stores.

There is now a Michael's in Manhattan and I've been in there several times. Recently I stopped in because an older child wanted me to teach her how to knit. I hadn't done it in years, but when I bought the needles and yarn and began to practice, I instantly remembered how absorbing, grounding, and relaxing it is.

We had a lot of fun together the day I showed her how. She picked it up fairly quickly, and was so very proud of herself when she got home from OT that evening and showed her mother what she could do. She went on to teach several of her siblings what she had learned and became the knitting teacher in residence. This child was a bit backward in a home full of superstars, so being able to teach them something and be their consultant was just wonderful for her self confidence.

In future posts I'll talk about the kinds of craft activities I use in the clinic.


Minna said...

Neat! So OT really is a type of art therapy :) It's amazing how art can help improve so many different areas both mentally, physically and even emotionally!

Anonymous said...

Yes, play is also a well-established method of doing psychotherapy for kids. Kids play not just to have fun but also to learn and practice life skills. And as you’ve pointed out, crafts are a form of play, or practice, that develops not only generalized life skills but also specific skills that are useful and even possibly vocational.