Introduction to Pediatric

Evaluation and Intervention Part 2

OT Tools of Practice
 Outline
✘ Play
✘ Therapeutic Use of Self (TUS)
✘ Therapeutic Use of Groups
(TUG)
✘ Songs
✘ Behavior Modification
Techniques
✘ Telehealth in Pediatrics

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Play
 Play (OTPF 3)

✘ Any spontaneous or organized activity that provides enjoyment,

entertainment, amusement, or diversion” (Parham & Fazio,
1997, p.252)
✘ PLAY EXPLORATION
✘ PLAY PARTICIPATION

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Characteristics of
Play Experience

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 Play
✘ Play is a vehicle that allows a child to access and
explore his or her world.
✘ Work of the child
✘ Play is the primary occupation of children.
✘ Play is both a part of and an outcome of occupational
therapy

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Playfulness
Bundy
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Play is a transaction between the child and the environment which
is intrinsically motivated, internally controlled, and
not bound by objective reality

Intrinsic Suspension of
Motivation Reality

Internal Control

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 Therapeutic Use of Self (TUS)

✘ Use of one’s personality and traits as a therapeutic tool

✘ A practitioner’s planned use of his or her personality,
insights, perceptions and judgments as part of the
therapeutic process (Punwar & Peloquin, 2000, p.285)
✘ Being aware of oneself and of the patient and being able
to control what one communicates

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 Therapeutic Use of Self (TUS)

✘ Active Friendliness
✗ OT takes the initiative in making friendly gestures
a. Extra attention
b. Reassurance
c. Praise for acceptable behavior
d. Companionship

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 Therapeutic Use of Self (TUS)

✘ Passive Friendliness
✗ OT is always available but never forces his
attention to the patient at any time
✘ Kind Firmness
✗ OT insists on requests to be followed but in a
friendly manner
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 Therapeutic Use of Self (TUS)

✘ Matter of Fact
✗ Makes no emotional response to patient’s pleas

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 Components of TUS

✘ Communication
✘ Empathy
✘ Rapport
✘ Reflective self-awareness

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Therapeutic Use of Groups

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 Types of Groups (I)

1. Functional groups
✗ Refer to groups that result in end products or help
members achieve desired skills and abilities
2. Process groups
✗ Refer to groups that work on the members’ interpersonal
abilities

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 Types of Groups (II)

1. Parallel group
✗ E.g. children exploring activities in a sensory room
2. Cooperative group
✗ E.g. children doing arts and craft activity sharing the same
materials and space but with different end products
3. Collaborative group
✗ E.g. children working together to create a mural painting

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 Planning Pediatric Groups
1. Individual OT goals and objectives for group members
✗ Help the practitioner design activities that meet the children’s
needs.
✗ May address multiple objectives

2. Present functional levels of the group members

✗ To determine the fit of each member or to decide if additional
personnel are needed for the group to convene
✗ Peer role model- children at different functional levels work to
help each other
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 Planning Pediatric Groups
3. Physical, social, and personality traits of group members
✗ OT attempts to create a group that will support each member and
allow each member to achieve his or her goals
4. Materials, supplies, equipment needs of the group
✗ OT secures the equipment and supplies prior to the group activity and
becomes familiar with the variety of ways the activity can be
accomplished.
5. Physical environment
✗ Settings that are overstimulating or unwelcoming may cause children
to experience stress and anxiety, affecting the group process
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 Leading Groups with Children
✘ The OT practitioner must have all materials, supplies, and equipment
organized and in good working order.
✘ Children require constant supervision, hand-over-hand assistance, and
frequent redirection.
✘ Providing children with a list of rules enables everyone to understand
the expectations.
✘ OTs who display playfulness, positive up-beat attitudes, and compassion
work well with children.
✘ Being prepared and having a variety of alternative activities that allow
the children to address their own goals is essential.
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Songs

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“ ✘ Where is?
✘ Wheels of the Bus
✘ If You’re Happy and You Know It
✘ Walking in the Jungle
✘ Warm-up Song
✘ One Little Finger
✘ Old Mcdonald Had a Farm
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 Songs
✘ Where is? ✘ Goodbye Song
Where is (name of the child) We are going (2x)
(2x) Now goodbye (2x)
Here I am (2x) See you on __ (2x)
How are you today? (2x) Now goodbye (2x)
Very well, fine thank you!
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Behavior Modification
Techniques

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 What is Behavior?
✘ It is what people do and say.
✘ It has one or more dimensions.
o Frequency
o Duration
o Intensity
✘ It can be observed, described, and recorded.
✘ It has an impact on the environment.
✘ It is lawful.
✘ It may be overt and covert.
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 Behavior Modification
✘ Involves understanding the causes of
behavior by looking at the relationship
between the environmental events and a
specific behavior

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 Behavior Modification
✘ Focus is on behavior.
✘ Procedures are based on behavioral principles.
✘ Emphasis is on current environmental events.
✘ Interventions can be implemented by people in
everyday life.
✘ Effectiveness can be measured through behavior
change.
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 Methods for
Encouraging
Positive
Behaviors

Behavior
Behavior Change
Modification
Techniques

Methods for
Handling
Undesirable
Behaviors
 Methods for Encouraging
Positive Behaviors

✘ Use of positive reinforcements

✘ Reinforcing with attention
✘ The Premack Principle
✘ Shaping
✘ Fading

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 Methods for
Encouraging
Positive
Behaviors

Behavior
Behavior Change
Modification
Techniques

Methods for
Handling
Undesirable
Behaviors
 Methods for Handling Undesirable
Behaviors

✘ Negative Reinforcement
✘ Time-out
✘ Reprimands
✘ Response Cost
✘ Overcorrection
✘ Planned Ignoring
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 Other Techniques

✘ Use of Behavior Chart

✘ Houserules/ Classroom Rules
✘ Behavioral Contract
✘ Restructuring the Environment
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Considerations for Practicing Behavior
Modification

✘ Consider the children’s age, skills, what

they know, how they understand the
things around them.
✘ Be observant.
✘ Be consistent.
✘ Make rules clear and specific.
Considerations for Practicing Behavior
Modification
✘ Correct inappropriate behaviors, but don’t
forget to acknowledge appropriate
behaviors.
✘ Encourage children.
✘ Set good example.
✘ They are children. They make mistakes. J
Telehealth
in Pediatrics

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 Telehealth
✘ Utilization of information and
communication technologies to deliver
health-related services when there would
be differences in locations between the
service provider and the client.
(PAOT, Board Resolution No. 2020-001)
 Equipment, Tools, Materials

✗ Computer, tablet, cellphone

✗ Headphones, earphones (for therapist)
✗ Camera or web cam
✗ Internet (at least 3mbps)
 What happens during Teletherapy
session?

✗ OT sends Activity Plan to parents

✗ Actual Session: 50-55 mins for client
care/ 5-10 minutes feedback to
parents/caregiver
✗ OT provides home instructions
✗ OT sends Running Notes to parents

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“

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Thank
you! J

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