Kailie is a 3-year old girl who was born with Duchenne muscular dystrophy (DMD). As she’s grown, her parents have noticed the physical challenges she has experienced. Some challenges were with walking and others were with grasping items in her hand such as eating utensils and crayons. They are aware that her muscle weakness is expected to worsen with age, affecting Kailie’s ability to breathe and maintain her physical energy. Recently, Kailie and her family have started working with an occupational therapist to help her maintain her muscle strength and coordination as well as introduce her to ways to adapt to daily activities as she gets older. This will ultimately bring her a higher quality of life.
Occupational therapy (OT) aims to help improve children’s participation in daily tasks and overall quality of life. This is especially true for children who have physical special needs. Children with low muscle mass, involuntary movements, or joint tightness can struggle with coordination and endurance for daily activities that are important to them. OT plays an integral part in helping these children function in daily life and to achieve the most that they can in self-care, school, community, and play activities. Treatment plans are individualized according to each child’s unique needs.

- What are some of the common physical disabilities in children that OT helps with?
Physical disabilities include any condition that affects a person’s capacity to participate in daily tasks due to unhealthy or abnormal functions of the body. Children may be born with physical disabilities, or can acquire them due to injury, or develop disabilities over time. Here are just a few examples:
— Muscular Dystrophy:
A rare childhood disease, muscular dystrophy refers to a group of disorders that decrease muscle mass. In other words, the child will experience gradual muscle weakness that will make basic functions more challenging with time, including sitting up, walking, swallowing, and breathing.
–-Cerebral Palsy:
Cerebral palsy (CP) is a group of disorders that affect the brain and spinal cord, causing muscle spasms, poor coordination and balance, and reduced joint range. Similarly to muscular dystrophy, CP makes mobility and balance difficult during all daily living tasks.
— Orthopedic Injuries:
Some children may experience life-altering injuries, including sports injuries, car accident injuries, or play-related injuries that require both medical attention and rehabilitation.
— Genetic Disorders (like Down Syndrome):
Although Down syndrome often presents with cognitive limitations, some children may also have low muscle tone that affects how the joints work. It’s common for children with Down syndrome to take their first steps as late as four years old due to muscle weakness and displaced hip joints.
— Traumatic Brain Injury:
Traumatic brain injury (TBI) occurs when a child incurs an injury to the brain. This can happen as a result of blunt force trauma to the head, poisoning, stroke, decreased oxygen to the brain, etc. Each TBI is incredibly unique and requires very specific interventions to improve a child’s ability to function.
–-Spinal Cord Injury:
A spinal cord injury (SCI) and a child’s limitations can vary depending on how complete or incomplete the injury is and what level of the spine is damaged. A child with SCI will need specialized adaptations, like wheelchairs, to get around and to prevent medical complications.
Whatever the physical special need, occupational therapy can provide equipment, educational tools, and exercises to help children restore movement, improve body coordination, increase endurance, and adapt to limitations. This will allow them to participate in age-appropriate activities.

- What are some goals that an OT seek to accomplish with a child who has physical special needs?
Occupational therapy is an ideal intervention option for kids with physical special needs. With the right tools that are highly tailored to the child’s needs, a pediatric occupational therapist can guide a child and their family through potential issues and daily limitations. Let’s take a look at some OT goals as applied to real-life case scenarios:
–To be Able to Engage in Age-appropriate Activities:
Cody is an 11-year-old boy who fractured his collarbone after falling off his bike. His goal is to be able to ride his own bike again without the need for training wheels or extra support from his parents. During his sessions, the OT works with Cody to regain joint range in his shoulder and arm so he can steer the bike on his own.
— To Develop Self-Care Skills (such as Dressing, Eating, Hygiene, Toilet Training):
Hannah is an 8-year-old with Down syndrome. Due to muscle weakness in her hands, she struggles with basic hygiene activities. Her OT has been providing Hannah with therapeutic strengthening and coordination exercises to help her hold her own toothbrush, hairbrush, and clothing.
— To Promote Independence in Various Areas Depending on Child’s Needs:
Mary is a 10-year old girl who experienced a stroke shortly after birth. Her OT has been promoting Mary’s abilities to write a school essay independently with her right hand, which has been partially paralyzed from the stroke. This includes providing her with adaptive tools to help her write legibly.
— To Learn how to Manage Sensory Input and Respond Appropriately to Sensory Stimuli:
Katie is a 14-year-old who experienced a traumatic brain injury. As a result, she struggles with walking to her classes through a noisy, crowded junior high school. This often results in her skipping class or huddling in a corner with her ears covered. Her OT has been helping her manage the extra audio input and respond appropriately by using specialized sensory integration techniques.
— To Help Learn Social Skills (turn taking, following directions, sharing etc.):
David is a 6-year-old with muscular dystrophy. He’s been attending OT sessions at school to help him improve his social skills with fellow kindergarten classmates. Some of his sessions take place in the classroom to help his classmates familiarize themselves with David’s wheelchair and other aids to improve reciprocal play, sharing toys, and following game rules.
— To Help These Children Integrate into a School Environment:
Leo is a 7-year old with a spinal cord injury caused by a car accident two years ago. Since then, an occupational therapist has been coming to his home to train him to propel his own wheelchair from room to room. Now that he’s attending elementary school, the OT has been helping Leo use his wheelchair at school so he can successfully participate in classroom tasks, bathroom tasks, recess activities, and extra-curricular tennis.
— To Help Teach Mobility (crawling, walking etc.):
Deanna is an 18-month-old with cerebral palsy who is struggling with learning how to crawl. Her hips and knees are very tight. The OT has been educating her parents on his to carefully stretch her joints in preparation for crawling.
Pediatric occupational therapy is designed to help children of all ages to overcome and/or adapt to physical limitations. Families who are new to the occupational therapy world have immediate access to rehabilitative resources that will help their children with physical special needs succeed. Check out The Therapy Place online to see if our services can help your child who has physical special needs (or any child!) develop and succeed. https://www.therapyplacenj.com/
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