Fine tuning play’s early work

2011-11-17 00:00

PLAY is a child’s work until he or she enters formal education. From then onwards, sport, learning to read, write, spell and do maths become their primary occupations. Free play time becomes more and more reduced as the demands of formal education increase. The foundation years are essential for developing the sensory system, gross and fine motor skills, eye-hand and eye-foot co-ordination, visual perceptual skills as well as integrating them all in preparation for the demands of the classroom and sports field. All these skills are non-verbal skills and are the focus of occupational therapists within the education context.

Some children are referred for occupational therapy intervention while they are still at preschool, when the teacher has observed difficulties mostly with gross and fine motor skills. Others are referred once they enter formal schooling when they are noted to be unable to cope with or are underachieving in the classroom and/or on the sports field. The aim of occupational therapy is to assist the pupil to reach his or her potential by achieving his or her optimum level of functioning.

There are many reasons a pupil may be experiencing difficulties with non-verbal performance in mainstream education, where there is no history of serious illness, injury or other diagnosis. Some of these reasons may be due to heredity, vision problems, poor language development, lack of opportunity, insufficient experience, rate of development, the influence of attention deficit, and too much passive activity such as watching television, playing Playstations and computer games. Whatever the reasons for a pupil experiencing difficulty with non-verbal tasks, through assessment, occupational therapy is able to identify which of the non-verbal skills are requiring development and provides a context in which learning takes place through therapeutic play to address any of the identified areas of difficulty.

More and more pupils are being referred for occupational therapy intervention because of handwriting difficulties and poor fine motor skills. Although visual perceptual difficulties may also be underlying handwriting skills, there is most often an underlying problem with postural control (ability to sustain an upright posture against gravity).This poor postural control causes the pupil to fatigue quickly, show restlessness and lose concentration while doing desktop activities. Furthermore, the development of fine motor skills hinges on the development of core trunk control The importance of participating in outdoor gross motor play of climbing trees and jungle gyms, running and ball play cannot be stressed enough to this end as it is these activities that build up the muscle strength of the trunk and upper limbs.

The natural course of development works from three-dimensional towards two-dimensional, from gross to fine and from the centre of the body towards the extremities. Outside preschool and formal school time, the tendency is for many pupils to spend their time watching TV and playing sedentary, two-dimensional computer games. Not only does this impact on gross motor muscle development, but also on the learning experience of playing sport and board games on a three-dimensional level which have social and language development aspects to them.

Children develop at different rates and they have their own inherent areas of strengths and weaknesses. It is when their functioning within the classroom or on the sports field shows significant difficulty that referral is made. Very often, these pupils have exhibited avoidance behaviours, reduced motivation and confidence to participate, slow completion or incompletion of written work tasks, poor legibility of written work, fatigue, poor posture while sitting at a desk, difficulty with cutting and colouring, use of a poor pencil grip and reading, spelling and maths difficulties.

It is essential for all pupils to have an annual vision test to ensure that there are no vision deficits that may be interfering with the learning process in the classroom and during sport. Although eye screenings are done during the year at school, a full vision assessment may be recommended if your child is experiencing specific difficulties with non-verbal performance. Apart from influencing co-ordination skills, vision deficits also impact on work speed, attention and concentration and self-confidence with task performance. Occupational therapy focuses on visual processing and progress within the occupational therapy programme will be affected if vision deficits are present.

Early intervention is always better than later. The longer it takes for a child to receive occupational therapy after they have been referred, the more the difficulties become compounded and the therapy process is thus lengthened.

Occupational therapists are part of a multidisciplinary team and should work closely with speech and language therapists, the class teacher, psychologists, doctors as well as the family. The earlier intervention is given, the greater the chance of success in helping a pupil to achieve his or her potential, gain confidence and motivation and therefore have an easier and more enjoyable schooling experience.

• Amanda Kuhn is an occupational therapist.

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