Stimulating Childhood Development

On May 31, 2018
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HIGHLIGHTS:

What are developmental irregularities?

Developmental irregularities can be observed in children who develop at a slower rate than children of the same age in the general population, including children whose development deviates from the norm (a table has been attached to the end of this paper so that parents and guardians may compare the developmental stages of their own child with the development of the general population in the same age group).

Common Conditions

Children who display muscular issues (spasticity) or whose muscles tense up without warning tend to have difficulty in controlling their muscle groups.
Children who have irregular muscular weaknesses, such as Down Syndrome.
Children who have communication and social issues, as well as children who have behavioral and emotional problems. These may be signs of Autism, Attention Deficit Hyperactivity Disabilities (ADHD) or Learning Disabilities.

Autistic Children

May have difficulty during social situations, and may be unable to express their emotions or seek out social interactions.
May have difficulty in their communication skills.
- May have stunted development or lack of development altogether in terms of oral communication.
- May repeat themselves when speaking or use unusual vocabularies.
- May play or copy others in an unsuitable manner.
May display repetitive behaviors or have limitations in how they behave, what they are interested in and the activities they participate in.
- May lack flexibility when undertaking various activities that they are familiar with.
- May display repetitive behaviors or movements, such as flicking their hands or fingers, spinning themselves around and/or repeatedly spinning their toys.

Children with Learning Disabilities

May have low levels of learning efficiency.
May have high scores in a particular subject but low scores in others.
May have issues with their listening, thinking, speaking, reading, writing, spelling and/or calculating skills.
May be afraid to express themselves.

Children with Attention Deficit Hyperactivity Disability

Will often not pay much attention to the finer details of an activity and will usually make mistakes in their homework and other various activities.
Will have difficulty in concentrating and completing their work or other activities.
Will often be careless.
Will display hyperactive traits or an inability to sit still for long periods of time.

Groups of Children at Risk of Irregular Development

Children born prematurely.
Children born underweight or children born with a weight below 2,500 grams, whether born prematurely or not.
Children who experienced difficulties during birth and/or asphyxia
Children with complications after birth, such as inadequately treated jaundice.
Children whose mothers contracted an infection during pregnancy.
Children with a family history of developmental issues.
Children who have a difficult temperament.

Treatments

Medical treatments, such as medication (e.g. children with hyperactivity disorder) and surgery (children with muscle spasticity).
Occupational therapy
- Sensory integration
- Gross motor and fine motor skill stimulation therapy
- Language stimulation therapy
- Stimulation of knowledge acquisition and concentration techniques
Physical therapy

What is occupational therapy?

An occupational therapist is a type of medical professional who utilizes various activities in order to assess, evaluate, diagnose, support, treat and rehabilitate the capabilities of those with physical and mental developmental conditions, or people with irregularities related to their mental wellbeing, mood and social skills. Numerous activities are undertaken by the patients to ensure that they reach their full mental and physical potential so that they may lead a full and balanced lifestyle both mentally and physically. This includes the prevention of any deterioration in their capabilities due to restraints in their ability to carry out certain tasks. Occupational therapy can be categorized into 4 main areas: Pediatrics, Physical Rehabilitation, Geriatric and Mental Health.

Pediatric Occupational Therapy

This therapy aims to stimulate the development of children to ensure that they develop at an appropriate rate to their age. This treatment is usually suggested for mentally disabled children; children who have problems with their mood, social skills, mental wellbeing and behavior; physically disabled children; children with multiple disabilities; children with learning difficulties; and children with Down syndrome. Specific equipments are adapted to enable these groups of children to carry out and overcome activities that they may encounter in their daily lives.

Physical Rehabilitation Therapy

This aims to rehabilitate and train the patient in the skills and operations carried out by various parts of the body. Equipments are adapted to enable these patients to return to their former capabilities and reach their full potential in order to lead normal lives. Physical rehabilitation can benefit certain groups of people, such as those whose conditions are related to their skeletal system and muscular structure or to the central nervous system as well as those who have cardiovascular irregularities and metabolism problems or those with injured arms or hands.

Geriatric

This refers to physical therapy which targets mental wellbeing and social skills affecting movement, sensitivity, knowledge and understanding in cases that these skills have begun to deteriorate, causing difficulties in leading normal lives due to various reasons such as disease, illness and accidents. The aim of this type of therapy is to rehabilitate and support the patients in leading their daily lives with as much independence as possible, as well as help them to reach their full physical potential through targeted activities and adapted devices, and by modifying their homes and surrounding environment.

Mental Health Therapy

Mental health therapy enhances mental wellbeing and social skills. Mental wellbeing plays a key role in a child’s development. The therapy also helps with irregularities, such as mood swings, schizophrenia, drug addiction, stress and irregular behavioral patterns. Occupational therapists will offer care, treatment and rehabilitation depending on each individual case in order to prepare the patients to return to their daily lives as their best selves.

The objectives of pediatric occupational therapists are to:

Assess childhood development, including gross and fine motor skills, language development, social skills, mood, and the ability to perform the activities required for daily life.
Plan on therapy through activities that develop the child’s physical capabilities, such as increasing their range of motion, muscle strength, muscle coordination, their ability to plan for their movement, balance and sensitivity, and improving languages and communication capabilities.
Plan on arranging activities to play in order to build the child’s knowledge and ability to carry out the activities necessary for daily
Plan on arranging activities to play to build the child’s self-esteem, as well as to help them overcome any fear or anxiety
Prepare activities that support the development of physically and mentally disabled children and enable them to develop at a rate as close to children without disabilities as possible.
Prepare activities that develop the skills necessary to adapt to the environment, and support them to fit into their childhood social circles.
Build understanding and develop a healthy attitude in parents or guardians of children in these groups so that they have a greater understanding of their child’s condition and expression

The work undertaken by pediatric occupational therapists

Occupational therapists assess the child, their environment, the child’s relationship to their environment, as well as the environmental effect on the child. This is done with the belief that children need to adapt to their environment and that they have a continuous effect on the environment they live in. The way in which children interact with their environment is constantly developing as they acquire more knowledge of the environment. The environment of the child itself also changes constantly as it adapts to the needs of the child.

The therapists will analyze a child’s capabilities by observing numerous activities in various situations and environments to discover the true potential of the child, including their limitations in various activities that may come due to factors such as the child’s skill set, internal factors and environmental factors.

Thus, an important part of a pediatric occupational therapist’s job is to analyze the functional performance of a child in order to categorize the factors involved, and specifically target those factors with therapy and treatment.

Schedule to show the usual age-related development of a child

	Movement	Hand-eye Coordination	Understanding Language	Use of Language	Social Skills and Independence
2 months	Lift the head to 45° while laying on their side.	Stare at an object from 20cms away.	Respond to sound with a look or through movement of the body.	Make sounds from the throat, like ‘Ooh Ooh, Aah Aah’.	Smile or make sounds when being played with.
4 months	Roll onto their side.	Pick up a toy by extending and flexing fingers.	Turn to face the direction of a spoken sound.	Make sounds with their lips, gurgling sounds and blowing bubbles repeatedly.	Display happiness through movements when they see their mother or a milk bottle.
6 months	Sit for long periods of time and use their hands to play with toys.	Use both hands to hold objects.	Sustain listening to people speaking, and look at objects for at least a minute.	Able to pronounce two syllable words.	Stare at and cry when meeting a stranger.
9 months	Walk with help.	Focus their gaze on a toy that has fallen to the floor.	Turn to face the direction of someone calling their name.	Knowledge of how to express rejection of something.	Use their hands to pick up their food.
12 months	Walk unaided for 2 meters by stretching their arms out in front of them.	Put objects into a small bowl.	Knows the members of their own household when they call out their name.	Imitate someone’s facial movements using one part of their face.	Bite, chew and swallow by themselves.
18 months	Walk comfortably by themselves.	Pick up a piece of string by using their thumb and index finger.	Point to a part of their own body.	Say around 4-6 words.	Imitate house work, such as sweeping and tidying up toys.
2 years	Run comfortably.	Imitate assembling blocks into trains.	Point to 4 different parts of their own body.	Use 2 or more verbs, such as ‘sit’ and ‘lay’.	Articulate or express themselves through movements when needing to use the bathroom.
3 years	Walk along 5cms wide lines for up to 3 meters.	Imitate drawing pictures and circles.	Select large objects.	Respond or reject through speech.	Undo up to 3 buttons with 2cm diameters.
4 years	Hop on one leg around 2-3 times.	Draw pictures of up to 3 different body parts.	Place objects in front of, on top of, behind or under other objects requested.	Tell people their own name and surname.	Wash their own hands and face by themselves.
5 years	Catch a ball of 15cms in size when thrown from 2 meters away.	Draw a simple picture that has 4 constituent parts.	Point to 19 of their own body parts.	Answer questions about the work carried out by various body parts.	Tell others their address (including road and sub-district).

* Data from the Child and Adolescent Mental Health Rajanagarindra Institute.

** Parents and guardians are able to compare their own child’s development to the age-related stages outlined in the table above. If parents or guardians wish to carry out a more detailed assessment of their child’s development or would like advice on issues related to each stage, including issues related to behavior and mood, they are able to find out more from occupational therapists at Samitivej Srinakarin Hospital.