Occupational Therapy is one of the mainstays of managing a child with Down
Syndrome. It helps to develop:
Activities of Daily Living (ADL Training) : feeding, dressing, grooming,
going to the toilet, etc.)
Maintaining and improving fine and gross motor skills
Rehabilitation Therapy depending on physical and intellectual abilities,
and trainable skills
Psycho-social adjustment through games and interactive projects, games,
plays, and other activities.
During Infancy
The child may have hypotonia and weakness of facial muscles, making it
difficult to feed the child. Here, an OT is needed to suggest correct
feeding techniques, suitable modified taking into account the disabilities
of the child.
The child needs regular monitoring and suitable Pediatric Therapy under an
OT to develop and preserve fine motor skills and other motor milestones.
An OT and PT (Physical therapist) has to work in coordination to develop
gross motor milestones like sitting, crawling, standing, walking, etc.
Emphasis has to be laid on promoting arm and hand movements. These will help
in improving fine motor skills. The muscle often have low tone and
hyper-mobility at joints. Individually modified exercises and OT/PT are
necessary to get long term improvement at these joints and limbs.
During the KG Stage
The child will start being outgoing. This may be encouraged under
supervision, to develop and broaden the mind and body skills of the child,
in order to improve the fine and gross motor skills. This is the time for
the OT to hone in the ADL Training, speech therapy, and social interactivity
by playing with the child, and allowing interplay with other children
This is a critical period to develop the fine motor skills under the
guidance of an OT. This is often difficult for the child because of lax
muscles and loose joints. Building blocks, crayons, erection type toys, and
things to manipulate physically, teach the child to develop the motor
control skills necessary for later life.
The OT is needed to assess the child, and guide the parent on how best to
manage the child with physical disabilities. This may include specialized
chairs, tables, spoons, potty-chair, walkers, splints, etc. as per
individual disability.
The Junior School years
Concentrate on speech therapy, lesson planning in collaboration with the
school teachers (the child may have to attend special need school, depending
upon the IQ level), and encourage self help and self sufficiency. Actively
encourage participation in extracurricular activities, in order to develop
physical, mental and social skills.
An OT can help and guide the child to learn printing, handwriting,
keyboarding, cutting etc. Their help may be invaluable to make a customized
chair and table to compensate for deformities and disabilities present in
the child, and in prescribing suitable physical goals for the child to try
and achieve.
Each child is highly individualized, with his or her own unique level of
personality development, temperament, motivation and sense of independence.
The help of an OT is needed to bring the child on par with other normal
children as regards motivation level, degree of participation in group
activities, self help as well as helpfulness to others.
The child may also have sensory deficit, and not be able to comprehend how
hard she is squeezing a toy or other object, or keep on dropping objects by
not holding them properly. The help of an OT may help the child to come to
terms with the sensory deficit and compensate for it.
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