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Occupational therapy for cerebral palsy

Occupational therapy can help with managing everyday activities and functions, like eating, getting dressed and using the bathroom. It does so by improving physical and cognitive ability and fine motor skills.

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How Does Occupational Therapy Help?

Occupational therapy helps people develop or recover the skills needed to lead independent, satisfying lives. The “occupation” in occupational therapy does not refer to one’s profession. Rather, it refers to the everyday activities that give life meaning.

For a child, these meaningful activities include playing and learning. Pediatric occupational therapy focuses on improving the child’s ability to play and learn, which are important for development and becoming independent.

For children with cerebral palsy, occupational therapy can help with muscle and joint coordination issues — issues that can make everyday tasks difficult. Some of these tasks include eating, brushing teeth and bathing. Occupational therapy can help to improve physical, cognitive and social abilities, as well as fine motor skills and posture. This therapy can also help address difficulties with processing sensory information.

Benefits of Occupational Therapy

Occupational therapy is beneficial for children with cerebral palsy in many ways.

By optimizing upper body function and improving the coordination of small muscles, occupational therapy can help children with CP master the basic activities of daily living.

Occupational therapy can help children by:

  • Increasing their chance for independence
  • Improving their ability to play and learn
  • Boosting their self-esteem and confidence
  • Helping them develop a workable routine
  • Giving them a sense of accomplishment
  • Improving their quality of life

Parents and caregivers spend a lot of time helping children with cerebral palsy perform basic day-to-day activities. As the child begins to see the benefits of occupational therapy, the parents and caregivers do, too.

For parents and caregivers, occupational therapy helps by:

  • Reducing the demand on them
  • Reducing stress
  • Providing a sense of security
  • Improving their quality of life
  • Allowing them to watch their child improve and become independent

Each type of cerebral palsy presents different symptoms that may hinder a child’s ability to live independently and complete daily activities.

Occupational therapy can help with the following issues related to each type of CP:

  • Spastic -  Muscle stiffness in the upper and/or lower limbs and jerky movements characterize spastic cerebral palsy. Among other things, this can lead to difficulty getting dressed, bathing, using the bathroom, eating, drinking, writing and holding objects.
  • Athetoid - Children with athetoid cerebral palsy are unable to regulate muscle tone, which makes it difficult to control their movements. Trouble with grasping objects, posture, drooling, swallowing, and speaking are common among children with athetoid CP.
  • Ataxic - Problems with balance and coordination are common among children with ataxic cerebral palsy. These children often struggle with precise movements and have tremors or shakiness. This makes it difficult to perform tasks like writing or eating that require precise finger movements, or repetitive movements like clapping.
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What to expect in occupational therapy

As with physical therapy and speech therapy, occupational therapy is different for every child with cerebral palsy. Each child’s occupational therapy treatment plan is highly individualized and tailored to their individual physical, intellectual and social-emotional abilities.

During your child’s first therapy session, the occupational therapist will perform a complete evaluation. This includes testing the child’s fine motor, perceptual and oral-motor development, and observing how the child responds to touch and movement. The occupational therapist will also interview the parent to find out about the child’s strengths and weaknesses when performing daily activities, as well as pinpoint the specific goals for the child to work toward.

Most children with cerebral palsy need to be reevaluated every six to nine months. After these evaluations, the occupational therapist will tweak the treatment plan accordingly based on progress and change.

Exercises Used in Occupational Therapy

Occupational therapy involves using functional activities to progressively improve functional performance.

Occupational therapy exercises focus on the following skill areas:

  • Fine Motor Control - Improves hand dexterity by working on hand muscle strength, finger isolations, in-hand manipulations, arching the palm of the hand, thumb opposition and pincer grasp. Activities include squeezing a clothespin, playing with water squirt toys and pushing coins into the slot of a piggy bank.
  • Bilateral Coordination - Play/movements teach the child to control both sides of the body at the same time, like drumming, pushing a rolling pin and pulling apart construction toys (Legos).
  • Upper Body Strength and Stability - Play focuses on strengthening and stabilizing the trunk (core), shoulder and wrist muscles through exercises, such as crawling, lying on the tummy while reading, playing catch in a kneeling position and pouring water from a pitcher into a cup.
  • Crossing the Midline - These activities, like making figure eights with streamers and throwing balls at a target to the right or left of center, teach the child to reach across the middle of their body with their arms and legs to the opposite side.
  • Visual Motor Skills - Improves hand-eye coordination through activities, like drawing, stringing beads or macaroni and catching and throwing a ball.
  • Visual Perception - These activities improve the ability to understand, evaluate and interpret what’s being seen. Activities include alphabet puzzles, playing with different shapes and matching games.
  • Self-Care - Improves the ability to perform activities of daily living and prepare the child to be more independent at home, at school and in the community. Exercises can be as simple as practicing these ADLs, like brushing their teeth, getting dressed and self-feeding.

Occupational therapists use specific techniques to help children reach their goals, including:

  • Pediatric Constraint Induced Movement Therapy (CIMT) - Improves the ability to move weaker parts of the body by restraining its stronger counterpart. For a child who has difficulty moving one of their arms, the stronger arm will be completely restrained for a period of time while the weaker arm is strengthened and trained.
  • Sensory Integration Therapy - Improves the ability to receive, register, interpret and act on information that comes to the brain through sensory receptors. These activities provide the child with different sensory experiences and can include playing with balls, play dough, silly putty, sand and water, walking on different carpet textures and finger painting.

Equipment Used in Occupational Therapy

Many different tools and assistive devices are used in occupational therapy. Equipment can range from common household items to high-tech assistive technologies.

Tools

  • Everyday household items (straws, clothes pins, tweezers, sponges, etc.)
  • Books
  • Adaptive scissors (with spring closures or grips for easier use)
  • Writing utensils
  • Splints
  • Adaptations to clothing (zipper pulls, button hooks, reachers)
  • Toys to help with the development of motor skills
  • Games and toys that help with motor and cognitive development

Assistive Devices

  • Pencil grips
  • Specialized feeding utensils
  • Seating and positioning equipment
  • Computer software and accessibility
  • Household aids and equipment
  • School chairs and tables
  • Toilet and bathing aids
  • Tablets

Occupational Therapy by Age

Occupational therapy helps people of all ages. For children with cerebral palsy, treatment will be based on the child’s physical, intellectual, social and language abilities, as well as their age.

  • Toddlers - Treatment for toddlers revolves around play and learning. Games and toys are used to improve the child’s cognitive and physical development.
  • Young Children - Therapy for young children works on improving cognitive and physical development, as well as the child’s ability to perform daily living activities. Occupational therapy can also improve the child’s performance in school and their socialization skills.

Finding an Occupational Therapist

Occupational therapists are licensed healthcare professionals. Finding an occupational therapist who has experience working with cerebral palsy patients is very important to ensure your child gets the best treatment possible.

If you need help finding an occupational therapists, ask your child’s pediatrician if they have any recommendations. Occupational, physical and speech therapists often work together to create comprehensive treatment plans. If your child is seeing a physical or speech therapist, they may be able to connect you with an occupational therapist.

To learn more about how to locate an occupational therapist, try downloading our free Cerebral Palsy Guide, which includes over 12 pages of in-depth information for children and parents of a child with CP.

kristin proctor registered nurseReviewed by:Kristin Proctor, RN

Registered Nurse (RN)

  • Fact-Checked
  • Editor

Kristin Proctor began her nursing career as a U.S. Army Nurse and has been a Registered Nurse (RN) more than 20 years. She has specialized experience in labor and delivery, as well as prenatal, antepartum, and postpartum care. Kristin uses this experience to educate and support families affected by birth injuries.

Cerebral Palsy Guide was founded upon the goal of educating families about cerebral palsy, raising awareness, and providing support for children, parents, and caregivers affected by the condition. Our easy-to-use website offers simple, straightforward information that provides families with medical and legal solutions. We are devoted to helping parents and children access the tools they need to live a life full of happiness

Sources
  1. Children with Cerebral Palsy: A Parent’s Guide 2nd ed. Edited by Elaine Geralis. Chapter 7: Physical Therapy, Occupational Therapy, and Speech & Language Therapy by Lynne C. Foltz, M.A., P.T., Georgia DeGangi, Ph.D., O.T.R., Diane Lewis, M.A., C.C.C. Chapter 3: Medical Concerns and Treatment by Dr. Gersh. Woodbine House, Inc. Bethesda, MD. 1998.
  2. My Child Without Limits. (2015). "What is Occupational Therapy". Retrieved on July 30, 2015 from: http://www.mychildwithoutlimits.org/plan/common-treatments-and-therapies/occupational-therapy/
  3. Therapies for Kids. (2015). "Cerebral Palsy-Occupational Therapy For". Retrieved on July 30, 2015 from: http://www.therapiesforkids.com.au/conditions/cerebral-palsy-2/
  4. Children's of Alabama. (2015). "Pediatric Therapy Outpatient Program". Retrieved on July 30, 2015 from: https://www.childrensal.org/PediatricCITherapyOutpatientProgram