Abi Johnson, an Independent Occupational Therapist talks about occupational therapists delivering health promotion with children.
Occupational therapists working with children are well placed to deliver health promotion. Examples include development of personal independence, promoting the importance of children’s occupations for development, parenting support and promotion of exercise and a healthy lifestyle in obese children. I am an independent occupational therapist working mainly with children who have poor coordination and handwriting difficulties. Enabling children to participate in childhood occupations at home, in the classroom, in P.E. lessons and during play time is vital for promoting health and wellbeing.
One example of health promotion in my area of work is developing hand-washing skills. Research about hand-washing in schools suggests that absence from schools can be reduced by introducing regular hand-washing. Public Health England advises schools that hand-washing is one of the most important ways of controlling the spread of infections. However, hand-washing is an activity that in my experience as an occupational therapist and as a parent is given low priority in some schools. Facilities for washing hands at school can be limited and confined to toileting areas while drying hands can be particularly problematic. It should not be assumed that all children will join reception with the ability to efficiently perform this task.
My ‘Get Ready Club’ groups for pre-school children encourage development of skills for school. The sessions work towards independence with dressing, feeding and toileting as well as encouraging development of motor skills, scissor use and pre-writing skills. While the groups are aimed at children without identified difficulties, it is common to assist parents to address anxieties and developmental issues.
The Get Ready Club includes craft activities which are messy and washing hands after these activities provides an opportunity to informally assess how thoroughly the children are carrying out the task. Following a messy activity children are taken through a fun routine to learn and practice hand-washing. Parents are provided with information and encouraged to teach the children to take responsibility for washing their hands after going to the toilet and before eating. A poster illustrating simple visual steps for hand-washing to put up on the wall at home is provided to reinforce learning.
As an occupational therapist, I use purposeful activity to develop skills; children participate in a variety of activities that are carefully planned for the age group and interests of the individuals. The groups give children confidence in many ways. The overwhelming feedback I receive is “Why didn’t I think of that before!” Applying the foundation occupational therapy skills of activity analysis and grading tasks to promote development are key to the success of these sessions. A parent recently said “I am now confident in knowing I am giving my child the right level of encouragement in the right way”.
One parent commented that “As a parent I was very impressed with the simple and what now seem obvious techniques! For me seeing my just 4 year old learning very easily to blow his nose, good pencil action and hand-washing were the stand out outcomes. Watching Jake blow his nose and washing his hands I can see how he has improved. With his hand-washing he shows me how he washes both sides of his hands and between his fingers and then makes sure to rinse off and dry them. He is very proud showing me and we say that’s how Abi taught us! It’s lovely to see that. The class where they practiced changing for PE and putting their clothes on their chair has also been commented on as his new reception teacher told me how well he had done on PE day”.
I think as occupational therapists we often forget how our training has enabled us to problem solve and assist children to compete their important everyday tasks. We need to remember that what we do is not simply ‘common sense’, as if it was then everyone would be doing it! Through doing these programmes it also reinforced for me how we need to be focusing on the outcomes for the children (i.e. what they will be able to do following occupational therapy involvement). I hope that these types of health promotion activities will continue to be an integral part of the services which occupational therapists offer and we advertise our potential to the wider health promotion arena. From doing this we can develop occupational performance and participation for all children, and potentially prevent future issues.