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The Pediatric Occupational Therapy Clinic 51¸£ÀûÉç Michigan University serves children who have diagnoses such as sensory processing disorder, ADHD, autism, cerebral palsy, Down syndrome, developmental delay, fine and gross motor dysfunction, fetal alcohol syndrome and cognitive deficits. We treat children six months to 18 years of age. Referral sources come from community mental health case workers and other clinics, doctors or hospitals in the Kalamazoo area. The focus of the pediatric clinic is to allow children to develop greater success in occupations that are meaningful to them.

The role of the OT interns, under supervision of the OTRL, includes providing evaluation, and designing client-centered intervention directed towards improving handwriting skills, motor skills, increasing sustained attention to task, increasing independence in self-care like grooming and eating, and improving safety awareness as they move through the environment and/or learn to interact socially. Interns are guided to developing client-centered & occupation-based intervention plans supported by appropriate theoretical approaches and empirical evidence. Interns also establish a strong therapeutic relationship based upon client-centered principles and guided by the theoretical concepts from the specific frames of reference and models of practice being used. Each student manages a caseload of clients following the client for the duration of the academic semester. Functional assessments are documented as are daily progress notes and semester’s discontinuation notes. Communication with the client’s family and caregivers is an essential component of the process and each student is committed to providing exceptional attention and care throughout the client’s stay.

Client evaluation process

The evaluation is scheduled over two one-hour sessions and consists of interviewing clients and caregivers, standardized assessments, and structured observations of things like play, motor skills, self-care activities and interaction with peers and caregivers. The evaluation identifies strengths and deficit areas that can be addressed through treatment to increase functioning. From assessment information, functional goals are developed in collaboration with the caregiver and client.

Client intervention process

Intervention is scheduled for one hour, once weekly sessions. Intervention is designed to improve motor skills, sensory processing skills, and independence in daily activities through one-on-one sessions targeting specific skills areas for the individual client. An individualized intervention plan is developed in collaboration with the client, if appropriate, and with the client’s family, caregivers, and case managers. Through collaboration and communication with caregiver, skills learned in the clinic will be generalized to the child’s natural environment.

In addition to MOHO as a guiding theoretical structure, the following frames of reference/treatment approaches may be used to guide intervention: sensory integration, biomechanical, rehabilitation, motor acquisition and cognitive-rehabilitation.

By the end of the semester it is expected that students will have developed the following basic competencies regarding working with children with difficulties with motor skills, sensory regulation, developmental delays, and overall decreased independence in daily routines:

• Evaluation and intervention process

• Building therapeutic relationships and therapeutic use of self

• Developing client-centered and occupation-based intervention plan supported by appropriate theoretical approaches and empirical evidence

• Providing intervention directed toward improving independence in daily tasks/school readiness, management of sensory dysfunction, and motor skills

• Implementing one-on-one intervention

• Collaboration with peers in a clinic setting