Fun and Games
The business of childhood is play, and it's the business of occupational therapists to make that play as effective, entertaining, and stimulating as possible. There's no better way to do that than to get right down on the floor and get into it.
To your child, an occupational therapist (OT) appointment will seem like a rolling, jumping, playing good time. The therapist will follow your child's lead while subtly adjusting activities to meet the goals you've set together.
Sensory integration therapy involves providing a lot of the kind of input that calms the child whose nervous system needs calming, or arouses the child whose nervous system needs arousing. Children may enjoy some of the activities and be fearful of some of them, and the therapist will make adjustments to reduce anxiety while supporting gentle progress.
If you feel your child has a weakness in a particular area and are frustrated that the therapist doesn't seem to be dealing with it, don't hesitate to ask about it. There may be skills the therapist wants to work on first in order to lay the groundwork for the skills you want targeted, or to overcome fears your child has.
Generally, an OT will work with your child one-to-one for an hour or so a week. This time may be broken up into several sessions, depending on your child's needs, his attention span, the therapist's schedule, and your schedule. If the therapy is being done in school or as part of an early intervention program, there may be some group sessions, but there should always be plenty of individualized time as well. The therapist should be able to tell you how much group time there will be and how it will be utilized.
Whether you're able to watch your child during therapy may be determined by the layout of the facility, the therapist's preference, how distracted your child is by your presence, and your desire to hang around during the therapy time. Some offices may allow you to watch through a window or two-way mirror. The therapist might call you in to show you a particular thing your child has accomplished or something to work on at home. At the end of each session, the therapist will likely bring your child out to you and tell you a little bit about how things went.
Goals for school occupational therapy are stated in the child's individualized educational plan (IEP). The OT will provide a report on your child's status and set goals for the following year. If you have concerns about therapy goals, share them with the OT before the IEP meeting or discuss them with the child study team members at the meeting.
If your child gets therapy at school, of course, you will be less involved. However, some school OTs send home notebooks in which observations can be exchanged and reports given, and you can always call to check on progress or request a meeting. It may be possible to sit in on a session at school or to bring your child before or after school for a session so that you can observe.
If your child is getting the therapy as part of early intervention, it may actually take place in your home. When the therapy takes place at an office, you may be able to observe sessions, or there may be a support group that you can participate in with other parents during that time.