An Intro to OT & HADDS
Written by Lauren L. Lynch, OTR/L
April 21, 2023
You may have heard of occupational therapy. You may know an occupational therapist. You and your child may currently be working with an occupational therapist. But the funny thing is, most people (including many occupational therapists themselves) struggle to really put into words what occupational therapy means or how it differs from physical therapy or speech therapy or recreational therapy, or the many other therapies you may have been exposed to. I have been an occupational therapist for over 20 years and have worked in almost every setting imaginable. I always cringe a little when someone asks, “What is occupational therapy?” because it’s hard to whittle it down to a short, easily explained definition. So here is my best answer, and it’s the reason why I think occupational therapy is the most special calling; occupational therapists work with people to help them participate to the best of their ability in the things that are most important to them and their families on a daily basis. Through the use of therapeutic activities, we help people reach meaningful goals to improve their participation in activities of daily living, whether that is at home, at school, at work, or at play. These activities are the person’s occupation, hence the name “occupational therapy”.
So, you may ask why should my child have an OT consultation? How does occupational therapy benefit a person with HADDS? Since HADDS is a fairly recent diagnosis and most of the people diagnosed up to this point are children, I will mostly address this from a pediatric standpoint, but all of this also applies to any person diagnosed with HADDS regardless of age. A referral to occupational therapy is important for a person with HADDS because OT’s specialize in helping a person successfully interact with their environment as independently and successfully as possible. OT’s work in many settings, such as home-based, in an outpatient clinic, or embedded within a classroom or school system.
Many kids with HADDS struggle with Sensory Processing Disorder (SPD) or have sensory defensiveness. OTs specialize in working with children who have sensory issues. SPD is very common in kids who have had feeding difficulties, communication difficulties, and Autism Spectrum Disorder (ASD) all of which can be common with a HADDS diagnosis. Kids with sensory defensiveness often have very limited diets-they can be extremely picky. They often experience difficulty with grooming activities such as tooth brushing, hair brushing, and baths. They may have difficulty with unpredictable environments such as crowded stores and loud places like restaurants. They may have difficulty with dressing, getting clothes on correctly, and they may be irritated by certain clothing and tags or labels. All of these difficulties can lead to behavioral issues that can be very difficult for daily life at home, at school, and in the community. One way OTs can help improve a child’s ability to tolerate unpredictable sensations in their everyday life is to help determine specific sensory activities that are enjoyable, calming, and/or stimulating. This is commonly called a “sensory diet”: a menu of sensory activities for home and school to help the child modulate the sensations in their environment and improve participation in home and school activities. An OT will commonly prescribe a sensory diet, and then work with the child, caregivers, and teachers to implement these activities and strategies into the daily routine to make dealing with SPD more manageable.
Low muscle tone (hypotonia) and ataxia (difficulty coordinating movements) are hallmark symptoms of HADDS. Helping develop motor control and strength is another specialty of OT. Through therapeutic activities focused on muscle strength, endurance, and coordination, OTs work with kids to improve trunk and postural control and coordination to help them sit up for the first time, stand to brush their teeth and wash their hands independently, or run along with their friends on the playground at school. OTs also frequently work with children to help improve fine motor control and eye-hand coordination, which can help improve a child’s ability to color a picture, cut with scissors, participate in games on the playground, or make a friendship bracelet for a pal.
Finally, OTs wear many hats when it comes to helping children and families meet their goals–we are wonderful inventors, adaptors, and collaborators. OTs work with people to adapt to their environment to help them become more independent. This may be through the use of adaptive equipment such as weighted utensils to decrease spilling with self-feeding, clothing with dressing fasteners that are adapted to improve independence, and adaptations in the bathroom to improve safety and independence with toileting and bath time. OT’s also work closely with other family members, teachers, and other healthcare professionals to help improve a child’s ability to perform daily tasks independently, safely, and successfully. For example, working with physical therapy to determine the best devices to improve independent mobility. Also, collaborating with speech therapy to improve self-feeding, swallowing safety, and communication through the use of adaptive communication devices. Additionally, OTs in the school system work closely with classroom teachers to implement strategies to improve a child’s success in the classroom, both academically and socially.
I hope I’ve helped you to understand a little about what an occupational therapist can do and how they can help a person achieve their goals, especially with respect to a person living with HADDS. As you can see, the possibilities are really endless. As long as a goal is important and meaningful to a child and their family, it’s covered by the occupational therapy scope of practice. And that, in a nutshell, is why OT is so difficult to define–even for occupational therapists themselves! If you are interested in learning more about occupational therapy, the American Occupational Therapy Association (aota.org) is a great resource to learn more about pediatric OT and the many other areas of practice.
Happy OT Month!
ABOUT THE AUTHOR
Lauren Lynch is a Louisiana native who currently lives on the “Space Coast” of Central Florida. She has over 20 years of experience as an occupational therapist, working in a variety of clinical settings with clients of all ages and abilities. She holds undergraduate degrees in both psychology and occupational therapy from Louisiana State University. Lauren became involved with the HADDS community when her niece, Collette, was diagnosed, and now serves as the secretary on the EBF3 HADDS Foundation's Board of Directors. Lauren and her husband Matt are the proud parents of three teenagers, Anna Kate, Noah and Charlotte.