Baby Blog

Understanding what Occupational Therapy is

When asking ‘What do you do for work?’ most people want and expect a short answer and something familiar. The answer, ‘I’m an Occupational Therapist’ is usually followed by a blank stare or some vague response.

Sometimes the curious will ask ‘What’s an Occupational Therapist?’ 

The answer to this is not a short answer and something along the lines of “we help people participate in the activities or ‘occupations’ that are meaningful to them when they have a disability or condition which stops them from doing what they want to do”. 

Occupational Therapy (OT) doesn’t fit in a box like other paid occupations. It’s a broad field, working with different populations across the lifespan. We have a broad range of job descriptions to choose from, and each day can look very different to the next. 

This is what is exciting about being an Occupational Therapist but equally makes it hard to explain. 

The key to understanding 'Occupational' Therapy is to broaden the definition of ‘occupation’ to more than just your job or what you get paid to do. An OT sees 'occupation' in terms of what 'occupies' our life. All the meaningful, or role-related, activities or tasks.  This can include paid employment, but more importantly, it includes everything else we occupy ourselves doing. 

Usually, parents are only aware of what OTs do because they or their families have come into contact with OTs within the neonatal setting, paediatric services, mental health, disability and chronic disease settings to name a few. Additionally, they usually only come into contact with OT services when things go wrong such as injury, illness or disability. Usually, this is in the context of providing therapy to the baby or child rather than for the parent.

OT's unique view of health and its interplay with everyday life activities means they are well-positioned to work in health promotion with a community focus. Unfortunately, OTs are so in demand in the traditional contexts of practice, the health promotion part of their role doesn't get the time or attention it should.

Traditionally, OTs haven't routinely worked with a focus on mothers. Still, I believe there is a huge scope for OT's to contribute to improve the health of the wider parenting community. 

What influences Occupational performance vs occupational dysfunction?

The core belief behind Occupational Science is that participation through active engagement and involvement in occupations contributes to the wellbeing of individuals and communities and overall satisfaction and quality of life (Baum et al., 2015). In other words, how we occupy ourselves with doing shapes all aspects of our health. In turn, our health then affects our participation in occupations.

Our performance of occupations (occupational performance) are the result of our mind/body/spirit performance components as well as our interactions in our environment. 

Our body and mind are considered a complex system which includes all the different components which make up our various bodily systems. How our body can perform and how it interacts with our brain,  including our thoughts, expressions and our sense of spirituality all influence our performance. 

Our person exists within our various environmental context,s including our physical, social, cultural, educational, natural and technological influences. These all impact on participation, particularly when the environments don't fit with the person's abilities or needs. 

When disruptive health or environmental factors are significant, this prevents a person from participating fully in the activities or roles that are meaningful to them. OTs call this occupational dysfunction. Dysfunction can occur across the lifespan (from neonates to end of life), contexts and populations. 

OTs see their core business is to help people experiencing occupational dysfunction.  They do this by improving the functional capacity of the person, improving the person-environment fit and encouraging participation in new occupations to create meaning and purpose to influence their health and wellbeing positively. 

Becoming a parent (particularly for mothers) is a time of significant mind, body and spiritual change and represents a transition into a new life stage. Even without additional physical or mental conditions, it is a time of occupational dysfunction. It is also a time of re-evaluating the home and cultural environments to fit the new needs of the family. This is why I believe the skills that OTs possess have applications to help new parents.

Occupational Therapy in the paediatric context

The factors which influence child development are complex, which is why there are so many paediatric health services (including OTs) with workers who have completed additional professional development training to work with children and their families. Since there is no mother or father without a baby, a big part of the parenting challenge lies with the health and development of the unique baby who enters the world. Any parent who has had more than one child can vouch for the fact that every baby is a unique combination of nature and nurture. 

OTs working in paediatrics see the full range of health conditions and developmental delays. Unfortunately, it can take a long time for developmental delays to be recognised, identified, and therapy to be accessed. In the therapy world, early intervention has the best outcomes. Early intervention therapists usually work with babies through to toddlers in a clinic or home setting. 

OTs understand that play is the child's primary occupation for learning about and understanding the world. Therapists use play to assess skills and also as therapy to encourage development. A skilled therapist will grade the (fun) activity to the child's level of competency while providing the opportunity for them to extend their skills to the next level. 

A great therapist recognises that the parent knows their child the best, their bond with the child provides the trust needed to feel safe and supported, and the parent spends the most time with the child. They use this connection to promote the best outcomes for the child in conjunction with the parent. As such, a huge component of what therapists provide is education to parents on how to encourage skill development at home through home-based programs and strategies. Therapy sessions are most effective when parents are involved, where they can learn activities and strategies to continue and practise in the home environment.

The determinants of health for the child starts even before the child is conceived. Working with expectant and new parents is truly the earliest intervention OTs can deliver - it is preventative and protective. Paediatric therapists have such high demand for their services that their attention is on the greatest need, when problems have been identified.

BabyPeg hopes to change the trends, to deliver information and suggestions to new parents on what they can do to actively promote healthy development for their babies. A parent who understands child development in terms of what baby can do, what baby wants to do and what they are working towards, has the framework to be proactive in shaping everyday learning and engaging experiences. This helps develop competence and skills appropriate for their child's developmental level. 

Future BabyPeg content will be focussing on parenting strategies to positively interact and create supportive environments from the earliest age so that each child's potential is reached.

How Occupational Therapy informed my parenting

When I was expecting my first child and then became a mother, it was hard to ignore the relevance of my training as an OT to this unique life stage. The changes in my body and mind required a change to my approach to my occupations and a change in priorities.

As a pregnant mother, I started to shift my routines and daily activities to accommodate the needs of my baby and the changes in my body. It was different from being sick or disabled, but all the same, I had to change the way I did things as my body shape, hormones, nutrition and rest requirements changed.

The pregnancy was the prep work for when I became a mother with a baby. It invited me to tune into my body and baby and slow down. I instinctually started to re-evaluate my home and social environments. It was an anticipation of my expected needs in my new role as a parent and the needs of my baby. This 'nesting' intensified towards the end of the pregnancy and motivated significant lifestyle and environmental changes. From my OT experience and my husband's child education experience, we knew that the home and everyday environments are where the most growth and development occur from the earliest age. We were determined to create a healthy, safe and enabling home environment to meet the needs of our baby as he developed to crawler, to standing, to walking and running. We would have to adjust as each new stage emerged.

When our baby was born, I had to accommodate into my life an entirely new set of occupations related to caregiving and providing for my child. 

The hardest part was adjusting to balance these demands with my self-care and other necessary occupations. This shift required previously meaningful and important activities in my life to be replaced or delayed in favour of my caregiving tasks. Being an Occupational Therapist was my 9-5 job, and it defined most of my waking hours. This was all on hold while an entirely new set of priorities set in. Meeting the urgent needs of my baby changed the whole look and feel of my life to something unrecognisable. 

During this transition, it felt like occupational dysfunction. It was compromise and re-organisation, with constant adjusting to a small person's needs and preferences. The predictability and familiar routines of daily life were no longer present. My sense of control over my life and choices would have to give way and be let go in favour of acceptance, deep breaths and the 'this too shall pass' mantra.

From being around other parents and children, it is clear that there can't be a one size fits all approach to parenting. This is because each parent is unique in themselves, unique in their context, and unique in their experience of life. It follows then that no parent can apply a one size fits all approach to parenting because each child is also unique in themselves, unique in their context, and unique in their experience of life.

The final word

My experience has shown me how supported, healthy and happy children must start with supported, healthy and happy parents.

The OT perspective of health and wellbeing and how this relates to what we can and want to do is especially relevant to parents. It has a lot to offer parents to improve their experience and ultimately contribute positively to their health and wellness as they adjust to the challenges of life with a new baby. 

BabyPeg is here to deliver that change.

Written by Anna Noud

Co-founder of BabyPeg, Occupational Therapist and Mother of 2 boys. Living on the Central Coast of NSW.

References:

Baum, C.M., Christiansen, C.H., & Bass, J.D. (2015). The Person-Environment-Occupation-Performance (PEOP) Model. In C.H. Christiansen, C.M. Baum, & J.D. Bass (Eds.), Occupational therapy: Performance, participation, and wellbeing (4th ed.) (pp.49-56). Thorofare, NJ: Slack Incorporated.

Cardin, Ashlea D., "Parent and Infant Occupational Performance in the Neonatal Intensive Care Unit" (2015). Doctor of Occupational Therapy Doctoral Project. Paper 2.

Slootjes, H., McKinstry, C., & Kenny, A. (2016). Maternal role transition: Why new mothers need occupational therapists. Australian Occupational Therapy Journal, 63, 130-133.