It Was All Greek To Me – Part 2

By Mili Cordero, Ed. D, OTR/L

The Basic OT Dictionary Motor Skills

Like other therapies, occupational therapy has a language all its own and can sound very foreign to a newcomer’s ear. Understanding the basic terminology helps equip parents to make effective decisions about their child’s therapeutic developmental plan.

What is occupational therapy? Isn’t that for adults who are re-entering the work/occupation force? Al though this is one aspect of occupational therapy (OT), pediatric OT works specifically to assist children in taking part in all activities (occupations) of childhood: playing, studying, eating and becoming independent in self-care. A child can be referred for occupational therapy from birth through school-age. Children age 3 and under receive OT as part of an early intervention program. The reasons for referral vary as widely as children differ from each other. The child may have a genetic condition, neurological issues or developmental delays. He may have difficulties with attention, motor coordination or in completing daily living activities such as feeding himself. Currently, many referrals are concerned with sensory processing disorders, behavior regulation or problems relating to and communicating with others. Once a child is assessed, including parental input, a plan of intervention is developed with particular goals. Following is an OT dictionary which will help parents familiarize themselves with the terminology.

Muscle tone – the quality of the muscle itself. It may be hypo (low) tonic, hyper (high) tonic or adequate. Some define tone as the ëtension’ in a muscle, which should be high enough to help defy gravity, but low enough to allow movement in space.

Muscle strength – the strength developed by the child as he grows, often confused with muscle tone. The child may have low muscle tone and still be very strong. These are two different measures.

Range of motion – the range through which a joint can be moved. This ability may be constrained by the quality of the muscle tone and/or by muscle strength. It may be that the child will have full range of motion (ROM) if assisted by other means.

Primitive reflexes – these are instinctive reflexes such as those that allow babies to move through the progression of crawling, sitting, pulling up, standing and walking. The reflexes ìintegrateî into normal development once the baby enters the toddler stage. The absence of a primitive re flex, or the reappearance of one after a certain point of development, can interfere with the performance of motor skills.

Protective reflexes – involuntary actions that protect the individual from harm. Examples: pulling hand back from hot stove, blinking when an object gets too close to the eye.

Postural control (head and trunk control) – the ability of an individual to defy gravity and maintain sitting or standing and moving in space without being pulled to the floor. Because it is the ability to control and or stabilize the body, it is basic to the ability to carry out a skilled task, such as cutting with scissors, reading and writing.

Gravitational insecurities – this term is used when the child experiences an unusual degree of anxiety in response to movement and/or the head position in space when his feet do not touch the ground.

Gross motor skills – the ability to complete tasks that make use of large muscles such as running, climbing, riding bikes and playing sports.

Fine motor skills – the development of skills that will ultimately allow for efficient, precise and timely manipulation of tools and/or objects. This skill is usually thought of as handwriting and closely related to schoolwork. Other tasks, such as dressing, oral-mo tor development and visual motor development are also considered fine mo tor skills.

Sensory motor development – the development of the individual’s skill to receive and act based on the information received by the senses. Inclusive in this area are the areas of postural control, sensory modulation and praxis.

Sensory modulation – this happens when the senses work together. Healthy modulation occurs automatically and unconsciously and allows children to stay organized and pay attention. For children with developmental challenges, the modulation process is inefficient and needs to be regulated through sensory integration therapy.

Sensory integration – the organization of sensory input so that the child can interact with the environment effectively.

Sensory processing – this term is used interchangeably with sensory integration. It refers to the ability to receive, organize and interpret incoming information from the senses in order to behave and learn appropriately and effectively. This term is part of the ënew’ terminology and some OTs may not be using it yet.

Praxis – the brain’s ability to plan and carry out a sequence of unfamiliar actions. Examples: climbing a jungle gym, riding a bike or playing catch.

Apraxia – the loss of the ability to execute or carry out skilled movements and gestures, despite having the desire and the physical ability to perform them.

Dyspraxia – having difficulty planning and completing intended fine motor tasks. These children have uncoordinated, out-of-balance movements.

Perception – the meaning that the brain gives to sensory input.

Sensory defensiveness – an increased level of arousal due to incoming sensory input. This causes the child to over-respond to the sensory stimuli.
Sensory under-responsiveness or sensory dormancy – a decreased level of arousal. The child is under-responsive to the sensory input.

Vestibular input – the input received from the vestibular or balance system. It provides the information of time and space, according to the head’s position in relation to gravity and movement.

Proprioceptive input – information received by the proprioceptive system (skin pressure located on joint and sensory receptors) which tells where one is in relation to his own body, i.e. where to scratch, how fingers bend, etc.

Crossing midline – the ability of the individual to use one side of the body in completing tasks that are on the opposite side without turning the body.

The goal of occupational therapy is to improve a child’s ability to complete and enjoy everyday tasks. By identifying the weaknesses in a child’s motor development, an occupational therapist can develop a plan which will build strengths and facilitate development. A good grasp of OT terminology allows parents to understand the therapist’s documentation. If parents encounter terms and notations they don’t understand, they should consult their child’s therapist. This OT dictionary is not inclusive of all terminology used, but is a good start toward getting parents educated and on the way to understanding their child’s particular needs.

Dr. Milagros (Mili) J. Cordero is founder and president of ITT’S For Children. She is a licensed, registered occupational ther apist with over 30 years of experience working with children with developmental disabilities. Dr. Cordero also has multiple academic appointments and trains occupational therapists in children’s therapy. She can be contacted at mili@ittsforchildren. com or 770-393-9901.

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