Occupational therapy (OT) interventions aims to help those with deficits or disabilities in various areas become as self-sufficient as possible in their daily lives. Occupational therapists often work with those with cognitive, sensory or physical difficulties to improve their daily living skills and autonomy. In children, occupational therapists commonly enhance independence by developing their self-care skills. This article focuses on how occupational therapy can help children build self-care skills to maximise their independence, better allowing them to achieve their goals and engage in their community as they wish.

What is self-care?

Self-care skills are activities of daily living (ADLs) that includes elemental tasks such as dressing and grooming, eating, toileting, bathing, general personal hygiene, sleep and rest. Indeed, while children are initially dependent on adults to complete these essential activities, they are expected to become self-reliant in these areas as they become older and more mature.

Developing self-care skills are paramount to a child’s development as they require the functional and practical skills of being able to plan and sequence tasks and physically control inanimate objects (i.e. motor skills). It is also considered that the progression of self-care skills heralds other general life skills, and when there are delays or deficits in a child’s expansion of these skills, it often hinders not just their independence, but their integration and participation in social scenarios.

How does an Occupational Therapist help self-care?

When a child has been referred to an occupational therapist to help build proficiency in self-care activities, they will firstly complete an initial assessment to gauge the child’s current state of functioning. The assessment usually involves standardised tests that seek to not only establish performance complications, but also determine if any aspects of the child’s environment (e.g. home and/or school) are causing them difficulty. The occupational therapist will usually also ask the family/parents questions regarding the current assistance the child requires, the family’s routine, home/school environment, and specific self-care areas they want to work on. Once the occupational therapist has insight into the everyday surroundings of the child, they can begin to formulate strategies to minimise physical or environmental barriers for the child.

Improving self-care skills

Occupational therapy interventions commonly focus on the following different areas to help improve self-care:

  • Attention and executive functioning: Children may have attention deficits when attempting to maintain self-care activities, and may be unable to recall how to perform a task, or be poor at organising the steps involved in a task.
  • Sensory processing: Some children have problems with distinguishing between relevant and irrelevant sensory stimuli. A child with sensory modulation deficits can often be overly sensitive to sensory input, potentially making them easily distracted, feel overwhelmed or perturbed. Or, conversely, they may be hyposensitive and fail to observe critical sensory material.
  • Motor skills: The development of fine and gross motor skills is essential to complete daily living tasks. Motor performance involves range of motion, strength and endurance, awareness of one’s body, dexterity, ability to grasp objects, and coordination.

After completing the required evaluations, if it is concluded that therapy would be constructive and useful for the child, the occupational therapist will organise practical interventions to improve self-care skills. Therapy also usually targets the progress of any lurking deficits in attention, executive functioning, sensory processing or motor skills. Any need for further supports such visual aids, adaptive equipment or home modifications will also be integrated into the therapy regimen.