Occupational Therapy: Skills for Living

Occupations are the familiar and meaningful activities that people do every day. Pediatric occupational therapy
(OT) helps children learn skills and participate in activities for successful, independent daily living. OT at
Cincinnati Childrens makes it possible for children, adolescents and young adults with injuries, physical
challenges or developmental disabilities to engage in normal daily life to the greatest extent possible.

What Occupational Therapy Offers

For children, OT focuses on developing specific life skills. Through specific exercises and task-related activities,
occupational therapists help your child learn or regain these critical skills. When skill and strength cannot be
developed or improved, we work with your child and family in developing creative alternatives to achieve goals.

Customized Treatment

Our occupational therapists work with physical therapists and other specialists to create a customized program
which addresses your childs unique needs. The therapy process includes an initial evaluation, during which we
assess your childs current level of function. After the evaluation, the occupational therapist will create a treatment
plan that may include:

Fine motor skills

Oral motor function and feeding skills

Activities of daily living

Cognition

Visual perception

Sensory integration

Aquatic (pool) therapy

Instructions for home exercise programs

Additional Occupational Therapy Services

Recommendations and training in the use of wheelchairs and other equipment that helps
replace lost function

Recommendations on how to adapt the home and school environment

Guidance for family members about safe and effective methods of caring for your child

Hand and Upper Extremity Therapy

Hand and Upper Extremity therapy focuses on use of the shoulder, elbow, wrist, and hand (upper extremity).
Treatment can be done as part of an outpatient program and / or after surgery.
Goals for this type of physical therapy could include:

Increased range of motion

Decreased pain

Strength

Flexibility

Specific skills (e.g. bathing, dressing, eating)

Leisure skills (sports, music)

Why Choose Us?

At Cincinnati Children's, our therapists:

Are trained in child development

Have specialized training in hand therapy

Deliver care in a child friendly environment

Work directly with the physicians in our Hand and Upper extremity Center

Who Can Benefit?

Infants, children, and teens who have difficulty with using their arms and/or hands can benefit from this
service. This may include children with:

Birth defects

Fractures and nerve injuries

Soft tissue damage including amputation

Cerebral palsy

A spinal cord injury

Chronic pain in the arm/hand

Loss of range of motion

Difficulty with skills at home, school, work or play

Location of Service

Hand and Upper Extremity Therapy services are offered at our Main (Burnet) Campus, as well as the Cincinnati
Children's Liberty Campus and Green Township campus.

Additional Programs and Services

Learn more about the various specialized programs and services we offer in the Divisions of Occupational and
Physical Therapy and Therapeutic Recreation.

Treatments
The Divisions of Occupational Therapy and Physical Therapy and Therapeutic Recreation provide treatments for
patients through a variety of technology.
Treatment options include:

Activities of Daily Living

Aquatic Therapy

Aquatic Wellness

Armeo Therapy

Assistive Technology

Autism Intensive Program

Cognitive Skill Training and Rehabilitation

Constraint Induced Movement Therapy (CIMT)

Cortical Visual Impairment (CVI) Therapy

Fine Motor Treatment

Gross Motor Treatment

Hand and Upper Extremity Therapy

Intensive Strengthening Program (SPIDER)

Interactive Metronome

Lite Gait

Lower Extremity Orthoses

Motion Analysis

Myofascial Release

Neuromuscular Electrical Stimulation(NMES) / Functional Electrical Stimulation (FES)

Oral Motor and Feeding

Orthopedic and Sports Physical Therapy

Outpatient Neurorehabilitation Team (ONRT)

Robotic-Assisted Gait Training (Lokomat)

SAEBO

Sensory Integration

Serial Casting (arm or leg)

Specialized Post Rhizotomy Intensive Therapy Program (SPiRIT)

Upper Extremity Splinting and Orthotics

Therapeutic Listening

Vestibular Rehabilitation

Visual Motor / Visual Perception

Wheel chair Assessment, Fitting, and Training

Activities of Daily Living (ADL)

Activities of daily living (ADL) are also called self-help or self-care activities. These activities can include everyday
tasks such as dressing, self-feeding, bathing, laundry, and / or meal preparation. Sometimes adaptive equipment
is needed to assist with these tasks, which can include items such as a reacher, long-handled sponge,
buttonholer, rocker knife, and / or built-up spoon.
An occupational therapist (OC) will work with the client to address these skills and work to improve as needed.

Why Choose Us?

One reason why you should choose Cincinnati Children's Divisions of Occupational and Physical Therapy and
Therapeutic Recreation -- we have access to ADL suites at multiple locations across our hospital campuses.
ADL suites are furnished rooms set up to simulate a home, and may include a bedroom, bathroom, kitchen, and /
or living area. Adaptive equipment is available to test and try out before purchasing.

Who Can Benefit?

Individuals who can benefit from ADL services include:

Those who are not as independent as they could be with self-care

Those who do not have skills at an age-appropriate level

Those who need to relearn skills after an illness or surgery

Assistive Technology
Assistive technology refers to the use of technology to help someone be as independent as possible with a task.
This may include suggestions and/or equipment. Areas of expertise include written expression (i.e. handwriting or
typing), computer access, and use of switches.

Why Choose Us?

At Cincinnati Children's, we offer a variety of options to develop computer access, writing, and use of switches.
Software programs and equipment available include:

Speak to type

Word prediction

Smart pen

Typing programs

Various switches

Alternative keyboards

Keyguards

Alternative mice

iPad apps
Some therapists have completed additional training to become certified Assistive Technology Professionals (ATP)
through RESNA.
For patients with complex communication or environmental control needs, a consultation may occur with The
Perlman Center.

Who Can Benefit?

Assistive technology may benefit children who struggle with the following:

Written expression

Switch activation

Computer access

Autism Intensive
The Autism Intensive Program is a program that includes treatment sessions three times per week, for 60-90
minute sessions, for up to six weeks. Treatment is provided by an occupational therapist (OT), and can address
skills such as the following:

Motor skills (fine and gross)

Visual skills

Handwriting

Activities of daily living (dressing, self-feeding)

Sensory processing

Play and leisure

Social interaction
The need for further services will be determined by the OT after the program is completed.

Why Choose Us?

OTs in the program have received specialized training by experts who work with children with autism spectrum
disorders (ASD). Children will receive treatment based on the most recent research, clinical knowledge and
experience available. We believe early and intensive treatment for children with ASD will provide better outcomes.

Who Can Benefit?

The Autism Intensive program can benefit children who:

Are not making gains with a more traditional model of OT

May respond positively to an intensive burst of treatment in starting therapy

Children may be referred to this program by their doctor or their current therapist. They must be 2 years of age or
older, have a diagnosis of ASD, and be able to participate in the full 6-week program. Children must also be able
to participate safely and be medically stable.

Cognitive Skills / Cognitive

Rehabilitation
Day to day living requires the use of both physical and cognitive skills. Cognitive or thinking skills can affect the
following:

Attention

Decision-making

Memory

Problem-solving

Safety awareness
Difficulties with such skills are associated with an injury to the brain, as the result of trauma or developmental
delay. Occupational therapists (OTs) are trained to identify difficulties with cognition, and the impact these
difficulties have on every day skills.
OTs work on improving skills and providing suggestions. For example; they can break down a task into steps (task
analysis). This method may make it easier to perform the task. Additionally, visual reminders may also help when
there is memory loss.

Why Choose Us?

All OTs at Cincinnati Childrens are trained in basic task analysis and adapting activities. Specialized rehabilitation
OTs have achieved advanced certification to become Certified Brain Injury Specialists (CBIS). These OTs have
advanced knowledge of the causes and treatments for brain injuries, which includes understanding different
stages of recovery for persons and families with brain injuries.

Who Can Benefit?

Any child who is having difficulty with cognitive skills can benefit from this service. Possible conditions include:

Brain tumors

Developmental delay

Pediatric stroke

Traumatic brain injury (TBI) from motor vehicle accidents

Constraint Induced Movement Therapy

(CIMT)
Constraint Induced Movement Therapy (CIMT) is used with patients who have weakness on one side. CIMT
includes:

Limiting use of the better arm by wearing a constraint

Providing intensive practice for the weaker arm

An occupational therapist (OT) provides the therapy which can be done in an individual or group setting.
Childrens has developed two CIMT protocols for patients and families. OTs at Childrens work closely with the
family to choose which of the two protocols will work best for them. Caregivers and patients are given home
program suggestions each week.
Protocol 1

Constraint worn for 2 hours a day

Structured activities done by the family while wearing the constraint

OT - 1x/week

Duration - 8 weeks
Protocol 2

Constraint worn 24 hours a day (removable cast)

Recommended activities done by the family while wearing
constraint

OT - 1x/week

Duration - 4 weeks
The goals of Constraint Induced Movement Therapy are to improve:

Range of motion

Strength

Sensation

Awareness

Use of the weaker arm

Specific skills

Why Choose Us?

Cincinnati Children's has developed an Evidence-Based Care Guideline (EBCG) for Constraint Induced
Movement Therapy. A care guideline for CIMT reduces variation in care, improves patient outcomes, and
promotes quality care based on current knowledge and research.

Who Can Benefit?

Children with many conditions and/or diagnoses may benefit from CIMT including:

Cerebral palsy

Brachial plexus injury

Traumatic brain injuries

Hemiparesis

Childhood strokes

Other central nervous system conditions

Cortical Visual Impairment / CVI Range

Children with Cortical Visual Impairment (CVI) often have typical eye exams. However, there are behaviors that
are common to children with CVI. Parents often report that their child:

Stares at lights on the ceiling

Enjoys playing with toys that light up and make sound

Make poor or no eye contact

See objects better close up rather than far away

Likes toys / items of a certain color (i.e. red, yellow)

Older children may:
Have difficulty finding things in their environment (restroom sign, game on a cluttered shelf, items in a

store)

Trip when walking (i.e. miss steps or curbs)

Difficulty telling the difference between similar letters (i.e. i and l; b or d).
Children with CVI can see but have difficulty understanding what they are seeing. With proper treatment, children
with CVI have the potential to improve.

Why Choose Us?

Occupational therapists on the CVI Team at Childrens have specialized training. They work closely with the
doctors (Ophthalmologists) to:

Evaluate a childs functional vision

Make sure proper vision services are in place

Therapists also help families:

Understand how their child sees best

Develop and improve skills

Find solutions to problems

Provide suggestions to set up or change an environment

Who Can Benefit?

Children who have a diagnosis of CVI will benefit from this service. CVI is also frequently seen in children who
were born prematurely and / or have a diagnosis of:

Brain Injury

Cerebral Palsy

Hearing loss

Microcephaly

Seizures

Stroke

Fine Motor Therapy

Fine motor skills involve use of the small muscles in the hands. These include skills such as: grasping objects,
writing, cutting with scissors, shoe-tying, and fastening buttons. These skills are needed to for self-care and
participation in activities at school and at home. Through occupational therapy (OT), patients can develop and
improve these skills.

Why Choose Us?

Occupational therapists at Cincinnati Childrens specialize in treating children with fine motor delays. We offer a
variety of services, including one-on-one therapy, group therapy, and an intensive therapy program. The OT
department strives to stay at the forefront of the field by using the latest technology and evidence-based
treatment.

Who Can Benefit?

A variety of diagnoses and conditions may affect a childs fine motor development, including, but not limited to:

Developmental coordination disorder

Premature birth

Neurological impairment

Developmental delay / delayed milestones

Sensory processing difficulties

Abnormal muscle tone

Dyspraxia (motor planning difficulties)

SPIDER (Strengthening Program of

Intensive Developmental Exercises and
Activities for Reaching Maximal
Potential)
We offer an intensive therapy program for children who need to build strength and improve functional skills. The
program consists of:

An intensive burst of physical therapy (PT) and / or occupational therapy (OT)

Therapy for 2-3 hours per day, 3 times a week, for 6 weeks with a break in therapy after the intensive
burst
Instruction in a home exercise program to practice skills

It includes:

Use of pulleys and weights to strengthen muscles

Improving balance, coordination, and sensory/body awareness in a dynamic suspension/bungee system

called a universal exercise unit
Working on specific skills

Goals of the program are developed with the family. They often focus on achieving a next skill level. In PT, this
may be walking with or without an assistive device. In OT, this may include working on fine motor skills,
handwriting, or self-care activities (dressing, self-feeding, bathing).

Why Choose Us?

The SPIDER program is six weeks in length, which is the minimum amount of time required to show improvement
in isolated muscle strength by evidence of strengthening research. The SPIDER program includes both
strengthening and focusing on functional tasks which has been documented to show progression in functional
skills. We have designed our SPIDER program with current research in mind to help children get to the next level
of skill.

Who Can Benefit?

This program is directed towards children and/or adolescents who would benefit from an intensive burst of
strengthening exercise. It may help develop a new skill or recover strength after an illness or surgery.
To participate in this program, children should be:

At least 4 years or older

Able to follow simple directions

Able to demonstrate active limb movement

Diagnoses include:

Cerebral palsy

Traumatic brain injury

Neurological disorders

Developmental delay

Gross Motor Therapy

Gross motor skills use the large muscles of the body. Commonly used gross motor skills include actions such as:
rolling, crawling, walking, jumping, riding a bike, and climbing stairs. Gross motor skills are essential to movement
and participating in activities at school and at home. Physical therapy (PT) can help develop and improve these
skills.

Why Choose Us?

Physical therapists at Cincinnati Childrens specialize in treating children with gross motor delays. We offer a
variety of services, including one-on-one therapy, group therapy, and intensive therapy programs. The Divisions
of Occupational and Physical Therapy and Therapeutic Recreation strive to stay at the forefront of the field by
using the latest technology and evidence based treatment.

Who Can Benefit?

A variety of diagnoses and conditions may affect a childs gross motor skills including, but not limited to:

Premature birth

Neurological impairment

Developmental delay/delayed milestones

Developmental coordination disorder

Abnormal muscle tone

Hand and Upper Extremity Therapy

Hand and Upper Extremity therapy focuses on use of the shoulder, elbow, wrist, and hand (upper extremity).
Treatment can be done as part of an outpatient program and / or after surgery.
Goals for this type of physical therapy could include:

Increased range of motion

Decreased pain

Strength

Flexibility

Specific skills (e.g. bathing, dressing, eating)

Leisure skills (sports, music)

Why Choose Us?

At Cincinnati Children's, our therapists:

Are trained in child development

Have specialized training in hand therapy

Deliver care in a child friendly environment

Work directly with the physicians in our Hand and Upper extremity Center

Who Can Benefit?

Infants, children, and teens who have difficulty with using their arms and/or hands can benefit from this
service. This may include children with:

Birth defects

Fractures and nerve injuries

Soft tissue damage including amputation

Cerebral palsy

A spinal cord injury

Chronic pain in the arm/hand

Loss of range of motion

Difficulty with skills at home, school, work or play

Hand & Upper Extremity Care Center

Experts in Hand Injuries & Congenital Hand Deformities

If your child has a hand or arm injury or condition, youve come to the right place. Our Hand and Upper Extremity
Center is one of just a few programs in the world to offer both surgical and non-surgical treatment of conditions
involving childrens hands and arms, including fractures and tendon, nerve and vascular injuries.
We diagnose and care for hand and upper extremity problems in children from birth through adolescence. Our
team of experts includes specialists in:

Orthopaedic Surgery

Plastic Surgery

Occupational and Physical Therapy

Hand and Upper Extremity Therapy Program

The specialists of the Hand and Upper Extremity Center at Cincinnati Childrens treat newborns, infants and
adolescents for the following conditions involving the hands or upper extremities:

Injuries

Fractures

Tendon, nerve and vascular injuries

Congenital or post-injury deformities

Neuromuscular problems with the hands or arms, including cerebral palsy

Tumors of the hand and upper extremity

Project Management for Externally Funded

Research
Investigators conducting health services research require support from a variety of disciplines. The Anderson
Center project management staff provides program and project support for externally funded research projects.
Support often includes planning, scope management, budget management, risk / issue management and
communications management.
With roles spanning individual contributor to manager level, senior project management staff also provide
direction and guidance to team members on creation of project deliverables.
Team leader Amanda Waltz and her staff support research across a projects life cycle.

Examples of Services We Provide

Funding Pursuit

Project Execution (Startup, Operations,

Manuscript Preparation Phases)

Develop pursuit timeline

Manage project plan, schedule and budget

Coordinate kickoff, review and

approval meetings

Communicate with internal and external resources

Develop / revise resource estimates

and budgets

Identify and mitigate project risks and issues

Support collection / compilation /

revision of submission materials

Monitor status and report to project leadership

Project Planning and Launch

Manage project scope

Develop project plan, schedule and

budget

Coordinate activities of project team

Refine project scope

Coordinate collection of data

Identify and obtain project

management staff support

Prepare / support creation of project deliverables

Project Closure

Execute basic data analysis

Compile / archive project work

products and deliverables

Support data input / import, cleaning and merge

Facilitate project logistics such as scheduling
meetings, conference rooms, conference calls

Our staff includes professionals from healthcare and research, as well as individuals with relevant private sector
project management experiences. Due to the variety of roles and skills required to support our projects, there is
no single profile for education or professional experience.
Many of our staff members have advanced degrees, with a masters in public health being the most common
(masters of health services administration and masters of business administration are also held by a number of
our staff).