ERGOTHERAPY IN AUTISM

Ergotherapy improves the physical, cognitive, sensory, psychological, social skills and abilities of the person through meaningful and purposeful activities; It is a person-centered health profession that aims to increase the level of independence and participation in daily life activities and to improve health and well-being.

Occupational therapists in Autism work with methods such as sensory integration, daily life activities training, use of assistive devices, visual perception, cognitive therapies and family training with the aim of adapting individuals to their own living environments, improving their independence and social participation skills.

What can be done in the autism rehabilitation process?

By determining the sensory characteristics of the child with autism and improving their sensory skills, appropriate behaviors are taught to them. In addition, sensory integration therapy is used to prevent the anticipated negativity and the onset of anger attacks, to relax and relieve stress.

Daily life skills such as eating, toilet training, bathing, dressing, and self-care are developed.

Social interaction of the child is achieved through the development of the coordination of, , body awareness and play skills. Studies are carried out on the development of language and communication skills.

The child is helped to develop adaptation and learning skills.

For the development of success in preschool and school years, treatment programs are prepared to develop fine-gross motor, attention-memory, motor planning and pre-writing preparation skills for the sensory-motor characteristics of the child.

Studies in the field of occupational analysis and vocational rehabilitation are carried out in line with the demands of the family and the activity in individuals with autism who are older in age.

For the motor planning disorder seen in autism, studies are carried out to automate motor behavior by increasing attention and performance skills in the process of learning movement with sensory integration.

Studies are carried out to improve chewing and tongue movements, to control saliva, to solve behavioral problems such as spitting food in the mouth, to increase the participation in meal time and the acceptance of foods with various sensory characteristics.

COGNITIVE THERAPY

What is Cognitive Therapy?

Cognitive functions can be defined as the ability to know, including awareness, perception, logical thinking, language, memory and reasoning.

These are;

• Attention (continuous, selective, scrolling),
• Perception (visual, spatial, auditory, tactile),
• Orientation,
• Memory (short term, long term, topographic-location memory),
• Administrative functions (problem solving and fast decision making,)
• Learning and using knowledge,
• Planning the acquisition of complex skills,
• Organization abstract thinking,
• Mathematical skills.

Cognitive functions are the mental processes that allow us to perform meaningful activities in daily life. We routinely carry out most of our daily work as a habit. Cognitive functions include a variety of routine and non-routine activities. Routine operations are automated processes that require very little attention. Non-routine operations are the operations that require attention control mechanism to focus on the new process. It requires practical application until non-routine operations are settled. New situations require planning and problem solving in order to achieve the goal.

Cognitive process information is important in activity performance analysis, activity limitations and participation limitations. In cognitive dysfunctions, habits, routines and roles of people are affected.

What is the Role of the Occupational Therapist in Cognitive Therapy?

Occupational therapists are experts in determining how cognitive problems affect daily activities, social interactions, and routines. Tasks of the occupational therapist,

• Assessment of safety, independence and performance ability in self-care activities
• Maintaining balance
• Educating family and caregivers
• Acute care follow-up
• Intervention to address gaps in attention, problem solving, and perception, and to manage impulsive behavior
• It is the organization of basic daily activities such as eating, bathing, dressing, care.

Who Can Benefit from Cognitive Therapy?

• Cerebrovascular accident
• Cerebral Palsy
• Traumatic brain injury
• Those with brain tumors
• Those with a brain infection
• Alzheimer
• Dementia
• Parkinson’s disease
• Down Syndrome
• Autism Spectrum Disorder
• Developmental disorders

Cognitive disorders often cause functional problems in people with neurological problems. Decrease in activity performance may manifest itself with problems in recognizing objects or a disorder in sequencing of events. Individuals who do not know their family members, have difficulty in memory, do not answer the questions asked to them, and have attention problems are encountered. Therefore, the ergotherapy application framework determines not only the body structure and functions of the person, but also the cognitive performance skills and the necessary requirements for the activity according to the characteristics of the environment and the activity or the role of the person.

How Are Functions Evaluated in Cognitive Therapy?

Interview and observation evaluation methods are used first to understand the determination of the problem and the effect of this problem on the life of the person. It is then used to determine the effect of cognitive impairment more accurately by applying standardized screening and evaluation tests.

How to Plan the Treatment of Functions in Cognitive Therapy?

• Process training: Cognitive functions focusing on all functions underlying the component
• Strategy training: By focusing on compensatory approaches
• Functional activity training: To train daily living activities and cognitive functions
• Education: Cognitive rehabilitation is carried out in these 4 stages, with a focus on developing insight.

OCCUPATIONAL THERAPISTS enable the individual to be included in the society in a more independent and unrestricted manner with these individual approaches.

Occupational therapists play a vital role for adults with cognitive impairments, helping to facilitate new brain pathways and improving functional skills by adapting and retraining activities.Enabling people to participate more extensively in care, work, leisure and community activities, while reducing the burden on caregivers and community resources, improve their quality of life.

ERGOTHERAPY IN MUSCLE DISEASES

What are Muscular Diseases?

Muscle diseases are disorders of the muscles themselves that help the body move. It disrupts the building blocks or the functioning of the muscle cells between the muscle tissues and affects their activities to a great extent. It is a common type of disease that can be seen in individuals of all ages in all stages of life from infancy to childhood, adolescence, adulthood and old age.

What are the Symptoms of Muscular Diseases?

Symptoms of muscle diseases that are quite common and prevent the individual from doing normal activities include:

• Gait disorders, as the muscles in the hips and around it will emerge
• Difficulty getting up and walking
• Children who develop muscle disease at a young age want to be held constantly while walking or climbing stairs.
• During adolescence, falling behind from their peers, changes in walking and movements are observed.
• Difficulty in raising, extending and moving the arms as the vertebra and surrounding muscles will be stuck.
• If hands and feet are affected, tripping and falling while walking (due to the rapid wear of shoes), a situation that cannot perform fine work by hand is observed.
• In rare cases, the eyelids drop gradually, eye movements may be restricted.
• Stiffness in swallowing or respiratory muscles
• Falling frequently, getting tired quickly
• Muscular diseases

Who Has Muscular Diseases?

In addition to the types that cause mild symptoms due to anomaly in the muscles, there are also varieties that cause a severe disability and reduce the life span:

• Muscular Dystrophies (Duchenne, Becker, FasioSkapuloHumeral, Limb-Girdle, Distal, Emery-Dreifuss)
• Congenital Muscular Dystrophies
• Myopathies
• Myotonias
• Dermatomyositis-Polymyositis

What are the Goals of Occupational Therapy in Muscular Diseases?

The purpose of rehabilitation approaches in muscle diseases is to increase the quality of life of the child and his/her family and to ensure their independent participation in activities. The purpose of the applications for this is as follows:

• Maintaining muscle strength or delaying loss of strength
• Utilizing appropriate tools, equipment and devices to support, protect, and increase function in different stages of the disease.
• Teaching methods to cope with fatigue
• Teaching joint and energy conservation methods
• Providing independence in daily life activities by increasing functional capacity
• With home rehabilitation, a safer and less energy-consuming living space is provided for the individual.

With preventive rehabilitation approaches, the existing functional capacity is tried to be preserved for a longer period of time.

WHAT IS SENSORY INTEGRATION?

Sensory integration is the ability to synthesize, organize and process the sensory information received from our body and the environment.

Sensory integration theory is a neurological process that organizes the senses coming from our body and our environment to enable us to use our body effectively in our interaction with our environment. The brain uses this process in daily life activities.

Sensory integration, in other words, is to create meaningful and purposeful responses to our sensory experiences, it is the ability to synthesize, organize and process sensory information received from the body and the environment.

It is to provide sensory-motor development by developing the brain with meaningful sensory-motor activity in order to realize its learning. For sensory-motor development, the individual must be in contact with the environment. Meaningful sensory-motor activity is important in sensory integration therapy, as correct communication shapes brain development and provides the nervous system’s capacity to change (plasticity).

What are the Principles of Sensory Integration Therapy?

According to sensory integration theory, learning is a function of the brain and learning difficulties indicate deviations in nervous system functions. Individuals with learning difficulties have motor and sensory problems; they have difficulty in perceiving and integrating sense information. The inability to integrate sensory stimuli causes behavioral and learning problems. This condition is defined as “Sensory Integration Disorder”.

Sensory Integration Approach; unlike other approaches to learning disabilities, it does not employ specific skills. It aims to increase the brain’s understanding, perception and motor planning capacity.

Who Has Sensory Integration Disorder?

• Attention deficit hyperactivity disorder
• Children with learning difficulties
• Autism (pervasive developmental disorders)
• Cerebral Palsy
• Developmental delay (fine motor impairment, gross motor impairment, visual motor disturbances, coordination disorders)
• Hearing language speech disorders
• Development delay due to premature birth
• Genetic disorders, chromosomal disorders

What Are Sensory Integration Symptoms in Occupational Therapy?

• Responding slowly
• Reduced attention span
• Inability to speak at the right tone and speed
• Constant tiredness
• Inability to concentrate in noisy environments, ear closure
• Concentrating on the wrong sound and missing the target
• Memory difficulties
• Not reacting to the sound, unable to find the direction of the sound
• Choosing food, sniffing food
• Not brushing teeth, cutting hair and nails
• Fear of falling
• Fingertip walking
• Clumsiness
• Constant desire to move

How is Sensory Integration Treated?

Pre-therapy sensory integration problems; Sensory processing problems and the effects of these problems on daily life activities are evaluated by considering the sensory systems.

In therapy, first of all, the child’s intrinsic motivation should be in balance, child should participate actively and should be able to tolerate stimuli. Active participation of the child always facilitates learning. The child easily adapts the information learned during communication and play to daily life activities.

Sensory stimuli are always planned according to the individual needs of the child using sensory strategies and the appropriate sensory diet is selected. Every child shows different sensory characteristics as they are different from each other. So it includes different intervention plans.

In order to continue the treatment effectively at home, the family is trained and the home, school and play environment is arranged according to the sensory characteristics of the child.

ERGOTHERAPY FOR INDIVIDUALS WITH DOWN SYNDROME

Ergo therapy improves the physical, cognitive, sensory, psychological, social skills and abilities of the person through meaningful and purposeful activities; It is a person-centered health profession that aims to increase the level of independence and participation in daily life activities and to improve health and well-being. In individuals with Down syndrome; problems such as slow learning, difficulty in problem solving and decision making, drooling, difficulty in speaking, delay in motor development, frequent falls and bumps, low muscle tone and delay in fine and gross motor development due to laxity in joints are experienced. Occupational therapists in the treatment of these problems uses sensory integration, vestibular stimulation, oral-motor therapy, cognitive therapy, daily living activities training and activity-oriented neurodevelopmental therapy methods.

What do occupational therapists do during the rehabilitation process of individuals with Down syndrome?

Individuals with Down syndrome who have sensory integration problems such as dropping objects on the ground, taking objects in their mouth, difficulty in adjusting body position, falling frequently, not combing hair, etc., are provided with a correct adaptive response with sensory integration therapy. With sensory integration of individuals with Down syndrome; awareness of their body and environment increases.

By providing sensory integration, visual perception skills, body awareness and visual motor coordination training, the foundations of cognitive rehabilitation are laid. Academic skills are also supported by improving cognitive skills such as attention, memory, problem solving, and orientation. It is easier for individuals with Down syndrome to learn with cognitive rehabilitation.

In early childhood, with activities including auditory-visual stimulation, neurodevelopmental intervention methods for laxity in the joint-ligaments and low muscle tone; it enables them to perform independent motor skills such as sitting, standing and walking. Individuals with Down syndrome with ergo therapy exhibits controlled motor behavior.

Developing strength and coordination in the arm, wrist and hand with activities meaningful for the person increases the level of independence in fine motor skills and daily living activities. The increase in the quality of life of individuals who develop fine skills such as holding a pencil and holding a spoon increases internal motivation.

Individuals with Down syndrome can be independent in daily living activities.

Children with Down syndrome have problems with nutrition, saliva control and speech due to weak tongue, lip and cheek muscles. Occupational therapists intervene with oral motor therapy, positioning methods, and nutritional techniques.

Vestibular stimulation techniques enable early motor behavior to be revealed. Equilibrium reactions, movement quality is increased, gravity insecurity is prevented. Individuals with Down syndrome can climb stairs and swing without fear.

Neurodevelopmental and behavioral methods are used for the development of social skills such as initiating, maintaining and ending verbal and non-verbal transmission, and communicating with meaningful purposes. Individuals with Down syndrome can understand you and express themselves.