What is occupational therapy?

Occupational therapists (OTs) are university-trained allied health professionals who work with children and adults to help them participate in all the things they need and want to do in their everyday life.

OTs are trained to assess how your current abilities impact your quality of life. They enable you to participate in the activities that give meaning and purpose to your life. This includes:

• Self-care: bathing, dressing, meal preparation, going to the toilet,
• Productivity: working at something that brings meaning, paid or unpaid/ volunteer and education, such as school, day-care and university
• Leisure: having fun, relaxing and participating in your usual hobbies, interests and social events.

When would I need to see an OT?

Depending on your condition and how it affects your daily life, you might see an OT for any of the following:

• Soon after diagnosis for a baseline assessment. This assessment could include personal care needs, current use of assistive technology, fine motor skills, cognitive function (how you know, learn and understand things), home access, the effect of pain and fatigue on function, education/ workplace requirements, transport, housing and support network
• Regular reviews throughout the year. This could be with your neuromuscular healthcare team, or to monitor how you are going with new activities or equipment. Your OT may visit you at home, work or school to see how you are managing in these environments
• Assessment of personal care and support needs
• Assessment and recommendations regarding assistive technology (aids and equipment) for activities of daily living such as eating, sitting, sleeping, meal preparation, showering, transfers and dressing
• Assessment, advice and recommendations on fine motor activities such as handwriting, doing up buttons, tying shoelaces, using cutlery and other home, school or work activities
• When you notice changes in your abilities or if you start experiencing difficulties with certain activities. For example, you might work very closely with an OT if you start having difficulty getting out of bed. The OT will assess if you need specific equipment, such as using a hoist for transfers from your bed to your wheelchair. Your OT will also have regular follow-up checks with you to make sure the equipment is a good fit and working well for you
• To assess and manage bladder and/or bowel issues
• Home modifications
• Vehicle modifications and driving assessments
• Housing assessments if you require specialist disability accommodation and funded support packages to be able to live independently
• Helping you to function in your environment, through access assessments, environmental scans, mobility training and the use of environmental controls. It also includes assisting you to engage with supported employment and training services, function in education settings, and using technology to maintain function. It includes all the activities you want to do at home
• Specialist assessment and treatment of children
• Whole of life personal planning and goal setting.

What treatments do OTs use?

OTs work with children, families and adults, providing a range of services, including:

Assistive technology

If certain activities are becoming difficult, there might be assistive technology (aids and equipment) to make the task easier. Assistive technology includes simple devices such as special handles for turning on taps, doing up buttons, slide boards and modified cutlery. It also includes more complex, specialised equipment such as wheelchairs, seating and positioning, hoists, shower chairs, commodes, electric beds and pressure-relieving mattresses. For more complex items, OTs will work with you and equipment suppliers to assess and trial the particular item, submit an application to the relevant funding body and be there when the equipment is delivered to ensure correct fit, function and safe usage.

Home modifications

OTs can provide advice about changes to the home to make it easier for you to be independent and safe in your home. Home modifications are classified as minor or major. Minor home modifications could include installing rails, pathways or small ramps. Major home modifications usually involve some structural change (eg bathroom and kitchen modifications, widening doorways) and these need to be done by a specialist OT. Your OT can refer you to a specialist OT for major home modifications.

Vehicle modifications and driving assessments

Some OTs provide driving assessments and recommend modifications to your vehicle, both as a passenger and as a driver. They will also be able to give you information about funding that is available for these modifications.

Transport assistance

An OT can provide advice about getting around your community, as well as travelling further afield.

Workplace and educational settings assessments, adaptations and training

An OT can assess your physical ability to meet the demands of your job, as well as recommend ways to adapt your work. They can also help you find the best job fit for you and suggest training options. An OT can work with you in the educational setting to ensure you have the appropriate technology and programs to function as best as possible.

Respite care and housing assessments

An OT can help coordinate respite care and housing assessments for people needing supported care. An OT will complete specific functional assessments and outcome measures to determine the level of care that is needed, particularly with view to independent living and support requirements. They will write detailed, complex reports summarising your housing and support needs.

Play and developmental

Paediatric OTs provide services for children with neuromuscular conditions. This can include specialist assessment and treatment for children to attain neuro-developmental milestones, and management of sensory processing issues, behaviour, cognition and physical abilities including fine motor skills.

Cognition

An OT can assess skills for learning, memory and planning with the implementation of practices to improve function in these areas. Cognitive changes can occur with some neuromuscular conditions, and OTs support people and their families to manage these changes. They provide an assessment of functional cognition, which includes everyday task performance, including initiation of tasks, correction of errors, sequences, and executive function in a timely manner. OTs can then implement strategies to compensate for cognitive difficulties and adapt to the environment. Fatigue, which is experienced with nearly all neuromuscular conditions, can also affect cognition and behaviour, especially in children. OTs have a role in formal cognitive assessments and implementing management strategies, plus helping to manage the impact of fatigue on cognition through the use of pacing strategies, equipment and task re-training/ modification and emotional regulation.

Functional activities

OTs provide assessment and advice re functional activities and symptom management such as pain management, the use of positioning and stabilisation to improve hand function, fatigue management and everyday activities that occur in the home. An OT can also assess and help you manage continence issues. OTs also provide direct therapy for attaining independence in self-care tasks and daily routines.

Communication support

An OT can help to improve communication and learning through the use of computers and tablets, specialised programs and apps.

Goal setting

An OT can help with goal setting and planning, including the transition of life roles e.g. from daycare to school, school to uni/ work, work to retirement, moving out of home, making and keeping friends, getting a job, budgeting. This also includes support to re-determine life goals and adapt the way you participate in activities of your choosing if your condition progresses.

Where to find an OT

1. Contact your state or territory neuromuscular organisation for information on where to find an OT. Some of these organisations have specialised allied health professional teams or may be able to advise on OTs who have a special interest in treating people with neuromuscular conditions.
2. OTs work in both the public and the private healthcare system. There are dedicated neuromuscular teams, linked to public hospitals in some capital cities in Australia which have OTs, or who may be able to link you with a local OT.
3. You can choose to see a private OT and pay through:
   • Your NDIS plan
   • Private health insurance
   • Medicare, through a Chronic Disease Management Plan prepared by your GP
   • My Aged Care-Home Care Package
   • Private funds