Skip links

Occupational Therapy

 Our occupational therapy program offers assessment and treatment services for a wide range of conditions and diagnosis. 

Services and Treatment Programs

  • Sensory Integration Therapy

* Sensory Integration is the neurological process of organizing sensory inputs for function in daily life. Our brain takes in information from the body and interprets that information so we can survive and make sense of our world. We use our senses to learn and develop. We also use our senses to help us interact appropriately within the environment. 

   Sensory Processing Disorder (SPD) is the difficulty using the information that is collected from our senses (vision, hearing, touch, taste, smell, movement, and body awareness) in daily life. 

   Occupational therapy works on techniques that introduce needed sensory information, allowing for gradual improvement in the child’s sensory abilities. Occupational therapists work to strengthen the children’s abilities to handle the information coming from their senses while also giving them strategies to find their own comfort zones without being disruptive to others.

  • Therapeutic Listening

*A child’s ability to appropriately process sound can influence his ability to interact with his environment and learn new skills. 

     Therapeutic Listening (TL) consists of listening to electronically altered music over specific headphones that are able to pick up higher and lower  than normal sound frequencies. Because the process of listening involves many levels of the brain, listening therapy can influence many aspects of a child’s functioning. Children with a variety of different presentations and needs can benefit from Therapeutic Listening. A customized listening program can be used to target a child’s sensory modulation abilities, behavioral regulation, emotional regulation, communication skills, postural control or motor skills, as well as auditory processing to reduce sensitivity and/or increase responsiveness. 

     The modified music utilized in this program provides input that stimulates not only the auditory system, but also the vestibular system due to the close proximity of these two systems within the inner ear. The music contains a variety of frequencies and rhythms, and stimulates sounds directed from different points in space. The combination of these variables helps a child to better understand their environment through enhancing spatial orientation and promoting attention and arousal level.

     When supervised by a skilled clinician, listening therapy can be carried out in the clinic, home or school.

Vital Links website: 

  • Astronaut Training 

*Astronaut Training is a program designed to directly impact the vestibular system, visual system, and auditory system. The vestibular system teams up with the auditory and visual systems to perform many important tasks by helping us understand the 3-dimensional space that surrounds us wherever we go. Through the proper functioning of our Vestibular-Auditory-Visual Triad the sights and sounds of our world biome meaningful and entice us to move, explore, and engage with objects, people, and events. 

     The dynamic interaction between the members of the Vestibular-Auditory-Visual Triad provides the backdrop for virtually everything we do and thus determines much about the quality of our lives. Listening to the carefully selected music and space-sounds on the CD while engaging in the specific head, body, and eye activities of the protocol can improve vestibular function.

 Vital Links website: 

  • Wilbarger Brushing Protocol

The Wilbarger Approach to Sensory Defensiveness (commonly referred to as “brushing”) is a highly individualized intervention protocol used to treat sensory defensiveness, particularly tactile defensiveness. The approach consists of education, individualized sensory diet activities and intervention from a professional trained in sensory integration theory and practice.

Tactile defensiveness and hypersensitivity happens when the nervous system does not interpret touch sensations and stimulation accurately, resulting in a child responding with fear, avoidance, withdrawal, or acting out with a “fight-or-flight” response to sensory stimuli. A child’s avoidance of tactile experiences and lack of engagement in tactile play ultimately limits his learning experiences and development of gross and fine motor skills. Functional implications of tactile defensiveness include avoidance of certain clothing textures; refusal to wear socks or shoes; discomfort with bare feet in sand, grass or on carpet; irritation from tags in clothing; and becoming bothered by various, every-day touch experiences that typically would not cause alarm or issues for others.

The Wilbarger Approach to Sensory Defensiveness can be used as early as the age of 2 months and into adulthood. The protocol requires use of a specific therapeutic, surgical brush that provides deep pressure tactile input and stimulation to the child’s legs, arms, hands, feet and back. The brushing is always followed by joint compressions at the head, shoulders, trunk, arms and legs to enhance joint perception and feedback, and to re-train the child’s brain to help identify and process various tactile inputs appropriately. The goal of the approach is to help clients develop more appropriate responses to sensory experiences through the use of enhanced sensation.

Many clinicians have found this protocol to be useful for treating other sensory processing difficulties as it generally helps to organize the central nervous system. From a sensory integrative frame of reference and what we DO know about the effectiveness of deep touch pressure and proprioceptive input on brain chemistry and processing.  Using this protocol to address areas other than sensory defensiveness needs to be discussed and monitored by very knowledgeable and experienced clinicians with specific sensory integration/sensory processing training. 

  • Handwriting Without Tears

Handwriting Without Tears (HWT) is an evidence-based program for teaching handwriting using a multi-sensory approach. Created by Jan Olsen, an occupational therapist who invented the program after helping her own son with handwriting in school, the program now includes handwriting instruction for kindergarten through 5th grade, as well as pre-writing instruction. This program uses developmentally appropriate sequenced instruction for letter formation and writing. Multisensory strategies are used to reinforce learning and make instruction effective (and fun!) for all types of learners. Research has shown that children who complete this program improve their writing skills, as well as build foundational skills for reading and writing. 

Handwriting Without Tears can help to teach foundational skills such as pre-writing, letter recognition, and letter formation. It can help with your child’s sizing, neatness, and legibility as letter formation becomes more automatic, as well as sentence structure and conventions. Cursive handwriting instruction is included in the program for grades third through fifth. 

Keyboarding Without Tears is a developmental typing program.

Learning Without Tears website: 

Background of HWT: 

  • Zones of Regulation

Zones of Regulation curriculum or Zones for short is composed of lessons and activities designed by Leah Kuypers, licensed occupational therapist, to help the child gain skills in the area of self-regulation. Most simply defined, regulation is to adjust, manage or control something so it works well. When applied to humans, regulation can go by many names, such as “self-control,” “self-management,” “emotional control,” “anger management,” or “impulse control.” These terms all describe a person’s ability to adjust their state of alertness, energy level, and emotions to help them attain personal goals, meet the demands of the situation around them, and gain a sense of well-being. Physiologically, when we are regulated, our brain and body integrated via the nervous systems work together to manage the situation at hand.

Regulation is something everyone continually works on whether we are aware of it or not. We all encounter trying circumstances that can test our limits. If we can recognize when we are becoming less regulated, we are able to do something about it to manage our feelings and get ourselves to a healthy place. This comes more naturally for some, but for others it is a skill that needs more attention and practice. This is the goal of The Zones of Regulation​.

Feelings are complicated. They come in different sizes, intensities, and levels of energy that are unique within our brains and bodies. To make them easier to talk about, think about, and regulate, The Zones of Regulation organizes our feelings, states of alertness, and energy levels into four colored Zones – Blue, Green, Yellow, and Red. The simple, common language and visual structure of The Zones of Regulation helps make the complex skill of regulation more concrete for learners and those who support them. We learn to regulate our Zones to meet our goals and task demands, as well as support our overall well-being. All the Zones are okay. We routinely experience several of the Zones across a day. It’s critically important that we don’t convey the message that the Green Zone is the only acceptable Zone to be in. Acknowledge, accept, and support these feelings, never make anyone feel like the Green Zone is the norm.

The Zones of Regulation is composed of lessons and learning activities designed to help children recognize when they are in the different Zones as well as learn how to use strategies to change or stay in the Zone they are in. In addition to addressing self-regulation, the students will gain an increased vocabulary of emotional terms, skills in reading other people’s facial expressions, perspective about how others see and react to their behavior, insight into events that trigger their behavior,calming and alerting strategies, and problem solving skills. A critical aspect of this curriculum is that all team members (parents, family members, teachers, etc.) know and understand The Zone’s language. This creates a comfortable and supportive environment for the student to practice his or her self-regulation skills. It also helps the student learn the skills more quickly and be more likely to apply them in many situations.

  • Alert: How Does Your Engine Run?

*The Alert Program was created by two occupational therapists, Mary Sue Williams and Sherry Shellenberger. The main purpose of this program is to teach children, ages 6-12, simple and practical strategies to “monitor, maintain and change their state of alertness”. The program uses  the analogy of a car engine and teaches the child to describe  their arousal state using terms such as “high, low, and just right’. The child participates in a variety of sensory motor activities to learn to label their engine speed, plays a “go fish” game, and a board game called “keeping on track”. For more information on the Alert Program please visit the following website:

  • Bal-A-Vis-X

                      Bal-A-Vis-X is a program that was developed by Bill Hubert. The program stands 

            for Balance/Auditory/Vision/eXercises which are done with sand filled bean bags or

            raquet balls, often while standing on a balance board. These exercises address visual 

            tracking, auditory skills, bilateral integration, impulsivity, and balance. The exercises are  

            Increasingly more complex and are deeply rooted in rhythm that require full body    

            coordination and focused attention.

  • Visual Perception/ Visual Motor Integration

      Occupational therapists can evaluate Visual Perceptual and Visual Motor Skills using 

 a variety of standardized tests. Visual Perception is the brain’s ability to see and recognize visual input and can be divided into several subcategories. These include:

Spatial relationships: This skill set includes the ability to orient one’s body in space, and to perceive the positions of objects in relation to oneself and to other objects. 

Visual discrimination: This skill involves the ability to discriminate dominant features of objects such as positions, shapes, forms, colors, and letter-like forms. 

Figure-ground: This is a form of visual discrimination that involves the ability to distinguish an object from background or surrounding objects.

Visual closure: This is also a form of visual discrimination and involves the ability to perceive a whole figure when only fragments are presented.

Visual memory: This skill requires the ability to remember and recognize a stimulus item after a very brief interval. 

Visual Motor Integration is the degree to which visual perception and finger-hand movements are well coordinated. Occupational therapists provide a variety of activities to help develop these skills as they have a great impact on the child’s success in daily living skills and academics.  

  • Fine Motor Developmental Skills

Fine motor skills involve the use of the smaller muscles of the hands and wrists. The coordination of these small muscles are required for small movements like cutting, writing, opening water bottles, tying shoes, etc. Young children benefit from daily practice to help develop fine motor skills in their hands and fingers. Efficient fine motor skills require a number of independent skills to work together to appropriately manipulate the object or perform the task. Strengthening these skills are important because they directly impact how well a school aged child can write as well as increases their stamina for writing. 

Fine motor skills include but not limited to:

  • Pencil skills (scribbling, coloring, drawing, and writing) 
  • Scissor skills (cutting on a paper in half, cutting on a line, cutting shapes)
  • Self care skills (tying shoelaces, fasteners, using utensils, opening containers, brushing teeth, brushing hair, toileting). 
  • Play skills (building blocks or Legos, puzzles) 
  • String beads or lacing
  • Turning pages in a book

Fine motor skills are essential for performing everyday and academic skills. Without the ability to complete these everyday tasks, a child’s self esteem can suffer, their academic performance is compromised and their play options are very limited. They are also unable to develop appropriate independence in ‘life’ skills (such as getting dressed and feeding themselves) which in turn has social implications not only within the family but also within peer relationships.

How can you tell your child has fine motor difficulties at a glance?

  • Preferring physical activity (to avoid sit down tasks).
  • Interest in ‘passive’ activities such as watching TV that don’t require fine motor skills.
  • No interest in pencil or scissors skills.
  • Being ‘bossy’ in play and asking others to  “draw a cat for me”.
  • Not persisting in the face of a challenge (e.g. asking parents to fix a problem without physically trying to fix it themselves).
  • Waiting for parents to dress them or clean their teeth rather than trying themselves.
  • Refusal to use stylus with the IPAD.
  • Activities of Daily Living

Activities of daily living (ADL’s) are activities related to personal care. They include bathing or showering, dressing, toileting, eating, grooming and hygiene are among the most common skills addressed in Occupational Therapy. These skills may be compromised for a variety of reasons such as a physical impairment, cognitive impairment, or sensory processing disorder. Occupational therapist’s can provide a variety of techniques or adaptive devices to assist the child in learning these skills in order to become more independent. 

  • Reflex Integration

Primitive reflexes are automatic stereotypic movements directed from the brainstem and require no cortical involvement (thought). They are needed for survival and development in the womb and in the early months of life. However, as higher, more sophisticated centers of the brain mature, these primitive reflexes become a nuisance and must be abated in order for  proper neurological organization of the brain to develop.

     If the Primitive Reflexes are retained past the first year of life (at the very latest) they can interfere with social, academic, and motor learning. Each reflex is associated with one or more of the sensory systems. Therefore, if retained, a child may experience dysfunction within one or several of the sensory processing systems.