'Animal walks' and bouncing on a trampoline — It’s all in a day’s work for a MINDS Occupational Therapist
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Don’t be surprised if you step into a room filled with children pretending to walk like a bear, sway like a gorilla, waddle like a duck, or even slither like a snake on a padded mat.
‘Animal walks’ are a common feature of Xu Cuili’s occupational therapy sessions. These exercises help the children meet their vestibular1 and proprioceptive2 sensory needs while working on their motor planning. It also improves their gross motor skills by building up their core strength, upper body strength; and improves coordination of their limbs. “Typically, the children sit in a classroom on a chair, so crawling around like this offers a movement break for them. They enjoy it,” says Cuili with a laugh. To encourage participation, Cuili uses the help of picture cards and models the movement for the children too.
This is all part of a day’s work for Cuili, an Occupational Therapist at MINDS Woodlands Gardens School. The 25-year-old has been with MINDS for the last 1.5 years and works primarily with the younger children.
A steep learning curve
Cuili recalls how it had been a steep learning curve, given that it was her first time being exposed to the disability sector as a fresh graduate.
Prior to this, Cuili completed her clinical placements of over 1000 hours primarily in acute hospital settings, where she worked mainly with elderly patients.
In the special needs setting, she had to learn to manage children with varying complex conditions while considering their age and developmental milestones.
These children have a mix of physical, cognitive, sensory, and visual difficulties, which required Cuili to think outside the box more when applying different techniques to each unique individual.
Initially, Cuili found it daunting to handle students undergoing meltdowns. She recounted that her most memorable experience was when she managed to calm one such student, during her second month into the job.
The student was initially overly stimulated from the noise and was displaying self-injurious behaviours. Cuili responded by applying strategies from her helpful allied health professional and teaching colleagues.
The student finally calmed down after Cuili gave a deep pressure massage, dimmed the bright lights, and spoke in a soft, assuring voice. “Seeing him transit into a more relaxed state made me feel accomplished,” she said.
A lot of people assume that people with special needs can’t do things by themselves… I hope one day people will learn to focus on their abilities rather than their disabilities.
All in a day’s work for an occupational therapist
Occupational therapists like Cuili work on a variety of skill sets to build students’ fine and gross motor skills, sensory processing skills and visual discrimination3 skills. These play a part in improving their executive functions, training them for daily living activities and eventually preparing them for employment. Occupational therapists also work in collaboration with physiotherapists, who focus on clients’ physical challenges.
These trainings are implemented during weekly therapy sessions which consist of group sessions, individual sessions, and classroom-based sessions.
As a result of the students’ varied needs, Cuili has learnt to be equally creative in her training methods as well.
She introduces the children to activities including bouncing on gym balls, climbing net ladders, and sensory play with a hand sewn tactile mat comprising of materials like silk, wool, and nylon netting. These activities provide tactile, vestibular, and proprioceptive stimulation to the students.
She also trains the children’s fine motor skills by getting them to practice writing their own name, and to hold their pen properly.
With the older students, the focus of their training shifts to developing vocational skills as they progress to various post-graduation pathways such as sheltered workshops. Some of the job tasks offered include packing of items, folding of towels, working in the bakery, or standing for long hours in retail.
To prepare them, Cuili does various activities with the students to train their patience, endurance, and to correct their posture while navigating through a task.
The work does not just end with the therapy session. Amidst it all, Cuili also organises her case notes, churns out reports, plans for future sessions, and conducts caregiver and staff training.
A mindset of continuous learning
Having the growth mindset and being open to learning is very important, says Cuili. She keeps an active lookout for training opportunities and enjoys sharing strategies with her colleagues.
“Google is my best friend. When in doubt, I will always go online to look for courses, webinars, or online forums to see if there are any people who have seen similar difficulties and what worked for them,” she explains.
She also subscribes to various occupational therapy websites and mommy blogs to crowd-source ideas on different strategies and activities that she can adapt.
For instance, she incorporated the use of Play-Doh, a children’s modeling compound, during colouring sessions. The Play-Doh acts as a physical ‘barrier’ and prevents the students from colouring outside the lines. This helps to improve their line awareness and control of their colouring strokes.
In addition, she regularly collaborates with teachers and parents, who are heavily involved in the student’s daily life. They know the students better, and their strategies and interventions can help with her sessions, she said.
To Cuili, she believes that every student has the potential to achieve greater independence. Seeing the students’ progress over the therapy sessions also gives her great motivation.
In one scenario, Cuili had stepped into a classroom, only to discover that many of the students were walking about dysregulated4 and had difficulty in following instructions or routines.
She conducted several sensorimotor group sessions together with a physiotherapist; incorporating both sensory and motor aspects in one class, where the children did ball throwing, trampoline jumps and swing activities.
Today, Cuili has observed a “big difference” since the start of the year. The students are able to take off their shoes and place them on a shoe rack, wait for their turn, and demonstrate better turn taking and in-seat behaviour.
Going forward, she hopes that people will gain greater knowledge on the needs of the special needs community. She also hopes for greater acceptance and a more considerate society, so that parents do not feel stigmatised when they bring their differently abled children out.
“A lot of people assume that people with special needs can’t do things by themselves… I hope one day people will learn to focus on their abilities rather than their disabilities,” she said.
Footnote:
Definitions obtained from: In Merriam-Webster.com dictionary. Retrieved October 19, 2023
- Vestibular – of, relating to, or affecting the perception of body position and movement
- Proprioceptive – of, relating to, or being stimuli arising within the organism
- Visual discrimination – prejudiced or prejudicial outlook, action, or treatment based on looks
- Dysregulated – impairment of a physiological regulatory mechanism (as that governing metabolism, immune response, or organ function)
We would like to express our heartfelt thanks to the Allied Health Professionals at MINDS, for their selfless devotion while playing a pivotal role in supporting the physical, mental, and emotional needs of our PWIDs throughout their lives.
Read about how Occupational Therapists and Physiotherapists work together in another story.
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