Building Independence, A Moment at a Time
When 33-year-old Mrs Neeta Ponmalar first met Sam, he was 6 years old and unable to eat or drink on his own. Although these may seem like basic tasks we do with ease, they may be challenging for Persons with Intellectual Disability (PWIDs) like Sam.
This is where occupational therapists like Neeta come in — they categorise these tasks as “occupations”, and design strategies to help their clients acquire the skills they need to perform them independently.
Occupational therapy is suitable for people of all ages, but as someone who is passionate about children, Neeta’s focus is on paediatrics. Her role at MINDS Woodlands Garden School is to help children with special needs improve their academic performance and pick up self-care skills for independent living.
Encouraging Self-Care and Independence
“I cannot reverse any conditions, but I can treat the symptoms,” Neeta explains of her work. “If the child does not use their hand, I can help them learn to use it. If they drool, I can design interventions to reduce drooling and give them more oral control,” she says.
She elaborates that Sam, one of her first clients, suffers from hemiparesis, the weakness or inability to move on one side of his body. Over time, his arm had become weaker and weaker, and when they met, he could almost not move it at all. Because of weakened facial muscles, he also had to lie down for about 30 minutes to take in fluids. Eating and drinking at mealtimes had become a long and frustrating endeavour for both him and his caregivers.
Neeta knew the first step was to strengthen Sam’s weakened muscles. Oral stimulation exercises were used to target the muscles around his jaw and joint compression was applied to his arm. Weight-bearing activities were also performed to improve muscle function. When Sam managed to regain some movement, constraint-induced therapy was introduced, and Sam’s functional arm was “bound” to encourage him to use the weaker one.
Creativity is Key
Then, noticing how Sam struggled to grasp a spoon, Neeta got creative. Surmising that his grip strength was weak, she inserted a spoon into a stress ball to make it easier for him to hold.
This “adaptive tool” hit the jackpot and when Sam discovered he could bring his favourite food to his mouth by himself, he could barely control his excitement, she recalls. Now, mealtimes are a different experience and with help from his “adaptive spoon”, Sam can feed himself almost three-quarters of the time. He also uses a “honey bear bottle”, with a straw capable of controlling the flow of liquid, to sit up and drink water.
“This is why I believe the main quality an occupational therapist needs is to be creative. We need to think creatively to simplify activities,” Neeta proudly shares.
Different Ways to Engage
This is especially true since occupational therapy brings its own challenges. Many of the children she works with are non-verbal, making it more difficult to gauge the type of interventions that they will be receptive to.
For some, material rewards are necessary, but for others, words of affirmation, such as telling them they did a good job, are enough. Thanks to her 8 years of experience with MINDS, Neeta is quick to assess and adapt to each child’s needs, adjusting her tone so it is firm with some, and softer and friendlier with others—even changing the pitch of her voice—to engage each child in a way they are comfortable with.
She also works closely with caregivers to find out each child’s history so she has the context to understand any triggers the child might have. “What keeps me going is when I can see every small change and satisfaction the clients and their caregivers have,” she says.
A Strengths-Based Approach
Neeta reiterates that adaptive living is not about big changes, but small ones that can improve quality of life. Her advice? That other therapists should be realistic about what their clients can achieve.
After all, too much optimism can raise expectations unjustifiably and make the therapy process even more difficult for parents and children if progress is slow. At the same time, it is also important not to discourage them, as this could hinder their desire to try.
What matters is to focus on what the child can do. “Every child is going to have challenges, but they will also have strengths. Source for these strengths, and concentrate on bringing them out,” she concludes.
As MINDS celebrates its 60th anniversary, we celebrate the creativity and commitment Allied Health Professionals like Neeta have devoted to their clients.
Allied Health Professionals play a vital role in helping our clients nurture the skills required to improve their quality of life. Learn more about our therapy services like occupational therapy here.
Supported by a team of Allied Health Professionals, MINDS Woodlands Garden School offers a curriculum and co-curricular activities conducive to help your child become self-reliant and integrate into society. Learn more about MINDS Special Education schools here.
Interested in making a difference in the lives of children and adults with special needs? Explore careers with MINDS here.