Occupational therapists and physiotherapists do some work that is similar, though physiotherapists tend to focus more on range of motion, orthopaedics, musculoskeletal concerns, and chest physiotherapy, while occupational therapists focus on feeding and sensory and motor development.
Physiotherapist
What is a physiotherapist?
Physiotherapists (PTs) are health care professionals who prevent, identify and correct movement problems. These problems can result from prematurity, serious illness, or birth defects. The goal of physiotherapists is to promote optimum physical health and mobility for newborns, babies, and children. They work closely with other members of the health care team, including nurses, doctors, respiratory therapists, and occupational therapists.
Physiotherapists can assess, treat, and provide consultation to premature babies who have problems affecting the heart and lungs, brain and behaviour, and muscles and bones.
Why might your baby need a physiotherapist?
A physiotherapist may see your premature baby to assess their developmental progress, and to plan an intervention program for your baby. If your baby develops respiratory problems while they are receiving assistance from a breathing machine or following surgery, a physiotherapist may be involved to help in improving their lung function. The right activities can help prevent things like blockage of the lung passages by secretions and lung infections.
How would your child see a physiotherapist?
In the Neonatal Intensive Care Unit (NICU), if your premature baby is having breathing problems, the doctor will refer you to a physiotherapist. If your baby is showing signs of musculoskeletal problems, a physiotherapist can help to address these types of problems as well. Some children will also see a physiotherapist in the Neonatal Follow-up Clinic if they have problems with their movements or muscle tone.
Occupational therapist
What is an occupational therapist?
Paediatric occupational therapists are health care professionals who work with premature babies, young babies, and children to help them overcome physical problems caused by prematurity, serious illness, and birth defects in order for them to grow and develop properly. Their goal is to help decrease the impact of disability on children, enhance their quality of life, and enable functional independence.
For example, the OT works with your child and family to help with:
- your child’s ability to do things for themselves, such as eating, bathing, standing to pull up pants, buttoning a shirt or tying shoelaces
- play skills, such as playing with toys or games, moving to get a toy or playing with friends
- school skills, including attention and memory skills, being able to organize tasks and printing or writing.
The term "occupational therapy" may be a bit confusing as it applies to youngsters, since "occupational" generally means "job related." When it comes to children, however, it refers to the functional skills and behaviours that are essential to common activities of daily living, like self-care, playing, and school skills. In the NICU, this means helping your baby learn to feed and to acquire skills such as holding their head up, looking and following with their eyes, soothing themselves, and bringing their hands to their mouth and body.
What is the OT's role in the NICU?
The OT provides developmental and feeding assessments and intervention for children during their NICU stay or when they visit a Neonatal Follow-up clinic. A feeding problem may be the result of prematurity or a birth defect. OTs work in collaboration with other members of the health care team, including nurses, doctors, social workers, dieticians, and physiotherapists.
What feeding problems need addressing?
Sometimes a premature baby experiences difficulty with feeding by mouth, also called oral feeding. The OT will assess the problem and provide recommendations to improve oral feeding and swallowing so that the baby can eat safely and efficiently. Some premature babies need help moving from tube feeding to oral feeding, or progressing through different textured foods as they get older. Other babies may be struggling with gastrointestinal problems or a sensitive throat after being intubated.
Depending upon the specific feeding issue, the OT will recommend feeding strategies such as changing the feeding equipment or method, altering the feeding position, or providing techniques to change the flow rate of liquid. All interventions are specific to the individual needs of each baby.
How would your baby see an OT?
A doctor or nurse may refer your baby to an OT if they or you have concerns about your child's development or feeding ability.
What does the OT look for?
When evaluating babies at risk, OTs look for possible signs of developmental delay. They do in-depth developmental, functional, and feeding assessments. They look at things like movement patterns, muscle tone, head control, and reflexes. The assessment may also involve the use of diagnostic tools, like X-rays. Once the source of the problem has been identified, the OT will develop and put in motion a care plan for the baby that will be carried out by the family and the health care team.
How will the OT help your baby?
While your baby is in the NICU, the OT can show you and the health care team ways to position, handle, and interact with your baby in order to promote appropriate development and prevent some problems that are more common in premature babies. The OT can also help you learn to read your baby’s cues and responses to the environment so that you can help to reduce the stress they may experience and help them learn to organize themselves.
As your baby gets older, if there is concern that they are not reaching developmental milestones, the OT will assess, provide therapy, and make recommendations to help. The OT assesses your baby’s developmental function in a number of different areas, including:
- motor skills, including movement, fine motor skills and gross motor skills
- personal-social skills, such as play skills and making friends
- cognitive skills, including attention, memory, and problem-solving skills
If a baby appears to be behind in achieving early movement skills such as rolling, sitting, or crawling, the OT will assess and provide specific therapeutic play activities or exercises to help. they may use direct intervention, bedside programs, home programs, caregiver education, or a combination of these options. The OT can also connect families with therapy services within the community if needed.
The roles of different therapists may overlap
The roles of the occupational therapist, physiotherapist, and speech language pathologist can differ and/or overlap depending on the hospital and the area. OTs and PTs receive similar training in many areas and most therapists who work in the NICU have taken advanced training courses and workshops. Speech language pathologists also have training in assessment and management of feeding and swallowing problems. Often one professional will be the primary therapist for your baby or child and will get input from the others as needed.