Occupational Therapy (OT) focuses on improving a person’s overall well-being and participation in daily life. Helping individuals overcome the emotional, social, and physical barriers preventing them from fully participating in their Activities of Daily Living (ADL’s) and Instrumental Activities of Daily Living (IADL’s). OT can also help improve an individual’s executive functioning skills, fine and gross motor coordination, activity tolerance, and wheelchair positioning. Occupational Therapists are qualified to suggest assistive devices, durable medical equipment (DME), environmental modifications (EM) and adaptive equipment to enhance an individual's safety and independence.

The basic ADLs include the following categories:

• Ambulating: The extent of an individual’s ability to move from one position to another and walk independently.

• Feeding: The ability of a person to feed oneself.

• Dressing: The ability to select appropriate clothes and to put the clothes on.

• Personal hygiene: The ability to bathe and groom oneself and maintain dental hygiene, nail, and hair care.

• Continence: The ability to control bladder and bowel function

• Toileting: The ability to get to and from the toilet, use it appropriately, and clean oneself.

IADLs require more complex thinking skills, including organizational skills:

• Transportation & shopping: Ability to procure groceries, make small purchases, attend events, and manage/organize transportation.

• Managing finances: This includes the ability to pay bills and manage financial assets.

• Meal preparation: i.e., everything required to get a meal on the table.

• Housecleaning & home maintenance. Cleaning kitchens after eating & maintaining living areas reasonably clean and tidy.

• Managing communication with others: The ability to manage telephone, text, and/or mail.

• Managing medications: Ability to obtain medications and take them as directed.

Activities of Daily Living - StatPearls - NCBI Bookshelf (nih.gov)

Occupational therapy consultation shall only be provided by an occupational therapist who is licensed by the Commonwealth of Virginia. The Occupational Therapist (OT) will provide an Individualized Therapy Support Plan (ITSP) and will model and train directly with caregivers, to best support the individual, while providing various supports to enhance the individual’s independence in the areas targeted.

Physical Therapy (PT) focuses on:

• increasing functional independence • improving motor skills • increasing cardiovascular activity tolerance • improving posture/alignment • easing pain/pain management • minimizing fall risk • addressing barriers to mobility • safely completing transfers/repositioning • improving range of motion (ROM) • improving poor balance • strengthening • minimizing pressure injuries • stair navigation • wheelchair positioning • wheelchair management

A Physical Therapist can also recommend assistive devices, durable medical equipment (DME), environmental modifications (EM) and/or adaptive equipment that will increase an individual’s safety and independence. PT is also able to help individuals enhance their community participation by helping to mitigate the barriers preventing them from actively participating in their community settings.

PT can address multiple conditions including but not limited to:

• Cri-du-chat syndrome

• Down syndrome

• Cerebral Palsy (CP) & Bell’s Palsy

• Hypotonia

• Congenital Muscular Torticollis

• Arthritis

• Idiopathic Toe Walking (ITW)

• Traumatic Brain Injury (TBI)

• Balance and coordination disorders

Physical therapy consultation shall only be provided by a physical therapist who is licensed by the Commonwealth of Virginia. The Physical Therapist (PT) will provide an Individualized Therapy Support Plan (ITSP) and will model and train directly with caregivers, to best support the individual, while providing various supports to enhance the individual’s independence in the areas targeted.

Speech-language pathologists (SLPs) work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults.

• Speech disorders occur when a person has difficulty producing speech sounds correctly or fluently (e.g., stuttering is a form of disfluency) or has problems with his or her voice or resonance.

• Language disorders occur when a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings (expressive language). Language disorders may be spoken or written and may involve the form (phonology, morphology, syntax), content (semantics), and/or use (pragmatics) of language in functional and socially appropriate ways.

• Social communication disorders occur when a person has trouble with the social use of verbal and nonverbal communication. These disorders may include problems (a) communicating for social purposes (e.g., greeting, commenting, asking questions), (b) talking in different ways to suit the listener and setting, and (c) following rules for conversation and story-telling. All individuals with autism spectrum disorder (ASD) have social communication problems. Social communication disorders are also found in individuals with other conditions, such as traumatic brain injury.

• Cognitive-communication disorders include problems organizing thoughts, paying attention, remembering, planning, and/or problem-solving. These disorders usually happen as a result of a stroke, traumatic brain injury, or dementia, although they can be congenital.

• Swallowing disorders (dysphagia) are feeding and swallowing difficulties, which may follow an illness, surgery, stroke, or injury.

https://www.asha.org/students/speech-language-pathologists/

SLPs can assist individuals with Intellectual Disabilities or Developmental Disabilities with improving communication skills, enhancing language development, promoting social interaction, increasing independence, addressing speech disorders and swallowing disorders. SLPs can also make recommendations for assistive technology (AT) including communication and AAC devices.

Speech consultation shall only be provided by a speech-language pathologist (SLP) who is licensed by the Commonwealth of Virginia. The SLP will provide an Individualized Therapy Support Plan (ITSP) and will model and train directly with caregivers, to best support the individual, while providing various supports to enhance the individual’s independence in the areas targeted.

Recreational Therapy (RT), also known as Therapeutic Recreation, seeks to improve/maintain one’s physical, cognitive, social, emotional and spiritual functioning in order to facilitate full participation in life through the use of recreational and leisure activities.

Recreational Therapy allows for individuals to express themselves freely and giving them a sense of control and autonomy, which in turn boost their self-confidence. RT can also help improve an individual’s motor skills, coordination, and concentration by engaging in activities. RT also helps individuals with I/DD develop social skills, build appropriate relationships, and integrate with their community.

Recreational therapy examples:

• Art therapy

• Animal-assisted therapy

• Gardening therapy

• Equine therapy/hippotherapy

• Yoga and meditation

• Aquatic therapy

• Sensory rooms/activities

• Music therapy

• Outdoor activities

Services are provided by a “Certified Therapeutic Recreation Specialist” (CTRS). The CTRS will provide an Individualized Therapy Support Plan (ITSP) and will model and train directly with caregivers, to best support the individual, while providing various supports to enhance the individual’s independence in the areas targeted.

Behavioral therapy is frequently applied to individuals with Autism Spectrum Disorder (ASD) and other developmental disorders that display negative behaviors. Behavioral Therapy may help an individual improve their social interactions, improve functional communication, learn new skills, increase attention/focus, and improve memory while also lessening unwanted behaviors. The goal of Behavioral Therapy is to eliminate unwanted behaviors while reinforcing appropriate behaviors.

Common goals for Behavioral Therapy:

• Reduce aggression

• Reduce disruptive behaviors

• Develop functional communication and language skills

• Integration into a community/group/peer setting

• Encourage independence with self-care tasks

The Behavior Therapist will create a Behavior Support Plan (BSP) after completing a Functional Behavior Assessment (FBA). The FBA is used to determine the cause of the unwanted behaviors. The BSP then provides a guide for families and/or caregivers to reduce the problem behaviors while being supported and trained by the Behavior Analyst.

Behavior consultation shall only be provided by a licensed behavior analyst (BCBA) or a licensed assistant behavior analyst (BCaBA) or a positive behavior supports facilitator (PBSF).

Sensory modulation/diet helps treat sensory dysregulation and sensory processing disorder (SPD). SPD is a neurological condition that affects the way an individual’s brain processes sensory input. The individual may become overstimulated and act out in extreme ways or engage in sensory seeking behaviors.

The EIGHT senses:

• Tactile-the sense of touch

• Visual-the sense of sight

• Auditory-the sense of hearing sounds

• Oral-the sense of taste and texture

• Olfactory-the sense of smell

• Vestibular-the sense of movement

• Proprioception-the sense of body position

• Interoception-the sense of one’s internal state

Sensory modulation is provided by an Occupational Therapist or a Physical Therapist. Sensory modulation can help an individual properly interpret their sensory input without feeling overwhelmed. It can also provide ways to meet an individual’s sensory needs to eliminate inappropriate sensory seeking behaviors. Sensory modulation can help one feel calmer, more motivated, sleep better, and improve engagement in tasks and social situations.