Treatments

treatments Click the treatment name below to read more.

Developmental Coordination Disorder (DCD) / Dyspraxia

Developmental Coordination Disorder is a DSM –IV recognised disorder that affects motor skills specifically. Children with DCD often appear clumsy or awkward and may have difficulties in some (but not always all) of the following life-skills:

Dressing (or doing so with speed)
Using a knife and fork
Handwriting – delayed letter formation, spacing, ability to stay on the line, pencil grasp or handwriting speed, posture when writing
Self-Care activities – washing or showering independently
Organising themselves or their belongings
May be unable to, or may appear “awkward” when completing gross motor activities e.g. hopping, jumping, skipping and star jumps next to peers their own age
May be more overweight than their peers
May tire easier than their peers
May have difficulties with attention and concentration, remaining in their seat or tending to day dream

DCD and Dyspraxia are diagnosed by using a battery of assessments that examine whether a child is developmentally delayed in coordination abilities or not. If you are concerned your child may have DCD, Dyspraxia or poor coordination, an Occupational Therapy assessment would indicate whether they meet the criteria or not and provide recommendations for the future.

If your child has a pre-existing diagnosis of DCD / Dyspraxia, Occupational Therapy Intervention is the most common treatment approach. Intervention sessions are tailored around your, or your child’s own personal goals and is graded at a pace that suits your family. Occupational Therapists specialise in the ability to grade activities and break them down into manageable steps that the child can practise at home in order to master a task. Parental and Teacher coaching on these techniques and the use of schedules and checklists is a vital part of encouraging the child to be independent.

If your child with DCD / Dyspraxia has poor self-esteem or motivation in sports and fitness, they may benefit from sessions with our Paediatric Fitness Instructor.

If your child with DCD / Dyspraxia has poor self-esteem, self-belief or behavioral difficulties they may benefit from some counselling or art therapy sessions at the Stepping Ahead Clinic.

Many children with DCD / Dyspraxia have secondary needs related to Sensory Processing Disorder.

Using a Team approach for your child with Coordination Difficulties:

The Stepping Ahead Clinic offers a unique team-based service.

Our Occupational Therapists have excellent relationships with schools and have contracts with numerous schools to offer intervention within the school, therefore educating Teachers and SNA’s how to work with and provide a sensory diet for your child within their school. We also have run sensory groups within schools, therefore educating school staff how to run a therapeutic group, including the development of social skills.

Our Counsellor Miriam McAuliffe provides emotional support for children and their parents in order to cope with the self-esteem and social immaturity that some children with DCD / Dyspraxia can present with.

Art Therapy is provided in the Stepping Ahead Clinic by Grace O Donoghue. This allows people with coordination difficulties who may find talk-based counseling too intense to express themselves and deal with their life challenges through art. It is especially useful for reflecting on elements of a child’s life story e.g. bullying.

Sensory Integration Dysfunction

Sensory Processing Disorder is a condition that exists in the background of many conditions that are on our home page. It is rarely a stand-alone diagnosis, but exists as an element of other conditions. Children with Sensory Processing Disorder may present with some, but not necessarily all of the following traits:

Hyperactive, with poor concentration
Sensitive to touch or high pain threshold
Upset by loud noises
“Tuned out” or “day dreamy”
Do not appear to notice sights or sounds in their environment
May be unintentionally “rough” during play with their peers
May be sensitive to certain fabrics or textures
May be picky eaters

In response to these needs, Occupational Therapy intervention, using a Sensory Integration approach and specialised equipment can assist to:

Regulate activity levels – calming or alerting activities
Increase attention span
Improve listening skills
Improve body awareness, therefore improving motor skills

Pervasive Developmental Disorder / Autistic Spectrum Disorders

Many people hear the phrase “Autistic Spectrum Disorder” or “Asperger’s Syndrome” and are filled with pre-conceived ideas and presumptions. The reality is that no two children who have this diagnosis are the same. The word “Spectrum” is extremely important, as it reminds us that there is a vast range of traits a child can have, as well as the fact that these can vary in severity. Not all children with this diagnosis fit the internal image of a child banging their head against a wall or who is afraid of touch and textures. Some children with one of these diagnoses can simply appear shy or as if they do not know how to start conversations. No matter which end of the spectrum a child lies in, Occupational Therapy can offer ideas and techniques to enable them to improve on their current function and live a more independent life.

Many children with Autistic Spectrum Disorders have difficulties relating to Sensory Processing Disorder. This can manifest itself as some, but not always all of the following:

Sensory Processing Disorder

Many children with an Autistic Spectrum Disorder experience more intense Sensory Processing Disorder and can often appear:

Repetitive movements or “stimming”
Hyperactive, with poor concentration
Aggressive in relation to touch
Upset by loud noises
“Tuned out” or “day dreamy”
Do not appear to notice sights or sounds in their environment
May be unintentionally “rough” during play with their peers

In response to these needs, Occupational Therapy intervention, using a Sensory Integration approach and specialised equipment can assist to:

Regulate activity levels – calming or alerting activities
Increase attention span
Improve listening skills
Appear more “connected” and responsive to their environment
Improve sleep patterns

Many behaviors which are thought to be simply part of Autism such as:

Head banging
Poor concentration (day dreaminess or hyperactivity)
Hand flapping (or other repetitive actions such as jumping)

Are in reality related to Sensory Processing Disorder and therefore can be reduced or worked on via Occupational Therapy with specialist approaches and equipment.

Motor Skills:

Children with ASD may be delayed in acquiring motor skills that require motor dexterity and may have “awkward” or “rigid” movements. They can have secondary Dyspraxia (challenges in motor planning). This creates the following challenges for children with ASD:

Challenges in gait and posture
Poor handwriting
Problems with visual-motor integration (copying from the blackboard / ball skills)
Further challenges in social skills, due to a reluctance to engage in team sports
Challenges in functional skills, such as dressing and using a knife and fork
Difficulties with organisational skills

These needs can all be addressed via Occupational Therapy intervention. Children with Dyspraxia often require tasks to be broken down in order to understand them and more time and practice before a skill can be completed in a smooth and automatic manner. Parental and Teacher coaching on these techniques and the use of Picture Schedules is a key part of this aspect of Occupational Therapy intervention, to increase the child’s independence skills and confidence.

Emotional and Behavioural Needs

A lot of challenging behaviour in ASD can relate to an underlying difficulty in Sensory Processing Disorder and/or challenges with social and emotional cues. Recent research has found high levels of anxiety in children with ASD. There are various techniques that Occupational Therapists use as part of their sessions that can be taught to parents and introduced as part of a school and home programme. These include:

Social stories
Contracts
Reward charts
Picture schedules
Creating family-centred routines e.g. bedtime routine
Parenting support and groups

Social Skills:

Children with a diagnosis of ASD frequently do not develop age-appropriate social skills naturally. There are high levels of anxiety and other mental-health difficulties in older children and teenagers with ASD relating to social isolation and poor self esteem. Occupational Therapy intervention provides tools and steps to break social skills down into manageable components (similarly to motor skills). This can take the format of individual coaching, or in groups, where practical tips and role plays are put to use.

Using a Team approach for your child with ASD:

The Stepping Ahead Clinic offers a unique team-based service that most children with ASD require for their complex needs.

At the Stepping Ahead Clinic we have liaised and contracted with ASD support groups, including adult Asperger’s Syndrome associations to provide inclusive and supportive Occupational Therapy for people of any age.

Our Fitness Instructor, Seamus O Connor works with children with various diagnoses, on individual and group levels to improve their motor skills and their confidence in group sporting activities.

Our Counsellor Miriam McAuliffe provides emotional support for children and their parents in order to cope with the self-esteem and behavioral difficulties that children with ASD often present with

Art Therapy is provided in the Stepping Ahead Clinic by Grace O Donoghue. This allows people with ASD, who do not necessarily have the emotional language to express themselves space in order to do so through image making.

Various Developmental Syndromes and Conditions

All staff at the Stepping Ahead Clinic have experience working with various developmental syndromes and diagnoses. Generally, such medical conditions may come with delays or complications in developmental milestones in motor development affecting the following areas of Activities of Daily Living:

Dressing (or doing so with speed)
Using a knife and fork
Handwriting – delayed letter formation, spacing, ability to stay on the line, pencil grasp or handwriting speed, posture when writing
Self-Care activities – washing or showering independently
Organising themselves or their belongings
May be unable to, or may appear “awkward” when completing gross motor activities e.g. hopping, jumping, skipping and star jumps next to peers their own age
May tire easier than their peers
May have difficulties with attention and concentration, remaining in their seat or tending to day dream

During an Occupational Therapy motor assessment, a battery of assessments can be used to examine whether a child is developmentally delayed in coordination abilities or not as part of their overall diagnosis.

Occupational Therapists specialise in the ability to grade activities and break them down into manageable steps that the child can practise at home in order to master a task. Parental and Teacher coaching on these techniques and the use of schedules and checklists is a vital part of encouraging the child to be independent.

Similarly children with pre-existing syndromes or genetic conditions often present with challenges relating to Sensory Processing Disorder. This can often appear as some, but not all of the following:

Hyperactive, with poor concentration
Sensitive to touch or high pain threshold
Upset by loud noises
“Tuned out” or “day dreamy”
Do not appear to notice sights or sounds in their environment
May be unintentionally “rough” during play with their peers
May be sensitive to certain fabrics or textures
May be picky eaters

In response to these needs, Occupational Therapy intervention, using a Sensory Integration approach and specialised equipment can assist to:

Regulate activity levels – calming or alerting activities
Increase attention span
Improve listening skills
Improve body awareness, therefore improving motor skills

Using a Team approach for your child:

The Stepping Ahead Clinic offers a unique team-based service that most children with genetic or developmental syndromes and conditions require:

Our Fitness Instructor, Seamus O Connor works with children with various diagnoses, on individual and group levels to improve their motor skills and their confidence in group sporting activities.

Our Counsellor Miriam McAuliffe provides emotional support for children and their parents in order to cope with the self-esteem and behavioral difficulties that children with genetic disorders can often present with

Art Therapy is provided in the Stepping Ahead Clinic by Grace O Donoghue. This allows children, who do not necessarily have the emotional language to express themselves space in order to do so through image making.

Dysgraphia

Dysgraphia is a Specific Learning Disability, which manifests a difficulty expressing thoughts in writing. Children with Dysgraphia are usually very bright and do well in school verbally, but have difficulty performing in written tasks. Dysgraphia is often indicated by difficulties in the following areas:

Writing contains difficulties with spelling, punctuation, reversals, numbers, writing words backwards
Sequencing i.e. being able to organise thoughts and actions in the correct sequence of steps
Slow working speed when writing
General auditory/language processing weakness
Cramped or unusual pencil grip
Poor sitting posture

Once a diagnosis of Dysgraphia has been confirmed via an OT assessment, intervention can take place focusing on the following areas:

Increasing muscle tone and strength to improve sitting posture and reduce fatigue
Improve fine motor skills and fine motor speed for handwriting and typing
Improve pencil grip
Provide foundation levels of fine motor awareness required for typing skills
Coaching on how to organise time, belongings and thoughts by working on sequencing difficulties.
Allocation of extra time in exams for second and third level.

Even without a diagnosis of Dysgraphia, some children may benefit from some OT sessions to target specific difficulties in handwriting, or from participating in a handwriting group.

Dyslexia

Dyslexia is a Specific Learning Disability and occurs in approximately 8% of the population with varying degrees of severity. Students with dyslexia are able to understand and assimilate knowledge but have greater difficulties in processing what they know into written language.
A dyslexic student may experience difficulties in acquiring the skills necessary for reading, writing, spelling and numeracy, despite average IQ. These difficulties are often exacerbated when the student is under stress or time pressures. Feelings of failure and decreased self esteem and confidence are common in dyslexic students, most particularly if there is no diagnosis.
With therapeutic support and guidance, dyslexic students can learn to understand their specific difficulty and learn to maximise and capitalise on their many strengths.

Children with dyslexia may have difficulties interpreting visual information. Visual perception is the ability to use visual information to recognise, recall, discriminate and make meaning of what we see. Good visual perceptual skills are necessary for many areas of academic learning and impact particularly on reading and writing skills and the development of such.

Occupational Therapists design visual perception programs to promote these skills. For young children, the theory is that a child should first develop these foundational skills before learning to read and write. Improved visual perceptual skills will also impact the child’s handwriting and their ability to copy from the blackboard. Developing visual perceptual skills will reduce the letter reversals and improve the fluency with which the child reads. Short term visual memory is also developed, an important component in word recognition and spelling ability.

For older students (second and third level), the management of dyslexia may include the development of visual perceptual skills but also helping the student to identify the learning style that suits them; auditory, visual, kinaesthetic. Occupational therapists are uniquely placed to utilise this mutlisensory approach due to the holistic nature of our work. Students are further supported to develop study techniques and learning strategies that work for them.

A student with dyslexia has many strengths. They are typically very creative and intuitive with excellent problem solving abilities and ability to ‘think outside the box’. Occupational Therapists channel these strengths and facilitate the student to demonstrate their full potential.

Learning Disability

Generally, learning disabilities may come with delays or complications in developmental milestones in motor development affecting the following areas of Activities of Daily Living:

Dressing (or doing so with speed)
Using a knife and fork
Handwriting – delayed letter formation, spacing, ability to stay on the line, pencil grasp or handwriting speed, posture when writing
Self-Care activities – washing or showering independently
Organising themselves or their belongings
May be unable to, or may appear “awkward” when completing gross motor activities e.g. hopping, jumping, skipping and star jumps next to peers their own age
May tire easier than their peers
May have difficulties with attention and concentration, remaining in their seat or tending to day dream

Similarly children with learning disablities often present with challenges relating to Sensory Processing Disorder. This can often appear as some, but not all of the following:

Hyperactive, with poor concentration
Sensitive to touch or high pain threshold
Upset by loud noises
“Tuned out” or “day dreamy”
Do not appear to notice sights or sounds in their environment
May be unintentionally “rough” during play with their peers
May be sensitive to certain fabrics or textures
May be picky eaters

In response to these needs, Occupational Therapy intervention, using a Sensory Integration approach and specialised equipment can assist to:

Regulate activity levels – calming or alerting activities
Increase attention span
Improve listening skills
Improve body awareness, therefore improving motor skills

Using a Team approach for your child:

Down’s Syndrome

Common characteristics of children with Down Syndrome are:

Low floppy tone or the arms, hands and trunk area
Low oral motor tone (hypotonia) or weakness of the muscles of the cheeks, tongue and lips
Physically broader hands and smaller short fingers
Loose ligaments or extra flexibility of the joints

This causes functional everyday challenges for the infant with Down Syndrome in the areas of:

Fine and gross motor development, even as early as infancy
Dressing (or doing so with speed)
Using a knife and fork
Handwriting – delayed letter formation, spacing, ability to stay on the line, pencil grasp or handwriting speed, posture when writing
Self-Care activities – washing or showering independently
Organising themselves or their belongings
May be unable to, or may appear “awkward” when completing gross motor activities e.g. hopping, jumping, skipping and star jumps next to peers their own age
May tire easier than their peers
May have difficulties with attention and concentration, remaining in their seat or tending to day dream

The role of an OT is to focus on the child’s ability to master skills for independence. This can include:

Self care skills
Fine and gross motor skills
Play skills
Oral motor tone
Oral sensitivities
Tactile awareness
Body awareness
Listening skills or auditory processing

Using a Team approach for your child:

We are proud to announce that we have a strong liaison with Cork Down’s Syndrome association, who subsidize fees for assessment and intervention in the Stepping Ahead Clinic.

Our Fitness Instructor, Seamus O Connor works with children with various diagnoses, on individual and group levels to improve their motor skills and their confidence in group sporting activities. Seamus is also available to work within schools completing and demonstrating to school staff how to run a therapeutic motor group as a part of P.E. curriculum. Seamus has vast experience working with children with Down’s syndrome and has run fitness groups targeting low muscle tone and hyper-mobility that is characteristic of Down’s Syndrome in liaison with Tipperary Down’s Syndrome Association.

Child and Adolescent Mental Health difficulties

At the Stepping Ahead Clinic we have experience working with children with various and multiple conditions associated with CAMHS services, including:

Attachment Disorders
Oppositional Defiant Disorder (ODD)
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Disorder (ADD)
Child and adolescent mood and anxiety disorders
Severe Emotional and Behavioral Disorder (SEBD)
Poor self esteem
Obsessive Compulsive Disorder (OCD)
Fetal Alcohol Syndrome
Tourettes Syndrome

Occupational Therapy can help children in stress management and coping skills by supporting them and their family in use of:

Social stories
Visual schedules
Creating an effective reward system

Many of these conditions, particularly ADHD and ADD have components of Sensory Processing Disorder. Where the child’s behaviour or inattention is triggered by various stimuli their body interprets as “intense” or “uncomfortable.” Specifically they may appear:

Aggressive in relation to touch
Upset by loud noises
“Tuned out” or “day dreamy”
Do not appear to notice sights or sounds in their environment
May be unintentionally “rough” during play with their peers

In response to these needs, Occupational Therapy intervention, using a Sensory Integration approach and specialised equipment can assist to:

Regulate activity levels – calming or alerting activities
Increase attention span
Improve listening skills
Improve body awareness, therefore improving motor skills

Children with these social and emotional conditions frequently require a team approach. The Stepping Ahead Clinic is unique in that it can offer Art Therapy and Counselling Services that can liaise with the Occupational Therapist and others involved in your child’s case.
Art Therapy allows for deep and long term exploration of emotional difficulties and feelings. The image decreases the intensity of the one to one interaction between therapist and client, which can suit children who are resistant to talking about their feelings. Through image making, the child or adolescent can tell their own life story at their own pace in a safe environment.

Miriam McAuliffe provides professional confidential listening, respect & understanding and emotional support for CAMHS clients and their parents who wish to discuss their family dynamic. Miriam has further training in Parenting Plus which aids to support parents in understanding and managing their child’s behaviors as a family unit.

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Treatments

Developmental Coordination Disorder (DCD) / Dyspraxia

Using a Team approach for your child with Coordination Difficulties:

Sensory Integration Dysfunction

Pervasive Developmental Disorder / Autistic Spectrum Disorders

Sensory Processing Disorder

Motor Skills:

Emotional and Behavioural Needs

Social Skills:

Using a Team approach for your child with ASD:

Various Developmental Syndromes and Conditions

Using a Team approach for your child:

Dysgraphia

Dyslexia

Learning Disability

Using a Team approach for your child:

Down’s Syndrome

Using a Team approach for your child:

Child and Adolescent Mental Health difficulties

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