In the span of a day I can work with a young adult to ensure AAC accessibility options are supporting his communication, facilitate 4-point kneeling and rocking with an infant who has undergone heart surgery, comfort a crying teen due to the very real presence of bullies with tea and fort building, make broccoli stamp art to encourage food exploration in a feeding session, do pilates with a 7 year old who had a stroke in-utero, paint my hands/the table/anything to make a mess to decrease tactile sensitivities, and get my arm workout with lots of swinging to help kids with sensory systems in need of organizing get the input they need to address regulation and readiness to learn. Sorry, that was a long sentence. And they are long days, but I love them! It's a messy, funny, very cute, sometimes stinky, heck of a fun way to spend a day. As I've grown into my practice, addressing behaviors and challenges related to pediatric mental health is absolutely a huge (and growing!!) part of my job. Post-pandemic life left many of us feeling disconnected, anxious, and worried about the future. Our children lived and felt these things too, but don't always have the skills to articulate their distress or comfort themselves. OT offers a space to develop social-emotional skills, healthy routines and habits, and coping skills to more gracefully manage life's challenges.
The way we occupy our time has a powerful effect on our mental health, so imagine the effect on a child when they struggle to make a motor plan to play on the playground, have challenges making or keeping friends, or wiggle and fidget so much in their seat they are constantly in trouble at school. Pediatric mental health has been in the spotlight in recent days, especially as we all come to grips with the lasting effects of the global COVID pandemic that altered work schedules, relationships, and the ability to engage in typical social interactions that are so crucial to human development. It is a joy to bring an occupational perspective to the practice of pediatric OT through a mental health lens. But what does taking an occupational approach to pediatric mental health look like? In my room, it looks like engaging in activities that are structured in a therapeutic way, with both long and short term goals built in, as part of a process to develop skills and behaviors to help a child adapt to their unique challenges and participate more fully in the world around them. It looks like games where we discuss emotions and solve problems based on real life situations. It looks like play!
Many who know me were initially surprised to hear I had landed in pediatric practice. I was too, until I really thought about it. Pediatrics doesn't just mean preschoolers and handwriting. It means 10 year olds who are developing emotions and struggling with regulation. It's children all the way from Kindergarten to college, and even beyond. Technically, our brains keep growing and developing until we're in our early 20's! So peds is handwriting and fine motor and playing to develop gross motor skills, but peds is also Autistic teenagers experiencing puberty and being curious about love and relationships. It's creating plans and visual schedules for everything from applying to college to brushing your teeth. And always, it is being sensitive to the earliest warning signs of anxiety, depression, or other mental health challenges. My passion for mental healthcare has pivoted from a reactionary approach where we treat issues after they've become functionally debilitating, to one in which we lay a foundation for mental health from childhood to avoid them ever reaching that crisis point.
Access to a rich play environment, with opportunities for sensory experiences, collaborative play, and imagination, are key to a child's development. Providing opportunities to build self-esteem and confidence can positively affect resilience and buffer against mental health risks. I strive to support children in achieving these goals and more in my own practice through arts and crafts, card and board games (yes, that IS a Dungeons & Dragons mat!), scooterboard obstacle courses, bubbles, interactive placemats, and of course, lots of time in the swing!