I had the privilege of interviewing our son’s occupational therapist, Michelle, to learn more about her journey and the vital role of occupational therapy in supporting children with neurodevelopmental disorders like CUL3. Michelle worked with our son for two years, from the ages of 8 to 10, and her friendly, caring, and energetic approach was a perfect fit for him.
Michelle holds an Honours Bachelor of Science degree specializing in Biomedical Sciences and Neuroscience, as well as a Master’s degree in Health Science in Occupational Therapy. As a licensed occupational therapist with extensive experience coordinating and facilitating programs for children and youth with special needs—including Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and behavioral management challenges—Michelle brings a wealth of knowledge and compassion to her work.
What inspired you to become an occupational therapist, and how has your journey evolved since?
I was inspired to become an occupational therapist (commonly referred as OT) while working in a special needs respite program for children with neurodevelopmental disorders. I was in high school at that point and I was very interested in learning how to support neurodivergent children as I was also tutoring students with learning exceptionalities. I immediately developed a passion for working with these children and seeked out multiple opportunities. I had decided on studying biomedical science with a specialty in neuroscience to complement these job experiences. I continued working with the respite program throughout my entire higher education, eventually coordinating and facilitating parts of their service model. I heard about occupational therapy through my co-worker, and I was so excited to hear about a next step that was so fitting to my academic and professional journey so far. Occupational therapy is a perfect blend of science, compassion and creativity – all of which I was looking for when choosing my career. I am very pleased with my decision to study and practice occupational therapy. I look forward to continuing to support wonderful children and their families for many years to come!
How do you approach working with children with neurodevelopmental disorders? What are some key therapeutic goals?
My approach in occupational therapy is based on ensuring that my client is regulated and having fun throughout their sessions. This foundation allows for clients to be open to learning opportunities and targeting goals using a collaborative approach. I work very hard to know the interests of my clients and include them in my intervention approach. I will always remember what one of my clients told me: “I know your secret, you make learning fun!” and I thrive to make this true for all the children I meet. Reaching goals requires motivation and motivation requires getting their interest :)
Throughout the years, I have also had the opportunity to work with many children with behavioural challenges and have been able to see the importance in learning foundational skills in self-regulation. I work to create a safe space for my clients, where they can freely share their thoughts and feel heard. This is especially important when working with children with neurodevelopmental disorders as they often have many questions/ideas, multiple encounters with health care professionals and are an active member in their therapeutic process.
There are many therapeutic goals in occupational therapy as we address all elements of daily living. This means anything that poses a challenge for your child in the activities that they do to function everyday. The list is long, however includes self-care activities (i.e., brushing their teeth, showering, getting dressed, tying their shoelaces, feeding and eating, etc.), productivity (i.e., challenges accessing their academic curriculum, at-home chores, etc.) and leisure (i.e., playing with friends, hobbies, recreational activities, etc.). The key therapeutic goals often targeted in private occupational therapy sessions are self-regulation skills, self-care, executive functioning skills required for academic tasks and expanding/discovering leisure activities.
What are some of the biggest challenges in treating children with neurodevelopmental disorders?
The biggest challenge when treating children with neurodevelopmental disorders is prioritizing therapeutic goals. As the scope of occupational therapy is so large and these children often have challenges in each domain (e.g., self-care, productivity and leisure), it can sometimes be challenging to identify the goals that are most important. This is helped through the involvement of other health professionals (i.e., speech language pathologists that can also help with social skills and executive functioning skills; physiotherapists that can also help develop gross motor skills). With a complete team, occupational therapists can work to “fill in the gaps” and address the challenges that are most important in the day-to-day life of the child and their family.
What advice would you give to other families whose children are just beginning occupational therapy for rare genetic conditions / neurodevelopmental disorders?
The advice I would give to families is to not hesitate to share their thoughts or feelings with their occupational therapist. All questions are valid as you work to navigate the healthcare and educational systems! As the scope of occupational therapy is so large, we can certainly discuss most challenges and/or redirect you to the right person if ever it is outside of our scope. The health care team affiliated to children with genetic conditions and/or neurodevelopmental disorders can sometimes feel overwhelming and occupational therapists are happy to help families navigate their different needs. We are also happy to advocate for families!
How can parents and caregivers best support their child's therapy outside of sessions?
Parents and caregivers can best support their child outside of occupational therapy sessions by implementing the recommendations provided during the sessions. Generally, this would be to allow your child to try things independently while learning and using the tools/strategies proposed by your occupational therapist to support them as needed. It is essential for caregivers to be active members in the intervention process as they are the experts of their child's needs/cues and they are with them daily. Parents and caregivers should also share with their occupational therapist about what is realistic for them to try in their every day life. Strategies and tools are supposed to be helpful, not feel overwhelming and impossible.
In your experience, how has occupational therapy evolved for children with neurodevelopmental disorders over the past few years?
Occupational therapy has greatly evolved for children with neurodevelopmental disorders. Both occupational therapy as a profession and neurodiversity are new elements in the healthcare system. With the recent information on neuro-affirming care, occupational therapists now often take a leadership role in healthcare teams to ensure that these children are met with understanding. It is essential for health professionals and families to consistently highlight the strengths in these children as this can sometimes be forgotten in a pre-established medical based system that is targeting the things that are challenging for them.
What are some common misconceptions about occupational therapy that you think parents should be aware of?
Occupational therapy and it's scope of practice continues to be unknown to many people. It is a relatively new profession, emerging in the 1930s, and has expanded in the healthcare system, especially when addressing pediatric populations. Some misconceptions are linked to the role of occupational therapy on the care team (i.e., limited to a single target area, addressing return to work skills only). Occupational therapy can help in many ways and should be a considered pathway for a child with neurodevelopmental challenges.
Can you describe any particularly rewarding moments in your work?
I have had many rewarding experiences in my work, however, one that has stuck with me is my involvement with a teenage client navigating the health care system as diagnosed with a rare genetic condition and several neurodevelopmental challenges. As an occupational therapist, I was able to address their challenges directly in our sessions while sending them home with tools to improve their every day life. They were always very happy to return with a tangible item that could make their days better immediately. The underlying rewarding experience was the rapport I was able to build with this client. I became an advocate for their care on their medical team and facilitated their involvement in decision-making through establishing a safe connection with me. They used to avoid speaking in their medical appointments and blossomed when feeling comfortable sharing their thoughts and feelings with their care team. I am so grateful to have had the opportunity to make this positive impact on their life and on their care team.
We are deeply grateful to Michelle for taking the time to answer these questions, helping to make occupational therapy more understandable and approachable for everyone, and emphasizing its important role in supporting our children. Thank you, Michelle!