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Newsletter 61 This article was originally published in issue 61 (Spring 2007) of the HemiHelp newsletter.

Achieving independence: occupational therapy for children with hemiplegia

When we think of therapy for our children, the first thing that springs to mind is physiotherapy. But Occupational Therapy is just as important for children with hemiplegia, although unfortunately it can be less readily available. Laura Miller, a Senior Paediatric Occupational Therapist, talks about occupational therapy, and how it can help children with hemiplegia.

What is occupational therapy?

Occupational therapy (OT) is a treatment that focuses on helping children achieve independence in all areas of their life. It uses play, adaptive and work activities to enhance quality of life, develop functional skills, increase independence and minimise disability.

Occupational therapy is a widely used form of treatment, and has been shown to be of benefit in the treatment of hemiplegia and cerebral palsy. It aims to develop children’s sensory motor, fine motor, cognitive, perceptual, and self care skills, by engaging them in fun and positive play-based activities.

Occupational performance

Occupational therapists working with children try to optimise a child’s occupational performance, in other words, their ability to function in their daily lives. Children have many important and complex occupations, which form an important foundation for the roles they will take on as adults. These include:

  • Player
  • Self carer - includes the activities of daily living (ADLs) such as feeding, toileting, dressing, grooming, mobility
  • Learner (school/work performance)
  • Family member (son, daughter, sibling, cousin, friend)

Occupational therapy and hemiplegia

When working with a child with hemiplegia, the main areas that occupational therapists address are the use of the affected arm and hand, bilateral skills and functional independence.

Occupational therapists work with children on the most efficient ways to use their arms, hands and upper body, teaching them ways to independently master tasks such as drawing, writing, cutting, dressing and feeding themselves, managing their own belongings, and taking part in PE sessions.

Occupational therapists may prescribe equipment (such as seating options, splints, specialised scissors, pencil grips, cutlery etc.) to help children develop their skills, prevent deformities of the affected hand and make some tasks a little easier.

Occupational therapists may also visit the child at school and advise teachers on how best to develop the child’s practical skills, as well as explaining the importance of such things as correct sitting and positioning in the classroom.

Different approaches to treatment

Occupational therapists may use different approaches to treatment, such as neurodevelopmental treatment (NDT), sensory integration (SI), sensory motor, perceptual motor and cognitive approaches, depending on what they are targeting and how the child responds to the different treatment approaches. Most therapists work with children with hemiplegia using a range of play activities that are stimulating, interesting, developmentally appropriate and challenging to the child. As all children learn through play, it is both a powerful and fun tool for working with children with hemiplegia.

Social and psychological development

In addition to developing the child’s physical functioning, the occupational therapist will also support the social and psychological development of the child. Promoting a child’s self esteem and confidence is a key component of occupational therapy treatment and is important in maximising the child’s ability to be a happy, independent, social and functional individual.

Laura Miller works at Kiki’s Children’s Clinic, a private paediatric physiotherapy and occupational therapy clinic in London, providing clinic, home and school-based therapy services to children with a wide range of difficulties. If you would like more information about the clinic, please call Kiki von Eisenhart Goodwin at Kiki’s Children’s Clinic, on 020 7207 4234 to arrange a consultation. Further information can also be found at

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