Occupational Therapy for Infant and Toddler (Babies)

Occupational therapy for Infant and toddlers (Babies)

Infant and Toddler-

Infant – A very young child or baby. We generally called them an infant, baby, or newborn. A child in between birth to 12 months of age comes under the term, “Infant”.

Toddler – A young child. A child in between 13 months to 36 months (up to 3 years) of age comes under the term, “toddler”. A toddler year is a time of great cognitive, motor, emotional, and social development.

Infants grow very fast and they develop some basic life-saving skills in the vulnerable phase of life. Infants are totally dependents on the parents.

Infants show some basic reflexes, which is essential for them like sucking, rooting, moro and more. These reflexes help infants to grow better and be safe.

Each reflex has its own importance and they are part of our normal development.

If the reflexes are not integrated with age or infant is developmentally delayed, not achieved typical milestones. They may need experts help to intervene the problem early.

The disease or disorder having developmental delays in infants/ toddlers includes down syndrome, ADHD, Autism, cerebral palsy and more.

Role of Occupational therapy in Infant-

A pediatric occupational therapist provides early intervention for the infant or babies.

In the case of infants, developmental delays can be missed initially. But the baby with premature birth, low birth weight, or babies born with some physical impairment or chromosomal genetic disorder, may need to intervene as early as possible.

Occupational therapy for infants and toddlers includes assessment and intervention to babies with low birth weight, premature babies, and infants with a chromosomal disorder.

Occupational therapy assessment in Infants-

Generally, premature babies/ infant lacks early reflexes and most importantly rooting and sucking reflexes, which is required to take milk.

Developmental delays in Infants / toddlers – There are many types of delays in typical development. They may include –

Language and speech
Vision
Gross motor skills,
Reflexes
Fine motor skills
Social and emotional skills
Thinking and cognitive skills.

To assess all the skills, the occupational therapist takes developmental history and parents interview. Therapist may prefer some tests-

Denver development screening test II
Bayley Scales of Infant Development 3^rd ED
Toddler and Infant Motor evaluation (TIME)
Infant/toddler sensory profile

Motor skills development delays in infants/ toddlers –

Developmental delays may be related to impairment in gross motor skills; such as standing, walking. Or fine motor skills; such as grasping a toy.

Social /emotional delays in infants –

The infants/ toddlers with ADD, ADHD, Autism may show early symptoms of social/ emotional delays in babies.

Red flags-

Does not smile at people,
Lacks eye contact
No affection of parents/ caregiver
Do not show interest in group activities.
Cognitive /perceptual delays in infants/toddlers includes-
Does not search for object
No gesture
No pointing to objects/picture
Basically does not know the function of a specific object like comb, spoon.
No simple commands following
No imitation of action.

Occupational therapy intervention for Infants and Toddlers –

Occupational therapy for the infants-

After assessing the areas of dysfunction, OT set the goal and objectives depending on the areas of delays.

OT intervention goals includes –

To improve motor skills
To improve social skills
To improve cognitive/ perceptual skills.

Occupational therapy in NICU-

Occupational therapist may visit NICU for neonates (birth to 28 days baby, called as neonates) having sensory/motor issues. Occupational therapist provides oromotor stimulation to premature babies to improve their rooting and sucking response. Stimulation can be applied on the different parts of the face to stimulate the facial muscles.

Reflex integration through NDT-

Integration of tactile subsystem (0-3 months)
Integration of primitive postural reflexes (3-9 months)
Maturation of righting and equilibrium reactions (9-12 months).
Integration of two sides of body, awareness of body parts and their relationship, and motor plan gross movements (1-2 years)
Motor plan fine movements (2-3 years).

These are the normal pattern of reflex integration. An occupational therapist helps to integrate these reflexes if not integrated in the developmentally delayed child.

Read this article to know, how an occupational therapist helps in primitive reflex Integration.

primitive reflex integration.

Sensory Integration-

Occupational therapist follows principles of sensory integration to deal with sensory issues.

Tactile, Proprioceptive, and vestibular sensory activities–

Sensory modulation for tactile defensiveness, over-responsivity/under-responsivity, and sensory seeking.

OT Provides deep touch/ firm pressure where the child can see the source of the stimuli, which tends to be more tolerable versus light touch stimuli.
OT begins with slow linear movements and deep touch pressure.

Tactile discrimination-

OT Provides graded activities requiring tactile discrimination activities using a mixture and items.

Proprioceptive and vestibular activities-

OT Provides slow linear movement, push or pull activities.
OT uses adaptive techniques (e.g., weighted vests)
OT Provides rapid rotary and angular movements with frequent starts/stops and acceleration/deceleration to increase the ability to distinguish the pace of movement.

Play-

Occupational therapist uses play as a medium of intervention in infants/toddlers. Occupational therapist involves babies in play according to the developmental level of baby.

Play facilitates active participation in cause and effect learning. Therapist with the help of parents promotes the play with siblings and/or peers.

Play help the child learn new skills and master the old skills. Here, occupational therapist may provide cues or support to complete the task or activity.

Occupational therapy toys for infant and toddlers –

Occupational therapist considers play as a primary occupation of an infant or a toddler. Occupational therapist prefers many toys to teach new skills. Many toys are available in the market that helps babies to learn a new thing or enjoy play.

Many parents ask the therapist, which type of toys should they buy for their babies?

Therapist prescribes toys/games according to the developmental level of a child.

Toys for Infant – up to the age of 1 year.

Hand-held toys – small sized. Toys that makes sound or light.
Music box – baby can attract towards it and help to develop neck control.
Sensory toys – toy with different textured materials.
Rattles – bright color with sound.
Wind chimes – babies love light music, they follow the sound.
Soft toys – love and affection, self-belonging.
Teething rings- to decrease oromotor issues.
Stocking blocks – help to improve perception.
Ring cones – color identification, size discrimination.
Balls – catching- throwing. Ball push-pull.
Shape sorters – size identification and discrimination.

Toys for Toddlers-

Building blocks/ Lego –constructive play.
Push-pull toys – proprioceptive activities.
Walker – assist in walking independently.
Ride-on toys- assist in walking independently.
Climbing gym – to develop gross motor skills.
Crayons paper – to start scribbling, pre-writing skills.
Puzzles – improve perception and cognition.
Manipulative toys – improve creativity and manipulative skills.

Summary –

Occupational therapy promotes play and functional skills in the developmentally delayed babies (infant/toddlers). The occupational therapist may use different approaches such as NDT, SI, Play to improve the motor skills, perceptual skills, and daily living skills.

Payal Pawar, OT