Occupational Therapy
Millstream Occupational Therapy
Kristy Casella
Kristy Casella Occupational Therapy
Kristy Casella Occupational Therapy Services • Developmental Delays • Autism Spectrum Disorder (ASD) • ADHD • Sensory Processing Difficulties • Emotional Regulation • Motor Coordination Difficulties • Fine & Gross Motor Skills • Play & Social Skills • Home & School
Jess Lowden
Occupational Therapist & DIR/Floortime Practitioner
Accredited Educational Remediation Provider • Autism Spectrum Disorder (ASD) • Global Developmental Delay • Down Syndrome • ADHD • Sensory Processing Difficulties • Emotional Regulation • Concentration & Attention • Fine & Gross Motor Skills • Play & Social Skills • Incontinence • Literacy Remediation
What is Interoception & Why is it so Important?
Interoception is about understanding and recognising our body’s physical signals. For example, if we feel hot, hungry, or tired. It can also help us recognise feelings such as being scared, sad or feelings associated with emotional invalidation when we are told ‘no’.
Children with neurodivergence (and without) can have difficulties tuning in to these signals and easily and quickly become overwhelmed without understanding why.
Occupational Therapy can help your child develop good interoception awareness to recognise and understand their body’s signals and help them communicate the signals more effectively to support emotional regulation.
Good interoceptive awareness can help children:
- Notice signals before a ‘meltdown’.
- Understand the signals and what their body is asking for.
- How to meet these needs themselves or ask others to help them.
- Building capacity to sit with uncomfortable signals before dysregulation occurs.
What is DIR Floortime & Why Is It So Effective?
DIR is a social-emotional developmental based model. It stands for Developmental Individual-differences & Relationships.
It outlines a foundational framework for understanding human development and applies a hierarchical understanding of social-emotional development.
For example:
- When regulated we can then also engage well with others.
- When engaged, we can then communicate effectively with others.
- When regulated, engaged and communicating, we can apply higher level thinking and problem solving skills.
The model is shown in the graph to the right. Floortime clinicians can work up the model with your child, starting with emotional regulation.
At Millstream, your child is partnered with another peer to develop social-emotional skills in an environment where they are unable to control all the factors. A skilled clinician scaffolds social engagement and joint attention, to higher levels of skills (e.g., communication & problem solving).
Strengthening Relationships & Developing Skills
Occupational Therapy is about so much more than daily skill development!
Occupational Therapy can help strengthen relationships and encourage growth in children by meeting them at their level. It’s all about joining in their world and making playtime meaningful.
By engaging with your child in activities they love, you create a space where they feel valued and understood. Through this playful interaction, children can develop important skills like communication, emotional regulation, and social interaction. Whether it’s playing with blocks, drawing, or pretending,
Connecting with them helps build a strong bond between you and your child, making everyday moments a chance for learning and connection. We embrace this connection as a platform for your child to thrive!
Ages & Stages
2-5 Years
For kids aged 2 to 5, OT focuses on developing the skills they need to explore, play, and learn. Through engaging activities like playing with toys, drawing, or climbing, OT helps children build important abilities such as fine motor skills, coordination, and self-care tasks like dressing and eating. It also helps with social skill basics, such as sharing, showing, using manners, waiting and turn taking. With the support of a skilled Paediatric Occupational Therapist, your child will have fun while integrating these skills, gaining confidence and age appropriate levels of autonomy. A special time where learning and play come together to help your child shine!
6-10 Years
Occupational Therapy (OT) for kids aged 6 to 9 is all about helping your child learn through practice to work towards independence in daily living skills. A skilled OT supports mastery in organisation skills, teamwork, schoolwork, sports, and self-management of emotions. Skilled Paediatrics Occupational Therapists use creative and interactive activities to boost abilities and confidence. From working on handwriting and coordination to learning how to manage emotions and follow routines, OT provides a supportive space for kids to grow and thrive. With the help of a caring therapist, your child will enjoy new challenges and celebrate their progress, making every step of the journey exciting and rewarding!
11-14 Years
As kids move into their pre-teens and early teens, they face new challenges and opportunities. Occupational Therapy (OT) can be a fantastic resource during this time, helping 11 to 14-year-olds adjust to high school, embrace their unique qualities, and handle increasing social and cognitive demands. OT supports students in developing strong organisational skills, managing time effectively, and tackling complex schoolwork with confidence. It also provides strategies for navigating social situations and handling changes gracefully. With engaging and tailored activities, OT helps young people build resilience, self-esteem, and the skills they need to succeed and feel great about themselves as they grow and transition into their teenage years.
Therapy Areas
- Social Skills
- Emotional Regulation
- Anger responses
- Routines & Change
- Organisational Skills
- Fine Motor
- Gross Motor
- Introducing New Foods
- Excessive Screen Time Use
- Reward Seeking Behaviours
- Social Skills Programs
- Back to Basics Programs
- Autism Support
- ADHD Support
- Family Support
Unoccupied Play 0-3 months
At this stage, babies move their bodies (e.g., arms, legs, hands, feet, etc.). They are learning about and discovering how their bodies move and integrating reflexes.
Solitary Play 0-2 Years
This is the stage when a child plays alone and hasn’t developed an interest in playing with others.
Spectator/Onlooker Behavior 2 Years
At this stage a child begins to watch other children playing but does not play with them.
Parallel Play 2 Years
At this stage, a child plays alongside or near others but does not play with them interactively.
Associate Play 3 to 4 Years
When a child starts to interact with others during play, although not substantial interactions, for example, doing an activity related to the kids around him, but not actually interacting with another child. For example, kids might all be playing on the same piece of equipment (e.g., climbing spider) but all are doing different things like climbing, swinging, etc.
Cooperative Play 4+ Years
At this stage, children play together, show interest in others and interact in cooperative play.
Emotions are what help us derive meaning from the world around us. Young children learn which emotions are associated with the facial expressions, tones of voice and actions that follow. Emotional development is key to living a healthy life.
Emotional development
Social referencing helps develop a child’s own response to emotional stimuli—they’re looking to you to model what comes next and how to respond.
Understanding of emotive expressions
Social referencing also teaches a child how to read the feelings of others in their environment. The child is referencing what they have so far learned to better understand someone else’s reaction.
Social Referencing guides decision making
When social referencing, you will often see children look to their caregiver for approval before acting on a decision.3 This approval, or disapproval, builds trust in a caregiver’s input and lays the groundwork for later decision-making processes.
Books:
- The Explosive Child (R. Greene) – understanding behaviours that challenge from a communication need and skill deficit model.
- Brain-Body Parenting (M. Delahooke) – parenting approach that considers a child’s nervous system.
- The Whole Brain Child (D Siegel) – Demistifying ‘meltdowns’ and aggravation using a brain-science model.
- The Tech Diet (B Marshall) – for parents wishing to adopt healthy boundaries with device and technology use in the home.
E-Safety:
Programs:
There are many programs and courses available to parents. With each family being unique, finding the right program that works for your family is important. Some programs available throughout Perth include:
- Circle of Security
- Triple P – Positive Parenting
- Behaviour Tonics
- 1-2-3 Magic
- Zone your home (zones of regulation)
Parenting can be challenging, and supportive and non-judgmental assistance can make all the difference.
Here are some strategies that support a positive family environment.
Shifting your Ideas about behaviours that challenge.
- Viewing your child’s challenging behaviours as a communication of a problem, or an unmet need, or an understanding that they have exceeded their coping strategies, is a helpful first step. With this idea, challenging behaviours become behaviours that challenge.
- By prioritising understanding the behaviour rather than stopping it can assist with it resolving faster.
- Don’t presume to know what is happening for your child and remaining curious and asking them questions about their actions and underlying feelings can be helpful.
- Don’t presume to know you child understands their behaviour and/or feelings. If they say, “I don’t know”, it is because they don’t know.
Remaining Calm and Providing a Positive Family Environment.
- Support a low conflict environment by modelling calmness and respectful communication.
- Provide a positive, loving, and safe environment is ideal for children to grow and learn.
- With angry child responses, slow communication down and support their regulation before continuing the communication.
- Give your child time to talk in communication, slow talks down and allow them time to finish what they wish to say.
Consistency and Clear Boundaries.
- To define family expectations, be consistent in your parenting practices (e.g., device time).
- Maintain clear boundaries to help children feel secure.
Use Positive Attention.
- Use praise frequently and try to be specific (e.g., “I liked the way you put the plate in the dishwasher without me asking.”).
- Use encouraging messages frequently to reinforce expectations, family values and desired behaviours. This is more effective than a punitive approach.
- Learn about your child. Ask them questions about their likes, dislikes and who they are or wish to be in the world.
Challenging Other Beliefs
- Typically, children are motivated to do well.
- An unmotivated child doesn’t mean they are lazy.
- Skill gaps may make it difficult for a child to do well.
- A child who is not understood, has difficulties understanding their challenges or struggles, and is repeatedly told they aren’t trying enough, may give up and stop caring – now looking like they are unmotivated to change.
Play Therapy is an effective approach in counselling children. This approach of therapy recognises that children often communicate and process their experiences through play, making it a natural and developmentally appropriate medium for therapeutic intervention.
Here’s why Play Therapy can be beneficial for children:
Developmentally Appropriate
Play is the primary language of young children. Through play, children can express their thoughts, emotions, and experiences in a safe and non-threatening way. Play Therapy leverages a fun communication tool and provides children with a familiar and comfortable environment to explore their feelings and experiences.
Expression of Feelings:
Children may not have the verbal skills to articulate their emotions or experiences directly. Play allows them to express complex feelings and experiences symbolically, through toys, games, and imaginative play scenarios. This process helps children process difficult emotions and experiences at their own pace.
Therapeutic Relationship:
Play Therapy involves a supportive and trusting relationship between the child and the therapist. The therapist provides a safe and accepting space for the child to explore and express themselves without judgment. This relationship serves as a foundation for trust, opening up and delving deeper into problems.
Effectiveness Approach:
Play Therapy is grounded in research and theory, with therapists accessing specific techniques and interventions tailored to each child’s needs. While it may appear as “play” it is a method that facilitates therapeutic outcomes.