Question
Do you repeat activities with sensory-enhanced pediatric constraint induced movement therapy?
Answer
It depends on the child. A lot of times we will repeat activities. Part of the process in the treatment is when we repeat those activities, we are changing or we are shaping the activity to increase what we are asking of the child. If it is something that they are highly motivated to accomplish, then we will repeat the activity. Obviously, if their motivation is increased, then you are going to get an increase in ability. Again, we would repeat activities but we would change them. Instead of reaching straight at waist level, to complete the activity, next time we would reach it to shoulder height. If we perform the activity again and we see that the child has improved, we would ask that they reach a bit higher to complete the activity. That way, we are gradually increasing the challenge in that activity.
Something else that we did with the children when the cast was off, was to ask them to complete an activity with their stronger arm and hand and think about how it feels. Then we would ask them to complete the activity with their weaker arm and hand to explore what differences they might be feeling between the two. We did this as a means of increasing their awareness throughout the course of the month. Overall, throughout this process, parents and children realized that the sensation component of this -- what the children are feeling and putting together functionally -- is not something that they have ever focused on. Typically, as therapists, we focus on motor ability and how that motor ability turns into function.
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