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Paediatric Occupational Therapy

Paediatric occupational therapy is dedicated to nurturing children’s skills for functional independence, fostering their growth into confident individuals. Through targeted interventions, we support children in overcoming challenges across physical, social and cognitive development stages, guiding them towards maturity with strength and assurance. Our occupational therapists specialize in working with children and adolescents facing various conditions or disabilities that hinder their participation in daily tasks. Employing an integrative client-centered approach, we offer practical solutions to enhance participation, independence, and engagement in all aspects of a child’s life. Our goal is to empower children to achieve maximum independence promptly, benefiting both them and their parents.
  • Autism Spectrum Disorder (ASD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Sensory Processing Disorder (SPD)
  • Global Developmental Delay (GDD)
  • Anxiety
  • Learning delays such as dyslexia
  • Various genetic conditions

Through comprehensive evaluation and targeted interventions, we strive to support children in achieving their full potential and thriving in their daily lives.

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Assessments

The occupational therapist, in conjunction with other practitioners, work together with the client to focus on individual and environmental abilities and problems related to activities in the person’s daily life.

Planning

The results of the assessment are the basis of the plan which includes short and long-term aims of treatment. The plan should be relevant to the person’s development stage, habits, roles, life-style preferences and the environment.

Intervention

Intervention focuses on programs that are person oriented and environmental. These are designed to facilitate the performance of everyday tasks and adaptation of settings in which the person works, lives and socialises.

Paediatric OT targets:

Fine motor skills:

Coordinating the small muscles such as the hand (usually in coordination with the eyes), to enable a child to hold, explore and manipulate toys and tools such as a pencil or spoon. Fine motor skills are used in activities such as handwriting, dressing, feeding and using scissors.

Handwriting:

A child must have sufficient manual dexterity, fine motor coordination and visual motor skills for handwriting. Areas such as letter formation, reversals, speed, legibility, pencil grip, reducing pain and/or fatigue may be addressed.

Gross motor skills:

Involve the large muscles of the body that are important for major body movement such as sitting, walking, jumping, and throwing a ball.

Tool use:

Involves utilising objects within the hand such as cutlery or pencils for play, self-care and handwriting skills.

Table top and school readiness:

These activities are generally the expected requirements when starting kindergarten. For example: drawing, cutting, on-task classroom behaviour, task completion, following instructions and craft skills.

Play skills

Are those that are used in everyday play, such as threading and using puzzles as well as the imaginative, social and communication requirements such as turn taking, sharing, winning/losing.

Sensory processing:

Involves the way the body processes and reacts to the information it receives from the surrounding environment. Children may demonstrate over or under sensitivity to certain sensations such as loud noises or certain items of clothing; sensation seeking behaviour, such as chewing on things or enjoying being spun repetitively; and difficulty maintaining a calm state.

Visual perception:

Involves understanding what is being seen. Visual perception is highly important in completing many activities, such as reading a story, completing a puzzle, identifying letters and numbers, copying and writing.

Self-care skills:

Involve skills such as feeding, dressing, bathing, grooming, sleeping and toileting.

Paediatric Occupational Therapy

Paediatric occupational therapy is dedicated to nurturing children’s skills for functional independence, fostering their growth into confident individuals. Through targeted interventions, we support children in overcoming challenges across physical, social and cognitive development stages, guiding them towards maturity with strength and assurance. Our occupational therapists specialize in working with children and adolescents facing various conditions or disabilities that hinder their participation in daily tasks. Employing an integrative client-centered approach, we offer practical solutions to enhance participation, independence, and engagement in all aspects of a child’s life. Our goal is to empower children to achieve maximum independence promptly, benefiting both them and their parents.
  • Autism Spectrum Disorder (ASD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Sensory Processing Disorder (SPD)
  • Global Developmental Delay (GDD)
  • Anxiety
  • Learning delays such as dyslexia
  • Various genetic conditions

Through comprehensive evaluation and targeted interventions, we strive to support children in achieving their full potential and thriving in their daily lives.

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Paediatric Physiotherapy

Physiotherapists focused in paediatric physiotherapy collaborate with children and their families to identify movement and functional challenges. Our goal is to assist children in managing their physical symptoms and attaining functional mobility. Through assessment, treatment, and guidance, we empower children to engage in exercises and activities both at home and in educational settings. Our paediatric physiotherapy service caters to a broad spectrum of conditions, including Autism Spectral Disorder, developmental motor skill delays, musculoskeletal issues, cerebral palsy, and various neuromuscular conditions. Utilizing play, activities, and tailored exercise regimes, we endeavor to support children in realizing their full physical potential. Central to our approach is the education of families and caregivers about the child’s condition, alongside implementing a structured program of activities aimed at skill maintenance or development. Collaboration with parents and educational professionals is paramount, and we frequently liaise with other healthcare, educational, and social care experts to ensure comprehensive support for the child’s holistic well-being.

Behavioural Modification & Family Coaching

Dr. Arini Verwer, PhD, developed Social Brain & Interaction protocols, which focus on brain development and the influence of the social environment on emotional state and behavior. This therapy aims to assist families in understanding each family member’s emotional needs through communicative patterns of behavior and movement. Social Brain therapy is grounded in the science of learning and behavior, pinpointing a child’s learning style, emotional needs, and value system that drive behavior. Through parental coaching, specific tools and skills are identified and applied to help the child in everyday life, fostering emotional regulation, independence, and improved social interaction.
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SLEEP IS THE BODY’S NATURAL STRESS MANAGEMENT SYSTEM

One of the most important building blocks for achieving health, wealth and vitality resides in the healing powers of sleep. Sleep is food for the brain, get enough of it and get it when you need it. After oxygen and water, sleep is the most important need, even more important than food. Sleep is divided into 4 stages of Non REM 75% (purple) sleep and REM (Blue) 25% sleep (Rapid Eye Movement). These are sometimes referred to as “sleep phases” or “sleep cycles“.
Non REM is responsible for regeneration, detoxification ( liver,gut, lymphatic system),repair, & hormonal regulation. REM sleep is responsible for emotional regulations, memory reconsolidation & learning. Dreaming occurs in both stages but mostly during REM sleep. Each cycle of NREM and REM is repeated every 90 minutes, 4 to 5 times a night. 5-6 cycles is an ideal amount of sleep required for everyone after 15 years old. Sleep is necessary for detoxification, immunity, tissue repair, regeneration, memory consolidation, learning, emotional balancing and most importantly for recuperation of the brain from the day’s activities. When we achieve quality sleep, we prime the emotional brain properly; balancing brain chemicals, creating a positive and energetic state of mind. The result is a feeling of mental and physical energy and an internal psychological push called motivation. Without it we may get depressed and sick.

Inspiring Choices Natural Sleep treatment addresses sleep problems from a unique and integrative approach that steers away from drugs, successfully treating.

Modalities utilised

Autism Spectrum Disorders and Sleep

Autism spectrum disorders (ASD), characterised by impairments in social communication and the presence of restricted and repetitive behaviours , are prevalent, affecting approximately 1 in 68 children . Among children with ASD, about 50–80% experience disrupted sleep, particularly related to sleep onset or maintenance insomnia . This prevalence stands in stark contrast to 11–37% among typically developing children . While the link between sleep disturbances and challenging daytime behaviours (such as symptoms of attention deficit hyperactivity disorder) is well-established in typically developing children , individuals with ASD may face even greater vulnerability to the adverse effects of sleep disruption on daytime behaviour due to their neurodevelopmental condition. Sleep issues in children with ASD have been linked to increased internalising and externalising behaviour problems, as well as poorer adaptive skill development . Research indicates that children with ASD who experience poor sleep (identified through parent reports, polysomnography, and actigraphy) exhibit more inattention, hyperactivity, and restricted/repetitive behaviours .

Sleep and Early Development

Sleep disturbances have been found to negatively affect behavior, cognition, and growth, areas that are also the focus of early intervention efforts. Conversely, developmental delays and disabilities themselves can contribute to the occurrence of sleep disorders. Among young children, those with developmental delays exhibit a higher prevalence of sleep disorders compared to their typically developing peers, with difficulties initiating or maintaining sleep and sleep disordered breathing being the most common types. While previous research has primarily concentrated on sleep issues in children with specific conditions such as autism, genetic syndromes, prematurity, and seizure disorder, this article aims to explore the broader impact of sleep problems across all children who undergo screening for early intervention services.
Early intervention eligibility assessments typically encompass five developmental domains: adaptive, motor, cognitive, communication, and socioemotional. Given that disordered sleep can manifest as symptoms related to socioemotional and adaptive functioning, incorporating sleep assessments into these evaluations may offer valuable insights. By identifying sleep problems during the eligibility evaluation process, early intervention services can be accessed in a timely manner, thus maximizing developmental potential through prompt identification, referral, and treatment.

Food & Dietary Coaching

Children with autism and developmental delay exhibit impairments in social interaction and display repetitive patterns of behavior. Autism encompasses a diverse range of disorders with an unknown etiology. Research in this field has expanded significantly, suggesting that environmental risk factors acting during the prenatal period could influence offspring neurodevelopment. The literature indicates that maternal diet during pregnancy plays a fundamental role in the etiopathogenesis of autism. Indeed, a maternal diet high in certain nutrients has been associated with either an increase or reduction in the risk of developing Autism Spectrum Disorders (ASD). Additionally, the dietary habits of children with ASD are crucial factors that can impact the severity of ASD symptoms. These children often exhibit food selectivity and limited diets due to sensitivities related to smell, taste, or other characteristics of foods. As a result, their eating routines and food intake patterns may lead to deficiencies or excesses of certain nutrients. Several studies have attempted to explore the potential relationship between nutritional status and autism. Following a metabolic assessment, we assist parents in implementing a tailored dietary program that best suits the child’s needs.
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Evidence Based Modalities

DIR Floortime

DIR Floortime is about making the child feel safe. The Developmental, Individual-differences, & Relationship-based (DIR) model, pioneered by Dr. Stanley Greenspan, serves as a foundational framework for comprehending human development. Emphasizing the crucial role of social-emotional development from birth onward, the model elucidates how individuals perceive and interact with the world uniquely. Central to the DIR model is the recognition of relationships and emotional connections as catalysts for development. While the DIR model facilitates understanding and fosters positive development in all children, it is primarily employed with those facing educational, social-emotional, mental health, and developmental challenges. Notably, DIR/Floortime, an offshoot of the DIR model, is widely recognized for its effectiveness in supporting children with Autism Spectrum Disorders (ASD).

Behavioural Modification and Social Brain Analysis

Dr. Arini Verwer, PhD, developed Social Brain & Interaction protocols, which focus on brain development and the influence of the social environment on emotional state and behavior. This therapy aims to assist families in understanding each family member’s emotional needs through communicative patterns of behavior and movement. Social Brain therapy is grounded in the science of learning and behavior, pinpointing a child’s learning style, emotional needs, and value system that drive behavior. Through parental coaching, specific tools and skills are identified and applied to help the child in everyday life, fostering emotional regulation, independence, and improved social interaction.

Functional Neurology & Neuro Rehabilitation/Melillo Method

The program aims to assist individuals in our community facing neurodevelopmental disorders, such as Autism spectrum disorders, Asperger’s, ADHD, Dyslexia, Processing disorders, Sensory processing disorders, Developmental delay, and Poor social skills. It integrates practices from functional neurology, occupational therapy, vision therapy, and cutting-edge digital technology, currently being patented as digital medicine.

Rationale behind the Neuro Rehabilitation/Melillo method

It is notable that areas of the brain involved in movement, such as the Cerebellum, Basal Ganglion, Thalamus, and prefrontal cortex, also play roles in cognition and emotional integration. These areas have motor and non-motor functions that collaborate to modulate cognition, emotional behavior, and movement.

Muscular activities pattern themselves during the development of primitive reflexes (fixed action patterns) as they adapt to gravity. The Cerebellum, vestibular system, limbic system (Basal ganglion, Thalamus), and prefrontal cortex serve as the control center for these movement patterns, influenced by chemical and structural stress, as well as the individual’s emotional state.

If these reflexes persist beyond their typical time span, they are considered aberrant, retained, and indicative of structural weakness or immaturity within the central nervous system. The integration and inhibition of primitive reflexes are crucial for maintaining brain energy efficiency.

Primitive reflexes emerge in utero, are present at birth, and typically are inhibited by 6-12 months of age. Reflex inhibition correlates with control by higher brain centers, facilitating the development of more complex neural structures and voluntary movements.

These fixed motor patterns give rise to goal-oriented movements and proper development of the neocortex. Delay or disruption in this bottom-up projection, termed “bottom-up interference,” can delay the development of more advanced brain areas, potentially hindering top-down maturational processes that inhibit these reflexes.

Retained primitive reflexes can also impact a child’s sensory perceptions, causing hypersensitivity or hyposensitivity and contributing to asymmetry in left and right brain information processing, speed, and timing.

Emotions can be viewed as a form of fixed action pattern, considered premotor in nature. Just as muscle tone serves as a base platform for muscle movement, emotions serve as premotor platforms that either drive or deter actions. For example, children with autistic spectrum disorders and attention deficit hyperactive disorders may exhibit stereotyped movement patterns due to uninhibited fixed action patterns, resembling hyperkinetic movements.

Some of the modalities utilized in the implementation of our Neuro Rehab and cognitive therapy protocol based on your child’s needs and evidence available for  their use are:

  • Therapeutic Listening Therapy: This therapy has shown global improvements supporting changes in brain performance across various domains such as executive function, communication, motor coordination, auditory processing, self-regulation, attention, social and emotional function, stress response, and creativity. TLP involves listening to acoustically-modified instrumental music through high-quality headphones.

 

  • Interactive Metronome: This training program improves timing in the brain through an organized, systematic, flexible, and engaging format. Research demonstrates that combining movement and cognitive tasks leads to better overall outcomes. IM challenges thinking and movement simultaneously, providing real-time millisecond feedback to synchronize the body’s internal clock. It progresses through 4 phases, with specific goals and exercises designed to be motivating and engaging.

 

  • Dynamic Neuromuscular Stabilization (DNS): Developed by Professor Pavel Kolar Pediatric Physiotherapist at Prague University, DNS focuses on successful motor movements in primitive reflex development stages in early childhood. It relates to sensorimotor integration such as sound and vision, regulated by the vestibular system. DNS enhances functioning in various areas including postural development and control, gross and fine motor coordination, timing and sequencing, spatial awareness and body awareness, balance, eye-hand coordination, eye-foot coordination, eye muscle control, visual motor skills, self-regulation, and attention.

 

  • MNRI Therapy: This protocol focuses on the assessment and integration of primitive reflexes and their influence on postural, emotional, and cognitive development. Integrative exercises improve learning behavior, attention, and focus. Without these exercises, delays in learning, poor balance and coordination, underdeveloped vestibular and proprioceptive systems, and trouble with motor planning may persist.

 

  • Photobiomodulation (soft laser therapy): This therapy increases energy (ATP) within cells to enhance nerve conduction and brain chemical production.

 

  • Brain Mapping/QEEG: A diagnostic tool that measures electrical activity in the form of brain wave patterns. It is sometimes referred to as “brain mapping”. QEEG can reveal brain wave patterns associated with impulsivity, cognitive inflexibility, anxiety, and other symptoms.

 

  • Neurofeedback: A training method to improve brain function by providing feedback on brainwave patterns.

Research

Pitcher TM, Piek JP, Hay DA. Fine and gross motor ability in males with ADHD. Dev Med Child Neurol. 2003 Aug;45(8):525-35.

Foulder-Hughes LA, Cooke RW. Motor, cognitive, and behavioural disorders in children born very preterm. Dev Med Child Neurol. 2003Feb;45(2):97-103.

Goddard S, A Teacher’s window into the Child’s Mind, Fern Ridge Press 1996 :P1-4

Connectivity in Autism Spectrum Disorders

by Robert Melillo 1,Gerry Leisman 1,2,*,Calixto Machado 3,Yanin Machado-Ferrer 3,Mauricio Chinchilla-Acosta 3,Ty Melillo 4 andEli Carmeli 1

  1. Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa 3498838, Israel
  2. Department of Neurology, University of the Medical Sciences of Havana, Havana 10400, Cuba
  3. Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana 10400, Cuba
  4. Northeast College of the Health Sciences, Seneca Falls, New York, NY 13148, USA

Brain Sci. 2023, 13(8), 1147; https://doi.org/10.3390/brainsci13081147

McPartland, J.; Volkmar, F.R. Autism and related disorders. Handb. Clin. Neurol. 2012, 106, 407–418.

Gabard-Durnam, L.; Tierney, A.L.; Vogel-Farley, V.; Tager-Flusberg, H.; Nelson, C.A. Alpha Asymmetry in Infants at Risk for Autism Spectrum Disorders. J. Autism Dev. Disord. 2015, 45, 473–480. [Google Scholar] [CrossRef] [Green Version]

Taking Sides: Asymmetries in the Evolution of Human Brain Development in Better Understanding Autism Spectrum Disorder by Gerry Leisman 1,2,*,Robert Melillo 1,Ty Melillo 3,Calixto Machado 4,Yanin Machado-Ferrer 4,Mauricio Chinchilla 4 andEli Carmeli .Symmetry 2022, 14(12), 2689; https://doi.org/10.3390/sym14122689

Cognitive Rehabilitation in Developmental Disabilities.

https://www.drrobertmelillo.com/research/2015-Machado-Leisman-BainConnectivity.pdf

QEEG Spectral and Coherence Assessment of Autistic Children in Three Different Experimental Conditions, Calixto Machado • Mario Este´vez • Gerry Leisman • Robert Melillo • Rafael Rodrı´guez • Phillip DeFina • Adria´n Herna´ndez • Jesu´s Pe´rez-Nellar • Rolando Naranjo • Mauricio Chinchilla • Nicola´s Garo´falo • Jose´ Vargas • Carlos Beltra´n

Journal of Autism and Developmental Disorders ISSN 0162-3257 Volume 45 Number 2 J Autism Dev Disord (2015) 45:406-424 DOI 10.1007/s10803-013-1909-5

Effects of Music Training and Production on Functional Brain Organization – 2012

Autistic Spectrum Disorders as Functional Disconnection Syndrome,  Robert Melillo1 and Gerry Leisman, Rev Neurosci 2009; 20(2):111-3

Contact Us For More Information

If you have a general inquiry that is not time sensitive, fill out the Contact form or contact us via details below and one of our team will get back to you. We are open daily 9:00 am – 5:00 pm Monday to Friday (excluding public holidays).

Call

+61 (07) 5575 7281

Email

info@inspiringchoices4kids.com.au

Location

Suite 1 & 3, 328 Scottsdale Drive,​Robina Gold Coast, QLD 4226