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Effectiveness of Occupational Therapy on Individuals with Down Syndrome

Author: Cacey Shelton

Course: HPER 353W, Exercise Physiology

Term: Fall 2016

Effectiveness of Occupational Therapy on Individuals with Down Syndrome

I. Introduction

a. Occupational therapy is an effective way to help individuals with down syndrome

perform daily tasks.

b. Basics of Down Syndrome

c. Activities to help with this phenotypic profile.

d. Explanation of occupational therapy

e. Occupational therapy and down syndrome are linked together by improving

cognitive capacity improvement.

II. Impact of occupational therapy

a. Thai elephant assisted therapy program

b. Parental surveys on sensory processing issues

III. Comparisons of occupational therapy and simultaneous sensory stimulation

a. Description of study

b. Conclusion of study

c. The effect of the study

IV. Difficulties of OT practices with individuals with Down Syndrome

V. The type of occupational therapy that is most effective when done alone.

a. Play based occupational therapy

VI. Conclusion

a. Occupational therapy is an effective way to help individuals with down syndrome

perform daily tasks.

b. Overview of studies
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Effectiveness of Occupational Therapy on Individuals with Down Syndrome

Introduction

Down syndrome is the most common (1 in 732 live births are down syndrome) immediate

neurogenic cause of intellectual disabilities, yet there are limited ways to help improve this

syndrome (Daunheaur & Fidler, 2014). One might ask, what is Down Syndrome? Down

Syndrome is a system of “delays and differences in cognitive, language, motor and sensory

development” (Bruni & Cameron, 2010). A study was conducted about the “phenotype of DS. It

was discovered that the DS phenotype and occupational therapy could potentially be relevant to

each other (Daunhauer & Fidler, 2010). With DS being such a common disability, it is necessary

to find ways to help alter the brain of those with DS to function properly. One of the most

prevalent ways is occupational therapy. Occupational therapy is utilizing the help of a therapist

to regain or develop lost daily tasks. Taking into consideration the two definitions just described

occupational therapy is one of the ways tested to help with the development of life skills for

those individuals with DS. But, is occupational therapy an effective way to help with this

syndrome? Further research has been conducted to solidify this question.

Impact of Occupational Therapy

Current research shows it seems that occupational therapy alone does not have the most

prominent impact on people affected with DS. All studies found during literature review, have

needed further research to test each hypothesis, even though the studies had results.

Thai elephant assisted therapy program

One study in particular had results that solidified how occupational therapy is effective to

those with down syndrome when done throughout their lives. The study tested elephant theories
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on one with DS to see if one could use elephant therapy to work posture control, balance, and

visual motor integration (Satainsukpong & Pongsakari, 2016). The study included sixteen

children with DS from ages one to six, placing them into two groups: a control and experimental

group. The researchers gave both groups the same schedule, one had an additional activity. The

experimental group took part in the Thai Elephant- Assisted Therapy Program(TEATP) two

times per week for two months along with their regular occupational therapy. At the conclusion

of the study, there were no major outcomes in postural control or balance, but there was a huge

difference in visual motor integration. The researchers that completed this study (Satainsukpong,

Pongsakri, and Sasat) came to the conclusion that all three categories could have benefitted if the

TEATP was completed more often and for a longer amount of time.

Parental surveys on sensory processing issues

In this study, parents completed surveys and questionnaires to address the development of

motor and sensory skills and the delays in language and cognitive abilities in their child with DS.

Parents of three to ten year olds were included in the study. When addressing the results,

researchers noticed that the most substantial differences were in the weak, unresponsive

sensation, and the auditory filtering sections of the surveys (Bruni & Dua, 2010). The results

show how difficult it is for not only the children with DS but also the parents. In the parental

questionnaire, information was gathered regarding differences in occupational performance.

Occupational therapy is conducted to achieve the goal of correcting disabilities, task that seem

minor to most, can be hard for those with DS. It is seen in these two studies that occupational

therapy is of utmost importance to those with DS, but it is most effective when combining

therapy and another corrective practice.

Comparisons of occupational therapy and simultaneous effectiveness of sensory

stimulations effects

A study was done to analyze occupational therapy and simultaneous sensory stimulations

(SSS) on patients with DS. Muscular hypotonia, developmental delays, and sensory integration

were analyzed. Two groups of six to eighteen month old babies were split into an experimental

and control group: one that participated in only occupational therapy and the other in

occupational therapy and SSS. Throughout the experiment, there was not a significant difference

between the two groups. When evaluating the end results of the experiment, it was discovered

that and early use of SSS can improve quality of fine motor skills in infants with DS (Karimi &

Nazi, 2010). Considering the results from this study, evidence has made clear that along with

other programs, occupational therapy is effective when correcting the complications in people

with this disability. Although these methods are connected with other practices, starting the

programs early enough can be thought of as early intervention.

Difficulties of OT practices with individuals with Down Syndrome

A typical occupational therapy environment for an individual with DS would include but

not be limited to participating in activities and exercises such as self feeding practice and fine

motor practice by helping them progress over obstacles that could take a lifetime without the

help of therapy. It may seem that this is a simple process can be completed and fix the problem.

But, in reality, there are a multitude of factors affecting the performance and progress of each

individual. A common misconception of therapy is that all cases are the same, but there are no

two people exactly the same. With this in mind, it may seem extremely hard to work with

patients due to differences in achievements. It takes a great amount of patience to be an

occupational therapist, but with the help of other programs that have been described, it becomes

simpler, and occupational therapy becomes effective to those who are affected by DS.

What type of occupational therapy is most effective if done alone?

As evidence has indicated, it has been advised that occupational therapy be conducted with

the addition of another activity like TEATP or SSS. But if only one therapy is used on correcting

this syndrome, what kind of occupational therapy would be the best to use? From current

research, play based occupational therapy seems to have the most positive results. A study was

conducted in Mumbai on ten children with DS that varied from ages 2-6 years old. In this study,

the ten kids were observed in a rehabilitation center for children for one month where they

participated in play based occupational therapy. When the month was over, there were

significantly higher results of success. The confidence interval rate is now at ninety- nine percent

when conducting this therapy (Solak & Gokhale, 2014). With results like these, it is hopeful to

many handling DS that these obstacles can be overcome with the right type of therapy for the

specific patient.

Conclusion

Throughout this research, it has been made clear that there are multiple factors affecting

the effectiveness of occupational therapy which help individuals perform daily tasks. With many

types of research that have been conducted and the ones being conducted now, the hope for

having little to no problem with the communication issues of individuals with DS is a goal that is

coming closer to being accomplished. Throughout this research, knowledge has been

accumulated concerning of occupational therapy along with additional sources of activity to

enhance the results. Testing that was discussed throughout this research included the Thai

Elephant assisted therapy program, parental surveys on sensory processing issues, and
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simultaneous sensory stimulations. In the TEATP, the results were not significant when it came

to the postural control or balance. The researchers who conducted this did find out that the visual

motor integration rate went up significantly. They also believe that it could have increased the

balance and posture if it was done more often. Even though this study did not have the most

adequate results, it did improve the quality of life in at least one way for the patients with DS.

The second study shown was the parental surveys concerning sensory processing issues. The

results from the parents was a definite difference in the energy, responsive, and auditory filtering

sections, all being inadequate. This study gave useful information to the parents and the

therapists concerning the processing of sensory patterns. It also provided a wholesome amount of

new data for future research. The third and final study that was reviewed for this thesis was

simultaneous sensory stimulation. SSS was tested to see if it could add any additional progress to

occupational therapy. Throughout the test, it was shown that SSS and occupational therapy

worked wonderfully together and had greater results than just occupational therapy alone had. To

conclude these studies, with the research being done, it showed how occupational therapy is

effective to individuals with DS to perform daily tasks. Without the help of occupational therapy,

these patients would most likely be unable to control the use of their facial muscle, making them

unable to eat independently. Also if an individual participates in occupational therapy, they gain

independence by learning how to take care of themselves: feeding, bathing, dressing, cleaning,

etc. Without the help of occupational therapy, these patients could not live on their own or even

begin to be an independent human. From the research, one could be made aware of the multitude

of benefits and opportunities of occupational therapy. It is essential to understand with

occupational therapy, to get the best results in all categories, an individual with DS could do

other activities like the ones shown in this study to improve exponentially. DS seems to be
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negative to some, but occupational therapy makes those who are affected by it more positive

about the gains that could be made throughout their life.

Works Cited

Satainsukpong N, Pongsakri M, Sasat D (2016). Thai Elephant- Assisted Therapy Programme in

Children with Down Syndrome. Occupational Therapy International 23: 121-131.

Bruni M, Cameron D, Dua S, Noy S (2010). Reported Sensory Processing of Children with

Down Syndrome. Physical and Occupational Therapy in Pediatrics 38: 280-293.

Daunhauer LA, Fidler DJ (2010). The Down Syndrome Phenotype: Implications for Practice and

Research in Occupational Therapy. Occupational Therapy in Health Care 25: 7-25.

Gemus M, Lane M (2009). Using Gross Motor Function Measure to Evaluate Motor

Development in Children with Down Syndrome. Physical and Occupational Therapy in

Pediatrics 21: 69-79.

Karimi H, Nazi S, Sajeda F, Akbar FN, Karimlo M (2010). Comparison of (sic) Effect of

Simultaneous Sensory Stimulation and Current Occupational Therapy Approaches on Motor

Development of the Infants with Down Syndrome. Iranian Journal of Child Neurology 4: 39-44.

Daunhauer LA, Will E, Fidler DJ (2014). School Functions in Students with Down Syndrome.

American Journal of Occupational Therapy 68: 167-176.

Spencer M (2016). Core Concepts and Definition of Occupational Therapy. British Journal of

Occupational Therapy 29: 115.

Solank PV, Gokhale P, Agarwal P (2014). To Study the Effectiveness of Play Based Therapy on

Play Behavior of Children with Down Syndrome. Indian Journal of Occupational Therapy 46:

41-48.