Occupational therapy case

The child presents as a lively two year old with a diagnosis of spastic right sided hemiplegia. They like to play with a variety of toys and can walk unaided indoors. They express themselves verbally using a mixture of gestures and reaching for what they want.

Parental concerns

• Limited use of right hand for play and self care
• Difficulties with balance

Goals of therapy

The occupational therapist watched the child playing and moving around the therapy room. These clinical observations helped decide on ideas for treatment. The main aim was to increase the time the child used their right hand for play. Three specific goals were agreed with the parents:

• For the child to pull up their trousers using both hands.
• For the child to stand symmetrically and play a keyboard using both hands for at least two minutes.
• For the child to throw a ball using both hands to knock over skittles at least three times.

Ideas for activities to reach the goals were suggested and tried out in therapy sessions and at home. Sessions were planned in the diary. Each week the parents reported back to the occupational therapist so ideas could be adjusted and new goals set.

Evaluation

The child made good progress over four weeks. The parents report that the child now uses their right hand more often and more spontaneously at home. Occupational therapy continues twice a month and therapy goals are reviewed regularly.