unilateral neglect

• child shows severe self care, reading and writing difficulties  which is a considered as a part of visual spatial deficit  is caused by deficit in arousal and attention can be due to neglect or improper working of  usually the right side of the brain

deficit manifest as-

• child or client unable to initiate movements in opposite space with either limb
• child or client unable to attend to stimulus  in contralateral space
• difficulty in attending to near objects but not the far ones( may show difficulty in table top activities but not while playing dart games
• shows difficulty in dressing reading and writing( he may neglect the reading one half of the page, buttoning his shirt, and may show difficulty drawing and completing figures)

how to evaluate neglect 

1. -drawing tasks
2. -line bisection test
3. -cancellation tests
4. -crossing out tasks

ruling out neglect from visual feild deficits and attention related issues are important for guiding treatment 

Body awareness as an axis for development of spatial organisation

Development of body awareness and spatial organisation begins as early as first two years of  through the sensory motor stage of child's life.It was initiated by the discovery of the existence of "Two Visual systems"one for object permanence and one for spatial organisation. It also involves understanding the relationship of these objects when there is a change in position. It is the ability to perceive two or more objects in relation to each other and to oneself.


As perception helps us to organise the sensory stimuli from our environment child may need to have adequate body awareness to be able to form relationship of its body with the stimuli and the objects within the space

signs and symptoms shown by children with poor spatial awareness

1. may appear clumsy
2. may bump into object or people
3. may stand too close or too far from people
4. may have difficulty in presentation of written work and may find it hard to structure or organize work
5. may show right/ left confusion
6. difficulty in understanding expressions as over, under, in and out
7. difficulty in team games or games using objects
8. difficulty in judging distance,speed and force
9. may show difficulty in maths due to  problem in visualising the abstract concept

children having difficulty in BA/ SA are usually good listeners showing good verbal comprehension skills leading to verbal and non-verbal reasoning

How to develop spatial awareness

• free play or floor time where the child is given opportunity to explore their environment and manipulate objects by moving towards it
• Activities that involve games which work on judging distance, speed and placements such as target hitting 
• obstacle courses which involves the body and help the child to be aware of where they place their body in relation to obstacles 
• music and movements or brain gym moves which helps with placement and co-ordination of body parts with relation to oneself and the environment.

Channeling self verbalisation into social speech for enhanced communication

@A MOMENT PLEASE---often we hear children engaged in private speech pattern where they  play and talk out loud to themselves...a preschooler engaged in verbalisation '' where are my shoes?I need the blue one.No i need the red one. uff ..! it dosent fit...ok the other one.'' when the child is engaged in self utterances they express thoughts in whatever form they happen to occur without waiting for the perspective of the listener.
This private speech pattern aids in language development of the higher centres involved in

• controlled attention
• deliberate memorisation and recall
• categorization
• planning 
• problem solving 
• abstract reasoning 
• self reflection

Channeling  private speech into development axis.

1. As the task is made more challenging in one to one Therapy sessions it increases the attention and cognitive processing  thereby declining the private speech showing better task performance.
2. In a social groups children interact with peers through social reciprocity..involving differences, similarities, questions , prompts and suggestions..which promotes turn taking and development of inter subjectivity.

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Child Development: Occupational Therapist Prespective

Occupational Therapy as a noble profession : To all my friends, far-n-wide, I would love to know how occupational therapist as a profession can benefit the society. OT is based on belief, that purposeful activity prevents or mediates dysfunction of physical or physiological origin.

The science of organized work for invalids providing them, an opportunity to use physical graded movements of muscles & joints with proper posture needed to accomplish the task in a stabilized emotional environment where their skills are enhanced for better performance provides the platform for our treatment.

The neuro plasticity theory of human brain, adaptability and role modeling are the mile stones for early interventions in infants and kids with dysfunction.

The different strategies of learning for behaviour and special education using Sensory Integrations (SI) Interventions, PECS, TEECH, ABA, VBA & other means of augmentative and alternative communications are employed to aid children with spectrum & learning disorders.

It is our role as parents, guardians & responsible citizens to help our kids & adults by identifying any development delays or anomalies at the earliest so that, we as an Occupational Therapist would be help you all with sincere and dedicated services for making them inclusive part of society.

A sincere request: Pls be alert & attentive to report at the earliest for the treatment to be effective!

Rashmi Sinha
Occupational Therapist (SI Trained)
dr.rashmi.sinha@gmail.com