A Conversation with Dr. Kanchan Singh
Occupational therapy aids individuals in developing essential life skills. Dr. Kanchan Singh, an expert at NIEPID, transforms challenges into opportunities, helping patients navigate daily tasks with tailored therapeutic strategies.
Dr. Kanchan, with your extensive experience at NIEPID, could you share with us how many cases you typically handle in a day?
On a daily basis, we deal with quite a number of cases—between 20 to 25 new cases, and 30 to 35 follow-up cases. Our clients primarily include children with autism spectrum disorder, ADHD, intellectual disabilities, and learning disabilities.
That’s quite a substantial number. When parents first approach you, what is the initial process like?
Initially, we gather detailed information from the parents about their child’s present complaints. It’s crucial, however, to note that there’s often a significant difference between the information provided by the parents and our own observations. For example, parents might express concerns about their child’s ability to walk or concentrate, or about delayed speech.
How do you go about verifying these concerns? What kind of observations do you make?
We conduct thorough observations to identify the specific issues each child faces. In cases of autism, for instance, we might notice that a child doesn’t respond to their name, avoids eye contact, or exhibits sensory sensitivities. We use various sensory integration equipments to assess these issues more accurately.
Can you give examples of how you use this equipment to identify sensory issues?
Certainly. If a child shows fear of swings or slides, it might indicate vestibular problems related to balance. Similarly, a reluctance to climb stairs or jump in a play ball can signal a fear of heights and depth perception challenges. These observations help us pinpoint specific sensory, vestibular, and proprioception issues commonly seen in children with autism.
After these assessments, what are the next steps in your therapy process?
Following our occupational therapy assessment, we take a detailed case history. This includes exploring prenatal, perinatal, and postnatal factors, as well as the mother’s health during pregnancy and any previous medical history that might affect the child, such as repeated miscarriages. We also consider the parents’ marital background, like whether it’s a consanguineous marriage, to understand genetic factors better.
It sounds like a comprehensive approach. How do these detailed assessments inform your therapy strategies?
These assessments are foundational for crafting personalized therapy plans. By understanding the unique challenges and backgrounds of each child, we can develop targeted interventions that address not just the symptoms but the root causes of their difficulties, enhancing the effectiveness of our therapeutic interventions.
Once the initial case history and assessments are completed, what steps do you take to ensure that therapy continues effectively at home?
After we complete the assessments, we provide parents with a home-based program and demonstrate how to carry out specific activities. This ensures that therapy extends beyond our sessions at NIEPID and becomes part of the child’s daily routine at home.
Could you elaborate on some specific techniques you recommend to parents, especially for children with challenges in speech as seen in autism spectrum disorder?
Certainly. For children who are not able to speak or maintain focus, which is essential for effective speech therapy, I often recommend starting with exercises to stabilize their attention. For instance, we use a therapy ball, or what you might know as a gym ball, which comes in various sizes. This helps the child to stay focused and maintain eye contact, which are preliminary steps before any speech therapy can commence.
How does the therapy ball help in speech therapy?
The therapy ball encourages the child to balance, which naturally requires them to focus their attention. This increased focus aids in making eye contact and stabilizing their position, which is crucial before starting any speech exercises.
You also mentioned the use of massages and different textures. How do these assist in therapy?
We incorporate sensory activities like body massages using different textures to stimulate the child’s sensory receptors. For example, we have tactile walls and various types of brushes. These tools not only soothe the child but also enhance their sensory processing abilities. By integrating tactile stimulation through massages and using items like tactile walls, we help improve the child’s ability to focus and engage during therapy sessions.
What are the expected outcomes of these sensory integration techniques?
By integrating these sensory techniques, such as the gym ball for stabilization and diverse tactile stimuli for sensory engagement, the child’s overall ability to respond to verbal cues improves. This means that when a parent speaks to the child, the likelihood that the child retains and processes those words increases significantly. Essentially, these techniques enhance the child’s cognitive engagement, leading to more effective learning and communication over time.
Dr. Kanchan, managing interactions with new students must be quite challenging. Could you share how long it typically takes for you to establish a connection with them during your initial meetings?
Absolutely, the initial connection with a new student can indeed be challenging, primarily because it’s our first interaction, and they need time to understand and trust us. Establishing rapport is critical. We generally allocate about 40 to 45 minutes to this process during the first meeting. We demonstrate relevant activities or exercises to the parents during this time as well. To facilitate this rapport-building process, we employ various reinforcements.
For instance, we use toys, which are plentiful here, as a way to engage the child positively. We instruct parents on different techniques, such as how to use the therapy ball, administer massages, and conduct activities that enhance their child’s ability to sit still, which in turn improves their attention span and concentration levels.
– Raja Aditya
