1. CORE THERAPY SERVICES
Club Rainbow works with various community partners and private organisations for the provision of therapy services to meet the needs of our beneficiaries.
Let’s hear from the therapists what they have to say about their work at Club Rainbow.
My clients in Club Rainbow have a variety of conditions ranging from Cerebral Palsy to Muscular Dystrophy to genetic or chromosomal syndromes, all of which contribute to some form of movement impairment and/or delay in their gross motor skills. After an assessment to identify such movement impairments and/or the aspects of gross motor skills in which the child is delayed in, I will set functional goals with the caregivers and the child (where able), in order to optimize the child’s functional mobility in the most efficient way possible.
Interventions will then be focused on the promotion of mobility and achieving age appropriate gross motor skills (eg. Crawling, walking, running, jumping) through fun games and activities that incorporate training for strength, balance, coordination, flexibility and endurance, depending on the child’s needs. Also, intervention would incorporate management of the secondary issues that the child may present with, such as coping strategies for scoliosis, hip subluxations/dislocations, optimizing respiratory function and infection control.
As majority of my clients are seen at the comfort of their own home, I modify the home exercise programmes according to what the clients have available at home; whether it is to use stools or the sofa, or even the neighbourhood playground/environment. I also teach caregivers handling skills and strategies for positioning for improved posture and comfort, especially for children who suffer from scoliosis arising from their condition. It is important for me to ensure that caregivers are comfortable in conducting the exercises on their own without compromising their own posture and comfort.
Ultimately, the aim of physiotherapy is to maximize your child's quality of life by working with their caregivers to empower the child and increase their independent mobility to their fullest potential. With that in mind, here are a few physiotherapy tips and strategies that caregivers can adopt:
1) Let your child do it!
More often than not, we tend to perform as many daily tasks as we can for our children. Daily tasks that we normally find easy such as putting on shoes and socks, feeding oneself, opening a bottle and so on, may be more difficult and time consuming for our children to perform, hence we tend to do it for them. However, it is so important for us to remember to include them in performing such tasks! Getting them to participate with varying degrees of assistance (from independent to hand over hand assistance) can increase your child's confidence and improve their self-esteem. It may be more time consuming, but imagine the joy and satisfaction they feel when you praise them for even trying to participate.
2) Have a stretching routine and stick to it!
If your child does not have a home stretching exercise programme yet, do ensure that you speak to a physiotherapist to obtain one. It is crucial for our children, especially those who are immobile, to have a stretching routine incorporated into their daily routine, whether it is passive or active. As children grow, their bones may grow faster than their muscles, especially in the case of children with physical disabilities due to the lack of usage of certain muscles. As such, muscles can become tight if not stretched out manually often enough, which may then contribute to further movement impairments and difficulties for the caregivers to shower or change diapers for the child, for example. Over time, tight muscles can become contractures and possibly lead to other complications such as hip dislocations, which may then lead to the need for other interventions such as surgery. Hence, by dedicating some time daily to perform a stretching routine for your child, you will reduce the chance or slow down the likelihood of the above from happening.
3) Choose your toys wisely!
When choosing toys for your child, cause and effect toys and toys that require movement from your child are the best. Cause and effect toys would be toys that require your child to for example push a button in order for the toy to play music, or light up etc. Such toys are helpful in the development of hand eye coordination, sensory exploration and can motivate them to move. Other toys such as blocks, ring stackers, puzzles and Lego can also be used as part of an obstacle course where they have to bring the toys from the start to the finish in order to complete the course. Remember to avoid toys that lets your child sit for long hours without any movement.
And lastly, always remember that your child is a child first, before a child with special needs. (:
1.2 Speech Therapy
In Club Rainbow, I see clients with a variety of speech and language difficulties that may or may not have resulted from their underlying diagnoses such as Autism Spectrum Disorder, Global Developmental Delay and Muscular Dystrophy. These clients first undergo an assessment to identify areas in which they are either not developing at the same level as children their age are, or have significant difficulties that impact their functioning in daily life.
Subsequently, these clients attend therapy sessions to work on goals targeted to their varying needs. Some of these goals include:
- Increasing the child’s understanding and use of different words (e.g. nouns, verbs)
- Increasing the length and type of sentences the child can produce
- Increasing the child’s understanding of concepts (e.g. same/different, location)
- Increasing the child’s functional communication, including using a picture communication system or selected words to communicate using speech or sign
- Helping the child speak more clearly
There are several ways in which you can support your child’s language and speech development. Here are some suggested strategies that you can adopt:
Be interested in your child’s interests
Your child will be most motivated to communicate on items, activities or events that capture their interest. Observe your child to see what they show interest in and how they react to it. They may react using sounds, words, gestures or facial expressions. You can respond by imitating them, interpreting what they are trying to say or commenting on what they show interest in. Your child will know that you are interested in what they are seeing and doing, and be more motivated to communicate with you.
Create communication opportunities for your child
You may also engineer opportunities for your child to motivate them to interact and communicate. This involves creating situations in their environment in which they would be motivated to initiate communication. Such situations include:
- Placing an item that the child likes within sight, but out of reach
- Introducing toys that are hard to operate, or within a tightly closed box
- Doing something unexpected (e.g. passing your child something different from what they need)
- Offer an item in parts (e.g. giving your child juice a little at a time)
- Offer your child choices by presenting them with a few items
- Wait and see what your child will do when they need help
- Stop during a routine or song and observe how your child reacts
Your child may respond to these situations through a variety of non-verbal communication modes (e.g. look at you, make sounds, reach out to an item, or appear excited). You can respond by interpreting their actions and expressions and giving them what they want (e.g. “Do you want the juice? Here you go.”
Read books with your child and talk through them. You can ask them
- What they think the story could be about (just by looking at the front cover and title)
- What they think might happen next in the story
- To think of another way the story could have ended
- To tell you how the characters in the story feel and why
- To tell the story again (without looking at the book) to their siblings
Use of total communication (gestures, pictures, body language)
Your child may have difficulty understanding and using spoken language due to their underlying condition. When speaking to your child, you are encouraged to support your communication with gestures (e.g. pointing to objects, key word sign), pictures (e.g. books), and body language (e.g. facial expression, body posture). Your child will have a better understanding of your message when you deliver it both verbally and non-verbally. They may also adopt these means of non-verbal communication to enhance the clarity of their communication.
- Speech Therapist
1.3 Occupational Therapy
In Club Rainbow, a wide range of clients from different age groups and medical diagnosis attend occupational therapy sessions, usually referred by doctors from NUH and KKH. Based on the initial screening of clients and parents’ interview, clients are shortlisted for therapy, which is on a weekly basis. Goals based on parents’ priorities are set, followed by a review when the therapy cycle ends after five months. There are two intakes of clients scheduled in a year. Any recommendation of additional therapy cycles by therapist is purely based on client’s performance and needs.
Session plans are based on individual client’s need and on the projected goals. Goals are functional and to maximize the client’s potential to help them gain independent, for instance, able to button or unbutton, eat finger foods, open water bottles cap and drink water, catch a ball, hold a writing device and scribble, colour, draw or write, putting in and take off socks and shoes, turn pages of a book, walk in the neighbourhood, maneuver motorized wheelchair, etc.
Understanding the importance of caregivers’ role in clients’ lives, strategies are shared with caregivers so they can help clients to practice the activities and create more opportunities to repeat the activities at home. Caregivers are also encouraged to attend sharing session conducted by therapist during term-break. It was observed that active engagement of caregivers helps clients to improve the skills faster and achieve individualized goals set by therapist.
In the centre, clients look forward for the occupational therapy session. They have fun while performing fine and gross motor activities in the gym and/or neighbourhood playground. It was observed that when clients have fun in participating in activities, they learn the skills faster. The activities were planned with just-right amount of challenges so that clients were able to complete the activity at end of the session. This improves their self-esteem and motivates them to try similar activities without any hesitation.
In summary, as an occupational therapist, I help clients to perform their occupation with the fullest potential, for instance, play, activity of daily living (ADL), fine and gross motor skills that required to perform typical tasks they supposed to do routinely across the settings including home, community and in school. In addition, accessibility training for wheel chair bound clients inside home and in the community to make them more independent in their mobility. Even providing training for taking public transport is a part of my job to make them independent so that they are able to moving around freely in their own community.
- Senior Occupational Therapist
2. COMPLEMENTARY THERAPY SERVICES
2.1 Art Therapy
Art Therapy is…
A way to express thoughts, feelings and emotions without words.
A way to explore materials and find ways to cope with complex emotions.
A way to build self-awareness and self-esteem
About enjoying the pleasure of creating in a safe and understanding environment
Art therapy is a form of psychotherapy that uses art media as its primary mode of expression and communication. Within this context, art is not used as a diagnostic tool but as a medium to address emotional issues which may be confusing and distressing.
Art therapists work with children, young people, adults and the elderly. Clients may have a wide range of difficulties, disabilities or diagnoses. These include emotional, behavioural or mental health problems, learning or physical disabilities, life-limiting conditions, neurological conditions and physical illnesses.
Art therapy is provided in groups or individually, depending on clients' needs. It is not a recreational activity or an art lesson, although the sessions can be enjoyable. Clients do not need to have any previous experience or expertise in art.
Art Therapy is being offered at Club Rainbow in collaboration with LASALLE College of the Arts and the MA Art Therapy Programme.
2.2 Play Therapy
Play therapy is a form of therapy primarily geared toward children. In this form of therapy, a therapist encourages a child to explore life events that may have an effect on current circumstances, in a manner and pace of the child's choosing, primarily through play but also through language.
Play therapy, can help individuals communicate, explore repressed thoughts and emotions, address unresolved trauma, and experience personal growth and is widely viewed as an important, effective, and developmentally appropriate mental health treatment.
TOYS ARE A CHILD’S WORDS!
Catered for those with physical limitations or find other forms of exercises unsuitable, this water based exercise helps major muscles groups to be well-engaged, helping to build strength and tone muscles.