Our Services

Occupational Therapists in a school-based setting typically work with children who are experiencing difficulties in play, learning at school or accomplishing age appropriate self-care skills. OT helps them to function optimally in these different contexts by focusing on the necessary underlying skills, including visual perceptual skills, gross motor (large muscle) skills or fine motor skills. OT uses specific activities and games that are meaningful to target their areas of concern, using the child’s internal motivation to drive the process. While observing a child in therapy it might look like they are just playing and having fun- the good news is that they are, but that these specifically chosen games are helping them develop and grow, often without them even realising it.

Following an assessment, a child typically attends sessions weekly or twice weekly. These are complimented by fun home-based activities, which are designed to become a part of their daily routine rather than being seen as “homework”. Practising skills learnt in sessions at home is important in ensuring progress and allows the Parent/Caregiver to become an active part of the Therapy process.

Belinda has successfully completed the DIRFloortime® 204 certification and qualified as a DIRFloortime® Expert Training Leader in 2021. Karen completed the DIRFloortime® 203 certification and she has the DIRFloortime® Advanced Certificate (DIR-Advanced).

Floortime, also known as DIRFloortime®, is an evidence-based intervention approach used with children of all ages to promote engagement, communication, positive behaviour and thinking skills. During Floortime sessions, the Therapist uses the power of relationship, joy and playfulness to connect with the child on their developmental level. The Floortime assessment determines the child’s differences concerning sensory processing and development of skills, making it a tailor-made experience well suited to various developmental delays and spectrum disorders.

The DIRFloortime® model was developed by Dr. Stanley Greenspan and his colleagues, and currently, it is used worldwide by parents, Occupational Therapists, Speech and Language Therapists, teachers and mental health professionals.

When the DIRFloortime® model is used, the facilitator/therapist will meet the child on their level by following his lead and engaging with him emotionally. Emotion is the drive behind Floortime and forms a vital part of the process. Dr Greenspan developed six functional and emotional capacities, and our aim in Floortime sessions is to support the child to climb the developmental ladder. The capacities or levels are as follows:

• Self-regulation and interest in the world
• Engagement and relating
• Two-way purposeful communication
• Complex communication and shared problem solving
• Using symbols and creating emotional ideas and
• Logical thinking and building bridges between ideas.

For more information about the DIRFloortime® model, please visit: www.icdl.com/floortime

You can also read more about the value of Floortime on the following sites:

affectautism.com jeffreyguenzel

Watch a video which explains the core concepts of DIRFloortime®

Watch a video which briefly unpacks the Functional Emotional Developmental Capacities and fundamentals of DIRFloortime®

Belinda and Karen are trained in Sensory Integration Therapy (SAISI) and are qualified to administer the Sensory Integration and Praxis Tests (SIPT).

Sensory Integration (SI) therapy or therapy using an SI approach is based on the work of Occupational Therapist Dr. Jean Ayres. It is typically used when children are experiencing Sensory Processing Disorder (Please refer to the FAQS page for further information on SPD). SI therapy aims to help the child respond appropriately to different sensations and accurately process the information their body receives from their various sensory systems. This is done using meaningful, fun activities so that they can function better in their daily life and at school. Occupational Therapists typically target the vestibular (sense of movement), proprioceptive (sense of body position) and tactile (sense of touch) systems, as well as the auditory system (sense of hearing) through other specialised SI treatment modalities (i.e. Therapeutic Listening®) or specialised educational programs(i.e. Tomatis® method).

SI therapy occurs in a playful and sensory-rich environment using activities pitched at the child’s skill level. These are adapted throughout the session to ensure the child is being challenged but still enjoying success. This helps them to adapt and progress within the session and then transfer these skills to their daily life (e.g. coping better in the classroom, enjoying extra-murals, being better able to adapt socially and emotionally to age-appropriate challenges, etc). Sessions are complemented with home-based sensory games and activities designed with the Parent/Caregiver.

Karen and Belinda have training in reflex integrating techniques, which they incorporate into their work with children presenting with:

• Sensory Processing Disorders (SPD)
• Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder (ADD/ADHD)
• Autistic Spectrum Disorders (ASD)
• Developmental Delays
• Learning Difficulties
• Fetal Alcohol Syndrome (FAS)

Primary reflexes (also called primitive reflexes) are repetitive, automatic movements that surface in utero and infancy. These automatic movements occur without conscious volition in response to specific sensory stimuli. These primary reflexes must be fully experienced to serve their developmental purpose (i.e. contribution to higher-level motor or cognitive skills) and to become integrated into the whole body movement system. This allows for the emergence of postural reflexes needed for more advanced systems of voluntary movement and postural control. Most primary reflexes should be integrated between 6 and 12 months. For various reasons, some of these primary reflex patterns never fully emerge or are not fully integrated and may be a contributing cause to attention-, sensory processing-, developmental-, learning, and behavioural challenges.

Please visit http://masgutovamethod.com/learn-more/glossary-of-terms for a comprehensive list of reflex descriptions and definitions.

Feel free to also visit https://masgutovamethod.com/learn-more/articles for scientific articles related to MNRI.

For more information related to the nervous system's physiology and reflex integration implications, visit https://masgutovamethod.com/the-method/reflex-physiology-the-nervous-system. Or watch the brief informative video explaining the value of MNRI Therapy.

The TOMATIS® method sound programme was created by Dr Alfred Tomatis, a French ENT (ear, nose and throat surgeon) around the 1950’s and 1960’s. The Tomatis® Sound therapy is based on the fact that the cranial nerve VIII transports auditory and vestibular information. The vestibular system has many interconnections with almost every other part of the brain; hence the Tomatis® sound therapy works on regulation, attention, body and emotional goals. In effect it helps to reorganise the foundations so that sensory information can be perceived in a more organised way.
Tomatis® regards the ear as an auditory and motor organ due to the “doorway” to the entire nervous system. The cochlea and the vestibular system are interconnected at brain level and combine their auditory and motor function into one single function, which is listening. The cochlea relates to the auditory part (i.e. brain energy, hearing, speech processing and musical analysis). The vestibular system relates to the motor part (i.e. brain energy, posture, balance, coordination, muscle tone, body schema and spatial navigation). The Tomatis® method always stimulates both the vestibular system and cochlea. The inner ear receives the information and then sends it to various areas in the brain which are involved in motor skills, memory, language, attention and emotion.

Electronic gating is at the core of the Tomatis® method. Gating is a system of alternating between two audio channels which are distributing the same information with different timbres and intensities. The gating is highly unpredictable for the brain. The alteration between the two channels will thus enable us to mobilize the auditory muscles. When this highly unpredictable process takes place, the brain is “interested in what is happening” and it triggers attention mechanisms.
The other core quality of the Tomatis® method is the use of bone conduction. The sound message is transmitted by a vibrator (on the top of the headphone) that connects with the skull. The sound goes directly to the inner ear via bone conduction without passing through the tympanum. The role of bone conduction is to prepare the brain to receive, accept and then process the incoming information which arrives through air conduction via the tympanum.

For more information about the Tomatis® method visit the Tomatis website
For information related to the research and publications about the Tomatis® method visit the Tomatis® association's website

Videos explaining the effect of the Tomatis® Method

What is the Tomatis® Method?

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Play to Learn is duly licensed by TOMATIS® DEVELOPPEMENT S.A. which is the owner of TOMATIS®, TOMATIS® +LOGO, SOLISTEN, TALKSUP Trademarks www.tomatis.com The TOMATIS® Method is an Educational Program, and is considered neither a medical treatment nor a means to establish a medical diagnosis. The content of this website is for informational purposes only. It should be neither considered as nor substitute for medical advice.

Belinda and Karen are qualified Therapeutic Listening® Practitioners.

Therapeutic Listening® is an evidence-based programme which works through the auditory system and is used as a part of a Sensory Integration approach in Therapy (see above). It was developed and researched to help people of all ages with difficulties with sensory modulation, attention, social skills and communication, praxis (motor planning), postural control, bilateral coordination, spatial perception, fine motor skills and visual motor integration (copying).

Electronically altered music is used to “tap into” or access the parts of the brain which regulate bodily functions, organize behaviour and increase attention and concentration. The music is specifically designed to provide the child with controlled sensory information. The music has built-in high-pass and low-pass filters (called modulated music) which trains the ear to shift back and forth between background and foreground sounds or near and far sounds, enabling them to work better in background noise.

A child uses specific over-the-ear headphones to listen to the modulated music as a part of their therapy session and/or as a part of a daily home programme. Each child’s music selections will be unique, as their programme is designed to suit their individual needs by their trained Therapist.

For more information about Therapeutic Listening® visit:
https://vitallinks.com/therapeutic-listening/parents/

Belinda von Wielligh completed her Master’s Degree in Play Therapy and provides Occupational Therapy and Play Therapy services at the practice in Parklands.

Children communicate and process life events, their experiences, feelings and troubles through play. In Play Therapy sessions, various play mediums are used such as mini-figurines, sand play, dolls, play-dough, paint and drawings, hand puppets or a dollhouse with family dolls so that children can explore their emotional world.

Play Therapy sessions take place within a safe and nurturing setting where children can express their needs, wishes, fantasies and emotions through these play mediums. Children are not always able to voice or explain what makes them feel sad, scared, anxious, angry or unpleasant; but through their play they get the opportunity to become aware of these feelings. Once children are aware of what it is that they are feeling, and where in their bodies they feel these emotions, it is easier for them to internalize strategies of how to handle this in the future. Establishing a good relationship and trust is a vital part of the process during Play Therapy sessions. Within the safe relationship they are able to process the troublesome events or feelings and reach solutions to difficult situations, or learn new skills such as how to manage their anxiety or anger better. Sessions are complimented with parent guidance and feedback sessions in order to also support and empower the parents.

The Muscle Mania® programme is a classroom based fine motor programme. It was developed by occupational therapist, Bunty McDougall, who has a special interest in fine motor, pre-handwriting and handwriting skills. This means that each of the lesson plans have been developed by a skilled clinician who understands that children learn while they are having fun. Although children are exposed to a wide range of fine motor opportunities in the classroom, our techno era children benefit from the more directly targeted input that is offered by Muscle Mania®. The programme offers a fine balance between specific muscle strengthening and applied functional fine motor skills.

The Muscle Mania® programme is has been offered at Reddam House Atlantic Seaboard since 2014. It is presented to the Stage 4’s (Pre-Grade R), Stage 5’s (Grade R) and Grade 1’s as part of the school programme. The success of this programme is ensured by the following:

• · It was designed to be facilitated by a qualified occupational therapist. Occupational therapists that work with children have specialist training in the development of the sensory, visual-perceptual and motor skills needed to successfully master pre-writing and handwriting skills.
• · At present there are two qualified occupational therapists in the classroom to provide a high adult to child ratio. There are four adults present and involved during the Stage 4 and Stage 5 Muscle Mania lessons and three adults present and involved during the Grade 1 lessons. This enables individual attention given to learners.
• · It is a carefully graded programme that builds, develops, and extends fine motor skills consistently over the course of the year.
• · All the activities are highly engaging and child friendly. Children learn and develop best when they are engaged and motivated.
• · The programme offers lots of repetition, but it is not repetitive in a boring way! The skills are introduced and mastered. They are then revisited in an upgraded form that requires the children to build on previously learned skills. So, throughout the year, the skills are repeated in a different and more challenging form.
• · The programme offers regular input, which enables the children to lay down the correct “motor maps” needed to establish age-appropriate scissor- and pencil grasp patterns, as well as the drawing of basic lines, strokes and shapes which are foundational to learning correct letter- and number formations in Stage 5 (Grade R). The Grade 1 programme continues to build on the foundational skills required for handwriting.

For further information please visit https://thehappyhandwriter.co.za/muscle-mania-2/

Telehealth is the use of telecommunication or virtual consultations for therapeutic services. As an alternative to face-to-face appointments, Occupational Therapists at this practice make use of video conferencing to offer assessments, therapy sessions and parent consultations through online platforms that are deemed safe and secure by South African health industry norms. We also make use of other platforms, such as WhatsApp (text messages, voice-notes, video calls, photo and video sharing), emails, home programmes and telephone calls, in order to provide therapeutic services.

Telehealth services are typically provided in situations where you or your child cannot attend face-to-face appointments. Telehealth services may also be provided in addition to face-to-face appointments to facilitate and enable ongoing support and guidance in the best interest of your child. Your therapist will discuss your child’s current functioning with you and will offer you support which is most suited to your child’s individual differences. Telehealth services, as with face-to-face consultations, are time-based billing codes and therefore billed at usual therapy tariffs, unless special billing arrangements have been agreed upon between the therapist and client.

Parents are welcome to accompany and support their children during their Telehealth consultations as they would during face-to-face therapy sessions. In certain situations, parent or caregiver presence may be required to ensure the success of the intervention. Please note that Telehealth therapy sessions will not be identical to face-to-face therapy sessions. Some therapeutic activities and techniques are reliant on hands-on facilitation and specialized equipment which cannot always be 100% replicated via Telehealth. Occupational therapy is, however, well suited to Telehealth services as Occupational Therapists are trained to be “out of the box” thinkers utilizing their skills in activity analysis and their continuous consideration of the environment the client finds themselves in. In our practice’s experience, Telehealth intervention has proved extremely useful to facilitate a deeper understanding of our clients and improving parent-therapist collaboration by bringing therapy into homes.