Occupational therapy is a health-related profession that primarily serves persons with disabilities. It is concerned with the well-being of persons in their everyday occupations (i.e., work, play, and daily living tasks). The profession sees occupation as a necessary aspect of life, contributing to physical, emotional, and cognitive well-being. Occupational therapists work with individuals whose participation in occupation is threatened or hampered by impairments and/or environmental barriers.
The origins of occupational therapy are the eighteenth-century moral treatment approach. Moral treatment was a European movement that saw mental illness as a form of demoralization emanating from disruption of a person's connection with the mores or customary activities of society. Moral treatment consisted of inviting and supporting participation in everyday activities as a means of “remoralizing” individuals by reintegrating them into ordinary routines of living. Moral treatment exported to North America and practiced in the eighteenth and early nineteenth centuries. In the mid-1800s, overcrowding and underfunding of state hospitals led to its virtual demise.
Motor skills are generally evaluated during an assessment in the schools by an occupational and/or physical therapist. Motor performance is also considered an important part of a neuropsychological evaluation. A neuropsychological evaluation assesses the relationship between brain activity and behavior (Teeter & Semrud-Clikeman, 1997). There are occasions when a school psychologist may need to provide additional measures of motor skills to provide support for a child or adolescent in the area of handwriting and copying.
Motor skills can be divided into several areas. The most obvious division is between fine and gross motor skills. Gross motor skills are the bigger movements (e.g., running and jumping) that use the large muscles in the arms, legs, torso, and feet; whereas fine motor skills are small movements (e.g., grabbing something with the thumb and forefinger) that use the small muscles of the fingers, toes, wrists, lips, and tongue. In order to more fully understand these measures, it is important to first review the structures that contribute to motor functioning.
The motor system is contained within the front part of the brain. This motor strip controls the execution and maintenance of simple motor functions. It is a crossed system so that the right hemisphere motor strip located on the right side of the brain controls the left side of the body, and vice versa. The premotor cortex lies in front of the motor strip and directs the primary motor cortex.
In addition to the frontal lobes, the parietal lobe is also involved with the motor system. The parietal lobe lies in the superior portion of the back of the brain. This section allows for not only the perception of touch and temperature, but also an awareness of the position and movement of body parts (kinesthetic sense). Similar to the motor system, the sensory system is also a crossed system. It is particularly important for motor skills in that the primary parietal region allows for a rapid cross-communication with the motor system, which is necessary for the execution of motor behavior (Teeter & Semrud-Clikeman, ...