Priya-the-OT

  'A' is a 5 year old boy I see at the clinic. He is on the spectrum and is very proprioceptive and tactile seeking. 'A' is not completely toilet trained. He does not consistently indicate his need to use the toilet, and he has a tendency to dribble multiple times in a day, and sometimes hardly notices that he is wet. 'A' is also constipated most of the time as he holds himself  for days together to avoid going to the toilet for the 'big job', as he doesn't feel 'safe' sitting on the toilet. 'A' has been off therapy for over 3 months as they have moved out of town, and is yet to find a Therapy Centre in their immediate locality. A 's mother called me one evening with concerns over his frequent accidents. "Who would you suggest I take 'A' to, a Nephrologist or a Urologist?", was her question. (Names hidden to protect identity) Before I go into what I told A's mother, let's first look at toilet training in

  Ask any newly qualified OT, what Occupational Therapy is, and 99.99% of the time you get the same answer, "Occupational Therapy is all about improving ADL skills and helping the client achieve ADL independence." Of course, if you probe deeper, you may get a more elaborate answer that may branch into other things (apart form ADL) that an OT can help a client with. Let me just a do a bit of introduction first, before I get to the point!  ADL, which stands for Activities of Daily Living, is the most common term you would hear many OTs use.  It is a term used to collectively describe fundamental skills that are required to independently care for oneself such as eating, bathing, dressing, toileting, grooming and mobility.  ADLs are essential and routine tasks that most young healthy individuals can perform without assistance. The inability to accomplish essential activities of daily living, due to an injury, illness or any other physical or emotional challenges, may lead to unsa