Gaining Independence with Daily Tasks

Throughout cancer treatment and recovery, it is important for children to remain as independent and safe as possible in daily tasks. Occupational therapy (OT) can help patients meet developmental milestones, including age-appropriate self-care skills and activities of daily living.

Occupational therapists are health care providers who specialize in helping patients do the tasks of daily life. Some children may need special equipment or adaptive devices for everyday activities.

Activities of Daily Living: Helping Children with Self-Care Skills

Cancer can make it hard for children to develop and maintain self-care skills. However, there are ways to help children be more independent, even when facing medical challenges.

Here are some ways to support activities of daily living during childhood cancer:

Self-feeding:

• Allow children to help plan and prepare meals and snacks.
• Child-friendly utensils, plates, bowls, and cups can help children eat and drink more easily. Dining aids such as curved or weighted utensils, high-sided plates, and spill proof cups are also available to meet specific patient needs.
• Positional devices can help children who have difficulty sitting on their own. This provides support to allow children to safely use their hands to eat.

If a child has problems with chewing or swallowing, a speech-language pathologist (SLP) may be able to help.

Bathing and showering:

• A shower chair placed in a shower stall or bathtub can help patients conserve energy while bathing.
• A tub transfer bench can lower fall risk. This is useful for children who have balance concerns who may not be able to safely lift one leg to get over the tub wall. For some patients, anti-slip mats or grab handles may help reduce the risk of falls.
• Long handled sponges are used to help wash hard to reach areas or minimize reaching for patients with balance problems.

Toileting:

• A toilet safety frame can be installed to help a child get on and off the toilet safely. This can be used for patients with balance problems or weakness.
• Some children may need to use a portable bedside commode if they have trouble getting to a bathroom toilet.
• Potty training during cancer can be especially hard. An occupational therapist can work with families to develop a toileting schedule that considers the child’s age, development, and medical needs.

Learn more about toileting routines from the American Occupational Therapy Association.

Getting dressed:

• Sitting down while dressing or undressing can help if children tire quickly or have balance concerns.
• Occupational therapy can help patients practice skills like buttoning clothes and tying shoes. Children may also need help learning to plan and carry out the steps needed to put on or take off clothes. In some cases, patients may need to learn adaptive techniques such as one-handed dressing or shoe tying.
• Adaptive equipment can make dressing tasks easier. These include:
  • Sock aids help patients put on socks without reaching to the ground. This device can be helpful for children with hip precautions after surgery or for those with balance problems.
  • Elastic shoelaces allow children to put on and take off shoes without tying or untying shoelaces.
  • Button hooks help patients pull a button through its hole. This device is helpful for patients who have difficulty with fine motor skills.

Independence is a normal part of childhood. Learning to do things for themselves is important for children’s physical, social, and mental health. The jobs of childhood include self-care, learning, and play. Occupational therapy can help patients be more independent in these tasks.

Tips to Help Kids Be More Independent in Daily Life

• Offer a variety of ways for children to participate in age-appropriate chores. Let children help in activities like cooking, cleaning, or shopping.
• Consider the length of time the activity will take. This will help you plan breaks that may be needed to conserve energy.
• Have the child sit during the task to allow participation for longer periods of time. Use positional devices to provided additional support if needed.
• If the activity involves walking or standing, plan breaks or use assistive devices to walk or stand safely. For example, a walker or wheelchair may allow easier participation in outings. Or a young adult may benefit from using a motorized scooter in order to shop safely.
• Use play to help children develop skills such as problem-solving, planning, organization, and self-care. Provide a safe play area such as a padded mat on the floor. Your occupational therapist can recommend age-appropriate toys that can encourage fine motor skills and physical development.
• Talk to your occupational therapist about assistive devices that can aid daily activities such as:
  • Hand aids to make it easier to hold and grasp objects
  • Slant boards and stands to help reading and writing
  • Weighted pencils or pens make writing easier for children who have tremors or ataxia
  • Braces and orthotics to help support weak joints or muscles
  • Positional devices that provide support while sitting and allow children to use their hands safely

Resources for More Information

Learn About Occupational Therapy for Children & Youth | AOTA

Functional Skills for Kids Series by OT and PT Bloggers | The OT Toolbox

Ways to Encourage Self-Help Skills in Children | eXtension Alliance for Better Child Care

When hands need help | St. Jude Children’s Research Hospital

Self care Development Chart | Kid Sense Child Development

CDC’s Developmental Milestones | CDC