Bailey Reilly-Montes, MOT, OTR/L
Lead Occupational Therapist

Activities of Daily Living, ADL, are an area of occupation, everyday activities, that pediatric Occupational Therapists treat in clinic. ADLs can be described as the following, “Activities that are oriented toward taking care of one’s own body… These activities are ‘fundamental to living in a social world; they enable basic survival and well-being” (Christiansen & Hammecker, 2001, p. 156).

Under the umbrella of ADLs, occupational therapists address the following:

  • Bathing and showering
  • Bowel and bladder management
  • Eating and feeding
  • Functional Mobility
  • Personal device care
  • Personal hygiene and grooming
  • Toileting hygiene
  • Dressing

For children, once they have mastered putting on and taking off clothing, it is important to be able to manage the fasteners of their clothing independently. The mastery of clothing fasteners leads to greater independence and less frustration and distress during morning routines, during toileting tasks, and when out in the community or at school when assistance may not be available.

Examples of areas of dysfunction that can affect a child’s ability to independently master clothing fasteners may include:

  • Vision: Is the child able to see the clothing fasteners to be able to manipulate?
  • Cognitive abilities: Is the child able to sequence the steps of the task (i.e. steps for tying a shoe, placing zipper in catch before pulling up)?
  • Body awareness: Does the child know where the clothing fasteners are in relation to their body.
  • Strength: Are they strong enough in their hands and arms to complete the task?
  • Endurance and body posture: Are they able to complete that task in a timely manner without becoming fatigued? Do they have the correct body posture to complete the task to reduce fatigue?
  • Attention: Does the child feel rushed or anxious? Is there something distracting them in their environment?
  • Fine motor dexterity and motor planning

Depending on which areas of dysfunction are hindering a child’s ability to participate in completing their clothing fasteners independently, an occupational therapist will have the child participate in a series of goal-directed and functional activities. Examples of activities could include:

  • Theraputty tasks and resistance training to increase finger and hand strength.
  • Weight bearing, throwing, and heavy work/resistance activities (yoga, animal walks) to increase arm strength, motor planning, and body awareness.
  • Bilateral coordination tasks: One hand stabilizes object (small container) while dominant hand places object inside, mixing ingredients in a bowls, etc.
  • Sequencing tasks to increase ability to follow sequencing of tasks.
  • Simulated dressing tasks off body to allow for greater visual ability.
  • Fine motor tasks: stringing, stacking, picking up small objects with thumb and index finger and placing in slots/small container.
  • Gross motor/kinesthetic learning tasks: practicing steps of tying the shoe lace with large rope

Modifications may include:

  • Larger buttons and zippers
  • Longer pull for zipper
  • Modified shoe laces
  • Button hooks
  • Velcro for fastening pants or shoes

To learn more, below are recommended references:

References are for informational purposes only and they are not intended to replace physician and/or occupational therapy treatment(s).