Watch How You Hold That Crayon

from the New York Times by Peg Tyre

NOAH LASCANO, 8, had a problem: His teachers couldn’t read his handwriting. His homework became a frustrating exercise in writing once, and then, at the teacher’s request, writing again, just for legibility.

His brother, James, 5, was struggling in kindergarten — even drawing stick figures was a task. When his mother, Paula Lascano, tried to cajole him into completing a few workbook assignments, he reported that “his hand got too tired.”

Like many parents, Ms. Lascano decided it was time for help, so 10 months ago she hired Casey Halper, a pediatric occupational therapist, to work first with James, and then with Noah, once a week. The boys manipulated stiff green putty, put pegs into boards, created chains of pennies and plastic connectors and wrote the alphabet — again and again.

These days, many little fingers are being drilled. Twenty-five years ago, pediatric occupational therapists primarily served children with severe disabilities like spina bifida, autism or cerebral palsy. Nowadays, these therapists are just as focused on helping children without obvious disabilities to hold a pencil.

In affluent neighborhoods in and around New York, occupational therapists have taken their place next to academic tutors, psychologists, private coaches and personal trainers — the army that often stands behind academically successful students.

Tim Nanof, legislative manager for the American Occupational Therapy Association, which has 38,000 members, said it’s hard to know exactly how many children are receiving these services. But parents, pediatricians, educators and early childhood experts agree that plenty of able-bodied children are receiving occupational therapy.

“Twenty years ago, you could find O.T.’s working with children at hospitals or schools for the blind or the deaf,” said Christine Berg, who oversees the curriculum for the Program in Occupational Therapy at the Washington University School of Medicine in St. Louis. “Now, many pediatric O.T.’s see their role as promoting fitness and enhancing kids’ performance in school.”

Pediatric occupational therapy may be something like Pilates for the pint-size set — a regime of techniques that promise to bestow unique benefits on the practitioner. Or, like the increase in neuropsychological testing and in the use of drugs to enhance a child’s attention, the increase in therapy could suggest something may have gone awry in schools, in our level of academic expectations or perhaps in childhood itself.

“On one hand, I think it’s perfectly in line with the contemporary trend for parents and educators to seek high-priced specialists to treat the routine problems of childhood,” said Dr. Philippa Gordon, a popular pediatrician in Park Slope, Brooklyn, who is a medical adviser to the highly opinionated Park Slope Parents Web site. “On the other hand, I see that early intervention can keep little problems from becoming big ones.”

Linda Florin, who runs a private concierge service in Manhattan, paid a therapist $125 a week for nearly three years to help her son, Wyatt, now a first grader at Columbia Prep, improve his hand strength and control a pencil. She says it was money well spent. “School isn’t easy and it gets harder as they get older,” Ms. Florin said. “I wanted him to be able to keep up with everyone else.”

She also said the stigma is gone: “Back when I was a child, seeing an O.T.? Forget it. That was for kids who had spinal cord injuries.” Last year, she said, so many friends from her social circle were taking their children to occupational therapists that it seemed like a part of normal childhood.

“Seeing an O.T. was once an admission that something was seriously wrong with your child,” said Paula McCreedy, who, with her partner, Prudence Heisler, opened a branch of their busy Greenwich Village practice in Brooklyn Heights in part to meet the growing demand of private paying families seeking therapy. These days, she said, “many parents are finding that pediatric occupational therapists can help their children to be the best that they can be.”

In Manhattan, the brutally competitive nursery and kindergarten admissions process is leading many parents to sign up their toddlers for therapy. “Preschool admissions tests loom large,” said Margie Becker-Lewin, an occupational therapist on the Upper West Side. “In many cases, parents know there is nothing wrong with their child, but they feel caught in the middle.”

OT and Handwriting