Imagine you’re cooking a meal for new friends. The challenge is that you don’t know their needs and preferences. In this case, you’ll cook up a variety of dishes with the hope that there will be something there that everyone can eat. It’s a good meal but it’s clearly not customized to the needs of each person.
Now compare that to the precision of a personal chef who is designing a meal specifically for you. They are going to create the meal around your exact preferences, dietary needs, and health goals. The magic here is that they know how to combine ingredients to create a meal that you both enjoy and fits into your overall needs and goals.
If you had dietary restrictions and health goals related to food, you’d likely pick the personal chef over the family-style potluck every day of the week.
This little scenario illustrates a needed perspective shift in healthcare and even occupational therapy today. Too often, healthcare is a guessing game where a buffet of options are offered with the hope that something will hit the mark. However, it’s not the same as serving up a healthcare experience that’s personally designed around your exact preferences and needs.
Cue the movement towards precision in healthcare to make the experience more personalized and effective. And while outdoor occupational therapy doesn’t provide healthcare in the traditional “medical sense” there is a lot we can continue to learn from this movement.
What does precision healthcare mean?
According to Dr. Virginia Spielmann of the Star Institute Sensory Symposium,
“Precision in healthcare is when we use all the tools that are available to offer personalized therapeutic supports that optimize outcomes for a client.”¹
This includes connecting the latest research, technology, and a collaborative team approach with the specifics of a dynamic and changing client including their genetics, neurology, social, and environmental factors¹ ²
In a nutshell, there is magic when the right activity is provided to the right person, in the right way, at the right time. Where the plan isn’t one that was pulled off the shelf, but one created specifically FOR a child and their family.
Let’s take a look at what precise, individualized occupational therapy looks like(3) and how we implement this at Bearfoot Occupational Therapy.
The Bearfoot Journey Toward Personalized Care
From the beginning, Bearfoot OT has always been focused on providing sessions, ideas, and goals unique to each child. After recently learning more about the concept of precision healthcare, we’re now wondering, “What if we take the individualized care that we’re already good at and do it even better?”
To give you more context, here is what the owner of Bearfoot OT, Marika, has to say when reflecting on what it means to provide individualized care…
“Back in my early days of being a pediatric occupational therapist, I personalized my sessions for each kid — but not as much as I do now.
For instance, when I worked in a pediatric clinic, I used to set up an obstacle course in the morning and use it for all my clients that day. And it was fun! The obstacle courses were beneficial because they allowed kids to work on a variety of important skills. It wasn’t harmful, it wasn’t bad therapy, but now I look back and see that it wasn’t precise. Or at least it wasn’t as precise as it could be, which impacted my effectiveness as a therapist and ultimately contributed to my desire to create Bearfoot OT as a place where OT is provided differently.
And then in 2023, I attended the Sensory Symposium at the Star Institute. The symposium featured leaders in sensory integration and OT, and the rising trend around precision in healthcare was featured. This challenged and inspired me and my team to continue to build on our work to individualize the therapy we provide.”
Occupational Therapy That Treats Every Kid as an Individual
To be targeted and individualized in our approach, the following ideas guide our work with kids:
Every kid is different.
There’s a unique plan, goals, and progression for each kid.
Every treatment session is custom and different.
No one knows everything about a kid so collaboration is key.
Every Kid Is Different
Your kid is not another name on our schedule. We see your child as a true individual with their own personality, situation, special spark, and developmental journey.
Being precise requires us to spend time thinking about — Who is this child, and what factors are coming together in this child’s experience at this time to create challenges and opportunities? That is how we come to each client with fresh eyes to see what they uniquely need.
To do this, we take the time to get to know and incorporate your child’s preferences, needs, family life, and interests.
This dedication to precision is especially true when we're trying to figure out the “why” behind an action or struggle. It’s tempting to quickly label an issue and match it up to a related skill to practice. For instance, consider the example of seeing a kid with proprioceptive issues who is bumping into people and hugging too hard. It’s not enough to label that challenge and simply start dropping random proprioceptive activities into sessions and hope it gets better.
Instead, we get curious and go deeper with the reason for the challenge. Are they having proprioceptive issues because their proprioceptive sense is under-responsive or over-responsive?
Or maybe it’s not a sensory system issue at all.
Maybe what they are doing is communicating that they need more connection with a parent and caregivers. Or maybe it’s a combination of the above.
It’s our job as therapists to examine and understand how all these dynamic and nuanced variables work together. That information is how we’re able to offer specific solutions to effectively address the challenge. Without this level of precision, you’re just throwing random treatments at the wall and hoping some of them are making a difference.
Create a Custom Plan
From this specific and dynamic understanding of each child, we create a unique treatment plan and progression. This is a comprehensive plan that continually guides our work together. Think of it like a roadmap that keeps us focused and moving towards the big picture goals.
This comprehensive plan of care is what guides each session instead of the activities themselves. To understand how this works, imagine the comprehensive plan of care as a roadmap that is running in the background of the brain of your child’s occupational therapist. This means no matter what activities end up happening in a session, we never lose sight of where the kid has been and where they are going. So when a kid shows an interest in climbing the octopus tree in the Presidio, we’re able to follow their lead while keeping in mind the specific needs and goals of this exact child.
The final result is that with precision and expertise — we’re going to customize that activity in the moment to the kid who is there with us. That means we’re always on our toes as therapists — offering different activities, observing how a kid responds, returning to the overall objectives for each kid, and dynamically offering support and skill progression. It’s not easy, but the ability to offer that specific level of support is sooo worth the effort.
Every Session Is Different
Meeting different personalities and needs in a precise way means no two sessions are the same. Each session is individualized and different.
That’s right, you might see us use some of the same items or activities, or we see the same kids from one week to the next, but literally every session is different.
Kids are in different moods or have different needs week to week. On top of that, being outside in nature means we’re adjusting our plans based on current weather conditions or opportunities that nature presents!
In a practical sense, we don’t come to a treatment session with a rigid plan, a one-stop shop obstacle course, or a to-do list. Instead, we follow the lead of the child. And since every child is different, they are going to be drawn to do different things.
Picture this happening in the head of a therapist as a child jumps out of the car, “Hello, what are you wanting to do today? And, “What does your body need right now?
And at the same time, we’re inviting the child into the planning by asking, “What's the weather doing today? And here are some ideas that we can do based on what nature is offering today.”
Does this mean we’re just winging it? Or there is no plan to what we’re doing? Nooo!!!! It’s quite the opposite.
We’re holding all the information about your child in our heads and pulling it together in the moment to create a customized, personalized session each time.
Learn About & Support a Child in Collaboration With Others
Like all humans, your child is a complex individual. And there is no way we can know everything about them from just what we observe during our time together in our outdoor occupational therapy sessions. And the same is true for other people in your child’s life or on their care team.
This is another part of precision healthcare that we LOVE. It’s that this movement values the importance of understanding all the different facets of people. Which then leads to a recognition of the value of different perspectives and areas of expertise¹.
That’s why a key element of precision healthcare is a call for healthcare professionals to work together to share their knowledge to be able to generate solutions that best fit the overall needs of each client².
At Bearfoot OT, we’re big into collaboration and sharing knowledge. Our services include collaboration with other team members like teachers, psychologists, doctors, and parents. That allows us to have more information to provide targeted care, and gives us ways to support each child in other areas of life.
The Power of Connecting Precision Healthcare With Outdoor Occupational Therapy
In our experience, this shift towards precision in healthcare isn’t easy to accomplish because it takes a time, focus and commitment to the goal, but it ultimately provides a better way forward for clients and occupational therapy providers alike.
There are better outcomes when healthcare becomes more precise² ⁴:
Offers more efficient progress towards goals
Improved well-being as individuals feel included & understood
Future problems are lessened or avoided
Care is geared towards client priorities
All of the benefits of precision in healthcare are things we want for the kids who come to Bearfoot for OT.
It’s so worth the extra effort to make precision in healthcare a daily reality. Offering services that are unique to each child, thoughtful, and precise, is not only the right thing to do — it’s the direction where occupational therapy and all of healthcare needs to be going. And we’re here to be a part of it so that more kids get the care that’s right for them.
Bearfoot OT is a pediatric occupational therapy practice in the Bay Area that combines outdoor sessions with caregiver collaboration to help children address social, emotional, motor, and sensory challenges. Learn more about our services.
In case you love research as much as us, here's the references:
Spielmann, V. (2023) . “Precision is…” 2023 Star Sensory Symposium. Denver, Colorado. https://sensoryhealth.org/basic/welcome-to-2023-star-sensory-symposium
Ryan JC, Viana JN, Sellak H, Gondalia S, O'Callaghan N. Defining precision health: a scoping review protocol. BMJ Open. 2021 Feb 16;11(2):e044663. doi: 10.1136/bmjopen-2020-044663. PMID: 33593787; PMCID: PMC7888329. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888329/
Dirette, D. P. (2016). Personalized medicine and evidence-based practice: Merging the art and science of OT. The Open Journal of Occupational Therapy, 4(2), 1. https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=1269&context=ojot
Fu, M. R., Kurnat-Thoma, E., Starkweather, A., Henderson, W. A., Cashion, A. K., Williams, J. K., Katapodi, M. C., Reuter-Rice, K., Hickey, K. T., Barcelona de Mendoza, V., Calzone, K., Conley, Y. P., Anderson, C. M., Lyon, D. E., Weaver, M. T., Shiao, P. K., Constantino, R. E., Wung, S., Hammer, M. J., . . . Coleman, B. (2020). Precision health: A nursing perspective. International Journal of Nursing Sciences, 7(1), 5-12. https://doi.org/10.1016/j.ijnss.2019.12.008
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