Ladder Approach

The ladder Approach was developed by an occupational therapist specifically for treating patients in the NICU.  Lisa Bader developed this tool to assist therapists in the NICU to have more direction and confidence when treating babies.  I personally found this tool helpful because it enabled me to think through my intervention sessions more clearly.

The ladder approach breaks down sensory development and describes it as steps of the ladder. A baby first begins developing their tactile system within the womb, and this system is the first to fully develop.  When treating premature infants, this system is the first to be addressed during interventions before progressing to other sensory systems in case an infant's brain, developmentally, is not ready to progress.  As stated in the manual, the tactile/proprioceptive system develops first, followed by vestibular, olfactory/gustatory, auditory and finally the visual system.

My therapy sessions always began addressing the tactile system to give me an opportunity to read the infant's cues and better understand what they could tolerate during the session.  If appropriate, I would then progress up the ladder to continue working on other sensory systems.  Within each sensory system there are various interventions and techniques which can be applied.

I was thankful to have found the ladder approach and have the opportunity to use it as a supplement to this rotation.  It further developed my understanding and knowledge when working with my mentor in the NICU.  This approach allowed me to better organize treatment sessions and better treat my patients.

For more information visit: http://www.otptinthenicu.com/