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Tobi Muftau-Lediju, OT

Jun 20, 2024

Tobi modifies video games as a therapeutic tool to help clients reach their occupational therapy goals. We talk about the importance of play and how to deal with the screen time dilemma.



Brennan Barber  0:31  

Welcome to the Theralinq podcast where we dive into the inspiring stories of individuals dedicated to reshaping the disability ecosystem. Join us as we explore the triumphs, challenges, and innovative solutions crafted by changemakers, striving to create a more inclusive world, from passionate advocates and trailblazing entrepreneurs, to the resilient individuals breaking down barriers. Each episode shines a light on the progress being made, and the work still to be done to create a more equitable society that enables every individual the chance to reach their full potential, get ready to be inspired, informed and uplifted as we hear from those who are reshaping the narrative around disability.


Bethany Darragh 1:18

Today on the podcast, we have Tobi  Muftau-Ledijuf. We're so excited to have her she's an occupational therapist, and she has a different perspective than we've heard before. But we'll let her tell you more about herself. Go for it Tobi.


Tobi Muftau-Lediju  1:32 

I'm an occupational therapist who loves using video games as a tool for skill development. I first started as a one to one which is a patient observer in the brain injury unit. And my mom was the person who kind of got me into like therapy before I became a one on one. I was you know, always kind of looking for something to do. My mom is an African mom. So she really always had my future in mind and she made sure to let me know she was thinking about my future. So she was like, You should come and see what they're doing and everything like that. And I was like, No, I want to be creative. I want to be a writer, Mom, I want to do things and she's like you can do things here. And you know, at first I was observing the PTs and I was really drawn to what the OTs were doing. And I saw this guy who was just like high fiving all these people and I was like, oh my goodness, he has so much joy like in his heart what is what's going on? And turns out he just for the first time did his ADLs independently. So that was something I was like, wow. If I could do that people, you know that that could fulfill like my cup. And you know, I became an occupational therapist and went to school and got my master's. And I did assistive living for a little bit. didn't really like that so much. So I went full circle back to where I did my one to one patient observing and actually did that for five years. So I got used to that, you know, experience working with brain injury clients and de-escalation and taking them to therapy and stuff like that. So when they saw me come back and apply they were like, okay, full circle. And it was great because I got to be with almost like the hospital family that I kind of grew up with. And I did brain injury for almost like two years and around the two year mark. I unfortunately hurt myself and my back and I was like you know what? I recall my teacher saying you will be so good and like pediatrics and I was like no, I'm scared of parents but turns out like I absolutely loved it. I love the fact that I got to play games and play games with kids and, and work on addressing all these skills and as a lifelong gamer in my OT brain and just how it works. I was like I'm doing all the skill development while I'm playing games. So why can’t I apply that with my clients? And that's what led me to be here.


Brennan Barber  3:57

That's great. Thanks. So I'm super intrigued by your perspective, and really how you're utilizing gaming as an extension of OT.  A little background so I have a six year old almost seven year old son with cerebral palsy, and I've seen this in action with him. He's very much into games, and I've found that in a lot of ways that's helped him develop some of his fine motor skills as he's worked with a stylus on an iPad. I'm just curious. Do you have a protocol that you follow designed to continually build skills with children?


Tobi Muftau-Lediju  4:33  

Well, that is a complex question only because there's so many different types of video games. And there's so many different types of input that we can do through video games. So like my protocols always from a strengths based approach of like, what can you know the client I'm working do and what do they love? Can I connect something that they love through a video game? And when you expand your mind into just how many video games are out there? Guarantee you can find one? You're gonna find a one or two that you know definitely, you know, fulfills that cup for that client or fulfills their spoons. What have you and I think my general protocols of course I check the age of the rating of the game because some kiddos like to choose games, they're not quite the age rating that they need to be. And I'm like, I'm smarter than the average bear. So I like to make sure I check. I check that and I check in with the parents and let them know about the game and what they'll be doing. I make sure that I'm attaching a skill to that. And then I my protocols are like, you know, can they access the game? Are parents on board or is the is a child on board. And you know, we take it from there and we build on the strengths and movement that they already have and just making sure that I'm there to walk them through and coaching.  Sometimes, the video games that I use are in a way preparatory for also like social stuff too, as well. One of my clients that I love talking about a story all the time. Her goal was to be able to play Minecraft with her friends, but she had ADHD and sometimes all the demands were really hard for her. So I basically was like, hey, I can run a Minecraft server. And in the back end side I basically in this is kind of where it goes in the therapeutic gaming. I basically changed the environment to suit her just right challenge. And I was like here's your main quest. What's our main quest? You'd like to build a house and shelter is like yes, me while I'm like deleting all the zombies that she has no idea about. Just trying to make sure if their therapeutic environment, it's safe for her. Um, and I made sure I kept her on track. And then where I work with, you know, OTs, I was mindful of the cues that I gave her I was gradually decreasing the cues. I was instead of me just saying oh, you know, you have two things to do. What are your two things I would just say what's next? And so eventually she in a way got into a rhythm of being playing Minecraft in survival mode that she didn't need me anymore. She already knew her objectives how to keep herself safe what to do if I didn't have my sword at the time and zombies chasing me, what I could do. We already went through all those things together so she could practice that and play with her friends, which is like my end goal for all my clients is for you to eventually not need me. Yes, check in I love the little things you sent me but I want you to be independent.


Bethany Darragh  7:35  

Yeah, I love that. So how do people find you? Are you are you working with kids virtually or in person or how's that work? 


Tobi Muftau-Lediju  7:43  

Right now I pause I used to do a lot of virtual clients where I but I pause that because I'm kind of deep diving into networking in the game industry. And that takes a lot of time. A lot of time and also a lot of travel and stuff like that. So and consistency is key right when you are working with clients. So I kind of like I kept my clients until they were ready to be discharged and I didn't take any new clients. Right now I'm restructuring myself to have my own business. I want to be seeing clients but I want to keep my clientele low number because I am networking with some companies I can't talk about now. But good things for me. But I don't ever want to leave that space. I still want to be able to apply video games therapeutically and play games to kids. I think that's what really fulfills my cup at the end of the day. But I also want the game industry and other therapists to know like use these tools. They're there.


Bethany Darragh  8:43  

Yeah, I hear you say everything you were saying about Minecraft. I'm just it just is all therapy language. But then you talk about manipulating a game and my head just like explodes like what. So yeah, I'm very excited to hear what you're doing next because I want it whatever it is. But I do want to ask you a question. I want you to just talk about play and talk about the importance of play as a modality and as an end goal, if you don't mind.


Tobi Muftau-Lediju  9:12 

Oh, I don't mind at all. So oh my goodness. Wow, play. You've opened and unlocked my soapbox, Bethany. Play is such I don't know. I feel like it's like maintenance for your brain almost inspires creativity in allows people to socialize and engage with stuff, especially when you talk about you know the different stages of play, which we also like all know, um, there are different cool stages of play where I like to at least talk about unoccupied play a little bit because we always like to just put that in a child children's perspective. But we also don't realize that adults also do this as well. When unoccupied play for any parents or anyone who else is listening is basically unstructured play. There is no means there's no end to it, but it's purely exploratory and some of the greatest inventions that have been made by adults today have just been scientists just putting things together and seeing like what sticks. So, um, play I think is the foundation of a ton of things that could work your brain in so many different ways. Play is something that you do from childhood to adulthood. And I think it's very important to remind ourselves even as adults that we still need play, play is re-energizing. Play can do a host of things. I can go through the six stages of play. That would probably be really long. But um, I like to remind people and parents alike play is very important and engaging with your play engagement in play with your children is also really important, especially when you want to tickle the imagination, parts of their brain, you know, being able to take something that's concrete and make it abstract is such a wonderful thing. And I feel like it's really important when we give and it's also really, it's also really cute and funny when I watch when I teach a parent how to play with their child for the first time. You can always tell a parent has never like played played and they're like, oh look, this is the car and then the child was like put it's a spaceship now and I'm like, yeah. And then you know, it's like I'm gonna do like a little coach like yes, go with it is a spaceship. And it's flying because he's picking it up or they're picking it up and they're flying all around. Now it’s a spaceship. Where do you go now? And it's such a really it's a beautiful connection when you watch parents just like no way let go. And just like just get down, have fun with their children. And then also, I think it also feels their inner child too, because they're, it's almost like you can apply that with other things too. You know? Especially when you're thinking about new creative ventures and business and stuff like that. Sometimes you got to pivot. And sometimes if you haven't really stretched those creative muscles, it's hard to pivot to different things. I hope that answers.


Bethany Darragh  12:07  

Yeah, and I think that a common held belief about play and maybe a misconception I kind of want to hear your take on it is that there's a hierarchy to play and like some plays are more elementary and some are more mature. And I think that there's value in all different types of play and we're not going backwards if we're doing parallel play instead of cooperative play. So kind of what's your take on that?


Tobi Muftau-Lediju  12:36  

Um, my take on that is basically similar to that because I have an example parallel play that I enjoy also as a neurodivergent person. I enjoy just being in a room with my favorite person and we don't have to talk. He might be on his phone. He might be on the switch. I might be on the switch. But that fills my cup and like we're both doing different things, but I like his presence there. And also it still feeds into my self advocacy and my self esteem and my boundaries because I'm like, Hey, I just want to engage in this way. And this makes me feel good. This regulates me and a lot of people who may not know it, engage in parallel play. I think it's not that we have tech in our lives in our hands. There's a lot of people who are doing parallel play and have no idea.


Bethany Darragh  13:27  

Yes, yes. I think it was a good reminder, you just said that. You know, a lot of the creators and inventors in our world were kind of absorbed in their own independent play because I hear so many parents stress out about they only play with themselves they don't play with other people you know, and and I you know, it's like you just got to get down and parallel play with them, you know, and, and wait for them to show you something or interact with you and I think something that also was really touching for me is that documentary on Netflix about the Rubik's Cube. Have any we've seen that documentary? You gotta watch it. But this mother, you know, she was talking about how she was concerned about her child not playing normal, you know, and then she finally just decided I got on the floor and just entered into his world and then she kind of discovered that she was doing a Rubik's Cube next to him. And he just kind of looked over and suddenly had this joint attention and suddenly, he's doing it perfectly, you know, and she's like, if I'd never sat down in parallel played with him, I would have never unlocked this passion of his you know.


Tobi Muftau-Lediju  14:37 

I have a story that, like, speaks to that too. There was a little boy on the spectrum, who mom was concerned about that too. He only plays and he his he loves watching things drop and fall. That was it. That was his whole thing that he loved doing. And mom was really concerned that you know, no one's in his bubble. He doesn't let anyone in his bubble. And I literally did what you know, spoke about drop down next to him. And then I started dropping things. And then I noticed like, I would pause and hold it and you wait for me to drop and I would say, ready, set, go and then he would drop his at the same time. I was like, That's engagement. There. There it there it is. He let me into space he let me into his bubble. And I was like you it may not be as complex as played as you think it is. But this is him going like I'm playing with you. This is play this is I want to be with you. I want you to enjoy the things I'm enjoying. And that really does help turn the perspective around into like a positive. It's a beautiful thing when when you watch someone like unlock that as a parent I would say my last thing on that


Brennan Barber  15:51  

What's interesting is some of what you're talking about is it almost seems counterintuitive in some ways. And I'll clarify that. So recently, I started reading a book it was called Stolen Focus. And the idea is that we are the general concept is that we are flooded with inputs constantly in our lives right now based on all the digital tools that we have. And because of that it's stealing our ability to think more deeply on topics. it's stealing our ability to focus and it's solely on complex problems that we come across in our day to day lives. What's really interesting though, is what you're describing is like almost a twist on cognitive development social development where through gaming through these inputs. We’re almost unlocking certain parts of the brain that maybe haven't been engaged as much as could have been at certain points in time. Would you say that's an accurate kind of description or what's your take on that?


Tobi Muftau-Lediju  17:03  

So My take on this is like, you know, when we are not? What's the word when we're not we're not when we don't pay attention to how tech is made and the reason of why it's made it kind of leads to those things. Because you know, a lot of apps that are made solely entertainment are made to take your attention. They're made, they get paid for how long you stay with their, with their application. And I think when we empower consumers and we empower you know, parents to understand what is the intention behind the app and what is the rationale. You know, everything has a purpose, you know, even to the day they've hired lawyers and neuroscientists to help build these products for purpose to grab your attention the longest so when you are aware of those things, I feel like that can shape how you use the tech that can shape your boundaries on the technology, and also in video games too. When you start to notice the rationale between why things are placed in video games, you start to also understand the you know everything comes with, you know, positives and negatives, right. You start to understand like, you know, some of the monetization things that are put there on purpose, you know, but when you educate also parents on those and they educate their children, they become less susceptible to those like monetization things and then they tend to use the tools more effectively that aids them. The way I would say that you want to approach is to do as much education on the tech itself. So you understand what are the what is what is really grabbing your attention and what for what is it made for? What does it mean to do?


Brennan Barber  18:49  

I think you're totally spot on. I think that there's Tech for Good and then there's tech that's used as you know, a tool for whether it's distraction, whether it's some ways even like nefarious means. You actually touch on a another chapter in this book where they've, the author has identified some employees that have worked for some larger social media companies and really uncovered the incentives that they have which ones keep people engaged, and stalker, you know, enraging material is engaging material. And one of the key arguments that the author ends up making is how, you know, technology can be a tool for good and there are a number of people within big tech companies that see this opportunity. And now that it's become more prescient, more noticeable in our day to day lives of how certain platforms can be manipulative. There's a bit of a focused effort on, you know, shifting away from those types of incentives and utilizing technology in a more conducive manner. So really interesting insights on your part there that align very much with, with that general narrative.


Bethany Darragh  20:20  

Tobi , Do you mind sharing a little bit about that recent WebMD article about gaming?


Tobi Muftau-Lediju  20:28  

Okay, so um, WebMD came out with an article basically acknowledging that video games can be beneficial for people who have ADHD, people have anxiety and depression and stuff like that. And my only caveat with that and I was like, Woo WebMD, like featuring video games. Yes. My only caveat is that as in you're gonna find this strange, but let me explain. It said that anything over 10 hours a week is excessive video games. And the reason why it had my brain thinking was like when someone we talked about accessibility and we talk about gamers, right, but it's a whole collective and a spectrum of people. Some people who are homebound who need video games as their only social input. When we start putting a broad number. You it's almost like, you know, we get to we're limiting how much time someone gets like oh, yeah, you only had 10 hours with your friends a week. And that sounds so weird to me. That sounds really strange. And I think we have to be I'm glad WebMD made an article, but I think we have to be careful on how we define screen time and how we define that, that in general because we might end up hindering a lot of other things when we're not clearly defining you know, video games and video games can come in all shapes and different sizes and you know, and forms and some video games you can play by yourself some video games, you actually need to work with people, you actually need to socialize and work with people towards, you know, an objective, and, you know, those kinds of games, you know, I kind of want to make sure that we were like, careful on how we you know, define what's too much because you know, that might be someone's you know, lifeline, and we don't know and not all video games are isolating if I want to just emphasize that too as well. Especially when someone meets in, even if they're playing alone. People met on Discord and have like a collective of they're playing video games but they're 10 other people who are talking with them talking about their whole day and it sort of goes into like you know a little bit like parallel play Discord is an amazing thing for that. People can be playing on separate games and still have you know, other people listening to you may not even talking but they like the presence of other people there.


Brennan Barber 22:54

So it’s really interesting too because as a parent I have this struggle with my son because he loves his ipad and for him it really is a tool that he has the most control of.  He has spastic quadriplegia due to his CP.  He also uses an AAC device to communicate and what he considers video games sometimes, I would not consider a video game, like google maps.  He loves maps.  He’s come up with a short hand for video games as well, so if he wants to play he will just say VG.  He’s created this love for geography and through that he plays stack the states and wordle.  


Tobi Muftau-Lediju 25:28

I love that he has expanded his work through video games.  I am excited for him and I haven’t even met him yet.  As a therapist I am just hearing great and amazing things.  A door was opened for him for access and he took it in stride.  The screen time question comes up all the time.  Look at it this way, what is your child getting out of it and is it impeding the things that they need to do to survive?  If it’s not hindering those things and it is self regulating then it is a regulation tool.  It is also ok to encourage parents to help them find a different regulation tool.   


Bethany Darragh 28:14

Is there a certain population that you find gaming as a therapy works best?


Tobi Muftau-Lediju 28:21

That’s also a complicated question.  People say that kids are easier to get into video games but believe it or not I’ve met kids who do not video games due to visual perceptual skills.  We now have adults who grew up playing video games.  I am seeing more adults who like video games and tech is more immersed in our households, grandpa can play wii sports with us.  There’s a really cool company called Tilt 5 that’s an AR game.  We know that the aging population lives longer when they are with younger generations.  I see Tilt 5 emerging in the geriatric space.  


Brennan Barber 30:51

Do you mind talking from a physical standpoint how gaming can be beneficial?


Tobi Muftau-Lediju 31:23

I love doing Just Dance for motor coordination, even when it comes to left right discrimination.  Populations in the hospital system who need to work on those repetitive movements.  We need more game devs in the health tech industry.  You can’t sterilize fun. 

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