Updates from Pittsburgh!

So right now it looks like we'll be leaving Pittsburgh around 10pm and getting in around midnight-ish. Funnnnnnn!!!!!

THE GOOD NEWS IS!!! Holly Hendryx, OT Vice Chairperson, showed up for a 650 flight to Minneapolis, and so she and I got to talk a long time about random OT-related things!! She was great! Haha look at me sucking up! Just kidding, I'm just telling the truth. 🙂 Anyway…we're just chilling. Our desk-lady (I mean ticket agent, according to Cheryl) is pretty fun so she is nice, and Cheryl and I have already gotten ice cream. I want to put up video/pictures and look through my notes to share more about conclave, but I guess it will be at least tomorrow.

Luckily Monday-Wednesday won't be horrible days, so maybe I'll survive the next few weeks…for a while I wasn't sure! Let's see if I can answer some e-mails now…oh wait, new tangent

BTW, two University of Alabama, Birmingham girls were also going to be on our flight (OT students that is) but due to the delays they got re-routed elsewhere. It was odd because one of the two girls is a girl running for Communications and Advocacy (Shannon Lindsey(sp)) and I had been talking about her earlier with another UAB girl, so it's really a small world! Plus, an AOTA staff member asked me if Rosemary (one of our professors) was still at UT Memphis – she apparently used to work with him like 12 years ago. She is legendary apparently!!!!!!!!!!!

Okay Cheryl is curled up next to me in a chair and I swear I'm gonna catch up on e-mails. No more tangent until tomorrow, unless I am wired when I get home tonight.

Yay for occupational therapy, boo for airport delays!

Guess who is stuck in Pittsburgh???

It's Sunday night. I checked out of the hotel at 1pm, got to the airport around 2pm…for a 5:45pm  flight, since there was nothing else we could do. Unfortunately, our plane has been continuously delayed, and right now instead of getting home at 650pm it will probably be closer to midnight. I dunno about y'all, but sitting approximately 12 hours in an airport and/or plane for a two hour flight, basically sucks. At least this airport has free wireless. Although my password will probably get sniffed and my identity stolen and someone will take over my life and IT WOULD BE THE END OF THE WORLD!!!!!!!!!!!!!!!!!!!!!!!1111!!!!!!!!

Just kidding. I'm delirious. I'm gonna let Cheryl check her e-mail, and then may catch up on old e-mails and blog entries from this weekend.

Saturday, November 17th, AOTA/NBCOT National Student Conclave, in Pittsburgh, PA

Saturday, November 17th, AOTA/NBCOT National Student Conclave, in Pittsburgh, PA

Today started at 6am (5am to my Central Memphis brain) after a night of tossing and turning! Registration was at 7am and went smoothly. We got our name badges. I ran into Holly Hendryx, who is current OT Vice Chairperson of the ASD Steering Committee and has the position I am running for!

Breakfast was my only real complaint for the day – it was limited to sugary breads/muffins, yogurt, and sugar fruit drinks. And it was expensive. I got a bread, yogurt, and grapefruit juice for 6.50! The main issue I have with it is that it was a hypoglycemia nightmare.

By 730 I had sat down with some Ohio State University girls, all of whom were very nice. One of them (Sarah) is running for Communications and Advocacy on the ASD Steering Committee, which is the same position my classmate Brooke is running for. She was a pro at walking around greeting people. I'm a little shyer that way, I was envious.

Due to technical difficulties with the Powerpoint, we got started with the welcome ceremony/key note address around 815 instead of 8am. Penny Moyers, president of AOTA, was supposed to speak, but there was a death in her family this week and so she could not make it. Instead, Dr. Florence Clark (sp) spoke to us about the Centennial Vision. I'm telling you guys, my blog is the epitome of Centennial Vision!!! Anyway…that was fine. Then we all bolted because there were four concurrent sessions from 9am to 10:30 and most of us wanted to be in “Empower your future: Fieldwork Education Strategies for Personal Satisfaction and Professional Success”. Kim Dickinson, current ASD Steering Committee Chairperson, was on the panel, since she is currently in her Level II fieldworks.

Then we spent some time with exhibitors. I ran into Josh who helps run the RehabCare blog, it was fun to meet him in person! I had been wondering if he'd be there. We got lots of free pens and stuff from the various vendors. And of course valuable information as well. 😉

The second session I went to was “How to be a successful agent of change: helping your new colleagues understand occupation-based practice”. This was essentially a lecture on avoiding cone-stacking and arm bike, unless you can really clearly articulate why what you are doing as a preparatory method will help that client with their future occupational performance/participation in meaningful activities.
 
Then it was lunch, which was MADLAM or whatever that word is. Oh yeah, bedlam. It was yummy pizza and pasta and salad. There was more Centennial Vision discussion as well as networking going on. I sat with some Virginia students.

Then I choose to go to the session on “reimbursement and documentation primer for the new graduate”. Unfortunately the room was so hot I thought I would die. Plus, while I know it is important material, it wasn't what I really needed at this point in my OT student life. So I ended up sneaking out guiltily, but took a much needed 15-minute nap. I am sooo tired. At least I didn't drive 9 hours to get here like the Wash U. girls did!

Then it was time for an introduction to NBCOT to learn about our national qualifying exam. I ended up randomly sitting with some Wash. U girls (12 of them were there), and I ended up actually sitting next to one of my opponents for OT Vice Chair! Her name is Erin and she's pretty cool, but I'm going to try and hate her anyway. Just kidding. She is great. But vote for me anyway. 😉

And then finally, I went to “tools for transitioning from student to entry-level practitioner”. By then it was 620pm and I had been on my feet for 12 hours and I am exhausted. BUT I'm going to go back downstairs soon because at 730pm a group is going out to eat etc, led by Pittsburgh native students, and we might get to go ice-skating as well. I have a few pictures and a little video, but not as much as I'd like. I'll probably get that up tomorrow.

I'm missing a sheet where I wrote down some information I wanted to share that I think is in my bag…plus this is plenty long. I'll flesh it out later. Just wanted to type some of it out while it was still fresh. I think I'm going to lie down for about 15 minutes before going downstairs.

So far, with the exception of crushing crowds at break, it's gone incredibly smoothly and everyone is really, really nice!

I AM IN PITTSBURGH!!!!!! STUDENT CONCLAVE!!!

Today's schedule:

9am -3ish Get up. Pack. Slowly. Agonize over what to bring and what to wear! Organize conclave materials and figure out hotel/plane/conference stuff. In general get stuff together, since life has been pretty hectic!! Get to miss leadership this afternoon in order to prepare/be able to get to airport early

3ish: Get picked up. Driven to airport by kind friends. Am very, very early, due to paranoia over missing flight since it is a Friday afternoon and you never know about security and missing this flight would be like a loss of hundreds of dollars blah blah blah.

3ish + 5 minutes: Walk in, one person in front of me in security line, gate is first one, have completed entire airport mission in 5 minutes. Meet Cheryl, fellow OT student, at the gate. Have several hours to wait.

Plane is about 20 minutes late. Sit next to lady who says not a word. Read, listen to iPod. Get nervous about tomorrow and doing lots of networking.

10ish: Get into Pittsburgh. Wait for shuttle. Meet one older OTA and two Puerto Rican OT students (did you know Puerto Ricans are under AOTA?). Find out that having a student ID is the difference between paying $38 for a roundtrip ticket versus $20 to get to the hotel from the airport. Sad because I did not bring student ID. Glad because lady let me do it anyway. Find out Pittsburgh is gorgeous at night, and there are tons of people on the streets. Too bad we got in too late for the fireworks.

Now it's almost midnight, I'm checked in and using the free Internet to check in with my OT peeps and then I'm going to bed.

Tomorrow I'm going to be up at 6am and put on a new outfit that Virginia designed for me that every other girl in the nation has already worn, but I'm always behind on the fashion curve. Because I just am. I'm a 90 year old at heart, I truly am. Okay I digress

7am is registration/breakfast, then things get started around 8ish…I plan to network, network, network….campaign….learn learn learn….blah blah blah. I'm excited. This is such a great opportunity. 🙂

I'm trying to take a little video on and off without getting too annoying, and will also try to get in some pictures. Seeing as how I'm all historian-like. More tomorrow!!!

YAY OCCUPATIONAL THERAPY STUDENT CONCLAVE!

Allens Cognitive Level Screen – lab for Occupational Therapy Students

The leather lacing assessment to determine Allen Cognitive Levels (called the Allen Cognitive Level Screen) is pretty neat and it really is used a lot in mental health. You can get it online for about $15 from http://www.allen-cognitive-levels.com/ It comes with the leather patch, the needles/threads needed, and the manual! We had to show one of our teachers, Rosemary, that we were competent doing it, and she role-played a client. For my friend Brooke, she kept complaining she needed a cigarette break. For me, she kept saying she already knew how to sew, this was a waste of time, she could do it with her eyes closed, etc. It was pretty funny. You have to instruct the client on three stitches (running stitch, whipstitch, and single cordovan stitch). Based on their abilities, you use the chart in the back to determine their cognitive level. You also have to make two mistakes on purpose and make them find it!

There are two versions of the video, because the first day we did it impromptu, sticking the camera on a pile of books and with an overly full memory card, so we kept having “commercial breaks” as the memory card filled up. In that version, I am the (relatively angry looking?) client and Allison is the therapist. In the second version, Allison is the client and Kerri is the therapist, and I’m recording. Poorly.

By the way, there are a ton of other assessments that are used in conjunction with the leather lacing. Like the Allen Diagnostic Manual or ADM(using crafts to assess ability), and the Routine Task Inventory, or RTI – which is free online at Claudia Allen’s website listed above.

*Thanks to Allison again for her help with filling in some gaps

Brain Train – Technique for OT Students

Us OT students recently had a presentation (by other students) on Brain Train. While infrequently used by occupational therapists, it is an assortment of computer programs, designed for people of any age who have difficulty processing information. The programs are Captain’s Log, Smart Driver, and SoundSmart. It was all developed around the 1990s. The games can teach self-control/patience, listening, speed, visual perception…just about anything. It may be having to follow directions that are interrupted by crazy noises, it may be having to count a certain number that gets flashed with a variety of other numbers, it may be waiting to answer a simple question until you get the go-ahead, etc. It’s pretty crazy.

UPDATE: I got a question on this game and what is shown in the video clip. Believe it or not, it is working like it is supposed to. It is a game of patience and it keeps making Brooke wait to put in her answer, or it changes what she is supposed to do and make her re-wait. Then Brooke messed up once because hello, HIGH PRESSURE! and it was on a very high difficulty setting…but it really was working correctly, and it was very neat. I recommend therapists look into BrainTrain, especially for kids with ADHD!

Prosthetic Lab for OT Students

We had a man with bilateral above-elbow amputations come in. He used a body-powered prosthesis. We also had a vendor come in from CFI to tell us about electrically powered prostheses.

There are three main prosthetic options
1. Passive, cosmetic arm/hand
2. Body-powered (through cable/harness)
3. Electrical prosthesis…maybe controlled by myoelectric sensors! (see video for example)

A lot of people have unrealistic expectations of how a prosthesis will help them. The truth is that the prosthesis will always be the assistant – it is not a fully functional hand. The ones that look like real hands are really not that functional – the hook is still the best option. Occupational therapists can help with education of this fact. It’s also important that the person with the amputation (it’s easiest to say amputee, but that isn’t person-first language!) understand the importance of checking their skin daily for irritation, how to keep a proper wear schedule, and how to take care of the residual limb/prosthesis.

The OT also needs to work on helping the person review the motions that will be necessary for using the cable-controlled body-powered device. Such as scapular abduction, elbow flexion, shoulder extension, etc.

The OT can also work on body positioning. A person who has had good training will be able to make their hook arm look so natural that you don’t even notice it. If the person does not have good training, it will be immediately obvious due to the awkward and uncomfortable position the person will be in.

Even bilateral amputees can put their own prostheses on, and can be independent in things like toileting, dressing, eating, etc. The toileting thing was the most fascinating thing to learn about. A below-elbow amputee can probably do it more or less the normal way, but if it is an above-elbow amputation, it may need to be done using a heel method or seat method, that allows them to wipe themselves by moving themselves against something stationary like the bathtub edge (with toilet paper put down first). I thought that was pretty creative.

The OT can assist the amputee in learning all the different ways he/she can be independent in their activities of daily life (ADLs). The OT can also educate the person their recreational options, the importance of follow-up visits, resources, assistive devices, and more.

Most of this information was paraphrased from a packet entitled “Adult Upper-Limb Prosthetic Training” by Diane J. Atkins

We had a lab where we got to put on the body-powered harnesses, trying to open and close the hook using their shoulder/arm muscles in various movements, and then playing with the myoelectric sensors

Sensory Integration Lab for Occupational Therapy Students

Your central nervous system can be considered a pyramid of learning. The bottom has your tactile, vestibular, and proprioceptive senses. Then you have sensory systems (like olfactory), then sensorimotor (like postural security), then perceptual motor (like eye-hand coordination), and then finally, cognition, which is where daily living activities and academic learning take place.

“Sensory Integration” is a big thing in occupational therapy, but it’s not what most people think. It’s not passive – it involves active participation from the client. Sensory integration is “the ability of the brain to organize sensory input so it can be used appropriately.”

Tactile System: Important for protection, discrimination, etc. The reason babies like to put things in their mouth is because the mouth has a lot of tactile receptors and so it gives them a lot of feedback!
One really neat way to work on tactile discrimination is to put easy-discernible objects in a little black box or in a bucket of dried beans/rice, and then have the child/person identify the object using only their tactile sense…no looking!

Proprioceptive System: It has to do with position and movement of body parts….like if you close your eyes and someone moves one of your arms, can you move your other one to match it? A lot of children benefit from proprioceptive input, like pushing against a wall or heavy furniture (joint compression). Knowledge of your body’s position in space is important for muscle tone, balance, motor planning, etc.
The little girl I used to work with, Celia, definitely had some proprioception issues. She seemed to have a better “feel” for herself after we would do things like push heavy furniture across the room.

Vestibular System: Figuring out your position of head in space (which therefore affects your body position) – important for balance, muscle tone, visual perception, etc. (This is where you get back into neurobiology and have to discuss things like “the bundle of the medial longitudinal fasisculus”, vestibulospinal tracts, oculomotor nerves, utricles and saccules, etc. I am doing a Level II fieldwork (3 months) in a vestibular program so I guess I better learn this stuff! I kind of think I have some vestibular issues myself!

Many people have sensory processing dysfunction, and there are three types – sensory modulation disorder, sensory discrimination disorder, and sensory based motor disorder.

Pretty much everyone has some kind of “sensory issue” though. Like some people hate getting their hands wet, or touching certain textures.

Some people are over-reactive to sensory stimuli and get really upset with things that don’t bother “typical” people (ie, non-noxious stimuli). Others are under-reactive and these are the people (or okay, kids) who you see rubbing against walls, falling on the ground for fun, leaning into their neighbor at play time…they are sensory seeking!

Now think about how important your senses are in terms of telling you about the world. If they are under active or overactive, it’s going to affect everything else about you!

A big part of sensory problems is dyspraxia, which has to do with a problem conceiving, planning, and/or sequencing new actions. So for example, you might pat your head, pat your tummy, pat your knees, quickly, twice in a row. A kid with dyspraxia would be all over the place trying to figure out how to coordinate their body.

The Sensory Integration and Praxis Tests (SIPT), developed by Ayres in the late 1980’s, are classics still used today!

The evidence on SI tends to be inconclusive in the sense that some studies show it works, other studies say it doesn’t. My opinion is that it can DEFINITELY make a difference for some kids when done by a well-trained and experienced professional, and that it never hurts to have the knowledge or “tools” to use some SI as needed.

I would write a lot more but I have to stop somewhere! Check out the Out of Sync Child and the Out of Sync Child Has Fun, for some great information about SI in kids!

Thanks, Allison, for helping me out with this!

HUGE DISCLAIMER: The information above was my paraphrased version of my own understanding of SI, based on a combination of lecture, books and personal experience. If anything is wrong or misleading or not worded well, it’s totally my fault! And don’t take anything I say as the final word since I’m a student and um, I’d like to become an occupational therapist one day and not be derailed by licensure issues. So go do your own research on SI if you plan to do anything based on this knowledge…I’m just sharing what is in my brain..right or wrong. And from now on I’m not going to even paraphrase lectures/give educational minies, since I’m going to try and stay out of the sticky world of intellectual copyright and all that!

P R O D U C T I V I T Y S P E L L S Y A Y

So, I've been pretty overwhelmed a while now – for a while I had no clean clothes, no food that wasn't frozen or packaged (besides one pickle, and a few cheese slices in the fridge), no clean dishes, a disheveled house, a three inch stack of papers, and oh, I don' t know, way behind on AOL mail, work mail, school mail, and Gmail. I've had a patho final, a peds final, a occupation centered practice in adulthood final, a cranial nerve presentation, and finalized my part of a group case study, within the last few days. As of yesterday though, I got close to done, and got to do two loads of laundry, wash a week's worth of dishes (nothing but cereal bowls!!), organize the conclave material, catch up on a few e-mails (still have a long ways to go to be caught up)….basically am starting to feel like there is a light at the end of this tunnel, assignment-wise.

Next week I need to work on finalizing a community initiative proposal, a treatment project, and prepare for my professional development evaluation…along with figure out campaigning strategies with Brooke, who is also running for a position on that Assembly of Student Delegates Steering Committee.

I managed to write up some SI information and next I'm going to do some amputation material (to accompany the videos) …

Sometimes the irony hurts….

Irony: Spending a ridiculous amount of time looking for a (useless) creative picture of “productivity” to use on a post about how productive I've been in the last two days.