11 Dec 2007

OT Tips from an amazing Preschool Special Ed Teacher…

Bethany, a preschool special ed teacher, wrote me this GREAT letter with some helpful OT tips. I was really impressed with her. I have permission to post. I'll post her e-mail address once I get final confirmation it's okay, if you have any questions. Update: I do have permission. It is InvincibleSummer, followed by @ msn.com.
Update 2: She works in a classroom setting with eight children with special needs, and two inclusion peers.

“
Hi,

I have been reading your blog for a while and it is very interesting and helpful. I am a preschool special education teacher, and so I frequently work with the OTs in my school. Preschool is a world unto itself, and I absolutely love it, but it requires a certain amount of creativity and flexibility. I thought you might be interested in some of the tools, tricks, and such that we have utilized in our classroom.

* Water makes anything more fun. To work on a pincer grasp we have a workbox where students fill different pipettes with colored water, transferring it from one container to another. To work on manipulation of small objects we have a tall tube that is filled with water and topped with a cap that has a slit in it. The students drop buttons through the slit one at a time and watch them fall.

* A ball pit is a lot of fun, but it is also fun when filled with more unusual substances. We have filled ours with shaving cream (about 1″ thick along the bottom), beans, and styrofoam peanuts. A lot of time is spent working with children who have sensory aversions using their hands, but we often forget that they may have the same aversions with their feet. We also frequently walk barefoot on fun textures like bubble wrap and mud, or use our feet to paint on giant pieces of paper.

* Velcro is our salvation. We hold our classroom together with it. Toys are held onto work surfaces, visual schedules are held onto the wall, picture choice cards are held onto cupboards and shelves, and it works well to help create nifty little single strap grips (a piece of fuzzy fabric sewn – of hot glued- into a tube with a slit cut into it to hold the object with velcro to close it around the hand). The best invention is velcro that has both sides on the same piece. Velcro is also great for subtle sensory input. Many of our chairs for circle time have little pieces of velcro on the arms (one arm soft, one arm rough) that the children can rub for input when they are expected to sit still.

* That rubber sticky stuff from the dollar store placed underneath the back two legs (or sometimes all four legs depending on how wiggly a child is) will keep them from being able to wiggle their chair away from the table. Building blocks make great footrests to allow a child to sit in a chair and still have their feet rest on something – the cardboard ones that look like bricks work the best because the chair legs can be pushed right into them.

* Dollar store backpacks on wheels weighted with books are great for slowing down children during transitions. They love pulling the backpacks and it prevents them from running as soon as the classroom door is opened. Obviously the weight is calculated carefully.

* Grip modifications we have used include tennis balls cut to hold a crayon, spoons and crayons inserted into fabric loops attached around a hand, velcro-closed mittens to help hold items (home-made using children's mittens and a velcro strap sewed on)

* For a child with visual impairments, we have used different textures (fabrics) to differentiate his communication switches.

* Whistles have never worked well for my children to encourage them to use oral motor skills for blowing but bubbles are magic. Nuk brushes are preferred when they are dipped in a flavor – I use the powders from the Lik-a-Stik or pudding, or the liquid candy sprays that are available depending on what each child can tolerate. Battery operated tooth brushes from the dollar store are wonderful for children to use themselves for oral motor input, and we try to brush our teeth every day after lunch using them (non-floride toothpaste and toothbrushes kept in individual drawers).

I don't know if any of that helps you, but it is some of the things I have learned over the past year or so in my class. The biggest thing that I wished that some of the OTs I have worked with would do differently would be to not pull a child out of the class activities and work with them off to one side in the corner of the classroom so much. Children do not use their skills in isolation with special toys in the corner of the classroom. They need to use these skills during their regular activities in order for them to be functional. Also, if I am supposed to carry on what is being done, then trying to leave the other children with my assistant so I can work with a child who has the direct attention of a therapist is difficult. This also poses the challenge of generalization, because some children with disabilities will master a skill in one setting but fail to generalize it to other environments or settings. Yet I must say that the OTs (and PTs and SLTs) that enter our classroom, that is in a perpetual state of controlled chaos and high-intensity, are compassionate and talented and rather brave. They never know what they are going to walk into, they have to come armed for being chew toys and art canvasses and living switch toys, and they do it with grace and humor. I have the benefit of orchestrating the chaos, while they work within it and then move on to other children who may or may not cooperate that day. All in all, we do make a good team.

Thanks for writing an interesting, informative, and enlightening Blog!

Bethany

I wanted to comment on what Bethany said about wishing OTs did not pull kids out of normal class activities. It's true the OT should always consider context. Just because a child can accomplish something in a quiet room, does not mean he/she can do it in a classroom filled with distractions. The OT should carefully consider the activities being worked on, and whenever possible, should do just as Bethany said above – work with the kid “en vivo”. 🙂

Thanks Bethany for the great tips!

Category: Occupational Therapy | Comments: none

11 Dec 2007

Oh-Tee Makes Me Hap-Ee

I was wearing my OT jacket on the airport shuttle today, and a person asked me to explain the difference between PT and OT. I really hate answering this question because I feel I can never do it justice in just a small sound bite. I said that OT can be similar to PT in that they can do a lot of upper-body work, but that more importantly, the focus was on the use of meaningful activities, aka occupations, to restore function, independence, and/or quality of life, to people of any age – from preemies to geriatric patients. They commented that that sounded pretty cool, and I agreed. I told them how happy I was that I had found a career I really cared about, and how neat it was that we had so many different ways to help others.

In the last few days, I've been able to give suggestions on basic environmental modifications (maybe lowering work surfaces for someone with a rotator cuff tear waiting for surgery), assistive devices (ice tips for crutches), and more. It was just with friends and suggested informally, since as always, I want to make the disclaimer that I'm A STUDENT and just sharing some of the information I've received…not practicing without a license!!! (::Stares at NBCOT:::) I'm so paranoid. I'm sorry.

It just makes me happy to have a mental toolbox that can help my friends in small ways…

So…a few blog goals in no particular order…

1. Special Ed Teacher Post
2. Discuss Caregiving &Preemie Book I read in Florida
3. More “Cookie Gimp” (disability activist) thoughts…I need to catch up on e-mails from him and will have more to ponder…
4. Talking about the smartest little boy EVERRRRRRRRRRRR who I got to meet in Florida…
5. Talking about playfulness/Greenspan's concept of Floor-Time
6. Talk about a recent victory where OTs don't have to be specifically certified to do wheelchair evals. Or something like that.
6. I dunno – I need more material from people. Send it on!!!
8. Learn to count.

Category: Occupational Therapy | Comments: none

11 Dec 2007

More points from the "Cookie Gimp"

More from the “Cookie Gimp”…I searched everywhere and can’t find this original e-mail, but he told me a lot of disability activists refer to themselves as crips or gimps. It reminds me of gangs! He had some good points I want to share here…it was just one of our many e-mails back and forth, so it’s informally written. Slightly edited to remove identifying information.

1. Re-consider family-centered practice. What is this anyway? Pillow angel is an extreme case that you personally will probably never have to deal with but there’s all kinds of situations, even minor ones, where these issues will arise. Take an easy one (to me): 14 year old gimp has CP. She is happy in a chair. Parents want her to undergo rigorous rehab three times a week even though this will screw up her GPA so she can climb stairs. Client centered? That means nothing. Who is the client. In 1955, she would be taken by force and given PT/OT. Today, I don’t know. Obviously you know what I think but these are genuinely difficult situations.

2. Money will limit what you can do but try to keep your non-elderly clients out of nursing homes. Nursing homes are hellish. They are not client directed. They are like rehab only worse. I was actually surprised what you said about “diapers” in rehab but nursing homes I think do it too. Here it’s solely for convenience of the staff.

3. I do recognize the boundary thing and thought your death posts were moving. But you could extend boundaries in minor ways (no I don’t mean bake cookies for gimps) I mean you could address access wherever you go personally. If you go to a movie with your spouse and the washroom sucks, complain to the manager. They will take it way more seriously from an OT than a gimp. I think THIS is partly a cultural issue because nothing is accessible but you’re also from CA, which creates a bias. Go to states like NY and MA and access is somewhat worse.

Category: Occupational Therapy | Comments: none

11 Dec 2007

Cookie Gimp" says…learn more about Disability Activists

“Cookie Gimp's” Contribution to my Blog:

The best way for occupational therapy students to learn about disability from a rights perspective (I *think* this is what Karen means by frame of reference but I am not sure on all the OT jargon) is by attending a disability rights conference and actually meeting activists struggling to change the world, physically and attitudinally. These are numerous in the US and Canada but the two best are Society for Disability Studies in NYC in mid-June (info at www.disstudies.org) and the Canadian Disability Studies Association meeting in Vancouver (not far from Seattle; info at www.cdsa-acei.ca). Short of that, read No Pity: People with Disabilities Forging a Civil Rights Movement by Joseph Shapiro or Handbook of Disability Studies by Albrecht, Seelman and Bury. Rehab has historically been part of the problem. OT students can be part of the solution if you take the social model of disablement seriously (focusing primarily on strucutral barriers not impairment). Karen already has the right psychological mindset; instead of rating pet injuries by numerical scales, that same instinct can be re-tooled to notice steps/barriers wherever you go.

Category: Occupational Therapy | Comments: none

9 Dec 2007

i am still alive

i will post in the next day or two. my computer was very sick and is being reformatted by my fabulous floridian friends so i am computerless for the most part. I get back to nashville monday night!! have a great weekend!!!

Category: Occupational Therapy | Comments: 1

6 Dec 2007

Books galore…interest in the life of others

Update: Patti, glorious OT student, also recommended this book:

You have enough to read,
but maybe during the next break definitely add “Where is the Mango Princess?” by Cathy Crimmins to your list.
It’s a caregivers experience with her husbands traumatic brain injury. It’s awesome, filled with facts, but also an incredible personal journey.
Oh and it mentions her experiences with OT…. that’s cool too : )

“Cookie Gimp” recommends:
*Rights of Inclusion by Munger and Engel. It’s an American book about narratives of disabled people
*No Pity: People with Disabilities Forging a Civil Rights Movement by Joseph Shapiro *Handbook of Disability Studies by Albrecht, Seelman and Bury.
*Anne Finger’s Past Due, about her pregnancy as a disabled woman.

I leave tomorrow and will be gone 3 weeks in 3 different states. I've asked for blog material and have received a few pieces already. There might be quite a bit of off-topic stuff…just go read the archives for OT-related things. I'm not apologizing because this is a student journey blog and guess what, students get breaks!! I'm busy packing and tying up loose ends today. I had breakfast with OTS Brooke at Brother Juniper's today (yum), and then I hit up the public library…my favorite is the 21-day HEALTH section. I just randomly skim titles until I find titles that look promising – I hate reading books with straight-forward facts – I love reading stories though that have those facts intertwined. I'm fascinated by all medical things and the lives of others. I got this many books (from my hands at my waist to my chin, like Gus the mouse on Cinderella), because I will be spending a lot of time in airports and on airplanes. I did the same thing in June. I can't wait to read some books for fun, FINALLY. I'm sure I'll end up picking up a few more books along the way – I didn't have a list with me to pick up some recommended books. The hardest part is accurately gauging how many books I can get through in a day of travel since books are HEAVY!

“Special Siblings: Growing up with someone with a disability” by Mary McHugh
“Sound-Shadows of The New World” by Ved Mehta – about blindness
“Touching the Rock: An Experience of Blindness” by John Hull
“Wayne: An Abused Child's Story of Courage, Survival, and Hope – by Wayne Theodore
“Swim to Me” by Betsy Carter (my one random fiction pick)
“My Year Off: Recovering Life after a Stroke” by Robert McCrum
“Defending Andy: One Mother's Fight to Save her Son from Cancer and the Insurance industry” by Marilyn Azevedo
“I want to grow hair, I want to grow up, I want to go to Boise: Children Surviving Cancer” by Erma Bombeck
“I had brain surgery, what's your excuse?” by Suzy Becker
“Healing and Hope: Six Women from Betty Ford Center Share Journeys of Addiction and Recovery” by Betty Ford
“Heroes with a thousand faces – true stories of people w/ facial deformities and their quest for acceptance” by Laura Greenwald
“Rescuing Jeffrey” by Richard Galli – traumatic spinal cord injury story”
“The Camera My Mother Gave me” by Susanna Kaysen – sickness journey
“Dyspraxia: The Hidden Handicap” by Dr Amanda Kirby
“Miracle Birth Stories of Very Premature Babies” by Timothy Smith
“Playing for their Lives: Helping Troubled Children through Play Therapy” by Dorothy Singer
“Acquainted with the night: a parent's quest to understand depression and bipolar disorder in his children” by Paul Raeburn
“A handful of ashes” by Dr Victoria Greenleaf, on raising an antisocial child
“Chicken Soup for the Caregiver's Soul”

Category: Occupational Therapy | Comments: 2

6 Dec 2007

Professional Development Evaluations…it's all over!

Professional Development Evaluations

In my program, we have to prove basic professional criteria in four domains, at the end of our first year. This is done through documentation of each criteria. It is stuff like being ethically-grounded, client-centered, evidence-based, …you get the picture. We were assigned a one hour session with our adviser and one other professor. I was really nervous that I'd end up crying unprofessionally if I was given a lot of negative feedback. I really thought they'd get on me for sometimes making inappropriate comments and things like that. Luckily, it went really, really well. I showed them my documentation and they were pleased with it. Then they gave me a piece of paper with information on it from the faculty. The faculty had gotten together previously to discuss each person and then feedback, both positive and negative, was written down. My positive feedback said I did well academically, did a lot for the class, things like that. The negative feedback was that I need to not be so self-deprecating and show more self-worth. It was also noted that I no longer make as many morbid comments, which made me laugh. I frequently say horrible things that I don't even mean at all, and people take me seriously, so I've been trying to be more careful.

Now I need to start preparing for intermediate PDEs, which are due in a semester…

OTS Patti who has a blog linked on my sidebar, told me via IM the other night that they have PBAs…Professional Behavioral Assessments…but that they don't actually meet with the faculty.

Does anyone else out there want to tell about their program and if it has anything similar to this?

Ok. I am officially done for the night. I'm dragging my feet over to my bedroom to start packing.

Category: Occupational Therapy | Comments: none

6 Dec 2007

The Kitchen Sink Frame of Reference & Other Random Resources

Caption: My sister and I chilling out in a kitchen sink

So…to close out this blog blitz with an alliterative bang, I was going to write an article on Frames of Reference and how it applies to Occupational Therapy….but then I got a wild hare or hair…I'm not sure which…and decided to search on Google first.

Lo and behold, there is a great basic resource for FOR at http://wind.cc.whecn.edu/~mwonser/OCTH2000/unit5.html

It talks about what Frames of Reference are…and how each frame of reference (biomechanical, developmental, etc etc) can provide a different theoretical framework to approach the problem.

There is one Frame of Reference that is missing though. While walking to the parking garage one day, some of us were talking about how we should have a “Miscellaneous” FOR when nothing else seems to fit. We decided it should be called “The Kitchen-Sink Frame of Reference”. That's even funnier than it sounds, because there is a girl in the class whose married name is Kitchens, and another girl whose maiden name was Sink. Fitting, huh. Are you dying laughing? Take a deep breath, it's going to be okay.

Also, I just did some sleuthery and found out if you go to http://wind.cc.whecn.edu/~mwonser/OCTH2000/ you have access to ALL the units, because this is an Online Intro to OT course! Pretty cool!

While I'm on my website frenzy….AOTA may bite me for this but I think it's open to all… if you go to www.aota.org, then click Student, then click on Handouts for Conclave…there are some great Powerpoints to download there too about a variety of things.

Ok…I'm done. I've crossed off all my blogging goals on my to-do list for a few days…now I can focus on more boring stuff like packing.

But, seeing as how I am Miss Procrastination, I forgot to tell you guys about my PDEs! One last post, I promise.

Category: Occupational Therapy | Comments: none

6 Dec 2007

The Recycling Occupational Therapist

Caption 1: Sister and I using recycled items wisely.
Caption 2: Barbara Smith, author of the Recycling Occupational Therapist

I talked about being interested in the book “The Recycling Occupational Therapist” a while back, and the author left me a comment. She pointed out the book is available on Amazon (kind of expensive though, I am a sad student).
She also left her website address,

www.barbarasmithoccupationaltherapist.com

I went dubiously to it AND GUESS WHAT! IT WAS PRETTY COOL! She had stuff on tons of areas from hippotherapy to low vision….a great source for people interested in a specific specialty and just wanting some basic information it, or wanting some ideas, or whatever. I recommend it.

Also, I thought this was neat…she had a disability awareness quiz…

http://barbarasmithoccupationaltherapist.com/disabiityawarenessquiz.html

Category: Occupational Therapy | Comments: none

6 Dec 2007

PLEASE SEND ME MATERIAL!

I'm writing up a flurry of posts today because I'm not sure how much I'll be posting the next few weeks…I'm going to try not to neglect it, but I'll be traveling a lot, so I dunno. One of my good friends, OTS Virginia, let me know she is going to write up a few posts…one about OTs working with troubled youth, and one about OTs working in hospice.

I would LOVE if people – OTs, OT Students, Random People, People who have had OT or have family members who had OT, people with tips for OTs…..ANYONE!!!!!!!!!!!!! would e-mail me material and specify how much credit you want (ie full name, email address….or just first name…or anonymous…or whatever you want). I'll put it up for you. The only rule is that it has to have SOMETHING to do with occupational therapy, and that it can not be offensive/inappropriate. I may edit it slightly, but would let you approve the edits before posting. I'm going to specifically call out a few people with suggestions:

Cookie Man: how you think OTs *can* help (be nice!!!) or ??
Virginia: Hospice, troubled youth
Burt: Real tools for an OT toolbox
Sarah: ??
Suzy/Arnie: Saran wrap and ?
Brooke: holding a leadership position in OT or ??
Kerri: ??
Allison: ??
Ryn of Ryn Tales/Dream Mom: View of rehab??
Mom: being the mother of the coolest occupational therapy student in the entire world…just kidding
Any person in my class: Whatever you want to write about
AOTA Staff (I'm pretending like this is a possibility): What you most wish OT students would understand about AOTA's role…or ??
Professors: What you wish OT students would most grasp
Everyone else in the world: I dunno, be creative

Category: Occupational Therapy | Comments: none

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