I'm starting to obsess over wanting to do more crafts this upcoming year with my school OT kids. I started using Pinterest today http://pinterest.com/funkist/pins/ to keep track of the crafts that may be promising in some way. Like for example, cutting pool noodles into slices to make giant beads!
Anybody have a social story written on what OT is for? And/or a contract? For use in the school system? I only work with K-6 and this year I am thinking about starting the year with both a social story and a contract for each child, where we review what OT is, who I am, what goals they have, etc. The contract would be to work on those goals/work hard/work together or something along those lines. I think a lot of kids getting OT have no idea what they are doing (including some of mine) so I would like to address that immediately this upcoming year. I think I'm also going to make sure to e-mail the teachers at the beginning of the year (after the craziness of the first week or so subsides for them), telling them what goals OT is working on specifically for the particular child(ren) in their class….and perhaps send home a note with the kids reminding the parents of my e-mail address.
That sounds like a lot of work. But I think it would be good to do. Does anyone out there already have a contract and/or social story for OT aimed at younger ages?
One of my goals for this upcoming school year is to try more crafts. Here is a couple that look interesting that someone does with her home-schooled children. 🙂 I especially like the first and third link, all from Angry Chicken!
Making a cloud with rainbows
maybe this one too…
and I think this one is beautiful….rose petal drawings
and this one for Halloween…
I spend a lot of time while working trying to make sure I get the lingo down and know what I am talking about. I write myself a lot of cheat sheets with things I observe/read that I want to use in the future. I don't do a great job of organizing it though. But here is an example cheat sheet from when I worked in adult physical dysfunction last year. Now it's all alien to me since school OT is a whole other area! But when I read some of this stuff it reminds me how complex OT can be. :0
PS: None of this should be taken as advice down below – it could be wrong for all I know, and it's certainly all out of context. Just showing all the complex terminology and thought processes etc. I do notice when I read through this the lack of occupation-based terminology. Oops. 😉
PS2: I am down to under 100 new mails. That's why so many new OT blog posts lately, I'm getting close to everything being cleaned out. 🙂
Abduction on sidelying
“composite digit flexion”
“Pt also demo intact LUE sensation to SWM 5.07 for protective sensation, however absent 2 point 1.0cm discrimination along L median nerve distribution/medial cutaneous nerve”
OT then applied gentle PROM to L digit flex/extend with differential FDP/FDS tendon gliding and pt instructed in joint blocking.
Increase facilitation of normal tone, neuro-re ed out of flexor synergy, activation of paraspinals and abdominals, long duration stretch with ext/sup patterning using deep tendon inhibition techniques, RUE through PNF D2 flexion patterns, OT maintaining flexor synergy inhibition points of contact for increased AROM while pt moved through PNF patterns
Sliding board with wedges
Straight cane to activate external rotation with ace bandaged hand
Scapular mobilizatios – elevate, me do it, then u try to help
Supine uphill, cocontractions
Do some oscillations on shld while supine, quick approximations as well, externally rotate thumb while trying to do elbow ext
Prone on elbows or table top
Closed chain/open chain
Lumbricals – tend to get clawed?
Intrinsic plus/minus positioning
Transfers to graded height surfaces
No proximal activation palpated
Performed closed chain task
Dynamic reaching over weak limbs?
To improve postural stability, stand on variety of unstable surfaces
Try to self-correct and improve postural integrity, perturbations –v estibular
Change velocity, angle, distance
Unilateral UE release to challenge dynamic sitting balance
Air splint for neutral warmth to decrease tone
Max A to find initial placement on L
Unilateral UE downward reach and hip flexion needed for LE clothing management
Intermittent hands on assistance to maximize full elbow extension, keep postural integrity
Lowered concentrically with control
Cross friction massage
FPL – same, only move IP of thumb
FDS – same, to move PIP
Isolated FDS, FDP, FPL tendon FDP – hol down palm up so can only move DIP
Scapulohumeral rythym discoordinated
Ulnar nerve paresthesias, 2/7 for 0.5 2 point discrimination
Stereognosis – no vision tactile search
Intrinsic: digit abd/add, interosseous lumbricals, so do pull apart fingers with resistance. Strengthen intrinsic plus position
Straighten elbow, FDP flatter stretch at IPS????????
Follow ulnar nerve tract up C8/T1 (brachial plexus)
Scaption to decrease impingement
Thumb up: coracobrachialis
Supination: biceps bracchi
Ulnar nerve glide ex: elbow extend etc
With OT correcting techniquers
CMC joint tightness
Resistive L digit extension
Difficulty with voluntary movement of thumb and digit opposite and lumbrical grip
Contract – isotonic
Hold – isometric
Agonist – pattern with limited motion
Antagonist – muscle shortened that limits range of agonist
D2 ext: ext add, int rot, flex abd ext rot, seatbelt side on top, cross on bottom
D1: flex/add/ext, ext/abd/int, cross on top, side on bottom
PNF – proprioceptive neuromuscular facilitation, increase response of nm mechanism by stimulating prioprioceptors, fl/ext, abd/add, int/ext R, rotary component, balance of antagonists, sag, front, horiz
Trophic changes – ie swollen shiny skin and nails with ridges, sign of CRPS
TENS : transcutaneous, sensory to decrease pain, no visible contractions, bipolar 2, quad 4, crisscross pattern, black delivers shock, red grand/receiving. Further apart pads, shallow, close together deep. IFC – inferential current,
Ligaments – frozen shoulder, distraction, rythymic stabilization
Facilitate motor return
Respiratory rate – count number of times chest raises
BP manual, valve tight, pump up past 180, slowly release, listen to brachial artery, first and last heartbeat
Try to normalize movement patterns
Media positioned to facilitate BUE
For improved proximal stability for ADL tasks
Performed to improve BUE extensor strength
QD – once a day
BID – 2x a day
Cross tendon massage, subscapularis massage from axillary angle
UE assisted pelvic elevation
Shoulder capsular massage
Interosseous mobilization – supination and pronation, go up and down, radius and ulna
Neuro – don’t go past pain, ortho- go past pain
Pain increases tone so only go to tolerance
Don’t stretch hypotonic
Performed eval and pt has potential to increase functional skills, need to redo home program with 2 visits.
“composite flexure contracture”
Viscolas Flexigrip Hand exerciser
Vision: contrast, geographical vs spatial, inattention, poor vision, eyes jump/nystagmus, boundaries ie red tape to red tape
0—- bp, then 0 seated, standing etc
Dissociation of body and limbs
Active assist bow activity, bow positioned to inhibit compensatory R shld abduction and facilitate flexion in slight scaption. Occasional manual assist to inhibit compensatory R trunk lateral flexion.
Media positioned to promote RUE AROM in diagonal patterns and improve standing balance. Min A to maintain dynamic balance during task, ball placed to provide proprioceptive input to RUE and resisted trunk flexion, to improve postural integrity, decrease compensatory movements, improve tone for increased efficiency with ADL and mobility tasks.
Stickler’s syndrome: decreased visual acuity, nystagmus, increased risk of retinal detachment and amblyopia
Swivel spoon/wrist splint, steering wheel covers, HEP tendon glide, nerve glide, gentle strength, rubber band extension, towel crumble
here were some of the ideas I had written down (some more occupation-based than others but just things to prompt my brain) while working in inpatient rehab….
PS: Belly dancing/fencing were two things I was into…belly dancing is GREAT for hip/core work (find just a basic video on youtube and they can work in the parallel bars, if not shy about it of course) and fencing (with foam swords) if you use the proper stance (google that too) is great for balance and strengthening/stabilizing lower body while also incorporating upper body. 🙂
Clothespins, racks, washclothes
|Lean on wedges to work on stomach|
|Wedge ramp, roll ball from one to another on wedge|
|Place paperclips under bottom, raise up and take away|
|Sit on BSC, raise up place tennis balls from either side|
|Dowel ladder, put cones on it or use weighted dowel|
|Lie on back, reach up and back for items|
|Ball or bolster rolling up and down wall|
|Partial sit to stand from mat|
|Pegs on vertical surface, place pegs in, maybe patterned|
|Theraputty hand exercises|
|Airsplinting to reduce tone in elbow|
|Velcro rotators for hand manip|
|Pick up rice pieces|
|Stack tiny cubes|
|Bend knee back, kick ball|
|Abacus with foot to slide beads|
|Hit ball with weighted dowel|
|marching in place|
|UE assisted pelvic elevation|
|scooting on mat|
|lateral weight bear for peg shapes on vert surf|
|sort cards by suit|
Canes: Sometimes the person with low vision is not quite at the level at really needing the white cane, but use it anyway because it warns other people to be careful/aware around them.
Reading: Many people with low vision can read, however the difficulty may be in sustaining it due to distance from print, nystagmus, general ocular control, etc.
Nystagmus: Sometimes a head tilt/turn helps quiet the jumping of the eyes and maintain optimal sight.
Here are some things I wrote down that I no longer have any idea what I was referring since it's been like three years 😡 If anyone wants to clarify any of this, go right ahead.
Fans – shadows
Grating acuities, teller acuities, etc, “Facile”
Stable or progressive vision issues
“achromats” = not people first language.Sensory channels most used – Learning Media Assessment.
Braille: A lot of kids actually read Braille with their eyes! If a kid has visual sensory preferences (even with low vision), it may mean Braille is not a great choice. A tactile child will benefit from Braille more.
all might have same diagnosis but want different choices .Some kids can see letters but not read due to saccade issues.
Visual function, with rehab, can lead to functional vision
Albinos – 1/2 fibers dessicate at optic chiasm. problems with stereoopsis? Need orientation and mobility – problems iwth depth perception
Nyctalopia – in to out, transitions – ie bright playground to normal classroom
Try and maximize remaining visision
Brain fools us – we think we see all around us but not raeallySighted kids rely on visually impaired kids for freeze frame data – complete change from before!
Desire to drive is often incentive.
I wrote this in 2009 and never finished posting it…the new test had just come out, with the CST part to it. So this is relevant to the new test, but I am NOT up to date on whether things have changed in the last few years, so read this with a grain of salt. Or maybe a salt shaker.
I didn't start studying nearly as early as I should have, but I used 3 sources: TherapyEd book & review course, NBCOT book + online practice exams, and friends.
If you can afford it, take the TherapyEd review course. If money is an issue, it's probably still worth it IF YOU HAVE TROUBLE TESTING (the cost of that course is cheaper than re-taking the exam). If you are a strong student, you can probably get by without it.
I liked the TherapyEd review book that came with the course. I basically memorized the vast majority of the book. You need to be able to spout off the information, NOT just “recognize” it. I did flashcards, not so much to actually use, but to help me concentrate so that I learned while making them. There is what, like, thirteen chapters? So depending on how slowly you study, try and give yourself a few days for each chapter if at all possible. DON'T SKIP ANYTHING. I really only glanced briefly at statistics/research/management, and I wished I had looked closer. Everyone's test is different, but everyone's test will most likely include a little bit of everything. The more you know, the more likely you'll pass, obviously, right?
Now, the TherapyEd questions are kind of weird, I admit. Long and oddly worded. Still good practice. And it has lots of CST to practice with.
The NBCOT book was much more like typical NBCOT questions, although oddly enough, the book didn't have any example CSTs…those new clinical simulation questions. (I ALWAYS confuse the words stimulation/simulation).
NEW NOTE: All this may have changed in the last few years with new editions!!
I HIGHLY recommend purchasing the NBCOT online exam that is 100 questions. According to a classmate who researched it, there is like a .9 (ie high) correlation between your score on that exam versus the real thing. I don't have the evidence though. Also, one of my classmates went up FIFTY points from practice to real thing so I guess um, well, ….anyway, it's still helpful to see how you do on that online exam. The other things you can buy I don't necessarily recommend…if you can afford it, great, it helps with confidence …remember you cannot necessarily go back and see the question though…and answers aren't always given I don't think. So examine everything carefully the first time, and jot down notes as needed.
My favorite study questions had to do with psych….here is a (very very) brief psych med overview. Like I said, it may or may not be on one of your tests, but you should know it regardless! It seemed like each study book had this same information in it.
Akathisia = restlessness, urgent need for movement, typically a psych med side effect.
(This is like my favorite word!)
Tardive dyskinesia = almost constant movement, more chronic and serious, does not go away, and is result of years of heavy psych meds. The movements are more writhing with a lot of oral motor involvement.
Make sure you know the difference between the two types of movement. 🙂
MAOIs = drugs used for depression. You have to be on a restricted diet on these medicines because of an amino acid blah blah – so they like to ask diet questions. They can't have like, pickled, smoked, cheesy things…and one of the first signs of toxicity is a headache. Your patients, whether you work in mental health or not, may be on this type of medication, so make sure you know the reasons for the special diet, etc.
Photosensitivity = lots of psych drugs cause people to be more sensitive to sunlight than normal. If you are doing psych activities/groups and it involves being outside, there is a good chance you'll need to remind the clients and/or be prepared to deal with that side effect.
***As far as I can tell after re-reading this repeatedly, I have not said anything inappropriate/proprietary….if anyone disagrees, please let me know. My intent is to share advice, not do anything illegal!! 🙂
I found these three things that might help me figure out a Staples button hack. I want it to say “help” instead of “That was easy!”. By the way, kids LOVE the Staples button and consider it a real treat to be able to hit the button after an activity. Even if the activity was actually somewhat frustrating, the kid gets a ghost of a smile on their face after hitting the button. The only problem is they usually try to hit it like six times in a row.
I have a child who doesn't like to ask for help….I wanted to make a Help button so she could hit it for fun. Seemed like a good idea. Only problem is, I'm not exactly handy with a drill so these hacks seem a little challenging for me. But wanted to throw out the idea of hacking out these buttons for basic communication needs or to be silly.
Other alternative….does anybody know of similar buttons you can buy to say whatever you want? I am sure there are OTs and/or SLPs out there working with AC who know way better than I do.