18 Jul 2011

Exerting too much pressure when writing…OT school ideas

I recently asked for ideas on working with a child who uses too much pressure while writing….I got a ton of great comments, most of which I have copy/pasted here…forgive me if I missed any. Most were anonymous, a few had just first names….go back to original posting if you want to see credit!

Most said provide some proprioceptive feedback first and then either use a mechanical pencil and/or shelf liner, mousepad underside, or sand paper, for extra feedback as well.

LOVED the comments. Thanks!!

Here they are:

For increased pressure I like to use mechanical pencils or have the child write on the underside of a mousepad 🙂 Increasing joint awareness in their hands can also help them with proprio feedback – I get childrent to press their hands together for 5 seconds and then clasp their fingers and pull hands apart.

writing on sand paper can increase awareness to exerting too much pressure – because they will tear the paper if they push too hard. or maybe it’s just because they have a funky grip? one of my client’s pushes too hard because they use a grip with zero webspace or wrist extension. i used a pencil grip to promote tripod grasp and this decreased the amount of pressure they used to write. good luck!

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For the kid that is pressing too hard, have him try writing prone on a carpet or put a carpet tile on a table. If he presses too hard, the pen will go through the paper. Or, have him write a sentence, then show him the how the back of the paper is all raised up, then have him try to make it so that the back of the paper isn’t raised after he’s written a sentence. Hope that helps!

All great ideas… also have student write on felt. When s/he presses too hard they will punch through the paper.

You can also try sensory input prior to handwriting. Anything with joint compression, heavy work… chair pushups, yoga downward dogs, animal walks. Good luck!

A) Another idea is to have the child use a mechanical pencil…if they push too hard the lead will break.

B) Writing a poem on the board with some words that are mispelled or out of order, see if they can correct as they copy.

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I’m a preschool teach, not an OT…working that way eventually.

Anywho, something I do with my kiddos is called crayon resist…a way you could make it easter-y (maybe next year!) would be to write on boiled eggs before you color them with white crayon or some type of wax, then dye the egg. The crayon/wax will resist the dye leaving lighter spots. I figure you have to write softly on eggs! Just an idea, hope it made sense!

also writing on tissue paper? or I’ll have kids draw with markers on coffee filters and use a squirt bottle to spray the paper, then let it dry and either cut it into something neat or turn it into a butterfly or flower with pipe cleaners. — both tissue paper/coffee filters rip super easy and the kid has to take their time.

Or drawing designs on aluminum foil with sharpie is pretty neat looking and you have to be gentle!

Like I said I’m not an OT just throwing some fun ideas from my experience with kids 🙂

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I would first work on preparing the hand to a writing activity. So, wheelbarrow walks, donkey kicks, wall push ups (all good weightbearing activities), theraputty activites.
I use a mechanical pencil, sand paper, tissue paper, writing while a Grip-It shelf liner (liner that is placed in drawers with small holes) is placed under the paper. This all gives feedback as to how pressure to exert.
I also wonder if a weighted pencil would also help?? Any thoughts?

Category: Occupational Therapy | Comments: none

18 Jul 2011

New OT blog

www.jezzabellasotexperiences.blogspot.com

New OT blog :) 

There is a blogpost a few down showing a Real Simple activity using half a balloon + a plastic cup that looks cool!

Category: Occupational Therapy | Comments: none

18 Jul 2011

Return to OT blog

I basically didn't have wireless access this past week, so no blog posts. However this upcoming week I have more time. My goal is to COMPLETELY finish responding to OT blog comments/emails etc within next week (perhaps a slightly lofty goal) + finish filing my OT work mail + organize my computer documents for work. Phew.

I got contacted by Dycem and they will be sending me a few products to review and I also have a book to review! I am really excited! I love reviews!

I am in Alabama one more week – back to San Diego next Sunday. Fun times in the South.

I am trying to get up the energy to go work out! One of my biggest, biggest issues is almost constant low energy. Bleh.

Well, this was a pretty worthless posting, but I wanted to say I am back to having wireless, back to responding to blog emails etc (I went from over 1,400ish to only 210 in the past two weeks). Another goal of mine – although not this week – is to write an article for OT practice about Colombia!

Category: Occupational Therapy | Comments: none

10 Jul 2011

Some AWESOME men Rehab OT ideas from a good friend

When I was helping out in physical rehab in the rural Deep South, it was often challenging for me to find ways to engage the men! One of my good friends, who happens to be a man from the South, sent me these ideas. Like two years ago. I love them ALL. 🙂 Now I am sharing with my blog with only minimal editing! He was meant to be an OT! It's too bad we can't bring in fake guns but I am sure that is a no no at any place. The laser refers to (probably, if my memory serves me right) doing something along the lines of fitting patient with a hand or arm weight, taping a laser light to it, and allowing them to point at a target with it. Gotta be careful about not getting it in anyone's eyes though.

As always, try any of this at your own risk! Consider insurance of your work, liability issues, etc.

Mail 1: Would they like outdoor magazines? Would your organization allow hunting and fishing magazines? Can they accept them if they are free? There is a forum called Georgia Outdoors or Georgia Outdoor Network – can't remember right now. If it didn't upset your bosses you could join it and ask for magazines, I think you would get a bazillion.

Also could you take patients on field trips? Shooting ranges often invite special needs shooters in for free days. I don't know but I bet there are a lot of ranges in GA.

On simple stuff, the laser taped to the hand weights is a really good idea. LEDs could also work over a short range.

Mail 2:
1. On the weekends go to the various car dealerships in the area. Get brochures of trucks, SUVs,cars, everything. You can cut up the catalogs, glue the pictures to index cards, and use them for sorting activities, guessing games (what kind of car is this?). I bet you could even come up with card games.

You are in the heart of NASCAR country. You could also do the same with drivers, racing teams, cars, factories.
You could also do the same thing with football teams.

2. Go to Walmart and get a couple of the Popiel Pocket Fisherman fishing rods. If y'all don't have the funds for buying stuff, I bet you can ask among the employees (Do y'all have an on campus BBS for lost and found, want ads, etc?) for a couple of old fishing rods. Tie a washer or other weight on the end of the line. Go to food service, get some large buckets, like pickle buckets. Let the guys cast the weights into the buckets. Sort of like fishing. Maybe a better outdoor, springtime activity.

3. Get a couple of old golf clubs (putters) and some big cups. Put put time.

4. Get a large piece of poster board and about two dozen large steel washers (about 1 to 1&1/2 inch diameter). On the poster board mark lines every five inches. Put designs on washers such as there are 6 different designs or colors on four washers each. In other words, you come up with 4 red washers, 4 green washers, etc.

Place posterboard on floor with lines parallel to wall. Have participants toss washers from appropriate distance. Person with washer closest to wall wins. Can be done standing, sitting left or right handed, etc. Watch this one though – chance of gambling occurring.

Category: Occupational Therapy | Comments: 2

10 Jul 2011

Prison settings and related populations (mental health)

Did you know OTs can work in prisons and related areas?
NGBRI= Not guilty by reason of insanity.
Pts = patients
Hx = history
SC = spinal cord
CP = cerebral palsy

A former classmate of mine (class below me) wrote this to me a loooong time ago about one of her rotations (she wrote the first part to me on FB, I responded and asked if I could share, then she shared the discharge status part. It took me over a year to finally post though):

All pts have pleaded NGBRI. I see only men and my case load consists of two higher functioning groups that I see twice a week, one lower functioning group I see twice a week, and two individual sessions one of which I see once a week and the other I see three times a week. They are all on a lock down ward that reminds me of a prison. I have warmed up to all my groups, however, I still remain a bit uneasy with my lowest functioning group….you never know if they will be stable throughout the session or not! I have issues sometimes trying to come up with group activities for that group that will keep their attention for the entire group session. Anyway, I feel as though I have put lots of effort into trying to help theses guys be successful and I have been occupation based and client centered at the same time

The discharge status of the patients at XYZ (my current facility) depends on their judges verdict, how heavy of a sentence they hold, how long they have resided at the facility, and how stable their behavior has been over the last year (among other things). Someone who has committed first degree murder will definitely be residing here longer than someone who has been charged with simple assault or battery. Discharge options range from group homes to nursing homes or being released to family. If a pt has a hx of violence nursing homes will usually not accept them and they have to qualify by other means as well such as different physical disabilities (Low vision, SC injuries, CP, ect.) Many of the pts have HIV from extensive hx of IV drug use and their sexual backgrounds. If this is the case, their only option for discharge is basically being released to family members even if their behavior is exquisite. There are many sad, sad cases…and even though I was very nervous in as my rotation commenced (and still am at times) I will definitely miss some of my pts and I hope I have made a difference in there lives.

Category: Occupational Therapy | Comments: none

10 Jul 2011

Q&A on OT

QUESTION VIA EMAIL, SLIGHTLY CHANGED TO MAKE MORE ANONYMOUS, from a few months ago: My name is Jane Doe and I am an older mother of 2 kids. I obtained an OTA degree back in the 1990s but never used the degree. I did very well in school but was unhappy in my clinical rotations. I was under two burned out therapists that didn't do anything with the patients. I also did not like the fact that no one knew what OT's did in addition to the degree being so broad; I felt it was hard to wrap my head around exactly what we did. I never used the degree and went on to pursue Bachelors/MBA degrees and then became a mom and have been home for the past 8 years. Now looking forward to going back to work when my youngest is in first grade, I applied for admission to a MOT program for Fall/2011 and think I have a very good chance of getting accepted. I decided to apply because I still really want to work in healthcare and thought maybe I would feel differently now if I were to pursue the MOT degree. I would like to work in a pediatric setting which is something I did not gain experience with during my schooling/clinical rotations. I was in an adult inpatient setting and adult outpatient setting/mostly home health.

Questions for you:

What are the biggest challenges in this field?

Do you feel like you are making a difference in the lives of the kids you work with?

Is there still a misunderstanding/confusion in exactly what you do?

Do you feel the profession as a whole is respected?

What do you dislike about the field?

How do you get away from people thinking you sit with a patient and a pegboard?

Do you still think it's a great profession?

MY (garbled, as always) ANSWER, slightly edited as well:
I am so sorry you had a bad experience in your clinicals. That can really mess your brain up, to see burnt-out and/or poor therapists. I agree it is a challenge that nobody knows what OT is and not only that, it's impossible to explain quickly. I hate being asked what I do!! Because there is no easy response. But at the same time I do love what I do!

Being an OT versus OTA is a big difference in terms of feeling empowered, I think. If you have a MBA you definitely need to be at OT level, and after going through OTA school you definitely are a very strong candidate and will be miles ahead of many of your classmates with your practical knowledge. Now you can add in the theory. 🙂

Working in pediatrics might also be a better fit and make you feel differently. Such a massive difference. Although it may be tiring to work all day with kids then come home to your own.

Okay, to specifically answer your questions.

What are the biggest challenges in this field?

In no particular order, in MY opinion – insurance reimbursement, difficulty quickly defining what we do, sadness that rarely people are aware of our profession, sadness that when people DO know of us its often pegboard related….also trying to do our best work with limited budgets/insurance reimbursements.

Do you feel like you are making a difference in the lives of the kids you work with?

At times yes. It depends. Some kids are just hard. Other kids you will say wow, I made a difference. But it depends a lot on YOUR style and ability to interact with family, other disciplines, etc. If you are a typical school OT for example who pulls the kid, treats them, brings them back, and doesnt say anything to anybody, then um, you probably wont feel like you made a difference bcause you didn't. 30 mins a week is nothing. But if you are proactive and try to really talk to parents, talk to family, look at the child's function within their environment and focus on that….yes, you might feel you made a difference. At times its frustrating. Honestly the ahrdest part of working with kids is the PARENTS – some are great, others are either overly or underly involved. Yes I am making up my own words.

Is there still a misunderstanding/confusion in exactly what you do?

Yes, definitely. I know we are actively trying to change that, but it's definitely an issue

Do you feel the profession as a whole is respected?

Controversial to answer this one. Yes, I think in general its respected, but there are plenty of individuals who had not had good experiences. It becomes your job to change their perspective. 🙂

What do you dislike about the field?

Everything I mentioned above about difficulty defining it, insurance issues, case overloads, etc.

How do you get away from people thinking you sit with a patient and a pegboard?

Role modeling. You show them that TRUE OT is very different and as they learn to respect your work they will see it's not true. I can't think of a better way than role modeling. One of my favorite books is called the Healing Heart by Ora Ruggles. Hard to get your hands on, but keep an eye out for it online. So worth it. 🙂

Do you still think it's a great profession?

Yes – I love it. I think its potential is sky high. Do we have a lot of OTs who dont know what they are doing, or worse, don't care? Yes. Are there times I am one of those OTs who don't know what they are doing? Yes. But I try really hard to be a good OT overall, and I love what we do. I wish I knew more but that will come with time/experience.

Overall I think its a great profession to go into – pays pretty well, very broad so you can essentially change professions within same field (ie adult phys dys, peds, hands, etc) if you get tired/bored of a certain area, or just need flexibility. Its a good job to have with kids as you can choose a job with no weekends or nights and/or part time, and nobody dies if you dont see them. 🙂 I think if you are cut-dry and don't want to deal with all the issues facing OT, then maybe PT or SLP is a better idea although you probably dont meet their educational criteria AND they of course have their own internal issues. I love OT…..it was the right fit for me.

Basically it's all about what YOU make of it. You will encounter plenty of bad apples and plenty of LOVELY apples (are you loving my midnight analogies?). Seek out the good, work hard, and you will rise to the top….don't let the bad ones bring you down. I sincerely hope you are planning on doing plenty of observation in pediatric settings (and other areas)!

Category: Occupational Therapy | Comments: none

3 Jul 2011

A google search day in the life of an OT

I found this google searchfrom when I was an OT working in Georgia (I think I saved it to one day post as example on my blog). Clearly my google got quite a work out. 🙂 All of it had to do with patients, whether it was helping the patient read their bible with limited hand mobility, or toileting, etc. I use a lot of paper and people resources, but Google is also really helpful for ideas as well.

Clear ×caregivers personal hygeine knee abductor · Web
Clear ×knee abductors for hygeine · Web
Clear ×cleaning perineal area spastic adductors · Web
Clear ×adductors abductor spasticity perineal hygeine · Web
Clear ×abduction toileting hygeine cerebral palsy · Web
Fri
Clear ×apraxia kids · Web
Clear ×my child has dyspraxia · Web
Clear ×developmental dyspraxia children support · Web
Clear ×developmental dyspraxia · Web

8
Wed
Clear ×sae-bo stretch · Webb
Clear ×aquatic therapy alabama · Web
Clear ×aquatic therapy · Web
Clear ×weighted book magnet amazon · Web
Clear ×weighted book magnet · Web
Clear ×USB mini keyboard one-handed · Web
Clear ×USB mini keyboard · Web

Clear ×multiple sclerosis ICD-9 code · Web
Clear ×rehab page turner · Images
Clear ×rehab page turner · Web
Clear ×Kindle Bible · Web
Clear ×can you read bible with e-reader · Web
Clear ×book butler · Web
Clear ×home exercise program after stroke shoulder

Clear ×exercises for shoulder subluxation · Web
Clear ×paraffin for acute rheumatoid arthritis · Web
Clear ×southern hand and orthopedics · Web27
Clear ×windows adaptive software · Web
Clear ×one-handed keyboard · Web

Category: Occupational Therapy | Comments: none

3 Jul 2011

NY Times article on OT in schools

http://www.nytimes.com/2010/02/25/fashion/25Therapy.html?emc=eta1

One on “Watch how you hold that crayon”….another possible re-post but this time I am deleting it from my inbox!! This one by NY Times on pediatric OTs working with handwriting etc. A slightly snarky article but still interesting.

Category: Occupational Therapy | Comments: none

3 Jul 2011

Sensory processing disorder in Time Magazine

http://www.time.com/time/magazine/article/0,9171,1689216-1,00.html

An article on sensory processing disorder in Time magazine from a while ago. This may be a re-post, I can't remember. I'm still going through old mail. Down to less than 500. If you've written me and I've never responded, feel free to either re-send (if you sent it more than 2 weeks ago), or wait and see if it gets handled in the next 400+ mails I have left to go through. I had over 1380 old and 150+ new a few days ago, now down to 0 new and about a third of old mails, so I am glad…but still a long way to go.

Category: Occupational Therapy | Comments: none

2 Jul 2011

OT books to read

I got an OT blog question about some books to read before starting a master's program in the fall….things to get started. I don't think y'all should start reading textbooks before you ever start, so here are some random ideas me and my OT friend Kerri came up with for for this student…I am in Gainesville, FL visiting her. She is a hand therapist and she rocks. 🙂

Hi “OT Student X”

Do you mean like OT textbooks, or do you mean more normal books? For example, one of my favorite books is The Healing Heart about one of the first OTs, Ora Ruggles……I also like the Out of Sync Child…….and the Out of Sync Child Has Fun is the activity book that goes along with it.

See if this website works for you!
http://myaota.aota.org/shop_aota/

I browsed it and didn't actually see much of interest. There is a Chicken-Soup like book that came out that i want to read but I couldn't find it…if I do I'll post on my blog.

My OT friend Kerri next to me recommends any book by Temple Grandin – especially her older ones, her autobiographies – which I recommend as well. She also recommends Oliver Sacks books. Phantoms in the Brain by Ramachandran….

I personally like first-hand accounts….so autobiographies…of people with various disabilities like cerebral palsy. I go to the library to the health section and browse for what look like autobiographies. 🙂

It depends on how much you like to read and what kind of things interest you. There are certainly textbooks you could start with, but I am sure your school will provide you with a necessary list soon. I'd focus more on the fun stuff to get you excited. The first semester is actually kind of boring with a lot of focus on what occupation IS theoretically (at least it was to me…)….anatomy/neuro is fun according to Kerri 😉 I disagree. ahahaha.

Hope that is a good start…
Karen
PS: Don't be surprised if in some of those first-hand books you get little mention of OT and/or it's somewhat disparaged! We have to keep working to get OT more respected. 🙂

Category: Occupational Therapy | Comments: none

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