12
Jun
2012
Meet Bill :) A soon to be OTD student with Asperger's
I had the pleasure of meeting Bill at the AOTA conference in Indiana. What a great guy. He agreed to do a three-part blog post on getting through OT school as a person with Asperger’s 🙂
Part 1-
I am going to be a licensed occupational therapist in a few months. I also have Asperger’s almost two years ago. From some people outside our profession, this might not make too much sense to them.  Occupational therapy (OT) is arguably considered as one of the most socially demanding professions. Being an occupational therapist not only requires great social skills, but also ability to read his/her clients’ social cues. Yet, here I am as a person on the autism spectrum beating the odds and flourishing in this profession. Not only am I close to getting my license, but I am also on top of the social scene in OT.Â
After careful considerations, I decided to break this into a 3-part blog. For this current part, it will talk about me up to the point I started OT school.
Per my mom’s account, I met most of my developmental milestones during the infant/toddler stage in Hong Kong, my birthplace. The only noticeable area of deficit was that I wasn’t able to speak until I was around two and a half to three year old range. Yet, through my mom’s help, I was able to get into a decent kindergarten less than a 5-minute walk away from the first placed I lived in Happy Valley, Hong Kong. (In Hong Kong, children typically spend 3 years in kindergarten from age 3-5.)
I didn’t truly know about my fine motor skills because I was switched from a lefty to a righty in my early kindergarten days. Meanwhile, I did enjoy playing with a kid who lived nearby during that time for play dates at a nearby field that has now become a practice field for local soccer teams. We enjoyed playing with each other. My social skills then were considered adequate.
However, I have a mild obsession with Hot Wheels like cars. I can play with them for an hour or two at a time. I also another obsession- keeping track of the numbers on the top of the trams passing by the porch near the place we live in Happy Valley. My mom thought it was a little weird, as she took me to a pediatrician. But, the pediatrician said that I wasn’t on the autism spectrum.
After my kindergarten years, my academic development and social development seemed to have gone their separate ways. Academically, I have performed at least average in academic subjects. Math had become my standout subject after I started 3rd grade. Sure, I had to spend 3 years to play catch up in regards to mastering English when my family and I immigrated to the states when I was in 6th grade. But, after I was mainstreamed in 9th grade for English, I continued to be a good, but not great academically in high school.Â
Undergrad was my first experiences of struggle academically. It was tough for me for several reasons. First, I was completely on my own with my studies, particularly in Statistics, as my parents no longer could help me in trying to help me understand what I was studying when I was unable to solve some problems. Second, I didn’t know that I would be in for theoretical and abstract math when I picked Math (and later switched to Statistics) as my undergrad major, which I struggled mightily because I couldn’t get a grasp of the concepts I was learning. Lastly, seeing everyone else also struggled (albeit to a little lesser degree) made it a very unpleasant experience even though my undergrad GPA might have suggested a different story.
Socially, however, was a major struggle during most of these times. I was constantly picked on for my arts and crafts projects when I was in elementary school in Hong Kong, and the D’s and F’s I received for them made matters a lot worse. Then, when I started middle school in the states, girls were freaked out when they had to touch my hands that can get sweaty without warning (which they had to during a dance elective in 6th grade). These two traumas significantly affected my social confidence, especially when I got to know someone for the first time. I also became extra cautious in making friends because I didn’t want to get hurt again emotionally.
In terms of autistic traits, my play skills were subpar during my elementary school and middle school days in Hong Kong. But, the fact that my social confidence was shattered can be considered as an “interaction factor”. Meanwhile, my eye contact only became an issue when I had to do assignments that require public speaking. However, because of my academic success, none of the teachers I had until I started college made much of an issue about the possibility of me having autism.
In my college days, I had become content of my own company. I never minded getting around school by myself. I also generally preferred engaging in solitary occupations, as practicing piano has become my go-to occupation when I wasn’t studying for school.
Another seemingly autistic trait is that I rarely make telephone calls with anyone. When email became a popular mode of communication, I used email to communicate in situations I would have called personally. My “rationale” for this was that I could make sure I said what I wanted to say in emails, where I might have left things out if I spoke on the phone.
Lastly, I was known as a competitor and my nickname since high school was the “human calculator”. In college, I found no limit texas hold’em. As soon as my dorm mates introduced the game to me, I have become obsessed of that poker game. After all, I know I can have an unfair advantage when I play the game with my math skills. Moreover, because of my love to compete, I always tried to learn the latest strategies. At a high point, I can be seen honing my poker skills via playing play money poker tournaments 3-4 hours a day on top of the home games with my dorm mates for at least another 6 hours (if there is a poker tournament that day).
Yet, unbeknownst to my family, the people around me, and myself, autism was still the last thing on anyone’s mind. In fact, I just perceived myself as an introvert who was capable of holding a decent conversation. After all, the occupations I primarily engage in seemed to be normal in society. In fact, Chris Moneymaker’s win at the World Series of Poker Main Event in 2003 actually “normalized” my obsession for poker.
To be continued….
Category: Occupational Therapy | Comments: none
11
Jun
2012
Tower Bunnies disguised in finger puppets….OT wackiness
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| We were “disguising’ the bunnies in the finger puppets…. “Hey TIGER! Why are you eating a carrot?! Are you a vegetarian now? This seems awfully fishy….HEY! You aren’t a tiger!! You’re a BUNNY disguised as a tiger!! You’re going to jail, Mister!!!” etc |
Category: Occupational Therapy | Comments: none
11
Jun
2012
my icky face :)
Kids like me because I end up with faces like this a lot! In this case I was trying dried seaweed….
Category: Occupational Therapy | Comments: none
10
Jun
2012
Fine Motor Coordination Ideas for Children in OT for the Summer
This is like a 3 page word document but I don't know how to link it as a document, so alas, you have to deal with it in copy/pasted form. I shared a version of this a few months ago, but now it's been updated. So far the teachers I have presented this to (with all the activities in front of them to try) have loved this. I recommend sharing a version of this next fall with your K, 1, and 2 teachers….at the very least, to build awareness.
Occupational Therapy: Ideas for Fine Motor Centers and More!
http://pinterest.com/funkist/ot-ideas   < -- start here for tons of fine motor craft ideas I have found that are great for young children and easy to implement
The following are things to work on to help children improve their fine motor coordination and strength, which can help their handwriting, and please note many of these activities could fall under MANY categories.
·     Precision (carefully manipulating tiny objects)
o  Cut up straws, then bead onto pipe cleaners
o  Beading onto pipe cleaners or tiny strings, or through colanders
o  Placing marbles on top of golf tees that the child has stuck into Styrofoam
o  Place beads/items on skewers placed in Styrofoam in various directions
o  Stack very small blocks
o  Match a bead pattern on a skewer to another skewer (on Styrofoam)
o  “Tight rope” – have them place small items on thick taut band that has been wrapped around a box, and/or have them hold a popsicle stick in the air in one hand, and place tiny objects
o  Folding paper, ie very basic origami
·     Tripod grasp (holding items with 3 fingers, not all five)
o  Clothespins [wolves] and cotton balls [sheep] game
o  Any type of tweezers or tongs, picking up objects and transferring them [I use ice cube trays]. Ensure only using 3 fingers by giving them something to hold curled up in their last two fingers if necessary.
o  Push pins and corkboard – with supervision
·     Open web space (“OK” sign) – look at thumb to index finger
o  Making the OK sign, pulling the OK sign apart, finger exercises
o  Picking up tiny objects using small eraser ends (those little rubber erasers you can put on the end of pencils – using those as tiny tongs!)
·     Strengthening of hands, upper arms/extremities (strong core/arms helps with fine motor coordination)
o  Arms: Do a lot of “crawling” or “animal walks”, weight-bearing into arms, while moving from center to center or during physical education
o  Arms: Wheelbarrow walks
o  Squeeze stress balls
o  Use play-doh to roll out logs, circles, squish thin on table, etc. Also remember they love “adult” tools – cheap 50 cent putty “knives” [make sure they aren’t sharp!] at hardware store, etc
o  Stamping – make it harder by having them repeat a pattern of some sort, and or stamping into a small area for precision
o  Turkey basters/eye droppers for water to “wash” things or to melt colors etc on coffee filters
o  Tear out of a piece of an old phone book, crumble up the paper in ONE HAND with the hand in the air, then throw to “hungry shark” aka recycle bin
o  Rip paper into wading pool or tray
o  Use “tennis ball heads” (tennis balls that you put a “mouth” aka a gash on – (be REALLY careful when cutting it! I use a clamp!) Then squeeze their sides to open their mouth to feed them, then – the popular part – make them throw up. Small sizes from pet stores best for smaller hands.
o  Wrap rubber bands, or hair bands, around boxes or containers
o  Geoforms – pegboards where you stretch rubber bands to make shapes or letters
o  Place golf tees into left-over Styrofoam
·     Manipulating a pencil  (Twirling it in dominant hand, “walking” fingers from tip to eraser and back, and turning it over to erase using only one hand.)
o  Practice ERASING. Kids struggle with the act of turning over the pencil with one hand to erase (they either put it down and pick it back up, or use their chest, or other hand, etc) – Practice this move but also practice the act of erasure itself. IE draw a line, flip over pencil, erase. TEACH how to erase. A lot of kids don’t do it very well and need guidance.
·     Shifting items within hands (picking up tiny items, placing into hand, then picking up the next item, etc, with 1 hand only) – I call it “squirreling”, ie storing nuts in a cheek – storing items in part of the palm)
o  Coins for piggy bank or tiny items into ice cube trays
·     Isolating fingers on command (ie show me your index finger, show me your ring finger, etc)
o  Make each finger “bow” or place fingers flat on desk, lift one at a time
o  Put a smiley face or drawing in a laundry detergent cap or on a tennis ball, then have the child use just the fingers of one hand to rotate the “face” around.
·     Directionality (up, down above, beside, etc) and lefts/rights
o  Incorporate “I Spy” and scanning games where child has to look for items by directions, ie “Look below the X”
o  Consider placing a small L and R on the children’s desks or on their hands each day with water-soluble nontoxic markers.
o  When walking places around campus, stop at turns and ask them which way to turn.
o  Great game called Left, Center, Right, for about 7 dollars you can buy at many toy stores or Target/Wal-Mart etc
·     Visual motor (using their eyes with their hands more so than in some other tasks)
o  Bendaroos/WikiStix – they can work on copying a design or writing own name or spelling words
o  Stacking up cubes of different colors/sizes then have child copy design
o  Marble/cup game, rolling across a table
o  Lacing & buttoning – big buttons are easier. Big laces too.
o  Sign language alphabet
o  Sort cards by suite
o  Balloon tapping – blow a few up, have the children keep in the air without touching ground as long as possible
·     Proprioception/tactile – knowing what their hands are doing/feeling without looking
o  Hiding objects in a bag or box game, figuring out what it is/manipulating it without looking. Start with easy discrimination such as long skinny cylinder versus fat round ball, then make more difficult as child has success
o  Moving or isolating their fingers with eyes closed
·     Cutting
o  Consider different types of scissors for struggling kids (scissors requiring less fine motor skills – ask an OT)
o  Start with snipping, cutting straws, and business cards and manila envelopes
·     Notes for older kids, ie 2nd grade:
o  Make sure – don’t assume – they can manipulate their pencil accurately and erase accurately as well. Watch them.
o  Shoe tying: If they still haven’t gotten this down – try having their laces in a single shoe be two different colors, ie neon blue on left side of one shoe, yellow on other side, so that when tying they can clearly see distinction between the two laces, ie “put the blue lace over the yellow”, etc.
o  Desk Organization: TEACH this skill,
ie “hard” books on one side, “soft” books on the other, small items in a basket, etc. No assumptions they know how to organize.
o  Office Supplies: Expose them to rubber bands, paper clips, hole punching, staples, tape, placing numbered or categorized papers into certain folders (ie papers with MATH on top go in Math folder – make sure they know how to actually put the piece of paper in properly).
o  Fidgets: A pipe cleaner on their pencil, a piece of yarn or two, can make a good fidget for a child who needs to play with their hands while listening.
Some pieces of advice?
1.    LOTS of gross motor time – play outside, dig for worms, run around screaming, swing, go to the playground, whatever.
2.    Limit screen time and pull out lots of crafts. I guarantee you they will ultimately benefit more from interaction in the 3-D world than ANY educational screen time. See pinterest account up top for tons of fun ideas. Maybe let the kid pick from the pictures!
3.    Don’t assume a child knows how to do anything (most especially when working with children with special needs). TEACH the skill – erasures, pencil manipulation, desk organization, folder organization, cutting tricks, etc.
4.    Oh yeah. Safety comes first. Don’t let kids swallow stuff, or stab themselves or each other, blah blah blah – supervise your children and ensure the activities are safe for their age and/or developmental level.
Contact me at otstudents.blogspot.com or karen.dobyns *** at *** gmail.com with questions. Thanks!
Final note: Yes, many of these activities would be great for people working on their fine motor skills for ANY reason, including adults after a stroke!
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Category: Occupational Therapy | Comments: none
9
Jun
2012
An intriguing OT oddity
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| This is one of those weird things that has been oddly popular. It started out as a child making a swing by threading the pipe cleaner through one of my pencil grips. Then a cocktail sword got added in but got half-bent off. But my kids LOVE this thing??? They ask for it. They consider it one of my monsters. I have tons of finger monsters the kids always want to use, but they will seek this one out, and some of my kids like to hold it in their non-dominant hand while they write with their other hand. It’s one of those things that is super bizarre. I am intrigued. |
Category: Occupational Therapy | Comments: none
9
Jun
2012
Wrapping up
I just finished my final day of my first full school year as a school OT, since I started in April 2011. I have all sorts of ideas/plans/thoughts on how to do things differently next year, seeing as how hindsight is 20/20, right? Technically there is one week left of school, but I have to go early for a special event in Scandinavia! I have been working many, many, many hours at night trying to catch up on all the documentation. I got behind and never caught up on the redundant system. IE I have it in one area, but never spent time to do it in the redundant area (grrr) so now I am paying for that.
Some of the things I want to do differently I TALKED about last summer but never implemented, either because of time or fatigue or blah blah blah. I did learn SO much this year, a phenomenal amount, but of course I have so much more to know/learn. I have so many resources I want to examine closely this summer! It's all scaffolding – it's like I look at things and can't memorize them yet because too much scaffolding isn't there, but eventually can go back and it makes more sense/is easier to memorize because the data has gotten filled in with experience/time etc.
Some of my goals for next year….
1. Try not to schedule kids during times of day that I know I am typically dragging, if at all possible, lol. Save that for paperwork/other things.
2. Try to be better about tabulating minutes I'm spending on e-mails or in quick convos, as they add up…
3. Provide more homework.
4. Do all my documentation DAILY in ALL redundant spots.
5. Put together my “go to” items, print or copy a bunch of them, and save them all in one organized spot, rather than constantly re-searching for stuff.
6. Start the year with every single one of my kids, based on their cognitive level, knowing exactly my name, my title, what OT is, why they are coming to OT, and what their goals are, and making sure I have phone numbers and e-mail addresses of all parents.
7. Printing out all goals in a format that lets me write directly on that piece of paper on their progress, and trying to divide up my sessions into always specifically addressing a goal for part of it, and then another part of it working on skills that address that goal. IE if the goal is board copying….specifically spend a few mins COPYING from the board, but then another few minutes doing visual motor tasks, near/far tasks, etc, that are foundational.
8. Work on rewards that are more sticker based or “time” based rather than candy….and ideally try to use my psych background to figure out ways to fade extrinsic rewards into more intrinsic rewards….
9. Have children who are working on handwriting repeat an identical 1-2 sentences every month and keep it carefully filed so each month we can compare progress.
10. Continue trying to incorporate more academics into each session,and not be a “clinic” OT in a school. I've come a long way in that arena, but can keep going.
11. Collaborate more with teachers to ensure more carryover and allow the teacher to feel more vested in OT time.
12. Try to push into the classroom rather than pull out as often as possible
13. Do workshops for K, 1, 2, for each of my four schools…have done one school and got great feedback…we also did instructional assistants for the district….
14…..uhhh
I have been working SO much on this paperwork……I really wanted to be done by tonight but alas, I have one more school to go, paperwork wise. Tomorrow I am doing a hike with some speech coworkers and lunch, then nails done for the trip, then some shopping for the trip, and then back to work!! I also need to organize all my toys!! I am a toy monster. Today I was sitting in a conference room and thank goodness we have a lazy janitor, as I spotted one of my mini figurines on the floor in front of me!! Yay! (Sometimes I work in there with kids if all other rooms are taken)
I am um, obviously, just rambling. I'm tired. I'm stressed. I am super glad to go on this trip, although part of me wishes I had more time before I left to work on getting affairs in order, but when I get back I hope to get on the OT bandwagon and get lots of work done to help start off the school year better. And hey robbers, other people live here, so me going on a trip means nothing. Just sayin'.
Ok my battery is dying. Good night….
Category: Occupational Therapy | Comments: 2
7
Jun
2012
Visual perceptual and/or motor challenges…
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| This is a kid with pretty significant difficulties in the sense that when I asked him to draw a banana, this is what he drew, and thought it looked great. The wiggles aren’t due to lack of coordination, just how he chose to do that….. |
Category: Occupational Therapy | Comments: none
7
Jun
2012
A great "spider " game for OT
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| Can’t remember if I posted this. You start at one side and have to get through to other side by wiggling or moving, without touching anything. The referee is the spider who calls you out if you touch anything. Another great game for encouraging each other (be careful! watch out!) etc ….and of course the motor planning aspect. |
Category: Occupational Therapy | Comments: none
6
Jun
2012
Angry Birds on Thin Ice
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| Angry Birds on Thin Ice…having to build the structure just like it does on the card. Can be a little challenging. Worst part was we kept jiggling the table…so guess it’s a good exercise for the visual system AND the frustration system 😉 |
Category: Occupational Therapy | Comments: none
6
Jun
2012
Eye bombing for OT
I recently did this with my kids around campus.
http://eyebombing.com/
Category: Occupational Therapy | Comments: none