A blast from the past from fieldwork

I found this in my “draft box” and it’s literally almost four years old, from when I was doing my FIRST Level II fieldwork, apparently near the very end of that first 3 month rotation. So here’s a blast from 2008 I think. I was just writing notes to myself to remember, I guess…



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Moment of the day:

Child with Aspergers says to Child with Down Syndrome and Open Trach: “Hey! What’s that hole you have there?!

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Some interesting treatment thingies:

1) Child with autism that we have discovered LOVES climbing on heavy bolster within ball bath, then jumping off it into the balls…but I’m standing right there in the balls to keep the child from just like, cracking his head open…anyway…he climbs/uses me as if I’m inanimate in the sense that he doesn’t particularly care where he holds onto me, lol, but today he kept on kind of grabbing me and having me look into his eyes…would smile…and since things were chaotic of course my attention was divided, but he repeatedly – at least 4 or 5 times – turned me slightly to look into my eyes and smile. Very unusual…and definitely not typical of him.

2) Another child with autism who was doing well today…so I pulled out the fingerpaint and painted his face in the mirror because I suddenly remembered reading somewhere about it….not like elaborately painting, just a few strokes on his face for novelty sake…and I asked him where he wanted me to put it and he actually answered (he usually has to be coaxed to answer questions or, most often, completely ignores you)…and actually wanted it…and he would look at himself in the mirror, and then I’d put some on me, and he’d look at me. Very cool.

3) Child with severe behavioral issues…used a heavy bolster for him to kick and punch some…then laid down on a mat with lights off,read some from a relaxation book for kids…did some squeeze and tightening of muscles and then relaxing into a wet noodle…I actually wasn’t thrilled with the wording of the book, I’m like, I need to make my own! So we’d squeeze everything then loosen up noodley…

4) Child with Aspergers…working on a puzzle with trusty Mr Snail…and he needs to work on frustration tolerance…Mr Snail was asking him for lessons on it…he was like…”Stop…breathe…think!”…etc.

5) COTA got a grasshopper up her scrubs while we were outside playing with bubbles, hahaha

6) I just realized I didn’t tell a single one of my older kids – ie, all the kids above, that I would not be back…yikes. I guess it just doesn’t feel like I’m leaving so it didn’t even occur to me to say anything. And I took back some of the toys I had brought in – the snail puppet that one kid loves so much, the SpongeBob Potatohead (that apparently is not easy to find) that another kid is OBSESSED WITH, the Gary the Snail blow-up that another kid loves, etc…a lot of cool toys…

Okay….augh it’s 120am…gotta be up in six hours. Better go to bed. Tomorrow I have to create an autism brochure, maybe help write up a one page proposal for a community psychosocial fieldwork or at very least set up stuff for it, set up stuff for someone else to do mileage/direction charts (or do it myself if there is time but I doubt it), finish up a few plans of cares/addendums for Medicaid, and put together all the pictures in a folder to transfer so they can deal with making a staff/kid picture wall. Gonna do the Medicaid stuff first since it involves money, then the autism brochure since that’s legitimately a project, then make sure all pictures are together, then work on those other projects. Oh yeah, and in the early afternoon I guess we’ll be doing my evals!

Halloween, eye hand coordination idea

birthday flowers :)

Empowerment via Education

I’d like to share a recent experience I had at Kohl’s and how it applies to our OT world.

Checking out at Kohl’s:

Me: Oooh, can I have some of these scratch off coupons? I’m an occupational therapist and I work with kids who need to work on fine motor skills and this would be great for them.

Cashier: Sure! Hey, my brother is in high school and he gets OT for fine motor stuff! That’s such a cool idea, I should bring some home for him.

Me: Look at these hangers with clips on them, those would also be great. And the stapler and the tape in front of you. Just look all around you and you can use almost anything!

Cashier: That’s really cool. I never thought of all that.

I’ve been thinking a lot lately about the power of client/patient/consumer/caregiver education. We need to remember the fish parable – if we give a person a fish they eat once. If we teach a person to fish, they eat forever. I know us occupational therapists pride ourselves on education and helping others, especially with things like “If X happens, try Y”. And we do try to teach our clients how to fish, but sometimes we teach them very specifically and it doesn’t generalize to other fishing poles, fishing locations, etc.

We need to look at education as an evolution of empowerment. We do need to teach our clients specific strategies but we MOST IMPORTANTLY need to teach our clients how to do their own problem solving by teaching them more global strategies they can use when encountering challenges. We want to help our clients develop self-efficacy, a sense of control of their environment, a sense of the importance of self-advocacy and taking responsibility. This is all done through education, but with the very important goal of empowerment. This is an evolving process, progress in empowerment can take time, but it requires encouraging creativity, flexibility, innovation, solution-oriented activities, and the “common” sense that we all know is actually quite uncommon!

When I was in Georgia, I worked with a woman who needed help with energy conservation and joint protection techniques. I gave her a ton of specific ideas and strategies, but a lot of our time was spent looking at how SHE could do the problem-solving and use her own understanding and knowledge of herself to see her world differently, even if the solution was not spelled out in front of her. It may even just be that she acknowledges the great things she was ALREADY doing and not even realizing how great they were (the self-advocacy, asking for help for certain strenuous tasks, taking breaks…).

For my slightly older kids who are cognitively intact (I’m only talking like 4th grade here), I’m doing more work with them on self-advocacy (a HUGE part of empowerment) as well as more work on problem solving things they encounter in their school day that are challenging. When they ask me a question, I often work with them to help THEM figure it out rather than me just answer “Oh, X happened? Do Y.”. Instead it’s more like “Well, that’s a great question. So X happened? Hmm, let’s figure out some of the ways we can solve that problem. What have you already tried? What do you think we could try?” Etc etc. We work as a team, and I’m modeling the problem solving strategies they can be using themselves.

All of this is often easier said than done, and it of course depends on context, environment, amount of time, cognition level, etc. But from a very global viewpoint, I think one of the most important things we can do as occupational therapists (or again, in almost any role) is see ourselves as agents of empowerment. Here’s a fish, now let’s have you fish, now let’s figure out how we can fish any time, any place, and share our fish with others too. 🙂

How to remember to write a number

I found this on a whiteboard at one of my schools. If anyone knows where this came from so I can give credit, I’d be happy to – it’s some very cool number stories 🙂 

OT Related Gift Ideas at Costco… Ideas at Costco

So lately I take pictures of everything under the sun that captures my fancy so that I can remember it later and decide if I care. I’m also using it as a strategy to stop buying so much stuff. Sometimes I think I buy a toy for my kids because I don’t want to forget about it as an option. Pictures are better since I have enough toys to fill a freaking warehouse by now. ANYWAY, this is kind of a random post since most of these things I haven’t tried, but I took pictures of things that seemed interesting to me for whatever reason. Mostly stuff for kids, but a thing or two for older people.

These were called Superstructs and I know the picture sucks but that was actually a video that Picasa turned into a picture. Whoopsiedoodles. Anyway, I have not tried these so I recommend you read some reviews as they are relatively expensive, but they looked like really great toys in terms of fine motor, problem solving, etc.

I actually do NOT recommend this wooden responsibility chart in that I think it’s easier to do very simple dry erase ones or plain ones and not have a million elaborate little magnets. With that said, if your kid sees this and likes it, and doesn’t mind a lot of visual clutter, then go for it. Many kids do MUCH better when the expectations are laid out. (I was intrigued by the fact that “worship” with a picture of candles was included in responsibilities!)

I thought this counting elephant looked super cute although I have no experience with it. 🙂 Same for Lalaloopsy – I like that she is colorful, bright, large, silly, imaginative…

For the Tummy Play Pad…some kids are not huge fans of tummy time and this can help make it a little easier. Tummy time is REALLY REALLY REALLY important so if your kids don’t like it, you need to find ways to make it more acceptable (that may include a visit to the pediatrician and perhaps a referral to an OT, cough) and this is one way it may work by making it slightly less horizontal… Anne Zachry has some great tips on tummy time on one her posts on her OT blog. [Insert link here if I was not so lazy about searching]
 

These building blocks seemed like sturdy, high quality blocks that allow for a lot of imaginative play. You may need to role model this kind of play. Don’t get these if your kids like to throw things, lol.

Those alphabet puzzles look awesome, nice and huge. But interlocking is not that easy so be prepared to teach puzzle strategies!

I liked these monster art tubs. Good stuff in there. And wow, that’s a LOT of play doh. I actually prefer making it by hand (tons of recipes on Pinterest) or using theraputty, but playdoh has a lot of great components to it and if you DO use it already, Costco has a large quantity of it available.
   

So I took a picture of this kitchen set box because it made me laugh that the girl was cooking and the boy was on the phone….will the gender role stereotypes ever stop?!! 😉  Then Tana making herself some pretend coffee with a perfectly straight face using that kitchen set…that’s exactly the kind of stuff you need to do to make your kids (or friends) laugh. 🙂
 
I like all these little pod things…squinkies, zinkies, pods….I don’t really care about the actual circle thigns or maybe what it’s truly intended for, but I do love the tiny toys inside as they are great for fine motor skills. I like using them with tweezers or tongs and putting them into ice cube trays but the possibilities are endless. Choking hazards of course though so be careful.

I want that pillow chum rainbow unicorn super bad. It’s nice and heavy and very soft. Nice for kids who like a lot of weight as you could put it on top of them WITH SUPERVISION (not covering their faces of course)…they also had giant plush angry birds that I am sure will be very popular with many kids. You could play ball with them. 🙂
 

I liked these large print word searches…great for elderly people who love them but need bigger print, but also great to use as Hart charts or word charts with kids to do things like have them scan for certain letters, work on left-right top-bottom scanning, etc etc. So I wouldn’t use them as word searches necessarily but use the charts in other ways.

These number flash cards looked better than some of the other ones I’ve seen that are way too complicated. Didn’t get to see this in depth, but the cover looked promising.

Same for those alphabet, counting, and silly sentences boxes! Nice, sturdy, big, bright, simplistic….

So for much everything I just talked about….choose at your own risk…just my THOUGHTS as I was strolling through…you are still responsible for safety etc!! I just wanted to share that if you are a Costco member, they have some very nice high quality products at a relatively low cost, that would not only be a nice gift but a way to work on OT skills!

"Early Therapy Can Change Brains…"

I am very curious about this article http://www.cnn.com/2012/10/31/health/autism-therapy-brain/index.html?hpt=hp_t3