22 Oct 2013

The Journal of an OT Shadow Part 1

I’m copying the journal entries first and then explaining them in more detail down below. Journal entries from my current OT shadow who just started 🙂 Yes, I’m apparently a goddess….but I felt that way about my OTs when I first started shadowing too, fifty million years ago. 🙂 No editing except to change names and add line breaks.

October X 2013


Today was my first day working with Karen, the OT for XYZ School District

I have never felt so excited about a life changing decision in my entire life. I am absolutely obsessed with OT and after working with the children and watching Karen impact their day I am positive this is the career path I am meant to be in. 

She tells the children it is her job to make peoples lives easier and it was then that I realized how impacted these children’s lives are by their disabilities and how important the job of an OT actually is. She has the children start the session with a task they often have to complete in class such as opening their binder, or stacking papers in order. 

I was astonished at how long it took for them and felt so much compassion for these children. I can’t imagine how frustrating it must be for them to keep up and learn in school when they have trouble completing a small task. Karen broke down the task in such small easy to understand steps that I would have never thought of before. Sometimes when she had a child do something like turn on the light I was confused and didn’t realize she was actually checking to see how they were paying attention or following directions. 

I came to the realization that helping these children help themselves with small tasks would allow them to pay attention and follow directions better in the classroom setting so they could keep up with their classmates.


I love the focus OT has on anxiety and self esteem. I was a very slow learner and never thought that I was smart in school. I was so moved the way Karen spoke to one little boy and made him look her in the eyes and tell her that he was smart. These children probably feel inadequate in school, and you could just see the way she had made him feel smart and special when he left.



NOTES BY KAREN: Shadow will learn that everyone has a different idea of priority and focus once she starts to see more therapists in action….I definitely do a lot of my approach via increasing self-esteem and decreasing anxiety. She also learned in her first few days that while it seemed at times I was being off-task/”slow”/inefficient/asking them to do odd things/not providing them with important items, I was actually 95% of the time doing it for the benefit of the kids…forcing them to ask for what they need, find what they need, follow basic directions and sequencing, do heavy work as they walk in the door to “set up”, give them some information or part of the task but not enough to finish it without some basic problem solving or requesting assistance, etc….simulating the kind of things that happen in a classroom setting. 

For example I might give them part of a task or task instructions without necessary supplies, then turn away and start “being busy” with something else for a minute to see what they do….if nothing happens, I turn around and cue as minimally as possible and act surprised….ie….why haven’t you started? “Because we don’t have pencils” and take it from there). After a few times of this being done dramatically they catch on, typically. Shadow wanted to help, ie popping up to get the pencils, and I had to let her know after a few minutes that unless I cued her “Miss Shadow, can you…” that I was being slow to force the kids to initiate and problem-solve. It’s one of those things that have to be explained because of course it makes sense to pop up and get pencils for kids who don’t have them when it seems like I just forgot. I would have done the same thing. And sometimes I do cue her to do it because I legitimately forgot! But usually….intentional mistakes. 🙂 


October Y 2013


I was working with a child JaneDoe on her math homework and was totally caught off guard by something Karen had shown her. She showed JaneDoe how to eliminate answers on a multiple- choice test without completing the problem first. I thought this was odd and that JaneDoe would cheat rather than finish the problem and I didn’t think it was a good idea. I later learned that JaneDoe often freaks out on tests and that she has very low self -esteem when it comes to test taking and Karen was trying to empower her and give her some confidence in herself during the test. 

I would have never thought of this, and was amazed at the small way Karen was able to help her have confidence during the test.  I also did not understand that JaneDoe bombs the tests and does not have time to finish. This showed me how OT really looks at the big picture and helps people deal with real problems rather than on the small scale how to get an answer correct, but how to complete a test overall and how to take all test efficiently and fix a larger scale problem rather than division skills.

*****(NOTES BY KAREN: Yes, I was working on test strategies rather than answers, including how to approach a multiple choice test and eliminate obviously wrong answers  – many of our kids KNOW the material but freeze up on tests due to stress/insecurity as well as not knowing how to approach a test. I do this from the OT angle though, of strategies, problem solving, slant boards/masking, visual clutter reduction, sequencing, etc etc) I want to write a whole blog post on this soon but for now…..yes, it was about having a child approach the test with confidence that they can get through it in the fastest and easiest way possible, that since they know the material they can do well on a multiple choice test because it’s a game, and that the answers are always right there.

It’s not about whether the child can do every single question correctly, it’s about whether the child feels confidence in their ability based on new OT-based skills, and can do better on the test, for example, if they have a 50% chance of right answer versus 25% by eliminating an answer or two without even having to do the full problem. Etc etc. Many times “strategy” starts with a feeling of confidence and empowerment and then it goes from there with foundational skills related to OT….and of course the academic ones, but I’m focusing on my part! 

They have to have foundational set-up skills to be able to do the academics efficiently/correctly/securely! Oh and yes, our children typically have IEP accommodations to allow for extra time….but extra time doesn’t mean much if the child becomes discouraged or easily fatigues and just gives up after a while!) 


Alright now for the chat about having a long-term OT shadow! I’m just naming her “Shadow” for the purpose of this blog but I don’t mean it in a rude/degrading way. I love her and it’s just an easy describing name! 

My shadows have been prospective OT student, both long-term. I’ve had great experiences so far (although this is only my second, and we interview carefully first!!). The initial set-up for them both in a district sense and an OT sense is challenging at first in terms of adminstration/hoops to jump through, but can be totally worth it. However, before a bunch of OTs get bombarded by hopeful shadows – every district/company is different, every OT is different in what they want or can handle, different legalities/policies….

Luckily my current shadow like
s to write and I’ve asked her to do some journaling for both herself and possibly for the blog. I just replace names out. 

I really encouraged her to not censor anything or not worry about relevance, etc, but so far I don’t think she believes me since this is like the nicest fan letter ever, ahahahaaha. 

She doesn’t know me well yet but I will continue to encourage her to be “real” – since I feel pretty certain she won’t be so flattering at all times….she’s in the honeymoon stage. 😉 She wants to organize the notes for me and I keep telling her not to do a thing unless its for HERSELF – I like transparency, and the messiness of learning, not the re-assembled learning after we go back and fix things with new knowledge. I like for people to see the WHAT?!!!! and the pre-fixing…the learning out loud, not the “learning out later”…actually I like both together, first out loud, then out later….nice to see the process.

Whoops I’m rambling again. My shadow is doing a great job and trying hard to meet my needs, I’m going to have to keep pushing her to include that my needs include not meeting my needs, ahahahaaha, meaning sharing the messy and scattered and unknown and MEAN things like “what the hell is she doing?” even if she figures it out later that it wasn’t as weird as it looked. ahahaha

So while her journal entries above are a way too glowing testimony (although when I look back at me as a prospective OT student I thought my OTs were gods for a long time), I do want you guys to see what it looks like when you are new and trying to figure stuff out.

There are a few pieces that aren’t 100% accurate in terms of IEP process but she is writing it based on only a few days of knowledge – so feel free to comment on whatever, but realize it’s a perspective that doesn’t have a whole or fully accurate picture yet, so please don’t assume something isn’t happening based on a statement…


In conclusion – I’m hoping to continue to share what Shadow is willing to share about the learning out loud process of figuring out what OT is even when it doesn’t make sense at first (or ever, haha), but also encouraging her to get that it is TOTALLY okay if it’s not this glowing, nicely organized piece…maybe next time it will be all over the place, that would make me even happier…;) ) 

Category: Occupational Therapy | Comments: 1

22 Oct 2013

Man with amputated leg has awesome Halloween costumes


This guy definitely fulfills our OT ideal of living life to its fullest. Love the creativity of his costumes incorporating – yet not – his amputated leg! 

Category: Occupational Therapy | Comments: none

7 Oct 2013

AnonymousOT – love her blog

I was searching the Internet for something I had written about a child’s handwriting progress as I wanted to bring up the picture for his upcoming IEP meeting – essentially when we started together, it was some of the worst I had seen – I had all these papers with a single line or two on them with pencil, then red marker scribbles on the rest. Now the handwriting is so amazing.

Anyway, as I searched, I came across a mention of my name and it was in this post, 
Now that I link it, it sounds like maybe AnonymousOT was talking about burnout for us, but actually she was talking about the challenges of burnout in general and referenced several “OT superheroes”, I am proud to say I was included in her list. I’ve had a hard time reading blogs this summer between a lot of distraction in personal life AND, most importantly of all, the sad demise of Google Reader which is how I did all my blog perusals. 
ANYWAY, I wanted to share this post because I know many of us have struggled with these burn-out feelings, or will struggle, or currently struggle. I’m currently in a great place where I LOVE LOVE LOVE what I am doing with the kids and need to write more soon as well as make more videos, but I have definitely been in dark places OT-wise. Not so much literal burnout so much as feeling like I wasn’t doing as good of a job as I should be able to. But here’s the thing about burnout.
The question that is so important.
Is it really burnout of OCCUPATIONAL THERAPY or is it burn out from your JOB? Because I can’t fathom a day, even on its worst day, that I wasn’t absolutely passionately madly in love about the theoretical tenets of OT, even if I’m upset or seriously burnt out based on job issues, insurance issues, etc. How can anybody not love a job where we look at any person in any situation and figure out how to make their life easier?
I can honestly say I have not learned a single fact or theory in at least 7 years that I don’t immediately apply to OT in some way. Okay fine, I guess if I learn about chloropyll or something I’d struggle to make the leap unless I could go into “reaching for the sun” or something. But you get the point. Nothing I learn goes to waste if it has even the slightest, tiniest, seed, that could be used to further OT development. 
And everything I learn I then think of how I want to best share it with others, because learning to me is most valuable when others can learn too, reflect, grow new branches, share, critique, whatever. Help further AOTA’s Centennial Vision for occupational therapy. I take pictures of things all day every day I want to share. Unfortunately I run around so much I don’t always get to post most of them, considering if I posted as often as I would like to with new information/ideas, I would post forty thousand times a day with only the TEENIEST bit of exaggeration. 
I now tell my kids that my job is to make their lives easier. Of course go into more detail after that to clarify what that means (ie I’m not implying they will get to sit and eat bonbons all day because of a decree I make). But essentially, after years of still struggling to come up with an “elevator” definition that is fast yet all encompassing yet not too vague, I’ve found that “making lives easier” is the easiest way to get it across to my kids and even a lot of adults if I only have a second. I give a few examples of how it can apply from age zero to two hundred in any setting and what “occupation” refers to, etc, if I have time. But if I only have one second? We make lives easier. 
Maybe AOTA’s headquarters peeps are reading this (hi everyone) although probably their eyeballs declared revolt years ago since they’ve known for a long time I don’t know how to shut up. But anyway if they are, they may be banging their collective heads against a wall for perhaps using a definition they don’t fully agree with (???), but I like to think it’s the awesomest definition of all. It’s such a comforting idea – we look at the world in the way that allows us to make lives easier for anybody and everybody and then everyone wins, and then everybody ideally gets to “live life to its fullest” due to helping learn “skills for the job of living” due to wanting to make lives easier. Occupational therapists, woo woo. 
WIN WIN GUYS! WIN WIN!!! Sis boom bah rah rah rah 2 4 6 8 who do we appreciate…OT OT OT….flashback to my classmate Stephanie from OT school doing a cheerleader OT chant for us in our Miss OTPF video 🙂 Oh the memories. Speaking of memories, she just had her first baby. So many of my OT classmates are on their first, second, or even third or fourth??? babies. Mostly firsts and a few seconds. I feel so old. 
I’ve got to say I have no idea I went from searching for a kid’s handwriting to burn out to ending with a cheerleader flashback, but it’s why I’m good at improv… 😉
Category: Occupational Therapy | Comments: 2

7 Oct 2013

"Learning Out Loud"

I loved this article as it really speaks to what I appreciate and what I strive for – a constant transparency to a process from beginner to expert and all the problems along the way that have to be solved, as well as true curiosity about experiences for all, thinking outside the box, etc etc. 

Category: Occupational Therapy | Comments: none

3 Oct 2013

Resonating words for me and hopefully my OT kids

I’m trying extra extra hard this year to remember that LEADERS MAKE LEADERS, NOT FOLLOWERS. 

My goals for my kids this year that really resonate are to teach them the following vocabulary words in relation to our sessions together…I can use simpler words as necessary or just the concept, but to reinforce the ideas that each kid can think these things on varying levels of understanding – I only do elementary schools and most of my kids are K-4 as I have a high functioning caseload, so some of this is lofty, but I think awesome and helpful and possible to help think of themselves differently even at a very young age. 
The key words: Empowered, Self-Advocate, Efficiency, Organization, Independence. My words of the year.
Some of the things I’ve done lately…have them come in, pull out their personal folders, sign in on special lined paper with full name and date, get out their reinforcing “dollar” and write their name on it and hand it to me as they may get it back at the end (after a few sessions they may earn enough for a few minutes of free choice, depending on the kid…), then for example…
1. Give them a bunch of scratch paper and have them follow my directions on labelling in a certain spot their initials and page numbers, ie 1-7 pages. Demonstrating how OOPS I FELL and throw everything into the air. Have them pick it back up and sequence it which will require some rotations and stacking. Surprisingly shockingly hard, you won’t even believe it. Most common issue is doing it backwards, ie 7 6 5 4 3 2 1 rather than 1 2 3…and then trouble with changing the sequence if so. 
2. Have them put things in sheet protectors and into a binder, in correct orientation…
3. Have them staple paper in the correct way and strategies to make it easier when it’s hard, such as pulling the stapler much closer to the edge of the surface closer to them, making sure its facing them with its teeth, and using both hands to push down hard on the stapler long enough to feel it really click…
4. Have them accidentally rip a piece of paper in half and then use tape to fix it. Focusing on strategies of where to hold the tape to most efficiently/easily/least frustratingly tear it off,  etc etc
5. Throw a bunch of stuff all over the table. A lot of stuff. A ton of papers and flat stuff all over, some pencils, a few pouches and random toys, etc. Ask them to take it all into another room. Then watching what ensues – wow. Some kids have a better intuitive grasp than others but all needed coaching on problem solving, knowing what goes on the bottom, etc. Then some need help understanding how to slide one hand underneath and clutching it to the chest for support while trying to open a door with their other hand, etc. Teaching problem solving, strategies, etc. 
In each case, we are working on functional classroom skills that they struggle with, ie rubber bands, hole punches, putting papers into folders, sorting, etc – to make their lives easier by showing them simple methods that give them a sense of power – wow, I can do this. I am powerful. I am a problem solver. I don’t need help. I am independent. Etc
Plus the more they can pay attention to learning versus slamming down a tape dispenser with frustration, the more we all win. 
These skills have almost immediate functional carry over into the classroom, especially with reinforcement and a follow up whole class-instruction on it, and ideally that child even teaching others the skills. 
I’m going to start doing a series of short videos I can send onto parents/teachers as sort of an informal RTI – maybe they already exist but I bet they aren’t quite what I have in mind. I need to go to bed now!! 
I’ve been taking amazing pictures lately of things my kids are doing (the picture in itself is not exceptional in its like, i dont know, high definition resolution, but the concept is cool)….now it’s just finding time to post about all these things. I’ve been in the process of moving so things are more hectic than even normal. But I’m happy. And have so much to share!!!
And by the way, my Pinterest has almost a 1,000 followers, 900 something……must throw a party when I hit that number. 

Use at your own risk! I haven’t tried a lot of what I post (unless of course the picture and description came from my blog, haha), just seems cool!
Okay BEDTIME FOR REALS THIS TIME. I don’t think I have EVER managed to stop writing right after I say that. 
Category: Occupational Therapy | Comments: 1

3 Oct 2013

Blowing gum bubbles and teaching how to do a ponytail, OT style

I work in elementary schools and obviously we work on functional classroom based tasks. But sometimes, for example, I’m asking a little girl to show me how to wrap a rubber band around a pile of popsicle sticks the way they sometimes do in class, working on basic functional utensils exposure, etc. I volunteer the information it’s like doing a ponytail. She says she doesn’t know how (and is way old enough to be capable). I promptly ripped the ponytail holder out of my hair to have her watch me slowly and carefully go through the steps, then helped her. We had just done a lot of challenging work writing and focusing, so our “break” was still OT but in a more personal way, ie not something that ends up in an IEP goal. 

Same with bubbles – it may be a small break for a kid who never quite has self-awareness of their challenges, but has just volunteered they wish they knew how to blow bubbles. (Sometimes because I let my kids chew gum to help concentrate and I join them and absent-mindedly blow a bubble!) As soon as a kid can volunteer a wish for something they’d like to do, I want to reinforce it and help empower them and understand how our job is to make their lives easier/higher quality. So then our short break can consist of bubble tips for a few sessions or something.  What a great way to work on sequencing, motor planning, following directions, oral motor skills, etc, while the child thinks they are on “break”. 🙂 I love using breaks as a way to do more OT. AHAHAHAA
Category: Occupational Therapy | Comments: none

1 Oct 2013

Even hula hooping becomes occupational therapy :)

Tonight I was trying to help a friend/new hooper how to do the “snake” like moves where you hula hoop on your chest. She was struggling and as I watched to analyze the task and break down where the issue was, I realized that it was due to her stiffness in that she struggled with scapular retraction, bringing her scapulas together in the back – she tended to subtly compensate by leaning slightly backwards so it took a while to figure out. I put my hands solidly on her hips to isolate and began to work with her on isolating her upper body and circling with emphasis on scapular retraction- but she needed more assistance than I could provide with two hands, so I enlisted her husband. He took over solidly holding her hips for me and I took over guiding the circular movements and using my hand to help encourage her scapular retraction when the movement called for it.

After a few minutes of his hip holding and my scapular facilitation, we faded to me holding her hips and her doing the circular motions with occasional verbal cues. Then I held her hips less tightly and ultimately not at all, then gave her feedback solely verbally and had her watch herself sideways in the mirror, etc. I also showed her husband how to assist her/know what to look for, since she is super motivated to learn hooping and he is super motivated to help her! 😉
This, to me, is a perfect example of how OT works – breaking down a task into small pieces to find out where an issue is arising, then pinpointing it and how to potentially fix it, work on fix, fade away assistance, and reinforce using internal/external forces, ie mirror, motivation, husband, etc. And not just the breaking down of a task, but a task that is really meaningful and “occupying”. Of course this was a friend, but the same applies to all OT!
I know I’ve been quiet lately – I am in the process of moving and it’s a lot of work. Also, because of the death of Google Reader, I’ve stopped reading blogs because I imported to Feedly and do not have the patience, time, energy, whatever, to figure it out…so I feel guilty about not reading others – and I think it makes commenting/interacting much harder as I feel like I’ve lost all my blog communities with the shift. 🙁 Anybody have one they like??
Category: Occupational Therapy | Comments: 2