10
Feb
2013
The Cricket Symphony: Surviving Childhood Without Social Skills
Every cricket had a job all throughout my childhood. Each time my mouth opened, the symphony began. People would look at me quizzically, alarmed by my nonsensical humor and lack of social understanding. One time, during Peter Pan practice rehearsal (I was Tootles, one of the lost boys), a girl complained of a mosquito bite. She reached over to scratch it as I laughed. What I wanted to say is “I am sorry you hurt your leg. That must really hurt.” But what came out was a short, tight, laugh. She looked at me with a pained expression on her face, noting out loud that I was weird. I felt bad, but I grinned at her exaggeratedly, unable to express myself properly.
Each time I was supposed to smile for a photo, my face and mouth would curl up in a grotesque, over-exaggerated, distorted version of myself. I couldn’t seem to just smile. “Karen!” They would protest, “don’t smile like that! Stop playing”! And yet I couldn’t. All my face could do is continue to freeze into that same warped smile, as everyone’s smiles around me melted into frowns. Every picture I have during that particular stage of childhood shows me, the little ugly duckling, trying desperately to fit in with the smiling swans all around me. I’d paddle and paddle but just never matched their grace.
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| Upper row, third from left…obviously! |
I survived my worrisome tendencies (and put a few crickets on unemployment) by escaping into the magical world of reading. I could transport myself into stories and not have to worry about saying or doing the wrong thing at the wrong time; my script was right in front of me. I read and I read and I read. I spent my childhood reading. Many trees met their deaths because of my insatiable urge for more books. I typically read at least nine books a week – I could read an entire Sweet Valley High book within a few hours when it took most children my age a week. Sweet Valley High books were fun because the protagonists were twins, just like me and my sister. I was more of a Elizabeth (minus the popularity) while my twin Kristina was more of a Jessica. Elizabeth was so good that Jessica could only look bad. It’s easy to look good when all you do is read. I also loved the Babysitter’s Club series as those girls were everything I wished I could be. The babysitters were prepared, smart, creative, funny, and courteous. This was me, except for well, the funny and courteous part. I was exceptionally funny in my brain, but I’d start to speak and my witty remark would come out as gobbledygook. I remember the way my 5thgrade teacher used to look at me. I’d try to impress her and instead confirm her belief that I was astoundingly weird. The crickets would chirp their agreement.
I started to read books like “The Stand” by Stephen King and “The Clan of the Cave Bear” when I was in 5th grade at 10 years old. The Stand was over 1,000 pages long in a time well before the Harry Potter books made that a less impressive feat. It had a tiny-font and was truly a tome of horror. I read that book every night and every week for hours, determined to present it for a book report. I recently stumbled across my teacher’s review of it and she was very impressed. I apparently knew enough to leave out the incredibly inappropriate parts of sex and gore, focusing on the main plot line of infectious disease. I am sure that presenting that book did nothing for my popularity, although I was very proud of myself.
As I am sure I’ve made clear by now, popularity was something I never had. I understand ways to reach that elusive status, but I either couldn’t or wouldn’t try. For one thing, you had to be able to smile and talk in a way that didn’t leave the crickets scrambling. For another, I had the perception that you had to be willing to do things that hurt other people. For example, I heard whispers of toilet papering and throwing eggs at houses, or shoplifting small items from Claire’s. The popular children laughed hysterically when discussing their exploits; to me all I could see was the face of the person left to deal with the mess. Popularity wasn’t worth that to me. I would rather read.
As I grew older I learned how to express myself in person better, although I still preferred to stay under the radar during middle school and high school years, when children are at their most cruel. Now that I am shockingly a grown-up, my awkwardness is more accepted and my popularity has increased, although I’ll never be part of any “in” crowd, unless it’s a dorky crowd. I survived childhood. I’m a (mildly) successful adult, although the crickets still linger nearby. I currently work as an occupational therapist in an elementary school setting.
In my particular case, I work with quite high-functioning children with various diagnoses, and I find most of them to be extremely delightfully quirky. They keep me smiling on a daily basis. However, these quirks, which adults find so sweet and endearing, make it very challenging for most of them to make friends with their peer groups. I completely understand their pain. I was there. These children end up in all sorts of social skills groups and therapies and interventions. I would have too, if such things had existed when I was in school. Sometimes it helps them and sometimes it doesn’t with regards to learning socially appropriate behaviors and applying them to real life scenarios.
I can’t force friends upon them, but I do my best to help them understand that life will better and better and that people get nicer and nicer.
Category: Occupational Therapy | Comments: 2
7
Feb
2013
Mat Man: Teach a Child How to Draw a Person Using Handwriting Without Tears
I had a first grader come in and I asked him to draw me a person. He did. It was the one on the left with the orange strip (which hides his name). So then I pulled out “Mat Man” with some slight modifications to his face since I was missing some pieces, lol. We went through “Mat Man”, which was developed by Handwriting Without Tears, and we talked about his body, his arms and legs, his ears, etc etc etc…then I drew Mat Man while he watched and I explained. Finally, he drew Mat Man, see drawing on right. This lesson was probably 10 minutes long. Pretty impressive, huh? To go from that left drawing to right drawing in a 10 minute span? We’ll need to do some follow-up to try to gain consistency.
*For those of you who are going to ask about the secret of Mat Man…there isn’t much of one. I showed him up above. He has a big blue body, stick arms and legs, curves for his head, etc…well you see him. Nothing is missing besides the hair (we ended using pencils for hair). I had to improvise his eyes and nose and smile etc, and in fact don’t remember what they normally use for that. It’s basically just the idea of showing them via 3-D objects and Handwriting Without Tears materials what a person looks like, before taking it to paper.
They also have songs about Mat Man. For kids who are auditory learners, they are pretty catchy 🙂
Category: Occupational Therapy | Comments: 6
5
Feb
2013
The Hidden Poignancy of the MMSE – When clients write a sentence.
The MMSE or Mini Mental State Exam is a 30-question exam that asks very basic questions and is designed to screen for cognitive impairment. I did a lot of them while I was doing a 3 month fieldwork as a Level II OT Student in a geriatric psychiatric ward in Tennessee back in 2009.
What I recall most about this exam is the poignancy of the responses when I would ask some of these clients to write me a sentence, any sentence they wanted. I wish now I had saved more of them. Some wrote things like “You are so pretty.”
Or “When will I get better?”
or “I want to leave.”
or simply writing down what I had said: “Write a sentence.”
One euphoric lady’s sentence was: “I am a very happy person and I love everyone.”
For one lady who talked/processed sooooo slowly, she reminded me of Alice in Wonderland, using circular answers such as: “That is the answer to which the answer is asked.” She could not remember the state she was in at all, or county, or town. She scored in moderate dementia range. Her written sentence was: “Please understand.” It gave me chills.
This particular lady (image) wrote “I wish and pray to the Good Lord I go get better” I seem to recall quite a few writing to the Lord to get better. It was always the sentence they wrote that was the most revealing to me as to their inner thoughts. Sometimes it made me smile, sometimes want to cry.
http://en.wikipedia.org/wiki/Mini%E2%80%93mental_state_examination
Category: Occupational Therapy, reflections | Comments: none
2
Feb
2013
A feline SOAP Note
This is a re-post in honor of Ravi. I think this is the one he said he liked…
http://blog.missawesomeness.com/2007/07/nikki-feline-soap-note.html (for original, including amazing picture, although meat of it copy/pasted here)
Initial evaluation with Nikki, a 17-year-old Tortoiseshell feline, home visit.
S: Nikki voiced her complaints of of arthritic pain in her joints
as well as stated she always has a generalized sense of anxiety.
Reports hobbies of watching ants, biting butts, sitting in windows,
and meowing.
O: Nikki was observed taking Amytriptline to calm herself. She
raced from room to room, meowing, as her owner cleaned. She jumped gingerly during window-ground transfers, and appeared agitated.
She bit the wrist of the owner’s friend and did not express remorse.
A: Nikki appears to have difficulty initiating appropriate social
interactions with other felines and humans. Sensory integration
approaches, such as a brush protocol and heating pad may help her
both with her anxiety and arthritic pain. ABA therapy could be used
to teach her to stop biting. She would also benefit from consistent
monitoring of her medications.
P: Discuss plan of care with owner & veterinarian. Visit home
again within one week to determine other possible negative environmental
influences. Train owner in proper sensory integration techniques, including Wilbarger brush protocol.
STG: Reduce Nikki’s biting by 50% using SI techniques, within two weeks.
Category: Occupational Therapy | Comments: none
30
Jan
2013
Guided drawings via Angry Birds
I have a kid who hates drawing but loves Angry Birds. He needs a LOT of work on drawing. Not because it’s important that he become an artist, but it’s important he know how to follow basic instructions and draw basic shapes so he can follow along with instructions in geometry, art classes, basic projects. We went shape by shape and did a guided drawing together. His angry bird is on the left. We had tried guided drawings together earlier and it was like pulling teeth. Once we switched to drawing together with angry birds, he did much better. 🙂
Category: Occupational Therapy | Comments: none
28
Jan
2013
Working on cutting long-term…
I have a kid who is working on cutting. He tends to not cut carefully. Each session he has to cut out several shapes very carefully (you can still see a few mistakes though, cough) and then glue them onto this one sheet of paper we keep. We have it going in “Mario style” (hence some of those question marks from the game) and then he gets to add a Mario sticker. He really likes this. I probably should have put dates on the shapes in tiny pencil too. Hindsight is 20/20 right!
But for those of you working on cutting…consider keeping a single sheet of construction paper in their folder that you just keep adding to, a few shapes at a time, to make a cool board game or Mario theme or whatever makes them happy, with stickers, etc. 🙂 That weird shape on top is a boomerang, by the way…lol.
If I were to do this again, and I plan to…I’d probably force him to go in a chronological order rather than haphazard. IE left to right so you can see the progression in time. Live and learn.
Category: Occupational Therapy | Comments: none
25
Jan
2013
Using stuffed animals in OT sessions…
Today I had one of my kids absolutely cracking up. I had forgotten how much a stuffed animal can help us out. I had Mr. Octopus join us.
Mr. Octopus showed us how he likes to color. He only knows how to scribble (I demonstrated Mr. O scribbling really badly outside the lines). Then my kid and I took turns showing Mr. Octopus, using grid paper, how we could outline a square then carefully color it in using just our fingers. After we each modeled a few squares, Mr. Octopus took a turn. GUESS WHAT! HE DID A GREAT JOB! WOW! We taught him how to color!!! We gave him a lot of high-fives, seeing as how he had 8 arms… 🙂
That particular kid normally scribbles herself, but because I made such a blatant example out of Mr. Octopus, and then we made ourselves the teachers, it really helped.
We also brought in Mr. Monkey who helped us with doing some counting (in this case for the fine motor piece (what we were counting had tiny holes we were placing onto a peg). Mr. Monkey wanted to do the counting but due to having velcro hands he couldn’t do the hard work himself, he could only give the directions. Unfortunately Mr. Monkey didn’t have much of a backbone (no pun intended) and so he kept falling over. This is one of those things where you can get frustrated OR you can turn it into purposeful activity. “Um, Mr Monkey? Why are you sleeping? We are working here. Wake up.” Instantly it turned into something silly and the frustration disappeared.
(Anytime I am working with a kid and a bead goes flying, or something unintentional happens that can get frustrating to a kid – turn it into something a little more silly – “Hey! Look at that bead, running away! Time out for you, Mr Bead!” (And also consider a small investment in something like Dycem, cough)
I want to take some pictures of a few other things of the day including robot space caterpillars and donuts but this is getting along and um, it’s time for bed.
Category: Occupational Therapy | Comments: 1
17
Jan
2013
OT Review of iPad App Dexteria for Fine Motor Skills
I was approached by BinaryLabs, Inc to review Dexteria on the iPad (and two other apps to come soon). Dexteria works on fine motor skill development and there are three components to this particular app.
1st component: Finger sequencing and isolation:
Place your thumb on an anchor point (either hand), practice isolating your other fingers in a varying sequence that the iPad provides. I see this being a great tool for the right person! I work with children in lower grades of elementary school, so it tends to be slightly too challenging. They can keep the thumb anchor point but then can’t isolate the correct finger quickly enough before it moves on. You can see in the screen shot that my child is using any finger possible. By the time she takes the time to figure out the correct finger, the sequence has already moved on.
My suggestion: instead of the program having a sequence that happens at a timed interval (it moves on regardless if anything is pressed), consider having the option to have a sequence that only moves on once a button is pressed. That way my kid could spend time figuring out the correct finger, press it, and then move onto the next one. However, I am sure for older kids and adults it is awesome just as it is. 🙂
2nd component: Fine motor manipulation and control:
You have to pinch little crabs. This one is super cute if not slightly awkward, especially depending on how long your nails are! I like this one as well and it gets fast quick! I saw Tonya of TherapyFunZone.com recently make her own version of iPad tongs. I wonder if they would work for this. http://therapyfunzone.com/blog/2012/09/ipad-chopsticks/
3rd component: Practice letter formation.
I was in an iPad class today and I had an OT remark that her children found this particular handwriting app very challenging. I was surprised by this. My little kids aren’t particularly fond of this one as it doesn’t have any bells and whistles to make it fun, but I haven’t seen them too frustrated by it. You can practice uppercase, lowercase, or numbers here, and it’s very straight forward. Not a lot of distractions. I think it would be great in cases where you don’t need any playfulness. You do need relatively good control as it dings you quick if you go outside of the lines.
A funny little note that I mentioned in a recent post: I’ve been using Dexteria with a little girl several weeks in a row and have used the name of the app with her without thinking about it. She came in the other day and said “Can we use Dexter?” My first thought was the serial killer, not the app. She then instantly swiped my iPad to the left to the search box and start typing in “D..e…x.. to find it. I was impressed with my little 2nd grader!
Have any of you guys tried Dexteria out? With who? What do you all think?
*I received a free copy of Dexteria (it’s less than five dollars) in exchange for providing a review on my blog. The review is unbiased as the opinions are solely my own.
Category: Occupational Therapy | Comments: 1
16
Jan
2013
Therapeutic Handling Lab Demo
Wow. I was going through old Youtube videos and I found an old Google Video I had made that got transferred over to Youtube. This was probably from 2006, so early on in OT school, after a therapeutic handling lab. Obviously, as you can see from this video, I was trying to rehash what I had learned in terms of hand placement and progression…just sharing as it is a blast from the past!!! And the kind of things current OT students will learn…although hopefully with less awkwardness 😉
Category: Occupational Therapy | Comments: 4
15
Jan
2013
My elementary school OT day in a nutshell….and oh a shameless request too.
http://www.indiegogo.com/missawesomeness
Okay all, I’m trying to raise money to fund my first children’s book (already written!) as well as educational ipad apps and some other branding initiatives for Miss Awesomeness! In other words, stuff you could one day use to work with your kiddos!!! My campaign ends next week and so I’m going to be as annoying as NPR only for a single week. Actually I’m exaggerating, I could never be as annoying as NPR during their drives when they ask for money every single second of the day. I’ll ask every few days for the next week and then it’s over. Seriously even a few dollars helps, not kidding, because it helps drive the “go factor” up and then it’s more likely to be seen by others… THANK YOU. Okay moving on… 🙂
Today included …….let me think….some swinging, trampoline, “verbalizations and visualizations” of a Pokemon character (and later a 50 foot baby) and starting to handwrite using hi-write paper about these ideas….some tracing, some Handwriting without Tears number writing, a lefts/rights/1-2 step direction game (ie go 3 steps to the left, two steps up….)…um….some angry birds on the ipads free choice time….some angry birds plush pencil toppers used for finger isolation….some adapted tripod grasping…some small tennis ball head man time (he was fed pennies)….a Touch & Write ipad app was used in conjunction with handwriting…cutting….guided drawings using angry birds….desk organization…..and an IEP meeting…….and a partridge in a pear tree…..etc 🙂
Tomorrow is an all day ipad class! And hopefully, finally, the Dexteria review!
Karen
Category: Occupational Therapy | Comments: 1