30 Sep 2014

Where's Waldo? But for Science – How Online Volunteer Programs can be used in Occupational Therapy


This article had some great implications for occupation-based therapies. Possible assignment for fieldwork students at bottom!

ARTICLE: Where’s Waldo…but for science” by John Sutter.

The article explains how an innovative program in Africa is being used to prevent poaching of rhinos and other wildlife, using a Where’s Waldo? approach. A drone takes pictures of the land of a wildlife refuge, and then the program coordinators has online volunteers sift through the pictures and circle any animals they find. They are called “digital rangers” and it was a way to quickly do a land survey.

My favorite part was the picture and caption. It shows an overhead land shot, with five clearly defined animals in the picture. The caption says "There are five oryxes in this photo. Can you spot them? If not, please don’t volunteer with this project.” It made me laugh. I attached the photo here, which came from the linked article.

The article made me think about how being a “digital ranger" would be a fabulous occupation-based method of working on important skills. While the book "Where’s Waldo?" may be appealing and appropriate as a play-based modality for many of our kids, it can be insulting to some of our older clients, or in my case, overwhelming.

However, as an adult, working on important skills via contributing to an online volunteer project aimed at conserving wildlife? Pretty Awesome. You get to work on problem solving, and scanning, and attention, and figure/ground, and all sorts of great yet often challenging skills, yet in a highly motivated state. (And could be done with the occupational therapist present to ensure accuracy!)

I also think many of our kids would prefer this type of task to the Waldo book, as primarily the kids who like Where’s Waldo? are the ones who least need to work on those skills.

Unfortunately, I believe this particular example was not open to the public, but the implications are far-reaching in occupational therapy. I’m realizing there are probably tons of projects that request online volunteers. For projects that allow the volunteers to spend as much or as little time as they want, the OT could sign up as an online volunteer and then work with appropriate clients in short bursts of time. I think Google Earth may have some.

Also, www.freerice.com is a brilliant site that allows you to gain knowledge while simultaneously giving to charity. For example, if you play their vocabulary games, each correct answer gives a donation of a few grains of rice to a charity. It can add up, and they have expanded to have many different learning games. Check it out.

Can any of you think of sites that ask for online volunteers? Or sites that allow you to gain knowledge while donating to charity? There are just so many possibilities. Maybe one of these days a fieldwork student could spend some time searching for online volunteer and charity opportunities and post a list to OT Connections. I was thinking it might be a great task for patients who have had traumatic brain injuries.

So……OT students or occupational therapists….assignment. Find online volunteer and online knowledge/charity sites, and share them!

Category: Occupational Therapy | Comments: none

29 Sep 2014

Hair straightener/flat iron as iron?

My friend Elle told me she uses her flat iron to deal with wrinkly sleeves/collars. A lot of people (mostly younger) don’t even have irons anymore. Granted I can’t do my entire curtains this way, but the edges were particularly wrinkled!

Use at your own risk and be safe. Don’t burn your house down.

It seems to me like an energy conservation technique – to just quickly use your flat iron for a sleeve or collar and not pull out the heavy iron and such.

Be careful, buttons/zippers/accessories would likely melt, and like I said, do at your own risk!!! A cool life hack if you don’t set anything on fire while using it. 🙂

Category: Occupational Therapy | Comments: none

21 Sep 2014

The importance of sensory play

I brought an apron with me to a client’s house because I knew we would be playing with whipped cream! I chose the whipped cream over shaving cream so that some tasting could take place. I bought the can of cream before the session and we used up the entire thing. We put plastic finger puppets on top of the canister, we drove cars through it, we got some plastic bugs dirty enough to need baths…

The child has a lot of tactile defensiveness and I was determining how it would affect typical play. I wanted to see if he could be coached into participation via modeling, distraction, slow exposure, or what, so that I could educate the family on how to approach this type of play. Children learn a lot – and get a lot of input – via exploring their environments, so if the child doesn’t have a willingness to get near new textures/sensations, it will affect their ability to learn how their hands work in differing situations as well as cause/effect/characteristics of items, and much more.

There are PLENTY of children who have issues with tactile defensiveness regardless of parental intervention.  Yet I’ve  noticed that many of the children who show signs of tactile defensiveness are being raised by parents who also dislike getting their hands dirty or have never thought to do sensory play. Sometimes educating the parents on the importance of sensory play, pointing out the similarities between parent/child, and/or showing them the strategies of exploration for a hesitant child, is enough to make a big difference in a child’s willingness to participate. Also, letting them know that children who are tactilely defensiveness typically do much better with firm pressure rather than light touch.

Does anybody have any favorite types of sensory play? I love water beads.

Category: Occupational Therapy | Comments: none

19 Sep 2014

Started the journey of getting a clinical doctorate in occupational therapy (OTD)!

I started my post-professional clinical doctorate program on September 2nd. It is an OTD (Occupational Therapy Doctorate) through Rocky Mountain University of Health Professions based in Provo, Utah.

It can be confusing to understand how doctorates work. Essentially clinical doctorates are used in actual practice. Doctors of psychology, optometry, dentistry, physical therapy, etc, are NOT actual MDs. They have a clinical doctorate like DDS, OD, PsyD, etc. Which is what I am getting as an OTD. For all of those areas, excepting perhaps psychology, most of them do not have PhDs. If they do have a PhD, it is in addition their clinical doctorate, not instead of.

Even in psychology I believe that most either have Masters or a PsyD (clinical). Many of these doctoral degrees can be entry-level (typically after a Bachelors). Meaning  the student has no actual practitioner experience and is starting from scratch.

However, there are plenty of practitioners who go into a post-professional program, which means we have been in practice for usually at least a year and typically 5+, so we have a lot of experience that guides our doctoral degree.

Most of the post-professional versions, at least in OT and probably most programs now, are primarily online. We all have our Masters (or older practitioners may have been grandfathered in through their Bachelors), and have been in practice for likely many years. In other words, many of us are established full-time practitioners with families. We have a very different level of experience going into this program.

At this point the next step is all of the scholarly work of research, writing, analysis. etc. At this level of schooling the professors are typically providing guided learning, not a typical lecture style where we are taking in basic information.

Getting a doctorate was not in my plans, at least not now, but as I describe later in this post, I had good reasons.

As I went through the orientation modules for this program, I was quickly humbled at how far technology has come for distance learning. I graduated from my Masters in OT program in 2009, and even back then distance education was not nearly as rigorous as it is now. But five years is a LONG time in the technology world. Back then people thought of online learning as the “University of Phoenix” style jokes. And now that I say that I may hear from angry people who had a good experience with that university. I don’t know anything but the stereotype that it was essentially a way to pay money, do a small amount of work, and get a degree. Please let me know if I am wrong (I certainly have not explored the evidence on it, this is completely hearsay!)

All I know is, I think some people still get skeptical when they hear of online programs. But these programs are rigorous, and interactive, and as I said above, humbling. I’m 32 and I was a very early adopter of technology. I started WORKING online when I was 13, way back before child labor laws and child protection laws were in place. (The labor wasn’t an issue – the protection was.)

And yet even with my familiarity with online work, more so than most people my age, I’ve had a lot of technology learning to do for this program! Wow. I am really impressed with a lot of the older professionals in this program, many of whom are NOT very familiar with online learning. To throw in a major tech learning curve on top of trying to do a doctoral degree while working full-time and taking care of a family? Wow. That’s discipline.

I used to think about doing a PhD, but realized that since I don’t have any strong interest in research or academia, it wouldn’t be a particularly enjoyable journey. I do love teaching, but not on the formal level of lectures of theory that students need to know for a test. And I love getting other people to research things, but I don’t want to do it myself.

I wrote another few pages about why I am doing this program now, and then I get hesitant about being so publicly transparent. I go back and forth on how much to share. I cut out those few pages and put them on my computer in case I decide to use them sometime later. I have shared in earlier posts that I have a very long history of depression and anxiety so I guess I can repeat that part. Some of it may be neurochemical, but most of it is based on over a decade of secrets (some of it thanks to that online world), and therefore a lot of pain.

I was relatively functional when I ignored it all, but it took a lot of energy to always wear a mask that made me look fine. It was exhausting and I paid a heavy price. As the years went by and the secrets continued to compress my soul, my weariness grew, and the darkness inside got so dense it felt like I was turning into a black hole. I was walking oh so perilously into Robin William’s world.

I crashed. Sometimes you have to hit rock bottom to get the momentum to (start to) bounce back.

To make this incredibly long story slightly shorter, and to not get too intimate, I had to fight. But even if you have a machete, you have to be in the thick of it to thin it! Wow I think my word play is so clever…hahaha.

So while I’m dealing with the fight, I haven’t been nearly as functional as I was when I ignored it all. But I also wasn’t okay. I’m better off now, with much more limited function, than I ever was before. Because now I at least know there is a light inside of me somewhere, even if I can’t see it. And sometimes I glimpse it, and sometimes I feel it. I’m just starting to feel better, but I struggle with feeling like the sky could fall any day now, where I wake up and the heaviness is back. It’s happened many times before, so it’s a legitimate fear.

Even doing better, I can’t tolerate much these days, and I will likely not be able to do full-time direct service again (or any job with a schedule controlled by others). I am introverted (I can still appear outgoing, but it’s draining), I don’t like unpredictability, typical work schedules are nearly crippling, and I have always had dread every time I’m about to see a client, no matter how much I love them and feel confident in my therapeutic ability. It’s not obvious because I am very, very skilled at wearing a mask when necessary, which has been at least half my life. Only in this last two years did it get increasingly impossible.

I am only working a few hours a week. I spend a lot of my time getting help in kind of a customized outpatient program.  But I’m making progress. I am doing this doctorate as a form of vocational rehabilitation so that I can stay within the field of OT even if I can’t do much direct service. Because it’s online (minus four days a semester), there is wiggle room within the modules to have off days, and the schedule is mine (often I work best late at night).

My goal with this “vocational rehab” clinical doctoral program, which is a lot less stressful (academics are my biggest strength) than direct service, is to find a way to stay firmly entrenched within the field of OT, but in ways that cater to my strengths and do not require a direct service model. I would love to keep a few direct service cases a week no matter what, but I am hoping to build up a curriculum for elementary schools as this doctoral program’s capstone project, or similar types of products, where I can work my own hours and have a lot of time for off hours/off days. I also hope that I will eventually be more up for furthering the Miss Awesomeness business cause of a more mainstream community empowerment model through the developmental knowledge that OT has provided me. Doing a presentation causes me less stress than direct service, weirdly enough.

The point of sharing all of this is that I want to get back to blogging. Some of it will be more typical blogging and pediatric-based, but some of it is going to be the journey of getting a clinical doctoral degree in occupational therapy. A lot of it will just be the “neurotypical” journey of getting an OTD, just like I did with my Master’s program where I rarely said anything about the mental health struggles. But sometimes, when it’s affecting me (which I anticipate being less and less), it will be acknowledged as a factor.

I have thought about doing this as a separate blog called 296.33, OTD, or something similar. (The ICD-9 code for depression for insurance purposes is 296.33 and I liked how it rhymed with OTD!)  I got feedback from many mentors and they varied in their opinion.

I know many, mentors or not, will disagree and feel I’m harming my future with this decision, but I need to do it anyway. I don’t want others to feel as alone as I have felt. I’m keeping it on the Miss Awesomeness blog for now, but may switch it over to  and delete any current entries. But maybe I’ll keep it here, and just show that it’s okay to be un-awesome sometimes. 😉 However, I am going to compromise and not share as much as I would like to, and keep it at a more formalized level (as formalized as you can get with vulnerability and transparency).

The good news is, even when frequently at varying low capacities, I’ve done a lot in the field of OT. It’s just that at full capacity, I can do so much more, and I know my potential. And I know 100% for sure I will be successful, and that I’m healing, and that the light is there. The journey will remain rocky but I’m learning how to anticipate the obstacles and dodge most of them. I still need a lot of support and am not able to do as much as I would like in the real world, but that’s slowly changing.

The singer Ingrid Michaelson has a song called “Keep Breathing” with a lyric in it that says “I want to change the world…instead I sleep.” See the video below.  That’s been me for a long time.  Now I’m ready to change that lyric to “I want to change the world…and I have started the process.”

This link goes to the song on Youtube. I couldn’t figure out how to embed it because the code kept showing up rather than the video.

Keep Breathing by Ingrid Michaelson


Category: Occupational Therapy | Comments: 8

19 Sep 2014

Imaginative play is cognitively enhancing

I saw this status on my Facebook feed and it made my day. It was written by one of the 3rd grade teachers at a school I previously worked. She had overheard her daughter, a vibrant and enthusiastic elementary schooler, exclaim, “Yay! A free box!” I LOVED THIS. We have so many children now who get exactly the toy they desire, rather than having to use sticks as swords, or use their imagination with empty boxes. Imagination and creativity are vital to a mentally flexible and entrepreneurial, problem-solving mind. Play-based learning, especially with items that require imaginative thinking, is so important, and so many caregivers forget that.


Category: Occupational Therapy | Comments: none

17 Sep 2014

A Stroke of Insight/Choreographer of Life

I recently listened to Jill’s TED talk on her “Stroke of Insight”. The book was intriguing. The part I remember most was how she felt sleep was the most reparative therapy of all, as I agree with that.

I had an ethically hard time with waking up patients for therapy as I often felt they needed the sleep more than anything else. Not of course if it was “depression sleep”, but if it was healing sleep. I know there are plenty of studies that say otherwise and that the mobility is important, blah blah blah. My personal belief is that sleep is often more important than anything else, when in the beginning healing stages. 

She comments that after her stroke, “I was no longer the choreographer of my life.” I love the poetry of that statement.  All of us have felt out of control at times, and to varying degrees of severity, and it’s often for that reason, that loss of ability to choreograph. The carefully constructed dance of life that was ready for primetime and yet had to be discarded, either permanently, temporarily, or partially. What grief must accompany that feeling, that sense of loss and helplessness. One of our jobs as OTs is to empower our clients to get back to their own life choreographies. 

Category: Occupational Therapy | Comments: none

15 Sep 2014

Kid version of ACLS ;)

Category: Occupational Therapy | Comments: none

6 Sep 2014

Make a transparent digital signature online without special software

I really wanted a digital signature with a transparent background and I was searching but most things involved Photoshop etc. I don’t have any special software.

So I finally found Lunapic for image background transparency and took it from there…

Wrote my (clearly example/fake) signature on a blank piece of paper…took a picture on my phone and sent it to myself on the computer. Notice the white background, where if I tried to use it as a digital signature, it would look messed up with all the white around it. I tried that once and the company refused it since it was clearly a copy with all the weird white. It would have been fine if only I had the transparent signature. Such a pain.

Now to make the signature have the ransparent background.


Menu > Edit > Transparent

or go straight here:


I uploaded the pic, and then clicked on the "make transparent". Slide the transparency bar until your signature looks good (clearly seen) but the background is basically just the white and gray checker pattern. It will be obvious. Save to your computer. It will still have a background when you open it randomly on your computer as an image. But when you go into Word, for example, to copy/paste it, it will have the transparency. YAY! Nobody will know it’s any different than a typical scan.

Also, FYI, on at least Mavericks for Mac…you can edit the PDF and it has its own signature capacity built in for you…pretty awesome and has saved me a lot of time since no more printing or scanning! Or PDFescape.com 🙂

Hope this works for you!! I’m posting here as a "lifehack" because it seems ridiculous it was so hard to figure out/find any information.

Category: Occupational Therapy | Comments: 8