Occupational Therapy

19 Feb 2013

Come to AOTA Conference, I beg you, I love you…

The American Occupational Therapy Association’s (AOTA) Conference is this April 25th through April 28th, and CHECK IT OUT, it’s in SAN DIEGO, CALIFORNIA!!!!!

This happens to be my hometown, which means I am definitely going to it. 🙂 
The keynote speaker this year will be Aron Ralston, who wrote “Betwen a Rock and a Hard Place” – remember the movie 127 Hours? His Story. Ouch.
If you aren’t a member and still want to go to conference, you can save 15% on membership and 30% on registration by signing up for both.
I love AOTA conference because it gives everyone a  boost of confidence and inspiration that we are in a great field with a great message surrounded by amazing and awe-inspiring people. I love all the OT energy you can find all in one small area. It’s amazing the Convention Center doesn’t go into ORBIT with all that energy. Pretty sure I just mangled some analogies (or metaphors, or something) there, but let’s go with it…cough, moving on…
Right now I’m sitting down with the conference booklet (or you can look on www.aota.org in their conference section), figuring out what courses I want to go to and what posters I want to look at specifically! What dates and times. 
And Expo Hall is my favoritest thing in the world. Well besides sloths. Expo is where there are tons of booths that give away free stuff, let you learn about places you might want to work (or do work), and sell stuff you’ve maybe never seen, or have seen and want to buy easily. I looove wandering around Expo. 
I’m going to be working my company’s booth, School Steps Inc., some of the time, and I don’t know their booth number but if you come to Expo, come say hi and tell me you’re a blog reader. 🙂 Or that you want a job with us at schoolstepsinc.com …!! 
I also know that on SATURDAY, April April 27th, I am part of Short Course (SC) 328, sponsored by AOTA: “What’s New in Digital and Social Media for Occupational Therapy?” The five of us presenting are the same as those of us that presented last year: Anita Hamilton of Australia (Whoah nelly lol), Cheryl Morris (OT Notes), Me (Miss Awesomeness/Days of Our OT Lives), Erik Johnson (OT Army Guy), and Christopher Alterio (ABC Therapeutics).
In an very appropriate and fitting nod to technology, within our presentation, Anita of Australia will be presenting from Australia this year since she can’t get to CA, and Cheryl will be presenting from Maryland since she will be about to have a BABY!!!!! Woot woot! I’m pretty sure she’s naming it Karen, don’t quote me on that….Actually quote me. Again, cough. Literally (I can’t get rid of it) and figuratively (since there’s no way). 
(I like parentheses)
AOTA would like if I posted seriously about how awesome AOTA conference is and didn’t add all this extraneous random crap that entertains solely me. Sorry AOTA. I love you guys and I love conference and I want everyone to go and nobody asked me to write this post, so I get to tell everyone how awesome it is and BEG THEM TO GO PLEASE COME PLEASE COME GUYS PLEASE I WANT TO YOU TO COME AND I WANT YOU TO COME SAY HI AND I WANT TO MEET YOU AND I WANT YOU TO COME LEARN ABOUT STUFF AND GET CONTINUING EDUCATION AND MOST ESPECIALLY COME TO EXPO WHICH IS SO COOL AND COME TO OUR PRESENTATION AND BE A PART OF AOTA. 
But also. I want to make myself laugh. Which I accomplished, becase as an easily entertained dork, I can do that with my own writing.
Mission accomplished. Go to conference, it’s pretty awesome. http://www.aota.org/conference
Category: Occupational Therapy | Comments: 7
19 Feb 2013

How to Not be a Crappy OT (Learned the Hard Way), Lesson #1

Edit: I’ve posted this several times, then unposted it. It makes me feel so weird to share one of my most shameful moments, even though I realize that this may not seem like a big deal for some people.

I can hardly share this without cringing. Every day this week I’ve passed the evidence with a wince and thought to myself, “do I really want to do this?” I decided that yes, I do. An important part of “learning publicly” is transparency, and that includes, at times, embarrassment.

This incident happened in my first week as a “real” OT, in Fall of 2009, meaning my first week as a registered/licensed therapist, working in Georgia. I share this with you as a precaution of what NOT TO DO! as an occupational therapist.
*Names have been changed to protect the innocent (him) but not the guilty (me).
He was a man who had had a a stroke (my notes say L CVA meaning left cerebrovascular accident). I’ll call him Bob*. We were working on him writing,  for the first time since the stroke. We were using a built-up pen. Now, before I tell you what I had him write, let me explain one thing in my defense: He was an easy-going guy, we had a good rapport, and he had a great sense of humor. We were both excited to have him write.
For his first sentence that he practiced, which was illegible by the way, I had him copy: “Karen is cool”.  I was kidding around with him. I didn’t really think about it.
I then had him write “Karen is here” then “I’m cool” then his signature.
On the next page, after he had some practice and we had done some adjusting and his handwriting was becoming legible, I told him to write whatever he wanted, as I had run out of ideas.
He thoughtfully paused for a second, then wrote, “*John and *Jane are my babies”
That sentence, my friends, is when I first realized the error I had made. As occupational therapists, we pride ourselves on working with people on the activities that bring meaning to their lives. Here I was, a brand new OT, fresh with theory and foundation and insight, and I had made such a basic error. I was so pleased with myself – so pleased that I had helped a patient who had a stroke learn to write again – that I had taken away something meaningful from him – his first written sentences after his stroke – and replaced them with something meaningful to ME. I had assumed he had no story of his own. I had made his first written words be “Karen is cool” (sure, funny to me at the moment) instead of allowing his preference, “John and Jane are my babies”.
I gave him a copy of the second piece of paper, which started with the sentence about his children, to show his kids how his first real sentence (his first legible one) was about his kids, and I saved a copy of the first page, to remind myself to never make that kind of mistake again. That it was always about the meaning for THEM first, not me.
I cringe writing this. I know ultimately it’s not the biggest deal in the world and bigger mistakes have been made, but I felt sick to my stomach as I watched him write the sentence about his babies and realized what I had done. We can be pleased with ourselves as OTs for helping a patient/client/consumer reach a milestone, but we need to make sure we let them attach the meaning to it themselves, and not steal it away with our own delight.

My one and ONLY reason for sharing such a shameful moment? To hope you as a new or future practitioner will never make the same mistake. That when your client is about to do something, or write something, that you make sure it’s with their best interest in mind, not yours. That you let them script their own story and don’t put words into their mouth, no matter how silly you think you’re being, if they have their own words you’re replacing.

I know I shouldn’t let things like this haunt me, but they do. Because I want to be a good OT, and that means not making mistakes like this – or at least learning from them.

Category: Occupational Therapy, reflections | Comments: 1
17 Feb 2013

Real-Life Dexteria: Practicing Finger Isolation with Popsicle Sticks

I like the program Dexteria, and have blogged about it here: https://missawesomeness.com/ot-review-of-ipad-app-dexteria-for-fine-motor-skills/

It is too fast for some of my elementary schoolers (and I bet for others with cognitive impairments or recovering from certain types of hand or neurological injuries). I’m hoping with a future upgrade they allow a setting where the sequence can be slowed down or press-dependent rather than by time. In the meantime,  I made my own physical version in 3 seconds by grabbing some colored popsicle sticks. By having my little OT kid practice with these popsicle sticks in real life, I’m hoping it will speed her up and carry over so she can do the i-Pad version soon, which is much more motivating/engaging. 🙂

Category: Occupational Therapy | Comments: 3
16 Feb 2013

Robot Space Caterpillars: Coloring inside the Lines

       

As an elementary school OT, to practice coloring inside the lines (when working on fine motor skills, keeping the wrist still and just moving the fingers, visual attention, distal control, etc) we make “robot space caterpillars”. We use small grid paper and practice outlining the shape before coloring it in. We usually do about 5-6 boxes at a time.

It’s definitely more fun to make robot space caterpillars than to color in boxes. 🙂

Category: Occupational Therapy | Comments: 1
12 Feb 2013

The "Love Potato" : Quick and easy OT Valentines Day Craft



Last night I said I wasn’t a good OT because I wasn’t going to do any Valentines Day Crafts with my kids. I perused Valentines Day stuff on Pinterest, and kept seeing the same things over and over again. Lots of hearts, lots of candy, lots of red. It just all looked the same to me. The only thing that even remotely interested me was lovebug stuff. Lots of it was super cute and awesome, I’m just a weirdo. So I made the executive decision that (some of) my OT kids are going to make love potatoes. That’s right. We’re going to cut out potatoes, put up to 9 googly eyes on it, and handwrite “I only have eyes for you, Be my Valentine?”…..because come on. Who else gets a love potato? It will be unique. 

I included a picture of my sample above! Inside it says “Dear Mom, I have eyes only for you. Be my Valentine? Love, Kid” 

The kids have to fold, cut, glue, deal with googley eyes, trace, copy, handwrite, etc…so a lot of great OT components. I can “grade” the activity (not give it an A or an F, but meaning make it harder or easier) depending on the kid’s ability level). IE maybe do some of the cutting or writing for them. I have at least a few kids I’d like to do this with. And I think the googley eyes part is what will sell it to them, haha. 



Today’s Facebook status was: 

May or may not have gotten under a table today with an upset student to meet them at their level. May or may not have made “love potatoes” today with googly eyes with a kid. May or may not have sung (only by request) a made-up song about a kid swinging to space on a blue hot dog rocket.


Shared here for those of you who aren’t on Facebook with me (if you want, follow me here (I think all you have to do is “Like” me to follow me): 
Category: Occupational Therapy | Comments: 4
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.
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
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