Rambling occupational therapy school OT thoughts…

It's past midnight, I didn't hardly get any sleep last night thanks to advocate concerns. As I earlier mentioned on Facebook…I don't care if I am the most perfect person and OT in the ENTIRE WORLD….if an intimidating educational advocate gets on board, I'm going to doubt myself. I could have written a fifty thousand page book on X, but if the advocate questions me I, inside of my head I am like WHAT IS X I FORGET AUGHHHHHHHHH and then I tear out my hair and run screaming from the room. 🙂 Just kidding. But seriously. Wow. I understand why parents hire educational advocates, but some feel like a great part of the team while others seem to exist solely for torture. Parents…if you're in a reasonably good district with good workers and a good reputation and you want an advocate….PLEASE consider hiring someone who is known for their teamwork/collaborative process with the team. The vast majority of IEP teams have good intentions and want to help your child as much as you want your child helped. A good advocate aids this process of collaboration and recognizes a good team. I, of course, am biased, but I think my district does an amazing job. I have quite a few schools and I am impressed with each team, even though they all have different personality dynamics, so it's neat to see the interactions between teams, parents, advocates, students, etc. 🙂 

My current favorite toy is http://www.amazon.com/Play-Visions-Stretchy-Mice-Cheese/dp/B0018KJTBC   I stumbled across it on Amazon and bought it and it's so worth it. The children try to stick the mouse through the cheese, and/or get it out, and it's got a mooshy rubbery texture and the kids really like it so far. Plus, then I pull out lots of tiny animals and bugs from my own collectionand then the MONSTER CHEESE EATS THEM AUGHHHHHHH….they love hiding the stuff in the monster cheese and then re-finding it and pulling it out. It's a nice NOVEL fine motor task that requires bilateral hand coordination and motor planning. It's not that expensive and I can definitely see a LOT of use coming out of that toy. I just realized it came with two mice? I only seem to have one now. I wonder where the other one went. Hmmm. Oh well, I actually prefer my version of “monster” cheese so that's okay.
This is another one I like. I also just stumbled across this on Amazon one crazy night when I bought like a hundred dollars worth of OT toys for no good reason besides desire. Stupid reason. 🙂 I JUST got this one and while it's really geared towards younger kids (like 3ish), I used it with a preschooler recently and we both enjoyed it. The tweezers are a little hard in that it takes a lot of pressure, but it was great for imaginative play. Especially because we used tweezers to put a bunch of bugs into the pie, and then I used file-drawer things stacked on top of each other to make an “oven” and then we baked the pie. While finding material to make the oven I found a tiny stretchy elephant and I showed the child and asked if we should include the elephant in the pie that we had placed in our oven. Apparently “No, that is too mean” is the proper response. We then presented the pie to people to eat and we enjoyed their “shock” at discovering bugs in our pie! It would be a great speech toy as well. We carried it with us to the speech therapy room so they could continue to chat about the awesome pie and all its many contents…fruit, bugs, animals, sections, colors, shapes, categories, whatever, you name it. 🙂
I've also been trying to do more creative letter stories…for example, a little person lives in “O” and if you don't close the O, the rain can leak in and get the person wet…yikes!! And that when 7 is the first in line, 7 is selfish and has a big hat and won't let anybody get under it… (working on not reversing the 7)…or things like the g has a curve so someone can sit in the swing. Turning the letters into little people. 🙂 
And that letters FALL FROM THE SKY, they don't grow from the ground. I make a big fuss with my beginning kids when they do letters bottom-up….do you think letters grow out of the ground?!! They're not vegetables. We don't want to eat our letters!!!” etc…Nooo they fall from the sky! 
I'm also trying to improve my IEP goals….they always focus on function, but sometimes I think the measurable piece ends up getting ridiculous depending on how written, and/or has too many elements within a single goal. I know Christopher Alterio of ABC Therapeutics's blog once wrote a post about how some OT school goals he has seen has like, eight elements in it. Ridiculous, yep. But almost all of us are guilty of it sometimes. So when I have a kid who needs work on EVERYTHING – letter formation, sizing, spacing, etc, instead of talking about accuracy within EACH arena, I am focusing on basic legibility without context. For example, if I am writing “My name is Karen” and I have a few messy letters but you are reading the sentence, you may figure it out. But if  you mask EACH letter individually, no context, then each letter by itself needs to meet basic criteria, so I'm focusing on the big picture of legibility which will INCLUDE working on each of those sub-areas. If the child only needs to work on a particular area then yes, goal, but I think legibility is a better goal when working on all sub-areas. And for typing…now with so many touch tablets and different sized keyboards, home row-key touch typing is less important. However, finding a key instantly is important. The keys don't move…a D is always where a D is. So my goals focus on a child being able to find each key within ONE SECOND, instantly zeroing in on a key rather than continuously scanning. A huge pet peeve of mine is people who have to scan their keyboard for letters. You've stared at them your entire life. They've never moved. Memorize them and save yourself SO MUCH TIME in the long run. Of course it can be graded, ie hints such as it's on the top row…etc. Another great typing goal can include just being able to input usernames and passwords from an index card or list, within a certain reasonable amount of time. Even our first graders these days are being asked to do that, and that can get frustrating. 
It's funny how as we learn, we focus on different things…so right now I'm focusing on certain types of goals, certain functionalities…I'm sure as I evolve (this is the start of only my second school year as an OT in schools), I will constantly be finding new things to look at in new ways..and all OTs see things a little differently. Like pencil grips….opinions vary dramatically. Of course ultimately you would ideally focus on the evidence-based research. 
Speaking of evidence-based research….Christopher Alterio of ABC Therapeutics once again, has commented on the scarcity of good evidence in regards to sensory strategies/accomodations in the literature. ONE DAY I WILL BE ABLE TO SPELL ACCOMODATIONS WITHOUT LOOKING! I *JUST* learned how to spell tomorrow properly…by thinking of it as the name “Tom Sorrow” to remind myself its one M and two Rs….) moving on….So, sorry that the evidence doesn't show X. But if I am seeing with my own eyes that X works for certain kids, and it's not harmful, then X will be used. Maybe I SHOULD get my PhD so I can do research in the school systems. 🙂 I hate stats but I
can just hire my OT friend Bill for that because he loves stats! 
Sorry this is the most rambling post ever. I know I'm not supposed to write so much random stuff at one point. BUT HAHA I CAN DO WHATEVER I WANT MUAHAHAHAHA THE POWER IS RUSHING TO MY HEAD!!!   Just kidding. But it is almost 1am. And I had chocolate.
Speaking of which….I know anybody who has read my occupational therapy blog for any length of time but doesn't know me in person, may have a warped sense of what I am like in real life. I'm calmer in real life, I swear. Way easier to be hyper online. I've recently met a few people in real life that only knew me online, and they all commented I seemed much more normal than they were expecting. This made me laugh. 🙂 Like I've been sharing my possum chronicles lately on Facebook as I've recently had a possum in my bedroom more than once. Apparently that story sounds hideous online only, but when I share it in real life, it “sounds almost normal.” I'm telling y'all right now, my entire life is one big possum chronicle of ludicrosity (word inventions), but it sounds less weird in real life. I think. Maybe. Sometimes. 
Okay I'm giving up and going to bed. Anybody who read this far gets my love forever. I have a lot of love to give. I haven't forgotten about my magic weighted blanket giveaway. I got side-tracked by advocate drama and – wait for it – BABY CUDDLING! Yes, I am officially a volunteer baby cuddler at a local hospital after being on a wait list for over two years. I used to do it in Memphis and am now resuming it here in California. Yay! 
The magic weighted blanket give away is for US residents only, can be for a weighted blanket up to $164 dollars, and they will make it/ship it to you. They are making me a lovely blanket to try out at my schools and I am very excited about it. You can enter just by submitting a comment, ideally one that says something they like about OT or weighted blankets. The winner will be chosen randomly using a random number generator (and by the way, I don't typically get many comments, so the chances of winning are likely really, really high). DO NOT comment about it on this post, but my next post should be the formal give-away. 
Thanks,
Karen 
PS: I know many of my readers want to read more about NON peds or school OT….I do have quite a lot to share/write in those arenas, it's just lower priority to my current life, but I will try to sprinkle them in more often. 

Aug 30, 2012 | Category: Occupational Therapy | Comments: 3