Week 10, Day 4, of Pediatric Fieldwork Rotation

I don’t even know where to start. Today was HECTIC (once I woke up at 1045am, I love having Thursday mornings off but don’t like 10 hour Tuesdays etc LOL).

The day started with a txt msg asking me to lunch but I couldn’t make it, I ran by UT to pick up a fieldwork manual for my OT to use as a guideline, then ran by car place so they could order the car replacement piece, got gas, then was on way to clinic to do paperwork (my schedule was 1 to 3 paperwork then kids 3 to 7) when my OT called to ask if I’d go on the home visit with her at 130pm so she could do some urgent paperwork.

So I joined her – the home is only 2.6 miles away from the clinic (mileage) lol – I worked with the 2 (?) year old boy while she sat on sofa and did her paperwork – this kid is really cute – he likes using the dry erase board, we make cookies (circles) with chocolate chips (dots) and then we use our fingers to erase, going nom nom nom nom nom. He loves the nom nom nomming. We also played outside some – did some blocks, made a block tower, made a train of blocks, worked on concepts of “hard” and “soft” from a sensory standpoint using a cool drum the mom provided, and then did part of a puzzle and he would mutter under his breath “Now where does this go, hmmm” – in a very stylized/stereotypical way – clearly something he had heard repeatedly elsewhere, not his own words. He is two. VERY cute. 🙂 And his little baby sister loves to cuddle and I love just hugging on her!

Then my OT went onto the new clinic far away to do some kids while I went back to the old clinic, me and the COTA had crazy schedules with lots of hard kids one after the other as well as overlaps, co-treats, etc.

Kid 1: Little girl with Aspergers but I wouldn’t have diagnosed her with such, she seems perfectly sweet to me – I co-treated some with speech and we did some work on frustration tolerance, idoms, and then I pulled out some half proverbs – there is a joke e-mail that goes around explaining that a first grade teacher asked her kids to fill in proverb blanks – since of course they don’t know them – and what kind of stuff the kids came up with – since having to complete odd sentences works on creativity/imagination/ideation which a lot of kids struggle with, it seemed like a good idea.

Here were hers, some of them had to be partially explained to her but this is pretty much her own stuff:

It’s always darkest before…./noon

Never…./eat something without asking…

You can lead a horse to water but…/you can ride it too

Don’t bite the hand that…/is on your dog

No news is…/funny

A miss is as good as a…/toy

Love all, trust…/my mommy

The pen is mightier than the…/pencil

Happy the bride who…/got married

A penny saved is…/money

We also worked on 3-4 part directions…using some colored circles, puzzle alphabet pieces, and vocabulary cards…like “Hand me two blue dots, a green K, and a leaf”……she did pretty well. 🙂

At the end we pulled in the COTA’s excessively shy little girl and we gave them each a puppet to use…I gave my kid a snail puppet and we got the Magic C Bunny of Handwriting without Tears for Shy Girl…lol…it kinda worked. 🙂 Then we had the shy girl sit on the rolling board and had my girl pull her out to the waiting room which she required assistance with, but it was fun.

The wating room was chaos as our next kids had arrived and they are wild – I had a young girl with Down, around 7 (?) and my COTA had a little boy with Down. The two kids adore each other but are both quite defiant and difficult to manage at times. Charlene (awesome COTA) took them into sensory room and let them play in the ball bath (I threw in a really heavy bolster “by accident” and had them push it out), with the tunnel, with heavy balls, etc, while I prepped their activity….good ol’ French fries since they are both low level. They cut out french fries on manila envelopes (just cutting lines across it), tore up red construction paper with their fingers for ketchup, then glued it all on there, and wrote names on the back. They did a relatively good job of staying on task. We had dim lighting with the fake fish tank up, Nick Jr radio on softly, and they had just gotten some heavy work in, so they were relatively calm.

Then my next kid came in but Charlene took him since her kid didn’t show up. In the meantime I had a 9 year old with Asperger’s who is very immature, plus a six year old, and we played with that marble down connective tubes game, plus with grocery shopping, etc…it wasn’t a great session for either one of them – or me for that matter – but the two kids are both very prickly and so it was a good social challenge. The best thing that came out of that though is that the kids pulled out this really neat fireman water tank that was hidden away in a cabinet…so when the 9 year old left for speech, I filled up the water tank for the six year old and we went outside ….you wear it like a backpack so it provides some heavy calming input, plus the hose part that comes out requires some hard-core action to pump the water out…and we blew bubbles and had them blow the bubble fire out…it was pretty cool. He loved it.

So of course when our final kid of the day came, a boy around 9 with Asperger’s who is SO classic Aspie, you can tell within 3 seconds…….he is very smart and sweet…I really like him. We spent half the session outside using the water-filled tank/hose – it was a co-treat with speech – and I filmed him – he would say (his own creation) “Hi my name is XXX and I’m a fire kid. Putting out bubblefire is my cool trick” AHAHAHAA. Then we went inside and I introduced him to Mr. Snail, that snail puppet that I make talk in a primordial dwarf voice (very high-pitched) since it’s the only voice I can easily do. He LOOOOOOOOOOOOOOOOOOOOOOOOOOOVED Mr. Snail and talked to him the entire session, which was great for the speech therapist. “Don’t worry Mr. Snail” he’d say, and pat it reassuringly. At the end of the session he was playing with some screw-driver toys and he was like “I am really good at screwing” and I was like ummmm….lol. The only thing I could think to say was “You sure are!” He would try to carry around Mr-Snail on my arm as if he were real. He got SO into Mr. Snail. He wanted to show Mr. Snail EVERYTHING. LOL.

Ok that’s enough for one post. Moving on, I have several other little things to post.

Tomorrow we have just two home visits – one home visit with two little boys, then the little girl with bilateral hypoplastic thumbs – looking forward to the little girl, we haven’t seen her since the eval, we’re going to be working on basic compensatory strategies for reaching/grasping, considering her thumbs mostly just get in her way…. 🙂

Sep 05, 2008 | Category: Occupational Therapy | Comments: none

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