Week 2, Day 2, Peds Level II fieldwork

Today wore me out!

Today I saw a young boy with a massive no-teeth grin, a “skills baby”…meaning exposure was the thing he needed most. He was about 3 or 4….We mostly did table-top activities. We had gotten this new toy – a bunch of clear magnetic circles and a magnetic wand to pick the pretty circles up with – that he really liked, so he did this a long time. I'd spread out the circles so he had to do reaching and manipulating with the wand, and we also did some of it by color. We also did some basic cutting with modified scissors and then some gluing. You know, I'm a horrible cutter/gluer, but it amazes me to see how hard these things are for some of these kids. Staying anywhere near the line, holding the paper in the right place, getting glue on all the right areas…it's hard sometimes to not be like “Let me do it!” LOL. We also tried to look at an “I Spy” book, but it was a little advanced for him – even I had some trouble finding the things it was talking about. And one of the things was a sea horse. A skills baby like him has probably no idea what a sea horse is, even! He picked out a starfish sticker at the end which we put on his forehead much to his delight. He got a quick turn in the ball “bath” or pit before it was time to go, and dude, his shoes were on sooo tight that it would have taken me all day to get them back on…..I walked him out in his socks and was like, here are his shoes …….LOL. I think it's interesting that they don't blink an eye at this stranger holding their kid's hand…I'm in scrubs and look the part so they are just like okay thanks bye. ot

My OT was in the room for the session working on her computer (she has an OT desk in her office) and she complimented me on the session afterwards, which I thought was kind. Especially since I wasn't expecting to see him and had no treatment plan in place, it was just kind of a “hmm let's do this!”. (Minus the cutting worksheet she had planned for him). I appreciated hearing her feedback – it really makes me self-conscious to know someone is listening to me babble to a kid so I'm glad when the feedback isn't “You're on crack.”

I also was supposed to see a little girl with Down Syndrome but she didn't show up. I went to lunch with the clinic director and billing chick (my OT went to the gym) and they are sooo funny. We went to some Mexican restaurant ($2 margaritas…!!)  Some of the talk was definitely not appropriate (I was more or less behaving btw, much to the shock of those who know me well) and they were teasing “Wow you're going to have a lot to blog about” but I assured them I wouldn't share any details. AHAHAHAHA. Somehow perfect strangers will tell me intimate life details within a few minutes, hours, or days of meeting me. I have no problem with it, it's just amusing. They keep hinting at me working there when I'm done but I have nooo desire to work in outpatient pediatrics…I'm just too easily fatigued for such things. Nor do I have the desire to work in Missisippi, even if it's a great place to make a difference. Everyone who works there is really nice.

I was talking to my little OT sib Talli today, she started back to school yesterday…I do not envy her one bit. I invited her to come observe my fieldwork placement some free afternoon as it might put her mind at ease to see it's not as scary as it looks…especially at a really laid-back place like mine.

This afternoon I saw a little boy with autism who is very low level – at about the level of a 1 year old instead of the 5 years old he is. Relatively nonverbal, prone to tantrums, and can't stand to hold a writing utensil – mostly likes pretty lights and playing in the ball pit. We did work some in the ball pit with ball colors and stuff, and then we worked in the speech therapist's room for a while for co-treating. He looked at a few books, touched a pencil for a few lines, then flipped out. Not even a spiderman sticker would get him to calm down and do some pencil work or crayon work. Then we introduced him to the Lite Brite that everyone had as a kid – he loved that and was actually doing some great fine motor work by putting in the pegs. Also, since his mom said she wants to give him a haircut, we worked a little on desensitizing him to his head and I have no idea why the mom is concerned, because I was running my hand through this kids hair and “clipping it” with my fingers the way a barber would, and he wasn't flinching a bit…wasn't even paying attention to me. Also one of his goals was to fingerpaint some – I got out the shaving cream to see how he'd tolerate it on the mirror and he did great. He got shaving cream all over his hands and we smeared it all over the mirror. He was even willing to write the first letter of his name with his finger in the cream. It was fun overall. He was a little wild at times but tolerating the shaving cream was big and the fine motor work with Lite Brite was also big, so a good session overall.

I got to write in-house progress notes on my two kids today plus two kids yesterday…my OT had to leave at 4pm so I did that while she was gone. I felt so official, sitting at a desk writing progress notes while the tech bustled around and I could hear the COTA rocking her bad self with her kids….the COTA is really really good. I like watching her because I think she is good with her disciplining – firm but not mean. I need to be more firm.

By 5pmish I was becoming a zombie, and since my OT was gone and I had done all I could do really, I watched the COTA until 6pmish and then I left with her permission since the last kid had canceled so it was time for her to go as well and there'd be no OT-related people left. It was nice getting home by 6:15ish but then I napped for like two hours really hard. Bad me. And I'm still tired!

Four other kids to note today:

1) A little girl with a hard Arabic name with autism who is really cute and says “Whooooahh!!!” constantly. We did some great work in the ball pit with various colored balls and also did some pattern matching. She was verbal with straight-forward facts like “Yellow ball” but wasn't much to talk otherwise. I really wanted her to interact – for example I wanted her to request something of me. I grabbed all the squares she was playing with in the pattern matching activities to try and provoke her to say something to me, even if it was just to get angry. I said say “please” and I'll give these all back to you. I repeated this in various ways…I know she knows she could have said a word to get it back, but somehow her brain wouldn't let her do it…she got mildly upset but refused to say anything…even though I had previously been able to prompt her to say things. She is pretty strong-willed and my OT has encouraged me to provoke the kids (a little bit) to try and work on valuable social skills, so I didn't feel bad upsetting her a little. In the real world, she'll have to get used to things not going her way and having to use her words to try and get back some control!

2) A little boy with Aspergers who I think is so cute…he walked in today and said brightly “Hi Miss Karen” even though he has only met me once before…a smart kid.

3) The little boy with ADHD was back…this kid CRACKS ME UP. He's cute so his constant buzzing around isn't quite as annoying as it could be. Look at this rock! Oh look at this one! Oh look at that one! Oh look…oh look at that one! Oh look at this wall! Hey how is this turtle going to get that present! Oh look at that! Oh scissors, I want to try! LOL. When I left he wanted a hug. He also wanted us to see the cool van his dad “boughted” with a “thang” (dream catcher)  in the front

4) A older boy with autism who is very difficult. He makes wailing noises, falls on the floor, screams, can't tolerate much of anything. The OT uses a lot of holding methods with him. His mom ap
parently came back then left again for a while and he freaked out, screaming Mommy for a ridiculously long time. I didn't see his session but I sure did hear it.


Today was an okay day except that the long days are sooo fatiguing. Yes I know it involves bright lights, ball pits, drawing, and other fun things, but all the kids are a handful!

Tomorrow I think I see the two girls of the triplet set plus at least one other little kid in the morning, then in the afternoon we head back to a small Mississippi town to do some home visits and clinic visits….I think all my best stories will be coming from this town! LOL

Jul 09, 2008 | Category: Occupational Therapy | Comments: none