Removing architectural and attitudinal barriers!

I am copy/pasting this e-mail to this blog, with permission. I haven't really personally encountered someone with a job like Keith's, and his work sounds very valuable and interesting. Just thought you all might find it neat too! And by the way, if you do want to share your experiences with Keith as he requests below, please comment or e-mail so I can pass it on to him!

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My name is Keith (Last name edited out),  and I just found your blog yesterday. It's great!

 

I have had Arthrogryposis since birth, and use a motorized wheelchair. Besides being a former Occasional Torture recipient (just kidding), your blog and OT interest me for a couple reasons. First, I work for a Center for Independent Living, which is a non-profit organization serving people with disabilities. Part of my job involves public speaking about the need to remove architectural and attitudinal barriers, and I frequently guest lecture to undergrad and grad OT classes. We also collaborate on joint projects. One year, a group of seniors conducted accessibility surveys of polling sites to make recommendations for changes in time for the presidential election.

 

Here's one that was fun: I met with a fairly small class of 5th year master's students. We divided them into pairs, and each pair would survey the accessibility of a restaurant of their choice. The kicker was that one student in each pair had to use a manual wheelchair, from the point of the parking lot to completion of the survey. They also had to check out restrooms. It was very enlightening!

When I met with the class, I asked if they encountered any attitudinal barriers. For instance, did the wait person asks the able bodied person what the person with the disability would have (happens much more often than you think), were they overly solicitous, etc. It was a fun discussion.

The second reason OT interests me is that I have OT students who are personal Care attendants. PA has a statewide program where a consumer can hire their own attendants after the consumer's been assessed for a certain number of hours of care per week. I've had students from a nearby university coming to my office at noon, weekdays, to help me with my lunch, for several years. They get paid, I get to eat, and they listen to my ramblings about disability issues. Seriously, they learn about my organization and our efforts.

Anyway, enough of my rants. I'd like  to hear your experiences  with volunteering/working with people with any kind of disability, and what area you're interested in. Have a great holiday, and I hope to hear from you.

 

Keith

Prep courses for NBCOT Exam

I just got an email that says "that 95% of first time test takers who took our course passed the exam." Wow! I guess if you have enough money (the course is expensive), you have a pretty good chance of passing the national licensing exam! Hmmmm, interesting.


(Can y'all tell I'm cleaning out my e-mail box right now?)

Yay! No certification needed for OTs doing specialty wheelchair evals!

Amy Lamb, Chairman of AOTPAC, sent out a newsletter that includes this great tidbit! Wheelchair certification and the therapy cap were going to be major deals for occupational therapists, but with the AOTPAC and AOTA advocating for us, the problems are being worked out. See, this is why membership in AOTA is so crucial - they need our help to mantain OT quality of life!!

(Below is a direct quote)

AOTA has been busy working for us with many issues and achieving results: including the Centers for Medicare and Medicaid (CMS) dropping a proposal to require RESNA certification for occupational therapists who perform specialty wheelchair evaluations, and Congress providing a six month extension to the therapy cap and increasing the physician fee schedule.  There is a great amount of resources for practitioners and students on these initiatives on AOTA's Web site at http://www.aota.org to find out more!

Environmental modification & OT & Levers

http://www.mercurynews.com/ci_7819057?IADID=&nclick_check=1

I recently read an article entitled "Market for doorknobs slowly losing its grip: Levers expected to gain upper hand one day", by Frank Greve.

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A few months ago, us OT students did a project on environmental modification. We were assigned rooms and a disability, and had to find out the proper environmental modifications and cost. We even had to draw up the before & after floor plan and follow two budgets - a low one and a high one. It was a fun experience. We learned about a ton of assistive devices and ways to help people function better within their own houses. One of the most basic devices that could help most people was a lever handle instead of a doorknob! Think about it - doorknobs involve twisting your arm, which can be painful and/or difficult for someone with arthritis or minimal hand function.

On the other hand, levers require very little movement to open - you don't have to have finger function, and it's a lot easier for people with arthritis.

There are a ton of other environmental modifications, but I only woke up about ten minutes ago, and my OT brain is rusty...so...yeah.

Next post will be how to make pom-pom ornaments and why it is applicable to OT! Apparently all old people already know how to make this, but I'm young and innocent and my peers will be excited.... ;)

I'm driving back into Memphis in about an hour! Yay I love spending 3.5 hours with lots of giant trucks while in my small car!!!!

My OT life is OVER!! OVER I TELL YOU!!

I typed in ot student and then ot students into Google..which used to put me in the first page of searches..and now I am nowhere to be seen! Yet another blow to my OT pride!! ::sobbing::

I think I'm going to go drown my sorrow in a dark chocolate truffle kiss.

I CANNOT WAIT TO SEE ALL MY OT FRIENDS AGAIN!!!!!!!!!!!!!!!!!!

Pictures from the trip..OT class starts soon...

I have lots to catch up on! I'm just starting to have my head above water! I am looking forward to seeing everyone in Memphis, soon! We start back in OT school on January 3rd. The few posts below are some random pictures from the trip. I'd caption them but Blogger is NOT COOL and is not behaving. As always.

Anyway...hope everyone had a wonderful holiday...looking forward to have OT stuff to talk about soon!

Random Pictures Part 2

Random pictures Part 1

Happy Holidays...

My San Diego trip is winding down and I'll be headed back to the mid-South soon! I didn't accomplish many of the goals I had set for myself, but I guess I just really needed the rest! I've slept more than anything!

January 3rd is our first day of real classes so I promise to get back into writing then!

Merry Christmas Eve ...

I've been enjoying La Jolla...taking lots of naps, sitting outside in the sunshine, visiting family...I had a wonderful fondue dinner with my grandfather the other night...and wonderful carne asada fries with my grandmother...and yummy pancakes w/ chocolate cake in them with my mom and dad...etc. A lot of eating!!

We decorated the tree the other day, and there were all these homemade yarn pom-poms. My mom says they are easy to make. They would be a great craft to use in OT - so I am hoping Mom will have time to teach me before I go. I also realized I should probably learn to wrap presents properly, if for no other reason than that would be another good OT activity. So...I guess I have never been motivated to learn to do things myself, but I'll learn for my future patients!!!

Right now my mom and grandfather and I and a kitty are chilling out in the sun-drenched living room...my sister is still asleep...we're going to work out, then do GINGERBREAD QUILTING!!!!!!!!!!! then go to Dad's for a prime-rib dinner with extended family.

Tomorrow we will have our annual Christmas picnic at some park!! Mortadella-Brie-Doritos sandwiches are the BEST!!

Gingerbread quilting - like a gingerbread house, only a flat surface, for architecturally challenged people like me.

Merry Christmas Eve and stuff!!!

PS as always: I'm again behind on e-mail. I'll try to get it all wrapped up within the next few days!!!!!!!!!!!!!
PS2: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Thank my sister for my crushed OT identity...

Last night, my mom and I went to pick up my sister at the airport. I was wearing my OT jacket that most of the girls in my class wear constantly (see above), and it has my full name embroidered on it. In retrospect it would have been cooler (and safer) to just have my first name, but hindsight is 20/20. ANYWAY, she saw my jacket and started laughing. She was like....OT isn't a sport...and you aren't on a team...and your full name is embroidered on it...that is so funny...you all seriously wear those?....etc etc etc

And so then I punched her in the face.

No, just kidding, but she did temporarily crush my OT soul. Or at least my OT fashion sense.

Don't fall down!! OT Neuro Lab

This was a really neat lab where we put vibrators (get your mind out of the gutter) on the Achilles tendons of a person who was blind-folded. We had the person (in this case, Stephanie, who btw just got married!!! Congratulations!!) on the table so that everyone (including our distance ed component in Chattanooga) could see better. It turns out that when you put vibration in this area while blind-folded, you get really disoriented and can potentially lose your balance.

If I were the kind of neuro student my professor wanted me to be, I would remember what this lab/lecture was about. But I'm not. My brain is broken for the holiday. So. It was still cool.

I decided to write this up because A) I just went through my thousands of OT pictures in order to send some to a faculty member for some project, and B) a really sweet person who just graduated OT school wrote me the nicest e-mail in the world, and C) we are waiting to pick my sister up from the airport and just found out it is delayed and D) I'm paranoid of losing all my beloved readers!!

The End.

Pre-Happy Holidays

"The 2008 Assembly of Student Delegates (ASD) Steering Committee Election will be held online from January 14 to February 20, 2008. All AOTA student members are eligible to vote." -

if you are not an AOTA member, become one! I promise it's worth it! And if you are an AOTA member...go check all the candidates out (you have to be a member to see the information) and then decide I'm the best for OT Vice Chairperson :)

http://www.aota.org/Govern/Elections/asde.aspx

So this isn't necessarily the most rousing "VOTE FOR ME" (And Brooke Ward!) post...but I'm OT-ed out for a while! It's the holidays! Send me material if you have some and I'll try to post occasionally so no one thinks I'm dead...but I don't really plan to get back into this full-gear until January 3rd, when classes start again...(it was supposed to be the 7th, then switched to the 4th, now the 3rd.....aren't we lucky). It's a semester that focuses on geriatrics, so get excited!...as OTS Meg would say.

AND, I'll start campaigning in earnest after Christmas...

Happy Holidays!!

Occupational Therapy School Withdrawal?

I have a confirmed case of OTSW. And I'm not the only one.

The day classes ended in December, I went home and had a mini freak-out session. I am a creature of habit and even though I love breaks, the transition is still hard on me. I thought I was the only one, but then I talked to two other OT students that night who were feeling equally frazzled. I was surprised.

I have been eating, sleeping, and breathing OT for so long - it's weird going days without the topic coming up!! I have kept in touch with OTS Kerri, Virginia, Brooke, and Allison...I need to contact some other girls too! OTS Stephanie just got married and the pictures on Facebook look breathtaking! The OT students who attended had t-shirts that said "OT Buddy"...cute!

I am looking forward to writing the post of play as occupation, and sharing a few new bloggers with you. I'm also looking forward to an interesting SURPRISE blog project....0o0o0o0ooooh. And now I'm looking forward to SLEEP.

Pumpkin muffins and Spanish. There is no relation.

This was my first full day back in San Diego.

Mom and I hit Costco for a ton of stuff, which included fresh berries. We also spent over an hour in our backyard with the cats, since it was a beautiful warm and sunny day. We could see white sailboats way far away in the ocean. It was very peaceful. We also went to a Gem fair, where she spent hundreds of dollars while I followed her around reading a book. I'm talented that way.

Tonight we made chocolate pumpkin muffins with peanut butter chips. It was yum. Except, this is the grossest thing in the world - a fly apparently got on a muffin without us knowing AND IT GOT BAKED!!!!!!!!!!!!! A FLY WAS BAKED ON TOP OF A MUFFIN!! I AM BARFING INSIDE MY MOUTH RIGHT NOW!!!!!!!!

I've been in the Eastern, Central, and Pacific time zones in the last week (thanks Scott), so I guess it's understandable that I'm really tired!

This morning I watched my mom interact with Lupita, the lady who cleans the house and only speaks Spanish, and then also use ASL with her roommate, Andy, who has Usher's syndrome and is therefore deaf with very low vision. I am envious of my mom's ability to speak English, Spanish, French, and ASL. I only know English, Norwegian, and a few words of Spanish and ASL. Unfortunately there isn't a lot of need for Norwegian in the U.S, haha.

I'm thinking about the possibility of spending some time in a Spanish immersion program after I graduate. I have heard bilingual OTs are in high demand. I have had Spanish most of my life, but I always forget it - immersion is the only way that works for me. I had one year of Norwegian when I was 15 via immersion in Norway, and I am still more or less fluent. Yet I've had Spanish probably 14 years of my life, and only remember a few words!! That isn't cool.

All I know is...I think it would be good for me to speak Spanish relatively fluently, as a U.S. occupational therapist.

Holiday Disclaimer: My MOT student journey includes breaks, so I'm in San Diego for the next few weeks. Not all posts will have to do with OT!

The Centennial Vision EXPLODES

I was talking to my non-OT friend the other day, who reads my blog, and she spit out phrases like "activities of daily life" and "Centennial Vision" like she was in OT school herself. I was like rock on, sister!

OT is NOT just walking up and down the halls...!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I was talking to a friend's mother the other day on the phone. She asked me how school was going and what exactly I was doing again. I told her I was in occupational therapy school, and she said "Oh, that will be a nice easy job. Just walking people up and down the hall holding onto their belt." AUGH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! And so then I had a brain aneurysm.

Leadership comes in many forms...

To me, a leader is always the person willing to scream for everyone's attention in a room filled with people. Because I am not that comfortable addressing large groups, I always assumed that automatically meant I was and would never be a leader.

Lately, during our OT PDEs (Professional Development Evaluations), I discovered that most of my criteria fit into the "Leader Change Agent" section. I was very surprised. And lately a lot of people have talked about me being a natural leader. Again, I don't really "get" it, but I've been thinking about the different ways a person can be a leader. I have realized that you don't have to be the loudest or most determined person in the room - you can be quiet and confident and lead by example, or you can have qualities that allow you to motivate people down a certain path. There are many ways to lead, and I always try to remember that followers should not be dependent on a leader. Rather the leader should give "followers" the skills that will allow them the ability to become leaders themselves. This kind of ties into the Centennial Vision - I will never be that loud leader, but I can lead through example and exposure, via online sources. And thereby close the circle of life, koom bah yay mah lord.

A pseudo developmental profile on Chase, Super Hero 2.5 year old...

Pictures: Combination of Sher, Craig, Chase, and me. Blogger is being butt-heady so I can't caption them individually right now.

I spent this past weekend visiting some old friends, Sher and Craig, who live in Florida. I have known them both since I was 13, before they even knew each other! I met them both online originally. I used to visit Sher every few years, and then she and Craig got married, and I visited them once, and then they had a baby...and I only just now got a chance to see them again! Their baby, Chase, is now 2 and a half! I was looking forward to seeing them and meeting their child.

I quickly realized that Chase is phenomenal. He speaks in complete sentences with proper grammar, has great fine motor skills, great motor skills, and great cognition. I've never met a smarter kid his age. And beyond being smart, he was loving and sweet. I was very impressed.

Here was my favorite conversation with him:

Him: ::kisses my arm:::
Me: Thanks! I'm going to take this kiss and put it in my pocket for later.
Him: No! Don't put it in your pocket! Keep it out!

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What I also thought was neat is that they have "Chase Cam" - they have a webcam over his bed to serve as a baby monitor. They can watch him on their TV while in other rooms and it obviously provides more information than just an auditory baby monitor. It could maybe be a great idea for deaf parents (?). Also, they have given the private webcam address to Chase's grandparents, so they can tune in for bedtime too! It's otherwise private. :)
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While Sher & Craig know I am just an OT student and could not do any formal assessments, they were still interested in hearing my opinion on his development, just out of curiosity. I'm no expert but I am going to try and share my thoughts. So, when you think about developmental assessments frequently used in OT, they typically measure some or all of four domains: gross motor, fine motor, cognition, and/or speech.

Speech: you don't often come across a 2 and a half year old boy who speaks clearly and in complete sentences!!

Cognition: Chase knew his colors, letters, basic numbers, shapes, could easily engage in pretend play, could imitate lots of emotions (ie sad, mad, happy, embarrassed, surprised...), and was able to discuss his opinions. He could verbalize his own feelings and answer "Why" questions with no problem.

Fine motor skills: He still uses a pronated grasp with crayons (a backwards fist with the thumb downward), which I believe is developmentally appropriate at his age. (I don't have access to any OT material for the next few weeks so if anyone wants to correct me, go for it.). He can manipulate objects within his hands and showed good finger-to-palm translation when handed small objects. That means he could pick up a coin with his index finger and thumb, then move it to his palm and hold it there, without using his other hand for help. I thought that was pretty good for a kid his age!!

Gross motor skills: He appears to be right-handed. He was able to cross midline, walk on his heels, tiptoe, run, jump, dance, balance himself, and climb. He showed good flexibility and motor planning.

The five well-known senses: Appeared within normal limits.

The three lesser-known senses so popular in Ayres' Sensory Integration:
Proprioception: Normal (sense of body in space)

Vestibular: Normal, he was completely fine & enjoyed being hung upside down or swung high in the air. He would occasionally, but very rarely, show "gravitational insecurity" in regards to being held upside down, but it was typically when not given warning or just not being in the mood.

Tactile: Normal, although he showed slight inconsistency with his ability to handle various tactile challenges. For example, sometimes he would happily stick his entire hand in paint to fingerpaint, while other times he would carefully hold something with just a finger or two to prevent the paint from getting on his hands. However, I think this type of slight inconsistency is normal at this age (or really any age), and that overall Chase is completely developmentally appropriate, advanced in all major domains! I think he is the first kid I've spent time with in a long time who did not have some sort of disability!

His Super Hero Aptitude Score: 100% ;)

Disclaimer as always: I'm just a student, and now I'm even without access to my OT materials. I frequently make mistakes or misunderstand. Take everything I say with a grain of salt and go see a real OT. :)


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His parents and I exchanged a few e-mails about this post, and we clarified some things. We discussed some ideas for texture play - not that he has any issues, but just that it's fun stuff to do with any kid!!

*Experiment with rough (ie sandpaper) versus smooth (silk)
*Put something grainy into the fingerpaints like oatmeal flakes or seeds..make sure it is nothing sharp.
*Fill up a bin with dried beans and rice, and put toys in it for him to find, and let him just play around with it...(it can get messy so choose wisely where to do this. *Show him some toys with very distinct shapes, put them into a small box with a hand hole in it, and let him put his hand in it and try and decide what object he is holding without looking at it...based solely on feel. It works on tactile discrimination. You can "grade" the activity by showing him the toys first, or only using 2 very diffferent toys, or whatever necessary to make it easier. It may be too advanced for him since he may not be willing to NOT look...
*An entire play session on Texture Time...playing with bumpy, smooth, rough, goey, slimey, watery, hard...basically anything you can think of.

I typed in "sensory games" into Google and found these cool websites below with great ideas. And again - don't necessarily get stressed out if your kid isn't cool with all textures. Everyone has their preferences. If you are concerned, contact your pediatrician/OT/someone with a license...;)

http://www.ecewebguide.com/preschool_themes/five_senses/sensory_games.htm

http://www.coping.org/intervention/sensory/sensintegact.htm

http://www.sensory-processing-disorder.com/sensory-integration-activities.html

Goal for next week: a post on play as occupation

E-mail amnesty...

I went from 1284 e-mails in Gmail an hour ago, to about 40 e-mails in Gmail to go through. Primarily because I liberally filtered and archived items that probably needed responses, but I was too overwhelmed. I for sure owe "Cookie Gimp" and famed OT of NZ, Merrolee, some e-mails...but other than that, I have declared e-mail amnesty. If you e-mailed me and I didn't respond, e-mail me again. I'll try and keep up this time now that I'm on holiday break!! Thanks for all the great comments and e-mails!

OT Tips from an amazing Preschool Special Ed Teacher...

Bethany, a preschool special ed teacher, wrote me this GREAT letter with some helpful OT tips. I was really impressed with her. I have permission to post. I'll post her e-mail address once I get final confirmation it's okay, if you have any questions. Update: I do have permission. It is InvincibleSummer, followed by @ msn.com.
Update 2: She works in a classroom setting with eight children with special needs, and two inclusion peers.


"
Hi,

I have been reading your blog for a while and it is very interesting and helpful.  I am a preschool special education teacher, and so I frequently work with the OTs in my school.  Preschool is a world unto itself, and I absolutely love it, but it requires a certain amount of creativity and flexibility.  I thought you might be interested in some of the tools, tricks, and such that we have utilized in our classroom. 

 

* Water makes anything more fun.  To work on a pincer grasp we have a workbox where students fill different pipettes with colored water, transferring it from one container to another.  To work on manipulation of small objects we have a tall tube that is filled with water and topped with a cap that has a slit in it.  The students drop buttons through the slit one at a time and watch them fall.

 

* A ball pit is a lot of fun, but it is also fun when filled with more unusual substances.  We have filled ours with shaving cream (about 1" thick along the bottom), beans, and styrofoam peanuts.  A lot of time is spent working with children who have sensory aversions using their hands, but we often forget that they may have the same aversions with their feet.  We also frequently walk barefoot on fun textures like bubble wrap and mud, or use our feet to paint on giant pieces of paper.

 

* Velcro is our salvation.  We hold our classroom together with it.  Toys are held onto work surfaces, visual schedules are held onto the wall, picture choice cards are held onto cupboards and shelves, and it works well to help create nifty little single strap grips (a piece of fuzzy fabric sewn - of hot glued- into a tube with a slit cut into it to hold the object with velcro to close it around the hand).  The best invention is velcro that has both sides on the same piece.  Velcro is also great for subtle sensory input.  Many of our chairs for circle time have little pieces of velcro on the arms (one arm soft, one arm rough) that the children can rub for input when they are expected to sit still.

 

* That rubber sticky stuff from the dollar store placed underneath the back two legs (or sometimes all four legs depending on how wiggly a child is) will keep them from being able to wiggle their chair away from the table.  Building blocks make great footrests to allow a child to sit in a chair and still have their feet rest on something - the cardboard ones that look like bricks work the best because the chair legs can be pushed right into them.

 

* Dollar store backpacks on wheels weighted with books are great for slowing down children during transitions.  They love pulling the backpacks and it prevents them from running as soon as the classroom door is opened.  Obviously the weight is calculated carefully.

 

* Grip modifications we have used include tennis balls cut to hold a crayon, spoons and crayons inserted into fabric loops attached around a hand, velcro-closed mittens to help hold items (home-made using children's mittens and a velcro strap sewed on)

 

* For a child with visual impairments, we have used different textures (fabrics) to differentiate his communication switches. 

 

* Whistles have never worked well for my children to encourage them to use oral motor skills for blowing but bubbles are magic.  Nuk brushes are preferred when they are dipped in a flavor - I use the powders from the Lik-a-Stik or pudding, or the liquid candy sprays that are available depending on what each child can tolerate.  Battery operated tooth brushes from the dollar store are wonderful for children to use themselves for oral motor input, and we try to brush our teeth every day after lunch using them (non-floride toothpaste and toothbrushes kept in individual drawers). 

 

I don't know if any of that helps you, but it is some of the things I have learned over the past year or so in my class.  The biggest thing that I wished that some of the OTs I have worked with would do differently would be to not pull a child out of the class activities and work with them off to one side in the corner of the classroom so much.  Children do not use their skills in isolation with special toys in the corner of the classroom.  They need to use these skills during their regular activities in order for them to be functional.  Also, if I am supposed to carry on what is being done, then trying to leave the other children with my assistant so I can work with a child who has the direct attention of a therapist is difficult.  This also poses the challenge of generalization, because some children with disabilities will master a skill in one setting but fail to generalize it to other environments or settings.  Yet I must say that the OTs (and PTs and SLTs) that enter our classroom, that is in a perpetual state of controlled chaos and high-intensity, are compassionate and talented and rather brave.  They never know what they are going to walk into, they have to come armed for being chew toys and art canvasses and living switch toys, and they do it with grace and humor.  I have the benefit of orchestrating the chaos, while they work within it and then move on to other children who may or may not cooperate that day.  All in all, we do make a good team.

 

Thanks for writing an interesting, informative, and enlightening Blog!

Bethany

I wanted to comment on what Bethany said about wishing OTs did not pull kids out of normal class activities. It's true the OT should always consider context. Just because a child can accomplish something in a quiet room, does not mean he/she can do it in a classroom filled with distractions. The OT should carefully consider the activities being worked on, and whenever possible, should do just as Bethany said above - work with the kid "en vivo". :)

Thanks Bethany for the great tips!

Oh-Tee Makes Me Hap-Ee

I was wearing my OT jacket on the airport shuttle today, and a person asked me to explain the difference between PT and OT. I really hate answering this question because I feel I can never do it justice in just a small sound bite. I said that OT can be similar to PT in that they can do a lot of upper-body work, but that more importantly, the focus was on the use of meaningful activities, aka occupations, to restore function, independence, and/or quality of life, to people of any age - from preemies to geriatric patients. They commented that that sounded pretty cool, and I agreed. I told them how happy I was that I had found a career I really cared about, and how neat it was that we had so many different ways to help others.

In the last few days, I've been able to give suggestions on basic environmental modifications (maybe lowering work surfaces for someone with a rotator cuff tear waiting for surgery), assistive devices (ice tips for crutches), and more. It was just with friends and suggested informally, since as always, I want to make the disclaimer that I'm A STUDENT and just sharing some of the information I've received...not practicing without a license!!! (::Stares at NBCOT:::) I'm so paranoid. I'm sorry.

It just makes me happy to have a mental toolbox that can help my friends in small ways...

So...a few blog goals in no particular order...

1. Special Ed Teacher Post
2. Discuss Caregiving &Preemie Book I read in Florida
3. More "Cookie Gimp" (disability activist) thoughts...I need to catch up on e-mails from him and will have more to ponder...
4. Talking about the smartest little boy EVERRRRRRRRRRRR who I got to meet in Florida...
5. Talking about playfulness/Greenspan's concept of Floor-Time
6. Talk about a recent victory where OTs don't have to be specifically certified to do wheelchair evals. Or something like that.
6. I dunno - I need more material from people. Send it on!!!
8. Learn to count.

More points from the "Cookie Gimp"

More from the "Cookie Gimp"...I searched everywhere and can't find this original e-mail, but he told me a lot of disability activists refer to themselves as crips or gimps. It reminds me of gangs! He had some good points I want to share here...it was just one of our many e-mails back and forth, so it's informally written. Slightly edited to remove identifying information.

1. Re-consider family-centered practice. What is this anyway? Pillow angel is an extreme case that you personally will probably never have to deal with but there's all kinds of situations, even minor ones, where these issues will arise. Take an easy one (to me): 14 year old gimp has CP. She is happy in a chair. Parents want her to undergo rigorous rehab three times a week even though this will screw up her GPA so she can climb stairs. Client centered? That means nothing. Who is the client. In 1955, she would be taken by force and given PT/OT. Today, I don't know. Obviously you know what I think but these are genuinely difficult situations.

2. Money will limit what you can do but try to keep your non-elderly clients out of nursing homes. Nursing homes are hellish. They are not client directed. They are like rehab only worse. I was actually surprised what you said about "diapers" in rehab but nursing homes I think do it too. Here it's solely for convenience of the staff.

3. I do recognize the boundary thing and thought your death posts were moving. But you could extend boundaries in minor ways (no I don't mean bake cookies for gimps) I mean you could address access wherever you go personally. If you go to a movie with your spouse and the washroom sucks, complain to the manager. They will take it way more seriously from an OT than a gimp. I think THIS is partly a cultural issue because nothing is accessible but you're also from CA, which creates a bias. Go to states like NY and MA and access is somewhat worse.

Cookie Gimp" says...learn more about Disability Activists

"Cookie Gimp's" Contribution to my Blog:

The best way for occupational therapy students to learn about disability from a rights perspective (I *think* this is what Karen means by frame of reference but I am not sure on all the OT jargon) is by attending a disability rights conference and actually meeting activists struggling to change the world, physically and attitudinally. These are numerous in the US and Canada but the two best are Society for Disability Studies in NYC in mid-June (info at www.disstudies.org) and the Canadian Disability Studies Association meeting in Vancouver (not far from Seattle; info at www.cdsa-acei.ca). Short of that, read No Pity: People with Disabilities Forging a Civil Rights Movement by Joseph Shapiro or Handbook of Disability Studies by Albrecht, Seelman and Bury. Rehab has historically been part of the problem. OT students can be part of the solution if you take the social model of disablement seriously (focusing primarily on strucutral barriers not impairment). Karen already has the right psychological mindset; instead of rating pet injuries by numerical scales, that same instinct can be re-tooled to notice steps/barriers wherever you go.

i am still alive

i will post in the next day or two. my computer was very sick and is being reformatted by my fabulous floridian friends so i am computerless for the most part. I get back to nashville monday night!! have a great weekend!!!

Books galore...interest in the life of others

Update: Patti, glorious OT student, also recommended this book:

You have enough to read,
but maybe during the next break definitely add "Where is the Mango Princess?" by Cathy Crimmins to your list.
It's a caregivers experience with her husbands traumatic brain injury. It's awesome, filled with facts, but also an incredible personal journey.
Oh and it mentions her experiences with OT.... that's cool too : )

"Cookie Gimp" recommends:
*Rights of Inclusion by Munger and Engel. It's an American book about narratives of disabled people
*No Pity: People with Disabilities Forging a Civil Rights Movement by Joseph Shapiro *Handbook of Disability Studies by Albrecht, Seelman and Bury.
*Anne Finger's Past Due, about her pregnancy as a disabled woman.

I leave tomorrow and will be gone 3 weeks in 3 different states. I've asked for blog material and have received a few pieces already. There might be quite a bit of off-topic stuff...just go read the archives for OT-related things. I'm not apologizing because this is a student journey blog and guess what, students get breaks!!  I'm busy packing and tying up loose ends today. I had breakfast with OTS Brooke at Brother Juniper's today (yum), and then I hit up the public library...my favorite is the 21-day HEALTH section. I just randomly skim titles until I find titles that look promising - I hate reading books with straight-forward facts - I love reading stories though that have those facts intertwined. I'm fascinated by all medical things and the lives of others. I got this many books (from my hands at my waist to my chin, like Gus the mouse on Cinderella), because I will be spending a lot of time in airports and on airplanes. I did the same thing in June. I can't wait to read some books for fun, FINALLY. I'm sure I'll end up picking up a few more books along the way - I didn't have a list with me to pick up some recommended books. The hardest part is accurately gauging how many books I can get through in a day of travel since books are HEAVY! 

1. "Special Siblings: Growing up with someone with a disability" by Mary McHugh
2. "Sound-Shadows of The New World" by Ved Mehta - about blindness
3. "Touching the Rock: An Experience of Blindness" by John Hull
4. "Wayne: An Abused Child's Story of Courage, Survival, and Hope - by Wayne Theodore
5. "Swim to Me" by Betsy Carter (my one random fiction pick)
6. "My Year Off: Recovering Life after a Stroke" by Robert McCrum
7. "Defending Andy: One Mother's Fight to Save her Son from Cancer and the Insurance industry" by Marilyn Azevedo
8. "I want to grow hair, I want to grow up, I want to go to Boise: Children Surviving Cancer" by Erma Bombeck
9. "I had brain surgery, what's your excuse?" by Suzy Becker
10. "Healing and Hope: Six Women from Betty Ford Center Share Journeys of Addiction and Recovery" by Betty Ford
11. "Heroes with a thousand faces - true stories of people w/ facial deformities and their quest for acceptance" by Laura Greenwald
12. "Rescuing Jeffrey" by Richard Galli - traumatic spinal cord injury story"
13. "The Camera My Mother Gave me" by Susanna Kaysen - sickness journey
14. "Dyspraxia: The Hidden Handicap" by Dr Amanda Kirby
15. "Miracle Birth Stories of Very Premature Babies" by Timothy Smith
16. "Playing for their Lives: Helping Troubled Children through Play Therapy" by Dorothy Singer
17. "Acquainted with the night: a parent's quest to understand depression and bipolar disorder in his children" by Paul Raeburn
18. "A handful of ashes" by Dr Victoria Greenleaf, on raising an antisocial child
19. "Chicken Soup for the Caregiver's Soul"

Professional Development Evaluations...it's all over!

Professional Development Evaluations

In my program, we have to prove basic professional criteria in four domains, at the end of our first year. This is done through documentation of each criteria. It is stuff like being ethically-grounded, client-centered, evidence-based, ...you get the picture. We were assigned a one hour session with our adviser and one other professor. I was really nervous that I'd end up crying unprofessionally if I was given a lot of negative feedback. I really thought they'd get on me for sometimes making inappropriate comments and things like that. Luckily, it went really, really well. I showed them my documentation and they were pleased with it. Then they gave me a piece of paper with information on it from the faculty. The faculty had gotten together previously to discuss each person and then feedback, both positive and negative, was written down. My positive feedback said I did well academically, did a lot for the class, things like that. The negative feedback was that I need to not be so self-deprecating and show more self-worth. It was also noted that I no longer make as many morbid comments, which made me laugh. I frequently say horrible things that I don't even mean at all, and people take me seriously, so I've been trying to be more careful.

Now I need to start preparing for intermediate PDEs, which are due in a semester...

OTS Patti who has a blog linked on my sidebar, told me via IM the other night that they have PBAs...Professional Behavioral Assessments...but that they don't actually meet with the faculty.

Does anyone else out there want to tell about their program and if it has anything similar to this?

Ok. I am officially done for the night. I'm dragging my feet over to my bedroom to start packing.

The Kitchen Sink Frame of Reference & Other Random Resources

Caption: My sister and I chilling out in a kitchen sink

So...to close out this blog blitz with an alliterative bang, I was going to write an article on Frames of Reference and how it applies to Occupational Therapy....but then I got a wild hare or hair...I'm not sure which...and decided to search on Google first.

Lo and behold, there is a great basic resource for FOR at http://wind.cc.whecn.edu/~mwonser/OCTH2000/unit5.html

It talks about what Frames of Reference are...and how each frame of reference (biomechanical, developmental, etc etc) can provide a different theoretical framework to approach the problem.

There is one Frame of Reference that is missing though. While walking to the parking garage one day, some of us were talking about how we should have a "Miscellaneous" FOR when nothing else seems to fit. We decided it should be called "The Kitchen-Sink Frame of Reference". That's even funnier than it sounds, because there is a girl in the class whose married name is Kitchens, and another girl whose maiden name was Sink. Fitting, huh. Are you dying laughing? Take a deep breath, it's going to be okay.


Also, I just did some sleuthery and found out if you go to http://wind.cc.whecn.edu/~mwonser/OCTH2000/    you have access to ALL the units, because this is an Online Intro to OT course! Pretty cool!

While I'm on my website frenzy....AOTA may bite me for this but I think it's open to all... if you go to www.aota.org, then click Student, then click on Handouts for Conclave...there are some great Powerpoints to download there too about a variety of things.

Ok...I'm done. I've crossed off all my blogging goals on my to-do list for a few days...now I can focus on more boring stuff like packing.

But, seeing as how I am Miss Procrastination, I forgot to tell you guys about my PDEs! One last post, I promise.

The Recycling Occupational Therapist

Caption 1: Sister and I using recycled items wisely.
Caption 2: Barbara Smith, author of the Recycling Occupational Therapist

I talked about being interested in the book "The Recycling Occupational Therapist" a while back, and the author left me a comment. She pointed out the book is available on Amazon (kind of expensive though, I am a sad student).
She also left her website address,

www.barbarasmithoccupationaltherapist.com

I went dubiously to it AND GUESS WHAT! IT WAS PRETTY COOL! She had stuff on tons of areas from hippotherapy to low vision....a great source for people interested in a specific specialty and just wanting some basic information it, or wanting some ideas, or whatever. I recommend it.

Also, I thought this was neat...she had a disability awareness quiz...

http://barbarasmithoccupationaltherapist.com/disabiityawarenessquiz.html

PLEASE SEND ME MATERIAL!

I'm writing up a flurry of posts today because I'm not sure how much I'll be posting the next few weeks...I'm going to try not to neglect it, but I'll be traveling a lot, so I dunno. One of my good friends, OTS Virginia, let me know she is going to write up a few posts...one about OTs working with troubled youth, and one about OTs working in hospice.

I would LOVE if people - OTs, OT Students, Random People, People who have had OT or have family members who had OT, people with tips for OTs.....ANYONE!!!!!!!!!!!!! would e-mail me material and specify how much credit you want (ie full name, email address....or just first name...or anonymous...or whatever you want). I'll put it up for you. The only rule is that it has to have SOMETHING to do with occupational therapy, and that it can not be offensive/inappropriate. I may edit it slightly, but would let you approve the edits before posting. I'm going to specifically call out a few people with suggestions:

Cookie Man: how you think OTs *can* help (be nice!!!) or ??
Virginia: Hospice, troubled youth
Burt: Real tools for an OT toolbox
Sarah: ??
Suzy/Arnie: Saran wrap and ?
Brooke: holding a leadership position in OT or ??
Kerri: ??
Allison: ??
Ryn of Ryn Tales/Dream Mom: View of rehab??
Mom: being the mother of the coolest occupational therapy student in the entire world...just kidding
Any person in my class: Whatever you want to write about
AOTA Staff (I'm pretending like this is a possibility): What you most wish OT students would understand about AOTA's role...or ??
Professors: What you wish OT students would most grasp
Everyone else in the world: I dunno, be creative

Review of "Ordinary Miracles"...

I bought and read the AOTA-recommended book "Ordinary  Miracles: True Stories About Overcoming Obstacles and Surviving Catastrophes", which was edited by Deborah Labovitz. Very chicken soupy. It has to do with how occupational therapists have helped people. Originally I was angry because I wanted to write a book like this and I was mad she beat me to it.

It's a really dense book with a TON of stories. I'm a fast reader and it took surprisingly long to finish it. Most of the stories are interesting, although a few of the stories were downright odd!

I guess I recommend it if you are a chicken soup kinda person, but you probably won't end up sobbing over it or anything.

The good news about OT is there is 323893933939393 million ways to help someone do whatever they want to do, so by the time I've been a practitioner a few years, I can write my own book, and I will become a bestselling author because the book is so inspiring to everyone, and then everyone in the entire world, even in tiny countries like Kuzuzueiistan, will know what occupational therapy is. And Deborah Labovitz and I will have a SHOW DOWN!!!!!!!!!!! Maybe on Jerry Springer.

edhelper.com a great free site...

We had a visual perceptual lab where we got to experiment with some worksheets, and I saw some were from www.edhelper.com. It has a lot of great worksheets in a variety of subjects for kids!

http://www.edhelper.com/

You know you've been in OT School too long when...

Scene:
OTS Karen (me) at OTS Kerri and her husband, Brent's, home. Playing with their new cat.

Action: Cat hits head against metal chair while playing

Brent : Poor kitty.

OTS Karen: Yikes, he might have a TBI. What do you think his GCS is?

OTS Kerri: Hmm, I'd say a 15.

OTS Karen: Oh good. I'd have been really upset if it was an 8.

Brent: Please stop.


-------------

Abbreviations explained for non-OTers:

TBI - traumatic brain injury
GCS - Glasgow Coma Score, anything lower than 8 has a lower survival rate

Occupational Therapy Students Talk About Gingerbread Houses

A lot of kids with sensory problems or other issues related to eating, may end up with very negative food associations, since the presence of food is usually associated with crying/screaming/frustration. A gingerbread house activity with some safe candies/items may be a good way to work on this. Ideally you'd contact a real OT though, since as students we can't give specific advice besides kids may appreciate food being fun through play! What we talk about is loosely based on the SOS Feeding Protocol. This video star is OTS Virginia. I'm the amazing cameraman.

Gingerbread Houses

OTS Virginia and I made gingerbread houses this morning. It was quite the experience. She made an actual house, I had to settle for a pueblo (flat roof) since I apparently don't have the skill to perform any basic task. But it got me thinking that maybe it would be fun to bake small square cakes...like four....and give each child one, and let them decorate it like a gingerbread house...and then put the four together as a cake quilt!!!!! Or something like that...

Here is a picture grid while I wait for the videos to finish uploading. I'm about to go get ready for my PDEs. Wish me luck. Maybe I'll come home a broken woman!!!!!!!!

How Not to Spend The Night Before Professional Development Evaluations for OT School

Hypothetically...that is....cough...

12am: Watch the heart-racing "Tornado" episode of Desperate Housewives.
12:40am Lay/lie/whatever the grammatical correct thing to say is, in bed, thinking of about 30 different cool OT videos to make and wanting to make them all right that second or at least write them down.
1:30am Start to get sleepy.
1:40am: Have large pile of clothes in closet shift and cause closet door to squeak open, making my heart race again and being scared my crazy neighbor is in the closet. Wish closet door was shut since it always freaks me out if it is open. But too scared to close it.
1:50am: think about more videos while blackness spins around in my brain.
2am: Get dizzier
2:10. Get up and dizzily go to kitchen to eat a few spoons of peanut butter as a dinner substitute. Have trouble seeing the peanut butter without glasses. Stumble back to bed.
2:15am: Turn on pocket watch light to see what time it is. Get scared by shadow it produces.
2:30am to 7:30am: Have repeated and horrible anxiety-producing nightmares about viruses infecting my computer and, even worse, trying to take a test and only figuring out a few answers, and crying hysterically...multiple times. Really, really upset in these stupid nightmares.
728am: Have mini dream someone throws something at me. Flinch. Unfortunately, my nails were against my forehead, so the flinch caused me to scratch my forehead and leave a red spot.
7:30am: Wake up really sad and depressed.
7:35am: Look in mirror and look HORRIBLE
7:51am: Hope mood gets better QUICK since about to have a really fun morning with Virginia and my Professional Development Evaluations shouldn't be THAT bad! I'll let y'all know how it goes!!
7:52am: Get up from chair and start getting ready for a hopefully fun but looong day.

I swear I'm not normally like this!!! What a horrible night!!!!!!! Hypothetically. I meant.

Tomorrow.........Frames of Reference

I'm feeling a little guilty that my slew of recent posts are about social events and not completely OT-correlated. So I had this burst of inspiration...I am going to cover my ears while you all squeal with excitement...one of tomorrow's post is going to be.... FRAMES OF REFERENCE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! YES!!!!!!!!!! YOU HEARD ME!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Every OT student's nightmare, every professor's love child, and every practitioner's forgotten memory!!!

Gingerbread houses and PDE are TOMORROW!

This morning I went to Costco to get my tires rotated & balanced, and met a non-OT friend to shop at Costco while I waited. Then OTS Virginia came over and we sat on my landlord's kitchen floor and played with their adorable new golden doodle puppy, I almost died it was so cute. But it peed a lot. :( We came armed in true OT fashion with towels to protect us.

Then we went to the Dollar Store since we had planned out a special Tuesday morning event for a Karen-Virginia bonding experience, and we needed to get supplies for our gingerbread houses! We got graham crackers, icing, and a bunch of random candies, carefully discussed and chosen for their colorful properties. Unfortunately, we got stuck in line behind someone buying about $90 worth of chips and cookies. I swear he smelled like he was wearing a sweater that had been sitting in cat pee in an old closet for six years. The smell of ammonia was so strong it almost made me hurt!!

Then we hung out at her house a while and she made me a delicious lunch...then I came home and future OTS (FOTS?) Talli, my little OT sib, called and said she wanted to bring me a special white chocolate macademia cookie from Miss Cordelia's, and coffee too! She is so thoughtful and sweet. So she picked me up and we ran by Starbucks. She got a normal decaf coffee, I got a decaf nonfat eggnog latte. I know that is so wrong. I am sorry. I guess I just realized I didn't eat dinner though. Oops. AHAHHA

Anyway, we hung out for almost 4 hours, talking about some random stuff and a lot of OT stuff. She is going to be like the coolest OT ever because she is really overly competent and smart. She can do things like make bamboo wind chimes without blinking an eye. She makes me sick. She has a unique name, so if you meet an OT named Talli, you should be filled with joy, ok?

Tommorrrowwwwww....Virginia and I have our special breakfast/ginger-bread house morning, and then I have my PDE (professional development evaluation) at 2pm...I hear it isn't so bad. I need to figure out something professional to wear. I'm thinking torn jeans and a shirt with a kitty on it...or maybe black pants and a nice top...I don't know yet...

THEN I am meeting at least OTS Kerri and her husband, possibly others for a celebratory post-PDE event of Costco hotdogs or pizza and the likes. Pretty fancy huh. Then I am spending some time with some non-OT friends, THEN I work 9 to midnight. It's fun getting to finally have time to do a bunch of non-stop social stuff after being in class since early July!!

My house is a wreck. I should probably be cleaning it right now instead of writing out every detail of the next day. But no. I am writing about this stuff because it makes me really happy and proud to get to have so many social experiences with my OT classmates. We have so much fun together and I hope every OT student gets to experience this with their classmates!!!!!!!!!!!!!

I just realized gingerbread houses might be a really fun activity to do with a client/patient/consumer. You could grade the activity by either providing the house part already made, or making the patient problem-solve the house structure, or provide hints, or whatever. You could also put the icing in different types of squeezies to make it easier/harder, and provide lots of little candies to work on fine motor skills. You could even work on some cognitive stuff like color sequencing, patterns, you name it. Activity analysis is the friend of any OT!

Occupational profiles...I can't stop myself

I was at an ornament party this weekend and I sat down next to a woman in her 70s. We started chatting and I swear to you, I was ITCHING to do a occupational profile!! I wanted to be like...tell me about a typical day...who do you live with...what do you do...how do you feel...blah blah blah. I had to restrain myself. I was kind of appalled at my own OTPF-osity.

Pediatric occupational therapy treatment project by OT Student Anna

Anna's Treatment Project for a Pediatric Patient!

Occupational therapy with sick babies?!

UPDATE: OTS Emily ran in the St. Jude 1/2 marathon quite successfully despite being in pain! Go Emily!!

Saturday morning did not quite go as planned...

I wrote this yesterday:
It normally takes me 5 minutes to get to the local pediatric hospital where I volunteer. This morning, it took 45 minutes. The St. Jude marathon was going on and they were running all around my area. I tried to go down Peabody. Nope. Went down Union. Blocked. Went to Madison. Blocked. Went to Jefferson, Washington, tried to go to Poplar...blocked. Went up a back alleyway. Got stuck. Two lanes only, and a stupid cop lets a hearse take up one of the two lanes. Seeing as how everyone in one lane is completely blocked and needs to turn around, a hearse blocking the other lane wasn't very helpful. It was sad there was a hearse there at all though, obviously. Anyway. Called the hospital security and was like um....I've been trying to get there for 30 minutes now. What do I do? They looked at a map and the only thing they could figure out to do was to take this huge circle around downtown, which I am not familiar with enough to be comfortable executing. I finally did what I should have done immediately had it occurred to me - park at UT Memphis and walk up the hill to the hospital. So I was 30 minutes late instead of 10 minutes early.

When I get there, I found out my two favorite babies of all time there, had passed away yesterday. Huge blow. :(
Held adorable babies for an hour and a half. I feel like my OT knowledge helps me better understand their needs, both medically and developmentally. I'm getting a lot more comfortable with the babies.

I feel like the pacifier fairy sometimes....running around just popping in lost pacifiers. I typically end up holding 1-2 babies in a 2 hour session. With gown changes, dragging up a chair, checking with a nurse, repositioning tubes, gingerly picking up the baby....it is a long process. Once I have the baby, I keep them for at least 30 minutes to an hour and a half plus, depending on how the baby is doing. So when I finally transition from one baby to the next, I pop in pacifiers for the crying babies as I go...with hand cleaning each time, of course! I am sad I'll miss the next three weeks while out of town, but starting in January I'm going to try to go at least once a week, maybe two. I'm excited. I find it very rewarding to hold these babies.

Went home...marathon still going on, so took me about 15 minutes with a few detours. Glad to see so many people support St. Jude, but it sure made my morning hectic.

I was thinking about how much I enjoy volunteering and/or the idea of being an OT with this type of population...sick babies. To me, it is kind of funny how I can cry at Gary the Snail from Spongebob almost starving to death, and yet two of my babies die and I'm like Ouch. Moving on. No tears. But I've thought about it and it's not that I don't care or have an emotional problem - it is that I know that if I want to keep helping these babies, I have no choice but to keep the heartbreak contained within a tiny area, so that I am not overwhelmed. I think the kind of person who can work with this population is just as compassionate as anyone else - we just have the ability to set emotional boundaries. If you would have asked me a few years ago if you thought I'd be an OT for sick babies, I probably would have laughed at you. And I haven't even started my Level II fieldwork's, so maybe I'll change my mind again. But for right now...working with the frail sick babies makes me most happy. Not the tiny babies though - I'm still freaked out by the newborns. They have to be a few months old before I stop being scared. I think with time I'll even get used to the teeny babies.
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Saturday night was the OT Christmas Party and it rocked! A lot! More details - and carefully chosen non-PDE ruining- pictures, coming soon.