Mind mapping OT competition :)

This was sent to me by Tommy Carr:

I wanted to get in touch with you again about my website - www.otstudent.info - as I am now starting a competition in which someone could win mind mapping software worth £199. Basically, in an effort to stimulate collaboration on the website and also creativity among OTs and OT students, I have started a competition for people to send in their mind maps on a subject related to OT. Any mind maps sent will be uploaded to the site (where appropriate!) and the best one will win the prize - closing date is 1st October 2011. The competition page is at:

www.otstudent.info/competition

Pinterest + OT ideas

I'm starting to obsess over wanting to do more crafts this upcoming year with my school OT kids. I started using Pinterest today http://pinterest.com/funkist/pins/ to keep track of the crafts that may be promising in some way. Like for example, cutting pool noodles into slices to make giant beads!

contracts/social story on what OT is

Anybody have a social story written on what OT is for? And/or a contract? For use in the school system? I only work with K-6 and this year I am thinking about starting the year with both a social story and a contract for each child, where we review what OT is, who I am, what goals they have, etc. The contract would be to work on those goals/work hard/work together or something along those lines. I think a lot of kids getting OT have no idea what they are doing (including some of mine) so I would like to address that immediately this upcoming year. I think I'm also going to make sure to e-mail the teachers at the beginning of the year (after the craziness of the first week or so subsides for them), telling them what goals OT is working on specifically for the particular child(ren) in their class....and perhaps send home a note with the kids reminding the parents of my e-mail address.

That sounds like a lot of work. But I think it would be good to do. Does anyone out there already have a contract and/or social story for OT aimed at younger ages?

Young people in nursing homes

http://www.huffingtonpost.com/2011/01/07/assisted-living-more-young-people_n_805772.html

My friend sent this article to me (a long time ago :x) with the enclosed commentary:

I thought you'd be interested in the link below.  It's an article about the increasing number of people under 65 who are in nursing homes. It really is a tragedy.  We have an institutional bias when it comes to long term care funding.  It needs to be shifted so that most of the money is spent on community based care.

school OT crafts I want to try!

 One of my goals for this upcoming school year is to try more crafts. Here is a couple that look interesting that someone does with her home-schooled children. :) I especially like the first and third link, all from Angry Chicken!

http://angrychicken.typepad.com/angry_chicken/2011/06/on-a-rainy-day.html
Making a cloud with rainbows

maybe this one too...
http://angrychicken.typepad.com/angry_chicken/2010/10/bone-digger.html


and I think this one is beautiful....rose petal drawings
http://angrychicken.typepad.com/angry_chicken/2010/10/rose-petal-drawings.html

and this one for Halloween...
http://angrychicken.typepad.com/angry_chicken/2009/10/that-silly-pumpkin-head.html

old OT reminders

I spend a lot of time while working trying to make sure I get the lingo down and know what I am talking about. I write myself a lot of cheat sheets with things I observe/read that I want to use in the future. I don't do a great job of organizing it though. But here is an example cheat sheet from when I worked in adult physical dysfunction last year. Now it's all alien to me since school OT is a whole other area! But when I read some of this stuff it reminds me how complex OT can be. :0

PS: None of this should be taken as advice down below - it could be wrong for all I know, and it's certainly all out of context. Just showing all the complex terminology and thought processes etc. I do notice when I read through this the lack of occupation-based terminology. Oops. ;)

PS2: I am down to under 100 new mails. That's why so many new OT blog posts lately, I'm getting close to everything being cleaned out. :)

Stroke:

PROM/AROM

Isometrics

Cocontractions

Rhythmic stabilizations

Scapular muscles

Weight bearing

PNF patterns

Abduction on sidelying

Regressive resistance

Short arc

 

Actaboski?

 

"composite digit flexion"

 

"Pt also demo intact LUE sensation to SWM 5.07 for protective sensation, however absent 2 point 1.0cm discrimination along L median nerve distribution/medial cutaneous nerve"

 

OT then applied gentle PROM to L digit flex/extend with differential FDP/FDS tendon gliding and pt instructed in joint blocking.

 

Increase facilitation of normal tone, neuro-re ed out of flexor synergy, activation of paraspinals and abdominals, long duration stretch with ext/sup patterning using deep tendon inhibition techniques, RUE through PNF D2 flexion patterns, OT maintaining flexor synergy inhibition points of contact for increased AROM while pt moved through PNF patterns

 

Ironing board/incline

Sliding board with wedges

Partial stands

Straight cane to activate external rotation with ace bandaged hand

Scapular mobilizatios – elevate, me do it, then u try to help

Supine uphill, cocontractions

Do some oscillations on shld while supine, quick approximations as well, externally rotate thumb while trying to do elbow ext

Prone on elbows or table top

Arm skate

Soques

Remiste

Concentric/eccentric

Closed chain/open chain

 

Lumbricals – tend to get clawed?

Intrinsic plus/minus positioning

Transfers to graded height surfaces

Recripocal patterning

 

No proximal activation palpated

Performed closed chain task

Dynamic reaching over weak limbs?

To improve postural stability, stand on variety of unstable surfaces

Try to self-correct and improve postural integrity, perturbations –v estibular

Change velocity, angle, distance

Unilateral UE release to challenge dynamic sitting balance

Air splint for neutral warmth to decrease tone

Max A to find initial placement on L

 

Unilateral UE downward reach and hip flexion needed for LE clothing management

Intermittent hands on assistance to maximize full elbow extension, keep postural integrity

Lowered concentrically with control

Paresthesias

Cross friction massage

Excursion

FPL – same, only move IP of thumb

FDS – same, to move PIP

Isolated FDS, FDP, FPL tendon     FDP – hol down palm up so can only move DIP

Scapulohumeral rythym discoordinated

 

Ulnar nerve paresthesias, 2/7 for 0.5 2 point discrimination

Stereognosis – no vision tactile search

Intrinsic: digit abd/add, interosseous lumbricals, so do pull apart fingers with resistance. Strengthen intrinsic plus position

Straighten elbow, FDP flatter stretch at IPS????????

 

Follow ulnar nerve tract up C8/T1 (brachial plexus)

 

Scaption to decrease impingement

 

Thumb up: coracobrachialis

Supination: biceps bracchi

 

Ulnar nerve glide ex: elbow extend etc

With OT correcting techniquers

CMC joint tightness

 

Resistive L digit extension

Difficulty with voluntary movement of thumb and digit opposite and lumbrical grip

 

Contract – isotonic

Hold – isometric

Agonist – pattern with limited motion

Antagonist – muscle shortened that limits range of agonist

D2 ext: ext add, int rot, flex abd ext rot, seatbelt  side on top, cross on bottom

D1: flex/add/ext, ext/abd/int, cross on top, side on bottom

PNF – proprioceptive neuromuscular facilitation, increase response of nm mechanism by stimulating prioprioceptors, fl/ext, abd/add, int/ext R, rotary component, balance of antagonists, sag, front, horiz

Trophic changes – ie swollen shiny skin and nails with ridges, sign of CRPS

TENS : transcutaneous, sensory to decrease pain, no visible contractions, bipolar 2, quad 4, crisscross pattern, black delivers shock, red grand/receiving. Further apart pads, shallow, close together deep. IFC – inferential current,

 

Ligaments – frozen shoulder, distraction, rythymic stabilization

Facilitate motor return

Respiratory rate – count number of times chest raises

BP manual, valve tight, pump up past 180, slowly release, listen to brachial artery, first and last heartbeat

 

Try to normalize movement patterns

Media positioned to facilitate BUE

For improved proximal stability for ADL tasks

Performed to improve BUE extensor strength

QD – once a day

BID – 2x a day

Cross tendon massage, subscapularis massage from axillary angle

UE assisted pelvic elevation

Shoulder capsular massage

Interosseous mobilization – supination and pronation, go up and down, radius and ulna

 

Neuro – don't go past pain, ortho- go past pain

Pain increases tone so only go to tolerance

Ribcage elongation

Don't stretch hypotonic

Manual protraction/retraction

 

Performed eval and pt has potential to increase functional skills, need to redo home program with 2 visits.

 

"composite flexure contracture"

 

Viscolas Flexigrip Hand exerciser

 

Vision: contrast, geographical vs spatial, inattention, poor vision, eyes jump/nystagmus, boundaries ie red tape to red tape

 

0---- bp, then 0 seated, standing etc

 

Dissociation of body and limbs

Active assist bow activity, bow positioned to inhibit compensatory R shld abduction and facilitate flexion in slight scaption. Occasional manual assist to inhibit compensatory R trunk lateral flexion.

Media positioned to promote RUE AROM in diagonal patterns and improve standing balance. Min A to maintain dynamic balance during task, ball placed to provide proprioceptive input to RUE and resisted trunk flexion, to improve postural integrity, decrease compensatory movements, improve tone for increased efficiency with ADL and mobility tasks.

 

Stickler's syndrome: decreased visual acuity, nystagmus, increased risk of retinal detachment and amblyopia

 

Swivel spoon/wrist splint, steering wheel covers, HEP tendon glide, nerve glide, gentle strength, rubber band extension, towel crumble

 

OT rehab ideas

here were some of the ideas I had written down (some more occupation-based than others but just things to prompt my brain) while working in inpatient rehab....

PS: Belly dancing/fencing were two things I was into...belly dancing is GREAT for hip/core work (find just a basic video on youtube and they can work in the parallel bars, if not shy about it of course) and fencing (with foam swords) if you use the proper stance (google that too) is great for balance and strengthening/stabilizing lower body while also incorporating upper body. :)

sorting junk mail sorting laundry sorting silverware working on calendar working with checkbook working with dayplanner opening up garbage bag dusting with weird confetti vacuuming wiping down table watering plants setting alarm clock or timer  making microwave meal inventorying area scrubbing spots on walls cleaning a mirror paint brush rolling on wall clocks - telling time, drawing clocks sorting nuts n bolts pilates, yoga belly dancing, fencing Clothespins, racks, washclothes

Dartboard, standing

Lean on wedges to work on stomach

Wedge ramp, roll ball from one to another on wedge

Place paperclips under bottom, raise up and take away

Sit on BSC, raise up place tennis balls from either side

Dowel ladder, put cones on it or use weighted dowel

Lie on back, reach up and back for items

Ball or bolster rolling up and down wall

Partial sit to stand from mat

Pegs on vertical surface, place pegs in, maybe patterned

Theraputty hand exercises

Airsplinting to reduce tone in elbow

Velcro rotators for hand manip

Pick up rice pieces

Stack tiny cubes

Bend knee back, kick ball

Abacus with foot to slide beads

Hit ball with weighted dowel

Basketball

marching in place

UE assisted pelvic elevation

scooting on mat

lateral weight bear for peg shapes on vert surf

sort cards by suit

Low Vision in Children

I went to a seminar on August 15th, 2008 hosted by the Hamilton Eye Clinic, called "The Children's Vision Rehabilitation Project: A MultiDisciplinary Approach to Low Vision in Children" with visiting professors Terry Schwartz, MD, and Rebecca Coakley, MEd, from the West VA Eye Clinic.  The seminar was for ophthalmologists, OTs, vision rehab professionals, educators, and more. One of my good friends Orli is a low vision occupational therapist at Hamilton Eye plus I always want to learn more about everything, so it was a very interesting day. I've intended to write this post for over a YEAR now. Finally got around to it. I should have written it the next day as my notes were not great so I'm missing 95% of it I feel. But I'll share what I did get out of it - note this is my own one year later understanding, so take it with grain of salt. :)

Low vision equipment: Many times expensive items are recommended to people but then sit unused for whatever reason - its too ugly or inconvenient or too hard to use or whatever. So ideally a clinic will set something up where for example you use something 30 days as a loan then buy from them as used equipment if you like it - win/win for all.

Starting low vision training: The younger the better. Even a 3 year old can get in some good training. For example let a child explore looking out an empty toilet paper roll. If you start young enough the child will see their low vision aid as practically an appendage because it becomes so integral to their quality of life. I thought it was interesting that it was pointed out that kids who are deaf tend to be more socially adept than blind kids, because of all the nonverbal social cues I guess. Also interesting that young children have an egocentric location thing going on - if you give a child that empty toilet paper roll they may put it between their eyes on their forehead, not on their eye as you would expect. 

Technology: It's now pretty cool to have technology so some of the odder looking devices that people use, are actually seen as impressive or neat, rather than negative. 

Large print: There is frequently at least a 4 month delay for reproduction of books into large print. Audiobooks, Braille, or other options may be better.  Many doctors and therapists assume large print is the answer to everything when in fact it can make things worse depending on the type of vision problem. For example if a person has a constricted vision field, large print just makes it HARDER to see as even less is now within their vision field at any one time.

Canes: Sometimes the person with low vision is not quite at the level at really needing the white cane, but use it anyway because it warns other people to be careful/aware around them.

Reading: Many people with low vision can read, however the difficulty may be in sustaining it due to distance from print, nystagmus, general ocular control, etc.

Nystagmus: Sometimes a head tilt/turn helps quiet the jumping of the eyes and maintain optimal sight.

Here are some things I wrote down that I no longer have any idea what I was referring since it's been like three years :x If anyone wants to clarify any of this, go right ahead.

Fans - shadows
Grating acuities, teller acuities, etc, "Facile"
Stable or progressive vision issues

"achromats" = not people first language. 

Sensory channels most used - Learning Media Assessment.

======
 

Braille: A lot of kids actually read Braille with their eyes! If a kid has visual sensory preferences (even with low vision), it may mean Braille is not a great choice. A tactile child will benefit from Braille more.

Alright, I'm headed out to a store, so I need to stop writing this post - so it's unfinished from this point down - I'll try to come back and edit it later today. 

all might have same diagnosis but want different choices .

Some kids can see letters but not read due to saccade issues.
Visual function, with rehab, can lead to functional vision
Albinos - 1/2 fibers dessicate at optic chiasm. problems with stereoopsis? Need orientation and mobility - problems iwth depth perception
Nyctalopia - in to out, transitions - ie bright playground to normal classroom
Try and maximize remaining visision

Brain fools us - we think we see all around us but not raeally

Sighted kids rely on visually impaired kids for freeze frame data - complete change from before!

Desire to drive is often incentive. 

timid kids that bruise and fall a lot - key that maybe field loss is problem.

Optical positions for visition, 

visual function plus rehab = functional vision

Learning Media Assessment - which sensory channels?

Kid may feel butons on your shirt or put head on table. Puppet in hand. Good clue as o visual or tactile. Visual - no Braille. Many kids just read the Braille. 

Each kid in fam may have same VA diagnosis but diff choices on which to use. 

Penlight and toy on penlight like a little monster. 

Tactile buttons or giant diagrams of microwave, dryer, etc. 

Contrast and lighting are two huge ones. 

safety pins on clothing or rubber bands around items

liquid level indicators

commercially available products like giant remote, magnifying glasses, etc

marroon blanket over beige couch

yellow towel over white tub

Tips for NBCOT Exam

I wrote this in 2009 and never finished posting it...the new test had just come out, with the CST part to it. So this is relevant to the new test, but I am NOT up to date on whether things have changed in the last few years, so read this with a grain of salt. Or maybe a salt shaker.

I didn't start studying nearly as early as I should have, but I used 3 sources: TherapyEd book & review course, NBCOT book + online practice exams, and friends.

If you can afford it, take the TherapyEd review course. If money is an issue, it's probably still worth it IF YOU HAVE TROUBLE TESTING (the cost of that course is cheaper than re-taking the exam). If you are a strong student, you can probably get by without it.

I liked the TherapyEd review book that came with the course. I basically memorized the vast majority of the book. You need to be able to spout off the information, NOT just "recognize" it. I did flashcards, not so much to actually use, but to help me concentrate so that I learned while making them. There is what, like, thirteen chapters? So depending on how slowly you study, try and give yourself a few days for each chapter if at all possible. DON'T SKIP ANYTHING. I really only glanced briefly at statistics/research/management, and I wished I had looked closer. Everyone's test is different, but everyone's test will most likely include a little bit of everything. The more you know, the more likely you'll pass, obviously, right?

Now, the TherapyEd questions are kind of weird, I admit. Long and oddly worded. Still good practice. And it has lots of CST to practice with.

The NBCOT book was much more like typical NBCOT questions, although oddly enough, the book didn't have any example CSTs...those new clinical simulation questions. (I ALWAYS confuse the words stimulation/simulation).

NEW NOTE: All this may have changed in the last few years with new editions!!

I HIGHLY recommend purchasing the NBCOT online exam that is 100 questions. According to a classmate who researched it, there is like a .9 (ie high) correlation between your score on that exam versus the real thing. I don't have the evidence though. Also, one of my classmates went up FIFTY points from practice to real thing so I guess um, well, ....anyway, it's still helpful to see how you do on that online exam. The other things you can buy I don't necessarily recommend...if you can afford it, great, it helps with confidence ...remember you cannot necessarily go back and see the question though...and answers aren't always given I don't think. So examine everything carefully the first time, and jot down notes as needed.

My favorite study questions had to do with psych....here is a (very very) brief psych med overview. Like I said, it may or may not be on one of your tests, but you should know it regardless! It seemed like each study book had this same information in it.

Akathisia = restlessness, urgent need for movement, typically a psych med side effect.
(This is like my favorite word!)

Tardive dyskinesia = almost constant movement, more chronic and serious, does not go away, and is result of years of heavy psych meds. The movements are more writhing with a lot of oral motor involvement.

Make sure you know the difference between the two types of movement. :)

MAOIs = drugs used for depression. You have to be on a restricted diet on these medicines because of an amino acid blah blah - so they like to ask diet questions. They can't have like, pickled, smoked, cheesy things...and one of the first signs of toxicity is a headache. Your patients, whether you work in mental health or not, may be on this type of medication, so make sure you know the reasons for the special diet, etc.

Photosensitivity = lots of psych drugs cause people to be more sensitive to sunlight than normal. If you are doing psych activities/groups and it involves being outside, there is a good chance you'll need to remind the clients and/or be prepared to deal with that side effect.

***As far as I can tell after re-reading this repeatedly, I have not said anything inappropriate/proprietary....if anyone disagrees, please let me know. My intent is to share advice, not do anything illegal!! :)

HELP button, staples button hack

 http://www.engadget.com/2006/07/19/hacking-the-staples-easy-button/

http://www.youtube.com/watch?v=6OEFxc3zTls

http://www.springerlink.com/content/v743km042677w8w0/


I found these three things that might help me figure out a Staples button hack. I want it to say "help" instead of "That was easy!". By the way, kids LOVE the Staples button and consider it a real treat to be able to hit the button after an activity. Even if the activity was actually somewhat frustrating, the kid gets a ghost of a smile on their face after hitting the button. The only problem is they usually try to hit it like six times in a row.

I have a child who doesn't like to ask for help....I wanted to make a Help button so she could hit it for fun. Seemed like a good idea. Only problem is, I'm not exactly handy with a drill so these hacks seem a little challenging for me. But wanted to throw out the idea of hacking out these buttons for basic communication needs or to be silly.

Other alternative....does anybody know of similar buttons you can buy to say whatever you want? I am sure there are OTs and/or SLPs out there working with AC who know way better than I do.

Exerting too much pressure when writing...OT school ideas

I recently asked for ideas on working with a child who uses too much pressure while writing....I got a ton of great comments, most of which I have copy/pasted here...forgive me if I missed any. Most were anonymous, a few had just first names....go back to original posting if you want to see credit!

 Most said provide some proprioceptive feedback first and then either use a mechanical pencil and/or shelf liner, mousepad underside, or sand paper, for extra feedback as well. 

LOVED the comments. Thanks!!

Here they are: 

For increased pressure I like to use mechanical pencils or have the child write on the underside of a mousepad :) Increasing joint awareness in their hands can also help them with proprio feedback - I get childrent to press their hands together for 5 seconds and then clasp their fingers and pull hands apart.

writing on sand paper can increase awareness to exerting too much pressure - because they will tear the paper if they push too hard. or maybe it's just because they have a funky grip? one of my client's pushes too hard because they use a grip with zero webspace or wrist extension. i used a pencil grip to promote tripod grasp and this decreased the amount of pressure they used to write. good luck!

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

For the kid that is pressing too hard, have him try writing prone on a carpet or put a carpet tile on a table. If he presses too hard, the pen will go through the paper. Or, have him write a sentence, then show him the how the back of the paper is all raised up, then have him try to make it so that the back of the paper isn't raised after he's written a sentence. Hope that helps!

All great ideas... also have student write on felt. When s/he presses too hard they will punch through the paper.

You can also try sensory input prior to handwriting. Anything with joint compression, heavy work... chair pushups, yoga downward dogs, animal walks. Good luck!

A)   Another idea is to have the child use a mechanical pencil...if they push too hard the lead will break.

B) Writing a poem on the board with some words that are mispelled or out of order, see if they can correct as they copy.

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

I'm a preschool teach, not an OT...working that way eventually.

Anywho, something I do with my kiddos is called crayon resist...a way you could make it easter-y (maybe next year!) would be to write on boiled eggs before you color them with white crayon or some type of wax, then dye the egg. The crayon/wax will resist the dye leaving lighter spots. I figure you have to write softly on eggs! Just an idea, hope it made sense!

also writing on tissue paper? or I'll have kids draw with markers on coffee filters and use a squirt bottle to spray the paper, then let it dry and either cut it into something neat or turn it into a butterfly or flower with pipe cleaners. -- both tissue paper/coffee filters rip super easy and the kid has to take their time.

Or drawing designs on aluminum foil with sharpie is pretty neat looking and you have to be gentle!

Like I said I'm not an OT just throwing some fun ideas from my experience with kids :)

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

I would first work on preparing the hand to a writing activity. So, wheelbarrow walks, donkey kicks, wall push ups (all good weightbearing activities), theraputty activites.
I use a mechanical pencil, sand paper, tissue paper, writing while a Grip-It shelf liner (liner that is placed in drawers with small holes) is placed under the paper. This all gives feedback as to how pressure to exert.
I also wonder if a weighted pencil would also help?? Any thoughts?

New OT blog

www.jezzabellasotexperiences.blogspot.com

New OT blog :) 

There is a blogpost a few down showing a Real Simple activity using half a balloon + a plastic cup that looks cool!
 

Return to OT blog

I basically didn't have wireless access this past week, so no blog posts. However this upcoming week I have more time. My goal is to COMPLETELY finish responding to OT blog comments/emails etc within next week (perhaps a slightly lofty goal) + finish filing my OT work mail + organize my computer documents for work. Phew.

I got contacted by Dycem and they will be sending me a few products to review and I also have a book to review! I am really excited! I love reviews!

I am in Alabama one more week - back to San Diego next Sunday. Fun times in the South.

I am trying to get up the energy to go work out! One of my biggest, biggest issues is almost constant low energy. Bleh.

Well, this was a pretty worthless posting, but I wanted to say I am back to having wireless, back to responding to blog emails etc (I went from over 1,400ish to only 210 in the past two weeks). Another goal of mine - although not this week - is to write an article for OT practice about Colombia!

Some AWESOME men Rehab OT ideas from a good friend

When I was helping out in physical rehab in the rural Deep South, it was often challenging for me to find ways to engage the men! One of my good friends, who happens to be a man from the South, sent me these ideas. Like two years ago. I love them ALL. :) Now I am sharing with my blog with only minimal editing! He was meant to be an OT! It's too bad we can't bring in fake guns but I am sure that is a no no at any place. The laser refers to (probably, if my memory serves me right) doing something along the lines of fitting patient with a hand or arm weight, taping a laser light to it, and allowing them to point at a target with it. Gotta be careful about not getting it in anyone's eyes though.

As always, try any of this at your own risk! Consider insurance of your work, liability issues, etc.

Mail 1: Would they like outdoor magazines?  Would your organization allow hunting and fishing magazines?  Can they accept them if they are free?  There is a forum called Georgia Outdoors or Georgia Outdoor Network - can't remember right now.  If it didn't upset your bosses you could join it and ask for magazines, I think you would get a bazillion. 

Also could you take patients on field trips?  Shooting ranges often invite special needs shooters in for free days.  I don't know but I bet there are a lot of ranges in GA. 

On simple stuff, the laser taped to the hand weights is a really good idea.  LEDs could also work over a short range. 

Mail 2:
1.  On the weekends go to the various car dealerships in the area.  Get brochures of trucks, SUVs,cars, everything. You can cut up the catalogs, glue the pictures to index cards, and use them for sorting activities, guessing games (what kind of car is this?).  I bet you could even come up with card games. 

You are in the heart of NASCAR country.  You could also do the same with drivers, racing teams, cars, factories.
You could also do the same thing with football teams.

2. Go to Walmart and get a couple of the Popiel Pocket Fisherman fishing rods.  If y'all don't have the funds for buying stuff, I bet you can ask among the employees (Do y'all have an on campus BBS for lost and found, want ads, etc?) for a couple of old fishing rods.  Tie a washer or other weight on the end of the line.  Go to food service, get some large buckets, like pickle buckets.  Let the guys cast the weights into the buckets.  Sort of like fishing.  Maybe a better outdoor, springtime activity.

3.  Get a couple of old golf clubs (putters) and some big cups.  Put put time. 

4. Get a large piece of poster board and about two dozen large steel washers (about 1 to 1&1/2 inch diameter).  On the poster board mark lines every five inches.  Put designs on washers such as there are 6 different designs or colors on four washers each.   In other words, you come up with 4 red washers, 4 green washers, etc.

Place posterboard on floor with lines parallel to wall.  Have participants toss washers from appropriate distance.  Person with washer closest to wall wins.  Can be done standing, sitting left or right handed, etc.  Watch this one though - chance of gambling occurring.

Prison settings and related populations (mental health)

Did you know OTs can work in prisons and related areas?
NGBRI= Not guilty by reason of insanity.
Pts = patients
Hx = history
SC = spinal cord
CP = cerebral palsy


A former classmate of mine (class below me) wrote this to me a loooong time ago about one of her rotations (she wrote the first part to me on FB, I responded and asked if I could share, then she shared the discharge status part. It took me over a year to finally post though):

All pts have pleaded NGBRI. I see only men and my case load consists of two higher functioning groups that I see twice a week, one lower functioning group I see twice a week, and two individual sessions one of which I see once a week and the other I see three times a week. They are all on a lock down ward that reminds me of a prison. I have warmed up to all my groups, however, I still remain a bit uneasy with my lowest functioning group....you never know if they will be stable throughout the session or not! I have issues sometimes trying to come up with group activities for that group that will keep their attention for the entire group session. Anyway, I feel as though I have put lots of effort into trying to help theses guys be successful and I have been occupation based and client centered at the same time

The discharge status of the patients at XYZ (my current facility) depends on their judges verdict, how heavy of a sentence they hold, how long they have resided at the facility, and how stable their behavior has been over the last year (among other things). Someone who has committed first degree murder will definitely be residing here longer than someone who has been charged with simple assault or battery. Discharge options range from group homes to nursing homes or being released to family. If a pt has a hx of violence nursing homes will usually not accept them and they have to qualify by other means as well such as different physical disabilities (Low vision, SC injuries, CP, ect.) Many of the pts have HIV from extensive hx of IV drug use and their sexual backgrounds. If this is the case, their only option for discharge is basically being released to family members even if their behavior is exquisite. There are many sad, sad cases...and even though I was very nervous in as my rotation commenced (and still am at times) I will definitely miss some of my pts and I hope I have made a difference in there lives.

Q&A on OT

QUESTION VIA EMAIL, SLIGHTLY CHANGED TO MAKE MORE ANONYMOUS, from a few months ago: My name is Jane Doe and I am an older mother of 2 kids. I obtained an OTA degree back in the 1990s but never used the degree.  I did very well in school but was unhappy in my clinical rotations.  I was under two burned out therapists that didn't do anything with the patients.  I also did not like the fact that no one knew what OT's did in addition to the degree being so broad; I felt it was hard to wrap my head around exactly what we did. I never used the degree and went on to pursue  Bachelors/MBA degrees and then became a mom and have been home for the past 8 years.  Now looking forward to going back to work when my youngest is in first grade, I applied for admission to a MOT program for Fall/2011 and think I have a very good chance of getting accepted.  I decided to apply because I still really want to work in healthcare and thought maybe I would feel differently now if I were to pursue the MOT degree.  I would like to work in a pediatric setting which is something I did not gain experience with during my schooling/clinical rotations. I was in an adult inpatient setting and adult outpatient setting/mostly home health.

 

Questions for you:

 

What are the biggest challenges in this field?

Do you feel like you are making a difference in the lives of the kids you work with?

Is there still a misunderstanding/confusion in exactly what you do?

Do you feel the profession as a whole is respected?

What do you dislike about the field?

How do you get away from people thinking you sit with a patient and a pegboard?

Do you still think it's a great profession?



MY (garbled, as always) ANSWER, slightly edited as well:
I am so sorry you had a bad experience in your clinicals. That can really mess your brain up, to see burnt-out and/or poor therapists. I agree it is a challenge that nobody knows what OT is and not only that, it's impossible to explain quickly. I hate being asked what I do!! Because there is no easy response. But at the same time I do love what I do!

Being an OT versus OTA is a big difference in terms of feeling empowered, I think. If you have a MBA you definitely need to be at OT level, and after going through OTA school you definitely are a very strong candidate and will be miles ahead of many of your classmates with your practical knowledge. Now you can add in the theory. :)

Working in pediatrics might also be a better fit and make you feel differently. Such a massive difference. Although it may be tiring to work all day with kids then come home to your own.

Okay, to specifically answer your questions.

What are the biggest challenges in this field?

In no particular order, in MY opinion - insurance reimbursement, difficulty quickly defining what we do, sadness that rarely people are aware of our profession, sadness that when people DO know of us its often pegboard related....also trying to do our best work with limited budgets/insurance reimbursements.

Do you feel like you are making a difference in the lives of the kids you work with?

At times yes. It depends. Some kids are just hard. Other kids you will say wow, I made a difference. But it depends a lot on YOUR style and ability to interact with family, other disciplines, etc. If you are a typical school OT for example who pulls the kid, treats them, brings them back, and doesnt say anything to anybody, then um, you probably wont feel like you made a difference bcause you didn't. 30 mins a week is nothing. But if you are proactive and try to really talk to parents, talk to family, look at the child's function within their environment and focus on that....yes, you might feel you made a difference. At times its frustrating. Honestly the ahrdest part of working with kids is the PARENTS - some are great, others are either overly or underly involved. Yes I am making up my own words.
 

Is there still a misunderstanding/confusion in exactly what you do?

Yes, definitely. I know we are actively trying to change that, but it's definitely an issue
 

Do you feel the profession as a whole is respected?

Controversial to answer this one. Yes, I think in general its respected, but there are plenty of individuals who had not had good experiences. It becomes your job to change their perspective. :) 

What do you dislike about the field?

Everything I mentioned above about difficulty defining it, insurance issues, case overloads, etc.
 

How do you get away from people thinking you sit with a patient and a pegboard?

Role modeling. You show them that TRUE OT is very different and as they learn to respect your work they will see it's not true. I can't think of a better way than role modeling. One of my favorite books is called the Healing Heart by Ora Ruggles. Hard to get your hands on, but keep an eye out for it online. So worth it. :)
 

Do you still think it's a great profession?

Yes - I love it. I think its potential is sky high. Do we have a lot of OTs who dont know what they are doing, or worse, don't care? Yes. Are there times I am one of those OTs who don't know what they are doing? Yes. But I try really hard to be a good OT overall, and I love what we do. I wish I knew more but that will come with time/experience.

Overall I think its a great profession to go into - pays pretty well, very broad so you can essentially change professions within same field (ie adult phys dys, peds, hands, etc) if you get tired/bored of a certain area, or just need flexibility. Its a good job to have with kids as you can choose a job with no weekends or nights and/or part time, and nobody dies if you dont see them. :) I think if you are cut-dry and don't want to deal with all the issues facing OT, then maybe PT or SLP is a better idea although you probably dont meet their educational criteria AND they of course have their own internal issues. I love OT.....it was the right fit for me.

Basically it's all about what YOU make of it. You will encounter plenty of bad apples and plenty of LOVELY apples (are you loving my midnight analogies?). Seek out the good, work hard, and you will rise to the top....don't let the bad ones bring you down. I sincerely hope you are planning on doing plenty of observation in pediatric settings (and other areas)!

A google search day in the life of an OT

I found this google searchfrom when I was an OT working in Georgia (I think I saved it to one day post as example on my blog). Clearly my google got quite a work out. :) All of it had to do with patients, whether it was helping the patient read their bible with limited hand mobility, or toileting, etc. I use a lot of paper and people resources, but Google is also really helpful for ideas as well.


Clear ×caregivers personal hygeine knee abductor · Web
Clear ×knee abductors for hygeine · Web
Clear ×cleaning perineal area spastic adductors · Web
Clear ×adductors abductor spasticity perineal hygeine · Web
Clear ×abduction toileting hygeine cerebral palsy · Web
Fri
Clear ×apraxia kids · Web
Clear ×my child has dyspraxia · Web
Clear ×developmental dyspraxia children support · Web
Clear ×developmental dyspraxia · Web

8
Wed
Clear ×sae-bo stretch · Webb
Clear ×aquatic therapy alabama · Web
Clear ×aquatic therapy · Web
Clear ×weighted book magnet amazon · Web
Clear ×weighted book magnet · Web
Clear ×USB mini keyboard one-handed · Web
Clear ×USB mini keyboard · Web

Clear ×multiple sclerosis ICD-9 code · Web
Clear ×rehab page turner · Images
Clear ×rehab page turner · Web
Clear ×Kindle Bible · Web
Clear ×can you read bible with e-reader · Web
Clear ×book butler · Web
Clear ×home exercise program after stroke shoulder

Clear ×exercises for shoulder subluxation · Web
Clear ×paraffin for acute rheumatoid arthritis · Web
Clear ×southern hand and orthopedics · Web27
Clear ×windows adaptive software · Web
Clear ×one-handed keyboard · Web

NY Times article on OT in schools

http://www.nytimes.com/2010/02/25/fashion/25Therapy.html?emc=eta1

One on "Watch how you hold that crayon"....another possible re-post but this time I am deleting it from my inbox!! This one by NY Times on pediatric OTs working with handwriting etc. A slightly snarky article but still interesting.

Sensory processing disorder in Time Magazine

http://www.time.com/time/magazine/article/0,9171,1689216-1,00.html

An article on sensory processing disorder in Time magazine from a while ago. This may be a re-post, I can't remember. I'm still going through old mail. Down to less than 500. If you've written me and I've never responded, feel free to either re-send (if you sent it more than 2 weeks ago), or wait and see if it gets handled in the next 400+ mails I have left to go through. I had over 1380 old and 150+ new a few days ago, now down to 0 new and about a third of old mails, so I am glad...but still a long way to go.

OT books to read

I got an OT blog question about some books to read before starting a master's program in the fall....things to get started. I don't think y'all should start reading textbooks before you ever start, so here are some random ideas me and my OT friend Kerri came up with for for this student...I am in Gainesville, FL visiting her. She is a hand therapist and she rocks. :)


Hi "OT Student X"

Do you mean like OT textbooks, or do you mean more normal books? For example, one of my favorite books is The Healing Heart about one of the first OTs, Ora Ruggles......I also like the Out of Sync Child.......and the Out of Sync Child Has Fun is the activity book that goes along with it.

See if this website works for you!
http://myaota.aota.org/shop_aota/

I browsed it and didn't actually see much of interest. There is a Chicken-Soup like book that came out that i want to read but I couldn't find it...if I do I'll post on my blog.

My OT friend Kerri next to me recommends any book by Temple Grandin - especially her older ones, her autobiographies - which I recommend as well.  She also recommends Oliver Sacks books.  Phantoms in the Brain by Ramachandran....

I personally like first-hand accounts....so autobiographies...of people with various disabilities like cerebral palsy. I go to the library to the health section and browse for what look like autobiographies. :)

It depends on how much you like to read and what kind of things interest you. There are certainly textbooks you could start with, but I am sure your school will provide you with a necessary list soon. I'd focus more on the fun stuff to get you excited. The first semester is actually kind of boring with a lot of focus on what occupation IS theoretically (at least it was to me...)....anatomy/neuro is fun according to Kerri ;) I disagree. ahahaha.

Hope that is a good start...
Karen
PS: Don't be surprised if in some of those first-hand books you get little mention of OT and/or it's somewhat disparaged! We have to keep working to get OT more respected. :)