(B)e(LO)n(G), OT

always new things

2012-01-27T00:12:00.001-06:00

This is just a stream of consciousness of stuff I've been doing/thinking lately.
I have 262 NEW!! mails in my gmail box I haven't even touched and about 400 I need to deal with. I've just been extra super demotivated lately, which is uncool considering I am helping present on social media in a few months at the April conference! Thanks for all the kind words. :)

I recently found some tiny clothespins that came in a travel kit for sewing, so I had to buy it of course. Today I used yarn to make a clothesline between two chairs, then I had a child rip out a single page at a time from a magazine i found in the recycling bin (with prompts to only get one page, and to rip the page out appropriately), then fold it in half (prompts for that too), then use a clothespin to pin it to the clothesline as if it were clothing, then use only their dominant hand to take the magazine back off the clothesline, unfold it, crumple it up in the air, and throw it to my "hungry shark" aka the recycle bin. Using just the one dominant hand forced a lot of instrinsic hand musculature use and a lot of in-hand manipulation. I came up with it like right before my kid got there so it was interesting, lol.

I also bought "toaster tongs" for $2 at Bed Bath and Beyond yesterday. I had them use their dominant hand (3 fingers only) to pick up bugs, and then they had to be holding open a ziplock bag with their other hand to deposit them into.

When I was done with the activity involving the clotheslines later on in the day, I had my kindergartener cut the yarn off the chair.

Lately I've been upping my game when it comes to fine motor....obviously dependent on the child's level. But I'm making things more functional/harder than I used to, with more steps and more complicated motions. I'm also trying hard to not thoughtlessly put up/down things, and to have the child have to figure it out. I tend to not waste time on the child cleaning up EVEN THOUGH I DO REALIZE ITS IMPORTANT, because often I have so much I want to cover, that unless I think the clean-up serves a therapeutic purpose, I just move onto the next item.

So yeah, now I try to make the child figure it out. I also try to have them do their own folding, hole punching, own stapling, own taping, paper clips, etc, and deliberately do activities that require the kind of activities they may be asked to do in their classroom, things that come easily to most children. IE wrapping a rubber band around a grouping of popsicle sticks in math.

I'm also trying to work more on Lefts & Rights within all sessions since most of my kids dont have that down. I use a magic marker to write L on one hand and R on the other, and then constantly refer back....today as I walked out a kindergartener to the lunch area after his session, I stopped at every turn and asked him which way, L or R. If he told me the wrong way I'd do it, even though it meant I walked straight into a balcony railing. Which amused him. :)

Also been doing some shoe tying lately for really the first time, I start with just a single lace tied around the holes in their chair...but I bought some funky different colored shoelaces since when on an actual shoe with two laces, way easier to teach when the laces are two different colors. I think shoe tying is great to work on in general as it works on so many different skills.

I'm left handed so I guess I"m teaching my kids a left-handed way to tie shoes ...I am kind of macabre, I tell the child the loop is a person and then a "snake wraps around him" since most of my kids are little boys that love that kind of talk......I don't typically do the bunny ear method.

What else. Let's see, one week I forgot my Staples "Easy" button and my kids with autism got very irritated with me. The next week the same thing happened but I didn't want to get in trouble with them, so I ran to a Staples and bought a new one, they were quite appreciative and noticed that I had it next time. So now I have two and one is going to stay in my car! (I have four schools).

What else....oh, I saw some dried macaroni pinwheel flower thingies? And I am going to have them put pipe cleaners through them. Big fine of small spaces and pipe cleaners ;)

Today a 3rd grader teacher taught me how to finger knit....new skill to me. Her entire class is doing it. Great skill to teach. Maybe youtube it ?

I've also been doing more academics but from an OT standpoint, focusing on the tips/tricks aspect. Spatially organizing notes, systematically going through multiple choice, highlighting key words, etc etc. I spent over an hour today with a child going over his math test and showing him ways to lessen his hurried mistakes. I know teachers today tend to be really overloaded and overwhelmed, and often they just don't have a chance to go back to the basics and teach basic test-taking strategies and skills. I do wish teachers would focus more on desk organization in younger grades. Their desks are atrociously messy and I think that's an important academic skill to learn, since it only gets harder. (I pretty much only work with K-3 graders, I have very few 4-6graders) so I'm looking at it from the young side.

I do know sometimes I tend to do more "clinic" based therapy within the school but I usually have good rationale and/or only do it for part of the session, but I'm definitely more and more evolving to a much more academic approach and bringing a lot less toys. I used to have bags and bags of toys, now I usually only have a few items at best, and often just work with whatever I can find in the special ed room that particular day. I've also been encouraging more teachers to give me work to do with my kids, so that its more helpful to them/functional etc and then I get a real feel for what they need to work on. I started last March/April, so really I've been a school OT less than a full year....While I think I was doing good OT even last year when I first started, I think I am definitely refining. I know SO MUCH now compared to last year, it's amazing to think how much I will know another year from now!

Tomorrow I fly up to Sacramento with a co-worker to attend a class on primitive reflexes, should be interesting. :) I also need to see if I am too late (kind of think I am) to do a Michelle Garcia Winner workshop in my area.

I'm still using my lava/worms/bee paper on a daily basis and for MOST of my kids, it makes a big difference. Using it at first really seems to give them the grasp of orientation, and then they carry it over to normal work. I think the biggest thing I notice is that they themselves notice the TINIEST error that may cause the bees or worms or lava to come and they quickly erase, whereas with normal paper, they don't really care. Sometimes I have to stop them because the mistake is so miniscule that it's not worth it, lol.

Well its 10 07pm and I should go to bed but unfortunately I took a long nap earlier, so I'm pretty awake now. I COULD benefit from this time and do filing/paperwork, but who am I kidding? I'm just going to keep blabbering away. Well not really. I don't know. I feel a little bit lost tonight. I know I have plenty to do, but I'm not really feeling it. I just found out my grandma is in the hospital and it makes me feel sad/guilty (I can't visit her until Sunday) that I didn't even know until today. That's the mean reason I wrote this stream of consciousness, as a distraction. I love my grandma!

So basically. OT wise. I continue to absolutely LOVE what I do, even though some minutes/days/weeks are harder than others. I am definitely refining my skills for the schools and I like to think increasing my awesomeness quotient ;) There are definitely sessions that occur where I am like yikes, that didn't go like I planned, but overall, fun times.

BLOG GOALS, which I know I have had for months: Reviews of Linda's book and Dycem/PenAgainproducts, catch up on 260 new mails + the 400 old ones, answer comments/the blog e-mails, put up more pictures, etc.

wow, blogging massive fail

2012-01-16T22:46:00.001-06:00

I have 158 new mails in my email box :( that i havent even seen. Literally over a 100 + from blog readers that I have read but not yet responded to. Just okayed 15 comments today. I am a blog FAILURE lately. My personal life is a little different these days so I've not been home nearly as much! BUT this week I should be home quite a bit so I hope to get caught up on blog e-mails and product reviews....

This week I have a triennial and two initial OT evaluations, but actually my schedule isn't too horrible with evaluations/reports for a few weeks (for once) which is nice. :) Normally it's pretty slammed and I'm frantically trying to get evaluations done in between treatment times etc. Lately I've been running to 3 schools a day. I know many districts have OTs that work in like, 10+ schools etc and they would scoff, but my district has a lot of high-powered parents/advocates so there is a LOT of extra work behind the scenes...

Anyway I wanted to share that I work with this adorable 5 year old who says things like "Wead my wips" for "Read my lips" and gets a lot of speech. But the other day I told him to pick out a crayon and he looks at me and says "They are CRAY-ONS not CROWNS" and I was like like....WOW. I just got corrected by a 5 year old in speech therapy!! Awesome!! hahahaa. It's true, for some reason I can NEVER say crayons, I always say crowns. (To me I'm saying crayons and it makes sense, but nobody else understands me)...but when I say crayon it sounds weird. The other word I can NEVER say: entrepreneur.

Hmm what else. The other day I told my little group of kids that call me Miss Awesomeness that we were going to do a craft involving tearing paper. A little boy looked at me and plaintatively said "This is just like torture." (Actually he can't say his R's either so it was cuter than that). I was like "You guys want to see torture? We could do HANDWRITING!" ahahaha jk.

I've been using the game Rush Hour Jr. a lot with some kids who need work on visual spatial tasks but actually the biggest thing I notice with it is that it is a great tool for working on frustration...

I need to check Pinterest for some new ideas for FM stuff...

Blah blah, honestly I need to be working on a big report due tomorrow morning, but I really wanted to check in on my blog because I have been soooooo bad. :( Sorry. Back to work.

Thanks for all the nice comments!!!
kd

Yikes

2012-01-01T11:38:00.001-06:00

I've been playing for the last two weeks of break!! Have not done anything good!! Like get ready to start back at work on Tuesday! Yikes tons of evaluations coming up to work on. Anyway, will try to get back into blogging as I get back to work! I have 233 new mails though :x yikes.

Fwd:

2011-12-14T00:17:00.001-06:00

I LOVE hair tinsel and I have been getting it put in for months...I got red, green, and gold for Christmas....my OT kids (and some grown-ups) love it too.....anyway, some of the cute comments:

from passing by second grade girls: "I love your bling bling!"

from a kindergarten boy: "where did you get that sparkly stuff?" "can you buy me some?

from a first grade girl, tentatively, after observing my hair bling and glitter eyeliner while I was observing in her class: "Were you in the Nutcracker?"

awwww....lol

You could argue it's not professional but it's for the most part subtle (it looks extra sparkly in the picture because of the lights in the salon), and for another, I work in elementary schools! I remember as a kid always being drawn to the colorful, sparkly, quirky adults in my life so I try to play that role now.... ;) Hmm speaking of being an adult, I have to get up in the morning, I should probably plan for the day.......have a self-regulation seminar of six kids, an OT treatment session, and a couple of evaluations and/or as many make-up OT tx sessions as I can cram in to do (I will probably try to focus on just 1-2 schools for make-ups and/or 1-2 schools for evaluations), plus we are dropping off cupcakes at the district office at the end of the day. :)

Lava Letters: Sizing/Line Orientation Game for Handwriting

2011-12-13T20:41:00.001-06:00

See attached. You should be able to print these out as full pages. It needs to be in color. The amazing Tonya Cooley of TherapyFunZone.com fame created these for me based on the game I explained on this blog previously. I have been using a version of this all fall and without fail, all my little guys have improved their handwriting....can't say for sure there is a correlation but I like to think so. ;)

Rules:

1. Bumblebees live above the sky and if you write something that goes above the sky (NOTHING ever should be up there), bees attack it.

2. Lava is that middle red line. Baby letters should never go above it (ie a, e, o, r, etc). "Tall letters" such as h, k, l as well as capital letters have lava proof suits so they can go above the lava. If a baby letter goes above the lava and shouldn't, it BURNS!

3. Worms live below the dirt. They love tail letters (g, y, p, etc) and get upset if the tails don't come hang out with them. But they do not like letters they don't know such as e, a....any letter that doesn't belong below the dirt. They bite/attack! (Sometimes I say the tail letters hang out, other times I tell them the worms love to eat the tail letters so if you don't feed them they get upset.....depends on the kid.)

4. You can save yourself. Either by not making a mistake in the first place, OR by "saving" your letter by immediately erasing the mistake with "medicine", aka the eraser. "Oh noo! The bees attacked! Quick, save your letter with your medicine!) If they save all their letters on a particular line, they become a doctor. "You saved all your letters! Good job, Doctor ___!" Depending on how well the child is doing, they can be a doctor at every letter, or every word, or line, or page, etc. I reward them for being a doctor with various tiny rewards. This week I used candy (cough) although I normally don't.

5. Another option if you want to work more on letter formation etc rather than erasing: "Zombie" letters instead of Doctor. They cross out the mistake letter and re-do it, the "zombie" letter. Or if you want to focus on erasing: You could deliberately make mini mistakes and then have them be the doctor that saves them (so the focus is on erasing rather than writing....a lot of my kids struggle with erasing!). I have to say that when I make a mistake, my kids ZERO in on it to point out what just got attacked/burned, lol....they notice tiny tiny mistakes.

6. PS: When using sentences, I tell them that if they forget the "guard bug" at the end of the sentence, the worms (or zombie, or something else scary) will eat up their entire sentence!!!

Sounds complicated but kids who are ready to work on sizing typically get it right away. I first introduce lava, then worms, then bees....either within one session or several depending on level. Typically we start working on sizing/line orientation around the middle of kindergarten/end of kindergarten. When I first start doing it with them, if they make a mistake, I quickly draw a worm or bee or "lava" around the mistake to show them what happened.

By the way, today a kid of mine was working and every time he made a "p", he would quickly make a tiny pizza (circle with dots) for the worms to eat. I thought that was funny. I could see doing a whole bunch of similar things...

The way we decide what words to write is based on each kid and their preference. I was using my corkboard/pushpin game a lot, but retired it for a while and will re-introduce in January. For some kids we play CandyLand and for each turn we write down the color they land on. If the color repeats, they can choose any word off the board to write such as licorice. For other kids I have them randomly pick a card from my I Spy card game and whatever the item is, we write. For other kids we pick a theme for each line and they can generate their own ideas. Etc etc.

Well I have so many other games/thoughts to share but this is getting quite long. I hope it doesn't seem too complicated....it's quite simple I swear! Just wanted to elaborate on some ideas. I hope to post a video really soon of me working with a few kids on it ( a friend's kids, not my OT kids, for privacy purposes of course).

Karen

Phew!

2011-12-08T00:41:00.001-06:00

Challenging day done. :)

Some recent events I have discovered/learned/have occurred/whatever. My black cat is providing moral support as I write this by sitting next to me purring with one paw on my chest.

*Angry Birds with a therapy swing: Take one therapy swing. Take stacked cardboard boxes with "pigs" (we used lightweight small balls) hidden within the boxes. Take one weighted ball of a few pounds dependent on kid's age. Have kid on stomach in therapy swing and throw weighted ball at cardboard boxes. (We had a few other lightweight things stacked in too, so it made noise). Explosion! As always, try this at your own risk, I take no responsibility if things go awry as you need to use common sense on how safe it is with your particular swing, child, weight, etc. It was quite popular with my little guys.

*Used The Print Tool by Handwriting Without Tears - not a huge fan but maybe it will grow on me with time. Hurt my brain a little but I know other handwriting asssessments are worse. I am, however, a fan of handwriting without tears in general.

*Tonya Cooley of TherapyFunZone.com awesomeness, helped develop the lava/worms/bumblebee paper! I think we're on a final prototype (I used it today with great success) and will be linking it soon. I also got a neat version from Munchkin! Tonya, by the way, dunno if I have mentioned using the "Eraser Superhero" (He needs a good name) - they can "save" their letters by swooping in with their eraser superhero. I was trying to think of a way to make it somewhat of a real game, where their eraser superhero can save letters up to 5x, blah blah, and the one with the most letters at the end (the ones that got bitten/eaten/attacked don't count) wins a prize or something. Must. ponder. further. I do like sky grass dirt paper and I think the lava/worms/bumblebee is similar in that we have dirt/sky, but I think of sky/grass/dirt as providing boundaries whereas lava/worms/bumblee (I need a bettr name for it lol), is more about the game experience of explosions, attacks, etc. Hmm. LAVA writing? LVB? Explosive Writing? Hmm.

Black Cat has upped his moral support, now his entire body is pressed against me. I sleep SO much better without him, but it's too cold for his fragile little body so it's me or no where. Blah.

I now have people at multiple schools calling me Miss Awesome (my kids at one particular school have evolved to Ms Awesomeness for some reason) and it CRACKS ME UP! I think it's hysterical. It really makes me feel good and bolsters me for the times I don't feel so good.

The new fidget my kids have been creating: You take extra fluffy pipe cleaners or stemmies or whatever the heck they are called now, plus straws, and you cut the straws however you want, then stick the fluffy pipe cleaners within them, and make random creations and/or fidgets. But you want to bend the wire at the very ends down as it can be dangerous.

I've been fencing with some of my kids at a particular school with principal permission, using obviously foam saber swords that I used to use way back when I fenced in college, when we were teaching the basics of saber fencing. It works on attention, impulse control, motor planning etc. The kids want to swing it all around and go crazy like in the movies but I teach them the different strokes, foot movements, etc.....they feel good and special about it and that's great.

I've been thrilled lately with how the handwriting of my little guys has been improving....we've been using the lava/w/b technique all this fall and it seems to be working. They love when I make the tiniest mistake and pounce on it with their worms. Tonya had a great idea of using tiny stamps for the worms/bugs etc. I love that idea. I need to get some stuff to make my own mini stamps.

I am trying to think of what else....I've been so busy lately that I haven't been able to write like I should. Last night I was up till midnight and then back up at 5:30am working on reports. So I came home, took a nap, then went to Pilates Plus, and now it's 1030pm and i should be asleep. I've turned off the lights in my room and hopefully sleep will come soon....

Um, I love thick bouncy dice....lately what I've been doing with my self-regulation seminar consisting of 6 kids is assigning them each a different number each time ( ie 2 is John Doe, 3 is Bob, etc) and then the first thing we do each time is movements. We used to do the 5 Tibetans but we've moved on to where I roll the dice, and then whichever kid/number it lands on, gets to pick the movement. Lately it's been pretty silly, like "alien dance!" - the kid demonstrates and we imitate for roughly 20 seconds (seems short but it's a long time when you are running around acting crazy). I love seeing all 6 of my kids plus a few adult aides running around the room joyfully doing silly things. Once all six of them have had a turn and gotten our engines revving, we start to slow things down. Sometimes we use stress busters or relaxation techniques from the Sensory Drive-Thru menu, sometimes we make fidgets and listen to native american indian flutes (the kids loved it), sometimes we play with theraputty and discuss different ways to self-regulate, etc etc. I used to REALLY REALLY dread it as I am NOT a group person and really prefer 1:1, but I am learning and enjoying it more and more. Kids have so much to teach us too!

I think next week we will play some form of "high engine, low engine" that may be similar to red light green light, but walking fast versus slow motion, etc....not sure. Need to ponder how to make that work.

I spend a lot of time with ideas in the back of my head like the one I just shared, and then eventually if i am lucky something clicks and I go ahead with it. I also experiment a lot, USUALLY with acceptable results.

Black Cat has decided to provide even FURTHER moral support by lying on me in such a way that I can barely see the keyboard/screen!

So this has gotten really long...........basically I continue to LOVE LOVE LOVE my job as a school OT (mostly because I looove my co-workers, area, kids, etc) although I think it's semi unusual in that my caseload consists of relatively high functioning kids as they are all general education. I do have rough days/weeks like yesterday where I have wayyy too much work and get stressed, but overall, love love love it.

Still continuing to get tons of great emails and I wrote Sam G. at AOTA to ask if there was a place I could send some of them to get answered as I am sooo behind again on responding. He said try goin to the prospective student chats that are monthly or see some of the forums at otconnections.aota.org.......I'll go see if he said anything else. But I DO RESPOND it just takes me awhile. I apologize. As always. Anyone who has followed my blog for the last 4+ years!!! knows I have a love/hate issue with email...love getting it, love reading it, and love responding, it just takes me many months!!

Anyone who has good ideas or wants to share stuff, go ahead....my current muses are Tonya at TherapyFunZone, the OT who runs the Public Schools OT blog, and pinterest.com/funkist/ot-ideas, as well as random life...and STILL got a few reviews to do, just remembered....Dycem, Linda, and PenAgain. Over Christmas break is my final goal. If I don't do it by then you all have permission to beat me with a huge stick.

Fwd:

2011-12-04T23:03:00.002-06:00

Here is my worm/lava/bumblee paper. Basically The blue line is sky and the brown line is dirt which is like the sky/grass/dirt paper already out there. The middle line is lava and it burns baby letters that go too high, ie a, e, r. Worms live under the lines and attack letters that go below the line that shouldn't (but they love tail letters like g, y, p, and get mad if the tail doesnt go below the line), bumblebees live on top of the lines and sting if you go too high. Sounds complicated but the kids grasp it quickly.
So in the following sample, "My name" is perfect. the "i" in is went too high - above the lava - and got burnt up, ouch. The "s" in is went too low and got attacked by worms (I usually say something like augh!! worm party!!). Then the "B" is too high and got stung by bumblees (should have been same color but I was working quick and forgot).

So I like to provide the paper and the kids write. With each letter, as they go (when they are first learning), I'll be like "ooh perfect" or "AUGH ITS BURNING ITS BURNING AUGHHHH" or "ouch, a bumblee just stung him" etc etc. Its really silly and dramatic and they like to draw in the red burn lines or worms or bees....so for a while it looks kind of messy with all the additions, but they get the concept. Typically I start with working on lava or worms then add in the other components as it gets a little overwhelming otherwise. And I ask the teachers/parents to also just focus on either a few letters a week and/or one aspect a week such as spacing, or sizing, etc, so its not a huge stress battle for each letter every day.

Hope that helps...I may see if I can get a friend's kid to work with me so I can record it.

Karen :)

wow, so behind on OT life

2011-12-02T17:16:00.001-06:00

Hi lovely readers,

Wow, I so desperately need to catch up this blog. I have lots of new ideas/activities to share + some sweet stories, etc. Unfortunately I've been running around like crazy. December is a rough month. One of these days I'll get to it!!! I think of my blog with longing almost every day and all the things I need (okay want) to share!!!

Pinterest occupational therapy ideas :)

2011-11-23T00:28:00.001-06:00

http://pinterest.com/funkist/ot-ideas/

I updated my Pinterest.com account with a bunch of new pediatric OT ideas..check it out...

Etsy occupational therapy gifts or ideas

2011-11-23T00:01:00.001-06:00

I used to search Etsy for OT regularly adn nothing would pop up but now there is plenty! Great place to find presents, or get inspiration to make your own OT stuff to sell, etc... :)

http://www.etsy.com/search/handmade?search_submit=&q=occupational+therapy&view_type=gallery&ship_to=US

Catching up on OT life :) LOOOOVE occupational therapy!

2011-11-22T23:46:00.001-06:00

So I have two new things I've been doing a lot lately. One is "High Five". I remember reading a (fictional) Emily Giffin book about a child who was severely burnt - she had OT in the hospital. The mom recounts how one of the doctors or something got the child to give her a spontaneous high five and she deliberately put her hand up high - the daughter put her hand up higher than they could ever get her to do in therapy, to deliver the high five. Because it was a joyful spontaneous act. So I've started doing spontaneous high-fives but with a twist....I immediately go into "high four, high three, high two, high one, high zero!" where I manipulate my fingers into the various numbers (ie high four is the four fingers with the thumb in the palm...high three are the three fingers, etc). The kids are caught in the moment and don't fuss, even though its often quite challenging for them to manipulate their fingers into the right patterns! And it's cute to do a high one with just your index fingers touching, lol.

The other thing I have been doing a lot is using Photobooth! (On my personal Mac laptop, so only with kids I trust not to break it!). I either use it as a reward (ie let the kid take a picture with one of the special effects that they choose), or I use it to let them watch themselves - for example, I have been lately teaching all my kids the sign language alphabet, again because of the fine motor skills. So I put them in front of PhotoBooth with their chosen effect, and then I give them like 1 minute to play and get used to it, and then I get behind the computer to show them letter by letter the alphabet. They can glance up to see my motion and imitate it, while watching themselves on screen. KIDS LOVE watching themselves so this is a big motivator. Of course you aren't supposed to tape kids without parental permission so I delete it once they have watched themselves once. :)

I go through stages where I tend to use the same game a lot....for example I was using my corkboard alphabet game a TON, but this last week I've given the kids a handwriting break and we've done a lot more of the hand manipulation stuff (which can help handwriting).

I also got a $5 weaving loom at Wal-mart (boo hiss) and I was impressed that I had several kindergarteners that could loop with it...they couldn't weave, which I didn't expect, but honestly I was even impressed they could loop!

Today I was in a first grade classroom when a child signaled to the teacher that he needed to do something. I think one finger means bathroom and two means drink, or opposite, I forget, anyway, the child got confused with his fingers and actually flipped the teacher off (without realizing it). She looked at him stunned, then told him he could go ahead. (She realized it was an accident/mistake and that he didn't know what he did). None of the other kids saw it but her and me. But as soon as he had left the room we (quietly, subtly) laughed so hard we were practically crying! Gotta love elementary school. :) I am personally a fan of using the twisted fingers "R" for restroom and three finger "W" for water, which is actual sign language....

The other day I was working with a few of my kids (my little trio that actually does call me Ms. Awesomeness lol), and one of my little guys wrote me a note that said "I luve you!" It was sooo sweet. :)

The last two days have been a little odd because of assemblies and Thanksgiving feasts etc...I don't pull kids out of class parties etc or assemblies, so I had to scramble. Sometimes you plan and get all this stuff out for a kid and then it falls through for reasons like that. I used to carefully plan each kid each day, but now I often just get a general vision and go with it. I know not all my sessions are 100% awesome and inspired, but I like to mix things up and keep it creative/silly, so I think USUALLY it is a good experience.

It seems like, knock on woods, my kids are doing great lately with handwriting. I keep getting glowing reports on their handwriting changes! They seem to really respond well to the lava/worms/bees, which I know I need to post in more detail on here. I think I am going to try making my own paper, a lot like sky grass dirt paper, but with my stuff instead. And I do like the Mead paper at Target developed by an OT (look on the back page of the journals etc).

Hmmmmmmm what else.
I always daily think of stuff to share but then it often leaves me! I have been pretty busy with initial OT evaluations, triennials (the big every 3 year evaluations), annual IEPs, 30 day reviews, etc. If I am not seeing kids I am either evaluating kids, consulting on kids, observing kids, or in various meetings. Last Friday I was supposed to hit 4 schools by noon but because of a late meeting with a mom I only got to three, but that's okay. I've had a lot of REALLY LONG mom e-mails lately. I can understand where the parents come from, but wow, sometimes it is overwhelming. I definitely do a LOT of work from home.

Still LOVING my job though, and LOVING my co-workers....had a 3 hour Happy Hour with the special ed team last week! (I only drank a single beer and then a shirley temple...the three hours was because of the company, not the alcohol!!). They are all so much fun to work with. Teachers are such a sweet lot. :) I am blessed with my kids, my co-workers, my schools, my bosses, etc. (School Steps Inc...google them! Fun company to work for!!).

Hmmm what else. Oh yeah! I am presenting in Indiana at the AOTA conference in April, along with four other bloggers...our leader is Cheryl of OT Notes. We met up on Google Plus on Sunday night for a meeting about our presentation. I have never used Google plus before but it was so neat, like a 4-way Skype! (One of our members didn't make it). It was my first time chatting with any of them "in person". One is in Canada and I think the others are all on the East Coast. The presentation is about social media and OT. Should be cool. It's going to be on Saturday morning and is AOTA sponsored, y'all should totally come!!

Believe it or not, I STILL have my bag of OT conference stuff by my side along with my products to review. It sits by my bed (my office is my bedroom, shh I know its bad feng shui etc). I look at it daily. I WILL GET TO IT! I WILL GET TO IT!!!! I have a lot of paperwork to catch up on the next few days (we get 3 days off for Thanksgiving).

When we get back I have to figure out how to do like 4 evaluations within a single week, because the week after that I have an annual, then another annual with a HIGH PROFILE ADVOCATE, then a triennial, and an OT evaluation. Oh and report cards are due so I need to annotate my goals ASAP. Ack. Must. Not. Think. About. That. Tonight. Or I will never sleep.

I think that's it for now. Still needing to work on e-mail responses and blog comments (I hate having to moderate them instead of letting them just show up, but I get TONS of spam otherwise). I always, always, LOVE LOVE LOVE hearing from you all....prospective OT students, current OT students, moms, practitioners, educators, whatever. :)

Keychain Connect 4

2011-11-14T22:34:00.001-06:00

The kids think my tiny Connect 4 is the cutest thing EVER and they love it....it's insanely tiny, see how its smaller than this 1st grader's hand?

Notice the child is using his middle finger instead of index finger....this tends to be typical of kids who have some fine motor issues......the middle finger is technically more aligned with the thumb and therefore a little easier for these kids, but ideally we want them to switch to their index finger as that is, biomechanically/anatomically, a better fit......I should be able to spout off musculature and stuff, but uh, I've been out of school too long. Better go review my Benbow stuff lol.

I need to go work on yet another report......one of these days I promise to get to all my blog comments and emails. I do love my job and I love love my co-workers. :)

Karen

OT inservice

2011-11-14T22:30:00.001-06:00

I did the fine motor component of our inservice! We also had a handwriting area, self-regulation, and sensorimotor break component with our 4 district OTs. :) I had lots of toys out to fiddle with! Everyone was drawn to my table for the toys although the other tables did AN AMAZING AWESOME job.....The 30+ instructional assistants who took the inservice were very complimentary of all the stations. :)

WHERE DID MY BLOG MOJO GO?!

2011-11-13T21:06:00.001-06:00

I still haven't done my three product reviews even though I keep it all next to me in my room so I am constantly staring at it, and I like them all, and I haven't blogged about the OTAC conference, etc etc....and I have over a hundred blog emails or comments to respond to. Wow. Yikes. FORGIVE ME :::flings self to floor::: I am in the midst of ten thousand evaluations with a lot of late night report writing .......is that a good excuse? I have two reports I am going to try to write up tonight so that I am not up so late on the week days....plus I've had several parents request a lot of information about certain interventions so need to gather that up, plus score a DTVP-2, etc etc.......blah blah blah. My cats are not impressed.

I'm going to go shower then come back and start working on reports/paper work.....I THINK I CAN I THINK I CAN....must....stay...positive.... :)

love it

2011-11-10T12:33:00.001-06:00

My coworkers at this particular school (I am here every Thursday), brought me pastries last Thursday to celebrate my birthday (which was over fall break), but I was sick. So they brought cookies today (M&M chocolate chip cookies, homemade), and they had my kids sing "Happy Birthday, Miss Awesome" to me and then we all got cookies....soo sooo soo sweet! Loved it! Love my job, love my co-workers.

PS: Yesterday was FREAKING INSANE schedule wise! I am so tired. I want to go into more depth later. But just wanted to send a quick YAY for now ;)

augh

2011-11-08T19:41:00.001-06:00

tomorrow:

School 1: Self-regulation seminar, 5 kids. Then see another kid, 45 minutes.
Bolt to School 2: Evaluate a kid for an hour
Bolt to school 3: IEP meeting (a big one)
Bolt back to school 1: IEP meeting

busy day tomorrow!! lots of running around!

Got some big reports to work on tonight! Yikes! Feel like I am back in school doing homework! Alas it's the real world, no extensions. :O

weighted blanket....

2011-11-07T21:00:00.001-06:00

I just got a THIRTY POUND weighted blanket!!! :) From my friend Paloma for my birthday a few weeks ago!! (I'm 29, ooooh, old). I am VERY excited! It feels good!

Hmm

2011-11-01T20:57:00.001-05:00

A little boy told me today, "I get speech, and I go to reading in the resource center, and I see you. That means I do three sports at my school!" After a moment's reflection he asked me, "Is that what these are? Sports?" I said "It depends on who you ask!" He said "Is this my school job?" I said "yes, that's a great way of putting it." He asked "can I be paid?" I said "nobody gets paid in school!" and that was the end of THAT topic but I thought it was a great perspective.

A few minutes later, he asked me if the people on the bottom of the world (he was looking at a globe) were upside down. I thought that was an awesome question. :)

yikes - OT chaos

2011-10-27T10:57:00.001-05:00

I had so many good intentions. I have so much to write about the OTAC conference, and the classes I took, and OT4OT, etc etc, and catching up on my 100+ blog comments/emails, but noooo...I continue to suck. :) Here is a screenshot of what my box looks like!!!! But I SHALL CATCH UP EVENTUALLY! I always do. You should see my floor - SO MUCH FILING!!! I accumulate awesome resources. Then they go into piles. Then they add up. Then I never use any of them because I have too many.

I like to think of myself as organized, but once I get overwhelmed that goes out the window for a while. So......still my ultimate goal to get it under control. Especially because I need to work on a few reports etc before back to work on Monday.

Anyway.......more later ;)

Join us NOW

2011-10-26T13:05:00.001-05:00

http://ot4ot.com/world-ot-day-2011/

We are in the start of OT4OT's big day!!! Join us!

OT4OT party time :)

2011-10-25T20:26:00.001-05:00

It's fitting that a recent OT Practice magazine was all about international work. I've observed OT in Colombia (for several months) and also in Norway. I've been in a lot of touch with the OTs in New Zealand, Canada, and the UK over the years. I get e-mails all the time from blog readers in foreign countries who want to touch base. In some countries OT is more understood - like in Norway, where everyone I knew made comments like "Ooh, this would be good to use in OT"....I was shocked so many people knew what it was and what we do. It was lovely. And it was great to see OTs working in Colombia who had limited resources as part of being in a 3rd world country, but still did a fabulous job of providing high quality care.

One of my long-term goals will be to go do OT in a Spanish-speaking country for a while, to get immersed and learn Spanish better (don't worry, School Steps - not planning for a long time ;)). And I know there are many therapists who do missions in other countries. I feel like OT most definitely has a global identity and it's fascinating to learn about how it works in other countries, from insurance to relationships to resource access. For example, in the USA we learn how to out-source, for example for custom burn garments. Because we can. But in countries like South Africa, the OTs learn to sew custom garments themselves, because they don't have outsourcing possibilities. That's amazing to me!

I don't have any major enlightening thoughts on this subject besides I am so glad that there is an OT4OT helping to further the profession of OT in a very Centennial Vision kind of way. :) Hopefully I can attend some of the sessions being held tomorrow!

http://ot4ot.com/world-ot-day-2011/

ouch!

2011-10-23T22:45:00.001-05:00

I got this lovely gem in my box. I stand corrected. I wrote that list during one of my first semesters in OT school and I never noticed my mistake, nor has anyone else ever pointed it out. I'll edit it to correct it, but I've got to say the tone of this correction kind of stung!

Anonymous has left a new comment on your post "Top Ten Ways to Impress your Occupational Therapy ...":

It's Case-Smith, not Case & Smith. Dr. Jane Case-Smith is an OT professor and researcher from the Ohio State University. If you're going to leave feedback for future students, at least leave correct information.

My birthday weekend!

2011-10-22T23:05:00.001-05:00

I turned 29 this past Friday the 21st. I'm old, yo. :) Having lots of small celebrations with family/friends this weekend. Tonight we had delicious Thai food in Pacific Beach. :) I got a Sonic Care toothbrush I've been wanting from my mom, and a Wusthof serrated paring knive I've been wanting from my dad. I also got some neat gift baskets/presents/cash plus a beautiful purse and some OT toys! My gift to myself was going to be a 21 pound weighted blanket, but my friend Paloma pre-emptively bought me a THIRTY POUND (??????) one, so I cancelled my order. We'll see how 30 pounds is, I'm a little skeptical as that doesn't fit the typical rule of thumb based on weight. (Weighted blankets can be dangerous - use carefully only with able-bodied and cognitively intact people!) Oh wait, cognitively intact? That takes me out of the running... ;)

Tonight my friend Paloma helped me organize my toys (again). I need to get a better system in place during the week so they don't get so disorganized. I like to have LOTS of options with me.

I have a few pictures to put up from conference, plus SO MANY random topics I want to discuss that I jotted down during the various sessions. Technically I have NO excuse that I haven't been working on it this past week. Just failed. NOT COOL! So gear yourselves up for a blogging blizzard one of these days soon.

By the way, I was talking to an OT who is stressed out with her job and therefore kind of burnt out on OT. She wanted to know how I mantained my passion and enthusiasm for OT and I explained to her that my love for OT is separate from my job - no matter how bad a day or stressed I am from my job as an OT, in THEORY I LOVE LOVE LOVE the field of occupational therapy and what it STANDS for and what it supposed to be like. I realize that no one, least of all me, ever meets OT perfection, but I am passionate about our foundational beliefs. Every day, in every way, I am an OT. It affects how I see the world. Every single neuron of mine has a tiny little OT bubble in it along for the ride. I cannot separate being an OT from being human. I adore it with every ounce of my being. Even at the worst of times.

Ideally, obviously, you have an OT job that rocks so that you don't have trouble keeping up your momentum....but even if you do have that trouble with a difficult job, try and remember the OT values, even if they seem fuzzy at the moment.

That was kind of a random side note. It popped into my head.

Tomorrow two OTs are coming over so we can work on a presentation coming up. They are coming to my house and I can show them some of my toys, I am excited...

My goals for next week include writing up two and a half initial OT evals, preparing for three or four others, continuing to organize toys, clean my car of crazy toys (vision tubes, shoes for lacing, random board game pieces, dry erase board, etc), and dealing with ridiculous amounts of paperwork. :) Procrastination is a bad thing.

The pictures: I need to try to get back to using more pics. I have thousands of OT pics on Facebook from like five years ago if people want to be my FB friend and go look at old albums (just tell me who you are when you request friendship, ie you are a blog reader). One is a LOLcat that I thought was amusing from an OT standpoint, and one is the pumpkin my talented friend Kerri carved a few years ago!

I think it would be very neat if people would take pictures of "OT" more often in various states such as sand, glass, tile, whatever.....do something creative. If you submit it I'll happily post it. My e-mail address is in the sidebar in the About Me section.

Okay I'll stop now. My friend Paloma is here reading Mommie Dearest (NOOO. WIRRREEE. HANGGGAAAARSSSS!) and I am playing online like a bad girl.

CIREC - an amazing rehab center in Bogota, Colombia

2011-10-18T23:47:00.001-05:00

I spent 2 months volunteering at the rehab center CIREC last fall in the OT department in Bogota, Colombia. They treat a lot of land mine victims there. There were tons of amputees wandering around and everyone was so friendly. I loved it. I am in the process of figuring out how to donate to them. I also want to write an OT Practice article about it eventually.

In the meantime, watch this 5 minute video. You'll get to see the gym where I was at and some of the staff and patients I got to see, as it's a pretty recent video. Most of it is in English. A lot of adorable kids!

http://www.youtube.com/watch?NR=1&v=UbW9a9HVpJg

oooh

2011-10-17T10:59:00.001-05:00

I had a great time at the OTAC conference...California's OT Association. Looking forward to doing LOTS of blogging as I wrote down oh, 15 topics or so I need to write about!! I am definitely back into blogging mode. For right now though, I just need a little time to recuperate!!! Hopefully by tonight I will start writing!

Occupy AOTA?

2011-10-13T23:48:00.001-05:00

http://articles.chicagotribune.com/2011-10-09/news/ct-edit-occupy-20111009_1_protests-occupational-therapy-financial-crisis

I was seeing how to find my blog on Google.com (type in Karen Dobyns, or ot student, or occupational therapy blog), and I typed in just occupational therapy. This news article linked above came up but it had to do with anguish of the Occupy Wall Street peeps. I was thinking on the way home today that AOTA needs to take advantage of this "Occupy" stuff and do a membership drive called "Occupy AOTA" or something, to get people to join! Just a thought.

By the way AOTA sent out a great little 2 page pdf on sensory issues and kids during Halloween. I forwarded it to all the educational specialists at my 4 schools and asked them to send it on to teachers of kids with autism/sensory difficulties.

I love being an AOTA member and I highly recommend it. Rah rah rah. :)

So....my clothes are in the dryer, I showered, my cat is sleeping on my leg, the fan is going full blast (Santa Ana here), and it's almost 10pm. I'm going to go to bed now, but get up at 5:45am to do some printing of conference handouts, my flight ticket, etc.....tomorrow I see some kids plus work hard on some billing stuff. Then rush home to shower/finish packing before our flight leaves! I am NOT taking my computer. I'll be back Sunday night. And PS, robbers, I have two other people living here, so don't rob us. Thanks!!! :)

Pumpkin vs OT. Pumpkin wins.

2011-10-13T22:08:00.000-05:00

My mother had me go out to her car asking me if I felt strong. She opened the car door and I said "Holy Bleep". Without the Bleep part. Then I carried it inside and it almost killed me. That is our ugly garage, don't judge. By the way, notice my roommate's blind cane glinting in the background?! :) Or is it a white cane. I should know the proper terminology.

OTAC Conference and random OT stuff

2011-10-13T22:07:00.001-05:00

1. I was out in the sunshine with a kindergartener so the sun was really showing off my hair tinsel. He asked me "Why does your hair glow up?"

2. My cat IS LITERALLY TRYING TO BITE MY FINGER AND KEEP IT HOSTAGE INSTEAD OF WRITING THIS OW

3. I took back my finger and now he has SWITCHED SIDES TO MY OTHER HAND!!!!

4. You know how I start OW ed a campaign to get my kids to call me Miss Awesome? (obviously a joke). Today I walked into a room with a 2nd grader who likes me a lot and his eyes lit up. He was working with an aide and the aide said "oh Miss Karen is here". He replied "No, it's Miss Awesome." AHAHAAHAHAHA

5. I should be doing laundry, showering, and packing for OTAC and yet I am sitting here blogging?!! I had an IEP meeting first thing, then an initial OT evaluation meeting, then training in billing, plus some observation of a few kids in between, then I went to Office Depot, Staples, TJ Maxx, Halloween Store, Target, Big Lots, Michaels, and Dollar Store to try and find this specific bulletin board I love, and the Target employee suggested I try wal-mart. and she is right, I think it's where I got it!! (I couldn't remember where I got it but I wanted more so I've been searching). I forgot about Wal-Mart since I only go there like once a year. Guess I have to go again. Heavy sigh. Barf. :) Much prefer me some Target action. Especially those dollah bins.

6. I am excited about OTAC! Should be fun! If you are going to OTAC leave me a comment or email or say hi if you recognize me! If you see a girl with black glasses and glittery hair, that's me!!

7. I really should stop now.

Going to the CA OT Association Conference this weekend!

2011-10-12T21:57:00.000-05:00

I am going to the California OT Association conference this weekend along with a fellow co-worker! My company, School Steps Inc, is based out of Sacramento, so I finally get to see homebase! I just got handouts I need to download as no hard copies will be available. I am going to bring address labels so I can quickly stick them on things at various booths instead of having to rewrite my address constantly. I also plan to bring business cards of course....and comfortable shoes! And a couple of fidgets like Tangle Jr's to mess with while I sit in course after course! I'm scheduled for all morning and afternoon Saturday and Sunday so it will be a lot of learning. Hope to network with a lot of other OTs!

I'm also compiling some tiny OT gifts to give to my awesome awesome mentor Tricia. :)

I got some more hair tinsel put in today again as it was mostly all gone. I got the most I've ever had - like 16 pieces! Purple and gold. I'm telling myself it's an October extravaganza for Halloween lol. I think it's still reasonably subtle so hopefully no claims of unprofessionalism will head my way! The kids (and I) love the sparkle. :)

I have been brainstorming a lot lately on things to get in dollar bins that can be used in different ways (a la the recycling therapist although I'm not quite so hardcore). I also got some of those popsicle molds and realized if I take off the tops, it's basically 4 containers attached together, so kids could sort 4 different things into the little bins. I also found some tiny tongs that LIGHT UP when you squeeze them closed, they came with a bag of gummi worms I got a long time ago. So of course I pulled that out.

I also added a toy car to my arsenal as I have a lot of young boys and Tonya once again of TherapyFunZone gave me some ideas on how to use the car with writing/drawing shapes/letters!

I had one triennial evaluation today (every three years a child gets fully re-evaluated to determine eligibility for special ed) at one school, then went to another to work on eval write-ups I should have done some make-ups but I am so swamped with paperwork that I knew I needed to finish the eval, and Wednesday afternoons are reserved for meetings/paperwork anyway really. Tommorrow I have an IEP, an initial OT evaluation IEP, and training in billing software, so I don't get to see ANY of my Thursday kids. That's a lot of make-ups as Thursday is typically my busiest day!

I haven't finished up my paperwork due tomorrow so I guess I better stop writing on here. I've gotten into a blogging mode lately. All the sweet comments and e-mails certainly contribute to my new burst of blogging energy. Thank you so much. As always, I assure you, you will eventually get a response if you emailed me. It will just be slow in coming. Thanks for your patience.

Can strainer and pipe cleaners - OT tip

2011-10-12T21:46:00.001-05:00

I recently posted about using a colander with pipe cleaners which I still think is awesome and fun! But I was browsing the dollar section at CVS the other day and found can strainers for $1 that basically can do the same thing on a much smaller scale.....since space can be a premium for traveling therapists, it may be more feasible to carry around a can strainer than a colander.

OT Tip- mechanical pencils

2011-10-12T21:44:00.001-05:00

For some kids with serious issues re-sharpening pencils or kids who need to learn to use less pressure, and/or kids who just like mechanical pencils, these are my favorites by Papermate. I've used them since I was a child and I have a student in a younger grade who uses them religiously now too. They are sturdier than most mechanical pencils.

Mini Connect 4 - OT Tip

2011-10-12T21:43:00.001-05:00

I stole this idea from TherapyFunZone's Tonya Cooley. She talked about the awesomeness of using a tiny Connect 4 because it really encourages a pinch grip etc. I found this - keychain sized - and can't wait to try it out....

Monsters individualize fingers - OT tip

2011-10-12T21:42:00.001-05:00

Monsters are great for individualizing fingers! "Blue monster, take a bow!" They are also great on thumbs for thumb wars etc as it encourages the thumb-up position so important in cutting and general neutral positioning!

augh!

2011-10-11T21:30:00.001-05:00

i totlaly didnt share the most outstanding session of my day. lol. I work with a child who for whatever reason HATES going below the line with his letters - ie g, p, y. He has a goal to do that. I've explained to him that the worms ATTACK people because they get ANGRY because they are HUNGRY and need to eat the tails of those letters. He thinks it is funny and will deliberately go out of his way to either avoid using tail letters or will say he doesn't care if the worms attack him. So today I pulled out one of my fake worms. We were re-copying a form letter for a final draft and each time we approached a tail letter I'd make the worm dance in front of him and act obnoxious. It totally worked. LOL.

THEN we used the second half of the session to work on touch typing. I wrote "A S D F" on his left knuckles and "J K L ;" on his right knuckles with a red magic marker. We played one of those free typing games, Space Invaders etc, using only the home row. So at first I literally helped push his fingers down one by one (he had initial trouble individualizing), but slowly he started getting more proficient with his home row. He never had to take his hands off the keys or scan since it was written on his fingers. I got the idea to write on his fingers from some gloves I saw in a catalog.

He enjoyed it! And so did I. After that session I felt like it had been a good use of our time. :) The End

PS: Notice the procrastination!!!!

Typical school OT day for me

2011-10-11T21:10:00.001-05:00

I've decided I can write a little bit about certain specific stories as long as I remain vague on identifying details. I'm going to refer to ALL my children as "he" just to avoid he/she language, and also I think most OTs have a much higher percentage of boys than girls on their school caseloads. Just an anecdotal guess. And if a child is in K through 3 I'll say lower elementary, 4-6th I'll say upper elementary. There. We have that established. And also, ALL my children are general education mainstreamed, with just special services as needed, ie one on one aide or time in the learning resource center, or speech/OT/adapted PE, etc. The other OTs in the district have special day classes meaning children with mild-moderate diagnoses in a classroom. So their days look different than mine!

So let's go through my day a little bit....

7:30am: Get to school. Work on an evaluation due the next day and other paperwork.
8:30am: Walk into lower elementary classroom and help individual children out during writing centers. I usually carry with me my "lava" (red pencil), a short fat pencil, a short skinny pencil, a small dry erase board (with 3 lines appropriate for younger grades), and a dry erase marker. That way I can write the writing prompts/sentences out on the dry erase board. Then, if given permission, I give their papers "lava" (redden the middle dotted line), and we start our writing with prompts from me to remember the baby letters versus tall letters etc.... to be clear, that's what I carry when I go into a push-in session for writing, meaning I am in the classroom. I bring a TON of stuff with me each day to each site for the kids who come to my corner.

9:50am: Recess for the kids....do some prep/paperwork, chat with teachers about kids (consulting)

10:30: Go into a lower elementary classroom and highlight writing for a young child who has serious fine motor difficulties. (I write in highlight, he traces). Then take him for pull-out for remaining fifteen minutes since rest of class is moving on. Work on handwriting and tweezers with bugs and theraputty with beads....

11: A child comes to me. We play the push-pin corkboard game (pushpins are game pieces) on a corkkboard with the alphabet in Sharpie on it in game board format. The child rolls bouncy dice (literally you have to chase them around the room) and whatever letter we land on, we practice. It can be just doing it 3x or a word starting with that letter or whatever, based on child's ability. I have discovered that two of my high functioning children with autism love making the game complex - we add on four extra invisible people. So the child gets a team of 3 and he names all his pieces, and I get a team of 3 and do the same. He rolls the dice for his 3 people, then he rolls for mine, and we have to keep track. For example, "Ladybug is the purple pushpin and she got a 6" "Kitty is the silver pushpin and she got an 11". The game gets a little crazy when you are playing with 4 invisible people but they stay MUCH more engaged with their fake people. Also, a lot of children with autism have issues with winning/losing, but when you have invisible people playing on "teams", it takes away SOME of that stress.

11:30: Lunch for the kids and therefore no one I can see. Paperwork/evals/talk to teachers/eat lunch in teacher's lounge to collect gossip/knowledge/consult etc

12:10: Work briefly with a child on re-writing a pen pal letter. Focus on logical flow, handwriting legibility etc. Have him write on every other line as he tends to write large. I had planned an activity to do with him, but his teacher hoped he could work on the letter so that was totally fine. I like it when they have work for me.

12:30: Another child comes to me. Play the push-pin corkboard game at his request with our invisible teams.
1pm: Run to IEP meeting for child, one with only a few goals and no parental issues so pretty quick this time.
2:20: Kids get out of school. Debrief/consult with teachers. Paperwork etc. Etc. Etc. Etc. Get theraband for a child's chair. Get inflatable cushion for another child's chair. Give an aide carbon paper to encourage a child with light writing to use more pressure with the magic paper! lol. Speak to some teachers about scheduling children around IEP meetings coming up. Make copies out of a journal for writing samples. Score writing samples.

Tonight: Write up a huge evaluation! And organize my current toy bag a little, it's getting a little nuts!

So....that was a semi typical day for me! Oh, highlights: a little boy telling me earnestly why he likes the theraband looped around his chair "It's so I can work and play at the same time." PS: I know it takes up more material but I much prefer to LOOP the theraband in a circle around the front legs of chair versus just tying a single piece to each side - the kids like to put their legs within the loop.

Another semi highlight: Me going to pick up one child and two others clamoring to go with me. ;)

Another semi hilight: Getting to hang out with awesome teachers and special ed staff and adorable kids!

I think that's it for now. I just wanted to write a lot. Probably mostly procrastination from this huge eval. :(

Thanks for the sweet comments lately!! Getting my head big. :)
PS: I didn't edit this/read this over, it's just stream of consciousness so don't judge harshly ;)

sparkle sparkle sparkle!

2011-10-10T21:11:00.001-05:00

The other day a child with pretty significant ADHD (not on my caseload) walked past me in the learning center (I was sitting at a desk doing paperwork) and instantly stopped saying "Sparkle sparkle sparkle!!" She started touching my hair. I have hair tinsel because I do LOVE sparkles. :) I was like Ooh! Do I have any left? I typically get about 12 pieces put in but I hadn't seen any in a while so figured they had all fallen out. She determined I had four pieces left. Then she saw my face. "Sparkle sparkle sparkle!" she said, pointing to my eyes. I also wear glitter eyeliner. Because again, I do love sparkles. :)

That encounter tickled me...she was enthralled. I've also had children with autism (notice my person first language?) look me in the eye because of my glitter eyeliner catching their eyes. I'm a big believer in appealing to the child demographic as an elementary school OT, even if it makes me a little extra eccentric to adults, lol.

(Side note - if you put a child with autism in front of a mirror and put fingerpaint or face paint on their face, they will often look themselves in the eye longer. And if you put the child with autism on one side of a tunnel and you on the other, essentially turning the tunnel into "blinders", they will also often look directly at you.)

I've also had two SEPARATE encounters where I walked into a 1st or 2nd grade classroom and a young girl sitting near the door in both cases immediately latched on to me saying "I like your glasses! I like your hair! I like your shirt!" etc, in one long breathless exclamation......both times I laughed and it made my day. It was funny it happened almost identically in two different classrooms!! I LOVE working with kids! They say and do the funniest things!

Just for the record though I've also had plenty of days where kids refuse to acknowledge my existence, haha. I just choose to remember the fun days... ;)

I've been using my push-pin on corkboard handwriting game with bouncy dice a LOT lately....pretty much all the kids are drawn to it. Then we proceed to use the lava/worms/bumblebee sizing rules....I know I was asked to put up an example, I will try to get a picture in the next day or so! Along with my long-promised Dycem post and Linda's daily living skills post! And soon a Pen Again post (those funky Y shaped pens)....a little girl today refused my normal pencils today, saying she wanted to use the "awesome pencil" (referring to the Pen Again samples I received today in the mail to review!)

I'm starting to feel significant stress for the first time this year as the demands increase, but overall still LOVING my job in the school system! SO much fun!

I just spent an hour on the phone with a long-term blog reader, Meredith, who is doing a fieldwork in one of my old haunts. It was lovely! Okay now it's 7:15pm and I should probably get some work done.....blah

Karen

I interrupt this OT announcement....

2011-10-03T23:03:00.001-05:00

Hey wait this is an OT announcement. I finally hit over 250,000 page views on this OT blog!! It only took me like five years, cough. :)

Today was a bouncing day with a bajillion kids and a bajillion teachers....I wore my cat out from afar as he is now asleep in my lap. Tomorrow is another busy day! I must go get toys and paperwork together! E-mails to be answered soon. :)

OT brain overload

2011-09-28T20:42:00.000-05:00

Today I went to one school to do my weekly self-regulation "seminar" with some kids with various special education needs, saw one kid for half his normal time then bolted to a second school for two meetings in a row, then bolted back to the first school to do an evaluation. I brought in THREE giant bags of toys for this one evaluation - I really need to work on streamlining my evaluation tools.

I read a recent article in Advance - which I typically skim and find like one interesting thing in - from this lady who talked about pulling up to schools with like a carnival in her car, but is getting away from that (ie not bringing OT clinic to school) and trying to stay more in the classroom. I agree that is an ideal situation, but there are so many variables that affect it. For example, the teacher has to have an open mind/reasonable attitude about your role/presence. (And I realize being a good role model/example is a good way to start building that relationship....). But also, and somewhat even more importantly, SCHEDULING gets in the way. If you have tons of kids in tons of schools in tons of grades with tons of different "special" events and special subjects (ie rotating art, music, computers, etc), it is a NIGHTMARE to schedule kids, period. And that's pulling them out. Pushing-in requires really careful coordination with a teacher to always make sure they are going to be doing a "valid" exercise when you are in the room - ie, not watching a movie. Many teachers will say "Oh, 9am to 930 is great for writing" and then you show up and they are on the playground until 9:15 and you've lost half your session...

Don't get me wrong, I push-in when I have to legally and/or when I think it is most appropriate, but depending on caseload/availability, it's not always feasible....it seems like some schools have a global attitude that is more accepting than other schools....every school has its own culture! And I learn different areas of culture....like in all of my schools, the special ed teachers ("educational specialists") tend to sit in their own rooms with each other at lunch whereas the lunch room is typically filled with general education teachers. I don't know if that's normal or not. I personally like doing both...you learn a lot in the lunch room/lunch time chatter in general. I guess gen ed sticks together the way special ed sticks together, and occasionally we get teachers who are bridges who like to hang in both areas!

I REALLY love working in my school system this year. Last year I was insanely stressed out learning my new job in the midst of IEP season. I had some great training but there is still a learning curve. This year I feel much calmer, even in the midst of ten thousand evaluations. I don't know why. Especially since I have some really challenging cases this year in terms of advocate involvement. :)

I think one of my big strengths is communication with parents via e-mail.....it's a lot of fun sharing what kids are doing with parents. I type fast/write fast/think fast/read fast so I get a lot of joy from that.

My brain feels full today with all the things I am trying to figure out. I know I have an eval Friday and Monday at one school for two young kids, that I have three evals I need to write up ASAP for kids ranging from Kindergarden to 5th grade, that I have more I need to schedule ASAP to stay within legal timeline, that I need to stop by to get some more theratubing from a fellow OT for my kids chairs and give her a pair of preschool scissors Faber-Castell has that I love, bring in some fidget choices for another child, and then of course just my typical treatments/consultations etc. Tomorrow I have a full day of kids that I need to plan for tonight, organize my toys for, etc.....typically I do a combination of either fine motor or visual motor or both + some handwriting....obviously it all depends on the kids goals though. Sometimes its a little scary putting all this out into the world....not that I think I am saying anything horrrible, but I definitely leave myself open to criticism.

My newest favorite tool is LAVA/WORMS. Sizing/line orientation can be a big issue for kids using the 3-line paper with a dotted middle line. I got the suggestion from a special ed student that LAVA works well. So you take a red pencil and cover the dotted middle line with red which is your lava. There are tall strong letters that can go through the lava like h, l, k....but also baby letters like a, e, r, that will burn if they touch the lava. Incidentally, if their letters drop below the line and they aren't supposed to, ie the a gets a little too low, the worms attack. The worms are only okay with familar tails like y, g, p....anything else is trouble. I draw in tiny worms and say Oh nooo the worms are attacking if they go too low, and I draw little lines coming from the top of the letter and say Ohhh ITS bURNING ITS BURNING if they go too high and touch the lava .......most of my kids respond really well to the drama of lava/worms.

The two biggest issues I run across is A) kids wanting to draw their own lava line and making a mess of it, and B) wanting to draw in worms/other bugs too and it gets messy.....but seriously, I've seen some really nice handwriting come out of the lava/worms. :)

This is the longest post I've had in a long time. I need to be thinking of a blog carnival post for World OT day coming up.

I still promise to respond to all my OT emails soon. I am getting 1-2 blog emails a day now which is a little crazy considering all my best posts are like 4 years old lol.

Dycem for OT

2011-09-27T18:54:00.001-05:00

I am not ready for the official review because I want to include a picture I take, but I want to say I LOVE The Dycem place mats (in shapes like a turtle) because when the child is dealing with something that might fly away, like a bead or a pom-pom, those semi-sticky mats are awesome and keeps things from getting away and minimizes frustration. I am using the Dycem placemats a lot now and want to order some more, and the other OTs liked it too. More soon.

Can I mention I love my job working in an elementary school system? The teachers/colleagues/SLPs/OTs/principals/etc are soo fun and awesome! I drive home smiling thinking of random events that occurred during the day. Well I guess not always smiling depending on how many meetings or crazy things happened that day, but most days. Like today.

I also want a scooter board. And a few yoga mats. And a few weighted lap pads and/or vests. Etc. Maybe for my birthday which is coming up!! (October 21st) I will buy myself some of that stuff! I am obsessed with buying new toys!! Okay. More later.

Quotes of the day...

2011-09-26T21:52:00.001-05:00

Playing a push-pin game with a kindergartener. I had a pink ball pushpin and he had a black normal pushpin. "Our pushpins are different because yours is a sphere and mine is a cylinder." Wow.

Walking past a kindergarten playground at another school: "SIMON SAYS KNOCK YOUR EYEBALL OUT!!!!!"

Having fun with my kids and my colleagues! Started putting pictures of the child's grasp in the OT evaluation report (just the child's hand, no identifying features) and it has been well received to have that "custom" picture. :)

I've been showing a lot of the teachers the stuff with styrofoam, golf tees, marbles, clothespins, cotton balls, etc, and they are enjoying it! :) Gives them ideas for fine motor centers.

I got to help a special ed teacher in training learn how to score the VMI the other day, that was nice. I also got to give a little informal talk to a couple of high schoolers today visiting a learning center - showed them my toys and told them what OT was and they were all like COOL! :)

For those of you who have recently emailed me - I have really been getting more blog emails than ever before - I promise I 99% of the time respond, I am just slow. I have them all saved as new to get too, I promise!

OT cleaning

2011-09-22T00:00:00.001-05:00

Every night I come home with about 3 bags of toys which I promptly dump all over the floor so that I can repackage for the next day. The last few days I've been bad about repacking and so things have gotten mixed together. You could barely walk in my bedroom because of all the toys. Now I've separated the golf tees from marbles from pipe cleaners from glittery poms from cotton balls from clothespins from fat pencils, skinny pencils, triangular pencils, fat short, fat long, skinny short, skinny long, pencil grips, fake bugs, yarn, straws, etc. So you can walk in here now. The bad news is, I stepped on a bamboo skewer and it really freaking hurt!

I've started taking pictures of my kids' hands while they are writing, during their evaluations, to copy/paste into the report as a visual. I literally only take the picture of the hand so it's otherwise not recognizable/a privacy issue. It helps explain their grip better. (I still am confused as to why some people say grip and other say grasp interchangeably yet I've joined the bandwagon).

My favorite new activities that I've been using constantly lately:
1) Corkboard alphabet game using push pins and dice, practicing the letter they land on. Home-made. And/or just sticking a pushpin in each square, kids are fascinated by pushpins.
2) Sticking pipe cleaners into colorful colander turned upside down, in any pattern/method they choose.
3) Sticking bamboo skewers into styrofoam and having the kids find beads in their theraputty then string them on the skewer.
4) Sticking golf tees into styrofoam and then having them balance marbles on top.
5) Using clothespins and/or tongs to sort fake bugs.

I think that's it for now. I want to start using paper clips and staples more often too. I am really getting great ideas on Pinterest (pinterest.com/funkist/ot-ideas) should take you to my area. I have like 10 more I want to add but Pinterest was having a temper tantrum earlier so I could not.

I feel a lot less stressed out this year so far, I think a lot of it is that I now know more what to expect and how to navigate the system, who people are, etc. I've enjoyed more kids learning my name. A few of them even come up to hug me. Including strangers. One little girl I've never met came up to me while I was sitting down and gave me a big squeeze hug and I was like um, hi? AHAHAHAHA

I had this conversation recently with a 5 year old:
Boy: This table is dynamite!
Me: So we are going to explode?
Boy: I am a parrot, I will fly away!
Me: What about me?
Boy: :::looks at me sadly:: You're going to die.

LOVE working in an elementary school setting! (Okay, four elementary settings) lol

Whew

2011-09-19T22:42:00.001-05:00

6 meetings in 5 hours + an eval today! Tomorrow includes an IEP meeting, treatments, an eval, and an OT meeting. I guess I should go get ready for tomorrow eh? My goals for this week include writing about Dycem and Linda's book! Also catching up on blog reader e-mails. Hopefully I can meet those goals!!!

PS: I saw an interesting article on a link between autism and atheism today......

Oh my beloved neglected OT blog..and neglected readers

2011-09-18T22:52:00.001-05:00

Somehow I've had a ton of e-mails from OT blog readers lately - I'm still down to less than 70 in my mailbox so I hope to get to them soon!! I think about my blog a lot but not much makes the leap to it since I always worry so much about privacy laws! Rightfully so, too...

This week I have a lot of meetings, plus several OT evaluations, so I need to prep my evaluation tools and for the meetings tomorrow.....I should probably get going on that, eh? :)

I'm still working in my head on a "typical day" post....have to kind of muddle it up a little so it's not a TRUE depiction of a day but a good representation....

Buying OT toys left and right....

2011-09-11T20:43:00.001-05:00

Last week I went to the teacher store, Lakeshore for some pencil grips, and then also found some awesome Faber-Castell items at Barnes & Nobles, such as pre-school scissors, and jumbo crayons. This weekend I went to a gourmet cooking store and bought some cute crocodile tongs for kids, then to the pet store to buy small tennis balls, to make tennis ball heads using the smaller tennis balls for smaller hands. :) I also bought some straws and an ice cream scooper for like, 25 cents, since you can never have too many straws for kids, lol. Blowing and sucking cotton balls etc! Also I bought some bamboo skewers to stick in styrofoam to make bead patterns on....actually now that I think about it the skewers may be too thick for my little beads. We'll see.

My room is filled with sooo many toys, it is unbelievable, considering I am a single female, not like a mom with fifty kids. :) I love toys a little too much and am constantly on the lookout for new ones, although most of the time they end up being like from a dollar store, office supply, pet store, kitchen store, Target, etc. Rarely are they true OT toys but I turn them into some. Like I am going to go raid my kitchen to see if I can find a melon ball scoopy thing, to use for collecting marbles...I also need a bottle and a spoon for a similar task, scooping marbles with the spoon and placing into the bottle....

I've discovered kids LOVE pushpins, and so if you can supervise them/trust them, just about anything you can dream of with pushpins will work. I've been using my new pushpin game I made this last week where the kids write out whatever letter they land on 3x, and they've been engaged for the entire activity, even though I would have thought they'd get bored of it halfway through.

My goal for tonight....well I have many goals for tonight, but one big one is making an eval cheat sheet which I should have done a long time ago. I have ten evals to get through in the next few months so I need to figure out a way to do them more efficiently without losing any data!

I have seen comments requesting a day in the life of a school OT....I'll have to think about that one! Sorry I have been such a blog neglecter lately. I don't even have the excuse of being too busy, just distracted by other things! I really enjoy my blog though so need to keep it up. Oddly enough even with the neglect i've gotten quite a few e-mails from readers with questions which I obviously need to respond to ASAP!

Alright that's it for now....I also have a review for Dycem and a review for Linda's daily living book to do sometime very soon! :)

Hope all y'all have a good week....I've got a combination of 30 day review meetings, treatments, and evaluations to get through this week! :)

My tennis ball friend

2011-09-03T21:35:00.001-05:00

Meet my tennis ball friend. Hold him open to give him yummy treats like pennies, then he can throw them up! The wider the mouth you make, the less resistance....I'm still on the lookout for the smaller tennis balls for smaller hands.

cool scissors

2011-09-03T21:34:00.001-05:00

I know this is a bad picture, sorry. I found these scissors today at Barnes & Noble from Faber-Castell and they are hopefully going to be great for beginning cutters! I hadn't seen any like that before in stores. I also have a few other types....

Weighted pencil

2011-09-03T21:32:00.000-05:00

I am figuring out how to make my own weighted pencils. I took a pencil and wrapped tape around it (the way you do a ring that is too big), then I put a bolt on it and it fits snugly. I had taken pencils to the hardware store and found bolts that fit close but still a little loose, so the tape was perfect. First I tried super glue but it wasn't quite enough. Tape worked better. :) But i am not sure the best placement of the nut on the pencil, so I may do some experiments with that, and also try putting more than one nut on, etc.

New game I made...

2011-09-03T21:30:00.001-05:00

I bought this strip of cork board at Office Depot or Target or somewhere. Then I used Sharpie to make it into an alphabet game board. You use push-pins as the game pieces. You roll a die (cupping the palms and working on those arches!), move your push-pin, then practice writing the letter you land on, or possibly a word starting with that letter, depending on how advanced your kids are!

asdflsadfj

2011-08-19T15:23:00.001-05:00

test

I start back TOMORROW! (Monday)

2011-08-14T23:12:00.001-05:00

I went in Thursday and Friday to prepare, and the kids come back tomorrow. We don't "pull" (take kids out of the classroom) the first week, but still lots to do to prepare in terms of setting up stuff, whether it's paperwork or supplies or learning about new kids etc. :) I have to brush up on the ALERT program so I can help a classroom with it and refresh my memory on social thinking etc. I bought so many freaking toys this summer to be better prepared for this school year, and spent a lot of time finding crafts on pinterest I might do.....but I still struggle with anxiety about it all, no matter how prepared I am. :) I just always want to be doing my best work!

Speaking of best work, I work for a great company based in California called School Steps, Inc. They are a small but growing business and they hire OTs, SLPs, PTs, and psychologists, for school systems, in various parts of CA. Their website is http://www.schoolstepsinc.com if you want more information. :)

That last post is by Tommy Carr, not me.

2011-08-04T21:35:00.001-05:00

I copy/pasted the Mind Mapping e-mail without attributing it to Tommy Carr. So oops.

Summer is almost over....I go back to work next Friday. A lot to do between now and then. in a few minutes here I'm going to buckle down and re-open files and start preparing for the year! I'm a little pre-emptively stressed out as I am warned the beginning of the year is stressful with scheduling and all. But I am trying to not let that knowledge get to me. :)

Sorry it's been quiet....my 1400+ mails has gone down to TWENTY....and since I haven't been working I haven't been doing a lot of OT stuff. Actually I have bought quite a few OT toys over the summer, like stamps and crafts supplies...but nothing besides buying compulsively, lol.

Mind mapping OT competition :)

2011-07-29T14:09:00.002-05:00

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

2011-07-26T00:28:00.001-05:00

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

2011-07-21T12:22:00.001-05:00

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

2011-07-21T10:11:00.001-05:00

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!

2011-07-21T09:37:00.002-05:00

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

2011-07-20T10:11:00.001-05:00

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

2011-07-20T09:40:00.001-05:00

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

2011-07-19T09:44:00.001-05:00

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.

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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

2011-07-19T09:33:00.001-05:00

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

2011-07-18T17:05:00.001-05:00

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

2011-07-18T16:53:00.000-05:00

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!

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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 :)

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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

2011-07-18T15:05:00.001-05:00

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

2011-07-18T09:15:00.001-05:00

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

2011-07-10T18:03:00.001-05:00

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)

2011-07-10T17:49:00.001-05:00

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

2011-07-10T13:00:00.001-05:00

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

2011-07-03T13:08:00.001-05:00

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

2011-07-02T20:18:00.001-05:00

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

2011-07-02T20:09:00.001-05:00

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

2011-07-02T18:01:00.001-05:00

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. :)

Adult SPD

2011-06-29T15:32:00.001-05:00

An adult friend of mine wrote this to me when discussing her sensory processing difficulties...I thought it was good insight. A lot of us OTs could probably have stood to have a little OT when we were younger....just like a lot of psychologists went into the field to search for their own healing, a lot of OTs go into the field because of their own recognition/awareness/compassion of people with similar difficulties!! PS: I am pretty sure I am going to buy a weighted blanket (maybe 15-18 pounds) for myself! I think they are GREAT for some kids and some adults too! Wish they were cheaper though. Don't buy one without researching proper weights etc. :)

"
Please don't let them put me in the O.T. zoo! If they do put me in the zoo, please make sure it isn't too bright, too loud, too smelly, and they don't make me wear uncomfortable clothes. Also, please make sure that my clothes are on correctly--I don't notice if my skirt is on sideways or my shirt is half tucked. Also, make sure I have a bubble, because I trip up/down steps or when there aren't any trip hazards. Oh yeah, it's super funny that I try to play tennis and ping pong using both hands at the same time and I swing after the ball has wizzed past, but make sure they don't play the clips continuously--I don't think my ears could take roar of laughter.--AND don't let the visitors walk up behind me and touch me lightly or try to put a vibrating Tickle Me Elmo doll on me. I'm terrified of the dark, so make sure I have a nightlight. I need a weighted blanket, a treadmill-or a place to keep moving, and earplugs--not headphones (they give me a headache). Make sure my food is extra plain and not lumpy or bumpy. O.K.?"

Enlarged utensils and T-stools, do it yourself

2011-06-26T21:28:00.001-05:00

http://www.instructables.com/id/One-Leg-Therapy-Stool-Autism/ I am tempted to try this! Try making this at your own risk - but T-stools in general are pretty popular with helping fidgety kids focus!

Also, I feel really stupid I didn't ever do this when I did rehab! Basically shelf-liner was used to enlarge these utensils!
http://www.instructables.com/id/How-to-make-gripped-utensils/

Amazing site for OT forms

2011-06-26T21:08:00.001-05:00

http://www.med.unc.edu/ahs/ocsci/nc-school-based-ot-site/guidance-documents-forms-and-practice-resources

Traveling!

2011-06-26T20:38:00.001-05:00

I am traveling for the next month. I will have a lot of down time as most of my Southern friends work (I am on our summer break as a school OT), so my goal for the next month is to get through the thousand+ mails in my gmail box, + deal with the 200+ in my work box that need to be filed. That means some OT blogging as I clear out my mail box, and readers may finally get responses - sometimes it takes me days, weeks, months, and gasp, possibly years, but I always eventually respond. :) So....YAY! Catching up!! I also plan to catch up on all my files from the last few months and get everything organized to start up next school year!!

I apparently am about to be featured in an e-zine called "Today in OT"....to any new readers, welcome!

Reversals

2011-06-20T12:29:00.001-05:00

I feel a little deja vu, like I've posted this article before, but I still like it!!

http://www.pediastaff.com/resources-dealing-with-the-reversal-problem--june-2008

School OT pediatric toolbox video, numbah 1

2011-06-16T21:57:00.002-05:00

This is a video I created a few nights ago with my best friend Paloma manning my Flip camera. We just used my room's floor so um, it's about as amateur as you can get. And yes, there is a funny noise in the middle of it. And yes, I call my blog the wrong title. And yes, it's not very technical. But whatever, maybe it will give you a few ideas, although most of it is pretty standard. I take criticism hard so while I don't mind constructive criticism try not to hurt my feelings too bad, okay? ;) There is one more coming, this is 9 mins and the other one is 7. I think this video is mostly geared towards like prospective OT students or early OT students who need some ideas; experienced practitioners know everything in this video.
PS: I have a really old pediatric toolbox video on youtube from like 4 years ago! This video isn't on youtube yet but it's a goal eventually.

Great new to me OT peds blog

2011-06-14T20:59:00.001-05:00

I spent an hour at least today looking over this blog, who, small world, is written by someone in Memphis who works at a place I WANTED to go volunteer/learn at, but they said no because too busy. :) (years ago).

http://drzachryspedsottips.blogspot.com/

Too bad since I like this Dr. Zachry!!
I tried to figure out how to contact her but don't see how. I also tried to leave a comment and couldn't. Maybe I'll try again on the whole comment thing. Anyway, I am going to be using a lot of her ideas!

inventing new games instead of paperwork

2011-06-08T21:43:00.001-05:00

So I was trying not to stress about all the work to do tonight paperwork wise, and somehow I end up gluing googly eyes onto cotton balls. What's up with that? :) I was going through my OT toys trying to think of new fun stuff for tomorrow's final sessions, and inspiration struck. "Wolf and sheep". I have a bunch of clothespins and a bunch of cotton balls - the wolf are clothespins, the cotton balls are sheep. Which now have eyeballs. Anyway I haven't fully decided how it will work but basically a bunch of cotton balls, maybe just one clothespin for each person, and then timing how many sheep we can each get in say, a minute. Or maybe I'll ahve each "wolf" get one sheep. I dunno. Something.

I also have a foamboard (?) from Target that is in the shape of a flower that I got in like the dollar section. I used Sharpie to write a color in each flower section and the pushpins are those different colors. They have to put the diff colored pushpins in their own flower section.

And I finally did the whole dried rice-with items inside thing and put it inside a larger container to avoid spillage.....

And and and. And I need to do PAPERWORK not invent new games.

KD

great OT comments...and now for OT thoughts...hmm

2011-06-04T21:37:00.001-05:00

Gotten some REALLY nice OT e-mails lately - love it when I hear from long-term readers for the first time! Obviously need to respond now since they all typically include questions of some sort. :) Will get on that soon. The good news is, this upcoming week should be the last one that is craziness with work.

I started photographing all my toys today, so that soon I can do a "here is ten bazillion toys to consider having". I might also make a YouTube version of what's in my "pediatric toolbox" - I did one many years ago and I apparently have issues with eye contact, so maybe in this one I'll do better, haha. But of course first I have to get dolled up! Which is not how I look right now!

Alright...it's a beautiful day here...I am sitting in my bed looking at the beautiful ocean....starting to be sunset...my cats (one mine, one stray) are both chilling beside me....and I am working! I did take a walk/mini jog (truly like no jogging but enough that I can say I did, haha) outside earlier. I have some Sensory Processing Measures to look at, and a huge evaluation to write up, and some cursive to print out for board copying, etc...lots to do...so I'll stop procrastinating now.

I swear I also do play, my friend is coming over soon to spend the night, and then tomorrow I have Pilates + seeing a good friend of mine who was one of my OT CLASSMATES! She came to town to run the half marathon. Of course we are doing In-and-Out. Can't wait to see her and also talk a little OT. ;) Interspersed between all these things, yep, is work.

By the way, this morning the first thing I did when I woke up is buy like 50 dollars worth of Tangle Jrs, and then like 20 dollars worth of random toys from I think it was officeplayground.com....I had typed in favorite OT toys and it popped up and it had tons of great fidgets etc....btw I keep seeing people spell it "figits"...am I crazy or is that totally wrong?

I also bought some dry rice today to put in plastic jars and then put in marbles, so that kids have to put their hand in and dig around to find the marbles without looking...great for tactile discrimination, some proprioception, etc. :)

Okay....well...I said I'd stop procrastinating 3 paragraphs ago. I mean it this time. Just like I always mean it. :X HAVE A GREAT WEEKEND!

Karen
PS: I swear I'm going to respond to all my emails soon, never fear :) It may not be until next week though that I start really catching up!

A walk through elementary school lane...

2011-05-30T23:36:00.000-05:00

I decided to go through my old papers from elementary school to see how things went for me. I started kindergarten when I was four years old with my twin sister at a private catholic school in CA. Apparently I was not a huge fan of work and was also quite adept at writing my name backwards ;)
I never ended up in OT and have pretty good writing, so I guess it's true what they say about reversals being common until around age 7! :)

Reversals are common until around age 7.

I apparently wasn't always interested in working...

This picture is a little disturbing. I think a person is being attacked in the sky.

Notice the combo of uppercase/lowercase, also common at first

wasn't exactly sure how to spell Elizabeth apparently...

Oh look, our beloved grids were popular even way back then. Notice my name.

I went to private catholic school. Crucifixion...

My elephant looks A like a platypus and B a lot like the elephant I would draw today.

Yep, say no.

Dang look at how nice my handwriting got!

I was surprised to see how I wrote my name...

OWL! I want to do this activity with kids.

Apparently we liked phonetic spelling back then too..

I wanted to have like a thousand kids with very specific bedtimes :)

This picture is within an egg crate -c otton balls - I want to do this craft too.

hmm

2011-05-27T23:09:00.001-05:00

i apparently meant to send this the other day and it failed and i didn't realize it....the first part talked about me being tired (so I deleted it, lol) but my PSs are semi amusing so I'm re-sending it....

PS: Making tennis ball friends (was it from school-OT.com or TherapyFunZone?
I can't remember) requires fearlessness....I used a clamp as I stabbed the
tennis ball so I could keep my fingers.....the kids like stuffing BUGS (like
Wal-Mart or Michael's cheap bugs) in their mouths! Fun to see tentacles
sticking out of his little mouth. One kid called the tennis ball a praying
mantis today...I said it sure was a fat one. :) They also like sticking
pennies in their tennis ball mouths and then making them throw up. :)
PS2: I know I am a school OT now because I carry my apron in my car to wear
from school to school as I eat my lunch as I drive! (At stoplights or easy
things to eat, I swear I'm not like, eating a salad on the freeway, no hate
mail please)
PS3: I also know I am a school OT because my room at home looks like a toy
store exploded in it...never know when you'll find a purple centipede on the
floor or a mouse-finger-light or what!
PS4: I am mad at TherapyFunZone and OT in Public Schools for constantly
putting up new posts that make me want to copy them! :)
PS5: I am delirious and going to bed.....

a recent comment

2011-05-27T22:27:00.002-05:00

Here is a recent comment....
Hi Karen, I love your blog. I just started OT school, in fact, we had our first day of class today. I learned a lot about what to expect from your earlier posts. I am sure you are overwhelmed with work especially coming down to the end of the year. However, it is not always necessary to post about it. As a former teacher, I know how easily a profession can get a bad rep for complaining about being tired or having too much work, and I don't want that to happen to you or OT. Your OT posts are so helpful and your passion really shines through. I don't want others to be turned away though or people to stop reading because they are constantly hearing how tired you are. If you are too worn out to blog, just put it off we'll understand, I promise! Keep up the good work and I hope you get everything done without too much stress!

So when I read this it hurt my feelings even though I know its with perfectly good intentions and actually a really good piece of constructive criticism...I wanted to ask what others thought. I know I post a lot how tired/busy I am but I also mention it's my own fault, usually. And I post that also to apologize for why I don't post as much or as nicely as i'd like....but I'd rather post regularly poorly than not at all, mostly because of how search engine optimization works and to let people know I am stll alive.

The good news is I can see the light at the end of the tunnel. I hope to be able to respond to quite a few FB comments, blog posts, emails, etc this weekend, and I think the worst of it is over!

So....i did want some feedback. Better to post less and stop saying how tired/stressed I am, or keep up with what I am doing ? I think in general I will try at least a little bit to be more cognizant of alienating people based on this comment. I hadn't thought of if that way...

PS:I *do* appreciate the comment whether it hurts my feelings a little or not - it's good for me to hear these things to grow from and ponder!

check out top link

2011-05-25T23:39:00.001-05:00

http://www.childdevelopmentclub.org/freehandouts.htm
go here, check out top link..its a SIXTY SEVEN page PDF handout of great crafts. I only skimmed a few (I need to be working on an IEP) but one that immediately caught my eye is snack butterflies! So cute! Check it out. If I understand correctly Laura Effinger who wrote an Egypt blog has developed this website. Don't quote me on that, I read it all a little too fast for comfort.

A lot of interesting blog network development going on behind the scenes...I have not been contributing/participating yet because I'm in IEP heck (cough) but I hope to catch up eventually!!

PS: Thanks Ashley B. for posting this link on FB.

Six IEPs this week

2011-05-23T00:53:00.001-05:00

Six. So I am really extra extra phenomenally busy this week. Hence, I still am weeks and weeks behind on answering emails. My hope is that this upcoming 3 day weekend will allow me to finally answer some of those questions/comments!! :crosses fingers::

Hey, I just learned that some of the fishing lures are kind of cool and may be good sensory tools, I will explore further at Walmart soon. Also, apparently fishing weights can be a way to turn a pencil into a weighted pencil?

Also, since I discovered aquarium tubing is not FDA approved, I bought some refrigerator tubing that is non-toxic, ie for water line, but it's much more hard than the tubing that was so pliable. Hmmm. I wonder if it will work. It's still coilable, but nothing like aquarium.

And finally, don't forget that google is your friend! Some amazing stuff on there if you search!
So I just finished work on 3 IEPs, time for bed!

Karen

too Light pencil pressure

2011-05-22T18:36:00.001-05:00

Thanks all for the great ideas on too heavy pencil pressure in a post below. VERY helpful. At the time I should have also asked for help with children who write too lightly!

Here is a hand-out I came up with for children pressing too lightly...if you have ideas you want to add, please comment. This is a combo of things I've seen on the Internet + a few of my own.

Too light pencil pressure:

1) Before starting to write, provide lots of proprioceptive input to the upper body. Crab walks, animal walks, downward/upward dog yoga poses, straightening elbows and pressing straight down onto desk (weight bearing into arms) 10 times, having him push his hands together, and/or chair pushups where he puts his hands on his chair and lifts up his bottom x 10, are all great ways to do this. The more input the better.

2) Consider trying a #1 lead pencil rather than a #2 pencil as it requires less pressure.

3) Practice fine motor activities in general, including cutting, lacing beads, theraputty or play dough activities, using tweezers/tongs, finger puppets, buttoning, zipping, etc.

4) Consider buying a weighted pencil, or making your own by supergluing or duct-taping some type of weight (perhaps using a nut of a bolt/nut combo, or some heavy washers) to the pencil, higher than his grip would be, of course

5) Try using tiny golf pencils, and/or if he doesn't like it, try using thicker/wider pencils.

6) Get some blank carbon copy paper to put under his writing so that he can send a copy of his writing to a loved one, and it requires a lot of pressure to show up!

7) Before writing, regularly use his pencil (both of you do this) to show a scale of "too light, just right, too dark" where you use shades of penciling to demonstrate this. Doing it regularly before writing will help remind him.

8) After he writes, go through and point to each letter. Is this a ghost letter or a just right letter? Let him count the letters that are just right, and that's how many minutes he gets for free choice time, or how many skittles he gets, or some other reward you want to use.

caregiving

2011-05-16T00:14:00.002-05:00

I spent the weekend babysitting my grandmother (update: got a great comment about not using the term babysitting. I am good about not using condescending language in general and I would never call it babysitting to her face, but it's true I should use a more respectful term...so....I spent the weekend CAREGIVING for my grandmother) since she lives with my aunt and my aunt had to go out of town. There were all sorts of OT things I did with her in terms of getting her out of her chair, helping her in the shower, etc. All stuff that would have puzzled me pre-OT days. Down side is, I was up almost every hour with her last night, and I was already exhausted, so that certainly didn't help.

So suffice to say, I have still not gotten to my e-mails. I apologize as I feel like I have quite a few new ones to respond to!

Tonight I bought Speedstack cups on Amazon.com (about 23 dollars and a great OT toy) + a poem book called What's for Dinner? that are squirmy icky poems that I saw in a child's 1st grade classroom. Not sure what i'll do with the poems from an OT perspective but you never know! I have been making "tennis ball friends" - kids love them. The former OT I shadowed had them, plus I saw a thing on them at school-OT.com.

Okay got to get back to paperwork. Just wanted to tell y'all I'm not dead! Just not being a very good blogger lately. Still read every comment/e-mail, just slow (dead snail slow) to respond these days. Good news is, last day is a little over a month away, so I can get through IEP season! I think I can, I think I can!

iep season

2011-05-03T23:44:00.001-05:00

So tired I could cry. :) Sounds like a country song. I took a nap from 8 to 9 just to try and survive. I'm semi falling asleep at stop lights! Went to bed at 3 on Sunday night, 12:30 last night...(luckily I napped yesterday too)....it's almost 9:45 and I hopefully can be done with my highest priority stuff by 11:00::crosses fingers:::....today I had 10 minutes to eat lunch and I felt lucky! The day before I didn't get a chance to eat lunch or even go to the bathroom until 4:30pm. It's my own fault, I am new and trying to figure out too much, it was not this grueling when I was shadowing the OT whose caseload I inherited! I just need to speed up and get things under control. In the meantime, utterly exhausted. I've gotten several blog emails lately - it may be at least this weekend (or worse) before I reply, just FYI. Always happy to hear from people though! Just not quick to respond these days.

Let me reiterate that if I wasn't the perfectionistic OT that I try to be, I wouldn't be quite as insane with my schedule. More or less all my own fault. Don't be scared of school OT! (Although IEP season really is rough. My cat agrees, he is trying to help me write this). Okay I had to rant. Back to work.

updates

2011-05-03T01:29:00.001-05:00

well I was up until 3am last night working on IEPs so I am worn out! Now it's almost midnight and I want to head to bed soon but I wanted to quickly say I have been getting GREAT ideas in the comments section about kids who use too much pressure while writing! So check them out!

Busy busy busy IEP season for a school OT!

2011-04-27T22:14:00.002-05:00

I gotta tell y'all, I am woorrrrrnnn out. I have been working all day, coming home, doing a few chores (ie shower, commute, fix lunch for next day), and otherwise pretty much working all night until midnight or, like Monday night, until 2 am. It's IEP season in the schools so things are crazy! Seeing as how this is only my second week alone in this new job, I'm having to work hard to keep up with all the paperwork. But everyone I work with is phenomenal and supportive and it's going to be okay. Don't be freaked out by how much I work, I'm sure half of it is unnecessary, but it helps me feel more in control. I don't work well under stress so having the day planned out helps. Of course things change (ie I discover a kid is on a field trip) but at least I have a skeleton in place. I just need to get used to how things work (and figure out how to better organize things). I need to invent a better OT cart to carry around - I got the foldable box one from Office Depot. Not impressed. And it's not big enough either, haha. I haven't searched online to see if they have any like hardcore OT rollies that are like double deckers. I would probably be willing to pay a lot of money for a really good one, I carry this sucker around nonstop and it's about to die after only a few weeks.

I am going to try hard to do a picture post this weekend of a lot of the stuff I am using/carrying around with me. I tried to do a picture post the other night as I went through all my own personal K-4 papers of childhood, but Picasa misbehaved :( Apparently I used to spell my name backwards, ie starting with the N, e, r, a, K. And look at me, I turned out okay (don't comment)! So maybe my reversals kids will be alright too. :)

Okay so....now that I've done a brief update to say I AM REALLY CRAZY BUSY...I am really crazy busy and therefore really crazy to be blogging right now. I need to prep for tomorrow! Starting...NOW!

Copying from the board, exerting too much pressure writing...OT ideas please

2011-04-19T23:43:00.001-05:00

Needing ideas for...

A) Child using too much pressure when writing (ie thick dark lines; fatigues easily from the effort of pressing so hard)

B) Giving a 15-minute or so lesson to an entire 1st grade class on copying from the board.

Have got a few ideas that I will share at some point soon, but would love to hear from my readers in the meantime. Going to do a quick Google search now (my brain is fried for the night...proof: I spelled that brian), and then go to bed...my goal was ridiculously early and it's already an hour past that....

Sooo many decisions to make for OT playtime :)

2011-04-17T21:24:00.001-05:00

I bought a Staples "Easy" button this weekend so kids could hit the "That was easy!" button after completing a task. :) I also bought stuff in Staples dollar section, like foam alphabet and a foam elephant puzzle. And a bizarre, long twisted eraser. And some gum since some of the kids attend better with it. And some creepy bugs. And then I'm going through old stuff, I found an old magic kit that I am pondering, plus an old road trip book for kids that I might steal some ideas from (like doing the cats cradle or whatever its called, in your hands)....and I have Animalia, and an adult coloring book for some of the more advanced kids....and some poms to use with Zoo sticks....etc etc. And a $1 Pilates ring I got at Target years ago that I use to have the kids put their entire body into and then out, somewhat like putting on/off clothes. (IE put over head, wiggle over body and down to feet, step out of it, then step back in and go bottom-top.) You can also use a tied in a circle theraband to do the same thing.

I need to take pictures of my OT stash which is accumulating daily and share more of it. Or maybe make another video - my last one about my pediatric toolbox is like...3 years old. Unfortunately I think I've spent more on OT toys lately than I've actually made in salary, haha. Most of it is from the dollar store or dollar sections, but it adds up quickly. :) And then I have a lot in my old craft bins I'm grabbing. It's a little overwhelming actually. Too much of a good thing, in a way. I need to figure out just what I want for tommorrow's kids and not go crazy figuring out the rest! :) One day at a time.

I also printed out a bunch of Tonya's TherapyFunZone stuff, like animal shapes and cootie catchers!! (I totally wrote cootchie by accident....that would be inappropriate).

One thing I'd love some feedback on is BEHAVIOR strategies. Like if I have a elementary school aged child who avoids cutting, drawing, writing, etc, how do I encourage them to do it? I am guessing people will say to avoid it for the most part as well and focus on underlying skills that are deficient and causing the difficulties. Or say use rewards. I just read an article on kidsatthought.com about how using reward systems is ultimately not helpful long-term. I think for a while, as the kids get used to me, since I'm new to this job, I will try to focus a little more on fun stuff so they grow to like me...then once they like me and think they're gonna have fun, I bring out the hard stuff and show them how wrong they were. :) KIDDING - I'm very big on making OT fun for them. Magical. But that takes a lot of hard work. So. I'm working on it. And I can't work on it if I am blogging. So. Off to go print stuff and go through my big ol' toolbox to figure out tommorow's games!

One wise OT (Orli I think?) once told me I could use the same activity in a given day with each kid, but modify it accordingly. IE a day where the children make spiders - it could be made easy or hard depending on how much cutting, gluing, coloring, writing about it, etc....and obviously based on what the child is working on in OT. So a kindergardener and 5th grader could do it at varying levels of difficulty and be working on completely different things. (IE one child is doing it for sequencing, another for fine motor). I liked that idea. I wouldn't do it all the time, but I could see how occasionally it would work well. Especially on theme days, like near Halloween.

Notice how I said I was off to do something then wrote another whole paragraph. Not cool, Karen. Okay this time I mean it. :)

Treating Private Patients in OT

2011-04-16T14:35:00.004-05:00

Jena Casbon contacted me about writing this article - I think it's interesting. I hadn't thought about taking a private patient or two on the side. And I probably wouldn't do it any time soon since I don't have enough years of experience. But it's something to think about for the future. :) PS I have no idea how it works from a billing standpoint!

Treating Private Patients: A Great Opportunity for OT’s

Experiences During School Will Prepare You For...
It never ceases to amaze me how rich and diverse the field of Occupational Therapy is. Many incoming and early graduate students tend to think of our field in terms of:

age range (mostly in terms of "kids or adults")
specific impairments such as arm and hand dysfunction, sensory integration, dementia, vision impairments, driving safety, or ADL’s
areas of practice such as physical health, mental health and community
treatment settings such as pediatrics, rehabilitation in hospitals, home health, private clinics, work hardening

Throughout your undergraduate/graduate coursework and clinical placements, you will gain exposure to a wide variety of age groups, disorders and practice locations. These experiences will help build your clinical skills, while molding yourself into a competent clinician.

Your Early Career
The first year after graduating from your OT graduate program is a both stressful and liberating time in your career. In many ways, you are on your own now: able to work on the areas where you feel your patient needs the most help. This degree of autonomy can be scary for many new grads, but hopefully your supervisor, colleagues or former graduate school classmates can support and encourage your clinical decision making.

During the first few years of your career as an Occupational Therapist you will continue to learn so much about disorders, how patients can present differently, how to manage patients and family dynamics, etc. At this stage you will likely begin to gravitate to a specific age group, diagnosis, etc. I urge you to take as many continuing education courses (CEU's) as you can as you build your expertise. You may even opt to change jobs or settings in order to gain more exposure to different aspects of our field. All of these things will help you to grow and provide excellent care for your patients.

I Wonder If I Could Ever Have A Private Practice...?
Almost every OT friend of mine started out dreaming one day of having a private practice- but as they got into the field more and more, the safety of a regular job with consistent pay won out over the risk of going out on their own. To be honest, starting a private practice has a lot of extra work, extra responsibilities and headaches- but the trade off of high-income and more autonomy is very alluring for some people.

Private Patients: A Great Way to Start
Most of us got into this field because we love to help people, not because we wanted to make money. As time goes by though, the reality of car or house payments, wanting to have extra income for our families, vacations, etc. starts to hit and we become frustrated with our regular pay. Another benefit to private patients is flexibility of your schedule and also getting to treat ideal patients. Treating privately is a great way to help more people while making more money by seeing one to several private patients on the side.

How Does Private Therapy Work?
At some point, you will know colleagues that are treating private patients and a patient or family member will ask if you can provide private treatment. Private occupational therapy is often requested as a way to deal with:

to provide consistent therapy during gaps over the summer for school-aged children
to supplement therapy already being received (kids or adults)
to continue therapy if insurance won't continue to pay for services (kids or adults)

Most private therapy occurs in the patients' home and OT's are paid either through cash/check or reimbursed through an insurance company. Therapists need to have their own liability insurance, document their treatment, market their services to obtain more clients and pay taxes on this extra income. Most therapists charge between $75-$125/hour for their services.

Is Private Therapy Right For You?
I recommend that you have at least 2-3 years experience as an OT before you begin treating privately. You need to build up your expertise in a diagnosis or treatment technique so that your services are truly valuable to your private patients. Because you'll be doing this on your own, you need to develop a level of confidence about both your clinical and business skills before you start. Starting to see private patients is almost like your first year of practicing all over again. Once you have some practice and experience, you'll feel much stronger. Some clinicians start with private patients and then graduate to starting their own free-standing private practice- others keep their regular job and see private patients on the side.

I hope this has helped open your mind to yet another really cool aspect of the field of Occupational Therapy!

________________________________________________________________________________________________
Jena H. Casbon, MS CCC-SLP is a Speech-Language Pathologist and founder of The Independent Clinician. After graduating from Emerson College in 2005, she has worked with adult outpatients in a rehabilitation hospital and inpatients in a skilled nursing facility. Three years into practicing as an SLP, she began treating private patients- but the lack of a "how-to guide" bothered her, so she wrote one.
Follow Jena on Twitter @IndClinician and Facebook http://www.facebook.com/independentclinician
Be sure to visit http://www.IndependentClinician.com to learn more about how to treat private patients.

Blogging blizzard complete

2011-04-13T01:38:00.002-05:00

I am sorry if your eyeballs have popped out of your head after like fifty thousand new blog posts. I got through literally hundreds of e-mails. Again, at expenses of taxes, cough. So when the IRS comes knocking at my door, I blame y'all. :)

I finally realized what I should have done - is save them all as drafts and then post like, one a day, rather than posting five thousand at once. I didn't realize this until late in in the process. So now I have like six saved to do over the next few days/weeks as I remember....I don't know how to automatically post them regularly at a certain time, with blogger.com. Dunno if it's possible. Don't care enough to find out.

I look forward to all y'all's comments!! One thing about catching up on e-mail/blogging is that then you get this whole new deluge of comments/e-mails. A vicious cycle. BUT I LOVE THEM SO PLEASE E-MAIL/COMMENT YOUR HEART OUT. I'm just slow to respond!

So it took me about two hours to do this blog blizzard - my cat is bored. That says a lot. Good night.

Matthew, a UK OT asks about Fieldwork placement...

2011-04-13T01:18:00.001-05:00

Matthew asks:

Not sure if this is appropriate to ask for input from your readers as I don't know if you have many from the UK but we are looking to offer an internship / placement opportunity to prospective OT students and would love to get any feedback around what would be the most helpful way of structuring this to make sure we give the students the most benefit:

http://www.inclusion.me.uk/blog/want-to-work-with-us-want-to-become-an-ot-or-get-back-to-being-an-ot-after-some-time-out-get-in-touch/

Any feedback from your readers would be fabulous and well done once again and hope it all goes well.

Matthew

Tips to Incoming OT Students? Anything to add?

2011-04-13T01:06:00.003-05:00

I was asked recently (by an enthusiastic Klaudia) if I had any updates to my "Tips to Incoming MOT Students", seeing as how I wrote that in month into OT school and now I've been out for several years. http://otstudents.blogspot.com/2007/04/tips-to-incoming-mot-students.html, and so I re-read it and decided....that first of all, wow, I wrote that in April of 2007, so this is five years later, zomg. :) I feel crazy old. But you know what? All those tips are still true. I don't think I have any new ones to add - the ones about being flexible and remembering the OT world is small (so watch the gossip) are probably the most valid. Anybody else have thoughts on the matter? New ones to add?

Updated my sidebar with new (to me) OT blogs

2011-04-13T01:03:00.001-05:00

Linda at http://www.lindasdailylivingskills.com has some really thorough and insightful blog posts on OT!

Dani, who says "Oh, add mine, add mine! I'm an OT student in the UK in my second year. It's not entirely about OT, but about my life learning in general." http://www.munchkinandflan.com

Tink who is about to become an OT student, http://tink343-unistudentlife.blogspot.com/

Mendel, with a really thought-provoking site at http://kidsatthought.com/

Don't forget to check out TherapyFunZone http://www.therapyfunzone.com/ which has great stuff (I saw she very recently posted some new ideas!) and I am also loving OT in Public Schools http://otinpublicschools.blogspot.com/

I recommend using Google Reader or some other RSS reader so that you know when new posts come in, all in one spot, rather than having to go check each blog individually. I love Google Reader. :)

Nurse in Haiti

2011-04-13T00:44:00.001-05:00

My cousin is a nurse who recently went to Haiti to help out for a week. She wrote us two mails - here is one and hopefully I will find the other one. I also know an OT friend who went to Haiti a few months after the earthquake and I am hoping she will share some of her experiences here! I just asked her. :) I know this is an OT blog and not a nursing one, but hey, it's healthcare, so good to see the perspective!

--------

Update:

No way I can even BEGIN to describe it here but, on a quick break so, little update.

First of all, wow! This experience is a real exercise in patience. For example, I'm hungry. We get 2 meals a day, 10am and 4hours later, 2pm (mind you, I am working nights so the food comes while I am sleeping). Luckily, I had found a stash of granola bars etc. in the fridge, which, was like gold. Then today, I went back, and the whole bag was gone. My heart dropped. Lying in bed, I was agonizing over the stolen power bars, "Why didn't I steal them first!?" I have never been in a place where there is no option for more food. So, I was lying there, trying to fall asleep, literlly unable to get the damn hyjacked granola bars off of my mind when I realized... what is really keeping me from falling alsleep? Am I really that hungry. When I focused more on the sensation of hunger, I realized, its not that bad... it was the frustration and loss of security of knowing that there is backup food that was really bothring me. So now, Im better... 2 meals a day is more than most people here get. I am definitely not starving. So, se la vie.

Many other things are difficult. It's cold (the americans I room with insist on air conditioning the room). I don't have a towel. Don't have lots of things... but, Ive adjusted...

I am working nights, 6pm-6am. Haiti is a total mess. When we arrived, people were hanging on the fences, clawing through the holes, yelling... Our haitian escorts rushed us through the crowds, jammed us into the back of a van, and swept us away. We are not allowed to leave the hospital compound... absolutely forbidden. And from the looks of the people comming through the ED, I understand why. lots of stab wounds, gashes, broken bones, etc.... Not even a local will walk home alone at night. I feel like I am working in a refugee camp. I have never before been somewhere so isolated... with no peek, other than the injured patients, at what lies outside the walls of this compound.

We arrived Sat around 10am, had orientation, slept a few hours and started working that night at 6. Luckily, I am here with a coworker, "T", and we were placed on the same shift. We literally jumped in. The "med surge" beds,"ëmergency room" and "icu" are all connected so, we work where we are needed. Last night, when the stab victim came in, I was on one arm starting an IV, another nurse on the other, and a 3rd woman priming bags of normal salined to start pumping fluids back into her. Everyone here works togeter... there is no doctor this, nurse that.... if a job needs to be done, you figure it out, and do it. Period. We don't know where anythings is, the supplies are noexistent or different, but, you do what you can do. I have started reusing gloves because we are running out. There is not even a sink to was your hands in. No soap. All the beds are in one small room, the family members stay close by and feed, toilet, and clean their loved ones. People, when they can, pee on a bucket on the floor.

I signed up to donate blood. That will be the one time I will get to get out of this joint and see what is going on behind these walls. There is no blood here. At home, we transfuse at a hemoglobin of 7, sometimes even 10. A woman came in today with a hemoglobin of 2! I didn't even know that was possible.

We will be working all 7 days. We sleep in bunk beds (there are 7 night nurses in one room) outside of the emergency room. I can not even put this experience into words quickly enough (I have to get back, I am on shift right now) but, let me say....

I don't know how I waited 29 years to do something like this. I am reconsidering my entire life plan and trying to figure out if it is possible to work internationally while being a mother. I have never in my life had such a humbling experience. I have never seen people that love their families so much. THIS is medicine. THIS is healthcare. There are no rules in place that dumb down the decisions you make or the actions you take. You look, listen, assess, and treat.

One of my patient's today is a 15 year old boy who was hit by a car, thrown up into the air, and broke his femur when he landed back on the top of the car.... I can't speak with him but, I wish I could. I wish I could comfort him more, give him a game to play with.... I considered bringing out my ipod but then realized it would likely create more drama that happiness. He is so stoic.

It's probablly 90 degrees here and we have no cups. We give patients water 30cc's at a time (less than a shot glass).

I could go on and on and I have only been here 1...2? days (nights is so disorienting).

All I know is,

this is life.

It kinda sucks (soap and a towel would be nice considering the blood I am stepping in) but, it's so invigorationg to feel like I am actually doing something with my life.

p.s. sorry for all the typos, super rushed,

xox

The classic, "perspective" we get when we leave our cushy lives.

Anwyas, internet here is spordic (there is one sometimes functioning laptop for all of us), but, Im here, safe, and happy.

SpongeBob washing + OT month in Times Square!

2011-04-13T00:39:00.001-05:00

Basically I am going through months of mail including newsletters, emails from former co-workers, blog comments, e-mails, etc, hence the massive posts right now as I try to clear through the mailbox - I still have 76 new mails + over a 1,000 to go through. :( Anyway, two random bits

1) During this month (OT MONTH! APRIL IS OT MONTH!), Times Square in NYC is running an advertisement for OT EVERY HOUR! That is CRAZY! Have any of you seen this? :) Definitely high-def.

2) A former-coworker/supervisor/physical therapist wrote me to tell me that one of my OT ideas is still a hit for the child to do while in PT! I got a turkey baster from the dollar store, filled a bin with water, and then the child "washes" SpongeBob using the turkey baster - I had a SpongeBob PotatoHead that likes to be washed! I left him in my former clinic because he was so popular. Anyway - so - idea - have the child use a turkey baster to "wash" their favorite toy. It works on the child's hand strength and a little on sequencing - so it can be an OT tool by itself, or it can turn into a PT tool if the child is using it as an engrossing activity while working on standing/kneeling/whatever! :)

I love OT, yes I do.....

2011-04-13T00:32:00.001-05:00

I love this!

One of my blog readers/now Facebook friends/current OT student/current OT student blogger, who I will label "M", wrote me to let me know one of her classmates found my blog by googling "I love OT". And then that classmate discovered through my sidebar that "M" had a blog too! Small world. I LOVE that my blog was found by googling "I love OT". And I love that M's classmate googled that in the first place. :)

Hey, speaking of loving OT....

http://www.youtube.com/watch?v=DJRIVUOtCzs this was our Miss OTPF pageant from 2008, one of our silly OT contestants was a cheerleader who cheers about OT spirit. :)

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