Tuesday, July 30, 2013

Teaching Functional Skills


The following is reprinted from an article by Preston Lewis which appeared in the December 1987 TASH newsletter under the title shown below. I have had it posted on my bulletin board at work for over 20 years. Every time it read it, I'm reminded of why I became an occupational therapist.

A CASE FOR TEACHING FUNCTIONAL SKILLS

My Older Brother Daryl.
18-years old, (30-40IQ)
Been in school 12 years.
Never been served in any setting other than elementary school.
He has a number of years of “individual instruction.”
He has learned to do a lot of things!
Daryl can now do lots of things he couldn’t do before!

            He can put 100 pegs in a board in less than 10 minutes while in his seat with 95% accuracy.
But, he can’t put quarters into vending machines.
            Upon command he can “touch” his nose, shoulder, leg, foot, hair, ear. He’s still working on wrist, ankle, hips.
But he can’t blow his nose when needed.
            He can now do a 12-piece Big Bird puzzle with 100% accuracy and color an Easter bunny and stay within the lines!
He prefers music, but was never taught how to use a radio or record player.
            He can now fold primary paper in halves and even quarters.
But he can’t fold his clothes.
            He can sort blocks by color; up to 10 different colors!
But he can’t sort clothes; whites from colors for washing.
            He can roll Play Dough and make wonderful snakes!
But he can’t roll bread dough and cut out biscuits.
            He can string beads in alternating colors and match it to a pattern on a DLM card!
But he can’t lace his shoes.
            He can sign his ABC’s and tell me the names of all the letters of the alphabet when presented on a card in upper case with 80% accuracy.                                  
But he can’t tell the men’s room from the ladies’ room when we go to McDonalds.
            He can be told it’s cloudy/rainy and take a black felt marker and put it on the day of the week on an enlarged calendar (with assistance).
But he still goes out in the rain without a raincoat or hat.
            He can identify with 100% accuracy 100 different Peabody Picture Cards by pointing!
But he can’t order a hamburger by pointing to a picture or gesturing.
            He can walk a balance bean frontwards, sideways, and backwards!
But he can’t walk up the steps of bleachers unassisted in the gym when we go to a basketball game.
            He can count to 100 by rote memory!
But he doesn’t know how many dollars to pay the waitress for a $2.59 McDonald’s special.
            He can put the cube in the box, under the box, beside the box, and behind the  box.
But he can’t find the trash bin in McDonald’s and empty the trash in it.
            He can sit in a circle with appropriate behavior and sign songs and play Duck, Duck, Goose.”
But nobody else in his neighborhood his age seems to want to do that.
            I guess he’s just not ready yet.

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9 comments:

  1. Anne, This is amazing. Such an eye-opening reminder that OT is about function! Thanks so much for sharing it. I will do the same!

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  2. As I'm sitting here preparing for my NBCOT-OTR exam in a few weeks, this is a huge eye opener. Function is the key! Thanks :)

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    1. I wish you the best on your exam. I'm sure you'll do well!!!!

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  3. Love this, will share , thanks :-)

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  4. Thanks for the opener as a new school year is about to begin

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  5. BRILLIANT!!!! Wow, I just love this!!!

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  6. Simply lovely and what more do we want!

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  7. This makes me think of two things: my time in therapy and my preference for French over English for many years...In French in school I learned how to have a conversation including variations in the same conversation based on the situation and the response of the other person, whereas in English I learned random grammatical rules that I didn't really have much use for--that's not the way "real people" communicate...as a result I craved French class and hated English, and for years if I was stressed out my brain switched into French (unfortunately as I learned to communicate I lost the French and can barely speak it anymore)...and in therapy I was taught talk to this person in this situation with these words...and it was too specific, as soon as something changed I was lost again because I wasn't being taught the reasoning behind it so I couldn't generalize from the specific example into how to modify it for future conversations...

    I think this is a powerful reminder to meet people where they are at...giving enough specifics to make the information useful but also providing generalizations so that the information can be applied appropriately...Clearly things like counting are great, but they are not very useful until you know what the numbers mean...LOVE this :)

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