Tuesday, April 21, 2015

OCCUPATIONAL THERAPY: It's the Little Things that Make Life BIG!

Thanks to Heidi at PediaStaff for asking Susan to write this "OT Month" post. Visit pediastaff.com 
to learn about therapy job openings. Their website is full of amazing resources for parents and therapists!

Greetings from the Last Frontier, the 49th state!

Alaska…where salmon is a staple and hearts, mountains, glacial lakes, eagles, bears, and moose are BIG!

The role of occupational therapy in a place of pioneering spirits and independently minded individuals can take varying forms and occurs in a variety of locations, including hospitals, skilled nursing facilities, rehab centers, home health, outpatient clinics, school systems and pediatric practices. Problem solving is heightened to a new level when considering the natural elements such as developing methods to make the trudge from a dry cabin residence with no running water into an outhouse at -40 degrees on a snowy path while using a walker or with reduced vision except for Northern lights swirling above. It may include donning a pair of mittens with one hand in order to observe an Ice Carving Competition or perhaps to assist and place a child in a car set during a blizzard. Plugging in your car while avoiding frostbite and hypothermia with reduced sensation or mobility can be quite a challenge as well!

Adapting a sled for a child with cerebral palsy or helping an injured ice hockey player with arm propulsion and balance to make a strike against the puck would also be vastly appreciated by many! Perhaps the task would include exploring how to most effectively use an electric scooter on the sidewalks of the renowned University of Alaska at Fairbanks so a college student can maintain independence and live in the dorm. A “ simple” task of successfully carrying a bag of groceries while maneuvering safely over an icy parking lot with a cane or wheelchair can surely be reason for celebration! How to sew on a moose hide or attach a beaver ruff on a pair of beaded slippers with arthritis or after carpel tunnel surgery may be culturally relative dependent on who is seeking assistance. Adaptively harnessing a sled team of lively Huskies would also “increase the anty” or stretch the adaptive mind and create an interesting scenario of trial and error. Whatever the daily task, one knows that duct tape is certainly on a list of adaptive devices and OT’s have a role.

Or…..perhaps in the world of pediatric OT it may all begin with therapeutic play, observation and treatment of the whole child by nurturing adults, and inclusion of children in a challenging developmentally sensitive environment such as a preschool with disabilities classroom where I have happily worked the past two school years. Opportunity is a key phrase with a keenly organized educator who has designed a program where modeling and instruction in the areas of language, socialization, sensory and movement activities are the norm! It is in this setting that I have had the absolute privilege to be involved with a precious five-year old boy’s life here in Fairbanks, AK! In the large picture, the “ little things of OT intervention ” do add up!

A rough beginning, including possible substance exposure and being kept in a playpen for years, shifted when this un-named youngster began attending a preschool program for children with disabilities at age 3 ½ years old! With encouragement, support, and ongoing communication this kiddo has evolved from a starting point of being nonverbal with no eye contact and self injurious head banging (with rapid grabbing of a helmet by staff) to a child that is speaking in 5-6 word sentences, sharing toys, following two step directions, and now seeding and zipping his own jacket as I just sat in his classroom and watched as he independently put on his “ winter gear” in April to ride a bus home to his incredible foster family.

Earlier OT sessions consisted of sensory strategies and structured play focused on imitation of positions and actions, reciprocal play of rolling a ball and sharing space without aggression and with eye contact in a shared experience, and concentrated work on functional use of toys or use of hands for interacting with the world. Gone are the days of rice and bean trays, ball bath play, hoola hoops to mark the spot of where to stand and hand over hand assistance for fine motor activities.

This super star is now using his vision and hands in a coordinated manner and is writing his name on his own spontaneously, creating sand and starfish collages and Easter egg pictures with sequenced actions of cutting and gluing, offering dinosaurs to his friends, and is using greetings of “Hi and Bye” throughout the school with a broad smile! Story and circle time takes on new meaning when you can sit attentively and have the self regulation or nervous system readiness to look, sit, attend, and learn while taking turns in “ show and tell.” Lining up of trains has been replaced with dress up activities, puppet play, book reading, coloring and building of elaborate constructional towers with a friend close by while gaining a teachers attention because a peer is crying and empathy is budding! The building blocks for school success are in the making!

With the high expectations of a highly dedicated educator, speech language pathologist, OT, foster parents, paraprofessionals, and direct and collaborative OT services, this little guy has shifted from using his peripheral vision and hands to “fly” and touch air particles on a regular basis to being a jokester in class, demonstrating explorative play, being tuned in, and transitioning well within his classroom and in the school environment! A transition card is no longer needed and this young boy now follows in line for visits to the library, gym, outside recess area, and on treasure hunts in the hall! A silly rubber green octopus head is placed on the end of a yoga “magic wand” and my little friend was gleefully just crowned “ King Yoga” in his weekly OT led yoga class. The various poses of “Down Dog, Cobra, Giraffe, Rainbow, and Butterfly,” are proudly executed as this young boy meets the motor planning, sequencing, two sided coordination, body stability, balance, and listening skill challenge of the hour!

Our unnamed boy, this young bundle of joy, is chosen to be a helper up front and center and waits attentively for directions and then beams as he leads his friends! All of this is accomplished, these “ little things” as fifteen preschoolers from two classes move through their typical day, week after week. OT has been a small part of this student success and my heart is warmed even on a blustery 35 degree April day in the Northland. OT truly does make a difference! Happy OT Month to you!

The author, Susan Mullins, OTR/L, is an occupational therapist with 28 years experience who values life long learning, creative OT practice, and Northern Light gazing. She enjoys long distance hiking, leisurely strolls, reading, international travel, and relaxing with her adopted dog “ Belle.”A sojourner of life she continues to explore Alaska and many new corners of the world. Susan can be reached at smullins4[at]gmail.com for any who are interested in corresponding.

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1 comment:

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