Never write anything on snow. You will be inundated by an ice blizzard and be the only therapist for the entire hospital. If you survive, you will definitely regret writing about snow.
1.28.2009
1.27.2009
OT WebGems- Snow Driving Edition
I loved snow days as a kid (who doesn't?) but as someone who spent an extra hour today scraping the windshield before and after work plus the 'commute' I am not in such a friendly mood toward snow. (I do prefer it, however to the days where I go to work in the dark and come home in the dark.) At any rate, snowy days always seem to make you realize how many people don't know how to drive in the snow. I was going to list my favorite tips, but why reinvent the wheel. After the jump are some good little tip sheets on snow driving, PLUS my addition of the #1 to #3 most needed tips.
Sorry, no cute writeups today. However, as promised, the tips that people really should remember:
#1- If you don't HAVE to drive, then don't. If you work outpatient, call and see if you have cancellations, or tell them you can't make it in initially. If you do home visits, such as early intervention or home health, cancel in bad weather. Even if it will be difficult for your coworkers, trust me, they'd rather have you late than dead.
#2- Learn to drive by practicing. It should be part of everyone's learn to drive experience to take the car into a snow covered parking lot and learning how to handle the car. Practice the tips in the following articles, figure out how it feels when the car skids so you don't panic.
#3- Drive on main roads. Surprisingly, this tip is not included in the other articles, and perhaps they were written in more urban areas. If you can avoid a backroad, even a lesser used road in town, by taking a more frequented (also hopefully flatter and wider) path, then you will likely have less difficulty.
http://www.edmunds.com/ownership/howto/articles/45193/article.html
http://www.weather.com/activities/driving/drivingsafety/drivingsafetytips/snow.html
http://car-reviews.suite101.com/article.cfm/how_to_drive_in_the_snow
http://chicagoweekendfun.com/2008/12/01/how-to-drive-in-snow-and-ice-chicago-winter-blizzard-style-winter-driving-tips-saftey/
http://www.safemotorist.com/articles/winter_driving.aspx
Sorry, no cute writeups today. However, as promised, the tips that people really should remember:
#1- If you don't HAVE to drive, then don't. If you work outpatient, call and see if you have cancellations, or tell them you can't make it in initially. If you do home visits, such as early intervention or home health, cancel in bad weather. Even if it will be difficult for your coworkers, trust me, they'd rather have you late than dead.
#2- Learn to drive by practicing. It should be part of everyone's learn to drive experience to take the car into a snow covered parking lot and learning how to handle the car. Practice the tips in the following articles, figure out how it feels when the car skids so you don't panic.
#3- Drive on main roads. Surprisingly, this tip is not included in the other articles, and perhaps they were written in more urban areas. If you can avoid a backroad, even a lesser used road in town, by taking a more frequented (also hopefully flatter and wider) path, then you will likely have less difficulty.
http://www.edmunds.com/ownership/howto/articles/45193/article.html
http://www.weather.com/activities/driving/drivingsafety/drivingsafetytips/snow.html
http://car-reviews.suite101.com/article.cfm/how_to_drive_in_the_snow
http://chicagoweekendfun.com/2008/12/01/how-to-drive-in-snow-and-ice-chicago-winter-blizzard-style-winter-driving-tips-saftey/
http://www.safemotorist.com/articles/winter_driving.aspx
Mini Sensory Success
I am seeing a 3 y.o. girl with PDD who is wonderfully high functioning and has very involved parents. She has some sensory issues and particularly HATES having her hair brushed. During our session, even though she was hyped up on sugar following speech therapy, after some deep pressure through shoulders and head (GENTLY, GENTLY, GENTLY! HAVE AN OT SHOW YOU FIRST!) she sat there and let me brush and do her hair. Then we took it out and had mom repeat the process w/o difficulty, and mom was really happy to have learned something she could directly apply at home. If kid and parent leave feeling happy and more knowledgable, then I feel like I did my job well that day.
1.25.2009
Giving an Inservice
I got an email recently asking for tips on picking a topic for an inservice presentation, which is usually a requirement for students during fieldwork. Here are some tips.
Selecting a topic- some sites or supervisors will save you the thought of this step by already spelling it out in your fieldwork documents, usually in the form of "You will do a case study." Otherwise, you will have to choose. My advice is to pick something that falls into one or more of these categories:
-Something you are interested in
-Something you would like to learn more about
-Something that your coworkers have expressed interest about
If you do a case study, pick out one special client and tell what you did that was special or innovative to their treatment. If you helped to develop a tool or a really different treatment with any client, overcome a difficulty in their treatment that you didn't think you could, that's a good case study.
If there's a frame of reference or new treatment idea that you learned at school that your coworkers haven't heard of and haven't had time to research, that's always a possibility. Some places still haven't been exposed to the practice framework language and are continuing to use uniform terminology. An update on the new language with examples of how to apply that to documentation is a good way to bring your site up to speed.
If you get a lot of clients with the same diagnosis, try to find a systematic review of the evidence and then showing how that research can be applied to client treatments. That would be helpful as many practitioners don't have or make the time to do evidence searches and often don't have access to all the awesome library resources you do as a student.
Other planning tips- take note during other students' presentations, as well as those done by paid workers. This gives you a better idea of the kind of presentation expected- do they want a full powerpoint or just an informal discussion? If you can't discern this from observation or asking your supervisor, then opt to be more formal.
It's good to plan on technological mishaps. Be able to give your powerpoint presentation in an effective way even if someone breaks the projector the day before. Minimize potential malfunctions by being familiar with the hardware (your computer or the staff computer, the projector, etc). Remember that powerpoints created on newer versions of microsoft office don't play the same on old versions- a better option instead of just opening the file from a disk or thumb drive is to Pack and Hold your presentation to a CD. This enables you to drop the CD into any computer (I don't think it even needs office on it) and your presentation should run just fine.
Don't forget to leave time for questions... I've found that often people don't have any, but if they do and you don't address them, it could lead to a poor reception of your overall project.
Above all, be relaxed and confident in your information... an inservice is usually the sign that your fieldwork is drawing to a close, so just think that you are addressing your colleagues instead of being graded by a supervisor.
Selecting a topic- some sites or supervisors will save you the thought of this step by already spelling it out in your fieldwork documents, usually in the form of "You will do a case study." Otherwise, you will have to choose. My advice is to pick something that falls into one or more of these categories:
-Something you are interested in
-Something you would like to learn more about
-Something that your coworkers have expressed interest about
If you do a case study, pick out one special client and tell what you did that was special or innovative to their treatment. If you helped to develop a tool or a really different treatment with any client, overcome a difficulty in their treatment that you didn't think you could, that's a good case study.
If there's a frame of reference or new treatment idea that you learned at school that your coworkers haven't heard of and haven't had time to research, that's always a possibility. Some places still haven't been exposed to the practice framework language and are continuing to use uniform terminology. An update on the new language with examples of how to apply that to documentation is a good way to bring your site up to speed.
If you get a lot of clients with the same diagnosis, try to find a systematic review of the evidence and then showing how that research can be applied to client treatments. That would be helpful as many practitioners don't have or make the time to do evidence searches and often don't have access to all the awesome library resources you do as a student.
Other planning tips- take note during other students' presentations, as well as those done by paid workers. This gives you a better idea of the kind of presentation expected- do they want a full powerpoint or just an informal discussion? If you can't discern this from observation or asking your supervisor, then opt to be more formal.
It's good to plan on technological mishaps. Be able to give your powerpoint presentation in an effective way even if someone breaks the projector the day before. Minimize potential malfunctions by being familiar with the hardware (your computer or the staff computer, the projector, etc). Remember that powerpoints created on newer versions of microsoft office don't play the same on old versions- a better option instead of just opening the file from a disk or thumb drive is to Pack and Hold your presentation to a CD. This enables you to drop the CD into any computer (I don't think it even needs office on it) and your presentation should run just fine.
Don't forget to leave time for questions... I've found that often people don't have any, but if they do and you don't address them, it could lead to a poor reception of your overall project.
Above all, be relaxed and confident in your information... an inservice is usually the sign that your fieldwork is drawing to a close, so just think that you are addressing your colleagues instead of being graded by a supervisor.
Before you go go
There's definitely an adjustment period to working in a hospital. Figuring out all the codes to the different supply rooms, learning the tricks to manhandling trays and hospital beds... it's those kinds of skills that come with practice. But until it becomes second nature, you still have a lot of things to check at the end of session. Here's some things that you should remember to check before leaving a pt after a treatment session to keep them safe and happy. Applicable to hospital and SNF rooms, a good checklist if you're new to the environment.
Ideally, you should just be reversing everything from your session so that the person is in the same condition as you found them, however, it's good to remember these things as there are often moments a person is without a crucial item.
Ideally, you should just be reversing everything from your session so that the person is in the same condition as you found them, however, it's good to remember these things as there are often moments a person is without a crucial item.
- Bed brakes locked, bed height lowered
- Top 2 siderails up (some facilities have a policy against this, mine is all for it. If your individual had all four rails up, recreate that)
- Bed/chair check applied (as applicable)
- Tray table either parallel to bed or across pt's lap (helps keep everything within reach)
- Call bell in reach (can tie to bedrail or clip to sheets)
- Phone in reach, attached to bedrail
- Urinal in reach (I try not to put these on the tray... germy)
- Restraints applied (as applicable- generally if the person has UE restraints I only have one arm out at a time. Also remember those bedrail covers)
- Abduction pillow and other braces applied (as needed)
- Oxygen on person and turned on at wall (as applicable)
- Empty BSC or bedpan if it was part of your tx
- Any changes in status or other requests reported to nursing
1.22.2009
I shall return!
Ack, sorry about the delay in postings. It is a goal today to post about the job site eval I did (once I finish writing it up!). I also have 7 partially written updates, and one really important one that I need to get written, and they will be finished at some point. Have to go run some errands now, but I will get back to blog life soon. :)
1.18.2009
Hopefully prepared
Tomorrow is my very first jobsite analysis... hopefully I am fully prepared. Have read up on diagnosis, reviewed info on repetitive strain injury, and taken notes from my old textbook "Ergonomics and the Management of Musculoskeletal Disorders" (this is why you keep the books). Have to make copies, get camera, get measuring tape, and find a goniometer before meeting up with my worker at the far too early time of 730 am. So it will have to be an early night... wish me luck!
1.14.2009
Some new unexpected opportunities
Past few days have brought about some new unexpected opportunities (TITLE ALERT!).
Our current SNF floor crowd has several back breaking patients who are MAX-DEP A 1-2 for bed mobility (none of whom have actually made it into standing yet). Hopefully my body mechanics will go well... I have some proprioception impairments. We've also got a fresh batch of people who place a high priority on their naps, instead of rehab. Another challenge to productivity. :-/
My one coworker who has been the resident expert on FCEs and work hardening (much to his chagrin, as he is also the resident expert on hands. and lymphedema. and thus, rather busy) casually mentioned that he had a worksite evaluation to do as a courtesy for another hospital employee. I didn't even know that we did that! At any rate, I have had an interest in ergonomics and other work hardening things, and this is a cool easy way to dabble in it a little bit. I know that I can't do FCEs and the pediatric tx at the same time... I think it would put me into some terrible personality issues going from one extreme to the other like that.
Also, I have decided to add a new little feature in here. Energy conservation/work simplification is one of the relatively few things that I enjoy about the SNF environment, and I have a lot of good tips for multiple situations since I use so many myself. So look for up to a dozen pieces in the coming year on energy conservation in different situations.
And in the "I knew it was coming, but now? Already?!" category, my one coworker near my age (actually a couple years younger) announced that she is pregnant(!). And for the moment she says that she'll be sticking around through the delivery and afterward as well, so it will be interesting to work so closely with someone as they go through this life transformation. I've never really had that kind of close contact with someone for the day by day updates. My first fieldwork supervisor was 6-8 months pregnant during my time with her, and it did not slow her down in the least. It'll be interesting to see how this goes with my coworker, and to theorize how it could go in my future... far future, preferably!
Our current SNF floor crowd has several back breaking patients who are MAX-DEP A 1-2 for bed mobility (none of whom have actually made it into standing yet). Hopefully my body mechanics will go well... I have some proprioception impairments. We've also got a fresh batch of people who place a high priority on their naps, instead of rehab. Another challenge to productivity. :-/
My one coworker who has been the resident expert on FCEs and work hardening (much to his chagrin, as he is also the resident expert on hands. and lymphedema. and thus, rather busy) casually mentioned that he had a worksite evaluation to do as a courtesy for another hospital employee. I didn't even know that we did that! At any rate, I have had an interest in ergonomics and other work hardening things, and this is a cool easy way to dabble in it a little bit. I know that I can't do FCEs and the pediatric tx at the same time... I think it would put me into some terrible personality issues going from one extreme to the other like that.
Also, I have decided to add a new little feature in here. Energy conservation/work simplification is one of the relatively few things that I enjoy about the SNF environment, and I have a lot of good tips for multiple situations since I use so many myself. So look for up to a dozen pieces in the coming year on energy conservation in different situations.
And in the "I knew it was coming, but now? Already?!" category, my one coworker near my age (actually a couple years younger) announced that she is pregnant(!). And for the moment she says that she'll be sticking around through the delivery and afterward as well, so it will be interesting to work so closely with someone as they go through this life transformation. I've never really had that kind of close contact with someone for the day by day updates. My first fieldwork supervisor was 6-8 months pregnant during my time with her, and it did not slow her down in the least. It'll be interesting to see how this goes with my coworker, and to theorize how it could go in my future... far future, preferably!
1.05.2009
Success Stories
Therapists, parents, teachers- Have some pediatric success stories? Your Therapy Source Inc is soliciting these for inclusion on their website and possibly elsewhere. Feel free to share here.
ALSO! Please fill out the poll on the right by picking your favorite features you'd like to see more of in 2009, and if what you want isn't there, drop it in a comment or email.
ALSO! Please fill out the poll on the right by picking your favorite features you'd like to see more of in 2009, and if what you want isn't there, drop it in a comment or email.
1.04.2009
An Unwelcome Challenge
I consider myself to be socially conscious and try to donate time/money/items to various program that assist those in need. But a recent event over my break challenged some of those concepts in my mind.
So owing to a 1-time forgetting to lock the car doors, someone decided to hop in our car and smoke a cigarette and take a few items. There was obvious rummaging through the glovebox and some in the rest of the car, wiped dog poop on some not-so-important papers. It is significant to note that since we are so fortunate and do have many things that it took us awhile to figure out exactly what had gone missing.
The final tally appears to be:
-Some food (crasins, miniature candy bars, lifesavers; the cookies from subway remained)
-Shelter (a sleeping bag)
-Some really random stuff (Led Zepellin CD, headphones, sunglasses and holder, and my husband's rx glasses)
Fortunately, we didn't have any money taken, wallets were in the house and even the spare change remained in the ashtray. And the only Christmas gifts that were taken were the CD and the candy bars. Nothing was of sentimental value and the most expensive pieces (glasses and sleeping bag) will not be an undo hardship to replace. However, there is the feeling of having your security violated. I had already been a little on edge since I had narrowly avoided a pickpocketing/purse snatching before we left on the trip. I don't consider the towns that I live in to be dangerous (or at least THAT dangerous) and it's a rude awakening when an unfortunate event that so often happens to others hits close to home. I was also struck by the random items that were taken, and I question how they can be potentially useful to someone. The lack of logic just confuses me, I expect rational behavior from others.
I was hurt by the fact that this did happen at Christmastime... also because I do routinely reach out and try to help those who are less fortunate. My husband and I participate in charity for our church, the salvation army, goodwill, coats for kids, planet aid. I used to be part of a school of medicine outreach to the homeless. I guess I felt like I deserved not to be affected by this kind of crime due to the charitable actions we take. But I was thinking about this today, and I guess that if there is one person in the community, country, or world that has to resort to theft to meet their most basic needs, then there's obviously more that we all should be doing. And this is relevant to OT as every OT (really every person at all, but everyone in the profession founded on helping others maximize their lives) should champion social justice causes. There are very few among us who cannot do more, and likely very many that just need to do something. Plenary sessions at previous AOTA Conferences have focused on OT and community involvement, and it is something that I believe our profession could easily reach into. But until then, we'll just have to do what we each can to try to help.
So owing to a 1-time forgetting to lock the car doors, someone decided to hop in our car and smoke a cigarette and take a few items. There was obvious rummaging through the glovebox and some in the rest of the car, wiped dog poop on some not-so-important papers. It is significant to note that since we are so fortunate and do have many things that it took us awhile to figure out exactly what had gone missing.
The final tally appears to be:
-Some food (crasins, miniature candy bars, lifesavers; the cookies from subway remained)
-Shelter (a sleeping bag)
-Some really random stuff (Led Zepellin CD, headphones, sunglasses and holder, and my husband's rx glasses)
Fortunately, we didn't have any money taken, wallets were in the house and even the spare change remained in the ashtray. And the only Christmas gifts that were taken were the CD and the candy bars. Nothing was of sentimental value and the most expensive pieces (glasses and sleeping bag) will not be an undo hardship to replace. However, there is the feeling of having your security violated. I had already been a little on edge since I had narrowly avoided a pickpocketing/purse snatching before we left on the trip. I don't consider the towns that I live in to be dangerous (or at least THAT dangerous) and it's a rude awakening when an unfortunate event that so often happens to others hits close to home. I was also struck by the random items that were taken, and I question how they can be potentially useful to someone. The lack of logic just confuses me, I expect rational behavior from others.
I was hurt by the fact that this did happen at Christmastime... also because I do routinely reach out and try to help those who are less fortunate. My husband and I participate in charity for our church, the salvation army, goodwill, coats for kids, planet aid. I used to be part of a school of medicine outreach to the homeless. I guess I felt like I deserved not to be affected by this kind of crime due to the charitable actions we take. But I was thinking about this today, and I guess that if there is one person in the community, country, or world that has to resort to theft to meet their most basic needs, then there's obviously more that we all should be doing. And this is relevant to OT as every OT (really every person at all, but everyone in the profession founded on helping others maximize their lives) should champion social justice causes. There are very few among us who cannot do more, and likely very many that just need to do something. Plenary sessions at previous AOTA Conferences have focused on OT and community involvement, and it is something that I believe our profession could easily reach into. But until then, we'll just have to do what we each can to try to help.
1.03.2009
Shower Remodel
So one of my first OT moments while at home was at my grandmother's house. She had a tub to shower conversion done about a month ago to replace the 19 y.o. metal stool she had been using as a tub chair. Sounds great, but there is more after the link...
this is what the new shower looks like-
and in theory, it is the 100% solution. However, my gram is 5'2" and only her toes can touch the floor while sitting on the built in bench. She knew this when the guy was installing, but he said it was as low as it could go and he couldn't do anything and there wasn't anyone there to make a suggestion. My thought was that during the install he could have rotated the seat 180*... this would have kept the piece aligned with the studs, and though we would have lost a small shelf, it would have lowered the seat. Where it is now prohibits the use of any other shower chair, especially because the rest of the floor is slanted for the drain. I really can't think of what to put down on the floor so that she can gain some more stability and not slip off the seat. We thought of those shallow crates they use for 2-liter bottles, which are about the correct width to fit in the shower base, however those things would hurt your feet!
So I'm calling out to the OT world, especially those who are in home mods- how would you fix a shower that's supposed to have already been fixed? I can't think of the solution- what do you think?
this is what the new shower looks like-
and in theory, it is the 100% solution. However, my gram is 5'2" and only her toes can touch the floor while sitting on the built in bench. She knew this when the guy was installing, but he said it was as low as it could go and he couldn't do anything and there wasn't anyone there to make a suggestion. My thought was that during the install he could have rotated the seat 180*... this would have kept the piece aligned with the studs, and though we would have lost a small shelf, it would have lowered the seat. Where it is now prohibits the use of any other shower chair, especially because the rest of the floor is slanted for the drain. I really can't think of what to put down on the floor so that she can gain some more stability and not slip off the seat. We thought of those shallow crates they use for 2-liter bottles, which are about the correct width to fit in the shower base, however those things would hurt your feet!
So I'm calling out to the OT world, especially those who are in home mods- how would you fix a shower that's supposed to have already been fixed? I can't think of the solution- what do you think?
The return!
I am back from my whirlwind holiday trip around the state, visiting with friends and family from afar. Ate lots of delicious foods (hopefully did not upset my chances in the "Maintain, Don't Gain" holiday challenge at work), watched lots of college football (after a promising start, I am definitely out of the running), and generally just enjoyed the down time. Very little computer time, and that was good too.
You can never take a full vacation from OT though, so my little brain wheels were turning throughout the time. Lots of thoughts related to the family and using OT to help them, some of which I will share as I catch up on updates. Also been thinking a lot about my personal career path... directions that I want to take and changes that will have to be made.
My shoulder is trying to act like it's going to get that impingement pain again, hopefully it will not so that after the unpacking and cleaning I can continue to have some computer time. Hope to have updates soon, depending on amount of work to do at home and amount of total procrastination :)
You can never take a full vacation from OT though, so my little brain wheels were turning throughout the time. Lots of thoughts related to the family and using OT to help them, some of which I will share as I catch up on updates. Also been thinking a lot about my personal career path... directions that I want to take and changes that will have to be made.
My shoulder is trying to act like it's going to get that impingement pain again, hopefully it will not so that after the unpacking and cleaning I can continue to have some computer time. Hope to have updates soon, depending on amount of work to do at home and amount of total procrastination :)
12.18.2008
Holiday Bouncing
Well, things are getting busy as it gets near to Christmas time... The acute care are trying to clear out their floors so our SNF floor will be filling up even as we try to discharge all that those that can. (word to the wise- don't get an elective joint replacement a week before any holiday that you don't want to spend in the hospital. even 2 weeks.) I won't be seeing any pediatrics in the next 2 weeks, due to this resulting business and my own vacation, but I did advise everyone to keep their kids' schedules as normal as possible during the holidays to prevent the meltdowns. I have some things to figure out... like whether to add cranberries to the dressing, what everyone's addresses are now for cards, how to get the most gifts from Jingle in Animal Crossing, and how to best coordinate a visit to 8 locations in 10 days and still have time for laundry. So as a result, I will schedule some updates if I find the time, but if not, oh well.
Until such a time, I leave you with a tip... if you don't want to scare away your coworkers who have a limited understanding of sensory processing, sit on a regular boring chair for your lunch party.
Until such a time, I leave you with a tip... if you don't want to scare away your coworkers who have a limited understanding of sensory processing, sit on a regular boring chair for your lunch party.
12.13.2008
OT WebGems- Brain Edition
OT WebGems charges on like a hybrid car rolling downhill! Ok, "brain" is a pretty broad term for an edition. The following links are mostly CVA related, with some NON-controversial information on stem cell research, and a couple of other thinly related articles. Who doesn't like neuro-know-how? Onward!
TIA Diagnosis- Neurologists have found 3 indicators to help avoid misdiagnose TIA. Briefly, if the person has had a slow onset of symptoms, vague symptoms (w/ or w/o neurological symptoms) and/or if a TIA had previously been ruled out at another time, then it is not likely a TIA. We do get therapy orders for pts w/ TIA, though they sometimes turn into a 'walky-talky' (as the speech therapist calls it) before we get there. I did get eval orders on a person who I had discharged on eval the previous day as she continued to have neuro events while in the hospital.
Stroke Centers- This study found that pts who received care at a specialized stroke center recovered better and stayed better than those who had care at a non-specialized hospital. They recommend telecommunication for rural hospitals, but I wonder if they explored the SES factors of their participants, as there can be some major overall health differences between city-dwellers & others who can get to a specialized center and those who are in a more rural environment.
Brain Implants- Scientists have found that there is some same-sided brain control over body movements, and are using brain-computer interfaces to help overcome hemiparesis. They can't leave the implants in long-term though... yet. Also, if you have not yet looked at BrainGate, you should definitely check into it. One of my classmates found this in late 2006, and they have continued to improve their research and tests.
Reprogramming Adults' Cells- Scientists have now taken a fully developed adult cell and transformed it into a different type of cell. This isn't super-new, especially because one of my former fieldwork CIs had a pt who had an experimental procedure where stem cells were used from his nose to help him overcome a paralysis. But, very cool.
Google- This was an interesting article about brain scans done in older adults during web surfing, but I think they missed a discussion point. It was the web-savvy users who showed the greatest brain activity during surfing, which I would think means that people need to develop their 'brain-gain' activities early in life and continue them, or that you would get less benefit from starting one of those activities later in life and being less skilled at it. I'm not sure if that really fits with what we already know about brain development though.
Amnesia- I throw this in here as a short, less-scientific but good intro to neuro article addressing amnesia and whether one knows they have it or not. Just happened to come across it while writing this.
Body Snatchers!- Scientists were able to create an illusion of body swapping between a person and a mannequin, tricking the brain's sensory perceptions. A cool jumping off point for robotics, VR, and possibly sensory reeducation?
TIA Diagnosis- Neurologists have found 3 indicators to help avoid misdiagnose TIA. Briefly, if the person has had a slow onset of symptoms, vague symptoms (w/ or w/o neurological symptoms) and/or if a TIA had previously been ruled out at another time, then it is not likely a TIA. We do get therapy orders for pts w/ TIA, though they sometimes turn into a 'walky-talky' (as the speech therapist calls it) before we get there. I did get eval orders on a person who I had discharged on eval the previous day as she continued to have neuro events while in the hospital.
Stroke Centers- This study found that pts who received care at a specialized stroke center recovered better and stayed better than those who had care at a non-specialized hospital. They recommend telecommunication for rural hospitals, but I wonder if they explored the SES factors of their participants, as there can be some major overall health differences between city-dwellers & others who can get to a specialized center and those who are in a more rural environment.
Brain Implants- Scientists have found that there is some same-sided brain control over body movements, and are using brain-computer interfaces to help overcome hemiparesis. They can't leave the implants in long-term though... yet. Also, if you have not yet looked at BrainGate, you should definitely check into it. One of my classmates found this in late 2006, and they have continued to improve their research and tests.
Reprogramming Adults' Cells- Scientists have now taken a fully developed adult cell and transformed it into a different type of cell. This isn't super-new, especially because one of my former fieldwork CIs had a pt who had an experimental procedure where stem cells were used from his nose to help him overcome a paralysis. But, very cool.
Google- This was an interesting article about brain scans done in older adults during web surfing, but I think they missed a discussion point. It was the web-savvy users who showed the greatest brain activity during surfing, which I would think means that people need to develop their 'brain-gain' activities early in life and continue them, or that you would get less benefit from starting one of those activities later in life and being less skilled at it. I'm not sure if that really fits with what we already know about brain development though.
Amnesia- I throw this in here as a short, less-scientific but good intro to neuro article addressing amnesia and whether one knows they have it or not. Just happened to come across it while writing this.
Body Snatchers!- Scientists were able to create an illusion of body swapping between a person and a mannequin, tricking the brain's sensory perceptions. A cool jumping off point for robotics, VR, and possibly sensory reeducation?
12.06.2008
OT WebGems- Autism Signs Edition
To the thrill of readers everywhere, OT WebGems returns! Source material is currently plentiful, but connections and potential segues for these have been scarce. Here are a few pieces of current items on early autism signs and general diagnoses, plus a little celebrity tidbit on SPD.
Developmental Milestones: this is a comprehensive list of links for milestones for infancy to adolescence. Written in layman's terms with lots of extra resources.
Unusual Use of Toys: a study looked at infants' toy use and then later followed up to see which children were diagnosed with autism. The children who were later diagnosed had a much higher tendency to rotate toys or look at them from the corner of the eye. The researchers noted that many parents noticed signs of autism before a diagnosis is made and are hoping to help develop better early screens.
Sound Processing: an MEG study found split second sound processing deficits in kids with autism compared to typically developing kids, which could be connected to the language issues seen.
Ok, this is a controversial piece. It had an equally controversial discussion, and the transcript to that is linked on the article's page. The author's son was diagnosed with autism at age 2 and they are now involved with a study about children who "emerged" from autism. It was an interesting read, but I think that the soundest words come at the end of the article from a researcher involved with a separate study and a member of Autism Speaks.
and, in mostly unrelated news, but mildly interesting nonetheless, Daniel Radcliffe (aka Harry Potter) is apparently now public about having dyspraxia, part of the SPD umbrella. The article is not particularly thoughtful about the hidden disability, but I found it to be an interesting tidbit.
Developmental Milestones: this is a comprehensive list of links for milestones for infancy to adolescence. Written in layman's terms with lots of extra resources.
Unusual Use of Toys: a study looked at infants' toy use and then later followed up to see which children were diagnosed with autism. The children who were later diagnosed had a much higher tendency to rotate toys or look at them from the corner of the eye. The researchers noted that many parents noticed signs of autism before a diagnosis is made and are hoping to help develop better early screens.
Sound Processing: an MEG study found split second sound processing deficits in kids with autism compared to typically developing kids, which could be connected to the language issues seen.
Ok, this is a controversial piece. It had an equally controversial discussion, and the transcript to that is linked on the article's page. The author's son was diagnosed with autism at age 2 and they are now involved with a study about children who "emerged" from autism. It was an interesting read, but I think that the soundest words come at the end of the article from a researcher involved with a separate study and a member of Autism Speaks.
"I don't know that the children 'recovered,' though they did improve . . . to the extent that they no longer met the diagnostic criteria," Stone said. "Almost all continued to have some form of developmental disorder."
"I think the most hopeful message we need to give parents," said Geraldine Dawson, chief science officer of the nonprofit group Autism Speaks, "is that all children with autism are capable of learning and developing new skills with the help of early intervention."
and, in mostly unrelated news, but mildly interesting nonetheless, Daniel Radcliffe (aka Harry Potter) is apparently now public about having dyspraxia, part of the SPD umbrella. The article is not particularly thoughtful about the hidden disability, but I found it to be an interesting tidbit.
12.05.2008
Some Online Therapy Toys Shops
Do you have any money left in your budget as the year comes to a close? Here's some places you can throw it! Not an all-inclusive list, but this could certainly help fill your clinic or playroom while stimulating the economy.
SPD Foundation has now opened a store where you can find different sensory products. The fine motor and social sections are rather bare, but the store is new so I imagine they will grow in the coming days. They also have free shipping on orders over $50 until 12/31/08.
Fun and Function is a store owned by an OT trying to provide affordable pediatric therapy toys. They have an "exclusive line of scooters and portable writing kits" which look pretty cool. The site is very well organized and has a lot of tools for social skills under the "resources" section. And if you like the clock timers that show the disappearing time... check out the wristwtach.
Pocket Full of Therapy has been around longer and is also OT owned. They have a good selection and there's not a lot of repeats between their categories. I can't link to specific items, but there's a lot of books that I'll be considering when I (hopefully) have fresh continuing ed money. There are also hidden holiday word scrambles that can earn you an extra gift at checkout.
Hammacher Schlemmer claims to 'offer the best, the only, and the unexpected.' I love this tilt board with modes to match sound/color/number, remember a sequence, or make a freestyle song. Cheaper than a WiiFit! I also like the Hide 'N Seek Monkey, and the ever-so-cute Constellation Turtle.
SPD Foundation has now opened a store where you can find different sensory products. The fine motor and social sections are rather bare, but the store is new so I imagine they will grow in the coming days. They also have free shipping on orders over $50 until 12/31/08.
Fun and Function is a store owned by an OT trying to provide affordable pediatric therapy toys. They have an "exclusive line of scooters and portable writing kits" which look pretty cool. The site is very well organized and has a lot of tools for social skills under the "resources" section. And if you like the clock timers that show the disappearing time... check out the wristwtach.
Pocket Full of Therapy has been around longer and is also OT owned. They have a good selection and there's not a lot of repeats between their categories. I can't link to specific items, but there's a lot of books that I'll be considering when I (hopefully) have fresh continuing ed money. There are also hidden holiday word scrambles that can earn you an extra gift at checkout.
Hammacher Schlemmer claims to 'offer the best, the only, and the unexpected.' I love this tilt board with modes to match sound/color/number, remember a sequence, or make a freestyle song. Cheaper than a WiiFit! I also like the Hide 'N Seek Monkey, and the ever-so-cute Constellation Turtle.
Small successes
My posts that can be labeled under 'inspiration' have been pretty lacking, which is probably an outlook thing. But here are 3 great small successes from pediatric land this week, plus a small SNF story thrown in. And though they are small victories, it's more than we often get.
Little Miss X is someone I've known for awhile. She is about 8, has autism, and has recently started ABA therapy at home, also on a new special diet, and they're making some great changes at school. I cotreat w/ PT and we have recently had some success with using patterns for different actions. This has really helped her with doff/donning shoes, she really loved the "monster under the bed" toy and really understood how to retrieve the object and then reinsert it under the pillow. We have worked on throw & catch for months upon months, and yet miss S would become distracted, just flip the ball out of her hands instead of throwing it accurately. I don't know what it was about Tuesday, because we have used the "ready, set, go (throw whether ready or not)" method with her before, but this time it really worked. Even when she wouldn't put out 'catching hands' ahead of time, she would bring her hands together in time to catch the ball. We worked up to 10 rapid catch/throws with no drops and accurate throws.
Little Miss Y has also been a long term client. She is 10, has CP, and has just restarted therapy recently due to an orthopedic surgery. Her mom has more focused goals now relating to her ADL performance and overall function. Her RUE is often held in elbow extension, extreme pronation, wrist flexion, and finger flexion. This has been a challenge for me in the past when trying to help her stretch or get in a more normalized position for an activity. But at this point, I just want her to use the RUE in a semi-functional assistive fashion. So we have worked on pushing objects across a table or holding them using the dorsal side of hand & wrist. We have also started a very very modified CIMT program where a thick sock is applied to the LUE, which she hasn't actually started to hate yet. At any rate, this week, when she was pushing these oversized jacks, I noticed that her thumb was more separated from the rest of her fingers for a change. So with a lot of coaching, she was able to basically drive her hand over the jack and manage to get one stick beside her thumb, and then get enough thumb adduction to actually pick up the jack independently! Previously, the only way I could get her to hold an object w/ RUE only was after placement, but she picked up 6 jacks and transported them across midline. Only assist was for wrist flexion to stimulate release.
Little Mr. Z is the third of the long-time peds clients. We are working on developmental skill progression. We have tried a lot of BUE activity, grasp & release, purposeful use of UEs. He's nonverbal, so we anytime we can get a smile basically makes a great day. This Monday, we were working on BUE coordinated use of toys using this accordion that I found in our closet. With PT on one arm and me on the other, we pushed and pulled and made the accordion make funny little sounds and Z just laughed and laughed.
I love the little smile moments, I love having something to tell the parent how wonderful their child did. Sometimes it's hard to feel that progress is happening, especially when therapy has been continually ongoing. Heck, my BKA pt. on the SNF floor couldn't even see her own progress over the past 2 weeks when she used to be a DEP Ax3 for supine to sit and now is SBA. She was also able to don pants in bed using semi-SCI method, and transferred to a chair for the first time using a sliding board and 2-3 person assist. At any rate, we all need to feel and share the successes when we can, since the lack of progress can be so disappointing. Parents, therapists, patients... we all need an uplifting moment to get through the day.
Little Miss X is someone I've known for awhile. She is about 8, has autism, and has recently started ABA therapy at home, also on a new special diet, and they're making some great changes at school. I cotreat w/ PT and we have recently had some success with using patterns for different actions. This has really helped her with doff/donning shoes, she really loved the "monster under the bed" toy and really understood how to retrieve the object and then reinsert it under the pillow. We have worked on throw & catch for months upon months, and yet miss S would become distracted, just flip the ball out of her hands instead of throwing it accurately. I don't know what it was about Tuesday, because we have used the "ready, set, go (throw whether ready or not)" method with her before, but this time it really worked. Even when she wouldn't put out 'catching hands' ahead of time, she would bring her hands together in time to catch the ball. We worked up to 10 rapid catch/throws with no drops and accurate throws.
Little Miss Y has also been a long term client. She is 10, has CP, and has just restarted therapy recently due to an orthopedic surgery. Her mom has more focused goals now relating to her ADL performance and overall function. Her RUE is often held in elbow extension, extreme pronation, wrist flexion, and finger flexion. This has been a challenge for me in the past when trying to help her stretch or get in a more normalized position for an activity. But at this point, I just want her to use the RUE in a semi-functional assistive fashion. So we have worked on pushing objects across a table or holding them using the dorsal side of hand & wrist. We have also started a very very modified CIMT program where a thick sock is applied to the LUE, which she hasn't actually started to hate yet. At any rate, this week, when she was pushing these oversized jacks, I noticed that her thumb was more separated from the rest of her fingers for a change. So with a lot of coaching, she was able to basically drive her hand over the jack and manage to get one stick beside her thumb, and then get enough thumb adduction to actually pick up the jack independently! Previously, the only way I could get her to hold an object w/ RUE only was after placement, but she picked up 6 jacks and transported them across midline. Only assist was for wrist flexion to stimulate release.
Little Mr. Z is the third of the long-time peds clients. We are working on developmental skill progression. We have tried a lot of BUE activity, grasp & release, purposeful use of UEs. He's nonverbal, so we anytime we can get a smile basically makes a great day. This Monday, we were working on BUE coordinated use of toys using this accordion that I found in our closet. With PT on one arm and me on the other, we pushed and pulled and made the accordion make funny little sounds and Z just laughed and laughed.
I love the little smile moments, I love having something to tell the parent how wonderful their child did. Sometimes it's hard to feel that progress is happening, especially when therapy has been continually ongoing. Heck, my BKA pt. on the SNF floor couldn't even see her own progress over the past 2 weeks when she used to be a DEP Ax3 for supine to sit and now is SBA. She was also able to don pants in bed using semi-SCI method, and transferred to a chair for the first time using a sliding board and 2-3 person assist. At any rate, we all need to feel and share the successes when we can, since the lack of progress can be so disappointing. Parents, therapists, patients... we all need an uplifting moment to get through the day.
12.04.2008
People Say the Darndest Things
A glimpse at some of the awful things pts have said lately that we have laughed over.
A mother was observing me in my second session with her child. She said, "Do you have to have any special training to do this?" I replied, a little icily, "Yes, I have a masters degree." Then her motive became clear when she said, "Oh... do you need an assistant?"
Our COTA gave the Mini-Mental to a man who is in early dementia but responds well when given extra time. His sentence: "I don't trust you."
We were getting ready to evaluate an elderly lady with compression fractures and she is making some pained faces as she gets out of bed. Then she says, "Don't mind me, I just bitch a lot."
I was going over the home safety cards w/ a pt. with considerable problem solving deficits. I showed him a card of a man having a grease fire on his stove, and said "This guy has a problem." He responds, "Yeah, he does. He's black."
Female PT and aide walk into a man's room and try to get him to take a walk. Man looks at the PT and says, "I'm not going anywhere with you, fatso." Aide goes, "who are you calling fatso?!" and man says "Her! [the PT]" As some background, this PT is probably the most 'in shape' person on the staff. Aide couldn't stop laughing for ten minutes!
Same PT is starting a fitness consulting business and wearing buttons with catchy slogans to advertise. I did a double take when I read her button... I thought it said "Decide, Commit Suicide." It actually says "Decide, Commit, Succeed" but my terrified expression became the laughing point of the day.
A man I am working with is struggling to get out of bed. He looks at my nametag and says, "occupational therapist... is that another term for sadist?"
A mother was observing me in my second session with her child. She said, "Do you have to have any special training to do this?" I replied, a little icily, "Yes, I have a masters degree." Then her motive became clear when she said, "Oh... do you need an assistant?"
Our COTA gave the Mini-Mental to a man who is in early dementia but responds well when given extra time. His sentence: "I don't trust you."
We were getting ready to evaluate an elderly lady with compression fractures and she is making some pained faces as she gets out of bed. Then she says, "Don't mind me, I just bitch a lot."
I was going over the home safety cards w/ a pt. with considerable problem solving deficits. I showed him a card of a man having a grease fire on his stove, and said "This guy has a problem." He responds, "Yeah, he does. He's black."
Female PT and aide walk into a man's room and try to get him to take a walk. Man looks at the PT and says, "I'm not going anywhere with you, fatso." Aide goes, "who are you calling fatso?!" and man says "Her! [the PT]" As some background, this PT is probably the most 'in shape' person on the staff. Aide couldn't stop laughing for ten minutes!
Same PT is starting a fitness consulting business and wearing buttons with catchy slogans to advertise. I did a double take when I read her button... I thought it said "Decide, Commit Suicide." It actually says "Decide, Commit, Succeed" but my terrified expression became the laughing point of the day.
A man I am working with is struggling to get out of bed. He looks at my nametag and says, "occupational therapist... is that another term for sadist?"
12.01.2008
Touching Moments
Every now and then a pt. says something so cute, personal, or touching that it just tugs at the heartstrings... here are a few.
I have a pt. now who has Parkinson's Disease. She has a 3 story house with the only bathroom on the third floor. Her husband of 57 years carries the BSC up and down the stairs every morning and night for her.
A 12 y.o. w/ Osteogenesis Imperfecta is receiving PT. He had a recent fracture and told his PT, "I was doing so good... I made it all summer without breaking anything!"
In a family meeting, an elderly man's children were trying to get him to adopt some safety measures, including not going up and down the steps. He likes to meet his Meals on Wheels deliverers at their car, and when it was suggested that they could bring the meals in, he said, "but some of them are in bad shape!" He also likes to use the steps to sit outside and feed his squirrels, which he has been doing daily for 45 years. When his family tried to say that they only wanted to make changes that would be helpful for him, he said, "how can I trust that you'll do that when none of you even feed my squirrels? They watch me eat breakfast by sitting on the skylight and will eat out of the palm of my hand, and none of you even put a tray out for them!" This man has such a deep affection for his woodland friends, even used to feed them with his now-deceased wife. It was really touching, but sad since he was obviously upset about the care the squirrels had received. He went home last week, so hopefully things worked out well for him.
In other news, I have had 3 work related dreams in the last week... not cool. Don't need to carry the stress home.
I have a pt. now who has Parkinson's Disease. She has a 3 story house with the only bathroom on the third floor. Her husband of 57 years carries the BSC up and down the stairs every morning and night for her.
A 12 y.o. w/ Osteogenesis Imperfecta is receiving PT. He had a recent fracture and told his PT, "I was doing so good... I made it all summer without breaking anything!"
In a family meeting, an elderly man's children were trying to get him to adopt some safety measures, including not going up and down the steps. He likes to meet his Meals on Wheels deliverers at their car, and when it was suggested that they could bring the meals in, he said, "but some of them are in bad shape!" He also likes to use the steps to sit outside and feed his squirrels, which he has been doing daily for 45 years. When his family tried to say that they only wanted to make changes that would be helpful for him, he said, "how can I trust that you'll do that when none of you even feed my squirrels? They watch me eat breakfast by sitting on the skylight and will eat out of the palm of my hand, and none of you even put a tray out for them!" This man has such a deep affection for his woodland friends, even used to feed them with his now-deceased wife. It was really touching, but sad since he was obviously upset about the care the squirrels had received. He went home last week, so hopefully things worked out well for him.
In other news, I have had 3 work related dreams in the last week... not cool. Don't need to carry the stress home.
11.29.2008
Things I Learned
Full title: Things I learned in school that I didn't think were important at the time.
Part of the reasoning for making this blog was to share information from school with other students. Here are some things that snuck up on me and I later realized were important.
Part of the reasoning for making this blog was to share information from school with other students. Here are some things that snuck up on me and I later realized were important.
- Don't take it personally- In preparation for Level II fieldwork, we had to read "The Four Agreements."I did not enjoy this, at all. Thought it was worthless. However, agreement 2 (Don't take anything personally) has proven several times to be very worthwhile. Often, things that people say or do that irritate us were never intended to do so, yet we take them as an intentional personal affront. By learning to not take the little words and actions personally, you can save yourself a lot of headaches, especially those that can come if you are in a catty workplace.
- Leave it at the door- As a corollary to the first point, there is a line between your personal and professional life (especially on fieldwork). Sure, you can share information about yourself and interests, but your main focus has to be getting work done or it will come back to getcha. And of course, you have to be careful about what and how much you share w/ whom... does your supervisor need to know about your hangover?
- Act interested- One of my teachers used to say this was key to keeping instructors happy. No matter where you are, this is crucial. Make eye contact, nod approvingly, ask questions. People respond to this, and they respond to the opposite as well... I think that one of my professors is still a little icy to me because of this.
- It's not about the site- I spent a lot of time obsessing about fieldwork sites... pretty much from the time that I got into OT school. I pursued a few specific ones like a trained attack animal wearing blinders. And, in consequence, I had a few experiences that could have been better, more challenging, more relevant to my daily practice. You can obsess about the name or prestige of a certain place, but you have a find a good fit for you and a place where you can learn. Get a heads up from older students about different locations. Talk to your fieldwork coordinator about your goals and desires, but trust that in the end, it will all work out.
- It's not about specializing- This is hooked to the previous point. I remember in first year of school we were all getting to know one another, and most people had a specific setting or population that they already wanted to specialize in. Many people wanted to work in a pediatric setting, but some of them found out that they truly preferred geriatrics. It's getting harder not to find out about specialties early, as OT is becoming filled with deep niches (that's a separate entry), however, don't cling too hard to these ideas you have about your career early in school. Be open to the possibilities.
- It's not about money- It's always hard to believe as a student, but one day, someone will pay you to work! There will come a day where student loans no longer matter and you can buy brand-name food! However, there always seems to be someone on the listserv asking about their choice for first job... great money or supervision? The consensus answer is always to take the better overall experience and not worry about the money. It's hard to believe that the money will come, especially when everyone loves talking about the economy, but a good base of experience is something you can't buy. Admittedly, I let the money factor into my first job decision more than it should have (separate entry- negotiating and money management) but the position did have a mix of experiences and I have been learning a good deal. This is also why many teachers advise against taking a traveling position right out of school, get the supervision and assistance when you first start, and then go for the lucrative placement if you want to.
- You get what you give- It's hard to find energy sometimes at the onset of a day, especially if you're a "morning eeyore" like me. But you can't expect to get great things from minimal effort. In school, we organized a study guide sharing effort between classmates and then passed these down to the underclassmen. I certainly don't know how everyone's tests went, but there does seem to be a correlation between putting in the effort to make your own guide and doing well. This translates into the work environment as well. If you show your clients that you care and want to understand what matters to them, they will try more during therapy sessions. It's hard to be "on" all the time, and those that don't work in direct consumer interaction don't always understand that. But give the best you can, as often as you can, and don't expect more from those you work with than you are willing to give.
11.24.2008
Gender Games
So I had a strange week, though it was several weeks ago now (I'm a little behind in blog posting). My hallway on the SNF floor has four 'semi-private' rooms. I would say that my 'average pt' is a 78 y.o. female with a condition causing general weakness and mild dementia. However, I had a set of weeks where it was all... men.
We rarely get ANY men on our SNF floor (staff or pts). And in this situation we had 9! My hallway had Mr. H after his hip fracture; Mr. R who was terribly deconditioned and had very little shoulder flexion either side; a man receiving IV antibiotics; Mr. L w/ confusion after UTI; Mr. N with mild dementia and THR; and Mr. Z w/ advanced dementia. It was interesting working with an all-male caseload for the first time ever... these guys had some good stories and some were very willing to work hard. I think in general they did have some apprehension about ADLs, probably more than my 'average pt' but I try to be respectful of such things.
I spent a lot of time working with both Mr. H and Mr. R, and can happily say that they improved greatly and are at home. The others, unfortunately, did not have the same result. I guess basically it worked out as it does when I have an all femme hallway, some worked hard, some wouldn't work at all, and some couldn't overcome their deficits in the time we had together. Hopefully they'll all continue to improve.
We rarely get ANY men on our SNF floor (staff or pts). And in this situation we had 9! My hallway had Mr. H after his hip fracture; Mr. R who was terribly deconditioned and had very little shoulder flexion either side; a man receiving IV antibiotics; Mr. L w/ confusion after UTI; Mr. N with mild dementia and THR; and Mr. Z w/ advanced dementia. It was interesting working with an all-male caseload for the first time ever... these guys had some good stories and some were very willing to work hard. I think in general they did have some apprehension about ADLs, probably more than my 'average pt' but I try to be respectful of such things.
I spent a lot of time working with both Mr. H and Mr. R, and can happily say that they improved greatly and are at home. The others, unfortunately, did not have the same result. I guess basically it worked out as it does when I have an all femme hallway, some worked hard, some wouldn't work at all, and some couldn't overcome their deficits in the time we had together. Hopefully they'll all continue to improve.
11.23.2008
How to continue receiving listserv emails
Several individuals on one of the listservs that I subscribe to were irritated/perplexed at the change from emailed listservs to forums on the OTConnections site. In reality, I think that this will operate much like everything did on the AOTA site, as you always had the opportunity to access the listservs in forum format (check out that alliteration!). But if you're having trouble changing over and would like to continue receiving emails of the new topics and discussions, here's a step-by-step process.
When you first go to http://otconnections.aota.org/ there is an option to sign up or log in. You use your same old AOTA.org name and password to log in.
At this point, you will be redirected to your 'homepage.' This page shows your latest activity and that of your friends. When you first sign in, the only friend you will have is "OT Connections." You don't have to get anymore if you don't want to. This is the page that you can go back to by clicking the "home" tab at top, and can help you navigate to other areas of the site.
To edit your public profile, click the link under the funny picture. This is in the top left. In this section you can upload a photo or pick a different clip art picture to be your 'avatar.' This is just
for what other people see when they look at your page. It's not necessary. You also have an option to add a public biography. What you DO need to do is go to the "Site Options" tab; put in your correct email address, and save the change at the bottom of the page. You can also choose what you get messages about and who can contact you in this tab.
Now, click the "forums" tab on the red bar at the top of the screen. On the right, under "shortcuts," is a link for "Forum Subscriptions."
Now you can scroll through the list and choose which listservs to receive by email. Simply click on the "No" beside the chosen listserv, and it will change to "Yes." And voila! Your listserv emails should return to your inbox unfettered.
If there is a problem with this, let me know and I will try to correct the directions.
And no, I don't work for AOTA, though I totally would if I had the chance. I'm just an OT who is also a computer nerd and thinks that being active in the state and national association is a good benefit. :)
When you first go to http://otconnections.aota.org/ there is an option to sign up or log in. You use your same old AOTA.org name and password to log in.
At this point, you will be redirected to your 'homepage.' This page shows your latest activity and that of your friends. When you first sign in, the only friend you will have is "OT Connections." You don't have to get anymore if you don't want to. This is the page that you can go back to by clicking the "home" tab at top, and can help you navigate to other areas of the site.
To edit your public profile, click the link under the funny picture. This is in the top left. In this section you can upload a photo or pick a different clip art picture to be your 'avatar.' This is just
for what other people see when they look at your page. It's not necessary. You also have an option to add a public biography. What you DO need to do is go to the "Site Options" tab; put in your correct email address, and save the change at the bottom of the page. You can also choose what you get messages about and who can contact you in this tab.
Now, click the "forums" tab on the red bar at the top of the screen. On the right, under "shortcuts," is a link for "Forum Subscriptions."
Now you can scroll through the list and choose which listservs to receive by email. Simply click on the "No" beside the chosen listserv, and it will change to "Yes." And voila! Your listserv emails should return to your inbox unfettered.
If there is a problem with this, let me know and I will try to correct the directions.
And no, I don't work for AOTA, though I totally would if I had the chance. I'm just an OT who is also a computer nerd and thinks that being active in the state and national association is a good benefit. :)
Merry File Sharing Day!
So I finally took my memory key to work and got my files off of there. Browse as you wish, I only ask that you do not plagiarize or submit works as your own, but feel free to print for patients. Burst ahead for file-sharing goodness!
OK... so apparently, you cannot upload text files or pdfs to OT Connections. Therefore, it cannot be the prime sharing source. Please let me know if the google documents do not show up correctly and I will email the item to you.
Homemade Adaptive Equipment- instructions for making sock aid, dressing stick, and long sponge in English and Spanish. I ran it through a translator, please don't blame me for the grammar. Speaking of long handled sponges & shoehorns, I always send people to the drugstore or dollar store for these items.
Potential Friends Worksheet- I made up this simple sheet for a child w/ Asperger's who was really upset about not being able to make friends. He liked to plan things out, so we tried breaking down introductory conversations step by step, and then practiced one of these with a PT on break.
Heavy Work Handout- Here's a handout on different heavy work activities, it's mostly for parents but does have a few ideas for classrooms. I did borrow and compile from different sensory resources, the main 2 are referenced.
Yoga Exercises for your Back- I copied and pasted out selected yoga exercises that work on back muscles, unfortunately, I cannot remember the source site.
Tips to Decrease Back Pain (for children)- Here are some child-specific strategies to reduce back pain.
UE AROM handout- goes through basic arm stretches in layman's terms.
I have a hip precautions handout, but only in pdf... I'll have to copy it into word format before sharing.
As an extra bonus for those of you who have read so far down the page, I will tell you that I found ALL of my files from school on this magical memory key, and will share them as quickly as I can, but it will be difficult as I am probably busier this time of year more than any other. There's some great stuff, and one early post will have to be on old-school homemade AE. For other great pediatric handouts, try Super Duper Publications and of course AOTA has great consumer tip sheets.
OK... so apparently, you cannot upload text files or pdfs to OT Connections. Therefore, it cannot be the prime sharing source. Please let me know if the google documents do not show up correctly and I will email the item to you.
Homemade Adaptive Equipment- instructions for making sock aid, dressing stick, and long sponge in English and Spanish. I ran it through a translator, please don't blame me for the grammar. Speaking of long handled sponges & shoehorns, I always send people to the drugstore or dollar store for these items.
Potential Friends Worksheet- I made up this simple sheet for a child w/ Asperger's who was really upset about not being able to make friends. He liked to plan things out, so we tried breaking down introductory conversations step by step, and then practiced one of these with a PT on break.
Heavy Work Handout- Here's a handout on different heavy work activities, it's mostly for parents but does have a few ideas for classrooms. I did borrow and compile from different sensory resources, the main 2 are referenced.
Yoga Exercises for your Back- I copied and pasted out selected yoga exercises that work on back muscles, unfortunately, I cannot remember the source site.
Tips to Decrease Back Pain (for children)- Here are some child-specific strategies to reduce back pain.
UE AROM handout- goes through basic arm stretches in layman's terms.
I have a hip precautions handout, but only in pdf... I'll have to copy it into word format before sharing.
As an extra bonus for those of you who have read so far down the page, I will tell you that I found ALL of my files from school on this magical memory key, and will share them as quickly as I can, but it will be difficult as I am probably busier this time of year more than any other. There's some great stuff, and one early post will have to be on old-school homemade AE. For other great pediatric handouts, try Super Duper Publications and of course AOTA has great consumer tip sheets.
11.21.2008
OT Connections
So I am on OT Connections now (Title links to the homepage). I uploaded a new picture for that avatar, so I will probably change this one to match. Obviously my wedding photo wasn't very OT-related, but I really don't have pictures of me doing OT-things. Someone should have been taking pictures in class, but even when our school did publicity photos of "OT class" they were always very staged.
Can't promise how much time I will spend on there, but hopefully some good networking and information sharing will come about. I haven't tested the file upload yet, but if it works well I will throw over Google Documents and share things over that network.
My inservice went well today, shared some updates about opening our state practice act and the changes that are intended... tried to bug my colleagues into joining our state association. It actually costs less than dinner for 2 most places, so for OTs who make 5 figures, it doesn't really seem like a big sacrifice. We'll see if my 'prodding' had any result. Also at work today, I got some sensory profiles graded and papers filed away (Coworker: "I can actually see the formica on your desk! There is a desk there!") AND I took my thumb drive and copied all my files, so hopefully I can spend a little time this weekend sharing some of the things I've been working on.
Also on the list of things to do is to make a handout for simple modifications to make a home w/c accessible, since I have my first amputee since fieldwork and this will likely be her discharge disposition. I have ample resources, I just need to combine them efficiently in handout form.
Can't promise how much time I will spend on there, but hopefully some good networking and information sharing will come about. I haven't tested the file upload yet, but if it works well I will throw over Google Documents and share things over that network.
My inservice went well today, shared some updates about opening our state practice act and the changes that are intended... tried to bug my colleagues into joining our state association. It actually costs less than dinner for 2 most places, so for OTs who make 5 figures, it doesn't really seem like a big sacrifice. We'll see if my 'prodding' had any result. Also at work today, I got some sensory profiles graded and papers filed away (Coworker: "I can actually see the formica on your desk! There is a desk there!") AND I took my thumb drive and copied all my files, so hopefully I can spend a little time this weekend sharing some of the things I've been working on.
Also on the list of things to do is to make a handout for simple modifications to make a home w/c accessible, since I have my first amputee since fieldwork and this will likely be her discharge disposition. I have ample resources, I just need to combine them efficiently in handout form.
11.20.2008
Doubts
I am a person who worries, doubts, and has times of self depreciation. This is probably evident to many people already, but a disclaimer to anyone else. On the plus side, I likely have those traits due to an urge to be better at the things that I do. Part of the duty of being a member of a profession is a continued commitment to improvement, and I feel that is especially important to be the best I can be so that I can best facilitate goal achievement in my clients. So it hurts when others suggest that OT is not effective, not science-driven, not worthwhile. I found this post linked from another blog, and was disappointed in many of the comments I saw. It also made me wonder if any of my clients or their parents are writing about me. If not writing, they may be talking... one of the things that I have noticed w/ my peds caseload is that some come in for an evaluation and a couple of treatments and are never heard from again, despite phone calls and notes. I often wonder what has happened in these situations when a kid disappears from my schedule and isn't heard from again. Some I know are for financial or personal family reasons, but I know that there's been at least one who didn't come back because mom didn't like me or the therapy session that she observed. It can make you a little paranoid, and I don't need help finding things to worry about.
More thoughts in the full post...
One specific problem that I have is that I feel I'm doing pretty well at evaluating kids and spotting a sensory processing difficulty, and I know that I can pick treatments that challenge them, but I'm not seeing these kids improve as much as I would like. Also, it's difficult to best know what to do for some kids.
I've had more parents observing sessions recently, which I don't mind most of the time, but would rather have a 2way mirror other times. I wish I had better answers for their questions sometimes. I can see in some of their eyes that they don't find me smart enough, or good enough to work with their kids. One set of parents was whispering back and forth to one another as I let their child engage in free play during the eval... they were very upset at her for 'not following directions.' Though I haven't had anyone confusing me with a high school student lately, I don't know that I'm giving off the vibe that I need to best interact with the kids and their parents.
I really wish that I had a fieldwork in peds, or someone else that would share the caseload and give me ideas, or (ideally) a mentor to help me grow as a practitioner. That is on my list of things to do this week... finding people to reach out to online as the ones that I have attempted to reach out to in person have not panned out well. Also on my list of things to do, and gaining priority with each passing second, is preparing my 'inservice.' I have to present it tomorrow. It's not a big thing, more like a five minute thing, but I need to get it done.
Haven't had a chance to check out the OT Connections site... also haven't been on OT Advantage for awhile anyway. Hopefully one or both of these will work out... I am already on the computer too much w/ reading interesting things. And my only network is Facebook, I try to avoid all the other stuff. I already need at least 24 more hours every week, I can't imagine trying to cram in a 'second life' of any sorts.
More thoughts in the full post...
One specific problem that I have is that I feel I'm doing pretty well at evaluating kids and spotting a sensory processing difficulty, and I know that I can pick treatments that challenge them, but I'm not seeing these kids improve as much as I would like. Also, it's difficult to best know what to do for some kids.
I've had more parents observing sessions recently, which I don't mind most of the time, but would rather have a 2way mirror other times. I wish I had better answers for their questions sometimes. I can see in some of their eyes that they don't find me smart enough, or good enough to work with their kids. One set of parents was whispering back and forth to one another as I let their child engage in free play during the eval... they were very upset at her for 'not following directions.' Though I haven't had anyone confusing me with a high school student lately, I don't know that I'm giving off the vibe that I need to best interact with the kids and their parents.
I really wish that I had a fieldwork in peds, or someone else that would share the caseload and give me ideas, or (ideally) a mentor to help me grow as a practitioner. That is on my list of things to do this week... finding people to reach out to online as the ones that I have attempted to reach out to in person have not panned out well. Also on my list of things to do, and gaining priority with each passing second, is preparing my 'inservice.' I have to present it tomorrow. It's not a big thing, more like a five minute thing, but I need to get it done.
Haven't had a chance to check out the OT Connections site... also haven't been on OT Advantage for awhile anyway. Hopefully one or both of these will work out... I am already on the computer too much w/ reading interesting things. And my only network is Facebook, I try to avoid all the other stuff. I already need at least 24 more hours every week, I can't imagine trying to cram in a 'second life' of any sorts.
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