Wednesday, July 15, 2015

A Wonderful College Resource for Students with Disabilities!


We Connect Now is a website dedicated to uniting people interested in rights and issues affecting individuals with disabilities, with a focus on college students and access to higher education and employment issues. The website provides resources and information that helps college students with disabilities to succeed in their studies by getting the information and support they need!  Click on the following link to visit We Connect Now!
Images used with permission from We Connect Now website.

Sunday, July 5, 2015

Does your child have difficulty zipping? Try this!

Here is a quick and easy idea to help a child manipulate a zipper on a backpack, lunchbox, or jacket. All you need is a medium to large sized split key ring.
The zipper pull will need to have a small hole in it. Attach the key ring to the zipper pull.
This will make it easier to grasp and pull the zipper. With a little practice, your child will be zipping and unzipping independently!
video


Sunday, June 14, 2015

Design Copy Worksheet Activity


Research reveals that there is a relationship between written language and the ability to draw or copy designs. If a child has problems with visual perceptual skills, fine motor skills, or visual motor integration, design copy activities can be an effective therapeutic activity.

Here are several of examples of “do it yourself” design copy worksheets that I frequently use with children who have visual motor challenges. The activity can be graded (made more challenging) by increasing the number of dots.  Kids typically enjoy attempting to copy the designs, and this is a fun way to work on directionality,  motor planning, attention to task, and visual motor skills.
video


Sunday, May 3, 2015

The Therapeutic Benefits of Flow: Storytelling Cards


I’m excited to tell you about this fun storytelling card game! Use the 48 beautifully illustrated cards that can be used to make up a story with your client. There are also 4 blank cards that you or your client can use to add characters, places, or objects when making up the story.

The set includes instructions for several different ways to play the game, including “creating a story chain” and “story race.”

In addition to working on storytelling, these cards are perfect for addressing additional skills, such as naming colors, objects, and shapes, as well as sequencing. They are also wonderful for language development, including using adjectives and adverbs appropriately.  The illustrations are appropriate for adult or pediatric clients. For more information, or to order a set, click HERE.

Wednesday, April 29, 2015

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



As an occupational therapist that will have been practicing for 24 years next month, I am privileged to have spent most of those years working in pediatrics.  In fact, when I first heard about the topic of this series of posts, my initial thought was that it would be much easier for me to write about the many ways in which I have benefitted from interacting with the children with whom I have worked.  As my perspective has shifted many times over the years as a result of connections I have made with others in my role as an O.T., one of the most powerful lessons I have learned also happens to involve a situation in which the thinking of others changed because of something that happened during an O.T. intervention.

About midway through my years as a school-based O.T., the kindergarten teacher of a child on my caseload approached me in the hallway one day after school.  She told me that the student, whom I will call “Carol,” had refused to follow directions given by the teacher in class earlier that day.  Evidently, the teacher had been calling on students one-by-by to go up to the front of the classroom and count to 20, as part of her assessment of their progress in math skills.  When Carol’s name was called, the child did not get up from her seat.  Even with prompting and encouragement from the teacher, Carol didn’t comply.  The teacher said she hoped to be able to document that the skill had been mastered by this bright little girl the following day and had emailed Carol’s mother to let her know what had happened.  Later that night, I got an email from Carol’s mom asking me if I had any ideas about what was going on or what could be done to remedy the situation.

As an O.T., I know that there are many dimensions of a person that go into his or her ability to perform a skill or to complete an activity – from vision and hearing, to focus and cognition, to motor skills and more.  Two things I learned early in my career to consider, especially when a child refuses to even try to do something, are motivation and emotion, and, with that in mind, I sent an email back to Carol’s mother asking her to bring Carol to school a little early the next day.

The following morning, after talking to the teacher to let her know my plan, I took Carol into the classroom and told her that I was going to do some “morning stretches” that she could do with me if she wanted.  After she had imitated my movements for a few minutes, I asked her what had happened the day before when she had been asked to count for the class.  “I felt way too hot,” she told me. “I wanted to do it, but I was just so hot.”

Realizing that motivation wasn’t a factor in her decision not to comply but that emotion likely was, I decided to shift gears.  I picked up a couple of beanbags from a bin in the corner and told Carol that I wanted to see if she and I could catch and throw together.  I said “Now!” as I released one beanbag to toss it to her, and she threw the second beanbag to me at the same time.  It took us a few minutes to get the rhythm just right, but after that we were able to keep things going without dropping either beanbag for several minutes at a time.  Once I could tell she was really focused, I said, “Let’s count each time we catch one and see how high we can get!” Without any help from me, Carol started counting and made it up to 24 before a beanbag fell to the ground.

“You’re really good at counting,” I told her, and she grinned from ear to ear.  “Do you feel hot now?” I asked.  “No!” she exclaimed. “That was fun!  Let’s do it again!”

“OK,” I said, “but this time, stand at the front of the classroom while we do it so you can practice counting there.”  After she had moved into position, we got started again, and she counted to 27 that time.  “Let’s try something a little silly,” I said. “Let’s do the same thing again, but this time let’s just pretend that we’re throwing the beanbags to each other.”  She willingly agreed, and that time we made it to 31, at which point I saw the teaching coming through the door. When I pantomimed dropping a beanbag, Carol looked up and saw her teacher and said, “Guess what!  I’m not too hot to count anymore!” 

Later that day, the teacher reported that Carol had counted to 20 in front of the class without hesitation, and then she leaned a little closer to me and said, “I didn’t think about why she wasn’t getting up to count yesterday.  It seems like she was just unsure of herself and so she was afraid or nervous.  Next time I run into a situation like that, I will think about the emotions that go into that kind of thing.”  In the weeks that followed, the teacher told that story to Carol’s parents, to the principal, and to the other teachers at the school; each time I happened to hear her talking about what had happened, I heard her end the tale with, “Who’d have ever thought that courage could be found through pretending to catch beanbags?”

Stephanie is an alumnus of Washington University in St. Louis, where she graduated with a degree in Occupational Therapy in 1991. As a school-based OT for almost two decades, Stephanie specializes in pediatrics and holds a certification as an Assistive Technology Professional (ATP) through the Rehab Engineering & Assistive Technology Society of North America (RESNA). Her professional interests include providing intervention services for individuals with disabilities and working with their families and other professionals in the field to promote evidence-based practice and to decrease barriers for people through design, selection, and implementation of A.T. materials and strategies. Please visit her website @ https://stephanielancasterot.wordpress.com.

Tuesday, April 28, 2015

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


I first met Sarah when I was a brand new OT.  Despite having grown up with a sister who had significant physical disabilities, I will admit that I was overwhelmed when I met her for the first time.  Severely impacted by a very rare and progressive neurological condition, Sarah was completely dependent for all movement and positioning, was nonverbal, and had already long outlived the very short life expectancy her doctors had set for her when she was diagnosed.
I am a school-based OT, and there was a stark contrast between the hustle and bustle of my usual primary school setting and Sarah’s home when I arrived there for our weekly sessions.  It was so quiet and at first, I felt awkward trying to chat with Sarah while I stretched her, positioned her, transferred her, and applied all of her orthotics.
Gradually though, I began feeling a warmth and closeness with Sarah – her strength and spirit shining through despite her limitations and silence.  Her mom and I also began a very comfortable friendship.  She shares stories about Sarah as a baby and toddler before she was diagnosed and I get a little glimpse into who she was, who she really is underneath all of the plastic splints and braces.  The funny, sassy things she used to say before she lost her ability to speak.  The quirky ways she used to scoot herself around as a baby and toddler before she lost her ability to move.
There are times when we as a therapy team worry about how we’re going to document progress in this case, how we are going to show that we’re a necessary part of Sarah’s school programming.  But it’s pretty clear to all of us that school for Sarah means something quite different from what it means at our hustling, bustling primary school.  Yes, we provide services related to preserving range of motion in Sarah’s body, we ensure that she has appropriate devices for seating and positioning, and we evaluate the fit and function of her orthotics.
But more importantly than progress and goals, for Sarah, therapy really means consistency, stimulation, touch, familiar sounds and voices, and support and routine for Sarah’s mom and dad. It is the truest case of “therapeutic use of self”.
For me, being Sarah’s therapist is about showing up. Not just physically showing up and going through the motions, but showing up in a very real and emotional way.  It’s about receiving the lesson Sarah teaches me every week – that life can be painfully fragile and unfair but that the human body, the strength of the human spirit, and the love of a family can go far beyond labels, diagnoses, and expectations.
Claire Heffron holds a Master of Science in Occupational Therapy from The University of North Carolina and has been practicing in public and specialized school-based settings for 10 years.  She and Lauren Drobnjak, PT, are the co-creators of The Inspired Treehouse, where they share useful information about common developmental issues along with hundreds of activities for kids designed to promote healthy gross motor, fine motor, and sensory development.  Follow The Inspired Treehouse on Facebook, Pinterest, Twitter, and Instagram!

Sunday, April 26, 2015

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


It’s the little things that make life big:  “See those pictures, mommy?”

I am honored to be a guest blogger on Dr. Anne Zachry’s “Pediatric Occupational Therapy Tips” as part of her special series to honor OT month!  Thank you, Anne.   I hope you and your readers will enjoy one of my favorite moments of my career.

Have you ever worked with a child and his mom who have both been around the therapy and medical scene for some time?  You can picture them now, can’t you?  They are both accustomed to a life that is basically a medical/therapy routine but have found creative ways to fit something besides appointments into their daily schedule!  Sometimes they have to travel an hour or so to their appointments, with most of their medical concerns being addressed in a larger hospital outside of their home town.  And almost from the day of his birth, the child has been put through rounds and rounds of tests, hospital stays, and treatments.  Let me introduce you to my “mom-and-son team” and the way that a “little bit of OT” made a “big” difference in their lives.

For confidentiality’s sake, let’s call my little man, Jack, and say that he is 6 years old.  Jack had been coming to this particular clinic for quite some time for occupational therapy to address his overactive sensory behaviors.  I was new to the clinic and Jack was one of the first children to be placed on my caseload.  Jack was small for his age; but what he lacked in size he made up for with mega amounts of energy and enthusiasm. Each time Jack was greeted at the clinic, he’d run headlong into you and grab your legs and yell, “Hello, Katherine!”  Yep.  Yell.  He loved people and couldn’t wait to get into the sensory gym to find out who was in there to play with him.  As soon as I’d open the door between the waiting room and the corridor, Jack would be slipping and sliding down the hall toward the gym, running face first into the walls and corners, and flying into the ball pit room by the seat of his pants, yelling, “Hello, guys!”  Everyone loved Jack.  There was no way you could resist his huge smile and extra warm greetings.  All of us did need to stand clear of him, however, whenever he wanted to hug you or run toward you.  Jack found it difficult to judge the pressure of his hugs and the force of his body as he “threw” it against something or someone.    Jack had been working on the underlying causes for these behaviors, as well as his unsafe movements, for some time and had not realized much success.  Let me note that this was not the result of inexperienced therapists or lack of family involvement.  So, when Jack was placed on my caseload, I was hoping that a new pair of “eyes” would uncover a different approach to address Jack’s needs.

One day about a month into our sessions, I had an “ah, ha” moment.  Jack’s activity of choice during therapy was the zip line.  Ours ran from one side of the room to the other, stopping right over the ball pit.  Each day, he’d run over to the ladder, stumble up it, grab the zip line (usually with only one hand), and zip  about half way to the ball pit and let himself drop off.  (Thank goodness for totally padded floors!)  I had worked on several strategies with him to help him maintain his hold on the handle; but I began to feel that the reason why he was “falling off” wasn’t due to a sensory or strength issue.  It was most likely a sensory issue, yes, but it was his visual sense!  Jack would attempt to grab the handle with both hands but only be successful with finding purchase with his right hand every time.  And although we would guide him with tactile, auditory, and visual cues toward the ball pit, he would always fall very short of the mark.  In the corridors, slowing down or holding hands did not prevent Jack from coming in close contact with walls, corners, and people.  All clues led to a visual concern.

My passion as an occupational therapist is the development and remediation of the visual skills.  I have worked closely with developmental optometrists in both the adult and pediatric populations.  That day at the zip line, I thought, “Now why did this take me so long?”  I continued to assess Jack’s visual behaviors during both fine and gross motor work and I found that, for the most part, he did well with fine motor activities.  In fact, they tended to calm his overactive movements.  But his unsafe gross motor behaviors certainly indicated that he might have a vision need in that area.  It was time to talk with mom.

Now, Jack might have been energetic and in constant motion; but his mom, in contrast, was quiet, but very confident.  She carefully weighed Jack’s therapy and medical options and was an active participant in his treatment sessions.  When I discussed my concerns about Jack’s vision needs with my supervisor, I had been guided against offering this mom any more to “put on her plate.”  It was felt that she was overloaded with bad news and should not be burdened with thoughts about possible vision needs.   However, although mom had worked closely with my supervisor before I came into her life,  she respected my work and my suggestions.  So, I made the “big” decision to say a “little” about vision at our next visit. 

At first, mom was reluctant to consider that Jack would benefit from a vision assessment by a developmental optometrist, as Jack was being seen regularly by a doctor at a prestigious children’s hospital for all of his medical needs, including “eyesight.”  I set the idea of a developmental optometrist aside and asked if she would consider having his medical doctor assess his vision skills in more depth, to include peripheral vision, depth perception, and visual perception.  She agreed on the spot.  She felt that if I was that concerned about his needs, she would make an appointment right away and provide the doctor with my written note about my observations.

A few weeks later, she and Jack came back from the doctor’s with great news.  Jack was going to get glasses.  My first thought was, “Yikes!  Glasses and the zip line and the ball pit!”  But, I also felt relieved and hopeful that Jack’s behaviors would be modified if his vision skills were indeed one of the culprits responsible for his unsafe behaviors.  The glasses were dispensed quickly, and the best part of this story was mom’s face and smile when she said to me, “Katherine, after he put on his glasses and we walked down the hall of the hospital – a hall he’s walked down many,many times – he looked up at the wall and said, ‘See those pictures, mommy?’ “  Now, that’s when a “little bit of OT” makes “life big!”

Now, it’s difficult to identify “the chicken or the egg” in this story – if his movement behaviors/sensory needs were indeed the result of a lifelong visual need or if the sensory behaviors developed in tandem with his poor visual skills.  But, considering the impact that vision development has on the learning of both gross and fine motor skills, I felt that it wasn’t important to determine which came first but to provide Jack with improved visual skills so that, in turn, our work on the sensory behaviors would benefit.  Vision leads the body in movement activities.  And now, Jack could actually “see where he was going.”

Happy OT Month!
Katherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of children’s handwriting development skills.  You can find her on her website, www.handwritingwithkatherine.com