Occupational Therapy Month Kickoff!

Welcome to National Occupational Therapy Month! This March, we will emphasize the following skill areas each week:

WEEK 1: Activities of Daily Living

WEEK 2: Fine Motor

WEEK 3: Sensory Processing

WEEK 4: Play

…so stay tuned for our weekly blog posts with tips and activities to promote each OT skill area!

Continue reading to learn more about our OTs and why they do what they do!…

Question #1: Why did you become an OT?

Nicole: I have always known I wanted to work with children in some capacity, but choosing a particular field proved challenging.  I was introduced to occupational therapy through a member of my family, and I quickly developed an interest in the field.  Occupational therapy sparked my interest because of its broad array of domains and areas of occupation, as it offers unlimited possibilities to people of all ages.  I wanted to play a part in enabling individuals to live life to the fullest.

Kavita: I’ve always wanted to work with young kids with disabilities. My mother was a preschool special education teacher and I have fond memories of being a peer model in her class when I was younger, and volunteering as an aide when I was older. I was first introduced to OT when I volunteered in high school at CCS (California Children’s Services).  The OTs made a huge difference in the quality of life for so many kids and I knew that was what I wanted to do too!

Jill: I became an OT because I wanted to help people in a way that was meaningful.

Erica: I decided to become an OT as an undergraduate Child Development major first and foremost because I love kids. I have worked with children with and without disabilities since I can remember, and love that I was able to make a career out of it!

Shana: I have always known that I wanted to work with children. When I was in elementary school I wanted to be a teacher, but as I got a little older I realized that I wanted to work with kids outside of the classroom. I fell in love with Occupational Therapy because I get to help kids achieve goals in every area of their lives. My job is to help kids learn to be kids. How cool is that?!?!

 

Question #2: What is your favorite thing about being an OT?

Nicole: During my field work in graduate school, I was given the opportunity to visit a variety of different occupational therapy settings; I immediately fell in love with my pediatric setting. Learning and teaching that play is the occupation for children was a revolution in my mind, and I could think of nothing better than to make pediatric occupational therapy my profession.  I love the experience of watching a child grow, be it through writing his/her name, tying a shoe, eating a vegetable, or playing with a peer.  I have learned that “play” can be challenging with children, but I look forward to each moment, and treasure the opportunity to be spontaneous and creative.  I enjoy the everyday challenges of thinking outside of the box and connecting with my inner child!  Not every person can say, “I had fun at work today,” but I can every single day!

Kavita: The occupation of being a child consists of exploring the world, playing, and becoming more independent. I love participating with children as they grow in these areas. Even though some days may be difficult, the overall progress that children and their families make is the most rewarding aspect of my job.

Jill: My favorite thing about being an OT is that I can be creative and really see a person as a whole.  I love that I not only work on the physical being but the emotional being and how they interact with their environment.

Erica: I like that I get to work with children and with families. I love that I get to play at work and that kids can work on their goals through activities that they enjoy. I also like to see the amazing progress that kids make, and those moments where it finally ‘clicks’ after weeks and months of trying a new skill!

Shana: There is nothing better than seeing a child’s face when her or she is able to a new skill completely by themself for the very first time. The pride and excitement that comes with independence is so empowering for kids.

 

Question #3: What are your go to OT words of wisdom?

Nicole: Play provides us with an endless opportunity to grow, learn, and experience our surroundings.  It’s through play in which we learn about ourselves and our environment.  There is no better time than the present to encourage new experiences so get out and explore.

Kavita: As therapists and parents, it is difficult to see kids fail or struggle. It’s important to remember that some of the best lessons are learned through mistakes. Let your child try their own way and be there when they need you for guidance. When children try, fail, and try again, they become independent problem solvers.

Jill: For parents, keep focusing on the positives no matter how small or large.  The hard times will come but in order to move forward it is important to always remember and celebrate the wins!  For providers, don’t be afraid to have fun.  We are always striving to reach goals and help families, but the road will be a lot longer if we don’t stop to enjoy our clients and families that we support.

Erica: Play is more of the most important and essential functions of childhood. According to AOTA, “It is a child’s ‘job’ or ‘occupation’ to play to develop physical coordination, emotional maturity, social skills to interact with other children, and self-confidence to try new experiences and explore new environments.” That’s why it is so important to find the time, even if it’s just for a couple minutes, to get on the floor and engage in some unstructured play with your child. Follow your child’s lead, help him/her expand on his/her play ideas by adding in a new element, and just get silly!

Shana: A kid’s job is to be a kid. They need to finish their homework and their chores. They need to be able to tie their shoes and brush their teeth. But, most importantly they need to be able to have fun. Run around on the playground and play a board game with friends. And at the end of the day enjoying a big bear hug from a loved one!

Posted by: Your Lakeside OTs – Nicole, Kavita, Jill, Erica & Shana.

PROMPT Workshop!

An example of what PROMPT looks like –  here I am providing an organizing, supportive parameter prompt to Charlotte.

Last week I attended a workshop to receive training in PROMPT – the acronym stands for “Prompts for Restructuring Oral Muscular Phonetic Targets.”  This a short description of what PROMPT is from the program’s official website (http://www.promptinstitute.com/):

The (PROMPT) technique is a tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, tongue, lips) to manually guide them through a targeted word, phrase or sentence. The technique develops motor control and the development of proper oral muscular movements, while eliminating unnecessary muscle movements, such as jaw sliding and inadequate lip rounding.

I look forward to using the techniques I learned in the PROMPT workshop to provide additional sensory input and postural support to encourage the production of speech and development of articulatory control.  I have already began using the techniques with some of my clients, and have noticed some positive results – although they might have been initially hesitant to allow me to touch their faces (as was Charlotte).

Posted by: Andy, Speech-Language Pathologist

Parental Involvement in Therapy

Even with an attempt to provide  the most intensive intervention schedule possible, children will almost always spend a greater portion of their time at home with their families than in therapy services.  And although a lot of this time should be “downtime” – children should not be expected to work the 70-hour grind of a high-powered stockbroker – there certainly exists the potential for implementation of therapy objectives and practice in the home environment with parents or caregivers as the agents of intervention.  If parents are able to address therapy goals with their children at home, they can accomplish powerful outcomes – children’s practice related to therapy goals will increase, the child will have the opportunity to generalize use of learned skills outside of the therapy setting, and the use of strategies related to improving communication skills will hopefully have the effect of deepening and enriching the relationship between the parent and child.

Consider this analogy – when a child is leaning to play a musical instrument, they are expected to practice at home to develop their competency.  If they only practiced during their music lessons, it would take a long time for them to bring their skill level to to point where they would be playing an intelligible song, much less occupying the first chair of the London Philharmonic or playing bass in a Journey cover band.  This is akin to the reality of therapy.  Change is certainly possible with direct contact with the therapist as the solitary means of intervention, but the possibility for a faster rate of change as well as increased generalization exists if parents and therapists can work together to implement therapy goals.

There are, of course, many reasons why parents are not always involved in delivering intervention in the natural home environment.  For one, the analogy between therapy and practice of an instrument does not really hold up upon closer inspection, especially in regards to speech-language therapy.  I would not want a parent to send their child to their room to say 100 words with the “th” sound, like you would direct a child to go to their room and close the door so you would not have to hear a squeaky, out-of-tune version of “Ode to Joy” for the hundredth time.  Rather, speech-language therapy objectives almost universally need to be targeted in the context of an interaction, whether in play or in conversation, and this takes time and effort on the part of the parent, and both time and effort might be resources which would be in short supply.  However, the time devoted to practice at home need not be as continuously intensive as in therapy – 5-10 minutes a day would be a fantastic starting point for many families.  Our goal with therapy objectives is not that children replicate these skills only in the therapy environment, but in their home, their school, and their community.  Parents supporting practice in natural environments will help make this goal a reality.

I know that it may seem daunting for a parent to adopt some “work” to do at home  with their child.  However, I think that it is important to realize that when pediatric therapy is done well, it should not seem like work – it is best when progress towards therapy goals is exciting and fun for both the child AND the adult.  The introduction of structure and expectations into play is basically a broad definition of pediatric therapy.  There are almost always methods through which therapy goals can be incorporated into preexisting play routines or activities which parents and children already make a habit of enjoying together.  For example, if a parent and a child have a routine of playing catch, the child could be asked to practice a therapy objective before each throw, whether it is saying a certain sound, balancing on one foot, or writing a sentence.

One of the most effective ways which a parent can become a “surrogate therapist” for their child is for a parent to join a session and be explicitly instructed on ways to incorporate and implement therapy strategies and support.  When a parent joins a session, they have the opportunity to become an active part of the therapy process, and to be coached in the tenants and techniques which result in beneficial outcomes for their children.  Therapists also benefit from the parent’s extensive knowledge of their child’s interests, and their ability to read their child’s emotions.  By making pediatric therapy a partnership between parents, children, and therapists, I believe that the best possible outcomes will be achieved.

Posted by: Andy, Speech-Language Pathologist

Motor Skill Tip: Flamingo Stand

The blurry picture above shows how wiggly this kiddo was when trying our next motor skill idea: Flamingo Stand! Flamingos are the absolute best at standing on one leg, and what better animal to try to be when working on those balance skills? Practicing standing on one leg like a flamingo works on a lot of skills:

• Leg strength
• Core strength
• Balance reactions
• Imitation (especially if you have the kiddo try to match your body position)
• Body awareness
• Coordination of the Left and Right sides of the body
• Motor planning

 

Getting a kiddo to try standing on one leg, especially when it is very challenging for them, can be tricky! Some ideas to try to sneak in this practice is trying to stand like a flamingo in line at the grocery store, while brushing teeth, or having contests with siblings or peers while playing games at home. You can challenge a kiddo to increase their balance time by giving them a time based-goal, such as 5 seconds or 7 seconds. If a child needs support, you can start by having them hold onto a counter or the wallt, then gradually move away from that support as they are able. If a kiddo bends at the hips to try to keep balance or is unable to stand on one leg for more than 1-2 seconds without support, it may still be beneficial for them to still try this skill while holding on (just slightly!) to a counter or wall so they can build their skills. Once they’ve (or you’ve!) mastered balancing on one leg without holding on to support, add the next step: hopping! Remember to try both legs…no lopsided flamingos!
Posted by: Carrie, Physical Therapist

Inspirational Videos to Help Survive Monday With

Last night, Comedy Central hosted a fundraiser which generated over $4 million dollars to go towards funding therapeutic interventions for autism spectrum disorders. Starring for the event was a young woman with autism named Jodi DiPiazza, who had the chance to sing one of her favorite songs onstage with the person who originally performed the song, Katie Perry.  Here is the video from the event, complete with a Jon Stewart introduction, a mini-documentary as a testament to Jodi’s progress in therapy, and Jodi absolutely blowing her celebrity co-star out of the water during the performance.

 

 

Another fine YouTube video performance from an individual with autism is one courtesy of Anthony Starego, a high school senior who kicked what turned out to be the game winning field goal for his school’s football team.  Not to be missed is his celebration, in which he runs almost the entire length of the field before he begins the obligatory chest bump process with his teammates.  Who can blame him?  The crowd absolutely erupted.  Just a hint more inspiring, say, than a Bengals-Steelers Sunday Night snoozefest.

 

 

Posted by: Andy, Speech-Language Pathologist

Physical Therapy Month – Parent Testimonial

 

When I look at the schedules of the families who come to our center, and think about the days that our kids experience, I feel overwhelmed. I am constantly amazed at the way that our parents and amazing kids keep up their energy and maintain those busy schedules. So amidst it all, I can understand how difficult it is to fit in another hour of therapy a week. However, I also believe in how important physical therapy is for kids who need it. Physical therapy can help support all areas of a child’s development. Don’t just take it from me, though! Here’s a parent’s testimonial about her family’s experience with physical therapy for her son:

“We knew adding physical therapy to our son’s busy therapy regiment would be beneficial but we had no idea how much it would develop his strength, coordination and confidence in such a short period of time.  It was exactly what he needed for gaining the ability to conquer his fears on the playground as well as in elementary PE.  Carrie Hoyt had the exact recipe for breaking down challenges into appropriate steps and encouraging him to continue trying new and difficult tasks while giving the right amount of support and encouragement. Our son blossomed under her care and direction.  Among the many goals she worked on were developing his core strength and balance, identifying and working on visual motor challenges and encouraging confidence in his abilities so that he doesn’t have to feel different from the other kids.  He used to watch the others navigate the playground and hang his head in despair because he couldn’t do what they were doing. The smile on his face and the look of pride in his eyes I see when he slides down the fire pole, climbs the rock wall or rides his bike at the park says it all.  I can’t say thank you enough for the amazing support physical therapy has played in our son’s development and self esteem.  I am so grateful to Lakeside Center for Autism for providing such amazing therapists and care to our son and so many amazing kids.”

Posted by: Carrie, Physical Therapist

Motor Skill Tip for Physical Therapy Month – Crab Walking

 

“If you never did, you should! These things are FUN and fun is good!” –Dr. Seuss

The grin on the kiddo’s face above and the quote by Dr. Seuss summarize what we think about working on motor skills: it should be FUN! There are lots of little ways to incorporate fun motor skill development into the day and, as part of National PT Month, we’d like to share some of these ideas!

First up: Crab walking! Crab walking is silly and also works on the following skills:

• Core strength
• Upper body strength
• Lower body strength
• Coordinating the Left and Right sides of the body
• Coordinating the upper and lower body
• Promoting an alternating, reciprocal pattern of movement
• Planning a sequence of movement (“arm, leg, arm, leg”)
• Planning a path for movement (steering around corners in a hallway or around furniture)

Crab walking works the whole body! It can be tiring, so gradually building up the time and distance for crab walking allows the child to build endurance of the brain and the muscles without being overwhelmed.  Try going from the bathroom to the bedroom crab walking for a week, then try a longer distance the next week, such as the bathroom to the living room! Once the child has built some endurance for crab walking, you can increase the challenge by trying crab walking backwards or sideways or playing crab soccer! (Did you know crabs like to play soccer? They do!) Most of all, be creative and have fun! Also, give a try with your kiddo – it is a good workout for adults, too!

Posted by : Amanda and Carrie, Physical Therapists

Why We Love Being Physical Therapists!

Carrie –

“I love being a Physical Therapist (PT) for SO many reasons! Ultimately, exploring a child’s world with them is refreshing and challenges me to see things with an open mind. When I get the chance to take the time to explore with a child, I am reminded how important it is to take time to look at the world around instead of being caught up in my own busy world! The look on a child’s face when they achieve a new skill, such as climbing, bike riding, or jumping, that allows them to expand the ways in which they experience and explore their world is my favorite part of being a PT. The look on their face at that moment is one of freedom, fun, and exhilaration that can’t be matched anywhere else. Lastly, I love being a PT because I get to have fun at my job every single day!”

Amanda –

“I love being a PT because I get paid to play! 🙂 Well, it’s not quite as simple as that, but in a way it’s true. I love the challenge of having objective, clinical, ‘grown-up’ goals to accomplish and finding ways for therapy sessions to be engaging, motivating and FUN for the kids I work with! Sometimes I have to be pretty sneaky to get kids to do things that are hard for them, but the payoff is always worth it. I love seeing the joy on the faces of the kids and their families when I share the little (and not so little) victories as my patients progress as a result of the work we do together.”

Posted by: Carrie and Amanda, Physical Therapists

October Is Physical Therapy Month

Physical therapy promotes gross motor skill development and can help children improve their strength, coordination, balance, and motor planning. Physical therapy helps children to explore their environments, engage in peer interactions and expand their recreational play skills.

It’s a small department here at Lakeside, but our physical therapists (PTs) make a big difference!! Carrie and Amanda are excited to spend the next few weeks sharing all the great things about their profession with the Lakeside community.

Amanda and Carrie are also excited to announce Lakeside’s Motor Skill Olympics in celebration of all things PT! Olympians of all ages are invited to complete challenging “events” with their families and their other therapists at LCA. Participants can earn medals and have their hard work recognized on our “Wall of Fame.”

Be on the look-out for bulletin boards and blog posts with lots of great information, stories, and family testimonials.

Cheap, Fun, and Highly Productive Play

I once conducted an entire 50-minute, speech-language therapy session with no other materials besides a  pinto bean and a Kleenex.

The client and I were solidly engaged in describing and elaborating on the actions and emotions of our two protagonists for the entire time we were together.  The pinto bean and Kleenex went to school, had lunch at McDonald’s, climbed a mountain, and went to bed exhausted.  Yes, our clinic is feeling the sting of denied insurance claims – but not to the point where we can not afford actual toys or high tech gizmos.  There just happened to be, in the therapy room we started our session in, a box of Kleenex and a bean which had fallen out of a sensory bin.  However, from these humble materials, I had the opportunity to target narrative development, verb tense, syntactical structure, and auditory comprehension.

Now, don’t get me wrong – I love flashy toys, iDevices, board games, and even the occasional Super-Duper product.  But I believe that there is no toy or technology greater, or more fun, than encouraging a child to use their imagination. “Spontaneous” production of speech and language goals is often the desired end result of intervention, but it also feels good to facilitate “creative” productions, as well.  It is a good thing for the client also, as no less a pseudo-deity than Rhea Paul wrote: “Play… is the most natural context for language learning.”  In addition, Paul said, “more advanced modes of symbolic thinking” will “provide even richer contexts for language acquisition.”  So there you have it – the next time your iPad’s battery dies, try channeling your inner therapeutic MacGyver, fire up your imagination (possibly with the help of a venti-quadruple shot-vanilla caramel latte with a chaser of Red Bull), and dive in.

Posted by: Andy, Speech-Language Pathologist