Online Therapy Services

Telepractice is a way for therapists to reach families in under served areas.  Telepractice is a way to support families without being directly/personally in the home.  This option can be used in conjunction with direct service models of therapy.  TinyEYE provides information about their Speech Therapy Online Services.

 

http://blog.tinyeye.com/2013/11/07/online-speech-and-occupational-therapy-what-we-are-not

 

 

e-occupational Therapy

The Canadian Association of Occupational Therapists (CAOT) had published a position statement on the use of telehealth practices for occupational therapists.  In their document they outline recommendations and initiatives.  Their recommendations include:

  • Use National Initiative for Telehealth Guidelines to promote quality services
  • Use Evidence Based Practice
  • Engage in Continuing Education
  • Work within your scope of practice, regardless of the service delivery method

The CAOT feels that telehealth services, including occupational therapy, can help with healthcare access and equality.

How do clinician and families in need of services meet?

 

Reference:

https://www.caot.ca/default.asp?ChangeID=170&pageID=4005

Occupational Therapy Month

April is occupational therapy month and also Autism Awareness month.  These two campaigns go well together as OT’s can have a positive influence on the lives of people with autism.  OT’s are often specially trained in sensory integration, teaching Activities of Daily Living, dealing with feeding/eating issues and improving social skills.

Back to School

September is a challenging time for many families as children with special needs transition back to school.  Some children really enjoy returning to the routine and stability that school provides.  Other children experience anxiety related to returning to school.  Here are a few helpful hints:

  1.  If possible, visit the school and/or teacher prior to the first day.  If not possible in person, see if there is a way to do a video tour of the classroom or Skype with the teacher.
  2. Have a printed schedule of the daily routine and review it with your child or begin to practice the week before.
  3. Create a special story or routine around a favorite or new toy that your child will be able to bring to school.  Older children could choose a special picture or necklace.
  4. Have a playdate with children from your child’s new class or old friends that they haven’t seen in awhile.

Although back to school can be a challenging time, it can also be a time to see your child shine as they grow.

Nature in OT

Do you incorporate nature therapeutically in your practice?  Do you point out natural elements, make use of the seasons or treat your patients outside?  I do.  Natural materials make excellent creative play materials that make suggestions, but do not force the imagination.  The seasons provide an ever changing focus for teaching ADL’s and social interactions.  Exposure to the outdoors provides improved outcomes for patients in medical based settings (such as hospitals) and I believe the outdoors also helps outpatient pediatric therapy be more effective.  The calming and ever changing characteristics of the outdoors help children with both underactivity and hyperactivity.

Boy Swinging from TreeYet, what does it mean to incorporate nature therapeutically into your practice?  Does taking a child to the neighborhood park count?  How about facilitating a playdate in the backyard?  What aspects of nature would be therapeutic to your client?  Does playing in a fenced yard beside a highway benefit the child?  Does riding a bike in a parking lot help the teenager connect to nature?  Does learning about bird calls on an iPad incorporate nature?

Incorporating nature therapeutically into your practice means considering which ways nature can assist in facilitating the clients OT goals.  This means that the therapist has engaged in clinical reasoning to determine which aspects of nature should be included and which aspects may be less helpful.  There are many sensory, physical and attentional qualities to outdoor spaces.  The therapist is in charge of defining what aspects should be included in the session.  In addition, the therapist is responsible for making sure the scene is safe for the goal to be addressed.

A neighborhood park may be an excellent place to work on gross motor skills or to learn how to introduce oneself into a play situation.  Either of these goals may include or ignore the natural elements at the neighborhood park.  Does the park have safe natural obstacles to foster gross motor skills such as climbing in, over or on?  The therapist must have knowledge of what surfaces and opportunities the park would offer for gross motor skills.  The texture of grass could help a child improve their walking by going barefoot.  Nature could facilitate a better walking posture by walking over varied terrain.  A child could learn how to introduce himself and play with others in the park outside of nature.  However, the therapist could facilitate mud pie building allowing the child with special needs an easy and fun way to introduce themselves to other children.

Facilitating a playdate in the backyard could also incorporate nature by using sticks and pinecones found in the backyard and creating a play scheme around these objects.  Just as easily the therapist could be in the backyard with both children and never invite nature to the playdate.  The therapist defines how much and when to emphasize the roll that nature will play in the playdate.  Children naturally gravitate to natural play if allowed free play times.  The therapist may also decide that the lack of a fenced back yard would make the playdate unsafe to hold in the backyard.  The inclusion of nature needs to be considered prior to the session.

What if the backyard is fenced by a highway?  What therapeutic value does this space have?  Does the child play indoors all the time due to her location near a highway?  The therapist could determine that the fence is safe and the yard is safe.  The therapist could then introduce a container garden for the child to include a more natural version of nature.  This may also encourage the child to go outside beyond the therapy sessions.  Perhaps, the therapist determines that the fest moving traffic is too disturbing for their client and that the outdoor environment would not be therapeutic.  The therapist may also try to facilitate a session that meets in a more conducive outdoor environment.

Riding a bike is an outdoor activity that people of all abilities engage in.  Learning to ride a bike in a parking lot may make the initial phases of learning to ride the bike easier through flat terrain and limited obstacles.  This wouldn’t necessarily connect this teenager to nature.  The connection to nature may come from riding his bike to a lake or nearby wooded area.  Without facilitation nature may not come into the bike riding conversation in a parking lot.  However, even the mention of the sun shining and the wind blowing may help that teenager make the connection.

Finally, teaching a child bird calls on an iPad may help a child with limited exposure to the outside connect with nature.  The iPad may be the link the child needs between the comfortable and the novel.  Some children appear afraid of large open spaces.  Learning to connect new sounds with birds may be a great activity prior to getting outside.  However, without getting outside the connection is abstract.  The connection to nature is virtual until the child goes outside and connects the learning with nature.

I hope to see more occupational therapist including nature in their practices.  I think the benefit that nature brings to my sessions is a catalyst to further learning and growth for me and my clients.

Holiday Gift Giving

Every year Toys R Us posts it’s holiday gift guide for differently abled children.  This is a great resource for families, relatives and therapists looking to get the right gift for a loved one in their life.

Here are  a few of my favorites:

Crayola Dry Erease Activity Board:This is a great gift that can be used during play time as well as to help structure your childs’ day!

Melissa and Doug Bake and Decorate Set :  I like this gift set because it encourages self-help skills that can be transferred into an activity with Mom or Dad.  I also like that the decorations can be wiped off and the cupcakes reused and redecorated.

Step 2 Wagon : This is kind of a classic type of toy.  It can be used indoors or outside and allows children to take their toys with them in creative play or for parents to take children with them on outdoor walks.  Anything that encouraged outdoor and creative play gets two thumbs up from me!

What are your favorite gifts?

STAAR Rehab Conference

The STAAR Rehab conference was another great experience.  I was able to take Sierra and learn more about PNF techniques and reviewed neurological rehab and progression.

“The Symposium on Therapeutic Advances in Animal Rehabilitation (STAAR) is a unique conference that provides continuing interactive, practical education for animal rehabilitation professionals.”

This conference has been a good opportunity for me as an occupational therapist to learn more about canine rehab from vets and physical therapists who are working in the field.  I love the focus that OT’s could bring to canine rehab with a focus on daily activities that the dog typically does such as eating, toileting, play, transferring into/out of a car, going for walks, etc.  Although dogs don’t need help with dressing- OT’s could still be helpful in the home care realm.

dog

The ups and downs of DM


We’ve been doing swimming this summer, but less so then last year. She needs help to keep swimming with her hind legs this summer. Underwater treadmill would probably be more helpful at this point as it would require more hind leg use. She seems to enjoy the swimming and seeing her doggie friend Milkway while she is there.

She has both good days and days that are more difficult. I judge many of her days by how well she is able to get up/down the steps, whether or not she plays in the yard and how much trouble she has getting up from laying down. The DM journey is full of ups and downs.

Back to swimming

Sierra is back swimming again and has been very perky since her swim yesterday. We just did 5 minutes in the pool as I didn’t want to push her too hard the first day. She swam the five minutes with ease and wasn’t too tired the rest of the day. I am going to try for 7-10minutes tomorrow or Thursday (depending on the weather).

I am also going to work with the families dog that has been kind enough to share their pool with me as their dog is having some hind end weakness. Hopefully, I will have a video to follow in the upcoming weeks.

I only wish the water was this nice:

The pool water was a chilly 70degrees this week.