I will be working as a COTA/L in an outpatient Peds clinic starting next month after working all summer in a SNF.( I did a 2 month FW rotation at the Peds Clinic) I have a background in Early Childhood Education as well. I remember well learning in ECE that "play" is a child's work...or we might call it their "occupation". Of course, my focus as a young adult in a childcare setting was focusing mainly on typically developing children. As a COTA/L I will deal with atypical children and the ability to play becomes even more important. I will deal with ADL's such as dressing and shoe tying but much of my job will consist of helping a child make sense of their environment through sensory play..especially the very young children. I will also compliment the goals that are typically "school" related with handwriting and other FM skills. It is very different than the FM activites we might find in a SNF as far as goals are concerned but we do have theraputty in common. LOL
I know we talk a lot on here about the inappropriateness of UE therapy for many patients in a SNF but pediatric patients almost never do reps with weights when UE strengthening is required. My favorite is a yoga board game where patients imitate animals doing various poses. In a SNF, functional therapy is appreciated more by patients than having it be necessarily "fun". But, for kids it is different. You often have to make therapy fun to reach functional goals. Diane R COTA/L -----Original Message----- From: [email protected] [mailto:[email protected]]on Behalf Of [email protected] Sent: Monday, August 24, 2009 19:39 To: [email protected] Subject: Re: [OTlist] A New One Ron, I worked in a public school district for 5 years. There were only 2 kids (out of about 70 on OT caseload) who had diagnoses such as CP that caused them difficulty with transfers or ADL's. The majority of kids I saw had more "soft" neurological symptoms due to sensory issues, fetal alcohol syndrome, developmental delays, ADD/ADHD, or were somewhere on the autistic spectrum. The kids with the physical problems as well as those with the severe sensory issues were also going for extensive outpatient therapy 2-3 times a week at the same time that they were receiving school-based OT. Most all of these kids could walk, carry their lunch trays, get on and off the swings, but couldn't open and close scissors, use a ruler, or write. So while of course we worked on these things, we also worked on the underlying causes, such as trunk and upper extremity weakness, spatial skills, and yes, fine motor skills. Don't forget we work on the patient's goals, and most of these kids cared very! much if they couldn't print their names or cut a straight line. These are all childhood occupations. On most school-based assessments, these very functional skills are classified under "fine motor skills" so I think when that teacher said "fine motor" she was thinking in terms of functional things like cutting, writing, etc, where you may be thinking of "fine motor" as pegs and other "exercises" that may constitute fine motor in an adult setting. Re: SLP's vs, OT's in SNF, when I see SLP's doing cognitive therapy in a SNF, they are doing tasks such as using flashcards, etc. for the purpose of remediation (which I think is silly when we are talking about dementia; it is not like TBI, in which functional gains could be realistically expected). When I do congitive "treatment" it is more compensatory to help a resident with orientation or ADL skills. An SLP's goals might consist of things like "Resident will recall 3/5 objects presented" where mine might be "resident will locate her room independently with visual cues (such as a picture placed on her door). I don't think we're necessarily competing with each other or working on the same things. Ilene Rosenthal, OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
