The differences between adults and children

Another obvious entry - perhaps. I used to work in a children's hospital and I enjoyed spending time in the orthopedic clinics. I particularly enjoyed splinting, casting, and fracture bracing. The best part was that despite having broken bones the kids were almost universally interested in getting back to their typical occupations. It was important to work with the orthopedic surgeon to make sure there was appropriate stability, but then we got to educate the family on how to reign in the energy of a 3 year old even though they had a long leg cast on, or talk about how to secure the child in a car seat with the cast, or how to take care of toileting needs. The interventions were direct, practical, and there was almost always the exact result that you expected. Kids heal well, they heal fast, and they don't like to wait while that healing process is proceeding.

I contrast this to working with adults who (as a population) respond very differently to a fracture than a child. Adults hold their broken extremities out like wounded paws. They don't generally rush back into activities. They take time off of work. Accordingly, the also develop complex regional pain syndrome at higher rates and have more complications. An adult who fractures their humerus may need therapy to strengthen the shoulder and to improve range of motion in the elbow. Most kids never need anything. Even when children do need therapy, they generally only need to be followed once a week to monitor a home program. I find this to be generally true even when there are temporary nerve problems that sometimes occur during pediatric supracondylar fractures.

This is on my mind because my daughter, who despite being instructed otherwise, decided to pretend to be Tony Hawk with her cousin's skateboard. As a result she fractured her left clavicle. There is little to be done about it other than wear a sling and suffer for a few weeks. She is undaunted though, and presently banging away on her drum kit upstairs to see if she will be in good shape for her upcoming concert.

Perhaps if everyone was like this there would be less of a reason for occupational therapists!

Comments

Cayzle said…
Chris! So now I have to read your blog to get basic family news! Huh!

Hope the kid is doing ok.
2:04 PM
Post a Comment

Popular posts from this blog

On retained primitive reflexes

Each year I receive several emails from colleagues about 'retained primitive reflexes.'  I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic.   Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.'  Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen. The following is the kind of information that causes concern and was provided to me by a colleague as a sample from a student's IEP: The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyri...
Read more

Deconstructing the myth of clothing sensitivity as a 'sensory processing disorder'

Please note first that there is no formally recognized clinical designation of  'sensory processing disorder.'   It is a term constructed by occupational therapists that has not been formally recognized by the larger medical community. In our clinic we receive many referrals from local pediatricians when parents have concerns about children being overly sensitive to their clothing.  Most often the children referred are from four to seven years old and the families are severely disrupted by the children's behaviors and responses to clothing issues.  Commonly, children will have severely constricted tolerance for certain outfits, want to wear the same clothes repeatedly, complain that clothing is itchy/scratch/bumpy/wiggly/ouchie, and this all leads to disruption of daily dressing routines.  There is no doubt that the behavioral concerns are very real. The pediatricians tend to be appropriately conservative and provide families with good behavioral manage...
Read more

On Ideological Shifts in Occupational Therapy Education: Reflections on DEI and the Presidential Executive Order

Image
The Accreditation Council for Occupational Therapy Education (ACOTE) Standards have evolved over time, with the 2023 updates reflecting a continuation of a broader ideological trend in the profession. Specifically, these updates prioritize Diversity, Equity, and Inclusion (DEI) in ways that raise fundamental questions about the balance between professional accreditation requirements and academic freedom.  The 2018 Standards recognized diversity as an important foundation for occupational therapy education. While encouraging awareness of diversity issues, these standards avoided prescribing specific ideological frameworks. This approach respected the autonomy of educational institutions, allowing them to incorporate diversity as they deemed appropriate while maintaining space for academic freedom and intellectual diversity. In contrast, the 2023 Standards explicitly embed DEI principles, including equity and justice, as requirements for occupational therapy programs. Faculty are now...
Read more