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Showing posts from April, 2008

Myofascial release and evidence-based practice

File this under 'required reading.'

Please head over to myphysicaltherapyspace.com, specifically to the entry on evidence-based practice and myofascial release interventions. This is an excellent discussion and I hope you all have the chance to take a look at it.

Myofascial release is a modality that is much more widely used in physical therapy than occupational therapy, but it still crops up in OT interventions from time to time. I am especially concerned about so-called craniosacral therapies and the ways that some therapists combine these dubious interventions with other OT quackery.

I really don't have more to add than what was posted by Jason Silvernail, DPT - so please go read his excellent entries!

ADHD - stock question and answer

I recently got this email question, again. It is a relatively common email that I receive so I thought I would post the question and my stock answer here...


The Question:

My school district/teacher keeps telling me that my child has ADHD and needs to be medicated. They have been harassing me at every IEP meeting and want me to medicate my child. I have absolutely refused because I never believed that medication would fix the problems my child has.

How do I know if my child even has ADHD, and what should I do about it? How do I get the school to stop harrassing me? Any advice would be greatly appreciated.


The Answer:

The school district is not qualified or licensed to make medication recommendations for your child. Medication suggestions should come from your pediatrician/other physician, or psychologist who is working in concert with the physician. The point here is that medication is a medical recommendation and not an educational recommendation. Only people who are medically qualified sh…

Dangerous things happen when flights are delayed

I am currently stuck in Chicago, and have been for the last several hours. To an action-oriented person like myself free hours feel like they are taffy-time - stretched beyond any point of recognition of what they originally were.

This means that I have uninterrupted opportunity to mentally operationalise some plans. Mental operationalisation is somewhat oxymoronic, and I will need to explain that at another time. Also, I don't mean to use spelling that would more likely be found in other countries but a certain letter on this laptop is not working (the letter after 'y') and so I can't spell things in the way I normally would.

Anyway, I spent some time thinking about occupational therapy 2.0, which of course is stolen from the web 2.0 lingo which I actually kind of think is funny. Again, a story for another time. Anyway, it is time for occupational therapy 2.0. The blog was the first foray for me into the 2.0 world, and I have talked about the power of social netwo…

Occupational Therapy Street Reality: Early Intervention

Here is a quick clinical scenario, in case anyone is out there glamorizing pediatric occupational therapy practice.

This one is more "dirt road" reality as opposed to "street" reality.

I have been in squatter's homes before that have amounted to little more than foundation-less sheds and shacks tucked away on corners of land that other people have abandoned or forgotten. These are sad stories, but they are realities nonetheless, and these people make up a certain underclass of society that require a lot of support. As I drove up a country road toward my destination I saw rows of dilapidated trailer homes with lots of bare plywood, litter-strewn 'yards', and many roaming cats. There must be good hunting for the kitties around here.

The saddest part, I considered, is that this is an organized trailer park. Someone is actually charging these people for the electric and water hookups. I wondered what kind of person would want to make a business of supplying wa…

Personal examples of 'being in place' and how it relates to parenting

OK that last entry was too philosophical so I needed to find something to counterbalance the point I was trying to make. I wrote this seven years ago and it will serve the purpose of illustration.

Again, the concept here is that there needs to be some way to approach the meanings and intentions behind parenting decisions, and to find ways to harness phenomenological analysis as a tool to help parents move from point A to point B.

Anyway, this is a personal example of how it applies - and I hope this will demonstrate the depth of meaning behind a parenting moment. Knowing this depth from a personal perspective actually intimidates me - how can we achieve this knowledge of parents whose children we evaluate?

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"The sun dipped slowly behind the last dying hill as I travelled westerly toward home. I used to look at the landscape when I first arrived here and bemoaned the lack of geographic relief - I was so accustomed to the lazy rolling of worn-down Adirondac…

On phenomenology and the challenge of helping parents

I know that I am a pediatric occupational therapist, but I am also an adult occupational therapist because all the kids come attached with parents. Often, the primary point of intervention is with the parent and I think the roadblocks that I run into make me spend a lot of mental time considering the problems that adults have in operationalizing their occupational roles.

Now I know that I just dared to utter the term 'occupational roles' which I believe is probably not theoretically in vogue, but the concepts are still quite useful at times. That is a discussion for another time, I suppose.

Anyway, I am currently stuck on Rowles again and the concept of 'being in place' particularly as it relates to parent's abilities to find themselves and function within some constricted occupational niche of parenting.

So of course this problem in helping parents brings me to the core of meanings, values, and intentionalities that underly adaptive parenting behaviors. This of cours…