The hands of a pediatric occupational therapist

When I get home from work I have things to do, like everyone else, and sometimes those things make my hands dirty.  Sometimes it is some minor maintenance on my car, or repairing something in the house, or doing a little gardening.  I know that I have to scrub my hands clean after these activities so that there is no evidence of dirt or paint or grease.  I keep my fingernails very short for precisely this reason.

What would I tell a parent the next day - that I have the residual stain of grease on my hands because I was elbow deep into my engine compartment the night before?  I suspect that most parents would understand, but it would not feel comfortable.  If you work on cars or paint a room you know how difficult it is to remove all traces of those occupations from your hands.

Cultural stereotypes abound surrounding the nature of a person's hands.  We even have idiomatic language about 'getting your hands dirty.'  This is a positive concept that means someone is not afraid to engage something or to work on something 'hard.'  Oddly, we have an opposing idiom about 'keeping your hands clean' which is supposed to be a positive attribute also.  I find it interesting that we have developed language with opposing analogies that are both meant to reflect something positive.

I guess I try to keep my hands clean, but I am not afraid to get them dirty when it is required.

My hands get 'dirty' in my job as an occupational therapist also.  A parent came in this morning and as I joyfully picked up her two year old into my arms she looked at my hands, which were undeniably marked by my occupations earlier in the morning.  "Looks like you have been doing some coloring with markers today, Dr. Chris!" she said with a smile.  There was no concern that my hands were 'dirty' because every mom knows that even the so-called water soluble markers don't come off in one scrubbing.

I guess that people ascribe meanings to things based on their perceptions.  The marker on my hands was a sign to this mom that I was elbow deep in trying to help some child learn how to write, and that made her smile.  It is a different kind of engagement than working on my car or in my garden, which might not have been met with a smile, even though my hands would have been no less 'clean.'

I guess there will come a day when I will no longer have marker all over my hands.  Someday I will not have to be so cognizant about how my hands look.  But today it is still a badge of engagement and I will wear it with honor.  I am a pediatric occupational therapist, and this is what my hands look like every day.

Comments

Post a Comment

Popular posts from this blog

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 management suggestions
Read more

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

Twenty years of SIPT - where do we go next?

Standardized tests are periodically discarded or updated because the normative group that the test was developed around may have changed characteristics. I am unaware of any 'industry standards' regarding the life expectancy of standardized tests; rather, professionals in a field tend to come to consensus about the relative usefulness of tests on their own. I would be interested in knowing what other therapists think about the Sensory Integration and Praxis Tests - which were published in 1989. I became certified in the administration of these tests seventeen years ago. At first I found them highly useful but the more I gave the tests the more I understood the limitations. Now it has gotten to a point where I do my best to discourage people when they ask for this test - not just because of the inherent weaknesses of the test construction but also because of how old the norms are. There have been some legitimate concerns with the tests including extremely poor test-retest re
Read more