ABC Therapeutics Occupational Therapy Weblog

I spend my time thinking about the topic of writing as occupation and whether or not it carries any therapeutic benefits. Here is an interesting article that caught my eye: Writing helping young Katrina survivors . I'd love to discuss these ideas with other people, so here are my thoughts - if anyone is interested. Why would people be interested in the private writings of another person? Bunkers and Huff (1996) explain that "diaries are not so much inclusive because they contain everything from a given day, as they are inclusive in the sense that they do not privilege 'amazing' over 'ordinary' events." This celebration of the ‘ordinary’ is a longstanding theme in understanding meaningful occupation. Diary writing and diary reading provides a vehicle of social connectedness through the ordinary. This is a human need and is the basis of interactivity between the writer and the reader. The use of the diary as an interactive tool provides an example of what Ro...

I was invited to teach a class at Keuka College. I used to be on the faculty there so it was something of a return for me. Although I thoroughly enjoy what I do, I have to admit that I miss teaching. The students were leaving the room, and I sat in the front of the class as is my custom and I watched them as they moved on with their day. Then they were all gone. As I turned out the lights in the room where the students had been just a few moments earlier, I felt a little sadness that I was alone. I considered how the room had been busy and full of chatter and even some excitement. We were learning about evidence based practice and early intervention. As I sat alone in the room, on a mat table in the corner, I remembered Stephen. Stephen was probably the most learning disabled child I have ever worked with. This will undoubtedly be very difficult for anyone to understand who does not know about learning disabilities. These kids walk and talk and superficially appear just like every oth...

I had a busy day today. I feel like expressing the daily variation in my clinical responsibilities. These are all single-frame descriptions. If you read them quickly, maybe you will see me moving. Is this the nature of disconnected discourse? How can I make this 'real' for you? My first task was to attend a planning meeting for a young child who has high functioning autism. He just transitioned into a kindergarten classroom and the parents asked me to participate. I have known this child for two years and had some input that was hopefully useful to the educational team. This meeting went well. Phew, they don't always. Next I had a phone conference regarding a 4th grade child in a distant school district. The family traveled a great distance to see me and I spent a full day (a couple weeks ago) completing one of our infamous 'intensive' evaluations. This CSE meeting also went well, so I was feeling pretty lucky at this point. Then I drove to see a little friend, just...

I’m in Chicago tonight. This is my last bit of travel for the rest of the year. I never expected to have to travel much when I chose this occupation, but this year alone I have been sleeping in hotels for over 40 nights, not counting three weeks of vacation this year. In other words, it is good that I work for myself because no employer in his right mind would ever tolerate this. In fact, if I wasn’t so invaluable to the organization I would probably fire myself. This is the insanity speaking; it was that kind of a day. I saw a group (not really enough to call them a flock) of seagulls today while driving to the airport. No big deal, except that they had located themselves in the middle of some completely landlocked farmland. Not a speck of water in site: no major rivers, no major ponds or lakes around for miles. And certainly not the ocean. Although to be technically correct I guess there is no such thing as a 'seagull.' I whipped out my Peterson's field guide and saw that...

I am having one of those days where I am not communicating clearly. At first it was just at work but in preparation for this entry I found that I also can't communicate with my own children. While taking the picture above I was having a hard time finding a suitable background that had enough light but not too much glare. I said to my daughter - "Go find me something that I can use as a backdrop that can absorb some of the light so I don't have so much glare. She gave me a sponge, obviously interpreting 'absorb' a little too literally. Note to self: daughter needs basic lesson in physics of polarization. *** Today I was working with Adam, who is a wonderful seven year old boy with superior intelligence and some gross motor delays. After some vigorous activity using the suspension equipment, I thought it would be a good idea to transition him back to his parents with a quiet activity so he wouldn't be bouncing around the car during the ride home. "Let's ...

Cameron was not impressed to see me. He had been kicked enough, I was sure, and did not need to have some other adult come into his life (only to leave, eventually). Still, his cardiologist wanted me to see him, to get him out of bed, and perhaps to do a little 'attitude de-funking.' Of course the script wouldn't say that exactly, but that is what the doctor asked me to do with him. Cameron was spending most of his time in bed, and it was complicating his status on the heart donor list. He was born with a rare condition called transposition of the great arteries - basically, the plumbing in his heart was all mixed up. He had gone through several cardiac surgeries in his life and there really was little else that the surgeons could do except wait for a new heart to come along. The problem was that Cameron was just wasting away in bed, and his inactivity and poor nutrition were complicating his immune status, and this in turn could have potentially compromised his ability to ...

I received an email earlier this week, asking me 'why' I write here. That was a hard question. Interacting in people's lives every day makes me think of so many stories, and sometimes I am not sure where to begin to make sense of it all. Writing them down helps me to understand them in the present, just long enough sometimes to begin to understand. T.S. Eliot wrote: At the still point of the turning world. Neither flesh nor fleshless; Neither from nor towards; at the still point, there the dance is, But neither arrest nor movement. And do not call it fixity, Where past and future are gathered. Neither movement from nor towards, Neither ascent nor decline. Except for the point, the still point, There would be no dance, and there is only the dance. Writing helps me to understand the dance.

I had the privilege of observing a child in their school this week, and I spent a few hours watching the typical routines of the classroom. I was a little surprised at the amount of information that some of the kids shared with me. I love talking with children. They interest me, generally far more than adults do. What I like best is that there can be gaps in the conversation and you can drop a subject or pick up a subject easily. I think I also appreciate the eye contact that children give me - which is generally more than adults do. Lots of adults don't stop to notice that kids are really good at visually attending to a conversation. I think they are often too busy talking to other adults, or they are above the eye level of the kids, or just too preoccupied to notice. Anyway, Rachel had me enraptured. She is one of the children in the class, and her eye contact was just so wonderful while we talked. I also caught her studying me several times during the day so I would smile at her...

I hope that everyone has the opportunity to read the latest study about child pedestrian safety. I have the press release, report, and safety tips available for download on the ABC Therapeutics website in the 'NEWS' and 'RESOURCES' sections. Nationwide, pedestrian injuries are the number two cause of accidental death among children ages 5 to 14. Each year in the United States, approximately 650 children are killed and 43,000 treated in emergency rooms as a result of pedestrian injuries. The total annual cost of traffic-related pedestrian death and injury among children ages 14 and under is $5.2 billion. We haven't gotten many calls on this issue - but hope that this will begin to raise awareness!

I am reduced to recycling my writing - but I have abused my responsibility to write in here so I feel the need to fill it up... I could focus on writing more if... (I won't bore anyone with excuses). Because I have been so chipper and upbeat lately I decided to take a drive through a former toxic waste dump. Don't ask me why; I have no answers. I don't live near this place, but it is not far to drive. Everyone has heard of Love Canal, but I felt some compelling reason to visit today - I have never been there before. Perhaps this was prompted by someone giving me directions to their home recently. "It is on such and such street, but not on the Love Canal side." She said it with a conviction, and a hope. I didn't understand, so I decided that I better visit the Love Canal side of such and such street. I hang out in Niagara Falls way too much. I have done some amateur anthropological studies, based on narrative searches for truth about why it is the way it is. I ...

"You think I'm licked. You all think I'm licked. Well, I'm not licked. And I'm going to stay right here and fight for this lost cause. Even if the room gets filled with lies like these..." I am in Washington, DC tonight. As part of my ongoing doctoral studies I am participating in some lobbying efforts to repeal the payment caps that were placed on Medicare Part B outpatient rehab services as part of the 1997 Balanced Budget Act . Since 1997 the caps have only been imposed for 3 months in 2003 because Congress passed moratoriums delaying the impact of the caps. Unless Congress takes action again, the current moratorium will expire on December 31, 2005, and the caps will take effect on January 1, 2006. The caps limit Medicare coverage to $1,500 for occupational therapy. What does that mean? Basically it means that people with Medicare will have limited access to OT, and it means that other insurance companies will be likely to follow suit. That's not good f...

It started out as a good day... I was having a little tooth sensitivity yesterday, but I mostly ignored it and tried to focus on the many tasks at hand. Life is busy as a pediatric occupational therapist in September. Then I jinxed myself. This morning my sister mentioned that my niece was having some pain with her new orthodontia, so my wise comment was - "Well when they find bones in Olduvai Gorge the most common bones they find are jawbones and teeth - which is proof that these structures are built to last and are not designed to be moved." I should have kept my mouth shut, literally, because I scheduled a visit to the dentist to have my own tooth sensitivity looked at. The dentist decided to pull my offending wisdom tooth, which was quite an experience. It didn't want to be separated from my jawbone, and it was in fact ankylosed. This interested me, because I never before considered that teeth could be ankylosed. The dentist's brow was beade...

I was driving in my car on my way to see some children for the early intervention program this morning, and I did not feel 'right.' I can't explain the feeling. The radio (my daily companion) was irritating. The sky and earth just didn't seem to meet at their ends. Everything was just 'tilted.' After fidgeting for 15 minutes I called my sister. She distracted me well enough and we had a pleasant conversation. I was able to refocus and I had wonderful visits with some new children on my caseload. September is always exciting to me because it is all about promise and beginnings. I spent part of the morning crawling around the gym of a Head Start program. The child that I see there couldn't ride a tricycle like the other children, so instead we parked ourselves near the gas pump and called the children over individually so we could 'fill them up' as they wheeled by. I think he liked it. I had a bittersweet feeling about that session all day long. End o...

I am now officially into my final semester as a doctoral student in the Nova Southeastern University occupational therapy program. For the past three years I have traveled to south Florida three times a year for the launching and wrapping of classes. In between, I have lived my life on the computer, completing my reading and research, responding to the posts of my colleagues, and participating in long distance chats with other OTs from Spokane to Puerto Rico. I would be remiss if I did not mention the writing - the innumerable research papers that have taken me on a journey from the genesis of occupational therapy all the way to consideration of virtual contexts and how they can be used as occupational therapy tools. Those papers have spawned one article submitted for publication, another article perpetually waiting to be submitted, one presentation at a national conference, and one presentation at a state conference. Not bad. I don't have too much that is profound to say about it...

R. Buckmister Fuller , my intellectual hero, stated that piano tops can make fortuitous life preservers - but that doesn't mean that the best design for a life preserver is in the form of a piano top. The piano top that I see us clinging to today is the disorganized message board and database system that is being used to help people 'find' each other who were displaced as a result of the recent hurricane. Because we tend to lack the ability to understand technological applications beyond their immediate design purpose, we lose a lot of opportunity to help real people. So my proposition of the day, as an OT who likes to view the world from a broad perspective, is to use the SIX DEGREES PATENT or some similar networking system like Friendster.com or Facebook.com to create a searchable and linkable network that will help displaced people find their friends and family members. It is such an incredibly simple solution, but who will think to apply social networking algorithms to...

Sorry for the long absence, everyone. My grandmother passed away last week so we have been spending time with family. I look forward to posting more adventures. The school year has started again so of course there is a lot of activity at ABC Therapeutics Central! Talk to you all soon.

We have received several phone calls in recent weeks regarding a controversial new 'research' study that was published on the 'Freakonomics' website. To view the article, click here . The article states that the Fatality Analysis Reporting System (FARS) data shows that child restraint systems are no more effective than regular seatbelts for children ages two and up. There are several potential problems with this conclusion that need to be resolved. First, FARS data only accounts for fatality crashes. The incidence of injury is far greater than the incidence of death in motor vehicle crashes, and this study doesn't address the way that child restraints may function to prevent injury in less-severe motor vehicle crashes. Second, the 'study' has not been peer-reviewed. We encourage the authors to submit their findings to a reputable peer-reviewed journal so that it can be scrutinized appropriately. Third, we are concerned that there has been no consideration fo...

I originally wrote this on 9/18/2001 while I was feeling under assault from the constant media coverage of the terrorist attacks. I felt a need to revisit something positive relating to Islam. I have been watching the National Geographic documentaries on 9/11 and that horrible feeling in my stomach returned, so I thought it might be a good time to dust off these old recollections. "As-salaam alaykum," the gentleman said to me as he made his way slowly into my office, leaning on a cane and lowering himself slowly into the chair opposite me. I looked at him, hesitantly, not knowing the proper response. "It's nice to meet you," I said, extending my hand. The man looked at me sternly and then said to me quite seriously and in a thickly-accented English, "This will never do. If you are to be the one who will help me improve my abilities, we will have to greet each other properly. When I say 'As-salaam alaykum' to you as I enter the room, you must return...

I glanced down at the intake sheet on the seat next to me as I crossed high over the arching bridge and downshifted into the city. I was running a little late but thought that the house would be easy enough to find. I dialed the house and told the family I would be there shortly. The mother's voice was uneven and slurred. "The house is on the corner, and my street is between 18th and 20th," she announced. I was a little concerned, because I was not sure where else she thought I would look to find 19th St. I entered the house by the side door, as instructed, and walked up a flight of deep and dirty steps to the second floor. I could tell immediately that the environment was not going to be pleasant. Cigarette butts were extinguished haphazardly and left on the windowsill next to some rotting food and too many flies. It was muggy and sticky just like the city gets in the hot August sun. "There would never be enough water to make this clean," I thought out loud as ...

There was a NY Times article today that outlined the degradation that people experience when they are admitted to hospitals or health care systems. I was a little bothered by the fact that this was presented as some type of news flash. I guess no one was listening over 30 years ago when Madelaine Gray talked about the same issue. This is probably too arcane for non-OT readers to find, but the citation is: Gray, M. (1972). Effects of hospitalization on work-play behavior, American Journal of Occupational Therapy, 26, 180-185. So there are a few problems here. First, we knew about a problem over 30 years ago, discussed it and debated it, but here we still are without a solution. That is just inexcusable, and I wouldn't blame patients for revolting. Second, how frustrating is it to be Madelaine Gray? I don't know if she is alive, and I doubt this could ever reach her ears or eyes, but I wish I could tell her that someone did hear her and that she was correct. As for the Times art...