the genesis of class warfare

When we see people who need occupational therapy they have to be understood in more than organic terms. That may seem obvious to some but I know it is not obvious to all. I know that it is not obvious to all because so much of clinical practice looks like it is oriented toward the organic or biological level.

People are more than the sum of their parts, of course - and that is why I find it so important to let my anthropologist out for a walk.


I was reviewing these 'field notes' from some time I spent teaching at a college - and I wondered how different the intervention plans would be if they both came to an occupational therapy clinic with similar injuries or needs:


Penny and Natalie are moving in two different directions. I watched their trajectories intersect for a couple months and it provided a lot material to think about.


Let me start by saying that they don't even know each other. But they are the same age - having both just turned 21. Natalie will graduate in a year from a professional college program and Penny will still be working as a housekeeper at the college.


Natalie celebrated in the typical college way. Her friends made her wear a t-shirt all day that announced her birthday and they got her rip-roaring drunk to celebrate the occasion. Standard 21 year old college fare.


Penny didn't celebrate her birthday other than to have her mother watch the baby. Penny is a single mom, and so is not able to go out much with friends. Most of them have moved on anyway - they just don't have much in common with her now that she is a mom. Besides all this, her friends don't go out much anymore anyway - don't want to get into any fights with those students. Students are always talking down to townies.


Natalie dropped an essay on my desk today, hoping that it would meet approval for her acceptance into an Honor Society. This would be good on her resume, she posits.


Penny came and emptied my garbage can, standing in the same place that Natalie stood in, and told me how her baby's father couldn't be trusted, that he abuses drugs, that he just lost his job, and that she hates having to comply with handing over her daughter to him for court ordered (supervised) visitation.


Penny barely graduated from high school and was in special education classes. She tells me now that she needs help to do the math for her checkbook and that long division is beyond her comprehension. She thought about becoming a nursing aide but could not read well enough to understand those complicated medical terms.


Natalie studies for her classes. Based on her grades, she is having difficulty with those complicated medical terms too.


When Natalie comes back to the dorms after celebrating on a Friday night, Penny cleans up behind her.


Penny does not know Natalie, and so holds no direct animosity toward her. But those college students sometimes throw paper towels into the toilets and this backs them up. Penny made a sign and hung it up on the bathroom doors. It says:

Please


Do not


Throw


Paper Towels


in the


Toilet
.
.
The Janitorial Staff


Thanks You.


I sit and stare at that sign every day, and I can't get over how very much it represents.

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