Showing posts from October, 2011

The end product associated with a decided lack of true productivity

We have a lion in my office that was left by a child several years ago. Here is his picture: I placed him on my cable modem in plain view of everyone who came into the office hoping that someone would claim him. No one ever did, and I felt sad about it because he is a Webkinz and they were rather popular for a while and I am sure that some child was very happy at one time to have this toy. Anyway, I leave him on top of my cable modem just in case his owner ever makes a claim. He is our office mascot, and I have come to enjoy his company every day. Today I was cleaning and organizing because I couldn't settle myself into documentation. I found a bunch of stray toys. I found the following: 1. a yellow clothespin that goes to a full set 2. an orange sheep that is matched to a full set of parent/baby animals 3. a green peg that goes to a pegboard activity 4. blue and yellow blocks that are part of a construction set 5. a peg from the BOT-2 (a motor test) 6. scissors 7. an ant fro

Product Review: The PenAgain

I was recently contacted by Baumgartens who sent several PenAgain products to my office and asked if I would write a review on my blog. I told the company that I only provide unvarnished reviews and I don't accept any compensation for my reviews - and since they agreed to those terms I was willing to take a look at their products. My first impression when I saw these pens and pencils was "So, how exactly are you supposed to hold the PenAgain?" The product doesn't come with any specific instructions so I looked at the packaging to see if that offered any hints. The picture on the package seems to show a person holding the pen in full pronation of the forearm so that there is very little to no ulnar contact with the writing surface. Use of the PenAgain in this position is supported by a few YouTube videos as well - although I don't know if the person who made these how-to videos has any relationship to the manufacturer. The idea of full pronation and the wei

Annual obligatory rant about health insurance premiums

Background reading: 2009 2010 Well this year the annual increase to our health insurance costs are only 19% but the plan has a higher out of pocket maximum and slightly fewer covered benefits so it isn't exactly the same plan. I thought I would be clever and call my Provider reps for the different plans and tell them that I would be shopping and purchasing based on information they could give me regarding 2012 fee schedules. Historically, even though the cost for these plans goes up exponentially the amount of increase that any provider might see is just a tiny fraction (and often even ZERO PERCENT) of that increase. Also, what happens each year is that the co-pays are increased so even though allowable fees might go up the costs are passed entirely to the consumer with higher deductibles and higher co-pays. In other words, the insurance company's objective is to put all of YOUR skin in the game and as little of their own as possible. The mechanisms that allow this to happe

When writing gives you the willies: Reconsidering 'tactile defensiveness'

For as long as I can recall most therapists talk about tactile defensiveness as being an oversensitivity to touch - and that it includes a sympathetic nervous system response that is allegedly 'out of proportion' to the incoming stimulus. The result of this characterization is that most people start looking AT the sense of touch as the primary culprit of the problem. This is why you then see therapists struggling to describe what textures a child tolerates and does not tolerate. This structural understanding of the problem is reinforced by sensory integration theory which posits that children are not able to process incoming sensory information accurately. In the real world this model is poorly described and subsequently notoriously unreliable - and again you will hear therapists explain the inconsistency in sensitivity as a "sensory modulation" problem because sometimes certain kinds of touch will be tolerated and other times it will not be tolerated. Still, the

An open letter to an occupational therapy evaluator

Dear Evaluating Occupational Therapist, You evaluated a preschool child who has been receiving private occupational therapy for a year. I referred the family to their local school district because I thought it would be a better option for the family to receive services this way. Your evaluation was thorough and a fair representation of how that child functions - which is always good to see because sometimes evaluating preschoolers is tough and their performance can be variable. I was a little disappointed that you didn't make any attempt to contact me and get any input on the case. I think it is important for evaluating therapists to talk to previous therapists especially when high stakes decisions are being made, like eligibility for services through a system. The agency that you work for sent a very nice person to the CPSE meeting to represent all of the evaluations that were completed. I asked the representative person what their position and role was at your agency and I l