Cara Koscinski, MOT, OTR/L is a pediatric Occupational Therapist and mom. She writes books and info. that contain questions frequently asked to pediatric occupational therapists about: -sensory processing -handwriting -core/body muscle weakness -feeding therapy -behavior -life-skills -coordination -transitions -school -IEPs -developmental information and MUCH more!
If you’ve followed my blog for any length of time, you know I’m the mother to two children with autism spectrum disorders. My boys are nineteen and sixteen. Over the years, I have supported numerous advocacy groups and delivered evidence-based information at conferences and seminars across the US. My six books sell across the world and I’m happy to help others. Please see my free resources page here.
I have a HUGE QUESTION for my fellow caregivers……..WHAT HAS YOUR ADVOCACY ORGANIZATION DONE FOR YOU?
I am asking to gauge the current climate and state of the autism community. I LOVE awareness and am thankful for the fact that practically everyone knows what autism is. My sons can proudly announce they are autistic individuals now! It’s wonderful. I noticed in April, Autism Awareness Month, that many people became irritated when I posted autism awareness materials and other facts. My readers told me, “We want acceptance and education for our family.” Is that your opinion also? What’s the best advocacy group? From where do you receive your primary support?
Please comment and share so I can continue to help my friends, followers, and readers. We are all in this together!
OT friends, you know how much I love traveling across our beautiful country delivering conferences to fellow therapists. Last week, I traversed to Albuquerque, NM, and Denver, CO. I can not begin to put the beauty of NM into words. The Sandia Mountains towered in a spectacular fashion and left me in awe. Denver, was rainy and snow moving in brought cold temperatures BUT the audience was HOT and ready to learn! PS: I enjoyed snapping a quick pic of the Blue Mustang at the airport……interesting.
As you know, I call ideas, ‘Out of the Pocket Tips.’ The book table was busy but since I’m not permitted to sell books onsite, many of you bought them on Amazon during the conference……THANKS!
Topic ONE: Know your state laws and whether or not your state follows NBCOT regulations.
I’m working to review each state’s laws, but I must admit, I have to focus on my own license. It’s your own responsibility to look at the laws in your state. You’ve worked hard for your license and you need to know what is expected of you regarding ethics, requirements, and continuing education. Here’s the link to the AOTA’s Code of Ethics (2015).
Although the AOTA cannot enforce the Code of Ethics if your state follows the Code than YOU need to read and understand what your professional responsibilities are. One of the huge benefits of this is that you can advocate for yourself. We need to be proactive and know when we are asked to complete a task that is unethical.
TOPIC TWO: Look back and refresh yourself with statistical terms.
Ouch! I may have touched a nerve there……forgive me! If we are to search for and utilize evidence-based practice, we need to understand what the basic statistical terms mean. I’m in the process of creating an hour-long on-demand course on basic statistics for OTs…… At one of the locations, I was asked more questions about basic statistics that at prior conferences. Remember, I would LOVE to support your learning in every way, but there are only so many hours in the day. Look up basic statistics on YouTube or do a simple Google search and you’ll be amazed at the free information you’ll find!
TOPIC THREE: OT is about relationship building.
Therapists tend to be kind-natured people. We are pleasers by nature. YOU set goals and expectations for your work. Others in your school do too. However, OT pushing into a classroom room or running a fine motor group during center time works for your students but doesn’t fit into the teacher’s daily plan. Communication on a regular basis will solve SO many problems.
The single most problem with communication is the illusion that it takes place.
Write a letter at the beginning of the year to introduce yourself and add a photo. Let the school know when you’ll be visiting and give them your contact information…..buying some donuts for the school’s secretary is always a great idea!
TOPIC FOUR: Make a list of professionals in your area.
At the beginning of the school year, create a list of neurologists, functional vision experts, websites, and helpful resources for children. Why? Many offices offer free training or lunch and learn sessions. For example, school districts complete regular vision screenings. OTs know that having 20/20 vision does not equal smooth visual processing skills. Here’s my earlier post about functional vision.
Many developmental optometrists in my area offer free open-houses. I always go to meet the staff, give them my card, and discuss common reasons for referrals. **PLEASE check your school districts’ requirements for giving caregivers information…..many districts are required to pay for any recommendations suggested made by related service professionals.
TOPIC FIVE: Occupational therapists should know the IEP and 504 plan law.
Our national organization, the AOTA, provides resources and ideas for helping OTs with advocacy. Many therapists transitioning to school-based OT need to familiarize themselves with the IDEA and payment sources for school-based OT. When working in an outpatient or clinic-based setting, the funding sources are often private insurance or Medicaid. ALL school-based OTs should understand both the IDEA and 504 law. Click here to read more.
I would love to meet you at one of my school-based conferences. Next week, I’ll be in Sacramento on May 22 and in Seattle on May 23.
Many adults and children with autism and other special needs have difficulty with executive function. Think of executive function as the chief executive officer (CEO) of the brain. It is responsible for planning, organizing, focusing, self-control, and following multiple steps. A great deal of frustration can happen when executive function skills are weak.
Easter is almost here! I always love this time of year because of Spring and new beginnings.
I am filled with joy and excitement for things to come when Easter rolls around. It’s fun to bring color to therapeutic activities. Here are some of my favorites I’ve shared with my readers over the years and I’ve added a few new ones too!
1. Plastic eggs are SO affordable and can be filled with anything imaginable.
Some ideas from the post include using pipe cleaners for differently shaped bunny whiskers. You can even build bunny ears out of pipe-cleaners! Try gluing cotton balls onto a paper plate to make a soft bunny. Looking for a challenge? Use tongs to pick up the cotton balls.
This year, OT Month is extra meaningful to me. I’m nearing the final semester of my OTD program. I have always loved our profession but have gained an even greater understanding of our profession since beginning school. There’s so much to learn and share when it comes to OT. We can work with different populations and in many settings. We can even start community programs and work in telehealth!
Here are 5 Tips to help celebrate OT Month this April 2019.
1) Have a coloring or other fun contest.
No matter what your setting, this is a fun thing to do. In the waiting room, place a coloring page or ask clients to complete an activity that fits your setting. It might be fun to ask parents to draw some shapes or a spouse to complete the 9-hole peg test. Maybe see how many words you can make with the letters: OCCUPATIONAL THERAPY. Be creative! After, choose a few winners and be sure to take pictures of them to post in your company newsletter, waiting room, or social media. Try to contact the newspaper or local magazine for extra publicity!
When you go to your child’s pediatrician, share a flyer about OT. Ask if you can hang one up in the waiting room or the exam rooms. Another idea is to ask the library, churches, and even coffee or bagel shops. There are so many places that permit free flyers.
OT Potential has an awesome OT Month Toolkit! I know because I purchased it and am using it to raise awareness of our awesome profession. The BEST news is that if you enter code: POCKETOT you’ll receive 30% off of your purchase! No strings attached……Sarah from OT Potential and I really want to spread the word this month! Click here for the link.
3) Pair up staff members and tell each other WHY you became an OT. We did this in our doctorate program and we experienced so many emotions! Thinking and sharing about your unique journey to therapy can renew passion. Consider asking each person on our staff to bring a special item of importance in their therapy journey. We called this an ‘artifact’ in our program. It is truly a wonderful experience to share your passion and joy with another person.
4) Offer a gift card or reward to celebrate your staff. Ask staff members to participate in a drawing or giveaway. Have a random drawing or competition for a small item. Ask your OT staff to color a page or do something creative and have the patients vote on the winner! Everyone likes to feel appreciated and honored. This idea helps to build staff morale too.
5) Raise funds for a cause. Make a donation on behalf of your organization for OT Month. Ask for donations, hold a fun event such as a carnival to highlight your business and post on social media. You could even ask attendees to participate in ‘therapy-related’ events. Be creative…..you’re an OT!
BONUS: Start an OT journal club! Focus on one article each month. Use AJOT, Google Scholar, and other online sources to find an article that pertains to your practice.
Let me know what activities you do for OT Month below in the comments. I love hearing from you!
*I make NO money from the sale of any items listed in the five points or bonus link.
How Can I Help My Teenager with Autism or SPD To Learn About Sex, Masturbation, & Menstruation?
This post comes from one of my readers. It’s a question I’m asked quite often.
The sense of interoception (our body’s eighth sensory system) can be decreased kids and teens with SPD. Interoception involves feelings, emotions, and internal body awareness. Sexual drive, toileting, hunger, thirst are all involved. Here’s my earlier post about interoception. Honestly, some kids are low-responsive and need more and more ‘input’ to the private areas in the form of grinding on (humping on) objects in order to achieve regulation……in the same way kids who never feel hungry stuff food in their mouths or kids who are constantly crashing need more input. Some children/teens simply crave more input or stimulation. If you have a sensory seeker, you know that some people just can not get enough of crashing, bumping, moving and fidgeting with their body. They just need more sensory activity in order to get comfortable in their own body.
Here are 5 tips to help your child/teen with his/her body awareness and other puberty-related topics:
1) I suggest a sensory diet every two hours in an attempt to regulate his/her entire body. By ‘diet’ I do not mean food, I mean activities that are designed to provide sensory input throughout the day. For example, use a weighted blanket or lap pad. Try pushing, pulling, lifting, and carrying which help with proprioceptive input. Doing chores, push-ups, using dough or theraputty, taping worksheets to the wall so they can be completed while standing, and placing therapy/exercise band on the legs of the chair all are excellent ways to build in sensory work. Making sure your child exercises after coming home from school is also critical. Getting the energy out with physical activity is always a great idea.
2) The thing about self-stimulation is that it’s immediately rewarding. When your child begins to self-stimulate, the feelings of arousal may occur quickly. Make sure to talk about this ahead of time so your child understands what is happening to his body.
I have a free handout on my website that I created during my doctoral program.
5) Use social stories and pictures to help teens to understand what puberty is and how their body may change. Topics might include periods, changes of the shape of the body, erections, wet dreams, and the changing voice. Be careful to avoid words that can be confusing. My son became very upset when I told him his voice might ‘crack.’ He thought it would actually break. I meant it might start high-pitched and then move to very low-pitch. Remember that our children/teens can be very literal.
I hope you’ve found this post helpful. I love hearing from you. Let me know if you have any more suggestions ~ especially books and other websites.
Therapists, looking for tips to assess your students’ movement for better functional outcomes?
Me too! I have been doing a ton of research for improving functional outcomes. Some of the same activities over and over get boring for me and for my students. While searching for evidence for my newest course, Building Better Brains Through Movement, I found really cool ideas for our clinic! Yes, I know some of you working in schools have offices (if you’re lucky) that are the size of a closet. Not to worry, find an open area and grab a roll of masking or other colorful tape and let’s go……
In my books and blog, I call my activities ‘Out of the Pocket’ tips. Look for them in easy-to-follow categories throughout the website.
Tip 1) Humans have spinal curvatures that formed from moving in different planes against gravity in the first few years of life.
Why do we care? Many children who have weak core musculature may need to work in prone and against gravity. Many children with special needs may not complete movements due to physical or sensory difficulties. They may not spend enough time working on crawling or tummy time. Often, they either skipped crawling or moved through the stages quickly. We can identify kids who literally fall out of their chairs when working at their desk. They may lack gross motor coordination for advanced playground movement such as climbing and swinging independently. Other signs include moving the body as a ‘unit’ instead of moving in a segmented way. Ideas to help include working on crawling and obstacle courses in prone.
“The standing posture results from an accurate sagittal arrangement of the various body segments with respect to gravitational forces. Thus the mechanical condition of each vertebral joint is the outcome of the balance between upper body weight and the ligament and muscle’s reactive strength” (Legaye & Duval-Beaupere, 2007).
Tip 2) Look at movement in the transverse plane.
Remember in school you learned about the planes of movement? The frontal plane, the sagittal plane, and the transverse plane. We are used to looking for a decreased ability to crossbody midline but we often forget to assess movement in the transverse plane. In my book, Sensorimotor Interventions, I discuss the planes of movement at length. Stand up and place your hands on your hips. Rotate at your waist from right to left. Every time you assess a student, ask them to do the same and take a look at their ability to move the top of their body apart from the bottom (below the waist).
Tip 3) Assess the tongue and chewing movement.
Yes, you read that correctly! Ask the parents to bring in a crunchy snack. Look at the movements of the tongue while chewing. Often, when children struggle with midline crossing, their chewing is more of a ‘munching’ than a rotary chew. Since we treat the ‘whole child,’ we need to understand the impact of decreased ability to move in all planes in all areas. A child’s functional outcomes depend on it! For more information about the development of jaw motion, read the article by Wilson and Green (2009).
Tip 4) Look at the eyes! Not 20/20 vision, but the ability to move to track.
To be thorough, ask the child to track throughout the visual fields with both eyes. Can the child focus on a moving object? I realize you’re not an optometrist, but you can look at a child’s ability to move their eyes smoothly. If you ever note nystagmus (repetitive, uncontrolled movements), a referral to a physician is ALWAYS needed. Here’s more information on nystagmus from the American Optometric Association.
Tip 5) Walk a taped line to assess balance, posture, and ability to move the body in specific ways.
One of my favorite assessment tools is a roll of tape! Look at the student’s ability to walk on the taped line in various ways. Pretend it’s a balance beam and check ability to walk toe to heel. Ask the student to coordinate the body to jump with both feet to the right and left side of the tape. Invent different ways based on your experience to look at movement patterns in your students. The more you look at the taped line walking, the more patterns you’ll notice in your students. It’s FREE and easy.
Check out my VAMPS assessment…..it will guide you as you learn to assess vision, motor, posture, and sensorimotor skills…..for children and adults over age two.
Let me know what tips you’ve tried with your students. I love hearing from you!
Legaye, J., & Duval-Beaupere, G. (2007). Gravitational forces and sagittal shape of the spine. Clinical estimation of their relations. International orthopaedics, 32(6), 809-16.
Wilson, E. M., & Green, J. R. (2009). The development of jaw motion for mastication. Early human development, 85(5), 303-11.