My second semester of OT school started earlier this week, and I had an awesome first day of school! The spring semester is going to be all about pediatrics (ages birth to 21), and I’m really excited to begin learning about the many facets of pediatric practice, from assessment and goal writing to intervention planning and outcome measurement. As I’ve been learning, the process of using clinical reasoning, medical knowledge, client interviews, and activity grading to provide quality therapy is pretty complex, and it changes with every client. I can’t wait to learn more about how to do all of these things, and begin doing many of them myself during my second semester of Level I Fieldwork!
On my first day back in class, we were introduced to the courses that we’ll be taking over the next several months. I like the way that my program is going to be teaching the courses, because all of the information we’ll be learning is linked to the information from our other classes. For example, one of my classes is a life course perspective on child development and behavior. In that class, we will be learning about how the time, place, and situation into which a child is born can impact their development, health, and well-being. Another course is about health and disabilities, and I’ll be learning more in-depth about specific diagnoses and conditions that my future clients may have. In that same course, we’ll also be learning about how parents, families, and individuals respond to receiving difficult diagnoses about their child, which is really important because with every person an OT provides services to, he or she is also involved with his or her family, significant others, and caregivers as well. In another course, we will be learning the practical skills that we will need as clinicians, such as client interviewing, task analysis, and intervention planning skills. All of these courses fit together nicely and draw upon each other. For example, at the same time I am learning how a child with cerebral palsy might develop and behave, I will be learning how to discuss the child’s strengths and potential challenges with a family and develop an intervention plan that will take the family’s wishes and the child’s diagnosis, prognosis, and abilities into account. Cool, right? 😀
The picture in this post is from the class in which we are learning how to use task analysis and clinical reasoning skills to develop interventions. Task analysis is a term that refers to the process by which an OT takes an occupation or activity and breaks it down to understand the physical, cognitive, social, and other processes that the activity generally requires, and it is crucial to OT practice. In class, we were able to practice task analysis when our professor broke us into small groups and gave each of us a toy or game to play with. My group got the Lego Duplo blocks in the picture, and other groups got Play-Doh, Chutes and Ladders, and Mancala, to name a few. We were instructed to play with the toys first, and then we had to break down the activity and use task analysis to understand more about what a child who was playing with the Lego Duplo blocks might be required to do and thus might have difficulty doing (depending on their reason for being in OT). We went through a long list of possibilities, and had to discuss the social, physical, emotional, cognitive, and other aspects of the task. After our analysis, we were asked to develop a few activities we would do with a young client and the blocks to work on various skills.
For example, my group decided that the blocks required several physical skills (among others), such as reaching, grasping, pushing, pulling, and remaining upright/stable enough to play with the blocks on a tabletop. For a 4-year-old child with cerebral palsy, we might use the blocks to work on fine motor skills like grasping or gross motor skills like reaching for objects. And while the blocks might serve as a great starting point for therapy, eventually the occupational therapist might begin to incorporate more “functional” activity into therapy sessions once the child’s fine and gross motor skills improved. She might replace the blocks with eating utensils or clothing fasteners once the child’s fine motor skills were significantly developed. OR, if playing successfully with blocks was the family’s goal, the OT might not graduate the child to these additional objects!
And therein lies the beauty of the profession – the relationship you have with the client and family, as well as your clinical judgment and professional knowledge, guide your practice every day. I could be working with two children of the same age, same diagnosis, and same home setup and family structures, but the treatment I would provide to each child could be completely different. Although I’m just starting out, I hope to keep in mind the lessons about being client- and family-centered and creative that I’m learning now in my future practice!