elf catheterization ow will you celebrate ot month? - illinois

CRO

R March/April•Issue9•2008

January / February / March • Issue 1 • 2013

In this issue:

I l l i n o i s O c c u p a t i o n a l T h e r a p y A s s o c i a t i o ncommuniquéTHE

H

elf Catheterization

…Continued on Page 3

S


Catheterization is not one of the firstADLs that comes to mind when we thinkof basic self-care. Yet, it is an importantissue for special populations, especiallythose with neurogenic bladder dysfunction.I was first introducedto self-catheterizationintimatelywhenIbegantostaffthespinabifida(or myelomeningocele)clinic at ShrinersHospitalsforChildren–Chicago. Workingwith the spina bifidapopulation allowedme to see how anoccupational therapistcouldbeacrucialteammember in evaluating a child’s readiness forself-catheterization. Early in life the parentsperformed scheduled catheterizations, justlikedressingorbathingtheirchildren. Children with spina bifida are typicallydelayed in their ADL independence by anaverageof2-5years.Therefore,itshouldnot

be expected that theywouldbe able to self-catheterize at the regularpotty-trainingage,between2-3yearsofage.Irealizedthattherewasnowaythatapatientcouldmaster self-catheterizationindependenceuntilthepatient

was independent inhisorherotherADLs.In addition to ADLindependence, anoccupationaltherapistmust alsoaddress thefollowing functionalareas before self-catheterizationcanbeachieved: bathroomtransfers, fine motorfunction, pinchand grip strength,

visual perception, perceptual motor skills,stereognosis, sitting balance, and cognition(specificallysequencingandproblemsolving). Intheclinic,Iobservedthatcatheterizationwasasourceofdeepstressforsomepatientsandtheircaregivers,especiallyifthechildwas

Reclaiming Independence

• Research Update

Learn about the Intentional Relationship Model Clearinghouse on 0.

• Student Voice

Read about Brittany Davis’ fieldwork in an early learning center on Page 6.

• Clinical Spotlight

Chana Goldstein discusses working in the Chicago Public Schools on Page 8.

• Reflection

A story about hope and working in pediatrics on Page 15.

• Introductions!

Meet the people who bring you this newsletter, starting on Page 11.

Rachel Galant Co-director of Rehabilitation Shriners Hospitals for Children

It brought the youth’s need for independence... to the forefront.

A light bulb went off and a new inpatient self-catheterization

program took shape.

“”

ow Will You Celebrate OT Month? AprilisOTMonth!

Wearelookingforyourstories.Pleasesendussomeinnovativewaysthatyouplantocelebrateorhavecelebratedinthepastandwewillshowcasetheminthenextissue.

ThemissionoftheCommuniquéistoinformIllinoisOccupationalTherapyAssociation(ILOTA)membersofcurrentissues,trendsandeventsaffectingthepracticeofOccupationalTherapy.TheILOTApublishesthisnewsletterquarterly.

ILOTAdoesnotsanctionorpromoteonephilosophy,procedure,ortechniqueoveranother.Unlessotherwisestated,thematerialpublisheddoesnotreceivetheendorsementorreflecttheofficialpositionoftheILOTA.TheIllinoisOccupationalTherapyAssociationherebydisclaimsanyliabilityorresponsibilityfortheaccuracyofmaterialacceptedforpublicationandtechniquesdescribed.

Deadlines and Information

Articlesandadsmustbesubmittedbythelastdayofthemonthpriortothemonthofpublication.ContacttheILOTAofficeformoreinformationandadvertisingsubmissionforms:

P.O.Box4520Lisle,IL60532

Phone:708-452-7640Fax(866)459-4099

Website:w w w.ilota.org

ILOTA Newsletter Editorial Committee CarrieNutter•MaraSonkin• LaVonneSt.Amand

NewsletterdesignbyHollyDeMarkNeumann

adva

nced

Rese

arch

TheIllinoisOccupationalTherapyAssociationofIllinoisistheofficialrepresentationoftheOTprofessionalsintheStateofIllinois. ILOTAacknowledgesandpromotesprofessionalexcellencethroughaproactive,organizedcollaborationwithOTpersonnel,thehealthcarecommunity,governmentalagenciesandconsumers.

President Peggy Nelson Bylaws:Position Open OfficeManager JenniferDang

Secretary Lisa Iffland Archives:AshleyStoffel& KathyPriessner

DirectorofFinance Lisa Mahaffey ContinuingEducationCo-Chairs CatherineBradyandKimBryze CEApprovalChairs KatiePolo&MarkKovic ReimbursementChair NancyRichman ConferenceCoordinator AnneKiraly-Alvarez ProfessionalDevelopmentCoordinator LisaCastle

DirectorofAdvocacy Rachel Dargatz PublicPolicyCoordinator KyleneCanham

DirectorofMembership Position Open RetentionCoordinator SusanQuinn ActivationCoordinator Position Open RecruitmentCoordinator Position Open DirectorofCommunication Carolyn Calamia WebsiteCoordinator Position Open NewsletterCoordinator CarrieNutter NetworkingCoordinator Position Open

AOTARepresentatives Robin Jones

ADVERTISING RATESVendor ads

Fullpage..........$535Halfpage..........$4251/4page...........$3151/16page..........$205

Employment Ads


Continuing Education Ads


Typesetting Fees


ILOTA Board The Communiqué

Don’t forget to renew your membership online at www.ilota.org!

August / September • Issue 3 • 2008

President’s Address As we continue to learn ofnewlegislationthatinfluencesservicedelivery of Occupational Therapyacrossallpracticeareas,ourassociationcontinuestoidentifyresourcestohelpnavigate strategies for success. Ourmission continues to demonstrate astrong statement of our purpose andinitiativestosupportthepractitionersinIllinois.

Mission of ILOTA:

The Illinois Occupational Therapy Association (ILOTA)is the official representation of the Occupational Therapyprofession in the state of Illinois. ILOTA acknowledgesand promotes professional excellence through a proactive,organized collaboration with Occupational Therapypersonnel, the health care community, governmentalagencies,andconsumers.

WiththesunsetofourPracticeActsoonapproachingin2014,therehavebeenseveralcommitteesestablishedtodiscusskeycomponents.ThesecommitteesreviewthecurrentlanguageofourPracticeAct andprovide recommended revisions toguideus intothenexttenyears. Examplesof this includeupdating the definition of educational requirements andinclusionof languagetopositionourprofessionforsuccesswiththecontinuedprogressiveuseoftechnologyinpractice.This draft is then sent to the Illinois Department ofProfessionalRegulationforreviewandfeedbackbeforeaBilliscreated.OnceapprovedbytheDepartment,aBillwillbecreatedandopenedforSenate/Houseandpubliccomment.PleasecheckourILOTAwebsiteforcontinuedupdates.

Additionally, inordertocontinuetoservethepractitionersthroughoutIllinois,wecontinuetorecruitvolunteerstohelpusachieveourorganizationalgoals.WehostedourfirsteverILOTA orientation program on February 16, 2013 at theRehabInstituteofChicagoforcurrentandincomingboard/committee members. This orientation program will beofferedannuallyatourstateconferencetoprovideongoingsupportformembersinterestedinservinginacommitteeorboardposition.Asyoureflectonyourprofessionfortheyear,pleaseconsiderhowyoucanworkwithustostrengthenourorganizationthroughoutthestate.

Visit our website today at www.ilota.org, or contact us [email protected],uptodatelistingsofopportunitiesrelatedtoopenpositionsontheILOTAboard,orhowyoucanparticipateintheassociation. You make all the difference!

PeggyNelson,PresidentofILOTA

Peggy Nelson

Here are just a few ways that you can help the Illinois Occupational Therapy Association ( ILOTA):

• JoinorrenewyourmembershipforILOTA• Jointheboardoracommittee• WriteanarticlefortheCommuniquenewsletteror

recommendanindividualortopic• Helpplanthestateconferenceorvolunteeronsiteat

theevent• Makeadonation(allsizesarewelcomeandhelpful)• Organizeanetworkingoreducationalevent• EncourageorganizationstoadvertiseintheCommu-

niqueorthroughILOTAe-mailblasts• Spreadthewordaboutthebenefitsofbeinganactive

memberinILOTA

WeappreciatethatmanyofyouarealsomembersoftheAmerican Occupational Therapy Association (AOTA)andaresupportiveofthestateandnationalPoliticalAc-tionFunds(PACs),mentorstudents,peersandco-work-ers,engageinlobbying,organizeeventsandadvocateforourprofession and shareknowledge about andpassionforOTinsomanyways!

Let the momentum continue and inspire each of us in 2013!

Celebrate OT Month (continued from page 1)Positioning ILOTA for Success


Opi

nion

sPh

oto

Photo Opinions

IfyouwouldliketobefeaturedinPhotoOpin-ionsorknowsomeonewhowould,[email protected]

Wevalueourcolleagues’opinionsandviews!Ineachissuewewillaskadifferentquestion.Somemaybe thoughtprovoking and somemaybemorewhimsical, since asOTswe facebothseriousconcernsandopportunitiesforcreativity.Wewillfeatureresponsesandphotosfromdifferentcliniciansorstudentsineachissue.Ifyouhaveanideaforaquestionorwouldliketobeconsideredforafutureissue,pleasecontactus.

Habilitation vs. Rehabilitation

IhavethepleasureofworkingwithbothadultsandchildreninmypracticeatEdwardHospital.Pediatricsisaninterestingpracticeareaduetothefactthatoftenitishabilitationinsteadofrehabilitation.Childrenareveryeasilyengagedintheiroccupationalrolesasfriend,familymember,orstudent. IreallyenjoyhelpingchildrenchooseactivitiesthatareboththerapeuticandFun.

What inspires you about working in pediatrics?

Jen Matern OTR/LEdward Hospital

Strengthening Roles I work at Aspire Children’s Services with children who havedevelopmentaldelaysanddisabilitiesandwiththeirfamilies.Workinginacommunity-based,non-profitagencyhasgivenmetheopportunitytobuildstrongrelationshipsbetweenchildren,families,andcommunities.IthinkoneofmymostimportantrolesasapediatricOTistohelpchildrensucceedatbeingthemselvesaswellastosupportfamilies’understandingand enjoyment of their child. I often tell my fieldwork students, “Itisnotmygoal thatachild learnsnewskills toplayand interactwithme as theOT. It ismoremeaningful for a child toplay and interactwithhis/herparents,siblingsandpeers.”BeginningmycareerinearlyinterventionprovidedmewithaframeworkofusingeverydayactivitieswithinnaturalenvironmentsthroughouttheOTprocess.AtAspire,I’mabletocarryovertheseideasintomyworkwithchildrenofallagesbyoccasionally seeingchildren intheirhomes, schoolsandcommunities,insteadofonlyatacenter.Anotherbenefitofmypositionisbeingpartofamulti-disciplinaryteam.Thisteamapproachpromotescollaborationand learning, and it encourages taking all of a child’s developmentalcomponents into account when determining interventions. I enjoysharingOT’suniqueperspectiveofnotonlylookingatbuildingskills,butalsostrivingtobuildrelationshipsandstrengtheningrolesthroughparticipationinoccupations. Collaborating with team members, then hearing the teachersreportsuccessesintheclassroomorwhenastudentnolongerneedsmysupport.And,ofcourse,thehighschoolpeertutorwhosaystheytoowanttobeanOTwhentheygraduate.Eachnewsuccessisastepinthedirectionofincreasedindependenceandawareness….andIlovebeingapartofthat!

Ashley Stoffel, OTD, OTR/LAspire

What inspires you about working in pediatrics?

Pediatrics brings a sense of satisfaction Myentryintotheworldofpediatricswasquitebychance,afriendbackinSingaporeinformedmethatapositionwasavailabletoworkasamobileoccupationaltherapistforanorganization thatwas advocating for childrenwithphysicaldisabilities tobe included intomainstreameducation. Needlesstosay,I left adultpsychiatricandphysical occupationaltherapy areas for pediatrics. As soon as I immersedmyself in pediatrics, I realized that IwasabletoapplyeverythingIlearntfrompsychiatrytohandsinthisareaofspecialization.Advocatingfortheneedsofthesechildrenhasneverstoppedanditvariesfromonechildtotheother.The jobsatisfaction thatcomeswith this lineofwork is thatasanoccupationaltherapistweapproachourworkbybeingfamilycentered.Thechild’sandfamiliesneedsareacknowledgedandweworktowardsthegoalsthatareformedwiththefamilyandchild. Thejoysofbeingapediatricoccupationaltherapistiswhenthechildcanenjoyplayandisabletoengagewithotherchildrentheirage.AsapediatricoccupationaltherapistIamabletomakethenecessarysensoryormotoradaptationsforthemtofunctionatthefullestpotentialbothatschool,homeandintheirplayorsport.Thesmileandtheacknowledgementofachildbeingabletoaccomplishanact/goalthatwaspreviouslyunattainableisjustprecious.Thesenseofempowermentbythechildandfamilymakesthislineofworkjustsomuchmoreenjoyableandsatisfying.

Kavitha N Krishnan MS OTR/LUniversity of Illinois

Pediatric Team

Destined to become a Pediatric OT IknewIwasdestinedtobecomeaPediatricOTattheageof13whenImetaCOTAatmyhighschool.IwasapeertutorinP.E.classandMs.JenniferwastheCOTAworkingwiththestudentIwasabuddyfor.Shepiquedmyinterestinwhatshewasdoing,invitedmetocomeobserveheratothertimesduringtheday,andthenhelpedmelocateinformationonbecominganOTR.Therestis,astheysay,history.WhileIhavespenttimeinalmostalloftheotherfieldsthatOToffers,Ialwayskeptcomingbacktopediatrics.Afewyearsago,Ireturnedtomypassion–workingintheschoolsystem.Beingaschooloccupationaltherapisthasitschallengesandrewards;butiswortheveryminute!Iloveworkingwithchildrenofeveryage!Startingwiththeyoungpre-kindergartenstudentswhoarelearningandgrowingatsuchafastpace,tothestudentsgettingreadytotransitionoutofhighschoolintothenextphaseoftheirlives,andallthoseinbetween.Asaschooltherapist,Igettobeajackofalltrades-creating,fabricating,constructing,makingsomethingoutofnothing,etc.-witheverydaybringingnewchallengesandsuccesses. WhileIthriveonthechallengesofeachdaywithscheduling,keepingtasksfreshandinteresting,meetings,reportsandsuch,thesuccessesarewhatmakeitallworthwhile.Suchasthesmileofastudentthefirsttimetheymasterataskorthestudentwhodoesn’twanttogobacktoclassbecausetheylovewhattheyaredoing.Collaboratingwithteammembers,thenhearingtheteachersreportsuccessesintheclassroomorwhenastudentnolongerneedsmysupport.And,of course, thehigh schoolpeer tutorwho says they toowant tobe anOTwhen theygraduate.Eachnewsuccessisastepinthedirectionofincreasedindependenceandawareness….andIlovebeingapartofthat!

Michelle Schmidt , OTR/L

Communiqué I Hear, and I Forget. I See, Brittany Davis, OTS

Lincoln Land Community College

Voic

eSt

uden

t

Student Voice

IfyouwouldliketobefeaturedinStudentVoiceorknowsomeonewhowould,[email protected]

In the Occupational Therapy AssistantProgram at Lincoln Land CommunityCollege,LevelIfieldworktakesplace in community settings,not in healthcare settings, asis the case with many otheroccupationaltherapyeducationprograms.Insteadofshadowingan occupational therapypractitioner and observingoccupational therapy, Level Ifieldwork is focused more ongaining professional behaviorswith both other professionalsandtheclients.MyexperienceonLevelIfieldworktookplaceattheCordeliaDammonEarlyLearningCenterinSpringfield,Illinois. CordeliaDammon offers programsthat help preschool children develop skillsthat will enable them to be successful inkindergarten.Italsoequipsthechildrenwithskillstobelife-longlearners.ThroughouttheweeksthatIwasthere,Iwasabletoenhancemy professional behavior through workingand playing with the children while alsoaiding and discussing the students with theteachers. ConcurrentlywithLevelIfieldwork,Iwasalso taking an occupational therapy theoryclass for mental health. Some of the topicscoveredinthatclasswereverymuchrelatedtomytimeattheEarlyLearningCenter.SeveralstudentsthatIhadthepleasureofinteractingwith had different diagnoses and conditionssuch as aggression, autism, attention deficitdisorder (ADD), and attention deficit-hyperactivity disorder (ADHD). Duringthementalhealthclass, Iwastaughthowtointeractwithchildrenthathadthese specificdiagnoses.Ifoundthisclasstobeveryhelpfulfor my role as a “helper” in the classroom.Someof the concepts that Iwas taught andwasabletoapplyattheEarlyLearningCenterwith the students included using very briefanddirectinstructionsforchildrenwithADDandADHD , aswell as ensuring that thereare minimal distractions, in order to moresuccessfullyperformactivities.Whileworkingwith the students on coloring activities orreading activities, I was able to apply theseconcepts. For example, one of the studentshad a very short attention span and wasverydistractible; therefore,while givinghimdirections,Ihadtobequitedirectwithhim

to keep his attention. When he would startto lookawayfromtheactivity, Iwouldhave

tosayhisnameinaratherloudvoice to get his attention backtotheactivity.Ifounditinterestingtoseehowthe teachers and other facultymembers applied the sameconceptswhileinteractingwiththe children. The classroomswereveryorganizedand labelswereplaced in each area, suchas “cubby area”, “readingbooks”or“kitchenarea”.Eachchild’s cubbywas labeledwiththechild’snameandhisorherphoto. The class agenda wasthe same every daywith recess

first, then restroom and drink time, snacktime,anOTsession,andmusictimewaslast.Havingtheschedulethesameeverydayhelpsthechildrentodeveloproutines,whichisanimportantpartofthelearningprocess.Astheteacherwouldgoover the agenda everyday,shewouldcallonstudentstohelphercompletesmalltasks,suchascountingthedaysofthemonth, counting the number of studentspresent,orfiguringoutwhatdayoftheweekitis.Ifoneofthestudentswashavingadifficulttime completing the task, the teacherwouldwalkthemthroughit.ForsomeofthestudentsthathadADDorADHD,someofthesetasksseemed quite difficult, so the teacher had toimplementsomeoftheconceptssuchassayingshort, direct statements and minimizingdistractions. Aggression was another topic that I hadthe opportunity of learning about in thementalhealthclass.Thisinformationwasveryvaluable tomebecause someof the studentshadaggressivebehavior.Oneof the studentswasoftencaughtkicking,hitting,andyellingat the other students aswell as the teachers.When the student would become bothphysically and verbally aggressive I wouldrememberwhat I learned during thementalhealth class when aggressive behaviors werediscussed.First,Iwouldexplaintothestudentthat hitting and kicking is not allowed andit isnotnicetohitoryellatothers.Iwouldexplain this inaveryclear and seriousvoicetokeephisattention.Theteacherswouldalsoavoidpunishingthestudentbecauseitwould


and I Remember. I Do, and I Understand.

gettingclose to teenageyears. In thesecases, itwasa taskthatparentsdidnotwanttocontinuedoingfortheirchildfortherestoftheirlives,anditwasalimitingfactorinsocialinteractionandconfidenceforthechild.Andyet, inotherfamilies, parents were content to continue doing this fortheirchild,andthechildwasunconcerned.Somecaregivers

had to go to their child’sschool to perform his/hercatheterization once ortwiceperday.Tohelpyouthunderstand the benefitsof self-catheterizationindependence, I wouldask them questions thatincluded, “Do you everwant to have a sleepoverat a friend’s house? Doyou want to live on yourown one day? Do you

alwayswant tohave to askmom or dad to help you

withyourbathroomneeds?”Itbroughttheyouth’sneedforindependencewithcatheterizationtotheforefront. A light bulb went off and a new inpatient self-catheterization program took shape. Starting in 2007, webegan scheduling rehabilitation admissions primarily forself-catheterizationtrainingafterbriefscreeningsinclinictoseeifyouthwereappropriate.Severalfamilieswereonboardwiththeidea,andweadmittedabout13patientsoverthecourseof5years.Eachchildwasidentifiedinclinicasagoodcandidateforcatheterizationtraining(ie.independencewithmostADLs,appropriatecognitive skills,youthandparentdesiretolearn)andparticipatedina3-5dayhospitalstaywithtwicedailyoccupationaltherapy(OT)servicesandnursingteamteaching.Occupationaltherapistsutilizedflashcards,teachingdolls,anatomyreview,andachievementcharts,andprovided aids (ie. mirrors, lower extremity positioners) tothechildrenasneeded.Wealsoemployedreadinessactivityskills that included fine motor strengthening, dexterity,perceptual motor, visual perceptual, ADL, and bathroomtransferstraining. Most children were able to complete steps of self-catheterization to a greater extent by the end of theirinpatient stays. Being in the hospital overnight allowedthemtoputtheirnewskillstouse24-hoursaday,whilethechildrenreceivedalotofsupportfromtherapyandinpatientnursing.Buttoreallyconfirmtheoutcomes,Idecidedtodoaretrospectivechartreview.Thirteenchartswerereviewed.Theaverageagewas11.2±2.4,andtherewere3maleand10femaleparticipants.Datawascollectedpriortotraining,atdischargeandataclinicfollowup.

Results Prior to training,54%ofparticipantswere completelydependentforcatheterizationand36%weredependentwithcatheterinsertionbuthelpedwithpre-catheterizationtasks.One participant continued to be dependent at dischargeand follow-up due to anatomy and dependence in lowerbody self-help skills. At discharge, 31% of participantsrequiredassistancewithcatheterinsertionandcuesforpre-catheterizationtasksand62%wereindependentexceptforverbalcues. Atclinicfollow-up(average6.5months),oneparticipantrequired assist with catheter insertion and cues for pre-catheterizationtasks,23%ofparticipantswereindependentwith catheter insertion with occasional cueing, and 62%werecompletelyindependentwithallaspects.Fiftypercentofparticipantsused amirror inbed to complete the task.Seventeen percent performed it in bedwithout aids, 17%usedatoiletandmirror,and7%usedatoiletwithnoaids. The results indicate that utilizing a combination ofintensiveinpatienthospitalstayandOTinterventionallowsmostparticipantswithSBtomakeexcellentprogressinself-catheterizationindependence.Andparticipantsmaintainedorsurpassedtheirlevelofindependenceatfollow-up. Untilrecently,ShrinersHospitalsdidnotbill3rdpartypayers.Wehadalotofflexibilityincaringforourpatientsin an inpatient setting withoutconcerns over insurance coverage.Due to the economic downturn,thehospitalsystemhadtoturntodependenceon3rdpartypayment,eventhoughwecontinuetocareforchildrenwithoutregardtopatientor familyability topay.With theonset of insurance authorization,manyofthesepatientsnowneedtobeseenonanintensiveoutpatientbasis for self-catheterizationtraining. Theresultsofthisstudyhavebeen presented as a poster at3 different conferences in 2012:The2ndWorldCongresson SpinaBifidaResearch andCare inLasVegas, ILOTAconference in Naperville, and Howard Steel Conference:PediatricSpinalCordInjuriesandDysfunctioninOrlando.

About the AuthorRachel Galant is co-director of rehabilitation at ShrinersHospitals forChildren–Chicagoandcanbecontactedatrgalant@shrinenet.org.TheShrinersChicagounitspecializesinorthopedics,spinalcordinjury,andcleftlip&palate.Ifyouwouldliketoreferapatientforthisspecializedmedicalcareortherapyservices,pleasecall773-385-KIDS(5437).

Self-Catheterization (continued from page 1)

Anatomical dolls allow practice and play while skills are being learned.

Games and tools assessand improve fine motor skills

and memory


Communiqué Clinical Spotlight Chana Goldstein MS, OTR/LChicago Public Schools

Spot

light

Clin

ical WhenIwasgraduatingfromhighschool

anddecidingonacareerpath,IknewthatIwantedacoupleofthingsformyfuturelife.IknewIwantedajobinthemedicalfield,andIknewthatIwantedtohavetimetohaveafamily.Whenresearchingpossiblejobsinthehealthcarefieldthatmatchedthesecriteria,IcameacrossOT.Firstandforemost,theOTprofession offered the ability to help peoplewith a wide variety of diagnoses. Second,with thewide range of job possibilities,OTofferedtheoptionofpart-timehoursorschoolplacement,whichwouldallowmetobalancehomeandwork. When I graduated ten years ago, I wasoffered two jobs onthesameday:thefirst,an outpatient clinicand the second, BeardSchool, a school forchildren with severeautismorE/BD.Withlimited experienceworkingwithkidswithAutism and torn as towhat to do, I calledKim Bryze, my pedsfieldwork supervisorand an unfailingsource of wisdom.She recommendedthat I take the jobat Beard because theself-contained programs in Chicago PublicSchools tend to be “hidden little gems.”Onherguidance,IacceptedthepositionatBeard,uncertainastowhattoexpect,andwasluckytofinditaperfectfit.The kids I met upon my arrival at BeardwerenotsimplyAutistic.Manyofthemhadalready failed in other programs that werelessrestrictiveandhadmoreaccesstoregulareducation peers. Their level of cognitivefunctioningortheseverityoftheirbehaviorshadmade it impossible for them to learn ina classroom larger than eight children withthree adults. Working with these kids wasphysically and emotionally demanding, andunfortunately,inmanycases,ittooktimetoseeanyresults. However,oneofthespecialthingsaboutworking at a small self-contained school isbeingapartofateam.Beinganitinerantschooltherapistcanbealonelyroleandachallengeforanynewtherapisttryingtolearnfromothers.Beardhousestwofulltimepsychologists,twofull time social workers, 3 speech languagepathologists,abehaviortherapistandsomeof

the best andmost dedicated teachers I haveever met. We collaborate with each otherdaily about behaviors that we observe, andeachdisciplinebrings itsownknowledge setinto interpretation and treatment. Workingtogether so closely allows us to build a planthat takes into account the focuses of eachprofessionalandtreatthewholechild.Ihavelearnedsomuchfromeachoftheseindividualsandmakingmyself part of a great teamhasmademebetter. WhenIstartedatBeard,themodelusedin treatmentwas a pull outmodel inwhichkids were removed from the classroom fortheir OT sessions, which often focused on

finemotortasks,andtransitionedbackintotheclassroomfollowingtreatment. Over the years, theother therapists and I realizedthat this nonintegrated approachto therapy kept us from reallygettingtoknowthestudents.Wewould sit in IEP meetings andhear descriptions of the child’sbehaviors thatwehadnever seenin our shortweekly sessions. Asa related service,we felt thatOThad to shift to amore integratedmodel. We started workingin the classrooms, and it wasnot long before teachers startedapproachinguswithconcerns farbeyond handwriting. Teachers

also began including us in curriculum andIEP development. Interactionswith parentsincreased as well, and we became an evenmoreintegralpartofthechild’seducation. Today, this integrated approach totreatmentisgoingstrong.Iassignmyselftoeach roomfora largeblockof time.Duringthat time, Iassistwitharrivalanddepartureroutines, toileting, snack, circle times, oneononebox times, andof course, directOTsessions. Consultation with the teacher fitsnaturallyintheday.Forexample,ifasensorymodification is required to increase a child’sattentionandparticipation, I can implementthose strategies in the moment. No timeis wasted waiting for the teacher to trackme down, describe the behavior, and beginthe trial and error process that comes withbuildinganysensorydiet.In addition to one on one and small grouptreatment, I also run groups in each of myclassrooms. Runninggroupswiththewholeclass, including those not on my caseload,also allows me to quickly target children


Clinical Spotlight

IfyouwouldliketobefeaturedinClinicalSpot-lightorknowsomeonewhowould,[email protected]

whoneedservicesbeforetheyfalltoofarbehindaswellasengagethekidsinamoreplayfulway.EachofmyteachersandIcollaborateonthetypeofactivitybestsuitedtothestudents.Wechoosegroupsthatwillchallengethechildren’sabilities as well as tap into their interests. I can connectwiththekidsduringafunactivitymorethanIcanduringhandwritingdrills,whichisespeciallycrucialwithkidswithAutismwhostruggletomakeconnectionswithothers.Irunfinemotorgroupsthatusuallyincludeasensorybasedcraft paired with a writing task. The craftsmay includecoloring salt tomake a beachposter for summer,meltingcrayonsontowaxpaper tomakea treechangingcolors inthe fall,mixing shaving creamwithglue tomake apuffysnowmaninthewinter,orpapermachetomakeafootballpinata for theSuperbowl. Ialsodosensorymotorgroupsdesignedtoincreasebodyawarenessandtoprovideinputtoincreasedoverallorganizationprior to tableworkactivities.Iuseseveralhomemadesensorygameslikesensorydice,afishinggamewithdifferent sensoryactivitiesoneachfish,and movement cards similar to yoga. I run fine motorboard game groups that also work on social interactions.Interactions between peers can be unpredictable and everchangingmakingitespeciallydifficultforkidswithAutism.Boardgamesallowinteractionsthatareunchangingandeasytoanticipatemakingitaneasyplacetofacilitatesuccessfulpeer interactionswhile stillworkingonmotor skills in anenjoyableway.Myfavoritegroupsaremycookingactivitiesthatincorporatesensoryactivitiesandself-caretasks.Foodissomotivatingthatmostkidsaremoreengagedinacookinggroupthantheywouldbeinanotherfinemotortaskevenif it includes the same challenging tasks. It also gives anopportunityforpickyeaters,asmanychildrenwithAutismare,toengagewithnewfoodsinthehopesthattheymaybewillingtotrysomethingnew. Inasystemalwaysshortonfunds,itcanbeastruggleto obtain the resources needed. I have written manygrantsovertheyearstoensurethatIhavethesuppliesandresources necessary tomake these experiences available tothekids. ChicagoFoundation forEducationandDonorsChoose are some of the organizations that provide simplegrantstopeopleworkingineducation.Iamgratefultotheseorganizationsformakingitpossibleformetoprovidetheseactivities,andIfeelthatthesegroupshaveincreasedthelevelofengagementIhavewiththeclassroomandthekids. Being a school based therapist with this difficultpopulationhasgivenmemorethanIcouldeverhavegiventhem.Igettoworkinthechild’snaturalenvironment,seeifmyinterventionsgeneralizetootherareas,andworktowardsthat end.My job also givesme a creative outlet somanyjobsdonotoffer.Igettocolor,meltcrayons,andplaywithplaydoh.Idoyoga,playcatch,andridearoundonscooterboards.Ihaveevenhadtheopportunitytobringmyfavoritepastime, cooking, intomy day. There is immense joy insomesmallthingswetakeforgrantedintypicalkidslikeasuccessfultoilettraining,selffeeding,andfiguringouthowtoputtogetheracrafttomatchamodel.Workingsohard

towards these goals makes the feeling of accomplishmentevensweeter.However,themostrewardingpartofmyjobismakingtheparentsseethevalueinthesesmallthingsaswell. BeingaparentofachildwithAutismcanbesofrustrating.Theamountofworkrequiredtomeetthechild’sneedsareimmenseandtheappreciationandreciprocitygivenfromachildwithAutismmaybevery limited. Additionally, theworldoftenjudgesratherthansupportsparentsofchildrenwith Autism. Because Autism often lacks any outwardphysicalsigns,peoplemayconcludethatparentsofchildrenwithAutismaresimply“badparents”whoareincapableofcontrollingtheirchildrenwhenoutinpublic.AsanOT,Icanworkwithachildonsomanyareasandoccupations,anditallowsmetobestrengthbasedwiththeparents,sharingthechild’spotentiallyhiddensuccessesinsteadofmerelythedeficitareas.IfIcanmakeaparentfeelgoodandproudoftheirspecialneedschildevenforamomentthenthatismygreatestreward. Threeyearsago,thestruggleagainstAutismhithome.OneofmyfivechildrenwasdiagnosedwithAutismatagetwoandahalf. Whilenoone can say they arehappy tohaveachildwithadisability,Icannothelpbutfeelthatithasmademeabettertherapistandgivenme“streetcred”.It is easy to fall into a pattern of giving parents somanyideasofthingstodoathometomaximizefunctionwithoutconsideringtheextrastressthatitmayputontheparents.Inowunderstandthestrugglesthatparentsarefacing,andI am familiar with the battle to incorporate therapeuticinteractionswithinabusyhomeroutine.I,too,havefiguredouthowtojugglekids,homework,therapies,andrunningahouseintomyscheduleandtrytosharethesesuccessfullytriedstrategieswithparents. My timeatBeardhasmademe see that the futureofOT is in making ourselves an indispensible part of theteamworkingwith a child. This includes supporting theothermembersoftheteamandtakingonjobsthatdonotinitiallyseemtobeourdomainforthegreatergoodoftheteam and therefore, the child. Occupational therapy canencompasssomanyoccupationsofchildhood,andwemustbe openminded as to our role in treatment. We cannotallowourselvestobeputinasmallboxasthepersonwhoworksonfinemotordeficits, thepersonwhodoessensoryactivities,orthepersonwhoworksondressing.Weareallofthosethings,butwearealsoawholelotmore.Ourroleintreatmentandasateammemberisonlylimitedbyourimagination, andwe can work in conjunction with otherstakeholderstobroadenourscopeandtreatthewholechild.Inthatway,OccupationalTherapycanremainastrongandimportantserviceinthefuture. Peopleaskifitishardtoworkwiththispopulationallday,onlyto leaveandbattle thesame issuesathome,andI understand their concern. The physical and emotionaldemands, as well as the constant changing nature of itspresentation,makeAutismadifficultbattletofight,butit’smybattleandIloveit.

Clinical Spotlight: Chana Goldstein (continued from page 8)


Upd

ate

Rese

arch

Research Update

IfyouwouldliketobefeaturedinaReseaerchUpdateorknowsomeonewhowould,[email protected]

Intentional Relationship Model Clearinghouse ReneeTaylor,PhD. at theUniversityofIllinoisatChicago,UIC,hasestablishedanintentional relationship model, IRM, Clear-inghouse.TheIRMClearinghouseisexpand-ing research, communication, and resourcesfor occupational therapists. The intentionalrelationshipmodel“explainshowcomponentsoftheclient-therapistrelationshipinteractandcanbeenhancedinthefaceofeverydaychal-lengestothatrelationship”(Taylor,2008). AtUIC,Dr.Taylorhas establishedaClearinghousewithmultiplefeaturessuchasaListServandwebpagetodisseminatehermod-el.TheIRMClearinghouseListServfunctionsto provide a communication link betweenthosewhoareresearching,studying,andus-ing therapeutic communication and use ofself.TheIRMListServwillshareeducationalstrategiesforteachingtopicsrelatedtouseofselfandclient-therapistcommunication,gainsupportfromsharedanonymousclientdilem-mas and topics regarding use of self, shareresearch projects involving IRM and obtainconsultation,andlearntouseandaccessIRMassessmentsforeducation,research,andclini-caluse. TheIRMwebpagewillserveasacen-terforresources,products,andarticlestohelpeducators, practitioners, researchers and stu-dents’bestutilize the therapeuticuseof self.Thewebpagewillalsoincludetoolsthatmayassist an individual use the intentional rela-tionshipmodel. InadditiontothecreationoftheIRMClearinghouse, Dr. Taylor is also expand-ing research on the intentional relationshipmodel.ThisresearchistoexpandevidenceonIRM and validate assessments that evaluateIRMprinciples.Current studies includeoneconjunctionwithHwei-LanTan andEsther

Tai at Nation-al UniversityHospital Re-h a b i l i t a t i onCenter in Sin-gaporeandDr.Taylor’s doc-toral studentSuRen Wong.This studyevaluates theclient-therapistrelationshipandclient-studenttherapist rela-tionship.The relationship isbeingmeasuredthrough the Clinical Assessment of ModesClient Version, CAM-C, before and aftertherapyinadditiontotheClinicalAssessmentof Modes Therapist Version, CAM-T. BoththeCAM-CandtheCAM-TareundergoingreliabilityandvalidationstudiesatUIC. The Department of OccupationalTherapyatUIChasjoinedwiththeUniversi-tyofIllinoisMedicalCenter,UIMC,toworkonbothreliabilityandvalidationofCAM-CandCAM-Tandprovidingresearchonclient-therapist interactions and perceived partici-pation.ThisstudyisaimedtobegininearlyAugust. ToJointheIRMClearinghouseList-Servpleaseemail“SUBSCRIBEIRM”tolist-serv@listserv.uic.edu.FormoreinformationontheIRMClearinghousepleaseemailirm.clearinghouse@gmail.comorvisitourwebsiteat https://www.uic.edu/IRM.

Reference:Taylor, R. (2008). The intentional relation-ship: Occupational therapy and use of self.Philadelphia:F.A.DavisCompany.

Baily Zubel, OTSUniversity of Illinois at ChicagoResearch Assistant

Weareinterestedinhearingaboutresearchprojects.Thesecanbeprojectsfacilitatedbystudents,cliniciansorprofessorsinacademicorworkplacesettings.Youarewelcometosummarizeresearchthathasrecentlybeenpresentedinpublicationsoratseminarsorpostersessionsatconferences.

Ifyouhaverecentlycompletedaproject,wewouldlovetohearfromyousowecanshowcasetheresults.Remember, research is important. Ithelpstovalidateourworkandinspiresustolookinto

innovativeideas.Allarticlesshortorlongareacceptedandenjoyed.Ifinterested,[email protected]!

Wanted: Research Studies


increase the aggressive behavior. Instead, they would sithim in the time-out chair until the aggressive behaviorsstopped.The studentwould then join theother students.Inaddition,duringthementalhealthcourse,Iwastaughthow to choose activities depending on diagnoses andcertainbehaviors.Asaresult,duringplay-time,Ihelpedtheaggressivestudentchooseanactivitythatwouldallowhimtogetsomeaggressionoutwhilenotbeingviolent.Whenthe student startedbeingmean toother students, Iaskedhimifhe’dliketomake“cookies”usingplaydough.Thisactivityallowedthestudenttouserepetitivemovementsinordertorollthedoughintoaball.Theserepetitivemotionsseemed to really calm him down. After the student hadplayedwiththeplaydoughwithoutthepresenceofotherstudentsforabit,Iinvitedsomeoftheotherstudentstojoinus.Withoutbecomingaggressiveorviolent,thestudentsatsidebysidewiththeotherchildren.

Though my LevelI fieldwork did nottake place in anoccupationaltherapysetting, I feel thatI gained a greatdeal of knowledgeand experience ininteractingwithbothprofessionalsandthestudents. I was alsoable to truly applythe concepts that Ihad learned in class tomyexperienceattheEarlyLearningCenter.Notonlywasmyexperienceextremelyenjoyable,itwasalsoverybeneficialtomeasanoccupationaltherapyassistantstudent.

Student Voice (continued from page 6)

Meet the Communiqué Committee!

Hi.MynameisCarrieNutter.I’vebeenamemberoftheCommuniquenewsletterteamsince2007andtheeditorsince2010.IreceivedmyB.A.inPsychologyandM.S.inManagementofPublicServicesfromDePaulUniversityandmyM.S.inOccupationalTherapyfromRushUniversity. IcurrentlyworkasanOTfull-timeatChicagoPublicSchools and part-time in the hippotherapy program at FreedomWoodsEquestrianCenter.

Besides school-based therapy, I also have experience working inhospital, long term care, outpatient andhome settings. Prior to acareerinoccupationaltherapy,Iworkedinsocialservicemanagement.Ivaluethehuman-animalbondandhavetakencoursesonanimal-assistedtherapy,hippotherapyandrehabilitationtohelpanimalswithdebilitatingconditions.Ivolunteerwithspecialeventsfornumerousanimalrescue/welfaregroups.

Myinterestsincludeanimals,vegetarianism/veganism,horsebackriding,tennis,partyplanningandwriting.IresideinLincolnPark(citycondo)andCarolStream(suburbanhouse)withmyhusband,Georgeandour13½yearoldGreyhound,Grayson and 6 year old long-haired cat,Monet. Thank you to everyonewho has helpedmake theCommuniquethesuccessitisandIlookforwardtohearingfromevenmoreofyouin2013!

Carrie Nutter


Opi

nion

sPh

oto

Photo Opinions

IfyouwouldliketobefeaturedinPhotoOpin-ionsorknowsomeonewhowould,[email protected]

Wevalueourcolleagues’opinionsandviews!Ineachissuewewillaskadifferentquestion.Somemaybe thoughtprovoking and somemaybemorewhimsical, since asOTswe facebothseriousconcernsandopportunitiesforcreativity.Wewillfeatureresponsesandphotosfromdifferentcliniciansorstudentsineachissue.Ifyouhaveanideaforaquestionorwouldliketobeconsideredforafutureissue,pleasecontactus.

Training Future Occupational Therapists

I enjoy educating students about fieldwork andwitnessinghow students blossom and grow into professional occupationaltherapists. Students go through an amazing transformation fromthetimetheyentertheprogramatorientationtothetimetheyleavefieldwork and emerge as competent occupational therapists. It isexciting to see the changeswhichoccurduringLevel IIfieldworkwhenstudentsapplywhattheyhavelearnedinschoolandtranslateit into occupational therapy practice. As an Academic FieldworkCoordinator,Irealizethistransformationisoftenfacilitatedbythefieldworkeducatorswhowillinglygiveoftheirtimeandexpertisetoeducatethenextgenerationofoccupationaltherapypractitioners. Iamfortunatetobeabletocollaboratewithagreatgroupof fieldwork coordinators and educators. I often have the addedbonusofcollaboratingwithformerstudentswhobecomefieldwork

educators.Itisalwaysextremelygratifyingwhenformerstudentscontact their schools because they “want to take a fieldworkstudent”.Itisveryrewardingtobepartofthisdynamiccircleoftrainingfutureoccupationaltherapists.

What inspires you about working in academia?

Minetta S. Wallingford, MHS, OTR/L Assistant Professor, Academic

Fieldwork CoordinatorMidwestern University

Witnessing the Joy in Discovery Peopleaskme if Imissworkingwithpatients,andI say,“yes,butbeing a facultymember allowsme tobepartof a similarprocesswiththestudents. Iobservethemlearningandgrowingandgoingontopursuetheirgoals,andIknowIamapartofthatexperience”.Afteralmost25yearsatUIC,Istillgetbutterfliesbeforethefirstdayofclass,and chokedupongraduationday.Teaching is thenextbest thing tohavingchildren,achancetoinfluencethefuture.Itispowerful–helpingtoshapethenextgenerationoftherapists.Knowingthatwhatyouteachthemmaygetpassedonastheyinterfacewithfutureclients,familiesandcolleagues;beingtheretowitnesstheirjoyindiscoveryandthose“ahamoments”;havingthemcomeuptoyoumanyyearsaftergraduationandtellyou that somethingyou taught themstuckwith themandhelpedthemoveraroughspot.IlovebeingateacherandfeelveryfortunatethatIaminaplacelikeUICwhereIcanlearnandgrowandhavemyown“ahamoments”onacontinualbasis.Beingpartofateaching/learningcommunityhasenrichedmylifeandIencourageallpractitionersandstudentstoconsiderwalkingdownthisroadatsomepointinthefuture.

Gail FisherUniversity of Illinois -

Chicago

What inspires you about working in academia?

Working with the disability community to overcome barriers AsapracticingclinicianinSouthwestLouisiana,Iwasalwaysinterestedinthequestionof“whathappensnext?”Whydosomepeopleflourishandsomeflounderuponcommunityre-entry?Criticaltothesequestionswereissuesofequityinserviceandresourceallocation.Myqualitativeresearchwithpeoplewithdisabilitieswhoarefacingmajorlifetransitionshashighlightedthataccesstosupportiveresourcesisfoundationaltopeople’sabilitiestoliveandparticipateinthecommunity.Negotiatingcareandcoordinatingservicesarenot,however,skills that are typically addressed in rehabilitation. Ido research thathelps tounderstandthebarrierstocareandsocialservicesthatpeoplewithdisabilitiesexperienceandtodevelopstrategiestohelppeopleovercomethesebarriers. Ibelievethatbyworkingcollaborativelywiththedisabilitycommunitywecanharnessexistingstrengthsandknowledgetodeveloppracticalsolutionstotheseproblems. Iamcurrentlyworkingontwocommunity-basedparticipatoryresearchstudieswiththeHealthPolicyTeamatAccessLiving(alocalcenterforindependentliving)toexaminebarrierstoprimarycareamongMedicaidbeneficiarieswithdisabilitiesandcancerscreeningamongwomenwithdisabilities.Weareworkingtodevelopingcommunity-drivenmodelsofpatientnavigationtohelppeopleovercomethesebarrierstocare.IdoresearchbecauseIbelievehealthisfoundationaltooccupationandbecauseIbelievethatnavigatingthesocialserviceandhealthcaresystemsarevitaloccupationsthatenablepeoplewithdisabilitiestolivetheirlivestothefullest.

Susan Magasi Assistant Professor

University of Illinois - Chicago

Sharing passion with OT students Iamhonoredtobeanoccupationaltherapyeducator.Thankstomymentorsandtheteacherswhocamebeforeme, Iunderstand theawesomesignificance thatoccupationhas inexpresslyshapingpeople’slives.Ibelieveinthehealingpowerofoccupationandappreciatetheartandthesciencethatisinvolvedinviewinganindividual’sengagementinoccupationasbothatherapeuticmodalityandanoutcomeofourinterventions.BeinganOTeducatorhasgivenmetheopportunitytosharethispassionwithOTstudents.Ifeelprivilegedtohaveahandinshapingmystudents’clinicalreasoning.Ienjoysupportingthemastheybegintoappreciatetheintricatedetailsofoccupationaltherapytheoriesandhowtheycancollaboratewiththeirclientstohelpthemfulfilltherolesthataremeaningfultothem.Iparticularlylovepreparingstudentstoworkintheareaofpediatrics.Ienjoywitnessingthetransformationthatmanystudentsmakefromseeingchildrenmerelyas“kids”toviewingandrespectingthemasindividualswhohavetheirownsetofvalues,interests,andbeliefs.Iamgratefulfortheopportunitytopreparethenextgenerationofoccupationaltherapists.Mygreatesthopeisthatmystudentswillgoontoholdfasttothecorevaluesofourprofession,advocatefortheirclients,andcarveoutnewrolesforusinemergingareasofpractice.

Susan Cahill Assistant Professor

Midwestern University

Communiqué

Meet the Communiqué Committee!

Hello, I am LaVonne St. Amand and have been working with the Communiquénewsletterteamsince2008.Ihavemorethan45yearsofexperienceasahealthcareprofessional presenting teaching and consulting in the areas of strategic planning,business development, program development communications and marketing tobusinessprofessionalsandhealthcaregraduatestudents.

MyundergraduatedegreeinOccupationalTherapyisfromEasternMichiganUniversityandmygraduatedegreeinAdministrationandBusinessisfromUniversityofHawaii.

IhavebeenfortunateenoughtoworkinalltraditionalvenuesforOccupationalTherapyandalsotakeouruniqueskillsandperspectiveintothebusinessworldtoadvocateand

educateaswell ashavingmyownconsultingpractice. I recently retiredasAsst.ProfessorandAcademicFieldworkCoordinatorforMidwesternUniversity.

Ihavebeenalifetimeadvocatefortherightsandaccessforthedisabledcommunitydemonstratedthroughmycommunityoutreach,personalandprofessionalactivitiesthroughoutmylifereceivingrecognitionfromanumberoforganizations.Isitonseveralboardsandhasbeenactiveinthevolunteercommunityforvariousorganizations.Mycareerhasprovidedmewithbeingaguestspeaker,writingandbeingpublishedforanumberofOccupationalTherapyandbusinessvenuesnationally.Mypersonalpassionsareanimals,nature,andpayingforwardinanywaythatpresentsitself.

LaVonne St. Amand, MPH, OTR/L

MynameisMaraSonkin.IhavebeenanOccupationalTherapistsince2007andpartoftheILOTAcommuniquefortwoyears.

IcompletedmyundergraduatedegreeatValparaisoUniversityinPsychologyandthencontinuedontoreceivemyMOTatMidwesternUniversity.

Iamluckytohaveworkedinacutecare,sub-acuteandoutpatientsettings.AtthistimeIamworkingintheacutecaresettingfocusingoncriticalcare.I also spend time working in outpatient performing cognitive and visualrehab.Ienjoyworkingwithavarietyofclientsandhavedevelopedastrongpassionforworkingwithstrokepatients.Irecognizethestrongcomponentof psychosocial factors involved in stroke recovery. I ampart ofmultiplegroupsthatpromotesocialinvolvementandeducationforstrokesurvivors.

OtherinterestsoutsideofOccupationalTherapyincludetennis,traveling,hiking,theater,andcooking.Itisanhonortobepartofsuchawonderfulprofessionthathassuchastrongimpactothers.IamlookingforwardtocontinuingtobeinvolvedintheOTprofessionandpartoftheCommuniqueteam.Ithasbeenawonderfulexperience.

Mara Sonkin, OTR/L


A Seed of Hope… Natalie D. Loewe, MS, OTR/L

Sittinginmycarinfrontoftheirhouseforthefirsttime,Ireviewedthereports—again.Ihadneverheardof his diagnosis before I looked it up, an autoimmunedisease that is degenerative and typically very quicklyprogressing.Iheldmybreathinthoughtforamoment,andwenttomeetmynewclient. His mother and grandmother greeted me andintroducedmetoChris.Hewasabeautifulblueeyed,brownhaired,5montholdlittleboy,withnomotorskillsorawarenesstonoteandverylowmuscletone.Tearfully,Mom told me, “His condition has been stabilized bymedications.But…thedoctorssaythathewillalwaysbeavegetable.”AsGrandmawatched,Iheldhim,rockedhim,rangedhislimbsandprovidedtactileinputtohisskin. Withalloftheearnestnessinmysoul,Ilookedeachoneinthefaceandsaid:“Ican’ttellyouthatthedoctorsarewrong.Icanonlytellyouthatwearegoingtotry.” It was the glimmer of hope that the family wascraving.Theirreliefwasvisibleastensionfellfromtheirbrowsandshoulders.Someonewasgoingtotry.“Thatisallweaskfor.” I criedwith the family thatday. I criedwith themmore times that I can countover themonthsworkingtogether. Chris’s family was full of love in doing the homeprogrammingwithChrisanddiligent inbeingpresentfor therapy sessions.Oneparticular summerdaywhenthe sun was shining, I arrived to find that Grandmahad laid-out a blanket under a shade tree and littereditwiththebrightandsqueakytoys thathadstartedtogainChris’sattention. Thoughtfully, sheaddedaglassof ice tea forme.Realizing that thechange in setting,sensation, and sunshineweregood forhim, the familywantedChristobeabletohavetimeoutsidetoo.Weall‘played’outsidethatday. After about 7 months of working together, thefamilyinformedmethattheywouldsoonbemovingtoKentuckyforfamilyreasons.Westartedtocrytogetheragain,astheydeliveredthetrulytragicnews:KentuckyEarly Intervention would not accept evaluations andreports from IllinoisEarly Intervention andwouldnotopen a file onChris until theywere actually living inKentucky. This information would most likely meanat least twomonths without any therapy for Chris. Ashifttoprivatetherapy,evenfortwomonths,wasn’tanaffordableoption. Tohelp,Iputtogetheralargebinderwithprogressivehomeprogrammingtohopefullygetthemthroughthetherapylapse.Eachofhistherapistsdid.Andthen,onmylastdaywiththefamily,amagicalmomenthappened,

which left an indelibleprint on my soul.The memory remainsburned in my mind,inthesamefashionmyown children’s birthsare. I was talking withMom and Grandma,saying goodbye, andglancing atChris as hesat contentedly in his swing.His pacifier dropped outofhismouthandontothetray.Hereacheddown,feltarounduntilhefoundthepacifier,pickeditup,turneditaroundandputthecorrectendofitintohismouth,andhappilycontinuedtosuckonit,hisbaby-cheekspuffinginandout. IcouldfeeltheteartracksasIturnedtohisfamily:“Idon’tknowhowfarChriswillbeabletogo,butthatisnotavegetable.”Andwecriedtogetheronelasttime. IthinkofChrisoften,andwonderhowheisdoing,whatheisabletodonow,andevenwhetherheisstillliving,asithasnowbeenabout9yearssinceIlastsawhim.Thereweresomanythingsthatmadethisfamilyspecial.HecontinuestobeoneoftheyoungestchildrenthatIhaveworkedwiththroughEarlyIntervention.HecontinuestobethelowestfunctioningchildthatIhaveeverworkedwith.His familywasmagnificent in theirlove, patience, diligence and hope for Chris. When itcame time todischargeChris, therewas still somuchlefttodoandsomanyquestions…thatwashardforme. ImetChrisduringmyfirstyearasanOccupationalTherapist, and he is the big one that sticks with me.UsuallywhenIdischargeachild,Ihaveanideaofwhattheprognosiswillbeforfuturedevelopmentandcourseoftherapyandsuch.WithChris,Ijustdidn’tknow.Stilldon’t know. I know that I made a difference for thatfamilythough.Itisverypossible,likelyeven,thatanothertherapistcouldhavegoneinandhelpedChristomakethegainsthathedid.Butitwasn’tanothertherapist.Itwasme.AndIbelievethatasmuchasIhelpedthefamilygainskillstohelpChris,Ibelievethatthebiggest,mostimportantthingthatIgavethatfamilywashope.

Hope for growth.

Hope for relationship.

Hope for a meaningful life for Chris.

EachissueoftheCommuniqueseekstohighlightareasofOccupationalTherapyPractice.Weappreciateourreaders’wide-rangingexperiences.Eachissuefeaturesadifferenttheme: Jan/ Feb/March: Education, Research, Pediatrics April/May/June: Gerontology, Home Health, Low Vision July/Aug/Sept: Physical Disabilities, Hand Therapy, Driving Rehabilitation Oct/Nov/Dec: Mental Health, Work Hardening, ErgonomicsDoyouhaveanarticlethatdoesnotfitthethemesalreadylisted?Send it.Wewelcomearticlesfromdiverseandnovelperspectives.

Article Guidelines: •Articlesshouldcontaintitle,introduction,body,summary,andreferenceswhenappropriate.•Themearticlesmightincludephotosand/orgraphics.•Articlesshouldbeapproximately300-1000words.•Authorsarerequestedtosubmitaprofessionalbiography,maximum35words.•Passporttypephotosarerecommendedforauthorphoto.•Allworkshouldbeoriginalwork.Ifworksubmittedisnotoriginal,onemusthavewrittenpermissionfromtheoriginalauthortoplacespecificiteminCommuniquepublication.Pleaseusequoteswhenquotingothersandgivecredittooriginalauthors.•Pleasegivecredittoindividualswhocollaboratedtocompletearticle(e.g.-thosehelpingwithresearch,providingbackgroundinformation,helpingwritearticle,etc.).•Forthenextissue,articlesshouldbesubmittedbyMay 15!

SUBMIT ARTICLES TO: [email protected] Communiqué editorial committee reserves the right to edit any material submitted.

Submit Articles to the Communiqué

elf catheterization ow will you celebrate ot month? - illinois

Documents