Happy National Occupational Therapy Month everyone! Today I am going to take you along a ride in the day of the life of a pediatric occupational therapist! Hope that you are all being safe, washing your hands, and connecting with loved ones at a distance. While things may look a bit different right now at what typically is our very busy clinic, I am tremendously thankful to have a bit of normalcy during these unprecedented times by being able to see a couple of the families I work with through telehealth. I will talk a little bit more about that later, but in the meantime, I will paint a picture of what a typical day usually looks like at the NAPA Center.
For those of you that may be encountering our blog for the first time, you may be asking yourself, what exactly is occupational therapy? While each occupational therapist’s definition may be different, based off of my various clinical experiences across different settings, I like to define occupational therapy as this:
Occupational therapy is helping an individual with the underlying skills that are essential to help them engage in activities to support independence, development, and personal meaning, defined as occupation.
Furthermore, what is defined as occupational therapy can vary from setting to setting. What I do as a pediatric occupational therapist may look different from what an occupational therapist might do in a skilled nursing facility, an oncology hospital, an outpatient mental health clinic, etc. Thus, what better way to hone-in on the what is pediatric occupational therapy than showing you what a day in the life looks like?
One of the coolest things about my profession is that I get to work with kids with a wide spectrum of abilities. For the sake of patient privacy, I will make up some pseudo names in reference to my patients.
He was born prematurely and has hemiplegic cerebral palsy, meaning that he has difficulty with the motor functioning and muscular strength on the left side of his body, and he is delayed on his motor milestones. Thus, my responsibility is to help this little dude develop the underlying skills that are needed to help him accomplish the developmental milestones that are essential for his age.
For Xavier, we are working on his ability to have more functional grasping of his left hand, his ability to have reciprocal movements in coordinating his left and right side, his ability to use his left hand for self-help skills, and his ability to work on coordinating his postural control muscles (the core muscles of his abdomen and back responsible for balance) to support his functional mobility. So, what might that look like? Well I mean, it’s pediatrics so of course EVERYTHING is in the context of play! Thus, I may set up a strategically constructed obstacle course that focuses on Xavier being able to execute appropriate motor milestones, such as working from his tummy to standing with anterior support, cruising to his left, squatting down to grasp toys with his left, and climbing slide ladders using both sides of his body reciprocally.
Delilah is an adorable 2 year old girl who is enrolled in our NAPA Kidz Academy. While she does not have a diagnosis, there are concerns regarding her age equivalency with her fine motor, gross motor, and self-help adaptive skills, so my responsibility is to get Delilah up to speed. Delilah tends to frequently fall accidentally because she has challenges with her postural control muscles, thus I set up an obstacle course with various dynamic (unstable surfaces) and help her figure out how to motor plan and safely traverse these obstacles. Dynamic is key, since it provides an opportunity for her to engage her core to bring her center of gravity within her base of support. Delilah demonstrates difficulties with sensory processing, especially with washing her hands. Thus, we do fun tactile play with shaving cream to help give her “My Little Pony” dolls a shaving cream bath, as a means to develop a more positive association with wet tactile mediums. Lastly, we finish by making a bracelet together using a stiff piece of twine and beads, with a focus on coordinating both sides of her body and using her fine motor precision skills to skillfully thread the bead onto the twine.
Intensive sessions are a bit different from traditional sessions in that with intensives, I have an opportunity to see a child and work with their family every day for 3 consecutive weeks. The child may receive anywhere from a 1-4 hour block combination of speech, physical, and occupational therapy, based on what is most needed to support that child’s development.
For this intensive, I get to spend an hour a day working with Jaden, a 5 year old boy diagnosed with Lissencephaly. Lissencephaly is a rare brain disorder where the brain appears to be smooth, rather than having grooves and ridges. The lack of brain folds develops difficulties with accomplishing age appropriate motor milestones, challenges with strength and coordination, as well as low body tone.
For intensives, the team formulates a plan of care to work on consistently executing 6-7 exercises over the course of a full hour targeting specific musculature and providing opportunities to master motor sequences. In addition, Jaden is wearing a NeuroSuit, which is designed to provide additional support to the body, but also provides increased resistance. Tension is strategically structured on the suit by through bungees set up by the therapist to facilitate proper movement and alignment, in addition to proving more feedback for the child to motor plan. Jaden’s activities are executed in succession, focusing on improving his motor planning skills, weight bearing, and trunk rotation. My handling technique is everything; I strategically provide enough support and stability for Jaden to feel secure and confident in being able to target muscles that are challenging for him. My support decreases as necessary as weeks pass, to continue to provide the just right challenge for Jaden to maximize his effort. Most of all, while we work hard, we have fun and it’s a great journey to experience collectively with the family.
I get to see more kids with varying degrees of abilities with different challenges, such as a little boy who is trying to expand his feeding repertoire, a young man with autism who is improving his sensory processing as it relates to function, a school aged girl who is trying to improve her attention and handwriting, and a little girl with global hypotonia who is trying to learning to sit upright while turning the page of a book.
However, I am also fulfilled. People ask me what I love about my job the most, and for me it is that I have the opportunity to help these kids self-actualize and become the best versions of themselves, all while I get to be a big kid playing with them therapeutically in the process. While no journey is truly linear, I can also say this:
There is no parallel for the joy that happens with the victories that come along the way.
Whether it be a parent witnessing their child being able to walk for the first time, a parent connecting with their child reciprocally because they now understand their unique sensory profile, or a child raising their arms in triumphant victory because they finished a challenging obstacle course in true America Ninja Warrior style. It is because of these reasons and more, that NAPA truly is a magical place.
Jonathan always knew that his life purpose was to help people. An avid surfer, Jonathan discovered occupational therapy through the Jimmy Miller Memorial Foundation (a therapy organization that surfs with at-risk youth and Veterans who have PTSD using an occupational therapy framework.) To be able to do something he loves to do as a means to help people solidified his career path. Jonathan is passionate about pediatric mental health, family centered practice, and learning more about innovative evidence-based therapies. Jonathan refers to himself as an “oversized child” and loves the process of families working together to maximize a child’s full potential. In his free time, Jonathan plays basketball and music, dances, travels, watches his teams play, and hangs out with his friends and family (most especially his dog!)
Looking for more OT fun? Check out Jonathan’s video sharing hand-eye coordination activities!