Congratulations, you have started your career as an OT. You have sat through so many courses, cried through exams, learned how to administer standardized tests, memorized pathways in Neurology (that will surely come in handy), presented your thesis, and are now ready to begin your career.
That first day on the job, you get dressed in the just-right outfit, not too fancy because you will be on the floor with kids, but not too underdressed because you want to be the professional you are, after all you did not get $100K big ones in debt to look like a shlub right?!?
You are excited and terrified as you pull up to the house. Will the parents be nice? Will you know how to handle this child? What happens if you don’t know the answer to the question the parent asks you????
You take a deep breath, try to calm your nerves, pick up your bag, straighten your name tag and walk as confidently as you can up to the front door.
We have all been there. 21 years later, I still get that little butterfly in my stomach breakdancing right before I meet a new client.
Every good therapist has their bag of tricks. One of my clients use to refer to me as “Sarah and her Party Bag”. I bring 3 toys with me and make sure to switch them out each week. This keeps the child’s interest in therapy because they never know what I am going to bring. However, I will usually keep 1 toy that is a favorite to use as a reward or motivational tool to assist me in therapy.
This is the first time you are meeting this child. When you called to make the appointment, what questions did you ask? You must be a detective. You need to find out what the child likes/dislikes, favorite TV shows, music or activities they enjoy. Imagine the roles are reversed. You need to be sympathetic to what this child is going through and how you are entering into their environment. If you come into their house with something they enjoy, they will more likely build a rapport allowing you to be able to work on the set goals. Take the time to ask questions like “What is your favorite toy, show, doll, etc.”. This will also allow you to know what toys/testing tools are appropriate to bring.
Imagine this situation, you are evaluating a 10-month old baby who is not walking and the parents are concerned. Well, that is ok, because typically babies don’t walk until 12 months. So that concern is unwarranted.
Why are you there? Because that 10-month old baby is not crawling. This is a real concern. When assessing the baby, see if the baby is capable of rolling, can push to sit, sit unsupported, maintain quad position, balance in quad and reach for a toy? If not, you now know what you need to work on. If they don’t have good balance and tone, they won’t be able to crawl let alone walk. You can explain these developmental milestones to the parents and show them through videos or images to help them understand.
Look around the house, what can you do to help this child achieve their goals? If you are working on crawling and they don’t have a tunnel, take 2 chairs and put a sheet over it. If they don’t have a therapy ball, pile up 2 pillows or couch cushions, if they don’t have a bolster, roll up a blanket. If they don’t have a puzzle, draw shapes on a plain piece of paper and cut them out! How can you utilize their environment to best fit them?
Make sure you leave the family with simple activities to carry over the skills you taught during therapy. Most therapists have sessions once a week. There is a lot of information we try to convey to the families we work with. Use a communication notebook. I often tell parents to log sensory activities, diet, and the child’s behavior. You could add session notes, what you worked on, how the parent could carry over these skills during the week. If the child has more than one therapist, this is a great way for the team to communicate.
Sarah is the author of “Play With Your Food” available on Amazon