Hi I'm Ashleigh. I'm an occupational therapist here at Therapy Playground. This is Lena who
she just completed her pediatric level II fieldwork with me. Lena, we would love to find out how
this experience was for you. First, can you give a little background as to how you got
to this point of being a level II OT student? Yes, I would love to. First, I completed my
undergrad at Loyola University in Chicago and I majored in psychology. Then, I knew
I wanted to go to graduate school and I was looking into occupational therapy programs.
By that point, I had graduated Loyola and there were some prerequisite classes I did
not have, so I attended a community college for a semester and a half to complete courses
such as anatomy and physiology, medical terminology, and some other courses. I am now attending
the masters of science occupational therapy program at Winston-Salem State University.
It is a 2 1/2 year program consisting 2 years of coursework and 6 months of level II fieldwork.
During the first year, we had level I fieldworks where it was mostly observation and little
hands on. During these past 6 months I have completed level II fieldworks at 2 locations,
with Therapy Playground being my last rotation. So as a level II student, you are expected
to act as the treating therapist. Describe some of the diagnoses you have seen and ages
we treated. We see kids as young as 12 months old to 12
years old. Diagnoses include kids who are on the Autism spectrum, kids who have ADHD,
PDD, and CP. The treatment sessions include focusing on how to help the child improve
function in activities of daily living. We also see typically developing kids who have
low tone impacting function or kids who have difficulty with handwriting.
How would you describe the evaluation process in the pediatric setting?
The evaluation process has many components so at times it feels like you have to juggle
a lot of things at once. The evaluation includes using a standardized assessment, we used either
the BOT for older kids ages 5 and up or the Peabody for kids 4 or younger. Then it also
includes interviewing the parent or caregiver about the child's abilities in activities
of daily living with things like dressing, bathing, feeding, and toileting. We also administer
a parent questionnaire, which is now in electronic format called the Sensory Processing Measure,
and it consists of questions the parents answer about their child's sensory processing skills
which helps us determine if there are any sensory processing deficits that we may need
to address. Next, there are clinical observations that we do to see how the child reacts on
the ball, on the swing, other floor activities, and evaluating their strength. The therapist
then has to score the assessment, interpret the results, develop goals, and set up a possible
time and date to start therapy if services are recommended.
Give me your opinion on the treatment sessions of OT in pediatrics.
The treatment sessions are really fun because you get to interact with kids. During treatment
sessions, we do activities to work towards goals that were established in the child's
plan of care. Usually we start off in the gross motor room and do activities like obstacle
courses, or exercises to improve core or upper body strength, or sensory activities such
as swinging on the swing. Then, we transition into the fine motor room where kids sit at
the table and perform fine motor activities such as handwriting, crafts that include cutting
or visual motor tasks. We like to switch up activities and make it fun for the child,
so this doesn't have to be done in order, for example we can work on handwriting on
the chalkboard in the gross motor room, it doesn't always have to be at the table. I
have also come to realize that sometimes the hour or 45 minute treatment time slot does
not allow for you to work on all of the child's goals and that this is ok.
As you stated earlier, you had pediatric courses in school. How was this level II experience
compared and contrasted to what you've learned? I have learned the most during my pediatrics
lab course. In the lab, we were able to go through several assessments and figure out
how to administer and score them. This is similar to my fieldwork experience because
we have two assessments that we use here as I had stated before, but this of course is
different and more fun because I administer them to patients and not students. Also in
my pediatrics class, we had a sensory lab where we did a lot of spinning, jumping, pulling,
wearing body socks and walking around, and this was good to experience the effects of
all this vestibular and proprioceptive input and what effects these activities may have
on the child. Overall, the best learning experience comes from actually being in the pediatric
environment which I am getting in fieldwork because I am able to implement things that
I have learned in class in a clinic setting. How did you feel about communicating with
parents? Parents either chose to stay in the waiting
room, or they came back and observed the sessions. If they stayed in the waiting room, I would
explain to them what we did during the session and what we worked on. We also provided the
parent with education regarding anything they could be doing at home such as sensory activities
like brushing, or upper body strengthening activities like doing animal walks at home,
or fine motor activities like doing puzzles or finding small objects in playdough or theraputty.
We see the kids for 45-60 minute sessions one to two times a week, so it is important
that parents provide good carry over at home of therapy strategies in order to make sure
that the child is maximizing potential. What other disciplines did you work with?
Here at Therapy Playground we have occupational therapists, speech therapists, and physical
therapists. We have co-treated with both speech and physical therapy when it was necessary
to enhance therapeutic handling strategies for a child who could not handle two different
therapies due to behaviors or attention. What types of assignments and research did
you complete while doing your level II? Making this video about my experiences of
being a level II student is one of my assignments. Other assignments included doing a literature
review on a pediatric topic of my choice. I decided to research the Wilbarger Brushing
Protocol and see what studies and other research have been done. I also researched any terms
or diagnoses I was unfamiliar with, and things like the Astronaut Program or Therapeutic
Listening that is done here with some of our patients.
What has been the most challenging part of your level II experience here at Therapy Playground?
The most challenging part is managing difficult behaviors. It is always great when kids do
exactly what you ask, but things don't always go that way. I find it difficult to know the
line of when to give the child space to calm down or when I should intervene and continue
to redirect.
What has been the most rewarding part of this experience?
The most rewarding part of this experience is seeing progress in kids. Now that I have
been here for almost 3 months, I have come to know the kids and their abilities and it
is great when they are able to do something new or more difficult than they have done
before.