A Pediatric Perspective

Oral Motor & Feeding Info

Wendy — Thu, 08 May 2008 13:05:00 GMT

Back in February I had posted a blog listing some helpful oral motor sites & articles and Samana Khan had left me a comment asking if I knew of any good oral motor/feeding courses. I would like to apologize to Samana first for taking so long to respond to her question and I would like to offer a few courses and books here that I have found helpful.

Working in the birth to three population I find that the role of helping with oral motor and/or feeding issues is usually left up to the Occupational Therapist or COTA. I know that this is not always the case when it comes to rehabilitation hospitals as the role there is primarily left to the Speech Language Therapist, with the OT/COTA backing them up. Oral motor and feeding is a hard topic to become proficient on because each child is individual and the reason they may not be eating could be due to any number of reasons. I'll go into this a little further in my next blog later this week. For now I would like to list some seminars and books that I have found helpful.

Classes are few and far between and there are times when the class tends to be more technical then helpful. I have tried to attend a few classes but find that I relay a good deal on books to help me with my oral motor/feeding strategies. With that in mind I wanted to offer this list of classes and books that you may find helpful. If there are other seminars/classes/books that you've found helpful I would love to hear about them. I will add to this list as new ones come to my attention.

I learned a lot from the first two classes/seminars in particular:

Picky Eaters or Problem Eaters (the SOS approach to Feeding) - given by Education Resources, Inc.

Tube Feeding with Love - given by Mealtime Notions (even though it is based on helping the therapist who works with children on tube feedings I came back with a lot of basic oral motor and sensory strategies that have helped children who were not on tube feeds).

Beckman Oral Motor Seminars - lists various seminars taught by Debra Beckman providing intensive hands-on workshops to learn the Beckman Oral Motor Protocol.

Innovative Therapists International - Oral Motor and Sensory Motor therapy seminars.

A few books on the subject also ....

Oral Motor Assessment and Treatment: Ages and Stages -

Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Childs Diet (Paperback)

Just Take a Bite - (One of my favorite books to go back and get ideas from) - "Just Take a Bite" takes parents and professionals step by step through the myths about eating to the complexity of eating itself, which leads to an understanding of physical, neurological and/or psychological reason why children may not be eating as they should.

Just Two More Bites!: Helping Picky Eaters Say Yes to Food

As a child my family's menu consisted of two choices: take it or leave it.

~Buddy Hackett

A three-year-old gave this reaction to her Christmas dinner: "I don't like the turkey, but I like the bread he ate."

~Author Unknown

Tuesday Tidbits: Inspirational Stories

Wendy — Wed, 30 Apr 2008 12:13:00 GMT

Today's tidbits are links to something we all need to be reminded of from time to time. When you work with children you quickly come to learn that with all the goals met and challenges overcome from time to time you also come across the case that ends up breaking your heart. We don't give up though - we keep teaching and coaching and trying to make a difference in the lives of the children we work with. Today I share with you some inspirational stories to honor the end of occupational therapy month and to remind us all why we are still in this field ... enjoy ....

"Soon to be a Butterfly" by Beth Larson, Phd, OTR

"Julia speaks with her eyes" by Joyce Saban, Phd, OTR, BCN, FAOTA

"Hello, can I help you?" by Jacqueline Goldberg

Occupational therapy helps people rebuild their lives

"Kelley's story - getting back on her feet" by Ariel Lewiton

The Brooke Ellison Story - by Brooke & Jean Ellison

One bead at a time - from Common Hope website

Hope you enjoyed a few of these stories and may you find the inspiration you need to continue to grow and bloom in the pediatric occupational therapy field.

Tuesday Tidbit - Don't forget ... April is OT Month!

Wendy — Wed, 23 Apr 2008 11:55:00 GMT

It's that time of year again for all OT's, COTA's and Occupational Therapy students to promote and to share the importance of Occupational Therapy. We are in the profession that is so commonly misunderstood. Physical Therapy and Speech Therapy are fairly widely recognized and what their roles are in rehabilitation is usually understood. When it comes to Occupational Therapy, especially in pediatrics, there seems to be confusion as to what we can offer as a profession to the children we work with. This is why this month is a great way to bring attention to the role of Occupational Therapy in the pediatric rehabilitation field. I've included a few links to sites that will help promote who we are and what we do, not just during OT month but during each and every month.

The American Occupational Therapy Association's awareness resource for the public and the professional: http://www.promoteot.org/AI_OTMonth.html

9 Ways to Celebrate your Profession: http://www.therapytimes.com/content=6001J64C489EA4941

Occupational Therapy - Skills for Daily Living Spotlight: http://www.imprintmall.com/ot/

Advance Healthcare POV - promoting OT month: http://community.advanceweb.com/forums/thread/27132.aspx

American Occupational Therapy Association - Promote OT Month: http://www.promoteot.org/

So tell me, what will you be doing to promote OT this month? Inquiring minds wish to know.....

Tuesday Tidbit: National Poison Prevention Week

Wendy — Tue, 18 Mar 2008 13:36:00 GMT

National Poison Prevention Week is March 16 - 22.

The American Academy of Pediatrics (AAP) reports that each year approximately 2.4 million people swallow or come into contact with a poisonous substance. More then half of the 2.4 million are under the age of 6.

With this week being National Poison Prevention Week, the AAP has come out with tips to help prevent and what to do should you have or know of a child who is poisoned or comes in contact with a poisonous substance.

Prevention is always the first and best step to take when it comes to poisonous substances and children. Most poisonings happen when a child is in their own home and their parent or caregivers are not paying attention. We all know how quick children can be and it only takes a moment for us to turn our backs for a child to get into something they should not be getting into. The most dangerous substances in our houses are:

Medicines
Cleaning products
Antifreeze & Windshield wiper fluid
Pesticides & Garden fertilizers
Furniture polish
Gasoline & Kerosene

Placing these items out of the reach of children is, of course, the best action to take. It is also important to put childproof locks on all cabinets that have dangerous substances in them. Medications with child safety caps should be purchased. Extra care should be taken when you are in a location you know has not been childproofed and/or when you are on vacation and staying some where you are not familiar with. Several other tips recommended by the AAP are:

Never refer to medicine as "candy" or another appealing name.
Check the label each time you give a child medicine to ensure proper dosage.
Never place poisonous products in food or drink containers.
Keep coal, wood or kerosene stoves in safe working order.
Maintain working smoke and carbon monoxide detectors.

If a child in your care should come into contact with poison it is important to contact 911 or your local poison control center as soon as possible. Keep the number of poison control on or near your phone. Have the container with the poison in it with you when you call so you can read off any ingredients or listed information the emergency personal may ask you for.

The AAP offers a list of different types of poison situations and what type of treatment should be offered:

Swallowed poison - Remove the item from the child, and have the child spit out any remaining substance. Do not make your child vomit. Do not use syrup of ipecac.
Skin poison -- Remove the child's clothes and rinse the skin with lukewarm water for at least 15 minutes.
Eye poison -- Flush the child's eye by holding the eyelid open and pouring a steady stream of room temperature water into the inner corner.
Poisonous fumes - Take the child outside or into fresh air immediately. If the child has stopped breathing, start cardiopulmonary resuscitation (CPR) and do not stop until the child breathes on his or her own, or until someone can take over.

Although the AAP lists the above treatments it is still important to call 911 or your local poison control center as soon as you can to advice them what has happened, what you have done, and how the child is acting.

Above all else remember - an ounce of prevention is worth a pound of cure. Keep poisonous substances out of reach and locked away from the curious eyes & hands of children.

OT in the News

Wendy — Fri, 14 Mar 2008 11:06:00 GMT

Looks like now is a great time to be in our field! Us News and World Report’s list of "Best Careers in 2008" lists occupational therapists as a great career choice in today’s world. They mention how occupational therapy "is a challenging career that's best for creative, practical people who find satisfaction in small successes." Like we didn’t know that already, huh? *smile* I think being able to be creative and practical is one of my favorite things about being a COTA and working with children. If you get a moment, check out the article. It’s not too long and has some nice links to explore.

http://www.usnews.com/articles/business/best-careers/2007/12/19/occupational-therapist-executive-summary.html

Also, in case you missed it, there is an article in Advanceweb about how PTs and OTs who work with children, adolescents and/or veterans may soon be eligible to apply for student loan forgiveness. Although the article doesn’t note when this may happen or how to apply for it I am including a couple links that may be able to help. I believe teachers have been eligible for partial or full loan forgiveness for a while now – depending on where they work and for how long they have been teaching. It’s nice to see that our profession is also being noticed when it comes to certain areas of need that we are fulfilling.

http://occupational-therapy.advanceweb.com/editorial/content/editorial.aspx?CC=107710

http://www.staffordloan.com/repayment/federal-student-loan-forgiveness.php

http://www.finaid.org/loans/forgiveness.phtml

Overcoming my fear of Autism

Wendy — Wed, 12 Mar 2008 12:55:00 GMT

When I was first out of high school ( 28 years ago) I worked at a day & residential center for Autistic children. This was my first exposure to the world of Autism and it was not a good experience. (Please keep in mind that this was 28 years ago and treatment for Autism has come a very long way.) I was hired mainly to help out in one of the residential group homes for teenage boys. The boys displayed the characteristics of what most people think of when they hear the word "Autism"... they would be in corners or sitting on the furniture doing a lot of flapping, no eye contact, no words, lots of grunting and sounds and totally unaware of their environment for the most part. It was our job to make sure they stayed dressed, ate/drank, and didn't hurt one another. We didn't do any training or try and help them break out of the world they were in. We led them around to stores and through planned activities but all we did was "lead". If they didn't want to participate we didn't force them. Many times "fights" broke out because of their inability to communicate to us their wants and needs. It broke my heart to work there and I didn't last more then a month before I gave my notice.

From that day on I was scared of Autism. I did not know how anyone could work with kids who were on the spectrum. I remember taking the developmental classes in college and learning about the characteristics and new treatments for Autism. I knew I wanted to go into pediatrics and I was sure it was not going to be working with Autistic children. My first job was in a sensory clinic and I worked with children who had CP, MD, oral motor defensiveness and sensory defensiveness. I worked with children who had feeding problems and children who had body awareness problems... and I worked with two children who had Autism. It was because of them that I started to be less afraid and more open to wanting to learn more about Autism.

I began to read books and attend conferences. I spoke with other therapists and families who had children on the spectrum. I eventually left the clinic and began working in Birth-to-three and found myself often with at least 1/4 to 1/3 of my case load consisting of Autistic children. I will admit I was nervous at first because of my past experience but as I worked more within the Autism population I came to see that with each opportunity to work with an Autistic child and their family I learned new techniques to reach out to and connect with them. I have had children from both ends of the spectrum - those who I was not able to reach and the only help I could offer was techniques to help with their sensory seeking behaviors and those who made remarkable progress and were able to move into a preschool setting with the ability to have basic communication skills. There is nothing quite like having a child who is seemingly in their own world suddenly look to you, smile, and gently touch your cheek with their hand. Of course I have had just as many kiddos reach out and pull my hair *smile* but they still reached out.

I am always amazed at the strength of the families who have been blessed with an Autistic child. They have strength and patience and love beyond measure. I know it is not a path they had wanted to take and I have sat with many a parent and listened as they have asked themselves "why me" and I have watched and seen their faces when their little one suddenly makes a connection and is able to complete a task we have been working on with them. I have also been there to try and answer questions when suddenly a new treatment or a new procedure or a new diet is in the news. I am no longer afraid of working with children on the spectrum - I actually look forward to it. I look forward to learning new ways to treat and help. I look forward to the day when Autism is no longer 1-500.

Ready for a summer adventure?

Wendy — Wed, 27 Feb 2008 13:31:00 GMT

Do you know what one summer "job" pediatric OTs are great at? It's a job that requires one or two or three weeks of your time during the summer months. It's a job that doesn't pay well (if at all) but what you will gain from that week of your time you will find more valuable then any amount of money you could have earned. It's a job that will use all of your OT skills without you even realizing your using them. It's a fun job where you will meet people of all ages and walks of life and there is a good chance you will make some life long friends. What is this job, you may be wondering? It's the job of a camp counselor but not just any camp counselor - it's a camp counselor position at a camp for special need children.

I spent three summers working as a camp counselor for children with MD and I loved every moment of it - as did the campers I worked with and saw each day. There is nothing better then watching children who have led sheltered and protected lives being able to play baseball, swim in a pool, go fishing, play pranks on their friends, flirt with one another, tell jokes and listen to stories around a campfire. Whether you may want to be a camp counselor OR if you know of a child who would love a chance to go to camp and do all the things that kids at camp do - my Tuesday Tid-bit for the week .... links to camps that specialize in making special memories for children with special needs. If anyone would like to share any links they may know of, please add a comment or email me and I will be happy to add them.

If anyone would like to talk with me about what it was like being a counselor for a child with special needs - or how much and what activities the children actually do while at camp, please email me - I would be happy to share my experiences. As with any camp experience - please be sure to research the camp - call the company who sponsors it, ask for referrals from past campers and counselors, check to see how long it has been around and what it offers the campers. It is always best to go with a well known camp that has an established record and experienced counselors.

Ready for camp anyone? ...

Camps for children with MD:

http://www.mdausa.org/clinics/camp/volunteer.html

Camps for children with Cancer:

http://www.acor.org/ped-onc/cfissues/camps.html

Camps for children with CP:

http://www.cerebralpalsy.org/camps-and-activities/cerebral-palsy-great-summer-camp-near-boston-subsidized-summer-camp/

Easter Seal Camps:

http://www.easterseals.com/site/PageServer?pagename=ntl_camping_recreation

International Association of Burn Camps:

http://www.iaburncamps.org/member_camps.html

Autism Spectrum Camps:

http://www.udel.edu/bkirby/asperger/schools_camps.html

http://www.veryspecialcamps.com/cgi-bin/vs_browse_camptype.cgi?SpecialtyAutism=Y&specialty_name=Autism

Learning Disorders & ADHD:

http://www.schwablearning.org/camp/index.asp

Numerous camps/disabilities/challenges:

http://www.yai.org/camping/?gclid=CMaBv5vv4JECFSOsGgodxUl0ew

http://www.fcps.edu/ss/prc/camplist.htm

http://www.google.com/Top/Recreation/Camps/Special_Needs/

http://www.ucp.org/ucp_channeldoc.cfm/1/15/63/63-63/4801

http://www.veryspecialcamps.com/

Tuesday Tidbit: Helpful Oral Motor Sites & Articles

Wendy — Tue, 12 Feb 2008 14:34:00 GMT

Recently a multiple office team meeting offered the chance for the occupational therapy practitioners from each office to get together and share ideas and strategies. One of the OTs who has been practicing for quite a while shared with us that she does not do any "yuck" oral motor therapy nor did she do any feeding/eating therapy either. I was quite surprised as I enjoy doing oral motor and feeding therapy. It is one of the areas that I look for classes in and search out any and all articles and strategies that will help me with the families I work with. I have come to find out after asking some other OT's that this is not an uncommon feeling. There are not many OTs who like doing oral motor or feeding therapy and the common theme seemed to be that it was more because they were not knowledgeable in the strategies as well as they would like to be.

There are not a great deal of classes during college offered for OT/COTAs nor are there many seminars offered either. There are a few books written that I have found very helpful. "Just Take a Bite. Easy, Effective Answers to Food Aversions and Eating Challenges" by Lori Ernsperger, Ph.D and Tania Stegen-Hanson, OTR/L is one book that I have found very helpful. Another book is "Feeding and Nutrition for the Child with Special Needs" by Marsha Dunn Klein, M.Ed., OTR/l & Tracy A. Delaney, Ph.D., RD. Both of these books offer good strategies and helpful hints to help with oral motor and feeding issues in children.

Another good site to go to is the "Talk Tools" article site where you can find numerous articles on oral motor and feeding issues, along with strategies to help.

Does anyone else have any good oral motor and/or feeding sites or articles that they have found helpful that they would like to share? I'd love to hear from you.

Sippy Cup Syndrome

Wendy — Fri, 08 Feb 2008 15:15:00 GMT

Several years ago a study published by the Journal of Dentistry for Children stated that out of 186 children presenting with baby bottle tooth decay like symptoms - 29% used sippy cups. This simple statement alone could, and did, cause many a parent to be worried about whether they should introduce sippy cups to their child as a transition from the bottle to the open mouthed cup. What is important to remember, and to share with the parents who are concerned, is that it is not necessarily the sippy cup itself that is the culprit but rather how it is being used.

Sippy cups were invented to help prevent messy spills when a child was transitioning from the bottle to the open mouthed cup. They grew in popularity because they not only prevented the frequent spills but also because they were a more acceptable option for children to have in their hands during car rides and trips around town. They were meant as a temporary solution to help the child learn how to use a cup. They were not meant to take the place of a cup.

The optimal way to use of a sippy cup is to utilize it in one of two ways. The first way is to offer them only at meal and snack times and to offer an open mouthed cup during the other times for practice. The second way is to do the opposite - offering a child an open mouthed cup at snack times and meals (with assistance until they know how to hold and take sips from it) and offering the sippy cup during the rest of the day to encourage fluid intake. It should not be used, however, all the time. It is important to introduce and practice several times a day with an open mouthed cup in order for the child to become proficient at it.

A sippy cup that has a straw instead of a spout would be more beneficial to the child. Drinking through a straw requires the child to use complex grading and coordination movements that would later benefit them when it comes to making sounds which require the same coordination/movement skills. Straw drinking will also promotes tongue retraction rather then tongue curling (around the straw in the same position as it would be in with a nipple when drinking from a bottle). Straw drinking is also the best choice if the child tends to drink more sugary beverage because the liquid will move further back in the mouth and not wash across the teeth.

It is not just the dentists who are concerned but several Speech Pathologists have also raised concern that sippy cups help to delay speech in children that use them all the time. They feel that the prolonged use of sippy cups causes a lazy tongue that produces sloppy "th" and "st" sounds. They have found that upon giving up the sippy cup and using a straw or open mouthed cup the child's speech improves.

If a sippy cup is used as it was intended to be used, as a transition object, then it would not be getting such bad press. It is important for us therapists to give parents a guideline on sippy cup use. Sharing with the family goals as to when to start and stop sippy cup use and how often and when during the day it should be used would not just benefit the child but also help the parents keep on track and transition smoothly to cup use.

Questions? Concerns? Comments? Suggestions?

Tuesday Tidbit – Read Books!; Browse Web sites!

Wendy — Wed, 06 Feb 2008 14:22:00 GMT

I would like to dedicate one day a week of this blog to sharing a website or article or technique that would be very helpful to those treating in Pediatrics. So I introduce to you "Tuesday Tidbits" …

National Braille Press is a wonderful company that offers books in Braille and/or large print for children who are visually impaired. They currently have a "Read Books!" campaign going on to encourage families with blind children to "read" books together. They are offering to any family that qualifies a book bag that contains:

An age-appropriate print/braille book for three age groups: birth-3, 4-5, and 6-7 in English or Spanish;
A braille primer for sighted parents entitled Just Enough to Know Better;
A colorful print/braille place mat;
Print/braille bookmarks;
Because Books Matter, a guide for parents on why and how to read books with their young blind child;
A gift coupon redeemable for another print/braille book or braille/large print playing cards;
Print/braille magnetic letters

You can find out more information and offer support by going to the following websites:

http://www.nbp.org/

http://www.nbp.org/ic/nbp/readbooks/index.html

Go Outside and Play!

Wendy — Thu, 24 Jan 2008 14:54:00 GMT

I'm often asked why it seems that children today need so much sensory input. Why are we seeing so many children exhibiting sensory defensive behaviors? My own personal thought on this is that times have changed. Not that long ago (when I was a child) we were often told to "go outside and play". It didn't matter if it was a beautiful day or an over cast and occasionally wet day, if we were not sick we should be playing outside - jumping in rain puddles, climbing trees, playing tag, rolling down hills. Doing all the things that help to regulate and give input to our sensory systems. We would go out right after breakfast and not have to be back until it got dark. If we were hungry we would go to whomever's house was nearest and have lunch. There were no play dates, there were no video games, and there were no 100 channels to choice from on TV.

How times have changed. Not only is it not safe any more to allow our kids to run around the whole day and not know where there are or who they are with but we have the added concern of what they might catch if bit by an insect (Lyme Disease, West Nile Virus to name a couple). It is rare to see a group of kids playing on a hillside or swinging on the swings at a local play ground. Parents prefer their kids to ride their bikes in the driveway instead of biking down the road to a friend's house. What happens to our bodies if we stop getting the input our bodies need to help us deal with our every day activities? My guess is that we become defensive because our bodies are not able to learn how to regulate and deal with getting daily sensory input. Our bodies aren't getting use to be messy or filing away in our brain that it is not dangerous but okay to have tree branches brush against our skin and long grass whip around our ankles as we after each other in a game of tag.

This is also one reason I do not believe that a child who is misbehaving should be punished by having recess taken away from them. If this is their only chance to run around and play and get the energy they've held in all day out, what is going to happen to their attention and focus if it is taken away from them? Thankfully with the advancement of having Occupational Therapy in the schools I am finding this practice of staying in from recess is becoming more and more rare.

Today it appears our children have less sensory input because it is safer to keep them inside playing video games, watching TV, reading or playing in their bedrooms. With both parents often working it is hard to find time to have one parent outside keeping watch while the kids are outside playing and face it, in today's world parents just don't feel safe allowing their kids to play outside by themselves. I will often suggest to families that are struggling with sensory issues that they take time at least once a day to do a sensory activity together. Tupperware containers are great for water play or bringing in snow or mud from outside to play on newspapers or towels. We've filled their bathtub with snow and had the kids reach in with buckets and shovels and make snow balls and mini snowmen and even snow castles. When we are done - it melts away and very little clean up is required. We've made home-made play-doh and goop. We've had rice and/or beans fill up Tupperware containers and then hidden toys in them for the kids to find. We've had finger painting sessions with applesauce and/or pudding. There is so much that can be done to help sensory defensive kids get more sensory input. The important thing to remember, of course, is not to force the child to touch or do anything they really don't want to do. More often then not, if they see you or a brother/sister or another child having fun they are more then likely to want to join in - even if it is looking from a distance at first and slowly getting more involved as the sensory sessions continue day after day. We've done these sensory activities in all of my pedi work settings - birth-to-three, school, and hospital.

So --my challenge to you this weekend is to find one or two sensory activities to do with your family. It could be going for a bike ride in the forest, making mud pies or snow forts, rolling down a hill or climbing a tree. Use your imagination and get in touch with your sensory side! Bring back a childhood sensory memory and share the experience with someone in your life. I would love to hear any cool ideas to encourage sensory defensive or sensory hesitant kids to participate in a sensory activity. What have you done that has been successful?

"They eyes are not satisfied by seeing - each organ seeks out one sensory quality."

Sri Guru Granth Sahib

~ Wendy ~

An Unexpected Detour

Wendy — Mon, 21 Jan 2008 16:58:00 GMT

When you are preparing to have a child you begin to dream of all the things your child will do and all the places they will go. In your dreams you see your child going through all the stages and growing up to be a wonderful son or daughter. You envision them graduating, meeting someone, marrying and giving you grandchildren. You know there will be difficult times. You know there will be nights where you aren't getting any sleep at all. You know there will be visits to the doctors. Yet, in your heart you are prepared for these because you feel they will be just a small part of childhood and that the majority of the time your child will be growing and laughing and playing and learning to talk and to walk and to eat. You smile as you think about the baseball and basketball games you will be attending, the concerts you will be sitting through and you start looking forward to it. It's the dream of every parent - a happy and healthy child.

Working in pediatrics you quickly come to see that this dream doesn't always come true. You meet parents who are struggling with coming to terms that their beloved child may not be able to do everything they have dreamed about for the past nine months. Working in Birth-to-Three and being in their home during the therapy sessions you come to realize that you aren't just there to help their child but that you are also there to offer guidance for the family. You become a great listener. You become a good researcher of support groups and play groups that would help the family as they come to terms with dreaming new dreams and foreseeing a new future for their son or daughter, brother or sister. Some times it takes a while to come to this realization and you are there when they begin to accept what limitations their child may have and what the future may hold for them. Other times you say "good-bye" when their child turns 3 years old and transitions to the school with a silent prayer that they'll be able to come to terms and get to the point of dreaming new dreams and loving their son/daughter for who they actually are and not who they had dreamed they would be.

When I was in college my pediatric professor handed out a piece of paper that I always keep in my day planner. I will often leave it with parents that I feel are ready to read it. Some of you may know this but those who don't I would like to share with you a lovely piece written by Emily Perl Kingsley concerning an unexpected detour that occurred in her life upon the birth of her child who was born with Down Syndrome.

WELCOME TO HOLLAND
by Emily Perl Kingsley

I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this...

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome To Holland".

"Holland?!?" you say, "What do you mean "Holland"??? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy"

But there's been a change in the flight plan. They've landed in Holland and there you must stay.

The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.

So you must go and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around...and you begin to notice that Holland has windmills...Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy...and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes that's where I was supposed to go. That's what I had planned".

And the pain of that will never, ever, ever, ever go away...because the loss of that dream is a very significant loss.

But...if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things...about Holland.

~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

May we all be able to catch our breath, look around, and appreciate the unexpected detours in our own lives.
~ Wendy ~

Welcome to a Pediatric Perspective

Wendy — Mon, 14 Jan 2008 16:30:00 GMT

I remember when I was studying to become a COTA I kept telling everyone that I wanted to work with kids. My professors would smile and nod and try as tactfully as possible to tell me that I really shouldn't get my hopes up as there were very few COTA opportunities in pediatrics. I never let that phase me. I knew in my heart that I belonged in pediatrics and that, when the time came, there would be an opening for me. I also knew that I wasn't going to just wait for something to happen. When it was time to start getting set up for our field work I sent out inquiries to pediatric therapy locations in Connecticut asking if they would allow me to do my fieldwork with them. To make a long story short a sensory clinic not only welcomed me with open arms but, once my field work was completed, offered me a position with them. My pediatric COTA career had started!

Over the years I have been able to have had the opportunities to continue to learn and diversify my skills in the pediatric field. I am glad I did not listen to my professors but, instead, listened to my parents who had always told me that if I wanted something bad enough I should do everything I could to make it happen. I feel I have done just that. I enjoyed my time at the sensory clinic but I wanted to learn more so I looked and found work opportunities in a school setting and then at a rehabilitation hospital on their pediatric floor. I have been lucky to work in each of these locations with a wonderful group of therapists (Speech, Physical & Occupational) who have offered their advice, their knowledge and especially their patience as I have learned and grown in my profession.

It wasn't until I came to work in the birth-to-three area that I finally felt like I had found where I belonged. It offers me the chance to work with a variety of health and developmental conditions (common and uncommon), a chance to use my skills in oral motor, feeding, sensory, and basic rehabilitation areas. It also allows me to brag about being one of the few people out there who actually enjoys going to work!

But, enough about me (for now *smile*) I would really love to know what settings you, the readers of this blog, are working in. Do you enjoy your setting or do you have hopes to one day move onto another type of setting? How long have you been working where you are and why did you choose pediatrics? I realize there may seem like a lot of questions but I would like this blog to be an interactive blog as much as possible. A place where we can share with one another therapy ideas/strategies, inspirational stories and discuss what we find challenging and rewarding working in the pediatric field. I'm hoping to start each week with a blog entry that would open up questions, thoughts, and comments that could then be shared and discussed in another end of the week blog entry. I would hope anyone who reads this blog would feel comfortable enough to comment, ask questions and offer answers and suggestions. Is there something you would like to see discussed here? Is there an area of therapy (i.e. oral motor, feeding, autism behavior techniques, etc) you may be struggling with and could use some advice from other OT/COTAs who have been there/done that and lived to talk about it? Come on now, don't be shy ...step forward....

Looking forward to hearing from you,

~Wendy~