So, woah, talk about missing in action!
To give ya'll an update, I'm completely finished with my pediatric FW 1 rotation. I finished the last week of June -- and yes, I passed! :) My mental health FW 1 rotation will be over next week. I'm going to go ahead and sum up my experience with my peds rotation!
So, in my last blog post, I mentioned how unorganized and frustrating the rotation was. The frustration subsided as the days went on, but our role and purpose was still unclear. So to give you some background, the rotation was 2 weeks M-W -- so a total of 6 days. We were expected to be there around 7:45am on those days (unless it was "our day") and we left around 12pm (unless we needed to set up for the next day). When we got there, we would assist the leaders of the day with any last minute things they needed to set up. At 8:25am, we all gathered together for a "walk through". The leaders would tell us the behavior regulation activity for the day, the name tag activity, the script study activity, the word study activity, the sound study activity, the OT graphic station, and what the snack for the day would be. Then we went outside and waited for our "little friends" to arrive. At the end, before we headed out, we had a debriefing and discussed what went well and not so well.
The group that I had was what they called the "higher level group." I worked with them in collaboration with one SLPS. I honestly wish that I would have had a more "lower level group." Although the kids in my group had several deficits in speech related areas, for the most part, they were developmentally appropriate in fine motor and gross motor skills. Their only deficits were in things like attention, behavior regulation, and sensory processing (two were sensory seeking and were unable to achieve the appropriate amount of vestibular and proprioceptive input). The two things that made it difficult working with this group were 1) we haven't had our pediatric class yet, we have it in the Fall and 2) it was hard finding a way to meet my "OT" goals, when the rotation had such a strong speech emphasis.
This particular fieldwork rotation started as a "camp" put on my the SLPS. This year they tried something new by allowing OT students to assist with the "camp." However, because our role was never thoroughly established, the activities catered to speech's goals (remember when I said word, script, and sound study...yeah all speech). I guess their attempt of incorporating OT was by adding the OT graphics station. However, unless your child had fine motor deficits or sensory defensiveness, which mine didn't, it was just more for creative expression or any opportunity to work on attention and behavior related things . So, for my kids, it was hard to implement interventions to address their needs. For my counterparts that had lower level kids, they had more opportunities to work with their kids on handwriting skills or fine motor skills, which worked out great because handwriting meshed well with speech goals and fine motor skills could be worked on during OT graphics. Are you understanding?
Anyways, so although I enjoyed interacting with my kids and everything, I don't really feel like I did much. I tried to work with them on following directions and turn taking. I also tried different transition activities between stations to try to increase attention like bear walks, stomping, big steps, etc. We also implemented a wiggle seat cushion because two of the kids were constantly rocking and fidgeting (the wedge seat worked better for them than the round one). I also took one kid aside and worked on his words for the script because I noticed he was really struggling and not getting the proper attention to be successful (not really OT related, but he ended up beasting his script by the end!). Other than that, that's about it. I didn't really feel like a valuable member of the team to be honest, but it was a unique experience.
So in the end, I passed my fieldwork and received positive feedback from my supervisor. Even though I don't feel like I did anything special, she and the SLP clinicians that all contributed to my overall rating saw something in me that I didn't see in myself. We were also able to give feedback about the rotation and I expressed my thoughts on the form.
Take away lesson: So, as with any experience whether bad or good, there is always something to take away from it. For this fieldwork, we had to write a daily SOAP note each day on the same kid. On the first soap note, we had to establish at least 2 goals for the kid based on our observations. It is always emphasized that your goals should be measurable, so I made my goals measurable -- I thought. However, what I realized is that you have to make sure that your measurable goals are realistically measurable. Are you actually able to measure your goals as written and will there be enough opportunities available to meet your goal as written. For example, if you say that the client will do something 4 out of 5 times within two weeks....will you actually be able to provide those 5 opportunities or will those times naturally occur? Also, are those opportunities expected to be given in one day (i.e., five opportunities each day) or over the course of two weeks (i.e., one opportunity for at least five of the days). As another example, if you say that a client will do something 80% of the time, will there realistically be enough opportunities for the client to meet that goal? Say that a client did something 3/4 times...There were 4 times the client could have done whatever but they only did it 3...that's pretty good right...right, but that's only 75%...goal not met. Do you get what I'm saying? Also, with everything that goes on during a session, can you realistically keep up with the goal you have established...I didn't realize how hard one of my goals would be to track over a 2.5 hour period. A lot of things happen in 2.5 hours and my job was to help all kids, not just one, so my attention was being pulled in multiple directions the entire time.
So my biggest lesson was to make sure I'm writing and establishing measurable, measurable goals. The more specific, the more realistic, the better. Think...if you had to miss a day of work and someone took your place, would they understand how to continue tracking your clients' goals based on what you wrote and could they effectively measure them? If the answer is yes, you are on the right track. If your answer is no, you may want to rethink how you are writing your goals.
I used this downloadable resource to help me come up with ideas for sensory breaks and transitions between stations.
<3 Bemo
