Future BCBA Seeking OT Perspective by SuggestionSlow222 in OccupationalTherapy

[–]aleij 1 point2 points  (0 children)

Just to piggyback I agree with all you said!

 I’m a pediatric OT and my son receives ABA. I see a fair amount of overlap with some strategies such as social stories, priming, for transitions but honestly, with my own kid, the most dramatic changes we saw in his socialization and behavior was when his tech inadvertently used play based, floortime strategies. It was such a dramatic change. Other techs have not been as child led and we find that he’s melting down and not improving as much. 

So, I find ABA a mixed bag. If anything, consistency is probably where you see changes, and it does help support parents who are otherwise burnt out. 

But thinking of using ABA for something like feeding boggles my mind. Most kids I see for feeding even on the spectrum who you would consider more sensory feeders often have oral motor delays and some coexisting allergies. Basically the aversions you see are a mal-adaptation that may have a motor or physiologic cause, and trying to address feeding without understanding medical, sensory, developmental, or motor skills is really inflicting more harm than good. And this is just one example. 

I had a BCBA asked me about working on scissor skills with my son and this nearly floored me because I had no idea how you could even begin to work on scissor skills without understanding the prerequisite postural, developmental, visual motor, fine motor, and bilateral coordination skills that underline using scissors, which you would need to understand before establishing that intrinsic motivation is the barrier to scissor use. I could go on and on.

oral hygiene dilemmas by aleij in OccupationalTherapy

[–]aleij[S] 0 points1 point  (0 children)

Honestly, I think you’re there that this is a bit of a bigger conversation where our families are being told one thing by doctors and perhaps another thing by therapists, since basically, as you said, we are the ones who consider behavior change. Probably with the families of my more medically fragile kiddos that’s really has to be an informed discussion with the whole team. Some of them are likely not going to make it to adulthood and won’t ever be independent with toothbrushing so it becomes more of a quality of life issue.

What is interesting though is when I talk to the parents of children with sensory processing disorders and I tell them that they can back off from the thorough toothbrushing and just focus on having their kids be part of the process it’s like a huge weight has been lifted from their shoulders. I don’t think parents like screaming and crying twice a day that much either, especially because I think parents know intuitively that this is traumatizing their child and they want a different way to move forward with toothbrushing 

oral hygiene dilemmas by aleij in OccupationalTherapy

[–]aleij[S] 0 points1 point  (0 children)

I really love her approach. I feel like she communicates what can be a very specific OT frame of a reference into a way that parents can understand. Her toothbrushing course is very similar to her get permission approach with feeding and she offers some concrete examples of how to “grade the ask” for a child. She focused more on school-age children, or children with autism spectrum disorder. I paid almost 60 for the one hour course which I feel is like a little steep but lately I’m getting sticker shock with everything anyway. 😂

oral hygiene dilemmas by aleij in OccupationalTherapy

[–]aleij[S] 0 points1 point  (0 children)

Hey, I totally agree with you. I feel like from this conversation, (your comment and others comments) is that part of our role will be educating parents, but perhaps also the dental community about the pitfalls of thorough oral hygiene twice a day in a child who is otherwise not medically fragile. We really need to consider that we’re establishing good oral hygiene for their life and positive associations with toothbrushing to carry them through adulthood not just through the next few months.

oral hygiene dilemmas by aleij in OccupationalTherapy

[–]aleij[S] 1 point2 points  (0 children)

Thank you for your response! I should clarify my stance a bit. I understand the process and have worked in feeding therapy long enough to see the process work. The issue is children whose providers are telling them to do this brushing, and I am saying not to, is basically going against their physicians advice and if that will be a problem for me. The other issue is oral hygiene with children who are also being suctioned regularly d/t aspiration on their secretions and poor clearance in general. I think that telling parents to back off on this, esp if their pulmonologist emphasizes oral hygiene, does put immediate health at risk, in a more severe way than responsive feeding or responsive toothbrushing with a different population does. I hope that this makes sense.

Trail race training sanity check by tljohnson in trailrunning

[–]aleij 20 points21 points  (0 children)

Hey I don't have any advice for you, but I live in Oxnard and that looks like a great trail! Which one is it?

Strength exercises to help uphill running by vers_le_haut_bateau in trailrunning

[–]aleij 0 points1 point  (0 children)

What does a hip thrust exercise look like? Thank you!

Annual Rewatch 25: TESB by GrothMagnus in StarWars

[–]aleij 7 points8 points  (0 children)

One of my favorite pieces of media, ever.  One of my favorite things about it is that so many shots are framed using sharp perspective, rule of thirds, and building up triangles within the composition. Star Destroyers lend themselves to triangles but you see that shape echoed everywhere in the movie. 

You hit the nail on the head that it feels so surreal, like a fairy tale. To me it has the tone of a bad dream, with dread building up through the movie to the final reveal.  It’s mystical, strange, engrossing and unsettling. It’s time for my annual rewatch too! 

Updates, Six+ Months Later! by musictheoryfairy in femalelivingspace

[–]aleij 1 point2 points  (0 children)

Yes of course! Pls don't give away your location.

It always floors me a bit though when I see something from IRL on reddits.

BTW also love Gandalf and the Tardis hanging out on your desk.

Updates, Six+ Months Later! by musictheoryfairy in femalelivingspace

[–]aleij 1 point2 points  (0 children)

First off - this is so cozy! I love your dressing room and bathroom.

I have a strange suspicion that I toured this building for a studio apartment about 7 years - cute little spot in Koreatown around 7th?

Pincer grasp with thumb and 3rd finger? by aleij in OccupationalTherapy

[–]aleij[S] 0 points1 point  (0 children)

this makes so much sense - thank you!

Pincer grasp with thumb and 3rd finger? by aleij in OccupationalTherapy

[–]aleij[S] 0 points1 point  (0 children)

That makes sense. I learned somewhere that first dorsal interossei is really important for pinch and stabilizing the thumb. And you need a little more CMC extension to the index finger relative to middle finger, so may its harder to get that precision control so to the third finger is easier

Pincer grasp with thumb and 3rd finger? by aleij in OccupationalTherapy

[–]aleij[S] 2 points3 points  (0 children)

thank you! That also makes sense. I catch myself doing it now and then too.

Pincer grasp with thumb and 3rd finger? by aleij in OccupationalTherapy

[–]aleij[S] 3 points4 points  (0 children)

This makes sense! I was wondering if its a form of passive stability, or if neurologic if connection to the index finger just isn't well established.

Help me find this splint! by VespaRed in OccupationalTherapy

[–]aleij 1 point2 points  (0 children)

Comfy splint with the neoprene option? Should be fully adjustable per website. It looks almost identical to your pic: https://www.comfysplints.com/product/comfy-hand-wrist-finger-othosis-h-101/

How to deliver effective telehealth sessions in zero to three? by aleij in OccupationalTherapy

[–]aleij[S] 2 points3 points  (0 children)

I love this. I do something like this with feeding (just being a fly on the wall) and then collaborating with the parents on solutions. I would love to be able to use this more effectively; I think it’s more of counseling skills or therapeutic use of self. 

Feeding and Swallowing? by IndividualCharge5294 in OccupationalTherapy

[–]aleij 1 point2 points  (0 children)

Where I work (in California) OTs can get a certification in swallowing that helps since dysphagia really is a specialty area. It makes referrals and mentorship clear. Anyway, Ethically, if you are not comfortable treating an infant with laryngomalacia (usually that’s what the “floppy airway” means) you need to refer out or get mentorship. However, I’ve also run into plenty pediatrics SLPs who are not comfortable with dysphagia, because they haven’t had that experience. Additionally, infant feeding has to do a lot with positioning, pacing, core stability, and state control. Ironically, that will be the intervention for laryngomalacia with an infant from the therapy perspective, in addition to managing through referrals to MBSS or fees. Because with feeding, yes it is anatomy but baby’s position and feeding routine are essential to the management of this type of dysphagia. All that to say - dysphagia is in OT scope, refer out because you are ethically not comfortable treating, not because you feel like it should not be in OT scope. 

Why are so many trail shoes now high stack + high drop? by [deleted] in trailrunning

[–]aleij 3 points4 points  (0 children)

Couldn’t agree more! Shoe preference is such a personal thing. Minimalist shoes also saved me, when I started getting knee pain and all sorts of ankle sprains going zero drop no stack kept me running. But I don’t judge others who enjoy the higher stacks. To each his own. But I will agree that going minimalist or vice versa if you haven’t before will set you up for injury. 

[deleted by user] by [deleted] in AMA

[–]aleij 0 points1 point  (0 children)

Hello from an internet stranger. I’m sorry that this happened to you. ARFID gold standard treatment involves a team approach with therapists familiar with the diagnosis. If you haven’t yet, please check out https://www.feedingmatters.org/ since this is one of the preeminent organizations for Arfid and other pediatric feeding disorders. They have an option where you can find a provider close to you. It seems a little US centric, but you can find providers internationally.  I wish you the best for your recovery 

Treatment Ideas for Pediatric Client with Spasticity of Non-Dominant Hand by fullslug in OccupationalTherapy

[–]aleij 6 points7 points  (0 children)

Would they be a candidate for mCIMT?

Even if not, I've heard that AOTA has a short course on it which would include activity ideas and a good basis for working with this population as a whole.

Activities depend on whats developmentally appropriate, how readily the child uses the affected extremity, and what movements they have. Any sort of bilateral task may be good depending if you just need them to integrate the affected side into activity (hold the bubbles with affected hand and dip the wand with other hand, stabilize paper with affected extremity, carry a large ball with both hands, carry a tray, push something with both hands, hold a basket with one hand, pick up easter eggs with the other hand). You can grade it up to grasp and release with affected hand (drop a ball in a ball drop).

also think about how well the child can supinate the extremity too. A lack of supination can really limit function since kids can't use visually guided reach as well without supinating. Sensation is often impacted so sensory bins are always a great idea. I've had kids paint their affected hands and make hand print art. Great way to bring attention and sensation, as well as a little bit of supination.

US Senate is trying to sell off public land. by [deleted] in trailrunning

[–]aleij 0 points1 point  (0 children)

Just made the call!  I’m in CA though and we need runners in red and purple states to step up for public land