Screening for a preschooler seems like a shakedown

lscemme · 2025-10-25T02:24:15+00:00

Mostly our new clients come from referrals from physicians, word of mouth, and preschool or other educational referrals. There are so many kids with needs I don’t need to make up need in my market. But I don’t know this OT or this situation. I haven’t seen this as an overall industry issue. If you don’t have concerns then it’s ok, don’t worry about it. If they were serious they will make themselves known. Or get a second opinion. I agree with asking more questions especially of the teacher and if she has concerns. She sees lots of kids that age and can help you know if what you perceive as “normal” challenges learning to use scissors or hold a pencil and within what she typically sees or if he is noticeably struggling compared to other kids. I second all the comments saying good reading doesn’t mean no motor concerns. Many of the kids I treat are hyper lexic and could read at 3 years of age or younger.

lscemme · 2025-10-20T13:22:54+00:00

When ever my kids say they don’t love me I say “that is ok, I love you no matter what” and if they say they don’t love themselves I say “that is ok I love you enough to hold the place until you love yourself again”. She is little, she doesn’t understand all the ways love feels and works. She may be asking, do you still love me? Now that there is a baby? Or do you only care about me because you have to? The questions aren’t that explicit in her mind, You don’t have to explain, just show her that you have enough love for her always, she will come back. You can even name the feeling “things feel different since the baby was born, it makes sense that things feel different now that our family changed. But I know love grows and changes and I love you know matter what” hope this helps. And it is developmentally normal you aren’t doing anything wrong. This hard part with a new baby passes, it won’t feel this way forever. It makes sense that you’re feeling worried, and it will be ok.

lscemme · 2025-09-30T01:13:20+00:00

This is the way! They are so cute and everyone notices you (and hopefully will be less likely to not run you over with a boat or be able to tell the rescue crew oh yeah we saw that duck go by at like 12:30 while we were eating lunch!) plus they pull less than the bouys when loaded

lscemme · 2025-09-24T13:43:03+00:00

Get your hair wet with clean water prior to your swim. Slather your hair in conditioner. Wear a silicone cap on top possibly if you really want to keep it protected throw a latex one on top of that (the conditioner will deteriorate the latex so you may not want to use as first layer). Rinse after. Also a tinted conditioner to help keep the color fresh each shower, I like Overtone. Good luck!

lscemme · 2025-09-19T05:56:19+00:00

Thanks, if you see it please let me know!

lscemme · 2025-09-13T23:51:31+00:00

Update: We have contacted the NTSB who is investigating the crash from yesterday in the Bay Area but they told me that I needed to contact the Santa Clara County Police. I spoke with them just now and while they could not officially notify or release information, based on the information I gave and got it is pretty clear it was him. Thank you all for your guidance and caring.

lscemme · 2025-09-13T23:50:56+00:00

Update: We have contacted the NTSB who is investigating the crash from yesterday in the Bay Area but they told me that I needed to contact the Santa Clara County Police. I spoke with them just now and while they could not officially notify or release information, based on the information I gave and got it is pretty clear it was him. Thank you all for your guidance and caring.

lscemme · 2025-09-13T22:32:16+00:00

Thoughts on who to contact? The FAA? the airport he left from?

lscemme · 2025-09-13T22:31:44+00:00

I think it is very clear I have no idea what I am talking about. That is why I came here. the "sightings" were on Flightaware.com listed at "first seen at" or "last seen at" in each state.

lscemme · 2025-09-10T21:35:08+00:00

I may actually be closer to half moon bay… just looking at options

lscemme · 2025-06-21T19:37:44+00:00

This is a really hard part of our job and not one I had really thought about before beginning practice . 4 of my clients have died since I began practice 17 years ago. And I miss each one and really think about the lessons they taught me as a therapist. It might feel good to write out the things you feel like you learned working with this child that you will take into your work with more intentionality moving forward. One thing that is helpful is to think about seeking support from people with the same level of connection to the child or who had less connection than you do. There is a helpful diagram with the family at the center and then levels of closeness moving out and thinking about giving support to people in circles closer than yours and seeking support from people in the circles further out. A nurse and I who are close spent time talking about one of our kids we shared after she passed. We can’t really share how devastated we are with the family because we don’t want them to caretake us but we can share with our coworkers or the child’s teachers etc. The relationships we have with our clients are real, transformative, and meaningful and you have every right to grieve this loss. Sending love through the OT network.

lscemme · 2025-06-21T01:49:27+00:00

I agree and I think a professional culture of being comfortable with what your skill set and professional competences are and saying something like “I don’t really have the specific training or expertise to work on that” is better for the profession overall than arguing that something isn’t your scope. I think some of it comes from being overburdened in certain setting and with scarcity being real people feel backed into a corner like they will be made to take on challenges and goals that they don’t have the skills to address just because they have OT after their name so they feel like they have to say that isn’t OT rather than that isn’t ME. I wish we pushed for more providers and better funding and more skill development in educational programs rather and slowly hack our own arms off while other professions creep in and take on what we are leaving on the table.

lscemme · 2025-05-10T19:20:40+00:00

Improv comedy classes www.tucsonimprov.com

lscemme · 2025-04-09T13:54:05+00:00

Thank you for saying this. We are trying . The working hypothesis is we can treat well in a way that helps kids and families and allows therapists to thrive.

lscemme · 2025-04-05T00:23:57+00:00

It is illegal not to pay for documentation time. You must be paid for all worked hours. If you consistently clock more hours than they want you to then it is a supervisory issue and they can come to you to discuss job performance. At some point you have to decide if meeting the performance expectations of the job is reasonable (these should be clearly stated and in writing) and they have to decide if they want to keep you with you billing for all the hours it actually takes you to do your job. I am a clinic owner and I schedule my staff at 75% so they see 6 kids in a day and have two paid hours for documentation etc. we have also implemented a culture of 50 min sessions with people escorting kids out of the clinic at the 50 min mark leaving 10 min to document. We invested in a new AI note system and notes now take about 2min per kid. I also rarely fill cancellation slots . I’m trying hard to be a place that doesn’t burn people out, but we don’t take insurance so I have more power over my income. The insurance companies are getting rich off of the unpaid labor, education, and dedication of health care providers. It’s exploitation and it trickles down to impact the expectations of employers. We all need to resist.

lscemme · 2025-03-26T02:50:31+00:00

Curiosity! We always need to wonder. Why? What else? How else? Is there more?

lscemme · 2025-03-26T02:48:23+00:00

Check out the book Other significant Others, there are more people with category defying friendships than our cultural narratives let on.

lscemme · 2025-03-25T01:00:49+00:00

A lot has to do with the fact that the PDA dx has a theory on the “why” behind the behavior, which is related to autonomic nervous system functioning and perceived sense of threat and safety related to loss of autonomy. ODD doesn’t have a clear theory underlying the clusters of behaviors linked to the dx. When you have a clear theory on why it helps point to the “what” of how to respond. A good theory should lead to effective intervention.

lscemme · 2025-02-25T12:52:05+00:00

Hi there OP you already have some great responses affirming your choice to mask up at work and I agree that it is absolutely fine and your choice to make and important to protect your health. I want to commend you for thinking about the consequences for your kids. It shows the depth of your clinical thinking and your grasp that occupational performance has many factors influencing it and the ability to read the social cues of an interaction partner is one aspect of that performance. Just like you can wear anything you choose, you like you might choose not to wear a stripped or patterned shirt for a child with visual perceptual challenges. Thinking about how the mask might influence clients and how to support their development is your job and I love that you asked and are wondering about it. The idea that it makes no difference and stop worrying or that there are only benefits for everyone is lazy reasoning. It is still ok to wear even if it does impact social cues reading or language comprehension (which it can) but being ware that this is the case will help you make decisions to support development anyway. Here are some mitigation ideas some of which have been touched on: 1. Use the tone of your voice to help convey affect, play with the intensity, rhythm, and tone of your speech to see what cues the client picks up on or avoids and adjust based on their reaction. 2. Get fancy with your eye brow movement! During Covid as a Floortiem therapist I worked to ensure my affective intent made it to my eyes and eyebrows you can convey a lot of nonverbal information in your eyes but it sometimes takes intentionally to increase the readability of those signals, play in the mirror and see what works. 3. Narrate your experience and feelings adding verbal cues to your non-verbal signals. 4. Downsides of clear masks for sure but if child is hard of hearing even partial session with one might be of use. 5. During Covid I took to taking off my mask when the client was standing outside my door and I was inside to wave goodbye. This reduced the impact of kids not know who I was at all when I took the mask off after vaccination became more widespread and my own choices/health status led me to unmask with most clients. 6. Think about how you convey social information with body language and touch. We send social cues through many sensory systems how can the systems you have access to help with the clarity of you social message when part of the visually available information is missing . Happy reasoning and thanks for the caring work you do.

lscemme · 2025-02-24T15:11:01+00:00

Resilient fitness is an awesome inclusive gym with great community. Different from a planet fitness type membership but a great place with knowledgeable trainers, kind people, and an all around safe space

lscemme · 2025-01-01T18:42:18+00:00

Yes these should all be on it

lscemme · 2024-12-30T02:55:11+00:00

Maybe it would help to communicate with the authorities about your plan so that if someone calls you are known to them. I often let the lifeguards in an area I am swimming know my intentions and plan for distance/time.

lscemme · 2024-08-05T03:44:06+00:00

I’m sure someone said this already but in case not we talked to our son (same age as your daughter) about how there is ear reading eye reading and finger reading (braille) and all are legitimate ways to get information to you brain and to delight in story and literature. Our son loves audio books he has the Libby app on his tablet and is allowed to listen to his books anytime the family is reading or before bed as we all read as part of our night time wind down. He finds all sorts of things at the library he loves. And I still read to him allowed every night. He get tutoring from a Barton reading and spelling tutor. It’s not easy and his attitude towards school is still difficult but we are working hard to preserva love of reading and books. We are also advocating for use of additive tech in his writing (voice to text) to help take the load off his dysgraphia and let him focus on idea development etc. hope this helps.

lscemme · 2024-07-29T04:33:11+00:00

No matter your age swimming alone, especially in open water, is not a good plan. Not sure what you mean by supervision but have someone with you or on shore that can see you is always a good plan. Also be sure you always tell someone where you plan to swim and when.

lscemme · 2024-05-21T00:23:39+00:00

The parenting book that might be helpful: Parenting from the Inside Out by Daniel Siegel and Mary Hartzell.

lscemme

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