Author: Samantha Dorfman

Today was my last day at Pediatric Therapy Associates and I had the chance to sit in on some speech-language pathology sessions (room seen in pics). The first session was a combination of both OT and speech therapy at the same time, so both therapists were in the room. This is because the child has difficulty focusing for extended periods of time. For her session we set up a sequence activity where she first had to “cross the lava” to work on balance, then she took a few minutes to work on her speech, and finished with shooting some baskets. The therapist showed her a picture of a boy on a beach and asked her what she saw in the picture. Then using the phrases she said the girl had to put them together to make sentences. When she finished with an object in the picture she could color it in.

The second speech session was explicitly focused on making the correct sounds and pronunciation. The child struggles with the middle constants of words (ex: saying mo-ey instead of mon-ey) and with making an “s” sound without having his tongue between his teeth. During his session, he practiced looking in the mirror and repeating words with “s” in different places within the word. He also practiced with letter puzzles where he matched two pieces to make a word based on syllables. He then had to say the word to practice pronouncing both parts of the word.

             

Over these past 4 days, I have learned a ton about OT and SLP and really enjoyed the experience!

 

One thing that I learned today was that the OTs use the swings when working on balance, correcting postural adjustments, and body awareness. Swinging can also address sensory processing as it provides vestibular input. Today one kid used the swing very cautiously to start to get comfortable with the sensation, while another kid used the swing at the beginning to fulfill the desire for that movement before needing to focus more. Also, one child with hemiplegia used a swing to practice extending, reaching, and holding their affected limbs in the air.

                     

Another one of the kids today has difficulty with spatial awareness. This presents itself with both her own body movement, but also her relation to other objects. For example, she struggles a lot with jumping jacks, but also handwriting. During the session, she used adaptive notebook paper, to help her with spacing words correctly and writing her letters in the right sizes.

Lastly, I worked with a kid today who has a severe fear of storms, particularly the sounds and looks. Her sensory issues exacerbate anxiety about inclement weather. During our session, I helped her make a weather chart so that she can mentally prepare for inclement weather and recognize the strategies she can use to calm down.

Today was another whirlwind day where I engaged in 12 different sessions! For the most part, the kids I saw today has either oral sensory issues or were somewhere on the Autism spectrum. I got to be a lot more involved with the kids, rather than just observing. This included talking with the kids and helping them in the activities alongside the therapist.

                         

I found the three feeding patients especially interesting, even though I couldn’t be as involved with them.  Two of the kids I saw today had hyper-sensitive oral sensory processing. This means that they may gag easily or become anxious or upset with new or nonpreferred textures, tastes, and temperatures of food. The kids I saw were all anxious about new foods and are very sensitive to the textures and tastes of new foods. During these sessions, we tried to distract the kids (to reduce anxiety/fear) or have a reward or point system involved to encourage them to try the food (Picture 1).  The third kid (Picture 2) is almost 2 years old but has a very hard time with self-feeding. This means that he can eat from other people’s hands but has a hard time gripping and grabbing food and staying focused on bringing the food to his mouth. This session involved a lot of repetitive practice, hand-over-hand motions, and positive responses when he successfully ate.

During my first day, I shadowed 10 different sessions where I bounced between two different OTs to get a feel for the different techniques they used and experience different kinds of kids. Most of the kiddos I got to work with today had sensory processing issues, so learned a lot about that. Sensory processing issues are difficulties with organizing and responding to information that comes in through the senses. Kids may be oversensitive to sensory input, undersensitive, or both. During the sessions, the therapists mostly started by working on sensory integration with tactile play. Also, some kids worked on fine motor skills, using the small muscles in the hands and wrists.

We also worked in the gym area where we set up “obstacle courses” that addressed a variety of skills and focused on sensory issues in the vestibular and proprioceptive systems. During each session, I set/cleaned up activities, observed, and then debriefed with the therapist about the child, the session, and any questions. It was a busy day, but I learned a ton!

This upcoming week I will be shadowing at Pediatric Therapy Associates & Sports Medicine in Wake Forest. They offer a range of therapeutic services for infants, children, adolescents, and young adults. I will be specifically focusing on occupational therapy and speech-language pathology. I am excited to have the chance to explore the field more and learn from the highly trained therapists I will be shadowing.