From Beanbags to Letter Formation: The Planning, Implementation, and Review of My First OT Sessions Alissa Bonjuklian 1/4/...
Role of OT <ul><li>In general practice: </li></ul><ul><ul><li>Increase participation in ADL’s and other meaningful occupat...
Intro to John* <ul><li>6 y.o. </li></ul><ul><li>Globally delayed: </li></ul><ul><ul><li>Cognitive developmental delays </l...
Role of OT in treating John <ul><ul><li>Occupational performance of children = self-care, work, and play activities </li><...
RESEARCHING <ul><li>Reflected on my 1 st  observation </li></ul><ul><li>Used resources at FBS & Greenland Rd for Rx ideas,...
Task Analysis of Handwriting: Performance Components <ul><ul><li>Sensorimotor components </li></ul></ul><ul><ul><ul><li>Se...
Week 1: Hand & Finger Strengthening <ul><li>Newspaper tear & crush </li></ul><ul><li>Thumb wrestle </li></ul><ul><li>Elast...
Week 1 Results <ul><li>Carried out the strengthening activities relatively well </li></ul><ul><li>Vaguely recognized lette...
Week 2: Bilateral Activities <ul><li>Big clapping sequences </li></ul><ul><li>Arm circles w/ and w/o beanbags    lazy 8s ...
Week 2 Results <ul><li>Much improvement as a result of the bilateral activities: </li></ul><ul><ul><li>Recalled letters mo...
Week 2 Results: Flag-Making
Week 3: Perceptual & VMI Activities (with  a Touch of Bilateral & Strengthening!) <ul><li>Bilateral Warm-Up </li></ul><ul>...
Week 3 Results <ul><li>Letter formation on the ground discrimination worksheet was  very  wobbly    indicates we should p...
Week 3 Results:  Figure Discrimination
Week 3 Results:  Visual Discrimination
Week 3 Results: Ground Discrimination
Week 3 Results: Mazes
OVERALL RESULTS: Week 1 vs. Week 3
Observation week vs. Week 3
<ul><li>Questions   ? </li></ul><ul><li>Comments ? </li></ul><ul><li>Feedback? </li></ul>
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Fitzjohns Presentation[1]

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As a pediatric occupational therapy intern at the Royal Free Hospital NHS Trust, I was allowed to meet with a primary school student with global developmental delays for OT weekly sessions. I observed sessions with him one week, and met with him by myself three more times. I was supposed to meet with him a fourth time, but he was out sick. I was responsible for the researching, planning, implementation, and review of his sessions. This presentation gives a brief overview of why OT is needed in pediatrics, OTs role in helping this student, the activities I included in the therapy sessions, and their results. I presented this PowerPoint to the Trust\'s Pediatric OT Department at monthly department meeting.

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Fitzjohns Presentation[1]

  1. 1. From Beanbags to Letter Formation: The Planning, Implementation, and Review of My First OT Sessions Alissa Bonjuklian 1/4/2009
  2. 2. Role of OT <ul><li>In general practice: </li></ul><ul><ul><li>Increase participation in ADL’s and other meaningful occupation </li></ul></ul><ul><li>In community paediatrics: </li></ul><ul><ul><li>Based on an understanding of the interactions among children, their activities, and their environments </li></ul></ul><ul><ul><li>Interventions should either: </li></ul></ul><ul><ul><ul><li>Establish a higher level of functioning </li></ul></ul></ul><ul><ul><ul><li>Compensate for activity limitations through adaptation and/or assistive technology </li></ul></ul></ul><ul><ul><ul><li>Modify environments </li></ul></ul></ul><ul><ul><ul><li>Change systems to increase participation (Case-Smith, 2001, p.3) </li></ul></ul></ul><ul><ul><li>Goal = help children cope with disability and master activities that have meaning to them </li></ul></ul>
  3. 3. Intro to John* <ul><li>6 y.o. </li></ul><ul><li>Globally delayed: </li></ul><ul><ul><li>Cognitive developmental delays </li></ul></ul><ul><ul><li>Physical/gross & fine motor problems </li></ul></ul><ul><ul><li>Perceptual impairments </li></ul></ul><ul><ul><li>Speech difficulties </li></ul></ul><ul><li>These impairments all hinder him from keeping up with his classmates and being able to perform important daily activities </li></ul>
  4. 4. Role of OT in treating John <ul><ul><li>Occupational performance of children = self-care, work, and play activities </li></ul></ul><ul><ul><ul><li>Work  academic tasks & functional tasks </li></ul></ul></ul><ul><ul><ul><ul><li>examples </li></ul></ul></ul></ul><ul><ul><ul><ul><li>“ The functional skill of handwriting supports the academic task of writing and allows students to convey information” (Case-Smith, 2001, p.545) </li></ul></ul></ul></ul><ul><ul><li>Role of OT = view the student’s handwriting performance by focusing on the interaction of the student, the school environment, and the school occupation (Case-Smith, p.546) </li></ul></ul><ul><ul><li>John’s treatment plan falls under the first category of interventions: “Establish a higher level of functioning” </li></ul></ul>
  5. 5. RESEARCHING <ul><li>Reflected on my 1 st observation </li></ul><ul><li>Used resources at FBS & Greenland Rd for Rx ideas, games, worksheets, props etc. </li></ul><ul><li>Read through HWT teacher’s manual </li></ul><ul><li>Used Lindsay as a resource for more in-depth info  task analysis </li></ul><ul><li>Integrated the ideas learned through research with my observations of John and his needs </li></ul><ul><li>Thought about the different activity ideas from the resources I used and arranged them in a flowing order that would be most effective </li></ul><ul><li>Spent time creating the props I needed (laminated mazes, worksheets, games, etc…) </li></ul>PLANNING
  6. 6. Task Analysis of Handwriting: Performance Components <ul><ul><li>Sensorimotor components </li></ul></ul><ul><ul><ul><li>Sensory </li></ul></ul></ul><ul><ul><ul><ul><li>Tactile/proprioceptive </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Visual perceptual skills* </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Kinesthesia </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Position in space </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Visual closure </li></ul></ul></ul></ul><ul><ul><ul><li>Neuromuscular </li></ul></ul></ul><ul><ul><ul><ul><li>Muscle tone </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Strength* </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Postural control </li></ul></ul></ul></ul><ul><ul><ul><li>Motor </li></ul></ul></ul><ul><ul><ul><ul><li>Crossing the midline* </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Bilateral integration  Bilateral sequencing skills </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Laterality </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Praxis </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Fine motor coordination* </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Visual motor integration* </li></ul></ul></ul></ul><ul><ul><li>Cognitive components </li></ul></ul><ul><ul><ul><li>Attending to a writing task independently </li></ul></ul></ul><ul><ul><ul><li>Recalling letter formations and handwriting strategies over time* </li></ul></ul></ul><ul><ul><ul><li>Generalising handwriting from an intervention program to real-life situations </li></ul></ul></ul><ul><ul><li>Psychosocial components </li></ul></ul><ul><ul><ul><li>The child’s values and interests, self-regulation, self-concept, and coping skills </li></ul></ul></ul><ul><ul><ul><li>(Case-Smith, 2001, p.553) </li></ul></ul></ul>
  7. 7. Week 1: Hand & Finger Strengthening <ul><li>Newspaper tear & crush </li></ul><ul><li>Thumb wrestle </li></ul><ul><li>Elastic band activities </li></ul><ul><li>Playdough work </li></ul><ul><ul><li>Hid toys in Playdough and ask him to find them </li></ul></ul><ul><ul><li>Rolled it out to make a “pizza” </li></ul></ul><ul><ul><li>Made a “snake” </li></ul></ul><ul><ul><li>Made the letter ‘C’ and other simple letters </li></ul></ul><ul><li>Mazes </li></ul><ul><li>HWT slate </li></ul>
  8. 8. Week 1 Results <ul><li>Carried out the strengthening activities relatively well </li></ul><ul><li>Vaguely recognized letters that were taught to him last week  indicates problems with letter recall </li></ul><ul><li>When asked to write the letter ‘C’, he drew: </li></ul><ul><ul><ul><ul><ul><li>instead of </li></ul></ul></ul></ul></ul><ul><li>This indicated that he may have trouble crossing the midline </li></ul>
  9. 9. Week 2: Bilateral Activities <ul><li>Big clapping sequences </li></ul><ul><li>Arm circles w/ and w/o beanbags  lazy 8s </li></ul><ul><li>Reached around body to grab another beanbag </li></ul><ul><li>Playdough work </li></ul><ul><ul><li>Made 2 “snakes”  cross them over each other to make an ‘X’. Run his fingers over it. </li></ul></ul><ul><ul><li>Drew an ‘X’ into patted-down Playdough. </li></ul></ul><ul><li>HWT slate </li></ul><ul><li>Mazes </li></ul><ul><li>Flag-making </li></ul>
  10. 10. Week 2 Results <ul><li>Much improvement as a result of the bilateral activities: </li></ul><ul><ul><li>Recalled letters more easily </li></ul></ul><ul><ul><li>Wrote the letter ‘C’ correctly </li></ul></ul><ul><ul><li>Receptive to learning the letter ‘X’ </li></ul></ul><ul><li>Continued to write very lightly  indicated more need of strengthening exercises </li></ul>
  11. 11. Week 2 Results: Flag-Making
  12. 12. Week 3: Perceptual & VMI Activities (with a Touch of Bilateral & Strengthening!) <ul><li>Bilateral Warm-Up </li></ul><ul><ul><li>Beanbag activities </li></ul></ul><ul><ul><ul><li>Arm circles  figure 8’s </li></ul></ul></ul><ul><ul><ul><li>Reached around body to grab beanbags </li></ul></ul></ul><ul><ul><li>Rolling object back and forth </li></ul></ul><ul><li>Visual Perceptual Activities </li></ul><ul><ul><li>Visual fixation/tracking activity: had him follow a moving beanbag first with his head then only with his eyes </li></ul></ul><ul><ul><li>Visual memory exercise: started with 5 letter cards and take 2, then 3 away </li></ul></ul><ul><ul><li>Figure discrimination : overlapping worksheet </li></ul></ul><ul><ul><li>Visual discrimination matrix cards </li></ul></ul><ul><li>Visual Motor Integration </li></ul><ul><ul><li>Mazes (also strengthening and bilateral) </li></ul></ul><ul><ul><li>PlayDough activities </li></ul></ul><ul><ul><ul><li>Strengthening warm-up </li></ul></ul></ul><ul><ul><ul><li>Formed letters with “snakes” </li></ul></ul></ul><ul><ul><ul><li>Wrote letters into patted-down PlayDough (strengthening) </li></ul></ul></ul><ul><ul><li>Ground discrimination worksheet </li></ul></ul>
  13. 13. Week 3 Results <ul><li>Letter formation on the ground discrimination worksheet was very wobbly  indicates we should perhaps work on more strengthening </li></ul><ul><li>He often fails to take up the entire area designated for a letter  leads me to believe there are still perceptual problems </li></ul><ul><ul><li>Performed very well on visual perceptual activities, which focused on visual fixation/tracking, visual memory, and visual, figure, & ground discrimination </li></ul></ul><ul><li>Has much difficulty in completing arm circles and rolling object back and forth  needs work with gross motor skills (although he gets this in a special session with Lindsay) </li></ul><ul><li>Continued to respond well to bilateral activities </li></ul>
  14. 14. Week 3 Results: Figure Discrimination
  15. 15. Week 3 Results: Visual Discrimination
  16. 16. Week 3 Results: Ground Discrimination
  17. 17. Week 3 Results: Mazes
  18. 18. OVERALL RESULTS: Week 1 vs. Week 3
  19. 19. Observation week vs. Week 3
  20. 20. <ul><li>Questions ? </li></ul><ul><li>Comments ? </li></ul><ul><li>Feedback? </li></ul>

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