Beth Recovers: How OT helped her regain independence

 

B is a young woman who suffered a major injury in a boating accident. As a student at UNM, her life was put on hold while she healed. She received occupational therapy services in a rehabilitation hospital. We thank her for sharing her experience with our OTNM interviewer this past spring.

OTNM:Thank you for agreeing to be interviewed about your experience with occupational therapy. Will you start by telling us a little about yourself?

I am currently a senior at UNM, I will be graduating with my business degree in May. I’m looking forward to it. Basically right now I’m just working hard to get that done. And then looking forward to starting my career in the business world and starting work somewhere to get some good experience and find out what I want to do as a career.

What are some things you like to do for fun in your free time?

I like to do crafting, creative things. I also really like to try to get exercise in fun ways whenever possible. Just really hang out with friends and be around people who make me happy. Enjoy the little things I guess.

Why did you seek OT services?

Last march, 2014, I went to Puerto Rico for spring break. I got into a boating accident while there and fractured my pelvis in several places. This left me unable to walk and do mostly everything. I sought OT services before returning home after my injury. I had to go and live with my parents for a few months while I healed and there were a lot of obstacles that I faced in their home including stairs. Just basic mobility stuff I had to relearn with my injury, because it was important for me to not put any weight on my left foot. So I just had to adapt everything that I did and OT helped me do that.

Can you give me an example of a barrier to participation you were facing in your living situation?

My whole living situation was completely turned upside down. I couldn’t walk like I said, or really do anything for myself in the beginning. So living wise, everything was changed, I couldn’t walk, I couldn’t sit, I couldn’t lay down. I couldn’t use the restroom on my own, I couldn’t shower on my own. Basically every aspect of my life was an obstacle at that point.

and you weren’t able to live in your house?

Right, I had to move out of my apartment and move in with my parents. Luckily my mom was able to provide a lot of care for me during that time. It wasn’t an option for me to live my normal, independent life that I usually did- before my injury.

How was your participation in your education impacted?

At that time, it was the spring semester of my junior year. I was taking 6 classes, 18 credit hours. Spring break is in the middle of the semester so I was at a break point at that time, which was helpful. But after the injury I just had to take incompletes in all my classes, which basically paused them for the time being while I healed. Once I could focus more on school work and had more time and energy and motivation to do those things, I was able to complete my classes over the summer. Even some of them before the semester ended. It put me back a little bit but I was able to successfully stay on track. It was definitely a feat doing so. I mean I just laid in bed and did homework for days on end, trying to finish my classes. It really made it harder to finish them. I had to do a lot of work in a short amount of time to catch up.

I imagine not being able to walk made it hard to go to school.

Yeah I couldn’t go to school but luckily my professors were really sympathetic and understanding to my injury and the crazy accident I had gone through. They were really nice about it.

What about some barriers to your work?

I wasn’t able to work at all for three months. I wasn’t able to make money to support myself. I just didn’t have the capability of physically doing work, I didn’t really feel up to working physically and mentally for a long time after the accident. Still even to this day I still can’t do everything that I used to be able to do. I have to face a lot more pain. So work wise it definitely affected me a lot.

What about your leisure activities, how were those affected?

It was really hard to do anything fun. Besides going to the movies or doing something where I didn’t have to walk or move around. So I didn’t really have a lot of chances to do fun things and play. I was kind of confined in the bed and in the house. I looked forward to just going downstairs just for a little bit of a change.

For all the barriers that we’ve discussed how long would you say you were affected?

It took about two months to heal, so everything was dramatically affected for about two months. At that point I could start to do some more limited things. But I would say a total of three to four months. And even now, almost a year from the accident, somethings are still affected.

Will you describe a session that you had with your OT?

So I had the majority of my OT at an inpatient rehabilitation hospital with my OT named Kathy. And she was really great, she pushed me really hard to work hard to reach my goals and not give up. It was very hard to stay motivated at the time because I just felt like I was never going to get better. There was one day when she turned to less serious things and just helped me make macaroni and cheese in the kitchen. It was really fun because I really like mac and cheese. Also, it was a simple task that I hadn’t even thought about tackling yet. So it was a challenge but it was rewarding to be able to do something like that on my own. So I thought that was really interesting and it was just a really nice change of pace from what we had been doing during our appointments. So that was one appointment that really stood out to me. She just showed me how to safely do things and make sure I don’t injure myself in the kitchen; where to stand, what to hold on to, what not to hold on to. Just simple things like that. It was a big game changer for me I think.

What was the most meaningful goal your OT helped you to reach?

Tackling the fear of stairs. At my parents’ house to get to the bedroom and shower, and bathroom you have to go up the stairs. So that was something I obviously needed to face but it was terrifying for me. Just because I didn’t want to fall. It’s extremely challenging to balance and hop up the stairs on one leg. The whole thought of it just gave me really bad anxiety and made me really nervous and scared. She just really took that process slow with me and helped me tackle it in small increments. But not only that, she helped me a lot with sitting up in bed and just helping me do the little things by myself, like putting on my socks and brushing my teeth. Just those little things that gave met that taste of independence that was taken away from me. I think those little goals were some of the biggest. Just readjusting in bed by myself and sitting up, turning over on my side; just those little things were some of the biggest goals.

Anything else you would like to add?

I think one thing that has really stood out to me about my experience is that my OT wasn’t always easy on me. There were days where she really stood her ground and was tough on me; “you need to learn to do these things by yourself and this is why” and “you can do this.” She wasn’t always there to just make me feel better, sometimes she really pushed me. Sometimes, when I really didn’t want to be pushed, but I needed that at the time in order to get better.

Great, well thank you so much for sharing with us.

No problem.

 


Leah’s Mom: How OT helped my daughter live, learn, and play.

 

OTNM: Thank you for agreeing to be interviewed for Occupational Therapy New Mexico. We want to share your experience with OT with other New Mexicans.

Please tell us a little about yourself.

I am mother of two wonderful girls. I work full time for a social service non-profit organization. Also, I volunteer in the community, especially working for people with disabilities.

Why did you seek OT services for your child?

My youngest daughter, Leah, was diagnosed with autism at around 2 years of age. OT services were recommended by a physician and the school system. At the time, I was not all that familiar with occupational therapy and its role for children. Leah began seeing a private OT and also received OT services through APS when she entered school.

What barriers to participation was your child facing . . .

In Everyday Life: She was very limited in her eating and would only eat a few different foods. She had some sensory issues, especially with sounds and touch. Also, she had a VERY hard time being toilet trained. There were noticeable social limitations, she was still mostly non-verbal around age 3. She had a hard time sleeping and a hard time with physical activities due to her poor coordination and muscle strength.

Learning: Initially, Leah had a hard time staying in a general education classroom without being disruptive. OT services were used in the school to help her stay in a general education classroom throughout the day, stay at the right grade level, (she was very bright), and to challenge her. Leah had disruptive behaviors when she became overstimulated so the OT also helped to provide acceptable modifications to use in the classroom to help her to self-regulate and calm down. This also involved sensory integration therapy both through the APS OT and the private OT.

Playing: The biggest barrier was the reaction of the other children. She was often judged or ostracized because she behaved and played differently than the other, typically-developing children. She did not have the appropriate social skills to interact or play with others so she often played by herself in her own little world. She also did not have the necessary physical capabilities to play games with others (e.g. four square or kickball). She took adaptive PE to try and help her improve in those areas and to place her with other children having similar problems. Leah was almost never invited to birthday parties, which became a problem as she became older and recognized that she was being left out and saw others invited.

Describe a session with your OT.

Sessions were a combination of physical activities that included a communication goal. For example: swinging in a trapeze and reciting numbers or letters. She did not have a good idea where she was in space so the physical activities would help her understand that. Often the activities were set up to make her frustrated in order to force her to talk or ask a question, and it was not always much fun to watch. Sensory integration therapy often occurred in the classroom. When she would “ramp up,” the OT would give her tricks to de-escalate such as a brushing protocol, breathing, or stamping feet. The key was that the OT took the time to know what Leah liked and what motivated her (princesses were huge!) so these were used as rewards and were integrated into her sensory tools (sparkly treasure chest that she could go to and pick out a piece of gum to chew on). The OT was so creative! For example, she put a pink boa over a chain that could be placed on her lap to help calm her and provide deep sensory input, she wouldn’t have allowed the chain to touch her if it wasn’t pink and fluffy. The OT would also provide a pink or purple sharpie that motivated her to practice writing. Leah had very poor grip strength and some teachers had recommended she just use a keyboard instead. Sometimes the “rules” don’t apply or work for everyone. This same kid who could not hold a pencil or verbalize what she wants can today draw and paint extremely intricate pictures.

What was the most meaningful goal your OT helped you to reach?

Our OT gave Leah one of the most helpful tools to help her be able to discern what was happening. It was called the SPACE Plan (Setting Problem Action Consequence Ending)

This plan could be used to help her through meltdowns and difficult social situations that just didn’t make sense to her. She had to write down on paper all the components of SPACE. This gave her a visual to look at, which are very helpful to her. A goal of the plan was to have her try and select the correct Action to deal with the problem (e.g. instead of screaming, ask a question for clarification). This has been an excellent life skill for her to have.

Results of OT

Physically, she was able to ride a bike, take ballet and belly dancing classes despite still having some poor coordination.

She was given skills to handle difficult sensory situations such as eating at a restaurant, where our family used to never be able to go to eat. She was able to go beyond the restrictions of her autism and try new things.

OT took her challenges from autism (social, sensory, communication) and pushed her to conquer them. OTs don’t take no for an answer and they don’t put up with anything. They pushed her out of her comfort zone and pushed her to break through the barriers. Through the challenges and the barriers the OTs saw the potential that maybe even I couldn’t see. For example, many parents may say, “She’s crying, you should stop doing that activity.” That attitude will never help them grow or become independent.

I would say the results of OT were very successful, her goals were met and her goals always evolved with her and became more challenging. She just moved into a house with three roommates, is about to graduate from the University of New Mexico, and is learning how to drive. Before OT, no one thought that would be possible.

I would still like OT services for her today if they were covered by insurance because I know that she could always benefit more from OT.

 


 

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