OT Learnings - Thriving in Therapy

Working as an OT in Private Practice has been challenging but very rewarding (cliché, I know, but it has!).

 It’s a wonderful privilege to enter people’s homes their safe places, life and world. Here is some of the things I’ve learnt along the way…

• ‘Disability’ is a whole new world (cue Aladdin and Princess Jasmin! ), not just for me, but for everyone that embarks on this adventure. There is so much to navigate; from NDIS, to realising everything is often more expensive when you add ‘disability’, to the world of school and Kindy. Everyone is doing their best to navigate it, bringing their unique situation, perspectives and knowledge.

• Learning the ins and outs of any new job is tiring! I have wished I liked coffee on one… or several occasions. I probably need to take my own advice (crazy right?!) and make time for self-care. The saying is true, “you cant pour out of an empty cup.”

• Wen working with kids with a disability, there are days where you take two steps forward, followed by one step backwards. This makes it all the more important to celebrate the wins when they come, and they do come!

• I am not the expert of the child and their situation by any means. The saying, “if you’ve met one person with a disability, you’ve met one person with a disability” is very accurate. Every child and family are so different. The day I stop asking questions about the child and their family and only have answers, is the day I stop being a good OT. I am only as good as my willingness to learn, whether that be about the child and their family, the child’s condition, the latest research or learning what works for the family.

• There’s so much to learn! I’m so grateful to so many wise therapists and colleagues that have poured into my life to help me be ta better OT.

• The children have taught me the wisest lesson. That is to always presume competence. Children can learn, can improve and can succeed. It is always more dangerous to presume they can’t.

I often come home with paint in my hair, sand in my shoes and pen on my hands - but I would not have it any other way! There is nothing quite like talking about poo several times a day to keep you humble!  I have loved every part of it!

Ashley

Why experts changed the way they look at challenging behaviour

Is challenging behaviour thus named because it is challenging to the individual experiencing it; challenging to the individuals who encounter it; or because it makes participating in desired roles and goals more challenging? Either way, it's a subject that divides many on the best way to manage it...

A wise OT (although all OTs that I meet prove to have generous measures of wisdom) once told me that it is folly to expect even adults to manage challenging emotions on their own. The lesson in this wisdom was that even adults rely on others (friends and family) and things (ice-cream, chocolate or exercise!) to manage strong emotions, like anger, disappointment or jealousy. Thus, expecting children to process, manage and resolve challenging emotions without BUCKETS AND BUCKETS of assistance from you is destined for failure. 

This is where Dan Siegel's book 'The Whole-Brain Child' comes in - it provides strategies that are easy to understand, backed by scientific theory and complement the strengths-based model we employ in individual occupational therapy. Don't stop reading - this is not a summary nor a book review (although Look, I love the book enough to do both). Dan's book introduces us to the idea that if we understand (and in doing so aim to integrate the logical left and the emotional right sides) the whole of our children's brain we are better able to support them in not only experiencing and managing those challenging emotions but also will empower them to live full and balanced lives. These are the (much much abridged) intricacies of (a very small bit) Dr Dan's written word:

Connect and Redirect:

Connect to the right (emotional) side of the brain by using your emotions to demonstrate to your child empathy and understanding. Then redirect to the left (logical) side of your child's brain by using logic to reason and rationalise with them. Dr Dan acknowledges that during instances of inappropriate behaviour (e.g. if your child is being disrespectful, hurting someone, throwing things), you may need to stop the behaviour, remove your child from the situation and then connect and redirect. He continues on to point out that to ensure your child is more receptive to the lessons that are to be learnt, that it is generally a good idea to discuss misbehaviour and it's consequences once your child has calmed down (which is true of adult disagreements too!). The authors provide simple sketches that help understand what this strategy may look like in action:

Siegel, D. J., & Bryson, T. P. (2012). The whole-brain child: 12 revolutionary strategies to nurture your child's developing mind. Brunswick, Vic.: Scribe Publications

Name It To Tame It:

This one is challenging even for me as an OT; no one wants to see a child upset and it often feels like a easier option to distract them with a toy or iPad than it is to sit with them while they experience challenging feelings. However, Dr Dan vouches for the neuroscience behind this strategy and emphasises the need to do so to support your child in their long-term development. He explains how you can help your child to manage their emotions by supporting them to understand and process what they are feeling. Talk through and name the feelings (the right side) and discuss what happened (the left side) so your child can tame how they feel and make sense of what is happening. Dr Dan tells us that kids often need someone to help them make sense of what is going on when they experience strong emotions; this is what naming and taming it does - it allows your child to understand themselves, what they are feeling and how what is going on around them has impacted that (it's the same science and cathartic experience that occurs when adults journal). 

The authors once again provide a beautiful comic that depicts a situation that we may encounter at home. It is a further credit to them that they can make a complex concept beautifully simple and easy to understand:

Siegel, D. J., & Bryson, T. P. (2012). The whole-brain child: 12 revolutionary strategies to nurture your child's developing mind. Brunswick, Vic.: Scribe Publications

As mentioned - this is a very, very abridged summary. My favourite part of this whole book is that the authors recognise how hard managing challenging behaviours are, and recognise that there are times when it is just too difficult to employ these strategies. There are many many more wisdoms that the authors share throughout the book, and as those who know me know I can NEVER suppress my love for a good book (sorry hubby),  and thus can't promise there won't be one or two more posts powered by my love of The Whole- Brain Child. 

Olivia

My Experience at an NDIS Planning Meeting

I recently had the privilege of attending a family’s NDIS Planning Meeting which I found to be a valuable learning opportunity.

In the first part of the meeting specific questions were asked about the child’s abilities across different functional areas and answers input into a computer.  The questions asked vary according to the child’s age.  Be aware it’s a standardized American questionnaire, so it’s not always culturally or geographically appropriate.  For example, “Can your child put gloves on?” ... I’m struggling just to get a jumper on my child, let alone gloves!

The questions were broadly about:

Self-care (e.g. dressing, grooming, toileting)

Mobility (e.g. standing, walking up and down stairs)

Community Skills (e.g. following signs such as “exit”, managing money, road safety)

Social Skills (e.g. negotiating with friends and teaching peers a new game)

Home Duties (e.g. putting things away or planning a play date)

Attention (e.g. impulsivity and getting organized for the day)

It was good to see the NDIS planner go “old school” for the second part of the meeting and use a note-pad and pencil.  This helped it feel like more of a casual conversation.  It gave the family the chance to talk openly about what their home life looks like, day to day with their child and their required supports. 

Towards the end, the planner asked the family to set 2 - 3 goals for the next 12 months.  It was lovely to see the planner use the family’s words – they didn’t need to be technical or fancy!  For example, “I want my child to make friends” or “I want my child to feel good about going to school”.

The planner also asked if they wanted a “self-managed” or "agency managed" plan, so it’s a good idea to think about this before you go:

https://www.ndis.gov.au/participant/self-managing-budgets.html

After the planning meeting a referral was made to the "Implementation Team" who help families connect with service providers (if need be) and teach families how to use the NDIS online portal. 

The family was told they should have their funding within 2 - 3 weeks after the planning meeting (fantastic news!).

With all the negative stories about the NDIS, It was great to have such a positive experience!

The team at Whole Hearted Kids are happy to help with your NDIS Planning meeting.  Please talk to us if you’d like some more support.

Jenni