Showing posts from January, 2009

Developmental attention and visual auditory synesthesia

Caveat lector: This post presents more questions than it does answers. It may also be appropriate to ignore all this theorizing and file this separately under 'Kids say the darnedest things.'

A colleague asked me to review one of her cases because the child was presenting with some peculiarities. This four year old child's main difficulties are that he is 'overly sensitive,' as well as having some functional problems with attending skills and fine motor coordination. The parent perceives the child as 'different.' This could be underscored by the child's recent statement of "Do you hear my eyes blinking?" and reporting that watching his father's eyes blink sounded differently than the sound of his own eyes blinking.

I am aware of the concept of synesthesia - and believe that most of what I have read is more related to color perception of words and other odd cross modal perceptions. I had not heard of auditory perceptions based on visual …

Psychosocial occupational therapy in schools

I am not certain how many problems can be solved at odd hours of the morning, but it is 4:30am and I can't shake some concerns I have about psychosocial intervention models in schools.

According to all data, occupational therapists are not frequently employed in psychosocial practice settings. There are all kinds of complexities behind this including

historical lack of parity for reimbursement in mental health systems that drove professionals out of psychosocial practicelost opportunities for OTs to have legislative inclusion as QMHPslack of vision and leadership in articulating the occupational therapy scope of practiceanalysis paralysis and inability to implement plans to reverse negative practice trends
lack of mental health fieldwork mandates for occupational therapy students
These contributing factors can all be debated - and there are chicken and egg conversation to be had - but these still represent some of the most salient issues.

Pragmatically I see that there are rather lar…

How do I choose an occupational therapist?

I received this question in email the other day:

Any tips (in a past or future posting on your blog) about how a parent can go about choosing an OT? We've been taking our 5-year old autistic son to an OT who is very nice and caring and with whom our son works well, however, she has recommended Wilbarger brushing, Therapeutic Listening and books written by Jean Ayres. Also, there seems to be no concern at all for when therapy might end - we have been paying privately for the past 2 years and just now got insurance that covers OT. I would like to find a new OT and would appreciate it if you could give some specifics about how to find one who is more interested in evidence-based approaches. It sounds like a judicious use of Wilbarger would be ok, taking into account the attitude of the OT toward such approaches.
In my opinion, all occupational therapy should have an end point. End points might look very different depending on the nature of the disability and the needs of the child at…

An example of a job well done!

OK, I admit that I snipe in here sometimes - but it is because I believe in my profession and I want to see it represented in what I consider to be positive ways - but this blog always represents just my opinion anyway - one voice in a very large universe of ideas.

Well today I want to turn away from sniping and instead give an unsolicited thumbs up to Toni Schulken who is a pediatric OT in North Carolina. I was browsing through Wal Mart today picking up a curtain rod for the office and I wandered past the office supplies section and some writing paper caught my attention.

Mead is marketing and selling some writing paper - some of it has raised ruling, some has ruling of various widths, some has highlighted margins, etc. You can view some of their products here. I am not endorsing this product because that is not what this blog is about - I really haven't used the paper and I haven't seen all of it but from my quick glancing I am certain that some of it is great for the inten…

Funding difficulties persist for NY State Early Intervention Program

Background reading: New York State's Medicaid Problem in the Schools

Governor Patterson's proposed budget cuts to the Early Intervention program have professionals across the state wringing their hands - read about the speech therapy association's concerns here. Although there are no public documents available currently from occupational therapists I have been sent a lot of internal communication from NYSOTA about that group's concerns.

Some of the concern is about the possibility of implementing family cost sharing for EI services. New Jersey advocacy groups are already on the record against these models. Reasonable cost sharing is a functional model - but of course there are always individual exceptions and sad stories to any cost sharing model that will make the front pages of the 'Living' or 'Family' section of local papers and invariably lead to embarrassment of local officials, if not lynching. It is also true that a cost sharing model, unchecke…