Spring Semester 2009

My list of classes:

1. Pediatric Evaluation & Intervention
2. Rehabilitation Evaluation & Intervention
3. Cognitive Evaluation & Intervention
4. Community Practice
5. Health Advocacy & Administration
6. Professional Issues II
7. Fieldwork I

Types of Apraxia

From the National Institute of Neurological Disorders and Stroke (NINDS)

1. buccofacial or orofacial apraxia - the inability to carry out facial movements on command such as licking lips, whistling, coughing, or winking
2. limb-kinetic apraxia - the inability to make fine, precise movements with an arm or leg
3. ideomotor apraxia - the inability to make the proper movement in response to a verbal command
4. ideational apraxia - the inability to coordinate activities with multiple, sequential movements, such as dressing, eating, and bathing
5. verbal apraxia - difficulty coordinating mouth and speech movements
6. constructional apraxia - the inability to copy, draw, or construct simple figures
7. oculomotor apraxia - difficulty moving the eyes on command

Once again, while reading the OT Exam Review Guide, I came across a question with answers I am not well-versed in. Based on these definitions, I'm still a bit confused. The question involves a man who can put dentures in his mouth but has difficulty applying denture cream to the right places and replacing the top to the denture cream by applying it either backwards or on the wrong end. He has constructional apraxia. The other 3 choices are (1) ideomotor apraxia, (2) dressing apraxia, and (3) unilateral neglect.

Constructional apraxia seems like the best answer, but I probably would have chosen ideational apraxia if it were a choice. The problem I'm having with many diagnoses, including apraxia, is that I need to SEE it. So far, YouTube does not have a video devoted to "constructional apraxia".

baby with hydrocephalus

It's time to return to blogging. And as I read the Occupational Therapy Examination Review Guide, I'm struck by how much of my learning is not sticking. I first YouTubed "hydrocephalus" because a line drawing is not worth a thousand words, but the video about Kadyn David is.



I wanted to see what a shunt looks like. A malfunctioning shunt causes irritability, nausea, pallor, visual perceptual difficulties, and headaches. A good OT would know this, right? Kadyn also has ASD (atrial septal defect) and VSD (ventricular septal defect). It's so much easier to remember things when those things you have to remember have a face...it also makes it sadder.

research photos

It's been a burn-out of a semester. So much to tell, so little time. When finals are over, I might be inclined to summarize the whirlwind of information blown at us from all angles. In the meantime, here are photos used for my research project on the Hareau Thumb Opposition Goniometer (HTOG).

The Hareau Thumb Opposition Goniometer

My hand in the HTOG

Me measuring my classmate's thumb opposition using the American Society for Hand Therapists (ASHT) ruler method

Me measuring my classmate's thumb opposition using the American Academy of Orthopedic Surgeons ruler method

memory activities

I'll be running a memory group in two weeks at a cognitive rehab program. I sat in 3 memory groups already; the topic for all 3 was "Memory for Names". Each session included work or activity sheets related to the topic. From what I've seen, they typically involve one sheet with faces and names and a second sheet with only faces. The patients are asked to memorize the first sheet, then they are collected and the second sheets are administered. They are asked to write as many names they can remember underneath the faces.

I'm wondering where I can get these activity sheets, are they in books or are they online? I have a feeling Barnes and Noble will have something to do with my leading this group.

Documentation Manual for Writing SOAP Notes in Occupational Therapy

The entire class is trudging through this book, probably putting more effort to comprehend it than is needed. The concept is easy.

S - subjective
O - objective
A - assessment
P - plan

I found I can write an entire paragraph in abbreviations, thanks to this book. The difficulty of SOAP notes, goals, and problem lists is knowing what to document. I frustrate myself with a level of redundancy in everything I write. Tack on the environment in which this documentation is written (mental health, peds, phys dys) and the style changes dramatically. Mental health documentation takes on paragraphs. Phys dys should be concise and to-the-point, lots of abbreviations, and do try to eliminate dregs like "a", "an", and "the". Who knows what peds is like; I won't have a fieldwork in that specialization.

I accidently (through every fault of my own) bought 2 copies of this book. Each page is perforated to make it easier for you to lose, so I'm thankful for my 2 copies--I lose things, rip things, drop things, forget things, and break things easily.

Sensory Integration

Jean Ayres was the pioneer of sensory integration. For future clinicians interested in SI treatment, there is SIGN.

summer's over and Fieldwork I begins

School started September 2nd and, for a week, I forgot I had this blog. lol
Here's a run-down of my classes:

1. Orthopedic Evaluation & Intervention
2. Neurological Evaluation & Intervention
3. Research Interpretation of Occupational Therapy
4. Mental Health Evaluation & Intervention
5. Fieldwork I - Psychosocial Development

Fieldwork was great. I go every Monday for 8 consecutive Mondays to a cognitive rehab program (CRP) in a rehab institute. My supervisor and all staff are friendly and very welcoming. It's the perfect environment to throw me in for my first fieldwork experience. My doubts and anxiety quickly melted away.

fieldwork I

Fieldwork I is coming quickly. I'm doing mental health first then hand therapy and finally phys dys. NYU requires mental health and phys dys for fieldwork. It seemed to be a topic to debate when students discovered this. Most want to work in peds. The NYC Dept. of Education, according to students receiving the DOE scholarship, mandate students to have a fieldwork in peds before working in schools. I don't know, nor do I care because I'm not working for the Dept. of Education anymore. Years ago, I considered taking their scholarship when the contract was something like this: DOE pays for one school year, I work for them for 1.5 years. They, recently, bumped it up to 2 years. I can't give the DOE 4 years of my life just because they paid for 2 years of my education. I want to work with other experienced OTs. I want to be in an interdisciplinary setting that promotes growth and development. I want to be properly supervised!

Beautiful Son

a documentary about healing autism

ReWalk Exoskeleton

I found this video on Gizmodo. It shows a paralyzed man walking with the help of an exoskeleton. Some extra details on Medgadget.

I'm seeing incredible gadgets of the future that will improve the lives of many. I'm also seeing money and insurance problems. What to do. What to do.

summer

I'm tempted to spend my vacation brushing up on the fundamentals of anatomy and neuroscience and reminding myself of frames of reference, theories, and research strategies. I don't want to forget anything I've learned when Fieldword I is so close. I'm going back to the basics and will find the time to read the books I've purchased about hand therapy. I'm also wondering if it's hands that's a passion and not peds.

1st half of the master's project

Today or noon tomorrow, my partner and I will electronically submit the 1st half of our Master's project about measuring thumb opposition, normal ROM, and the reliability of the Hareau Thumb Opposition Goniometer (HTOG). Our mentor managed to contact Hareau for permission to let us copy her dissertation. I'm sitting on my bed with the manual lying open at my feet, yellow Post-Its sticking from the edges and notes in black ink at the margins. Makes me want to develop a tool myself and write all about it.

There isn't much we can report on the HTOG because our research study begins in the fall. We'll set up a little spot in the lobby of an NYU building where people will generously volunteer a bit of their time to have their thumb opposition measured. In the meantime, all I have on this goniometer is information provided by Hareau herself. It appears hopeful that a new tool may finally replace the error-prone ruler method.

pondering and wondering

I love finding my professors in bylines of journals and textbooks. It makes me want to aspire to such greatness. One of my very first classes in this program was taught by Jim Hinojosa who is well-known in OT circles--and well-written.

As I languidly pore over papers, articles, books, and websites for "a clue" as to where I'm going with my literaure review, I found another professor in my textbook Occupational Therapy for Physical Dysfunction. Jane Bear-Lehman, my professor and the principal investigator of my master's project, occasionally pops up hither and yon in the forestry of academic publications. It distracts me, and I soon find my head in the clouds instead of published materials describing the measurement of thumb opposition.

searching CINAHL and other how-to's

I stumbled unto this link while searching for information that had nothing to do with what I found. It's a little how-to about searching on CINAHL, which you will do a lot if you're an OT or OT student. It gives you a heads-up if you missed that mandatory library class in which a librarian walks you through the science of database-searching. I'm a little jealous; I couldn't find such a neat link on the NYU Libraries site, only video tutorials and exclusive internal how-to's for NYU students that would be of little use to people with no access.

Rummage around through this site. There are helpful links on EndNote, RefWorks, ProCite, or other cheat sheet tools to make the lives of grads easier. These should be provided by your wonderful school.