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[Podcast] The Sensory Corner Ep. 1 - OT School Vs. OT Field Work

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Hello world! Welcome to the very first episode of the sensory corner. Podcast surrounding all conversations, sensory, occupation and parenting related. My name is Mark, I’ll be your host for today and this podcast is being brought to you by Senso Minds.

Throughout the series I’ll be sharing my conversations with OTs, SLPs, and even parents within the field so that we can share knowledge together as a community and how-to best help children learn, grow, and develop.

Hopefully from this podcast together we can share a discourse on what it's truly like, the pursuit of a world with sensory issues or special needs.

More so, we can share ideas and help each other work through these problems so that we can all help children integrate into the world around them. My name is Mark, I’ll be your host for today. This is the Sensory Corner. 


Mark: I personally am really excited about today's topic and this discussion will surround the whole difference between OT fieldwork and actual occupational therapy practice. There's a very big discrepancy between what occupational therapy students have and what they've learned versus what they'll actually encounter once they become occupational therapists.

Joining us today to help us out with the discussion is @beckyb.ot. That's her Instagram handle. She actually goes by Rebecca Burgess. She's been an OT for eight months thus far. So she's a new grad.

However, with a caseload of a hundred children, she's had her fair share of OT experience. She'll be going over what she learned in school, what was applicable, what wasn't applicable, and what were the things she learned on the fly and actual OT work. On top of this all will be bringing up tips and tricks which use parents can pick up from an actual OT so that you can employ them with your child and help them integrate into the world around them. Let's get to it.


Rebecca:  Okay. So I grew up in Maryland and graduated last May with my master's in occupational therapy and moved to North Carolina where I'm working in an outpatient pediatrics clinic. And then I also do some school visits and early intervention.


Mark:  Seems like you’ve earned your stripes as an OT? 


Rebecca: I think I have. 


Mark: So it's been, what, almost a year, you said last May, right? How many children do you deal with on a day to day basis over the past year?


Rebecca:  I see 10 kids a day. And I have 47 sessions a week. And the number of kids that I have treated overall, an eval is probably well over a hundred.


Mark: Safe to say that she has earned stripes as an OT. When I found out about you, you were really striving to help other OT students but you're also very blunt and honest about what OT work is all about.

How does that interaction look like with incoming OT students and what exactly do you tell them as they're going through their fieldwork and when they're about to go into the real OT world?


Rebecca:  Yeah. So I did a combined bachelor's, master's program and so it was five years and I had OT classes mixed in and I was 17 when I started. And so I really just didn't know what hit me.

And then I learned a lot like the transition from graduating OT school, taking the board, started working like my first eight months now as an OT. And so I feel like I'm trying to just fill in like the gaps or things that I wish I knew. I'm trying to like teach current OT students about that and other new grads. So like they know what I wish I had known.


Mark:  What do you wish you would've known? While you're in OT school, before going into the field whatsoever, what are the top three things you wish you would’ve known?


Rebecca:  I'd say? I definitely did not realize how stressful it was going to be.


Mark:  OT's out there listening to this are probably nodding their heads. They're like, yep.


Rebecca:  Not going to lie. It's very stressful. There's a lot of hard classes. It's a lot at once. Working is totally different than school, like actually worked when you're one on one with a patient you're like, Oh, this was not in the textbook. There's just so many. Like I feel like that first few months after you graduate, there's just so many big events all at once that's so much to handle. And so like I really just was kind of winging it, but now I’ve learned from it. I want people to know like, you should save up some money cause it's going to be a while before you get a paycheck and you know, it's okay to hound your coworkers for advice if you don't know what you're doing.


Mark:  Okay, cool. Cool. In those first three months, four months when your entering the OT world. Once you get that position, what does that exactly look like?


Rebecca:  Especially now looking back, like I have clicked back through my schedule to my first week and like see the first kid that I treated on my own and then I'm like, oh my gosh, we have come so far. Or reading old session notes that say like, you know, max assist for everything. We did not get anything done. And now like, you know, the kids know me, and we go, and we do our work and we get stuff done and we learn stuff. But I feel like really the most like meaningful things are like the first time that like a parent tells you like you've helped so much, or they've changed so much since I started therapy and I'm like, Oh, I'm hoping. 


Mark: It's all paying off. Yes. The snot on my shirt wasn't for nothing. I'm kidding. Hehehe. So it's those little moments, despite how hard it actually is, is what keeps you going.


Rebecca:  Yeah. Like a kid colored me a picture yesterday in their speech session and gave it to me and I was like, okay, this is really sweet. Like today's a good day now.


Mark:  That's amazing. How exactly does school ever prepare you on how to get on the child's level? I hear that so many times within the OT world and having conversations with you guys. Not trying to force the child to do something, ibut more so about trying to meet them where they are and trying to work them through their issues & work them through these certain occupations. Do they ever teach you that in school?


Rebecca:  At least like classwork wise, I don't really remember much of like, I don't remember them saying like how to actually like get one on one with a kid. Like they taught us how to test for reflexes. They taught us like about all these diagnosis we might work with. And then, during like our field work where we're with an OT, then you learn stuff. But I have just worked with kids since high school and I have a lot of experience with it. So I was like, regardless of like what my role is, like I need to meet the kid where they're at, like get down on eye level with them. I kneel down in front of kids and then they kneel down I was like, no, no, I just want to see your eyes. [07:51 inaudible].  


Mark:  In the OT curriculum do they teach you the hardcore skills you need to know or just leave it to the theory-based topics?

Do you ever see yourself pulling upon that knowledge or do you just wing it on a day to day basis almost?


Rebecca:  So like classwork wise, I feel like a lot of it's like subconscious, like those theories and you know, that drive us to choose service and interventions or we learn different interventions you could do but they didn't teach you what to do when the kid just throws every single toy like into the hallway. So you know, or you learn about a diagnosis, but you don't learn what to do if the kid who has like four of them. And then fieldwork is when you're working with an OT. And we have what's called level two field work and you're basically working full time and ended up carrying the full case load for the OT. So that's when you're really like get the like one on one with the patients and learn the most about like what to do in the field. So it's like a nice bridge from like classwork to actually working. But I feel like [09:29 inaudible] thing you've learned in OT school becomes almost like a subconscious kind of thing. And there's times that I like get out textbooks and I look stuff up, but sometimes you really are just winging it. Like you have all the knowledge you need, but then you're like, okay, here's the person in front of me. How am I going to make what I learned in schoolwork for this kid so that we can meet whatever goals? 


Mark:  I know parents, they love to research, especially with sensory being such a big topic thus far. And they really try and get down to the theory so they can best understand their child. Is that the right way to approach it? Say if I was that parent right now, what would you say to me?


Rebecca:  I would say that Google is not your best starting point. 


Mark: Interesting... 


Rebecca: I'd say that if you think your kid has sensory concerns or sensory aversion or anything sensory related, I will start keeping a log, they cry when the dog barks. They scream when there's like an itchy tag on their shirt and then go to their doctor, their pediatrician or family care doctor and talk to them and ask for an OT referral because instead of Googling and going down the rabbit hole and finding everything out, I would say go right to OT because we do this every day and we can do assessments and talk to you and you know it's gotten much more personalized than Google. Because we can talk through, like you said, they cry at bath time. What part of bath time is it when their hair gets wet? Is it when you have to comb their hair out at the end? Is it when the water is running?


Mark:  Everything you learn in OT school; those are the topics which come up often. You go on Pinterest; you go on Google. A lot of those strategies and practices com up and often times, parents want to deep dive into those areas.

More so for OTs, as the experts in this field, you are all able understand the kid and get down on their level. However, as a parent, you know, they don't know what they don't know? And it's hard for them to play that Early Intervention role within their own children’s lives, especially if their child has like sensory issues or they do have a developmental delay.

The amount of times I’ve heard from parents, “I just thought that was who they were” or “I just thought that was just part of being a young kid. I didn't know that they actually had a developmental delay in this area. How exactly would you tackle that issue of ambiguity & lack knowledge without having a parent going on an extreme deep dive into something which may not be related to their child whatsoever?


Rebecca:  I would say if you are going to Google, I Google stuff, look at resources that come from hospitals or like the national Institute of health or that are research based. And so then they're backed by fact and research and so like you can look up developmental milestones and you can like look up developmental milestones and then throw in the keyword red flags and then see like I have like favorite websites that will say like, if your child has trouble with this, this and this, then it might be a good time to see an OT if they have trouble with this and this and it might be a good time to seek speech or [13:21 inaudible].  If you're going to Google look for resources that come from universities and hospitals and are backed by research.


Mark:  Is there a lot of research within this field? Which resources do you refer to on a day to day basis? Any sources which we could give to our viewers and listeners?


Rebecca:  They're on my work computer, sensory doesn't have a ton. Sensory has research but it's not as like set in stone. Like developmental milestones are like, at this age you should be able to put on this clothing and this age you should be able to use a spoon. It's not set in stone like that for sensory. But a good like the guideline is if you see your child around like here's like if you go to the class party and your child seems to like becoming upset really easily or overwhelmed by like the sound and the lights and all of that going on, like comparing them to their peers and then asking for an OT referral.


Mark:   Going back to the topic of classwork versus fieldwork. Do you get better at trying to how certain diagnoses kind of fit together or how certain sensory processes mesh together and what usually pops up? Is that something you can prepare for as an OT student going into the OT realm?


Rebecca:  I feel like you can prepare it to some extent like, but autism spectrum disorder and sensory processing disorder go together often. But then a lot of times they don't go together and or you can like develop kind of like a list in your head of like go to activities for like preschool aged kids or go to activities related to handwriting. So you can have like you know, come up with ideas for like different diagnoses or different age groups, different like intervention and goal areas. But a lot of it just depends so much on the kid you're working with. Like they might not like any of your go to activities.


Mark:  How many times does that happen for you if you don't mind me asking?


Rebecca:  I had a kid last week who I planned out this whole session and I thought it was a great idea and we read this great book of that being a picky eater, all this stuff. And then he said it's just a book. I don't care. Okay, we will close the book, never mind.


Mark:  Wow, the child just told you how it is. This is just a book…. Coming into this field, did you think that will ever be the case, where children would not be attentive whatsoever? What were your expectations going into the occupational world?


Rebecca:  So I guess I knew that patients might refuse sometimes, but like my other big field work was in a skilled nursing facility with older dogs and so they were easier to reason with like you can tell them like we're going to do this activity so that you can get back to doing whatever it is. And they're like, okay, well I want to do that. And kids are like, but I see a gym with a slide and so I don't want to practice writing.


Mark:  They always want to go to the fun things….


Rebecca: Yeah. They also play in the ball pit….


Mark: When children are refusing to partake in task, such as handwriting or feeding because they're just boring. But then they see all these toys around them or they see other activities and they're like, I want to do that.

How exactly do you as an OT navigate that balance there of trying meet them on the same level but also getting them to learn the same task what you want them to learn.


Rebecca:  So sometimes I’ll alternate like a preferred task and then non-preferred tests. So their choice and then my choice. And when we go back and forth. Other kids, I tell them like if you do everything we have to do, then you get to do your choice at the end. So some kids are fine. I can just tell them at the beginning like, I know you want to play in the gym, we're going to do X, Y, and Z, and then you get to go the gym. Sometimes I have made charts that has boxes and then a picture of our gym and the clinic. And so they get a sticker for every time they do one of my activities. And if they filled the boxes, we are playing in the gym. Sometimes I had a kid today who just wanted to play in the castle and so I just took ever anything that I wanted them to do and put it in the castle and then they were willing to do it there. I didn't care that we didn't do it at the table and did in the castle Instead, we worked on the [18:31 inaudible] skills. I had to get today, who wouldn’t sit in the swing. So I just put the button board on her lap in the swing and she did it there. So a lot of times just combining what they want to do, what you want to do like makes a world difference.


Mark: And it seems like you're giving them a lot of choice, framing it again in such a way where they have control but you're still getting what you want as an OT. Has that always been your approach, or was that something which is being shaped over the past eight months?


Rebecca:  I was a camp counselor for six years, so I feel like I got pretty good at reasoning with children before I started working as an OT. But there's definitely times at the beginning where I like I guess wasn't, couldn't think on the fly as much. And so I was like, well I plan this activity and they said no and now I need a minute to like replan and now they're like, they just shoved off the table and I'm like, plan B, I am ready for it.


Mark: It’'s good that you're honest. So you just get better at adapting to those situations. In those moments where you freeze, what ends up happening then?


Rebecca:  So I have some like go to toys that I pull out of the closet every day and have in my room that I know I can use like; I always have blocks because you can work on so many skills with blocks. I always have crayons and paper and coloring books. I always have scissors. I always have button and zipper boards. I always have just, and I always windup toys cause all the kids love windup toys and I never have a sensory bin because I pulled them out today and it got dumped on the floor. So then I had to vacuum. I have some like goto things that I know I can always fall back on. Also swigs and poppers, always a big hit and work on fine motor strengthening. So I always have those as backup options because you know if the kid refuses everything, they're probably not going to refuse squiggs. And then while they're pulling on and off a wall for fine motor strengthening, I have a hot second to plan you know, if it's plan B, C, D or E [20:57 inaudible]. 


Mark: Yeah, 30 minutes into your appointment, you're already on plan Z, you know, like, oh gosh, there's no more letters to exhaust here, but only 15 more minutes. I'm kidding.

Do you ever learn that in OT school? What tools you should have in your toolbox? That seems like such an abstract thought. Like what do I need as an OT to keep in my back pocket? So I'm prepared for anything. Do they teach you guys that?


Rebecca:  They teach us about different tools. I remember learning like different feeding tools, like adapted utensils and bowls and cups and, but I don't remember anyone saying like, here's the top 10 toys I use. And just since I started working, like we have a closet that all the therapists share, and I just started a going list on my computer of things that I use a lot. Or when I do home visits, I did one yesterday and the parent was like pulling out all the toys and they were like, my kid loves these toys. And I was like, I’ve never seen them before and started writing down what they were all called, so I could look them up. I just have a going list now. Like my goto or things that I’ve heard about that kids have loved so then I can pass them on to other parents.


Mark:  It seems like you've built up this curation over time based on what you've seen has worked. A part of me doesn't want to believe that school is an absolute waste. What can an OT student salvage from their education? I definitely don't mean that in a cynical way either!


Rebecca:  Well, you learn so much about like different skills you're going to work on, like how to write goals, what skills you're going to work on, what populations you'll work with. All of that, just they aren't like squigs you should use these or windup toys, you should use these. So I try to post things a lot of times. Like I found this in the dollar store, and it works on this and this because everyone can go to the dollar store and buy the same thing that I just did for a dollar.

The number one thing I'd say is to just work on those skills or those areas as much as possible just incorporate into everyday life. Don't save it for the one or two session a week, like if you're working on dressing, have them help themselves get dressed every morning or if you're working on sensory activities, if they're getting an OT, ask their therapist like what you can do at home and just repetition. Practicing as much as possible is the best way to learn.


Mark:  Awesome. And I guess for like OT students listening in onto this podcast, what was like one tip you would give to them before we end this all off.


Rebecca:  I'd say that you learn the most during field work and through therapist, like through the therapist that you shadow and work with during your schooling or [25:26 inaudible] you're going to learn the most from because they're in the field and working every single day.


Mark:  To recap, don’t miss any learning opportunities to get that real-life experience is what you're saying. And definitely ask questions from other OTs cause they're going through it as well.


Rebecca:  And just write everything down.


Mark:  Everything down and keep a notebook, notebook folks.

Thank you so much Becky. This has been super helpful. That's pretty much the end of this first episode, the sensory corner.

I'm just going to drop in a few things. So I met Becky on Instagram, so if you want to shoot her or follow her Instagram at is @beckyb.ot

That will be placed in the description of this podcast and none the less, but if you want to shoot her or follow, she's extremely candid and honest about her experiences. However I don't want to be speaking on your behalf, but if OT students or parents have questions,  can they shoot them over your way?


Rebecca:  Oh yeah. And I get messages all the time and I love responding to them.


Mark:  Well that's all for today. Thank you so much for tuning into the sensory corner. We'll be hosting another episode soon. Hopefully you tune in for that. Thank you so much guys. Peace out. 



The following podcast, the sensory corner is being brought to you by Senso Minds. Senso Minds is dedicated to developing and designing new sensory tools and kits, which will help children integrate into the world around them.

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