We are pleased to announce our 2016 schedule of continuing education courses.
We listened to your suggestions and requests and we are excited to offer many new speakers, with new titles and content.
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EDUCATION RESOURCES is committed to ensuring class participants learn effective techniques and critical problem solving skills that can be immediately applied to the work setting.
Education Resources provides continuing education that can truly make a difference for Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapists Assistants, and Speech Language Pathologists and their patients.
Our distinguished and world renowned faculty are leaders in their field, and provide clinically relevant, evidence based, dynamic and engaging CEU courses.
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Please click here for a listing of upcoming courses in 2016, full course information, dates, venues, CEU information and registration details.
]]>Guest Blogger: Kathryn Biel
I’ve had that moment lately. I’m not proud to admit it. Every few years, I work with a student who makes me feel this way. I have no idea what I’m doing with and for the student. Before you go judging me, stop and think if you’ve ever felt this way. For me, it’s with severely autistic students. The kids who can walk and move around. In my experience, they’re usually pretty strong, which we all note as they’re hitting and kicking and throwing objects.
My usual way of thinking doesn’t work, and I’m at a loss for what to do.
My role is to ensure safe and efficient access to the educational process. One of the challenges with working with moderate to severely impaired people with autism is breaking through, and assigning intrinsic value to an extrinsic idea. Lots of time, I get these kiddos with goals to improve ball handling skills. I had one student once that we worked on this goal for a number of years. Finally, I said to the parent, “I can throw a ball at him for 24 hours a day, 7 days a week. Until it matters to him, we’re not going to see significant improvement in his throwing skills.” Perhaps a crude way to put it, but it was the truth. Improving ball handling skills was important to the parent, not the student. Finding what matters to the student is what challenges me.
I can often address stair climbing skills as it is such a rote skill, especially when paired with counting that it becomes ingrained quickly, providing the necessary strength and range of motion are present. After that, I struggle. Why is it important to the student that he or she stands on one foot? While these measurable skills are often delayed or lacking as compared to same-aged typical peers, often their balance is functional.
I find it challenging to increase the movements and activities in the student’s repertoire. They like what they like and they don’t like new things. This, however, can lead to secondary impairments as the child ages, especially when combined with a diet lacking in variety, as is often seen. Motivating a student to move is one thing. Motivating an overweight student to move becomes entirely more difficult.
Then, there’s toe walking. How aggressive are we being in treating it? Are we letting it occur (while monitoring range of motion) to provide sensory input? Is toe-walking alone an impairment that restricts access to the educational environment?
I struggle with working with the student who flits from object to object, activity to activity, never quite getting the functional use out of anything. These 30 minute sessions drain me, and as much as I like the child, I am filled with dread when I think about them. I know that any “plan” I make is likely to be tossed out the window as soon as the session starts. Do I just follow the child’s lead and try to make functional what I can? Do I engage in a battle of wills in order to get the student to do what I want him or her to do? I know what I’m supposed to be working on. I know why it’s functional. But my student doesn’t. How do I help my student become invested in what I am trying to work on? How important is it that I make this already challenging student faster and stronger and more agile? What do I need my student to be able to do to be functional? Am I looking at functional for the whole world or functional for his or her world?
If you’ve ever felt lost, or wanted to know what motor skills we should be working on for our students with Autism, check out Kym Doherty’s presentation, Addressing Motor Issues in Autism: What’s Realistic and Relevant? at the Sixteenth Annual Therapies in the School Conference.
~Kathryn Biel, PT, DPT
]]>Dan Malone just published (as first author) a paper in the journal Physical Therapy (Volume 95, Number 10) October 2015 titled “Physical Therapist Practice in the Intensive Care Unit: Results of a National Survey”.
The group sent out a survey to members of the Acute Care Section of the APTA addressing staffing, training, barriers and protocols to determine perceptions about providing rehabilitation in the ICU. The survey identified barriers to providing ICU rehabilitation as: insufficient staffing (the primary reason), lack of training, departmental prioritization policies and inadequate consultation criteria. Other barriers included sedation of the patients and scheduling conflicts related to the timing of medical procedures.
The type of training for this setting most frequently cited in this survey was “informal training” relying on mentorship and department-based competency requirements. The article mentioned that there are very few cardiovascular and pulmonary residencies and critical care fellowships currently credentialed by the American Board of Physical Therapy Residency and Fellowship Education to train this at this high level.
The survey group was given 6 hypothetical cases that might be encountered in this setting and was asked to recommend treatment frequencies for each diagnosis. Interestingly, none of these cases received recommendations for daily physical therapy. Although each of the cases was deemed to be “medically stable”, ambulation was not recommended for the majority of patients. More therapists working in an academic setting were apt to recommend early mobilization/ambulation than those working in a community hospital setting. The conclusion drawn was that physical therapists working in acute care and ICU environments need further training to recognize the need for safe early mobilization.
]]>GUEST BLOGGER: Kathryn Biel
We’ve all sat in those meetings. The one where the Committee Chair, or the pre-school director, or the classroom staff, or the administration says those dreaded words.
“We don’t treat just sensory.”
“OT is for fine-motor and visual-perceptual skills.”
“We don’t provide sensory diets.”
If you’ve never heard these cringe-worthy statements made, consider yourself lucky.
I get it. Sensory issues are tricky. Truth be told, I feel lost with them. I feel like I understand a fraction of what there is to know about Sensory Processing Disorder (SPD). Admitting this is difficult, considering my own child has SPD. But I know, if I’m mystified, then others out there must be equally as lost.
I know they are.
Classroom teachers’ eyes glaze over at the mention of a sensory diet. Shall we count how often the sensory diet recommendations are carried out? I’m guessing we can do it on one hand. It’s not for lack of trying on the teachers’ parts either. Resources are stretched too thin. Training is too sparse. It’s easier just to refer out to OT to get the job done. It doesn’t work if it’s treated with a “one-size-fits-all” approach. Heck mention of the Wilbarger protocol alone sends shudders of terror down my spine. And let’s be frank–our kids barely get time to eat and have recess. No one has time to brush someone every two hours, not to mention how socially off-putting this can be to other children. (NOTE: While writing this, a teacher came in and asked about a standing desk to try with a student. The student is currently using a T-stool but a classmate has started picking on her for it.)
But then there’s flip side–we can’t expect children to learn until their sensory systems are modulated. Sure, some information can get in here and there. These kids are smart and will find a way. But smooth, coordinated learning, not to mention social interaction–in other words, success–will be impacted in children with an undermodulated or overmodulated nervous system.
Just because we know these issues are there doesn’t mean there’s an easy solution. From a therapist point of view, providing a sensory diet seems like a good solution. But we all know the reality of this. The cookie-cutter approach doesn’t always work. So, what else can we do? How can we meet our children’s sensory and social needs?
Like most therapists (and those awesome Tiger parents), we know it’s time to think out of the box. Sometimes, the answer is easy. For my son, Jurassic Park, with its roaring T-rex was too loud. We had to leave the movie. When the Jurassic World came out, we had a new plan. That pair of headphones (the cheap version of Beats)–they block the sound too. And my 11 year-old looked like any other kid with his iPod in the pocket of his hoodie. Thinking outside the box while fitting in. We’ve been doing this all along. Or we should be.
OT Doreit Bailer explores a problem solving approach to sensory issues in her seminar, No Longer A SECRET: A Theoretical, Practical Approach to Helping Students with Sensory and Motor Challenges Experience Success at the Sixteenth Annual Therapies in the School Conference.
~Kathryn Biel, PT, DPT
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