Occupational Therapy Celebrates 100 Years

By Lauren Francis, occupational therapist at CHOC

Occupational therapy is turning 100! The specialty’s roots formed in 1917 as “reconstruction aides” who helped rehabilitate wounded soldiers returning from battle in World War I. Today, occupational therapists apply a holistic approach to help children and adults engage in meaningful activities.

Occupational therapists are experts in addressing any and all areas that “occupy” one’s time. For infants and children, occupational therapy (OT) includes play, learning to move and explore, feeding and eating, and bonding with parents and caregivers. For children and teenagers, this can include gaining independence with self-care, being successful in school, and playing with friends. Pediatric OT sessions often look like play to the untrained eye – most children really enjoy therapy!

CHOC’s occupational therapists (OTs) are highly skilled and trained to help children of all ages who have unique needs. Some key components of OT are:

Feeding Specialists

For a variety of reasons, children may have trouble getting the nutrition they require to grow and develop. CHOC’s occupational therapists help treat a wide range of feeding issues, including babies who have trouble with breast and bottle-feeding, children who have oral motor or sensory difficulties and cannot manage textures of food, and teenagers who may have had an injury or procedure that affected their ability to eat. OTs at CHOC are also highly skilled in specialty therapies such as feeding tube weaning and swallowing therapy.

Sensory & Developmental Specialists

CHOC’s occupational therapists have advanced expertise and techniques to offer children and families with an assortment of developmental challenges as well. From supporting a child to stay strong and active through chemotherapy to helping a child recover from a neurological disorder or brain injury, occupational therapy can be a crucial part of a multidisciplinary care team. Children who have difficulty with sensory processing, learning delays, challenges with self-care, visual motor or visual perceptual deficits, difficulty coordinating their arms and hands, or who aren’t meeting developmental milestones, can all be excellent candidates for occupational therapy intervention.

Parent/Caregiver Collaboration

Perhaps one of the greatest roles occupational therapists play is working with the parents and families of the children we serve. Parent education and involvement in therapy is an essential component to ensuring a child meets his or her goals. Through CHOC’s commitment to patient- and family-centered care, our OTs closely partner with parents to create individualized treatment plans, offer customized home programs unique to each child’s needs, and engage them in all aspects of care.

Preventative Care

CHOC OTs work tirelessly as part of an advanced team to screen children who may be at risk for developmental delays. They apply years of clinical experience and expertise along with standardized testing to assess a child’s movement, mobility, hand use, interaction with the environment, and feeding skills. For children who require a long hospital stay, OTs help provide developmentally appropriate stimulation to help each child continue to grow and develop during their hospital stay.

If you think your child would benefit from occupational therapy, speak to your child’s primary care doctor.

Learn more about rehabilitation services at CHOC.

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CHOC Physical Therapy Improves Quality of Life

The American Physical Therapy Association declares the vision of the physical therapy profession as “transforming society by optimizing movement to improve the human experience.” The movement system is complex and includes various conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and integumentary systems and their complex interaction that allows kids and teens to experience their environment and actively participate in the activities they enjoy.

How do physical therapists play into this at CHOC? You may see them addressing a wound care plan, educating a family on developmental play activities after an open- heart surgery, teaching a patient how to use crutches after surgery, helping a child balance and coordinate a multi-step task after brain surgery, or progressing the endurance and strength of a child on chemotherapy. Most of all, you will see them educating CHOC families on self-empowerment and independence.

From working with neonates who are learning to self-regulate, to high school athletes hoping to return to their sports after injuries, CHOC’s physical therapists are involved in improving quality of life for our patients and families.

Meet Amanda Traylor, a pediatric physical therapist at CHOC.

Q: What aspect of pediatric physical therapy are you most passionate about?

A: I love working with kids, and we get to work with a diverse age range. I also enjoy the multi-disciplinary collaboration of the rehabilitation department, which includes not only physical therapy, but also occupational therapy, speech and language therapy, and developmental therapy.

Q: What inspires you most about the care being delivered at CHOC?

A: I am inspired by the constant striving of the care team to provide the best evidenced-based practice for our patients and families. Our staff is so involved in our community with different events, education opportunities, and training of future professionals; we really make an impact on Orange County.

Q: What have you learned from your patients?

A: My patients have taught me to focus on what is important and meaningful. Being a part of the medical field, we often establish a plan of care and goals based off the impairments we see, but ultimately it always comes down to what is meaningful for the patient and their family.

Q: What, if anything, surprised you when you became a pediatric physical therapist?

A: We don’t just treat the child; we treat the whole family. The families are truly our backbones for patient care.

Learn more about pediatric physical therapy being delivered at CHOC.

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Olympic Medalist Turned Physical Therapist

When athletes of any caliber come to physical therapy appointments, they often struggle with emotional hurdles as big as their physical challenges. Working with an expert who understands their struggles can make it easier to cope, especially when that expert is a former Olympian.

Robin Beauregard, a physical therapist at CHOC and two-time Olympic medalist in women’s water polo, understands the physical challenges that can sometimes stand in the way of achieving athletic goals.

olympics

“Having a career in athletics helps me establish a rapport with my patients, particularly my history with sustaining and overcoming injuries,” she says. “Sincere empathy creates a stronger bond than sympathy.”

Shortly before the team was named for the Sydney Olympics in 2000, the first time women’s water polo was to be recognized as an Olympic sport, Beauregard dislocated her knee and didn’t know if a recovery was possible. Distraught but determined, she committed fully to her physical therapy plan, as well as a rigorous conditioning program, and made the team. They’d win a silver medal that year, and a bronze four years later. She was later inducted into the USA Water Polo Hall of Fame.

Beauregard’s experience with physical therapy in the midst of her Olympic career ultimately played a big role in her professional career.

“I was not the perfect patient, but it prepared me for being a physical therapist because it gave me an idea of asking only what is reasonable of my teen and young adult patients,” she says. “I really do understand their worry of not being able to get back to the top level in their sport, but also weighing the risks of not wanting to cause further or permanent injury.”

Growing up in Southern California, Beauregard loved to be outdoors and was always active. Having an older brother who was also athletic made her competitive, too. She started swimming competitively for a local club team on her fourth birthday simply because her brother swam, and she wanted to be as a good as he was. Water polo came into play just four years later, and by age 8 she joined a competitive club team.

But when she got to high school, there was no girls’ varsity team. Instead of giving up on her passion, she simply joined the boys’ team instead. Playing with the boys didn’t faze her, or them, since they’d been competing together for almost a decade by that point. When opponents made comments about playing with a girl, she channeled it into her game and used it as fuel to play even harder.

olympics

After high school, she attended UCLA to play water polo, and originally planned on becoming an orthopedic surgeon. She later changed her path to physical therapy, which would ultimately give her a different kind of interaction with patients and athletes.

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Concussion Program Prescribes At-Home Exercises

Athletes and other adolescents with mild to severe concussions who experience symptoms such as dizziness, feeling unbalanced on their feet, blurred vision or trouble focusing on objects, may be good candidates for at-home visual and vestibular exercises recently designed by experts of the CHOC concussion program.

“Concussions are like puzzles, and every one is a little bit different,” says Dr. Jonathan Minor, a CHOC sports medicine specialist. “As many as fifty percent of concussed athletes may experience these symptoms and could benefit from these exercises that may get them back on the field or back in the classroom sooner.”

concussion exercises
Dr. Jonathan Minor models one of several at-home exercises recently designed by experts of the CHOC concussion program.

The convenient and self-explanatory exercises are ones that athletes and students can perform at home, but should only be started under the guidance of a concussion specialist, after an appropriate evaluation, and as part of an overall post-concussion treatment plan. These exercises are intended to enhance and improve a patient’s recovery from a concussion.

“Patients should be aware that beginning these exercises may stimulate some symptoms for a short period of time, such as trouble focusing, dizziness, nausea or headaches. But after just a few days of daily exercises, they may find that they can tolerate each exercise for a longer period of time,” says Minor, who is a lifetime athlete himself.

“We encourage our patients to only perform these exercises for the duration tolerated, rather than endure and push through worsening symptoms initially. Seeing a difference quickly with improved tolerance resonates especially with athletes, who are used to training and then seeing improved results.”

Download your copy of the vestibular/balance exercises and the visual concussion home exercises.

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Speech and Language Pathology Empowers CHOC Patients

In honor of Better Speech & Hearing Month, we spoke to Nicole Paine, who has been an outpatient speech therapist at CHOC for 4 years, working with patients with feeding and swallowing disorders, speech delays, brain injuries, and vocal cord dysfunction. She also works in CHOC’s Early Developmental Assessment Center , a resource for families with children born early or who had difficulties at or shortly after birth, who are concerned about their child’s development. Speech and language pathology at CHOC helps children develop or improve their speech, language, memory and attention, breathing, and feeding and swallowing in a state-of-the-art rehabilitation center.

Q: Why did you want to become a speech therapist?

A: I have always had a passion for working with children and the special needs population. One of my previous jobs was a special education classroom assistant and one-on-one aide. I was able to see speech therapy firsthand with my student every week. I loved how functional, beneficial, and enjoyable it was for him. I asked his speech-language pathologist questions about the field, borrowed textbooks from her, and sought out additional observation time. I went forward with pursuing a post-baccalaureate degree in communicative disorders and eventually my master’s. Each class and internship I completed made me more confident that this was the field for me!

Q: What part of being a speech therapist are you most passionate about?

A: I love the individual time I get to spend with each patient and their family. It is so rewarding to work together as a team to overcome difficult issues like oral feeding aversions, behaviors, and communication difficulties. Being a part of patient progress is the best part of my job. Whether the progress is big or small, it is all about helping each child reach their best potential. I am also incredibly lucky to work with such a talented team of speech-language pathologists, occupational therapists, and physical therapists  that share my same passion. I love the collaboration on multidisciplinary teams that takes place here at CHOC.

Q: What advice would you offer someone considering pursuing a career in speech therapy?

A: I would suggest interviewing and observing speech-language pathologists in action as much as possible. Our scope of practice is so broad that there are endless opportunities, therapy approaches, and settings to work in. Some college or graduate school programs will allow prospective students to sit in on a class or two. It doesn’t hurt to ask!

Q: What attracted you to CHOC?

A: While in graduate school I was lucky enough to be accepted into CHOC’s full-time outpatient internship program. I knew CHOC was well-respected for many reasons, but was finally able to see that first hand. For 12 weeks I observed, learned, and worked alongside my speech-language pathologist supervisor, treating patients and diagnoses of a wide variety. I lived and breathed what working at CHOC would be like. It was challenging, rewarding, and a ton of fun! There are endless learning opportunities here and I always felt supported by the rehabilitation services team.

Q: What else should people know about speech therapy?

A: People often think we exclusively treat articulation disorders, like making ‘r’ or ‘s’ sounds. We actually can treat a variety of different deficits including fluency (stuttering, cluttering), language (spoken and written), literacy, social skills, cognition (attention, memory, problem solving, reasoning), voice, resonance, auditory rehabilitation (speech delays due to hearing loss), feeding, swallowing, and breathing. It’s typical in a medical setting such as a children’s hospital for speech-language pathologists to treat many patients with feeding and swallowing disorders. Speech-language pathologists need specific education and specialized training by mentors and continuing education courses to work with such patients. We’re able to treat feeding and swallowing disorders in addition to speech because we have extensive knowledge of the mouth and throat anatomy and physiology.

Learn when to ask your pediatrician for a referral for speech or language therapy.

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