Occupational Therapy Notes: AOTA

Showing posts with label AOTA. Show all posts

6.11.2013

c'mon get Appy (part I: Apple)

Editor's Note: another example of how entries go awry. I started writing this a couple years ago when I was working in the school system and had an iPad to use. Since then, there's been a multitude of new apps and developments and there are many better sites that discuss apps (I have linked some at the bottom). But read on for some of my thoughts on the apps I was able to use.

When I worked in the school system, we got iPads as part of a grant. My fellow OTs and I developed a list of all the apps we wanted, and then that list got cut to a very small number. So I didn't get to use anywhere near the number of apps that I wanted to or felt would help for work. But here are my thoughts on some of the apps that we did have access to.

IPad Apps I Have Used:

- Camera - This is standard on the IPad. I could (and probably will in the future) use it to take grasp photos. But right now, my main use is to have a large mirror. You can flip the camera to face you, which can be very motivating for some of my lower level students. I wish I could make it make a noise when it was touched but it's handy.

- Photo Booth - Also standard on the Ipad and I use basically as a mirror with a bit of fun attached due to the extra features.

- Dexteria - this app purports to be developed in conjunction with OTs. It has 3 games: Tap It, Pinch It, and Write It. Tap It requires you to place a flat hand on the screen and tap the finger that is indicated. I haven't had any kids in the preschool or the other areas I cover that have been able to get through the calibration, let alone the game itself. I find that the Write It game is too unforgiving for even my older and higher level students. Pinch It is my favorite of the games. It starts with stationary crabs, progresses to moving crabs, and then adds in visual discrimination in the color of the crabs. It can be difficult to get a perfect pinch on the crabs, and the red/green crabs aren't exactly kind to the colorblind. But it is a fun game and the kids like it. It also keeps track of the times for all the levels and you can review it later after the session, even after switching to another app.

- iWriteWords - probably my favorite app for tracing letters. It has a "connect the dot" feel as you trace the letters and short words. It was forgiving enough for most of my kids to be able to succeed, without losing the intent of the letter formation.

- Sam_Phibian - this is a really cute game that works on a lot of concepts. Little bugs of different colors fly by Sam the frog and he needs to eat the designated number of each kind. If he eats too much, he falls off his lily pad and is eaten by an alligator (implied). The bugs move in different patterns and speeds, and there are also fun things to eat that will put outfits on Sam. Kids love making Sam eat things by tapping like crazy. Following the instructions was too high level for most of my kids, but might be better for your caseload.

- KandyFish- I like this app. The music can be kind of annoying, but it is cute. In this game you can choose color matching, pattern finishing, or tracing (prewriting) games. There is also a coloring feature. I like that you can control which game to play, and skip through the prewriting shapes to get the one you want.

- AMaze Yourself- This app allows you to create mazes of different sizes and guide a mouse through to find his cheese. It's nice to have unlimited mazes that can be so easily customized but the sensitivity is very poor, so it was very frustrating for the kids to try to get the mouse on the right path.

- Pocket Pond- we have the free version which is kind of limited in what can be added to the pond. But my low vision kids like the sound that they get for touching the screen.

- Tanganku- This game presents as having potential but didn't really pan out well for me. You're presented with multiple colored moving dots and asked to press the black ones. But the touch controls don't seem to be sensitive enough to consistently activate. And there's no way to customize the game, it progresses in speed and difficulty no matter the accuracy of the user. It uses the same pattern for each game and only lasts about a minute.

- Monkey Preschool LunchBox - I have yet to meet the child who does not like this game. There are puzzles, counting games, identifying colors, and identifying differences games all presented in rapid fire with an animated monkey dancing every time you get something right. It also lets you pick a virtual sticker for every 3-4 games done correctly.You can't pick the games or difficulty level, and there's no automatic continuing if you struggle badly on a game. But kids love this crazy monkey... it was a major reinforcer.

- Caseload Tracker - This is an app developed for SLPs to keep track of their school based caseloads, when reports are due, what their IEP goals are. I had caseloads of 80-120 kids, and was not about to tappy-type in each kid's name and goals when I already had this information elsewhere. We had an online IEP system so goals were available there, and also usually printed out in a binder for the specific school. Simple charts accomplished all this a lot easier for me. Even with the few kids I tried this out for, I didn't really find the app useful.

- Redfish- this app comes packed with a lot of additional games that may not be readily apparent in the description. There is a regular piano which will do playback of your song, as well as a funny noise piano. There are puzzle games, different activities for each letter of the alphabet, and various games to encourage understanding of cause and effect. I like the variety of games involved though some are pretty limited.

- Labyrinth LE - remember the old wooden labyrinth games with the metal ball? Super fond memories for me of my great-grandma's house. This app allows you to get the same effect on the iPad. I think you were able to choose which level to try, but I can't remember. I thought this would be a great praxis task, but it was extremely hard for my kids just to hold the board steady. Most needed HOH assist to stabilize and grade their movements.

- Tangram - This is a very basic tangram game that allows you to choose which picture you want to attempt. You can touch the pieces to drag into place. My kids had a hard time understanding how to flip the parallelogram and how to use 2 fingers to turn the pieces. You get a really cool fireworks display if you complete the puzzle, but the sensitivity is off so even when the puzzle looks complete, it doesn't register as complete.

- Injini Lite - This is a great game that I continue to recommend to iPad owners for their kids. This app offers tracing, pattern recognition, matching and some easier cause and effect activities for kids. You can choose which section to work on and it was pretty reinforcing for the kids. The full version is expensive but the lite version is a must-have.

Other helpful app resources:
AOTA 'Appy April series
AOTA list of OT related apps (members-only content)
Advance Magazine Speaking of Apps
Army OT Guy's Apps for mTBI

4.23.2013

#AOTA13 Social Media Presentation

I wish I was preparing to head out to sunny California and join the OT A-Team in the second edition of our social media presentation, but let's be honest: if I haven't had the baby yet, I'm probably taking a nap. Here is some supplementary information to my part of the presentation.

Title: What’s New in Digital and Social Media for Occupational Therapy?

Short Course 328 Saturday 2-330pm

Digital and social media can facilitate interventions with clients and advance occupational therapy practice. In this era of constant change it is difficult to keep up with the latest tools. Presenters will share their knowledge and expertise about five key categories of digital and social media essential for practice.

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My category is networking- how we develop relationships and communicate online. You can watch my presentation on video here. Most people are familiar with social networking sites (Facebook, LinkedIn, Google+ and Twitter) but may not be aware of how to use these for professional development. There are also niche communities for therapists such as OTConnections or OT Exchange. Mainstream networks have an advantage over niche sites of greater usage, wider functionality, reduced cost, integration with other sites.

Here are some of the ways that you can use networking websites to advance your professional development as an OT practitioner.

Most people are familiar with Facebook since it has an estimated billion monthly users worldwide (http://newsroom.fb.com/Key-Facts). Website is open to anyone with an email address and allows you to “friend” people you know, “subscribe” to public updates of others, and “like” pages representing brands, public figures, or organizations.

Many groups use Facebook because the wide usage is a great way to get lots of members for brainstorming and crowdsourcing of ideas. Group pages currently represent a way to start discussions, share resources or files, and host events. Some of the most popular Facebook groups are in the “4OT” series- OT4OT, AT4OT, MH4OT.

Public pages are a way for organizations, brands, or public figures to present information to the Facebook community at large. (These pages used to be truly public, offering a free website service, but this has changed) Page owners try to communicate with those that “like” them but can be limited by changing algorithms and restrictions from Facebook on number of posts allowed or likelihood of those posts to show in a person’s newsfeed.

Some of the negatives regarding Facebook usage include frequent changes in privacy and features without notice, the lack of control over what exactly appears in your newsfeed, and the advertisements (some of which are less obvious than others). Facebook is also publically traded and trying to turn a profit.

Exemplars: OT4OT group connects therapists around the globe as they share resources related to online technology and occupational therapy. Kawa Model page gets interaction from OTs related to the Kawa River Model.

Twitter is a microblogging site allowing only short updates of 140 characters or less. This provides a quick platform to provide a status update, share a link, or interact with a wide audience. This is an easy way to connect with peers or engage in upward networking with a public figure or organization. Hashtags allow for ongoing conversations on a subject or event.

Twitter chat can be topical or during events and offer a way to share resources, connect to other professionals, and process information in real time. Some offerings for OTs include the expanding #OTalk brand ( #OTalk2us #anzOTalk ) #occhat #aota13 #ot24vx. The 24 hour OT Virtual Exchange lecture series is a setup of live OT lectures presented via web video, which gets great worldwide attention on twitter. Anita and Chris have also been using twitter to solicit interaction from international participants for the OT classes they teach.

Twitter chats shouldn’t be carried off as a lecture. The best ones are dynamic between participants. Sometimes this is accomplished by having specific questions also tagged in the post, or by a few participants having a side conversation marked by their names. This should not be considered a distraction, but a separate learning process to synthesize ideas. Just as some people learn better by doodling or talking during an event, these ongoing discussions can help a person achieve a deeper learning than just sitting idly by.

Some of the disadvantages of twitter are that you are limited to a short phrase to share, so it can be hard to explain something in detail. There can be a large flow of information which can be overwhelming for some to manage (though tools like Tweetchat and aggregators can assist in this). While there are private messaging options, most conversations are very public. I sometimes have to unfollow people even when they are interesting because they have too many tweets or too many replies cluttering the feed… conversely, if you do not post very often your tweets may get completely overlooked.

Exemplar chat: #OTalk -the original chat runs biweekly out of the UK (Tuesdays 3pm Eastern) on various topics related to OT. Make sure that you also check out #OTalk2US one Sunday each month at 7pm Eastern. Exemplar user: @gilliancrossley who tweets her blog posts, helpful OT info, and participates in multiple chats.

LinkedIn is a professional networking site designed to contain only people you actually know to advance your business world connections. It allows you to build an online portfolio showcasing your work history, projects, and awards. You can see connections of your contacts to try to gain an introduction into a particular company. You can also search for jobs or be contacted by a prospective employer if your profile is set up in this manner. Group pages allow for discussions related to an overall topic.

Some of the downsides of this site that I have found are the frequent requests to connect from recruiters, lack of variety in group posts, and inability to message a person you may be acquainted with.

Google+ is part of the integrated google platform that allows you to subscribe to individuals’ posts and categorize them into interest circles. The advantage over groups here as opposed to other sites is that you can integrate easily with Google Drive to share and edit documents and video chat. The open video chats are a unique and worthwhile feature. There are a number of other features which do not have to be used in a “social” manner, such as automatic photo backup and updating your contacts on your phone. Google also uses its trademark algorithm to try to find interesting posts and people for you to add to your circles.

While Google is a household brand and has a variety of products (search, Android phone/tablet platforms, calendar, drive, etc), Google+ still needs to gain active users to really gain momentum. Social sites are only useful if their participants have a number of active connections.

Individual blogs can also be a way for networking to take place. Frequent commenters can develop a community as they interact with one another over posts. Some of the qualities I look for in a good blog are frequency of updates (I prefer between once every 2 weeks to 3x/week), quality of writing and posts, and ability to foster interaction on the page. Tonya from TherapyFunZone has been trying to encourage monthly link-ups of fun activities in the comment section, and YourTherapySource also is good about encouraging interaction. The exemplar for a true networking community on a blog would be the Mothers in Medicine blog, which has a group of authors who also comment frequently on others’ posts as well as a large group of followers that comment also.

Trends in networking

Peer to peer communication remains a main use for social networking sites. But now it is becoming far more common for users to engage in upward networking- contacting celebrities or organizations directly and expecting a response. In the general usage, power companies are responding to users directly when issues arise. AOTA has really improved in the past 3 years of responding and recognizing OTs on social networking sites, and is great about answering questions.

The netiquette for making new connections varies on the context and an individual’s preferences. I prefer to keep facebook friends to people who I actually know and am share more with those I am close to, but others (cough cough Erik) are fine with maintaining a more public presence. Most people keep their Twitter accounts open for all to follow. I try not to follow too many people as it can be too distracting for me. Facebook, Twitter, and Google+ all offer options to subscribe to public posts, instead of needing approval.

Integrated options are gaining ground across the web. These can offer ease of use if you no longer have to remember multiple logins but beware, this log in can follow you and be a sleeper program in the background. You may be unknowingly acting as an advertisement on your friends’ pages or affecting their search results. The use of your login may also give the site or application access to your friends or other private information. Social reader options are not taking off because people want to be able to read in peace.

We are also seeing a big uptake in mobile applications for online sites and organizations like Google and Facebook making their own phones. We now expect applications to work across multiple platforms to be useful. In the US, this is a matter of convenience, I want to be able to access information while on the go or without having to boot up a computer. But in many countries, access to the internet is primarily through mobile devices instead of computers. So mobile usage becomes essential for any connection to the international audience.

Most of the popular sites are basically stealing each other’s ideas and features. As Pinterest gained momentum, you saw an increase in visual media usage for the other sites, such as Facebook acquiring Instagram and Google+ encouraging users to share their uploaded photos. This feature thieving is at a point where some of the main social media sites are becoming bogged down with features that have been rushed to market in attempt to compete, and may not be fully functional or bug-free. I believe that this trend, along with the frequent changes in how content is presented and privacy is managed, is why many people take a hiatus from social networking.

My keywords for social networking are integration, moderation, separation, and filtration. I want to integrate my participation into routines that I already have instead of trying to start an entirely new habit. For me, this also means that I prefer to use applications that work on both my computer and my phone so that I have multiple options to access when I have the time. I moderate my screen time and don’t feel bad about un-following or un-friending if I find that someone’s posts aren’t helpful to me or are too time consuming. You also shouldn’t feel bad about having networks that you prefer and ones that you don’t use. I keep my personal and professional lives separate online to an extent, which I think helps me stay less stressed and better balanced. Similarly, I try to filter what I allow in and what I put out. Thinking before I post or add someone else to my circle has been helpful. By following those principles, I can keep my overall media time low while still getting the useful professional development and lighthearted fun that I want. Social media usage can easily be balanced into your life to facilitate professional networking in an innovative way.

Overall, there are many options for OTs to find professional networking and information sharing online. Experiment with a few sites to see what works best for your interests, learning preferences, and time available.

Check out my superb cohorts:
Anita @virtualOT TechnOTs blog
Chris @chrisalterio ABC Therapeutics blog
Erik @armyOTguy Army OT Guy blog
Karen @funkist Miss Awesomeness blog

and I believe special thanks is owed to Allison Sullivan @allisulliOTprof for running a twitter chat during the session (#SoMeOT ) and Bill Wong @billwongOT for assisting with streaming video.

4.12.2013

What a great week!

I'm going to break my Tuesdays-only rule for a Friday post because this has been an awesome week!

First, I was the featured interview this week for Abby's blog (Notes from a Pediatric OT) in her OT's Perspective series. Be sure to check that out, but be prepared, I'm my usual wordy self. There are also some pictures that you may not have seen before, including one that features my swan neck deformity, lol. Be sure to add Abby's blog to your list of good reading to follow!

Then, before I even got to return to my normalcy, I also got to pop up on the AOTA Checking the Pulse blog! Stephanie Y is doing an 'Appy April feature where AOTA members get to describe a favorite app and how it helps them. I discussed how I use the Due Today app on my phone (combined with ToodleDo on my computer) to keep up to date on all my to-dos.

Teaser alert- if you like info on how to get organized, I do have a more explanatory post of some of my methods with pictures coming up in early May, so watch for that!

Additional teaser- I finished my video presentation for the AOTA conference! If you can't go to the conference, you will be able to catch our whole presentation streaming online, just pay attention on twitter for details. I will also have a blog post that week that goes into a bit more detail on some things, because we have already established that I am wordy.

Have a great weekend!

3.19.2013

#10minTues - Advocacy on the Quick

Often, when I talk with people about OT advocacy, they are interested but not really sure where to start. They also want to avoid a big time commitment. Here's a few super-quick ways for super-busy people to still take action.

First of all, are you an AOTA member? Because if you care about OT being represented on a federal level especially, then you need to join. AOTA (just like other professional organizations like the AMA) can only claim to represent the practitioners who are actually members, not all the OTs in the country. Also, the political action committee, AOTPAC, cannot take money from non-members. So if you're an non-member OT/A who benefits from the work that AOTA is doing (and you probably do), that would make you dead weight. Don't get offended, just get active. TOTAL TIME: 15 minutes to setup

AOTA has this great resource called the legislative action center. Using this literally can take less than a minute, and still is a way to make a big impact. I get an email from an AOTA staffer describing an action alert- here recently it was the Occupational Therapy in Mental Health Act (HR 1037). (sidenote, when your job title is in the title of the bill, it is a BIG DEAL. Action cannot be delayed.) Staffer sends a link to the action center, and since I am already a registered user, it knows from my saved zip code who all my senators and representatives are. Then it provides me with a form letter (which I usually change, and is why it takes longer than 1 minute) and automatically emails it to all the right people. Baddabing, baddaboom, it's done. Occasionally I get an email (or even a letter!) back from the congressperson's office. And your representatives seriously do care what you think on issues. There are so many bills in and out everyday, they don't read them all, and if a constituent has an opinion, that can sway their vote. TOTAL TIME: 5 minutes to setup, 1 minute or less thereafter

Social media is changing how issues are communicated. As it is now, I get detailed emails from the state legislative staff (by virtue of my Advocacy VP position in my state organization) but I can't read them all in-depth. What I do read are the Stop the Therapy Cap facebook posts, and the updates I get on twitter from the organization and legislative staff. I'm already on those sites, and getting a quick update on where the issues stand as I'm browsing through is so simple.TOTAL TIME: 2 minutes to setup, 1 minute or less thereafter

In the same way that social media has affected our information acquisition, so has mobility/portability. I like things I can do from my phone instead of tied to my computer. So while I know I can look up online various bills and what my reps are doing, there's an app for that- (and it's a free one!) called Congress (Android and Windows) or MyCongress (Apple). The free app helps you find your reps via zip code and allows you to favorite them, giving you quick access to how they're voting, their committees, and a way to contact them. You can also favorite bills to check their status. If you're super involved you can get push notifications on when committees are meeting or when a hearing is going to happen for your bill. TOTAL TIME: 2 minutes to setup, 2 minutes or less thereafter

So many people are afraid to get involved with advocacy efforts. Don't be! By virtue of being an OT practitioner, you are an expert in OT! Share that expertise with the people in power using these quick methods. Feel free to share your preferred ways to advocate or other advocacy questions/concerns you have in the comments below.

Additional resources
Want to do Advocacy? There's Something for Everyone by AOTA
AOTA Advocacy section
Lifehacker article How to Discuss Politics Without Sounding Like an Idiot (has info on the apps)

3.11.2013

Advocate Or Be Replaced

This is an article from the American College of Sports Medicine on fitness trends expected to be sought after in 2013. The stated purpose is to assist their readership (Athletic Trainers, exercise physiologists, personal trainers, "fitness specialists" etc) in continuing profitable business. Here are the top 20 trends that they identified.

This list provides some things to think about. Here are a few that sprung to my mind.

#1: Educated, certified and experienced fitness professionals: sounds like a no-brainer, right? No one wants to think that the person helping them in their fitness quest just walked out of a high school weightlifting class and is now using that as their entire knowledge base. But with a personal quest for certifications and increased legitimacy comes a professional quest for licensure in attempt to get a greater piece of the monetary pie.

#8 Functional fitness: some of this is the Crossfit movement, and some is also code words for "daily activities." We OTs feel very protective of ADL however it is a phrase that is increasingly being inserted into practice acts for physical therapy or athletic training.

#11 Worksite health promotion: There are great OTs who work in industrial settings, though this is still more of a niche or emerging practice area. One piece of wording that you may need to watch for is the term "industrial athletes" which may be applied to military or first responders (firefighters, police, EMT). This may affect whether those individuals would be referred to an OT work-hardening program or an athletic trainer.

#19 Reaching new markets: This makes sense for a business. There's only so much you can do with your current market, and to increase your business, you must bring in some new consumers. Outreach to new markets may include consumers who were not previously service users before, or it may include individuals who were using OT and try to replace that service with something else. There's only so much "insurance money pie" and everybody wants their slice.

Pay attention to who is trying to get licensed in your state, and how they're defining their scope of practice. Does it properly encapsulate their training? Is it going to try to restrict your practice? You might be surprised. I'll admit that I come across as paranoid and defensive, but it's much easier to start from that position and work toward a mutually beneficial middle ground than to assume that every other profession is out to play nice and that we should be nice too. Remember what AOTA President Florence Clark said: It's not playing nice- it's playing dead!

If something is happening in your state and you need assistance, contact the AOTA state affairs group. The staff is excellent at analyzing legislative issues and can help you in responding appropriately. Just one more reason you should be an AOTA member. Also, please consider donating to AOTPAC, they are the only people fighting for OT on a national level.

9.04.2012

Acute Care Tricks

There are so many OTs in the Acute Care/Hospital setting, and yet sometimes it's as if we're the black sheep of the OT family. There's not a lot of OT research done in the field, we must work within the medical model, and turnover of patients and therapists is high. I remember when I was getting started, I borrowed books on PT in acute care to try to bridge some knowledge gaps and vowed that there should be more on the role of OT. (click through to continue)

After spending four years in the hospital system, I had made up a list of topics that were relevant to OT in acute care that weren't covered well in my textbooks and had decided to do a series of serious blog entries covering these topics. Of course, this was in my +50 hour work week and long commute days and just never got it started. That is about the time that I saw this book coming out, and while I was excited, I was also really depressed about not doing my series ahead of time, and I stopped writing on the topic for awhile. (I haven't been able to see the book yet, but based on the contents I think that it would be really good for people new to the acute care setting)

Anyway, that's a really long intro, but I wanted to share some of the off-book tips for acute care therapists (many of these would be relevant to physical therapists as well) that I've developed (or stolen from smarter people) over the past few years.

- learn to get good at manipulating equipment. If you don't know what it is, what it does, or what happens if it gets disconnected- ask and figure it out. A good nurse friend will come and disconnect IVs, foleys, and PEG tubes if they're able to per order. Ask people to show you how to pop the ICU monitors off the wall. Stack your O2 tank on the IV pole, hook a chest tube on a walker, pin loose drains to the patient's gown... possibilities are endless. Pay attention to what the good nurses and techs do and take a page from them.

- double up on everything. Think you need 2 washcloths for your ADL? Better bring 4. Because one will drop on the floor or get really dirty and you'll need another.

- Be creative with what you have. You can't carry a lot of items with you in acute care, so nothing can be a unitasker. A mitten (used to keep people from pulling wires) can be a ball, which is a good early purposeful activity in the ICU. Objects like a safety pin and comb can be good for fine motor and stereognosis testing.

- speaking of the ICU, if you are working with someone (particularly male) who isn't able to stay covered with a gown and is kicking the covers off, the sleeves of a gown can become leg holes to help keep some modesty.

- Try to make it easy for the next person who comes along. This is a list of things you should return to place before you leave the room. If your patient is anything less than 100% ambulatory, make sure the bed is right beside the chair. Don't leave all the cords tangled up in a corner. And if you can make the bed fresh (or even get the tech to help you during the tx) then it will very much be appreciated. When you're working with someone on their first day after an orthopedic surgery, or any time that you don't feel very confident that the person will actually make it to a chair, you need a different bed changing strategy. As a person is sitting EOB, (maybe as you're taking vitals or the PT is checking something) pull the four corners of the sheets off the bed. Then your helper can put the new fitted sheet and a folded draw sheet on as close to the patient. When your patient stands up, the helper pulls off the old and moves over the new stuff LICKETY SPLIT. Voila! new bed, ready for your person to collapse back onto if needed.

- In a pinch, the back of a sturdy chair can serve as a walker for standing. This usually ends up happening in the ICU when you weren't expecting a person to do any standing, but they surprise you in a good way. Not such a good way that they start cartwheeling across the room, but good enough to get a short stand in.

- lastly, there's one accessory you should never be without. Jumbo safety pins. Stick 10 of them on your lanyard or off your badge tag- they are so often useful.

What's the trick that makes your life in acute care easier?

4.26.2012

Come to my AOTA12 sessions!

Are you in Indianapolis? Then I hope to see you at my #AOTA12 sessions! Read through for details.

Session No.: SC 300
Session Title: (AOTA) Using Social Media Resources Effectively, Efficiently, and Ethically
Session Start and End Times: Saturday, April 28, 2012, 9:30 AM - Saturday, April 28, 2012, 11:00 AM

A panel of bloggers and social media experts will talk about how to integrate various social media platforms into your occupational therapy practice. There will be discussion on using AOTA's ethical guidelines for social media in daily life.

Our awesome panel features terrific bloggers who I hope you're following:

Christopher Alterio (ABC therapeutics)

Karen Dobyns (OT Students Belong)

Anita Hamilton (Virtual OT)

Erik Johnson (Army OT Guy)

Session Number: SC 314
Session Title: (AOTA) State Legislative and Regulatory Forum: Trends, Scope of Practice, Autism, and Health Care Reform
Session Start/End Time: Saturday, Apr 28, 2012, 1:45 PM - 3:15 PM

I will be a panelist discussing legislation in Maryland. This includes our Lobby Night event, working with a lobbyist and our bill review committee. We will also discuss the impact of Maryland budget legislation on OT board and licensure fees and how we were able to advocate.

Hopefully these will be informative to all in attendance and no one will be disappointed with content/delivery/my height/ etc. Saying that I am nervous might be putting it mildly, but hopefully it will all go well.

4.22.2012

Unanticipated Blessings

I'm a firm believer that we cannot control our whole life and that things are orchestrated with a reason that we may or may not find out later. This is just a short reflection on how some things (that maybe didn't seem right at the time) have unanticipated blessings that we realize later.

My first job was fine for my first job. I had great friends who helped me learn and was forced to do things I didn't know I could. If another worker hadn't quit the day I accepted the job, I wouldn't have been involved in the pediatrics part of the clinic at all. I had absolutely NO intention of ever venturing out of my acute care box when I took that job, but felt compelled to due to staffing shortages. If I would not have done that, there would have been many kids who didn't get any OT, but I also would not have known that I actually liked working with kids. While I still preferred working on the adult side of the fence, it definitely planted a seed within me regarding the future.

We spent 2 years in Baltimore with massively long commutes so that I could work at a big place. I think that my husband was afraid that if we didn't try this out early in our lives, I would have a mid-life freak out and demand that we move to Chicago or Atlanta so that I could work somewhere demanding. Some days, when I was up til 10 doing notes for that day, it was hard to see the blessings. But they were there. I made some great friends. We had so many things close at our fingertips- great dining, great entertainment, easy access to DC/NY- and we took full advantage of that. One year, we went to 10 concerts, and there was a period when we went to a Broadway show (NY or traveling cast) once a month. Pretty freaking awesome. But the unanticipated blessing may have been finding out that though I identify a lot with my job (and have a blog about it, no less) I don't want it to be ALL I do. I needed more balance, and had to get off balance to realize it.

I usually get the flyer for the AOTA conference and if I am going, start planning the moment it arrives. I have schedules blocked off in 15 minute increments with first, second, and third choices for courses. I pack snacks and never leave the convention center. It becomes an over-planned activity and thus there are many ways for things to go wrong, and I always wind up exhausted. This is my first year presenting, and in being wrapped up with my presentation groups, I have not given any thought to the rest of the conference. I know that I have a flight and a hotel, otherwise, I haven't looked into it. Part of this is that I know I can easily meet the hours I need to renew my license. (by my purely unofficial estimate based off previous years, you can get 24 hours if you bust it, but get 16 without too much effort) And though it seems counter-intuitive, the lack of planning has made me less stressed. I'm not worried about the little things, because the big things seem more appropriate to worry about. And since a large part of the big things is dependent on others, I'm trusting that they'll take care of what needs to happen, so I'm trying not to worry about that either. Taking on extra work and responsibility has brought me less worry time! that is a good unexpected blessing.

Can you think of a blessing that you never saw coming based on the events? Feel free to share.

4.18.2012

April Challenge: Sign up for COOL

I'm really glad that it's Web Wednesday and that we have a nice easy challenge for today lined up, because I am rather jet lagged. Today's challenge should take all of 7 minutes to complete, so I really would urge you to follow through with this! Today, you should be COOL!

If you haven't heard, COOL is AOTA's volunteer database that you can sign up for online. COOL stands for "Coordinated Online Opportunities for Leadership" and lets you identify your areas of expertise and interest. Then you can enter how much time you could be available for. AOTA staff and SIS chairs can then access this information to find fresh new volunteers for their projects.

I think that COOL is a good thing for several reasons. First off, when you are young in the profession, you don't know a lot of people. When you talk with the people who have achieved various positions of leadership, they always say that they got started by knowing someone who invited them to do something little first, and then over time they took on more responsibility until they achieved their current position of awesomeness. But it seems insurmountable when you don't know many people. And I remember being very frustrated because I had time and interest to give, and no way to give it. (I still get this way sometimes, but not often). So COOL allows you to get connected before you make those personal connections.

Another of the benefits to COOL is that having a wider pool of volunteers means that no one gets overused and burned out. Also, you can get introduced to opportunities that you would not have thought of before. This isn't signing up for a lifetime commitment, just offering to be potentially available in the future.

One of the COOL things that I got to participate in was review submissions for this year's AOTA conference. It was simple and done all online, but it was kind of fun to get to feel like I was a part of making conference happen. Have you done a COOL job? Are you willing to sign up? It will take you a lot less time to sign up than to read this whole post, that's for sure!

4.07.2012

April Challenge: Sign up for OT Connections

Are you down with OTC? (yeah you know me!) If you haven't signed up for OT Connections, here's why you should.

There are so few places that are really OT-places. If you want those places to be fruitful and useful, it does take some investment. Not lots of time, but a little.

AOTA rolled out OT Connections (or OTC from here on out, b/c abbrevs r my frnd) a couple years ago. This site combines the old listservs into forums, allowed for the flexibility to form groups, and incorporated a social networking feature with blogs, uploaded files, and friends. Best part- it's free! Anyone can access the basic forums, AOTA members have access to SIS forums and extra forums such as the great RA debates.

There's great stuff on OTC, but it could be better with more involvement. And the first step is just committing to sign up. AOTA members don't even need to set up an account, their existing account information will be the login.

A few quick OTC tips:

-Receive updates to your forums by email (a'la listserv)

-Or you can sign up with an RSS reader and get updates that way (to any post or forum)

-Bookmark the Active Topics to quickly see what people are talking about all over

-Be relevant with your posts. If your post doesn't match the board topic at all, you won't get a lot of responses. If you have a question for a specific person, just message that person directly.

So try it out. I think a weekly check provides a lot of interesting topics to think about. Let me know what you think.

4.06.2012

April Challenge: Place OT lit in a public place

This is a pretty easy, yet effective method of outreach to spread the word about OT.
Chances are, you may have a waiting room at your place of employment. People are looking for something to read besides that copy of Newsweek from 1996. Why not take in some old copies of OT Practice that show some awesome examples of OT in action? This trick can also work at the doctor's office or multidisciplinary lunchroom- provide the reading material and expose the public to OT one little step at a time.

AOTA provides the consumer tip sheets and role of OT fact sheets for free to members- this can help you tailor your efforts appropriately.

If you're feeling a bit more ambitious, I will share the project a PT at my first job had started. She had taken a binder and put some labels regarding gross motor development, fine motor development, speech and oral motor... you get the picture. Then we would place interesting articles in the various sections, to give the parents of our pediatric clients something relevant to read during sessions they weren't observing.

10.25.2011

Our OT Identity

In celebration of World OT Day, we are discussing the Global Identity of Occupational Therapy. It's an interesting topic since there has been a lot of discussion about our national OT identity with the approaching Centennial. I think the best thing that I can share for this topic is my summary of two of the best AOTA sessions from the 2011 conference (and maybe from ever).

Last spring, there were two talks that best fit with the presidential address and stood out as completely awesome. One was "OT Survivor: Protecting Your Turf in a Competitive Healthcare Market" by Pam Toto and the other was "Practicing Authentic OT: Strategies for Becoming a Reflective and Reflexive Practitioner" by Debbie Amini. These ladies are both well recognized in the field. Energy was definitely palpable in both rooms, and I even got to meet (again) Suzanne Peloquin during one session. (If a Slagle lecturer shows up in your room- you know the topic is superb!) By discussing what was reviewed in these sessions, I think we can get great input into our OT Identity.

"What is occupational therapy?"

How often do we hear those words?! Yet Toto points out that each OT area has its own definition. What I do on a daily basis in the school system is nothing like what I used to do in the hospital and that would look nothing like the life of a hand therapist. Even within the hospital, my practice could vary widely from the NICU to the Neuro ICU to the orthopedic floor and so on ad nauseum. Toto said this was like blind men describing an elephant- we tend to describe our practice in a reductionist way of what we regularly do, sometimes missing the big picture of OT. This can lead to confusion from consumers, referrers, and payors. Amini points out that if we want to achieve the Centennial Vision goal of a consistent recognizable image, we much EACH take it as a personal responsibility. The "Authentic" version of OT is client centered and occupation based, with occupation as both an outcome and a treatment. Amini pointed out that this is often an espoused belief of practitioners, but not necessarily an enacted one.

A person may not even realize that they aren't enacting their beliefs until there is an additional level of reflection involved. Amini described reflection as thinking and critically examining yourself, skills, and practice. Reflexive practice takes reflection further by then comparing reflected behavior to espoused beliefs, determine any incongruence, and then act to change the behavior or the belief. This process can be done by personal journaling, mentoring, using the AOTA professional development tool, creating a portfolio, or joining a community of practice. Toto states that one of the best ways to advocate for OT is to practice consistency in areas you address, services provided, assessments and intervention approaches. In doing so, you create an image that others will remember and identify as occupational therapy.

There are perceived challenges to authentic and reflective practice. Amini includes corporate policies, reimbursement, productivity, supply cost, time, and decreased support from peers or supervisors. Toto described threats to our practice: complacency in our documentation (failing to specify our unique practice), viewing OT as a job instead of a career, moving from ADLs to preparatory/adjunctive treatments, accepting the status quo (including that laid down by the boss), and allowing any other service to be a "gatekeeper" to OT. Don't allow other professions to represent you. If your services are special and unique, NO ONE can say OT isn't needed! Remember that documentation is important. It's hard to remember that when you're writing 6 evals a day and don't think they're ever read. But think back to being in school when you learned about how each note was a legal document, the only proof of what really happened with a client. Toto discussed that it is important to use our practice framework language and reference evidence in our documentation. The most skilled part of a person's OT session may not have been the hands-on portion, but the clinical reasoning and decision making you engaged in. And speaking of clinical reasoning- don't short sell our value by saying that it's just "common sense!"

Toto discussed at length the importance of advocacy for OT. We're great at being advocates for our clients to get the best care, but more reluctant to stand up for ourselves. There are a limited number of healthcare dollars, and other groups would love to take our share. We can't be timid and "nice." As Dr. Clark said in her presidential address, if you let others take OT for granted, "it's not playing nice, it's playing dead!" Remember, there is no mysterious "they" who will advocate for you. AOTA and your state association may be able to take action on a government level to defend OT, but without your membership, they are hard pressed to do so. And they certainly won't be coming to all your referrers and coworkers and asserting the OT scope of practice. That falls to each of us. Amini reminds us (especially those AOTA members) to use the official documents as leverage during advocacy efforts.

Toto described that there are two ways to make light- you can be the candle or the mirror. When your client is successful, they need to understand who you were, what you did, and how your intervention has impacted their occupations and participation in life. Discuss and hand out goals. Hand out a business card. Make sure that you identify yourself as an Occupational Therapist and not just an OT or OTA. Have several elevator pitches for different audiences that include evidence. Most importantly, let everyone know the good that you do, so that others may receive your awesome authentic services.

I hope you find these points useful for your daily practice. The field of Occupational Therapy and our consumers will definitely benefit from authentic practitioners. Let's all strive for that in the coming week.

4.23.2011

OT in HD: Presidential Address

AOTA President Florence Clark opened the 2011 AOTA Conference with an excellent presidential address describing the need for OTs to compete.

(Photo credit to Cheryl Crow, videographer extraordinaire, from the OT Connections Gallery)

We live in a world of competition. Especially now, in a time of health care reform where decisions are being made about what services are necessary in the future, we as occupational therapy practitioners need to be engaging competition with (not against) others to ensure our role in promoting occupational fulfillment to the public. Competition needs to be acknowledged. It drives innovation and can improve practice. It's not going away, so get comfortable with it. Victories are won often by teamwork, but always by competition. But, as Dr. Clark said, "let's face it- we're nice." OT attracts people who are cooperative and kind. But if you let others take OT for granted, "it's not playing nice, it's playing dead!"

"HD OT" requires power, and we as a profession need to embrace our collective power. We can't stand alone, but together, we have a power that can't be ignored. As a group, we are witnesses to the "transformative power of occupation" and this must be shared with the public! The public mindset is shifting toward wellness and participation, which is a foundation concept to OT. One example is the case of Congresswoman Giffords. Per Dr. Clark, it was not so much of a question of 'would she walk again?' but one of 'would she run again- for Congress?' People are concerned with the ability to fulfill a role- one of the things that makes life worth living!

Dr. Clark drew some analogies to Rocky, who demonstrates caring and competitiveness, sensitivity and toughness. We have to be "in the ring" during the healthcare debates. We have to bring our "playbook." That includes evidence on our effectiveness, increased grants, decreased hospital readmissions and documentation. Our documentation should not over-emphasize motor-based components, but embrace our multifaceted approach dedicated to the whole person, environment, and occupation. We need to be intensely involved in advocacy to make the message heard- that Occupational Therapy helps people LIVE LIFT TO ITS FULLEST!

A recurring theme of President Clark's address was to strive for "arete," an ancient Greek concept referring to excellence, effectiveness, fulfillment. We each need to strive for everyday excellence in our work, with our clients, and how we represent ourselves. Fire up your competitive juices!

Dr. Clark's message goes hand in hand with 2 other excellent sessions I attended and will share at a later date. I hope that the call to "arete" resonates with you.

4.15.2011

AOTA Conference 2011

The 2011 AOTA Conference: OT in HD is in full swing!

Wow. This has been a truly awesome experience thus far. I know people want updates, and it's so hard to encapsulate because there are a million wonderful things going on in all facets of OT practice. Deciding where to begin is difficult.

First off, I think it has been great to be able to come with a friend. My best friend (also an OT, how convenient) got to come this year and this is her first conference, so it's been exciting to see things through her eyes and have someone to bounce ideas off of and be interested in similar things. It's also nice to have someone to sit in the big sessions with and go out in the evening together. So her presence has made this conference an improvement over others in that regard.

Another "people power" effect is that since I have become more involved in OTConnections, my state association, and NBCOT, I have met a lot of people and it's very fun to get to meet them in person or see them again. I also have at least a fair memory for names and faces, so I will see someone's name badge or recognize them from a photo and say hello. I've had a couple of people spot my badge and ask about various people at the hospital and life in Baltimore and I enjoy those chance meetings. I have gotten to see several of my former professors and had time to catch up with them, which is great. There are such terrific people in the field that by just talking to others in your sessions you can find out great things and see that there are OT revolutionaries all around.

I have been to some very informative sessions on a wide range of topics thus far. Started with a course on Infant Driven Feeding in the NICU, also got to see some ground breaking research on Contemporary Motor Control with guidelines for practice. Today I had GREAT sessions which have warranted their own posts at a later date- a session on being a Survivor in a tough market which segued well into the presidential address outlining benefits of being competitive. I got to be part of an intensive discussion on telehealth with (dare I say it?) other OT geeks, and then the Slagle lecture was terrific. Tomorrow is very up in the air... I have 3 sessions that are interesting in the morning and 3 in the afternoon that all overlap. I don't have a 3 sided coin. and we are planning on going to the AOTPAC night which judging by last year's pictures should be a lot of fun.

I've got a lot of notes from the various sessions and I'm really glad that I took off Monday to process everything.

Looking at the conference program, I realize I saw several of the "pixel people" at sessions today... I've also been able to match up the color photos with the grayscale on the cover... totally dweeby of me.

The updates on twitter under #AOTA11 have been interesting to follow, but I'm only getting them sporadically given the spotty wifi and cheap cell phone coverage. It's exciting to see so many people posting. I hope that people will also go back and use OTConnections more post-conference to make some dynamic SIS-type interactions.

Sorry this is so random, but that's the way of things during this time of sensory overload and OT-awesomeness. There's a lot of excitement tomorrow and I need my beauty sleep! More updates to come after I get home for sure.

1.07.2011

Looking forward to 2011

Goodbye 2010. I don't have the energy for a LONG year in review, but...
I will touch on a few ups and downs of the year.

Firstly, let me thank all readers. I really appreciate the comments (that aren't plugging fake universities or spam in other languages) because I like to see that there has been an effect from my efforts. I don't look at the stats often, but glancing today, I see that since I started tracking in 2008, pageloads have increased by 20,000- more than 300%! WOW! And the cross-posts in the sister blog on OT Connections have brought in an extra 50-350 viewers each time, with one anomaly (thank you 1-minute update). It's really exciting to see how this blog has grown and spread, and gets me thinking about some plans for the future (more on that later). So a BIG THANK YOU to each of you, and please always feel free to comment or email me with suggestions.

Most popular pages on this site continue to be Writing Goals and a Case Study With Goals, which is understandable since this is one of the more difficult skills in OT that is not hands-on. I do intend to spend some time getting back to the 'roots' of this blog and posting about decision making, goal writing, and treatment plans. Perplexingly, a rather random What a Week post is the most read on the mirror site, with the exception of my post about Glee that got picked up by 1-minute update. Ironically, some of the posts I spent the MOST time on (e.g. Metacognition and Serial Casting Case Study) don't seem to be as popular, but I don't have tracking to that degree so I can't be positive. I did get several thoughtful comments on my most emotional post (Struggling as an OT for my Family) so I appreciate that deeply.

2010 was the first AOTA Conference I've been to as a practitioner, and even the first I saw after fieldwork. It was great to re-energize and network with other therapists. I think that as you are in the profession longer, you become more aware of others in the field, so I spotted dozens of OT Celebrities this year and got to talk with many, which was awesome.

It was interesting to see all the uproar in AOTA this past year with the potential organizational changes. As we are heading into election season again I see the new blogs and OTC memberships cropping up and it's always notable to see who sticks with it. Props to Bill Wong for continuing to post, and also to Florence Clark for taking up the mantle of the President's Blog.

There were some serious downers last year. We lost my husband's grandmother to Alzheimer's Disease in the summer, which was very difficult for the family. Then over the holidays, we had several additional hospitalizations of our family members, which have yet to completely resolve. Health is so very fragile and some families are like a house of cards... I am learning to take pleasure in contentment and tranquility, because it can all be very fleeting.

I struggled on my final rotation of the year on the cardiopulmonary floor, made extra difficult by the chronic nature of those diseases. It is hard to watch others' independence fade as their bodies fail, and I felt like the efforts I made brought about little change. There were some truly tragic stories in the ICUs that even made attending rounds difficult. I did my best for them, but I am so thankful to be back with a more stable patient base.

As the year ended, I realized that I am no longer really a "new practitioner." Granted, most of my experience is consolidated in one practice area, and I certainly don't know all there is to know about the acute care setting, but I now have a valuable level of skill. I feel like I could go to any adult hospital confidently and be a skilled member of their team. I caught multiple strokes and other medical problems, which makes me feel bad at the time (I hate to see people doing poorly) but it makes me feel that I am a competent professional doing my best to look out for my patients. I progressed with treating pediatrics by taking on outpatients for a few months and doing some feeding interventions for the infants. I was really proud to recognize self-soothing in the baby I evaluated my last day, because even though it's simple, it shows that I am retaining what I've learned though my time to practice is sporadic. I also had my first true fieldwork student, and I don't think I screwed up too badly or she would not have sent beignets. :)

I have a lot to look forward to for 2011. My goal is to spend less time typing notes at home (which is awful!) and more time being able to participate in my "OT extracurriculars"- this blog, OTC, twitter, association stuff. I am now the VP of Advocacy Relations for the Maryland OT Association and things are already in full swing. We are planning for Lobby Night in Annapolis, and would certainly love your company if you're able to attend. I am looking forward to the AOTA Conference in Philly (a mere 2 hours away) and the MOTA Conference (a mere 15 minutes away). I really enjoy how close Baltimore is to fun and excitement, so I know there will be more trips to DC and NY this year too.

Happy, healthy, awesome new year to all.

6.01.2010

Yikes!

Holy cow... it's been almost a month since conference. Where has the time gone?
I would say that I want to go back... but the time since the conference has been pretty rough as evidenced by the scarce/nonexistent updates. And at such a terrible time, after handing out those nice business cards haha. So, some brief updates.

- I took no time off after the conference, and that was not smart. Next year, I take a day to recuperate and absorb info. I still need to print out handouts- both for sessions that I attended and others that looked interesting- and then compile my notes.

- I went to some great sessions and met more "famous" OTs than ever before. I think that the quality of presentations was very high this year.

- I hope to get a submission in so that I might present next year in Philadelphia, Pennsylvania, April 14–17. I've had a gigundously large and cruddy list of things to do lately, and it's been pushed aside, but I really must do it.

- Speaking of cruddy things to do, I have been documenting at home almost every night, including tonight. I continually wonder how people meet productivity standards and get documentation done.

- April and May definitely kicked off my season of concerts and travel. I have had 1 weekend at home since conference and will not have another uncluttered weekend until July. Obviously I am mixing in some fun times, but it's wearing me out.

- had my first pt. with what I consider a contemporary popular name. I have been mildly wondering what it will be like when nursing facilities have hoardes of Jennys, Kelseys, Chelseas, Kaitlins, Stephanies, Kimberlys and Lindsays... not to mention when the following phase of names ages, leaving us with Tylers, Taylors, Collins', Houstons, Austins and the like as patients.

- I got a really nice bag at conference... messenger bag in a pretty blue with lots of cool features. Got it on the last day of conference. Went to pack it in the taxi to the airport the next day and a clip snapped off. Packed it to work the following day and the snaps holding the strap broke. I was so mad at the people, I said to myself, "I'll show you, I'll go back to my crappy tote bag from before." I noticed later that day that the tote bag, which I had gotten at previous AOTA conference, was from the same darned nursing home. And the zipper is trying to break. Darn you unnamed NURSING HOME!

- Posted on the Acute CareOT Forum about ICU evals. Hope to see that forum stay active. I have been tardy in adding friends I made at conference to my OTC list, but it is very hard to search for people. Feel free to add me.

- Less than a month left of doing outpatient pediatric work. As it was before, part-time peds work is difficult. Been reading up on Developmental Coordination Disorder, want to take our unit blocks (small, interlocking squares) and make lego-like designs with picture instructions to use as a clinic tool.

So, times have been busy and will only continue to get busier. The blogging break was good, if unplanned and ill-timed. I will try to be a little more active before my real vacation comes. Things I intend to do before then (OT related):
-write proposal for AOTA conference
-post more videos from conference
-post all 80-some photos from conference
-write a post on energy conservation for summer travel

Until then... here's hoping there's not too many more late nights documenting from home!

5.03.2010

Joan Rogers' Award during Conference opening ceremonies

To start the first of many shared media files from Conference, I present to you Joan Rogers accepting the Presidents' Commendation during the Opening Ceremony. Video is in the full post. While the technical quality is not superb, the content certainly is.

Still to come- video compilation from opening ceremony dancing, video from Penny Moyers Cleveland's farewell address, photos and videos from expo, photos from conference classes and events. Full uploading to be done at OT Connections.

5.02.2010

Almost Over

Our conference time is almost at an end...
Saturday was a long day, but still had some highlights. I got some good videos and pictures, which will all be uploaded to the OT Connections Conference Gallery either at the airport or Monday after I get home. So if you're not already on OT Connections... get there! I have been talking especially to acute care practitioners at conference trying to get them involved w/ OTC because I feel that we are very isolated in our practice and need to connect so we can determine what is best practice and what is just "facility tradition." It's hard after conference to maintain the same energy and excitement, and I feel that using OTC can help keep that feeling alive longer in the face of everyday work.

Time to go to my last workshop... these Sunday sessions are hard to get motivated for since all the fun and most of the people have gone. Then the exciting time of 6 hours at the airport!

5.01.2010

Notes from Friday

Friday was VERY busy
I think my longest break between everything was built at 30 minutes... one presentation ended early so I wound up with 45 minutes at one point. Chatting with several different people, most of whom I did not know. Had a good conversation about the evolution of the Slagle lectureship with a 50+ year member, which will get written up eventually. Had a good SIS discussion on issues with oncology and a great NICU course.

On today's slate is either a course on acute management of TBI/SCI or a discussion on the AOTA guidelines for CVA/TBI care which are unfortunately opposite one another. Also of course is the address from incoming president Florence Clark. Trying to decide whether to go to the business meeting... I am anti-meeting in general (and this is run in parli-pro style so even more dry than a staff meeting) but they have occasionally been lively with debate. Unsure if they will ratify RA decisions during the meeting. I heard Thursday from multiple reliable sources that the suggestions from the Participation Ad Hoc committee did not pass in whole, though the COOL and other options for increasing leadership will still proceed. A new committee has been formed to deal with restructure of the organization. Some people are obviously happy about this decision, I saw RA members and several folks I recognize from message boards discussing this happily, but there's still a long road to hoe in increasing participation, and I hope someone in the RA is sitting on some good ideas at how to make it work. More on all that later, got to get out the door.

4.30.2010

Thoughts from Thursday

Not only am I attending, I'm here!
Here's some of the cool things that happened on Thursday...
One of the fun parts of conference is that you can meet people I call your "OT heroes," people that you have read about or heard of that are fairly famous in the OT world. Yesterday I ran into Chuck Willmarth and Tim Nanof from AOTA, Paul Fontana of industrial rehab and lately elected to AOTA position, The editor from OT Practice whose name has unfortunately slipped my brain, Ingrid Kanics of play center fame, and Salvador Bondoc and the other leaders of my PDSIS. And of course, Frank Gainer was ever-present, I always consider him the conference guru because any time I've ever had a question during conference, I could find him and he would have the answer.

Went to some interesting sessions yesterday and got some good pictures from wandering around and also during opening ceremonies. Opening was awesome, with the floor literally bouncing up and down as people danced in the aisles. Seated next to me was a woman from the Netherlands, who was astounded at all the action and the great turnout. I have some videos of different parts of the opening fol-de-rol and also took a fairly good video of Joan Rogers (sp?) receiving the Wilma West Award from AOTA & AOTF. Hopeful to get that up for viewing soon, just need a slightly more stable internet connection.

Got to get going now- have a workshop on the NICU, SIS roundtable to discuss outpatient oncologic rehab, and some other cool things in the afternoon which have slipped my mind.

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