OT Month Celebration

Washington University Occupational Therapy works with many healthcare providers, physician groups, living facilities, and community organizations to provide the best care, When & Where our patients need it most. During the month of April, we will be celebrating OT Month and promoting all that our providers and colleagues in the field do for our adult and pediatric patients. To our Community Practice Therapists and Therapists at the Milliken Hand Rehabilitation Center, thank you for all that you do for our patients our clinic wouldn’t exist without you and the expertise that you bring to the field of OT.  Please take a moment and see what the field of OT has been able to contribute to the daily well-being of patients. Learn more about Occupational Therapy from AOTA.

Expanding To Washington

Ryan Risley, MPM, meets with contractors just weeks before OT Services’ new clinic in Washington, Mo., is set to open. The 2,500-square-foot space is located approximately 50 miles west of downtown St. Louis in Franklin County. It is the culmination of four years of research, strategizing and planning for Risley, the manager of practice development for the Program in Occupational Therapy’s clinical operations. OT Services therapists will provide general and specialty patient care in the clinic and in home, school, workplace and community settings in Washington and the surrounding area. Risley has not only a professional, but also a personal, stake in the clinic’s future success: Washington is his hometown, and he is fully invested in the health and well-being of his community.

Expansion planning

Risley recalls discussing expanding OT Services’ footprint in his first interview with Pat Nellis, OTD, OTR/L, the director of the Division of Clinical Operations, more than four years ago. “Right off the bat, we discussed what the one-, three- and five-year plan should be for clinical services. One of the five-year goals was to be experiencing growth at a level where we could branch out to another satellite clinic,” Risley says. “Pat is a big proponent of rural communities having access to health-care services, so I conducted competitive market analyses of surrounding counties north, west and south of metro St. Louis.”

Risley dove into key data points such as population growth, demographic data, chronic disease prevalence, insurance provider options, and payment mechanisms. There also had to be future marketing opportunities and economic development in the area. “We wanted to offer that access to health care, but it had to be a solid investment as well. I put together market scorecards for each area to present to Program leadership and discuss which location made the most sense for us. Washington checked all the boxes, even though it is in a competitor’s area. However, they don’t offer the same services that we do,” Risley says. “That being said, we knew we could leverage our existing brand and bring our personalized, one-on-one approach to the area and beyond.”

“Washington University has such a reputation for excellence, and our occupational therapy services are vastly different than what anyone else offers,” adds Nellis. “We’re committed to making sure those living outside our urban reach have access to what we have to offer. Rural Missouri deserves the best, too.”

A hometown perspective

Risley was 4 years old when his family moved to Washington after his father was relocated there for his job and has lived there ever since. He has seen the area go through a period of tremendous growth in recent years.

“In high school, I remember the downtown area being somewhat stagnant. Downtown Washington, Inc., a coalition formed in 1989, had a vision for the town to serve as a center of commerce in Franklin County. Farmland at the main intersection of highways 100 and 44 were sold, and businesses started moving in. Fast-forward to today, and the real estate market is much different . Downtown is booming with commerce, so finding clinic space that fit our needs was a challenge,” Risley recalls.

After traveling extensively over the county, Risley eventually found a space for lease in a former sporting goods store situated in a complex adjacent to a Walmart Superstore and next door to a Department of Veterans Affairs Clinic Office with a flat parking lot and spots right by the entrance. In November 2020, he and Nellis presented the pro-forma report to Program leadership and to the Faculty Practice Plan (FPP).

“The original space was 5,000 square feet, but we only needed half of that. We set up meetings with FPP and worked with the Dean’s office to negotiate the lease. Then we started working with the architects and a design group to build out the space. We wanted an open floor plan and treatment space in addition to private rooms for one-on-one and telehealth services. Accessibility was a priority; we want to accommodate all clients, including those with mobility issues. They can park right in front of our clinic and enter without any obstacles,” he says.

Forging partnerships

While finding the right clinic space was certainly a priority, so was forging partnerships with local community providers and organizations to promote the clinic and its services.

“I met with the Franklin County Health Department, the Franklin County Community Resource Board, assisted living facilities, and area physicians to name a few,” Risley says. “Another health-care system has been firmly planted in the area for decades, but my approach has always been to offer our services as another option for providers and patients. Therapy, especially at the beginning, can require two or three appointments a week. We may be able to see the patient sooner, or the clinic might be easier to access. We’re here to serve the community in whatever way we can.”

Risley anticipates that the expertise of Milliken Hand Rehabilitation Center therapists will serve the needs of people who have experienced a work injury or the effects of aging. “Washington and the surrounding area are home to many manufacturing and agricultural industries. I’ve met with several workers’ comp physicians who see patients with hand, shoulder and upper extremity injuries or who experience ‘wear and tear’ on hands or joints from repetitive tasks. Hand function also decreases with age due to rheumatoid arthritis, osteoporosis and even Parkinson’s disease. Our therapists provide services to address and support all of these conditions.”

The move to Washington is also an opportunity to expand existing community partnerships. Pediatric therapist Karen Balk, MOT, OTR/L, will provide services to families with school-aged children, and Katie Bogan, OTD, OTR/L, will be able to use the clinic as a base for early intervention services through the state’s First Steps program for children from birth to 3 years of age who have disabilities or developmental delays. Aging Ahead, which supports older adults and their caregivers, provides programming in senior centers throughout the area. “We are already connected with Aging Ahead in the St. Louis region, and they are interested in working with us in Franklin County,” says Risley, who attends the agency’s monthly meetings. “The Four Rivers YMCA will be hosting their annual adult literacy event; we plan to be a part of it.”

Open for business

The Washington clinic officially opens its doors on April 11. Several existing patients who drove to other locations for care are now able to schedule their visits closer to home. Therapists Stacy Baker, MS, OTR/L, CHT, and Jill Jonas, MSOT, OTR/L, who also live in the area, are looking forward to seeing familiar faces and meeting new patients.

“Patients I’m currently treating at our Milliken Hand Rehabilitation Center Chesterfield location are eager to come see me at our new Washington clinic because it is closer to their homes, and they appreciate that,” Baker says.

Risley is already planning to bring the latest service line to the Washington clinic. “We now have therapists providing support, recovery, and rehab services for COVID ‘long haulers’ that address lasting effects such as fatigue, brain fog, and task management. Jamie Archer, MOT, OTR/L, and Debbie Turley, OTR/L, are already seeing clients in St. Louis; I imagine those services will be needed in Washington as well,” Risley says. “I’ve long referred to occupational therapists as ‘the engineers of the healthcare field.’ They provide solutions so people can manage their health and get back to the activities they want and need to do. I’m proud to bring our therapists to the Washington community.”

Photos of new clinic in Washington, MO

Common Sense of Learned Skills?

Parents – does this sound like you?

  • I don’t understand how you’ can get 100% on your math test but you forget to turn in your homework every day!
  • You’re so great a building complex Lego kids, but why can’t you organize and clean your room better?
  • The refrigerator is RIGHT THERE! Please just open it and put the milk back in next time rather than leaving it on the counter.

If so, then you are most definitely NOT alone!

Some of these skills may seem like common sense. Skills in one area, like math or tinkering and building, are strengths for our children. But these skills don’t necessarily translate to other important areas of functioning, like remembering to turn in homework or organizing a messy room (which have nothing to do with intelligence).

When looked at through a lens of discreet skills that are actively developing in our children, then we see a more comprehensive picture than just “smart” or “logical.” We start to see our children’s skills of organization, time management, working memory, and planning. Then, we can start to provide direct and specific strategies to support the development of these skills.

Called executive functions (EFs), these can set your child up for not only school success but for life success, as well. These higher-level thinking skills, like working memory, planning, and attention, are so important that the Center for the Developing Child at Harvard University reports that “individuals and society experience lifelong benefits” when opportunities to learn and practice EF skills are presented. And research backs up that EF skills can be explicitly taught (Takas, Z. K. & Kassai, R, 2019).

WashU’s Program in Occupational Therapy offers just such an opportunity for your 9-16 year old each summer. The Train Your Brain summer camp is a week-long, half-day program for your child (with or without a diagnosis that affects EF skills) that explicitly teaches time management, planning, goal setting, and organization through engaging STEM projects. Different than other science or STEM summer camps, Train Your Brain uses STEM projects as a means to an end of learning EF strategies that campers can take with them to use at home and school.

So if you see yourself in the statements at the beginning of this article, take a look at the Train Your Brain summer camp and consider giving your child an opportunity to learn and practice important life skills.

 

COVID-19 Recovery Resources

Occupational therapy’s goal is to help patients utilize their strengths, maximize their potential, and counteract their limitations to help them meet their goals. As we continue to see rising numbers of COVID-19 cases, our team is here to work with patients recovering from the physical and emotional challenges patients may be facing from the virus. Please read through this article and see below for some COVID-19 related resources that you can share or contact us regarding OT Services for COVID-19 Recovery & Rehab.

 

COVID Recovery Website Resource

Mindfulness Resources:

Mindfulness is being present and aware of what you’re sensing and feeling, without interpretation or judgment. Mindfulness has been shown to improve mental health, cognition, and sleep quality. Mindfulness helps you pay attention to what is happening, which may enhance your memory, as well. Paying attention to your surroundings and yourself can lead to insights about current stress levels and help you respond with a sense of calm. There are many ways to practice mindfulness. Listed here are some resources to get started.

 

Stress Management Resources

Self-Compassion Affirmations
Caring for yourself not only makes you feel better, but research shows that self-compassion makes you more likely to care for others, as well. Repeat these affirmations to yourself.
  • I accept myself as I am.
  •  I am enough.
  • I am worthy of compassion.
  •  I allow myself to make mistakes and learn from those mistakes.
  •  I let go of the old and make room for the new.
  • I am resilient.
  • I nurture myself with all the kindness I would shower on someone I cherish.

Progressive Muscle Relaxation
Tighten each body part for 5 seconds. Release for 10 seconds. Repeat for all body parts listed.

  • ï‚· Forehead (raise eyebrows)
  • Mouth (smile wide)
  • Eyes (squint)
  • Head (tilt up)
  • Hands (clench fists)
  • Arms (flex biceps)
  • Shoulders (raise arms)
  • Upper back (shoulder blades together)
  • Chest (deep breath)
  • Stomach (deep breath)
  • Low back (arch)
  • Buttocks (clench)
  • Thighs (press knees together)
  • Feet (point toes toward the sky, then ground)

Grounding Techniques to Reduce Anxiety in the Moment
These techniques may help distract you from anxiety and refocus on what’s happening in the present moment.

  •  Pay attention to what you are touching, smelling, hearing, tasting, and seeing.
  • Focus on your breathing.
  • Take a short walk.
  • Move around.
  • Do math problems or count backward from 100.
  • Recite something you know by heart.
  • Describe what’s around you.
  • Picture the face of someone you love.
  • Sit with a pet.
  • Visualize your favorite place.
  • Listen to music.
  • Put your hands in water or hold a piece of ice.

Keep Kids Active During Summer Break

While the school year might be over and “traditional” learning is on pause for a few months, the summer is a great time to help kids continue to learn and gain skills.  Keeping kids active and learning over the summer helps make sure they are ready for the grade ahead and don’t regress in any areas.  The summer is the best time to try out new and exciting learning opportunities that are hands-on and engaging.

  1. Explore local attractions. Within the St. Louis metropolitan area, there are so many great local attractions to check out.  Even if you have been to these places before, there are always new things to explore and new ways to keep your child learning throughout the experience.  If you go to the zoo have your children plan out on the map how they are going to get around to see their favorite animals, or if you go to the botanical gardens have them practice their reading skills by reading out loud the postage signage.   Regardless of where you go there are so many opportunities to keep children learning while at our local attractions.
  1. Attend a local summer camp. While all camps are great for keeping kids active, if you want to keep your kids learning over the summer look for camps that focus on science, art, and other educational skills.  Washington University Occupational Therapy offers its’ own summer camp for children ages 9-12 and new this summer 13-16 yr olds with executive function difficulties (difficulty with planning, organization, goal-setting, task monitoring, etc.).  If interested in learning more about this camp, see the link below.

                   https://otservices.wustl.edu/items/trainyourbrain/

  1. Explore the outdoors. Thankfully this summer has more opportunities to experience indoor attractions due to more things being open and available, but it is still important to spend time outdoors.  Whether this is going for a hike and learning about the leaves and trees around you, camping for the weekend and problem solving on how to pitch a tent, or trying out fishing for the first time and researching the different species of fish, each of these opportunities provides a fun experiential learning experience for kids and parents alike.
  1. Cook together. Cooking is a great home-learning opportunity that combines math, science, and reading skills.  From picking out a recipe, getting and measuring the ingredients, as well as learning the science behind how foods are cooked, this fun activity will keep children constantly learning.  If you want to change things up, even more, have themed cooking nights where you cook foods from different cultures and eat the meal the way individuals would in those countries.
  2. Fuel their passions. While there are certainly many ways to try and keep your kids engaged and learning over the summer, the best way to do that is to incorporate their passions and favorite things into learning experiences.  Whether they are into sports, Minecraft, gymnastics, space, or history find age-appropriate ways to feed their interests through books, movies, games, and other hands-on experiences.  The more they are interested in what they are learning the more they will get out of it.

No matter how you choose to keep your kids engaged, the value of any learning over the summer cannot be overstated.  While this summer certainly holds more opportunities for traveling and being with others, also use this time as a great way to explore new learning opportunities while gearing up for the school year ahead.

Your Kid Needs a Brain Break

After the school year that our kids just went through, their brains are fried. Isn’t yours? Especially for our children with learning needs, this year’s virtual learning environment presented huge challenges. We are multisensory beings in a vibrant environment, and we learn through all of our senses. Online school only gives our children visual and auditory information, which can dull our senses, lead to boredom, and create difficulty fully exploring new concepts and ideas. Our attention, task monitoring, problem-solving, and planning are all dulled by this monotonous routine. Let’s go have fun at summer camp!

Thankfully, Washington University Occupational Therapy is offering an in-person option for learning fun. Train Your Brain (TYB) summer camp is back to support children’s executive functioning skills through hands-on games and motivating projects. Following COVID-19 safe protocols with fully vaccinated staff, TYB will offer hands-on activities that stimulate your child’s mind in multisensory ways.

This year, camp will feature egg drop activities in which campers must build contraptions to protect a raw egg from falling 10+ feet. They will set goals, plan, problem-solve, manage time, and edit their work to make a successful egg protector. Children and teens ages 9-16 are eligible to join in the fun. So if your child’s executive functions are dulled from online learning, consider Train Your Brain to sharpen their cognitive skills this summer. Learn more about our camp and register here!

 

Infant Toddler Autism Program (ITAP)

The Infant Toddler Autism Program (ITAP) has recently made its home in the Washington University Occupational Therapy Pediatric Services portfolio of clinical offerings.  In addition to providing community education and student learning opportunities, ITAP offers a high-quality, parent-mediated, early intensive behavioral intervention service for infants and toddlers through the MC²: Motivation, Connection, Communication intervention.  MC² was developed under the direction of Dr. Michael Gaffrey at the Washington University William Greenleaf Eliot Division of Child and Adolescent Psychiatry.  Dr. Gaffrey is currently on faculty at Duke University.

ITAP’s MC² intervention is designed to increase the social engagement and functional communication skills of infants and toddlers (age 6-33 months) who exhibit early signs of autism, which may include any the following:  frequently not responding to their name, not sharing interest by showing or pointing, delayed communication skills, limited eye contact, and appearing to pay more attention to objects than people.  Social engagement is a critical component of communication and learning, and while caregivers often recognize their child is not meeting milestones as expected, they often report not knowing how to best support their child’s development.

For that reason, ITAP’s MC² is a parent-coaching program.  A therapist works with the caregiver over the course of 24 sessions to teach the intervention and coach the parent on using the strategies fluidly with their child.  The strategies are designed to be easily implemented within daily activities and routines, allowing the parent to realistically use them given time constraints while also giving the child access to higher levels of therapeutic dosage within their natural setting and schedules.

Sessions are typically scheduled for two 60-minute sessions/week for 12 weeks and occur in-person in the family’s home.  During the Covid pandemic, accommodations were made to the intervention to allow for virtual sessions when needed.  ITAP has partnered with Missouri First Steps and offers the program through the early intervention system when authorized by a family’s therapy team.  Additionally, moving into the OT program has allowed ITAP to now offer a self-pay option for families who are not enrolled in First Steps.

To learn more about ITAP and the MC² intervention, or to make a referral, please visit itap.wustl.edu.

Managing Stress During The Holidays

November and December are times that families cherish; as it brings warm memories of cherished traditions. Many emotions surround this timeframe including stress, excitement, and love. 2020 has brought with it many changes to how we do things within our own families and our communities. Which will affect how we will celebrate this holiday season. Washington University Occupational Therapy would like to provide you with some tips on how to maintain self-regulation during a challenging holiday season.

Tip #1: Simplify the expectations of your holiday events. Identify the top 3 to 4 things that are important to your family and set goals to do those things.

Tip #2: Pre-plan, identify barriers that will affect your holiday activities, and identify solutions 1-3 weeks prior. Preplanning decreases stress and promote self-regulation to enjoy the event.

Tip #3: Use self-affirmation messages to help remind you of the goals set for the holiday season. Self-affirmation messages help self-regulate your brain by providing a plan and a solution. It also helps manage negative thoughts. An example of a self-affirmation message is, “Making this apple pie by myself with keep me and my mom safe. It will feel good to give her the pie as it will help her remember our past holiday traditions”.

Tip # 4: Use self-regulation strategies when feeling stressed to calm your emotions.

Self-regulation strategies include:

-Taking a walk to clear your mind

-Listening to calm music to slow your breath and heart rate

-Journaling your thoughts to help manage when you feel overwhelmed

-Snuggling up in a comfortable outfit or with a comfortable blanket; it is like giving yourself a hug

-Eat crunchy food or food that makes your mouth work to promote self-regulation through sucking and swallowing or chewing.

Washington University Occupational Therapy pediatric and adult services are available to help people through this challenging holiday season by assisting with identifying strategies to plan, organize, and self-regulate their life.

Learn more about our adult and pediatric OT Services...

Pediatric OT Presents Research on GNAo1 Disorder

This month we are highlighting and giving a special congratulations to one of our Pediatric Therapists, Karen Balk, MOT, OTR/L. Karen presented her pediatric research work on GNAo1 disorders internationally earlier this month.

Karen’s pediatric research presentation on patients with GNAo1 disorder and gene mutations was attended by roughly 160 attendees from 20 different countries as apart of the GNAo1 European Conference which was held virtually this year.

To learn more about Karen and her work with GNAo1 take a look at an article from the St. Louis Post Dispatch highlighting the GNAo1 clinic.

Learn more about our Pediatric OT Services

Train Your Brain Summer Camp

Summer is a time for us to relax and take a load off of our brains that we’ve been putting to heavy use throughout the academic year. But for children with executive dysfunction, the long summer break with a lack of structure can hurt their brains’ ability to maintain what they just learned in school, because of this we offer Train Your Brain Summer Camp! Our executive functions are the cognitive skills that help us make and carry out a plan, such as setting up a lemonade stand, playing hide and go seek with friends, or completing a book report. Children with ADHD, autism spectrum disorder, or learning disabilities often have difficulty with executive functioning skills, but children with other diagnoses, or even without a diagnosis, can also struggle.

To support these children during the unstructured summer months, Washington University Occupational Therapy offers Train Your Brain, a week-long, half-day summer camp to support children’s executive functioning skills. This year, Designed with fun in mind, this camp will support your child in using the critical skills needed for successfully planning a project and carrying out the plan. Using evidence-based
and fun activities, your child will design a bridge and test its strength and durability. While learning the simple science behind what is needed to design a bridge, campers will spend equal time using strategies for time management, organization, attention, and emotional – regulation. Camp will culminate in an exciting day of bridge-building, testing, and re-vamping that combines the planning skills learned and practiced during the week! These real-world skills come with tangible strategies that campers can use at home and in the upcoming school year. For more information about Train Your Brain, or to register, click on the link or email Kaylee Breitenbucher, MOT, OTR/L to discuss how this camp would benefit your child!

Summer Activities For Kids!

Parents are always looking for ways to keep their kids engaged and learning throughout the summer.  But it seems like this summer, the need for summer activities for kids are even more apparent.  The school year did not wrap up the way it was intended; many homes were turned into classrooms, and many parents were putting on their teacher hats.  While students may not be logging on to zoom calls to check in with teachers, there are still ways to keep kids learning and engaged while socially distancing and being safe amongst a global pandemic.

  1. Take a virtual field trip.  During these socially distant times many museums, aquariums, planetariums, etc. have started offering free virtual experiences online, see some great option here.  While it may not quite feel the same as visiting these places in real life, it is a great opportunity to take your child’s interests and explore even deeper.  Whether this is by reading a book or article based on something interesting you found on your tour, re-creating a painting you saw in a museum, or star gazing outside, these resources are a great way to get the ball rolling on ways to continuously learn.
  2. Attend a local summer camp. While traveling long distances and attending out of town camps may not be happening this summer, St. Louis County has released guidelines for local summer camps to continue with camps safely.  While all camps are great for keeping kids engaged, if you want to keep your kids learning over the summer look for camps that focus on science, art, and other educational skills.  Washington University Occupational Therapy offers its’ own summer camp for children ages 9-12 with executive function difficulties (difficulty with planning, organization, goal-setting, task monitoring, etc.). Learn more about this camp.
  3. Explore the outdoors at a distance. Unfortunately, many summer plans have been canceled or adjusted due to COVID-19 and the need to maintain social distancing, but one thing that is still a great option is spending time outside.  Whether this is going for a hike and learning about the leaves and trees around you, camping for the weekend and problem solving on how to pitch a tent, or trying out fishing for the first time and researching the different species of fish, each of these opportunities provides a fun experiential learning experience for kids and parents alike.
  4. Cook together. Cooking is a great home-learning opportunity that combines math, science, and reading skills.  From picking out a recipe, getting and measuring the ingredients, as well as learning the science behind how foods are cooked, this fun activity will keep children constantly learning.  If you want to change things up, even more, have themed cooking nights where you cook foods from different cultures and eat the meal the way individuals would in those countries.
  5. Fuel their passions. While there are certainly many ways to try and keep your kids engaged and learning over the summer, the best way to do that is to incorporate their passions and favorite things into learning experiences.  Whether they are into sports, Minecraft, gymnastics, space, or history find age-appropriate ways to feed their interests through books, movies, games, and other hands-on experiences.  The more they are interested in what they are learning the more they will get out of it.

Regardless of which way you choose to keep your kids engaged the value of any learning over the summer cannot be overstated.  While our world may continue to look different and our summer plans are continuously changing, use this time as a great way to explore new learning opportunities while gearing up for the school year ahead.