Frame of Reference for Development of Handwriting Skills

        Development of Handwriting Skills is a Frame of Reference that identifies functions and dysfunctions in five areas of handwriting for children. These areas include proximal posture, components, use of writing tools, grasp, and handwriting. All of these areas are necessary for effective and legible handwriting for a child.

        Good proximal control is requirement for functional distal control of the writing utensil. Essential components include could-motor skills, attention, and memory. Writing tools such as pencils and erasers need to be stabilized and positioned in the right way for legible handwriting. Lastly, functional grasp is needed in order to manipulate the writing tools.

        During an evaluation, the OT might look at legibility, alignment, spacing, and size. The OT can also perform some assessments to measure visual-perceptual skills and fine-motor skills. The treatment can be done in the classroom being that that is his natural environment. The aim of the treatment is for the child to be able to develop complex fine-motor skills and be able to participate in occupations as a student that are age-appropriate.

       Three terms that are used in this theory are Frame of Reference, evaluation, and occupation. A frame of reference uses theories to guide evaluation and assessment and application to the practice. An evaluation is a process that takes place on the first visit where the OT identifies the diagnosis, reason for referral, and information for an occupational profile. An occupation is daily activity that is meaningful to you.

Health Promotion

Two areas that stood out to me in today's health promotion lecture was the IHI Triple aim and health literacy. The IHI Triple Aim is a framework developed to improve the patient or client's experience. There are numerous people that visit doctors offices everyday and leave with a handful of questions.  For example, giving prescriptions with instructions to take twice daily, but not informing the client what time. If the patient is consuming two pills at one time, that could potentially be very harmful. I can see where this easily happens because I have been in that situation many times. When you give prescriptions, instructions, or take home exercise programs it is crucial that you explain it in a language that clients can understand and confirm that there is not any confusion. Also, health literacy is very important and is something that has never crossed my mind. Health literacy is the degree at which individuals understand and process basic health information. Prior to acceptance, I worked in a outpatient clinic and had to help many elderly patients fill out paperwork because they didn't have their glasses, but never considered that they might not be able to read. This is also something to consider in the work place, but most importantly, making the client feel as comfortable as possible.

Cherry Pie

Prior to my acceptance into the program I spent many hours in nursing homes and outpatient clinics observing occupational therapists and learning what it was all about. One session that stood out to me was observing an older lady in the nursing home who was diagnosed with congestive heart failure, bake a pie. We had a lot of fun during this session and I could tell she was enjoying it and motivated, but truly had no idea how this session related to her illness. Now that I have learned more about this field it all makes sense. This lady obviously wanted to be well enough to be able to bake again, but with her illness, she was too weak to stand for long periods of time. My OT would observe her everyday in the kitchen while she went through the steps of baking, time how long she was able to stand and would teach her precautions to take when she got too weak and tried to find ways to adapt. I learned how to make a cherry pie that day, but looking back I learned a lot more than I thought I did!

Art Therapy

Leisure Exploration and Creativity with Veterans and Service Members was the podcast that I chose to listen to. This podcast stood out to me because I have multiple family members that are veterans. Rusty Noesner, a US navy seal veteran, suffered two traumatic head injuries. When he returned to the US, he began therapy at Walter Reed, and had many benefits from art therapy. Rusty discusses the importance of art and self-expression and how he used this creative process to adapt back into his life. Using different kinds of art mediums, he was better able to express his anxiety and frustrations.

The process of art therapy puts your brain into a creative process and areas of your brain begin to come back to life. He was touched so much by this process that he began his own nonprofit for veterans, War Paints. He explained how many veterans were afraid of trying art therapy because it wasn’t “masculine” enough for them. As occupational therapist, it is our job to encourage art therapy and explain that expressing yourself is a strength. Veterans do not want to be pitied or looked down upon, so it is very important on how you initiate this process. Art can range from woodworking to photography to journaling. It is not about just painting a picture, it is about engaging in a creative process of your choice to stimulate your brain. Data shows that 20 veterans a day die of suicide. Leisure participation has also been found to increase quality of life, self-esteem, and emotional well-being.

What is OTPF?

Occupational Therapy Practice Framework is an AOTA document widely used in the education and profession of occupational therapy. This is a very important document that guides the practice of occupational therapy. The OTPF is a reference that provides common language and communication for practitioners and students. This framework highly focuses on the use of occupations to promote health and wellness.  The two big areas of the OTPF are domains and process. The domains are what the occupational therapist does with the client, where the process is how the occupational therapist does it, therefore, this document can be very helpful during evaluation and intervention.

Era Presentations

Being able to participate in the the era project, as well as listen in on others, was a very fun & unique way to learn about the history of Occupational Therapy. It is amazing to see all the transformations this profession has made over the decades.  There were many important names mentioned throughout the presentations that have impacted the field of OT, but Dr. Gary Keilhofner (1980s) stood out to me the most.  Keilhefner developed the Model of Human Occupation, which helps OT practitioners to better address the important issues concerning their clients.  He provided the profession with evidence supporting occupation-based practice and different assessments.  When a client is unable to perform an occupational role, it is then OTs role to identify the cause to overcome the problem.  These assessments become very beneficial when evaluating the clients to help solve the problem and form goals.  Dr. Gary Keilhofner's creativity and passion has shaped the profession of Occupational Therapy and also been beneficial to both practitioners and clients.

Client vs. Patient

Before I started this new journey in occupational therapy school, I thought I had a decent understanding of the profession, but I am quickly finding out that there was so much more to learn.  One thing that has stood out to me since day one was using the term “client” rather than “patient”.  Being that I worked in an outpatient clinic as a technician for the last year and used the term “patient”, it has been a difficult transition.  A patient refers to someone who receives medical care whereas a client is someone that seeks assistance of a therapist. Moving away from the “medical model” was one of the best decisions because one simple word can make or break someone.  “Sticks and stones may break my bones, but words will never hurt me” is  one old tale that is far from being true. The words we choose to use as individuals play a huge role on how the world looks at us.  This connects to person-first language, which is also something new that I have recently learned.  In today’s society we heavily use a medical diagnosis to label a person, which can be very powerful and hurtful.  The proper way to address a client is put them first and their diagnosis second.  People with disabilities or illnesses are mothers, fathers, uncles, and sisters. They are humans too and they do not deserve to be treated differently.  We as practitioners have to be very careful and keep these things in mind before labeling a person and potentially doing more harm than good.

Living Life to the Fullest

Have you ever taken something as small as handwriting for granted?  Most of us do not think about how important simple everyday tasks are until they are suddenly taken from us.  I came across an Everyday Health article about a middle-aged woman who was diagnosed with MS (multiple sclerosis).  MS is a disease that can affect your brain, spinal cord, and eyes.  It can cause problems with vision, balance, muscle control, and other basic body functions.  Lisa was experiencing numbness and delayed motor control which was affecting her ability to write; even something as simple as her signature.  She mentioned that it felt like she was wearing a glove when trying to write with a pen.  With some small adjustments and the help from her occupational therapist, Lisa was able to write again.  Although Lisa was not using a normal pen, she found the right one for her lifestyle that would help her participate in every day life again. That is what occupational therapy is all about.  Although this article mentions Lisa getting help from an occupational therapist, it does not explain what the profession is.  This profession is one that is misunderstood by many, therefore, OT does not always get the credit that it should.  Occupational therapists help clients, like Lisa, so they can enjoy the things in life that are meaningful to them, whether it be handwriting, gardening, or getting dressed.  Occupational therapists help others live life to the fullest!

References: https://www.everydayhealth.com/multiple-sclerosis/treatment/what-when-ms-affects-your-ability-write/