Occupational Therapy Level II Fieldwork Student Objectives

Hi I’m Ashleigh. I’m an occupational therapist here at Therapy Playground. This is Lena who just completed her pediatric level II fieldwork with me.  Lena, we would love to find out how this experience was for you. First, can you give a little background as to how you got to this point of being a level II OT student?

Yes, I would love to. First, I completed my undergrad at Loyola University in Chicago and I majored in psychology. Then, I knew I wanted to go to graduate school and I was looking into occupational therapy programs. By that point, I had graduated Loyola and there were some prerequisite classes I did not have, so I attended a community college for a semester and a half to complete courses such as anatomy and physiology, medical terminology, and some other courses. I am now attending the masters of science occupational therapy program at Winston-Salem State University. It is a 2 ½ year program consisting 2 years of coursework and 6 months of level II fieldwork. During the first year, we had level I fieldworks where it was mostly observation and little hands on. During these past 6 months I have completed level II fieldworks at two locations, with Therapy Playground being my last rotation.

So as a level II student, you are expected to act as the treating therapist. Describe some of the diagnoses you have seen and ages we treated.

We see kids as young as 12 months old to 12 years old. Diagnoses include kids who are on the Autism spectrum, kids who have ADHD, PDD, and CP. The treatment sessions include focusing on how to help the child improve function in activities of daily living.  We also see typically developing kids who have low tone impacting function or kids who have difficulty with handwriting.

How would you describe the evaluation process in the pediatric setting?

The evaluation process has many components so at times it feels like you have to juggle a lot of things at once. The evaluation includes using a standardized assessment, we used either the BOT for older kids ages 5 and up or the Peabody for kids 4 or younger. Then it also includes interviewing the parent or caregiver about the child’s abilities in activities of daily living with things like dressing, bathing, feeding, and toileting. We also administer a parent questionnaire, which is now in electronic format called the Sensory Processing Measure, and it consists of questions the parents answer about their child’s sensory processing skills which helps us determine if there are any sensory processing deficits that we may need to address. Next, there are clinical observations that we do to see how the child reacts on the ball, on the swing, other floor activities, and evaluating their strength. The therapist then has to score the assessment, interpret the results, develop goals, and set up a possible time and date to start therapy if services are recommended.

Give me your opinion on the treatment sessions of OT in pediatrics.

The treatment sessions are really fun because you get to interact with kids. During treatment sessions, we do activities to work towards goals that were established in the child’s plan of care. Usually we start off in the gross motor room and do activities like obstacle courses, or exercises to improve core or upper body strength, or sensory activities such as swinging on the swing. Then, we transition into the fine motor room where kids sit at the table and perform fine motor activities such as handwriting, crafts that include cutting or visual motor tasks. We like to switch up activities and make it fun for the child, so this doesn’t have to be done in order, for example we can work on handwriting on the chalkboard in the gross motor room, it doesn’t always have to be at the table. I have also come to realize that sometimes the hour or 45 minute treatment time slot does not allow for you to work on all of the child’s goals and that this is OK.

As you stated earlier, you had pediatric courses in school. How was this level II experience compared and contrasted to what you’ve learned?

I have learned the most during my pediatrics lab course. In the lab, we were able to go through several assessments and figure out how to administer and score them. This is similar to my fieldwork experience because we have two assessments that we use here as I had stated before, but this of course is different and more fun because I administer them to patients and not students.  Also in my pediatrics class, we had a sensory lab where we did a lot of spinning, jumping, pulling, wearing body socks and walking around, and this was good to experience the effects of all this vestibular and proprioceptive input and what effects these activities may have on the child. Overall, the best learning experience comes from actually being in the pediatric environment which I am getting in fieldwork because I am able to implement things that I have learned in class in a clinic setting.

How did you feel about communicating with parents?

Parents either chose to stay in the waiting room, or they came back and observed the sessions. If they stayed in the waiting room, I would explain to them what we did during the session and what we worked on. We also provided the parent with education regarding anything they could be doing at home such as sensory activities like brushing, or upper body strengthening activities like doing animal walks at home, or fine motor activities like doing puzzles or finding small objects in play dough or theraputty. We see the kids for 45-60 minute sessions one to two times a week, so it is important that parents provide good carry over at home of therapy strategies in order to make sure that the child is maximizing potential.

What other disciplines did you work with?

Here at Therapy Playground we have occupational therapists, speech therapists, and physical therapists. We have co-treated with both speech and physical therapy when it was necessary to enhance therapeutic handling strategies for a child who could not handle two different therapies due to behaviors or attention.

What types of assignments and research did you complete while doing your level II?

Making this video about my experiences of being a level II student is one of my assignments. Other assignments included doing a literature review on a pediatric topic of my choice. I decided to research the Wilbarger Brushing Protocol and see what studies and other research have been done. I also researched any terms or diagnoses I was unfamiliar with, and things like the Astronaut Program or Therapeutic Listening that is done here with some of our patients.

What has been the most challenging part of your level II experience here at Therapy Playground?

The most challenging part is managing difficult behaviors. It is always great when kids do exactly what you ask, but things don’t always go that way. I find it difficult to know the line of when to give the child space to calm down or when I should intervene and continue to redirect.

What has been the most rewarding part of this experience?

The most rewarding part of this experience is seeing progress in kids. Now that I have been here for almost 3 months, I have come to know the kids and their abilities and it is great when they are able to do something new or more difficult than they have done before.