Final Entry

I have really enjoyed this prac placement.Looking back at my predicitions I was fairly spot on as theres a very large focus on the multidisciplinary team at next challenge. I've enjoyed learning about the various roles that OT and speech play in a child's development and have picked up skills from these to use in sessions in the future. Also I feel that I would have a good idea whether or not a child needed to be referred on to OT or speech pathology. I found that OT and PT particularly overlap in some areas in paeds. A lot of children were referred fro PT from OT for UL strength and core stability to help improve handwriting and school work.


I think over the course of this prac my communication skills and intervention strategies have considerably developed, especially ways in which to integrate your intervention into play time. This placement gave us alot of independence particularly with the therapy sessions at Roseworth PS each thursday where we took individual and group sessions tailored to specific areas (strength, coordination, balance etc) This required us to manage a case load and I gathered skills in organisation and prioritisation. The thing I enjoyed the most was organising sessions/ coming up with activities that engaged the child and motivated them to participate.


After this placement I still really enjoy paeds and I think I would eventually like to end up working as a peads physio :)

Week 4

S- A boy we had been referred from kindy at roseworth PS was found to have a a waddling gait which he was very ER and walked on his toes, whis family is from Sudan and there was question of nutritional issues. We didn't have alot of background information on him so we organised a meeting with his father. We found that his primary problem was tight gastrocs causing him to walk on his toes

T- Interview the father about his birth hx, PMHx, SHx etc, provide him with exercises to stretch the gastrocs and suggest an orthopaedic review with PMH.

A- We did the above things and showed the father correct handin techniques when stretching and also educated him on the importance of stretching and exercise for his son.

R/E- The interview went very well and it tested our communication skills as english was his second language. Our actions were effective because the father was eager to help his son improve his walking, he stated that he didn't think that his walking was too severe but was aware that it would have more serious implications in the future. I think I did well with discussing with the father what his concerns were and extracting the information that we wanted. I found it a little tricky to demonstrate the exercises we wanted him to do- patricularly the important things to remember such as handling and positioning of feet as it was hard to kep his son still to show him.

S- strategies, is to be clear of important points you want to get across to the father rather than giving him a long speal- by being precise he will understand better and also remember it better. I found that getting the father to do the exercises himself was very important rather than just showing him as we could correct his technique then.

Week 3

S- We went on a home visit to see a 10yo boy with an ABI. He is a contract client with next challenge so his physiotherapy sessions are covered by insurance. He is triplegic so both his legs and L) UL are affected. his L) UL particularlyhas high flexor tone.

T- The task was to get him moving aorund on the mat and improve ROM and reduce the tone because he is in a W/c for the majority of the day

A-
- Wake up songs--> tapping his legs, L) hand (in flexor pattern) and his stomach
- leaning forward in w/c when tilted back to activate abdominals
- rolling on mat and stretching UL and trunk so reduce tone and improve ROM
- facilitate reaching for toys and using L) hand aswell (prevent neglect)
- in sitting reaching for bubbles and facilitate sitting up tall (tends to slump or lean on therapist)
- posting box: picking up item and reaching up to put in post box
- passive stretching of LL into extension

R
- the intervention was successful because it temporarily reduced the tone in his UL and trunk and also the LL

E
- Pt seeked sensory stimuli so every toy he was gien would put it into his mouth and chew, so we had to very vigilant in discouraging that behaviour (and instead give him his biting toy which was flavoured)
- I think i did well engaging with him and performing the stretching techniques, i found that play time flowed seamlessly with actual intervention so it was more enjoyable
- Next time i see him i will provide more firmer and less stimulating handling (ie. avoid tickling or brief tactile feedback as this confuses him as it overloads his sensory system)

S
- prolonged stretching/rotation of trunk
- reaching for a toy then as reaching apply over pressure to ensure good stretch
- promote awareness of L) UL to prevent neglect
- use sing song tone of voice as he understands it better
- provide firm facilitation rather than quick brisk movements

Week one/two

S- I had a student physio session with a 7yo boy who was referred by the OT for strength issues regarding writing skills and also has congenital hpermobility. The student session means that instead of payng 90 odd dollars for a session with the physiotherapist they can have a student session for $15

T- The task was to improve UL and core strength to improve writing skills and general performance of GMS and also to review his home exercise programme.

A- My intervention for this session was
- animal walks
- went through HEP (mother hasn’t been following it due to busy schedule can’t find the time)
- yoga cards
- fitball reacing for bean bags throw in hoop
- 4 pt kneeling reaching forward and kicking back
- SLS, R>L
- UL (50x punch in air with bean bags, 10x punch with therapy balls, unable to hold arms out to side with therapy balls)
- ROM of LL full> excessive
- situps 10x
- superman held for 10secs

R- I think my intervention was successful (i'm seeing him this afternoon) however he was VERY energetic and distractable and was bouncing off the walls.

E- I think i handled my first session quite well, I found it challenging to try and calm him down whilst providing him with stimulating activities that just made him more hyper. I think I did well with engaging the child because he felt comfortable to be himself in the session (if not too comfortable- as he began to test the boundaries!)

S- This afternoon I'm going to make sure the session is very structured with no distracting equipment in the room (large coloured balls are his favourite) . I'm going to use a picture timetable where I will spread out a number of activities on picture cards and he can choose when he does them by putting it on the timetable, i think this will give him focus and motivation as each time he completes one he can take it off the board. Also by making activities into a small circuit ie. UL strength and core stability circuits hopefully will focus him to the task and will be stimulating at the same time.