Monday, April 6, 2015

A Day in the Life | Pediatric Clinic

Today I have Christie of Mama OT stopping by to share what a typical day in a pediatric clinic setting is like for her. Christie works in both school and clinic settings and I'm so happy that she is sharing what a "typical" clinic day looks like for her. 

Photo via Flickr / text added

Life as a pediatric occupational therapist is anything but boring! I currently work as an OT in both the clinic-based and school-based settings, with one day per week being in the clinic, and the rest of the days being in a nearby school district. Each setting involves different task and scheduling demands. It’s so hard to provide ONE example of what my day is like in either of these settings because there can be so much variation depending on the day of the week and time of year. That’s something I love about this job – variety in the midst of the routine. I’m the type of person who craves routine but also needs variety to keep me engaged and on my toes, so it’s a great fit for me.

For the purpose of this post, I’m going to walk you through what a “typical” day might be like for me in the pediatric clinic setting. The clinic I currently work for provides pediatric OT, PT, and Speech within the clinic setting, plus we are also an insurance vendor for in-home ABA (behavioral) services for children with autism. We also routinely host OT observers, volunteers, and fieldwork students. Because of this, our clinic is typically filled with lots of different types of individuals from a variety of disciplines, which is awesome for collaboration and professional growth. 

“Typical” Clinic Day:

8:15-9am – Admin time. Arrive, settle in, grab charts for clients I’ll be seeing that day, set up mats in the OT gym for the day, prep any materials or activities needed for morning clients, gather any swings or other therapy equipment I might need for the morning, check email if time.

9-9:50am – Provide treatment to a 4 ½ year old child with fine motor delays and low muscle tone/endurance, focusing on postural strength and control, hand strengthening, and dissociation of the two sides of the hand for improved tool use. Talk to parent for last 5 or so minutes of session to review how last week went for them at home, share some highlights from the session, and discuss what they can do at home during the rest of the week to support progress on OT goals.

9:50-10am – Write as much of the treatment note from the previous session as possible while also grabbing the next client’s chart and setting up for that session.

10-10:50am – Provide treatment to a 2 ½ year old child with a medical diagnosis of Autism who presents with limited attention to tasks, low frustration tolerance, lack of verbal language, tactile defensive and vestibular and proprioceptive seeking patterns, and generally disorganized and injurious behavior to self and others (head banging, biting, scratching, pinching). Fine motor and self-help skills are significantly delayed as a result. Session focuses on organizing behavior through sensory and behavioral strategies to extend ability to engage in functional and meaningful tasks in order to support progress on self-help goals. Parent is present in therapy room for duration of session and participates in training opportunities throughout session as it relates to encouraging participation in fine motor and self-help activities, as well as related to meeting/addressing sensory needs. 

10:50-11am – Clean up room, take a quick breather.

11-12pm – Admin time. Finish treatment note from 10:00 session. Write up a home program for a client I started working with a few weeks ago, as mandated by the insurance provider. Check and respond to emails. Make sure materials for afternoon clients are available. Collaborate with other therapists if needed/available.

12-1pm – Clinic closed for lunch. Sometimes my husband and two little ones come have lunch with me and my co-workers at the clinic, which my boys love because they get to play with fun stuff while they’re there! Usually I stay at the clinic for lunch and powwow with the other therapists, or we’ll take a walk to the nearby coffee shop to fuel up for the afternoon stretch of clients.   

1-1:50pm – Provide treatment to a 4 ½ year old child with a recent diagnosis of Autism, along with challenges with sensory processing, motor planning, and self-help skills. Parent is present for full session and participates. Session focuses on sensory diet activities, fine motor development, practicing self-help skills appropriate to the setting, parent education, and collaborating on ideas for home carryover.

1:50-2pm – Decide I’ll have to get to my 1pm session note later and move around mats and materials for next session.

2-2:50pm – Provide treatment to a 5 ½ year old child with global developmental delays and medical diagnosis of Autism. Parent is present for full session and participates. Session focuses on overall strength and stability, motor planning, fine motor development, and practicing self-help skills appropriate to the setting. Parent education and collaborative planning for home carryover occurs throughout session.

2:50-3pm – That note will have to wait as well!

3-3:50pm – Provide treatment to a 10-year-old child with Asperger’s and Developmental Coordination Disorder who presents with delayed self-help skills, sensory processing challenges, and difficulty with emotional control. Session focuses on overall strength and control, praxis, sensory diet activities, practicing self-help skills appropriate to the setting (such as tying shoes), and addressing emotional control with the Zones of Regulation program to support progress on goals. Talk with parent for last few minutes of session.

3:50-4pm – Write part of that 3:00 note and get set up for the last client of the day.

4-4:50pm – Provide treatment to a 6 ½ year old child with no formal medical diagnosis, but who presents with challenges with social interactions, sensory processing, emotional regulation, praxis, and fine motor skills. Session focuses on sensory diet activities, fine motor development, and working our way through the Zones of Regulation curriculum. Talk with parent for 5-10 minutes after session about how things went last week and additional suggestions for the coming week.

4:50-5pm – That conversation runs long (they always do!).

5-5:30pm (or whenever I finally finish) – Finish up treatment notes from earlier in the day. Send follow-up emails to parents from today as necessary. Respond to any final emails that can’t wait until tomorrow. Make a list of what I need to get done when I work in the clinic again next Monday since I only currently see clinic clients one day per week (e.g., home programs, progress reports, etc.). Return clients’ charts, lock up, and head home. I don’t take clinic work home with me. 

About Christie:

Christie Kiley, MA, OTR/L, is a mom of two and a pediatric occupational therapist with experience working in early intervention, clinic-based, and school-based settings. Christie is passionate about helping children reach their potential while empathetically encouraging, educating, and empowering the adults in their lives. She is the author of the blog MamaOT.com, where she shares information, insights, and kid-friendly activities from an OT perspective to inspire those who care for children. 

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