A Student’s First AOTA Conference

By Grad II Sarah Plummer

This year a record number of VCU OT students attended the American Occupational Therapy Association’s 2017 Annual Conference in Philadelphia to celebrate the profession’s centennial birthday. Using money from donations, the Student Occupational Therapy Association was able to run a raffle which paid for 3 students’ conference fees, and numerous other students and faculty attended as well.

The conference included the poster sessions, short courses, scientific research panels, a huge Expo, the Eleanor Clarke Slagle lecture, and numerous other speeches, addresses, and meetings. In honor of the Centennial, there was also a special Centennial bash with a band and dancing, a Knowledge Bowl, and an opening ceremony describing OT’s rich history. VCU students and faculty proudly represented the department’s tradition of excellence with a variety of posters, booths at the Tech Day “Appy Hour,” research presentations, a team competing in the Knowledge Bowl, faculty inductions for Stacey and Tony into the Roster of Fellows, and a lively dance circle at the Centennial Bash.

To capture the wide variety of experiences, I collected the following quotes from VCU students who attended the conference:

“The conference was such an amazing experience! It was very exhilarating and empowering to be in attendance alongside over 13,000 other OT professionals, students, associates, and supporters. The opening ceremony presented a wonderful video re-telling the history of occupational therapy followed by therapists from both the United States and abroad celebrating the value of occupational therapy through anecdotes from their experiences in practice. It was also amazing to actually attend an Eleanor Clarke Slagle lecture – the role of technology is a relevant concept both within occupational therapy and healthcare and society as a whole. It was inspiring to listen Dr. Smith’s journey in the field and vision for the future. Lastly, I attended a variety of research panels and short sessions. My favorite session focused on neuroscience underpinnings and incorporating these concepts to guide and enhance intervention in all settings. Since I have both a background and fascination in neuroscience, it was an interesting session to attend and refreshing to know that therapists are considering the biology of the brain throughout our field.”

Next year’s conference is in Salt Lake City, Utah. Hope to see you all there!

My Path to FREE: A Priceless Experience!

By Grad II Varsha Dante

Grad IIs at FREE

Grad IIs at FREE

Born and raised in India, I was exposed to poverty, homelessness, and disability at a very young age. Catching a glimpse of someone in need in Mumbai was as common as driving by a McDonald’s in Central Virginia. In an effort to avoid feeling any sort of pity for these individuals and giving them every rupee I had in my pocket, my culture taught me to pretend I didn’t see them. But all of that changed when I visited an orphanage near my grandma’s house in Kemmannu, India.

A rough translation of the name of this orphanage from Telegu to English is ‘Motivation’. Spandana is a non-profit organization that houses boys and men with various disabilities who have been disregarded by their parents. In many cases, the parents intentionally gave their sons away when they found out about their disability. Sadly, this is a typical case in India as disability is regarded as bringing shame on a family. Luckily, orphanages like Spandana take such individuals in as if they were their own. Some of the members of Spandana have intellectual disabilities, but a significant amount of them also have physical disabilities. On my very first visit to Spandana, I was astonished at the level of creativity it took to create makeshift (albeit somewhat unsafe) mobility aids such as canes and walkers for some of the men. However, most of them used self-identified compensatory strategies to work around their physical conditions. I continue to marvel at the fact that these members are able to make the most of their situation in spite of having so little.

So, when I heard about a non-profit organization called F.R.E.E Foundation in Richmond, VA that provides donated medical equipment to individuals who are unable to afford them, I wanted to learn more. This is a resource that is unheard of in Kemmannu, India, so naturally, I felt inclined to get involved with this organization. By simply cleaning, organizing, tagging, and matching the equipment to their customers, I feel like I am on the path to becoming a caring occupational therapist. The amount of clinical insight and judgment it takes to provide a client with the most optimal piece of equipment for their use at home is commendable and I am incredibly grateful to be a part of this process. Additionally, by simply volunteering a few hours of our time, we can alleviate some of the burden of the F.R.E.E. staff, understanding the mechanics of disability and selecting the most appropriate piece of equipment to accommodate the disability, and recognizing that F.R.E.E. provides an avenue for members to continue being productive members of society.

The lives of the men living in Spandana would be so different if this resource was available to them. It’s only a matter of time before these resources make their way to India, but until then, I plan to do my part of advocating for our profession and the resources available to our clients with the hopes that they may one day spread to all parts of the world. While I plan to continue volunteering at F.R.E.E. after I graduate from this exceptional program, I (and my fellow volunteers) would like to pass the torch to the future graduates of VCU’s OT program.

Whether it’s volunteering from 5-7pm every Tuesdays or simply for an hour a month, I promise you, it’s worth it your time. Catch me in the hallway or email me at dantevj@vcu.edu and I can help you get involved!

The Occupation of Infant Care

By Associate Professor Stacey Reynolds

Stacey and Maddox

I’ve been a mom for almost 10 years. So when I became pregnant last year I thought I would have an easier time than most “new moms” because I wasn’t a new mom. However, Daniel was six years old when I adopted him- he was potty-trained, dressed and fed himself, could entertain himself, and was able to communicate his needs verbally. Imagine my surprise when my son Maddox was born this fall and required 24 hour assistance from me to do all of these things!

My new role as “mom of an infant” has been both rewarding and challenging; and at times very isolating. In the past 3 months I’ve gone through a variety of stages, such as: (1) Oh my gosh, what did we do?, (2) I can survive the next 60 seconds, and the next, and the next, (3) Oh, you smiled, I will do anything for you, and (4) our current stage of enthusiastically celebrating every new language and motor skill he masters. Clearly I love him more than I ever could have imagined.

Throughout all of these stages I’ve struggled to combat my desire and need to devote most of my physical and cognitive energies to Maddox, while simultaneously wanting and needing to keep up with teaching, mentoring, and research. Despite having flexibility to work-from-home these past few months, it has been hard to “flip the switch” from mom to professor whenever he goes down for a nap (if he goes down for a nap). Apparently, this is not uncommon. Recent research (summarized here: http://www.cnn.com/2016/12/22/health/pregnancy-brain-changes/) indicates that there is actually a synaptic rewiring of the brain that occurs after giving birth. The authors of this article compare this to the major pruning process that happens during adolescence. In moments of stress, I picture my “research neurons” dying off and being replaced by lyrics to Old MacDonald. Unfortunately, the evidence suggests that these changes can last several years…

What, if anything, does this have to do with OT? As a pediatric OT it is important to understand that our clients are not only the children that we see but their parents as well. Not only do parents of infants with disabilities face the same stressors as all parents, they are often dealing with exacerbated challenges in feeding and sleeping as well possible medical concerns. It may take longer for their child to smile, babble, or make eye contact; which can impact early bonding and attachment. It may also take longer for their child to reach motor milestones and be able to play (entertain themselves) independently. Parents of children with disabilities may also be unable to return to work or regular community activities, leading to social isolation. It’s unsurprising then, that parents of children with developmental delays and disabilities are prone to higher rates of stress and mental health conditions such as depression.

When working with families of children with disabilities, particularly young children, it is important to understand how parents are feeling and to consider what is most important to the family when setting and prioritizing treatment goals. For some families feeding is going to be a priority, while others may be more focused on bonding with their child. I know for me a major milestone was when I could put Maddox down long enough to wash my face and brush my teeth every morning. Part of our role as OT’s may also be helping families understand the importance of their own mental health, and providing them with resources to connect with other families or community resources. Finally, as OT’s we can help families understand that while their child may not hit all of their developmental milestones on time (and it is important not to compare their child to other children), that is no reason not to celebrate every time a new skill is acquired. Most important, raising Daniel and Maddox has reminded me never to judge other parents.

Our Newest Professor!

By Assistant Professor Virginia Chu

Hi VCU OT family, I am excited to join the faculty of the department of Occupational Therapy at VCU. I recently moved to Richmond from Chicago, where I was an occupational therapist in Early Intervention and pediatric outpatient therapy practice. I am a biomedical engineer and researcher by training. I have a Ph.D. in Bioengineering from Stanford University, where I studied motor learning and perception of motor variability in children with dystonia. I finished a postdoctoral fellowship at the Rehabilitation Institute of Chicago (RIC) in the Sensory Motor Performance Program studying reflexes and sensorimotor control in people after stroke and spinal cord injury.
Since coming to VCU, I have been busy setting up the Sensorimotor Performance and Rehabilitation Engineering lab. My primary research interest is understanding the role of multi-sensory integration in motor control. During my studies in occupational therapy and my clinical experience in pediatrics, I have seen the need for better understanding of sensory deficits in children who are seen by occupational therapists. There is limited scientific evidence supporting effective sensory interventions, particularly, limited understanding of why some interventions work. My research goal is to understand the effects of sensory deficits on motor learning and motor control, especially during the formative years of early development. As part of my research plan, I will design and test assessment techniques for measuring sensory deficits in children that will eventually be made available and appropriate for clinical use. I hope that by improving assessment techniques for sensorimotor deficits in children, we can better target therapy interventions.
Outside of work, I love cooking, making crafts and building things. I cannot say I am an expert in any particular crafting or cooking technique, but I love to explore new ideas. I also am passionate about social justice issues and enjoy spending time with community organizations and volunteering. In the past, I had volunteered and engaged with the homeless community, youth in crisis and immigrant families. I am still exploring the Richmond area and looking for ways to engage with the RVA community.

I look forward to forming collaborative research and scholarship partnerships with students, faculty, clinicians, and scientists in the VCU community. If you are interested in pediatric sensorimotor research or just want to chat, feel free to contact me at vchu@vcu.edu. I’d love to hear from you.

(Re)working Rest

By Grad I Paul Kehrer

During the holiday break I became intrigued by a subject that is appropriate to consider during a few weeks off: rest. I mean healthy rhythms of work and rest in particular. Overworking for a time is a requirement for completing any major project. If people did not agree and even commit to overworking, at least for a set period of time, there would be no health profession graduates, no professional musicians, and no entrepreneurs, just to name a few. Altogether, being overworked is unavoidable, but the retreat between semesters is a good time to plan a sustainable rhythm of work and rest. But what really is restful, and how is it done well?

A common side effect of over work is over-rest, often being one of a pool of activities with the word ‘binge’ added on the end. I’m thinking of past-times like Netflix, food, alcohol, sleep, video games, all of which are fine in and of themselves, but done in high concentration result in a vegetative state that leaves the participant more tired than when (s)he started.

People often ask one another, “Who is the best at something?”. Such as, who is the best singer, cook, etc., but no one ever asks, “Who is the best rester? Who gets the most rejuvenation from their rest?” Are there role models or examples for resting well? (I can think of plenty of examples of burn out, but chill out?). Until now, I never thought of rest as a skilled discipline that can be learned and intentionally applied with useful outcomes until I needed it in my life and then I was too busy to figure out how to get the most out of rest.

Productive rest does not come naturally to me, and the more responsibilities compound the harder it is to learn the skill of doing restorative, managed, rejuvenating rest. However, I admire the priority of restful self-care that I see in many of my classmates and it has been inspiring to me. I did my undergraduate degree in fine arts, and I loved it, but one thing I can say for sure is that OT students are much healthier than art school students, and having a clue how to rest well is part of the reason. Hopefully this is a skill I can acquire and apply and I encourage you to do so as well, before you really need it.

Transitions

By Jayne Shepherd, retired Professor Emeritus, VCU, Department of Occupational Therapy

jayne-retired-2016

How many times have you had to change gears to do something different? As many of you know, I am passionate about the topic of transition…and here I am in the midst of transition after 30 years + 4 months of teaching occupational therapy at Virginia Commonwealth University. Where has the time gone? It seems like yesterday when Jane Case-Smith and I joined VCU as newbie faculty members and mothers. The faculty welcomed me, many who were my professors when in OT school: Craig Nelson, Patti Maurer, and Tina Brollier. Sandy Cash and Tina mentored me in teaching, organization, and fieldwork and were great collaborators. Judy Hanshaw and her VCUHS staff gave me opportunities to work in pediatrics one day a week to enhance my knowledge and “stories” for class.
As I began teaching 3 classes my first semester I occasionally used the ONE LARGE computer that was in the department conference room. Although I had a degree in education, the learning curve was steep and continued to ebb and flow throughout my tenure.

So to keep these 30+ years short…What is VCU OCCUPATIONAL THERAPY to me?

V – A variety of valuable and versatile learning opportunities and experiences from faculty, staff, students, and colleagues that I will hold close to my heart;
C – Curious, compassionate, comical, client-centered, and collaborative
U – Unique individuals, classes, community partners, and fieldwork placements.

O – Open to new ideas, opportunities, and occupations,
C – Clever, capable, and caring,
C – Crafty, courageous, occasionally contrary, and now computer strong!
U – Unstoppable VCU graduates and faculty who are making a difference in their client’s and family’s lives, in research and the profession;
P – Person-centered, passionate, pediatric strong, and party people (with a little prodding).
A – Amazing, accountable, articulate, and activity and assistive technology driven.
T – Tenacious thinkers and top notch transformers of lives with
I – Interdisciplinary learning, innovative, imaginative, inquisitive, and an infectious quest for knowledge.
O – Outstanding observations, original ideas, often in overdrive yet orchestrating optimists with
N – Noteworthy suggestions, new ideas, and nimble fingers to splint, sew and woodwork.
A – Adaptive, aspiring, approachable, and appreciative of all and the Dollar Store!
L – Lecturing and launching students with laughable moments; loving OT and leaping into laudable colleagues and careers.

T – Thoughtful teamwork and tech savvy for terrific therapy while using
H – Humor and humility with honored fieldwork educators, faculty, students, and staff.
E – Energetic, engaging, enthusiastic, evidence-based practitioners who are
R – Realistic, respectful, responsive individuals providing rewarding returns.
A – Avid advocates for persons with disabilities, affirming meaning and joy.
P – Playful pals, powerful costumes, productive professors and progressive, professional students and colleagues…
Y – Yielding a wonderful career in academia….YAHOO! Yeesh, 30+ YEARS+!

I am honored to have taught over 1450 occupational therapy students who are now or will soon be my valued colleagues. Many are now adjunct faculty or faculty members at VCU or elsewhere or serve as essential fieldwork coordinators or directors of occupational therapy departments. It has been a privilege and I thank you all for your patience, forgiveness, and collaboration.

We are selling our house in Richmond and moving to Warsaw, Virginia on Cat Point Creek where we will build the second floor to our house. Then I plan to work part-time in OT while enjoying nature, kayaking, painting, and volunteering. So I hope to see many of you around the world of OT. Thank you to the faculty, students, and the VCU and OT community who have given me a great send off. I know this quote by Kristin Armstrong will be true….and I’m ready!

“Times of transition are strenuous…they are an opportunity to purge, rethink priorities, and be intentional about new habits…to make our new normal any way we want.”
Onto the next phase! Much admiration for YOU.

OT Collaboration with SwimRVA Autism Swims Program

By Assistant Professor Carole Ivey, PhD OTR/L

Accidental drowning accounted for 91% of US deaths in children with autism spectrum disorders from 2009-2011 (National Autism Association, 2016). Because of this, SwimRVA began planning in 2015 to expand their swim lessons to include lessons for children with autism, a decision that is compatible with their mission to “elevate swimming in the Richmond region making water safety and aquatic fitness more accessible to all.”

The SwimRVA group embarked on eight months of research and assembled a team of experts, from the Central Virginia Autism Society, Chesterfield County Public Schools, Chesterfield County Support Services, and Carole Ivey, from our OT Department. Additionally, they traveled to Kansas and Georgia to train and observe current best practices in swimming instruction with children with autism (some who happened to be OTs). From this, the SwimRVA Autism Swims program was developed. The goal of the program is to teach children with autism to swim. Unlike other swim programs for children with disabilities, this program is provided in the community by the community, run by SwimRVA swim instructors. In order to do this, the SwimRVA instructors would need assistance on how to work with children with autism and adapt their instruction to the needs of this population.

Swim instructors completed the online course for paraprofessionals through VCU’s Autism Center for Excellence (http://www.vcuautismcenter.org/training/paraprofessionals.cfm). This was followed by a lot of training, including an overview of autism by Tammy Burns from the Autism Society of Central Virginia, and sensory processing in children with autism, by Carole. Based on this instruction, we worked with the swim instructors to determine supports that might be needed for the lessons. We determined that visual schedules, video modeling of skills, and video social stories should be developed, as well as considerations for adapting the sensory environment. But how would these be developed?

As part of the Occupational Therapy Practice Activities III course in our VCU OT curriculum, students design and fabricate low technology devices for clients or facilities. The SwimRVA Autism Swims request was submitted by Carole to develop the adaptations for the swim program. Grad II’s at the time (now Grad III’s soon to graduate) Corinne McLees and Liat Damari signed up for this project. Their background as swim instructors, their pediatric interest, and Liat’s expertise in technology was a huge asset for this big project. They worked with SwimRVA to develop 3 adapted materials, a video social story “Entry Video,” video modeling skills videos, and visual schedules. Collaboration was key to this project. The goal of this program was not to have the children “hang out” in the water for 30 minutes, but to actually learn to swim by going through the same SwimRVA swim “stations” that any other child would. This required them to immerse themselves in the SwimRVA culture – how do families enter the building? Where do children wait for the lesson? What are the words instructors use in a lesson? What are the skills required in each station? These were all incorporated into the adapted materials.

Video Social Story “Entry Video” – The purpose of this video is to prepare swimmers on how to enter the building, check in, change, use the bathrooms, enter the pool area, and wait for the instructor. This video is posted on the SwimRVA YouTube channel to allow children to watch the video prior to their swim lessons. (https://www.youtube.com/playlist?list=PLWZ12AmzTh9HYYgkMt2Z2c_Jt28CwroOG)

Video Modeling Skills Videos – The purpose of these 19 videos are to provide a visual model of the swimming skills in the first three stations. Thirty-eight skill videos were developed – 2 for each skill with one having audio directions and the other having no audio. These videos are also posted on the SwimRVA YouTube channel and can be watched by children during lessons or before and/or after swim lessons.

Visual Schedules – The purpose of the schedules are to help swimmers follow the structure of the swim lesson. Ten sets of schedules were made, with each set containing cards for each of the 19 skills along with “break” activities and blank cards.

The week before the Autism Swims program began, Corinne, Liat, and Carole went to the facility to train swim instructors in the use of the adaptive materials. This allowed swim instructors to ask specific questions regarding interactions with children with autism, and to collaborate on how to best envision these materials working.

The SwimRVA Autism Swims Program officially started on April 5, 2016. Lessons are offered two days a week and to date have been provided to 42 children. There is currently a wait list of 19 children. At this time, all nine swim instructors have remained with the program. Swimmers range in age from 3-17 years. To date, 31% of the swimmers have advanced 1 or more stations, and the SwimRVA goal of water safety in the Richmond region is getting closer one lesson at a time.

Capitol Hill Day 2016

By Associate Professor Jodi Teitelman, PhD

Over 600 OT students trekked to Washington DC recently to support AOTA’s annual day of Federal advocacy, this year for the first time in collaboration with the American Society of Hand Therapists. I was pleased to be part of a delegation of enthusiastic OT graduate students who refused to let the day’s soggy weather put a damper on their readiness to push for policy change in support of people receiving OT services. For those of us who are Virginia residents, it was especially fun to sit in on the briefing session with Senators Mark Warner and Tim Kaine’s aides, knowing that Senator Kaine is running for Vice-President of the United States this year!

While debriefing on the drive home, Dianne Simons and I agreed that, while the day had certainly been successful, it seems we fight some of the same legislative battles year after year. Of the four issues on AOTA’s 2016 agenda, only one – requesting Medicare funding for lymphedema compression treatment supplies – was brand new. Requests that OT be able to open home health rehabilitation cases and that the National Institutes of Health be allowed to develop a plan for coordinated, collaborative rehabilitation research have been “on the plate” for several years now. And the never-ending quest to permanently repeal the Medicare outpatient therapy cap has been with us for almost 20 years!

And yet, cause for optimism remains. Of necessity, politicians — regardless of partisan affiliation — need to focus on the bottom line. Systems change is not going to happen unless we can prov not only the clinical value of OT, but its cost-effectiveness as well. AOTA has recently cited two just-released studies in Health Affairs and Medical Care Research and Review, documenting how home-based OT can reduce disability and promote aging in place, and how an investment in more hospital-based OT is associated with lower readmission rates. This is the evidence that has been missing in our previous efforts to persuade legislators to support our policy interests. Perhaps now, as research confirms the fiscal benefits we’d always suspected, our push to promote positive change will be…slightly less challenging?!

A Tough Pill to Swallow

By Associate Professor Stacey Reynolds, PhD OTR/L

For children and adults with chronic health conditions, taking medications orally is part of their everyday lives. While some medications come in liquid format, oftentimes pill format is the only option. Swallowing pills, however, can be a challenge to individuals whose diagnostic condition includes sensory sensitivities, postural control deficits, and oral-motor coordination problems. This is the case for individuals with Barth Syndrome.

Barth Syndrome is a rare genetic disorder that affects only males and that impacts the cardiac and skeletal muscles ability to generate energy for use. There are new clinical trials being initiated for this population; however inclusion into the trials requires the ability to swallow the large encapsulated pills. To help overcome challenges to pill-swallowing, I was invited- along VCU adjunct instructor Emily Burgess, MS, OTR/L- to host a pill-swallowing clinic at this year’s International Barth Syndrome conference held in Clearwater, Florida.

Before running the clinic Emily and I went to the literature to see what had worked before with other populations of children and adults. The most common approach used a technique called behavioral shaping in which individuals practiced swallowing a variety of candies that progressively increased in size (e.g. cupcake sprinkles, Nerds, tic-tacs, M&M’s, and Mike & Ikes). Other strategies included altering head positions during the swallow (e.g. with/without chin tuck, or head turned to side) and use of adaptive equipment like the Oralflo pill swallowing cup (Oralflo.com) and flavored Pill Glide sprays.

At the clinic Emily and I used questionnaires and clinical tools to evaluate sensory, motor, cognitive and behavioral/psychological issues related to pill swallowing. Based on the participant’s age and profile we selected evidence based strategies to help facilitate pill swallowing. We assessed progress based on the subject’s willingness to engage in the pill-swallowing process and the size of pill (candy) they were able to swallow. Out of the 16 boys and men who participated in the clinic, all 16 made significant progress towards pill-swallowing independence and many were able to progress to the largest size pill (candy) by the end of the brief intervention.

Emily and I have been invited to present our pill-swallowing methods at the 2017 Annual Conference of the American Occupational Therapy Association in Philadelphia- so stop by and see us there to find out more!

Stacey sets up candy at the conference.

Stacey sets up candy at the conference.

Emily tries out pill swallowing strategies with a conference attendee.

Emily tries out pill swallowing strategies with a conference attendee.

Introducing Our Newest Faculty Member: Patty Laverdure

Assistant Professor Patricia Laverdure, OTD, OTR/L, BCP

Assistant Professor Patricia Laverdure, OTD, OTR/L, BCP

I am thrilled to join the faculty and staff of the occupational therapy department at Virginia Commonwealth University! I am an occupational therapist with extensive educational, mentoring/supervision, administrative, and clinical expertise acquired throughout my career. I hold a post-professional Doctor of Occupational Therapy degree from Creighton University, Nebraska and have focused my efforts in the last number of years on the advancement of pediatric practice competency, value added evaluation of occupational therapy contribution, and the translation of evidence to support the critical analysis of pediatric occupational therapy practice. I am a detail oriented educator, scholar and leader and have presented at local, regional and national levels on pediatric and school based practice and evidence based practice and practice change. I have been very active in leadership positions in the Virginia Occupational Therapy Association and currently serve as the chair of the American Occupational Therapy Association’s Early Intervention and Schools Special Interest Section. I regularly advocate on behalf of occupational therapy, occupational therapy practitioners, children, families and schools.

I began my career in early intervention serving children and families in suburban and rural settings. I later transitioned to work in pediatric rehabilitation and hospital settings where I worked with children and families in maternal and child health, neonatal intensive care, behavioral-cognitive, and psycho-educational units. I have spent the last several years working in school divisions in both rural and urban settings as a school based practitioner, private practitioner, consultant and administrator. Prior to my transition to VCU, I was the Program Manager of Physical and Occupational Therapy Services at Fairfax County Public Schools, Fairfax, Virginia.

I enjoy forming collaborative partnerships and recognize reciprocal opportunities for professional training, practice scholarship and academic advancement among practitioners, researchers, community agencies and health care facilities. In my role as Director of Fieldwork, I am looking forward to working collaboratively with the students, faculty, and practice community to continue our tradition of excellence in academic to clinical transition; promoting evidence based practice in the field; and deepening opportunities to build meaningful relationships and networking opportunities that advance clinical practice. To that end, I am in the process of forming a VCU Fieldwork Advisory committee of interested community fieldwork and practice community partners. Please contact me at PLaverdure@vcu.edu if you are interested. I look forward to meeting and working with you!