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Archive for category: Original Posts

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Turtle Twins (Part 1) – Auditory Processing Disorder

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

In recognition of Speech and Hearing Month, I wanted to tell the story of my personal experience as a mom of a child diagnosed with auditory processing disorder (APD).

APD is best explained using the example of the game “Operator”.  If the first person is the ears, and the last the brain, everyone in between is the channel by which the message travels.  And remember what happens?  By the time the message reaches the “brain” it has been altered.  So, really APD is just that – when a message or sound changes as it travels from the ears to the brain resulting in the brain getting the wrong message.

Signs of APD can include difficulty with: communicating in noisy environments, following multi-step instructions, and wrongly hearing words, sounds and sentences.  As an overlap exists between the signs of APD and other disorders, and this may coexist with other problems, it can be difficult to diagnose.

Being a clinician, I recognized early that my daughter struggled with “hearing”.  Yet at 18 months her hearing test was “fine”.  When she was three I remember telling her that her “ears and brain were not talking”.  In school she would become easily distracted, would struggle with multi-step instructions, and did much better in classes that were smaller, less chaotic, or when she sat closer to the teacher.  At home the presence of her APD was apparent when my instruction “change your shirt” would be met with the response “I am not wearing shorts”.   Or, when the instructions “brush your hair, grab your lunch and put your coat on” might result in one, maybe two, but rarely three of those instructions being followed.  But my favorite remains when my daughter told her sisters they were “turtle twins” as she had misheard the word “fraternal”.

The diagnosis of APD is made by an audiologist when the child is at least 7 or 8 years old.  However, psycho-educational tests can also be helpful to rule out other or comorbid problems.  In adults, APD also exists, and can be the result of many factors, including acquired brain injury.  Also, some research suggests that men start to struggle with APD after age 35 and women after menopause.  My next blog will focus on ways we managed our daughter’s APD at home, in sports and school, and these same strategies could also be used by others who have, treat, or know someone with APD.

 

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Workplace Safety – Not Optional

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

The International Labor Organization estimates that there are 2.34 million occupational fatalities every year across the globe. In Canada alone injury and illness at work continues to be a significant problem.

It is estimated that musculoskeletal disorders (MSDs) from working cost Canadian society upwards of $20 billion a year. Reports from the Workplace Safety and Insurance Board in 2012 indicate that 43% of the claims were due to sprains and strains, 20% were due to low back injury and 19% were due to overexertion.

In Ontario, the Ministry of Labour enforces the Occupational Health and Safety Act. Occupational safety and health (OSH) is a cross-disciplinary area concerned with protecting the safety, health and welfare of people engaged in work or employment. This Act explains the procedures for dealing with workplace hazards and allows the law to be enforced when workplaces have not adhered to the policies put in place.

Occupational therapists are experts at helping injured people to return to their jobs in modified or full capacities, or assist people to be retrained or find alternative forms of work if their previous occupation is no longer suitable. We conduct jobsite evaluations to outline the physical and cognitive work demands, assess the individual’s physical, cognitive and emotional preparedness to return, and often look at the ergonomics of their workstation or body positioning when doing the job. The overarching goal of all this is to ensure that people can return to work safely, can perform tasks independently, are productive, and to reduce the risk of re-injury. We also provide devices, education, organize work schedules and gradual return programs, and collaborate with employers, physicians and other health professionals to promote a successful outcome. With respect to prevention, we conduct workshops and provide education and training programs for employers and employees alike to promote health and safety while engaging in all work tasks.

April 28th is recognized as The World Day for Safety and Health at Work. It is held as an annual international campaign that seeks to promote safe, healthy and decent work environments. It also commemorates people who have had an accident or injury in the course of their job. It is important that we are all involved in this initiative – workplace safety should not be optional. Consider these four steps to make sure that health and safety are paramount in your organization:

  1. Get on board: You don’t have to be an owner or boss to be concerned about safety. Everyone is responsible for contributing to a safe workplace.
  2. Get in the know: Understand the hazards and risks at your own workplace.
  3. Get involved: If you see a hazard on the job, speak up and offer your insight and possible solutions.
  4. Get more help: All workers have the right to refuse work if they have reason to believe it is dangerous. Speak to a supervisor if you have concerns, or seek guidance from the Ontario Health and Safety Contact Centre at 1-877-202-0008.

Or, if you are off work due to injury or illness and need help returning, would like solutions to help you work more comfortably, or are concerned about the impact of your job on your physical, cognitive or emotional health, consider contacting an occupational therapist. We are here to help.

References

Workplace Safety and Insurance Board. http://www.wsibstatistics.ca/asset_files/images/ByTheNumbers2012_S1_pg5.pdf

United Nations. https://www.un.org/en/events/safeworkday/

Ministry of Labour. https://www.labour.gov.on.ca/english/hs/prevention/index.php

Ministry of Labour. https://www.labour.gov.on.ca/english/hs/pdf/workbook.pdf

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Life is a Terminal Disease – Palliative Care and Occupational Therapy

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

It was a life-changing experience. I was 19 and essentially never stopped. I had goals, drive, energy, and big plans for my future. I was a varsity athlete, had three jobs, was a full time university student, owned a student house, and had bought myself a dog. Knowing I wanted to work in healthcare, and after strongly connecting to some school courses in death and dying, I decided to pursue a volunteering opportunity at the local Hospice Society. This required a comprehensive training program followed by placement in the home of someone who had a terminal disease. My first (and only) placement was with a mom, age 37, who was dying of cancer. She had a 7 year old daughter and a husband who was also ill. I would attend their home once a week to spend time with the daughter, help to prepare meals, and would even assist with running errands and groceries. I provided emotional support and mentoring to a scared little girl, and was an extra set of hands for a dad and desperate husband. I was fortunate enough to be involved with the family for many years as the mother passed about a month after my wedding – four years after I met them. My husband and I tried to stay in touch with the daughter following, but dad really struggled and eventually his phone was disconnected.

The impact of this experience on me personally was huge. The things my parents had been telling me were true: “stop to smell the roses”, “don’t sweat the small stuff”, “make sure you have fun too”…I was intense and driven to the point of missing it. My experience in Hospice changed my outlook, my appreciation for my health, family and all those blessings that we take for granted daily.

Recognizing it is National Hospice Palliative Care Week, I wanted to showcase the role of Occupational Therapy in this challenging but

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rewarding field. To do this, I reached out to a colleague who has spent many years practicing occupational therapy in palliative care settings. Her reflections are as follows:

What I have learned is that Palliative Care is not particularly a specific intervention but rather a perspective of care that can be provided in a multitude of settings where end of life is faced such as our homes, hospitals, hospices or long term care facilities.

The Canadian Hospice Palliative Care Association defines End-of-life care as aiming to relieve suffering and improve the quality of living while dying for persons diagnosed with an advanced or terminal illness or who are bereaved.

Who defines how the client is suffering (physically, emotionally, spiritually) or that what we as healthcare providers do is indeed improving quality of living while dying? In a truly client centered approach, it is the client or their substitute decision maker that determines this. A collaborative interprofessional team has the potential to honour the client’s hopes and decisions in an identified plan of care.

The Canadian Association of Occupational Therapists identifies various interventions in palliative care, based upon clinical setting, that the therapist can provide including addressing activities of daily living (ADLs), psychological and emotional issues (including stress and anxiety), exercise programs, splinting and positioning, energy conservation, relaxation techniques, seating and mobility, comfort, adaptive and assistive equipment, support and education for the family caregivers, connecting the client with community services and supports, and conducting home assessments.

What this can look like is, for example, providing mobility devices such as a walker or wheelchair to address declining physical abilities while maintaining engagement with family in a safe manner. Considerations also include provision of therapeutic surfaces whether on a bed, wheelchair or favourite recliner to help reduce the development of pressure ulcers once time spent sitting or lying in bed increases. It can be planning and preparing with the client and the team to assist the client attend a final function such as a family wedding where comfort, endurance and being relatively symptom free are the goals.

Ultimately, as roles in life are challenged due to losses with life limiting illnesses, the Occupational Therapist attempts to facilitate meaningful engagement that reflects a client’s goals in a dignified manner.

Carla Floriani, OT Reg Ont

I want to thank Carla for providing this insight and for guest-blogging on our site. Personally, I miss my volunteer work in Hospice but know that this is something I will eventually return to as it impacted me in a way I have not forgotten. The harsh reality is that life is a terminal disease – but we should not need to be given a deadline to act that way.

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LOL…OMG…RIP

Julie Entwistle, MBA, BHSc (OT), BSc

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(reference: www.zazzle.ca)

What a great bumper sticker created to remind people of the risks of texting and driving. Why is this necessary? Because texting while driving has recently surpassed drinking as the # 1 cause of vehicle collisions. In fact, texting drivers are 23 times more likely than non-distracted drivers to be involved in a crash. The largest problem is with teens, but 47% of adults also admit that they are guilty of this habit.

I can see the pattern already…back in the 70’s when people were dying or getting seriously injured in car accidents they made seat belt laws. Then, kids were still getting hurt, or worse, because they were too small for the belt. So, they made car seats and enacted strict laws about their use. Drinking and driving was then on the rise, and many people (young and old) were losing their lives because of their own poor decisions, or due to the carelessness of others. Drinking laws come in, MADD is formed, and slowly the rates start dropping. When it was realized that some people were still not wearing belts, they brought in air bags. The increased safety of these for a seat-belt wearer was minimal, but for a non-wearer, somewhat protective.  Soon, the car phone is invented and this is replaced with the cell phone. Talking and driving becomes the norm. Arrive texting. Accidents relating to cell phone use in general increases, and now in Ontario there is a stiff fine for not being hands free in the car. Texting is more discrete when driving because the phone can be concealed below the eyesight of other drivers (versus attached to your ear). But when the driver is looking down, not ahead like they are supposed to, it is easy to surmise what they are up to. Texting and driving laws fall under “hands free” but based on the latest stats, it is clearly still happening.

If we break this down, we can see that texting and driving is not the real problem. This is just a symptom. The real problem is a society addicted to technology. A new generation of adults, tweens and teens that are so attached to their device(s) that they are unable to function without them. Instant gratification, the latest news and gossip, the ability to multi-task all the time. We have created a culture of people that literally can’t wait to communicate.

So, what can we do to try and help the pendulum to swing the other way? Here are some thoughts…

1. Like anything, as parents and adults we need to model appropriate phone behavior. No phones after a certain time, none at the table, not in your bedroom, and NEVER WHEN DRIVING. I still see adults driving, talking on the phone (illegal) with their tween in the front seat. Good luck teaching your kid how to follow the rules and drive safely if you are not doing this yourself.

2. Silent mode is an option. Turn the darn thing off. If a ding, ping, or funky tune has you desperate to find your phone and respond, power it down, use airplane mode, shut off the Wi-Fi – anything to pull you from the device at times when its use is not appropriate.

3. Don’t start this stuff too early with your kids. I love the quote from the book Queenbees and Wannabees “If your child is between the ages of 7 and 12 and has a cell phone, you have lost your mind”. Wow, I know a lot of people that are insane then. It is everywhere. For me, my kids can have a phone when they can a) afford it or b) show enough responsibility that its’ use will be proper. They still can’t hang up their coats so why would I assume they can manage a phone? Saying no as a parent is one of the greatest gifts we can give our children.

4. Support the cause. There are some great people and organizations out there that are trying to educate the youth of today about the perils of texting and driving. Check out www.DontDriveDistracted.org. – a crusade and website that is being managed by a 16 year old. Impressive! Or, www.textingthumbbands.com where you can purchase bands to place over your phone for in the car, or thumb bands reminding you to text responsibly.

As an occupational therapist working with car accident survivors, I can tell you no message, text or call is worth it. The impact of an accident on you physically, cognitively or emotionally can be severe, devastating, catastrophic. The way you are treated by your insurer may disgust you. The length of time it takes to get back on your feet, to return to work, play, fun, will surprise you. And if you don’t value your own life to stop these dangerous habits, then value the lives of other drivers that rely on you to be focusing on ONE thing when driving – THE ROAD.

In May, Entwistle Power will be at the Hamilton Health Sciences Conference giving out wrist bands to spread the “don’t text and drive” message. While I love my job, I would rather see car accidents disappear.

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Seeing Yellow: Occupational Therapy and Cancer Recovery

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

When my mom was diagnosed with breast cancer, she was required to have a mastectomy.  Feeling helpless but wanting to support her, I sent her a list of the things we could do together pre-surgery.  This included anything from loading up an iPod with her favorite tunes and stand-up comedic acts, sorting my ridiculous stack of family photos, scrapbooking, and of course some retail and spa therapy.  I figured the less time she spent just waiting for surgery, thinking and processing what was to come, the less this diagnosis would impact her now and into the future.  She responded to my ideas with something along the lines of “you should help people through tough times for a living” and I reminded her that my job as an OT allowed me to do just that.

The yellow daffodils in April signify that this is the month of Cancer Awareness.  Defined, the word “Cancer” is a blanket term used to describe the abnormal growth of cells in any part of the body.  There are more than 100 types of cancer, which may affect specific tissues, organs, blood, or lymphatic systems. Cancer remains the leading cause of death in Canada, responsible for about 30% of all deaths in our country.  Many of us have been affected by cancer, either personally, through friends or a loved one. My mom is only one example of how cancer has affected my family, and sadly I have countless other stories of friends and colleagues who have also been impacted.

Cancer and cancer treatment can lead to changes in how we do our daily activities due to physical, cognitive or emotional changes resulting from the diagnosis, resulting surgery, medications, chemo and radiation. For a cancer patient sometimes just doing daily activities leaves little energy for leisure, social, or work-related tasks.  Common side effects of cancer or its treatment include fatigue, pain, weakness, cognitive difficulties, anxiety or depression, and changes in self-esteem or self-image. Each person diagnosed with cancer will experience different challenges in his or her participation in various daily activities and life roles over the course of the disease.

Occupational therapists have knowledge and expertise to allow individuals with cancer to do the things they want and need to do to maintain their level of independence and quality of life. Occupational therapy services are helpful for individuals throughout the continuum of cancer care, including those who are newly diagnosed, undergoing treatment, receiving hospice or palliative care, or who are survivors reintegrating into previous roles. Caregivers also benefit from the training and education provided by OT’s as this arms them with the essential tools to offer support and assistance to their loved ones when performing daily, important, and meaningful activities. Some of the things occupational therapists can help with include:

  • Education on management of activities of daily living (ADLs) such as bathing and dressing through adaptations to the activity and environment, and/or the use of assistive devices.
  • Sleep and fatigue management such as education in and demonstration of energy conservation and relaxation management techniques to support health and the ability to participate in purposeful roles.
  • Cognitive strategies to address memory, organizational executive function deficits, and low-energy tasks that focus on restoring engagement in daily occupations such as sitting in the park, reading a newspaper, or conversing with a friend.
  • Therapeutic exercise and positioning to maintain functional range of motion, mobility, and strength such as home exercise programs, splinting, wheelchair fitting, bed positioning, etc. to provide support and comfort.
  • Mental health treatment to encourage the return to life roles that will help increase mood, reduce depression, restore hope, and lessen anxiety.

Other roles for occupational therapy also include return to work involvement post-treatment, education on general health issues, and training on use of a prosthetic if an amputation was required.  Some therapists are also specifically trained to provide lymphatic drainage to reduce the swelling and pain that can result from the disease, its’ surgery or treatment.

So, for the month of April let’s honor those fighting and remember those that fought.  Buy some daffodils, donate, wear a ribbon, or call or visit with someone you know that has been impacted by this prevalent disease.

References

American Association of Occupational Therapists (2011). https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/MH/Facts/Oncology%20fact%20sheet.pdf

Canadian Cancer Society (2013). http://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=on

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Best Of The Blog: Pin The Tail On The OT

After a year of blogging I’ve been approached by many colleagues who have thanked me for spotlighting the wonderful profession of occupational therapy on the web and social media.  I am hoping that my efforts will bring increased awareness to the benefits Occupational Therapy.  The following post from September 2013 is a favourite that gives an overview of OT and how it works to provide solutions for living.

Pin The Tail On The OT

I dream of the day when Occupational Therapy (OT) becomes an understood profession and is a conversation at the dinner table (“maybe an OT could help?”).  I feel that the internet, Facebook and You Tube will help this to become so.  I love the inspirational videos and stories that are being posted online.  Stories of people overcoming adversity, showing how attitude and ambition mixed with creativity can conquer challenges and overcome barriers.  I thought instead of talking about OT, I would show its power.

Watch this video and know that OT is:

  • Helping people to maintain a positive attitude, and to have hope, despite personal circumstances.
  • Overcoming the “can’t” to become the “did” – no matter what that “did” looks like.
  • Showing people how to open the door of a fridge, car, microwave and building when they can’t use their arms.
  • Providing equipment to facilitate driving when the traditional steering wheel, gas and break, cannot be used normally.
  • Teaching people how to use a computer, and designing a conducive workstation, when their use will be unconventional.
  • Designing, sourcing, and providing equipment to facilitate independence in: eating (or dressing, grooming, showering, anything), lifting and carrying personal items, washing a car, or managing in the community.
  • Helping people with unique challenges to find a suitable profession, secure a job, and sustain work.
  • Creatively solving problems to participation (i.e. riding a bike).
  •  Fostering mental health through participation, engagement and function.
  • Reducing dependency on others through facilitating independence in daily activities.

These are just a few examples.  Really, OT is everywhere.  Many people actually “OT themselves” by finding new ways to overcome challenges.  We all might do this every day even if we are not disabled.  OT is a great profession – why struggle to solve problems of function, take longer than needed to complete tasks, rig up unsafe solutions, or become unnecessarily dependent on others?  Consider OT.  We are here to help, and love nothing more than sharing our skills and knowledge.

 

 

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Best of the blog: Computer vs. Car Insurance… Gigabites or Irb…

Car insurance in Ontario is mandatory. However, how much do you really know about your insurance? Many shop on price, not recognizing that, like many things in life, they may get what they pay for. I wrote the following in June 2013 about why it’s important to really know your coverage. Hopefully you’ll never need it, but if and when you do, you will want it to meet your needs!

Computer vs. Car Insurance… Gigabites or Irb…

It is widely known in my industry that the people of Ontario generally don’t understand their auto insurance coverage – until they need it. For example, when buying a new computer you might look at screen size, megabytes, RAM, GIGs, processor, operating system, anti-virus software and extended warranty. But when buying car insurance do you look at the coverage for housekeeping, NEB, IRB, attendant care, med/rehab, liability, and care giving? No? So, it begs the question: why are you paying for something you don’t understand?

In a brilliant display of smoke and mirrors, your auto insurance company (via the Insurance Bureau of Canada – IBC) pulled some tomfoolery in 2010. They didn’t increase your car insurance premiums, but dropped your coverage significantly. So, in essence at renewal you got half (or less) of the coverage for the same price. That is like spending the same money on your previous computer to now only get the monitor.

So, being an educated consumer, I “bought up” and paid extra for the same coverage I had before the changes. I am one of less than 1% of the population that did so. Now, IBC is saying they are going to drop rates by 15%. Well thank you oh noble insurers. That will give me the same coverage I had before 2010 (because I bought up) for the same price (because of the rate reduction). So, I am back to where I started, but the other 99% of the population are getting 50% of the coverage for 85% of the price. They are still at a significant loss.

In a recent MBA class we talked about risk. Driving a motor vehicle is the # 1 most unsafe activity when compared to 29 other activities people perceive to be risky (including smoking, drinking, extreme sports, risky professions, flying, etc.). So, if driving is our riskiest activity, signifying a high probability of injury, why are

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consumers so unaware of their coverage? Is it because we don’t think we will get in an accident (the “it won’t happen to me phenomenon”), or because insurance is “mandatory” we just purchase on price?

I find it strange that people take the process of buying a computer more seriously than the process of renewing insurance – especially when driving is the riskiest thing we do daily. In a PC World survey (2012), 63% of people indicated they bought a computer “extended warranty” yet research repeatedly shows that the $16B spent yearly on extended warranties is a waste of money. Compare this to the less than 1% of people that bought an “extended warranty” (i.e. extra coverage) on their car insurance. Buyer Beware! It is time that Ontario drivers start to understand the product that is car insurance so they can ensure they have appropriate coverage for an appropriate price.

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Happy Anniversary! Julie’s Top 6 Blog Tips

Julie Entwistle, MBA, BHSc (OT), BSc
 
I love milestones.  They are a time to reflect on the good, bad and ugly, and to look ahead with excitement and optimism.  Today marks the one year anniversary of the launch of this blog.  What started as an opportunity to spread the word about all things occupational therapy, has morphed into a new passion, a positive outlet, and hopefully one more way I can help others and matter in this world.   The result?  77 pages and over 41,000 words in original post writings, and an excess of 12,000 blog views.  Not bad!  But the biggest excitement for me are the conversations I have had with others – comments, positive feedback, ideas and emails that help me to stay inspired and think of stories to tell and things to showcase.
 
So, in celebration, this week will be “The Best of the Blog” where we will highlight the most popular posts from the year – the ones that were shared and read above all others.  But I wanted to launch the week by answering the question I am most commonly asked:  “what are your secrets to blogging and how do you do it?”  Well, here are my Top 6 Blog Tips:
 
1.       Like writing.  If you are not a writer, don’t enjoy it, or find it immensely time consuming, chore-like or difficult, blogging may not be for you.  Personally, I love writing and find the process of putting my thoughts on paper therapeutic, fast and easy.  This makes blogging for me a natural fit. 

2.       Be okay with criticism.  Blogging, like public speaking, is essentially “putting yourself out there”.  This exposes you to comments, sometimes ridicule and nastiness.  Everyone is entitled to an opinion and you can’t take it personally when that opinion differs from yours.  I actually love a good debate and enjoy hearing multiple perspectives on an issue. 

3.       Be inspired.  Like anything in life, success comes from being impassioned.  If you truly love something, and want to share that with others, then blogging about it is easier.  I am so inspired by the profession of occupational therapy, and by stories of amazing people who say and do amazing things, that it makes it effortless to tell these tales and to find sharable greatness everywhere. 

4.       Have help.  While I write my posts and proof and edit all my blog content, I am personally not responsible for posting and monitoring the end result.  Erin, my blog manager, keeps this organized, sends me stats, helps me to find awesome stuff, and reminds me of the things I should be mentioning or celebrating in different weeks or months.  While I love to write, I don’t love technology so if needed, find someone else to handle that part. 

5.       Keep it personal.  I know people (and companies) that have blogs that they don’t write (or even read) the content that is posted in their name.  While that is an effective way to be on social media and to build online presence – is it genuine?  Does it reveal anything about who they are or what they know?  The most fascinating thing about this world is the people in it – their experiences and knowledge.  Share that! 

6.       Blog often.  Personally, I think you are better to NOT start a blog at all if you can’t maintain it.   Nothing to me looks worse than a blog that was started and then ignored.  Don’t put a marginal effort into it as that just negatively reflects your own brand personality.  Or, if you do start a blog, and realize it is not for you, shut it down, lick your wounds, and move on.  But before you even launch it, write 8-10 posts so you have a head start.  If you can’t do that, or don’t enjoy it – red flag! 

Rightly or wrongly, these are my personal blog pointers.  And revealing that begs the question:  “What is next for me and this site”?  Well, as I said, this one year milestone has me looking ahead with excitement and optimism.  More guest bloggers, original posts, controversial content, and video.  Stay tuned! I have a few fun projects in the works that I hope to launch here in the next few months.  And as always, I would love your feedback.  Ideas?  Comments?  Bring them on!
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Service Dogs are in the Grocery Store, Why Not the Schools?

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

In a previous blog called “Dog Awesomeness” I outlined how service dogs are being used more and more to help disabled children and adults function more independently and safely in their home and communities.  These dogs have been so widely recognized as useful for people with disabilities, that they are now allowed in public places, on airplanes, and even privately owned commercial establishments.   People with disabilities have fought long and hard to make this happen, and society has accepted these animals as working assistive devices – well trained and not to be tampered with or touched.

More recently, there has been growing research to support the use of service dogs for children with Autism to help them manage both inside and outside the home.  To recap, Autism is a complex developmental disability that typically appears during the first three years of life and affects a person’s ability to communicate and interact with others. This disorder is defined by a certain set of behaviors and is a “spectrum disorder” that affects individuals differently and to varying degrees. There is no known single cause, and no cure.

Inside the home, Autism service dogs can help to modify behavior in these children. Many parents have reported that the service dog provides a calming influence as the child pets the dog, or has it lying close by. This comfort can also allow a child to cope with transitions between places, activities, changes in routines, and may even help to improve sleep patterns. The child is able to get through anxieties that may be associated with daily activities with the help of his or her dog.

When outside the home, the service dogs is trained to respond to commands given by the caregiver or educator, particularly “stop”. As a result, this prevents the child from entering into potentially dangerous situations and gives the caregiver or educator time to intervene if needed. The service dog also prevents the child from wandering away from the family while out in public settings, and provides opportunities for parents and caregivers to teach their child about staying with their service dog and walking safely outdoors. The dog also acts as a companion for the child, constantly next to them to pet or cuddle which relieves anxiety.  Essentially, the dog forms a physical anchor, making public outings easier to cope with for all involved. Because the child also shares in the responsibility for caring for their service dog through exercise, grooming and feeding, this increases the opportunities to enhance the child’s independence, while also allowing them to achieve a sense of responsibility.

Considering the immense benefits of these dogs for children with Autism, I was surprised to read a Toronto Star article that reported that Canadian parents of these children have had to fight to get service dogs allowed at school. While parents are getting some legal help to lobby for a fair and standardized policy on this, nothing has been developed and most parents are having to fight on an individual basis as each school, and school board policy, is different.

My mom told me a comical (and gross) story of a puppy service dog (“in training”) who she saw in the grocery store.  As the trainer was obtaining items from the bulk bins, the dog was head deep in another bin eating mouthfuls of something while drooling and slobbering all over the place.  The owner didn’t notice.  As the man walked away with the dog, my mom alerted a clerk who had the bin emptied and cleaned.  But the story leads to the question – if service dogs are allowed in the grocery store, why not the schools?

If service dogs are truly “assistive devices” aimed at improving independence, behavior, providing comfort and safety, and reducing anxiety in a child with Autism, then the schools should be required to accommodate.  Now I recognize that some other children could be allergic or fearful of dogs, but this will be the minority and with some careful planning, classes could be organized to meet the needs of all.  I think society, and the parents of today, are more apt at supporting these accommodations – we have already adapted to nut-free schools, litter-less lunches, nutrition policies, technology for learning, multiple page trip waivers – evidence that we are open, understanding and willing to evolve the meet the changing needs of our times, and our children.

References

Autism Dog Services www.autismdogservices.ca

The Toronto Star:  The Toronto Star:  Parents With Autistic Kids Fight To Get Service Dogs in Schools

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Leisure Anyone?

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

I took this photo on a recent vacation. I am always thrilled to see resorts and establishments making an effort to include people of all abilities in their offerings.

The recent Olympics and Paralympics remind us of the importance of sport and leisure in our society. These games, and the immense displays of athleticism during the same, inspire people of all ages and abilities to either start, or increase, their participation in sporting activities. Sport is an avenue that provides people with a sense of physical, mental and emotional challenge, camaraderie, a sense of purpose and fun. Whether it be at a competitive level, or a game of pick up on the weekends, sport is one form of enjoyable leisure activity.

Leisure activities are those things we do or engage in during our free time, and can be passive or active in nature. Passive leisure activities are those types of activities that we often engage in alone and involve slower paced activities. This can be things like reading, watching a movie or painting. Active leisure activities on the other hand are often completed with others and tend to be faster paced and more physically demanding, including

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sports, gardening or going skiing. Regardless of the preference for passive or active leisure, in our fast paced society, the importance of making time for leisure cannot be overstated.

Leisure activities provide us with opportunities to socialize and develop emotionally, as well as provide physical and cognitive development to improve health and well-being. Our participation can also impact those around us as they help us to build skills that support us in both work and life.

However, when we think of leisure, we often think of opportunities that are easy and convenient for most people. Yet, for individuals with disabilities, participating in leisure opportunities, while equally important, is often more difficult. Individuals with disabilities often have less free time due to lengthy morning routines, the increased time it can take to manage daily tasks, and often frequent medical or rehabilitation appointments. Environmental barriers can also be present such as lack of transportation, inaccessible venues, or inherent aspects of the leisure activity that aren’t suited to the individual’s skills or interests.

Occupational therapists recognize the importance of leisure activities for persons with and without disabilities. We work with clients to help explore their interests to help expand their repertoire of leisure activities, and find ways to address the different barriers to engaging in these meaningful past times. Whether it be altering the activity so that it is better suited to one’s capabilities, making the environment more accessible, or helping someone with strategies to alter their schedule to include more time for leisure activities, occupational therapists can help people bring more fun back into life.

If you have a disability and would like to expand your leisure opportunities, or try something new, consider some of the following activities that, if modified or locally available, can be enjoyed by all:

  • Golf (see the previous post on Golf Fore All)
  • Martial Arts or Tai Chi (also a previous post)
  • Yoga
  • Sit-skiing (downhill or water)
  • Sledge Hockey
  • Modified Scuba Programs
  • Fishing
  • Swimming
  • Horticulture
  • Cooking classes and education on use of modified kitchen tools
  • Hiking or Walking (on paths or rail trails)
  • Cycling (pedal or hand biking)
  • Scuba or snorkeling
  • Curling
  • Sailing or rowing…to name a few.

Those are just a small snapshot of examples. For more ideas (including extreme sports such as bungee jumping or sky diving) check out Abilities Magazine, or contact an Occupational Therapist to discuss what might be a good fit!