Meet the Kids

Hello everyone!

It’s been a while since I’ve shared an update—my apologies! Life has certainly become busier as I have become more settled and taken on more in my role here. For a while I have been wanting to share more about the children in our homes and the work I do on a day to day basis, so prepare yourselves to see some beautiful faces and learn a bit more about what I do as an occupational therapist. Enjoy!

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I continue to work 5 days a week in our two (soon to be three!) children’s homes, providing occupational therapy to all of our children with special needs. In total there are 25 children between the two homes that I work with on a weekly basis.

What exactly does my role as an occupational therapist look like? Many people, especially here, have little familiarity with the profession of occupational therapy. People hear the word “occupation” and think “job” or “work”, so how does that apply to children? In the context of our profession, the word “occupation” means “meaningful activity”—every meaningful activity that is a part of a person’s day. From being able to physically get out of bed and get ready for the day, to preparing meals and eating them, to going to school or work, to participating in leisure or play activities—all of these are meaningful activities in our day to day lives. But what happens when a person has some sort of limitation preventing them from doing these activities independently? This is where occupational therapy comes in. Our role is to help facilitate the development of the needed skills or find a way to adapt the environment or activity to allow the person to participate at their highest capacity.

The children in our home have a wide variety of diagnoses—autism, cerebral palsy, Down syndrome, developmental delay, microcephaly—to name a few. Each of them has their own individual needs, and with each child I have established a care plan of developmental skills to target during therapy.

Meet some of the kids! It won’t take long to see why I adore them:

Olimpia and Alison are our two children with Down’s syndrome. Alison is nearly if not completely deaf, and is learning Guatemalan sign language to be able to communicate. As is common for children with Down syndrome, both girls have low muscle tone and delays in fine motor and gross motor skills, cognitive skills, and balance, among other things. Though at times stubborn (also typical of children with Down’s) they are a joy to work with in therapy with their lively personalities.

Olimpia

Alison

 

"Am I rocking this extra chromosome or what?"

Roxana is on the autism spectrum, and much of my work with her is on meeting her sensory needs and working on her ability to follow basic instructions and maintain attention to an activity for a period of time. She is making steady gains week by week. She’s a wild child, and I love her for it.

Roxana

Roxana

Jarred has cerebral palsy. He is a smart and happy 4 year old with a smile that will melt your heart. Though unable to speak, he knows exactly what he wants, and he isn’t afraid to make it known. Some of the skills I work on with him include improving the coordination of his dominant hand so he can do basic tasks such as feeding himself and playing with toys, increasing the use of the right side of his body, and improving his core strength and balance to be able to sit and stand with less assistance.

Jarred

Jarred

Paola has severe cerebral palsy with little control over the movement of her body. She has multiple contractures (connective tissues that have become constricted and no longer allow movement of a joint beyond a certain point). Her potential to gain any meaningful level of independence is negligible; however, it is important to maintain the mobility in her joints to prevent further contractures and resulting pain, and to position her in a safe manner that prevents further damage. Another huge part of my role here is to educate our staff, so I teach Paola’s caregivers how to stretch her and position her safely.

Paola

Humberto has cerebral palsy with fluctuating muscle tone that makes it extremely difficult for him to coordinate the movement of his arms and legs. Several months ago our ministry received a donation of two eye-tracking communication devices. During therapy, Humberto is now learning how to interact with a computer interface solely through the movement of his eyes. He can select objects on the screen by maintaining his gaze for fractions of a second. As his accuracy improves, he will be able to communicate simple answers and requests through the use of this communication device. It is such a big deal when a child has a means of communication!

Humberto

You may remember Kevin from a previous post—a malnourished child we received in March and nursed back to health. He’s no longer skinny, that’s for sure! Kevin has delays in all areas, but one of the main areas of focus right now is improving his ability to eat more-solid food—this means adjusting the texture and consistency of the food he eats to match what he is physically capable of manipulating in his mouth and swallowing, while also implementing techniques to improve the coordination of movement and strength in the muscles required for eating—at times these muscles fatigue quickly and as a result eating is a lot of work for him. But he is surely receiving adequate nutrition! We are also working on improving his core and neck strength so he can hold his head up on his own when he is sitting and propped on his elbows on his stomach.

Kevin the day he came to us

Kevin (now)

Kevin (now)

I also get to make splints and adaptive equipment for the children. A few months ago, the director of our second home approached me asking for a method for several of her children to be able to color. Due to their cerebral palsy and fluctuating muscle tone, maintaining a grasp on a crayon is extremely difficult. In collaboration with another occupational therapist who was visiting for a few days, we developed and created these devices that strap to the child’s hand and wrist and maintain a grasp on the crayon. All the child has to do is move his/her hand to color on a piece of paper.

 My role also involves making sure wheelchairs are an appropriate fit and functioning properly. It’s crucial to prevent the children from getting pressure sores or from sitting in a position that does damage to their joints or muscles. I learned so much in this area during my trip here last year, where my primary role was wheelchair fittings and adjustments—this has quickly become one of my favorite things to do here. Access to custom-fit wheelchairs is a rarity, so often we are customizing wheelchairs the best we can to achieve a safe and functional position for the children. Last week I made a custom cushion for pressure relief for one of our children with scoliosis. When resources are low, you become creative in using what you have available.

Last week, our nurse Katie opened up a nutritional training center in our town, named Hogar Rosalinda. Mothers bring their malnourished children and live in the home for several weeks to months at a time, where Katie teaches them how to provide better nutrition and care for their child. There are currently two mothers, each with a son, living in the home. Both of the boys (ages 1 year 8 months and 3) have special needs as a result of the malnutrition, so I work with them regularly to help facilitate developmental skills, just as I do in our two children’s homes. We hope to see significant gains as their nutrition improves.

Therapy at Hogar Rosalinda

I have also begun to see a few patients in our community. As my Spanish improves I am able to do more home visits without having a translator present. I am now working weekly with an adult patient who suffered a cervical spinal cord injury after a fall—he’s been in bed for the last several months and has lost a significant amount of muscle mass and strength in addition to the muscle atrophy that has been caused by a lack of nerve innervation due to the damage in his spinal cord. I am hopeful we will be able to reach a point where he can sit in a wheelchair and complete basic tasks without minimal assistance—like feeding himself, using the TV remote, and brushing his teeth—but it’s going to take a long time and a lot of work to get there. Please keep him in your prayers—he has a long journey ahead of him.

Incorporating our rabbit into therapy with a woman from the community

I continue to visit a rural clinic every month to assist with patients there and support the therapy aide who manages a caseload of nearly 35 children and adults per week. It is common in this clinic to receive patients who have been misdiagnosed or underdiagnosed by physicians, and I am frequently expressing my concerns and doubts about the information they have received and subsequently requesting referrals to additional specialists for a second opinion. The lack of education in the medical field is discouraging, and many families don’t have the health literacy to question the accuracy of the information these doctors provide them. Providing education to these patients and their families is absolutely crucial. I now have an even greater appreciation for the years I worked at the hospital and all the medical knowledge I gained during my time there.

When I told this woman to push me away (to assess her arm strength) she said "I don't want to push you, I want to hug you"

There is no shortage of work to be done—the needs are great and I love being in a position where I can provide purposeful education. One of my favorite aspects of working in the hospital setting back in Ohio was being able to be a source of hope for patients and families, and that continues on here. Without a doubt, I love what I do, all the people I have the opportunity to interact with, and how I am able to serve here.

Thanks for reading, and as always, thank you for your love, support, and prayers.

Lindsey