I was told by many that my clinical rotations would fly by. In the moment, it really doesn’t feel like it, between all of the preparations (mentally, financially, physically). From all of the cross country flights and broken planes to evaluations and treatment planning, it definitely flew by.  Some time has passed since I successfully completed my behavioral health rotation in Erie, PA and my pediatric rotation in Lake Tahoe, NV so I wanted to take some time to reflect on some of my experiences before the new semester takes over and I move into my LAST semester of on-campus courses ever.

This reflection is primary going to focus on my pediatric experience, since it is more recent and fresh in my mind. I learned a ton in my behavioral health rotation, but that will definitely take a separate post, so stay tuned for that as well.

When we start applying for or attending OT school, we often get the question, “what setting do you want to work in?”. Some of us know what we want, some of us need to explore more. I’d like to say that I always knew I wanted to work in the pediatric setting. I absolutely love kids and I know how important OT is as early as birth! I was so lucky to have had the opportunity to complete my 2nd rotation in the early intervention/pediatric setting in Lake Tahoe, Nevada. My clinical instructor, Courtney, was amazing in so many ways and I will forever be thankful for her taking me in for the experience and really allowing me the opportunity to ask questions, take challenges, and grow my clinical skills.

Population/Setting
My setting was community-based and we served children and adolescents in Nevada. In early intervention, I was able to see clients who had a wide range of concerns  such as sensory processing difficulties, rare genetic diseases, fine/gross motor delays, and difficulties with attention/behavior. I really enjoyed this setting because it was community-based, meaning we meet the families where they are whether it be at home, in the school/daycare, or park! Wherever the kids were, that’s where we would go.

Interventions
Each intervention was tailored to the individual goals of each client. If you are an OT or OT student, this is super important. We go into the community to meet the clients where they’re at and focus therapy around what areas need to be improved so that the child can function in that setting. During the first couple of weeks, Courtney had me observe settings so that I could get a feel for the setting and see what she was doing with each client. This was really helpful because I had the opportunity to get to know the clients and their families while trying to really get familiar with what early intervention is all about. As the weeks progressed, I came to better understand the purpose behind each intervention and how it helps the client. Since I was working with kids and some teens, there was a lot of play! Some of the interventions that I observed and carried out myself include:

• Body Sock
• Ball Tower
• Marble Run
• Astronaut Training Protocol
• Lots of crafts (even more fun since it was around Halloween/Thanksgiving/Christmas!)
• Board Games
• Scooter Board Activities
• Behavioral Techniques
• Writing/Drawing/Coloring
• Parent Education

Documentation
Documentation is something that I tried to prepare for in class and hope for the best. I was nervous for documentation because I know that it is just so different across settings, populations, and among documentation programs. For my rotation,  I used WebPT. I honestly am so glad that my first real-life documentation experience was with WebPT and I was so lucky that Courtney was so good at documentation herself. The program was extremely easy to use and by the end of the 12 weeks, I felt confident in my documentation skills. I hope that in the future I get to use this program again because it was really great, especially for a beginner such as myself! When I first started writing up session notes, I had somewhat of a difficult time but I learned that it was so important to really look at the client goals and how the intervention tied in with that. After more practice, I found myself becoming more concise and having the information in my notes flow better. I also used WebPT for documenting evaluation information. I had some difficulties navigating that because there were so many boxes and check marks, leaving me confused at some times. Thankfully, Courtney was always there to help guide me when needed. I felt confident when conducting evaluations and I was able to learn how important it is to really listen to what concerns the parents or teachers may have while also picking out the important information. I loved the evaluation process and I really had the opportunity to improve my interviewing and communication skills.

Assessments
Conducting assessments on real kids can definitely be intimidating.. I am glad that my pediatric interventions course really hit on many different settings and populations when it comes to pediatrics, rather than just focusing on school our outpatient therapy. I feel I greatly benefited from having multiple perspectives during that course, as it allowed me to become familiarized with a wide range of assessments and interventions. Some of the assessment tools I used during my rotation include the PDMS-2, Sensory Profile, Beery VMI, and the Motor Free Visual Perceptual Test.

Key Players
In the early intervention setting, it’s important to know that you aren’t just working with the child. You are working with the parents, the caregivers, the teachers, other health professionals. I enjoyed getting to communicate and interact with the other team players because it allowed me to better help the client. When teachers or caregivers were onboard, it allowed for the client to be supported all around.

Meaningful Takeaways
Like I mentioned earlier, I always knew I wanted to work with kids and teens. Having a hands-on, immersive experience really helped solidify things for me. I always knew that with my previous educational background and interests I wanted to work with children who had behavioral, social, and emotional difficulties, but I didn’t know if I would be good at it. Having this experience and having Courtney cheering me on, I realized that it is right where I need to be.

I learned that to succeed, you have to ask questions. You have to be confident, yet humble. I found success in situations where I took chances and jumped right into things. Of course there were times that I didn’t feel confident, but I made sure to take the steps to be proactive and ask questions while being open to learning. When working with kids, you have to be able to have fun and stay up-to-date on things like Paw Patrol and know all of the lyrics to Frozen. But, you also have to be able to have sometimes difficult conversations with parents or caregivers. I learned that you have to be flexible and compassionate. Sometimes, well, a lot of times there can be cancelations due to sickness or other causes, but you still have to continue your day. You have to show compassion and respect to everyone because honestly, those parents and children are dealing with a lot-from having OT, Speech, and Developmental Specialists coming in and out of their homes or doctor appointments, all on top of normal daily activities and trying to navigate the world. I learned that you have to be open-minded and respectful. Some of the families lived very far away with little resources and you have to go into the homes like it’s any other house you’ve been in. There is no place for judgement when it comes to serving any population. We go in there and make a difference for the client.

Through this experience, I was able to see a lot of Nevada- from the beautiful lake to houses out in the desert where horses ran free. I got to finally have an In-N-Out burger (or a few) and to experience my first snowy winter. I met so many amazing, strong little kids and will always remember all of the fun times. Although this is only the beginning of my journey, I have learned so many valuable lessons that I will carry with me as I continue my adventure to become an OT. Thank you to all of the teachers and mentors who were always there for me when I needed support or ideas and thank you to Courtney for being an amazing CI.