#251 - Home Health Occupational Therapy with Jessie Given, COTA/L

April is OT Month - Check out our OT Month Digital Course Sale! harkla.co/otmonth

Sale ends April 30, 2023

Jessica Given is a pediatric Certified Occupational Therapist Assistant with 6 years of  intensive experience in the outpatient clinic setting with an emphasis in sensory integration. She is currently serving in the home health setting and has been since 2021. Jessica has completed certification as a Therapeutic Listening Program provider and Clinical Anxiety treatment professional, in child and adolescents. She has extensive experience working with a variety of diagnosis and rare genetic disorders specializing in Autism and Sensory Processing Disorder.

She is incredibly passionate about learning all evidence-based therapeutic interventions and programs to best reach goal outcomes and the highest level of functioning for all children. Some of her favorites include: Beckman Oral Motor Protocol, Pediatric Rock Taping, Bal-A-Vis-X, Movement and Therapeutic Listening Program, Primitive Reflex Integration, and Yoga and Mindfulness.

Throughout her practice, Jessica always felt drawn to the effects of mental health and behavior and the impact it can have on treatment and goal outcomes. She pursued her certification in anxiety treatment  to improve her holistic approach and empower her clients and families to achieve optimal performance levels and highest function.  Jessica served for 6 years in the Idaho Occupational Therapist Association Board in the roles of Legislative/Reimbursement Chair and as Co-Chair Outreach Coordinator.

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Transcript

Jessie: 0:00

So you could take playing cards, I mean, something as simple as a card stack. Everybody has them, almost every home has them. But you can bring them it fits in your pocket. And you take it into a home and you're working on working memory, Lucky sevens great game. You're working on speed games, where they're happy to make matches really fast and using those ocular motor functional skills. You can address sequencing. So you have to wait your turn, you have to go in a certain order, you have to be able to control your impulses, super hard. But you're also working on those fine motor dexterity and hand manipulation skills, and bilateral integration because you have to use both hands to play cards.

Rachel: 0:48

I'm Rachel

Jessica: 0:49

And I'm Jessica. And this is All Things Sensory by Harkla.

Rachel: 0:52

We are both certified occupational therapy assistants and together with Harkla. We are on a mission to empower parents, therapists and educators to help raise confident and strong children of all abilities.

Jessica: 1:04

On this podcast, we chat about all things sensory diving into special needs, occupational therapy, parenting, self care, overall health and wellness and so much more.

Rachel: 1:14

We're here to provide raw, honest and fun strategies, ideas and information for parents, therapists and educators as well as other professionals to implement into daily life.

Jessica: 1:25

Thank you so much for joining us. We have something really cool to offer you today. It is April and April is OT month. And in celebration of OT month, we're bundling some of our favorite digital products together and giving them to you for a discount, want to call this the OT digital bundle because the digital courses that we've bundled together for April will just help you become a better therapist.

Rachel: 2:01

They're not only beneficial for therapists but because we are celebrating OT month, which is occupational therapy, we are giving our primitive reflex course our sensory diet course as well as our three skills courses, which include gross motor skills, fine motor skills, and visual motor skills. And so you're going to get all five of those courses, which is a $220 value for only$149 which is basically 50% off.

Jessica: 2:35

Almost a 50% off discount for five courses. Just kind of a quick rundown if you're not familiar with our digital products. Our primitive reflex course, we teach you how to identify routine primitive reflexes as well as provide you the specific exercises to help integrate primitive reflexes. So it's great for therapists or parents who are learning more about primitive reflexes. Our sensory diet digital course teaches you how to identify sensory preferences, how to meet the sensory threshold and how to put different sensory strategies together in order to help your child feel regulated in order to get through their day. So another great one for therapists to help them better understand how to help their clients. And then like Rachel said, our three skills courses. The three skills courses are very activity based so our fine motor skills course gives you a ton of new therapeutic activities to work on fine motor skills. Same with the gross motor and the visual motor courses. So those three are really awesome. If you are looking for more treatment ideas.

Rachel: 3:42

You can take advantage of this sale this bundle this fabulous discount we are sharing through the end of the month. So if you're listening to this after April, I'm so sorry, you know but you missed out, maybe next year. Just want you to know that we appreciate you listening to our podcast, we appreciate the consistent support. And you know this is just a little way of saying thank you and go OT!

Jessica: 4:11

Yes, exactly. The link to take advantage of this bundle is going to be in the show notes but the link is harkla.co/otmonth

Rachel: 4:24

Again that's Harkla h a r k l a.co/otmonth.

Jessica: 4:31

Okay, now we can jump into the episode.

Rachel: 4:33

Okay, enjoy. Hey there welcome back to another episode of All Things Sensory by Harkla. We are excited to have you back. We are sharing a fantastic interview with you today with someone very special.

Jessica: 4:48

We are interviewing Jessica Given, she goes by Jessie, and we know her because we worked with her for many years.

Rachel: 4:56

Yes we do. I love it.

Jessica: 4:58

She is a fellow COTA, and she is going to talk to us about working in home health. She has worked in home health for going on two years now. She is also certified in a couple of different protocols or programs including the listening program. She's also going to talk to us about an anxiety protocol that she's certified in and then she also recently took a course through the Beckman.

Rachel: 5:28

Deborah Beckman, yeah, the oral oral motor course.

Jessica: 5:32

So she's a very well rounded therapist, and she truly believes in gaining as much knowledge in as many areas as possible to help her clients, which is why she's such a great therapist,

Rachel: 5:45

You are going to love her energy, her spirit. So without further ado, let's meet Jessie. Welcome to the All Things sensory by Harkla podcast studio.

Jessie: 5:57

Thank you for having me. I'm excited.

Jessica: 5:59

We're really excited that you are here in person because we don't get very many of our guests to be in studio with us. And it's a whole different vibe. Yeah, body language, the energy in the room, all of it and the energy is high today.

Jessie: 6:07

You are a high energy person

Jessica: 6:09

I am. It works for most clients.

Rachel: 6:18

Today, we're gonna be talking about home health. But before we do we have five secret questions for you.

Jessie: 6:23

I love it. Shoot.

Rachel: 6:24

The first one. What is your dream vacation?

Jessie: 6:30

I will go to Tahiti. But my dream vacation will be an African safari where I take a couple months and do that and explore South Africa and then stay to do a humanitarian effort with occupational therapy.

Jessica: 6:50

That's my new dream vacation. It's gonna be amazing.

Rachel: 6:53

But what happened to Tahiti?

Jessie: 6:55

Well, Tahiti was like since elementary. I just want to be in Tahiti. I thought the name was cool. But the more I look into it, um, there's multiple places though. You want to go Peru, Bali. You know, all the places see all the things. But yeah, my dream vacation will be extended time off.

Jessica: 7:15

Next question, would you rather spend five years in jail or be in a coma for 10 years?

Jessie: 7:20

Oh, a coma for 10 years. So you don't have to deal with people. No, I just need the break. I deserve it. I'm in my second stage, you know, of life, like up over the hill and coming down. And yeah, if I could rest for 10 years, I come back so strong.

Rachel: 7:40

That's so relatable right now. I would I would do the same thing. If you could choose a different career, what would it be?

Jessie: 7:47

Hmm. That's, that's a good question. I would love to do art therapy, music therapy, similar careers in the profession. But if it had to be completely different, I would probably do something more physically challenging. So I would be, I don't know probably like, nonprofit humanitarian building things.

Rachel: 8:18

I was gonna say that's not like, different different but the building things.

Jessie: 8:23

Yeah. I like to move my body and like shall heavy work. Sensory seeker that is true. I always have been.

Jessica: 8:34

Okay, next is what is your spirit animal? I think I know what it is. I don't know. I have my guess.

Jessie: 8:43

So my spirit animal in fact, until first grade, I thought it was a unicorn. I would even run on the playground because I was the fastest girl in the class. I'd beat the boys and pretend I was a unicorn. Um, my guess was a horse. Yes. So yeah, my spirit animal would definitely be a horse.

Rachel: 9:05

I love it. Good job. You know, fun fact real quick. The reason why we call Jessica, Jessica and Jesse Jesse is because when we all work together, there was too many Jessica's so we had to come up with different names.

Jessie: 9:19

We did, but it fit because all my close friends and family call me Jessie. Built close relationships. It did fit.

Rachel: 9:29

Yeah. So our last question. Yes, the best one. And we probably know the answer to but our listeners will get the deep dish here. What is your sensory quirk?

Jessie: 9:41

Ooh, I've got several but yes, I'm definitely a sensory seeker. So just finding that just right sensory diet where throughout the day I can ground myself and calm myself is important. My families appreciate that. But also, I only like to eat off plastic and paper. I am single handedly ruining the environment.

Rachel: 10:06

Now why is it that you like to do that?

Jessica: 10:09

Wait, because you don't like to do dishes because I don't think that's a sensory quirk.

Jessie: 10:14

You know what that is the benefit actually, but it is a sensory cork because I don't like the feel of the metal on my teeth with silverware and the clanking or the smell of the glass dishes coming out of the dishwasher

Jessica: 10:30

Or like that scraping of somewhere against the porcelain?

Jessie: 10:34

I don't like that. It's true and I've just as an adult, I can make that choice to be like, I'm just gonna opt for paper this time. I can do it. I can if I go out to eat I will not ask for paper or plastic at a fine dining establishment but that is just what I do at home.

Jessica: 10:51

There it is. Great. All right now that everyone knows your deepest, darkest secrets, can you tell our audience who you are, what you do and why you do it?

Jessie: 11:00

Yes, I am Jessie Given. I am a certified Occupational Therapist Assistant. I come from a background of working at a sensory integration clinic outpatient pediatric facility in Eagle Idaho. I worked there for six years and then moved on to the home health setting and have now done that for two years in the Treasure Valley. Love it. I did two peds rotations, so that's kind of where I got my niche with peds. I got fortunate I thought it was gonna go into nursing, assisted living facilities. Love my geriatric crowd, love them. However, that just wasn't in the cards for me. And I just really found my niche in pediatrics. And I've stuck with it.

Rachel: 11:46

You and me both girl. So like I already mentioned, we're going to talk about home health today. It's not a topic that we've actually covered on the podcast, but we needed someone who could share the ins and outs of home health. If you are a therapist listening, you and you are in home health, you're considering changing to home health. We definitely want to fill you in on Jesse's experience. And she's going to share some tips hopefully share some tips. And we're gonna jump in. So the first thing, how does home health compare to seeing kids in the clinic?

Jessie: 12:28

There's pros and cons to both for sure. In clinic, you have the support of a team, you have the support of having strategies at your fingertips equipment at your fingertips, you can modify and accommodate utilizing different therapeutic techniques that maybe you don't have the space for in a home health situation, or the equipment. And definitely not the program's. Families, you know, it's new for them, typically. Kids in clinic, you work towards goals by teaching them those underlying skills that they might be missing. You definitely can hit goals and reach goals. You see them be successful in real time in the sensory gym, or whether it's back in one of the work rooms. And you're super excited and happy that they're reaching these goals and meeting these milestones and you send them home talking to the parents briefly for 10 minutes, giving them a home program or something to work on to address whatever deficit they're working towards. And, you know, briefly show them you might have a two minute little demo of what you need them to do. And you send them on their way. Unfortunately, parents are already feeling frustrated, anxious, disheartened, because their kids are struggling. And now you've given them this little two minute blurb. And they get home and they're like, What did she say? How did that look? Oh, yeah, I recorded her. Let me look, I don't even know what she's doing. Here. I've been trained and had years of experience, on top of taking continuing education courses, in depth courses where I'm certified in some and it's been years of experience. And I'm giving a two minute blurb to this parent, and they come back and a lot of times they come back time and again with the same challenges or the same deficit or they're like, Hey, you said they reached this goal or they're meeting this milestone. They're not doing it at home. They're definitely not doing it at school. And so kids can't generalize those skills we're teaching them all the time at the clinic, or they're showing us that they can be successful because we're facilitating and simulating activities that look like real life or they're doing in real life. But then they're not able to carry over in that home setting to be successful.

Jessica: 15:04

I mean, we've all experienced that the three of us because we worked in the clinic setting, and that was the main driver of starting the podcast many years ago, was because the parents didn't get enough information from us in that 5 to 10 minutes that we could talk to them in a busy clinic waiting room that was full of too much stimulation for them to be able to process what we were telling them. And so yeah, it's, it's tough.

Jessie: 15:33

It is, it's disheartening to therapists and kids. Yeah, you lose your momentum with treatment, because they come in so excited, they're ready to grow, learn, experience new things, and build skills that they need to be successful in real life. And when they're still, you know, after six months struggling with those same challenges, and you can't move on, you just you lose on your momentum.

Jessica: 15:59

And that's not to say that the clinic setting is terrible or not beneficial. It's just kind of the downside to the clinic compared to home health. Right?

Jessie: 16:08

Correct. There's also extreme benefits to outpatient therapy and clinic settings. Kids, some kids, I have found will do better in outpatient away from the home setting, where they, you know, are away from that environment that's triggering or they're struggling, and they get 30 good minutes of sensory prep and functional, you know, stimulation with gross motor, and activating both sides of the body sequencing steps for your gross motor skills, learning how to control your regulation, and sensory processing, and then moving on to a fine motor task or completing an ADL. And that's great. They make great strides with that, because they're doing their whole body and that holistic approach to each individual child, where, you know, in the home, we get 30 to 45 minutes, we're barely barely regulating before we're already jumping into a functional activity. Sometimes it's incorporated to both. And at home, some kids get so set and rigid with their routine, the structure of the routine, who feeds them, who close them, you know, what shows they're going to watch, sometimes I interrupt, you know, Baby Shark, it's over, done deal, because that is their time to have that music. And I just came in and I'm like, let's do this functional peg task. And they're like, what, no way. And I get major pushback. And some kids, depending on the severity of their diagnosis, won't just pop out of that rigidity, no matter you know, how much intervention I'm implementing, they really need a different setting. They need to be shaken up a little bit to be successful, and then home health might be beneficial. So I have referred families to outpatient.

Jessica: 18:14

I wonder what would what would it look like for a client to be able to do both maybe do like home health once a week and in the clinic once a week?

Jessie: 18:24

I think we'd have the most success. If we were able to do that. Right now insurances won't pay for that. Certainly not Medicaid. So we as therapists in whatever setting you're working in, absolutely need to educate the parents as far as, hey, there's also co-op groups, there's these resources in the Treasure Valley that you can get involved with. This is how you're going to get the social aspect, which is great with clinic based settings because you can interact with other kids and therapists. You're their motivator, you're their champion, you're their coach to get them involved in other things. So during home health. Home health has its pros because like I said, you're working on these ADLs. Let's take showering, for example. In the clinic, you can sequence the steps all you want, you can facilitate it all you want. You can you know simulate an activity where they're doing multiple steps, and you're making sure they have their visual chart to hit each step. You're making sure they have the gross motor skills, functional postural control, right? Trunk rotation, fine motor, dexterity, grasp strength. Being able to wash your own hair, make sure you're efficient and washing your body, washing all the conditioners shampoo out of your hair, and then getting out and drying off, towel drying, getting dressed all that stuff you can facilitate in a clinic, you can actually do it. So in home, in real time, kids don't have to generalize skills you're teaching them. You're in real time giving them all the tools they need to be successful, giving them all the underlying functional skills so that they will be successful. And they're doing it. And they can generalize it because they're there. This is where they shower. But my most favorite thing that I get to do in home health, is empower and educate parents. So I've been given and had the opportunity to have, you know, years of education, years of experience worked with multiple diagnoses and different kiddos of all ages zero to 21. And I'm able to empower parents to do what I'm doing. So the carryover, which is hard in clinic, is phenomenal in home, because you're one on one in it with those parents. They're in real time seeing it, they're seeing the real modifications, the real accommodations, a sensory strategy, or a sensory diet in real time, real life, and how it changes the outcome of the session, but also the success and independence of the child. And when parents realize what their kids can actually do and what they do. You know, the whole room lights up, kids are happy, parents are super ecstatic. And they're like, Yeah, we got this, we can carry this over.

Rachel: 21:32

Yeah, that's a good point. So what does a typical day in your life look like, as a home health, occupational therapy assistant?

Jessie: 21:43

It varies. I wake up and I have to organize myself, that is one of the, you know, cons to home health is you have to be extremely organized and prepared. You can't just go in and you know, grab a piece of equipment and know you're working on this skill, but everything's readily available. So I have to have my my plan, my treatment plan, you know, my evidence based, all my protocols, all the different treatments I can offer at my disposal and just plan my session start to finish to meet that guideline of 30 minutes. So I'm in routine, you know, sensory prepping them, we're doing a multi sensory activity, engaging the whole body, the whole brain, and then going into, you know, that very functional task of, let's see, you be successful now with, you know, this deficit that we're working on, and still being able to educate the parents throughout or after, if they're watching. And then clean up and pack it all back up into the car. So it comes with a challenge. But now my after two years of this experience, you know, I grabbed my my bag, the kids love it. They're like, yes, it's the Mary Poppins bag, because it has all the good stuff in it. And I change it frequently. Kids love novel. So I bring it into the house. They're ready. They're excited to see me. We do our session, we talk to the parents. I find out, you know, what's been challenging this week? What hasn't? Where would you like to go? Is there anything immediately that needs, you know, concerns that need addressed? And then I'm cleaning up, you know, and leaving them with whatever they need to work on for that next week, before I return?

Rachel: 23:39

What types of clients do you typically see? And then how often do you normally see a client?

Jessie: 23:43

So my clients range from birth to 18 years in the home health setting. I do anything from autism spectrum, ADHD, ADD all the way to rare genetic disorders where I'm working with... and everything in between. So just even milestone, you know, Miss milestones developmental delay. I see clients depending on their severity, or what they qualify for after initial eval once or twice per week. Okay.

Jessica: 24:22

So all of that, like your clients, and the amount of time you see them is pretty much the same as in the clinic setting.

Jessie: 24:30

Correct. Clinic setting is usually 60 minutes. And then home health, we are allowed our 45 minutes.

Jessica: 24:41

Interesting, because oftentimes in the clinic, too, we'll do extended sessions where it's like an hour and a half.

Jessie: 24:47

You can yeah. We don't bill the same codes. So we are, you know, your highest level of therapy and giving resources home setting is a little bit different too, because they, you're justifying progress. And then reaching goals. So if your goals if you're not reaching progress or meeting those goals, they look at discharge or a different setting or other avenues of care.

Jessica: 25:21

So it's almost more like strict, kind of?

Jessie: 25:25

It can be strict, yes and no, because we always want the best ethical treatment for our clients. But we are hyper aware of very functional goals. So we're looking at ADLs. IADLs, and the child being their optimal level of function in each setting of their life. So goals are the same, you'll still have your fine motor goals, gross motor goals, ADL IADLs, but in home health, with this company, we also offer speech therapy and physical therapy. So once you get an interdisciplinary team working, that 30 minutes can really be utilized for specific goals, but very much occupational goals. And then you know, somebody's coming in to address the gross motor, or the gait, or the range of motion, muscle strength, or, you know, speech patterns, interactions, social skills, which makes it awesome, because you're not trying to compact everything into that 30 minutes. You can incorporate it still, but it's not your main focus.

Rachel: 26:46

I just feel like 30 minutes, you just like you have a conversation with the parents, and then like, Okay, bye. Like, I just feel like 30 minutes is so short.

Jessie: 26:55

It seems short, because we're used to 60. Right? And finding things to do for the kid. But if you think about it, you have a six year old, maybe, you know, maybe, maybe 20 minutes of direct attention. And that's with sensory strategies. So you're getting in, you're showing them things they can do for their body for the best, functional optimal level of performance. And then showing them they can be successful with a certain task or activity, and then educating the parent how to do that. And honestly, at first, it was a little tight because I wasn't used to it. And now I come in, and it's just it's you just get in a mind frame where it's, you're down to business, best quality treatment, there's no wasted time. There's no chit chatting with clients or parents, you're not happy to redirect them a lot, because it's not an extended time period. And they're excited to do it. So that 30 minutes is really optimal. Kids by 30 minutes, they're like, well, I wasn't finished, or I want to keep playing. Okay, great. Play with your parents now. You can you're regulated, you're organized, and you're doing this task. Great. Pretty awesome.

Jessica: 28:13

What does documentation look like in this setting? Is it different than in the clinic setting?

Jessie: 28:20

Actually, it's very, very similar. So we still use one of those programs, kind of like Fusion where you have all your goals. Yep, exactly like a SOAP note. So you're still writing subjective when you came in, parents are telling you how it's been. If there's any, you know, complaints, if they're filling great, if they're ready for therapy, what's happened during their week? And then your writing, you know, what activities you did, what strategies you used, what protocols did you implement? How did you facilitate that? What kind of modifications or accommodations and then what what level of assistance did that child need at that time to be successful?

Rachel: 29:09

I guess my my other question is when do you do see again for 30 minutes you hop in the car do you like voice memo on your phone something to remember to like document like like how logistically, how do you do it?

Jessie: 29:23

Idaho is great. So we use that other time allotted for documentation, parent debriefing, making home programs, you know, finding other resources for families and children that are specific to them. But I unfortunately still do my documentation on my own time at home. But a lot of therapists will do it right after you know the session which is best practice. And I you know, I'm waiting till the end of my day because I do typically see back to back kids. So if I'm in the Nampa area, I'm going to get all my families in on that day. If I'm in Meridian area, I want to do all of Meridian. And the same with Caldwell, Nampa Star, we're all the way out to Fruitland now. Where, you know, we just you, you're not allowed to, you know, have distracted driving, we take courses to be part of this company so we can show that we know all the things not to have distracted driving. And to be a good driver, and all of those things. So a lot of therapists will after their sessions, right before they take off to the next house.

Rachel: 30:37

Gotcha. Typically. Let's switch gears a little bit. You talked about your Mary Poppins bag, Mary Poppins bag, tell us what's in it right now.

Jessie: 30:45

There is always going to be markers, pencils, various paper. So that's just a go to you could do so much stuff with that. But right now, because it's St. Patrick's week, I have a little gold coin treasure hunt. Rainbow craft. Yes, the kids love it. For my bigger kids, they have a little science experiment that they have to read instructions, comprehend them, and then put it together. And it's actually a light up, little lantern. But it's rainbow colors. And then I also have a game that has rainbow colored marbles. It's called the stomper game. And I would highly suggest you go and purchase one. It's so many ways that you can utilize one game and, you know, vary the levels of dip difficulty for our kids. And as therapists we're just programmed to do that. So it's like a great visual motor activity, but it teaches them ocular motor functional skills. And then with their fine motor and that visual motor force modulation, but then you can also chain it so you're doing okay, now let's do a color pattern. You know, green, purple, yellow, and then they have to do it in order.

Rachel: 32:13

You have to tell us what it is. We're trying to find it. We're gonna link it in the show notes for our listeners.

Jessie: 32:20

Oh, it's because I told you the wrong wrong game. Stomple. It's so fun. And kids from like, seriously, one to 18 are like, Yeah, let's do this. Wow, we like just make it harder. So I don't use it the way it should be functionally used, or the way the rules say because everybody gets their color.

Jessica: 32:44

That's part of OT. We don't use any games the way they're designed.

Jessie: 32:49

And I love when kids get so excited that I pull out a game. And they're like, yes, I've wanted to play this. And I'm like, but we're gonna do it the OT way. And they're like, oh, man.

Jessica: 32:59

I just remember we used Twister all the time in the clinic. And I don't think we ever played Twister the way it was meant to be played. Not even once.

Jessie: 33:08

No, absolutely not. There's better ways to play it. Yeah, yeah. So there's so many other skills you can incorporate. It's got to be multisensory.

Rachel: 33:17

So going along with that, what are some of your go to activities for maybe therapists who are just starting out in home health? They're like, Well, what the heck do I take into a into a home?

Jessie: 33:27

That goes back? Oh, my goodness. So I love this question. Because when we're in school, we have that activity analysis, where we break down, you know, the skills that one activity addresses. So you could take playing cards, I mean, something as simple as a card stack. Everybody has them, almost every home has them. But you can bring them it fits in your pocket. And you take it into a home and you're working on working memory, Lucky Sevens- great game. You're working on Speed games, where they're having to make matches really fast. And using those ocular motor functional skills. You can address sequencing. So you have to wait your turn, you have to go in a certain order, you have to be able to control your impulses, super hard, but you're also working on those fine motor dexterity in Hammond manipulation skills and bilateral integration because you have to use both hands to play cards. You can even play Go Fish with regular cards. So there's some certain things that I will always have in my bag. But my my favorites by far are any game, you go to the store, you could pick anything out and make it into a functional obstacle course, games that you can pack but you bring them in and you can change it seven different ways to meet every level of function. And it has to work work for kids, you know, let's say one to the 18. Yeah. So if there's no like, go to that I necessarily need, I can pick any game and you should be able to as a therapist, modify it to meet the needs of a child and show a family how to do that.

Jessica: 35:21

Totally. What are some of your favorite sensory based treatment interventions in homes where there's very little equipment or even no equipment available?

Jessie: 35:32

Yeah. And that's what I find in the valley, are homes that just haven't had a lot of resources or don't kind of know where to start, or they've said they've tried to make a sensory room but really struggling with what my child needs. I don't know anything about sensory equipment. And it's great because I get to go in there and just say, hey, you don't even need to purchase anything, you have everything at your fingertips. And that's with practice. And I think that's the one thing, you know, if anything, COVID gave me as a therapist, because I had to think outside the box. Most of my families were stuck at home in home. And I had to think what would they have at their house that I could use for a functional activity that's engaging, but that also would work on the skills I need the child to work on. So you can make obstacle courses, couch cushions, blankets, you can get vestibular, if you have, you know, two adults that can provide that vestibular with swinging kid in a blanket, you're still offering prope, I didn't need the rainbow swing that I thought was my favorite. I mean, it still is my favorite. It's pretty cool. But you found other ways to facilitate the same activity with the equipment a parent would have. If there's limited space, I love the warmer seasons just because I can get kids outside. And I love incorporating nature into their treatment. But honestly, if there's limited space, I make it work because each family is different. And each household is different. And the way they function or their routines that are in place just to get them through the day, I don't want to come in and necessarily just messed that up. Because a lot of these parents have high anxiety with their kids, and they really don't know what to do. They're working with a kid with special needs. And it's fight/flight all the time for the child and the parent. So I don't want to, you know, overwhelm them. I want to still empower them to say, hey, but you got this, this and this. And this what we're working on. So let's grab a table, some chairs, blanket, let's make a fort. Let's do this under you know, so yeah, it's just figuring out what works for each family in the space they have.

Jessica: 37:57

I think that's a good point that you can get just as much good sensory input from using cushions and blankets and pillows and, you know, just normal household objects. It's definitely beneficial to have all the cool equipment, if you can have a swing in your house, if you can get the balance beams, all of that, but you don't need them.

Jessie: 38:21

Yeah, a lot. And there are some parents that have had therapy, you know, for several years, and have made a sensory room and do have equipment. And I love that for the kid to have their own space to go and experience that. Or if they get overwhelmed, and are having a hard time in just the family environment that they can go and have a routine sensory diet in a very specific spot. And they're set up for success. However, it's not necessary,

Jessica: 38:51

And it's not available for every family.

Jessie: 38:54

Correct. Yeah, sensory equipment can be really expensive. Yeah, for sure. Therapeutic equipment. Totally super expensive. Therapeutic games really expensive. I can show you how to do the same thing with what's in your drawer.

Rachel: 39:08

I'll never forget doing telehealth when COVID hit and I remember having a kid sit or lay on a cookie sheet because we didn't have a scoreboard. And I was like all right, hold on and pull over. And they loved

Jessie: 39:24

it. I'm sure they loved it. Yeah, it's amazing what you can do we can provide, you know, with just what you have.

Rachel: 39:33

Yeah. So for a therapist who is maybe looking into working in a home health setting, what's one piece of advice that you could give them?

Jessie: 39:43

So much advice I want to give them. One piece of advice I would give them let's say it's a new grad coming out of school. You are fresh, ready to go, fired up, ready to change the world one family at a time when childhood home, right? My advice to you, if you do want to do the home setting, I don't want to discourage you, because it is vital and amazing. I would highly suggest you find a mentor in your area and/or have a team of support with other therapists that are working in other settings that can provide you ideas, activities, modifications, accommodations, different treatment for different diagnosis, diagnoses, but also just their level of knowledge and skills and you should meet regularly, if that's available to you, I absolutely go for it. What new therapists have found just in the few that I have interacted with, that have worked for the company, that are brand new out of school is they wish they had more hands on either training experience, that a lot of times they reach out and say, Hey, I've this kid, A, B and C, what you know, what would you do, but in the home health setting, it's just you're, you're almost like a lone wolf out there. We still have a team, we still have a company, we still have therapists doing the same thing. And for COTAs, we still have our OTs, you know, that are overseeing the treatment plan. However, in the home health setting, you don't have a lot of time. Yeah, you're treating, you know, back to back clients typically. And then going home. And there isn't you can't hold someone's hand, you're, you're way too busy. They're way too busy. A lot of times schedules conflict, you're not connecting. And there's just not the information, you know, that you can give them in real time in the moment to help them be successful. So you're waiting, sometimes weeks before you can be like, oh, yeah, that strategy really would have worked? You're right. I'll implement that now.

Jessica: 42:07

Yeah, I think finding a mentor or group of other Yeah. therapists that you can bounce idea ideas off of is so helpful. But also, you know, search out more continuing ed courses that, you know, are quick courses, there's plenty out there that are an hour, hour and a half, that you can gain a handful of new ideas to use with your clients. And you should be doing that on a regular basis, not just right before you need to renew your license, you know, do those shorter continuing ed classes regularly throughout the year, and you're going to build so many skills that are going to benefit your clients.

Jessie: 42:45

And a lot of times those courses will provide you with immediate interventions you can utilize, you know, the next day exactly, which is great, but there are a lot of continuing education courses where you can get certified in certain areas and be a specialist in certain areas. And I highly suggest you do that. Because for occupational therapists we are, you know, taking a holistic approach to the child. And you want as many interventions and evidence based protocols in your bag ready to go, tools you can pull from at a given moment. But for people looking to get, or other therapists or therapists looking for a different setting, because maybe they've worked in one for nine years and want to change, I can't recommend it enough. It's fantastic. I mean, getting to work hands on with a kid in their environment, you know, where it's their rules, and getting them to be successful and parents seeing it in real time. I can't be repaid enough in this job, not even like monetarily. I just have been so inspired by what these families can do and what the kids can do. And after you know even a few sessions, you're seeing significant changes and progress, but also a whole different outlook on therapy and seeing how it really does you know facilitate success and growth.

Rachel: 44:13

So I feel like we might already know the answer to this. But the last question we have for you here one of the last questions which do you prefer home health or clinic ot outpatient clinic OT?

Jessie: 44:24

I knew you were going to ask that.

Rachel: 44:25

We did send you the outline in advance.

Jessie: 44:30

And it's such a hard question for me because I truly loved both and love both and still recommend to some of my clients outpatient clinic is a better setting for right now. And selfishly, I'm going to go with home health, because I see parents begin to relax, begin to enjoy, begin to see the progress that their kids are making, but also have the knowledge and skills to be able to facilitate that day in and day out. Regardless if I'm there or not. A lot of parents in the clinic setting, you know, what will we do without you? Or we're gonna miss you. Or how are we going to do this along? But they're not alone. They feel that way. They feel isolated. And when I can interact with them in their home, where they've let me into the most intimate, you know, portions of their life. Yeah. And we have a team around this child, and we're all rooting everybody on. It's just life changing. It's just such a different vibe.

Jessica: 45:47

Yeah, those are really good points. I love that. What's a piece of advice that you would give to parents who are listening, whether they're taking their children to clinics, or doing home health with their child? Or if they're not even receiving services for their child? What's a piece of advice you could give to our parents? Maybe even something that you've provided to your families that you work with?

Jessie: 46:09

It's interesting, because I love this. I love this question, because it makes you think deep, because if you had to give one piece of advice, like wow, right?

Rachel: 46:19

No pressure, right?

Jessie: 46:22

But honestly, the whole reason I got certified and trained in childhood and adolescent anxiety was not only for the kids, I was going to be treating because a lot of these kids come in, you know, they're dealing with deficits, we don't even we can't even comprehend. And with that comes a lot of anxiety, they're anxious about just about everything. But you look at the families, and they as well, are anxious about everything. And sometimes don't have a lot of support. And it wasn't even just for my kids, it was for me as well like to be able to use my best therapeutic self, and not be overwhelmed or get anxious for them. And so it just my one piece of advice is to seek out whatever is your biggest struggle, your what's holding you up, or what's making you fearful of getting your child, whatever service they might need. And you know, intuitively something's going on, something just isn't quite right. You know, friends say, oh, no, they'll grow out of it. Or you watch other kids and you're like, Oh, that's not that big of a deal. But you know, intuitively, there's something going on, what is your biggest hang up for not pursuing therapeutic services or therapy for your child? And then maybe start with that and see what you can do to get yourself in the right frame of mind for therapy. And then just, you know, talk with your pediatrician, get a recommendation for you know, whatever deficit you think your child has, or whatever milestone they're not reaching, or talk to, reach out in your community and see what support groups are out there for, you know, children who are similar, demonstrating similar challenges. Yeah, I'm like, what's the right word? Because it's not, they can be so empowered and so successful. You just got to find the right help. That was a lot of words.

Rachel: 48:39

A lot of really good words. I was just thinking like, I need you need to start speaking more.

Jessie: 48:43

Oh, no, this is way outside my comfort zone.

Jessica: 48:47

Which is why it's so good for you.

Jessie: 48:48

You're right. You're not growing if you're comfortable.

Rachel: 48:52

So last thing, just for fun. Do you have any questions for us?

Jessie: 48:56

Yeah. Get ready. No, just kidding. No, I just love what you're providing to the communities, multiple families you know, listen to your podcast are a part of Sensational Brain, know about Harkla in this community. It's on our list of resources for our families that we give them of where they can reach out how they can get different equipment, how they can get different ideas. And you know, it's it's one of my go-tos now, I'm like there's other families you know, get on this Instagram page, follow this, watch these ideas. And that's what we just need to do as a community is build each other up as therapists our community small we know most therapists in this valley. And if we just all you know, rally together, yeah, but the momentum and we just get going. I mean, it blew my mind going into the home health setting where I was like, Whoa, There are way more kids that are needing services that are not getting them. Yeah, this is eye opening. And they're all around. They're all around where I live. And there's waits for like, a year, a year and a half some of these facilities, and, you know, go with your best option, start, that's bottom line, just start, get information, but it can be as easy as getting on to, you know, Instagram, and finding resources.

Rachel: 50:33

So you didn't have any questions? You're right.

Jessie: 50:35

I just wanted to talk more.

Jessica: 50:37

Okay, good.

Jessie: 50:42

Some of our families we do have like your handles in like sensational sensational brain and some different, you know, internet resources of where they can go and and find things. Therapeutic listening program, all that good stuff.

Jessica: 50:56

Well you just recently got certified as a provider for the listening program, didn't you?

Jessie: 51:00

I did. Yes. But mostly I did that so that I was just educated, current on the most up to date, treatment interventions you can provide, and also how to facilitate that in home when they sign up with the therapeutic listening program. Because it is an amazing, amazing tool to have. So I mean, just continue to do what you do. I love it.

Jessica: 51:26

You keep doing what you're doing,

Jessie: 51:28

We're all doing it. We're all in it together.

Rachel: 51:32

Okay. Well, thank you so much for hanging out with us coming to the studio. It was so fun.

Jessie: 51:37

This was a blast. Thank you so much for having me. This was an experience. And I love experiences.

Jessica: 51:46

All right. Hopefully you enjoyed this episode. It's so funny because Jesse came in and said how nervous she was, which is kind of a running theme for some of our interview guests. They tell us they're nervous to talk on the podcast.

Rachel: 52:01

We are so intimidating. I know.

Jessica: 52:04

What ends up happening is they ended up being some of our best interviews because they're just so knowledgeable. I mean, all of our passionate, yes, all of our interviews have been great. But Jesse is very passionate about what she does. She's a very good speaker. And I think she really brought some great insight in today's episode.

Rachel: 52:25

Yep. If you are a therapist in the home health area, or if you are thinking about, you know, going that route as a therapist, you know, hopefully, we hopefully this just enlightened you and kind of lit that spark for you, because you can tell that she really enjoys the connections that she's making and the progress she's seeing with her kiddos. So I love that I'm I'm happy to see her thriving and you know, just helping so many families.

Jessica: 52:54

If you found this episode helpful, make sure you share it with a friend. And thanks for being here.

Rachel: 53:02

Okay, okay, bye. Thank you so much for listening to all things sentry by Harkla.

Jessica: 53:08

If you want more information on anything mentioned in the show, head over to harkla.co/podcast to get the show notes.

Rachel: 53:17

If you have any follow up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at Harkla underscore family or at all things sensory podcast. If you just search Harkla You'll find us there.

Jessica: 53:33

Like we mentioned before our podcast listeners get 10% off their first order at Harkla. Whether it's for one of our digital courses or one of our sensory swings, the discount code sensory will get you 10% off. That's s e n s o r y

Rachel: 53:51

Head to harkla.co/sensory to use that discount code right now,

Jessica: 53:57

we are so excited to work together to help create competent kids all over the world. While we make every effort to share correct information, we're still learning.

Rachel: 54:06

We will double check all of our facts but realize that medicine is a constantly changing science and art.

Jessica: 54:11

One doctor or therapist may have a different way of doing things from another.

Rachel: 54:15

We are simply presenting our views and opinions on how to address common sensory challenges health related difficulties, and what we have found to be beneficial that will be as evidence based as possible.

Jessica: 54:27

By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your child.

Rachel: 54:35

Consult your child's pediatrician or therapist for any medical issues that he or she may

Jessica: 54:40

be having. This entire disclaimer also applies to any guests or contributors to the podcast.

Rachel: 54:47

Thanks so much for listening