Day 7

I’ve been a bit MIA the last couple days from writing, and for what I think is a good reason!

Tuesday I was back shadowing in the Early Childhood (EI) centre, and was able to find out a little bit more about the child I met on Monday. It will be a small adjustment to treat a child daily, but also a great opportunity to see (hopefully) steady improvements in his abilities, and build a positive relationship with him and his mother. I will hopefully pick up one more client in the EI centre, so I have two there, and then two in my next project!

As part of the funding provided for ASSA, one of the donors is asking that the Canadian Occupational Performance Measure (COPM) be administered to parents of children receiving home therapy (this is really cool and I will explain about home therapy shortly. Hang tight!). The COPM is traditionally an OT measure, and looks not only at the child’s performance of a task (e.g. how well they dress themselves, do they need assistance for the entire task? some? just buttons?) on a scale of 1-10 but also the parental satisfaction about the child’s performance. The satisfaction is the key component; by measuring the changes in the parents response we can see if the parents feel the therapy is working and worth while. I travelled 2 days this week into rural villages along with my supervisor and other health care professionals (HCPs) (special educators, speech teachers, community resource workers, which I dont entirely understand their role yet but Im sure I will become more familiar with) to meet families and trial the COPM with them. Wednesday we met with 4 families; I was able to complete 2 of those interviews and then coached the other  HCPs that afternoon and today about what types of questions to ask, how to explain the tool and the scoring system. Its a challenge to coach, especially as not all of the words or phrases translate well into Tamil, so its forcing me to be precise and specific in my words, and not to overcomplicate things by talking too much (which, clearly, I like to talk). Part of my learning objectives here will be to improve my coaching skills, and to learn more about adult learning styles so I can be the most effective coach and enable the people Im collaborating with to problem solve through the assessment and truly understand its purpose.

Today we saw 6 families; after the first child’s visit, the mother toured us to the nearby Kundar Dam.It was about a 1.5-2 km walk, and it was so peaceful. The water level was quite low; there hasnt been rain in over a year (Im sure I’ve mentioned that before, sorry, the heat is melting my brain and memory).

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Hardly any traffic, the birds were chirping, the sun was shining… I was very grateful for the opportunity to be there, and for the choices that I had made to bring me to that moment.

On the way back to where we needed to catch the auto to go to the next client’s house, we stopped at a playground. Im pretty sure the HCPs had more fun than the client who was with us! It was really cute to see everyone having a nice time. This statue was in the middle of the playground, not sure what the symbolism was but definitely a sight to see! There was also dinosaurs, which for some reason surprised me… They seemed a little out of place? But kind of reminded me of being at the Calgary Zoo. Regardless of how scrambled my brain was/is, the park was a good time!

 

After that, we visited a couple more families and had lunch. This was the view out of the one family’s home.. So. Amazing.

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We visited more families in the villages; one family had two children with special needs and did not wish to receive therapy as they were afraid it would make their children worse and that they would one day be suddenly “cured”. This happens in Canada too, and its so hard to walk away from the situation, knowing that therapy could make a difference for that child and family, but that they have a different lived experience than myself (or other HCP) and it is just as valid as anyone else’s.

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The air in the villages is fairly clean, and it is nice to enjoy a breeze; it can be over 30 degrees (32-35) during the day. It can be a lot to take while walking through the maze like streets and between villages.

We also came across many goats and cows; this lady seemed to enjoy having her photo being taken and posed for me in the middle of her meal! If you look closely, you can see the gaps between buildings; there are small narrow lanes and often many homes tucked away along the lanes.

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The kids I will be working with on a weekly basis are both low vision with some other conditions (epilepsy, CP etc); one is very complicated and has very low muscle tone, along with a lot of sensory processing/stimulation difficulties. He will be the most challenging of my kids I think, but also one that I believe will really benefit from OT, and that I am able to be effective in my treatments and family education for carry over and continuation of therapy. It will be especially challenging as these families live in quite drastic poverty, so any therapy interventions I recommend should be sustainable and easily accessed in the local community, with minimal (ideally no) cost. We shall see, fingers crossed!

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