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A Day in the Life of a Pediatric Occupational Therapist

A Day in the Life of a Pediatric Occupational Therapist

Think about the minute-by-minute unfolding of a therapy session. The child arrives and anticipates the greeting from their therapist. Countless developments have occurred between visits. The twosome is not just picking up from where they left off, but processing how the learnings of the previous session have played out during the week. So much to discuss. So many new skills to share.

The session begins. A brief exchange of small talk softens the vibe. The therapist has an agenda based on practiced methods and treatment planning. Yet, the conversation explodes without adherence to the agenda. The kid grabs a fidget from the bucket on the shelf. The reading cube beckons to provide pseudo-privacy. The robot they built last week needs reengineering.

Tension rises. The tasks and tools are slightly beyond the capacity of the kiddo. Chaos threatens, except the constancy of the clinical atmosphere contains. The therapist reads the signals and selects an intervention.

Biofeedback. Belly breathing. Smell the flower, blow out the candle. Name the feeling.

Rinse and repeat.

Coping skills are taught and modeled. Situations are anticipated and role-played. Safe space is created for vulnerability. Failure leads to problem-solving. Play morphs into learning. Healthy doses of dancing, singing, joke-telling, silliness, and laughter are sprinkled throughout.

The session ends. Trials are designed and shared with caregivers. Treatment goals are recalibrated and put to the test for the following week. Life inside and outside of the therapy space comes together. Parents, grandparents, teachers, and professionals unite on behalf of the child.

The child who reunites with their adult outside the therapy space is slightly different. Their skills have evolved, ever so incrementally. The goodbye is as valuable as the hello exchanged 60 minutes earlier. What happens in the next 167 hours then shapes the agenda of the next session.

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and a pediatric occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

You Have This Moment

You Have This Moment

What’s in front of you at any given moment is your life, quite literally. Here’s the dictionary definition of life (n.): “the animate, immediate existence of an individual.” Let’s stop here. The picture is too big. The present is sacred and it’s the only time we really have.

Taking things for granted is a common trap. If we fail to take advantage of the present moment, the odds are good we will also fail to do so at some hypothetical moment in the future. Keeping ourselves in a constant mode of preparation for the next thing means we’re always keeping our gaze on something that doesn’t exist.

Stakes are higher when we have rapidly growing kids. Blink, and your baby starts kindergarten. Blink again, and your kindergartener has the car keys. Children don’t wait around for us to start paying attention. Time marches on and takes childhood right along with it.

Stressful, right?

The big problem is that parenting requires tons of planning and a near-constant juggling act. How can we possibly balance everyone’s needs while fully appreciating our kids during the short time we have them around? It’s a puzzle I’ve struggled with personally since the moment my oldest son was born.

I’m sorry to report that I haven’t discovered the universal secret sauce to staying present and keeping all the balls in the air, but I have stumbled upon something that makes it easier. It’s the same thing I teach even my youngest clients when they come to me overwhelmed by life.

Breathe.

It seems foolishly simple, I know. But when we simply attend to our breathing we refocus on what’s real. Not yesterday’s memories. Not tomorrow’s projections. Right now. In doing so, we surrender the stressors that are out of our immediate control – if even for a moment.

Yes, there’s a high-stakes assignment due this weekend. Yes, that bully at school will need to be dealt with on Monday. Right now, you have a moment to breathe and see clearly. Inhale deeply. Exhale slowly.

Preparing for what’s to come is easier when you have presence of mind. By some miracle, staying in the present makes it more possible to manage your future with clarity and grace. Breathing in the moment keeps you grounded and lifts the weight of uncertainty. It narrows your focus while broadening your perspective.

It just feels a whole lot better, too – because deep down, we all understand that each new moment is the only thing we truly possess.

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and a pediatric occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

The Case Against Perfection

The Case Against Perfection

We all enter parenthood with the hope that we’ll do it right. As our kids don’t come with instruction manuals, we read blogs, buy books, ask questions, and take notes about others’ successes. We catalog the wins and losses from our own childhoods. With a blend of confidence and trepidation, we imagine cheerful, happy children and a joyful family.

Then life happens.

Our babies grow. They challenge us. We make mistakes. We lose our temper. We yell. We worry, feel frustration, and maybe even rage. We’re embarrassed to imagine what others might think if they knew the truth about what happens behind closed doors. We lay awake feeling guilty and wonder where it all went wrong, and why we’re so bad at this.

And yet… what if the point isn’t blissful perfection?

Compassion and hope live in the mending process that occurs whenever we’ve messed up. With each misstep, we have an opportunity to model for our children that we can grow from the stumble. Kids develop a healthier sense of themselves every time they see us fix our mistakes and give ourselves grace. A connection broken and mended is often stronger than a connection never broken.

Not only is the goal of perfection a setup for failure, but its pursuit prevents growth. Our kids yearn to see how we navigate adversity and solve problems. For them, it’s like watching a compelling sitcom. The plot toggles between conflict and resolution in each episode.

Kids only get to witness this when we give ourselves permission to struggle. They learn as we learn. We become authentically human in their eyes. They discover that not knowing what to do is okay because it leads to exploration. They come to see that mistakes are opportunities.

Parenting is hard. There is not a parent alive who hasn’t been overwhelmed by the process. But in the end, when repair occurs, everyone benefits from the growth and closeness that comes from shared experience and understanding.

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and a pediatric occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

New Year’s Resolution

New Year’s Resolution

New Year’s arrival inspires us to make hopeful predictions about the future. It’s a curiously strong tradition that most of us uphold – even when our ideas don’t often pan out. So why do we feel compelled to keep doing this?

Our ancestors hardwired us to see the world through an imaginary crystal ball. We can’t help ourselves – the conscious brain’s main purpose is to make predictions. Jeff Hawkins, author of A Thousand Brains, explains: “Prediction is not just one of the things your brain does. It is the primary function of the neo-cortex and the foundation of intelligence.”

To deal with uncertainty, we enlist the neurobiology of prediction. In other words, we assess the environment and guess what will happen next. The brain loves predictability because the threat level is already known, so whatever decisions we need to make require less energy and generate less stress than when the degree of threat is uncertain.

While this function used to keep us safe from wooly mammoths, it’s now about getting us through the day. Simplifying the world through prediction makes our experiences more manageable, takes less brain power, and can make life feel more enjoyable. The trouble is, we can get ourselves stuck in overdrive.

Here’s why: two parts of the brain are always working in partnership: the prefrontal cortex (creative thought, problem-solving, attention) and the limbic system (emotions, memories, survival). When we feel secure that things are under control, we’re operating calmly from the prefrontal cortex. But when things get complicated – unexpected variables, too much environmental stimulus, an onslaught of information to sort through – the limbic system flips us into the dreaded flight/fight/freeze mode.

We’re all living in a period of constant upheaval. The world feels unstable, we’re endlessly busy, and our kids are ticking time bombs of tantrums and out-of-control behavior. When something goes awry, such as getting stuck by a train or not getting a prompt response to an important text, our already heightened state of arousal flips directly into flight/fright/freeze. Everything feels like a crisis – and we’re desperate for resolution so we can calm our system.

We see this same phenomenon in our kids all of the time. The world is still new and often overwhelming. They are operating in a heightened state of arousal whenever events feel unpredictable. Their limbic systems are poised and ready to take over at a moment’s notice. Add a couple of caregivers who are modeling high-stress responses to mini-fires into the mix, and things can spiral out of control quickly.

So this year, consider adding a new resolution to your list on behalf of your brain, and the brains of all the children in your life. As you feel yourself flipping into ancestral fight/fright/freeze mode come January, take a couple of deep breaths to hold the limbic system at bay. Then take a quick moment to assess the scene – is this something I need to predict and control after all? Or will I likely survive (and even thrive!) no matter what comes?

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and a pediatric occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.

Housekeeping versus Homemaking

Housekeeping versus Homemaking

Question: do you spend more time on housekeeping or homemaking? There’s a subtle emotional difference, and each has its own spin. Although there’s plenty of crossover between the two, the distinction is real. The question already ignites our biases.

So, before we go any further, let’s quickly get an outdated stereotype out of the way. This is not a discussion about Donna Reed-caliber housewives in scalloped aprons and lipstick, vacuuming already-tidy living rooms. What we’re really talking about here are the countless ways we intentionally craft and manipulate our living spaces – in other words, the specific roles we all play in our relationships with our homes. Let’s begin with two definitions:

Housekeeping is creating and maintaining an environment of cleanliness, order, and beauty.

Homemaking is creating and maintaining an environment specific to the needs, comfort, and harmony of your family and friends.

Most of us serve both roles. Knowing which one you tend towards starts with figuring out your central priority. What truly drives you as you clean-up, set-up, and fix-up your home? Are you most excited by having people ‘oo’ and ‘ah’ when they come over? Or are you more energized by arranging things to improve how you and others experience your space?

Beautifying and caring for your home usually has the bonus perk of boosting some family comforts. However, if your main goal is having a magazine-worthy abode and curb appeal that earns long glances from passers-by, you’re likely in the realm of housekeeping.

Homemaking starts from another place altogether. Homemaking is about promoting a welcoming vibe and anticipating people’s needs. It’s about creating ease and facilitating everyone’s well-being. Your home speaks uniquely to everyone who enters or lives in the space. It aims to make the space work for the people’s interests by maximizing the intersection of feeling and function.

Homemaking is personal, and it’s meant to flow with the times. It’s a dynamic and adaptable endeavor that evolves over time based on changing family needs. Even shifts in geography don’t have to alter the homemaking process much. For example, one can execute a near-exact version of it in a vacation rental. The central component of homemaking lives in the family system.

Housekeeping can evolve and be flexible, too, but it’s more often based on routines that depend on external priorities. Housekeeping tends to go on hiatus when there’s a disruption to schedules or you’re on vacation. It can be outsourced completely to professionals. It’s often based on a one-size-fits-most methodology. Homemaking, on the other hand, is as unique as the individual orchestrating it.

This is never an all-or-nothing state of affairs. In reality, we each do both. Mopping the kitchen floor is not warm, fuzzy, or personalized, but it is necessary. Designing a beautiful room, while incorporating the latest decor trends, still requires taking your family’s needs into account.

Whether the scales tip toward housekeeping or homemaking simply depends on where you’re placing the bulk of your focus. This brings us back to our original question: How do you allocate the priorities of your time? And then, a bigger question: How would you like to spend more of your energy going forward? Clean and beautify the space, or create a warm and welcoming place?

Space or place?

About the Author

Kerry Galarza, MS OTR/L is the Clinical Director and a pediatric occupational therapist at Elmhurst Counseling. She provides specialized assessment and intervention with children of all ages and their families. Kerry engages clients with naturally occurring, meaningful home-based methods to empower autonomy and maximize functioning.