I have a kid who I love to pieces. A teenager, I love working with this pt. My friend has made such tremendous steps since I first saw a session, it is incredible. Today... started off a little rough.
The session began a little late because pt. was upset (understandably so and totally normal) about being in the hospital. It sucks having a TBI and being stuck in the hospital away from you friends and you can't convey what you want to say because of this pesky little thing called aphasia. The PT I was working with kinda led the first interaction with this pt, so she gave him some time to calm down before therapy. We started with him selecting a song from the ipod to listen to while he walked on the treadmill. Slowly he started bobbing his head to a Lil Wayne song (very slightly). Soon he was ready for another tune, and selected one that he picks a lot: "Blame It" by Jamie Foxx. You could tell as he was walking that he started singing it in his head a little. His hands started moving to the beat, and that carried through his whole body and demeanor. THEN we hear from someone working with another pt in the gym, who had not been a fan of therapy today, to turn it up so this kid could sing along. No more talking about the pain this pt was in, it was all about this song for a few minutes. One of my other friends in the gym stated singing along too, and it was just a little jam session.
From there, my pt. was in a better mood (not all bright and smiley) and decided he would like to do some drumming. Now we know he has access to a CD player, and naturally I put this song on the CD I burned for him.
So this is my "thank you" to Jamie Foxx for releasing such a ridiculously catchy song that it got one of my pts. to feel a little better and want to do some therapy AND got all the other kids in the gym to sing along. From all of us in the MT department at my hospital, thank you Jamie Foxx, thank you.
Monday, August 22, 2011
Saturday, August 13, 2011
iPad Nation
I promised to post about this lovely piece of new technology a while ago. Sorry it has taken so long!
Our MT department now has an iPad to share between all of us for use in sessions. We live in an era obsessed with technology, and many of the kids we see have seen an iPad before, or love computer and video games. What I really love about the iPad is that you can do everything by just touching the screen, which is great for kids with limited UE use, or the use of just one hand, etc. And, since many kids are so used to computer games and the like, it makes for a GREAT distraction tool during Botox treatments and dressing changes, especially because the kids want to know what comes next, and what that pig is going to do if you tap on it. But, what does this have to do with Music Therapy?
Well.... there are a ton of awesome music-related apps for the ipad that are great for working with kids and teens alike. Some of my favorites (and a bunch are free!) are:
As wonderful as it is, I want to be clear that it doesn't work in every situation, and it is JUST a tool that we can use. I love it, but in this day and age, it's hard to keep it from being your "go-to" item, so I often use it as my back-up plan, rather than my number one tool. Unless of course, it has worked well in the past, or is a good reward tool for a teen. Music Therapy is really so much more than taking out an iPad during procedural support, but it sure can be awesome!
Our MT department now has an iPad to share between all of us for use in sessions. We live in an era obsessed with technology, and many of the kids we see have seen an iPad before, or love computer and video games. What I really love about the iPad is that you can do everything by just touching the screen, which is great for kids with limited UE use, or the use of just one hand, etc. And, since many kids are so used to computer games and the like, it makes for a GREAT distraction tool during Botox treatments and dressing changes, especially because the kids want to know what comes next, and what that pig is going to do if you tap on it. But, what does this have to do with Music Therapy?
Well.... there are a ton of awesome music-related apps for the ipad that are great for working with kids and teens alike. Some of my favorites (and a bunch are free!) are:
- Songify- Record yourself saying something, and the program puts in autotune and turns it into a song! This is especially great with computer-minded kids who are working towards articulation and speech volume goals in ST.
- Falling Stars- You click on different icons and drag to make different vines across the screen, then click on stars. The stars fall, hit the vines you made, and make music!
- Rhythm Racer- You move a spaceship around to catch different colored balls of light to get points. There are 2 different ways to move the spaceship. One way is to drag your finger across the screen (fine motor) and the other is to tilt the whole iPad (gross motor). Both are pretty tricky!
- Garage Band- On the iPad it's a tad different than on the computer. They have some pre-made loops, but it's more about you making your own beats, tunes on guitar, piano, or bass, and recording your own stuff. I especially like using it with teens.
- "Old MacDonald", "Itsy Bitsy Spider", and "Wheels on the Bus"- all interactive song books. I absolutely love them. Kids (and adults) can touch the different animals, people, and buses, and they move, make noises, etc.
- Tap Tap Revenge (and all its incarnations)- tap on the different colored balls when they hit the right spot. With three different lanes, it requires a lot of concentration and fast finger movements to get it right!
As wonderful as it is, I want to be clear that it doesn't work in every situation, and it is JUST a tool that we can use. I love it, but in this day and age, it's hard to keep it from being your "go-to" item, so I often use it as my back-up plan, rather than my number one tool. Unless of course, it has worked well in the past, or is a good reward tool for a teen. Music Therapy is really so much more than taking out an iPad during procedural support, but it sure can be awesome!
Struggles...
Power struggles, that is. This post is mainly for everyone who thinks that music therapy is nothing but rainbows and sunshine. It is much, much more than butterflies and flowers, even at a children's hospital!
Most kids who get music therapy really enjoy it, but what happens when you get a patient who gets MT as part of his or her therapy who is... less than enthusiastic about doing things that may be more difficult than he or she wants to do? I'm not saying that MT is the problem here, rather doing things that make this kid work a little harder so he or she can go home is. How do you work with kids who literally stalemate and shut you out in therapy when they need to have it?
Story: Met with this kid for a session (and not the first) and we were doing an UE movement task. Things were a little slow and full of complaints, and then out of nowhere, this kid stops. For about ten minutes pt. just sat there not wanting to finish the number of reps. Eventually, the pt. completed task, but it was... quite a power struggle between us for a little while.
So my latest project (and things have been slowly getting better) has been to find new interventions that this kid will like and will work toward our goals, as well as providing the right reinforcers. But for everyone else out there, How do you help someone who doesn't seem to want to help themselves?
Most kids who get music therapy really enjoy it, but what happens when you get a patient who gets MT as part of his or her therapy who is... less than enthusiastic about doing things that may be more difficult than he or she wants to do? I'm not saying that MT is the problem here, rather doing things that make this kid work a little harder so he or she can go home is. How do you work with kids who literally stalemate and shut you out in therapy when they need to have it?
Story: Met with this kid for a session (and not the first) and we were doing an UE movement task. Things were a little slow and full of complaints, and then out of nowhere, this kid stops. For about ten minutes pt. just sat there not wanting to finish the number of reps. Eventually, the pt. completed task, but it was... quite a power struggle between us for a little while.
So my latest project (and things have been slowly getting better) has been to find new interventions that this kid will like and will work toward our goals, as well as providing the right reinforcers. But for everyone else out there, How do you help someone who doesn't seem to want to help themselves?
Friday, August 5, 2011
this is not kim kardashian's botox...
.... okay, actually it is the same thing BUT these kids need it (and not in their faces)!
Botox paralyzes muscles. That's what it does! The way muscles work (for those who don't know) is that each muscle has an opposing one that allows us to move our bodies. With each movement, muscles oppose one another. In many people with cerebral palsy or other illnesses that effect their muscles, they experience contracture with some of those, where one (or many) muscles in a limb are too tight to stretch. Botox is injected into those muscles, which relaxes them and allows for stretching and physical therapy to take place. It takes about 7 days to take full effect. In our rehab clinic at the hospital, kids come in every 4 months or so to get those injections.
Our body is full of TONS of muscles, so the kids who come in usually need multiple shots. Even though the needle is tiny, it still hurts, and the muscles that need the injections are so specific that the kids have to be entirely still during the procedure. Why am I telling you all this? Because today I spent the entire day doing procedural support in this clinic, and it was fantastic!
The kids who come in typically get EMLA cream where the injections will be, which helps to numb the skin. The only thing about that is that it takes 30+ minutes to really take effect, during which the kids are sitting and waiting. in anticipation. of shots. That's where the Music Therapists (and interns) come in! We start by building rapport and playing/doing music tasks before the procedure to help calm the kids and provide some fun distraction, and then we stay through the needle sticks to help that calm environment and provide more distraction during it. As someone who had lots of scary needle sticks growing up, I can say that music helped distract me, but being held down was the WORST part.
It was a little strange being on the other side of those shots, and being there when the kids are crying and screaming (because really, needles hurt and nothing we do is going to keep a kid in pain completely calm), but it was wonderful being there and seeing those kids look up at me and reach toward the guitar or ipad (more on that later) and just have that moment where even though they are NOT happy, they have something they can focus on that they like. As my first kid (a 5-year-old veteran of botox) said when I walked in, "yeah! and you stay here the WHOLE TIME!" with a huge smile on his face.
That's why I love procedural support in this unit. I get to be the "music lady". I'm fun and they trust me, and that little bit of extra support during those needle sticks helps!
Botox paralyzes muscles. That's what it does! The way muscles work (for those who don't know) is that each muscle has an opposing one that allows us to move our bodies. With each movement, muscles oppose one another. In many people with cerebral palsy or other illnesses that effect their muscles, they experience contracture with some of those, where one (or many) muscles in a limb are too tight to stretch. Botox is injected into those muscles, which relaxes them and allows for stretching and physical therapy to take place. It takes about 7 days to take full effect. In our rehab clinic at the hospital, kids come in every 4 months or so to get those injections.
Our body is full of TONS of muscles, so the kids who come in usually need multiple shots. Even though the needle is tiny, it still hurts, and the muscles that need the injections are so specific that the kids have to be entirely still during the procedure. Why am I telling you all this? Because today I spent the entire day doing procedural support in this clinic, and it was fantastic!
The kids who come in typically get EMLA cream where the injections will be, which helps to numb the skin. The only thing about that is that it takes 30+ minutes to really take effect, during which the kids are sitting and waiting. in anticipation. of shots. That's where the Music Therapists (and interns) come in! We start by building rapport and playing/doing music tasks before the procedure to help calm the kids and provide some fun distraction, and then we stay through the needle sticks to help that calm environment and provide more distraction during it. As someone who had lots of scary needle sticks growing up, I can say that music helped distract me, but being held down was the WORST part.
It was a little strange being on the other side of those shots, and being there when the kids are crying and screaming (because really, needles hurt and nothing we do is going to keep a kid in pain completely calm), but it was wonderful being there and seeing those kids look up at me and reach toward the guitar or ipad (more on that later) and just have that moment where even though they are NOT happy, they have something they can focus on that they like. As my first kid (a 5-year-old veteran of botox) said when I walked in, "yeah! and you stay here the WHOLE TIME!" with a huge smile on his face.
That's why I love procedural support in this unit. I get to be the "music lady". I'm fun and they trust me, and that little bit of extra support during those needle sticks helps!
Thursday, August 4, 2011
rehab rounds
Lately I have been talking a lot about going with the flow of your pt. and being flexible. There is one place where things are a little bit different: rehab.
I am currently on my rotation in inpatient rehab. If a kiddo is in this unit, it means that physically they are not able to go home safely yet. It is mainly comprised of kids with TBIs (traumatic brain injuries) and SCI (spinal cord injuries). Rehab is also an incredibly structured unit. Every kid on rehab gets 2 hours of PT and OT each day, as well as ST and MT, which gives them a pretty full schedule. Sometimes those sessions may get started a little late, but they will happen unless a kid is really sick or another clear cut medical reason. Being tired is not an excuse to not have therapy because the purpose of all this is so that the kids can get stronger and go home.
One very cool thing about this unit is "rehab rounds". This is where the doctors, a representative from nursing staff, Child Life, PT, OT, ST, MT, social work, nutrition, psychology, and chaplaincy all get together once a week during lunch and go over their goals for the pt. for that week and what they have accomplished, etc. It's really interesting to listen to the other disciplines talk about each kid and what works well, progress they have made, and it lets other disciplines know any issues they might be having. This is all so that the kids we see can get the best care possible. THIS week we had 7 kids to talk about. That is a beyond huge number, and we are going to be getting more, soon. So with an hour and a half to talk about all these kids, everyone had to be super succinct and quick with their goals and notes.
On rehab services we have very specific goals that we work toward, so the sessions tend to be more structured than in other areas. Instead of choices between tasks, the choices are between what we do first or last. We also do LOTS of co-treats with other disciplines! This week I have had 2 co-treats with ST and OT, and I have observed a few more with OT, ST, and PT.
Anyways... rehab is tons of fun, and is very different from the other areas I have seen so far!
I am currently on my rotation in inpatient rehab. If a kiddo is in this unit, it means that physically they are not able to go home safely yet. It is mainly comprised of kids with TBIs (traumatic brain injuries) and SCI (spinal cord injuries). Rehab is also an incredibly structured unit. Every kid on rehab gets 2 hours of PT and OT each day, as well as ST and MT, which gives them a pretty full schedule. Sometimes those sessions may get started a little late, but they will happen unless a kid is really sick or another clear cut medical reason. Being tired is not an excuse to not have therapy because the purpose of all this is so that the kids can get stronger and go home.
One very cool thing about this unit is "rehab rounds". This is where the doctors, a representative from nursing staff, Child Life, PT, OT, ST, MT, social work, nutrition, psychology, and chaplaincy all get together once a week during lunch and go over their goals for the pt. for that week and what they have accomplished, etc. It's really interesting to listen to the other disciplines talk about each kid and what works well, progress they have made, and it lets other disciplines know any issues they might be having. This is all so that the kids we see can get the best care possible. THIS week we had 7 kids to talk about. That is a beyond huge number, and we are going to be getting more, soon. So with an hour and a half to talk about all these kids, everyone had to be super succinct and quick with their goals and notes.
On rehab services we have very specific goals that we work toward, so the sessions tend to be more structured than in other areas. Instead of choices between tasks, the choices are between what we do first or last. We also do LOTS of co-treats with other disciplines! This week I have had 2 co-treats with ST and OT, and I have observed a few more with OT, ST, and PT.
Anyways... rehab is tons of fun, and is very different from the other areas I have seen so far!
Monday, July 25, 2011
different strokes for different folks
I am going to touch very briefly on a topic one of my fellow MT interns did, which is Music Therapy is not for everyone. While I have not met anyone who fits this subject yet, I have met some who.... usual MT techniques don't necessarily work for. This kid is going to require us to be very creative.
Every patient we see is different, and they all have different needs. Sometimes a pt. is very active and wants to get up and run around, sometimes the pt. is sleepy, or confined to his or her bed. And sometimes.... they just want to sing! I've said it before and I will say it again, the key to this internship and Music Therapy in general is being flexible! If you want to intern in a hospital and you lack this trait, brush up on it fast, cause MT is not the profession for you if you don't have it, and an internship will drive you crazy!! Anyways... back to my original story, my very first week of my internship I saw a pt. and last week I saw her again. We did some instrument stuff, like with the Q-chord (love that thing), but mostly she just wanted to sing along with me, so we did some of that. Okay, we did a lot of that! I have never before learned a song on the spot with a pt, but I did in that session, because she really wanted to sing it. It was Rihanna's "Take a Bow", and I got her playing a drum along with the beat. And then we sang Justin Bieber's "Baby", and by that I mean the chorus and Ludacris's part, because that's all I could remember at the moment. It was epic. Point is, I had planned some other stuff to do, but singing was what she really needed, and I have never seen her so interactive and smiling so much! I was still able to focus on my goals for her, just with a different approach.
Speaking of being flexible... this week I am starting my second rotation, where I will be in the inpatient rehab unit and providing procedural support in the Botox clinic. So far the rehab pts. we will be seeing this week are all male, and 15,16,16,&17 years old. That's, um, VERY different from the babies-and-oldest-patient-being-12 thing I had going on in my last rotation. It's time to flex those working with teens muscles again!
Every patient we see is different, and they all have different needs. Sometimes a pt. is very active and wants to get up and run around, sometimes the pt. is sleepy, or confined to his or her bed. And sometimes.... they just want to sing! I've said it before and I will say it again, the key to this internship and Music Therapy in general is being flexible! If you want to intern in a hospital and you lack this trait, brush up on it fast, cause MT is not the profession for you if you don't have it, and an internship will drive you crazy!! Anyways... back to my original story, my very first week of my internship I saw a pt. and last week I saw her again. We did some instrument stuff, like with the Q-chord (love that thing), but mostly she just wanted to sing along with me, so we did some of that. Okay, we did a lot of that! I have never before learned a song on the spot with a pt, but I did in that session, because she really wanted to sing it. It was Rihanna's "Take a Bow", and I got her playing a drum along with the beat. And then we sang Justin Bieber's "Baby", and by that I mean the chorus and Ludacris's part, because that's all I could remember at the moment. It was epic. Point is, I had planned some other stuff to do, but singing was what she really needed, and I have never seen her so interactive and smiling so much! I was still able to focus on my goals for her, just with a different approach.
Speaking of being flexible... this week I am starting my second rotation, where I will be in the inpatient rehab unit and providing procedural support in the Botox clinic. So far the rehab pts. we will be seeing this week are all male, and 15,16,16,&17 years old. That's, um, VERY different from the babies-and-oldest-patient-being-12 thing I had going on in my last rotation. It's time to flex those working with teens muscles again!
Thursday, July 21, 2011
flyin' solo
In the words of a former Sunshine camper, "What a great day, what a great life it's been..."
This week (and last week) I have been pretty much on my own leading sessions. Ashley is back this week, so she observed me in some of them, but a lot of times I have been seeing kiddos all on my lonesome! And it has been fantastic. This week I also got my very own pager. woot.
I had a pt. I have been following for about 2 weeks, so I got to put in an assessment for her AND get to address those goals in a session (which does not always happen). It was so cool to see her grow and change while in the hospital, and a lot of that had to do with Music Therapy.
Kids are all so funny and different. There are those who tend to give you a hard time to get a session. They really make you work for it, but once you get started they love it. Then you have those like my one friend from this week. Literally jumped out of his skin when he saw me coming he was so excited. This kid had one of the biggest smiles ever when doing music, and then that affect totally switched when a doctor came in. It's crazy.
Last week I got to lead an intervention in a different MT group, got to go to my first rehab rounds, and I got my orientation to the Botox unit, but more on that later. I have also been seeing a lot of babies lately! I love working with babies, from the itty bitties to the less itty bitty. I got a smile out of one today who never smiles. Ever. Tomorrow will be my last contact with babies for awhile because next week I start my second rotation. This rotation will be in the Botox unit and with Rehab kiddos. I'm excited to get some new experiences under my belt and to meet some awesome TBI kids.
So forever ago I made a list of goals for myself for this internship. One of them was about using the piano and getting more comfortable with it. I can say that yesterday I used piano in every one of my sessions with pts. Not so today, because I pretty much just saw wee ones. Another one of my goals was to make friends in time to see Harry Potter. Another check off my list! Bah I can't believe it's all over. It makes me a little sad, but I'm glad I got to see it all the way through and really be there when it all happened.
Well that's all for now!
This week (and last week) I have been pretty much on my own leading sessions. Ashley is back this week, so she observed me in some of them, but a lot of times I have been seeing kiddos all on my lonesome! And it has been fantastic. This week I also got my very own pager. woot.
I had a pt. I have been following for about 2 weeks, so I got to put in an assessment for her AND get to address those goals in a session (which does not always happen). It was so cool to see her grow and change while in the hospital, and a lot of that had to do with Music Therapy.
Kids are all so funny and different. There are those who tend to give you a hard time to get a session. They really make you work for it, but once you get started they love it. Then you have those like my one friend from this week. Literally jumped out of his skin when he saw me coming he was so excited. This kid had one of the biggest smiles ever when doing music, and then that affect totally switched when a doctor came in. It's crazy.
Last week I got to lead an intervention in a different MT group, got to go to my first rehab rounds, and I got my orientation to the Botox unit, but more on that later. I have also been seeing a lot of babies lately! I love working with babies, from the itty bitties to the less itty bitty. I got a smile out of one today who never smiles. Ever. Tomorrow will be my last contact with babies for awhile because next week I start my second rotation. This rotation will be in the Botox unit and with Rehab kiddos. I'm excited to get some new experiences under my belt and to meet some awesome TBI kids.
So forever ago I made a list of goals for myself for this internship. One of them was about using the piano and getting more comfortable with it. I can say that yesterday I used piano in every one of my sessions with pts. Not so today, because I pretty much just saw wee ones. Another one of my goals was to make friends in time to see Harry Potter. Another check off my list! Bah I can't believe it's all over. It makes me a little sad, but I'm glad I got to see it all the way through and really be there when it all happened.
Well that's all for now!
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