Rehab Stretching

Prelude: Stairway to Nowhere

To kick off my stretch, I had the pleasure of working with an 8-year-old boy who has grown up with a rare form of cerebral palsy. There currently is no cure but stem cell therapy is introducing hope for a reversal of its symptoms. While working with him, I quickly realized the complexities of trying to remedy a condition as abstruse as cerebral palsy. For now, he works with therapists to gain control over his movements on a trial and error basis. Even though there are other young boys with cerebral palsy, therapy is never identical in any case. Therapy is personalized not stencilled. Together, our end goal is to foster independence in a way that he finds suitable and comfortable. His end goals are to improve running, getting into vehicles and climbing stairs. And so we began, walking over hurdles, stepping onto platforms and learning strategies to reduce muscle spasticity when running.

Finally, we attempted the “stairway to nowhere” (a set of stairs enclosed by railings and effectively only for the purpose of climbing).

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Therapy Room A

“Ok..are we ready to climb the stairway to nowhere?” I asked

“Yup, I’m ready… but they’re stairs to somewhere for me”. The 8-year-old replied.

“Oh? Where do they lead?” I said.

“If I can climb these…then I can climb my stairs at my home and at my school”. He replied.

It was truly a heartwarming experience to witness a child redefine a staircase that was inadvertently labeled with negative connotations and a lack of purpose, ultimately making it his own personal success. He understood his goals, the purpose of rehabilitation and the underlying reason for why he practices climbing stairs. This session reminds me of why I’m here and the brilliance in the ways a child thinks. I often remind myself of this session in the morning when I’m climbing the stairs to get to the Children’s Rehabilitation office in Camrose. It’s truly a privilege to get to work with these children and Occupational Therapists (OT).

I had the opportunity to test my skills and provide therapy with children on caseload that experience stutters, autism, apraxia, a missing corpus callosum, developmental coordination disorders, FASD and of course a full range of social circumstances, such as bullying. I had the opportunity to interact with kids who spoke French and others who spoke low German from a Mennonite family. This is only a glimpse of a therapist’s scope of practice and its breadth has shown me the value of an interdisciplinary team.

Stay tuned…

I didn’t see it coming.

I took on the challenge of reading the literature surrounding Occupational Therapy best practices to eventually create research presentations. This has allowed myself to understand Occupational Therapy and how to support children who struggle to communicate their thoughts, stories and writing assignments. By broadcasting these findings, teachers and parents can learn the most recent research on how to best support their children who have complex behavioural disorders. I also never knew how challenging and interesting working on a grant proposal could be. I taught myself how to design blueprints for the construction of a sensory room, communicate with equipment companies about the intricacies of designing a sensory room and helped back our proposal with the most current Occupational Therapy research in the last 5 years. To top that, I loved working with the kids on caseload and running a skipping program for some of the coolest kids on the face of earth. Because I can’t babble about everything Children’s rehab has to offer, I’ll share my favourite and most unexpected project with the local library.

A library is a place with four walls for silence and reading right? Not always. The Camrose library is a place where you can make connections, engage in intergenerational programs or go outdoors to read and be active. The city of Camrose is one that supports physical activity and literacy no matter someone’s age. This belief made it possible for Erin Branton and I to collaborate with the Camrose Wellness Coalition and the Camrose Canadian Tire to fund the Book Bike – a program that offers a mobile gym and library in an all-in-one package. The Book Bike is one of the library’s newest programs that has developed from the exploration of accessibility for the next generation – maybe the most important generation of them all. The Book Bike program has proved to have tremendous worth in a city like Camrose because it is part of the solution to overcome a lack of public transport, something the PLLC Augustana forum has already taken action towards resolving in their vodcast https://www.youtube.com/watch?v=ZW2EIc4cEjQ&t=121s. WOOHOO!

In the summer, students use the Book Bike to pedal around several parks, farmers markets, old folks homes and local events in the city. This allows the library to act as a traveling hub for people to meet, learn and interact beyond the library walls. The bike is always on the go with a sense of community following closely behind. With many new partners this year, Erin Branton and I were able to outfit the Book Bike with equipment worth several hundreds of dollars, which allows people of all ages the abilities to keep their mind and body in shape. Again, a big shout-out to the Camrose Wellness Coalition and Canadian Tire for making it possible! As for me, I had a ton of fun selecting 75 games and activities that are inclusive of any age or ability, to put in a book that students can use with the kiddos and old folks’. Lacrosse, baseball, bocce…you name it, the Book Bike has it in a variety of modified versions. Come enjoy some new games!

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75 Inclusive Physical Activity Games
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Physical Literacy Booklet

The Book Bike program primarily enables children to independently access books and   organized physical activity. But it also encourages people to spend time outside, attend social events and make meaningful connections. It brings education to kids and invites them to be active outside as opposed to being active on social media, which is more important now than ever. Although it is only the beginning of an initiative like the Book Bike, this program is taking steps towards outing an indoor generation (https://www.youtube.com/watch?v=ygHU0mQGuJU). Most have forgotten what it feels like to enjoy the outdoors as they resort to hiding behind screens or walls, and I hope I know the Book Bike will refill our deserted parks with a sense of community.    

Although our project favours the next generation, the Camrose library hasn’t forgotten its elderly population. How is someone suppose to get around and be apart of a sprawled out city if they can’t drive at the age of 80? Well…when was the last time you saw someone pushing 80 get around using a bike?…it might just have been here, in Camrose. Through the Camrose library you can cycle without age limits by using their trioBike, which is a bike that allows the elderly and disabled community the chance to experience biking as a passenger rather than a driver https://www.youtube.com/watch?v=O6Ti4qUa-OU.

Now you can use the TrioBike to cycle without age limits and the Book Bike to stay well-read and active. Both bikes are hurdling a lack of public transport and adding to the mobilization of the city.

As I reflect on this project with a couple weeks left, I realize that I have worked with many people that I didn’t intend to. I truly didn’t plan to work with a team of librarian assistants and physiotherapists during my stretch, but these ladies helped remind me that everything worth doing is best done by a team. Most of the time people believe you have to go it alone in the change you want to make but the reality is that those around you will have similar aspirations or a willingness to help. By collaborating with the Camrose library, we were able to create a lasting impact. We combined and leveraged our resources to create a service that is stronger than what it would have been as individual pursuits and it feels great to see it in action.

OT’s are the Linchpin.

Sometimes the wheels fall off, people break down and people act irrational. I believe that Occupational Therapists could be the linchpin to the complicated structure that is socially constructed masculinity. 

Now that I have completed my stretch I can look back on it with more depth than before. A discussion about how everyone’s abdominal separation (when your ab muscles start to separate during pregnancy) was doing after pregnancy was quite literally the last thing I expected to be listening to during the first half-hour of my stretch experience. Then again, I wasn’t aware that the east central zone consisted of an overwhelming 77:3 ratio of female therapist compared to male therapists. In terms of Occupational Therapists, there weren’t any male therapists on staff. Of course, there was never anything wrong with having an all-female team. My previous job together with the PLLC Roundtable Committee was made up of brilliant women and these teams were nothing less than efficient and well-rounded teams much like Children’s Rehab. But it kind of makes a fella wonder. What if more males were involved in Occupational Therapy and where are they?

Coming from a background in construction and agriculture, the argument is similar. We need a more balanced gender ratio. These industries are flooded with men and could benefit from the diverse ways that women think differently from men. Now that I’ve moved on to Occupational Therapy the story is the same but reversed. Male Occupational Therapists are lacking. Professions such as Occupational Therapy and Speech Therapy are frequently sporting a woeful 5% male representation or less. Even though women do very well in these positions due to their caring and creative nature, there is a need for male therapist in this field due to the population that children’s rehabilitation serves (many young boys and girls with behavioural issues). You could argue that women are known to be more in tune with their emotions and are therefore steered to professions like OT more often than men because OT involves behavioural and sensory regulation. This fact often suggests that gender affects the quality of therapy and that women are better positioned to be OT’s, which in general is probably accurate. However, I discovered that the opposite can also be true; the impact of gender on the value of therapy could be negligible. A good therapist is a good therapist. A bad therapist is a bad therapist. It frequently depends on the practitioner’s strengths, the client and the task at hand.

In my own experience, I felt my work was susceptible to blind spots: a lack of education, a lack of experience working with kids and forgetting how kids think. Many of the women in my office had the “mom gene” and were very good with kids or had kids of their own. However, it was interesting where I received positive feedback. Comments such as “it’s because he’s a guy” and “he’s good at that kind of thing because he can relate” caught my attention. They brought to my attention an advantage that I had when building rapport with these young boys. I could name Pokemon, action figures and cars at the same rate as they did. Few female therapists grew up in a similar environment and could relate to them. There were other times that I believed this factor was so prominent that young boys might have felt more comfortable with a qualified male than female. This is not to say there are discrepancies in the quality of work but rather to highlight the need for diversity in a team. In the midst of redefining masculinity as a society, I think it would be wise to consider the gender of an OT in pediatrics. Young boys take up a large portion of clinical caseload in the pediatrics specialty because many boys struggle with behavioural problems at a young age. We need to consider what kind of impact therapists can have on the kids who have complex needs and behavioural conditions – many of them boys – who are receiving therapy but would prefer or benefit from a male OT. We learn best from those we aspire to be; therefore, decent men could have a profound effect on boys who do not have coping mechanisms for their violent, irrational or simply compulsive behaviours. If we explore this idea with a broader lens I think it has a significant role in reframing manhood. It doesn’t have to fall on the shoulders of a single father to raise a boy but rather on all men and women equally to teach a young man how to cope with adverse times growing up and understanding how to navigate stressful social environments.

During my time in rehab, I met youngsters who were respectful and quite aware of their behaviour. I met several other young boys who were bullied, scared and anxious. On the other hand, I met some that acted aggressive and inappropriate. In the end, I noticed that I could relate and work with young boys better than girls. These realizations were nothing shocking to me but provoked some important questions. What pushes a boy to each end of the anxious-arrogant spectrum? Do female therapist work better with young girls than boys? And if so…are boys then underserved in comparison to girls because there are no male OT’s around to give services?

Of course, the differences can be subtle and it would be difficult to answer these questions but they’ve pushed me to research and question why I think more males should consider this profession. I don’t have any answers, but I can give you an opinion. In brief, WHAT IS SAID is important but WHO SAYS IT is just as important. Male OT’s have a big voice when heard by small ears. In a one-on-one interaction, a boy will inevitable place more value on how a man tells him to behave or “be a man” as opposed to anyone else. As male therapist, you have immense power when teaching the next generation occupational skills or proper behaviour because you are crafting how males are portrayed to younger generations – which leads me to consider a much broader context.

In reference to the tragic shootings and Me Too movement that have recently covered the front pages, the media and its readers are quick to ponder the motives, weapons, mental state, family history, location and many other compounding factors that are involved in the event. Yet, most overlook a variable that is constant in contrast to these other factors. The fact that nearly all mass shootings are done by males tells a fundamental truth about the society that men grow up in and the molds that we are told to stereotypically fit. I say this not to criticize masculinity but to criticize society as a structure and force.

If we want to address recent mass shootings that have been predominantly done by men then we need to address the issue from the same place they have occurred…schools. After observing the male pediatric population in our education system, I’ve become convinced that educating young children about regulating one’s irrational behaviour should receive more attention and should occur earlier than later. Young men deserve to be taught how to regulate their behaviour and irrational thoughts, so they can protect themselves and others from thoughts that are socialized into us. I don’t believe that men are born violent or born unable to control irrational actions any different than women. So, I’m led to believe that these actions are taught. Many attribute these actions to sports, modern music or video games, but I also know many men who I respect most that have been cultured and shaped by these hobbies. Without getting too far down the rabbit hole, I’ll just say that the traditional mentality that boys “can handle whatever comes their way on their own” is a idealization of the thick skin they presumably wear.

As severe and subtle as it may be, we can all think of a time that we crossed the line of acceptable behaviour, were verbally or physically violent or harassing. So, I hope that critiquing the society that produces all of us is something that crosses your mind for more than the couple minutes it took to read my thoughts.

This experience enabled me take on new perspective and stretch my knowledge into a new field of work. I can confidently say that switching from an industry with a hyper-masculine culture to a field of caring and mentoring youth challenged me. Having one foot in vastly different fields has made me think a little more creatively. This stretch was and is a tremendous experience giving students the chance to use their message to reframe their own life and take action. I appreciate all those that helped me along the way because it’s definitely not a stretch to say that this field has a steep learning curve that I haven’t surmounted yet.

I truly thought that I would have a clear picture of my future after these past couple months, but I ended up being interested and enjoying new professions. My choice of a future career is still up in the air. Now I am simply juggling more options, which is not a bad thing. So, thank you to the amazing family of rehab specialists in Camrose. It’s been my pleasure!

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Children’s Rehabilitation Centre

Trent Hebert

 

 

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