Monday 12 November 2007
hyperactive child
For my mid place Ax i was assessing this young boy who had suspected DCD as well as significant behavioural issues. He was very in tune with what his limitations were and as soon as he knew he couldn't do something he would play up / run off in the middle of my Ax, therefore a lot of my Ax was spent trying to calm him down and focus his attention to the tasks at hand. Whilst this Ax was going on his mum was freaking out saying that his co-ordination / behaviour was not normally as poor as he was showing during the Ax. The difficulty was that my facility tutor had asked me to fill out the entire Ax form as it was the first time that I did a full sensori motor Ax but the Ax procedure is long and rather boring for a child to complete. Needless to say, whilst i was supposed to testing half of the items the child was bouncing off the walls and I couldn't focus him back onto the tasks despite trying to make the Ax into a game and as fun as possible. At the time i felt like i was doing the best i could be doing, but after I felt as though i would have got more out of the vhild and session if I picked out the key areas first and just Axd those parts. I also would have been able to chat to the mum more and re-assure her that her child was not doing as poorly as she thought. Any thoughts on juggling the pt and the carer at the same time as completing an Ax form??
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2 comments:
I haven't done paeds since Feb but I agree I remember that was really hard- sometimes I would let the child run back to the mum while I spoke to her, sometimes I would try and leave the child doing an exciting activity while I scribbled a couple of things down and often I just had to run with what was happening and remember and write it down after. This is what annoys me about prac; in real life you would do half the tests in the first session, do some Rx that was fun to encourage compliance, chat to the mum to calm her down and get the child back the next week to finish the Ax but because its prac and someone's watching you ticking boxes you can't always provide whats best for the pt. Some supervisors are happy when you do whats logical and most beneficial for the client but others seem to just want you to jump through hoops without any regard for the real situation!
I guess I've been lucky enough on my paeds placements to justify omitting certain Ax's for reasons very similar to what you have suggested.
Children are different characters and often if you don't show them your full attention they won't respond to you. So often I'd have to do a lot of remembering afterwards and not write anything down at the time.
Also for children who have ADHD type tendencies or difficulties in concentrating for long periods of time, let them go nuts and run around the room or bounce on a ball (as long as there's not other people around). They need that opportunity to vent and then refocus...sometimes easier than said.
As to supervisors who make you jump through hoops..we've all been there but I firmly believe if you can justify yourself and your aims for doing what you did than you can't be wrong so long as its logical.
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