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Spotlight on Occupational Therapy

“Knowing I gave a child some strategies to help them be more confident and able to complete a necessary task is very satisfying,” says pediatric occupational therapist Danielle Harling. “There’s something lovely about being able to say ‘Congratulations, you don’t need me anymore’.”

October is Occupational Therapy Month, and Shared Health celebrates occupational therapists for helping people achieve independence in their everyday lives. Occupational therapists (OTs) help patients develop, recover, improve, and maintain the functional ability needed for daily living and working.

You’ll find OTs working as part of health care teams in hospital settings such as critical care, mental health, inpatient and outpatient rehabilitation, burns and plastics, and research. OTs work very closely with other disciplines, especially physiotherapy, to ensure comprehensive and consistent treatment for each patient. Much of the OT work in hospital involves discharge planning, setting up equipment, and helping to get patients back home safely. OTs also practice in community settings including private clinics, homes, schools, and other institutions.

Occupational Therapy is a Master’s-level university program requiring an undergraduate degree. OTs are regulated by the College of Occupational Therapists of Manitoba and must be licensed to practice.

This month we shine the spotlight on Danielle Harling, a pediatric OT who works in a hospital setting. She treats orthopedics, juvenile idiopathic arthritis (JIA), and burns and plastics inpatients and outpatients.

Danielle specializes in treating children who have hand injuries such as finger fractures and tendon injuries. This work mostly involves providing appropriate lightweight splinting to protect fingers and joints while they heal. She also works with children with arthritis, recommending general strategies and techniques for managing fatigue and energy conservation. These interventions allow young patients to do all the important ‘jobs’ of children: being able to play, being able to learn, and continuing to improve their personal care skills.

Danielle reflects on how practice has changed because of the different stressors and demands introduced by the pandemic. “It has changed how we interact with our patients and some of our contact within the community, such as school re-entry for children recovering from burns. It’s changed how frequently we see people, the way we see people, and the kind of recommendations we make because people are doing things differently than they did before. For example, a child who has arthritis in their fingers requires different strategies to be able to adapt to remote learning and using a computer keyboard instead of sitting in a class setting and using a writing instrument.”

Previously, all appointments were in person. Now when in-person is not absolutely needed many families appreciate having the option to visit online, especially if their child has complex chronic medical conditions that require limiting contacts outside the household. For some families in remote communities, ‘virtual’ visits can reduce the amount of travel required while providing the needed support. Video can also allow the OT to help prepare a child for what to expect when they must attend an in-person appointment. Danielle explains, “I introduce myself, and then put on a mask and face shield to demonstrate what the child will see when they get here, and to reassure them that under the PPE we are friendly people.”

Computers and internet service are not available to everyone, so the team has been creative in finding other ‘virtual visit’ options for families who are not able to meet online. Staff conduct visits by telephone and assess whether an in-person visit is needed. They also connect with patients who come in for other appointments, so the family requires only one trip to the hospital.

Prior to the pandemic the team was already delivering enhanced care with online resources, as a supplement to in-person visits and to distant locations. The resources they have developed include a series of educational videos and handbook outlining safe caregiving for children and adults with abnormal tone issues, a video for families and caregivers to help them care for little ones with issues after substance exposure in utero, a video series for caring for babies who need extra help with eating, and a video and presentation for school re-entry assistance after burn injuries. These tools are now more important than ever to support families and caregivers, and are available on YouTube (https://www.youtube.com/user/hsccomms/playlists).

Danielle says, “I love the diversity of pediatric occupational therapy. It’s also a wonderful exchange of knowledge. We learn so much from our patients and families, and from our colleagues. Being able to make a difference for a child is very rewarding.”

This month we highlight and celebrate the work of OTs as they promote participation in productive and meaningful activities in everyday life. Through their compassionate and innovative provision of therapy services throughout Manitoba, occupational therapists support Shared Health’s mission to create equitable, safe, accessible, trusted and sustainable pathways to care.

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