Strategies For Implementing Pediatric OT Groups: A Capstone Experience
I recently completed my capstone rotation at Acorn Children's Therapy in St. Louis, Missouri, and what a fun summer it was! Acorn provides occupational therapy (OT), physical therapy, and speech therapy to pediatric clients to help them achieve their goals outside of the school setting. While this practice is only 3 years old, the practitioners and owners have established great rapport within the community. I will dive more into my work later, but first, I would like to share how I got here! As I entered my fieldwork rotations, I knew I wanted to become a well-rounded clinician, but I also needed to figure out where I wanted to end up in the future. Therefore, I completed my first Level 2 rotation in inpatient rehabilitation and my second Level 2 rotation in school-based early childhood OT. While these two rotations couldn't have been more different, I believe they prepared me well to enter a pediatric outpatient setting. Between the two settings, I learned how to navigate a fast-paced schedule, maintain a high standard for documentation, think like an OT, and, most importantly, make things FUN!
After a really enjoyable rotation in the school setting, I knew I wanted to work more with kids. I was put in contact with the co-owner and OT at Acorn by my program director and was presented with the opportunity to be a part of summer groups. I said yes, and I'm so glad that I did! During my capstone, I helped lead clinic-based and nature-based groups for kids ages 3to 6 years. While participants can sign up for multiple weeks, each week consists of a different combination of children. The groups are made up of both structured and unstructured activities and are centered around learning and interacting through play. Therapists, or implementers of the groups, strive to meet an array of needs to facilitate participation and peer interaction. The OT at Acorn, who also takes part in leading the groups, expressed that their greatest interest is to better understand the social-emotional skills of these young children in order to identify how OT groups can help foster growth and development. Children should form relationships with those around them from a young age, continuing to enhance their social-emotional skills through play and interactions with others. Through the bond of shared activities, children learn how to understand emotions, communicate with peers, and handle different situations, showing the importance of social-emotional development in overall well-being.
When thinking about a capstone project, I would encourage other students to dream big. Capstone is an opportunity to make your mark in the field of OT, but also a chance to give back to the profession. Therefore, it is important to consider ways in which you can make the capstone project a positive experience. Implementing OT groups for pediatric clients is a great way to promote skills that are more difficult to address during individual treatment sessions. However, implementing pediatric groups can be, simply put, a circus. I've learned a few lessons along the way, and I want to share them with you!
Strategies for implementing pediatric OT groups
1. Listen to the voices of the clients (children).
As part of my Capstone project, I collected outcome measures to gain insight into
what occurred over the course of the summer. While I had all implementers take data on the social-emotional skills of the participants, I wanted to be sure to include the voices of the participants as well. While my project was not considered research, it is common for research to be conducted on people rather than with people, especially with the pediatric population. To gain insight into the social-emotional and cognitive skills of the participants, I created an emoji scale to help the children tell me how their bodies felt at the end of the group and had them draw a picture of themselves at the end of each week. These outcome measures, which were designed with the cognitive abilities of young children in mind, were shared with clinic staff to increase awareness of individual experiences during group activities.
2. Offer multiple approaches.
This summer, Acorn Children’s Therapy offered a clinic-based and a nature-based group. Offering groups in different settings with different activities allows for different therapeutic approaches to be used. When you have clients with diverse needs, it is important that clinicians provide opportunities to promote participation and success for everyone.
3. Allow the clients and their families to see and hear about what they are capable of doing.
Technology is often a hindrance to our daily lives, but I would also argue that, when used appropriately, it can be used to enhance our lives. Children love to see pictures and videos of themselves on a phone. For example, I would take videos of the participants jumping off of a tall rock while at nature group, which they were very excited to watch afterward. While I was proud of their gross motor skills and confidence, they were excited to see the big, cool jump they just did. Not only do the participants need to know what they are doing well, but their parents need to know, too. At the end of each day, the parents were always verbally provided with a highlight of their child from that day. Sometimes, parents can become focused on the weaknesses their child may be experiencing, and they have a hard time seeing the strengths. Therefore, it is part of our job to inform the parents of the successes as encouragement to both them and their child.
4. Be part of a team.
When I first started planning my capstone project, I thought that I would need to implement everything on my own. I even wrote my learning activities under my objectives to reflect this. When I started on-site at the clinic, we ironed out the details, and I was informed that I would be part of an interprofessional team. Everything fell into place, and I didn’t need to do any recruiting to find help. I quickly realized the importance of a team during group implementation. It would not be effective or safe to implement these groups by myself. Being a part of a team can be a beautiful thing and at the end of the day it allows for more fun to be had for all.
5. Make it sustainable.
When you enter into a space and implement your capstone, it is important to consider how you will implement, maintain, or support a process that can be continued over time. One-time implementation does not necessarily provide benefit to a practice. Therefore, I provided the clinic with a manual to guide both the clinic-based and nature-based groups, along with nature-based resource guides. While these may not be considered the gold standard, they can be used to assist with future implementation of the program. The capstone project is an opportunity you may never get elsewhere, and it is most important to always keep in mind how you will give back to the practice, clinician, or program that gave you this opportunity.
Baylee Bleikamp, OTD, completed her degree at Washington University in St. Louis in August of 2024. Baylee is currently applying for school-based opportunities to use her knowledge to support pediatric clients in an academic setting. She hopes to continue her love for nature-based work someday in an effort to advocate for the benefits of outdoor exposure for young children.