How to Become an OT in the NICU

Hi readers!

Over the last nine weeks, you probably have gained plenty of knowledge on what occupational therapy is and how OTs can treat the smallest of patients in the Neonatal Intensive Care Unit (NICU). We have discussed Kangaroo Care, Oral Motor Stimulation, Pain Management, Hand Splints in the NICU and more! Now, some of you may be interested in this career choice, so I would like to talk about the education needed to become an OT in the NICU. As for parent readers, you can learn about the education level of your child’s therapist.

To practice occupational therapy, you must receive a master’s degree following your bachelor’s degree, no matter what setting you decide to work in. You can obtain a bachelor’s degree in majors such as kinesiology, psychology, biology, anthropology, or sociology followed by a master’s program in occupational therapy (“How to Become”, 2012). However, some schools offer accelerated programs where you can receive your bachelor’s and master’s degrees in occupational therapy in about five years. Master’s degree programs in occupational therapy “include courses in functional anatomy, medical and social conditions, assistive technology, patient care concepts, and research methods” and usually consists of anywhere to 20-40 hours of field experience in different OT settings (“How to Become”, 2012).

After both degrees, you must become licensed in the state you wish to work before you can practice. Once you have completed an accredited OT school program and have completed field work, you must pass the National Board for Certification in Occupational Therapy (NBCOT) exam (“How to Become”, 2012). Afterwards, you are a registered occupational therapist; however, you must do continued education coursework to maintain the credential.

Finally, after practicing OT in a pediatric setting for 2-6 years, you may be qualified to work with the highly vulnerable population of NICU babies.

As always, thank you for reading!

 

Kayla

Works Cited

"How to Become an Occupational Therapy Professional." Study.com. Study.com, 2012. Web. 9 Nov. 2016.

Hand Splints in the NICU

Babies in the Neonatal Intensive Care Unit (NICU) commonly have hand deformities and hand dysfunction. Since occupational therapists help with daily activities like eating and other fine motor skill tasks, it is important for OTs to try and fix these hand deformities quickly and accurately, so that the baby can perform daily activities of life now and in the future.

Hand deformities and hand dysfunction, being common in the NICU, can be caused due to many things. The authors stated that, "problems are due to increased tone resulting from central nervous system damage associated with CNS developmental anomaly, hemorrhage, hypoxia, infectious processes, tumors, or trauma" (Anderson & Anderson, 1988, p. 222). Rare yet possible, hand dysfunction isn't usually caused by the ingestion of a drug or other toxin during pregnancy.

Due to NICU babies' instability and time constraints, OTs usually opt for the intervention of hand splinting, to try and correct the deformity and dysfunction of a hand. Splints can provide protection, support, and immobilization. Orthotic splinting can hold a joint in a function position through a series of changing molds in order to force a joint into better alignment over time (Anderson & Anderson, 1988, p. 225).

Safety is very important when splinting, especially on infants, since they can't directly tell you what hurts. Premature and ill infant are more at risk for skin ulcers due to diminished fat pads on their hands. Therefore, it is important to watch carefully for irritation from the splint. The straps, if pulled too tightly, may also cause edema. The straps should be loose and wide so that the pressure is spread over a great area. The glue used to adhere the straps should also not come in contact with the baby in order to prevent contact dermatitis. Finally, a sock usually is put over an infant's splint in order to prevent injuries or removal by infant (Anderson & Anderson, 1988, p. 225).

Thanks for reading,

Kayla

Works Cited:

Anderson, L. J., & Anderson, J. M. (1988, April). Hand Splinting for Infants in the Intensive Care and Special Care Nurseries. The American Journal of Occupational Therapy, 42(4), 222-226. Retrieved November 4, 2016.

Settings of Occupational Therapy

Hi readers!

Occupational therapists can work in many different places beyond in the NICU. This week I would like focus on my friend’s blog. Megan is in the Saint Louis University occupational therapy program with me. Her blog is dedicated to all the different settings OTs can work in. The flexibility in settings is one of the most unique things about occupational therapy and one of the main reasons I fell in love with the career.

Megan discusses the OT settings of NICU, oncology, mental health, acute care, school, and nursing homes. As you can see, it is a wide range from beginning of life in the NICU to the end of life in a nursing home. For each setting, she discusses the types of patients the occupational therapist works with, what the patient’s diagnosis might be, and what and how an occupational therapist can help the certain type of patient whether newborn with sensory integration difficulties or with a geriatric patient after a stroke (Cussen, 2016).

I encourage you to go to her blog to learn more about each setting and how an occupational therapist can help you at any age or stage of life. Please visit this link http://sluengl4000.blogspot.com to go to her blog. I really enjoy reading it, and I know you will too.

Come back next week!

Kayla


Works Cited:

Cussen, M. (2016, September 16). What is Occupational Therapy?? [Web blog post]. Retrieved October 28, 2016, from http://sluengl4000.blogspot.com

OTs Helping Patients with Down Syndrome

Hi readers!

Occupational therapists help diagnose babies and play a large part in early intervention therapy to help physical, cognitive, and social development. For example, OTs help babies with Down Syndrome, which is a chromosomal disorder caused by the presence of all or part of an extra 21st chromosome. Down Syndrome causes low muscle tone or hypotonia, which makes one feel floppy and have reduced strength and endurance (“Occupational Therapy”, 2016). This makes learning gross and fine motor skills very difficult. Children with Down Syndrome also have short arms and legs (“Occupational Therapy”, 2016). This can make fine motor, gross motor, and functional skills harder to perform. Occupational therapists’ goals with patients with Down Syndrome is to help improve their quality of life. OTs can start as early as in the NICU by assisting with arm/wrist/hand strength, control, and coordination. They can also address cognitive development through play and learning. Due to hypotonia and cheek, tongue, and lip muscle weakness, feeding can be difficult for some babies with Down Syndrome (Bruni, 2012). OTs can help with positioning and feeding techniques and request feeding studies. OTs can also start helping possible future difficulties involved with short arms and legs such as dressing and toileting and certain hand/arm movements such as coloring and opening things (Bruni, 2012). OTs can help promote arm and hand movements with infants to help lay the foundation for the future. It is all about early intervention in order to help a child with Down Syndrome have the best quality of life.

Talk to you next time,

Kayla

 

Works Cited

Bruni, M. (2012). Occupational Therapy & Down Syndrome. Retrieved October 21, 2016, from http://www.ndss.org/Resources/Therapies-Development/Occupational-Therapy-Down-Syndrome

Occupational Therapy for Down Syndrome. (2016). Retrieved October 21, 2016, from http://www.therapiesforkids.com.au/conditions/syndrome-2/
 

Pain Management by OTs

Hi Everyone!

Occupational therapists (OTs) play an important role in managing pain in infants in the Neonatal Intensive Care Unit (NICU). Babies are under a lot of stress when in the NICU. They are under bright lights and hear loud sounds. These are all things that are new from the womb, and on top of that, they are premature and do not have developed sensory integration patterns yet. Sadly, painful procedures are performed on infants in the NICU often like blood tests. Pain experienced this early in life has the potential to change the development of the brain and lead to unwanted long-term outcomes.

Therefore, it is important for an occupational therapist to prevent NICU pain and stress triggers to promote the best neurodevelopment possible for the baby. Occupational therapists evaluate the environment that influences’ the babies like light and sound. They try to reduce the light directly over the baby in the isolette. Also, they watch the baby’s reactions to be able to tell what causes them stress since they can’t communicate with us. Premature infants do experience pain differently than other infants due to immature brain and muscles.  

In order to give accurate pain evaluations, an assessment called Behavioral Indicators of Infant Pain (BIIP) helps “evaluates the presence or absence of five anatomically defined facial processes, two hand reasons, and sleep/wake states” (Holsti, 2011, p. 9). Babies in the NICU cannot take normal medication due to significant side effects. Hence, occupational therapist promote non-pharmacological treatment to activate innate pain moderating systems. By encouraging multiple activities at once, it reduces pain. Sucking a pacifier stimulates hormones such as serotonin, which reduces pain and by holding the baby at the same time or feeding. Positioning can also be crucial to pain control. Trunk tucking or the action of flexing the babies arms, legs, and head into close proximity gives the baby support, comfort, and control stress. OTs also educate parents to notice when their baby is in distress during certain activities, so that the OTs can work with them to minimize it in order for the baby to have the best neurodevelopment in and out of the NICU.

Thanks for reading,

Kayla

 

Works Cited:

Holsti, L. (2011). Occupational Therapists Play an Important Role in Managing Pain in Infants in Neonatal Intensive Care Unit. Occupational Therapy Now, 14.5, 8-9.

Oral Motor Stimulation

Hi readers!

Premature infants before 32 weeks gestational age (weeks from conception to birth), are not developed enough to orally feed from breast or bottle. Before this premature age, without help, neonates cannot do suck-swallow-breathe coordination, which is a necessary component for being able to orally feed. Therefore, premature infants are fed by a nasogastric tube, which leads from their nose to their stomach, in order to be fed properly by nurses despite not knowing how to suck on a bottle.

However, it has been found that around 32 weeks gestational age, premature babies are developed enough where they can be taught how to suck (and therefore orally feed) through oral motor stimulation. Oral motor stimulation can be many things including stroking newborns’ cheeks, lips, gums, and/or tongue. Vibrating pacifiers have also been implemented in oral motor stimulation.

In a case study, for 15 minutes before each feeding for 10 days, occupational therapists provided oral motor stimulation to the experimental group out of the total 32 premature infants at 28 weeks gestational age. The OT researchers found that the experimental group developed sucking patterns to be able to suck-swallow-breathe and orally feed 10 days sooner than the babies in the control group, who did not receive oral motor stimulation before feedings. The babies who could orally feed 10 days sooner were also discharged 10 days sooner at a healthy weight than the babies who were not treated.

These results help show that oral motor stimulation does help premature infants orally feed sooner leading to healthy weight gain and quicker discharge from the hospital.

Thanks for reading,

Kayla

 Quote of the day: “Occupational Therapy: Develop, Recover, Maintain” –Unknown

Works Cited

Fucile, S., E. G. Gisel, and C. Lau. "Effect of an Oral Motor Stimulation Program on Sucking Skill Maturation of Premature Infants." Developmental Medicine & Child Neurology 47.3 (2005): 153-59. Scopus. Web. 21 Sept. 2016.

Kangaroo Care

Hi readers!

I am excited to teach you about kangaroo care, an occupational therapy treatment used in the NICU. Kangaroo care (KC) is a way for a mother or father to hold their newborn involving skin-to-skin contact. The baby, naked except for possibly a hat, diaper, and blanket over its back, is laid on the mom or dad’s bare chest. This method is similar to a joey (baby kangaroo) in its mother’s pouch, which explains the name. Occupational therapists encourage new NICU parents to do kangaroo care with their premature infants.

Kangaroo care has been proven to benefit babies in many ways. Kangaroo care can stabilize a baby’s heart rate, improve oxygen transfer, regulate body temperature, and much more. Breasts can change temperature by themselves in order to help the baby regulate their temperature. For example, if the baby is cold, breasts naturally increase in temperature in response. Also, through studies, it has been shown that babies during kangaroo care can fall asleep within minutes. The extra sleep on a mom’s chest, with help in regulating temperature, helps the baby save energy and calories, which allow the baby to concentrate on growing rather than temperature regulation.  

An occupational therapist’s goal is to help patients thrive in life. Sometimes OTs need to help and support the parents too in order for them to best support their child (the patient). Moreover, kangaroo care also helps the parents, which tends to lead to better care of the baby. Kangaroo care has been shown to increase breast milk production, increase parents’ confidence to care for their baby, and improve bonding with their baby, which has been shown to decrease the occurrence of postpartum depression in new mothers.

Thanks for reading,

Kayla

"All kids need is a little help, a little hope, and someone who believes in them” –Magic Johnson

 

 

Works Cited

"Kangaroo Care." Children's Cleveland Clinic. The Cleveland Clinic Foundation, July 2015. Web. 29 Sept. 2016.

Vergara, Elsie, et al. "Specialized Knowledge and Skills of Occupational Therapy Educators of the Future." American Journal of Occupational Therapy 63.6 (2009): 804-18. Aota.org. American Occupational Therapy Association. Web. 30 Sept. 2016.