The Mel Trotter Ministries level 1 fieldwork clinic began in September 2013. At the clinic we work with infants and children as well as adults who have been impacted by homelessness and related challenges.
Infants and children
Children who are homeless experience environmental, socioeconomic and biological risk factors, which place them at higher risk than other children for developmental delays and disabilities. Recent studies on the effects of homelessness on children include increased incidence of learning disabilities, cognitive impairment, language and fine motor delays, and psychological problems, such as anxiety, depression and behavioral disorders.
At the Trotter Ministries clinic we serve infants and children in the childcare area of the women and children’s shelter. The role of the OTS, under the supervision of the OTRL, is to carry out developmental screenings, standardized evaluations, design OT treatment programs specific to the child and family, and to collaborate and coordinate with existing community service providers. Our services are strengths based, with family and child centered care. The OTS utilizes the person-environment-occupation model, dynamic systems theory, developmental and sensory integration frame of reference, along with research-based evidence to guide clinical reasoning and interventions.
Our goal with the infants and children is to facilitate development in the areas of gross motor, fine motor, visual-motor, play skills, social-emotional development, communication skills, self–help skills, as well as to provide parent education in all areas of child development. We aim to make sure that linkages among community services are established prior to the family leaving the Trotter Ministries clinic. Coordination with the family and childcare staff is ongoing.
The OTS completes an occupational profile and full developmental screening with the children living at the clinic. Additional standardized testing is completed if indicated. Once testing is complete a developmental summary, along with recommendations are provided and reviewed with the childcare staff and parents. When appropriate an OT treatment plan specific to the child and family is developed and implemented.
The OTS administer the following formal and informal evaluations with the infants and children:
- Occupational profile and interview with parent
- Infant-toddler development assessment
- Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition
- Infant-toddler sensory profile
- Short form sensory profile
- Clinical observations
- Peabody Developmental Motor Scales, 2nd Edition
- Reflex testing
Testing is completed with the parents present. Reports are free of jargon and results are provided both in person and in writing. Parents are involved in the discussion of results including delineating service needs and discussing options for accessing such services. Every effort is made to inform and advise families of their child’s right to early intervention and special education services if indicated. We educate parents on how to advocate on their child’s behalf and how to become collaborators in their child’s development.
Intervention is specifically designed to address each child’s unique needs. Therapy is once a week with a one-to-one or two students to one child, for one hour. Group sessions are also provided to the children whose developmental skills do not indicate the need for direct OT services. The groups focus on the development of fine motor skills, visual perceptual skills, feeding skills, play skills and sensory processing enhancement.
We work with adult men and women who are part of the Trotter Ministries S.A.V.E. program. S.A.V.E. stands for spiritually, accountable and vocationally equipped. This 90 day transitional housing program combines work, counseling, discipleship and teaching in a structured, therapeutic community for people struggling with homelessness and related challenges. This program also provides an additional time period for those who have found full time employment and need time to create and implement a budget and find housing.
The goal of occupational therapy at the Trotter Ministries clinic is to help individuals improve their health, productivity, and vocational potential. Our emphasis is to facilitate participation, strength-based and client-centered. Occupational therapy students utilize the recovery model, Allen Cognitive Disabilities Model, person-environment-occupation model, and model of human occupation frame of reference together with research based evidence to guide clinical reasoning and interventions.
The role of the OTS, under the supervision of the OTRL includes:
- Ongoing coordination with caseworkers
- Administration of assessments and standardized evaluation tools
- Development of an individualized treatment program
- Implementation of the individualized OT program
The OTS may administer the following formal and informal evaluations with the adults at Trotter Ministries:
- Occupational profile interview
- The Canadian Occupational Performance Measure
- Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition
- The Allen Cognitive Level Screen
- The Developmental Test of Visual Perception for Adolescent and Adults (DTVP- A)
- The Montreal Cognitive Assessment
- The Standardized Mini-Mental State Examination
- The Trail Making Test
- Quick Neurological Screening Test 3
- Box and Blocks Test of Manual Dexterity
- Jebsen-Taylor Hand Function Test
Initial assessment is completed in a 1.5 hour session. This includes an interview to obtain an occupational profile of the individual, self-help screening, pre-vocational skill assessment, cognitive testing and visual perceptual/visual-motor evaluation. If results of the initial assessment indicate a need for further assessment, additional standardized tests are administered.
Results are reviewed with the caseworker and individual the following week. Following the evaluation, the OTS collaborates with the appropriate caseworker to add to the individual’s recovery plan. An OT treatment program is then designed that includes goals and a plan of care so that it aligns with the individual’s needs and overall mission at the Trotter Ministries clinic.
Occupational Therapy’s treatment approach is holistic in nature and provided individually and in groups. Intervention is provided on a consultative or direct approach on a weekly basis. The focus of intervention is to maximize the individual’s strengths and to build skills. We focus on teaching life skills to assist with independent living, to help individuals improve their health, improve productivity, or gain a skill to improve vocational potential and therefore, housing potential. These skills may include but are not limited to: activities of daily living, personal care, parenting/childcare, energy conservation, joint protection, food preparation, money management, health awareness/management, public transportation, community reintegration, computer skills, resume writing skills and individualized pre-vocational training.
By the completion of the semester it is expected that the occupational therapy students participating in the Trotter Ministries clinic will have developed the following basic competencies.
Screening, evaluation, treatment planning, and intervention with infants, children and adults.
Development of client-centered, family-centered and occupation-based intervention plans supported by appropriate theoretical approaches and research based evidence.
Providing intervention directed toward improving overall development, independent living, communication and interaction skills, and prevocational skills.
Implementation of both individual and group intervention treatment.