Monday, August 6, 2012

Reverse Discrimination

Twenty-three years old, Jamie lives at home with her mom but for the most part is fairly independent and self-sufficient.  Upon our initial meeting, I notice no obvious disabilities but through my observation of her occupational therapy (OT) sessions, Jamie’s challenges become evident.  Jamie has central nervous system dysfunction; at some point her brain suffered an injury, mildly impacting her cognitive skills and muscular motor skills.  Cognitive skills include attention (both focus and to details), memory, the speed at which one processes information, logic and reasoning.  Motor skills involve movement of the body’s muscles: gross motor skills are the abilities to control the larger muscles of the body for walking, jumping, running and other such activities.  Finer motor skills deal with smaller actions, such as grasping an object between a thumb and a finger.

Jamie’s developmental disabilities are mild and subtle, leaving me to wonder upon meeting her as to why she was even in OT at all.  In conversation, Jamie will often repeat a statement over and over again, injecting it into the conversation at unusual times. She’ll also change the subject dramatically from the topic being discussed, revealing some social challenge.  Jamie also struggles with follow-through on basic tasks or projects.  Her attention to details, for example, to cooking something or brushing her hair may go unattended or unfinished. I notice an awkwardness in Jamie's body coordination when undertaking an activity that involves both her upper and lower body (gross motor skill).  Most wouldn’t notice these subtle cognitive impairments, and may perhaps pre-judge Jamie as “odd” or “inappropriate.”  Unfortunately, I’m told by her sister that these very subtleties challenged the diagnosis process of her disability through the years.  Without obvious presentation of her disabilities, others’ have refused to accommodate Jamie's needs, which could ironically be considered “reverse discrimination.”  For example, Jamie’s request for bumper pads for the gutters at a bowling alley was once rejected.  According to the bowling alley, this accommodation tool is used for children, elderly and those with disabilities, and thus initially refused the family’s request for their use because Jamie didn’t "look like" someone with a disability.

Jamie started her OT sessions in November 2011 with Jill Boeglin after a therapeutic evaluation.  With input from both Jamie and her mom, they together identified a few OT goals for Jamie:  improve follow-through and safety awareness when performing a task, especially in the kitchen; develop attention to details when performing a task; improve social skills and etiquette; develop gross motor coordination as well as muscle strength and endurance in Jamie’s upper and lower body.  These goals will support Jamie’s ability to become more independent, and lessen concerns for her safety and well-being.
With these goals identified, Jill incorporates a variety of OT activities and exercises that will address the identified challenges Jamie experiences in her day-to-day function of living.  I am fascinated by the creativity Jill uses in administering the OT treatment, designed to support Jamie’s efforts in achieving Jamie’s goals in a fun and entertaining way.
First up:  Bouncing balls!

In the Next Blog Entry: A Ball of a Time - Jamie bounces this ball. . . . I notice her struggle to keep control of its bounce. . . . . . Suddenly, the ball moves out of her bounce zone. . .
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