Daycare Routines Assessment - 16 Days Until Casting….

Today we did a routines assessment at Summer’s daycare. The purpose is to identify all the things she does in the day and then assess where she needs help during her three week casting.

It also helps us determine when she will receive 1:1 time with her helper to work on her therapy activities.

We also looked at the environment to see if there are any safety issues.

There are the daily necessities such as:
Eating
 Ann and Marg to look for adaptive utensils that will still promote skill/movement development.
 Consideration for finger foods when appropriate.
Drinking
 Initially to use sippy cup with handles with progression to open cup with small amounts.
Dressing
 Assistance with coat as required.
Toileting
 Assistance with toileting – may require assistance with pants.
 Supervision required for safety
 Step up stool needed
Glasses
 Will require assistance in taking off and putting on glasses.

Wow, we take all these things for granted. Summer has developed all of these skills and does these tasks more or less independently. We’ll be temporarily disrupting her independence and will have to plan for her frustration and needing help.

I've set some goals for us to work on:
1. More frequent automatic inclusion of her right hand in play.
2. Incorporation of her right hand into eating routines.
3. Increase in dexterity and fine motor control in right hand.
4. Consistent ability to get right hand into wrist neutral position.

I know some of the skills she develops will be subtle and maybe I will be the only one to really see the improvement.

Then there is the ‘fun’ stuff - Play and Therapy Activities
 Painting – bulb shaped paintbrushes
 Cutting – training or spring loaded scissors available
 Drawing – larger crayons
 Gluing – use glue sticks
 Sandbox – consideration for keeping the cast as clean as possible.

We have few safety concerns:
 Stairs – Summer will require help with the stairs until we can assess her confidence while casted, as well, on the playground – Summer may not be stable enough for scooter and tricycle play. (Also - the sand box will be awful - but first things first - I'll have to find a cover for the cast to keep the dirt out/off.


Support for Summer:
 One of Summer’s teachers (who we really like – so calm and patient with the kids) will be backfilled for 2 hours per day so that she can spend some 1:1 time with Summer as well as help her when needed.
o She will build up to 1 hour for practicing 1:1 therapy and 1 hour classroom activity assistance.
o We’ll provide her with a daily therapy plan for the 1:1 time – specific activities and tasks to carry out.
o Provide training for the tasks with supporting visual materials.
 Ann– OT support Tuesdays at 09:00am
 Marg– IDP Once a week ad hock 09:00am
 OT assistant – participation to be determined.

General comments:
 Initially the 1:1 therapeutic activity session may be shorter and will lengthen as Summer builds up stamina.
 Summer may have different levels of tolerance from day to day – depending on her fatigue.
 Frustration cues for Summer are usually less emotional in the daycare setting. She is very good at asking for help when needed. She is more a whiner than a cryer when frustrated.

16 days... yikes it is coming up fast!