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A psychologist’s journey into occupational therapy

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PMG Conference 2017 - both challenging and welcoming

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Tina Lavender

Occupational Therapist


31 August 2017


I feel privileged to have received a bursary to attend the PMG Conference 2017, and found the event really useful on a number of levels.

As a children’s community occupational therapist (OT), not a wheelchair therapist, I was hoping there would be enough variety of sessions to influence and challenge my clinical practice in the assessment of posture, and in the provision of seating and lying supports. I was not disappointed!

I spent much of the event building relationships with my local wheelchair service colleagues, which I believe will enhance our provision to the children and young people we serve. As for the programme itself, the speed networking session provided a structured but informal introduction to the whole event, and helped start conversations which continued over all three days.  It felt good to be part of a multi-disciplinary mix of professionals, discussing and comparing common issues and experiences.

The opening presentation by Chris Rattenbury (PL1.1) was inspirational, and his achievements are incredible. It also provided insight into the coping mechanisms of a parent with a child with a disability – a new understanding which I will take with me into my work with families. Then, the Surgical aspects of treating Myelomeningocele (PL1.2) provided me with a better clinical understanding of the interventions involved, and will help improve my assessments and prescriptions when I work with children, post-surgery, at home.

The presentation Exploring seating solutions for children with complex physical disabilities – less is more (FP1) reinforced some practice that our service has also initiated, particularly within special schools. We complete detailed postural assessments prior to prescribing any seating for a non-ambulant child with a neurological condition and, working closely with the wheelchair service, we prescribe the most appropriate seating.  We no longer routinely provide an additional chair in school, unless there are specific features that are required (such as a high-low base for younger children to facilitate transfers), and all clients are considered on a case-by-case basis. We also provide more custom moulded seating than previously, and consider this to be a preventative intervention when there are postural rather than structural asymmetries.  On reflection with my colleagues subsequently, we are not considering ‘one child, one chair’ as a service standard, but we continue to assess on an individual basis with ‘less is more’ in mind. Our assessments will continue to be multi-disciplinary, with OTs taking the lead on seating and lying supports.

The session A person-centred approach to the protection and restoration of body shape (PS3) reinforced the need to complete thorough assessments and to document clinical reasoning. I take photographs during my assessments, but tend to use supports to maintain the most symmetrical posture, rather than as serial positioning tools which may lead to improvement. This session demonstrated the application of the latter and, alongside the use of the Goldsmith Measurements, could be an area of practice for me to consider.

The sessions on temperature control and pressure care were interesting in terms of new technology to meet long-standing issues, although not something I would be able to use in my current role because the products demonstrated are wheelchair specific.  However, these are issues I am now more aware of when considering seating.

Of the plenary sessions on the final day, the Little Explorers (PL3.3) presentation by Jo Jex challenged my thinking the most – i.e. encouraging children to experience independent mobility from 18 months of age. It’s not something I would routinely explore with families, but will consider doing so from now on!  I had always assumed that a high level of cognitive ability was required, but Jo’s presentation has enlightened me. [Photograph: Jo Jex presenting about early wheeled mobilty. Photo courtesy of Suzie Hunt]

The free paper on shared decision-making processes described conversations that are had as a matter of course with children, young people and their families, but it challenged the way I record conversations. I have previously used the Ottawa Decision Tool to facilitate particularly difficult decision-making, but now I’m mindful of recording the views of the child/parents more clearly in my notes.

Lone Rose’s Aldersea Lecture 2017 highlighted how far we have come in the assessment and provision of posture and mobility aids; Lone also alerted us to the further changes and challenges ahead – exciting times!

Having been involved in the local pilot on personalised wheelchair budgets for low level need users, it was interesting to hear the national perspective as well as the presentation from my colleagues in Gloucestershire (PL4).

I found that the structure of the days, with long breaks, provided plenty of time to use the exhibition well. I was able to identify changes in familiar equipment, as well as meeting manufacturers, and finding out about new products. It was an ideal opportunity to feed back about equipment we have used that are fairly new to the market.

As well as the exhibition, posters, and teaching sessions, there was a great social atmosphere; people met up with old colleagues and developed new working relationships at the various networking events – the Welcome Night at Smoke Haus, plus the Drinks Reception and Gala Dinner. 

I would like to thank those involved in the planning and delivery of such a varied conference, and also the sponsors for the extras provided.  I am grateful for the opportunity to attend - what I have learned will definitely be implemented into practice - and I hope I can come again next year!

Referenced sessions

PL1.1: A struggle?...I think not! Chris Rattenbury, Wheelpower ambassador

PL1.2: Surgical aspects of treating Myelomeningocoele Mr Paul Leach, Consultant Paediatric Neurosurgeon, University Hospital of Wales, Cardiff

FP1: Exploring seating solutions for children with complex physical disabilities – less is more Caroline Desjardins, Leicester Wheelchair Services and Susanne Ziegler, Leicester Partnership NHS Trust

PS3: A person-centred approach to the protection and restoration of body shape. Tessa Ellis and Helena Poulton

PL1.3: Little explorers. Jo Jex, Active Design

THE ALDERSEA LECTURE: Change: good, bad, or ugly? Lone Rose, National Spinal Injuries Centre, Stoke Mandeville

PL4: Personal Wheelchair Budgets (PWBs)

  1. Personal wheelchair budgets update. Kate Buffery, Senior Programme Manager Personalisation Wheelchair Services, NHS England
  2. PWBs in action – the pilot stage. Frances Beavis, Clinical team leader/operational manager, Gloucestershire Wheelchair Service
  3. Question Time Panel chaired by Dr Linda Marks

Frances Beavis

Kate Buffery

Debbie Gray, Gloucestershire Clinical Commissioning Group

Krys Jarvis, Chair of National Wheelchair Managers’ Forum

Dr Jean Waters, Chair of PWB National Steering Group

 

Video recordings of conference proceedings will be available towards the end of 2017.

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