For Cara Koscinski, OTR/L, MOT, occupational therapy is a personal and a professional passion. Her two sons, Jacob, 13, and Joshua, 10, have autism and sensory processing disorder. Joshua also has eosinophilic esophagitis, is allergic to virtually all foods, and uses a G-tube. After her sons’ diagnoses, Koscinski became an expert on working with children with autism and special needs and co-founded Aspire Pediatric Therapy in the Pittsburgh area. In 2009, she moved with her family to South Carolina, where she home-schools her younger son. She and her husband created Route2Greatness, a company that provides in-home services and consultations to school districts, and creates and produces CDs for children with auditory sensitivity. She also has written a book, "The Pocket Occupational Therapist," for parents and professionals who work with children who have special needs.
Q: You’ve been an OT for 15 years and were practicing before your children were born. What inspired you to go into the profession initially?
A: When I was a junior in high school, I was interested in doing something in the health field. My mom worked for an orthopedic surgeon, and she made an appointment for me to spend some time with different therapists. After a half-hour with the occupational therapist, I remember thinking, "This is so amazing; I have to do this." I never looked at anything else. As an OT, I had worked with children with autism, but it was not my primary specialty. When my children were diagnosed, I was doing hand therapy and adult rehab.
Q: When your children were diagnosed with autism — and when your younger son was diagnosed with eosinophilic esophagitis — how did your profession help you?
A: After the diagnosis, the first thing that helped was being able to know what services were available. Most parents, when they get that initial diagnosis of autism or any special need, are thrown a packet of information, and they leave that office thinking, "Where do I go from here?" I knew where to start, what therapies were out there. I felt overwhelmed, but not as much as most parents, who didn’t have that knowledge. I started to attend [my children’s] therapy every week. It was like another clinical experience. I also had books from my own pediatric fieldwork [and] a little bit of knowledge of sensory integration. And I started taking courses — that’s what propelled me. Every single course I’ve ever done was for my children primarily, and then for my clinics.
Q: How has your experience as a mother of children with special needs helped you in working with special needs kids and their families?
A: The parents I work with are always surprised and pleased that I have the same life they do. I feel it gives them an extra little bit of confidence in me. I invite them to sit with me during the sessions, too, because I like it when my children’s therapist involves me. I feel like the parent feels less stressed if they know they can calm their child down with different strategies. By giving them treatment strategies, we can empower them in different ways.
Q: What spurred you to become an OT entrepreneur?
A: It was a natural transition — just me trying to help other people, teaching them what I learned. I’m a handout-rich occupational therapist because as a mom, I always want to know, "What can I do?" I would make handouts and put them into a big binder. When I handed it to parents, they were like deer in the headlights. So I thought, "I’m going to have to put this into a book."
For the CDs, Jacob, my older son, did not like loud noises. The ABA [applied behavior analysis] therapist suggested turning the vacuum cleaner on and off, and it helped him to hear it and see it wasn’t going to hurt him. I thought, how do we [address] thunder, fireworks, sirens? I rented a recording studio and bought some sound bites. My sister is a music therapist, so I had her sing a melody. We put a drumbeat to it. We recorded it for Jacob and started to sell the CDs locally for other kids, and the special needs catalogs picked them up.
Q: Do you still have a clinical practice? How do you balance your personal and professional lives?
A: I do private consultations; I do online consultations with school districts; I write a lot of articles for magazines; and I’m marketing the book and the products I’ve created. The most challenging thing for me is that I get so excited about the profession, about the things we can do, that I cannot shut my brain off. It’s exhausting living with it and working with it. It’s special needs life 24/7. I go for a walk or a bike ride. I go shopping. But it’s very hard for me to take any amount of break.
Q: What do you see as the role for OTs in schools, and how can OTs support parents who choose to home-school their special needs children?
A: OTs in the school system are spread really thin. We need more time with the students to do hands-on work. For parents who home-school, OTs can play a critical role in setting up the home school, giving parents the tools to set up the appropriate classroom. They can help set up the room, structure the home-school day, get parents the appropriate tools, and choose the right curriculum, fitting the curriculum to the child.
Q: Are there facets of autism spectrum disorder OTs do not understand?
A: The bandwagon now is everyone has to be an expert on sensory processing disorder. But it’s just one thing in our toolbox. We’re not always using other strategies, and that may be a weakness. I feel like we’re missing some neuromuscular things, or things other than sensory processing. For example, kids with autism might not crawl. They may start out not crawling for sensory reasons — maybe they don’t like the feel of the carpet — but then they’ve missed a key developmental stage. So later, when they can’t ride a bike, we are saying maybe it’s because they are gravitationally insecure. But maybe they are not riding the bike because their core muscles are weak because they didn’t crawl.
Q: How can OTs become more educated about autism and sensory processing?
A: Take more courses. I feel like continuing education courses have piqued my interest. I think parents are sometimes reluctant to take advice from new grads, and that’s where new grads need to step up and say, "I’ve taken a course." Every parent wants a confident therapist. If you don’t know something as a new grad, you say, "I’ll figure it out and let you know." Parents love that.
(Source: todayinot.com)
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