3.31.2015

It’s true what they say about life’s best lessons occurring outside the classroom; our fieldwork at CTS-AA holds testament to this fact. Despite numerous client changes and delays, we were finally able to implement our instructional design, which involved an obstacle course to promote wellness. Although I have to admit, it tired me out more than it did our clients!

Handling persons with cognitive impairment is no easy feat. One must be conscientious of many factors, be it the client’s developmental age, communication abilities, personality, size, and safety concerns, among others. Given these factors, it was particularly challenging for us to get them to focus and accomplish the prepared tasks in our obstacle course. For instance, though some clients understood the general idea of the task and were able to do a return demonstration, others needed someone to guide them throughout the activity; otherwise they’d deem it boring and wander off to other more interesting corners of the clinic. 

It was also difficult to correct their forms and give appropriate feedback. As we went about the obstacle course, we noticed that our clients responded well to positive reinforcement, and so we decided to give a surplus of that throughout the session. It only occurred to me afterwards that we were giving inappropriate feedback—that is, positive reinforcement for a wrong behavior. In example, for the “piko” station of the obstacle course, one had to hop on one leg or jump with both feet at certain intervals. When client A jumped all throughout, we praised him for a job well done even if he didn’t follow the instructions to a tee. 

Nonetheless, I felt that we achieved our original objectives, and at the same time, enjoyed the session. Despite having communication difficulties, our clients were very receptive and enthusiastic about our activities. I must admit, I did have my apprehensions when I learned that they had some behavioral issues, but once I got to meet them, I found that there were multiple ways to get them to cooperate. In fact, they seemed quite happy to interact with a group of anxious teachers. 

At the end of the day, I learned that we can’t be too rigid in physical therapy. Each client is unique and learns at his or her own pace, thus, there are bound to be several hitches in the PT’s treatment plan. It all comes down to how well the PT adapts to these hurdles and gets the client moving in the right direction. But hey! That's what being a movement expert is all about, isn't it?