Mentor Assessment #2: Clinical Observation #2

Date:​ March 29, 2018

Topic: ​Pediatric Occupational Therapy

Preview:

This mentor assessment (#2) will cover my most recent mentor visit with Mrs. Hocson,

on Wednesday, March 29th. During my recent clinical observation, I was able to have new

encounters with different patients. I had some great initial observations of Mrs.Hocosn as she

worked with a patient who has Shaken Baby Syndrome (SBS).

Shaken Baby Syndrome is a traumatic brain injury that is caused from a child being

forcefully shaken. Babies have weak neck muscles and struggle to support their heads so, when

they are shook excessively by an adult out of anger or frustration, this then causes the brain to

move back and forth in the skull. This syndrome destroys the baby’s brain cells and causes the

brain to not get as much oxygen and also causes bruising, swelling and bleeding. Most babies

with this syndrome have little to no mobility, non-verbal communication, can also lead to

intellectual disability and developmental delays. These lifelong medical conditions are many of

the few things that maybe occur when a child has SBS.

My last mentor visit, I was able to see a seven year old boy who had been diagnosed with

Shaken Baby Syndrome who had little to no mobility, was only able to speak a few words but for

the most part was non-verbal. When I first saw the patient, I assumed it was cerebral palsy or any

other type of paralysis but, Mrs.Hocson explained to me what the patient had been diagnosed

with. One of the other OT’s in the clinic, Ms.Uralle had explained to me what exactly the patient

was able to do and not able to do as well. I had noticed that the patient had poor muscle tone,
inability to crawl or walk but tried to communicate through humming and mumbling. Ms.Uralle

explained to me that the goals of the patient was to increase his arousal through oral motor,

visual and vocalization. One of the main exercises that was performed on the patient was laying

him down on his prefered and not preferred positions. The preferred position was setting the

patient on his back on the inclined slope while attempting to increase his neck extension. This

exercise allows him to keep his legs,back and all lower body to be laid on the slope while trying

to help him increase his neck muscles/extension. The other position was the not preferred, which

involved the patient lying on his stomach while attempting to lift his head and shoulders up off

of the edge. This exercise helped the patient strengthen his neck and back muscles while also

helping have increased attention span.

The seven year old boy is also lethargic, lethargy is a symptom in which the patient has

the inability to stay awake, lack of movement and extreme tiredness. The way that the patient is

able to stay awake is when he is covered up, with warmth and also constantly having his

attention focused on something. This symptom can not be treated but with constantly being

covered up and being kept awake, he is able to get through lethargy. Mrs.Hocson said that the

patient had been going ahead of his goals and going above of what they had expected of him.

Through this internship, I have had the privilege to be able to learn more about the

different disabilities in Mrs.Hocson clinic and that other OT’s encounter as well. I have learned

more about the disabilities and gained experience and knowledge that i'm not able to gain

through a computer. There are many different difficult things that I encounter in this mentorship

such as, disabilities that truly make me emotional and I see how much some of the patients

suffer. This however, never discourages me from pursuing this career. When I see a patient that
has had traumatic experiences and a difficult life, it motivates me even more to learn more about

pediatric occupational therapy.