Racial-Ethnic Diversity in Occupational Therapy

I read an interesting article today about attrition and racial and ethnic diversity. This article is in the Journal of Allied Health (which is a great resource, btw), vol 39, issue #2, pages 104-109 entitled Racial-Ethnic Diversity in Allied Health, the Continuing Challenge, author Fred Donini-Lenhoff.

The article discussed how "the racial-ethnic diversity of health professionals has not kept pace with demographic changes in the general population of the United States, with significant consequences for the health of minority populations and access to health care services."

Some interesting points:

• "Student attrition in allied health educational programs is not a new problem"
• "...attrition among students from underrepresented minorities remains high (most noticeably at for-profit institutions)"
• " In addition, attrition is an issue throughout the community college environment, where many allied health programs are located, 'because many students are ill-prepared academically when they enter college and juggle classes with work and family obligations. Little is offered in the way of tutoring, counseling or financial aid.'"

I can attest to the truth of this statement, at least here in Chicago. I completed my pre-requisites at a few community colleges and the support and guidance are NON-EXISTENT. Were it not for my driven personality, the support of my family, my business background and the fact that I have an undergraduate degree I probably would have given up. I see how easy it may be for someone to give up on pursuing a career in allied health, or any profession for that matter.

• "...variables associated with a lowered persistence rate (attrition) in completing an allied health education degree in the United States included

1. being under the age of 22,
2. having a mother with a college degree,
3. having low college entrance exam scores,
4. having a low GPA or no reported GPA,
5. working full-time,
6. and attending a for-profit institution."

Again, I saw people who fit this demographic at the community colleges I went to and I can attest to the truth of this statement.

• "To help individual students, mentoring, counseling, and academic/financial assistance - both pre- and post-admission - are needed to reduce attrition at all institutions, public and private, nonprofit and for-profit alike."

This article brings up some interesting points that I would one day like to pursue further. I thought it was interesting and found it important to share.

Volunteer. It's important.

Another thing that's interesting about that last post is that when I told some friends that I met a girl who can't read they were just as incredulous as I was. One guy actually said, 'C'mon now, she has to know something.' I thought it was interesting that none of us could believe that someone actually can't read. It's like hearing of the Loch Ness monster or Big Foot or something where you're always asking 'does it really exist?'

How sad that right HERE in America this can happen!

Ninety-five percent of my nuclear and extended family members have a college education and many have Master's degrees and PhD's. All of my friends have a college education. This situation made me think how fortunate I am! I'm essentially shielded from illiteracy. Most people I know and associate with have some college education. I know very few people with only a high school diploma, let alone bare minimum reading skills.

I would really like to give back to people like this. It's hard to find time to do things like this. It's so easy to make excuses. I'm so busy with school and all my other extracurricular activities that sometimes it's overwhelming. I would really like to find a way to incorporate volunteering to this group a priority.

I met a 17-y.o. girl who can't read. No, seriously, it's true.

I'm changing some facts to this story due to the privacy of the matter...

I met a girl, who is 19, that reads on a kindergarten level.

During one of my volunteer activities I was sitting around chatting with some girls when one girl asked me to write some loving words on a birthday card to her boyfriend. A younger girl immediately volunteered and wrote an amazing passage on scrap paper and passed it to the first girl, who did not look at it. Instead, the first girl immediately passed it to me and asked me to write those words on her card. I was confused as to why she couldn't write it and why she didn't even look at it so I asked her a few times ,'Well, did you read it?' She lied and said 'yes' even though she so obviously passed the paper to me and did not even look at it.

When I pressed her by asking why can't she do it she said something like she likes the way I write or something of that nature (although she had never seen me write). Eventually, it hit me--this girl might not be able to read!

After writing the passage on her card I wanted to confirm my suspicion so I told her she needed to sign her own name. She wanted to write 'Love Always, Girl X.' I had to spell out the letters of each word for her (amazing) because she did not know the spelling (thankfully she can write her own name). When I got to the 'Y' in 'always' she said, 'Does that letter go like this?' and she proceeded to mime the writing of 'Y' in the air.

I was floored.

Although I played it off I was really surprised... and scared for her. She is young, very friendly and very pretty. In the hands of the wrong person this type of situation can end up badly for her. Illiteracy prevents you from being independent, such as finding your way home by reading street signs if you get lost, ordering from a menu at a restaurant or, even more importantly, finding a job. This is also how young girls become prostitutes. When you can't read, you're dependent on other people to do things for you.

I pray to God she lives life safely and learns to read.

FAQs--OT School w/out prereqs??

So, here's another question I received waaaaaay back in May! I'm so awful. I feel so badly.

Ok here's the question:

Kimberly, I am sorry but do you mind sharing how you managed to get into OT school without prereqs?

I wish I could say I had it like that but I don't! I actually had to take prereqs! An entire year I did this. I worked 8 hours a day and went to school at night for another 3-4 hours. I spent an entire summer going to school just for biology pre-reqs FOR the prereqs (crazy, right!)--mon-thurs from 6-10pm! And this was AFTER I had worked 8 hours earlier that day.

It was really tough. Sometimes i even worked 2-3 jobs to pay for school and my bills. For about 2 months I delivered pizza on the weekends! Yes, I'm not ashamed to admit this. That was REALLY hard because I had no life--it was work, school and more work and then studying. When it was slow I would sit outside the restaurant and study in my car! It was summer during this time so I didn't freeze while doing this. The other drivers treated me well and respected me. It was a very humbling experience.

I also worked at a Latin dance studio for a while. That was fun and interesting and stressful. I had to give up my weekends for that gig too. *Sigh*

I even sold my beautiful car to cut down on expenses and free up extra cash. Amazingly, I don't miss it. I use the money to pay for interesting experiences that, in turn, make ME a more interesting person!


So anyway, every morning I managed to get up at 5.15am and go to the gym. It was easier then than it is now; I think that's what helped me keep my sanity.

I have a finance degree as well [the author of the question has a degree in Finance] and one day I just sat down and wrote out a plan on how I could finish all my prereqs in one year. I had no science class history. None! I went to the school and talked to the OT admissions staff and clarified what I needed, which classes I already had that counted as pre-reqs and which didn't, and which classes were necessary to take. I made sure I could go to the city colleges for pre-reqs. Sometimes I had to take pre-reqs for pre-reqs so I added that in the plan as well. By talking with the staff I discovered that some classes counted for some required pre-reqs--information I would not have known had I not gone to the school and inquired.

I missed out on a lot of time with family and friends but I WANTED to be an OT bad! So, I complained sometimes and I was ALWAYS tired but I made it happen.

You CAN do it, too. Just sit down and PLAN it and talk to the counselors and OT staff at the school you want to go to to see if some of your past Gen Ed class at previous institutions count for prereqs. It won't be easy all the time. But as my aunt told me once, "But in the end it will be SO worth it." This keeps me focused.

Good luck!

Bully words

Like I said before, these children often have trouble with their behavior and emotions and they often lash out with intense, negative words.

They have postings on the wall about 'Bully Words.' I found it interesting because one of the words was 304. I had no idea what that was. I asked the clinician on site and she said 'spell it backwards and change the numbers to letters' (for those who don't get it--it's a derogatory name for a 'loose' woman; also spelled the same as a common garden tool).

Immediately I got it! Wow! How...expressive. But kids are saying this? They range from 4-12 years. They're too young to even really know what that means.

They also had the word 'Critch.' That's new to me. I wonder if its the same as a curse word that starts with a different letter. Also, 'bop.' Does anyone know what these mean?

Another thing that struck me were the words 'skinny' and 'fatty.' How interesting that we use both ends of the spectrum to put someone down! I guess humans find anything to make people feel badly about themselves, huh? It's sad when kids do it, though.

Finally, the last thing I found interesting was the number of words on the list! These are words that the kids thought of! On their own! I counted 56! Fifty-six words on just ONE of the posters; there were two posters. Fifty-six bully words from kids!

Being a kid is tough.

Are you angry because you're poor??

(Of course I can't tell you where I am or show the kids faces or images of the facility but here are three of the wall postings to remind the kids of emotions and anger)

Every week the kids work on a theme. One particular week the theme was 'anger' and all of the activities stemmed around things that you make you angry, managing anger, etc. Now remember, these kids are labeled as having behavior and emotion problems so activities like these are designed to help them manage those emotions. One of the projects asked the kids what makes them angry.

So when this question was posed one of the college assistants (working for the summer), let's call him Dan, carried a conversation with one of the kids who's about 8 or so, let's call her Mary, that went something like this:

Dan: Hey, Mary, you should be working on this activity on what makes you angry. You need to write down what makes you angry, ok?
Mary: Ok.
Dan: So, what makes you angry? That you're not rich?

I'm sorry, what? I didn't know whether to laugh or correct him. This happened on my second day when I was only observing so I certainly did not correct him. But I chuckled a little out of shock. These are FOSTER kids. They don't live with their biological parents. They have problems that you would not believe and the LAST thing they need is someone reminding them of what they don't have. Plus, she's an 8 year old kid.

The room is large and there are a lot of kids so the clinician did not hear this exchange. But I just had to shake my head and smile at myself at how experience (and age) influence how you talk to and relate to people.

FAQs--Costa Rica

Someone sent me a question about my trip to Costa Rica:

Meredith writes: Did you go through a program or did you set this up yourself?

I set this up myself. I saved for a LOOOOOONG time in preparation for a similar trip that I ended up changing my mind on. My dad also gave me some money to help me out. I researched various programs (thank God for Google) for about a month and finally decided on one about 3-4 weeks before I left. I highly recommend this experience to anyone who can afford it. Depending on the country it can be pretty cheap--from as little as $100 a week for economically challenged countries to as much as $500 for those more comparable to America. I recommend you do your research and ask lots of questions!

Good luck!

I'M SO SORRY!!!!

OK, I OWE A TON OF PEOPLE A HUGE APOLOGY.

So, when I signed up for this blog through Google I never did any 'training' to learn how to operate it. I just jumped right in. I also never knew how to check my Gmail account through this blogger. It's silly. I know. I should know better.

So, people have been sending me a TON of messages that I am just now getting. So, for that I say I'M SORRY. Please, PLEASE forgive me. I've already responded to like 7 or 8 of them this evening and i'm going to keep going through them until I respond to every single one. Some of the answers to your questions will be blog posts as I'm sure many others have the same questions.

Also, I think I mentioned that this year I am working for the school to pay for my tuition and from April 30-mid June I was not myself. I was some OTHER person because I was taking 17 hours of INTENSE pass/fail courses and I was working 20-25 hours a week. It was really tough but I made it through. Thank God. I didn't blog much during that time because like I said, I was some OTHER person. Some monster woman, like Cruella De Vil or soemthing.

So, I'm working on all the responses to your questions. Please be patient. Thank you!

How old you is?

Here's another post from my journal on communication with one of the 'clients' at the site:

Here's an example of a conversation I had with one of the younger members of SWM today:

Me: Hi, (child's name), how old are you?
J: I'm four. How old you is?
Me: Four is awesome! You can say "How old ARE YOU?"
J: I'm four! How old you is?
Me: (trying not to laugh) Well, I'm a lot older than you. So, let's say together "How old are you?"
J: I just said that. I'm four.

Eventually, I got her to understand that her English was incorrect and the correct structure is "how old are you?" however, she said she did not want to correct her English. If this were my child/niece/nephew, etc. this would be an issue but I understood she was purposely being difficult so I left it alone and praised her for being an incredible four years old. I did not want to beat a dead horse over her grammar when she has bigger problems but the situation irritated me slightly because when she realized I was correcting her English she immediately stiffened and withdrew. This alarmed me because when I correct the English of my niece and nephew they embrace it. This child's reaction was...different. It made me curious as to how she is treated in the home when she does something incorrectly. I realized that I just needed a different approach and maybe, in some instances, no approach at all.

I observed that the children communicate very aggressively with each other. While playing games, I was constantly parenting on how to 'play fair,' or 'play nice' or 'do unto others as you would have them do unto you' and 'judge not lest ye be judged.' I'm being slightly fecetious but the children use strong, negative language that is incongruent with their age. They see nothing wrong with talking to each other in this manner. "you're stupid," "I can do it better," "You can't do it," "You don't know anything" and so forth flowed freely and regularly between the children. I was very surprised. Interestingly, I don't see (yet) why they are behavior disordered children. For the most part they played better than I expected for children with this label. They were not so aggressive that I would label them as 'behavior disordered' but aggressive enough for me to notice.

(What would an OT do at this facility?)

As for the younger foster children--I think an OT would focus on developing relationships between the kids and their parents. According to [names removed] the foster parents don't do much with the children. They drop them off at camp and then they leave, only to return a few hours later to pick up the kids. They feed and clothe the children but they don't spend time with them or teach them life skills--they don't 'parent' effectively. I definitely see an opportunity for an OT here in that regard.

An example of living a life of mistrust

When we first arrived at the site, one of the clinicians described how the girls are almost always angry and mean. She warned us about some the things that we might see and hear. She told us (I am at this site with another student, who is AWESOME!) that they would interact defensively with us and would not be welcoming. She also said that if we react impulsively and are offended easily we won't make it. You have to be strong and have a lot of confidence in yourself because the girls will 'try' us and attempt to push every hot button. Here is my journal entry from that day:

I close with this (paraphrased) quote from a supervisor to illustrate the life and thought process of girls who are always defensive: "These girls have lived a hard life in the 'system'. They have been hurt so many times by those closest to them that they don't know how to trust. They immediately lash out with anger and strong words. You two are young, pretty girls so be prepared for the language and the attitude. You're already on their bad side. You need to have a lot of confidence in yourself to work here because [pointing at my peer] you'll be a white b*tch and [pointing at me] you'll be a black h*e. You need to be prepared to hear that without responding negatively."

Update on first Level I Fieldwork

So, I've started fieldwork and it is very interesting to say the least. There are good time and there are bad times but it's all interesting. I'm doing a mental/behavioral health fieldwork right now.

As I've mentioned before the girls are homeless and were in foster care or just recently came from an unfit household. New girls come and go weekly and sometimes they run away. They all have some pretty serious problems, unfortunately, and it's pretty obvious when we talk to them. Sometimes I see them blow up at the staff for no reason; sometimes they have a HUGE issue with saying please and thank you; and sometimes they just have an attitude for no reason.

I am also working with children with some of the same issues. All of the kids are in foster care and that is another post all it's own. In a nutshell I feel sorry for both the kids and the older girls. They have no one but themselves--no parents that love them and many times the foster parents take them in for the money. It's very....disheartening. Last week I started to tear up when hearing some of the stories from the staff.

The most interesting and heart tugging thing I've heard over the last week is that some the girls come to the home with just the clothes on their back. As a result, they often only have 1 or 2 pair of underwear. 1 or 2 pair! I have enough underwear to last me over a month, just so I can avoid washing! How blessed I am! Can you imagine having only 1 or 2 pair of underwear????!!!! Every day you would have to wash your underwear and hope it's dry by morning, assuming you choose to wear underwear given your circumstances.

The girls are very guarded, as would be expected in these types of situations. When you say hi you're lucky if they speak, and very rarely do they speak with a smile. Some of them are nice and I'm always curious why, given their situation. Generally, they are dry, uninterested, resistant and combative.

It's interesting....