BY VICKI MASON, D.HSC, DEBBIE BUCKINGHAM, OTR, MS, CVE, CCM, CRC, CHARLENE DICKINSON, RDH, BSDH, MS, AND SCHELLI STEDKE, BSDH, MDH
Persons with developmental disabilities often experience challenges in getting appropriate medical, dental and health care services. Access issues (cost and transportation) and a lack of awareness on the part of healthcare professionals add to the difficulties according to the Centers for Disease Control (2016). Innovative partnerships can contribute to the health and well-being of persons with developmental disabilities today, while educating the health care professionals of tomorrow.
One of the professions that is uniquely qualified to contribute to the needs of persons with developmental disabilities is occupational therapy. Occupational therapists focus on the activities that occupy a person’s daily life. This may be independent living activities (personal grooming or homemaking), leisure pursuits, and employment or volunteer work. Occupational therapy professionals emphasize changes that can be made in the activity or environment to improve an individual’s participation in meaningful activities to enrich their lives.
In summer 2014, faculty member Vicki Mason, from the Texas Woman’s University Master of Occupational Therapy (MOT) program assigned students to Special Abilities of North Texas as part of service learning in a community wellness course. Special Abilities, a 23-yearold nonprofit organization with two sites serving over 100 adults with developmental disabilities, agreed to host the students. Each student spent 30 hours onsite interacting with clients and promoting leisure activities and social inclusion for Special Abilities’ clients through activities, games, puzzles, and exercise.
The summer service-learning collaboration highlighted additional opportunities for collaboration in Mason and Debbie Buckingham’s course the following semester. The initial concept was that MOT students could develop occupational therapy based activities for individuals attending the Special Abilities day program to compliment the organization’s five program pillars: academics/continuing education, pre-vocational and vocational training, health/nutrition/fitness, community inclusion and social development, and independent living skills. The programs were developed in the fall 2014 and students returned to Special Abilities for summer service learning in 2015 to implement activities for clients.
By fall 2015, the purposeful partnership was continuing to develop. Special Abilities Director of Nursing, Jordan Drake, requested that students develop hand washing and oral hygiene programs to impact clients’ health. Drake, a certified developmental disabilities nurse, shared that hand washing was especially important during flu season and also emphasized the connection between oral hygiene and general health. She felt that these two programs could impact clients’ general health and well-being. The programs were developed by the end of the year for implementation in spring 2016.
Student teams were onsite at both locations once a month for three months offering 1½ hour hand washing programs. Approaches included bingo, coloring sheets, and lessons on how germs can make people sick. Students used petroleum jelly and glitter along with a handshaking activity to show how germs are passed from person to person. Black light exercises showed why good hand washing is important and illustrated how we can’t always see germs. Clients visited hand washing stations and learned proper technique and how long to wash by singing a hand washing song to the tune of “Row, row, row your boat.” “Use of multiple activities over a period of time helped to address each individual’s unique learning style, and reinforce information being taught,” says Buckingham.
On those same Fridays, occupational therapy joined forces with TWU dental hygiene faculty Schelli Stedke and Charlene Dickinson and their students to collaborate on 1 ½ hour oral hygiene sessions at both locations. (Session topics alternated between morning and afternoons). Special Abilities’ clients learned through activities including brushing hard-boiled eggs that had been stained with cola, a game about happy tooth/sad tooth foods, dental bingo, coloring sheets, and brushing a puppet’s teeth with an oversize tooth brush. Each individual received a toothbrush, floss, and toothpaste, and benefited from a personal tooth brushing session with a student team. Built up handles for toothbrushes were provided for those who needed assistance with grasping and holding. “Developing independence in this area promotes self-esteem, and can decrease caregiver responsibility,” notes Buckingham. An over the door shoe rack was provided and individual compartments were decorated and personalized to hold everyone’s oral hygiene supplies.
The oral hygiene care was not limited to instruction. Clients and their families were offered the opportunity in fall 2016 to complete a health history packet and give permission for a dental hygiene and occupational therapy screening. Special Abilities dedicated staff time to accompanying and transporting clients to the TWU on-campus dental clinic. Every detail from which entrance to use, to which dental chair, what view the chair faced, and even which type of toothpaste was carefully considered with specific client needs in mind, according to Stedke and Dickinson. Stedke adds, “Working with the clients at Special Abilities and in conjunction with the TWU OT students was truly a unique and beneficial learning experience for our students. They were given the opportunity to work with special needs clients to provide oral screenings and an inter-professional perspective was gained by working side by side with occupational therapy.” In addition to the services, each client received a gift bag at the conclusion of the visit with appropriate oral care supplies for their personal capabilities and needs. This included toothpaste, toothbrush, mouthwash, and floss, along with an easy grip handle to make holding a toothbrush easier, and a squeezing tool to help roll up the toothpaste tube. Appropriate clients were referred to return for a cleaning and to see a dentist. There was no charge for the visits.
About the same time, Special Abilities moved into a larger facility with space to expand programming. Five teams of occupational therapy students visited the new facility, measured rooms, and developed floor plans and step-by-step activities with comprehensive budgets as part of programming in independent living skills, social inclusion, and vocational training. JaChel Redmond, CEO, and Jordan Drake attended the student presentations along with Donna Reekie and Carl Buck, members of the Board of Directors of Special Abilities. Buck commented, “This fall we were blessed to have five TWU student projects to develop programs to utilize at our new facility. Each program was different and provided a vision for best utilizing our new facilities. We are currently implementing these programs into our 2017 budget. We look forward to a continual partnering with TWU to both strengthen our programs and provide a place where students can ‘learn on the job’.”
The newly developed client-centered activities are to be implemented by the next class of students in summer 2017. Brochures and surveys for staff, clients, and families explain the new programs, identify client interests, and evaluate activities afterwards. Take home materials range from signs with basic grooming steps (for the bathroom mirror or wall), laminated placemats to practice table setting and pictures with steps for bed-making and folding towels. Follow up forms ask about carryover of skills to home. Plans for 2017 also include exploring the possibilities of mobile dental visits, hearing and swallowing screenings performed by TWU speech language pathology students, and assessments conducted by occupational therapy students. These screenings and assessments would become part of each client’s individual program profile.
The collaboration is much closer than ever imagined. Clients have benefited from social inclusion and the many activities focused on their health and well-being. Students had the opportunity to learn about the health care needs and concerns of persons with developmental disabilities, and enjoy relationships with clients. The university provides additional manpower and services that fall outside the scope of many small, but dedicated organizations. Special Abilities CEO, JaChel Redmond, says, “Hands-on partnerships like the one we have with TWU are important because the students are learning from some of the most recent research and data. It’s impressive to see the modules they create with thought-out instructions to implement and evaluate success. This is an astounding benefit to our clients and our commitment to enriched programming.”
Mason and Buckingham encourage educators to creatively explore how their students can learn from and contribute to the health of persons with developmental disabilities. “Organizations need not wait to be contacted,” offers Mason, “if a local university has not yet reached out to your organization, administration, board members, and families can network to explore possibilities within their local communities.” “Be patient, but persistent,” Buckingham adds, “developing purposeful partnerships takes time, but by working together we can make a difference!”•
ABOUT THE AUTHORS:
Vicki Mason is Assistant Clinical Professor and Debbie Buckingham is Associate Clinical Professor in the School of Occupational Therapy at Texas Woman’s University.
Charlene Dickinson and Schelli Stedke are Clinical Assistant Professors in the Dental Hygiene Program at Texas Woman’s University.
Centers for Disease Control and Prevention. (2016). Disability and Health: Information for Health Care Providers. Retrieved from https://www.cdc.gov/ncbddd/disabilityandhealth/hcp.html