January 2014, Week 4: The power of preparation

The session I wished to reflect was last Monday’s with CGFC, a 7-year-and-1-month-old female, diagnosed with global developmental delay, Rett syndrome and neuromuscular thoralumbar scoliosis. The aspect I wished to highlight in this entry was how the session went through.

Most of the time, I do preparations for my clients’ sessions.  I usually work best with Plans A, B and so on and I am quite certain that that’s how it also works for everyone else. Anything goes wrong and I still have Plan B. I have to admit though that when my finite number of plans were exhausted, I usually panic; that’s probably why I have been called rigid by most (I hope not all) my clinical supervisors most (I hope not all) of the time.

During my session with CGFC, I brought my bookstand and my tablet for the session. The first one was for story-telling and the latter for music therapy. During my session with another client whom I also did story-telling for sitting maintenance, I had a difficult time because of simultaneously translating the story to the Filipino language, holding the picture book and doing what I should do with the client. (The caregiver did not stay in the clinic.) However, during this session of concern, I could concentrate on correcting the client’s postural faults, which was the focus of the activity.

During my previous session with CGFC, the mother also played nursery rhyme songs on her mobile phone to facilitate the client’s movement. However, besides the volume’s being low, the room did not also loud enough due to the large room so there was difficulty using the phone as a tool for facilitation. During the session of concern, the session was held in the Sensory Integration room, a smaller room than the previous one. (I could have use the Isolation Rooms 1 to 3 but the former room had the pediatric standing frame, which I also planned to use for the patient’s physiologic standing.) I used the tablet, which provided me three advantages: (1) it has greater number of nursery rhyme songs; (2) it shows the lyrics of the rhymes and; (3) it is easier to manipulate than the caregiver’s mobile phone because of its larger screen.

I also prepared the pediatric standing frame for CGFC. However, the client could not be properly positioned due to her flexed knees that were difficult to straighten passively, most likely to the client’s fear of assuming upright. In the end, I decided against using it and proceeded with the physiologic standing with I and the caregiver’s providing the support. Despite not using the frame, standing was still maintained with proper joint alignment. Also, the table complement of the standing frame was where the client propped her arms.

I consider the session successful because the activities were executed properly and the client responded, although not optimally, in a way that she would still benefit from these activities. Moral of the story: Preparation counts.


I may not be like Aizen of Kubo’s Bleach whose plans were almost always realized, but just like what Kagami of Fujimaki’s Kuroko no Basuke said, “There’s no such thing as useless effort.” Something from this unrealized plan, or from this useless effort, may come in handy later. Just like the standing frame table.