u/Hot-Bed-8157

I have kiddo still using a fisted grasp after over a year of OT. Developmentally speaking they “should be” using at least a static quad with emerging distal movements if not a full dynamic quad or tripod. They had lots of other goals to work on and have met those but still have that fisted grasp. With one cue they can switch to a dynamic quad but will always pick the marker/crayon etc up in a fist independently.

I’ve of course been focusing on strengthening and separating out that side of the hand for a long time. Have also tried visual and tactile cues on the marker and their hand (stickers on the marker, grips (which they don’t like and won’t use), and “Mr. Alligator/Mrs. Unicorn” on the web of their hand.)

A parent has a wonky grasp and the child is aware of this and I feel it may be a component, especially since it works for them. But it is not a fisted grasp.

Visual motor is all on target and they are young so they aren’t experiencing challenges due to grasp with low-no academic demand.

Do I discharge with an exercise program and hope they’ll switch to a more functional grasp as they age, since they know how to do so just don’t want to? Do I keep them on my caseload until they start using a different grasp? It seems like not enough to keep them on since it is currently functional, but I’m worried they’ll end up in third grade with fatigue from an inefficient grasp like I see so often and don’t want to drop the ball right now.

I work with very experienced OTs who have given advice but nothing has worked.

Hi all - my partner, our 3 pets, and I will be loading up and driving from MD to Washington in July in our 04' CRV with 190k miles on it. It will be just under 3k miles and we plan to do it in roughly 6 days. Knock on wood, she's been a great car for shorter road trips (like 200ish miles, in Shenandoah so a bit mountainous) and weekend errands but we mainly take public transport living/working in a big city so she isn't a daily driver.

We're due for an oil change right before we go, anyway, so of course we will get that done. We live in MD which has a very strict state inspection, so when we bought the car last September we got 4 new tires, had the front control arms replaced, new brakes all around. Nothing else popped up on the inspection (aside from the lock switches not working, which we also had to have fixed to pass inspection.) We are getting a knock sensor code intermittently, which we'll have fixed when it goes for an oil change.

What services should we consider having done (if any) prior to our trip? I've heard conflicting things about basically "if it isn't broken don't fix it" and following regular maintenance schedules. Neither of us are car savvy beyond changing a tire and I've held a flashlight for my very mechanically inclined dad many a time and done a few oil changes, so we'd love any advice about the drive and maintenance in general.

Thanks in advance!

I’m an occupational therapist and moving to Washington this summer. I’ve gotten two job offers and I feel overwhelmed between multiple interviews, negotiating salaries, and recruiters constantly asking me “how I feel.”

I’m torn between these two offers. Job #1 initially low balled me a bit and has been persistently trying to get me to sign the offer. Job #2 gave me slightly more money than I asked for (after benefits) and has been pretty chill overall.

I’m leaning toward job #2 but am feeling guilty about negotiating with #1 (and getting what I asked for) and expressing significant interest to the owner prior to my interview with #2.

I think I mostly need advice about how to handle this without burning bridges with the other clinic.

Job 1: has a bonus structure for productivity. They pay an “admin time” rate of $32/hour and billable session rate of $48/hour (I negotiated this up from original $46.) Basically if I’m not treating, I get paid admin time. I work with kids and kids get sick and cancel a lot in my experience so this is a factor.

Base salary at minimum productivity standards (28 patients a week) is $88k before benefits. At highest productivity (34 kids a week) the salary is $93k after bonuses.

They cover 1/2 of health insurance costs (up to $3k) and match 4% to 401k after the first year on top of salary. 104 hours of PTO which is paid at admin rate.

Job 2: more traditional salary structure. $90k/year with an expectation of 32 kids per week, but no pay deduction if I have extra cancels or something.

They cover 90% of health insurance and match 3% to IRA. 3 weeks of PTO included in salary.