Elizabeth Pauly, OTD, OTR/L, ATP

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Vernon, CA
Elizabeth Pauly, OTD, OTR/L, ATP

Doctor of Occupational Therapy in Los Angeles providing CreativeOT content, treatment and services that go above and beyond! Evidence based and passion driven

03/16/2023

This weekend, I had the incredible opportunity to attend the Hippotherapy Treatment Principles Part 2 course in Northern California at ! I learned SO much and really developed my practice as an occupational therapist utilizing hippotherapy as a tool in my treatment. I was able to connect with an AMAZING group of therapists and instructors, gain hands on experience and real-time feedback in treating clients, and learn how to long-line with my new friend Elf. It was also SO FUN to be back in these types of continuing education workshops in-person- always brings us new perspective and keeps us up-to-date in the latest and greatest in our practice. And, thank you to for having provided me with a SOLID foundation in my practice! Excited to see what comes next 😀

01/23/2023

LET’S TALK HANDWRITING ✍️a lot of people see OTs as “handwriting tutors” and I have to provide a lot of education in order to support my patients in learning fine motor skills required for functional, legible handwriting 📝

Some of the things I look for during an evaluation include:

✏️ Overall legibility (can I read this? If I jumbled up all the letters of this sample, could I distinguish which letter is which?)

✏️ Functional grasp (I have to consciously correct my grasp when I work with my writers- I have a grasp that looks like the way you hold a violin bow, but also have beautiful penmanship without cramping up!)

✏️ Endurance (how long can they write for?)

✏️Visual motor integration (can their hands copy what they see on a sample and from their memory? Can they write in a straight line?)

✏️ Visual vestibular integration (do they get dizzy when copying from a near or part point sample?)

✏️ Letter formation (is the way they are forming their letters impeding their ability to legibly form letters?)

✏️ Gross motor and postural control (can they sit up and provide the core stability required for their hands to move freely and functionally?)

I have seen some teachers and parents hold writers to an impossibly high standard when there are more pressing areas to be addressed, and I have often seen schools write off handwriting because “it’s good enough,” when the student is really struggling. Assistive technology can also provide supports or modifications as needed ⌨️Holistic OT intervention provides remediation and adaptations to support handwriting development in children and adults, and hopefully have fun while doing it!

01/18/2023

Let’s talk about rest! 😴In addition to working on active engagement in meaningful occupations, OTs can also address some of the underlying barriers to engagement, including rest and sleep hygiene. Once I learned about Dr. Dalton-Smith’s 7 types of rest, I have been better able to identify what my needs are and address them as someone who works… a lot… and I’ve applied this in my practice as well! This is helpful when working with kids on self-regulation and sensory processing, and in working with parents, caregivers, students and fellow OTs, because we all need to take care of ourselves in this fast-paced world 💓

01/16/2023

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01/15/2023

One of the most common things I have to educate my clients and their families on is the difference between a visual support and AAC. In my experience, this is because because we try to make a device (such as an iPad) the center of all the cool assistive technology available and lose sight of why we are using it, sometimes jumbling the two. Also, sometimes we try to see AAC as a means to compliance to directed tasks rather than allowing self-expression 🥴

I simplify it by saying that AAC is expressive, and visual supports are receptive 💡

Now, there are SO MANY WAYS to use technology and AAC and no two people use it the same way- this is why it is so important to have a multidisciplinary team 👯‍♀️working with the user to create the best unique system fit for their needs… and provide ongoing support for dynamic needs! I will often refer out to speech therapists specializing in AAC because my OT/AT experience only goes so far.

I usually recommend starting out by using a device for AAC 📱and incorporating separate, old-fashioned low-tech visual supports ☑️ so that the individual can figure out how to best express themself. The visual aids are separate so we can differentiate the two, and really apply purpose to their application.

01/08/2023

As much as it pains me to say it… a lot of people don’t *really* understand what occupational therapy is. So let’s define it!

Occupational therapy is a medical profession where therapists use occupation, or any meaningful activity that someone wants or needs to do, in order to promote improved independence and performance in everyday activities.

I usually then provide some examples like:

🙌🏻 Helping someone gain upper extremity skills after having a stroke, so that they can feed themselves, write their name, and get dressed without help

🚽 Providing home modifications to people who come home from the hospital to prevent falls

🛝Supporting children in meeting their milestones for fine motor, gross motor, play, social, and feeding skills, and supporting self-regulation in order to be able to engage in those skills.

👩🏼‍💻Providing ergonomic consults in corporate offices

🍎Implementing lifestyle changes in people looking to manage wellness

🦽Adapting activities to help people cook in their homes independently

Some OTs work in hospitals, schools, mental health facilities- our field is really one of endless possibilities! I really try to steer clear of comparing us to physical therapy or speech therapy since we are very different, but will highlight that we often work ALONGSIDE these professions (co-treating is honestly one of my favorite ways to support my patients)

01/05/2023

One of my favorite treatment tools from last year was *drumroll please* a metronome! For those of you less familiar with it, a metronome is a device that produces a consistent “clicking” sound at a rate you set to beats per minute, often used by musicians to support their ability to stay on rhythm as they practice their instruments. Metronomes can be powerful treatment tools as a part of OT intervention to support body and temporal awareness, behavioral organization, and more. And while some may remember the dread of their music teachers pulling out the metronome during elementary piano lessons…I promise my treatment ideas are way fun and super effective! Check out my blog later this week for more on how I use this treatment tool 🥁

Some of my favorite treatment activities using a metronome:

🎵Throwing a ball to a partner on the beat (my favorite option to grade down for motor accuracy has been switching over to a “squishmellow” toy)

🎵Pairing sensoriomotor movements with the beat (OT with me can include the robot 🤖 and play hand clapping games like slide👏)

🎵Practice making lines, shapes, and letters to the beat during handwriting practice (resistant writer? Set the metronome s-l-o-w and playfully challenge them to stay on beat ✍️)

🎵Just turn it on! Sometimes adding in the consistent beat (quietly) can be very regulating and organizing. Or, turn on some quiet music (research backs 60 bpm as the magic number!)

Bonus fun fact: during hippotherapy🐴 the leader will keep the horse moving at a steady, consistent beat to support the therapist’s intervention- rhythm plays a big role!

01/04/2023

Happy 2023! One of my resolutions is to work on my professional social media presence - 2022 was a great year- I was able to expand my service offerings into self-determination through multiple regional centers in Southern California! I am looking forward to all that 2023 brings and to continue to bring innovative therapy to the LA/South Bay Area ✈️

04/02/2022

April is Occupational Therapy and Autism Awareness Month! While there are many conditions that need awareness, autism is near and dear to my heart and quite frankly, one of the driving forces that led me to becoming an OT! I am immeasurably lucky to be able to work and be friends with some incredible autistic folks, who reinforce my “why” of becoming an OT- everyone can find independence in the things that they want or need to do 💙

01/08/2022

Happy Friday! With this next surge of COVID hitting us, I thought that I would focus on tips to support mask wearing. 😷 Wearing a mask helps keep others safe and can also provide protection to the wearer, and is essential for kids returning back to school. I’m incredibly amazed at how so many of my clients have adapted to mask wearing, but know that it can still be a challenge for some. Here are my suggestions:

✔️ It is important to play around with the type of mask to see what works best. Many of my clients like the soft cotton masks (soaked in hot water and washed with unscented detergent to remove any “funny smells”). Some of my sensory seekers chew on these masks, but do not like the “taste” of a disposable mask. I have found that the structured KN95s work well for kids who chew, or adding in a “mask frame” to keep the mask off the face. Also look up “singer’s masks” if cloth is preferred!

✔️ Straps make a huge difference, especially for kids with tactile defensiveness. There are many options- cord locks adjust strap fit behind the ears, and extenders can take pressure off the ears, if that is more comfortable. There are baseball hats that also have buttons to strap the mask to, if that is a preferred option.

✔️ Social stories and parent/family member modeling may support and prepare the individual for community outings. Remind your mask-wearer that they are a superhero for protecting others!

✔️ Offer breaks 6 feet away to support regulation

✔️ Look up “enclosed face shield” which is an option for those who cannot tolerate a mask directly on the face.

I hope some of these tips are helpful, even two years in to this pandemic!

12/21/2021

🕹Technology Tuesday 🕹

Today we are *switching* it up! Switches are super useful tools that allow users to access a device in a new way- if you think about a light switch, you turn the switch on and off to control the power. There are a million different types of switches to adapt almost anything, but today I want to talk about one of the most basic button switches that anyone can use.

✔️ Voice recording switches are a great way to allow a user to prepare for AAC use or support language development. These are widely available (even on Amazon!) and allow the user to record any sound on them for playback. Remember the Staples “That Was Easy!” Button? That was a voice recording switch!
✔️ There are many toys/gadgets that come pre adapted to accept a switch, but these are often expensive and in the case of toys, the user may lose interest… this is why I love battery interrupter kits! These kits allow you to
modify almost any simple toy into a switch activated toy by placing a special plate between the battery and the connection plate. This allows for the user to use any readily available store bought product and modify it according to their needs, rather than ordering an adapted product.
✔️ There are a thousand and one sensory switches available on the market, and these switches help teach cause and effect to younger users or users with cognitive challenges. These often become a fun toy and allow for further assistive technology training! These switches can play music, vibrate, light up, have texture and even more that help reinforce skills necessary to access various technologies

Again, there are a wide variety of switches, and even more ways to access switches. It is highly recommended that you work with a rehabilitation professional or educator to determine the right switch and access point for your needs and to obtain funding when possible!

Address

PO Box 3069
Vernon, CA
90245

Telephone

+13106929801

Website

http://www.paulytherapy.com/

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