Today was our first day treating at the orphanage. First, we met with the director of the center who welcomed us kindly and said that he was open for any suggestions we may have to improve the lives of the children. We decided our best plan of attack was to split into groups of two and hit two different modules that morning. Cristina and I began on the first module with the kids in wheelchairs, in which each child received a functional assessment to determine their level of independence. Each child was transferred out of their wheelchair and were assisted to the floor. We all joined in together and sang Romanian songs while observing each child's posture, range of motion, sitting balance, and behavior. Our translators were so helpful in giving us background information, telling us what the children wanted to do, and asked questions about how they could help them. Most of the children there were begging to walk and so happy to try. We also spoke with Maryanne, the caregiver for the children in this module, and asked her what the most difficult part of her job was. She stated that transferring the larger children into the bathtub was difficult because they are so heavy. We will be working with Maryanne in the next couple of days to give her suggestions on body mechanics and different techniques to make her job easier as well as adapt the equipment to suit the child's needs. Sarah and Valdora were paired together in the second module, which housed most of the children with sensory impairments. After seeing all of the children gather on the porch, Sarah and Valdora decided to divide the children into groups of four and treat one group at a time. The group was focused on sensory input, integration, and organization to prepare for social interaction. They quickly observed the different activities that benefitted the children's organizational skills and body awareness, and after a few minutes of sensory activities, they were able to work on "turn taking" play. The sessions ranged from jumping activities, to crawling obstacle courses, and deep pressure with each child preferring a certain type of input and some eventually began asking for more of the input they preferred. One 6 year old boy in particular exhibited the greatest change presenting initially with uncontrolled screaming, flapping of his arms, and avoidance of eye contact. After repeated proprioceptive techniques, he was able to calm down, sit at the table, and play a back and forth game with one of the other children. It was amazing to see how quickly the right technique and devotion of time helped this child to organize and be able to play for the first time ever. For lunch we came back to the transitional home for a delicious meal of chicken, bean soup, vegetables, and a homemade Romanian dessert prepared for us. After lunch, we were able to spend some quality time getting to know our translators and learning more about the Romanian culture. Cristina was able to talk to one of the girls who was part of the Heart of Hope transitional program and was surprised to learn that she not only spoke Romanian, but also English, Spanish, and Chinese... and knew all about Columbian culture!
After lunch, all four of us decided to tackle the third and final module, filled with the crib ridden children. We were able to take each of them out, quickly assess their function and developmental needs, and determine what the easiest intervention would be that wouldn't require much work from the caregivers, but would make the greatest impact. We provided the children with opportunities to explore their environment, their own bodies, and to play with each other for most likely the first time ever. We were able to observe some of the staff feeding the children and it was almost too difficult to watch. The child with the visual impairment we mentioned in the last blog, we were told hardly ever eats and he never drinks because everything falls out of his mouth. I was able to watch him try to eat a mashed mixture of biscuits and water with spoonful after spoonful being shoveled in his mouth. He did not demonstrate any control of his mouth or tongue, and was gagging as the food entered, unable to perform a swallow. The worker stated he just sometimes doesn't want to eat. We realized after watching this, how great this lack of education actually was and how much we needed to focus in this area. We ended our day with another awesome dinner at Pardon Cafe and Bistro, just a short walk away from our hotel, and of course gelato.... yum. Buna Seara!!
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