Playgroup

Throughout my rural placement each week I attended a playgroup organised by the senior paediatric occupational therapist. Each of the families invited to join the playgroup had a child or children with a physical, neurological and/or social disability. The common feature amongst these parents (besides their children) was that each had avoided social situations such as mother’s groups, playgroups etc due to their child. The senior OT felt that these parents were missing out on an important social and support network thus decided to set the group up. The aim of this group was to create an environment where the children could play with their parents, without it being ‘therapy’ (which is what a lot of the parents did – any quality time they spent with their child was doing ‘exercises’ etc and not bonding) and also to provide a forum where the parents could talk amongst each other, swap ideas etc as all parents do in the playgroups.

It took a couple of weeks for the parents to get to know one another and start forming friendships, which is when the swapping of ideas and sharing tips began to occur. As a therapist this was great as it is exactly what we had hoped would happen, however a few problems arose which we had not foreseen. A number of the children were developmentally delayed and had been provided specialised equipment from the hospital to assist them. This equipment was provided for that child alone as it addressed their specific needs. Two of the parents at the group were talking amongst themselves close to the group of therapists about a ‘standing frame’ that one of their children had been using. The mother of the child whom it had been given to was telling the other mother that they don’t use it, but they would give it to them to try with their child (whom had a completely different pathology and thus different needs/requirements).

This provided us with a dilemma which we talked about whilst this conversation was occurring. On the one hand we didn’t want to interrupt their conversation, as it would highlight the fact we were listening in, thus undermining the whole aim of the program (that it isn’t about therapist intervention). However, on the other hand, the child whom has been provided with the equipment required it to improve their standing – thus we needed to reiterate that to their mother. In addition it’s an expensive piece of equipment belonging to the hospital and needs to be kept track of ie it doesn’t belong to that mother; therefore she does not have the authority to ‘lend it out’. Whilst it was great the mothers were talking and swapping ideas and tactics that had worked for them it wasn’t the sort of conservation the playgroup was aimed at. It was appropriate for the parents to share what sorts of therapy their child has been receiving, what wasn’t appropriate was that specialised equipment provided by the hospital was being loaned out by parents. Those types of issues needed to be discussed between the parents and the therapists

The course of action decided was not to approach the parents at that point, continue to let them discuss ideas etc as we didn’t want to jeapordise that for in the future, and also to maintain the fact that the playgroup wasn’t ‘therapy’, we were there only to set it up, the parents were to take over from us. Instead the OT would speak to the mother at her next appointment and review the child and what equipment they still require from the hospital – and if they didn’t require it ask them to bring it in. The following week this occurred, and the mother confessed that they weren’t using that particular piece of equipment as the child couldn’t tolerate it. The frame was brought back to the hospital and the parents given different strategies to improve their child’s development.

In the end the outcome was positive for all, the parents still maintained that support network, the mother now had effective strategies for their child and the hospitals expensive piece of equipment wasn’t ‘lost’. It made me think that the manner in which we deal with various problems that arise is dependent upon the context and situation in which they occur. The outcome of the above scenario could have ended in numerous different ways, with the parents feeling like they were constantly ‘being watched’ at the play group if we had intervened there and then or if we had stepped back completely then numerous pieces of hospital equipment could be lost and the children not receiving appropriate intervention. I will now always carefully consider all the options and their implications when dealing with an issue that arises in the health system.