Since I graduated in 1978, the practice of physical and occupational therapy has undergone significant improvements, driven by advances in research and clinical experience. In our early careers, therapists established patient goals and interventions. By the 1990s, a holistic transformation was underway: patients were increasingly involved in shared decision-making, leading to more personalized and effective outcomes. This modern, person-centered care values the patient, and critically, the family, as knowledgeable partners who understand the patient's full well-being—social, psychological, and emotional. We had been impressed by Sunnyview Rehab Services' ability to implement this philosophy and trusted the RTC staff to do just as well, or even better. Their willingness to embrace our roles as Matt's parents and our professional insights as therapists was invaluable, profoundly impacting my state of mind and Matt's recovery.

Generally, therapists draw from a range of treatment options grounded in evidence-based principles, informed by research studies and clinical experience. Each rehab profession prepares graduates with essential knowledge and skills, but since the field of practice continually grows, rather than being Jacks-of-all-trades, clinicians most often will pursue extra training and specialization in a handful of additional techniques. To regain function, reduce pain, and improve quality of life, therapists create personalized plans that are adapted to sustain progress. The plans may entail a single approach, a combination of several, or involve another clinician whose expertise differs. The RTC, with over 50 clinicians from diverse backgrounds, experiences, and expertise, exemplified this, with each colleague valuing, collaborating with, and tapping into one another's knowledge. While the same might have been true for the Sunnyview outpatient therapy employees (where we'd been “strongly encouraged” to take Matt), they couldn't have competed with the personalized, loving investment of time and attention my coworkers poured into championing Matt’s full recovery. Over the course of three years, Matt ultimately benefited from working with six therapists, each with distinct skill sets.

Jacqui, his occupational therapist, brought the most years of experience to Matt’s team. Her talent stemmed from exposure to a wide range of patients and conditions, continuously refined by observing their varied responses to her interventions. Her treatment plan for Matt included exercises to increase arm flexibility, strength, hand coordination, and dexterity, as well as arm-teaming for joint endeavors such as eating corn on the cob held between both hands. Early tasks, for instance, involved Matt sitting in a chair and holding a cane or the handles of overhead pulleys to stretch his tight shoulders up and down or out to the side, all while maintaining a tight grasp so it didn’t slip out of his right hand. Additionally, he practiced reaching for cones from an overhead position, stacking them on a lower shelf, and then reversing the motion. Many tasks simultaneously addressed multiple impairments, such as strength, coordination, and balance.  

In order to improve global function, she incorporated activities to help Matt compensate for his visual deficits. Limited spatial awareness hindered his ability to perceive his body in relation to other objects and to navigate in space effectively. In addition, he also faced difficulties with visual-motor integration, which encompasses visual perception and processing, as well as eye-hand coordination—the synchronization of eye and hand movements. Furthermore, Matt's peripheral vision, his ability to see objects and movement outside his direct line of sight, required significant attention. These visual components were woven into every aspect of his occupational therapy program.

It was common for Matt to cut right corners too tightly, bumping his walker—or later, his shoulder—into our entertainment center as he passed. He'd also cut off people walking through a store because he didn't see them. To counter this, Jacqui created strategies to increase his peripheral vision and encourage him to compensate by scanning right more frequently. Standing, they threw a ball: overhand, underhand, off to the side, and off the floor. I emphasize standing because maintaining an upright stance added a considerable layer of complexity and difficulty, often requiring a second person to guard him early on. 

He carried objects of various sizes and weights, holding them with both hands in front or with one in each hand at his side, as he moved around the room and upstairs. One day, he played the mailman, carrying an over-the-shoulder bag and pulling things out to deliver them around the clinic. Another time, they pretended he was carrying firewood into the house, taking a step up and setting the wood down.

And last, but certainly not least, was cognitive training, seamlessly interwoven into every one of these tasks—from following a simple command to executing a complex sequence of instructions. For instance, Matt had to walk around the clinic, scanning high and low, looking for cones hidden in odd places. On another day, they made brownies. While it sounds simple, the task involved multiple steps: setting the oven temperature, gathering the necessary ingredients, bowls, and a pan, spraying the pan to prevent sticking, carefully reading and following the instructions, pouring the batter, putting the pan in the oven, setting the timer, and ensuring it didn't burn. These seemingly simple activities were the true culmination of his therapy—the point where strength, balance, coordination, and mental focus all converged. Jacqui’s gift was her ability to make these threads of recovery feel less like a clinical regimen and more like the very fabric of his future life.

© 2025, Sarah Watkins