I could use some encouragement RE: P.T. Clinicals

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AspieSingleDad
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27 Mar 2018, 7:34 pm

So I just had one of my college instructors visit my clincal location to get a review from my clinical instructor. With the grading system of below expectations, meets expectations, exceeds expectations, or outstanding, I just got a review of outstanding. Remember, this is the clinical is the one I thought I'd struggle the most in.

So after my review I left for the day and my college instructor was getting into her car. I couldn't resist asking if an outstanding rating is commonly given. She said I'm the only student in the class to get that rating. So with the five University of Colorado graduates who have worked in clincics for years as techs and had two separate outpatient clinicals, the autistic guy with no prior physical therapy experience gets the outstanding rating.

I have 2.75 weeks left. Maybe I can get a final assessment of entry level with accommodation.



kraftiekortie
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27 Mar 2018, 7:52 pm

You did better than me, my friend.

In my practicum while I was taking undergraduate speech pathology, I got an A in the academic part, but a C in the clinical part. For most students, it was the other way around.



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28 Mar 2018, 7:31 am

Congratulations AspieSingleDad for being Outstanding. Sounds like you thoroughly deserved that rating.


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29 Mar 2018, 7:26 pm

Thanks for the encouragement!

So a couple of days ago my CI worked with a patient complaining of lower back pain. I was focusing on my own patient, but I could tell he was autistic. As you know, I suspect my CI might know I'm autistic as well. So I'm thinking in the back of my mind, I wonder if I'll be assigned this patient.

Come in today and sure enough that patient was on my schedule. So I got to work with a guy who I'd guess is probably has Level 2 autism who was presenting with groin pain (basically sciatic pain). It was cool to have the extra challenge of working through his trouble understanding auditory instructions by using visual and tactile (touching) cues. However, it makes me wonder if my CI didn't place him with me because my CI knows I'd work best with the patient.



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29 Mar 2018, 7:36 pm

Congratulations on your successes, your outstanding and your excellent work. I hope you can continue to contribute and you might well be able to assist autistic patients better than NTs. I am happy for your and for your patients.


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AspieSingleDad
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30 Mar 2018, 10:39 pm

Thanks again. Believe me, I don’t think that type of thing will come up much. This is my third clinical and the first patient I’ve worked with who has that level of autism. He came in today pretty happy though, because his back pain was pretty extreme and in two visits (the initial evaluation with the P.T.) and the intervention with me have brought his back pain down drastically. Of course, results aren’t usually that quick.

Anyway, my CI will be out from Monday to Wednesday of next week. He gave me instructions/advice for success. Basically I’m going to get more patients and I need to oversee the patients including the intervention and also oversee a plan for their exercise (an area of weakness for me). So I’ll be in charge of progressing the patient based on the evaluation from the P.T.

Also, he told me that when I ask a question I need to wait for the complete answer instead of finding out a step and then proceeding to do that step. So, apparently I’ve had an issue realizing when somebody is done talking and leaving early in the conversation. Freakin’ autism.

The thing is, he’s so patient with this advice. He didn’t say that I did that. He just told me to stay and wait for full advice and ask follow up questions if I don’t understand. I had to ask him if I was leaving early in a conversation and he said a few times, but I always listened and asked questions when he was giving me instructions on a new technique.

He also emphasized that if I feel overwhelmed, to say something. Again, he was very patient and calm about it. And when we have these conversations, his eye contact is so intense, he’d have to realize I’m not making eye contact much of the time.

In short, I think this guy knows....I mean....I’m about 90 percent sure....



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31 Mar 2018, 5:40 pm

But if he does or doesn't, does in matter? He is giving you the coaching you need to do the job and apparently thinks highly of you and respects you. That is what really matters....


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01 Apr 2018, 2:51 pm

Sweet Pea hugs


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AspieSingleDad
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04 Apr 2018, 7:10 pm

I suppose it doesn’t matter whether he knows or not. My silly thought is that maybe he’s giving me good reviews because he knows I’m autistic and he relates to me through his son who has HFA. Also, maybe he’s taking my autism into account and thinks I’m doing outstanding “for an autistic”. I know, I get a good review and then I sweat it. In fact, getting the good review increased my level of anxiety and I actually had an outload conversation with myself in the car arguing with my CI about how he gave me an outstanding review on midterms, so why’d he give me such a low final grade. Freakin autism....

Thanks CockneyRebel!

So, I now have 7 days of my clinical left! And I have a lot of patients for Thursday and Friday. Yay!



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05 Apr 2018, 7:10 pm

I used to get paranoid when I had a good review at work. Before my disclosure at work my paranoia was about "when will they realise I'm faking it" variety, and once I had disclosed (my ASD and my MH problems with the exception of BPD because it's so stigmatised) I thought they were just being sympathetic and being nice to me because I "had problems". I disclosed because I had a lot of time off sick when I was hospitalised etc and it provided me a way out of the "always faking" feeling that I suffered with.

And I do the out loud conversations thing quite a lot. Usually I do this at home, and in public manage to just rehearse the conversations in my head - but sometimes they slip out while I'm walking along a street or on the bus. I get some weird looks sometimes! I always thought everyone rehearsed conversations the way I do (I have to do several versions accounting for the variety of responses the other person might give) until I actually asked my (now) ex-husband about it after reading about rehearsed conversations on this forum and he said he didn't do this. I was also surprised he had never thought about suicide - it's been an almost constant presence for me since I was a child. I didn't think most people had it as bad as I did, but I thought everyone thought about it now and again. Turns out they don't. Hey ho. This has nothing to do with your thread, I'm just rambling because I'm tired and can't sleep. I'll shut up now!

Please try not to second guess your "outstanding" rating too much. I feel sure you have worked really hard and thoroughly deserve it.


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AspieSingleDad
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06 Apr 2018, 4:14 am

I get paranoid too. I’m paranoid right now. My CI gave me the feedback that I’m not asking enough questions. That’s because I’m thrashed. I’m just simply giving all that I can and hoping its enough. I don’t think I could offer anymore improvements if I wanted to.

I bet I’ll be having conversations in my head as I drive to work today. I’ll probably begin to have out loud conversations. It’s funny because if somebody were witnessing this, they’d think I was skizophrenic.

Thanks for the support, it’s good to know I’m not the only one who’s stressed out of their wits (or can be). Not that I wish stress on anybody.



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06 Apr 2018, 9:36 pm

So I have some major updates. I haven't had time/energy to post these things.

We'll start by going back a couple of weeks....

My uncle (who told me he has ASD on the same phone call, incidentally) owns several condos in Florida that he rents out for extra monthly income. He's getting old, and there are two in Jacksonville, FL that are particularly far from where he now lives, they they are harder to manage. He offered to give me a lifetime interest in the top floor condo, and my mom a lifetime interest in the condo right below it. When my uncle dies, I'd inherit the upper condo and when my mom dies, I'd also inherit the first floor condo. After some thought, I decided to move from the little town in Colorado I currently live in to Jacksonville, FL. This move would likely take place around August 1st.

In the mean time, I told my mom that plans are not final and to hold off telling family members in Colorado the news about the move UNTIL I'M DONE WITH MY CLINICAL! So naturally she tells my son's aunt and uncle right away and I get a text message from them asking to talk about it during the families' easter celebration that took place last Saturday. So I go to this event and I hang back from the crowd of family members. I feel incredibly uneasy. I'm not sure why, and I'm not sure why I'm hanging back (stupid alexithymia), but I do so anyway.

Anyway, the event is finally over and all of the family members basically ignore me like I'm a ghost (which is what I wanted). So I talk to Jacob's aunt and uncle and they basically say that my mom has told them in the past that my Florida uncle (my mom's brother) has been verbally abusive towards her and they don't feel like Jacob would be safe there. They also state they are concerned that I'm being given a condo by my uncle so he can control me. I respond by letting them know that I'm autistic and I can tell they are totally shocked, they had no idea. I then tell them that because I'm autistic, I assess everything all of the time, and have already assessed that Jacob is safe with my uncle. I also pointed out that my uncle was fun to be with when I was a kid.

They basically pointed out that my uncle didn't have a relationship with his children anymore, and also to his past verbal abuse of my mom. I told them that people are complicated, they can be mean to certain people in their lives due a past in the relationship, but then turn out to be a great uncle/grandparent to kids. That's just the way the world rolls, where a person isn't all good or all bad, but a combination of both. Jacob's uncle then basically stated that he'd literally kill anybody who'd harm Jacob (and I totally didn't understand he was getting upset). I told him that he'd have to get in line, because I'd already take care of somebody who harmed my son before he could get to them.

I also stated that it seemed they were throwing s**t against the wall to see what sticks by making up all of these accusations. I basically pointed out I had raised this kid for 10 years now and he's turned out so great they fell in love with him, so they shouldn't even have come to me with these concerns, they should have just shut the f**k up and let me take care of the details concerning my son. So Jacob's uncle gets up and tries to get me to go outside to have a fist fight. I'm 20 years younger, 6 foot 2 inches and weigh about 240 lbs with a fair amount of muscle, but I'm a peaceful guy and was close to a meltdown.

Anyway, I came close to cutting off the aunt and uncle completely, but they are an important part of my son's life. We did finally talk reasonably in the end, but I have a sour taste in my life and I'm having a hard time forgiving them. I'm pissed that they did this when (at the time) I had 2 weeks left in my internship. I had schoolwork to do on Sunday, and I didn't even complete it.

As a result of this, I had trouble performing as well on my internship. Cut to today and my CI asks me why, after 3 weeks of good performance, I seem to be regressing in my performance. I ask him into the back office area. Near tears, and looking to the lower right at the floor, I ADMIT to him I'm AUTISTIC. He takes it very calmly and asks what he can do to help me. I tell him I don't know, but one of the issues is that I was late picking up my kid at school because they scheduled me with patients too late in the evening.

He then indicated that he wanted me to ask questions when I needed help, but I hadn't asked him a question for the last week and a half. I told him that he's always with patients and I don't know how to interject in the middle of a conversation between him and a patient to ask my question. I told him I don't understand the flow of conversation or non verbal cues that tell me I can ask my question. My CI stated, just go into the patient room and ask the question, don't worry if I come across as awkward. He then asked if what else he could do to help.

I told him there's nothing more he can do them to just understand how hard I'm working. That I'm already giving all of my effort. I told him that I come into any situation, whether social or at work, and all I have to rely on is a script of social interactions I've memorized from the past. I asked him that surely, based on the fact that he has a child with HFA, he'd understand what I'm saying. He was sympathetic and stated that his son struggles with anxiety, has sensory challenges, and can be awkward socially. I told him that it might get better as an adult, but that pretty much sums up where I'm coming from. He certainly seemed to understand and be sympathetic.

I also told him that the reason why I would ask for help and then leave is because I have trouble knowing when somebody is done talking. He told me I should ask the person if they are done before I left, and not worry about if it appears awkward or not. Today I asked him several questions and would almost walk away but would stop myself and say, "Is that it?" And he'd nod. It was weird to be out as an autistic with him and follow social cues he was providing for me to improve my functionality.

More than anything, I felt this burden lifted off my chest. I felt so rejected Easter weekend. I was beyond thrashed and I know I was not performing at the same level.

After that conversation, which took place in the morning, it was going to be the busiest day in the history of the clinic. What's more, they had a brand new tech overseeing the exercises instead of the two experienced techs who were on vacation. Long story short, I freakin' killed it that day. I asked the right questions at the right time. I got my CI involved in three different interventions where the patient needed adjustments (kind of my from a chiropractor but more sophisticated), etc. I gave good treatments. I helped fold laundry. I helped the new tech out by giving a heads up on when my patients would be coming out of my treatments for exercises. I practiced countless joint mobilizations and soft tissue mobilizations with my CI. The list goes on and on.

Sorry for the book! I really needed today to happen. I needed a break. I needed somebody to accept my autism in person (not just Facebook). Not only did he accept me. I asked him if he knew and he told me he had his suspicions. But he also gave me functional advice with specific social cues I could implement at the clinic and they worked fine. I feel like I can be myself and sort of act neurotypical around the patients, but let my guard down when dealing directly with staff. I don't have to hide as much anymore.



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07 Apr 2018, 9:32 am

Glad it went well in the end, it must be a big relief that you can be honest and open with him.

I think your son's aunt and uncle's behavour stems from the fact that they might feel they are about to loose him from their lives. The feeling of helplessness (they have no say) does tend to bring out peoples fears. Your Mum shouldn't have told them before you were ready, does she have concerns about the move too?



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07 Apr 2018, 11:53 am

Thanks, I’m glad I could be honest and open with him as well. It’s been very difficult for me to even acknowledge my autism and accept myself for who I am. A part of accepting myself is to not hide who I am with others. Besides, those who are autistic usually don’t like to lie, and I viewed trying to hide my autism as a form of deceit.

I totally agree that the underlying concern was that I’d be moving 1,800 miles away and taking my son with me. But that was no reason for that behavior. I feel like I should have been given a chance to explain my plans which included having my son go down for visits, etc. Ironically, because of the incident, I have yet to disclose those plans and even question those plans. It was not a productive meeting, especially as far as they are concerned. They have far more to lose than do I, and they should have realized that. That’s the problem when behavior is ruled by emotion and anger instead of objective assessment.

My mom is the person most looking forward to the move. Right now she’s in an apartment that is not in the best condition, and has had issues in that apartment. This condo would give her closer access to my son (and me) while giving her a much nicer place she can call her own for as long as she lives. That’s why she shared this news with Jacob’s aunt and uncle, she was excited. And of course, I paid an incredible price for it. I’m always left with the results of my mom’s actions, though I’ve been less of an enabler over the last few years.



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07 Apr 2018, 3:17 pm

How nice not to only be accepted when you disclosed your autism to the CI, but also to get good, solid advice on how to deal with some specific situations you found difficult (which all sound very familiar to me!).

As for the move, big news! Unfortunate that your mum couldn't manage to keep it in until your were ready to tell people and would've had more energy to deal with their reactions.

I hope you manage to get some good rest this weekend.


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AspieSingleDad
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07 Apr 2018, 4:16 pm

YellowBanana wrote:
How nice not to only be accepted when you disclosed your autism to the CI, but also to get good, solid advice on how to deal with some specific situations you found difficult (which all sound very familiar to me!).

As for the move, big news! Unfortunate that your mum couldn't manage to keep it in until your were ready to tell people and would've had more energy to deal with their reactions.

I hope you manage to get some good rest this weekend.


Thanks YellowBannana! The move is huge news. It’s added stress right now, but obviously it’s good news. I can’t wait until I’ve met all of my goals in Colorado so I can move on to hopefully better opportunities.

I wish I could get rest this weekend, but I just completed a bunch of patient notes I had to do because the clinic was so busy on Friday. I also have a presentation I need to complete because I have to give that presentation on Monday. This last few days is going to be a marathon for me, but I’ll just have to tap my reserves to get the remaining stuff none that needs to get completed.