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TigerOT Experiential Learning Clinic a Game Changer for Students, Clients

When 9-year-old Hunter Brown takes the baseball field with his YMCA team this spring, he’ll use a one-handed method of throwing and catching he’s been practicing for months. In January, Hunter told student occupational therapists Lyndi Plattner and Makayla Thompson, and their faculty mentor, Tiffany Bolton, that he wanted to play baseball, and they’ve worked hard together to make sure he’s game ready.

After a stroke at birth, Hunter was diagnosed with left hemiplegic cerebral palsy, meaning he struggles with pain, weakness and muscle control on the left side of his body. He’s been in occupational and physical therapy since he was a baby, but came to TigerOT two years ago, when long-time occupational therapist Tiffany Bolton, now Assistant Clinical Professor in the Department of Occupational Therapy, needed a client to work with to help train student OTs. TigerOT is the experiential learning clinic in the School of Health Professions Department of Occupational Therapy. Bolton says TigerOT is unique because it’s a teaching clinic. “We don’t bill insurance, so students can work with clients in a variety of contexts to meet goals they set together – in whatever context it takes to overcome a particular challenge. For some clients, it can be grocery shopping, for others it’s visiting a restaurant. For Hunter, it’s playing baseball.”

Image: Hunter Brown in the TigerOT clinic with student therapists Makayla Thompson and Lyndi Plattner.
Hunter Brown in the TigerOT clinic with student therapists Makayla Thompson and Lyndi Plattner.

Hunter’s mom, Bobbie Clark, said that since coming to TigerOT, Hunter has been more vocal about his goals and more confident in his progress. She attributes this to his work with student clinicians. Even though they change every semester, she said he really connects with them. “They’re young, enthusiastic, and able to partner with him on his goals,” Clark said. Bolton says the transition of care each semester is part of the learning process for students too. “They review progress notes from the previous clinicians, but also get the opportunity for a fresh start – engaging with the client and family to assess where they are now,” Bolton said. “In Hunter’s case, it gave him the chance to talk about new goals that were important to him.”

Occupational therapy student Lyndi Platter is one of Hunter’s therapists this semester. She says that working in TigerOT has been the most beneficial part of her education so far. “The clinic is beautifully set up so we are able to interact with and treat real clients and gradually increase our independence using clinical skills throughout each treatment session,” she said. “On top of that, the research opportunities present through our program have substantially increased my appreciation for occupational therapy as a profession.”

Image: Hunter readies to hit a pitch from Plattner during a therapy session at TigerOT.
Hunter readies to hit a pitch from Plattner during a therapy session at TigerOT.

Research is a fundamental part of the experiential learning that takes place with students in TigerOT. Kyle Faulkner, one of Hunter’s student therapists from last semester presented at the American Occupational Therapy Association national conference this spring. “We researched a lot about the topic of participation in occupation for children with cerebral palsy, which helped us shift our mindset from trying to get him to do what WE wanted to doing what HE wanted,” Faulkner said. Plattner agrees. As a follow-up to Faulkner’s research, she and fellow student therapist Makayla Thompson are studying whether a standard OT tool, the Goal Attainment Scale (GAS), can be effective when completed by clients themselves, instead of the therapists.

“Typically, the therapist helps the client come up with the goals and writes them in a structured manner on the GAS,” Plattner explained. “Instead we explained the GAS to Hunter and let him write his own goals so we knew from there on all of our treatment sessions would be important to him.” One of Hunter’s goals was to catch and field balls successfully. So, together, they watched videos and decided to try the one-handed technique, and he picked it up like a pro. “We are hoping to present research on using the GAS differently – with clients writing their own goals completely,” Plattner said.

Image: Hunter fields a baseball with his right hand, then removes the glove to throw the ball with his right hand too.
Hunter fields the ball with his right hand, then removes the glove to throw it back with his right hand too.

The combination of hands-on clinical experience and translational research experience under the guidance of faculty clinicians is unique to TigerOT. Faulkner is in a clinical outplacement this semester, and is hearing first-hand what sets Mizzou OT students apart. “Multiple supervisors have commented things like, ‘Wow, your program really covers a lot,’ or ‘Level I fieldwork students from Mizzou are like most Level II students I’ve had.’ I feel well equipped at my current placement on the acute care trauma unit at BUMC in Dallas and I’m definitely prepared to lock down a job that is right for me based on the knowledge and experience I’ve gained.”

Bolton says participation in Tiger OT benefits both students and clients. “The greatest advantage for the students is being able to experience research, clinical practice, and their classroom learning really come together,” she said. “They get to learn in a safe space where they are allowed to try things on their own, but with enough supervision and guidance to learn from everything that happens.” Plus clients and families receive the dedicated focus of the students’ attention to occupation-based practice and research, and the flexibility to meet their needs in ways that make sense for them.

Image: Hunter with student therapists Thompson and Plattner before the Mizzou baseball game on May 4.
Hunter with student therapists Thompson and Plattner before the Mizzou baseball game on May 4.

Occupational therapy is a profession dedicated to helping people overcome challenges and participate fully in the activities of daily life that are most important to them. For Hunter Brown, that means sports. And having the confidence to play them on his own terms. As it turns out, confidence is contagious. As Faulkner’s and Plattner’s confidence in delivering Hunter’s therapy increased, Hunter’s confidence in playing baseball increased. Of the student therapists, Bolton noted “I’ve seen their confidence improve naturally as they work with Hunter and help him do his own problem solving. They are infinitely patient and respectful with him because they’ve taken the time to really understand what builds him up and why he needs it.”

As for Hunter: his student therapists, and even his family have all noticed not just the improvement in his baseball skill, but his confidence in his skill as well. He told Faulkner, “I don’t want to be on the adapted baseball team.” And Platter noted how hard Hunter worked every week during his sessions. “He was not afraid to give us input, which allowed us to make sure our therapy was always geared toward what is important to him,” Plattner said. “He was able to advocate for himself with his coach during his first practice on his YMCA team, and he genuinely seemed happier and more energetic during our last few sessions. I am very confident that Hunter will go on to be a powerful example for other children with disabilities and accomplish great things in his future.”

Hunter’s mom agrees. “Sports are a huge part of who Hunter is and for him to be confident enough to play sports that are not adaptive is heartwarming for any parent to see,” Clark said.  “Lyndi and Makayla have been wonderful with him and really got him excited about playing to his fullest potential. I’m so proud of him for embracing his differences and knowing he can work hard and do whatever he sets his mind to.”

Image: Hunter discusses his first pitch strategy with Mizzou Baseball coach Steve Bieser prior to the game.
Hunter discusses his first pitch strategy with Mizzou Baseball coach Steve Bieser prior to the game.

To celebrate Hunter’s progress this semester, TigerOT partnered with Mizzou Baseball to provide some unique baseball experiences for a pretty unique kid. On Friday, May 4, Hunter and his family were guests at the ball park, and Hunter got to spend some pre-game time on the field with the Mizzou Baseball coach and players – just being one of the guys. He got to meet the team, throw out the ceremonial first pitch, and officially start the game by commanding “Play Ball!” over the PA at Taylor Stadium. Coach Bieser asked Hunter what pitch he would throw to start the game, and without hesitation, Hunter replied, “I’m going to give ‘em the heater.” Thanks to the faculty and students in TigerOT, Hunter did just that.

Check out more photos and videos from Hunter’s therapy and his night at the ball park.