#281 - Why We Decided NOT to Get Our Masters in OT

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC November 08, 2023

#281 - Why We Decided NOT to Get Our Masters in OT

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Why We Decided NOT to Get Our Masters in OT

Today we answer your questions!

First question: help for a 2.5 year old Down Syndrome child who drools constantly.

Second question: why did we decide not to get our masters in OT.

Third question: help for a 5 year old boy who displays a “humping” behavior.

Fourth question: help with potty training in an outpatient pediatric clinic.

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Ep. 159 - Tips for Oral Seekers

YouTube - 5 Strategies for Oral Seekers

ARK Therapeutic Z-Vibe

HoMedics Mini Massager

Free Social Story Template

Ep. 191 - Tips for Toilet Training

YouTube - Strategies for Toileting and Potty Training

Ep. 41 - All Things Poo

Ep. 216 - Activities for Interoception


Why We Decided NOT To Get Our Masters In OT

Rachel and Jessica delight in answering questions from their podcast listeners and providing valuable expertise on topics related to occupational therapy. As certified occupational therapy assistants (COTAs), they bring a unique perspective to the field of OT and are passionate about sharing their extensive knowledge with others. 

Constant Drooling And Mouthing Objects

Question: How can we provide support to a two-and-a-half-year-old child with Down Syndrome who is experiencing difficulties with excessive drooling and mouthing objects?

Find The "Why"

Consistently stimulating oral muscles throughout the day is crucial for proper development, particularly for children with Down Syndrome who may have low muscle tone. Understanding the underlying reasons behind this approach is paramount.

  • Why is the child mouthing these objects?
  • Why is the child drooling?
  • Do they have low muscle tone?
  • Are they seeking oral input?
  • Do they need something in their mouth in order to help increase their oral awareness?

Support Sensory Needs

Children with Down Syndrome may encounter challenges with sensory processing, and engaging in oral exploration of objects can provide a calming effect. Offering suitable and secure items for the child to chew on can help fulfill their sensory requirements and minimize excessive drooling.

Here are some of our top picks:

  • The Z-Vibe from ARK Therapeutic to provide vibration to various parts of the mouth before mealtimes.
  • HoMedics vibrating balls for use during playtime.
  • Dry brushing the face can help stimulate the muscles of the mouth and face.

Enhance Oral Motor Skills

Keep in mind, the main goal is to engage the muscles in the mouth and stimulate the brain, establishing connections with all the different parts involved.

  • Utilize oral stimulation tools to improve a child's mouth awareness and facilitate better saliva regulation.
  • Engaging in different blowing activities, such as lying on the floor and directing a pom pom towards a specific target, can help manage saliva control.
  • Once the child can control saliva, move on to using a straw to blow the pom-pom. This technique promotes correct lip closure, tongue positioning, and reduces drooling.
  • Create bubble mountains by using water, dish soap, and a straw to blow bubbles.
  • Include heavy work throughout the day, such as animal walks or pushing and pulling heavy objects like a weighted basket. These activities provide deep pressure and proprioceptive input to the body.

Career Goals In Occupational Therapy

Question: Why did Rachel and Jessica decide not to pursue master's degrees in Occupational Therapy? Additionally, who is responsible for conducting evaluations and assessments for them, and what is their relationship with the occupational therapist in question?

Rachel's career as a Certified Occupational Therapy Assistant (COTA)

Initially, Rachel pursued undergraduate studies in Occupational Therapy for two years before transitioning to the associate's program. Although this unconventional educational path may not be the norm, Rachel's primary goal was to commence her professional career and potentially pursue the Bridge Program in the future.

Rachel eventually obtained her degree as an Occupational Therapy Assistant (OTA) in 2014 and approximately two to three years later, she was accepted into the bridge program. Doubts started creeping in, leading Rachel to question if this path was truly the right one to pursue as she was also exploring a new business venture known as the Sensory Project.

After careful consideration, Rachel made a deliberate choice to prioritize her business and create an occupational therapy program in a rural region, instead of pursuing additional education. This decision granted her a level of flexibility that is not typically associated with being an occupational therapy assistant.

After giving birth to her son, Rachel made the decision not to go back to the clinic, and she feels a sense of longing for it. However, she is filled with immense joy to have the opportunity to follow her passion and be there for her children at home.

Jessica's Journey as a Certified Occupational Therapy Assistant (COTA)

Jessica and Rachel both attended the same school and earned their degrees at the same time. However, unlike Rachel, Jessica never felt compelled to pursue a bridge program.

Jessica is content with her associate's degree, which enables her to delve into various interests without the need for further education. Presently, she works part-time at an outpatient pediatric clinic where the owner, who is an occupational therapist, performs evaluations and assessments.

She values the independence she has gained through dedicated efforts, such as pursuing continuing education, hosting podcasts, and creating compelling content on YouTube. These endeavors not only expand her knowledge but also nurture her professional growth.

Humping Behavior In An Inappropriate Environment

Question: How can parents be supported in the occupational therapy clinic when their five-year-old boy, diagnosed with autism, exhibits inconsistent humping behavior that tends to escalate before illness? Various approaches, including deep pressure, tactile stimulation, and vestibular activities, have been attempted to enhance sensory input.

Activities that have proven successful in their clinical experience

  • Swinging high and spinning in a compression swing.
  • Obstacle courses to stimulate the mind and body.
  • Compression clothing, like specialized underwear for enhanced sensory input, a waist compression wrap, or a weighted vest.
  • Vibration is an input that can be used to stimulate the arms, legs, and back, providing valuable sensory input.

It is suitable for the developmental stage

From a biological standpoint, it is natural for children to explore themselves and acquire knowledge about their bodies and sensations. Typically developing children learn to differentiate appropriate behaviors in private or specific settings, whereas autistic children may face challenges in grasping this concept.

The disconnection can stem from the challenge of identifying appropriate contexts for particular actions. Consider the following suggestions:

  • Create a social story to set clear expectations for appropriate behavior.
  • Ensure there is a designated area where he can gather this information without it turning into a form of avoidance or consuming his entire day.
  • If he expresses a desire, you can offer alternatives: taking a break or exploring alternative options with similar benefits.

Exploring potential triggers for sensory needs

The humping behavior seems to occur more frequently prior to the child experiencing discomfort. It's as though his body is sending a signal, indicating that something is wrong or that he is on the verge of falling ill.

In that scenario, it would be advantageous to bolster his immune system and offer him added deep pressure, along with other measures. Utilizing visuals can be highly beneficial, such as providing a picture card that illustrates alternative behaviors.

It may also serve as a form of stimming, acting as a mechanism for self-regulation. It is crucial to carefully consider the removal of something that fulfills this purpose, while simultaneously prioritizing his acquisition of appropriate social skills. 

Assisting With Potty Training In A Clinical Setting

Question: As an occupational therapist at a pediatric clinic, many parents seek assistance with potty training their 2-4-year-old children who have been diagnosed with autism. What guidance can you provide for consistent support at home and effective therapy strategies in the clinic? Unsure if challenges stem from interoceptive difficulties, readiness, or skill comprehension.

Is the child ready for toilet training?

According to research, it is generally recommended to start potty training between 18 and 24 months of age. However, due to the neurodiversity of individuals on the autism spectrum, it is crucial to assess their readiness for toilet training on an individual basis.

Sensory-based intervention strategies for potty training

  • Addressing interoceptive awareness: This refers to the ability to perceive and interpret internal body signals, such as the urge to use the bathroom. Occupational therapists can work on enhancing interoceptive awareness through activities that involve tactile input, such as playing with different textures and sensations.
  • Pre-potty sensory routine: A consistent pre-potty routine can help prepare the child for success. This could include using a specific type of toilet paper, a designated seat cover, toys for use only while pottying, or playing their favorite song before sitting on the toilet.
  • Visual supports: Utilizing visual schedules or social stories can help the child understand and prepare for the steps involved in using the bathroom.
  • Motor skill development: Occupational therapists can work on developing core strength, balance, and coordination through fun activities like obstacle courses or animal walks. These skills are crucial for sitting on the toilet and maintaining balance during bowel movements.

Ultimately, consistent support from both home and therapy can help a child successfully navigate through the potty training process. It is essential to prioritize patience, understanding, and individualized approaches in this journey.





While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.

Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for you.

This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/l, AC, CPRCS, and Jessica Hill, COTA/L, CPRCS are Harkla's in-house Certified Occupational Therapy Assistants (COTA) and Certified Primitive Reflex Clinical Specialists. They have been working with children for over 6 years in outpatient settings. They specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica and Rachel are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Jessica and Rachel, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.

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