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What is an OTD Capstone? 

The occupational therapy doctoral (OTD) capstone is a chance for current students to utilize their education to create a project based off the needs of an individual, community, or society. It consists of a self-directed experience and a project. To learn more...

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What is GLAD House? 

GLAD (Giving Life A Dream House) is a mental health treatment center for children and families who have experienced substance abuse. GLAD House provides therapy, social-emotional learning, prevention education, as well as acts as a safe space to provide an environment where kids can be kids. They serve children aged 5-12 years old within three different groups based on age and development. During the school year, GLAD House serves children from 3-6pm Monday-Thursday, while during the summer they serve children from 10am-3pm Monday-Friday.

Click here to see my Capstone Proposal

My Capstone Project

My capstone project will be conducted at GLAD House, a nonprofit organization dedicated to supporting high-risk youth aged 5 to 12 who have been impacted by a family member’s addiction. The goal of this Doctoral Capstone is to develop consistent language and strategies for the various professionals working with children affected by substance abuse within their homes. These early experiences can significantly contribute to the development of adverse childhood experiences (ACEs), which can have long-lasting effects. To address this, I will conduct interviews with professionals—including foster care workers, guardian ad litems (GAL), court-appointed special advocates (CASA), foster parents, educators, case managers, therapists, and social workers. Based on these insights, I will create an educational module aimed at enhancing professionals' knowledge of social-emotional strategies and fostering a shared language to ensure greater consistency in supporting these children. Additionally, I will update the sensory areas at GLAD House with evidence-based sensory equipment designed to improve the children's self-regulation skills, offering them more effective tools for managing their emotions and behaviors.

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64% of U.S. adults report experiencing at least one ACE by age of 18

1 in 6 adults reported experiencing 4 or more ACEs

The needs for this capstone...

12.8

is the average age of first use of alcohol or other drugs within the Cincinnati, OH area (Sawmiller, 2020)

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70%

Experiencing an ACE increases the risk for injury, STDs, involvement in sex trafficking, chronic diseases (cancer, diabetes, etc), mental health concerns, unstable work conditions, and more

70% of children who try an illegal drug before the age of 13 are likely to develop a substance use disorder (National Center for Drug Abuse Statistics, 2023)

Capstone Goals

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By the end of Capstone, I will feel more confident working as a member of an interprofessional team based on a Likert scale. 

By the end of Capstone, I will recommend at least 3 evidence-based items to be added to the sensory areas that are non-breakable and do not require further training from staff. 

  • Research reliable, unbreakable sensory equipment

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  • Provide at least 3 recommendations of sensory equipment to the team at GLAD House for financial approval

  • Lead interviews with at least 3 different professionals.

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  • Increase my understanding of each profession’s role within the children’s lives to know how OT can be a part of the team.

Faculty Mentor

Dr. Leah Dunn, EdD & OTR/L

Site Mentor

Ashley Tomlinson, LCCP-S
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Child & Caregiver Toolkit:
Cultivating Self-Regulation After ACEs

 Child & Caregiver Toolkit: Cultivating Self-Regulation After ACEs is the title that included all aspects of my capstone project. There were three main activities included within the project. 

The first part of the Child & Caregiver Toolkit: Cultivating Self-Regulation was titled, Use Your Voice! Creating the Same Language & Strategies for Continuity of Care, which required IRB approval as it involved conducting research. This part of the project involved completing interviews with different professionals to understand their role and gage their understanding of self-regulation programs, curriculums, and strategies. Then an educational module was created & sent to all participants that included an introduction to ACEs, common language, glossary of each professionals' role, self-regulation curriculums and programs, information about GLAD House, & community resources. An adapted version was created to present to GLAD House staff. 

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Sent to all participants who completed an interview

Training completed at GLAD House with all staff

The second part of the Child & Caregiver Toolkit: Cultivating Self-Regulation was providing recommendations for sensory supports to aid in self-regulation. After using clinical observation skills for each group at GLAD House and observing use of their designated sensory areas (sensory room & gross motor bin), I made recommendations for sensory supplies to purchase. The sensory rooles recommended are linked below in the "GLAD House Sensory Support Priority List" and within the Excel sheet linked below with all rationale provided for each tool. The Development Director then applied for the Max & Victoria Dreyfus Foundation with support from myself to obtain the financials to purchase the supplies. Below is the slideshow that prioritized the sensory supplies and included a dream sensory supply list that was not limited by space or funding. Additionally, the implementation of different types of visuals included making coping skill posters, feelings check-ins, and more. Also below I have images of some of the sensory equipment that had been donated or created by me being put to use. Lastly, visual timers were added to the group rooms to help with time management and other executive functioning skills. However, the end sound of the timer became triggering to some children, so I met with the CEO of Time Timer to address these needs and am continually working with their product developer to potentially design a different end time. Time Timer also donated a multitude of timers to GLAD House after meeting with the CEO. 

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Click on these images to take you to the powerpoint or Excel sheet 
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The final part of the Child & Caregiver Toolkit: Cultivating Self-Regulation was visiting local community resources. In doing so, connections were made and people were more willing to participate in interviews. Additionally, visiting local organizations provided me with insight into the resources available to share with other providers and families. Touring and speaking directly to staff the organizations allowed for more clear direction of the programs and services they offered. All community resources feature their own slide on the educational module with a description of the services and links to their websites. 

Why was OT beneficial at GLAD House?

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Click on the image to watch the video

Capstone Resources

Capstone Report
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Capstone Poster
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Capstone Video
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Beach Sand

The Doctoral Capstone process has been both challenging and profoundly rewarding. Throughout this experience, I witnessed firsthand the real-world impact that adverse childhood experiences (ACEs) have on children. I also had meaningful opportunities to collaborate with providers from diverse backgrounds and explore a variety of local community resources. I feel incredibly fortunate that the team at GLAD House was so open to hearing and implementing my ideas. Together, we frequently collaborated to create solutions that supported both individual children and larger groups. Working in a setting without an occupational therapy (OT) presence highlighted the essential role OT can play in mental health environments and strengthened my commitment to advocating for the profession. During my time there, I was able to contribute sensory supports, create new routines, self-regulation strategies and curriculum, motor skill interventions, and recommendations for sensory equipment. Equally important, I was able to build safe, healthy, and trusting relationships with many of the children at GLAD House—children who have experienced ACEs and are often seeking connection with a consistent, supportive adult. Reflecting on this experience, I recognize how much I have grown since first beginning the project. I spent countless hours discussing, reviewing, and researching self-regulation in children affected by ACEs. I now more deeply understand the importance of building a relationship with a child before attempting to support their regulation, and that regulation must always come before expectations.

Reflection on Capstone

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