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"Occupational" Retuning



Published March 23, 2005 at 5:00 p.m.

As Jordanna Dulaney swivels on a platform swing, she tosses small beanbag frogs or tennis balls at numbered plastic cups randomly placed on the floor. This game is intended to improve the second grader's motor coordination and muscle tone. But pediatric occupational therapist Deborah Kratz also turns it into a math quiz by periodically calling out an addition or subtraction problem that the 8-year-old can solve by hitting the correct target. When the girl knocks over a cup marked 18, she is providing the answer to "20 minus two" and mastering balance at the same time. Easier said than done.

"Jordanna has to plan what she's doing because there is a sequence of movements needed," explains Kratz, 45, who launched Wee Works of Williston at her home in 2003. "It's actually a very complicated activity."

The room is filled with toys, art materials and an enormous, cloth-covered mound of pillows and foam rubber she calls a "crash pad." Kratz's four "therapy cats" --Billy, Patty, Carrie and Cindy --often drop in on the sessions. Down-stairs, her husband David frequently romps with their six other kitties, keeps the books and repairs instruments for a living. The couple married in 1991, while soldiers in a U.S. Army marching band. They both play French horn. She once envisioned that instrument as her passport to a career in classical music.

It took more than two decades for Kratz, now legislative chair of the Vermont Occupational Therapy Association, to make the transitions from orchestral performance to military marching to promoting recovery and rehabilitation in youngsters. While she now deems occupational therapy with children "more fun than I ever had in my life," the changes have proved easier said than done.

SEVEN DAYS: Is it tough to switch gears at an age when many people have settled into their sole occupation?

DEBORAH KRATZ: Yeah. When I joined the Army, I was living in a barracks with women who were mostly just out of high school. At OT school, I was once again older than almost all the other students. And the schedule was so demanding that had I to give up music altogether.

SD: What are the most common problems you treat as an occupational therapist?

DK: If basic motor skills are not in place, everything else in life becomes difficult. We need to catch them early. And every child I work with has poor ocular skills, so they struggle with visual work. Kids are less active these days. Their hands and eyes are not getting a good workout.

SD: Lifestyle is an issue?

DK: Yes. I'm also trying to train parents to be detectives. The things that calm some people down might make a child hyperactive. One girl I saw was incredibly fidgety and liked to run on all fours. Her parents, who were very sedentary, thought it was behavioral. They began to realize their daughter needed activities throughout the day to stay on a more even keel. The dad told me: "You saved my family. We just thought she was a bad kid." He cried.

SD: Why is that making you cry now?

DK: When I was growing up, my parents thought, "Debbie just has her quirks." Some kids are hypersensitive to things like the tags on the back of their shirts or, like me, the seams in their socks. Sensory issues can hold a family hostage. They might not be able to take a child shopping because of the sights, sounds and smells in a supermarket.

SD: What kind of upbringing did you have?

DK: From fourth grade through high school, we lived in Tampa. My mom was a homemaker and my dad was a hydrologist with the U.S. Geological Survey. He coined the term 'aquifer.' I have three biological sisters. After my brother Rob served in Vietnam, he battled demons and eventually committed suicide in 2001.

SD: How terrible.

DK: As I was studying OT, I suspected Rob had Post Traumatic Stress Disorder. My mother said, 'He'll get over it.' Occupational therapy has strong roots in the mental health field. It was started after World War I to rehabilitate shell-shocked soldiers. April is National OT Month, by the way.

SD: Did your undergraduate education prepare you for what was to come?

DK: Not really. In 1982, I got my bachelor's degree at the Indiana University School of Music. By then, I was already performing with regional orchestras. But my first job after graduation was at the drive-through window of McDonald's. That was all I could find. In 1986, I signed up for the Army. That was the first time my mom ever said she was proud of me, but I felt it was a huge step down.

SD: Then why enlist?

DK: So I could join a military band. I felt like a rolling stone and needed stability. The first step was eight weeks of basic training at Fort Jackson in South Carolina. I left with the rank of staff sergeant at the end of January 1987, when I went to Fort Myer in Virginia. I was the first woman in an all-male horn section.

SD: Was that a good experience?

DK: Mixed. I discovered that I had a foot deformity. So I came to the band damaged, with bad feet, but my job was marching. I also had carpal tunnel syndrome, tendonitis and melanoma. I took a medical retirement in early 1993. While I was still there, though, I volunteered to do community service in the occupational therapy clinic at Walter Reed Army Hospital. I thought, "This is pretty cool." It had everything I liked, all wrapped up in one profession: the body, psychology, creativity and really listening to people.

SD: And that persuaded you to go into this field?

DK: Yes. I got a master's degree from Shenandoah University, which has a great OT program. After graduation, I worked in the public schools of Fairfax (Virginia) and played with a brass quintet in my spare time. But 9/11 and seeing the Pentagon engulfed in smoke just two miles from our house was the catalyst to move out of the state.

SD: Why Vermont?

DK: David's a native, from Pittsford. And I have two sisters in Massachusetts, so this seemed like the right place to be. I started Wee Works in January 2003 and, that March, Northwestern Medical Center in St. Albans hired me half-time to help set up a pediatric rehab department. I did that until about a month ago. Now I've got enough of a clientele, between 10 and 15 kids, to go it alone.

SD: Alone except for David and the therapy cats?

DK: Exactly.