1. My Experiences As a Locum/Per Diem Occupational Therapist: From An Autistic Individual’s Perspective
By: Bill Wong, OTD, OTR/L

2. Background on Myself
Licensed occupational therapist since October 2012 in US
Received my OT masters in 2011, clinical doctorate in 2013
Currently working in skilled nursing facility setting (aka step down unit in UK)
Specialties in OT- social media and lived experiences of autistic individuals
Diagnosed with Asperger’s Syndrome in August 2010
Presenter at TEDxGrandForks in 2015

3. Significance of Topic
Unemployment rate of autistic individuals is relatively high comparing to general public in countries across the world
Clinical environments in healthcare are unpredictable and extremely unstructured
Autistic individuals’ skill deficits can increase their difficulties in retaining a clinical job due to the nature of clinical environments

4. Employment Statuses in My Setting
Full time, part time, or per diem/locum
Change of status is fluid. Takes a few months to move from one status to another.
All statuses can allow anyone to accumulate full time hours (35+ hours per week)
Full time and part time are less likely get shifted to another facility on a weekly/daily basis than per diem’s.

5. Employment Statuses in My Setting
Per diem’s get paid more on hourly wages, but have limited benefits
Can say no to buildings that are too far.
Per diems are more likely have to be ready to go to different buildings with little or no notice each morning
Anyone can work 7 days a week if desired.
First 8 hours- regular pay, 8th to 12th hour- overtime; 12th+ hour- double time

6. Employment Statuses in My Setting
Staffer is responsible for making sure needs of each building is met in terms of coverage for OT, PT, and ST
Per diem’s communicate to staffer on daily or weekly basis, depending on whether there is work assigned to them already.

7. Me and My Job So Far…
I live in an area where I can ask for work from 3 staffers, since they each have buildings within 25 miles of my home.
Have been to 24 buildings to date across LA and Orange counties in California
Been to some buildings for 1 day, and some for several weeks at a time.

8. Me and My Job So Far…
Each building might have slightly different rules and expectations on daily tasks
Minimum expectation- must complete daily responsibilities in reasonable amount of time, aka productivity standards.
Different schedule every day, especially true in bigger buildings.

9. Why Is It Difficult For Autistic Individuals?
Social skills (with co-workers and patients)
Making good first impressions at every building
Sensory
Unstructured Environment & filled with unpredictability
Dealing with different expectations on daily tasks
Adjusting to work area setup’s at different buildings

10. Why Is It Difficult For Autistic Individuals?
Sharing clinical equipment when department is busy
Finding unfamiliar residents
Come up with treatment plans without missing a beat
Be calm under pressure when plan A doesn’t work or not available.
Finding rooms in different buildings efficiently after being shown around once.
Creating structure in an unstructured environment

11. How to Cope (Job Demands)?
Constant keeping track of time, especially after having a solid idea on my work pace
Get an idea on what I can use clinically in each work place before I start my first treatment
Experience in variety of situations increase confidence quickly
Taking mental health days off when I feel is necessary
Eased myself into handling more hours as time went on

12. How to Cope (Workplace)
Small talk (to get a feel of patients in general/specifically and other staff)
Identify possible coping areas during facility tour
Ask questions on any expectations that are not clear when doing some familiar tasks for the first time
Seeing familiar rehab staff
Using humor

13. How I Become Successful?
A strong support system
Strong self awareness of strengths and weaknesses
Clinical experience over time
Improved social skills since diagnosis
Motivated to be like peers I respect
Maintain autonomy with my work schedule
Emphasis of being mentally flexible since childhood

14. Take Away Point to Parents
Once your autistic children thrives with structure, it’s OK to see if they can succeed just about the same with decreased structure over time.
Social skills classes or tutoring sessions can only teach basics, the ability to use and expand on what are learned require time and practice.
Encourage your children to reflect and learn from their failures. Facilitate if needed.

15. Take Away Point to Parents
Parents can only provide so much, encouraging autistic individuals to create support for themselves eventually.
Autistic individuals might need some support to be self sufficient when they become adults
Versatility and flexibility can be nurtured, but it is important to emphasize it early