Latest / Two Girls and a Cup of Wellness / Occupational Therapy: Why Independence Matters with Marisa Mueller | Ep 12

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Occupational Therapy: Why Independence Matters with Marisa Mueller | Ep 12 · Two Girls and a Cup of Wellness

• Crissy Florio: Today's guest, Marissa Mueller holds a bachelor's degree in health science and a master's degree in occupational therapy from Florida International University in Miami with 14 years of experience as an occupational therapist. Her career began primarily in acute care and geriatrics, specializing in adult rehabilitation. Much of her clinical background was rooted in the ICU along with additional experience in home health care and management. After more than a decade in acute care, she felt the call to make a meaningful shift and transitioned into pediatrics two years ago. The move brought both a significant change and a steep learning curve, and she has happily embraced this new chapter of the practice. She currently works at a private outpatient clinic near St. Lucie Medical Center. She lives with her husband who she had met in fourth grade in their dog, Franklin. again. Hello, and welcome back for another Two Girls in a Couple Wellness Chat. My name is Chrissy. And my name is Marie. And today we have a good friend of both of ours, actually. We both know this girl. Her name is Marissa. And Marissa is an occupational therapist. And it's April. And it is Occupational Therapy Month. Yay! There's a month for everything. And I'm just so excited that we're able to talk about all things occupational therapy. Outside of work, she enjoys traveling, exercising, and spending time with friends while savoring everyday life. Let's welcome Marissa. So exciting. So Marissa, welcome. Marisa Mueller: Thank you. Thank you for having me. I love to be here and I love to ⁓ highlight our month, which happens to be April. So this was great timing that we could all reconnect. And I love the fact that we all kind of have history together, ⁓ whether it's just through friendship or health and wellness and actually working together. We can touch on that. Marie, I know you. Crissy Florio: Mm-hmm. Marisa Mueller: through working in healthcare. used to be an OT doing home health with Marie and health and wellness. I used to take Chrissy's yoga classes. So we're all kind of coming back to a full circle here. And that's why it's so important to ⁓ not burn any bridges in the healthcare community, because it's very cool. ⁓ Crissy Florio: That's right. Right. Create these beautiful bonds. So I'm excited for you to bring like some clarity to occupational therapy. I briefly, I'm just going to tell a story. So when I was in nursing school, we were all miserable. We had bags under our eyes. We were studying like crazy and I would just look at the occupational therapist and they had so much fun and they had all these tools and I'm like, I hate them. I'm losing sleep over here and they're having a good time. And then you even have a Marisa Mueller: Absolutely. So much Crissy Florio: good time in the hospital while in the ICU stressed out about life and death and beeping and pumps and keeping people alive in the occupational therapist like we're so happy with our life. Marisa Mueller: Yeah. Yeah. Playing with their tools, playing with each other, doing co-treats, running around with all this energy. Yep. Yeah, that's us. cool profession. Crissy Florio: Amazing. Well, let's start with really what is occupational therapy? Marisa Mueller: question of the day, what is OT? And I get asked all that time and it's so funny because most of the people in the history of my practice would ask me and those were geriatrics because they would say, I don't have an occupation anymore, I'm retired, so why are you coming to work with me? So, and I've said this before, I've said this in multiple podcasts in the past and this... Crissy Florio: . Yeah. Marisa Mueller: quote always stuck with me from one of my professors, occupational therapy is anything that occupies your time. ⁓ A lot of people, right? That's kind of cool. A lot of people ⁓ confuse occupational therapy with physical therapy. And while our practices are ⁓ a lot alike and we do... ⁓ Crissy Florio: Mmm. Yeah, that's good. Marisa Mueller: you know, have crossover of services. ⁓ We do split it up. We split up the body. We split up our disciplines ⁓ and it kind of, you know, it depends on where you are at in the lifespan. And that's the beauty of OT. We address different things that occupy your time depending on where you're at in the lifespan. So if you're a baby, you know, whatever occupies your time is gonna be different than ⁓ what occupies your time, you know, as an adult or a geriatric patient. ⁓ So basically our job is to get you back to functioning how you were before you were sick, had an illness, had a disability. We might not get you there fully at 100%, but we're gonna try to get you there pretty closely, maybe with adaptions, modifications. ⁓ you know, whether it's tools, equipment, ⁓ stuff like that. But that's our job to get you back to where you should be functioning ⁓ at your current level or as closely as to where, you know, you should be depending on what your age is or your milestones. If that makes any sense. Crissy Florio: Okay, so when I think about what I would do with occupational therapy in the hospital setting, we would always call you in for our stroke patients. So is that a common? Okay. Marisa Mueller: Yes. Totally. Yeah. So I can give you an example of that. And ⁓ most of my experience is in the hospital. That's kind of where I started ⁓ was at Cleveland Clinic or. Mart Memorial back in the day for many years in the ICU. so a lot of acute rehab does start ⁓ with OT or we start at, I would say the first line of defense in the hospital. know, people come in with those acute injuries. ⁓ any age really, but let's say you have your adults with a stroke. so we would go in and we would do that initial eval, starting, how were you before you came in and look at you where you're at now. ⁓ And then kind of do that full assessment, really starting from head to toe. ⁓ Crissy Florio: Mm-hmm. Marisa Mueller: do you know a history how you were functioning ⁓ in your home you know were you independent were you using equipment looking at your left side your right side your fine motor ability your gross motor ability even your vision stuff like that and then really in the hospital since you're not going to be staying there long we'll work with you for whether it's a day a few days and then we make those ⁓ discharge evaluations for where you're going to go ⁓ after the hospital do you need further rehab do you need to go to a place like a subacute rehab like in compass do you need to go to a longer term rehab like a skilled nursing facility can you go home with home health like where we used to work together and you know Do you need to maybe be moved out of your house? Are you losing a lot of your independence? Do you need a higher level of care? So that's when we all work with the team in the hospital, case management, doctors, PT, speech. We come together and then figure out where you go from there. And then that's when the next line of defense, of PT, OT, and speech in those settings takes over and then really start to work on the plan of care and the rehab process continues. So it's, you know, one step at a time. Crissy Florio: Mm-hmm. Yeah. Yeah. It's so needed. My father had a stroke when I was five years old and he was 35. And so that was all. Marisa Mueller: ⁓ my gosh, what do you remember what type or was it because you know, there's hemorrhagic and then there's ischemic. So did he have a bleed or a clot? Crissy Florio: I, be honest with you, I don't know. He was actually in surgery when it occurred. ⁓ and so I don't know, I don't know, but he did come out of it paralyzed on one, his whole right side of his body is paralyzed. and obviously a little bit of a brain damage as well, but, ⁓ he's, know, he, it's kind of beautiful to see because they told him he would never walk or talk again. And within six months he was driving a car. Right. So. Marisa Mueller: either. Yeah. That's so amazing. Well, and I will say, and what I learned ⁓ being a neuro rehab therapist is those six months are the most crucial times ⁓ for neuro rehab, for neuroplasticity and neuroplasticity for anyone that doesn't know exactly what that means. That's the time where your brain is relearning, it's regrowing. It's when all those damaged neurons from the injury of the stroke, whether it's a bleed, a clot, anything, ⁓ Crissy Florio: putting the time and the efforts into it. Yeah, it was really very inspirational. Marisa Mueller: those neurons, they can reconnect, they can regrow ⁓ by teaching. And teaching is therapy, but those six months are so crucial. And that's why, you know, they call us, you know, just the rehab terrorists. And we come in and we say, you know, do 50 repetitions, do 100, do a thousand, because the brain actually takes onto that. There's a method to our madness. When you do these hundreds and thousands of repetitions, your brain is relearning that and it's reconnecting those wires. ⁓ Crissy Florio: Mmm. Marisa Mueller: What we tell our patients is that, you know, it's so upsetting and disheartening when you see an injury to your arm or your leg and it's paralyzed. But the truth is that it's not really an injury to your arm or leg. It's an injury to your brain not connecting the signals. to the muscles and the nerves to say, you know, open and close or take a step pattern this way. So you retrain the brain to do the right movements and then everything starts firing again. But that's why it's so important. Like I'm sure you saw for your dad, those first six months to get into rehab, to work hard. And of course being young, I'm sure was in his favor too. So that's an awesome story. And I'm so grateful that I'm sure he had the therapy he needed and the family support and family support also is just as much, you know, Crissy Florio: I'm sure, yeah. And point. Marisa Mueller: Just as crucial as it is, you know, having a good therapist, you know, carry over with family and home exercise programs. Marie, know, working in home health, ⁓ so important. So, yeah. Crissy Florio: Mm-hmm. Yeah. What are some of the other types of situations you find in your clients as far as injuries or diagnosis? Marisa Mueller: Well, so it changes across the spectrum. So as you know, ⁓ with all therapies, ⁓ occupational, physical, and speech therapy, we see clients throughout the lifespan, starting from babies in the NICU ⁓ all the way up through hospice even. We can actually ⁓ treat and bill for patients in hospice. It's a fine line. ⁓ But for maintenance and for family education, there's always a way that we can provide services and help. ⁓ For me right now currently, I'm in pediatrics. I've been doing that for two years. So ⁓ my caseload right now, I would say it's about 75 % autism spectrum disorder with a lot of co-diagnosis with that. So you see a lot of autism with a co-diagnosis of ADHD, ⁓ a lot of behavioral disorders, sometimes conduct disorder, oppositional defiant disorder. We have some kids with cerebral palsy, some genetic disorders, abnormalities. ⁓ But I would say mostly I treat autism and other diagnoses along the spectrum. We have a very big umbrella term for autism and the diagnoses that fall within and a lot of kids that aren't diagnosed as well and that's fine. ⁓ Crissy Florio: Mm-hmm. Marisa Mueller: Oftentimes, you know, I tell the family we don't treat the diagnosis, you we treat the child, we treat the symptoms. And so with that being said, that's what I'm seeing now. ⁓ A lot of it again is, it's different for a child. So I've kind of had to, like I told you, my background being an OT for 14 years has mainly been with adults. ⁓ As I'm sure you guys know, and most healthcare practitioners can agree with me on this. ⁓ burnout is real in healthcare. But also the beauty of being a healthcare practitioner, especially in therapy, is that we have the ability to move and grow and change settings. And that was so great for me. So when I felt like I was getting that the burnout was real working with adults, ⁓ I made the jump into pediatrics. And I've been doing that for two years and it's been a learning curve. Pulled out the old books from college, still have them. Crissy Florio: Yeah, it sure is. Mm-hmm. You Marisa Mueller: And ⁓ so I'm still working out the kinks and I love it. It's a pretty stress-free job. It's fun, but now I have to gear my brain towards different goals and outcomes because again, going back to what we said, ⁓ occupational therapies, anything that occupies your time, right? So adults, you're getting them back to doing, it could be work rehab programs, it could be being able to drive a car, it could be doing their daily care, going to the mailbox, anything that occupies their time in their day. But a kid, I'll ask you this, what is a kid's main occupation? Hey. Crissy Florio: They want to play. Yeah. Marisa Mueller: Remain in occupation. Play in school if they're old enough. So if a is delayed... in any milestone. ⁓ They're going have a hard time playing. They're going to have a hard time in school. They're going to have a hard time socially interacting with their peers. They're not going to meet their milestones for their ADLs, which are their activities of daily living. So potty training, feeding, using utensils, ⁓ bathing, dressing. mean, things that even adults do normally that we work on that they want to regain their independence with, with kids, they're not even there yet at the right ages. So ⁓ we're just trying Crissy Florio: Mm-hmm. Marisa Mueller: to get them to meet their milestones and do, ⁓ again, things that occupy their time but at a child level. And again, it's mainly play. And a lot of these kids who have these diagnoses of autism and other things, just getting them to initiate play, getting a toy, bringing a toy to me, taking a turn with another child, those are big steps and big gains. And that's really what we're working on. So. Crissy Florio: Mmm ⁓ I'm sure that the kids love you too. Right. Lisha, you're bubbly, cute personality. I think you're in the perfect place. Marisa Mueller: You think I'm a kid? Yeah, I always say you keep growing and I keep staying the same height so I'm gonna be big platform to choose to work. Crissy Florio: That's funny. Marisa Mueller: So it's been fun. It's a lot of caregiver education. You you bring the parents in. We do hour sessions with the kids and I bring them back about 10 minutes before, try to tell them how the session went, what we worked on and give them homework to do at home. And we usually have pretty good carryover with the parents. They're very much involved and it's been nice. It's been a really nice change. Really refreshing, I will say. Crissy Florio: Yeah, I love that. Yeah. And I love the fact that you are taking the time to really educate the parents also as to what the work that you did, how they can continue that and how they can keep going that also within the home or within their schooling or whatever, maybe even passing it along to their teachers if they're at that school age. But again, just the education part of it is really important. Marisa Mueller: Yes. Get out. And a lot of our kids who are in school at the school age do get therapy in school too. So they can do that. It's not a crossover of services. So they do often get OT or speech, but it's not a lot. Usually it's just like one session a week. Sometimes it's for an hour only or just a group session. So oftentimes the parents come to us and they want additional resources or therapy for their kids on an outpatient level. So we can do that. Crissy Florio: Mm-hmm. Good. Marisa Mueller: a crossover of services, whereas you know if you have adults you would call that like you know double dipping different settings and stuff so we can provide that for the kids which is also really nice. We get their IEPs from their school which is their educational programs so we can work with the teachers and their therapists and make sure that we're you know working on the same things which is nice. Crissy Florio: Mm-hmm. Yeah. Mm-hmm. Mm-hmm. As far as pediatrics is concerned, what's the age range? Like what, up till 18 or? Marisa Mueller: Yeah, yeah, so it varies. mean, ⁓ we can start as young as taking NICU graduates. ⁓ We don't really have a lot, I would say, because a lot of them do like the early steps program and a lot of them prefer to get therapy in the home because they are medically fragile. They can have oxygen tubes, they can have feeding tubes, but we can take them in our clinic. do ⁓ right now currently have one or two children with a trach. We have a child with a feeding tube. So we can take them to very young and fragile and work with them. ⁓ But yeah, babies. Crissy Florio: Mm-hmm. Marisa Mueller: And we have some children high school level and I think up to our oldest like 18 19 or 20 So yes, they're adults, but you have to think you know when we test them what their age equivalents are They test you know at a pediatric level Crissy Florio: Mm-hmm. Marisa Mueller: you know, more so in the teenage or even younger childhood ranges. So it is more appropriate for them to stay at our clinic ⁓ as opposed to maybe going to an adult place and getting therapy there. ⁓ Although eventually, I mean, it probably would be our goal to take them to an adult facility ⁓ if they test at an adult level, you know, if that makes sense. Yeah. Crissy Florio: Mm-hmm. Is there a transition ⁓ from that, know, kind of going from pediatrics to the next level if they are starting to test out at that timeframe? Is there a transition into another aspect of it? Marisa Mueller: Sure, yeah, so if the child meets our goals and they graduate, that's awesome. We want them to graduate. Because, know, we can, like, you know, like I said, we only have certain standardized tests that test certain. Certain goals certain milestones, you know, i'm working on ball skills, you know catching balls around balls i'm working on handwriting ⁓ primitive reflexes making sure your reflexes are integrated, you know, that's from in the womb So like you said there's only to a certain point i'm going to be testing too and once you Reach those milestones and you're good and I feel like I can discharge you. ⁓ I'll do that because again, we have to show progress. ⁓ with our goals like i'm sure I don't know like Maria, anyone in healthcare, you have to show progress in order to get reimbursed by insurance and to continue to get authorization for your kids. ⁓ if we can't show progress for our standardized tests and our goals, then we'll discharge and then move them to a different clinic for more advanced treatment or advanced goals. And if they're appropriate for adult therapy in a different setting, then we would recommend that. ⁓ Or maybe they're just at a level where they're good. Crissy Florio: Mm-hmm. Marisa Mueller: You know, maybe then you put them in like a work hardening program, something, you know, like Publix, you know, they have those like special programs, you know, they're ready for that. ⁓ and try to get them out into the environment. But I mean, some of these kids graduate from therapy, from pediatrics, and they're, they're good. They don't need any more. And some, you know, they're going to be needing therapy lifelong, you know, depending on what their diagnosis is, if this low level autism, you know, a low level chromosomal issue. ⁓ so they'll, they'll be either with us or they'll move on to another facility or maybe a group home and then you just assess that when the time is ready. Crissy Florio: love to see some of the organizations that hire ⁓ children with special needs. just to see them, there's I know, down in Broward, there was a car wash, and they had just a bunch of kids like working there. And I think that is so important for if they're if they're capable, obviously, right. But some people that may be kind of on one side of the spectrum, they might want to be able to to Marisa Mueller: You can't walk. Crissy Florio: work and make some money and adult to a certain extent. So I love seeing that. It makes my heart happy. Marisa Mueller: Really? And you hear, you see all these videos and memes and stuff, all this negative ⁓ feedback or, feedback's probably the word, about kids with autism, you know, not being able to be like functional members in society. And that's so not true. I hate seeing that because, I mean, I have just kids right now on my caseload, way smarter than me at math. I'll just say that. They're like nine, 10 years old and they are just... Crissy Florio: Yeah. Thank you. Marisa Mueller: They bring me their math homework. I'm like, I can't even do this. You know, I mean, these kids are so smart and they will be. I have kids that are so good at sports, know, they're they, you know, they work for rewards. So they work to go in the gym and they make, you know, 15 baskets in a row at the basketball net. They work for bowling. Crissy Florio: Yeah. So I felt with my kids, I couldn't. Marisa Mueller: Like I said, they know their numbers, their letters, they're so young. mean, yes, they have other social issues and behavioral issues we have to work on, but their other skills trump that. And ⁓ like you said, these communities are in these agencies that help support them. ⁓ I love learning about those and being a part of it. We have like Surfers for Autism here that are currently. Crissy Florio: ⁓ yeah, my daughter was a big volunteer for them for a few years. Marisa Mueller: Yeah, so that's happening right now. And that's great. Actually, a few of my kids on my caseload go out and do that. And they're so good at it. There's also another ⁓ ⁓ Agency that I'm a part of here. It's called socially synced. My friend Katrina runs it her son is autism She's a nurse and every year they do a big event. It's actually Next nope, it's it's next Sunday. I want to say April 19th at Indian Riverside Park and it's a huge event It's a big walk ⁓ like I said at Indian Riverside Park and you bring all the kids and the parents and they have all the vendors and Just they usually have like a fake snow machine with bubbles and ice cream cones and all this stuff and it's just a way to get everyone together, know, just big resources for the community and it's just, I love how it's so tight knit and everyone is there supporting each other and giving these kids just outlets and resources that we might have not had before, you know, so it's really great. Crissy Florio: To see them all come together in community is great because then they start to see other children that they may feel more connected to because they're similar, right? And then the parents too, being able to connect to parents who are in a similar situation. Marisa Mueller: Mm-hmm. I was just gonna say. The parents need it the most. ⁓ That's something that I've taken ⁓ from this job the past two years is the support that we give to the parents and that the community gives to the parents. ⁓ Just the parents meeting in our waiting room have become friends because their kids play and then they have that in common. I I'm not a parent, so I don't. have that experience. So that's one thing I lack. mean, yes, I have, you know, 50 kids a week on my caseload, but you know, I'm not a parent. And I'm not a parent of a child with special needs. So I can only empathize so much, you know. ⁓ But it is nice to see these parents coming together in our clinic with the kids and then to have all these options on the weekends and ⁓ A lot of these parents that run these groups give other things to the moms, like little yoga sessions and little dinners and night outs and stuff. It's really nice. So we have a good community and we try to offer as much as we can to everyone. Crissy Florio: That's cool. You seem happy in this position. Marisa Mueller: Yeah, well, you knew me when I was in home health. It's just, ⁓ it's a different type of special place. This is a different type of stress. I would say every job has its pros and cons. ⁓ but you feel like you're, you're making more of a difference here. think I see progress quicker. they're more motivated. The parents are more motivated. ⁓ geriatrics are great. Crissy Florio: It's a special place, Home Health. Thank you. Mm-hmm. Marisa Mueller: they are but you know when you get but sometimes you know you get the same patients over and over again with the falls and the failure to thrive and you know the hip fractures and sometimes you know you see the same thing and sometimes it's like you know they don't want to be there i'm like well why am i here what are we doing you know so Crissy Florio: They are amazing people. Good evening. Yeah. Marisa Mueller: And in the hospital, I loved acute care. I will always tell everyone up and down. That was probably one of my most favorite jobs was working in the ICU for so many years because I had so much experience. You you learn so much in the hospital, especially as like your first job and the camaraderie was so great with the whole interdisciplinary team. ⁓ but the sad part was that none of my patients really remembered me. You know, you work with them in the ICU, you're getting them up on the vent and, ⁓ Crissy Florio: Mm-hmm. Yeah. ⁓ Yeah. Marisa Mueller: and then that's it. It's like, remember me, I got you out of bed for the first time after you had a stroke or spinal cord injury, you know, po-po. So, this is nice. You really develop and you keep relationships with your kids and your families and you watch them grow and you watch them. Actually, just before I got on the podcast with you, a kid's mom texted me a picture of him writing out the full month and the date. And it's just something so small means the world to a parent and to me and it brought tears to my eyes. So, it's just stuff like that. great. Crissy Florio: That's how they go. Mm-hmm. Mm-hmm. That's cool. So what do you do at the end of a workday to be able to disconnect, to fill your cup, to let go of the day and whatever happened that day? What is some of your afternoon or evening routines for yourself? Marisa Mueller: Yeah. That's a really great question. ⁓ So I drive home with a lot of really loud rap or R &B music. Crissy Florio: love it. I'm a big music girl, so I feel you on that one. Marisa Mueller: Usually on a Thursday or Friday. Also, sometimes I drive home in complete silence because my days are filled with just noise. Crissy Florio: Mm-hmm. Marisa Mueller: Just noise, just loud. So sometimes you just want that silence. And sometimes I just sit in my garage too when I pull in and I just need that five minutes. Cause I know as soon as I walk in, my husband and my dog are gonna be right there. So, and I will say, this is gonna maybe sound a little cheesy. Sometimes I call my mom too on my ride home because even as a 38 year old, grown up independent woman that preaches independence for someone else, there's nothing like calling your mom at the end of the day. and asking for advice right but other than that when i come home mindless tv although sometimes my mindless tv is wheel of fortune and jeopardy and then my husband's like ⁓ we're actually using our heads yeah yeah but i i try not i try not to do Crissy Florio: That's the best. I love that. Yeah. Right. I'm really thinking here hard. That's cool. Marisa Mueller: anything because it is I will say it's a long day. It's a lot of ⁓ being on your feet moving around. You're active. You're running around. We're bouncing kids on balls. We're throwing them. We're swinging them. You're chasing after them. So I try to keep my evenings pretty pretty open ⁓ to do not not much. I'll be honest with you. Yeah. Crissy Florio: Mm-hmm. Mm-hmm. Yeah. Nice and chill. Oh, that's okay. That's awesome. Well, I think it's important. Everybody has their own things of what helps for them to relax, right? And especially for people who work with young kids, that is a lot. That's a A lot of stimulation going on, a lot of activity, a lot of noise, like you said. So... Marisa Mueller: Yeah. Mm-hmm. Yeah! Crissy Florio: I was curious as to what helps wind you down. And I appreciate the stillness and the quietness so much. I'm so happy that you said that sometimes with just just driving with nothing on, you know, is very soothing. Marisa Mueller: Love it. Yeah. And I will say, ⁓ I'm sorry. ⁓ Crissy Florio: ⁓ no, I was just going to say I worked in pediatrics too in Boston and 50 % of your job is parents, I would think. know, so and I love educating the parents, but it's like you got to spend time with the child on the vent and ICU and then you got to also educate the parents and I love that, but that's very draining because you're doing two jobs. Marisa Mueller: It is. It is. It is, it's, is very draining. And what I was going to say is that my hours have also changed in pediatrics and there's any OTs out there listening. Most, most of our hours are early. We get in early, we get out early, especially in the hospital setting. It's like you, used to clock in at 6 30, be out by 2 30. So then I would have my whole afternoon to do whatever exercise, you know, used to play tennis. I used to run. used to go to happy hour with my friends and I was always a morning, a morning, you know, bird and have my evenings. And now. Crissy Florio: Mm-mm. Marisa Mueller: doing outpatient peds, you we're more of an afternoon evening clinic because you have to think these kids go to school, they need afternoon hours. So that was, that was a big mind thing for me when I signed on to this, you know, I'm, I'm very like scheduled and routine. So, um, I said very, very Virgo, like very, like, so when I met with my boss, I was like, so what's the earliest I can come in? She's like, well, you know, we normally start like around nine 30. I'm like nine 30 for the first two hours of my day. Crissy Florio: Mmm. Big transition. Hahaha. Half your day's gone. Marisa Mueller: So, so that's been a little bit of a change for me and, ⁓ I've had to adapt and, it took a little bit, but so yeah, I go in later and I get home later too. So oftentimes I'm not getting home until after six, six thirties, sometimes seven. So by then it's like dinner and bed. ⁓ I'm in bed, you know? Yeah. Yeah. So that's, that's kind of how my days are, but it's good. Cause now have my mornings, you know, I get up, can. Crissy Florio: Long day. Yeah. Right, right. I'm just like, lay there like, Marisa Mueller: I want to sleep in, spend some time with my husband in the morning, do some chores in the morning. And so it's just a rewiring and a work in progress. Crissy Florio: Sure. Which you know we can do, right? Coming back to that neuroplasticity. Marisa Mueller: Well, I'm just trying to rework it and work my brain and it's like I said, it's been a work in progress, but actually kind of like it now. So it's cool. Yeah. Crissy Florio: Awesome. Well, I'm sure that doing the work with the kids also is helping your own brain also, right? It's like you're doing the job, but it's also doing the job on your brain as well. Marisa Mueller: It is! It is! Totally, and I also get a great workout during the day too. So it's fine. If I don't come home and exercise and like, I know I probably burned like probably a good amount of calories today. Totally. Yeah. Crissy Florio: Yeah. Win, win, win. We got not just a win, not two wins, but a win, win, win. Oh, well, this was wonderful. I think you help open the eyes and the ears and the knowledge to so many people because I definitely did not know what an OT versus a PT did. So definitely opened up my eyes. Marisa Mueller: Yeah. Yeah. And I would just say, like, if there's any ⁓ parents out there that have any concerns about their child, ⁓ don't wait. That's like the four rule one. If anyone out there is listening, don't wait. ⁓ It's so much better just to get your kid checked out. A lot of parents are Crissy Florio: Hmm. Yeah. Marisa Mueller: in fear and I don't think denial is the right word but I mean yeah I mean it could be but you know Crissy Florio: Or denial. Yeah. mean, yeah. Well, you just think that's not going to be my kid and they're going to outgrow it. This is just a phase. Marisa Mueller: hear it all the time and maybe and maybe they will but you know what it's why wait just get your kid checked in now and a lot of a lot of you know I'm in a lot of forums and Facebook groups about autism and just kids with delays and a lot of the things I read our parents like what do I do next what's the first step my kid is experiencing this my kid is showing this who do I call and Crissy Florio: Right, rather be safe than sorry. Yeah. Marisa Mueller: A lot of people don't know what to do. just so if I can give some information, the first thing to do is go to your pediatrician. ⁓ and have to get a referral. Pediatricians cannot diagnose ⁓ any type of ASD, anything on the spectrum. ⁓ They can give referrals ⁓ for therapy. What they can diagnose is just, and again, I could be wrong, but I'm almost positive they can diagnose what they think is a developmental delay or a delay in milestones. But again, they cannot diagnose autism spectrum or anything that's a formal diagnosis that has to be done by a pediatric neurologist. We do have a few around here. Crissy Florio: Mm-hmm. Yep. Mm-hmm. Marisa Mueller: in Palm Beach, we'll start off with just going to the pediatrician. And oftentimes they don't send you directly to the ⁓ neurologist. What they do is they send you first to us and they say, have the child get some therapy, see what the therapist think. Let's try it for six months, maybe a year. Let's see if they progress. ⁓ you know, because we're maybe not convinced it is what we think it is. And then let's circle back. If we don't see progression or if the therapist think it's something else, then we'll send you for a referral to a neurologist and see what they think. But that's kind of how it goes. If you have any, you know, concerns about your child, maybe they're not up to par with their speech. ⁓ You know, this kid is, you know, saying these words, but this kid, my kid's not, you know. My kid's not holding a pen, my kid's not eating, my kid's refusing different types of foods, my kid's pocketing foods, know, anything. It's okay, it's okay. ⁓ Crissy Florio: Sorry. She's so cute. Her dog is so cute. Lucy. Like honestly, like most lovable dog. The other day we did another interview as she's getting her. The other day we did an interview and she sat her on the bar stool right next to us and she like fell asleep with her head on the table and Marisa Mueller: We'll see. Crissy Florio: She is the cutest, yummiest thing. And I just love and adore her. We knew at one point we would get her barking in one of our interviews. So kudos to you, Marissa. Lucy loved it. Yes. Well, thank you, Marissa. It was so good meeting you. Marisa Mueller: Thank ⁓ that's so funny. Yay! She loves me! But yeah, I would just say, you know, yeah, just get your kids checked out. mean, you know, better to be safe than sorry. So, that's it. Don't wait. Thank you. Crissy Florio: Yeah. Beautiful, beautiful information and very helpful because I'm sure I think that a lot of our community, our parents of all different ages, right? And if they are, if any of you are contemplating or questioning, like Marissa said, go to your pediatric and pediatric, pediatrician, pediatrician, blah, blah, blah. Marisa Mueller: We're going! Yeah. Pediatrician, yeah, it's never too late. It's never too late. And I'll say we have kids starting therapy at the age of one, we have kids starting therapy at the age of 18. Obviously, know, advocating for your child at an earlier age is always best, you're gonna have better outcomes, but it's never too late, so. Crissy Florio: ⁓ this was amazing. Amazing. Yes. Thank you so much for taking time to chat with us in our community. Marisa Mueller: Thank you guys so much and if you have any parents or kids that you know Need an evaluation always feel free to give them my contact and I'm happy to take a look at them for you Crissy Florio: Definitely. Yeah. Yeah. We'll definitely add all of your information to the show notes too. So they'll be able to just click it and find you and follow you and do all of the things. So thank you so much for your gift and your light. Thank you. Marisa Mueller: Sure. Awesome. Well, happy OT month and happy weekend. And I hope you guys have a great rest of your day and I hope to see you guys soon. All right. Take care. Bye. Crissy Florio: Yes, you do. Thank you. Bye.