 Guest Post by Jean Wetherilt In occupational therapy we often refer to the adaptive response, described as the interaction between an individual and the environment in which the individual meets the demands of the task. The “Adaptive response” took on new meaning both personally and professionally as I walked the cobblestone streets of Antigua and Santa Maria de Jesus, Guatemala. I learned from the wonderful people in those communities including the children and families, the staff and volunteers of New Life School and the best teacher and translator ever, Megan Lewis! Experiencing the daily life of Guatemalan children gave me a different perspective of pediatric occupational therapy. Many years of working with children have been focused on my Americanized views of the occupations of children: to develop independence, to learn through play and an education, and to be social beings. In Guatemala, where living conditions are significantly different than in the U.S., these occupations are similar but also uniquely different. For example, play looks different. In the market, I watched siblings wrestle behind their mama’s table, while another little girl gathered up her pile of plastic spoons to pretend to sell them, using what she saw her mother do daily as a model of this play task. In the therapy room at New Life School, I watched a boy build his version of Antigua, a nearby town that he has heard of but may never visit, with wooden blocks. On rooftops little girls played house as they did the real household chores of hanging laundry on lines with their stuffed bunny wrapped on their back like their mothers care for their babies. In Santa Maria de Jesus, the school day ends at noon because children are needed at home, in the fields and in the market to help their families make money and survive. The family unit is the priority in this culture, different from the U.S., which means children and adults collaborate together to ensure survival. Unfortunately, the important daily activities rarely include play like we may expect it to look here in the U.S. I saw situations children needing to grow up fast in order to take care of their siblings at a young age, do all household chores, and manage adult activities and responsibilities. Most of the children we worked with have not had a chance to have a carefree childhood that we, in the US, might hope for all children. One night while walking through a market I saw a toddler of about 2 years of age, propped against a fence asleep while his mom sold her wares. Some extremely unfortunate and dire situations lead to children being taught to not only beg but also steal from tourists.  In order to be culturally relative, Megan’s school-based and community-based occupational therapy services have had to adapt. Activity analysis is something occupational therapists use to determine the developmental milestones and necessary skills needed for a child’s daily life and occupations. In this culture the therapist’s mindset is focused on examining tool use in their homes and fields, household tasks including gathering water and food, sweeping the dirt floor, learning to tie knots in rope to go around bundles of wood, carrying large baskets to the market and taking care of younger siblings. Education becomes a second priority and seen as a luxury when survival is on the mind of children and parents. Learning to read and being educated is slowly becoming a cultural value and occupation of children. One of my favorite memories from my trip was watching 3 children in a social skills group learn to jump rope together! It was sweet because none of them have had the fun opportunity to play in such a way, a new occupation for sure! On these cobblestone streets, the reality for children is harsh, the demands of the tasks they perform every day are great but the children are adapting, learning, and growing! GOT ministries is adapting as well, continuing to be intentional regarding cultural expectations and determining best practice for serving and investing in the children and families they serve. Please pray for the therapists, the staff, occupational therapy interns and most of all the children. May they learn the steadfast love of a heavenly Father who created us all to work, play and love one another. 
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