Why an Occupational Therapist Came to the U.S. as a Professional Au Pair

September 19, 2016
After completing her training as an occupational therapist, Julia Riemann, age 23, had a choice to make. She could go to work immediately for a clinic in her native Germany – or she could travel to the U.S. and live with a family who had a child diagnosed with autism spectrum disorder. She chose the later, and today, nearly two years later, she has no regrets.

“At first I was nervous – coming to live with a family that I’d only spoke with several times via Skype,” said Riemann. “What would it be like? But, the experience has been so valuable, both personally and professionally.”

Riemann is one of dozens of occupational therapists from Germany and other countries who, rather than put their professional aspirations on hold for a post-college gap year, have discovered a way to further develop their professional skills while experiencing the benefits of living in another country. For many – like Riemann – the experience has profoundly affected their approach to occupational therapy.

Through PROaupair, Riemann matched with the McBride family of Baltimore, Maryland. The McBride family has two children – eight-year-old Ella and seven-year-old Mikey. Mikey was diagnosed with autism when he was about a year old.

“Once we figured out what the costs were going to be, there was no way that one of us could stay home,” says Luisella McBride. “And what does staying home mean? Am I or is my husband the right person to provide what Mikey needs for his success? We wanted somebody who knew how to work with Mikey and was on board with our goals.”

After two years of working with Mikey, Riemann has seen significant improvement.

“When I first arrived, I needed to tell Mikey every single item that he had to put on the morning and help him with buttons and zippers,” she explained. “In the last 20 months he’s improved his fine motor skills to the point where he is able to close most of the buttons and zippers on his clothes independently.”

Riemann is in close contact with Mikey’s therapist and works together with an interdisciplinary team of OT’s, teachers, psychologists, and ABA and TEACCH therapists. They come up with routines and materials that help Mikey internalize things he needs to do on a daily basis.

“In the beginning, Mikey had a hard time tolerating the sensory input of a toothbrush in his mouth,” Riemann explained. “Now he can hold the toothbrush himself and brush his teeth for more than a minute.”

Riemann has benefitted from her unique perspective living with the McBride family.

“I have grown so much as a person and gained experience that has impacted my client-centered view on therapy,” says Riemann. “I have also experienced the importance of working together as an interdisciplinary team with teachers, therapists, and doctors – but also parents – to assure the best care possible for each individual.”

Living and working with a family is an intimate experience that provides Riemann with a window into the life of the whole family, not just Mikey.

“It’s hard to fully understand the family of a child you are working with when you only get to see them after a twice-weekly therapy session,” Riemann said. “Being around them 24 hours a day gives me a better perspective on what it really means to live with a child with special needs and see the effect it has on the family.”

She has been impressed with the passion and dedication she’s seen from her host family, and how they try to make their kids happy. The admiration is mutual.

“Julia gets as excited as I do when Mikey or Ella accomplishes something they’ve been working on,” said Luisella. “We really admire Julia’s dedication, work ethic, and the drive she has to help both of our kids succeed. Julia’s background as an OT has been very beneficial when I have sought advice on how to help Mikey with certain behaviors. She also works with his OT on helping generalize at home what he is learning at school.”

Even thought Riemann is looking forward to her return to Germany, she acknowledges that she’s been changed by her time in the U.S.

“I’ve become a much more independent and mature person in the last few years,” she explains. “Living in a different country, with a whole different culture, and speaking another language affects you in so many ways. The experience is something that no one can take away from me.”

The core of that experience is Riemann’s client-centric philosophy, inspired by her time with the McBride family.

“Even if you have a fantastic sense of empathy you don’t know what it’s really like to be part of a family with a child who has autism,” she said. “As a therapist you might hear excuses from families about why homework wasn’t done, etc., that are hard to understand. But, when you live with a family you see how hard the parents are working and what they are going through on a day-to-day basis. You also see how much faith they put in the teachers and therapists to help them with their children.”

Riemann’s support and training has benefited the entire family, not just Mikey.

“There are a lot of challenging things that come with having a child with autism,” said McBride. “But, having someone else there with you who is not a parent but a professional that can provide you support and understanding, it makes a huge difference. There are times when I’ve felt overwhelmed and ready to throw in the towel and then here comes Julia and she says ‘I’ve got it.’”