ADVANCE Outlook: OT

Occupational Therapy. Living Life to Its Fullest

2008-04-15T03:45:00Z

When we walked into the RA meeting last Wednesday in Long Beach, the assembly was about to close its doors in executive session. In 15 years of covering the Representative Assembly, I had never heard of a closed-door session in task group preparation. All that usually entails is assigning delegates to the particular committees that will discuss the pros and cons of motions that will come before the body later, to make a recommendation that the group can either accept or reject.

As we were courteously escorted out of the room, along with everyone else who was not officially involved with the RA, I asked what was going on. (Reporters hate executive sessions. They are usually about keeping secrets the press thinks should not be kept.) So I was surprised when someone told me it had to do with an announcement that AOTA President Penny Moyers Cleveland was going to make in her presidential address on Friday. Something about a new "branding" the association was undertaking. It was meant to be an unveiling of some kind. So, ADVANCE waited, along with everyone else.

When the big day came, we learned that AOTA had adopted a new slogan, the first in more than 10 years, as I remember, that was meant to make the concept of OT "click" in the minds of the public: "Occupational Therapy. Living Life to Its Fullest."

The slogan supersedes "Occupational Therapy. Skills for the Job of Living." It is meant to associate OT in the public mindset with more than just function. Fulfillment is now the goal. The new brand is more in keeping with the context of occupational science, which sees "doing" as a first principle of human existence; that is, it is the nature of people to be active during their waking hours in activities and roles of their choosing that have meaning to them, personally. OT's job is to help them make healthy choices and undertake activities that lead to personal satisfaction in their lives.

In this context, occupational therapy goes beyond the clinic and the classroom. It goes to a lifestyle that involves a healing connection with others through participation, in all aspects of one's life.

All of this, of course, is to help set OT up for achieving the Centennial Vision, a practice model that AOTA wants to see the profession achieve by 2017. It is an undertaking that has consumed AOTA's time and resources for more than 5 years. And it means, as Cleveland states, that every OT and OTA out there needs to develop an "attitude of unreasonableness."

By that she means that you are not going to take no for an answer in any situation that is critical to your patient's welfare or your profession's future. You will need to know your stuff and be willing to go out on a limb to make what needs to happen, happen.

"We will be knocking on big doors," Cleveland told her audience. "These doors will not open by themselves, therefore we will knock loudly. We cannot practice business as usual. Knocking on these doors will take some of us out of our comfort zones."

Knocking on these big doors "means that many of us have to step up into leadership roles in our profession and in society."

Rather than looking up to our heroes, she added, "we would benefit more by looking into them, emulating them. If each one of us does our part, then many of these doors will open."

The doors she describes are the power brokers of other organizations whom OT needs to convince of its value. They include professional and consumer organizations whose goals and approaches to health intersect with ours. The doors are also those belonging to state and federal lawmakers and administrators who have the power to put us on solid footing.

In the past few years, AOTA has partnered with several such organizations in mental health and services for the aging, in particular. It will continue to pursue such partnerships. The national association is also partnering with the National Institutes of Health to revise its research agenda along the lines of national priorities in societal health issues.

"Your leadership story might be to promote the value of OT each and every time you encounter a new client and his or her family," Cleveland said of OT and OT practitioners, "reinforcing what you are bringing in terms of your knowledge, perspective and skills and most importantly, how those differ from the other professionals providing services to this client...your strategy might be to make sure your colleagues really know and understand OT...

"When OT says the impossible is possible, we are helping people live life to its fullest. We go forward with the message that living life and occupational therapy are inextricably intertwined."

The Annual Business Meeting

2008-04-13T06:53:00Z

The 2008 business meeting of the American Occupational Therapy Association took place in Long Beach on Saturday, with reports from AOTA officers and executive director Fred Somers.

AOTA ran in the black for the third year in a row in fiscal 2007, with nearly a $200,000 profit, showing a strong comeback since its 2004 fiscal low point. Membership dues still account for about 37 percent of its $15.9 million revenues. Conferences brought in 15 percent of the revenue. This year more than 5,500 registrants attended the national conference, including 354 exhibitors. Registration was up by 600 over the2005 Long Beach conference.

Last year AOTA spent about $15.8 million, with professional development programs and publications expenses accounting for more than 50 percent of expenditures.

A review of AOTA headquarters' compliance with ADA standards has been completed, and and the board received a final report on it in February. Results are available at aota.com.

Indiana licensure for OTs and the regulation of OTAs in Virginia capped the organization's advocacy efforts in fiscal 2007, but AOTA is asking for an immediate response from its members and non-member practitioners to contact their federal legislators to push back the June 1 extension for re-implementation of the cap on outpatient therapy reimbursement. AOTA is asking for an 18-month extention, hoping to permanently repeal the measure.

A full report on the business meeting is available on the AOTA Web site. ADVANCE will offer a more detailed analysis in print shortly.

It wasn't money the RA wanted

2008-04-12T05:15:00Z

Each year the RA challenges its members to individually support the AOT political action committee (PAC), the organization that funds AOTA's lobbying, both on Capitol Hill and within the states as requested and needed. Each year many RA members rise to the challenge. But until lately, the assembly has shied away from requiring such support. The debate is a legitimate one: should the congress of AOTA state representatives make it a part of a rep's job responsibility to donate personal money to the cause?

Over time, the debate has boiled down to an argument over whether leaders in the profession should, so to speak, put their money where their mouths are. The donations are always anonymous to the public. It's not a matter of putting anyone on the spot. Nonetheless, the word "require" sends up a red flag to many free-minded people

I have to admit that as a journalist, I am one of those people. When the inevitable annual motion to set this in stone comes up, my first reaction is to say no. It should be a personal decision. This smacks of dictatorial reasoning.

But suddenly, Friday morning when the motion came up, something opened my eyes. It lifted me above my rebellion. I saw there was another side to this story that goes beyond loyalty and role modeling. It lies in the very real power of purpose. OTs and OTAs see that power at work every day in their professional lives. It is the wellspring of the ordinary miracle. The visions of the future that therapists help their patients/clients see and achieve, come to fruition because people are more than the sum of their parts. Once an individual or group of individuals recognizes that fact, he learns to trust in the force behind it. Psychologist Carl Jung would call the font of that power the universal consciousness. Others call it spiritual grace. But it doesn't really matter what you call it - it is a universal law that bread cast upon the waters returns.

It will take much money and effort to bring the Centennial Vision to reality. The RA is asking that its members take a leap of faith. If we succeed by 2017, it will not be because we made all the right moves, dodged all the bullets or saw the future with a clear eye. It will be because our faith in our purpose was strong enough. And we'll have to sacrifice - pay a price - for what we desire. That is the message of life.

The RA passed the requirement for 2008 Friday morning; but even before it did, I could tell that I wasn't the only one who had sensed the truth. There was 100 percent donation. It was an a-ha moment. I hope we see a lot more of those.

- E.J. Brown

Slagle Lecture: Assessing Assessments

2008-04-12T04:22:00Z

Earlier tonight, Dr. Wendy Coster of Boston University delivered the Eleanor Clark Slagle Lecture to a crowded auditorium of occupational therapy practitioners. The Slagle Lecture is always dense and thought provoking, and this year was no exception. Dr. Coster's talk was titled "Embracing Ambiguity: Facing the Challenge of Measurement." Coster has worked on several assessments, including the Pediatric Evaluation of Disability Inventory (PEDI) and the School Function Assessment (SFA).

Her premise: many of the assessments available today, especially those taken from outside OT, do not always tell the full story of OT clients. One must carefully determine whether the assessment accurately reflects what it is one is trying to measure. For example, the SF-36, a gold-standard assessment of health-related quality of life, asks whether a client's health limits him from performing certain activities. A client who recently had a stroke may answer affirmatively to many of the questions, but a client with congenital cerebral palsy may not see his chronic condition as a health limitation; rather, it is just part of who he is and has been for as long as he can remember. One must look with a critical eye at assessments, whether using them in one's own practice, or considering research that makes assumptions based on assessment results.

OTs must be conscientious of the assessments they choose to use, critical of research that bases determinations of a treatment's effectiveness on assessment results, and active in developing assessments that can accurately tell a client's full story. Many things can hinge on an assessment -- a client's eligibility for services or funding, for example. OTs need to be sure that clients are not being deprived and that OT practice is not being restricted based on the results of assessments that are not appropriate for the situation at hand.

ADVANCE will feature a full analysis of Dr. Coster's Slagle Lecture later this spring. In addition, the full text of the lecture will be published in the archival issue of the American Journal of Occupational Therapy at the end of the year.

Imagining the Possibilities

2008-04-11T06:12:00Z

Possibilities are the theme of this year's AOTA conference, and the message was in no short supply at the Opening Ceremony earlier today in the Long Beach Convention Center. AOTA President Penny Moyers Cleveland told the audience that with a strong profession and a strong association, there were no possibilities that occupational therapy could not make reality.

Keynote speaker Warren MacDonald put a face on the message of possibilities. MacDonald suffered the loss of both his legs to amputation after they were crushed in a freak rock climbing accident. Only 10 months later, he sat atop Australia's Cradle Mountain. "When you change the way you see the world," he told the captive audience of thousands of OTs, "you change the world."

Of course, the ceremonies were full of festivity as well. The opening act, a local band called Ready Freddie, had OTs dancing in the aisles (it wouldn't be an AOTA conference if OTs weren't dancing in the aisles!) to R & B favorites. One of the things that truly makes OT unique, in my opinion, is that at conference you see even the most prestigious leaders of the profession dancing alongside OT students and practitioners. Everyone is equal, and everyone is fully engaged in the occupation of having fun!

After the opening ceremonies, attendees packed the exhibit hall to visit with the 350+ exhibitors who have their products and services on display (including tons of possibilities for job seekers). ADVANCE's booth was packed early on as attendees came to check out all the OT gear available through the ADVANCE Healthcare Shop.

For photos of the evening's events (including plenty of shots of OTs shakin' what their mommas gave them!) head over to our photo galleries and take a look at our AOTA Day 2 photos.

RA Moves to Strengthen Physical Rehab Education

2008-04-10T21:17:00Z

Motion 1 was a hot topic on AOTA listservs prior to the conference. The motion asked the Representative Assembly to create a committee to establish competencies in upper extremity rehab for entry-level practitioners. While Motion 1 was defeated earlier today, the RA took three subsequent actions to support occupational therapy's role in physical rehab and strengthen the focus on core sciences and practice skills in this area in OT school curricula.

Part of the rationale behind Motion 1 was a perception that current OT students and new practitioners are not well-enough prepared in core sciences like anatomy and kinesiology, as well as in hands-on skills like splinting and manual muscle testing. The American Society of Hand Therapists had disseminated a survey to its members prior to the conference regarding students' preparation in these areas; more than half of the roughly 1200 respondents said they were seeing problems in this area, according to information that was discussed by Motion 1's originators during task group deliberation on this issue.

The task group decided to defeat Motion 1, with the originators' agreement, because they felt that a committee to develop competencies in this area was not the best way to address the problem at hand.

The three actions the RA took were:

1) To have AOTA staff develop a fact sheet on occupational therapy practice in the physical rehabilitation of the upper extremity, due by the fall online RA meeting - this would help AOTA staff as well as therapists to establish the role and expertise of OTs in this area when working with payers and addressing professional encroachment issues.
2) To recommend to the Blueprint for Education for the Future committee to recommend course content to retain excellence in physical rehab - the Blueprint committee, the second phase of the Model Curriculum committee, will be developing specific competency and course content recommendations that will reflect excellence in occupational therapy practice.
3) To have AOTA staff deliver to OT program directors a presentation on the state of education in the core sciences - since ACOTE's Standards already address competencies in physical rehab and UE skills, the task group questioned why students aren't being adequately prepared in this area. They felt a presentation to program directors on the importance of education in this area would help ensure that faculty are not just teaching this content, but teaching it thoroughly and in ways (for example, hands on labs as opposed to Web-based modules) that will better ensure new practitioners' competence in applying these skills in the clinic.

The full text of Motion 1 is available on AOTA's Web site on the RA page; the listserv discussion on the motion is available on AOTA's Physical Disabilities Special Interest Section forum. Both require AOTA membership to access.

RA Passes Voluntary Credentialing for Fieldwork Educators

2008-04-10T18:59:00Z

The RA has passed the motion to implement a voluntary credentialing fieldwork educator (VCFWE) program. The motion requests that an initial training program be implemented at the 2009 AOTA conference.

The task group who worked on the motion felt that the program should be urgently addresses and therefore moved up the timeframe which reflected a substantial financial savings for AOTA.

The VCFWE program was developed on a train-the-trainer model and includes a two-phase plan for implementation. The program provides a mode for best practice for fieldwork educators.

For more information on the VCFWE program, please see our story, A Big Investment.

Representative Assembly Passes SSSIS Name Change

2008-04-10T17:45:00Z

After 3 years of ball tossing, the 2008 RA ahas just pproved a name change that will add EI to the name of the School System Special Interest Section.

It happend a few minutes ago, after some discussion, and against the recommendation of the task group that discussed the issue yesterday afternoon.

The new name of the SIS will be the the School System and EI Special Interest Section, nomenclature meant to clarify that practitioners who treat children from birth thorugh age 3 and a half (entering pre-school) are qualified and actively doing so in the OT profession. It will also give these practitioners a definie "home" among the special interest sections.

On a standing vote, the assembly ended more than 2 years of discussion over the issue, precipitated by the fact that there are distinct differences between the two practice settings; most EI practitioners treat in the child's home. They may or may not use sensory integration as their primary approach to treatment, and they also have to educate parents in handling their young children.

The task group had recommended defeat of Motion One, brought by SIS chair Barbara Chandler, in line with a planned upgrading of the name that was part of a strategic planning process of the section. It has moved through the RA three times, each time running into questions as to whether this was the "brst" SIS to represent EI practitioners. Chandler noted that EI operates under Part C of IDEA, even though therapists are paid by several different entities. EI was iidentified as being included whent the school system section was organized a number of years ago.

The task group had made no substitute motion, but outlined several rationales for allowing EI practitioners to work toward their own group by using the newly-created EI listserv, supported by the old SSSIS, the Sensory Integration Special Interest Section (SISIS) and the Developmental Disabilities Special Intereset Section (DDSIS). The process would have taken several years

ASAP Rep. Rebecca Argabrite-Grove reminded the assembly, "This is the third time this has come before us We just keep dragging our feet on it. I don't feel that it leaves out people practicing in the NICU."

Nancy Scott (MN) agreed. "I see this as a way of attracting more therapists to AOTA," she said. The new SSEISIS will now begin to look for more resources for those in EI practice.

AOTA Conference: Just Gettin' Started

2008-04-10T00:56:00Z

Registration officially opened this morning at the Long Beach Convention Center! While early birds could be seen picking up their name badges and wondering the grounds of the convention center and conference hotel (the Hyatt), the majority of attendees won't arrive until tomorrow for the opening ceremony, keynote speaker and the grand opening of the exhibit hall.

Pre-conference institutes and seminars included Train the Trainer: Education Competencies for Fieldwork Supervisors; CarFit Technician Training: OT's Role in this Community Event; AOTA Board Certification and Specialty Certification: Who, What, When, Where, How...HELP!; and several others.

The American Occupational Therapy Foundation (AOTF) held a Japanese Garden Tour and Lunch on the Long Beach campus of California State University to support the foundation's research and educational programs. Participants toured the Earl Burns Miller Japanese Gardens and learned the art of origami and bonsai.

The Representative Assembly convened bright and early this morning to discuss new business and then broke into six separate task groups to hash out motions that will be presented at the RA meeting beginning tomorrow. The groups worked diligently into the evening, some on into the night.

The ADVANCE team will bring you timely coverage of the RA's meeting, so be sure to check in with our blog over the next few days. We will also be adding photos daily on our conference photo gallery, which you can find on our homepage.

And if you are in Long Beach, be sure to share your own conference experiences in our forum and to send your photos to us at jlagrossa@merion.com!

All our bags are packed!

2008-04-07T19:09:00Z

We at ADVANCE have packed our many, many bags and are ready to go to Long Beach for AOTA's national conference! We look forward to bringing our readers all of the latest conference coverage daily live from Long Beach. Check out our Web site at www.advanceweb.com/ot for up to the minute commentary on conference activities.

Coverage will include:

Daily photo galleries
Live conference blogs
Conference forum discussions

Come find us in the exhibit hall at booth 804. We'd love to meet you in person!

And don't forget to tune in from home after the conference for even more, including:

"Conference Experience" videos
Photo galleries of your photos and conference stories/experiences
Surveys

Court Rules in Autism-Vaccine Case

2008-03-06T21:41:00Z

The news spread like wildfire today among the health care industry and autism circuits:

The US Department of Health and Human Services has ruled in favor of the family of 9-year-old Hannah Poling of Athens, GA, entitling compensation from a federal vaccine injury fund. Government health officials conceded that vaccines "significantly aggravated" Hannah's underlying mitochondrial disorder and led autism-like symptoms.

For more information, read:

Government Concedes Vaccine Injury Case

First Autism-Vaccine Link: How Hannah Made History

The family held a press conference in Atlanta today and will be appearing tonight on Larry King Live.

ADVANCE first reported on the first test case for a larger group of autism-vaccine claims-the Omnibus Autism Proceeding in the US Court of Federal Claims-in June of last year. That article can be read here.

The most recent update in the U.S. Court of Federal Claims was filed on Jan. 17 and divulged the following:

* Currently, there are 4,900 petitions in autism cases pending, all dependent upon the Omnibus Autism Proceeding (OAP).

* Additional petitions are always being filed.

* The first set of three test cases was presented in the OAP for the first of three varying theories of general causation-the theory that MMR vaccines and vaccines containing thimerosal combined can cause autism.

* Test cases for the first theory include first test case Cedillo VS HHS, no. 98-916V (began in of June of 2007); second test case Hazelhurst VS HHS, no. 03-654V (began in October 2007); and third test case Snyder VS HHS, no.01-162V (began in November 2007).

* Evidentiary hearings for all three cases in the first theory as well as opening briefs have been conducted. Additional briefs are forthcoming. A written ruling will be made once all additional briefs have been filed.

* Test cases for the second general causation theory-the theory that vaccines containing thimerosal alone can cause autism-were identified early this year and include first test case Mead VS HHS, no. 03-125V; second test case Krakow VS HHS, no. 03-632V; and third test case King VS HHS, no. 03-584V.

* An evidentiary hearing for the three cases for the second theory of general causation is scheduled for May 12-30 of this year in Washington, DC.

* Test cases for the third theory-the theory that MMR vaccines alone can cause autism-will be identified by May 5 of this year with an evidentiary hearing scheduled for Sept 15 in Washington, DC.

Parties have been instructed to complete evidentiary hearings for all test cases for the second and third theories by Sept. 30, 2008.

(The full report can be obtained here.)

"Where would you go if you’d never been away from home?"

2008-02-04T19:08:00Z

15-year-old Darius Weems, who had never left his hometown of Athens, Ga, knew exactly where he wanted to go when asked. West to Los Angeles.

Born with Duchenne Muscular Dystrophy (DMD), the most common fatal genetic disorder to affect children worldwide, Darius has lost all use of the muscles in his legs and is dependent upon a wheelchair to get around. In 1999, he lost his beloved older brother, Mario, to the same disease at age 19.

A group of Darius's college-age friends, who knew Darius needed a chance to experience life to its fullest, rented a wheelchair-accessible RV and took Darius, "on the adventure of a lifetime". Darius and his friends traveled 7,000 miles cross-country to LA and along the way evaluated wheelchair accessibility in America. Also while on the journey the group celebrated the 15th anniversary of the Americans with Disabilities Act (ADA) and raised awareness of DMD. Their adventures were made into a documentary--Darius Goes West: The Roll of his Life.

Darius--who had never seen mountains or the the ocean--ultimately wanted to convince MTV's hit show "Pimp My Ride" to customize his wheelchair while in LA. While he never made it on the show, he and his buddies don't feel defeated. Instead, they "found joy, brotherhood and the knowledge that life, even when imperfect, is always worth the ride."

Appearing in film festivals around the world, the documentary has won 25 awards to date.

The DVD is now available for $19.99 here.

To read more about Darius and the documentary, check out our online top story, Darius Goes West.

OT in the New York Times!

2008-01-18T19:56:00Z

I don't know Jodi Levin, but I admire her. She's featured in a recent article in the New York Times on January 15 entitled "Coaching the Comeback." The article describes Ms. Levin's role on the brain injury unit at Kessler Institute for Rehabilitation in West Orange, NJ. Now matter how her patients come to her - some are accident victims, some reacted badly to drugs, some are drunk drivers - she treats each one with the same care and dedication. I know that's her job, that is her ethical obligation as a medical professional, but its not always easy to give someone your all when you don't agree with the choices they've made.

I'm glad author Jan Hoffman chose Jodi for her article--she really represents the best that occupational therapy has to offer. The article also portrays the challenges that patients with brain injury, and their families, face every day. That even just being able to hold up his head, or say hello, can be a victory for a patient. Onlookers who see patients counting coins or sorting plastic utensils often don't realize that these seemingly simple and mundane tasks would be impossible for patients without the work of OTs. Thanks to Ms. Hoffman for doing such an excellent job of depicting the role of OT in brain injury rehabilitation. I encourage OTs out there to share this article with friends, patients and their families to help promote a better understanding of what occupational therapy has to offer.

Stardate 2012: The World of SPD

2007-12-03T15:32:00Z

The Dec. 10 edition of Time.com had a great piece on sensory processing disorders that outlined Lucy Jane Miller's ongoing attempt to get enough research on the books to put SPD into the DSM V, that's due out in 2012. Some of the newer research is interesting, and it's not being done only by OTs. In the article, psychology professor Alice Carter of UMass-Boston, who is conducting her own research on SPD, believes it might be added to an appendix in the DSM V that lists disorders worthy of further study. But the manual is updated only once a decade, so that would be it until sometime in the 2020s.

The author of the Time article, Claudia Wallis, talked about the "parallel universe of occupational therapy." What a neat quote! Here's the link to the story:

http://www.time.com/time/magazine/article/0,9171,1689216,00.html

OT Song

2007-11-06T18:47:00Z

I love youtube.com-what a terrific way to pass the time I don't really have to waste! I stumbled across a great song about occupational therapy a few months back that I knew our readers would love but didn't have a way to share it. But thanks to the blog I can now post it here. I hope you all enjoy it as much as I do. Share it with your OT friends, coworkers, patients, etc!

Cheers,

Jessica

The Occupational Therapy Song (top), and The Redo (learn to play the song-bottom):

Download the mp3 here for only 99 cents!:

http://www.boazandtheband.com/id1.html

LYRICS

I woke up this morning
I couldn't even get out of bed
I stumbled on my feet to brush my teeth
and I didn't have the strength...to find my sink

(chorus)
It sounds like I need some OT
It sounds like I need some OT
It sounds like I need some occupational therapy

So they dragged me out of bed
To do some therapy activity
To bake a cake and fold some clothes
They told me I can't go home
unless I'm safe when I'm alone
It looks to me instead...that someone is just lazy

(chorus)
It sounds like I need some OT
It sounds like I need some OT
It sounds like I need some occupational therapy

So if you find yourself putting on your t-shirt wrong
or sometimes wondering if you've left your stove on
Lets make it very clear...You don't need physical therapy

(chorus)
It sounds like you need some OT
It sounds like you need some OT
It sounds like you need some occupational therapy
lalalalalalalalala

Now wait a minute, is there a speech therapist in the house?

(chorus)
It sounds like you need some OT
It sounds like you need some OT
It sounds like you need some occupational therapy

Sometimes we forget about that other therapy
we always seem to think physical therapy
but without OT, people are going to think...and would be stinky

So thank you, OT
For all you do, thank you
Thank you, thank you occupational therapy

You need some OT? You know you do!
Who's the vice president?
You need some OT? Your shoelaces are untied
You need some OT? Your fly is open
You need some OT? You know you want some?
You need some OT? You know you do.