Every year since 1955, an occupational therapy leader has been honored to give the Eleanor Clark Slagle lecture at the AOTA annual conference and expo. Slagle was a pioneering occupational therapist, co-founding the National Society for the Promotion of Occupational Therapy in 1910, and a dedicated social activist, working with Jane Addams at Chicago's famed Hull House.
This year the honor went to Maryalynne D. Mitcham, PhD, OTR/L, FAOTA, of the Medical University of South Carolina. On Friday, April 4, Mitcham gave attendees-including some vocally supportive MUSC students-her talk: "Education as Engine."
Barbara Hooper, PhD, OTR/L, FAOTA, and a former student of Mitcham's, introduced her, saying "For the better part of her illustrious career, Dr. Mitcham has been steering occupational therapy along various routes. Hooper told of another former student, who wrote to Mitcham. "Each and every day, I strive to engage my students in meaningful ways like you engaged me."
Mitcham explained the genesis of her lecture topic. "An engine creates a great image for an entity that creates power-power to transmit, power to transfer and power to transform." At its best, occupational therapy education does all three. But first, Mitcham cautioned, "We need to put together the raw materials to encourage common success."
"My goal was to promote the best learning practices." She admitted that graduates need to acquire more than new knowledge, as that is never-ending. To truly serve its students, OT education needs to offer both the cognitive hard skills needed to strive in any digital context, and the soft skills to communicate, collaborate, connect, and create.
Yet educators must be careful of piling on too much, Mitcham cautioned. "We don't know how to save ourselves from the incessant urge to add one more thing to our curriculum," she said to laughter. OT schools need to equip students with better problem-solving skills rather than cram in every possible theory and case study. "The challenge is to do more thinking, more debating, and more discussing." And as the age gap between the OT professors and the OT students widens, the professors must become adroit at crafting learning for different recipients.
"Occupation needs to be at the core of the profession. Nobody does it the way we do," summed up Mitcham.
"I am honored and to stand before you as the 29th president of the AOTA." So said Virginia "Ginny" Stoffel, PhD, OT, BCMH, FAOTA to a crowd at the 2014 AOTA Annual Conference and Expo on Friday, April 3rd. Her presidential address was called, "Attitude, Authenticity and Action: Building Capacity."
"There is no question about the power of attitude," she said. For occupational therapy clients, attitude creates the emotional fortitude to pursue well-being. Clients fill many roles-parent, child, employee, employer, etc.-and need to be clear about what matters the most to them. "We facilitate reflection on what makes life worth living," Stoffel explained.
She went on to define the 6 emotional styles that affect attitudes and by extension, how client's deal with their recoveries. Resilience is how fast one recovers from adversity. Outlook is the capacity to remain upbeat. Social Interaction is the consideration of non-verbal cues. Self-awareness is being highly conscious of one's inner thoughts. Cultural Sensitivity is being aware of societal expectations. Attention is the ability to screen out distraction.
"Attitude affects perception. We start by offering unconditional support and acceptance of each person."
Occupational therapists must understand each client's lived experiences in order to be authentic.
Authenticity is an important aspect of heartfelt leaderships. It can be defined as "being true to oneself in spite of outside pressures."
It's clear that people have better health and quality of life when they are involved in meaningful occupations. Authenticity means understanding the person, environment, and occupation interaction. Occupational therapy can re-open the door to new possibilities. "We beget real-life change and authentic working relationships."
Attitude and authenticity lead to great philosophical discussions, but are incomplete without action. "We are a profession that is ready to roll up our sleeves," said Stoffel. OTs are no longer content to let other disciplines take the lead when it comes time for health policy discussions. "AOTA is building bridges by focusing on the value OT brings to primary care."
At last year's Capitol Hill Day, 750 AOTA members, representing 34 states, came to Washington, D.C. to lobby Congress. Additionally, members sent their Senators and Representatives over 1300 pro-occupational therapy letters in one day alone.
To support finding new directions for occupational therapy, the AOTA and the AOTF partnered together to give 5 researchers $50,000 grants. Those grants will support the Centennial Vision goal to be science-driven and evidence-based. The researchers will focus on autism and healthy aging, areas that have been identified as health priorities.
"We can do together what neither of us could do alone."
Baltimore, April 4, 2014-You may have seen a commercial featuring a bunch of guys playing wheelchair basketball. At the end of their game--which featured all the good-natured trash-talking typical of the scene--all but one of the guys gets out the wheelchairs. As this is a commercial for Guinness, the next scene shows the group at their local pub, sharing a laugh, a pint, and most of all a common bond. Although it is a beer commercial, Virginia "Ginny" Stoffel, PhD, OT, BCMH, FAOTA, current president of the AOTA pointed out that it could very well be a commercial for occupational therapy.
She showed this commercial at the Welcoming Ceremony and Keynote Address Thursday, April 3 at the 94th Annual AOTA Annual Conference and Expo. Although those men are actors, not soldiers, it exemplified the theme of the address, "The Wounded Warrior and the Art of Independence."
Stoffel said, "Occupational therapy is the key to providing hope for wounded warriors and providing for their reintegration." That message was exemplified by three extraordinary speakers. In front of a packed ballroom at the Baltimore Convention Center, Stoffel hosted a conversation with Sgt. Travis Mills, Sgt. Monte Bernado, and Corp. Tim Donley. All three were severely injured by IEDs in the Iraq and Afghanistan wars. Donley lost both legs below the knees; Bernado also lost both legs and one hand; Mills is one of only 5 Afghanistan soldiers to survive becoming a quadruple amputee.
Also present was Major Eric Johnson, MS, OTR/L, the first occupational therapist to deploy with a combat brigade and noted researcher on the field of combat TBI, who was one of their OTs at Walter Reed National Military Medical Center.
Stoffel asked Mills, Bernado and Donley what was their biggest fear after their injuries? Mills confessed to his fear of not being able to take care of his family. Bernado spoke of the feeling of helplessness. Donley feared never being able to make a contribution to society.
Luckily for them, they had dedicated and skilled OTs. When Stoffel asked what occupational therapy meant to them, Mills said, "OT taught me a new way to do things." He recalled the story of how his OT made a splint and an adaptive spoon, teaching him how to feed himself.
Bernado described himself as independent and mechanically-oriented. "Therapy opened all these doors to the way my life was before. My OT and this hand there (he waved his prosthetic hand) have done that for me. There's nothing I can't do."
Donley echoed the door theme. He remembered feeling humiliated that is family and friends had to take care of him. "Major Johnson opened a new door to make me feel independent again."
Occupational therapy, of course, is all about returning clients to function. Mills said, "I'm not a sob story. I can get through life easier." He's grateful his OTs forced him to do the work and did not feel sorry for him. That tough love was the lesson he wanted other occupational therapists to take from his experience.
Bernado reminded the OTs in attendance, "It's not just a job. You're making our lives, our lives again."
Donley summed up the sentiments of all three wounded warriors and the thousands of OTs, OTAs and OT students at the conference. "OTs, they're changing the world for the better every day."
Baltimore--Today's session "Centennial Vision Progress and Issues Facing the Profession," followed a town hall format as AOTA leaders Virginia C. Stoffel, PhD, OT, BCMH, FAOTA, Amy Lamb, OTD, OTR/L, FAOTA, and Frederick B. Somers answered audience questions. The following are some of the thought-provoking questions and equally thought-provoking answers.
Q: How is the AOTA going to help people who may have evidence from their clinics but don't know how to present research?
A: The AOTA is looking to create a national database of research data. They're refining the evidence-based practice section of their website and encourage clinicians to visit. The goal is to have more tools for researchers. As Stoffel said, "We must use the best tools to move forward."
Q: Is there discussion around changing the entry point for OT education?
A: On that matter, there are continuing discussions planned around different people's perspectives. After conference, the AOTA Board of Directors plans to open a dialogue to consider if the OTA entry point should move from a two-year degree to a bachelors' degree. The speakers asserted that this is a work-in-progress with much to be evaluated.
Q: How can I bring the centennial vision to my practice?
A: Develop a network of people you can lean on. Define what aspects of the vision speak to you and match your professional expertise. Then go be powerful and promote it. "As a new practitioner resist the urge to let someone burst your bubble. You know what's right and the best way to practice," said Lamb.
Q: How can we have good quality outcomes when clinician attendance is on documentation and not their patient?
A: AOTA is working to help clinicians understand those mandates. We must move from a problem-centered orientation, asking "What is the matter with you?" to a person-centered orientation, asking, "What matters to you?" Leaders from AOTA met with leaders of APTA and ASHA to discuss current guidelines for therapy practitioners and to consider if they need to be adjusted. No conclusion was made, but more conversations are encouraged.
Stoffel called on audience members to wear their ambassador hats. "We must be purposeful in how we promote occupational therapy." She reminded the audience, "OT brings a unique value to individuals and organizations.
"The absolute best advertisement for OT and our value is our everyday practice," concluded Lamb.
Baltimore--On Thursday, two OTs from Ohio State tackled an area where occupational therapy is under-utilized--transition planning. In "Job Matching for Individuals with Intellectual and Developmental Disabilities," Andrew Persch, MS, OTR/L and Dennis Cleary, OTD, MS, OTR/L talked about how to best prepare people with disabilities so they are prepared for when they reach age 21 and age out of the public school system.
"We haven't done a good job advocating for our place at the transition planning table," said Persch. With federal law mandating transition planning at age 16 and people with disabilities entitled to occupational therapy under IDEA, OT and transition planning should be a good match, considering occupational therapy's goal of helping people across the lifespan. He called transition planning, "A huge opportunity for is to interfere in a meaningful way with those who need our services."
Two ways that opportunity is being met are Project SEARCH and the Vocational Fit Assessment. Both operate on the premise that students' ability to self-determine is the best predictor of a successful adult life. A client's interest in a particular line of work, their willingness to learn, a natural support system, and honest expectations about their abilities are the core of transition planning.
Project SEARCH is a national internship program that matches businesses with adults with intellectual and developmental disabilities by capitalizing on their unique skills. One client with OCD and autism got a job sterilizing the bassinets in a NICU. His laser-focused attention to detail is ideal for that task.
The Vocational Fit Assessment was developed at Ohio State as a formula to better match up a job's demands with the worker's needs. Researchers create profiles for different job possibilities and profiles of people enrolled in the program. Using a green, yellow, red motif--green meaning the worker his a high ability in a certain area, yellow meaning the worker needs additional training in a certain area, and red meaning the worker has little or no ability in in a certain area--the VFA presents a colorful chart of all possible job matches.
The goal is to improve long-term outcomes for individuals with disabilities. Just like all of us, if they are engaged in their work, they will do well.
Baltimore-- A panel discussion this afternoon at the AOTA annual conference focused on how occupational therapists can help children with disabilities and their parents transition between different parts of their academic lives.
The opening part focused on the transition from early intervention to preschool. One of the major changes is the transition from the family-centered practice of EI, where the family's priorities help set the OT goals for the child, to the school-centered practice, where the classroom needs help set the OT goals. Although EI services formally end at three-years of age, the panelists recommended early intervention therapists have earlier, honest conversations with parents about children's expectations and the options for preschool education. "We look at all developmental domains and help parents make good decisions. Positive working relationships between service providers and family members is the most crucial factor in successful transitions to inclusive environments for children with disabilities," said Christine Myers, PhD, OTR/L, Eastern Kentucky University.
In the second part of the talk, speakers shared that parents of children with disabilities are more nervous than parents of typically developing peers about the transition from preschool to kindergarten. These fears are not unfounded. Unlike the EI to preschool move, which is governed by strict regulations, no laws oversee this big change for five-year-olds. Moving from the informal, learning-by-play environment of pre-K to the formal, structured environment of kindergarten, with larger class sizes, is a challenge for any young child, yet alone one with special needs.
Occupational therapists can ease this transition by seeking the collaboration of everyone the child will come into contact with--general education teachers, paraprofessionals, physical therapists, speech-language pathologists, school administrators, and so on. One school district started a program called Jump Start in which the entering kindergarten class comes to school one week in August. The children meet their teachers and get familiar with the building and school routines in a safe, closed environment. Just as with the early transition, positive communication between OTs and parents is paramount to helping these kids move successfully onto the next phase of their education.
Baltimore--At the Baltimore convention center this morning, occupational therapists and occupational therapy students presented on a variety of research topics spanning the gamut of patient ages and conditions.
Long the purview of speech-language pathologists, augmentative and alternative communication devices have begun to infiltrate OT's practice. Maura Regan, BS, OTS of the University of Scranton looked at whether High-Tech or Low-Tech AAC does a better job at improving communication among non-verbal children with autism or PDD-NOS. Regan's poster presentation consisted of literature reviews of existing studies on the topic. She found, when applied to the overall population, there is no discernible benefit to using a low-tech option, like a picture board, versus a high-tech, computerized model. Regan concluded that child preference is the best way to select the appropriate device, adding sometimes the child will use one kind at home and another kind at school. For her part, she would like to work with children with autism after graduation, so this research project played into that goal nicely.
In another presentation, Maneshka Perera, MS, OTR/L and Nandita A. Singh, MPH, OTR/L discussed a collaborative rehab program they have with physical therapy at Rusk Rehabilitation at NYU Langone Medical Center. An OT and a PT co-treated spinal cord injury patients that were not as functional as they could be. Using low-tech methods of gait belts and exercise balls, Perera, Singh, and their colleagues where able to re-engage muscles with manual techniques. In just 8 visits, some patients saw extreme functional outcomes. One patient cited being able to transfer from his bed to his wheelchair without assistance--an improvement both physically and for his self-esteem. As occupational therapists, they are able to translate this research into setting new, functional goals to help these and other SCI patients with their ADL's.
Deirdre R. Dawson, PhD, OT Reg and her colleagues at the University of Toronto researched an elemental aspect of all our lives--music. In a currently ongoing study, they are observing unilateral, first-time stroke victims to see if making music can improve their recovery. Over the course of 15 visits, the patients play the drums for gross-motor skills, play the keyboards for fine-motor skills, play the bongos for a more complex mental and physical coordination task, and listen to popular songs to engage their memories. So far, the researchers have seen an improvement in executive functioning, motor skills, and mood. One patient observed that his stroke had less of a negative effect on his life since his participation in the music group.
Thus were just a sampling of the innovative research being done by OTs. Be sure to stop by CC Ballrooms I and II if you're at the AOTA annual meeting and learn more about the cutting edge of the profession,
It's that time of year again! From April 3-6, over 5,000 OTs, OTAs and OT students will descend on Baltimore for the 94th AOTA Annual Conference and Expo. "Charm City" promises to be a gracious host for those rehab professionals.
After a day of intense pre-conference workshops on April 2, the event kicks into full swing. The schedule is packed with short courses, long courses, research presentations, and poster presentations. From children and youth to mental health to work and industry, there is sure to be a category of event that fits your professional goals.
On April 3, at the opening keynote, "The Wounded Warrior and the Art of Independence," three wounded service members will share their personal occupational therapy success stories. Newly elected AOTA president Virginia Stoffel will present the annual Presidential Address on April 4: "Attitude, Authenticity, and Action: Building Capacity for Occupational Therapy."
Each year, a highlight of the AOTA conference is the Eleanor Clarke Slagle lecture. The award honors an occupational therapist who has contributed to the body of knowledge of the profession. This time, Maralynne D. Mitcham, PhD, OTR/L, FAOTA, of the Medical University of South Carolina, will speak on "Education as Engine."
The annual meeting is a time for occupational therapy professionals to honor their own. The awards ceremony on Saturday, April 5 will highlight the best and the brightest from both the AOTA and the American Occupational Therapy Foundation. Who will win the Award of Merit, the Writers' Awards, the Roster of Honor Award, and the AOTF Meritorious Service Award?
Yet it's not all lectures and classes. OT students can mingle at Students Unconferenced on Thursday night. Early birds can partake in a free Friday morning Pilates session or a Saturday morning 5K around the Inner Harbor. And put on your dancing shoes and raise a glass Friday night at the AOTA gala at the American Visionary Art Museum.
And of course, the exhibit hall is a major part of the conference. Approximately 350 exhibitors will be presenting their products and services, so be sure to carve out some time to walk through. ADVANCE will be in booth 218, so stop by to renew your magazine subscription, pick up the latest issue and purchase one-of-a-kind OT gear from the ADVANCE Healthcare Shop. You might even run into staffer Danielle Bullen.
Yes, ADVANCE for Occupational Therapy Practitioners will be on site in Charm City. Be sure to return to the ADVANCE Outlook blog during and after the conference and keep up with us on Facebook and Twitter to get the latest news from the Inner Harbor.
See you there!
In this season of giving thanks, ADVANCE has so much to be grateful for. Besides the rewarding response we continue to receive for our dedicated print reporting on the rehabilitation profession, our efforts to expand web and social media coverage have engaged record numbers of readers and fans.
Just as the rehab profession is constantly evolving and reacting to new developments, so too is the journalism profession. We at ADVANCE take pride in our ability to push the cutting edge, offering our community of rehab professionals vital information about the profession you love, while providing opportunities to share your thoughts on these developments through our various interactive platforms.
On our website this month, keep an eye out for Top 10 lists of the most popular blogs and app reviews from 2013 -- which continue to build followers as two of the most popular departments ever offered by ADVANCE. We'll also be showcasing Top 10 lists of the year's best features, multimedia and Student Center articles.
Finally, we want to thank you. Without our tens of thousands of dedicated print readers, hundreds of thousands of web fans and talented contributors too numerous to name, none of this would be possible. We rely on you for interviews and freelance contributions, guest editorials and reader comments.
Your feedback and participation are what enable ADVANCE to keep our fingers on the pulse of the rehab profession. Your passion for that profession inspires us every day. So to all of our readers and fans across the country and around the world, cheers to a great 2013 and here's hoping for an even better 2014!
I did it. On Sept. 15, I attempted and completed my first-ever 13.1-mile race -- the Philadelphia Rock ‘n' Roll Half-Marathon. Although I've been running since I was 13, this particular accomplishment meant a lot to me because my ability to run has been hampered for about 15 years by recurring iliotibial (IT) band tendonitis in my right knee.
I wrote a guest blog post for Philly.com last week about the origins of my injury and how I've tried to manage it. In a nutshell, for most of the past 15 years my efforts to combat the inflammation have consisted of rest, ice, protective knee straps, Ibuprofen, not running on consecutive days and generally limiting myself to about 3 miles when I did run. That was all well and good if the only races I ever wanted to run were 5Ks. But over the past couple years, I became determined to push my limits and stop letting my knee hold me back.
So after doing some research, I incorporated two new key elements into my training. The first was a shortened stride, because I read that keeping it more underneath my center of gravity would decrease stress on my knee and help soften stride impact. The second was regularly using a foam roller to loosen up my hamstrings, quads and IT bands.
Armed with these supplemental tactics, I've been gradually increasing my training mileage and race distances since the spring of 2012. I capped off last year's running season in November with an 8.4-mile loop race along the Schuylkill River in Philadelphia, the first time I had run that far since high school. Then I challenged myself early this running season by taking on a 10-mile race in ADVANCE's hometown, King of Prussia, PA. But all the while, I knew my ultimate goal was to complete a half-marathon -- and that judgment day finally arrived this week.
So how did it go? Well, I can truly say it was the most physically grueling challenge I've ever faced. But not because of my knee, which held up great. The course was beautiful and the weather perfect (about 60 degrees with clear skies). Music bands and cheer squads along the way definitely helped keep me going.
My goal was to not only finish the half-marathon, but run it at 8-minute-mile pace. I actually impressed myself with how consistent a pace I was able to keep -- almost exactly 8 minutes a mile for each of the first 11 miles. At that point, I found myself staring at 2 miles to go and about 30 seconds overall ahead of goal pace. Mentally I felt very good about the position I had put myself in. Physically, I felt like every muscle in my legs was about to seize up. "Just hold on!" I told myself. "You can do it. You don't have to run any faster -- just maintain." Easier said than done, but I willed myself forward.
By the 13-mile mark, I knew I had lost some seconds and it would come down to the wire whether I reached my time goal or not. So I steeled myself to give every last bit of energy I had for the final 0.1 miles, which turned out to be... uphill. My legs felt like lead weights but I forced them to surge ahead and actually started passing other competitors in the straightaway. As the end loomed, I coaxed one last burst of speed out of my spent body and shot through the finish line. Struggling to walk on wobbly legs in the post-race area, I felt overwhelming relief and satisfaction from having passed such a daunting test.
But did I reach my time goal? I wasn't sure -- and actually thought I might have missed it by a few seconds. Later that day, I pulled out my smartphone and went to the race website in search of posted results. To run at exactly 8-minute-mile pace or better, I needed to finish with a time of 1 hour, 44 minutes and 52 seconds. So I inputted my name, took a deep breath and hoped for the best. My time? 1:44:51! Incredibly, over the course of 13.1094 miles, I had beaten my goal by a single, solitary second. It was an amazing cap to what I already felt was a terrific accomplishment.
Who knows if I'll ever run another half-marathon again? But finishing this one, especially considering the challenges I had to overcome to even reach the starting line, has to rank as one of the greatest moments of my life.
Cancer. It's a scary word for someone of any age, but especially for a child. Great strides have been made in research and treatment, and the long-term survival rate across the board for pediatric cancers stands at roughly 80%.
But going into remission is not the end of the battle. Just like their adult counterparts, young cancer patients can face issues with cognitive and fine-motor skills.
Luckily, concentration, memory, handwriting, social skills, and other issues fit right into the OT wheelhouse. In children's hospitals across the country, occupational therapists are a vital part of a multidisclipinary treatment team. Before and after surgies, chemotherapy and radiation, they work to get their patients back to being themselves again.
September is Childhood Cancer Awareness Month. Do any of you work with pediatric cancer patients? Share how you help bring back their smiles.
U.S. News and World Report revealed its ranking of the 100 best jobs. Occupational therapy placed 11th.
The report called the market for OT jobs "especially favorable," predicting the number of opportunities will grow more than 30% between now and 2010. The median salary, according to U.S. News and World Report's data, was $73,820 in 2011. For lucky OTs in certain metro areas, though, the average salary rose to greater than $90,000.
But as dedicated OTs, you don't need a report to know that job opportunities and salary are not the only factors that make occupational therapy a rewarding job. The real rewards come in the work that you do every day.
Whether it's Tessa Perkinson, MS, OTR/L, who works as a member of the rehab team in a skilled nursing facility; or Ashley Case MS, OTR/L, who teaches her fellow OTs the P.L.A.Y project to better work with autistic children; or Mary Ann Dykstra, OTR/L, CHT and Lisa Gandor, MS, OTR/L, who teach patients home exercise routines after being discharged from the hospital; or Stephanie Farm, MS, OTR/L, who guides stroke patients back to function; or John Damiao, MS, OTR/L, ATP, who teaches adaptive soccer to kids with multiple disabilities, the field is full of shining examples of occupational therapists proving that it earned it's spot in the top 20.
As one of our Facebook fans commented, "I love OT. I've been one for 21 years and I hope to be for many more years. It's a very rewarding career."
Happy first day of summer!
What does summer mean to you? Whether you're a parent or a school-based therapists, it means school is out for the summer, which brings changes in daily schedules and routines for everyone. For those in long term care, it means opportunities for outdoor therapeutic activities, as well as making sure patients stay cool in the increasing heat. OTs in acute and outpatient settings may see more "summer injuries," such as fall-related injuries from more time outdoors; overuse injuries from activities like swimming, biking or mowing the lawn; and even burn injuries from bonfires, barbeques or fireworks. Hopefully it also means a summer vacation for you!
Here at ADVANCE, summer means it's time to get social! Beginning today, we'll be sharing even more of our great articles, photos, videos, app reviews, patient handouts, salary information and so much more via our social media networks. You can find us on:
"Getting social" means unique new features exclusive to our social media networks. For fans of memes, starting today we will be posting a new quote of the day picture, with inspirational quotes and images themed around healing, motivation and positive reinforcement, some with well-known sayings from founders and leaders in occupational therapy. Feel free to share, re-pin and re-tweet them, and comment or reply to us with your own favorite quotes. Look for the hashtag #QOTD on Facebook and Twitter.
Other unique posts and tweets will include the popular Throwback Thursday, or #TBT. Every Thursday ADVANCE will pull an "oldie but goodie" out of our archives to share. Just yesterday we posted a feature on the Kawa Model we created back in 2009, including a video interview with its creator Michael Iwama, an interview with students who have studied the model, and an illustrated interpretation of Kawa's "river" metaphor. Look for more of these "vintage" ADVANCE features every Thursday with the hashtag #TBT, and be sure to comment or tweet us your favorite ADVANCE content from "back in the day."
As summer progresses we'll add even more to our social media offerings and outreach, including contests, surveys and more. And because it's meant to be "social," don't forget to interact with us through tweets and comments to tell us what you want to see more of. Share and retweet your favorites to your own social media networks and bring them into the conversation. And most of all, have fun! Happy summer everyone!
[Guest blogger Stacey Miller is editor of our sister publication, ADVANCE for Speech-Language Pathologists & Audiologists.]
The Fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released May 18 during the APA's annual meeting in San Francisco. In the days leading up to the official announcement of the changes, controversy began brewing.
ADVANCE has reported on the changes coming to autism diagnoses, most notably the elimination of the diagnoses Asperger's syndrome and Pervasive Developmental Disorder- Not Otherwise Specified. Moving forward, these diagnoses will fall under Autism Spectrum Disorders. In DSM-5, "autism" will truly be a spectrum. Patients will receive diagnoses of: mild (level 1), moderate (level 2) or severe (level 3).
Lori Sherry, president of the Asperger Syndrome Education Network, told The New York Times in March, "Our fear is that we are going to take a big step backward. If clinicians say, ‘These kids don't fit the criteria for an autism spectrum diagnosis,' they are not going to get the supports and services they need, and they're going to experience failure."
Other families, however, are embracing the change. Four of Kelli Gibson's sons have been given different labels (Asperger's, autism) under the DSM-IV, which was released in 1994. "To give it separate names never made sense to me," Gibson told CBS News. "To me, my children all had autism."
Asperger's elimination aside, the Associated Press points out other contentious changes:
- Extreme sadness, weight loss, fatigue following a loved one's death is now diagnosed as "major depression."
- "Disruptive mood dysregulation disorder," characterized by frequent, extreme temper tantrums, is a new diagnosis. The APA is adding the diagnosis because some children had been misdiagnosed with bipolar disorder previously, but critics say it is turning normal tantrums into mental illness.
- "Mild neurocognitive disorder," characterized by mental decline that goes a bit beyond normal aging, is a new diagnosis. Affected people may find it takes more effort to pay bills or manage their medications. Critics say it will stigmatize "senior moments."
- Calling excessive thoughts or feelings about pain or other discomfort "somatic symptom disorder," something that could affect the healthy as well as cancer patients. Critics say the term turns normal reactions to a disease into mental illness.
- Adding binge eating as a new category for overeating that occurs at least once a week for at least 3 months. It could apply to people who sometimes gulp down a pint of ice cream when they're alone and then feel guilty about it.
Allen Frances, MD, retired Duke University professor who headed the psychiatry group's task force that worked on the previous handbook, says new diagnoses "would turn everyday anxiety, eccentricity, forgetting and bad eating habits into mental disorders."
"Way too much treatment is given to the normal `worried well' who are harmed by it; far too little help is available for those who are really ill and desperately need it," he writes in his book "Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life."
Unlike medical conditions, where a scan or lab work will help make a diagnosis, psychiatrists have to rely on symptoms alone to treat a patient, and often that treatment comes in the form of medications. Cynics of DSM-5 think some of the changes are due to Big Pharma's influence, and new diagnoses will mean new patient to write prescriptions for.
Would a psychiatrist actually "treat" downing that pint of ice cream in a sitting as "binge eating"? Highly doubtful. I think any healthcare provider using the new manual will fill in any blind spot with their professional common sense.
On the evening of April 27, the American Occupational Therapy Association and the American Occupational Therapy Foundation presented their annual awards to occupational therapy practitioners who have made outstanding contributions to the profession in leadership, advocacy, education, practice and research.
Former AOTA President Penny Moyers Cleveland, EdD, OT, BCMH, FAOTA, received the AOTA Award of Merit for her career-long work as an influential scholar, educator and leader in the profession. Moyers is only the 8th recipient of the award, the highest honor the association bestows, in AOTA's history.
Glen Gillen, EdD, OTR, FAOTA, who presented the Eleanor Clarke Slagle lecture the previous night, introduced the recipient of this year's lectureship award, Maralynne Mitcham, PhD, OTR/L, FAOTA. Mitcham is a recognized leader in OT education, especially in the areas of interprofessional collaboration, faculty development and community-campus partnerships. She will present the Slagle Lecture at the AOTA Conference in Baltimore next April.
Barbara Prudhomme White, PhD, OTR/L, received AOTA's first-ever Outstanding Mentor Award. The newly created award recognizes practitioners who have demonstrated outstanding mentorship, whether to a student, colleague or employee, in a sustained partnership. Prudhomme White received the award for mentorship of her students as associate professor at the University of New Hampshire.
Ken Ottenbacher, PhD, OTR, FAOTA, received the AOTA-AOTF Presidents' Commendation for the volume and quality of his research work. Ottenbacher, a chair, professor, director and dean at the University of Texas Medical Branch in Galveston, currently serves as principal investigator or co-PI for projects receiving over $20 million in federal grants.
Additionally, the following awards were presented:
Lindy Boggs Award
Paul Fontana, OTR/L, FAOTA
Recognition of Achievement Award
Carol Blackburn, OTR/L, CDRS
Denise Donica, DHS, OTR/L, BCP
Mary Hager, MA, OTR/L, FAOTA
Beth Rollinger, MHA, MS, OTR/L
Linda Schuberth, MA, OTR/L, SCFES (awarded posthumously)
Cordelia Myers Writer's Award
Carolyn Stoller, MS, OTR/L, RYT
Jeannette Bair Writer's Award
Catherine Verrier Piersol, MS, OTR/L
Tracy Vause Earland, MS, OTR/L
E. Adel Herge, OTD, OTR/L
Special Interest Section Quarterly Writer's Award
Marnie Renda, MEd, OTR/L, CAPS, ECHM
Academy of Research
Christine Helfrich, PhD, OTR/L, FAOTA
Stephen Page, PhD, MS, MOT, OTR/L, FAHA
Sylvia Rodger, BOcc, Thy, MEd St, PhD
AOTF Award for Community Volunteerism
Fengyi Kuo, DHS, OTR, CPRP
A. Jean Ayres Award
Patricia Davies, PhD, OTR, FAOTA
Virginia Scardina Award of Excellence
Mary Schneider, PhD, OTR/L
AOTF Meritorious Service Award
Sharon Ryan, OTR
AOTF Leadership Service Commendation
Additionally, 26 occupation therapists were added to the AOTA Roster of Fellows and one occupational therapy assistant was added to the Roster of Honor. Sixteen practitioners received 2013 Retired Educator Awards, and four were recognized for their work in reviewing applications to the Dissertation Grant Research Program of the AOTF Institute for the Study of Occupation and Health. Over 280 practitioners received AOTA Service Commendations for their work on various committees and projects of the association and/or in service to the profession.