ABC Therapeutics Occupational Therapy Weblog

I read the recent AJOT article, “ Occupational Therapy in Crisis, ” with interest and some frustration. Interest, because I agree with the basic premise. Occupational therapy is in a period of identity instability. The profession is struggling with questions about its theoretical base, its view of humans, its scope of practice, and its methods of creating change. Those are not small questions - they are the questions that define a profession. Frustration, because this crisis did not suddenly appear in 2026. I have been writing and presenting about these same tensions for years, often in less formal spaces and often without the kind of protective language that makes professional journals comfortable. So, welcome to the crisis conversation. I actually mean that sincerely. I am glad the issue is being named in AJOT. I am glad the word “crisis” is being used. I am glad there is some recognition that occupational therapy may not have a shared understanding of what it is, what it does, or ho...

NBCOT recently released a crosswalk analysis comparing the OTR examination content outline with the ACOTE educational standards . Most of the document tells us what we would expect: the entry-level practice tasks described in the certification exam outline are broadly represented in the ACOTE didactic standards. That is useful, and it is reassuring, but it is not the most interesting part of the document. The more interesting part is Table B, which identifies the ACOTE standards that are not reflected in the NBCOT examination task statements. Some of those differences make immediate sense. Professional history, philosophy, the distinct nature of occupation, policy, advocacy, and systems-level thinking are not always going to map cleanly onto a certification exam content outline. Certification exams are task-oriented by design. Educational standards should be broader than test preparation because occupational therapy education is not simply about preparing people to pass an examination...

  I recently wrote that occupational therapy’s real AI problem is not ChatGPT itself, but us. More specifically, it is our profession’s vulnerability to confident, polished, automated explanations built on partial knowledge, private frameworks, and unexamined assumptions. I argued that the real risk is not that a machine will invent nonsense from nowhere, but that it will absorb and amplify the profession’s existing epistemic weaknesses. Now we have Part II of this discussion. I was reminded of this topic when I posed a straightforward question to AOTA’s new chatbot . I asked it "Has there ever been any tension around how to operationalize the ethical principle of social justice in occupational therapy, and what would a violation of that look like in practice?" The answer I received was plausible, polished, but very superficially informed - and thus, fully incorrect. It discussed system barriers, inequities in access, conflicting values, organizational constraints, and the ...

Before the profession gets too deep into updating the Occupational Therapy Practice Framework, I think we should take some time to pause and reflect on both the substance and process of the revision. While preparing a lecture recently, I found myself revisiting a section from my occupational therapy theory textbook where I trace the successive definitions of occupational therapy that have appeared in the various editions of the Practice Framework. I included that section in the book because the pattern bothered me when I first noticed it, and it still does. When the definitions are placed side by side, something becomes clear that is easy to miss when each revision appears on its own. Since the first Occupational Therapy Practice Framework was published in 2002, the profession has repeatedly revised its official definition of occupational therapy through successive editions of that document. None of the changes are dramatic in isolation. But taken together they represent a gradual and ...

I recently came across a project from students at Rochester Institute of Technology that got me thinking. At the Game Developers Conference, RIT students showcased a collection of alternative game controllers that were definitely not standard - they were i nterfaces built from oversized scissors, giant toothbrushes, physical wiring stations, and other unconventional objects. The assignment challenged students to design interactive systems that deliberately moved beyond traditional controllers like keyboards, mice, and gamepads. At first glance, these projects are playful and experimental and I think that is part of the point. The exercise seems designed to disrupt assumptions about how humans interact with digital systems. But the deeper idea embedded in the project is more interesting and is something I would like our future occupational therapy students to deeply integrate into their thinking: Input is not fixed. Once you step outside the standard paradigm of buttons and joysticks, y...

At the recent ALC meeting of the AOTA, there was a question about why we are seeing a drop in student interest in OT programs. There seemed to be a hesitancy to look internally and critically at the real reasons so I decided to do my best to answer that question. Label me as a reluctant futurist. +++++ Occupational therapy stands at a pivotal moment. For years, we’ve operated with an assumption that the future of the profession should be bigger, more academic, more credentialed, and more “doctorate-forward.” For a while, that vision aligned with workforce need and cultural momentum. But lately, the data tell a more complicated story and I believe that many of us in education and professional governance have been unwilling to confront directly. Here is the uncomfortable truth: The rapid proliferation of OT programs, especially entry-level doctorates, is no longer being driven by workforce demand, public need, or educational innovation. It’s being driven by institutional survival, tuit...