ABC Therapeutics Occupational Therapy Weblog

Several years ago, I wrote about the confusion that arises when occupational therapy conflates charity with social justice  and about the subtle but important shift from the Social Gospel tradition toward a politicized discourse of redistribution and equity   At the time, some dismissed these concerns as overly semantic. But the receipts are there: once you build “social justice” into the profession's  Code of Ethics , you’re no longer talking about voluntary altruism. You’re talking about mandatory redistribution. And now, as discussion emerges on academic listservs about the decline of student volunteerism , some are discovering that not all students are enthusiastic about forced redistribution. So, what’s the next move? You start mandating volunteerism. Think about that for a moment. Mandatory volunteerism. That phrase itself is a contradiction so sharp it should stop us in our tracks. If the goal is charity , it cannot be compelled because coerced charity is ...

For twenty years, I have used this blog to document occupational therapy as it unfolded: its controversies, contradictions, policy shifts, and unfinished arguments. This archive records my evolving perspective as well as the broader struggles of the profession to define itself. It is not tidy, and it was never meant to be. Sometimes sharp, sometimes uncomfortable, occasionally at odds with what the field preferred to hear, but always honest. The blog has received more than 1.7 million pageviews since 2006, with an estimated 200,000 to 250,000 of those representing real human engagements. That is a remarkable footprint in a small profession where many peer-reviewed articles are read only a few hundred times. Spikes in readership came during inflection points such as the doctoral mandate debate, showing that the blog became a gathering point when the profession was most unsettled. Even in quieter years, thousands still returned, treating the archive as a touchstone for reflection and cr...

I came into occupational therapy as a street level clinician. Like many of my generation, I learned Ayres Sensory Integration (ASI) in school. I took additional steps to get certified to administer and interpret the Sensory Integration and Praxis Tests (SIPT) when they were first published, and tried to make sense of what the model promised. Over the years, I watched that test become outdated, all while  waiting for the robust evidence base to emerge. I was told at countless workshops and conferences, " The research is coming. " It never did. In the meantime, neuroscience did not stand still. We now have dynamic systems theory, heterarchical processing models, robotics, and AI-driven neural networks that give us far richer and more precise understandings of how brains actually develop and adapt. These frameworks have left Ayres’ mid-20th century metaphors behind. I say this not as an outsider taking potshots. I am a clinician who has lived with the sensory integration mode...