ABC Therapeutics Occupational Therapy Weblog

Lately, the conversation around gender in athletics, education, and therapy has gotten a lot more complicated. Questions about fairness, biology, and statistical interpretation are at the heart of some heated debates—whether it's about competitive advantage in sports or access to essential services like therapy. While these issues might seem separate, they both hinge on a common problem: how statistics are used (or misused) to justify decisions. I recently came across a post from an athlete who was assigned male at birth but is now competing in women’s sports. This issue connects directly to occupational therapy because it highlights how statistical reasoning—whether in competition or clinical settings—can shape real-world opportunities. The athlete argued that their transition had led to an ‘equitable’ change in performance by comparing their high school results in men’s competitions to their current college results in women’s competitions. The key claim? Their relative standing w...

Maybe some. A couple years ago I wrote this 'screed' on trauma informed care (TIC) models.  My concerns at the time were related to the lack of direct intervention that was promoted as part of this model - and that it appeared that some OTs were adopting a social work approach to the issue. Last night there was an #OTalk2Us twitter conversation about these models; I was not able to participate but I have been studying the conversation.  I think that this is a good opportunity to see if we are progressing ideas on TIC to be more occupational therapy directed and intervention-focused. It was good to see more conversation around the areas of occupational therapy assessment and intervention.  I think that we still need some direct conversation about how this problem gets addressed from an intervention perspective.  In my local experience, most of the conversation around TIC models is still oriented toward 'awareness' and is being driven by systems-level consultants...

***As a commenter below noted, as of 9/22/17 the link to the AOTA infographic with dubious information is broken/has been removed and now serves a 404 error.  Hopefully this is an indication that there will be more care in the future about quoting statistics. The removal of the infographic does not address the question about whether or not there may be more impactful injury prevention efforts than concern with wearing heavy backpacks.  (edited, 9/22/17, CJA). According to the American Occupational Therapy Association, heavy backpacks can cause serious injury to children.  The AOTA claims that heavy loads carried by 79 million students across the United States "can cause low back pain that often lasts through adulthood."  The AOTA also claims that according to 2013 statistics from the US Consumer Product Safety Commission nearly 22,200 strains, sprains, dislocations, and fractures from backpacks were treated in hospital emergency rooms, physicians' offices, and cli...

On 11/8/16 I wrote In both of these cases it is important to carefully analyze the details of what is actually being litigated.  So often the truth of what is being discussed gets lost in poor reporting about the topics.  For example, many news outlets focus on the 'evil school district vs. the child in the wheelchair with Wonder the GoldenDoodle' meme instead of focusing on the decidedly less appealing 'what is the importance of due process' angle. As OTs become more savvy with policy analysis they will avoid the bias-trap of media reporting and try to approach a more 'rational comprehensive' method of considering the actual facts.  They will also become more savvy by dropping the naive notion that just because an issue might have the superficial appearance of something that should be supported, it is important to dive deeply into the actual policy to make sure we are promoting what is best for the people who seek our services. Turns out th...

The settlement house movement originated in England in the late 1800s and was a mechanism for supporting poor people through social and cultural integration.  The model was translated to the United States by the efforts of social reformers like Jane Addams who founded Hull House in Chicago (later supported by the efforts of future occupational therapist Eleanor Clarke Slagle) and Robert Woods who pioneered the South End House Movement in Boston (supported by the design efforts of future occupational therapist George Barton).  These efforts were notable for their philanthropic origins; that is, they were primarily funded by the private and charitable efforts of socially-minded people who genuinely wanted to improve the living conditions and outcomes for poor people.  As turn of the century immigration grew the ability of private philanthropists to address urgent needs was strained.  Hull House is a good example of an institution that started off being funded through...

A number of my students at Keuka College have been working on policy and advocacy projects that I wanted to share.  The students researched a topic of their interest, met with their legislators, and developed a broad action plan to increase awareness of their topics.   This information is provided courtesy of Sarah Watson, a graduate student who is interested in promoting increased awareness of privacy concerns and FERPA in context of computerized record keeping and documentation. Extra note: I was really happy to see one of my students tackle this topic - I have seen many privacy breaches because of improper permission settings in common software used by many school districts, most notably the IEP Direct product.  School support personnel need to be regularly inserviced on how to use permission settings so that providers do not have blanket access to a district's entire special education database.  This is a common problem. Additionally, procedures ne...

A number of my students at Keuka College have been working on policy and advocacy projects that I wanted to share.  The students researched a topic of their interest, met with their legislators, and developed a broad action plan  to increase awareness of their topics.   This information is provided courtesy of Jenna Soldaczewski, a graduate student who is interested in promoting a workload approach in school systems.  She found out how a parallel profession in NY (speech therapy) promoted change by advocating for alterations to the Part 200 NYS regulations that govern special education: Many occupational therapists in school settings have caseloads so large that it negatively impacts the way that they can help children.  Some therapists have proposed using a 'workload' approach for better managing productivity in the school systems. After studying the caseload versus workload approach debate I created a quick presentation to encourage and inform OTs ...

This week has been identified as the #OTWeekOfAction by the American Occupational Therapy Association.  They are encouraging member actions on a number of policy initiatives; however, as noted in the previous blog post, it is important for occupational therapists to independently assess the nature of these proposals before blindly writing letters of support to Congress. Individuals may learn that they agree with the positions of the professional association or they may learn that they disagree.  Today's topic is the Every Student Succeeds Act (ESSA) which is an important law for pediatric practitioners to be aware of.  The act was signed into law in December 2015 and its purpose is to replace the No Child Left Behind Act.  ESSA has new requirements for accountability and transparency in school operations and includes mandates for low performing schools.  It continues the NCLB testing regime and mandates 95% participation in testing for grades 3-8.  How...

The OT Capital Briefing in the November 7, 2016 OT Practice analyzes two Supreme Court cases that are summarized together as follows: If the Supreme Court finds in favor of the families in both cases, the expertise occupational therapy practitioners provide will be more important than ever to ensure students with disabilities receive a meaningful education, and that schools fully comply with the ADA and Section 504. This is a confusing summary because neither case has anything to do with OT specifically and in fact if the Supreme Court finds in favor of the families there may be unintended consequences that are damaging. In the first case, Endrew F. v. Douglas County School District , the issue of concern has to do with what constitutes FAPE, or a free appropriate public education.  In this case the parents removed their child from school because they believed that his progress was insufficient as it relates to his autism condition.  The enrolled him in a private schoo...

Each year I receive several emails from colleagues about 'retained primitive reflexes.'  I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic.   Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.'  Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen. The following is the kind of information that causes concern and was provided to me by a colleague as a sample from a student's IEP: The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyri...

I went to an IEP meeting with a parent the other day and was greeted with hesitance by the occupational therapist on the educational team. "Why are you here?" asked the therapist.  "Are you here because you are actually treating the child or are you here as an advocate?" Neither characterization seemed correct.  I paused and thought for a few seconds as I was not sure why it mattered.  I also was not sure if I was free to divulge the information.  I ran for the safest middle ground I could find and responded, "I know the child and I am helping the family."  Both were true. I know that the word "advocate" is often perceived negatively by school based practitioners.  I have been attending IEP meetings as an 'outside' therapist for over 20 years and I tend to avoid the term 'advocate' because it engenders a lot of negativity.  I see a lot of reactivity in educational teams when an 'advocate' is involved. Bruce and Ch...

I sat on the witness stand, about 20 feet away from the parents that I had known and worked with for the last five years, and did my best to answer the Judge's questions as accurately as possible.  I think that I was more uncomfortable than the parents were and they did not seem to have any ill will and did not seem to be upset about my testimony.  They knew that I was just telling the truth, I think. I told the Family Court Judge that I knew the family for several years because several of their children had been assigned to me for early intervention occupational therapy.  I was asked about one of my therapy sessions on a specific date and I told the Judge that as I sat and played with the child the fleas were jumping out of the carpet and onto little Jenna's legs.  And onto my socks and pants.  Jenna's legs were covered with bites and streaked blood from all the scratching.  The week prior to that session I taught the parents how to use commercially avai...

Yesterday I saw Daniel who was mad at his mother for lying to him - something to do with whether or not he could play his Nintendo DS - I am not sure.  He spent most of the time under the table so we couldn't complete much of an evaluation.  But this is what I could surmise through interview: Daniel is 13 years old and his mom brought him to see me because she is concerned that he has a 'sensory processing disorder.'  The referral from his physician indicated that his diagnosis was bipolar disorder, r/o paranoid schizophrenia, oppositional defiant disorder, and ADHD. Of course the schizophrenia concerns are very preliminary but Daniel has reported seeing black caped shadowy figures scratching at doors and windows ever since he was old enough to talk.  He states that the combination of Lithium and Seroquel mostly keeps things in check.  His mom isn't so sure, because the family is walking around on eggshells for fear of contributing to his spiral into an emotio...