ABC Therapeutics Occupational Therapy Weblog

In the recent AJOT Fleming-Castaldy and Gillen wrote an interesting article entitled "The issue is: Ensuring that education, certification, and practice are evidence based."  In the article, they examine why outdated neurophysiologic techniques are promoted in the profession of occupational therapy as opposed to more current and evidence based motor learning and motor control theories.  They argue that outdated models based on Bobath and Brunnstrom have no place in contemporary practice. In spirit I agree wholeheartedly.  There are many techniques that are still present in contemporary practice and we hang onto those techniques even in the face of mounting evidence that other models are more appropriate.  I have spent considerable time in this blog discussing this issue as it relates to certain sensory-based approaches and the very limited evidence that exists for their continued promotion and use. Toward the end of the article they suggest that educators need to...

There has been some noise and distress in social media circles with the recent advertisement run by MSNBC regarding 'who should be responsible for raising children.'  Here is the video: This academic/pundit has since walked back some of her comments, stating that people just didn't understand the nuanced nature of what she was saying about 'collective' efforts in raising children. I suppose that if she wanted her message to be that we need to 'build a world together' that she should have said that in the original message instead of a bizarre statement that we need to 'break through our kind of private idea that kids belong to their parents.'   Mo st parents I have spoken to about this weren't impressed with being informed that they just weren't nuanced enough to  understand the original message. This is an issue that directly relates to therapy services for children because we are at a point in time where it is becoming increasingly ...

If you pay attention to the news you will notice that Governor Cuomo is on a self congratulation tour for an on-time state budget.  However, what is not mentioned in his self congratulation is the systematic dismantling that is occurring with the State's Early Intervention program and the devastation to social service programs that is left in the wake of his policies. Families need to be aware because as of April 1 there are many providers around the State who are no longer sanctioned to be early intervention providers.  Additionally, for those who have elected to remain in the system, there has been an absolutely dysfunctional last minute document cram to get contracts in place and according to the Bureau of Early Intervention it seems that many providers were not even aware of the whole process.  Some of us have been blogging and talking about this for over a year - but the reality is that apparently there were a lot of providers who were not tuned in and had no idea...

I just got back from a meeting where the NYS Office of the Medicaid Inspector General informed a County that there was inadequate documentation of supervision and that a number of claims were therefore ineligible for reimbursement. At this exit interview I made the following speech to the OMIG auditors: Thank you for the opportunity to participate in this exit interview.  I have been an occupational therapist for over 25 years and I have experienced many audits from CARF, CORF, JCAHO, NYSDOH, IPRO, and many others.  Generally when there is an allegation of violation there is also an accompanying citation of the regulation that was violated.  That citation is particularly useful for the provider community because that allows the provider to access the precise information on what is required, and that empowers the provider to offer the information to the auditor.  The information on the alleged violations on lack of adequate supervision are rather imprecise, an...

The New York State Early Intervention Coordinating Council was scheduled to meet a couple days ago but the meeting was cancelled and a subsequent video/teleconference was scheduled for today, 3/15.  The original meeting was rescheduled to 4/18, but that may still change based on member availability. It is difficult to not be cynical, but did they cancel the meeting to limit participation and comment prior to their 4/1 switchover when NY State takes responsibility from the Counties for administration of the program?  I asked people in the Bureau of Early Intervention in Albany and they told me that they thought that having a video/teleconference would allow more people to participate than if they just had the meeting in Albany.  What they failed to mention was that the new meeting would not be open for public comment or participation.  In other words, today's meeting was a one way communication and propaganda opportunity for the Department of Health. During the...

Jim Hinojosa (2013) wrote an interesting essay in the recent AJOT entitled "The evidence based paradox" which was published in "The Issue Is..." section.  I believe that this is an important article to read and discuss. I was a little concerned when I was reading the article because although he took some rather specific steps to tread cautiously and he did not go so far as an outright rejection of an evidence-based model there is still danger in propelling our thinking backward when you express the kinds of concerns that he expressed. Hinojosa outlines barriers to EBP including possible inapplicability of the established levels of evidence given the important qualitative and individualized nature of OT practice.  He correctly references the revised model that Tomlin and Borgetto (2011) presented that has already addressed this concern.  Tomlin and Borgetto (2011) proposed a model of a 'Research Pyramid' that includes and expresses a value for qualitative...

It is important for families to understand how dysfunctional our municipal entities are in administering healthcare systems.  The current problems with the municipal early intervention program underscores ABC Therapeutics' commitment to providing private services for families through their own health insurance plans.  Still, there is a need for a municipal system that serves as a social safety net - I am just not sure if there will be any providers willing to work in those systems if things continue down this road.  -CJA Brad Hutton, Director New York State Department of Health Bureau of Early Intervention Empire State Plaza Corning Tower, Room 287 Albany, NY 12237-0660 February 14, 2013 Dear Mr. Hutton: I am in receipt of the recent email announcement regarding cut off dates for transfer of responsibility for early intervention billing from the Counties to the State that will be effective 4/1/13. There is a concerning lack of information ...

There is a preliminary injunction regarding the Early Intervention arms length (conflict of interest) regulations.  The new regulations that prohibit agencies from both evaluating and providing services will apparently not be in effect until a final decision in the case is granted.  Municipalities are now waiting for actual BEI direction on how to proceed. For background: 1. The NYS Developmental Disabilities Planning Council has a good compilation of links describing the adopted changes HERE 2. My blog post supporting the regulations and additional justification for that support can be found HERE 3. You can view the ACTS press release HERE .  I have a copy of the order granting the injunction but am having some technical difficulties getting it uploaded onto my server - so I will provide a link as soon as I am able. The order is very interesting and the Court essentially found that there was merit to the argument that the Governor overstepped his authority an...