Showing posts from March, 2006

The role of occupational therapy in family reunification

For background information, you may first choose to reference this entry: An analysis of foster care policy and its impact on occupational therapy INTRODUCTION Children are placed in temporary foster homes when their parents are unable to care for them; foster care is generally designed as a temporary service for children and families who are experiencing a crisis. Children in foster care are more likely to experience psychological and developmental problems (Simms, Dubowitz, & Szilagyi, 2000); therefore, there is an increased likelihood that they attend early intervention and preschool programs where occupational therapists provide services. Occupational therapy education programs have been successful in increasing therapists’ knowledge and skills in working with parents of children who have disabilities (Hinojosa, Sproat, Mankhetwit, & Anderson, 2002). However, little has been written about occupational therapist’s interactions within the foster care system, particularly as

Blog business

Hi everyone... Just a quick note to let you know that after playing around a lot between ATOM and RSS I decided to keep the ATOM format for feeds. So if you saw a funny version of the blog in the last 24 hours with RSS feeds enabled, I was just kidding. Occupational therapists are not supposed to know about programming these changes, and that is my excuse. Either that or Blogger doesn't like RSS. I am wondering now how much damage and confusion to my site feeds I have caused with these changes. Oh well.

Lessons about healing

Tony was a middle-aged man of Italian-American descent. I watched him limp toward me slowly as he leaned a little too heavily on his cane for support. He had a difficult time walking: his left leg was held relatively stiff and he struggled to avoid dragging his toes as he worked diligently to advance his hemiplegic extremity. His left arm was not faring much better. It hung limply at his side, obscenely lifeless. "My arm feels like a puppet on a string," he would say to me, "but there is no Gepetto to make this tired old body move." Tony wasn't really that old. He had just retired from the railroad where he had worked for the last 35 years as a conductor. His only child was grown - a successful radiologist in the rural community where we lived. Tony and his wife had no real plans for retirement. They didn't have much of an opportunity to formulate plans before he had the stroke. The stroke primarily affected Tony's left arm and leg. He was able to commun

Snoezelen: The continuing slide of occupational therapy mental health practice into the abyss

Let me first say that I have no doubt in my mind whatsoever that Snoezelen-type environments are soothing, relaxing, and stress-reducing. I don't need to read any scientific articles to tell me this - although I did do an OVID search tonight and was not surprised to see many studies (of varying degrees of quality) say that Snoezelen was effective toward these ends. But I don't even doubt the poorly designed studies - I accept their reports of support for the calming effects of Snoezelen environments. Snoezelen and other sensory based interventions for adults who have psychiatric disorders were discussed in this week's OT Practice (Costa, Morra, Solomon, Sabino, & Call, 2006). The article describes Snoezelen as 'failure-free' and 'passive' but apparently some of the interventions involved actively teaching the clients relaxation exercises and deep breathing techniques. The authors report that the clients had some increased relaxation, even to the point of

Occupational justice? Analysis of Palestinian occupational therapy student access to the West Bank

There is a longstanding lack of access to educational programs for students from the Gaza strip. This issue is very controversial as it is steeped in the regional geopolitical quagmire of the Israeli-Palestinian conflict. Some of the reasons for Israeli control of movement between the occupied territories seem legitimate - from their perspective, people under the age of 35 represent the greatest threat with regard to terrorism. Are the ten occupational therapy students currently in the news likely to have explosive belts under their clothing? I don't know - but this is a topic worthy of discussion - it is a real-life manifestation of the concept of 'occupational justice.' Occupational justice may not be a term that is well known to all occupational therapists, particularly those in the United States. Wilcock first identified the term, stating that it was an extension of social justice and specifically relating to opportunities or lack of opportunities for normal human occup

A new world for Billy

This is a follow-up of another story that you can find here: Billy's World I was surprised as I read the fax that was printing out the new referral. The school system wanted Billy re-evaluated - which I thought was odd because last I knew he was already enrolled in a preschool program. The information on the referral indicated that he was now in the custody of his aunt and that she was trying to get him re-enrolled in the preschool program. I called the referral source and stated that I knew Billy and that I looked forward to seeing him again. My immediate thought as I entered his aunt's home was that it was much cleaner than where he previously lived. The strong odor of cigarette smoke hung in the air and in every corner, so despite the fact that the home was superficially clean I still knew that I would have to de-fumigate myself after the visit. This made me feel badly for Billy, because he has to live in it every day. Still, this in itself is nothing that is reportable - ma

Hermeneutic rediscovery of personal context through ego-surfing

The Occupational Therapy Practice Framework (AOTA, 2002) identifies personal contextual factors that support occupational performance. The Framework identifies these factors as “features of the individual that are not part of a health condition or health status.” This definition is directly quoted from the International Classification of Functioning (WHO, p. 17). Unfortunately, although contextual factors are identified in the Framework, the relationship to occupational performance is not clearly stated. So although personal contextual factors are not clearly defined, this Framework represents another step that explicitly identifies contextual factors as being critical to occupational performance. Several different sources in the post-modern period had a strong influence on the inclusion of personal contextual factors in practice models. New practice models that specifically emphasize these factors are still being developed and refined. Many concepts from the new discipline of occupat

The Passion of the Christ: A Kid's Perspective

A fairly standard component of my pediatric occupational therapy evaluations is to ask the child to draw a picture of themselves. This assessment technique provides an opportunity to evaluate the child's skill with writing and also is a functional assessment of their cognitive and perceptual ability. Sometimes kids draw things that just beg to be probed and questioned - as was the case today. I watched intently as 6 year old Patrick drew a decent representation of himself, but then he began adding odd details to his picture. First he colored dark spots on his figure's hands and feet, and then added a row of X's across the forehead. I leaned forward and quizically asked, "Patrick, what are these marks here?" He looked at me for a moment and then responded: "Jesus died for you, you know. He got nailed to a cross, in his hands and his feet. My Dad said that he had to wear prickers on his head and it made him bleed." "Oh," I replied, not knowing w