ABC Therapeutics Occupational Therapy Weblog

A crisis of confidence is defined as a situation in which people have stopped believing that something is good.  Such a point has been reached with the American Occupational Therapy Association's Representative Assembly. Here is some data for those interested in understanding our current Representative Assembly and the meeting that is happening that is precipitating a crisis of confidence. FIRST OF ALL, it is clear that there are many dedicated people who are attending the meeting, voting, and representing you as is their responsibility.  It takes time, energy, and commitment to volunteer. However, here are some statistics to consider: 1. At the time for discussion on an item that was pulled from the consent agenda, only approximately 61% of those eligible to vote had even responded to a roll call.  Only two representatives discussed the item, which is only 4% of the members.  Both of them were from NY, which does not bode well for the rest of the c...

As part of a multi-year research effort into the nature of Social Justice I have been participating in an lengthy conversation about this topic on the OT Connections forum, which is an official message board for the American Occupational Therapy Association. From the beginning of the discussion some have claimed that Social Justice is a Core Value in occupational therapy.  This has been a difficult claim to validate, because there does not seem to be a a standard definition of 'Core Value' just as there does not seem to be agreement on the definition of Social Justice itself. "In 2003, members of the AOTA Representative Assembly Coordinating Committee recognized that the philosophical and historical roots of occupational therapy were not known to all occupational therapy professionals. In response, the 2003 RA adopted a motion to form the Ad Hoc Committee on Historical Foundations, which was chaired by Kathlyn Reed and included Suzanne Peloquin and Christine Peter...

The American Occupational Therapy Association Board of Directors has issued a position statement that future occupational therapists will need to be doctorally prepared for entry-level practice by 2025.  They have arrived at this recommendation after undergoing an insular process that neglected to engage broad stakeholder participation. I understand that this is a weighty charge, so I will outline the evidence as clearly as possible. The AOTA Board informed their decision on two workgroups: one an Ad Hoc Board Committee on the Future of OT Education chaired by Dr. Thomas Fisher and the other an internal subcommittee of the Board itself that reviewed the Ad Hoc Committee's findings. The Ad Hoc Committee was comprised of occupational therapists who also served as Deans, Provosts, or other high ranking University officials as well as the AOTA Director of Accreditation and Academic Affairs.  Task groups were developed to address specific questions.  Specifically, o...

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...

Two years ago I blogged about NYS Department of Health emails that instructed the field in use of Level II HCPCS codes.   At that time I stated:  Promoting use of Level II HCPCS codes can only mean they are incredibly misinformed and clueless OR they are throwing in the towel with trying to get reimbursement and they intend on replacing skilled services with services provided by non-licensed people with 'generic' developmental training. It seems that we have received an answer in the form of a final response to a systems complaint initiated against the NYC Department of Health and Mental Hygiene on the topic of Embedded Coaching.  Click here to read that determination. The allegation was that in NYC providers were being forced to address functional IFSP outcomes that fell outside of their scope of practice.  The Department of Health's determination was that NYC was in violation of 10 NYCRR 69-4(f)(3) regarding use of individualized approaches and they were ...

According to Bill de Lancey (1958), a writer for the Geneva Times, "Mr. Barton was born in Boston, of a family steeped in the arts and letters."  Occupational therapists know that Barton was an architect and that he was an important Founder of the profession, but few know about the depth of his other talents and interests. During the early 1900s, while he was encouraging Emily Post's literary career and while he was becoming more established in his own architectural practice, Barton also collaborated with others on musical and literary projects. Isabel Barton (George's wife), wrote an AJOT article in 1968 that briefly mentioned some of these other collaborative products.  George Barton was very interested in Nero and wrote a play about his life called "Swift-Heeled Steeds."  The title likely refers to the famous line from the Iliad when Nestor states "The sound of swift-footed horses strikes upon mine ears."  This line was reportedly repeated b...

Emily Post continued her literary career and in 1910 An Eagle's Feather was published.  Apparently, she was still in contact with George E. Barton.  Here is a copy of the inscription to him in this book: I am having a little difficulty with reading the print - it seems that Emily Post is stating her dissatisfaction with something - I was assuming it might be with the cover picture?  If anyone has any good guesses on what she was referring to I would love to hear opinions. Whenever I can't read someone's writing I am always surprised to find out how it was so apparent to someone else - and then in looking at it a second time I don't know why I didn't see it!  Any help with this is appreciated.

In response to questions by members of the Legislature as part of the February 3, 2014 Joint Budget Hearing on the 2014‐15 Executive Budget for Health/Medicaid, the New York State Department of Health Early Intervention Program provided a progress report with the transition to the State fiscal agent. No one stopped to think that self-assessment for progress reporting might not be the most accurate measure.  Perhaps the most shocking misrepresentation in the report was regarding timeliness of payment.  They report that 2013 fourth quarter mean time to payment was 14 days following claim submission.  As a mean involves calculation including all ranges of payment, reporting a number without capturing the full range of data is a an absolute statistical manipulation.  A more reasonable and reliable statistic is to look at second quarter payments, which hopefully have all been compiled and adjudicated, except for extreme outliers.  That statistic is that the mean ...

I was very happy to see another article on weighted vests in the current issue of AJOT (Lin, Lee, Chang, and Hong, 2014).  The last opportunity we had to look at this issue was the excellent pilot study completed by Collins and Dworkin and published in the November/December 2011 AJOT.  In that study ( reviewed here ) the authors found that the weighted vests were not effective in increasing time on task, but cautioned that the results should be generalized cautiously owing to the small sample size and participant selection process. The current study, completed by colleagues in Taiwan, employed a much more rigorous randomized and two period crossover design with a much larger sample of children.  110 children participated in the study that measured their performance on the Conners' Continuous Performance Test and recorded behaviors during weighted and non-weighted vest wearing conditions. The researchers made good attempts to control for bias by blinding the video cod...

When you say the name “Emily Post” most people automatically think of her contributions as ‘Miss Manners.’ Although they were actually very close in age, it is probably a forgotten fact that George Edward Barton acted as her “Godfather” and editor who helped to launch her literary career. A very reasonable question is “How was George Barton associated with Emily Post?” In 1889 Emily Price (Post) was a debutante and her arrival on the social scene is well documented in various New York newspapers of the day as well as summarized quite thoroughly by Claridge (2008). At about the same time, George Barton was riding a bicycle through the English countryside, whistling operatic arias and singing with King Edward VII. Tuxedo Park is likely the point of commonality that brought George Barton and Emily Price (Post) into contact with each other. Emily Price’s father, Bruce Price, was also an architect and his most famous work involved the design of the Tuxedo Park community, as commissi...