New School OT

Some professions are easier to understand than others. When someone says they’re a doctor, lawyer, or electrician, there’s no elevator speech to explain what they actually do. However, occupational therapist?? Yeah, insert your first impression guesses here.

In a nutshell, occupational therapists (OTs) help people live an independent, functional, and meaningful life in their environment. How we do that depends on the needs and values of the individual and family. Where it gets tricky is that purposeful activities vary from person to person.

For example, one person may do a physical labor job and their body would need certain skills and exercises to keep doing that job, like stretching, orthotic shoes, rest breaks, etc. Another person may sit at a desk all day and they would need different skills and exercises, like an ergonomic chair, posture help and resting the eyes. This is probably the most straight-forward example, but for kids there is the additional component of development milestones and building a skill foundation.

Our profession has and continues to shift with cultural and societal progress, constantly influenced by the latest research and trends to assist individuals with their daily functions and enhance their quality of life. Because of this, the understanding of what we do gets muddied. Here are some examples:

  • Occupational Therapists help people get jobs. It doesn’t help that the word “occupation” is in our name which can be interchangeable with “job”. Here, the term refers to the tasks/activities that people engage in as part of their daily lives. “Occupations” involve physical, cognitive, and emotional abilities needed to complete meaningful actions and tasks. Think about all of the motions, skills, and coordination you needed to make a meal, participate in game night, or yes, obtain and maintain a 9-to-5 job. For Child(ish) Advice, the main occupation for a kid is playing and learning. So we get into all the things kids need to be able to play and learn successfully.

  • OTs and PTs are the same thing. Uh, no. Simply put, OTs focus on analyzing an activity and how an individual can accomplish it (What skills are needed to complete the task? Can this person do it? If not, how do we improve their skills, modify the task, or adapt the environment so they can?). PTs, on the other hand, examine the mechanics of the human body and determine what may be affecting appropriate movement (muscle weakness, endurance, range of motion, motor control, etc). With our powers combined, we can help individuals complete a task safely and independently.

  • Occupational Therapists are for the elderly or kids with autism. On the contrary. We work with anyone of any age regardless of their diagnosis. If they are having difficulties participating in meaningful tasks, we are there to assist them. Although we do help the geriatric population, approximately 1/3 of the national OT caseload is with kids (from newborn NICU babies to teens transitioning into the workforce/college). With pediatrics, we also address the needs of the family and work with teachers to ensure the best performance outcomes and classroom alternatives. Adults may require our services if physical or cognitive limitations affect their ability to complete functional daily living or vocational tasks.

  • OTs just do arts/crafts, games, and puzzles with kids. We might, but there’s a reason for it. We utilize these engaging activities as a means towards a therapeutic goal. If a child likes to color, we use this enjoyable task to help improve skills they may need to work on. For instance, retrieving the crayons from one end of the room via obstacle course to address motor planning and coordination skills. We may have them break crayons with both hands to build hand/grip strength and promote bilateral integration. We might have the child use those broken crayons and color a picture on the wall while standing to stabilize their shoulder girdle and trunk needed for fine motor precision.

History Lesson

Despite the clarification, more questions arise. Like, why have a name that is so confusing? Why do you look and operate like your rehab counterparts? And what’s with the arts and crafts, seriously?  Occupational Therapy is a patchwork of all its influences since its genesis. What started as a method of humane care for those with mental disturbances has evolved into a legit rehab profession. So how has OT changed in the last three centuries? Here’s a crash course:

  • Late 18th century The implementation of “moral treatment” replaced physical restraints with physical exercise and manual occupations (gardening, sewing, knitting) to treat those in mental institutions in England.
  • Late 19th century The Arts and Crafts Movement promoted handmade objects where craftspeople and artisans could take pride and feel a connection in the creations they produced. The first OTs adopted this approach when working with their patients.
  • 1917 The National Society for the Promotion of Occupational Therapy (now called the American Occupational Therapy Association) was created. Many names were tossed around regarding this new form of treatment like activity therapy, moral treatment, the work cure, and ergotherapy. However, the newly found group settled on the term occupational therapy to best describe their use of purposeful tasks to treat patients.
  • World War I The application of wartime occupational programs (metalwork, woodworking, weaving, toy making, etc.) expanded the practice to not only treat those with psychological or psychosomatic trauma, but to restore physical function to those who sustained critical orthopedic injuries.
  • World War II – Many veterans returned home from the war with severe physical and mental impairments, causing the push to formally establish and recognize rehabilitation (which included OT) as a legitimate medical service. 
  • 1940s/50s – Medical advancements (antibiotics, prosthetics/orthotics) resulted in more adults living with physical disabilities. The use of the medical model during the Rehabilitation Movement altered how OTs worked with patients. Focus was placed on assessing and addressing client functions that were hindering their self-care and vocational performance.
  • 1960s – With an increase in new information, technological advances, and disorders, the profession became specialized in various fields (sensory integration, burns, hand, mental health, etc).  
  • 1970s/80s – The deinstitutionalization of mental health patients resulted in healthcare moving from the hospitals to the community. OTs established themselves in schools, outreach programs, community services agencies, and private practices.
  • 1990s – A rise in cultural diversity in the U.S. population allowed OTs to return to a more holistic approach in their practice, looking at the whole person and addressing the skills or adaptations needed for them to live a functional and meaningful life.

What’s Trending

Technological advancements are always shaping our cultural landscape. Not only do we have information in the palm of our hand, but we also have our own wearable health trackers monitoring the number of steps we take, our heart rate, blood pressure, even our sleep and breathing patterns. We are more in control of our health and wellbeing, and telehealth is on the rise since the start of COVID.

We are more informed about child development and child-rearing because of internet accessibility. If we have questions about our kid’s development or if something they are doing is typical, we can easily look it up. We also have an informational and emotional support system of influencers and content creators to crowdsource things we’ve never considered before. This sheds light on all the possibilities available to your child and normalizes a lot of the specialized care once only considered for children with a cognitive or physical diagnosis. Again, OT is for everyone!

Pediatric OTs are here to help your child succeed in anything they do. Chances are your kid’s elementary school probably has an OT on staff already working with kids in all grades. Just because they receive a referral to see an OT doesn’t mean that something is horribly wrong with them, or that our therapy sessions are just playtime and a waste of your insurance.

We hope you got something helpful out of this post as we close out National OT Month. We love doing deep dives into how kids operate and giving you, the parent, useful knowledge to raise your kids.

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The Latest Trends in Occupational Therapy | OneRehab
Myths and misconceptions about occupational therapy | Bonners Ferry Herald
Punwar, A. J., & Peloquin, S. M. (2000). Occupational therapy : principles and practice. Lippincott Williams & Wilkins.

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