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AOTA T H E

AMERICAN

OCC U PAT I O N A L

T H E R A P Y

A S S O C I AT I O N

JULY 23, 2012

Time Well Spent


Empowering Communities to Help At-Risk Youth Engage in Healthy Occupations

PLUS

Researchers in Action iPads, Apps, & Social Media News, Capital Briefing, & More
CE ARTICLE

CE
SPECIAL
2012 Continuing Education Directory: See page 26.

Creating an Ethical Climate in Your OT Department

essential learning on Mental Health Practice with children and Youth!


Mental Health Promotion, Prevention, and intervention with children and Youth: a Guiding framework for occupational Therapy
Edited by Susan Bazyk, PhD, OTR/L, FAOTA

New Self-Paced cliNical courSe

earn 2 aoTa ceus (25 NBcoT Pdus/20 contact hours)


Occupational Therapys Role in Mental Health Promotion, Prevention, and Intervention With Children and Youth is a critically important professional development tool for occupational therapy practitioners who work with children and youth. It provides a necessary framework on mental health that can be applied in all pediatric practice settings and lays a foundation for conceptualizing the role of occupational therapy in promoting, preventing, and providing mental health intervention for children that may or may not have disabilities, mental illness, or both, in school and community settings. Chapters take a public health approach to occupational therapy services at all levelsuniversal, targeted, and intensivewith a clear emphasis on helping children develop and maintain positive mental health psychologically, socially, functionally, and in the face of adversity. Learn how to contribute your occupational therapy expertise to mental health promotion, prevention, and intervention with children and youth through AOTA learning!

order #3030. aoTa Members: $259, Nonmembers: $359

CE-205

Shop online at http://store.aota.org/view/?SKu=3030, or call 877-404-aoTa

Chief Operating Officer: Christopher Bluhm Director of Communications: Laura Collins Director of Marketing: Beth Ledford Editor: Ted McKenna Associate Editor: Andrew Waite CE Articles Editor: Maria Elena E. Louch Art Director: Carol Strauch Production Manager: Sarah Ely Director of Sales & Corporate Relations: Jeffrey A. Casper Sales Manager: Tracy Hammond Advertising Assistant: Clark Collins

AOTA THE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION


V O L U M E 1 7 I S S U E 1 3 J U LY 2 3 , 2 0 1 2

FEATURES
Time Well Spent

Ad inquiries: 800-877-1383, ext. 2715, or e-mail sales@aota.org


OT Practice External Advisory Board

Donna Costa: Chairperson, Education Special Interest Section Michael J. Gerg: Chairperson, Work & Industry Special Interest Section Dottie Handley-More: Chairperson, Early Intervention & School Special Interest Section Kim Hartmann: Chairperson, Special Interest Sections Council Gavin Jenkins: Chairperson, Technology Special Interest Section Tracy Lynn Jirikowic: Chairperson, Developmental Disabilities Special Interest Section Teresa A. May-Benson: Chairperson, Sensory Integration Special Interest Section Lauro A. Munoz: Chairperson, Physical Disabilities Special Interest Section Linda M. Olson: Chairperson, Mental Health Special Interest Section Regula Robnett: Chairperson, Gerontology Special Interest Section Tracy Van Oss: Chairperson, Home & Community Health Special Interest Section Jane Richardson Yousey: Chairperson, Administration & Management Special Interest Section
AOTA President: Florence Clark Executive Director: Frederick P. Somers Chief Public Affairs Officer: Christina Metzler Chief Financial Officer: Chuck Partridge Chief Professional Affairs Officer: Maureen Peterson
2012 by The American Occupational Therapy Association, Inc. OT Practice (ISSN 1084-4902) is published 22 times a year, semimonthly except only once in January and December, by The American Occupational Therapy Association, Inc., 4720 Montgomery Lane, Bethesda, MD 20814-3425; 301-652-2682. Periodical postage is paid at Bethesda, MD, and at additional mailing offices. U.S. Postmaster: Send address changes to OT Practice, AOTA, PO Box 31220, Bethesda, MD 20824-1220. Canadian Publications Mail Agreement No. 41071009. Return Undeliverable Canadian Addresses to PO Box 503, RPO West Beaver Creek, Richmond Hill ON L4B 4R6. Mission statement: The American Occupational Therapy Association advances the quality, availability, use, and support of occupational therapy through standard-setting, advocacy, education, and research on behalf of its members and the public. Annual membership dues are $225 for OTs, $131 for OTAs, and $75 for student members, of which $14 is allocated to the subscription to this publication. Subscriptions in the U.S. are $142.50 for individuals and $216.50 for institutions. Subscriptions in Canada are $205.25 for individuals and $262.50 for institutions. Subscriptions outside the U.S. and Canada are $310 for individuals and $365 for institutions. Allow 4 to 6 weeks for delivery of the first issue. Copyright of OT Practice is held by The American Occupational Therapy Association, Inc. Written permission must be obtained from the Copyright Clearance Center to reproduce or photocopy material appearing in this magazine. Direct all requests and inquiries regarding reprinting or photocopying material from OT Practice to www.copyright.com.

Empowering Communities to Help At-Risk Youth Engage in Healthy Occupations

10

Joseph Brunner, David Valvano, and Alexander Lopez describe how Stony Brook University students and faculty contributed to a local communitys effort to help at-risk youth find occupations that positively influence health and well-being.

CE
SPECIAL
Continuing Education 26 Directory
A handy reference guide to CE offerings nationwide.

DEPARTMENTS
News Capital Briefing
AOTA and State Associations: Collaborating on Local Reimbursement Issues

2 5

Researchers in Action

A Look at the Influential Studies of Three Occupational Therapy Academics


Andrew Waite profiles three occupational therapists who are conducting research in an array of specialty areas and contributing to the Centennial Vision of occupational therapy as a widely recognized, science-driven, evidence-based profession.

14

Practice Perks

Fieldwork Level II and Occupational Therapy Students: A Position Paper

6 7 18 19 21 41 48

Tech Talk

Touch the Future: Using iPads as a Therapeutic Tool

Social Media Spotlight

Updates From Facebook, Twitter, and OT Connections

CE Article
Leading With Ethics: Creating an Ethical Climate in Your Occupational Therapy Department. Earn .1 AOTA CEU
(1 contact hour or 1.25 NBCOT professional development units) with this creative approach to independent learning.
COVER PHOTOGRAPHS COURTESY OF ALEXANDER LOPEZ. COVER ILLUSTRATION ALEX STSJAZHYN / ISTOCKPHOTO

Continuing Competence

Decisions About Doctorates: Deciding Whether, When, and Where to Go

Calendar

Continuing Education Opportunities

Employment Opportunities Questions and Answers


Cheryl Bregman

Discuss OT Practice articles at www.OTConnections.org in the OT Practice Magazine Public Forum. Send e-mail regarding editorial content to otpractice@aota.org. Go to www.aota.org/otpractice to read OT Practice online. Visit our Web site at www.aota.org for contributor guidelines, and additional news and information.
OT Practice serves as a comprehensive source for practical information to help occupational therapists and occupational therapy assistants to succeed professionally. OT Practice encourages a dialogue among members on professional concerns and views. The opinions and positions expressed by contributors are their own and not necessarily those of OT Practices editors or AOTA. Advertising is accepted on the basis of conformity with AOTA standards. AOTA is not responsible for statements made by advertisers, nor does acceptance of advertising imply endorsement, official attitude, or position of OT Practices editors, Advisory Board, or The American Occupational Therapy Association, Inc. For inquiries, contact the advertising department at 800-877-1383, ext. 2715. Changes of address need to be reported to AOTA at least 6 weeks in advance. Members and subscribers should notify the Membership department. Copies not delivered because of address changes will not be replaced. Replacements for copies that were damaged in the mail must be requested within 2 months of the date of issue for domestic subscribers and within 4 months of the date of issue for foreign subscribers. Send notice of address change to AOTA, PO Box 31220, Bethesda, MD 20824-1220, e-mail to members@aota.org, or make the change at our Web site at www.aota.org. Back issues are available prepaid from AOTAs Membership department for $16 each for AOTA members and $24.75 each for nonmembers (U.S. and Canada) while supplies last.

OT PRACTICE JULY 23, 2012

News
AOTA News

Association updates...profession and industry news


SIS Call For Nominations (Chairperson Positions)
ominations are being accepted until September 15 for the next chairperson of four SISs: Education, Gerontology, Physical Disabilities, and Technology. The term of office is 3 years, beginning July 1, 2013. The chairperson coordinates the projects and activities of the Standing Committee, including the sections program(s) at AOTAs Annual Conference & Expo, SIS Internet activities, and the topics for the SIS Quarterly publication. The chairperson represents the SIS with all bodies of AOTA and is a member of the SIS Council. Each nominee will submit the information outlined in the SIS Chairperson Nomination Form (Attachment E of the SIS SOPs) to the Nominating Chairperson via e-mail. This form is available on the AOTA Web site in the Nominations and Election Areas area of the SIS section. Nominees may also request this form by contacting the SIS administrative assistant, Barbara Mendoza, at bmendoza@aota. org or 800-SAY-AOTA, ext. 2042. Self-nominations are welcome. and occupational therapy assistants to complete continuing competence requirements. The New York State Occupational Therapy Association (NYSOTA) had lobbied in favor of this requirement since legislation to mandate continuing competence requirements was introduced in 2004. The bill, which is also supported by AOTA, will next be sent to the governor for approval. In addition, the New York State Senate passed Assembly Bill 10118, which allows occupational therapy assistants who have obtained appropriate education to acquire a limited permit to practice with direct supervision in certain settings, such as public hospitals and schools. NYSOTA had pursued this legislation, which also is supported by AOTA, to make technical corrections to the practice act. For more information, visit the Advocacy Highlights section of the AOTA home page, at www.aota.org. ters degree in occupational therapy. OR 2. Completion of an entrylevel masters degree in occupational therapy from a government authorized and/ or WFOT-approved college or university occupational therapy educational program. In addition to the masters degree requirement in occupational therapy, applicants must complete the National Board for Certification in Occupational Therapy (NBCOT) Occupational Therapist Eligibility Determination (OTED) review to determine comparability with U.S. occupational therapy educational accreditation standards/ competencies. All internationally educated occupational therapists reviewed under current OTED eligibility standards and approved for exam eligibility with a bachelors degree in occupational therapy must take the OTR examination by July 31, 2014. After this date, only those approved with a masters degree in occupational therapy deemed comparable with a U.S. entry-level accredited masters degree in occupational therapy will be eligible to apply for the OTR examination. For more information, visit www.nbcot.org.

Supreme Court Upholds Health Care Reform Law: AOTA Analysis

n a 5-4 decision, the U.S. Supreme Court upheld the Patient Protection and Affordable Care Act (ACA), including the minimum coverage provisionmore widely known as the individual mandatethat is the centerpiece. For AOTAs analysis of the decision, including information about how it will affect occupational therapy, go to www.aota.org.

Advanced Practice Specialty Conference


ccupational therapy can be an essential service for those recovering from a traumatic event. Join outstanding speakers, leaders, clinicians, educators, and researchers for 2 incredible days focusing on science, innovation, and evidence at AOTAs Advanced Practice in Traumatic Injuries & PTSD: Lessons for Military, VA, & Civilian Practitioners conference, to be held from September 7 to 8, 2012, in San Antonio, Texas. Topics will include upperextremity orthopedic injuries, pain, burns, vision loss, traumatic brain injuries, warrior transition units, amputations, posttraumatic stress disorder, spinal cord injuries, driving and community mobility, technology, and return to work. Early registration ends August 20. Regular registration ends September 4. For more information, contact specialtyconference@aota.org or visit the AOTA Web site at www. aota.org/confandevents.
2

New NBCOT Rules for Internationally Educated OTs


ffective July 31, 2013, internationally educated occupational therapists must meet one of the following minimum criteria to be considered eligible for the OTR certification examination: 1. Completion of an entrylevel bachelors degree in occupational therapy from a government authorized and/or World Federation of Occupational Therapy (WFOT)approved college or university occupational therapy educational program and a postprofessional mas-

Industry News

New York Passes Two Bills to Amend the States OT Practice Act

AOTF Academy of Research Invites Nominations

he New York State Assembly recently passed Senate Bill 2935. In doing so, the state is poised to join 42 other states and the District of Columbia in requiring occupational therapists

he American Occupational Therapy Foundation (AOTF) Academy of Research invites nominations of individuals who have made exemplary and distinguished contributions toward advancing the science of occupational
JULY 23, 2012 WWW.AOTA.ORG

therapy. Both self-nominations and nominations submitted by colleagues are welcome. The deadline for submitting nominations is September 1, 2012. AOTF established the Academy of Research in 1983, and to date 52 individuals have been elected to this organization by its membership. Nominations should include: (1) a cover letter addressed to the Nomination Committee of the Academy of Research indicating the nominees major research contribution(s); (2) three references (the cover letter signed by nominator(s) will count toward references); (3) a current curriculum vitae of the nominee; and (4) three to five representative research publications of the nominee. A sample cover letter can be found on the AOTF Web site at www.aotf.org under Awards & Honors/For Research/Academy of Research in Occupational Therapy. Please send the nomination package via e-mail, using any attachments as necessary, to research@aotf.org. AOTF supports the development of occupational therapy through programs of philanthropy, research, education, and leadership, and, in doing so, promotes a society in which individuals, regardless of age or ability, may participate in occupations of their choice that give meaning to their lives and foster health and well-being.

available information, tools, resources, and employment data to build tools that promote the employment of people with disabilities. The deadline for submissions is August 23. First-, second-, and third-place winners will receive $5,000, $3,000, and $2,000, respectively, with winners to be announced on August 29. For more information, go to http://disability.challenge.gov.

A O TA B u l l e T I N B O A r d
OUTSTANDING RESOURCES FROM

Occupational Therapy Practice Guidelines for Children With Behavioral and Psychosocial Needs
L. Jackson & M. Arbesman verview of the occupational therapy process for children and youth ages 3 to 21 years with behavioral and psychosocial challenges. Describes evidence-based practice and summarizes the evidence from the literature about best practices in activity-based interventions for this population. $59 for members, $84 for nonmembers. Order #1198C. http:// store.aota.org/view/?SKU=1198C

The Short Child Occupational Profile (SCOPE) (CEonCD)


P. Bowyer, H. Ngo, & J. Kramer Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). ntroducing practitioners to the SCOPE assessment tool, this course provides a systematic way to document a childs motivation for occupations, habits, roles, skills, and environmental supports and barriers. $210 for members, $299 for nonmembers. Order #4847. http:// store.aota.org/view/?SKU=4847

NYC Students and Faculty Walk to End Mental Illness Stigma


ore than 75 occupational therapy educators, clinicians, and students in New York City joined forces on Saturday, May 12, with the National Alliance on Mental Illness (NAMI) affiliate NAMI-NYC Metro to walk for recovery, wellness, and an end to the stigma of mental illness. Students and faculty from York College, New York University, Columbia University, Long Island University, and the State University of New York Downstate Medical Center gathered at the South Street Seaport in downtown Manhattan for the 10th annual NAMINYC Metro Walk. Occupational therapy participants walked halfway across the Brooklyn Bridge and back in honor of the professions dedication to mental health advocacy and recovery. For more information, visit www. downstate.edu/CHRP/ot/nami. html. To find a NAMI Walk Event near you, visit www.nami.org/ walks.

Evaluation: Obtaining and Interpreting Data, 3rd Edition


J. Hinojosa, P. Kramer, & P. Crist his edition of the classic text focuses on the role of the occupational therapist as an evaluator with assessment support provided by the occupational therapy assistant. Chapters discuss the various aspects of a comprehensive evaluation, including screening, reassessment, and re-evaluation, and reaffirm the importance of understanding people as occupational beings. The expansion of this revision reflects contemporary evaluation approaches and discusses the influence of comprehensive evaluation. $59 for members, $84 for nonmembers. Order #1174C. http:// store.aota.org/view/?SKU=1174C

Exploring the Domain and Process of Occupational Therapy Using the Occupational Therapy Practice Framework, 2nd Edition
(CEonCD) S. Roley & J. DeLany Earn .3 AOTA CEU (3.75 NBCOT PDUs/3 contact hours). upports occupational therapy practitioners by providing a holistic view of the profession. Topics include the importance of facilitating occupation within diverse areas of practice, expanding performance skills, expanding interventions for populations and organizations, and achieving meaningful outcomes. $73 for members, $103.50 for nonmembers. Order #4829. http:// store.aota.org/view/?SKU=4829

Labor Department Contest to Build Apps for People With Disabilities

he U.S. Department of Labor launched a new contest to encourage the development of apps that improve employment opportunities and outcomes for people with disabilities. The contest calls on participants to use publicly
OT PRACTICE JULY 23, 2012

Resource

Bulletin Board is written by Amanda Fogle, AOTA marketing specialist.

Updated Tip Sheet on Healthy Gardening

n updated tip sheet on healthy gardening can be found on AOTAs Web site

Ready to order? Call 877-404-AOTA or go to http://store.aota.org Enter Promo Code BB

Questions? Call 800-SAY-AOTA (members); 301-652-AOTA (nonmembers and local callers); TDD: 800-377-8555

c A p I TA l B r I e F I N g

AOTA and State Associations: Collaborating on Local Reimbursement Issues


Stephanie Yamkovenko
proposal, AOTA met with both NYSOTA and ConnOTA to develop a strategy to raise concerns. Staff worked with volunteer leaders to develop comments and talking points to discuss during the meetings with NGS. LCDs impact payment at the local level, so it is important for a state association to attend meetings and submit comments, says Jennifer Bogenrief, manager of AOTAs Reimbursement and Regulatory Policy Department. AOTA can help develop comments and provide other assistance. At the invitation-only meeting, the state association representatives told NGS their concerns about the draft LCD and provided written comments. With feedback they received from NGS during the meeting, the state associations and AOTA developed the final comments due in late June. All three associations submitted comments to NGS, and are waiting to see the final LCD. AOTA posts information about LCDs in the Reimbursement News section of its Web site (www.aota.org/reimb), and individuals can also join the e-mail listservs of their local Medicare contractors. To see the CMS list of LCDs, visit tinyurl. com/cms-state-lcd. Bad LCD policies can affect access to occupational therapy services, restrict what treatment interventions an occupational therapy practitioner may provide, or impose unreasonable and burdensome documentation requirements, says Jeffrey Tomlinson, OTR, MSW, FAOTA, the NYSOTA Legislation and Government Relations coordinator. How do you develop comments? My advice [when working on comments] is to be prepared, says ConnOTA President Susan Goszewski, MSM, OTR. Review what is being proposed and what is written in the Medicare Benefit Policy Manual, Chapter 15. Have written comments reviewed by AOTA, along with experts in the field from your state organization. Goszewski also recommends networking with your states physical therapy association because both groups often have common goals, and it can be beneficial to have a consistent message about delivering therapy services. State and local issues can affect access to services and whether clients receive appropriate coverage. Decisions are being made every year by state legislatures, local governments, and school districts about how occupational therapy services will be paid for and who will get our services, says Tomlinson. In todays economy, we cant assume that occupational therapy will be adequately mandated as a covered service for all of those in need. n
Stephanie Yamkovenko is AOTAs staff writer.

or many occupational therapy practitioners, getting reimbursed for services is an important and often time-consuming process. Reimbursement can also be complicated because of varying state and local payment policies, as is the case with reimbursement through Medicare, which is run by the federal governments Centers for Medicare & Medicaid Services (CMS). With Medicare, claims are reviewed and paid for by Medicare administrative contractors, who can develop their own payment policy local coverage determination (LCD) when Medicare does not have a national coverage policy on an item or service. AOTAs Reimbursement and Regulatory Policy Department advocates with agencies, contractors, and other groups that establish payment rules for therapy. Although many regulations come from federal agencies, there are often federal contractors that establish payment policies on the state or local level that can affect reimbursement. One such case occurred in early May, when the New York State Occupational Therapy Association (NYSOTA) notified AOTA that the Medicare contractor in New YorkNational Government Services (NGS)had invited it to attend a meeting about a draft LCD. NGS also contacted the Connecticut Occupational Therapy Association (ConnOTA) to attend a similar meeting. The draft LCD included some provisions that would make documentation requirements more cumbersome for occupational therapy practitioners. The proposal would change supportive documentation recommendations to supportive documentation requirements that exceed national standards from CMS. Upon learning about the

GET INvOLvED
Being aware of and getting involved in local and state reimbursement issues is an important aspect of advocacy for individual practitioners, too, Bogenrief notes. Comments on draft LCDs do not only have to be from associations individuals can and should submit comments, especially when providing clinical insights on how the draft LCD would affect Medicare beneficiaries. If you find a problem with a draft LCD, contact AOTA, says Bogenrief. Even if you dont understand the issue completely, we will help you develop comments. Sometimes weve actually worked on a similar issue in another state and can provide you with resources, materials, and past comments.

OT PRACTICE JULY 23, 2012

prAcTIce perKs

Fieldwork Level II and Occupational Therapy Students: A Position Paper

Q A

Debbie Amini
I have been an occupational therapy assistant for more than 1 year and would like to begin taking occupational therapy assistant Level II fieldwork students. Does AOTA have a document that addresses issues related to supervising occupational therapy and occupational therapy assistant students?
AOTA recently published a position paper written as a joint effort between the Commission on Practice (COP) and the Commission on Education (COE). Fieldwork Level II and Occupational Therapy Students: A Position Paper was created to define the Level II fieldwork experience and clarify the conditions and principles that must exist to ensure that interventions provided by Level II fieldwork students are of the quality and sophistication needed to be beneficial to the client.1 In the document, AOTA asserts that when appropriately supervised, following the principles of the profession and practice, and in conjunction with other regulatory and payer requirements, the services of Level II fieldwork students are skilled according to their level of professional education. At the point in their professional education where they are able to enter a clinical setting and provide occupational therapy services, students have completed all necessary and required didactic coursework; their interventions should reflect preparation at this level. The Level II fieldwork experience is designed to provide students the opportunity to carry out professional practices and responsibilities under supervision and with appro-

Jyothi Gupta

AOTA recently published a position paper that defines the Level II fieldwork experience and clarifies the conditions and principles that must exist to ensure that interventions provided by Level II fieldwork students are of the quality and sophistication needed to be beneficial to the client.
priate role modeling.2 The position paper clearly states that both the academic program and supervising occupational therapy practitioner are responsible for ensuring that the type and amount of supervision meets the needs of the student and ensures the safety of all stakeholders in settings where an occupational therapy practitioner is on staff.2 Several specific factors, representing minimum criteria, are set to ensure the quality of the services provided by occupational therapy and occupational therapy assistant fieldwork students. These criteria include the following: n Supervisors must have 1 year of experience except in the case of nontraditional Level II experiences, in which case occupational therapy or occupational therapy assistant supervisors must have 3 years of practice experience.2 n Direct supervision of occupational therapy or occupational therapy assistant students in a practice setting where there is no occupational therapy practitioner must occur a minimum of 8 hours per week; occupational therapy supervisors must be available for all other work hours via a variety of methods. An on-site designated nonoccupational therapy contact person must be available at all times when occupational therapy supervisors are not on site.2 An occupational therapist can supervise both an occupational therapy and occupational therapy assistant student, but an occupational therapy assistant, under the supervision of an occupational therapist, can only supervise an occupational therapy assistant student.3 Services are billed as being provided by the supervising and licensed occupational therapy practitioner. The supervising occupational therapy practitioners shall be aware of and recognize when direct versus indirect supervision is needed and ensure that the breadth and scope of supervision matches the current and developing needs of the occupational therapy or occupational therapy assistant students.

According to the Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services,3 direct supervision occurs in real time and offers both audio and visual continued on page 9
JULY 23, 2012 WWW.AOTA.ORG

T e c H TA l K

Touch the Future

Using iPads as a Therapeutic Tool


Cathy Hoesterey Carol Chappelle

s the technology specialist in a school district, I (first author Cathy Hoesterey) am constantly on the lookout for new and emerging technologies to support therapeutic goals of students. Although tablet computers have been around for several years, it became clear soon after the launch of the iPad in 2010 that this product has the versatility and built-in technologies to be a powerful therapeutic tool for children with disabilities.1 Apple has seen explosive growth in the sale of iPads and this trend quickly took off in schools. Early in 2012, Apple announced that more than 1.5 million iPads are in use in educational settings, with 20,000 education and learning applications or apps created specifically for the iPad.2 Apple recognized how the iPad enables children with disabilities to interact with content in new and unique ways and has created a special education section in the App store with more than 10 categories, including communication, organization, and life skills.3 Many of these apps are useful in meeting therapeutic goals for students and clients in occupational therapy settings.

Therapists use the iPad as a tool to support students in working toward many different therapeutic goals, including motor, sensory, visual perception, and social participation.

In fall 2011, the occupational therapists at Bellevue School District each received an iPad with more than 200 free and paid apps. The iPads came in a protective case with a cover that doubles as a stable stand; a neoprene case for holding the iPad; and accessories such as an A/C charger, stylus, and VGA adapter for projecting apps and images. Therapists were then able to use iPads with students in inclusive preschool, elementary, secondary, and transition programs. A survey done by second author Carol Chappelle 3 months after the iPads were distributed indicated that the majority of the therapists (80%) were able to use the iPad with 90% or more of their students. During a typical therapy session of 30 minutes, 60% reported using the iPad for an average of 5 to 10 minutes of that time.

PROJECT BACKGROUND
Bellevue School District, a suburban school district in the greater Seattle, Washington, area, purchased 68 iPads in 2011 with federal stimulus funds. The iPads were distributed to occupational therapists, physical therapists, speechlanguage pathologists, special education teachers, and individual students with special needs. Over the previous 8 months, we had trialed iPads very successfully with five students who had significant communication needs. We were excited about expanding the use of iPads within our Special Education Department.
OT PRACTICE JULY 23, 2012

USES OF THE IPAD


Therapists reported using the iPad as a tool to support students in working toward many different therapeutic goals, including motor, sensory, visual perception, and social participation. The following is a sampling of ways iPads and apps were incorporated into therapy during the past school year. Cause/Effect Skills: There are numerous free apps that encourage exploratory play using the touch interface of the iPad. This is a good way to see the students level of engagement with the iPad and begin to determine if he or she has the requisite motor skills to activate

and use apps. iLoveFireworks Lite, for example, creates a burst of fireworks with each touch, and Fluid simulates the movement of water in what is initially a still pond. Upper Extremity Coordination: MeMoves is an app that encourages bilateral coordination in a series of movement activities. MeMoves can also be projected onto a whiteboard through the iPad VGA or HDMI cable hooked to a projector, or wirelessly using Apple TV. This allows the student to trace the exercises with much larger upper-extremity movements. Social Participation: Toca Tea Party and Toca Hair Salon are excellent apps for turn taking and role playing. One of our speech-language pathologists shared that a young girl with selective mutism was playing Toca Hair Salon with a peer when she blurted out, Dont cut all her hair! surprising herself and everyone around her with the unexpected vocalization. Organization: There are apps using visual supports to assist in reminding and helping organize ones schedule. There are also video apps such as Video Scheduler, allowing demonstration of new skills that can be customized for whatever task is being learned. Our staff work collaboratively with Transition Program teachers and paraeducators to provide supports on the iPad for transition student jobs in the community. For example, one student had to prepare garments for a catalog photo shoot. A visual schedule was created to help her
7

Time Well Spent

hat were your occupations as an adolescent? Did you play sports, pick up an instrument, or learn to dance? Did you go camping, swimming, or fishing? What was your motivation to engage and participate in activities and occupations? Were you encouraged by your parents, siblings, or teachers? In what context did you discover and pursue these occupations? Engaging in healthy occupations plays a crucial role in our growth and development. Individuals learn valuable living skills through exploration, engagement, and participation in valued occupations. Through participation, we acquire skills and competencies, connect with others and our communities, and find purpose and meaning in life. It leads to self satisfaction, a sense of competence, and is essential for psychological and emotional development (p. 644).1 Conversely, individuals who live in environments that do not provide affordances and demands to engage in healthy occupations have difficulty acquiring skills for healthy develop10

Stony Brook University students and faculty work with community members of a local Long Island town to help at-risk youth find occupations that positively influence health and well-being.
ment. Individual participation can be limited by reduced access to services, fear of harm to self or others, or the inability to perform valued roles. For example, people who are unemployed, underrepresented socially and economically, and living in areas of conflict are at a high risk of experiencing occupational deprivation and its devastating effects.1 Occupational deprivation is, in essence, a state in which a person or group of people are unable to do what is necessary and meaningful in their lives due to external restrictions. It is the state in which the opportunity to perform those occupations that have social, cultural, and personal relevance is rendered difficult if not impossible. Other factors that can attribute to occupational deprivation are poverty and a lack of resources.2 Of particular interest to the authorstwo students and a professor at Stony Brook University, in Long Islandare the youth of a nearby town called Brentwood, which has a relatively high rate of poverty and crime compared with other communities in the state of New York and nationwide. Youth of a high socioeconomic status have the opportunity to pursue, engage in, and gain satisfaction from a large range of organized leisure and recreational activities such as sports, dance, and music.3 These structured leisure activities entail rules-guided interaction, a regular participation schedule, specific skill development, and performance that requires sustained attention.3 Meanwhile, youth living in poverty or fragmented families have fewer opportunities to explore and participate in structured occupations.4 The Brentwood community is home to many non-English speaking minorities, undocumented immigrants from Central and South America, single-parent households, and low-income wage earners. The Brentwood community has the highest poverty index for the Long Island area and has the second highest Hispanic population in New York in its school district. Children living with such socioeconomic challenges live in households where parents must choose between occupations (work) that afford basic human necessities and occupations (play) that foster youth growth and development. Adolescents living in underrepresented communities learn to live within their contexts. The demands and afforJULY 23, 2012 WWW.AOTA.ORG

Empowering Communities to Help At-Risk Youth Engage in Healthy Occupations

JOSEPH BRUNNER DAvID vALvANO ALExANDER LOPEz

The youth summit brought together more than 150 leaders and concerned community members to formally advocate for real changes that facilitate youth health, wellness, and safety.

ILLUSTRATION ALEX STSJAZHYN ISTOCKPHOTO PHOTOGRAPH COURTESY OF ALEXANDER LOPEZ / STONY BOROOK UNIVERSITY

dances of those contexts can have lifelong consequences.5 In Brentwood, the youth suffer from a lack of engagement in healthy occupations. The healthy resources available to them are scarce compared with those in wealthier neighboring towns. Other factors contributing to Brentwoods contemporary state are idle time; dangerous living situations; a lack of available financial resources and family involvement; and, most notably, gang participation.

YOUTH SUMMIT ORGANIzED


In May 2011, a youth summit to build a safe community for youth was organized by a local community organizer and educator, Anna Torres. The event was funded by Torres, local businesses, nonprofit groups, and faith-based organizations. The vision of the summit was to address the health, wellness, and safety disparities that contribute to participation in health-compromising activities of Brentwood, where the prevalence of gang activity has increased dramatically. Co-author Alexander
OT PRACTICE JULY 23, 2012

Lopez, then clinical assistant professor of occupational therapy at Stony Brook University, was charged with designing and facilitating the youth summit and did so based on a key concept within occupational therapy: that individuals find meaningful existence through occupation. The principal design of the Summit was based on the Occupational Therapy Practice Framework: Domain and Process, 2nd Edition6 and Ecological Models in Occupational Therapy.7 The summit was designed to identify how people, contexts, and occupations intersect and affect the health, safety, and well-being of youth in Brentwood. The student co-authors participated in the group process of two of the focus groups. The youth summit brought together more than 150 leaders and concerned community members to formally advocate for real changes that facilitate youth health, wellness, and safety. Divided into 11 focus groups, the summit participants included Spanishand English-speaking law enforcement

officers; educators; parents; pastors; social workers; veterans; union workers; middle school, high school, and college students; and first responders and other health professionals. The health professionals included physicians, nurses, occupational therapists, and social workers. Together, all of these youths, parents, professionals, and concerned community leaders contributed their thoughts and expertise about the health and safety concerns of youth.

THEIR CONCLUSIONS
Collectively, participants in the summit agreed that many of the local youth are deprived of sufficient engagement in community and family activities and support. There are multiple social and environmental factors contributing to the lack of healthy occupations for youth in this community. Affordable afterschool programs and activities are difficult to access and most parents of non-English speaking households are unaware of available programs because of language barriers. Most participants agreed that the high cost of living in Brentwood and a large number of single mothers and absentee fathers are not the only factors contributing to occupational deprivation. Many single parents in Brentwood work several jobs to support their families, leaving very little time for activities and involvement with their children.
11

Researchers
Research is a vital part of occupational therapy, especially as evidence-based practice becomes the expected
norm in health care. Fortunately, occupational therapists are already conducting research in an array of specialty areas. What follows are stories of three investigators who have their hands in some particularly interesting work.

A Look at the Influential Studies of Three

KATHY zACKOWSKI, PHD, OTR


Kennedy Krieger Institute Assistant Professor Departments of PM&R, Neurology

athy Zackowski used to work full time in neurological rehabilitation. She loved it, but she was frustrated when her therapy programs would help some clients but not others. It seemed so random. I assumed it was because I didnt know enough and I just hadnt learned enough in school, Zackowski says. So I was just like, I need to go back to school, because I dont really know if I am doing what I am supposed to be doing. So Zackowski went for her research doctorate at Washington University in St. Louis and worked with a neurologist who studied the cerebellum, the part of the brain associated with coordination, and began learning how different movements originate from different parts of the brain. I was interested in understanding how you piece different movements together. Just to get your hand to a cup is this really complicated task. I have to know the weight of my arm. I have to know how my shoulder is going to move relative to my elbow, relative to my wrist

and my fingers, and because they all have weights to them, there are a lot of interaction torques that go with them. So for me to even get there and not knock [the cup] over is really complicated. As Zackowski discerned the link between brain activity and movement, she began seeing her work in the clinic in a totally new way. It started to make sense that certain clients could do certain tasks while others struggled. Clients levels of function could be traced back to what happened to their brains. Zackowskis research made her realize that occupational therapy is at a crossroads. Treatment needs to continue becoming more systematic, she says. It made me recognize that its not me that doesnt know how to do it. Its the system that doesnt really know. We havent made the process of rehab more systematic, and I think thats the downfall. We need to understand that each person is slightly different, but we should be able to group people a little

bit better. So someone with a particular kind of stroke would be better served by certain kinds of rehab, says Zackowski, noting that medical professionals, in order to continue improving, always need to work on updating the theories and research that drive practice. Evidence-based practice is at the heart of Zackowskis work. At the Kennedy Krieger Institute in Baltimore, she conducts research on subjects with brain degenerationspecifically, people with multiple sclerosis and who have had strokes. Zackowski records an MRI scan of each subject to find the precise location in the brain that has been affected. Then, Zackowski and her team equip subjects with sensors, much like the kind used in producing video game simulations, to record how they walk and move. By analyzing the types of mobility problems associated with different parts of the brain, Zackowski is hoping to be able to develop more systematic therapy regimens that align functional goals with specific brain defects.
PHOTOGRAPH COURTESY OF KATHY ZACKOwSKI ILLUSTRATION KYSA / ISTOCKPHOTO.

By analyzing the types of mobility problems associated with different parts of the brain, zackowski is hoping to be able to develop more systematic therapy regimens that align functional goals with specific brain defects.

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JULY 23, 2012 WWW.AOTA.ORG

Occupational Therapy Academics


In oversimplified terms, Zackowski would like to see occupational therapy use some elements of the medical model, while still taking a holistic approach. If a sick patient visits his or her physician, the physician will analyze the symptoms and prescribe a medication. Zackowski wants occupational therapists to be able to do something similar during the evaluation. So if a patient were to see an occupational therapist, the therapist could look at an MRI, see what part of the brain has been affected, and understand what sort of therapy regimen to suggest based on the type of mobility impairment that typically arises when that part of the brain is affected and what activities the patient wants to participate in. Providing another tool could help reduce the amount of time spent on evaluation, allowing more of a focus on the therapy and goals. MRI is used universally in the medical field to diagnose. So it would be nice if we could use some of that information to get at the pathology. Or if the physician could even relay particular features, that might be helpful to the therapist, Zackowski says. I didnt learn very much about MRI in school at all, and I dont think we need to be experts in MRI reading, but I think the system could be set up so there is more communication. I think the physicians in general dont really think that the therapists want to know that information, and I dont know if our programs are really set up to teach therapists how to use that information. But I think that would be a better way to guide our treatment. n

in Action
J

ANDREW WAITE

JOHN A. WHITE, JR., PHD, OTR/L


Program Director and Professor Pacific University School of Occupational Therapy

PHOTOGRAPH COURTESY OF JOHN A. wHITE, JR.

ohn A. White would like to send you to jail. He doesnt work in law enforcement, but he is researching the value of occupational science applied to the prison population and knows that the more occupational therapy practitioners there are paying attention to inmates, the better. Whites work started as an innovative practice project in 2000, when Pacific University students conducted a community outreach initiative at the Washington County Community Corrections Center in Oregon and provided occupational therapy services to some of the inmates. In 2004, the school conducted multidisciplinary follow-up assessments, involving psychologists and physician assistants as well as occupational therapists, among others. The promising results of that assessment led White to begin a full-fledged research study examining the effects of occupational therapy services on people in prison. White and his research partner, Sandra Rogers, and students inter-

viewed about 40 inmates using the Canadian Occupational Performance Measure1 and other tools and are still working the dataset to mine it for value. But the early results are promising. The research suggests that occupational therapy services can greatly reduce rates of re-offending by better preparing inmates for re-entry into society, White says. What we found was fairly consistent with the larger body of literature around criminal justice in that as people look to transition to getting out, particularly for first-time offenders, they tend to have some anxiety about it. They are worried that they might fail and end up back in jail. Securing a job topped the list of inmates concerns. One of the problems with employment is that [former convicts] tend to be in entry-level positions and they are bored. They dont feel challenged, and, so, they may well end up being fired or quitting a job before they really get a chance to establish [working] as a new habit pattern. An interesting barrier for inmates that White came across in his research is the idea of occupational displacement, meaning many offenders have been consumed by the wrong occupations. As we talk with them about their occupational routines, they fairly consistently describe how drug taking, drug obtainment, and partying were

The research suggests that occupational therapy services can greatly reduce rates of re-offending by better preparing inmates for re-entry into society, White says.

OT PRACTICE JULY 23, 2012

15

sOcIAl MedIA spOTlIgHT

www.aota.org/twitter

Personal Space
http://otconnections.aota.org/forums/t/14731.aspx

Heather Evans Posted: Wed, Jun 13 2012 3:50 AM


I am treating two teenagers (age 15) with Aspergers who have difficulty with personal space (tend to talk and stand too close to the person they are having a conversation with, especially when discussing something they really enjoy). Does anyone have any suggestions on how to address this topic? Thank you!

ralph kohl @AOTArkohl Heading to #DemocraticCongressionalCampaignCommittee (DCCC) race review to get their take on House of Rep races for November elections 22 June AOTA News & PR @AOTAIncPR 12 tips for managing #lymphedema in the hot #summer months http://ow.ly/bEhrV 19 June AOTA News & PR @AOTAIncPR #OccupationalTherapy makes No. 6 on @CareerBuilder s top 10 in-demand careers nationwide. Online on @MSN Careers at http://ow.ly/bBiQ2 15 June

barbara smith replied on Wed, Jun 13 2012 10:48 AM


I just wrote a book review on Visual Strategies for Developing Social Skills by Rebecca Moyes. One of the strategies is to teach personal space using small hoola hoops. There are many detailed directions on lessons that teach social skills... http://www.recyclingot.blogspot.com Hope this helps

Find us on Facebook www.aota.org/facebook


American Occupational Therapy Association June 29

Going to a baseball game this weekend?


The New York Mets are considering an autism-friendly quiet section for Citi Field. http://goo.gl/DpaGM

kgloss replied on Sat, Jun 16 2012 6:31 PM


Here are 2 things that work for me: 1. Visuals of expected behavior and unexpected behavior. I post the expected behaviors on a green sheet of paper and unexpected on a red sheet. The visuals can be Boardmaker pics or actual photos of behavior. These are put on a zip tie and hung somewhere for easy access and teaching. 2. Video modeling. Take a short video of the expected behavior (flip camera or iPad). You can also video the unexpected behavior. Load video on iPod touch or iPad for easy viewing and teaching.

Cristina Reyes Smith, Azucena Del Rosario, and 43 others like this. Nick Albert: Thats cool! June 29 Kristin Tursky: Awesome! Im a Mets fan, and a pediatric OT working primarily with children on the spectrum and children with SPD, this sounds wonderful! June 29 American Occupational Therapy Association
June 28

AOTA staff call it a mob scene at the Supreme Court. Our AOTA legal expert is
reading the courts decision and writing an analysis. Stay tuned to aota.org for updates. Want to read the decision? Its here

Sandygrogerotr replied on Mon, Jun 18 2012 11:23 PM


There is a good book called The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situations by Brenda Smith as well as its companion page-a-day calendar, to address a variety of social situations. Personal space is addressed, as well as a host of other common etiquette and social rules.

http://t.co/HB8uZpCx
Kimberly Russell: This has got me thinking I want to go to OT Capitol Hill day. When is it this year or is this it? Did I miss it? June 28 American Occupational Therapy Association Hi Kimberly Russell. This years Hill Day is September 24. We hope you can join us! June 28

BACKGROUND ILLUSTRATION wILLIAM CRAIG / ISTOCKPHOTO.COM

For more of this discussion and to view other posts, go to www.OTConnections.org. New user? Click on Users Guide in the upper right hand corner of the Web page.

Youll also find AOTA on


18

www.aota.org/youtube and

http://pinterest.com/aotainc
JULY 23, 2012 WWW.AOTA.ORG

cONTINuINg cOMpeTeNce

Decisions About Doctorates

Deciding Whether, When, and Where to Go


Pamela Roberts Sue Berger Mary Evenson Mary Khetani Patricia Crist
therapists can better map out their trajectories and devise strategies to facilitate the reality of pursuing a doctoral degree. what type of degree to pursue, consider your prior educational experiences to identify your strengths and challenges in a student role. In prior degrees that you have completed, how was the curriculum structured, where was the program located, and what types of strategies did you employ to matriculate? Prior experiences may have been in a traditional on-campus program of study; however, technological advances mean that distance learning is available in various formats, including online or hybrid programs. Hybrid programs may include online and in-person classes and other meetings with instructors and fellow students, synchronous learning (i.e., a group of people in the same place learning the same things simultaneously), and asynchronous learning (i.e., self-study of coursework materials combined with peer-to-peer interactions by phone, e-mail, videoconferencing, etc.).

octoral education is one approach through which practitioners can work toward becoming scholars who are prepared to contribute to our profession through innovative, occupation-centered, and evidence-based solutions for an ever-changing health care environment. Pursuing doctoral education fits with AOTAs Centennial Vision,1 emphasizing the need to facilitate stronger links between research, education, and practice. For fiscal year 2013, one of the priorities of AOTAs Board of Directors is to reduce faculty shortages by developing programs that encourage faculty to pursue doctoral degrees.2 There are myriad degree options and potential career trajectories that are possible with a terminal degree.3 It is important to find the best match between your professional goals, personal resources, and existing programs. Since 2007, the authors have been working to promote dialogue on the topic of doctoral education among occupational therapists. Representing diverse career trajectories, we have each addressed a common set of issues en route to finding the most suitable professional path. Through our work, we have identified four key, interrelated considerations that appear relevant for occupational therapists to think about when considering doctoral education: (1) the desired outcome/goal; (2) current qualifications; (3) degree options; and (4) practical considerations such as time, money, personal commitments, lifestyle, and geographical preferences. These four considerations are highly congruent with a person-environmentoccupation approach to needs assessment. By answering questions related to each of these areas, occupational

PERSONAL FACTORS: GOALS AND QUALIFICATIONS


In mapping a course toward completing a doctoral degree, consider first your motives, interests, and qualifications. Ask yourself, Do I know why I want to pursue a doctoral degree? Goals typically include creating career mobility and satisfying a desire for continued learning. Motives and interests may include advancing in your specialty area of practice, acquiring research training, gaining experience in effective teaching, and/or assuming a leadership role in health policy or health care management. Next, reflect on your current qualifications. Do you have the necessary skills for doctoral-level work? Determine what entry-level degree is required to enter a particular academic program, whether you need experience or specific professional credentials, whether there are prerequisite criteria, and what level of information literacy and technology fluency is needed.

ENvIRONMENTAL AFFORDANCES AND CONSTRAINTS


Identify the practical considerations of pursuing doctoral education in terms of time, money, and lifestyle. The differences between full- and part-time options are based on how much time you spend while completing your course of study relative to outside employment, family responsibilities, or other commitments. The funding available for your doctoral studies may significantly affect your need to work full- or part-time. There are generally two types of funding opportunities: funds that are directly available (e.g., university fellowships, faculty research projects, training grants, teaching assistant positions, part-time/per-diem jobs, dissertation grants, personal affiliations, educational loans), and funds that can
19

TYPES AND DEMANDS OF DOCTORAL PROGRAMS


There are two major types of doctoral degrees: a research degree, which is awarded in recognition of academic research that is publishable in a peerreviewed academic journal, and a professional or clinical doctorate, which is awarded in certain fields in which most holders of the degree are not engaged primarily in scholarly research but rather in a profession. This latter type of degree often involves a leadership project or comprehensive examination on a focused topic. In deciding

OT PRACTICE JULY 23, 2012

indirectly support your degree completion (e.g., research assistant and leadership fellowship positions or other resources and assistance to support your educational and professional development). Another practical consideration is availability of mentoring. Considering a change, such as pursuing a doctoral degree, provides an opportunity to reflect on your current network of supports and to look forward to developing new mentoring relationships. Ways to improve the quality of relationships with mentors include having realistic expectations, making explicit how your mentor or peer can assist your learning and development, and finding opportunities to discuss both technical and personal aspects of your work. What are your personal and professional resources? Do friends, family members, or colleagues advise and encourage you? Do you thrive in an academic environment, or does going back to school scare you? Are you good at balancing multiple roles? Finally, what are your personal commitments? Do you need or want to live in a specific state or region? Do you have family obligations or are you

responsible for just yourself? Reflecting upon the environmental and practical considerations will help you determine priorities as you move forward in your decision to pursue doctoral education.

org/News/Announcements/Priorities-2013.aspx 3. American Occupational Therapy Association. (2004). Academic terminal degree (2003 statement). American Journal of Occupational Therapy, 58, 648. doi:10.5014/ajot.58.6.648 Pamela Roberts, PhD, OTR/L, SCFES, FAOTA, CPHQ, is

CONCLUSION
Based on our professional presentations and conversations with prospective doctoral students in occupational therapy, we developed a self-assessment tool called the Doctoral Education Readiness Matrix (DERM). We are beginning work to explore the utility of this tool. For more information about the DERM, visit www. cperl.colostate.edu/team/contact.asp. For more information on postprofessional occupational therapy programs, distance education, career planning, and more, visit www.aota.org/educate/schools. n

the manager of rehabilitation and neuropsychology at Cedars-Sinai Medical Center in Los Angeles, California. Sue Berger, PhD, OTR/L, BCG, FAOTA, is a clinical associate professor at Boston University Sargent College of Health and Rehabilitation Sciences in Boston, Massachusetts. Mary Evenson, OTD, MPH, OTR/L, is a clinical associate professor and the academic fieldwork coordinator at Boston University Sargent College of Health and Rehabilitation Sciences. Mary Khetani, ScD, OTR, is an assistant professor of occupational therapy with a secondary appointment in Human Development and Family Studies at Colorado State University in Fort Collins, Colorado. Patricia Crist, PhD, OTR/L, FAOTA, is a professor in the Department of Occupational Therapy at the Rangos School of Health Sciences at Duquesne University in Pittsburgh, Pennsylvania.

References
1. American Occupational Therapy Association. (2006). AOTAs Centennial Vision. Retrieved from http://www.aota.org/News/Centennial/ Background/36516.aspx 2. American Occupational Therapy Association. (2012). AOTA board of directors approves priorities for FY 2013. Retrieved from http://www.aota.

TIME WELL SPENT


Empowering Communities to Help At-Risk Youth Engage in Healthy Occupations continued from page 13 These adolescents have a right to live without fear, to discover their talents and roles, and to follow their dreams. The summit is just the first step in empowering and restoring occupational justice in the community. As occupational therapy practitioners, we are an underutilized resource. The value of occupation can be transformational. We often see the transformation in clinical practice. However, we have the knowledge and skills to move beyond the clinic. n References
1. Law, M. (2002). Participation in the occupations of everyday life. American Journal of Occupational Therapy, 56, 640649. doi:10.5014/ ajot.56.6.640 2. Wilcock, A. A. (1993). A theory of the human need for occupation. Journal of Occupational Science: Australia, 1, 1724. 3. Mahoney, J. L, & Stattin, H. (2000). Leisure activities and adolescent antisocial behavior: 4.

5.

6.

7.

8.

9.

10.

11.

12.

The role of structure and social context. Journal of Adolescence, 23, 113127. Csikszentmihalyi, M. (1993). Activity and happiness: Towards a science of occupation. Journal of Occupational Science: Australia, 1, 3842. American Occupational Therapy Association. (2008). AOTAs societal statement on youth violence. American Journal of Occupational Therapy, 62, 709710. doi:10.5014/ajot.62.6.709 American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62, 625683. doi:10.5014/ajot.62.6.625 Brown, A. (2009). Ecological models in occupational therapy. In E. Crepeau, E. Cohn, & B. Schell (Eds.), Willard and Spackmans occupational therapy (pp. 435461). Philadelphia: Lippincott Williams & Wilkins. Whiteford, G. (2000). Occupational deprivation: Global challenge in the new millennium. British Journal of Occupational Therapy, 63, 200204. Lopez, A., Hammock, H., & Vidal, C. (2011). Citizens for Peace Leadership Summit: The voice of the community. Summit conducted at the meeting of the Youth Summit, Brentwood, New York. Braveman, B., & Bass-Haugen, J. D. (2009). From the desks of the guest editorsSocial justice and health disparities: An evolving discourse in occupational therapy research and intervention. American Journal of Occupational Therapy, 63, 712. doi:10.5014/ajot.63.1.7 Snyder, C., Clark, F., Masunaka-Noriega, M., & Young, B. (1998). Los Angeles street kids: New occupations for life program. Journal of Occupational Science, 5, 133139. Garton, A. F., & Pratt, C. (1991). Leisure activi-

ties of adolescent school students: Predictors of participation and interest. Journal of Adolescence, 14, 305321. 13. Larson, R. W., & Verma, S. (1999). How children and adolescents spend time across the world: Work, play, and developmental opportunities. Psychological Bulletin, 125, 701736. Joseph Brunner and David valvano are students in the Stony Brook University School of Health Technology and Managements Occupational Therapy Program. Alexander Lopez, JD, OT/L, former clinical assistant professor at Stony Brook Universitys Occupational Therapy Program, is an assistant professor at Touro College School of Health Sciences Occupational Therapy Program in Bay Shore, New York.

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JULY 23, 2012 WWW.AOTA.ORG

cAleNdAr
To advertise your upcoming event, contact the OT Practice advertising department at 800-877-1383, 301-652-6611, or otpracads@aota.org. Listings are $99 per insertion and may be up to 15 lines long. Multiple listings may be eligible for discount. Please call for details. Listings in the Calendar section do not signify AOTA endorsement of content, unless otherwise specified. Look for the AOTA Approved Provider Program (APP) logos on continuing education promotional materials. The APP logo indicates the organization has met the requirements of the full AOTA APP and can award AOTA CEUs to OT relevant courses. The APP-C logo indicates that an individual course has met the APP requirements and has been awarded AOTA CEUs.

professional Doctorate of occupational therapy


Sept. 1215

Contact Maribeth Conway at 617-923-4410 ext. 231 for more information.

Syracuse, NY

Eval & Intervention for Visual Processing Impairment in Adult Acquired Brain Injury Part I. This

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an increased understanding of sensory integrative problems in children with autism. Learn strategies for clinical assessment and treatment of sensory integration problems in children with autism. Emphasis on assessing and treating sensory modulaDenver, CO Sept. 1525 tion and discrimination problems. Lecture format, Lymphedema Management. Certification courses small group discussion, and case presentations will in Complete Decongestive Therapy (135 hours), be used to reinforce learning. Geared toward interLymphedema Management Seminars (31 hours). mediate level OTs, PTs, SLPs and OT and PT assisCoursework includes anatomy, physiology, and tants. 1.2 CEUs Enhance your career and become a leader in your profession available. Also coming up: Write pathology of the lymphatic system, basic and adOn! Oct. 14, 2012; SI Treatment Intensive: Refin techniques of MLD, and bandaging for vancedApply principles of evidence-based practice as a basis for Intervention for Children with SPD, ing Praxis primary/secondary UE and LE lymphedema (incl. Jan. 2024, 2013; and Spiral Foundation Symclinical decision making pediatric care) and other conditions. Insurance and posium: Early Identification of SPD and Related billing issues, certification for compression-garment Gain advanced knowledge of occupational therapy practice Diagnosis, March 21-23, 2013. Registration for all courses available at www.thespiralfoundation.org. fitting included. Certification course meets LANA

the field of low vision rehabilitation and research while earning valuable continuing education credits. Attend the multi-disciplinary low vision rehabilitation and research conference dedicated to improving the quality of low vision care through excellence in professional collaboration, advocacy, research, and education. Envision Conference, September 1215, 2012, Hilton St. Louis at the Ballpark. Learn more at www.envisionconference.org.

Envision Conference 2012. Learn from leaders in

requirements. Also in Charlotte, NC, September 1525. AOTA Approved Provider. For more information and additional class dates/locations or to order a free brochure, please call 800-863-5935 or log on to www.acols.com.

intensive updated course has the latest evidence based research. Participants learn to identify visual processing deficits, interpret evaluations, develop interventions and document. Topics include: visual inattention and neglect, eye movement disorders, hemianopsia and reduced acuity. Faculty: Mary warren PhD, OTR/L, SCLV, FAOTA. Also New Orleans, LA, March 9 to 10, 2013. Contact: www.visabilities. com or (888) 752-4364, Fax (205) 823-6657.

October

Newton, MA

Sensory Integration Assessment & Intervention for Children with Autism. Presented by Teresa A. May-Benson, ScD, OTR/L, FAOTA. Gain

Sept. 2122

San Diego, CA

Eval & Intervention for Visual Processing Decits in Adult Acquired Brain Injury Part II. Continua-

Oct. 1214

tion of Part I course, this intense practicum provides hands-on experience in administering, interpreting, and using evaluation results to develop intervention for visual processing decits including eye movement disorders, hemianopsia, reduced visual acuity, and visual neglect. Offered only once a year. Faculty: Mary warren PhD, OTR/L, SCLV, FAOTA. Also Boston, MA, November 810, 2013. Contact visABILITIES Rehab Services: www.visabilities.com or (888) 752-4364, Fax: (205) 823-6657.

Ongoing

Internet & 2-Day On-Site Training

professional through the study and application of occupational science literature and occupation-based intervention Doctorate of Design, implement, and evaluate the effectiveness of innovative occupation-based programs in your chosen area of interest occupational DOCTORATE of OCCUPATIONAL THERAPY PROFESSIONAL therapy 24/7 online experience, with just two short residencies, allows
Continuing Education

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Bachelors Degree-to-otD option


Experienced occupational therapists who hold a bachelors degree in occupational therapy but do not hold a masters degree have the option to bridge into Chathams OTD program

Enhance your career and become a leader in your profession Apply principles of evidence-based practice as a basis for clinical decision making Gain advanced knowledge of occupational therapy practice through the study and application of occupational science literature and occupation-based intervention www.chatham.edu/ccps/ot Woodland Road . . . Pittsburgh, PA Design, implement, and evaluate the effectiveness of innovative 866-815-2050 . . . ccps@chatham.edu occupation-based programs in your chosen area of interest OT 24/7 online experience, with just two short residencies, allows PRACTICE JULY 23, 2012 www.chatham.edu/ccps/ot you to study with convenience and flexibility

Enhance your career and become a leader in your profession Apply principles of evidence-based practice as a basis for clinical decision making Gain advanced knowledge of occupational therapy practice through the study and application of occupational science literature and occupation-based intervention Design, implement, and evaluate the effectiveness of innovative occupation-based programs in your chosen area of interest 24/7 online experience, with just two short residencies, allows you to study with convenience and flexibility Develop skills in areas of professional advocacy, education, and business Taught by clinical educators distinguished nationally and regionally in specific areas of expertise Accredited by Middle States Association of Colleges and Secondary Schools

Bachelors Degree-to-otD option

Experienced occupational therapists who hold a bachelors degree in occupational therapy but do not hold a masters degree have the option to bridge into Chathams OTD program
Woodland Road . . . Pittsburgh, PA 866-815-2050 . . . ccps@chatham.edu
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ACROSS PRACTICE AREAS NEW! OT Manager Topics, by Denise Chisholm, Penelope Moyers Cleveland, Steven Eyler, Jim Hinojosa, Kristie Kapusta, Shawn Phipps, and Pat Precin. Supplementary content from chapters in The Occupational Therapy Manager, 5th Edition with additional applications relevant to selected issues on management. Earn .7 CEU (8.75 NBCOT PDUs/7 contact hours). Order #4880, AOTA Members: $194, Nonmembers: $277. http://store.aota. org/view/?SKU=4880

Occupational Therapy in Action: Using the Lens of the Occupational Therapy Practice Framework: Domain and Process, 2nd Edition, by
Susanne Smith Roley and Janet DeLany. Occupational therapy and the occupational therapy process as described in the 2008 second edition of Framework. Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). Order #OL32, AOTA Members: $180, Nonmembers: $255. http://store.aota.org/ view/?SKU=OL32

Assessment & Intervention Training 2008 Conference Schedule


San Francisco, CA Feb 29-Mar 1 Two Days of Hands-On Learning (1.6 CEU) Burlington, NC Mar. 14-15 Houston, TX Mar 28-29 Upcoming Locations & Dates: McAllen, TX Apr. 4-5 Chicago, IL Apr 11-12 Harrison, AR August 1617 San Antonio, TX Apr 19-20 Charleston, SC Apr 25-26 Warrenton, VA August 2324 Tampa, FL May 2-3 San Antonio, TX October 45 Manhattan, NY Jul 17-18 Virginia Beach, VA Sep 20-21 Miami, FL October 1314 Morganton, NC Sep 25-26 Chicago, IL November Kissimmee, FL Oct 10-11 12 Columbia, SC Oct 16-17 Sacramento, CA Oct 24-25 Stafford, TX January 1819, 2013 Orlando, FL Nov 14-15

2-day hands-on workshop (1.6 CEU)

Assessment and Intervention

CEonCD

ASSESSMENT & EvAlUATION

Self-Paced Clinical Course

Occupational Therapy and Home Modification: Promoting Safety and Supporting Participation,

CEonCD

presented by Deborah Yarett Slater. Foundation in basic ethics information that gives context and assistance with application to daily practice and rationale for changes in the Occupational Therapy Code of Ethics and Ethics Standards 2010. Earn .3 AOTA CEU (3.75 NBCOT PDUs/3 contact hours). Order #4846, AOTA Members: $105, Nonmembers: $150. http://store.aota.org/view/?SKU=4846

NEW! Everyday Ethics: Core Knowledge for Occupational Therapy Practitioners and Educators, 2nd Edition, by AOTA Ethics Commission and

edited by Margaret Christenson and Carla Chase. Education on home modification for OT professionals and an overview of evaluation and intervention and detailed descriptions of assessment tools. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3029, AOTA Members: $259, Nonmembers: $359. http://store.aota.org/view/?SKU=3029

CEonCD

The Short Child Occupational Profile (SCOPE), by

For complete training schedule & information visit Host a Beckman Oral Motor Conference in 2009! www.beckmanoralmotor.com For Hosting info call (407) 590-4852, or email Host a Beckman Oral Motor Seminar! info@beckmanoralmotor.com Host info (407) 590-4852, or info@beckmanoralmotor.com

www.beckmanoralmotor.com

For additional info and to register, visit

D-6064

CEonCD

Yarett Slater, Staff Liaison to the Ethics Commission. Professional, ethical, and legal responsibilities in the identification of safety issues in ADLs and IADLs as they evaluate and provide intervention to clients. Earn .1 AOTA CEU (1.25 NBCOT PDUs/1 contact hour). Order #4882, AOTA Members: $45, Nonmembers: $65. http://store.aota.org/ view/?SKU=4882

NEW! Ethics TopicDuty to Warn: An Ethical Responsibility for All Practitioners, by Deborah

Patricia Bowyer, Hany Ngo, and Jessica Kramer. Introduction of SCOPE assessment tool and description of documenting child motivation for occupations, habits and roles, skills, and environmental supports and barriers. Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). Order #4847, AOTA Members: $210, Nonmembers: $299. http://store. aota.org/view/?SKU=4847

CEonCD

CEonCD

Ethics TopicsOrganizational Ethics: Occupational Therapy Practice In a Complex Health Environment, by Lea Cheyney Brandt. Issues that can

Structured, semi-structured, and general clinical interviewing and set of norms and communication strategies that can maximize accurate, relevant, and detailed information. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4844, AOTA Members: $68, Nonmembers: $97. http://store.aota. org/view/?SKU=4844

Strategic Evidence-Based Interviewing in Occupational Therapy, presented by Rene R. Taylor.

Neurorehabilitation for Dementia-Related Diseases (Order #3022 http://store.aota.org/view/?SKU=3022), Neurorehabilitation for Stroke (Order #3021 http:// store.aota.org/view/?SKU=3021), and Neurorehabilitation for Traumatic Brain Injury (Order #3020 http:// store.aota.org/view/?SKU=3020). Each: 1 AOTA CEU (12.5 NBCOT PDUs/10 contact hours), AOTA Members: $129.50, Nonmembers: $184.10.

CEonCD

influence ethical decision making and strategies for addressing pressure from administration on services in conflict with code of ethics. Earn .1 AOTA CEU (1.25 NBCOT PDUs/1 contact hour). Order #4841, AOTA Members: $45, Nonmembers: $65. http://store .aota.org/view/?SKU=4841

CEonCD

CEonCD

of todays health care environment and results in increased moral distress for occupational therapy practitioners. Earn .1 AOTA CEU (1.25 NBCOT PDUs/1 contact hour). Order #4840, AOTA Members: $45, Nonmembers: $65. http://store.aota.org/ view/?SKU=4840

Ethics TopicsMoral Distress: Surviving Clinical Chaos, by Lea Cheyney Brandt. Complex nature

Kielhofner, Lisa Castle, Supriya Sen, and Sarah Skinner. Information from observation, interview, chart review, and proxy reports to complete the MOHOST occupation-focused assessment tool. Earn .4 AOTA CEU (5 NBCOT PDUs/4 contact hours). Order # 4838, AOTA Members: $125, Nonmembers: $180. http://store.aota.org/view/?SKU=4838

Model of Human Occupation Screening Tool (MOHOST): Theory, Content, and Purpose, by Gary

perspective in defining the process and nature, frequency, and duration of interventions and case studies of adults at different stages of Alzheimers disease. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4883, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/ ?SKU=4883

NEW! Using the Occupational Therapy Practice Guidelines for Adults with Alzheimers Disease and Related Disorders (ADRD) To Enhance Your Practice, by Patricia Schaber. Evidence-based

ADED Approved CEonCD

Determining Capacity to Drive for Drivers with Dementia Using Research, Ethics, and Professional Reasoning: The Responsibility of All Occupational Therapists, by Linda A. Hunt. Re-

BRAIN & COGNITION

Self-Paced Clinical Course

CEonCD

Official documents and materials that support OT concept of wellness, interdisciplinary literature, and models from other disciplines. Earn .25 CEU (3.13 NBCOT PDUs/2.5 contact hours). Order #4879,
OT PRACTICE JULY 23, 2012

Lets Think Big About Wellness, by winnie Dunn.

garet Newsham Beckley, and Mary A. Corcoran. Includes 4 componentsthe Core SPCC, and 3 Diagnosis-Specific SPCCs. Core SPCC: Core Concepts in Neurorehabilitation: Earn .7 AOTA CEU (8.75 NBCOT PDUs/ 7 contact hours). Order #3019, AOTA Members: $91, Nonmembers: $128.80. http://store.aota. org/view/?SKU=3019. Diagnosis-Specific SPCCs:

Neurorehabilitation Self-Paced Clinical Course Series, by Gordon Muir Giles, Kathleen Golisz, Mar-

quired professional reasoning and ethics for making final recommendations about the capacity for older adults with dementia to drive or not. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4842, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/?SKU=4842

ChIlDREN & YOUTh

Self-Paced Clinical Course

Early Childhood: Occupational Therapy Services for Children Birth to Five, edited by Barbara E.
Chandler. Federal legislation in OT practice and public awareness strategies on expertise in transi-

23

CE
2012 Occupational Therapy
Continuing Education Directory
AOTA Single COurSe ApprOvAl
Continuing Education for Occupational Therapy Practitioners

features continuing education opportunities in a variety of learning formats and interests to provide you with the very best options to reach your professional development goals, and to encourage lifelong learning, in occupational therapy. Take advantage of these possibilities!

his essential resource guide

Academy of Lymphatic Studies

A.T. Still University

5850 E Still Circle Mesa, AZ 85206 USA 480-219-6070 (fax) 480-219-6100 lnishijima@atsu.edu www.atsu.edu Linda Nishijima, Program Manager

11632 High Street, Suite A Sebastian, FL 32958 USA 800-863-5935 772-589-3355 (fax) 772-589-0306 admissions@acols.com www.acols.com Carrie Brubaker, Admissions Representative The Academy of Lymphatic Studies provides education and training in Lymphedema Management. We are the leading school in the United States for lymphedema certification training for health care professionals in Manual Lymph Drainage and Complete Decongestive Therapy. Become a Certified Lymphedema Therapist today! AOTA approved provider.

Approved Single Course Provider


If you, your employer, or school offer occasional live OT-related courses or conferences, you can gain unparalleled exposure and credibility as an AOTA Approved Single Course Provider. You now have the chance to offer valuable AOTA CEUs to your single course attendees. Providers who offer only occasional courses relevant to occupational therapy can apply to have a single live course approved. Approval is limited to a maximum of 2 courses or 2 occurrences of a course in a 12-month period.

AACPDM

555 E Wells Street, Suite 1100 Milwaukee, WI 53202 USA 414-918-3014 (fax) 414-276-2146 meetings@aacpdm.org www.aacpdm.org/meetings/2012 Marie Grevsmuehl, Meetings Manager

Academy Medical Systems

Abilities OT Services and Seminars Inc. (AOTSS)

PO Box 393 Bend, OR 97709 USA 866-414-3500 541-306-3795 (fax) 949-606-8400 lezliep@academymedical.com www.academymedical.com Lezlie Putnam, Accreditation Manager

To learn more, visit us at www.aota.org/appinfo. AOTA Members: 1-800-729-2682, x2834 Nonmembers & Local: 301-652-6611, x2834 TDD: 1-800-377-8555 E-mail: APP@aota.org
PR-179

Pikesville Plaza 600 Reisterstown Road, Suite 600GH Baltimore, MD 21208 USA 410-358-7269 (fax) 443-438-9948 info@aotss.com www.aotss.com Shoshana Shamberg, OTR/L, MS, FAOTA, President

Access 7 Services, Inc.

6080 Jericho Turnpike, Suite 200 Commack, NY 11725 USA 631-864-7770 (fax) 631-864-7773 info@access7online.com www.access7online.com Dave Anton, Executive Director of Business Operations

ABOARDs Autism Connection of PA


35 Wilson Street, Suite 100 Pittsburgh, PA 15223 USA 800-827-9385 412-781-4116 (fax) 412-781-4122 support@autismofpa.org www.autismofpa.org Marie Mambuca, Family Support

Achieve Beyond

70-00 Austin Street, Suite 200 Forest Hills, NY 11375 USA 866-696-0999 718-762-7633 (fax) 718-886-8694 info@achievebeyondusa.com www.achievebeyondusa.com Sonu Sanghoee, Director of Speech Supervision
JULY 23, 2012 WWW.AOTA.ORG

26

Adams Brothers Communications


PO Box 293 New Market, MD 21774 USA 877-428-2527 301-694-7418 contactus@icuclass.com www.icuclass.com Gregory Adams, Continuing Education Administrator

Alvernia University

Occupational Therapy Program 400 St. Bernardine Street Reading, PA 19607 USA 610-568-1539 (fax) 610-796-5516 neil.penny@alvernia.edu www.alvernia.edu Dr. Neil H. Penny, Occupational Therapy Program Director

Continuing Education

Adaptive Mobility Services, Inc.

1000 Delaney Avenue Orlando, FL 32806 USA 407-426-8020 (fax) 407-426-8690 spierce@adaptivemobility.com www.adaptivemobility.com Susan Pierce, OTR, SCDCM, CDRS, President

American Academy for Cerebral Palsy and Developmental Medicines


555 E Wells Street, Suite 1100 Milwaukee, WI 53202 USA 414-918-3014 (fax) 414-276-2146 info@aacpdm.org www.aacpdm.org Marie Grevsmuehl, Meetings Manager

Sensory Integration Techniques for Healthcare Professions


Award Winning Online Course with Companion Therapy Tool at www.sensoryintegrationtraining.org 0.4 Contact Hours
CED-6058

Advanced Brain Technologies

5748 S Adams Avenue Parkway Ogden, UT 84405 USA 888-228-1798 801-622-5676 (fax) 801-627-4505 info@advancedbrain.com www.advancedbrain.com Stevie Zanetti, Office Assistant Advanced Brain Technologies (ABT) is a neurotechnology company that develops and distributes interactive software and music-based programs for the improvement of sensory processing, self-regulation skills, communication abilities, attention, listening, and more. In addition, we offer professional training, certification, and continuing education opportunities to become providers of The Listening Program.

American Occupational Therapy Association


4720 Montgomery Lane Bethesda, MD 20814-3425 USA 800-SAY-AOTA (members) 301-652-6611(nonmembers/local) (fax) 301-652-7711 cedept@aota.org www.aota.org

Alabama State University

Department of Occupational Therapy PO Box 271 Montgomery, AL 36101 USA 334-229-5056 (fax) 334-229-5882 www.alasu.edu

AOTA Continuing Education offers some of the highest quality and most relevant continuing education available to the occupational therapy profession and to educators for supplemental use in their classrooms. CE opportunities include the AOTA 2013 Annual Conference & Expo (April 2528 in San Diego), Self-Paced Clinical Courses (SPCCs), online courses, Continuing Education Articles in OT Practice, CEonCDs, and Conference Webcasts. Learn more about the wide variety of courses and topics available at www.aota.org/ce.

AMPS Project International

American Society of Neurorehabilitation


5841 Cedar Lake Road, Suite 204 Minneapolis, MN 55416 USA 952-545-6324 (fax) 952-545-6073 asnr@llmsi.com www.asnr.com

American Society on Aging Allen Cognitive Network and Advisors


PO Box 1093 Norton, MA 02766 USA database.acn1@gmail.com www.allen-cognitive-network.org Deane B. McCraith, Continuing Education Administrator ACN is a nonprofit, international membership organization that promotes the cognitive disabilities model introduced by Claudia Allen through networking and education. ACN will sponsor the 9th Cognitive Symposium, Practical Approaches to Promote Best Ability to Function, in San Diego, CA, November 1 to 3, 2012 (18.5 AOTA CEUs). See details on Web site.
OT PRACTICE JULY 23, 2012

71 Stevenson Street, Suite 1450 San Francisco, CA 94105 USA 415-974-9600 (fax) 415-974-0300 info@asaging.org www.asaging.org/aia Nancy Decia

PO Box 271928 Fort Collins, CO 80527 USA 970-416-8612 info@ampsintl.com www.ampsintl.com Jo Becker, Business Manager AMPS Project International provides continuing education for occupational therapists and develops tools for occupation-based practice. The Assessment of Motor and Process Skills (AMPS), School AMPS, and Evaluation of Social Interaction (ESI) are designed to evaluate a persons quality of occupational performance (i.e., activities of daily living, schoolwork tasks, and social skills, respectively).

Anat Baniel Method

CE Directory listings of organizations that have met the requirements of the full AOTA Approved Provider Program (APP) include this icon.

4330 Redwood Highway, Suite 350 San Rafael, CA 94903 USA 415-472-6622 (fax) 415-472-6624 executive.admin@anatbanielmethod.com www.anatbanielmethod.com Natasha Katz, Executive Assistant

27

neW FrOM AOTA COnTinuing eDuCATiOn

OT Manager Topics
CEonCDTM
By Denise Chisholm, PhD, OTR/L, FAOTA; Penelope Moyers Cleveland, EdD, OTR/L, BCMH, FAOTA; Steven Eyler, MS, OTR/L; Jim Hinojosa, PhD, OT, BCP, FAOTA; Kristie Kapusta, MS, OT/L; Shawn Phipps, PhD, OTR/L, FAOTA; and Pat Precin, MS, OTR/L, LP

Earn .7 CEU (8.75 NBCOT PDUs/7 contact hours). Successful occupational therapy management in both clinical and leadership positions is essential to ensure high-quality practice for clients in all settings. This new CE course presents supplementary content from chapters in The Occupational Therapy Manager, 5th Edition and provides additional applications that are relevant to selected issues on management. The course focuses on 6 specific topics with individual learning objectives, and it is strongly recommended that participants read the selected chapters prior to studying the topics. Topics Occupation-Based Practice in Management Evidence-Based Occupational Therapy Management Evaluating Occupational Therapy ServicesContinuing Quality Improvement Continuing Competency Conflict Resolution Employee Motivation.

Order #4880. AOTA Members: $194, Nonmembers: $277

RECOMMENDED READING The Occupational Therapy Manager, 5th Edition


Edited by Karen Jacobs, EdD, OTR/L, CPE, FAOTA, and Guy L. McCormack, PhD, OTR/L, FAOTA

This latest edition of an AOTA bestseller includes 37 new and updated chapters, discussing the how-to aspects of creating evidence-based practice; effectively leading and motivating staff; ensuring ethical service delivery; and important day-to-day items such as budgeting, documentation, and reimbursement.

Order #1390C. AOTA Members: $79, Nonmembers: $112

OT MAnAger SeTpurchase Together and Save 15%! Order #4880K. AOTA Members: $232, nonmembers: $330

Shop AOTA today! Call 877-404-AOTA, or shop online at http://store.aota.org


CE-248

eMplOYMeNT OppOrTuNITIes
Faculty Faculty

The UTMB Department of Occupational Therapy invites applications for two positions: a 12-month full-time, tenure-track faculty position at the rank of assistant or associate professor and a 12-month .75 FTE nontenure track position at the rank of clinical instructor or assistant professor. Rank and emphasis of duties will be commensurate with the individuals record of prior experience and productivity. Duties will include teaching; research and scholarly work; service on departmental, school, and university committees; and faculty practice. We welcome the opportunity to expand our faculty with the addition of team-minded individuals committed to education and to expanding the knowledge base of occupational therapy. These individuals would benefit from associations with experienced occupational therapy faculty and opportunities to network with faculty from other schools, the Division for Rehabilitation Sciences, and various centers of excellence. Founded in 1891, UTMB is a major medical research and medical humanities center located within a resilient and multicultural community that offers numerous venues for collaboration and practice. The successful applicant will have a minimum of 2 years of practice in occupational therapy and eligibility for occupational therapy licensure in Texas. Preferred education will be an earned PhD degree in occupational therapy, rehabilitation sciences, or other related discipline, or an OTD. Please send a letter of application and curriculum vitae to: Patricia Fingerhut, OTR, PhD Chair of the Occupational Therapy Search Committee Department of Occupational Therapy School of Health Professions The University of Texas Medical Branch at Galveston 301 University Blvd. Galveston, TX 77555-1142 The University of Texas Medical Branch is an Affirmative Action/Equal Opportunity institution that proudly values diversity. Candidates of all backgrounds are encouraged to apply.
F-6083

assistant or associate Professor of occupational Therapy


The University of North Dakota Department of Occupational Therapy, in the School of Medicine & Health Sciences, is inviting applications for a full-time, 12-month assistant or associate professor who will begin December 1, 2012, at our Casper, WY, site. Candidates will have the opportunity to be an integral part of an occupational therapy program that grants an entry-level Master of Occupational Therapy (MOT) degree on two campuses, located in Grand Forks, ND, and Casper, WY. The program is a satellite of the University of North Dakota professional-level MOT program, and is housed at Casper College in Casper, WY. The University of North Dakota Occupational Therapy Program in Grand Forks began in 1954 and the Casper satellite opened in 1993. PoSiTioN QualificaTioNS aNd reSPoNSiBiliTieS required Candidates must possess an earned masters degree, minimum of 2 years of clinical experience, evidence of teaching experience, strong leadership background, and familiarity with a variety of educational approaches (e.g., traditional, online, distance). Candidates must hold current certification by NBCOT and be eligible for licensure in North Dakota and Wyoming. Each full-time faculty member is responsible for supporting the teaching, scholarship, and service missions of the department as designated in collaboration with the department chair. The faculty member is responsible for providing effective learning experiences for students with diverse interests, abilities, and expectations. Faculty members are expected to engage in creative/scholarly activities and be involved in activities that support individuals and or groups in the institution; university system; professional associations; or external communities at the local, state, regional, national, or international levels. The position also includes undergraduate and graduate student advisement. The individual will be responsible for teaching in his or her area(s) of expertise in relation to being able to teach a variety of courses within physical disabilities, psychosocial occupational therapy, adaptive technology, and ergonomics. The individual must have strong written and interpersonal communication skills. Responsibilities will also include undergraduate and graduate student advisement. Additionally, this position will hold administrative responsibilities in accordance with ACOTE standards for satellite program administration. Preferred Earned doctorate (or progress toward this degree), experience in higher education, and proficiency in using multiple modes of teaching/learning technologies, including video-conferencing and online instruction. Veterans preference does not apply to the advertised position. SalarY: Commensurate with experience. aPPlicaTioN ProceSS Apply only online via https://secure.med.und.edu/search/occupational-therapy/. Application review will begin August 1, 2012, and remain open until the position is filled. Interested candidates should submit: (1) a letter of application that includes a copy of current licensure and information on past state licensure; (2) curriculum vita; (3) a teaching statement; and (4) the complete names, addresses, and phone numbers of three references. A criminal history record check will also be completed per State Board of Higher Education Procedures 602.3. Questions concerning this position may be directed to the Search Committee Chair: Anne M. Haskins, PhD, OTR/L, Associate Professor University of North Dakota School of Medicine & Health Sciences, Department of Occupational Therapy 2751 2nd Ave. N, Hyslop 210, Stop 7126, Grand Forks, ND 58202 anne.haskins@med.und.edu or 701.777.0229 GeNeral iNforMaTioN Founded in 1883, the University of North Dakota has a student enrollment of more than 14,500 students and is one of only 47 public universities in the United States that has accredited schools of both law and medicine. UND offers 89 undergraduate majors, 63 undergraduate minors, 57 masters programs, 23 doctoral programs, two professional programs (medicine and law), and a specialist diploma program in educational leadership. UND is an equal opportunity/affirmative action institution. The Casper, WY, satellite program was developed in 1993 in response to a critical shortage of professional therapists in that state, and the absence of occupational therapy education in Wyomings higher education institutions. It has been accredited since 1995. The Casper site allows the University of North Dakota Occupational Therapy Department to assist in fulfilling university strategic planning initiatives by providing highly trained medical professionals in the region and the nation through a fully accredited mirror program. Casper is the second largest community in Wyoming, with a 2010 population of 55, 316 residents. Set in between Casper Mountain, the north most part of the Laramie Mountain Range, and the Platte River, Casper offers year-round activities in a safe, midsize city. F-6084 41

School of Medicine & Health Sciences Department of Occupational Therapy

OT PRACTICE JULY 23, 2012

Q &A

uestions and Answers


Cheryl Bregman, MS, OTR/L, and her Abilipad app (www.abilipad.com) have been gain-

ing more and more national attention from occupational therapy practitioners and other professionals. The adaptive keyboard allows children of all abilities to develop writing skills and to communicate with the help of pictorial cues, text-to-speech technology, word prediction, and other enhancements. The app, available on iTunes, really took off when it was listed on www.appsforaac.net, a listserv that updates visitors on effective apps for augmentative and alternative communications, and it received praise from assistive technology specialist Jane Farrall. Bregman recently spoke about Abilipad with OT Practice associate editor Andrew Waite.

Waite: How did you get the idea for Abilipad? Bregman: The idea was born at the Shire School in Virginia, where we use iPads to address learning goals for kids on the autism spectrum. As the kids started doing more writing on their iPads, I began searching for a keyboard with lowercase letters that would better support their literacy program. I discovered that there was none, and thats how it all started. Waite: How has the app evolved?

Bregman: As soon as the app was


released, I started receiving requests to add various features. The first was to link keyboards to one another so that one can, for example, shift from a word bank back to a QWERTY keyboard. Next we enabled pictures to be placed onto the keyboard. We also received requests for different languages to be added and have included Spanish, French, and German word prediction and text-to-speech engines. Waite: How often do you use the app in practice? Bregman: Every day, and every student uses it differently. One student might use the word prediction to assist with spelling and to reduce keystrokes. Another may use the text-to-speech feature to hear what he or she has written so as to correct spelling and grammatical errors. The key48

board allows for as few or as many letters, as needed, to be visible. Because words, sentences, or pictures can be added to the keyboard, an activity [can be graded] to make it work for students with varying abilities. For example, one can include only the letters of a students name on the keyboard. Once they are able to type those in the correct order, more letters can be added or the target letters can be highlighted to make them more noticeable. I also create spelling activities, word games, and sentence-building activities based on a weekly theme and upload them into the shared keyboard section for the students homework. Their parents in turn download those activities, and it is a great way for them to share in what is being done at school. Waite: What are some of the challenges you faced when creating the app, and are there resources you would recommend? Bregman: Because I needed to outsource the programming, the first challenge was finding a developer. After many disappointments, I eventually had success using elance.com, a site where one can hire freelance professionals. Another challenge was marketing. Prior to developing Abilipad, I never had a Facebook or Twitter account. It quickly became evident, though, that social media would

be fundamental in getting my app visible amongst the excess of apps available. So I have to wear many different hats and be open to new challenges every day. One of the greatest resources I discovered was the Moms With Apps (www. momswithapps.com) group, which is an online community of developers focused on kids apps. They provide a forum for sharing information about marketing and technical issues, as well as an archive of articles from seasoned developers on their experiences. All in all, it has been an incredible learning process with many surprising twists and turns. I feel that [occupational therapy practitioners] have a significant contribution to make in this arena and that there is still a great need for quality apps. Waite: Is this the beginning of a new career for you? Bregman: I see it more as an extension of my therapy services. One uses the same principles to create an app as one would to adapt an activity, a device or an environment in order to help a student overcome an obstacle and be more independent. n

JULY 23, 2012 WWW.AOTA.ORG

Advance Your Practice in Traumatic Injuries & PTSD!


AOTA SPeCIALTY COnFeRenCe

Advanced Practice in Traumatic Injuries & PTSD: Lessons for Military, VA, & Civilian Practitioners
September 78, 2012 San Antonio, Texas earn Up To 13 Contact Hours! early Registration ends August 20! www.aota.org/Confandevents/ Advanced-Practice
Thousands of veterans and civilians have suffered severe traumas or life-threatening events where they felt severe role disruption for themselves and their family members. These individuals need occupational therapy to rehabilitate and reintegrate them into their communities. If you are part of this critical needor want to beattend the outstanding AOTA Specialty Conference on Advanced Practice on Traumatic Injuries & PTSD! SeSSIOn TOPICS Upper Extremity Orthopedic Injuries Pain Burns Vision Loss eXPeRT SPeAKeRS KeYnOTe: COL Paul F. Pasquina, MD; Walter Reed National Military Medical Center PLenARY: Leslie F. Davidson, PhD, OTR/L, FAOTA; Shenandoah University PLenARY: Mary Vining Radomski, PhD, OTR/L, FAOTA; Sister Kenny Rehabilitation Institute Krista L. Brown, CPT, SP, OTR/L, CHT; U.S. Army Medical Specialist Corps Ted Chapman, MS, OTR/L, CHT; U.S. Army Medical Specialist Corps Joyce Engel, PhD, OT, FAOTA; University of Wisconsin-Milwaukee Paul A. Fontana, OTR, FAOTA; Center for Work Rehabilitation, Inc. MAJ Sarah B. Goldman, PhD, OTR/L, CHT; Office of the Surgeon General Yasmin Gonzalez, OTR/L, ABDA, CLT; James A Haley VA Medical Center Gregory Leskin, PhD; UCLA National Center for Child Traumatic Stress Imelda Llanos, MS Visual Disabilities, OTR/L; James A Haley VA Medical Center Sheri Michel, OTD, OTR/L; Warrior Transition Battalion, Brooke Army Medical Center Melissa L. Oliver, MS, OTR/L; McGuire VA Medical Center Theresa Prudencio, MPH, OTR, CDRS; William Beaumont Army Medical Center Elizabeth Sadler, MHA, OTR/L; Army Office of the Surgeon General Lynn Stoller, MS, OTR/L, RYT; Cotting School Lisa Smurr Walters, MS, OTR/L, CHT; Center for the Intrepid
PR-205

Traumatic Brain Injuries (TBI) Warrior Transition Units Amputations Post Traumatic Stress Disorder (PTSD)

Spinal Cord Injuries (SCI) Driving & Community Mobility Technology Return to Work

Help protect all


that youve worked for with the AOTA-sponsored Disability Insurance Plan.
As a healthcare professional, you probably know the importance of having a solid, dependable health insurance plan for yourself and your family should one of you become ill. But what if you become seriously ill or disabled, causing you to be out of work for a lengthy amount of time? The risks are real. It could happen to you. Whats more, what if you were Totally Disabled and didnt have your full paycheck? Think about it: would you and your family be able to live on less than what you normally earn today? Thats why AOTA makes available the Disability Insurance Plan for its members. This important disability program can pay more and pay longer than many plans, and offers you the quality protection youll likely need.

Disability Insurance Plan highlights:


n Monthly benefit options from $200 to $5,000. n Benefits paid up to 60% of your Pre-Disability

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n Coverage you can take with you, even if

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n Part-time work benefits available

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P-6045

Education Article

(one contact hour and 1.25 NBCOT PDU). See page CE-7 for details.

Earn .1 AOTA CEU

Leading With Ethics


SHARON KURFUERST, EDD, OTR/L, FAOTA
Vice President, Rehabilitation and Orthopaedic Services Christiana Care Health System Wilmington, DE

Creating an Ethical Climate in Your Occupational Therapy Department


on those issues that are faced by organizational leaders (Suhonen, Stolt, Virtanen, & Leino-Kilpi, 2011). Challenges in the workplace often have multifactorial causes and no silver bullet solutions; however, creating an ethical climate for occupational therapy practitioners in the workplace is critical. Shirey (2005) indicated that creating a good and acceptable ethical climate increases employee morale, enhances organizational commitment, and fosters an engaged and retained workforce (p. 65). Occupational therapy leaders must be prepared to raise the bar on ethical behavior and to create a workplace climate that fosters ethical decision making regardless of environmental forces.

JANE R. YOUSEY, OTR/L, ACC


Director of Rehabilitation Development SAVA Consulting, LLC Atlanta, GA This CE Article was developed in collaboration with AOTAs Administration & Management Special Interest Section.

ABSTRACT
This article will demonstrate the importance of creating an occupational therapy department culture that embodies the best principles of organizational ethics and ethical practice. In particular, the article will introduce concepts of organizational ethics and ethical leadership, with a secondary emphasis on applying tips and strategies to align departmental operational processes with these concepts.

UNDERSTANDING ORGANIzATIONAL ETHICS


Organizational ethics is more complex than examining clinical or bioethics, professional codes of conduct, or business ethics individually. Organizational ethics requires a critical evaluation of the interplay of all of these areas, especially in the health care organization of today, in which providers face pressure from many sourcesconsumers, regulatory bodies, organizational managers, and others. Brandt (n.d.) noted:
Occupational therapy practitioners are not immune to these pressures. Most are familiar with the pressure to do more with less, whether manifested in a lack of resources or increased productivity standards. Constraints in time and money will continue to exist in health care; therefore, occupational therapy practitioners must understand how to handle these problems ethically while addressing the needs of the clients and the communities they serve. Practitioners may work within an organization, but they also belong to a profession with core values based on concepts of altruism, equality, freedom, justice, dignity, truth, and prudence.

LEARNING OBJECTIvES
After reading this article, you should be able to: 1. Recognize the key elements of organizational ethics. 2. Identify components of ethical leadership. 3. Apply concepts of organizational ethics to commonly encountered situations in an occupational therapy department. 4. Differentiate between ethical decision making and decision making that puts ethical outcomes at risk.

INTRODUCTION
Health care professionals, including occupational therapy practitioners, work in environments that are constantly changing relative to clinical decision making and practice, policy, political contexts, team structures, and consumer demands (Gallagher & Tschudin, 2010). These variables often intersect to produce a complex environment that is ripe for conflict. If left unmanaged, this conflict can result in practitioner frustration and anger, employee disengagement, moral distress, and potentially unethical conduct. Kerns (2003) reminded practitioners and leaders that ethics is about good behavior. Defined broadly, organizational ethics refers to administrative and management issues that arise in the health care setting and is typically focused
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Organizational ethics can be defined and discussed in two ways. Descriptive ethics are those actions that people actually take. They are the behaviors that can be observed and described, with the reasons for those behaviors articulated (Mihaly, 2007). Descriptive ethics are often concerned with examining and analyzing the reasons that people give for their moral beliefs and behaviors. Prescriptive, also called normative, ethics look at those actions that ought to be done (Mihaly, 2007). Prescriptive ethics provide reasons for behavior that are open to scrutiny by others and seek to identify the authoritative standards that govern moral choices (Csongradi, n.d.). Much of the focus in health care organizations surrounds normative ethics; however, it is impossible to separate factors of descriptive from normative ethics in everyday occupational therapy practice within an organization.
CE-1

OT PRACTICE, 17(13)

ARTICLE CODE CEA0712

AOTA Continuing Education Article


CE Article, exam, and certificate are also available ONLINE. Register at http://www.aota.org/cea or call toll-free 877-404-AOTA (2682).

Brown (1989) supported this view and identified the need for both an individualistic approach and a communal approach to looking at ethics in organizations in order to gain a greater understanding of the problems that may exist. The individualistic approach focuses on individuals in the organization and the degree to which they are morally responsible for their own behavior. Efforts to modify that behavior should be aimed at the individuals themselves (Brown, 1989). The communal approach recognizes that individuals do not function in isolation but rather as members of a larger entity or community (organization). This community must take some responsibility for the behavior of the people in it. To change individual behavior, there must also be a change in how the larger community behaves (Brown, 1989). As occupational therapy practitioners and occupational therapy leaders, we must recognize that the interplay between the individual practitioners behavior and the behavior of the larger organization (or the occupational therapy department) are co-mingled, with one impacting and shaping the behavior of the other. Elements of an Ethical Organization Many occupational therapy practitioners think of organizational ethics in terms of the ethics applied to providing direct care rendered to clients. But creating an ethical workplace climate, whether at the larger organizational level or at the level of the occupational therapy department within the larger organization, goes well beyond the services delivered to clients. It encompasses all activities within the department. The shared perceptions by practitioners of the characteristics and values, both overt and covert, that shape the organization, affect the decisions that are made in every interaction. These decisions are complex and happen at the organizational, departmental, and individual levels. Berghofer and Schwartz (n.d.) stated:
An ethical organization is a community of people working together in an environment of mutual respect, where they grow personally, feel fulfilled, contribute to a common good, and share in the personal, emotional, and financial rewards of a job well done. There is a shared understanding that success depends on a constellation of relationships, both internal and external, not all of which are under the organizations control, but which it can influence through the way it operates from a platform of ethical principles.

organization. Although originally aimed at the global business world, the principles may be applied to a vast array of organizations, including those in health care. They can also be applied to departments within a larger organization, such as occupational therapy departments, to begin the process of determining strengths and areas needing development in the journey toward establishing truly ethical climates. The areas requiring examination as part of this model include the organizations values, stakeholder balance, process integrity, long-term perspective, and leadership effectiveness (Jondle, Shoemake, & Kowske, 2011). Winkler, Gruen, and Sussman (2005) similarly identified four key considerations in developing an ethical organization, with their research specifically focused on health care organizations. These considerations consist of providing care with compassion, treating employees with respect, acting in a public spirit, and spending resources responibly. Although each of these elements that support the development of organizations or departments that foster an ethical climate warrants a more in-depth study, the remainder of this article focuses on effective and ethical leadership. As occupational therapy managers and leaders, we must develop a robust and mature sense of ethics in our own leadership skills and style, culminating in the ability to incorporate the other elements into our departments and communicate their importance both directly and indirectly to those we lead.

ETHICAL LEADERSHIP
Occupational therapy leaders must take not only an individualistic approach to managing ethics, but also a communal approachthat is, they must foster a climate in which each member of the occupational therapy department is supported and guided in making ethically sound decisions. According to Prince, a leaders most important responsibility is to influence others to make ethically sound decisions, and that starts with leaders personally behaving ethically (Squazzo, 2012, p. 37). Gardner (2007) reiterated that the best way for a leader to stand up to ethical pressure and behave as a role model to others is to believe that retaining an ethical compass is essential to the health of your organization (department) (p. 54). But that is easier said than done. Amid the current pressures of productivity expectations, reimbursement challenges, staffing shortages, and more complex health care systems to navigate, a leader may be just one decision away from eroding the ethical climate in his or her department, albeit unknowingly and unintentionally. Ethical leadership is knowing your core values and having the courage to live them in all parts of your life in service of the common good (Center for Ethical Leadership, n.d.). The inability to execute this definition of ethical leadership in everyday practice and departmental operations can lead to moral distress, defined by Mitton, Peacock, Storch, Smith, and Cornelissen (2010) as the physical and emotional
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This platform of ethical principles has been described in the literature by many, with varying degrees of overlap in the characteristics of what makes an organization ethical. One of the most concise and understandable models comes from the University of St. Thomas Center for Ethical Business Cultures, which developed The Minnesota Principles (Center for Ethical Business Cultures, n.d.). These principles were designed to encourage dialogue among leaders in international business regarding the components of an ethical
CE-2

ARTICLE CODE CEA0712

OT PRACTICE, 17(13)

Earn .1 AOTA CEU (one contact hour and 1.25 NBCOT PDU). See below for details.

How To Apply for Continuing Education Credit


A. After reading the article Leading With Ethics: How to Create an Ethical Climate in Your Occupational Therapy Department, register to take the exam online by either going to www.aota.org/cea or calling toll-free 877-404-2682. B. Once registered, you will receive your personal access information within 2 business days and can log on to www.aota-learning.org to take the exam online. You will also receive a PDF version of the article that may be printed for personal use. C. Answer the questions to the final exam found on p. CE-8 by July 31, 2014. D. Upon successful completion of the exam (a score of 75% or more), you will immediately receive your printable certificate.

Final Exam CEA0712


Leading With Ethics: How to Create an Ethical Climate in Your Occupational Therapy Department July 23, 2012 To receive CE credit, exam must be completed by July 31, 2014. Learning Level: Intermediate Target Audience: Occupational therapists and occupational therapy assistants Content Focus: Category 3: Professional Issues 1. Occupational therapy departments that either overlook or permit compromised ethical practices often struggle with which one of the following? A. Understanding AOTAs Occupational Therapy Code of Ethics and Ethics Standards (2010) (Code and Ethics Standards) B. Having foundational organizational policies and systems in place C. Employing adequately trained and experienced staff to provide care D. Understanding the interplay of human behavior in the organizational environment 2. Creating an ethical climate in an occupational therapy department can serve to: A. Improve employee morale B. Foster an engaged and retained workforce C. Foster an environment that supports descriptive ethics D. Both A and B 3. The best definition of prescriptive ethics is: A. Looking at those actions that ought to be done B. Examining those actions that were done incorrectly C. Watching employees actual behaviors D. Evaluating the environment for areas requiring change to support ethical behavior and decision making 4. An employee is billing inaccurately and has submitted charges for services that were not rendered. The best course of action is to: A. Interview all clients that you suspect were falsely billed to determine whether they received occupational therapy services. B. Discipline the employee for falsely billing and involve the human resources department. C. Back out inappropriate charges for the services not rendered. D. Do nothing immediately and see whether the thirdparty payer notices the problematic charges. continued on next page
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Brandt, L. C. (n.d.). On organizational ethics. Retrieved from http://www.aota. org/practitioners/ethics/advisory/organization.aspx Brown, M. (1989). Ethics in organizations. Retrieved from http://www.scu.edu/ ethics/publications/iie/v2n1 Brown, M. E., & Trevino, L. K. (2006). Ethical leadership: A review and future directions. The Leadership Quarterly, 17, 595616. Center for Ethical Business Cultures. (n.d.). The Minnesota Principles: Toward an ethical basis for global business. Retrieved from http://www.cebcglobal. org/index.php?/about/the-minnesota-principles/ Center for Ethical Leadership. (n.d.). Ethical leadership. Retrieved from http:// ethicalleadership.org/about-us/philosophies-definitions/ethical-leadership Centers for Medicare & Medicaid Services. (2011). 42 CFR Parts 413, 424, and 455. Federal Register, 76(88). Retrieved from http://www.gpo.gov/fdsys/pkg/ FR-2011-05-06/html/2011-10555.htm Csongradi, C. (n.d.). Why the topic of bioethics in science classes? A new look at an old debate. Retrieved from http://www.accessexcellence.org/LC/SER/BE/ definitions.php Gallagher, A., & Tschudin, V. (2010). Educating for ethical leadership. Nurse Education Today 30, 224227. Gardner, H. (2007). The ethical mind: A conversation with psychologist Howard Gardner. Harvard Business Review, 85(3), 5156, 142. Hofmann, P. B. (2012). Fear of conflict: Management and ethical costs. Healthcare Executive, 27(1), 5860. Jondle, D. J., Shoemake, R. C., & Kowske, B. (2011). Assessing the ethical culture. Retrieved from http://www.kenexa.com/getattachment/5660e59e-ea7340f6-a3db-35fb74639073/Assessing-the-Ethical-Culture.aspx Kerns, C. D. (2003). Creating and sustaining an ethical workplace culture. Gradiadio Business Review, 6(3). Retrieved from http://gbr.pepperdine. edu/2010/08/Creating-and-Sustaining-an-Ethical-Workplace-Culture Markkula Center for Applied Ethics. (2009). A framework for thinking ethically. Retrieved from http://www.scu.edu/ethics/practicing/decision/framework.html Mihaly, M. (2007). Moral theory: The fundamentals. Ethics and Behavior, 17, 406407. Mitton, C. S., Peacock, J., Storch, N., Smith, & Cornelissen, E. (2010). Moral distress among healthcare managers: Conditions, consequences and potential responses. Healthcare Policy, 6(2), 99112. Shirey, M. A. (2005). Ethical climate in nursing practice: The leaders role. JONAs Healthcare Law, Ethics, and Regulation, 7(2), 5967. Squazzo, J. D. (2012). Ethical challenges and responsibilities of leaders. Healthcare Executive, 57(1), 3138. Stenmark, C. K., & Mumford, M. D. (2011). Situational impacts on leader ethical decision-making. The Leadership Quarterly, 22, 942955. Suhonen, R., Stolt, M., Virtanen, H., & Leino-Kilpi, H. (2011). Organizational ethics: A literature review. Nursing Ethics, 18, 285303. Winkler, E. C., Gruen, R. L. & Sussman, A. (2005). First principles: Substantive ethics for healthcare organizations. Journal of Healthcare Management, 50(2), 109119. JULY, 2012
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