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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

®

MARCH 26, 2012

Caregivers
•  eetingtheNeedsofCaregivers M ofPersonsWithDementia • CaregiverTraining&OT
PLUS

Caring for

Reducing Work Injuries Social Media Spotlight News, Capital Briefing, & More
CE ARTICLE

Evaluating Sensory Processing in Mental Health OT Practice

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
VOLUME 17 • ISSUE 5 • MARCH 26, 2012

FEATURES
Meeting the Needs of Caregivers of Persons With Dementia
An Important Role for Occupational Therapy
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Ad inquiries: 800-877-1383, ext. 2715, or e-mail sales@aota.org
OT Practice External Advisory Board

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Tina Champagne, Chairperson, Mental Health Special Interest Section Donna Costa, Chairperson, Education Special Interest Section Michael J. Gerg: Chairperson, Work & Industry Special Interest Section Tara Glennon, Chairperson, Administration & Management Special Interest Section Kim Hartmann, Chairperson, Special Interest Sections Council Leslie Jackson, Chairperson, Early Intervention & School Special Interest Section 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 Regula Robnett, Chairperson, Gerontology Special Interest Section Missi Zahoransky, Chairperson, Home & Community Health 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 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 AOTA to reproduce or photocopy material appearing in OT Practice. A fee of $15 per page, or per table or illustration, including photographs, will be charged and must be paid before written permission is granted. Direct requests to Permissions, Publications Department, AOTA, or through the Publications area of our Web site. Allow 2 weeks for a response.

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Catherine Verrier Piersol, Tracey Vause Earland, and E. Adel Herge discuss how occupational therapy practitioners, in their efforts to build research, education, and practice in dementia care, can better provide for the needs of caregivers.

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DEPARTMENTS
News Capital Briefing Practice Perks
Partnering for Practice Protection Reducing Work Injuries and Promoting Worker Productivity

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Helping the Helpers

Caregiver Training and Occupational Therapy

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Tech Talk

Assisting Clients With Amyotrophic Lateral Sclerosis: The Bidet

Social Media Spotlight

Updates From Facebook, Twitter, Youtube, and Pinterest

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Andrew Waite talks with occupational therapists who are working to provide better caregiver training to help seniors live life to its fullest, in the home and in pursuit of daily activities and occupations.

Calendar

Continuing Education Opportunities

Employment Opportunities Living Life to Its Fullest
OT Reflections from the Heart Do Not Walk Outside This Area

Evaluating Sensory Processing in Mental Health Occupational Therapy Practice
Earn .1 AOTA CEU (1 contact hour or NBCOT professional development unit) with this creative approach to independent learning.

CE Article

• 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.otpractice.org/currentissue 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 Practice’s 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 Practice’s 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 AOTA’s Membership department for $16 each for AOTA members and $24.75 each for nonmembers (U.S. and Canada) while supplies last.

OT PRACTICE • MARCH 26, 2012

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RegisteR today at www.aota.oRg/confeRence

AoTA 2012 AnnuAl ConferenCe & expo
April 26–29 indiAnApolis, in

Why you should attend
The AOTA Annual Conference & Expo is the best time and place each year for occupational therapy practitioners, educators, researchers, and students to meet and grow professionally. It is an experience that you don’t want to miss! • Advanced-level learning in Pre-Conference Institutes and Seminars • More than 650 sessions targeted on special practice areas and topics • Continuing education opportunities to earn up to 24 contact hours • Insight and inspiration from Dr. Florence Clark’s Presidential Address • Special events, networking, and exhibits!

science. innovation. evidence.
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news
Association updates...profession and industry news
AOTA News
Nicole Cortes: Student Representative to Commission on Education (COE) Kristin J. Davis: Student Representative to the Representative Assembly (RA)

AOTA 2012 Election Results

2011–2012 Student Membership Circle
OTA’s Student Membership Circle project began in 2007 as a way of engaging occupational therapy and occupational therapy assistant students through their colleges or universities by recognizing the role they play in supporting AOTA efforts and helping achieve Centennial Vision goals, while showing them the value of AOTA membership in supporting their academic education in career preparation. Gold level programs achieved 100% percent AOTA student membership, Silver level programs received 80% student membership, and Bronze level programs achieved 75% student membership. Congratulations to the following Student Membership Circle programs for the 2011–2012 academic year.

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he Nominating Committee is pleased to announce the results of the election, which concluded on February 28, 2012. A special thanks to all the candidates who were willing to serve the Association and to all members who took the time to vote.

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Conference Blog Will Get You Set for Indy

GENERAL ELECTIONS Virginia (Ginny) Carroll Stoffel: President-Elect Amy Lamb: Vice President Shawn Phipps: Director to the Board of Directors Pamela E. Toto: Director to the Board of Directors Andrea R. Bilics: Commission on Education ChairpersonElect Yvette Hachtel: Ethics Commission Chairperson-Elect SPECIAL INTEREST SECTIONS (SISs) Jane Richardson Yousey: Administration & Management SIS Chairperson Dottie Handley-More: Early Intervention & School SIS Chairperson Tracy Van Oss: Home & Community Health SIS Chairperson Linda M. Olson: Mental Health SIS Chairperson ASSEMBLY OF STUDENT DELEGATES (ASD) Laura Mills: Chairperson Russell Thompson: OT Vice Chairperson Sara Androyna: OTA Vice Chairperson Ashley Nichols: Secretary Jamie Morris: Communications & Advocacy Chairperson

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OTA’s Annual Conference & Expo is just a month away, from April 26 to 29, and the Conference blog is your way to stay on top of preparations. Check out the blog, at http://otconnections.org/blogs/ conference, for the latest videos and bulletins to get you ready for the big event, and continue to check the blog during Conference for more updates live from Indianapolis. For those who have not already registered, go the Conference blog or www.aota.org/confandevents/ 2012conference and register to attend the profession’s premier networking and professional development event.

Occupational Therapy Programs Gold Level— 100% Student Membership
Belmont University Boston University Cleveland State University The College of St. Scholastica Columbia University Dominican University of California East Carolina University Eastern Kentucky University Eastern Michigan University Florida Gulf Coast University Governors State University Howard University Husson University Indiana University–Purdue University at Indianapolis Kean University Loma Linda University Long Island University Louisiana State University Health Science Center–Shreveport Louisiana State University Health Science Center–New Orleans Medical University of South Carolina

RA Feedback Deadline March 31

Misericordia University Mount Mary College Ohio State University Richard Stockton College of New Jersey Rockhurst University Saginaw Valley State University Saint Louis University St. Catherine University Stony Brook University Touro University Nevada University of Central Arkansas The University of Findlay University of Indianapolis University of Kansas University of New England University of New Hampshire University of North Dakota University of North Dakota/ Casper Location University of Pittsburgh University of Puget Sound University of Southern California University of Southern Maine University of St. Augustine University of St. Augustine/San Marcus Campus University of Tennessee Health Science Center The University of Toledo University of Utah Utica College Virginia Commonwealth University Winston-Salem State University Xavier University

Silver Level—80% Membership
Chatham University Colorado State University Creighton University James Madison University Lenoir-Rhyme University Quinnipiac University Sacred Heart University St. Ambrose University SUNY Downstate Medical Center Thomas Jefferson University University of Illinois at Chicago University of Mississippi Medical Center University of South Dakota University of Southern Indiana University of Wisconsin–Madison University of Wisconsin–Milwaukee Washington University School of Medicine continued
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he Representative Assembly (RA), your “congress” in the profession of occupational therapy, is busy preparing for its spring meeting in Indianapolis on April 25 and 26 and wants you to provide feedback by March 31 so that it can be informed of your opinions as members debate the business set before them. Details of the motions and other action items are posted on AOTA’s Web site, at www.aota.org/governance. Click on the RA tab, then the RA Spring Meeting link.

OT PRACTICE • MARCH 26, 2012

A o TA B u l l e T i n B o A r d
OUTSTANDING RESOURCES FROM

Bronze Level—75% Membership
Chicago State University Nova Southeastern University Pacific University School of Occupational Therapy University of New Mexico University of Texas Medical Branch

Cognition, Occupation, and Participation Across the Life Span: Neuroscience, Neurorehabilitation, and Models of Intervention in Occupational Therapy, 3rd Edition
N. Katz his comprehensive new edition represents a significant advancement in the knowledge translation of cognition and its theoretical and practical application to occupational therapy practice with children and adults. Chapters, written by leaders in an international field, focus on cognition that is essential to everyday life. $89 for members, $126 for nonmembers. Order #1173B. http:// store.aota.org/view/?SKU=1173B

An Occupation-Based Approach in Postacute Care to Support Productive Aging (CEonCD™)
D. Chisholm, C. Dolhi, & J. Schreiber Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). eviews the characteristics of occupationbased practice with a focus on postacute care practice settings for older adults. Practical strategies are presented in an interactive format to promote the practitioner’s ability to integrate occupation throughout the occupational therapy process. Real-life scenarios illustrate the occupation-based approach for facilitating productive aging. $210 for members, $299 for nonmembers. Order #4875 http://store.aota. org/view/?SKU=4875

Occupational Therapy Assistant Programs Gold Level—100% Membership
Allegany College of Maryland Anoka Technical College Casper College Central Community College Cincinnati State College Greenville Technical College Hawkeye Community College Itawamba Community College Kennebec Valley Community College Middle Georgia College Murray State College Nashville State Community College Newman University Northland Community and Technical College Parkland College Philadelphia University Continuing and Professionals Studies Pulasku Technical College/Baptist Health Schools Little Rock South Arkansas Community College Lake Area Technical Institute Saint Louis College of Health Careers

Lieberman, Maria Elena Louch, Lauro Munoz, Meira Orentlicher, Ann O’Sullivan, Maureen Peterson, Laurel Radley, Dianne Rios, Regula Robnett, Sandy Schefkind, Elin Schold Davis, Deb Slater, Karen Smith, and Judy Thomas.

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Embracing Children’s Mental Health Awareness Day
ay 9 marks Children’s Mental Health Awareness Day, when occupational therapy practitioners can take extra time to highlight the profession’s ability to address function and increase children’s participation. Those looking for ways to highlight the value of occupational therapy as it relates to children’s mental health will find a wealth of information in the Children & Youth section of the Practitioners area on AOTA’s Web site, at www.aota.org/practitioners. On that page, members can find links to pediatric virtual chats on bullying and obesity; tip sheets on preventing obesity and encouraging play and productive recess; a consumer’s toy checklist, and more.

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Occupational Therapy in Acute Care
H. Smith Gabai his important text lays the foundation for occupation-based practice and addresses the contextual issues of working within the acute care setting. Detailed research covers the importance of occupational therapists’ knowledge of how diseases affect the human body, including the cardiovascular, nervous, and endocrine systems. $109 for members, $154 for nonmembers. Order #1258. http://store. aota.org/view/?SKU=1258

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Strategic Evidence-Based Interviewing in Occupational Therapy
(CEonCD™) R. Taylor Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). egins with an introduction to the three types of interviews most commonly applied in occupational therapy practice: structured, semi-structured, and general clinical. Through evidence-based examples, the course describes a set of norms and communication strategies that are likely to maximize success in gathering accurate, relevant, and detailed information. $68 for members, $97 for nonmembers. Order #4844 http://store.aota.org/ view/?SKU=4844

Silver Level—80% Membership
Anamarc College Bristol Community College Lewis & Clark Community College North Dakota State College of Science Penn College of Technology Salt Lake Community College

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Industry News

Bronze Level—75% Membership
North Shore Community College

Questions? Phone: 800-SAY-AOTA (members) 301-652-AOTA (nonmembers and local callers) TDD: 800-377-8555 Ready to order? By Phone: 877-404-AOTA Online: http://store.aota.org Enter Promo Code BB

OT Practice Thanks Reviewers

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Bulletin Board is written by Jennifer Folden, AOTA marketing specialist.

he staff members of OT Practice thank the following persons for sharing their expertise by providing content reviews of manuscripts and articles from January 23 through March 26: Marianne D’Amico, Tara Glennon, Dottie Handley-More, Neil Harvison, Gavin Jenkins, Deborah

SSO: USA Announces Research Grant Opportunity for Students
ttention students with an idea. The Society for the Study of Occupation: USA invites occupational science students to submit research grant proposals that demonstrate direct relevance to at least one of the priorities of the society. Awards of up to
MARCH 26, 2012 • WWW.AOTA.ORG

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Meeting the Needs of

Caregivers of Persons With Dementia
CATHERINE VERRIER PIERSOL n TRACEY VAUSE EARLAND n E. ADEL HERGE

An Important Role for Occupational Therapy

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ccupational therapists and occupational therapy assistants should expect to work with persons with dementia now and into the future. Currently, an estimated 5.4 million Americans are diagnosed with Alzheimer’s disease and related dementias (ADRD), which means 1 in 8 adults ages 65 and older (13%) have dementia.1 If current trends continue, by 2030 the number of persons over age 65 diagnosed with ADRD is estimated to be 7.7 million. This is a 50% increase from the current number.1 Persons with ADRD can present with a unique constellation of needs based on the changes associated with the particular diagnosis. The symptoms of ADRD, including loss of intellectual functioning, changes in personality and mood, and/or the manifestation of problematic behaviors, can make caregiving a very difficult and complicated task. Because of occupational therapy’s holistic approach, it is appropriate and imperative that the profession be a leader in research, education, and practice efforts with regard to dementia care, which must include the needs of caregivers.

The occupational therapy profession must consider the needs of caregivers in its efforts to build research, education, and practice in dementia care.
and are supported by informal caregivers1—typically, relatives or friends who provide daily care and oversight.2 Nearly 15 million informal caregivers are providing 80% of the care for a person with ADRD in the home, totaling an estimated 17 billion hours, which averages 21.9 hours of care per caregiver per week.1 Most of these caregivers are women (60%), aged 55 or older (56%), married (66%), and have less than a college degree (67%). More than half of caregivers are the primary breadwinners of the household (55%) and nearly half are employed full or part time outside the home (44%).1 Often, caregivers are told by health care providers only the types of activities or functions that their family member with dementia can no longer do. The heart of occupational therapy intervention for persons with dementia focuses on what the person with dementia can do—that is, his or her functional capacity to perform daily activities. Thus, occupational therapy practitioners bring important professional skills and expertise to the care of patients with dementia and the education and support of caregivers. Over time, the person with dementia requires more assistance and supervision with daily activities and routines for safety as physical, sensory, and cognitive functions decline. Family caregivers must often provide this care; however, they may not possess the knowledge and skills to effectively function in this role. Caregivers often experience distress, depression, emotional upset,1 and anxiety,3 and they are at high risk for poor physical and emotional health and decreased quality of life.2,4 The responsibilities of caregiving can disrupt routines of employment, leisure exploration, social participation,5,6 and health maintenance.7 Caregiver stress frequently increases when the person with dementia exhibits challenging behaviors that typically manifest as part of the disease. Examples of such behaviors include agitation, wandering or excessive moving, refusing or resisting care, inappropriate or destructive behaviors, physical or verbal aggression, rummaging and hoarding, or distressful feelings or beliefs.8 Evidence suggests that family caregivers find these behaviors very disturbing and difficult to manage.8–10 Research indicates that persons with dementia have a higher rate of negative
MARCH 26, 2012 • WWW.AOTA.ORG

CAREGIVERS OF PERSONS WITH DEMENTIA
Care for persons with dementia is provided by formal (paid) and informal (unpaid) caregivers. Seventy percent of persons with ADRD live at home
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A woman with dementia and her caregiver read a birthday card.

behavior symptoms when their family caregivers are stressed.11

OCCUPATIONAL THERAPY AND FAMILY CAREGIVERS
Successful approaches and techniques used when caring for a family member with dementia may be counterintuitive to caregivers. In fact, their best intentions may actually trigger certain types of behaviors. For example, not correcting a mistake or going along with something that is not true may feel deceitful and wrong to the family member providing care; however, this strategy can minimize anxiety and other problematic behaviors in the person with dementia. Research shows that family caregivers need and benefit from training in managing behaviors and promoting function in their family member.5,12–14 Evidence suggests that interventions that include the caregiver have been effective in improving the occupational performance of the individual with ADRD as well as increasing caregiver competence and skill at managing challenging behaviors; reducing caregiver stress, anxiety, and depression; and improving caregiver sense of health.3
OT PRACTICE • MARCH 26, 2012

Occupational therapy practitioners are in a unique position to help families understand the disease process, set up or modify daily routines, provide training on effective strategies to manage difficult behaviors, and teach family caregivers ways to reduce their own stress and take care of themselves.15 Evidence-based practical approaches are effective in helping family caregivers manage the care for persons with dementia.

CONCEPTUAL FRAMEWORKS GUIDING PRACTICE
Conceptual frameworks offer a foundation for occupational therapy practitioners to approach family caregiver education. These frameworks are built on what we know about reducing the stress in the environment. Through the use of these frameworks, occupational therapists can develop approaches, treatment goals, and interventions that improve the competency of the caregiver and ultimately the participation in daily activities of the person with dementia. A few frameworks describe the interaction between the person with dementia and his or her environment.

The Competence–Environmental Press Model suggests that the interchange of the declining competency of the person with dementia, and the physical and social environments presenting greater demands, leads to maladaptive behavior and dysfunctional outcomes.16 As the caregiver simplifies components of the multi-layered environment to align with the person’s reduced competency, he or she may display less excess disability.17 Training the caregiver to obtain that “just-right fit” between individual capabilities and external environmental demands results in positive behaviors and enhanced quality of life for both the caregiver and the individual with dementia. The Progressively Lowered Stress Threshold model views dysfunctional behavior as a response in part to the build up of environmental stressors that overwhelm the capacity of the individual with dementia.18,19 By teaching the caregiver how to modify environmental demands that exceed functional capacity, the individual with dementia will exhibit less occupational dysfunction. The caregiver can promote more adaptive behavior by regulating activity and stimulation levels
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PHOTOGRAPH © STEVE DUNWELL / AGE FOTOSTOCK / GETTY IMAGES

EARN YOUR CE CREDITS WITH AOTA CEonCDs !
TM

Welcome to AOTA Learning! Our CEonCDs provide relevant continuing education on a wide variety of topics in an easy-to-use format with electronic exam. Choose any of these CEonCDs or others at http://store.aota.org to advance your professional development and meet your state licensure requirements!
CHILDREN & YOUTH Autism Topics Part I: Relationship Building, Evaluation Strategies, and Sensory Integration and Praxis
Edited by Renee Watling, PhD, OTR/L, FAOTA Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours) Order #4848 AOTA Members: $210 Nonmembers: $299

PRODUCTIVE AGING An Occupation-Based Approach in Postacute Care to Support Productive Aging
A collaborative project between AOTA and Platinum Partner Genesis Rehabilitation Services Authored by Denise Chisholm, PhD, OTR/L, FAOTA; Cathy Dolhi, OTD, OTR/L, FAOTA; and Jodi L. Schreiber, MS, OTR/L Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours) Order #4875 AOTA Members: $210 Nonmembers: $299

GENERAL PRACTICE Let’s Think BIG About Wellness
Presented by Winnie Dunn, PhD, OTR, FAOTA Earn .25 AOTA CEU (3.13 NBCOT PDUs/2.5 contact hours) Order #4879 AOTA Members: $68 Nonmembers: $97

Response to Intervention (RtI) for At Risk Learners: Advocating for Occupational Therapy’s Role in General Education
Authored by Gloria Frolek Clark, PhD, OTR/L, BCP, FAOTA, and Jean Polichino, OTR, MS, FAOTA Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours) Order #4876 AOTA Members: $68 Nonmembers: $97

Using the Occupational Therapy Practice Guidelines for Adults With Stroke to Enhance Your Practice
Presented by Joyce Sabari, PhD, OTR, FAOTA Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours) Order #4845 AOTA Members: $68 Nonmembers: $97

Everyday Ethics: Core Knowledge for Occupational Therapy Practitioners and Educators, Second Edition
Developed by the AOTA Ethics Commission Earn .3 AOTA CEU (3.75 NBCOT PDUs/3 contact hours) Order #4846 AOTA Members: $105 Nonmembers: $150

The Short Child Occupational Profile (SCOPE)
Presented by Patricia Bowyer, EdD, MS, OTR, FAOTA; Hany Ngo, MOT, OTR; and Jessica Kramer, PhD, OTR Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours) Order #4847 AOTA Members: $210 Nonmembers: $299

Strategic Evidence-Based Interviewing in Occupational Therapy
Presented by Renée R. Taylor, PhD Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours) Order #4844 AOTA Members: $68 Nonmembers: $97

Determining Capacity to Drive for Drivers With Dementia Using Research, Ethics, and Professional Reasoning: The Responsibility of All Occupational Therapists
Presented by Linda A. Hunt, PhD, OTR/L, FAOTA Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours) Order #4842 AOTA Members: $68 Nonmembers: $97

Model of Human Occupation Screening Tool (MOHOST): Theory, Content, and Purpose
Presented by Gary Kielhofner, DrPH, OTR/L, FAOTA; Lisa Castle, MBA, OTR/L; Supriya Sen, OTR/L; and Sarah Skinner, MEd, OTR/L Earn .4 AOTA CEU (5 NBCOT PDUs/4 contact hours) Order # 4838 Member Price: $125 Nonmember Price: $180

Young Adults on the Autism Spectrum: Life After IDEA
Authored by Lisa Crabtree, PhD, OTR/L, and Janet DeLany, DEd, OTR/L, FAOTA Earn .3 AOTA CEU (3.75 NBCOT PDUs/3 contact hours) Order #4878 AOTA Members: $105 Nonmembers: $150

Skilled Nursing Facilities 101: Documentation, Reimbursement, and Ethics in Practice
Presented by Christine Kroll, MS, OTR, and Nancy Richman, OTR/L, FAOTA Earn .3 AOTA CEU (3.75 NBCOT PDUs/3 contact hours) Order #4843 AOTA Members: $108 Nonmembers: $154

USE PROMO CODE: ACE11
CE-221

ShOp at HTTP://STORE.AOTA.ORG Or Call 877-404-AOTA!

Helping the Helpers
Caregiver Training and Occupational Therapy
laire Cohen, now 64, felt overwhelmed. When her husband had a stroke 5 years ago, she consulted many professionals who she thought could provide advice on how to best care for her newly impaired spouse. “I knew how to put a Band-Aid on and that was about it,” Cohen says, half-kidding. She visited social workers and nurses, but she wasn’t getting any in-depth answers. “What do people do when suddenly faced with this situation? Nobody would tell me to go off the deep end, but they would say, ‘This is a rough one. I don’t have a solution,’” Cohen says. “I wanted and needed solutions.” Cohen’s husband, now 69, had been a career-focused computer scientist, but his hemorrhagic stroke left him a changed man. He couldn’t walk without the help of a 4-pronged cane, couldn’t drive, and couldn’t use his dominant left hand. In addition, because the stroke occurred in the right front temporal lobe, the part of the brain involved in planning, organizing, problem solving, and personality, he lost most of his computer skills. After 3 years without finding any great solutions, Cohen learned about the Customized Toolkit of Information and Practical Solutions (C-TIPS) program (http://c-tips.com), a caregiver training course created by Mary Corcoran, PhD, OTR/L, FAOTA, that provides practical, personalized advice on how to better care for a patient and also offers participants one-on-one caregiver training consultation. “It was an eye-opening course because it actually gave me real insight
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ANDREW WAITE

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Occupational therapy practitioners are working to provide better caregiver training to help seniors live life to its fullest, in the home and in pursuit of daily activities and occupations.

from a patient’s perspective,” Cohen says. “It was something that I could do in the privacy of my own home, at my own pace, and at that point I was leaving no stone unturned in my quest for caregiver knowledge. I had already talked to social workers and other caregiver groups. I had also already looked at some other online sites. Maybe this was something different.” Cohen found the site’s instructional videos and tips about previewing activities especially helpful. As an example of what she learned: “[If] I was going to take my husband to the movies, [I knew that] maybe I should swing by the movies and see where the curb cut was.” The training was effective because it allowed Cohen to see what caregiving style was going to work for her. She knew she would need a strategy that would allow her to continue her full-time job. She also knew any hired caregivers would have to be able to provide her husband with both mental and physical stimulation. Corcoran, an associate dean and professor at George Washington University in Washington, DC, who provided Cohen’s one-on-one training as part of C-TIPS, suggested Cohen contact a local college and hire occupational therapy students as her husband’s weekend caregivers. That suggestion turned out to be the perfect solution.

Two years later: “He’s on the computer all day long. He’s taking seminars, installing a little bit of software, and playing games. I mean, even the students, for example, said they were looking to buy a computer, and he was helping them try to figure out what’s the best deal,” Cohen says. “When you first go through this, you feel like you’re alone and that you are the only person that it’s ever happened to. But once you have the right caregiver education, you realize lots and lots of people are going through this, and you do everything possible to make it work.”

INDIVIDUAL APPROACH
As the American population continues to age, health care in this country increasingly will focus on end-of-life treatment. Most adults are looking to remain in their own homes as they grow older, a decision that saves money and leads to happier seniors.1 Better caregiver training is one way to help seniors stay out of skilled nursing and assisted living facilities, but improving caregiver training requires reassessing old methods. Those whose mission is better training say the future of successful caregiver education focuses as much if not more on the caregiver as on the care recipient. Since 1997, Corcoran has interviewed nearly 100 people who provide daily
MARCH 26, 2012 • WWW.AOTA.ORG

care for a family member. (Her work has focused on Alzheimer’s disease but the principles can be applied to general caregivers as well.) Her research was published in the February 2011 issue of The Gerontologist.2 What Corcoran found is that caregivers, like parents, have different styles, and if we want to most effectively harness people’s caregiving abilities, we must identify how they approach the role and what unique skills they bring to the table. “I noticed very early on, probably close to 30 years ago, when I started out in OT, that you could offer the same strategy to five different people and some would embrace it; some would kind of shine you on, and others would tell you flat out that it wasn’t going to work for them,” Corcoran says. By observing and asking myriad questions of each caregiver—some as basic as, “How do you and your care recipient spend your day together?”— Corcoran’s research classified caregivers into one of four categories: facilitating caregivers, who focus on emotional health; balancing caregivers, who maintain a balance between their needs and the care recipient’s needs; advocating caregivers, who are
OT PRACTICE • MARCH 26, 2012

“We need to ask the right questions of the caregiver. How much time are you going to be able to assist? Are you going to be able to physically assist? Are you just going to be able to be there as supervision?”
especially mindful of the care recipient’s well-being; and directing caregivers, who are focused on the recipient’s physical health.2 “We can begin to tailor caregiving interventions not by trying to change anyone’s style but by offering suggestions that are consistent with style,” Corcoran says. The C-TIPS program that worked so well for Cohen is a way to implement the tailored approach. “I also ask the caregivers to assess their own style, and based on the results of those assessments, I send them to our C-TIPS matrix that represents caregiver style in terms of the types of things they would hope to prioritize in the C-TIPS program,” Corcoran says. The notion behind Corcoran’s research and C-TIPS is that a greater emphasis on the caregiver and his or her technique will lead to caregivers who are more able and willing to do everything necessary to best support the person, which, in turn, leads to more productive aging. As Corcoran notes in The Gerontologist article, “Evidence suggests that such tailored interventions are more culturally relevant, support health behaviors, and reduce health disparities. Because tailored caregiver skill building interventions are designed to reflect the caregiver’s intrinsic attitudes and beliefs, adherence is likely to improve, and the likelihood of successful outcome will increase” (p. 472).2

PHOTOGRAPH © ROB MARMION / SHUTTERSTOCK

A CHANGE OF MINDSET
Corcoran is not the only caregiver trainer who believes in paying an increasing amount of attention to caregivers.
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soCiAl MediA spoTligHT
www.aota.org/twitter
AOTA News & PR @aotaPR: Hippotherapy for children with cerebral palsy—is it effective? Check out this video about new OT research: http://ow.ly/9pAXQ 2 Mar 6 MarAOTA @AOTAInc: Occupational Therapy listed as one of the Best Jobs of 2012 by U.S. News & World Report @usnews http://ow.ly/9kWIM #careers 28 Feb Heather Millar-Gowan @HeatherOT: Quinnipiac OT Students Teach Kids Safety http://awe.sm/5fyER 21 Feb AOTAEvents @AOTAEvents Facebook Fans are telling us St. Catherine Univ has 21 headed to conference! and 50+ from Creighton Univ! #AOTA12 http://ow.ly/9ubpE 6 Mar

www.pinterest.com/aotainc

Conference in Indy
Looking for things to do and places to see in Indy while you are there for Conference? We’ve started a Conference in Indy board to help you plan your visit. If you come across any other resources, please leave us a comment to add it. See you in Indy.

www.pinterest.com/aotainc/conference-in-indy

Conference Blog http://otconnections.aota.org/blogs/conference/default.aspx Conference Badges http://www.aota.org/ ConfandEvents/2012Conference.aspx Things to Do in Indianapolis http://www.tripadvisor.com/Attractions-g37209-ActivitiesIndianapolis_Indiana.html Top 25 Things To Do in Indianapolis http://indianapolis-indiana.funcityfinder.com/indianapolisthings-to-do/ Indy attractions coupons! http://visitindy.com/indianapolis-planner-toolkit-coupons What to eat? Well, you’ve got 200 choices within walking distance from the Indiana Convention Center. http:// visitindy.com/web_files/map/DTRestMap_c040110.pdf Indianapolis Convention Center—home of AOTA’s 2012 conference! http://www.icclos.com/attendees/Default.aspx AOTA Poll Results

“ Do you use smartphone or tablet apps in the clinic?”
I do not use apps in the clinic ........................................... 32% I use apps with many clients............................................. 27% I use app occasionally, not often....................................... 26% My facility does not let me use apps ................................. 11% I use apps for work, not with clients .................................... 4%

To vote on and see results from other AOTA polls, visit
the 1-Minute Update Poll at www.aota.org/polls/minute-poll. Check out AOTA’s new listing of apps, based on practice area, at www.aota.org/apps.

Find us on Facebook www.aota.org/facebook
American Occupational Therapy Association

www.aota.org/youtube

With the help of OT volunteers, CarFit helps senior drivers make adjustments to ensure safety.
http://ow.ly/99yFC Visit http://www.car-fit.org/ to volunteer at a CarFit event near you or to host your own!
Melony Logue, Jean Gallaza, Virginia Augustein and 49 others like this. Lois Dellinger Great idea! February 21 at 7:44am.

BACKGROUND ILLUSTRATION © WILLIAM CRAIG / ISTOCKPHOTO.COM

Improving Fine Motor Skills with Occupational Therapy:

Meet Sylvie
www.youtube.com/watch?v=oL2yRE107IE

“Her story shows us the value of pediatric occupational therapy.”

Deborah Frigon What a great thing!! The worst thing for an older person is to lose their car. This could be a way to help them to keep their independence!!! OT—what a wonderful occupation!! February 21 at 5:26pm
19

OT PRACTICE • MARCH 26, 2012

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. April
educators, researchers, and students. Focusing on science, innovation, and evidence, these 3-1/2 remarkable days will provide attendees with continuing education up to 24 contact hours through advanced-level learning in Pre-Conference Institutes and Seminars and more than 700 educational sessions; inspiring special events such as the Presidential Address, Eleanor Clarke Slagle Lecture, and Plenary Session; and numerous networking opportunities to connect with colleagues and leaders. Register online at www.aota.org/conference.

Continuing Education Sensory Integration Certification Program by USC/WPS Regina, SK, Canada: Course 2: May 3–7 Richmond, VA: Course 1: May 17–21 London, ON, Canada: Course 1: May 31–June 4 For additional sites and dates, or to register, visit www.wpspublish.com or call 800-648-8857
D-5779

San Francisco, CA

Warren, MS, OTR/L, SCLV, FAOTA. This updated course has the latest evidence based research. Participants learn a practical, functional reimburseable approach to evaluation, intervention, and documentation of visual processing deficits in adult with acquired brain injury from CVA and TBI. Topics include hemianopsia, visual neglect, eye movement disorders, and reduced acuity. Also in Syracuse, NY, Sept. 29–30, 2012. Contact www.visabilities.com or 888-752-4364. Fax 205-823-6657.

Eval & Intervention for Visual Processing Deficits in Adult Acquired Brain Injury, Part I. Faculty: Mary

Apr. 14–15

contact hours for CDRS renewal and advance your career in the field of driver rehabilitation. Contact ADED 866-672-9466 or visit our Web site at www. aded.net.

September

St. Louis, MO

Envision Conference 2012. Learn from leaders in

Sept. 12–15

May

Milwaukee, WI

Handling the Rib Cage. This workshop has been

Apr. 19–20

Baton Rouge, LA

May 5–15

designed for speech language pathologists, physical therapists, and occupational therapists who have minimal experience in focusing on rib cage activity and its influence on respiratory, general movement, and oral-pharyngeal function in terms of the evaluation and treatment services they provide. Anatomical/kinesiological and developmental characteristics of typical rib cage activity will be reviewed. Atypical rib cage activity in infants and young children with neuromotor involvement will be discussed. Treatment strategies will be explored through group movement lab sessions. For additional courses, information, and registration, visit our Web site at www.chs-continuing. uwm.edu or call 414-227-3123.

in Complete Decongestive Therapy (135 hours), Lymphedema Management Seminars (31 hours). Coursework includes anatomy, physiology, and pathology of the lymphatic system, basic and advanced techniques of MLD, and bandaging for primary/secondary UE and LE lymphedema (incl. pediatric care) and other conditions. Insurance and billing issues, certification for compression-garment fitting included. Certification course meets LANA requirements. Also in Palm Beach Gardens, FL, May 5–15, 2012. 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.

Lymphedema Management. Certification courses

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 12–15, 2012, Hilton St. Louis at the Ballpark. Learn more at www.envisionconference.org.

Ongoing

Internet & 2-Day On-Site Training

Become an Accessibility and Home Modifications Consultant. Instructor: Shoshana Shamberg,

Ongoing

Milwaukee, WI

Manual Edema Mobilization for the Sub-Acute Upper Extremity Edema. Therapists are often frustrated

Apr. 20–21

Hanover, MD

The Impact of Disabilities, Vision, & Aging, and their Relationship to Driving. Course designed for
driver education and allied health professionals who wish to apply their knowledge of the different types and levels of disabilities to the driving task. Course: DRV 509. Call 410-777-2939 or visit our Web site at www.aacc.edu.

May 17–18

with persistent edema that continues to return in spite of their best efforts. Specific techniques to activate the lymphatic system will quickly and permanently reduce edema that presents as viscous, thick, and very slow to “rebound” from being pitted. Manual Edema Mobilization (MEM) was designed specifically to activate the lymphatic system. The extensive lab time and case study presentation enable participants to feel confident to immediately apply techniques in a clinical setting. For additional courses, information, and registration, visit our Web site at www.chs-continuing.uwm.edu or call 414-227-3123.

OTR/L, MS, FAOTA. Over 22 years specializing in design/build services, technologies, injury prevention, and ADA/504 consulting for homes/jobsites. Start a private practice or add to existing services. Extensive manual. AOTA APP+NBCOT CE Registry. Contact: Abilities OT Services, Inc. 410-358-7269 or info@aotss.com. Group, COMBO, personal mentoring, and 2 for 1 discounts. Calendar/info at www.AOTSS.com. Seminar sponsorships available nationally.

Clinician’s View Offers Unlimited CEUs

Two great options: $177 for 7 months or $199 for 1-Full Year of unlimited access to over 640 contact hours and over 90 courses. Take as many

June

Orlando Florida

Building Blocks for Becoming a Driver Rehabilitation Therapist. A comprehensive live workshop for
the therapist who has little or no experience in driver evaluation or driver rehabilitation, is developing a new driving program, or is joining an established program. Guidance for the clinical and in-vehicle portion of a comprehensive driving evaluation is taught within the OT Practice Framework. Hands-on with evaluation tools, equipment, vehicles, and real clients. Instructors: Susan Pierce, OTR/L, SCDCM, CDRS; Carol Blackburn, OTR/L, CDRS. Contact Adaptive Mobility Services, Inc. at (407) 426-8020 or visit us at www.adaptivemobility.com.

Jun 25–29

courses as you want. Approved for AOTA and BOC CEUs and NBCOT for PDUs. www.clinicians-view. com 575-526-0012.

AOTA Self-Paced Clinical Course

Milwaukee, WI

McConnell Approach to the Problem Shoulder.

Apr. 20–21

Learn how the static and dynamic posture of the upper extremity may contribute to the patient’s signs and symptoms at the shoulder. This program includes a review of shoulder biomechanics and will examine the influence of thoracic spine stiffness, muscle tightness, and muscle control problems on shoulder girdle movement. Numerous intervention strategies will be discussed. There is an extensive lab component teaching Jenny McConnell’s shoulder taping and muscle training techniques. For additional courses, information, and registration, visit our Web site at www.chs-continuing.uwm.edu or call 414-227-3123.

July

FAOTA, and Carla Chase, EdD, OTR/L, CAPS. This new SPCC consists of text, exam, and a CD-ROM of hundreds of photographic and video resources that provide education on home modification for occupational therapy professionals. Practitioners who work with either adults or children will find an overview of evaluation and intervention, detailed descriptions of assessment tools, and guidelines for client-centered practice and occupation-based outcomes. Earn 2 AOTA CEUs (20 NBCOT PDUs/20 contact hours). Order #3029, AOTA Members: $370, Nonmembers: $470. http://store.aota.org/view/?SKU=3029.

NEW! Occupational Therapy and Home Modification: Promoting Safety and Supporting Participation. Edited by Margaret Christenson, MPH, OTR/L,

AOTA 92nd Annual Conference & Expo. The 2012 AOTA Annual Conference & Expo will be a vibrant gathering of occupational therapy practitioners, 20

Indianapolis, IN

April 26–29

Kansas City, MO

sionals specializing in the field of driver rehabilitation meet annually for continuing education through workshops, seminars, and hands-on learning. Earn

ADED Annual Conference and Exhibits. Profes-

Jul. 29–31

AOTA Self-Paced Clinical Course

PhD, OTR/L, FAOTA. This important new SPCC provides a framework on the role of occupational therapy

Mental Health Promotion, Prevention, and Intervention With Children and Youth: A Guiding Framework for Occupational Therapy. Edited by Susan Bazyk,

MARCH 26, 2012 • WWW.AOTA.ORG

CAlendAr
Continuing Education

Tex as Woman’s UniversiT y
online Ph.D. in occupational Therapy
Texas Woman’s University offers the traditional doctoral degree through contemporary technology. Therapists across the nation can obtain the highest level of occupational therapy education in a wellestablished (1994) Ph.D. program offered primarily online, with two oncampus workshops each semester. Blended delivery has been offered for the past two years and the feedback is excellent! • The Ph.D. degree offers the greatest opportunity for career growth in practice, academia and research • Doctoral teaching faculty are full-time TWU faculty and recognized scholars in their area of research • Applicants identify a faculty Research Mentor as part of the admission process • Students are admitted as a cohort each fall limited enrollment • Current students come from across the nation: Massachusetts, Minnesota, Nevada, North Carolina, Pennsylvania, South Carolina and Texas • TWU is a state university – Ph.D./OT online students can enroll at resident tuition rates For more information, contact: Sally Schultz, OTR, Ph.D., LPC-S sschultz@twu.edu 214-207-6943
LOGO 6

in mental health interventions for children that can be applied in all pediatric practice settings. The public health approach to occupational therapy services at all levels puts an emphasis on helping children develop and maintain positive mental health psychologically, socially, functionally, and in the face of adversity. Earn 2 AOTA CEUs (20 NBCOT PDUs/20 contact hours). Order #3030, AOTA Members: $370, Nonmembers: $470. http://store.aota.org/view/?SKU=3030.

AOTA Self-Paced Clinical Course

Early Childhood: Occupational Therapy Services for Children Birth to Five. Edited by Barbara E.

Chandler, PhD, OTR/L, FAOTA. This course is an enlightening journey through occupational therapy with children at the earliest stage of their lives. Explores the driving force of federal legislation in occupational therapy practice and how practitioners can articulate and demonstrate the profession’s long-standing expertise in transitioning early childhood development into occupational engagement in natural environments. Earn 2 AOTA CEUs (20 NBCOT PDUs/20 contact hours). Order #3026, AOTA Members: $370, Nonmembers: $470. http://store. aota.org/view/?SKU=3026

AOTA Self-Paced Clinical Course

Kavanaugh Scheinholtz, MS, OT/L. A comprehensive discussion of recent advances and trends in mental health practice, including theories, standards of practice, and evidence as they apply to occupational therapy. Includes content from several federal and non-government entities. Earn 2 AOTA CEUs (20 NBCOT PDUs/20 contact hours). Order #3027, AOTA Members: $370, Nonmembers: $470. http://store.aota.org/view/?SKU=3027
D-5832

Occupational Therapy in Mental Health: Considerations for Advanced Practice. Edited by Marian

www.twu.edu/ot

AOTA Self-Paced Clinical Course

Dysphagia Care and Related Feeding Concerns for Adults, 2nd Edition. Edited by Wendy Av-

Continuing Education

ery, MS, OTR/L. Provides occupational therapists at both the entry and intermediate skill leves with an up-to-date resource in dysphagia care, written from an occupational therapy perspective. Earn 1.5 AOTA CEUs (15 NBCOT PDUs/15 contact hours. Order #3028. AOTA Members: $285, Nonmembers: $385. http://store.aota.org/view/?SKU=3028

AOTA Self-Paced Clinical Course

Skills2Care™
for caregivers of people with dementia

Specialized Training and Certification for Occupational Therapists:

Home-based program to reduce stress and help caregiver: – Manage challenging behaviors – Enhance ADL performance – Make environment safer May be reimbursed by Medicare Parts A and B when provided to caregiver as part of the patient plan of care Two-year certification with annual re-certification requirements

Barbara Hanft, MA, OTR, FAOTA, and Jayne Shepherd, MS, OTR, FAOTA. Engages school-based occupational therapists in collaborative practice with education teams. Identifies the process of initiating and sustaining changes in practice and influencing families/education personnel to engage in collaboration with occupational therapists. Perfect for learning to use professional knowledge and interpersonal skills to blend hands-on services for students with team and system supports for families, educators, and the school system at large. Earn 2 AOTA CEUs (20 NBCOT PDUs/20 contact hours). Order #3023, AOTA Members: $370, Nonmembers: $470. http:// store.aota.org/view/?SKU=3023

Collaborating for Student Success: A Guide for School-Based Occupational Therapy. Edited by

• •

AOTA Self-Paced Clinical Course

Strategies to Advance Gerontology Excellence: Promoting Best Practice in Occupational Therapy. Edited by Susan Coppola, MS, OTR/L, BCG,

Next individual Skills2Care ™ training sessions: May 10 – 11 and August 9 – 10. Group training available for agencies.
D-5909

Redefining Healthcare Education Thomas Jefferson University

eldercare@jefferson.edu
www.jefferson.edu/elder_care

Philadelphia, PA

FAOTA; Sharon J. Elliott, MS, OTR/L, BCG, FAOTA; and Pamela E. Toto, MS, OTR/L, BCG, FAOTA. Foreword by: Wendy Wood, PhD, OTR/L, FAOTA. Excellent resource for gerontology practitioners today to help sharpen skills and prepare for the spiraling demand among older adults for occupational therapy services. Special features include core best practice methodology with older adults, approaches to and prevention of occupational problems, health conditions that affect participation, and practice in cross-cutting and emerging areas. Earn 3 AOTA
MARCH 26, 2012 • WWW.AOTA.ORG

22

eMploYMenT opporTuniTies
Faculty Faculty University of the sciences samson coLLege of heaLth sciences Department of occUpationaL therapy The University of the Sciences is seeking three dynamic individuals to join our Department of Occupational Therapy in new 12-month assistant or associate professor positions, rank commensurate with experience. These positions offer the right candidates a unique opportunity to be involved in the inception of our entry-level doctoral program, which has an emphasis on leadership and community-based practice. This is an exciting opportunity that involves working with faculty leaders, program development, and a chance to influence the future of the profession. University of the Sciences is a comprehensive health care university situated in the University City area of Philadelphia, offering tremendous academic and educational opportunities. Our department is known for providing a wide variety of hands-on learning experiences. We have developed strong community partnerships, which provide active service learning programs for our students. We highly value student centered learning, innovative teaching, and active scholarship with student participation. Applicants with clinical expertise in cognition, neuroscience, and mental health preferred; however, strong candidates will be considered regardless of expertise. Assistant or Associate Professor of Occupational Therapy (Tenure Track) • Candidates should have teaching experience and a defined research agenda. The ideal candidate for this position will hold an earned doctorate, have at least 3 years of clinical experience, and have some teaching and research experience. All candidates must be initially certified by NBCOT and be eligible for a Pennsylvania license. • Responsibilities include scholarship, teaching in our post baccalaureate MOT and entry-level Dr. OT programs, and service to the University. Assistant Professor of Occupational Therapy (Non-Tenure Track) • The ideal candidate for this position will hold an earned doctorate and have at least 3 years of clinical experience. Teaching experience is preferred. Candidates with terminal degree in progress will be considered. All candidates must be initially certified by NBCOT and be eligible for a Pennsylvania license. • Responsibilities include teaching in our postbaccalaureate MOT and entry-level Dr. OT programs, scholarship, and service to the university. Academic Fieldwork Coordinator of Occupational Therapy, Assistant Professor (Non-Tenure Track) • Master’s degree in occupational therapy or related field is required. Candidates with an earned doctorate or a commitment to pursuing doctoral education are preferred. A minimum of 3 years of clinical experience, including 2 years supervising fieldwork students, is required. All candidates must be initially certified by NBCOT and be eligible for OT licensure in Pennsylvania. • Collaborate with current academic fieldwork coordinator to coordinate Level I and Level II fieldwork placements, mentor students through the fieldwork experience, academic advising, teaching in areas of expertise, and service to the university. Qualified applicants are invited to submit their resume, unofficial transcripts, and a cover letter indicating position of interest via e-mail attachment to Colleen Maher, OTD; Search Committee Chair; E-mail: otprof@ F-5925 usciences.edu. Electronic (e-mail) submissions only. MS Word or PDF format only. EOE/AA. Faculty

OTA Program Coordinator
Keiser University is looking for a full-time program coordinator for its Occupational Therapy Assistant Program. Must be an occupational therapist or certified occupational therapy assistant with a minimum of 3 years of clinical experience, including administrative/supervisory experience and at least 1 year of full-time teaching and experience supervising occupational therapy assistants. Must have at least a master’s degree from a regionally accredited university and hold a Florida license. To apply, send resume and unofficial transcripts to: Annie Mathews Keiser University 1800 Business Park Blvd Daytona Beach, FL 32114 Fax: 386-274-2725 amathews@keiseruniversity.edu

F-5877

http://www.aota.org/facebook

Find AOTA on Facebook

Follow AOTA on
http://www.aota.org/twitter

ASSISTANT PROFESSOR of OCCUPATIONAL THERAPY
The School of Occupational Therapy at Belmont University is seeking applications for two tenure-track faculty positions at the rank of Assistant Professor beginning August 1, 2012. Belmont University seeks to attract an active, culturally and academically diverse faculty of the highest caliber skilled in the scholarship of teaching, discovery, application, and integration of faith. Belmont is among the fastest growing Christian universities in the nation. Ranked No. 7 in the Regional Universities South category and named for the fourth consecutive year as one of the top “Up-and-Comer” universities by U.S. News & World Report, Belmont University consists of approximately 6,400 students who come from every state and 25 countries. Committed to being a leader among teaching universities, Belmont brings together the best of liberal arts and professional education in a Christian community of learning and service. The university’s purpose is to help students explore their passions and develop their talents to meet the world’s needs. With more than 75 areas of study, 20 master’s programs and four doctoral degrees, there is no limit to the ways Belmont University can expand an individual’s horizon. The School of Occupational Therapy is recruiting for two facutly positions. One position requires expertise in the content areas of research, assistive technology, and/or rehabilitation (orthopedics and cardiovascular preferred); the other position requires expertise in the content areas of research, neuroscience, and/or rehabilitation (general), although those with other areas of expertise will be considered. A minimum of 5 years clinical experience in occupational therapy is required. Two years of full-time graduate teaching experience or its equivalent is preferred. An earned doctorate (PhD, EdD, DrPH, post-professional OTD) is required. Occupational therapy candidates must have certification by NBCOT and must be eligible for licensure in TN. The university seeks persons of Christian faith and commitment to the mission of the university. For additional information about the position and to complete the online application, candidates are directed to https://jobs.belmont.edu. During the application process, applicants will be asked to respond to Belmont’s mission, vision, and values statements, articulating how the candidate’s knowledge, experience, and beliefs have prepared him/her to contribute to a Christian community of learning and service and give a brief statement of teaching philosophy. An electronic version of a Cover Letter, Curriculum Vitae, and List of References with contact information must be attached in order to complete the online application. Review of applications will begin immediately and continue until the positions are filled. The selected candidate for this position will be required to complete a background check satisfactory to the University. If you have questions about the position, please contact Faculty Search Chair: Teresa Plummer, PhD, OTR, ATP, CAPS at (615) 460-6707. A comprehensive, coeducational university located in Nashville, Tennessee, Belmont is a student-centered Christian university focusing on academic excellence. Belmont University is an equal opportunity employer committed to fostering a diverse learning community of committed Christians from all racial and ethnic backgrounds. Women and minorities are encouraged to apply.

WWW.BELMONT.EDU
F-5895

OT PRACTICE • MARCH 26, 2012

27

eMploYMenT opporTuniTies
Faculty Faculty

A.T. Still University, Arizona School of Health Sciences, Department of Occupational Therapy
invites applications for a newly created faculty position at the assistant or associate professor level to teach in the residential entry-level Master of Science Degree Program, conduct facultyled student research projects, and participate in developing a postprofessional online doctoral degree program. Responsibilities include teaching, scholarship, mentoring, and service. Rank and salary are commensurate with experience and qualifications. Qualifications: PhD or other research doctoral degree and 4 years of teaching experience preferred. Candidates with a postprofessional master’s degree near completion of doctoral degree will also be considered. The ideal candidate will also demonstrate excellence in teaching at the graduate level, a clinical background in the area of adult neuro-rehabilitation, and interest in scholarly activity. Candidates must be eligible for and agree to secure occupational therapy licensure in Arizona. ATSU is a fully accredited graduate health professions institution offering doctoral degrees in physical therapy (entry level and postprofessional), osteopathic medicine, dentistry, and audiology. Master’s programs are offered in occupational therapy, athletic training, and physician assistant studies. Opportunities for interdisciplinary education and research are available and encouraged. As the founding school of osteopathic medicine, ATSU is committed to the integration of body, mind, and spirit. Additional information can be obtained from our Web site at www.atsu.edu. The residential Occupational Therapy Program is located on the Mesa, Arizona, campus close to the Phoenix metropolitan area. Mesa is an eclectic mix of museums, culture, and heritage set in the beautiful Southwest, offering year-round opportunities for outdoor recreational activities with nearby lakes, canyons, golf courses, and the Superstition Mountains. Interested applicants should fill out an application at www.atsu.edu/contact/app_distributed.pdf and send a cover letter and curriculum vita to: Bernadett Mineo, PhD, OTR/L Chair, Occupational Therapy A.T. Still University 5850 E. Still Circle Mesa, AZ 85206 Phone: 480-219-6075 E-mail: hraz@atsu.edu F-5928 Faculty The University of Missouri invites applications for TWO positions. Join a dedicated faculty with a strong commitment to teaching, research, evidence-based practice, and clinical service. ASSISTANT OR ASSOCIATE PROFESSOR Description: Full-time 9-month tenure-track position to teach courses in research and other related courses. Qualifications: An earned PhD or OTD, or eligible, certification by NBCOT, and eligibility for licensure in Missouri. Previous teaching experience, evidence of scholarly work, or research experience recommended for this position. Duties: Primarily a research position, with service on committees and student advisement. Candidates are required to conduct research, apply for and receive funding, and mentor students on research projects. Salaries: Competitive and commensurate with experience. CLINICAL ASSISTANT PROFESSOR Description: Full-time 9-month nontenuretrack position to teach courses in research, mental health, and neuroscience. Qualifications: An earned PhD or OTD, or eligible, certification by NBCOT, and eligibility for licensure in Missouri. Previous teaching experience, evidence of scholarly work, or research experience recommended for this position. Duties: Primarily teaching position, with service on committees and student advisement. Candidates are also encouraged to conduct research and pursue scholarly endeavors. Salaries: Competitive and commensurate with experience. ———————— Application Procedure: Go to http://hrs.missouri .edu/find-a-job/academic/index.php. LINK the following materials in the Cover Letters and Attachments section once you have registered with the system. You can link the required application materials either before or after submitting your application. There is no restriction on file type for your attachments. Each file can be no larger than 20MG. You will be able to link your CV as part of the application when you apply for a specific position. Submit: • Letter of intent addressing position qualifications, teaching experience, research interests • Curriculum vitae • Three letters of reference Application Deadline: Review of applications begins immediately and will continue until the positions are filled.
The Department of Occupational Therapy does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, age, disability, or status as a protected veteran per the policy of the University of Missouri. For additional information, please see the MU Statement of Nondiscrimination.

F-5935

F-5933

28

MARCH 26, 2012 • WWW.AOTA.ORG

Living Life To Its Fullest
OT Reflections From the Heart

s I buckled myself into the surprisingly small airplane headed from Montana to Colorado, I noticed the firm directive affixed to its wing: “Do Not Walk Outside this Area.” It occurred to me that in one way of thinking I had done just that. As bookends of our generation descended from sturdy farmers, my cousin Bev and I have always been an unusual pair. Although she is 32 years older than me, we have an esprit décor that would have brought smiles to our predecessors, so when able I occasionally return to Montana to visit her. After a great deal of pragmatic decision making, Bev recently left our family home for the steady and predictable environment of the Sweetwater Retirement Center. For the better part of a week, I bunked in with her and learned more about the subtleties of retirement center living than I had in my 30-year career as an occupational therapist. As a card-carrying member of the “sandwich generation,” I am a busy person, juggling relationships with my spouse, children, and in-laws with professional and civic responsibilities. Typical for people my age, I take pride in being able to do four things at once—frying bacon for everyone’s breakfast; checking a backpack or lunchbox; and verifying the chickens, dogs, and peacocks have been fed and watered—all while preparing a mental list of occupational therapy responsibilities. That’s why the lovely environs of Sweetwater were so difficult to settle into. Things were smooth: ambient lighting just right, noise level comfortable, and meals reliable. All the multitasking skills I have mastered really didn’t seem necessary there.
32

A

Do Not Walk Outside This Area
Tina Fletcher
report our experiences to the class. From my new perspective in the Sweetwater dining room, the raisin meditation seemed a little silly and contrived. Here, I was learning mindfulness from the masters. Evenings at Sweetwater involved ambling beside Bev while she expertly maneuvered on her scooter, oxygen bottles plunked in the handlebar basket. People congregated around a few of the lobby windows. Some offered the best views of local jackrabbits, while others provided a glimpse of the little wild duck who recently made her nest in an ornamental shrub. One night, just as darkness descended, we were finally rewarded with a startling view of the largest rabbits I had ever seen. Soon, I was back in the Denver airport. As always, people rushed around checking their electronic devices, squabbled with ticket agents, and comforted bawling babies. I recalled how one of the retired farmers at Sweetwater wryly asked if I was one of those busy city folks who couldn’t move a muscle without having a telephone in hand. My feelings about the utility of occupational therapy in a world like Sweetwater have shifted. Working there, I would shift my focus away from exercises and stretches to a world that embraces mindfulness and mutual support. We’d build duck boxes and bake biscuits rolled out and cut with a floured cutter and not dropped from a spoon. We’d learn how to help the community maintain a husk of jack rabbits, and figure out ways to share some wisdom with the younger, technology-bound generation. We could all use a little Sweetwater. n
Tina Fletcher, OTR, EdD, MFA, is an assistant professor in the School of Occupational Therapy at Texas Woman’s University in Dallas.
MARCH 26, 2012 • WWW.AOTA.ORG

To give Bev my full attention, I turned a blind eye to my iPad, laptop, and phone, vowing to leave them tucked into my luggage while I immersed myself in her world. She described the mealtime routine as a nearly 2-hour-long layering of visiting, selecting, eating, more selecting, more eating, and finally, more visiting. It had been a very long time since I had enjoyed such a leisurely meal. It was time to slow down, speak less, and enjoy more. During my first meal at Sweetwater, one of our tablemates was reminded it was her birthday, and her response to queries about her age was a rejoinder that age really doesn’t matter, but enjoying the day did. Typically, our mealtime chit-chat centered on small matters and soon lapsed into a quiet, calm meal experience where food was tasted and savored, each bite thoroughly chewed. I remembered a long-forgotten exercise from a meditation class many years ago. We were told to chew on a single raisin for no less than 5 minutes, and then

PHOTOGRAPHS COURTESY OF THE AUTHOR

April is OT Month
Celebrate it all year!
You are part of a vitally important profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities. Let’s promote occupational therapy—and honor it all year—as a top 2012 New Year’s resolution. Start celebrating OT Month today! Share the value of your profession through OT Month products, special events, and messages; and reward your occupational therapy team with gifts from the 2012 OT Month Catalog. These new items feature our OT brand Occupational Therapy: Living Life To Its Fullest® and the special theme “Building Skills for a Better Life.”

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Car Magnet OT39

Promotional Kit OT60

PR-191

Education Article

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

Earn .1 AOTA CEU

Evaluating Sensory Processing in Mental Health Occupational Therapy Practice
TINA CHAMPAGNE, OTD, OTR/L
Occupational Therapy Program Director, Institute for Dynamic Living International Consultant, Champagne Conferences & Consultation Springfield, MA ments (U.S. Department of Health and Human Services, 2003a, 2003b; NASMHPD, 2009). In addition, there has been a rise in research on sensory processing problems in people with mental health symptoms and conditions and sensory processing’s effect on occupational performance. Research demonstrates that although sensory processing problems are often evident without the presence of other mental health conditions, they may be a result of or contribute to some mental health symptoms and conditions, such as trauma and attachment disorders, schizophrenia, mood and anxiety disorders, pain catastrophizing, and learning disabilities (Brown, Cromwell, Filion, Dunn, & Tollefson, 2002; Butler et al., 2009; Canbeyli, 2010; Engel-Yegar & Dunn, 2011; Hoffman & Bitran, 2007; Lane, Reynolds, & Thacker, 2010; van der Kolk, 1994; Van Hulle, Schmidt, & Goldsmith, 2011; Yeap, Kelly, Reilly, Thakore, & Foxe, 2009). The comorbidity of sensory processing disorder (SPD) and mental health conditions was demonstrated in a recent study by Carter, Ben-Sasson, and Briggs-Gowan (2011) of 338 children ages 7 to 10 years. In this study, 24.3% of the children had an elevated sensory overresponsivity (SOR) score while also meeting the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-VI; American Psychiatric Association, 2000) criteria for a mental health condition, and 25.4% of those with an existing DSM-VI diagnosis also had an elevated SOR score. Given the advances in the use of sensory approaches in mental health practice, there has been an increase in the demand for some of the following types of occupational therapy services: evaluating sensory processing as part of the occupational therapy process; developing intervention plans that include sensory approaches (e.g., ASI interventions, sensory diet, sensory modalities); developing sensory supportive modifications and enhancements to physical environments (e.g., sensory rooms); and training interdisciplinary staff, clients, and their families in understanding and using sensory processing–related interventions (Champagne, 2011; Moore, 2005; Hughes & Koomar, 2010). Occupational therapists have also taken a leadership role in working with interdisciplinary professionals and policy makers to help create policies and tools to promote the role of sensory approaches and occupational therapy in mental health practice (Commonwealth of Massachusetts, 2006; Hughes & Koomar, 2010; LeBel & Champagne, 2010; Stromberg, Bluebird, & Champagne, 2003; Warner, Cook, Westcott, & Koomar, 2011). This rise in interest suggests that occupational therapists in mental health practice need to re-examine the
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JANE KOOMAR, PHD, OTR/L, FAOTA
President, Occupational Therapy Associates–Watertown Board President of the Spiral Foundation Watertown, MA This CE Article was developed in collaboration with the
Mental Health Special Interest Section.

ABSTRACT
This article will demonstrate the importance of evaluating sensory processing as part of the occupational therapy process when working with clients in mental health practice. In particular, the article will introduce assessment tools and clinical observations that may help in exploring sensory discrimination, with a secondary emphasis on sensory modulation and praxis.

LEARNING OBJECTIVES
After reading this article, you should be able to: 1. Recognize the importance of evaluating sensory processing in mental health occupational therapy practice. 2. Differentiate among the sensory processing disorders. 3. Identify a variety of evaluation tools that help assess sensory processing patterns with clients of different age ranges.

INTRODUCTION
Ayres’ sensory integration (ASI®) approach has been employed in occupational therapy practice for many years (Ayres, 1972, 1979). Modifications to ASI and its use with people with mental health conditions was introduced by Lorna Jean King (King, 1974). The use and modification of ASI principles for application within mental health practice has grown exponentially over the past decade (Champagne & Stromberg, 2004; LeBel & Champagne, 2010). This growth is due in part to the national and international mental health initiatives promoting the use of sensory approaches in mental health practice (National Association of State Mental Health Program Directors [NASMHPD], 2009; Sutton & Nicholson, 2011). These national initiatives include the trauma-informed care, seclusion and restraint reduction, and recovery moveMARCH 2012
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ARTICLE CODE CEA0312

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).

assessments they use as part of the occupational therapy evaluation process (Champagne, Koomar, & Olson, 2010). Evaluation is necessary to identify the symptoms of sensory processing problems that may be affecting occupational performance, participation, and the recovery process. Thus, this article explores a variety of assessment tools, some of which mental health occupational therapy practitioners may already be familiar with, and some of the sensory processing areas targeted by these tools.

SENSORY PROCESSING TAxONOMY
Miller and colleagues proposed SPD as a new diagnostic category for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders. SPD is an umbrella term for sensory processing problems that includes sensory modulation disorder, sensory discrimination disorder, sensory-based motor disorders, and dyspraxia (Miller, Anzalone, Lane, Cermak, & Ostein, 2007). Sensory modulation is: The capacity to regulate and organize the degree, intensity, and nature of responses to sensory input in a graded and adaptive manner. This allows the individual to achieve and maintain an optimal range of performance and to adapt to challenges in daily life. (Miller, Reisman, McIntosh, & Simon, 2001, p. 57) Sensory modulation is the regulatory component of sensory processing and is explained in terms of neurological thresholds for sensory over-responsivity, sensory underresponsivity, and a behavioral response continuum of sensory avoiding and seeking (Dunn, 1999; Miller et al., 2007). Regarding the functional implications of sensory modulation on occupational performance, there is often a one-to-one correspondence with sensory modulation problems (e.g., sensitivity to taste and smell) and specific outcomes (e.g., eating a limited diet, avoiding people wearing perfume or shopping at stores with strong scents). As the regulatory component of sensory processing, sensory modulation problems may appear to be more directly related to psychosocial and emotional difficulties in mental health practice than other SPDs because people with mental health symptoms and conditions often have difficulty with self-regulation. It is important to recognize, however, that sensory discrimination problems often also coexist and can add to difficulties with occupational performance and participation. Sensory discrimination is the ability to take in information from the physical environment and gain spatial, temporal, and perceptual awareness (Ayres, 1972; Koomar & Bundy, 2002). Difficulty with sensory discrimination can negatively affect some of the following abilities: to feel bodily present and organized, to safely negotiate one’s environment, to function with automaticity and ease, to attend to personal hygiene, and to pick up on social cues. For instance, sensory
CE-2

discrimination problems may increase arousal and anxiety and first present as modulation problems (e.g., a person with poor vestibular discrimination may appear to be fearful and demonstrate isolative and avoidant behaviors). At times, people may appear to have poor hygiene or to avoid social and leisure activities, but these problems with participation may be due in part to difficulty with sensory discrimination and not only to problems with sensory modulation, cognition, or volition. When sensory input is not easily located and identified in space and time or within and around one’s body, anxiety often increases, which may raise arousal levels and compound any existing sensory modulation issues (e.g., hyper sensitivities) and difficulties with global cognitive performance. Sensory discrimination problems, however, are often less discernible without direct assessment. Sensory-based motor disorder includes problems related to postural control and motor coordination. Praxis is the term used to describe the ability to plan, sequence, and execute nonhabitual or new actions, and difficulty with praxis is referred to as dyspraxia (Ayres, 1972; Koomar & Bundy, 2002). Motor and praxis performance skills contribute to the ability to move the body, coordinate movements, maintain balance, make postural adjustments, and sequence through the steps of an activity. Problems with motor, coordination, or praxis skills can negatively affect occupational participation (e.g., self-care, home care, sports participation). It is important to emphasize that sensory discrimination abilities (e.g., proprioceptive, vestibular, tactile awareness) provide much of the foundational support for motor and praxis performance skills (May-Benson, Ingolia, & Koomar, 2001).

OCCUPATIONAL THERAPY PROCESS
The occupational therapy process in general consists of evaluation, intervention, and monitoring and targeting outcomes (American Occupational Therapy Association [AOTA], 2008). The evaluation process is collaborative in nature and includes developing an occupational profile and analyzing occupational performance. The occupational profile consists of “information about the client, the client’s needs, problems, and concerns about performance in areas of occupation” (AOTA, 2008, p. 649). Analysis of occupational performance “requires the understanding of the complex and dynamic interaction among performance skills, performance patterns, contexts and environments, activity demands, and client factors” (AOTA, 2008, p. 651). Occupational therapy practitioners are uniquely skilled in understanding how all of these variables influence occupational performance, participation, quality of life, and the recovery process. Occupational therapists use theory and frames of reference as well as their knowledge, skills, and understanding of the existing evidence base to guide the occupational therapy process (AOTA, 2008). In analyzing occupational performance, assessment tools are often used to help identify and target strengths and barMARCH 2012
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ARTICLE CODE CEA0312

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