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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

®

AUGUST 6, 2012

Focus on

• OT and Medication Management • Community-Based Youth Groups for Mental Health • Health & Wellness Camp • School Programs Supporting Mental Health

Pediatrics

PLUS

Launching the School Year News & Capital Briefing Continuing Ed & Employment Opportunities

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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: racy Hammond T Advertising Assistant: Clark Collins

AOTA • THE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION
VOLUME 17 • ISSUE 14 • AUGUST 6, 2012

Focus on

FEATURES
The Role of Occupational Therapy in Managing Medication for Children
Nancy Bagatell and Martha Sanders outline strategies that occupational therapists can use to promote medication adherence.

Ad inquiries: 800-877-1383, ext. 2715, or e-mail sales@aota.org
OT Practice External Advisory Board

Pediatrics

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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, Suite #200, Bethesda, MD 20814-3449; 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, 4720 Montgomery Lane, Suite #200, Bethesda, MD 20814-3449. 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.
COVER PHOTOGRAPH © OJO IMAGES / SUPERSTOCK

Creating Occupational Therapy Groups for Children and Youth in Community-Based Mental Health Practice
Tina Champagne describes how her outpatient clinic uses therapy groups to help facilitate occupational performance, participation, and satisfaction.

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DEPARTMENTS
News Capital Briefing
Moving Forward: Health Reform in the States

3 6 7

Calendar

Continuing Education Opportunities

22 27 33

Employment Opportunities Questions and Answers
Susan Bayzk: School Programs Supporting Mental Health

Perspectives

Launching the School Year: Practical Skills for School-Based Occupational Therapy

In the Clinic

Camp Watakamini: Promoting Health and Wellness for Children and Youth at Sleepover Camp

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• 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 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, 4720 Montgomery Lane, Suite #200, Bethesda, MD 20814-3449, 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 • AUGUST 6, 2012

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Stand from the ordinary.
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News
AOTA News

Association updates...profession and industry news
future leaders, the SISs are initiating a 1-year student internship pilot program. The Physical Disabilities SIS (PDSIS), Home & Community Health SIS (HCHSIS), Gerontology SIS (GSIS), and Developmental Disabilities SIS (DDSIS) volunteered to participate in this pilot program, and each chairperson or designee from these SISs will serve as a leadership mentor by collaborating with the interns to select appropriate projects and opportunities for enrichment and education about the leadership structures and processes of AOTA. After completing the pilot, interns and mentors will complete surveys to analyze the outcomes of the program. Students were invited this spring to apply to participate in the program and an unexpectedly high number of very qualified applications were received. The following members were selected to take part: Jennifer Nash, University of Washington. Tracy Jirikowic, DDSIS chair and mentor. Stephanie Reitemeier, Thomas Jefferson University; and Sarah A. Guariglia, Quinnipiac University. Regula Robnett, GSIS chair and mentor. Rachel Wiley, Thomas Jefferson University; and Samantha Stern, Quinnipiac University. Tracy Van Oss, HCHSIS chair and mentor. Courtney Zon, University of Pittsburgh; and Helen Magers, St. Ambrose University. Lauro Munoz, PDSIS chair and mentor. Human Services outlining the coverage data to be collected from certain health insurers to inform the definition of essential health benefits. The rule also proposes the first of a twophased approach for recognizing accrediting entities to implement the standards established under the Affordable Care Act for qualified health plans. For more, visit the Advocacy News section on AOTA’s Web site at www.aota.org/news/ advocacynews. tions for its director of Region II, which includes Florida, Georgia, Maryland, North Carolina, Pennsylvania, South Carolina, Virginia, Washington, DC, and West Virginia. If you are interested in serving on the AOTPAC Board of Directors and reside within the geographical boundaries of Region II, contact AOTPAC at AOTA headquarters by e-mail at aotpac@aota.org or call 800729-2682, ext. 2014, to obtain an application form and further instructions or to get additional information. An application form is also available on the AOTA Web site at www.aota.org/aotpac, under Resources.

Advanced Practice in Traumatic Injuries & PTSD

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housands of veterans and civilians have faced severe traumas or life-threatening events that have severely disrupted roles for themselves and their family members. Occupational therapy makes a significant difference in their lives through rehabilitation and reintegration into their communities. Are you part of this important role of occupational therapy, or would you like to be? If so, attend the AOTA Specialty Conference on Advanced Practice in Traumatic Injuries & PTSD: Lessons for Military, VA, and Civilian Practitioners, to be held from September 7 to 8, 2012, in San Antonio, Texas. You will experience indepth learning from excellent speakers on important topics such as traumatic brain injury, posttraumatic stress disorder, upper-extremity injuries, pain, burns, vision loss, amputations, spinal cord injuries, and more. Plus, you will earn up to 13 contact hours. Register before August 20 to take advantage of early registration fees. Join your colleagues in San Antonio!

AOTA Members Sought to Serve on AOTPAC Board of Directors
he American Occupational Therapy Association Political Action Committee (AOTPAC) Board of Directors seeks a director for its Region II area. The selected candidate will serve a 3-year term starting January 1, 2013, and ending December 31, 2015. The application deadline is August 27, 2012. If you are an AOTA member who has been active at the state and/or federal level advocating for your profession or working on campaigns for elected office, AOTPAC needs you! Apply today to represent your fellow members and work with a dynamic group of AOTA members from around the country on this important committee. Help make occupational therapy a profession that is taken seriously in the political and legislative arenas—a profession that is known by all members of the U.S. Congress and one that is consulted on national health, education, and labor initiatives. The AOTPAC Board of Directors is seeking nomina-

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CMS Issues Proposed Physician Fee Schedule Rule
he Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule entitled, “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013.” The proposed rule includes a plan to collect data on patient function next calendar year to inform how Medicare pays for occupational therapy as well as physical therapy and speechlanguage pathology services. According to CMS, the proposal also includes a plan to increase payments to family physicians by approximately 7% and to other practitioners providing primary care services by between 3% and 5%. The increase in pay3

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Students Selected for AOTA SIS Internship Program
he Special Interest Sections (SISs) recognize that students play a key role in the future of our profession and in the realization of AOTA’s Centennial Vision. To increase student utilization of SIS resources and aid the development of
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AOTA Submits EHB Comments

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OTA submitted comments on July 3 in response to a proposed rule from the U.S. Department of Health and

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

Early Childhood: Occupational Therapy Services for Children Birth to Five
(SPCC) B. Chandler Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). ocuses on community-based programs, examines the impact of federal legislation on occupational therapy practice, and explores ways to articulate and demonstrate the expertise of occupational therapy in transitioning early childhood development into occupational engagement in natural environments. $259 for members, $359 for nonmembers. Order #3026. http:// store.aota.org/view/?SKU=3026

Occupational Therapy in Mental Health: Considerations for Advanced Practice
M. Scheinholtz iscusses recent advances and trends in mental health practice, including theories, standards of practice, and evidence as they apply to occupational therapy. Includes content from the National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration, and the National Council on Persons With Disabilities. $70 for members, $99 for nonmembers. Order #1257. http://store.aota.org/ view/?SKU=1257

ment to family practitioners is part of the proposed rule that would update payment policies and rates under the Medicare Physician Fee Schedule for calendar year 2013. For more information, visit www.aota.org/ news/advovacynews.

Industry News

AOTF Seeks Award Nominees

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SIS Call for Nominations (Chairperson Positions)

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Mental Health Promotion, Prevention, and Intervention With Children and Youth: A Guiding Framework for Occupational Therapy
(SPCC) S. Bazyk Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). eflecting a public health approach to occupational therapy services at the universal, targeted, and intensive levels, this course emphasizes helping all children develop and maintain positive affect, positive psychological and social functioning, productive activities, and resilience in the face of adversity. This course may assist therapists in their efforts to become BCMH certified. To learn more go to www.aota.org/certification. $259 for members, $359 for nonmembers. Order #3030. http:// store.aota.org/view/?SKU=3030

Autism: A Comprehensive Occupational Therapy Approach, 3rd Edition
H. Kuhaneck & R. Watling sing the Occupational Therapy Practice Framework: Domain and Process, 2nd Edition as a guide, this book provides the information occupational therapy practitioners need to work with individuals with autism spectrum disorders in clientcentered and occupation-based practice. This book is a must-have resource for occupational therapy students and practitioners at all levels. $69 for members, $98 for nonmembers. Order #1213B. http:// store.aota.org/view/?SKU=1213B

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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 section’s program(s) at AOTA’s 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.

he American Occupational Therapy Foundation (AOTF) is seeking nominees for the AOTF Award for Community Volunteerism, which will honor an individual occupational therapist or occupational therapy assistant, or group of practitioners, who demonstrate(s) commitment, excellence, and/or innovation in providing U. S. community-based volunteer services using occupational therapy skills. Nominations are due October 1, 2012. For more information, visit www.aotf. org/awardshonors/forleadership service/aotfawardforcommunity volunteerism.aspx.

OT Students Part of Rebuilding Together

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he Master of Occupational Therapy students at the T. Boone Pickens Institute of Health Sciences–Dallas Center partnered with Rebuilding Together Greater Dallas to volunteer their time and efforts to provide repairs and home modifications, such as accessibility modifications and equipment to promote safety, in homes of low-income elderly persons, people with disabilities, and low-income families with small children. The master’s students have participated in more than 20 home accessibility evaluations for Rebuilding Together and volunteered their time throughout this past year to help bring the home modifications they recommended to fruition.

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

Virtual Chat on Handling Workloads
he next AOTA Pediatric Virtual Chat, on Caseload to Workload, is scheduled for August 21 from 4 p.m. to 5 p.m. EST. To participate in the chat and view chat archives, check out www.talkshoe.com/tc/73733.

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

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Intersections
n Maureen Peterson, MS, OT/L, FAOTA, AOTA’s chief Professional Affairs officer, was recently interviewed by the Center for Association Leadership about AOTA’s Emerging Leaders Development Program. To read
AUGUST 6, 2012 • WWW.AOTA.ORG

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the article, visit www.asaecenter. org/Resources/ANowDetail. cfm?ItemNumber=182045.
n AOTA announced the appointment of three members to American Medical Association (AMA) committees associated with the Common Procedure Terminology (CPT) system. Leslie F. Davidson, PhD, OTR/L, FAOTA, has been appointed by the AMA House of Delegates to the Editorial Panel. To replace Davidson as AOTA’s CPT advisor, AOTA appointed Mary Johanna McGuire, MS, OTR/L, OTPP, FAOTA, to serve on the CPT Health Care Professionals Advisory Committee (HCPAC), which reviews the development of new codes and redefinition of or updates to existing codes. Additionally, AOTA appointed Mary Katherine “Katie” Jordan, OTD, OTR/L, as alternate advisor to the Relative Value Update Committee

HCPAC Review Board, which oversees the determination of values for codes. For more, visit the AOTA News section at www.aota.org/news.

Practitioners in the News
n Rita Fleming-Castaldy, PhD, OTL, FAOTA, associate professor of occupational therapy at the University of Scranton, presented two research studies at the British College of Occupational Therapists’ (BCOT) annual conference recently held in Glasgow, Scotland. The first presentation focused on wellbeing and self-directed living for persons with disabilities. The second presentation discussed the relationships between information literacy, historical research, and the formation of students’ professional identity. n Jane Koomar, PhD, OTR/L, FOTA, will be honored at the

national ATTACh conference in Baltimore, Maryland, on September 21, 2012, as the first recipient of the ATTACh Award for Innovation. A co-author of the Smart and Safe Place models for working with children who have disorders of trauma and attachment, Koomar has provided important leadership, publications, and training in the emerging field of combined sensory integration and trauma/attachment intervention. ATTACh is an organization of multiple professional disciplines and families who work to address trauma and attachment disorders of children. For more information, visit www.attach.org.
n Karen Z. Kowalski, MPH, OTR, academic fieldwork coordinator and instructor for the University of Medicine and Dentistry’s Occupational Therapy Assistant Program, in Newark, New Jersey, appeared on local New Jersey

television to provide seniors with suggestions on how to safely remain within their homes and communities as they age. To view the segment, visit http:// cvp.telvue.com/player?id=T014 11&video=60099.
n Amy Wagenfeld, PhD, OTR/L, CAPS, and Daniel Winterbottom, RLA, FASLA, professor of landscape architecture at the University of Washington, recently signed a contract with Timber Press to write Designing the Healing Garden. The book will have a collaborative, interdisciplinary focus on occupational therapy and landscape design. If you have a healing, therapeutic, or sensory garden at your facility and would be interested in sharing a photo to possibly be included in the book, please contact Wagenfeld at amy.e.wagenfeld@gmail.com. Andrew Waite is the associate editor of OT Practice. E-mail: awaite@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 7–8, 2012 San Antonio, Texas
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 need—or want to be— attend the outstanding AOTA Specialty Conference on Advanced Practice on Traumatic Injuries & PTSD!

Earn Up To 13 Contact Hours! Early Registration Ends August 20! www.aota.org/ConfandEvents/ Advanced-Practice

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c A p i TA l B r i e f i N g

Moving Forward

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Health Reform in the States
Dan Brown
HHS did not identify a process for states to use in selecting benchmark plans, but it did identify a list of eligible plans, a deadline, and a default benchmark if a state fails to make a selection. As a result, states may select benchmark plans in different ways. Some states may pass legislation identifying the benchmark plan. Other states created advisory groups to make the decision. Still others have taken no action. Regardless of the process a state has chosen, occupational therapy practitioners have a significant interest in this issue, because a state’s benchmark plan and the related HHS regulations will determine whether and to what extent occupational therapy services are covered for rehabilitation, habilitation, and mental health/behavioral health treatment. The upside for occupational therapy is that the service is covered in virtually every health insurance product now because of the profession’s growth and influence over the last 30 years.

he Affordable Care Act (ACA) largely survived its Supreme Court challenge, but the court’s ruling has significant implications for implementing the ACA, particularly at the state level. First, because the court rejected the challenge to the constitutionality of the so-called “individual mandate,” states may be more inclined to move forward in implementing key elements of the ACA. Those elements include adopting benchmark plans for essential health benefits (EHBs) and creating health insurance exchanges. Second, because the court’s ruling prohibited the federal government from withholding all Medicaid funds from states that fail to expand Medicaid eligibility, some states may opt not to implement the expansion envisioned by the ACA. How states react to the court’s decision will significantly affect the profession of occupational therapy, because it will determine how many consumers have health insurance and what that insurance covers—and thus whether they will have access to occupational therapy.

MEDICAID
The ACA calls for an expansion by 2014 of Medicaid eligibility to all citizens with incomes below a certain level. However, with the Supreme Court ruling as it did, states are no longer at risk of losing all their Medicaid funding for failing to implement the expansion, and as a result, a number of governors have publicly declared that their states will not participate. By one estimate, in five states expected not to participate, approximately 3.9 million fewer people would be able to access Medicaid through new eligibility criteria. But public announcements by political leaders may not tell the whole story. In many states, Medicaid coverage is provided through private managed care organizations, which will have an incentive to lobby for the eligibility expansion. Similarly, increased Medicaid coverage will reduce the cost to hospitals of providing uncompensated care, motivating hospitals to also push for the expansion. In the near term, with the federal government picking up the whole cost of the expansion, states may find it difficult to avoid implementation. However, some critics argue that absorbing administrative and other costs of the expansion from the beginning will dissuade states from participating, given their budgetary challenges. The American Occupational Therapy Association and state occupational therapy associations are closely monitoring these issues and advocating for the profession. Your membership enables us to be effective in these efforts to meet your needs and the needs of your clients. n
Dan Brown is AOTA’s senior state policy analyst.
AUGUST 6, 2012 • WWW.AOTA.ORG

ESSENTIAL HEALTH BENEFITS
The ACA establishes 10 broad categories of services that it deems EHBs. It requires all health insurance plans sold in the individual and small group markets to provide coverage for EHBs. However, the U.S. Department of Health and Human Services (HHS), which was tasked with establishing the rules related to EHBs, has allowed states to select a benchmark plan from among certain existing health insurance plans to serve as their EHB model. Although the final regulations from HHS regarding EHBs have not been released, HHS’s decision empowers states to significantly affect what the EHBs require.

HEALTH INSURANCE ExCHANGES
The ACA directs states to create health insurance exchanges, through which consumers may purchase insurance coverage and, if they meet certain income thresholds, receive subsidies. If a state fails to create an exchange, the federal government will create one for them. The exchanges must be fully operational by 2014; however, it is unclear whether the states or the federal government will meet that deadline. Only about a third of the states have taken significant steps toward establishing exchanges, and the federal government’s progress to supplement the states’ efforts has been called into question.

perspecTives

Launching the School Year

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PHOTOGRAPH COURTESY OF THE AUTHOR

Practical Skills for School-Based Occupational Therapy
Veda Collmer

ties when scheduling. For t’s never too early to start example, children in thinking about next year. fourth grade and beyond No matter how many sometimes have to change years I have practiced in classes after each subject. the school system, my Many middle school gut still gets twisted in students have study halls knots when it comes to or homeroom periods scheduling my workload. I where you can schedule start early, determined to treatment times without design the perfect schedsignificantly affecting ule. One that allows me to academics. Get a copy of maximize every possible your students’ schedules, minute of the school day identify possible times for providing services exactly service, and then talk to as the Individuals with the teacher. Disabilities Education Act Minimize travel time (IDEA)1 mandates. Three between schools. Freweeks later, I’m still trying quent travel between to squeeze in that once-aOften, the scheduling process will be your first chance to meet the teacher with schools eats up valuable week appointment with a whom you ll be developing a relationship over the course of the school year. time. Explain to teachers high school student who Make a good impression to open the lines of communication. that you provide services has zero availability. Luckin several schools and need to schedule student. Leave your contact informaily, the majority of scheduling occurs on certain days. tion with the teacher and the rest of merely once a year, with some tweakAvoid speeding tickets and ulcers. the school team, like office personnel ing. Over the years, I have developed Be realistic about your travel times. and the principal, so they can reach some tricks to make the task a little Don’t just factor in the driving distance. you easily. Use this opportunity to more manageable. Working in the desert heat of Arizona educate about your role—for individual Take a deep breath. Scheduling stumay mean waiting several minutes with students, groups, whole classrooms, dents is an exercise in patience. I have the air conditioning on full blast before and whole school initiatives—as well as had the misfortunate of scheduling my you can even touch the boiling-hot the student’s individualized education entire workload long after all the other steering wheel. Our Northeast winters program (IEP) goals. services were finished. That meant I give us plenty of practice brushing Don’t procrastinate. Procrastination was left with mere scraps of time. Keep snow off of our cars and scraping the is as effective for solving a problem in mind that everyone is facing this windshield. Therefore, be kind to as dousing flames with gasoline is for struggle. Don’t let your frustration spill yourself and allow some wiggle room. putting out a little campfire. Tackle the over onto innocent victims. Often, the If you find that you’re racing between scheduling process early. This ususcheduling process will be your first schools, then re-arrange your schedule ally means you’ll get first bid on prime chance to meet the teacher with whom to allow for extra time. times for service. Also, the sooner you you’ll be developing a relationship over Block scheduling can be your best start, the sooner it is over and you can the course of the school year. Make a friend. When I have several students in begin working with your students. good impression to open the lines of the same classroom, I like to block off Consider student priorities when communication. Bring your notebook a chunk of time in my schedule. This scheduling. Consider critical need, and jot down any of the teacher’s allows me some flexibility, especially if scheduling conflicts, and other prioriobservations or concerns about the
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OT PRACTICE • AUGUST 6, 2012

even contributing to wholeone of the students is absent school initiatives, such as or at a school assembly. Also, anti-bullying campaigns. block scheduling saves time Never be lured into the false in the beginning so you can belief that your schedule will focus on the students with always remain this light. As limited availability. Rememthe school year progresses, ber, the occupational therareferrals will flood in, students pist’s role is to support the will move into the district, and student’s general curriculum. projects will crop up. When I IDEA mandates that you am buried in work, I definitely provide services in the least do not want to discover that restrictive environment.1 I haven’t been providing the A block schedule will allow mandated frequency of seryou to shift students around vices to a particular student. if the teacher needs you to Therefore, take advantage of adapt a woodshop project your down time. You’ll love or provide support during a yourself later and commend math lesson. yourself on your foresight and Keep in mind different Get a calendar and use it. My calendar is valuable and I am not sure what excellent organizational skills. arrival and departure times. would happen if I lost it. I m still keeping track of my dates with old fashioned Organize and order. Comb Different schools and difpen and paper, but use what works best for you. through the therapy materiferent grades have different als. Clean up and organize the and work on another project. Review schedules for the school closet or storage space. Remove broken your IEPs. Use the time away to collect day. Before you start scheduling, find equipment. Order new or necessary yourself so that when you venture out out arrival and departure times. This will equipment. At the beginning of the year, again, you’ll be in a more positive frame maximize your service time. As the school there may be more funds for equipof mind. year progresses, you’ll learn that there ment. Think ahead about what is needed Block off time for classroom support. The just is not enough time in the school day, and keep a running list. Look through IDEA defines the occupational therapy so stretch it as much as possible. evaluation kits to determine if all forms role as one of support in the general curGroup students based on needs. and parts are in the right place. Identify riculum.1 Gone are the days when you Sometimes the IEP will specify group treatment resources and keep a file of treatment. In some school districts, you’ll picked the student up at the classroom worksheets for the entire year. Disperse have the option to decide whether to door, went to the therapy room, performed materials to different sites if travel is group students. Develop groups based your “treatment,” and then returned the necessary to avoid lugging around lots of on similar goals, such as handwriting skill student to his or her peers. Now, occuequipment. development. It’s easier to plan your sespational therapy is part of the classroom, Become acquainted. In the first few sions when your students are working on which is a positive change because it is weeks of school, I learn the names of similar goals. Also, keep in mind the ages within the least restrictive environment the staff and obtain a roster with phone of the students. Try not to group students and promotes full participation during numbers and e-mail addresses. I personmore than a grade or two apart. naturally occurring typical routines. Someally introduce myself to the principal, the Accept that you will interrupt the class times, you have to attend the assembly custodian, the special education coordiwhen scheduling. There is no way to slip to determine what is affecting a student’s nator, other related services staff, and the unobtrusively into a kindergarten classbehavior. Or the art teacher wants you to teachers. I hope they will remember my room. All students will turn and stare suggest ways to adapt the paintbrushes so face and know that I am a resource. This curiously at you. Attention on the lesson a student with orthopedic limitations can practice also saves time later because I will be lost. However, because teachers participate in the same project as other know whom to contact with specific quesare extremely busy, locating them can be classmates. Give yourself the flexibility to tions and concerns. tricky. When they are not teaching, they meet those needs so that you’re providing Make lists. Nothing is more gut are off running errands or planning their best practice services. wrenching than forgetting that you had a next lesson. Many teachers don’t mind Getting organized in the calm before student on a quarterly consult at the end the interruption. If it is a problem, offer the storm. The first few weeks of the of the school year. So, keep a list of your to return at a more convenient time. school year are peacefully slow. Usually, students on workload. You can include Take a breather when necessary. PerI will have a medium-sized workload the IEP treatment frequencies and teachhaps you passed the director of special and a few evaluations left over from the ers’ names as an additional reminder. education in the hall and learned of six previous year. I can meander through Review for accuracy. At the beginning more students to add to your workload. my day, brainstorming with teachers of the school year, comb through each Or there is one student who is busier than about classroom adaptations on the spot, student’s IEP. Make sure the student a Fortune 500 CEO. When you’re feeling observing the gym class, participating in this way, put away the schedule briefly curriculum-based teams, and potentially continued on page 18
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AUGUST 6, 2012 • WWW.AOTA.ORG

PHOTOGRAPH COURTESY OF THE AUTHOR

The Role of Occupational Therapy in

Managing Medication for
NANCY BAGATELL MARTHA SANDERS

Children
Strategies that occupational therapists can use to promote medication adherence.

H
PHOTOGRAPH © OJO IMAGES / SUPERSTOCK

ealth management, including medication routines, is an instrumental activity of daily living included in the Occupational Therapy Practice Framework: Domain and Process, 2nd Edition.1 Although managing medication routines is most often associated with older adults, there is a growing need to address medication management in children. Medications are used to improve physical health and functional abilities for chronic conditions such as juvenile arthritis, asthma, and cystic fibrosis. Children also take medications to manage behavior and promote academic and social participaOT PRACTICE • AUGUST 6, 2012

tion for conditions such as attention deficit hyperactivity disorder (ADHD), depression, anxiety, and autism spectrum disorders. Although occupational therapy practitioners provide interventions to promote engagement in occupation for children, little attention has been given to practitioners’ role in managing medications. This article addresses strategies that occupational therapy practitioners can use to promote medication adherence.

FAMILY ROUTINES
Medication adherence refers to the extent to which the clients’ actions are consistent with recommendations

by health care providers.2 Adherence rates for children vary from 18% to 90% across conditions.3 Adherence is complex, influenced by family routines, parental knowledge and beliefs, stress, and children’s behaviors. The use of routines has been shown to improve medication adherence while decreasing parental distress and difficult child behaviors.3–4 Fiese, Wamboldt, and Anbar suggested that medication use should be “framed as part of the family’s daily or weekly routines, such as vacuuming the house once per week, monthly cleaning of duct systems, and monitoring peak flows” (p. 171).4 However, family life can be unpredictable, making it challenging for families to consistently adhere to medication regimens around such non-routine events as birthday parties, soccer tournaments, and vacations.5 Both parents and children indicate they often forget to take medications when engaged in leisure activities.6 Occupational therapy practitioners can collaborate with families to determine how medication administration can be embedded into current routines, such as bedtime or breakfast
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sequences, or develop new routines. Practitioners can also devise strategies for tracking medication use, picking up refills, and handling unplanned events that interrupt medication administration.4 Strategies may include using timers and application software as reminders to take medication.

Table 1. edication Category M and Common Side Effects
Medication Category Selected Common Side Effects for Children

MANAGING BEHAVIORS
A significant barrier to medication adherence is medication refusal, whether due to defiance or challenges ingesting medications. Children may be fearful of choking, find the taste of the medication unpleasant, and/or have difficulty swallowing pills.5–6 Gagging, vomiting, and spitting out medications are commonly reported behaviors in young children. Children with sensory processing concerns may be especially sensitive to the taste and smell of medication. Occupational therapy practitioners can work with families and pharmacists to identify a preparation that is most suitable, such as liquid, chewables, or pills. Droppers and dosage syringes can be used to squirt the medication into the cheeks or back of the throat. Pacifier medicine dispensers provide another option. For some children, mixing medications with a small amount of juice or food (particularly sweeter foods) may be helpful. Occupational therapists can experiment with various flavors and consult with the pharmacist, who can prepare a child’s medications using FlavorRx. Finally, providing children with a “chaser,” such as chocolate, can effectively mask the taste of medications.7 Occupational therapy practitioners can help families address medication refusals by collaborating to develop reward systems. Young children may be motivated by sticker charts, while older children often respond to token reinforcement systems or reward charts.8 Charts can be prepared using simple online templates.

Psychostimulants Headache Stomach ache Difficulty getting to sleep Decreased appetite Growth suppression Rebound phenomena Antidepressants Suicidal ideations Anxiety Agitation Hostility Restlessness Impulsivity Weight gain Fatigue Memory problems Attention problems Tremors Involuntary movements of face or body Increased appetite Weight gain Growth suppression Fluid retention Gastritis Mood swings Increase in blood sugar Hypertension Muscle wasting

Antipsychotics

Corticosteroids

MEDICATION SIDE EFFECTS AND IMPACT ON CHILDHOOD OCCUPATIONS
All medications have side effects that affect each child differently. The ability to manage side effects has important implications for adherence and children’s participation in childhood occupations. Side effects of psychostimulant
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medications taken to manage ADHD and attention deficit disorder symptoms include lack of appetite, difficulty getting to sleep, and a “rebound” effect when children cycle off medication dosages (Table 1). These issues become paramount because nutrition and sleep are critical to childhood development and school performance.9 Occupational therapy practitioners can provide input to physicians and encourage parental advocacy to promote optimal dosing schedules. Occupational therapists may suggest taking medications after meals to minimize the impact on appetite, yet long before bedtime to minimize sleep interference. If a rebound of ADHD symptoms occurs at the end of dosing,

parents may advocate for longer-acting medications; alternately, a “booster” dose can minimize a rebound and provide coverage for homework or late afternoon activities.9 Occupational therapy practitioners can also work with families to promote good nutrition with healthy snacks during the day. Steroid medications may be administered to decrease severe inflammatory responses in children with conditions such as juvenile rheumatoid arthritis or asthma. Common side effects include increased appetite, weight gain, and muscle wasting. For adolescents, weight gain may impact body image, identity, and participation in social activities. Occupational therapy practitioners can promote a positive body image by inviting cosmetologists to teach adolescents how to highlight their appearance using make-up, optimal hair styles, and current fashions. Because some children with arthritis do not have the muscle strength or endurance for sports, practitioners can help them develop other leisure interests and “special strengths” (e.g., art, magic, music) that contribute to a positive self-identity. Antidepressant medications can be highly effective for children with depression, mental illness, or other conditions. However, antidepressants come with a “black box” warning of potential suicidal ideation for children, adolescents, and young adults. The risk is most concerning within the first weeks of taking medications and until a therapeutic dosage is reached.10 Because warning signs such as agitation, anxiety, talkativeness, and some types of self-injury are not always obvious, occupational therapy practitioners can help parents and health care providers identify behaviors and work with families to recognize triggers, create calming environments, prepare for transitions, and develop routines to decrease stressors. Finally, occupational therapy practitioners can engage children in physical activity to promote endorphin release and decrease anxiety.

FACILITATING DECISION MAKING
Parents are initially faced with the difficult decision of whether their child should take medication. They may experience a wide range of emotions
AUGUST 6, 2012 • WWW.AOTA.ORG

fOr MOre iNfOrMATiON
Activity Analysis, Creativity, and Playfulness in Pediatric Occupational Therapy: Making Play Just Right By H. Kuhaneck, S. L. Spitzer, & E. Miller, 2010. Boston, MA: Jones and Bartlett. ($68.95 for members, $97.95 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store. aota.org/view/?SKU=1444. Order #1444. Promo code MI) Mental Health in Children and Youth: The Benefit and Role of Occupational Therapy www.aota.org/Practitioners-Section/Children-andYouth/Role-of-OT/Fact-Sheets-on-the-Role-ofOT/44479.aspx?FT=.pdf AOTA Self-Paced Clinical Course Mental Health Promotion, Prevention, and Intervention With Children and Youth: A Guiding Framework for Occupational Therapy Edited by S. Bazyk, 2011. Bethesda, MD: American Occupational Therapy Association. (Earn 2 AOTA CEUs [25 NBCOT PDUs, 20 contact hours]. $259 for members, $359 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http:// store.aota.org/view/?SKU=3030. Order #3030. Promo code MI) Mental Health Resources www.aota.org/Practitioners/PracticeAreas/ MentalHealth AOTA Self-Paced Clinical Course Occupational Therapy in Mental Health: Considerations for Advanced Practice Edited by M. Scheinholtz, 2010. Bethesda, MD: American Occupational Therapy Association. (Earn 2 AOTA CEUs [25 NBCOT PDUs, 20 contact hours]. $259 for members, $359 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota.org/view/?SKU=3027. Order #3027. Promo code MI) Occupational Therapy Practice Guidelines for Children and Adolescents With Challenges in Sensory Processing and Sensory Integration By R. Watling, K. P. Koenig, P. Davies, & R. C. Schaaf, 2011. Bethesda, MD: AOTA Press. ($69 for members, $98 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store. aota.org/view/?SKU=2218. Order #2218. Promo code MI) Occupational Therapy Practice Guidelines for Children With Behavioral and Psychosocial Needs By L. Jackson & M. Arbesman, 2005. Bethesda, MD: AOTA Press. ($59 for members, $84 for nonmembers. To order, call toll free 877-404AOTA or shop online at http://store.aota.org/ view/?SKU=1198C. Order #1198C. Promo code MI) Specialized Knowledge and Skills in Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice By American Occupational Therapy Association, 2010. American Journal of Occupational Therapy, 64, S30–S43. doi:10.5014/ajot.2010.64S30 Working With Children and Adolescents: A Guide for the Occupational Therapy Assistant By J. DeLany & M. Pendzick, 2009. Upper Saddle River, NJ: Prentice Hall. ($60 for members, $85 for nonmembers. To order, call toll free 877-404AOTA or shop online at http://store.aota.org/ view/?SKU=1437. Order #1437. Promo code MI)

THE REGULATORS
The title “The Regulators” was created by the first group of teens (13 years and over) attending the group series. Although the general goals for each of the 8-week groups was similar to those of the Sensory Mod Squad, the actual group activities and media used were carefully chosen, organized, and based in part on the goals, interests, and requests of the teenage participants throughout the 8 weeks. This ensured a client-centered, individualized approach specific to the age range and the individual interests of the participants. For example, the first Regulators group included a review of each participant’s interests, and a common theme of arts and crafts emerged. All of the participants of the first Regulators group happened to be females, and the common theme of having an interest in self-care– related activities also emerged. Thus, throughout each group a craft was used as one of several activities in which the participants made many of the items that they used as part of their sensory diet and/or kit. For example, as part of one group effort, participants made self-care items such as sugar scrubs and bar soaps using a self-identified, favorite essential oil blend for sensory modulation purposes. Each participant was able to take home her scrub and soap to use during self-care activities at home as part of her sensory diet. All participants created a sensory kit by the end of the 8-week group series complete with a large variety of age appropriate tools.

CONNECTIONS
Discuss this and other articles on the OT Practice Magazine public forum at http://www.OTConnections.org.

games (e.g., name games, emotion identification). Over the course of the 8 weeks, increased trust and socially appropriate interactions emerged to varying degrees within the participants (e.g., awareness of social cues, interpersonal effectiveness, boundaries).

SENSORY MOD SQUAD GROUP
Sensory Mod Squad is open to clients ages 7 to 12 years. They are split into two groups: 7 to 9 years and 10 to 12. These age ranges are split up into different groups to accommodate different developmental and learning needs and capabilities. The Sensory Mod Squad group meets once a week for 8 weeks, with the last 5 minutes of each meeting used to summarize each week’s group activities with parents and caregivers. Throughout the 8 weeks, children learn to self-rate their emotions and the emotions of others,
OT PRACTICE • AUGUST 6, 2012

trial and rate the influence of strategies from each of the sensory system, complete weekly handouts that are collated into workbooks by the eighth week, and each child creates an individualized sensory kit containing the sensory tools each has created each week. As part of the last session (week 8), parents and caregivers are invited to participate, and the children/youth and group leaders review and demonstrate the skills learned, and the purpose and contents of the sensory mod squad workbook and sensory kit each child creates and keeps upon discharge. After completing the 8-week group program, there is an individual discharge meeting and a discharge summary is provided with the assessment results and therapeutic recommendations. Additional resources provided include free informational handouts and monthly seminars for parents and caregivers.

OUTCOMES
Each of the three group types was well received by the participants, parents, caregivers, and referral sources. Feedback and suggestions for change about what was liked and disliked was collected through interviews with participants and parents/caregivers throughout the course of each group and also at the end of the 8 weeks. In addition, the occupational therapists and students who ran each group reflected weekly to identify perceived strengths of each session, ideas for change, and other potential intervention ideas for future activities. The overall success of the groups was most
17

evident during week 8, when the clients were able to independently demonstrate and explain the skills learned for parents and caregivers. Moreover, upon completing the 8-week groups, the clients, parents, and caregivers unanimously and successfully advocated for creating a “part two” (a second 8-week series of sessions) of each group to be offered in order to continue building upon skills learned. Since this first round of groups, from year to year, the names of these particular groups at our clinic has stayed the same, and the age ranges generally remain the same, but the group content is modified based on the clients’ interests, needs, and goals. These groups continue to evolve over time based on client, caregiver, staff, and student feedback. In this way, we are able to ensure a client-centered approach to group program development, implementation and evolution while at the same time targeting the specific goals, interests, and needs of each participant. n

References
1. Wilcock, A. A. (1998). An occupational perspective of health. Thorofare, NJ: Slack. 2. National Technical Assistance and Evaluation Center for Systems of Care. (2008). An individualized, strengths-based approach in public child welfare driven systems of care. Retrieved from http://www.childwelfare.gov/pubs/acloser look/strengthsbased/strengthsbased1.cfm 3. National Traumatic Stress Network. (2005). Understanding child traumatic stress. Retrieved from http://www.nctsnet.org/resources/ audiences/parents-caregivers/what-is-cts 4. Perry, B. (2004). Video series 1: Understanding traumatized and maltreated children: The core concepts. Retrieved from http://www.lfcc.on.ca/ Perry_Core_Concepts_Violence_and_Childhood.pdf 5. Teicher, M. D. (2000). Wounds that time won’t heal: The neurobiology of child abuse. Cerebrum: The Dana Forum on Brain Science, 2(4), 50–67. 6. Bassuk, E. L., Konnath, K., & Volk, K. T. (2006). Understanding traumatic stress in children. Retrieved from http://www.familyhomelessness. org/media/91.pdf 7. van der Kolk, B. (2005). Developmental trauma disorder. Psychiatric Annals, 35, 401–408. 8. van der Kolk, B. (2006). Clinical implications of neuroscience research and PTSD. Annals of the New York Academy of Science, 1071, 277–293. 9. Bowlby, J. (1988). A secure base: Clinical applications of attachment therapy. London: Routledge. 10. Schore, A. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Hillsdale, NJ: Erlbaum.

11. Luxenberg, T., Spinazzola, J., Hidalgo, J., Hunt, C., & van der Kolk, B. (2001). Complex trauma and disorders of extreme stress (DESNOS) diagnosis, part two: Treatment. Directions in Psychiatry, 21, 373–392. 12. Cook, A., Spinnazzola, J., Ford, J., Lanktree, C., Blaustein, M., Sprague, C., & van der Kolk, B. (2007). Complex trauma in children and adolescents. Focal Point, 21(1), 4–8. 13. Miller, L., Anzalone, M., Lane, S., Cermak, S., & Ostein, E. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135–139. doi:10.5014/ajot.61.2.135 14. Champagne, T. (2011). Sensory modulation and environment: Essential elements of occupation. Sydney, Australia: Pearson. 15. Caldwell, B. (2012). Strength-based treatment. In J. LeBel & N. Stromberg (Eds.), Creating positive cultures of care: Resource guide (pp. 1–5). Boston: Massachusetts Department of Mental Health. 16. Dunn, W. (1999). Sensory Profile user’s manual. San Antonio, TX: Psychological Corporation. 17. Gioia, G., Isquith, P., Guy, S., & Kenworthy, L. (2000). Behavior rating inventory of executive functioning. Lutz, FL: Psychological Assessment Resources.

Tina Champagne, OTD, OTR/L, is program director of CHD’s Institute for Dynamic Living in Springfield, Massachusetts. For more information, visit www.chd.org/OT

PERSPECTIVES
Launching the School Year
Continued from page 8 has goals that can be addressed by occupational therapy. Check the frequency for services. Is the student receiving occupational therapy individually or in a group? Look for any specialized equipment provided by occupational therapy, such as an Alpha Smart or slant board. Jot down the student’s goals and other related services in a notebook or on index cards for quick reference. Knowing the IEP and checking it for accuracy will be your most valuable time-saving tip to prevent confusion and ensure accurate delivery of services. Get a calendar and use it. My calendar is valuable and I am not sure what would happen if I lost it. I’m still keeping track of my dates with old fashioned pen and paper, but use what works best for you. The IDEA requires the initial evaluation to be completed 60 days after receiving
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the parental consent. Note that deadline in your agenda and then highlight it. Now create a self-imposed deadline at least 1 week in advance for completing your written report. Become attached to your calendar. Look at it often throughout the day— in the morning, around lunch, and then in the afternoon before you go home. Never schedule anything without first consulting it. Write down all appointments, meeting times, and makeups so you don’t forget them. Otherwise—trust me on this—you will remember that you talked to the third grade teacher on your way to lunch last Tuesday about a last-minute Committee on Special Education meeting scheduled for Wednesday of the following week about 10 minutes after it’s too late. Besides, your tracking system can be another modeling behavior to teach your students efficient organizational skills.

as early as possible to get to know my students. My treatment sessions are usually very structured. However, during those first few weeks, I use the treatment to determine each student’s skill level. If I have worked with the student previously, I can determine whether he or she has retained skills over the summer break. I can obtain a comparison writing sample for my students with written communication goals, or make other evaluations in consideration of interventions related to activities of daily living, behavior, and much more. Remember always to provide the student with some choices of activities. Be creative and have fun! n

Reference
1. Individuals with Disabilities Education Improvement Act of 2004. Pub. L. 108-446.

Veda Collmer, JD, OTR/L, has practiced occupational

Treating Students: The Fun Part!
Beginning sessions within the first few weeks of school may be determined by the IEP. I prefer to begin treatment

therapy in a variety of school settings across the United States. She is licensed to practice law in New York and specializes in family law.

AUGUST 6, 2012 • WWW.AOTA.ORG

iN The cliNic

Camp Watakamini
Promoting Health and Wellness for Children and Youth at Sleepover Camp
Pamela Toto Mary Lou Leibold Sam Boardman Maggie Corcoran Kourtney Heichel Kate Schramm Rachel Simon

“Hey…. You knuckleheads!!!!”
were the words that greeted five occupational therapy students from the University of Pittsburgh as they experienced the traditional friendly banter of everyone participating in the first campfire sing-a-long at Camp Watakamini. These students were participating in a novel Level I pediatric fieldwork experience that targeted health promotion and prevention during a 1-week resident (i.e., sleepover) camping experience for children ages 4 through 16 years of age. Camp Watakamini is a long-standing annual camping experience set in the Laurel Ridge Mountains of southwestern Pennsylvania. The program is offered through the Mon Valley Youth and Teen Association (MVYATA), a nonprofit organization that provides programs and activities for promoting self-esteem and responsibility to self and others (http://mvyata.webs. com). The organization serves the community of the Monongahela Valley, an area south of Pittsburgh famous for its historical production of steel in the mid-20th century and for being the birthplace of Stan Musial and other historic athletes. In addition to an annual resident camp, MVYATA hosts year-round programs, including youth groups and Kids Connection, an afterschool enrichment program for children in elementary school. Once part of a booming industrial area, the towns served by the MVYATA are now economically depressed, with approximately 70% of students in this region qualifying for free or reduced cost
OT PRACTICE • AUGUST 6, 2012

school lunches.1 Research suggests that children of low socioeconomic status are at increased risk for experiencing health problems, occupational performance limitations, and/or behavioral problems,2–3 underscoring the opportunities that exist for local occupational therapy professionals and students to help. Traditional settings such as hospitals, outpatient clinics, inpatient rehabilitation units, and schools are venues where opportunities for occupational therapy student learning abound and are commonly used. All students in the Master of Occupational Therapy Program at the University of Pittsburgh participate in Level I pediatric fieldwork. All fieldwork experiences, traditional and novel, are selected in accordance with AOTA’s Accreditation Council for Occupational Therapy Education Standards and the objecA nutrition session

tives outlined for our program’s pediatric course. Students are matched with an occupational therapy practitioner and spend 50 to 60 hours at their site throughout the term in which they are concurrently enrolled in a pediatric course. In practice today, occupational therapy services for children and youth include but often span beyond these traditional settings. Thus, in preparing students to be the practitioners of tomorrow, novel settings for Level I fieldwork are always welcome and continue to emerge. Camp Watakamini was one of two “camp experiences” offered by the University of Pittsburgh academic fieldwork coordinator Mary Lou Leibold, PhD, OTR/L, as an option for satisfying the Level I pediatric fieldwork requirement. It was a unique experience in that it included a health and wellness focus targeting

PHOTOGRAPH COURTESY OF THE AUTHORS

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A nutrition session

A discussion on self-esteem.

Table 1. Occupational Therapy Program Content Offered at Camp Watakamini
Nutrition • ctive Learning: Use heavy vs. light A backbacks to illustrate the challenge of carrying extra weight; discuss impact of lifestyle, diet, and nutrition on health. • avorite Foods: Use campers’ favorite F foods to introduce the new USDA food plate and food groups. • ealthy Snacks: Introduce campers to H three fun and healthy snacks. • ecipe Book Making: Have campers put R together an index card “recipe book” with fun snacks and healthy meal ideas. • lanting: Campers plant peppers, tomaP toes, or cucumbers and identify ways to use them in meals. Self-Esteem • he Web: Using a ball of yarn, campT ers make a web by tossing the ball to individuals while giving them a genuine compliment. Group then discusses how the experience made them feel. • ruit Salad Shake-Up: Musical chairs F type of activity that encourages cooperative interaction. • elf-Reflection: Pencil/paper activity to help S campers think about how they view themselves and how they are viewed by others. Healthy Relationships • ershey Kiss Arm Wrestling: Icebreaker H activity to demonstrate the advantage of teamwork vs. trying to win on your own. • ocial Skills Brainstorming: DiscusS sion stations on topics such as keeping friends, first impressions, manners, and group dynamics. • hadow Screen: Role playing through S nonverbal techniques to communicate body image, personal space, body language, sharing, and waiting your turn. • artner Communication: Activity to P teach verbal and nonverbal skills for communicating effectively. Physical Activity • igarette Chain Tag: Group activity to C demonstrate that smoking slows you down. • ail Tag: Group game to encourage T movement while having fun. • orest Scavenger Hunt: Activity combinF ing nature, physical movement, and targeted goal. • ore Circuit: Use of items at camp to C promote strength, balance, and cardiovascular endurance in a novel way.

children without a medical diagnosis. Additionally, students benefited from on-site supervision and support from an occupational therapist and University of Pittsburgh faculty member, Pamela Toto, PhD, OTR/L, BCG, FAOTA, who annually volunteers on the camp staff. Once we determined that the course objectives could be met, this camp experience was introduced to occupational therapy students who were invited to apply. They submitted essays describing why they wanted to participate and included any relevant experience they thought
20

might be beneficial during the fieldwork placement. As expected, the number of applicants exceeded available slots. Five students were selected for this opportunity. They were provided with background information about the history of Camp Watakamini and typical camp routines, and then charged with developing an educational model targeting health promotion and prevention that would “fit” both the setting and population. As per the Occupational Therapy Practice Framework: Domain and Process, 2nd Edition, health promotion is an occu-

pational therapy intervention approach that provides an enriched experience to enhance performance for a person, organization, or population that presents with no disabilities or limitations.4 Prevention is an occupational therapy intervention approach that shares similar features with health promotion, but specifically targets those who present with increased risk for developing occupational performance problems. The students identified four content areas to address through their program: nutrition/healthy eating, healthy relationships, self-esteem, and physical activity. These topics addressed several areas of occupation, including health management and maintenance, meal preparation, and social participation. The occupational therapy students were required to develop the program, acquire all necessary materials, and run activity sessions with 87 campers. (See Table 1 for details regarding program content.) Although the camp program targets a typically developing population, a number of campers had medical conditions (e.g., severe allergies, diagnosed behavioral disorders). When the students were not conducting the occupational therapy educational modules, they served as assistant group leaders and participated in supporting all other camp activities. The four programs each lasted approximately 1 hour and were designed to be delivered to small groups of campers over the course of 5 days. The students were given a copy of the daily routine, and planned program delivery around previously scheduled activities such as meals, showers, chores, and crafts. However,
AUGUST 6, 2012 • WWW.AOTA.ORG

PHOTOGRAPHS COURTESY OF THE AUTHORS

Table 2. Campers’ Satisfaction and Learning
Averages by Group Exercise and Healthy Overall (Grade Finished) Physical Activity Nutrition Relationship Self-Efficacy Score Older girls (7–10) Older boys (7–10) Middle girls (5–6) Young girls (3–4) Young boys (3–5) Little girls (pre-K–2) Little boys (pre-K–2) Total 4.50 3.83 4.52 4.50 4.00 4.14 4.20 4.24 4.50 4.25 4.67 4.36 4.33 3.71 4.20 4.29 4.25 3.33 4.61 4.14 4.40 5.00 5.00 4.39 4.50 3.75 4.71 4.07 4.75 5.00 4.60 4.48 4.44 3.79 4.63 4.27 4.37 4.46 4.46 4.35

93rd annual conference & expo
 in 

AOTA

Note: Scale of 1 to 5 (5=highest satisfaction) integrating new educational programming into a 65-year-old camping program laden with traditions and expectations was not always easy. These challenges included scheduling, modifying materials for different age levels, and overcoming preconceived attitudes of campers about not having to “learn” during summer break. The occupational therapy students addressed these challenges by being flexible, developing a rapport with both staff and campers, and making the sessions fun! This year’s camping session had a theme of “Every Day Is a Holiday.” Whenever possible, the occupational therapy students coordinated the theme into the program activities. For example, as part of the session on physical activity, campers were charged with searching in a wooded area for items from “The Twelve Days of Christmas” song. In addition to developing the program content, the occupational therapy students created a survey to measure the campers’ learning and satisfaction with the program (see Table 2). On a scale of 1 to 5 (with 5 being the highest satisfaction level), campers scored the four programs favorably, with a combined average of 4.35. In addition to this objective feedback from the campers, anecdotal feedback from the camp staff was extremely positive, with the occupational therapy programming cited by many at a postcamp staff meeting as “the best thing about Camp Watakamini 2011.” From the students’ perspective, they not only had the chance to apply their occupational therapy knowledge with a broad population of children, but they were able
OT PRACTICE • AUGUST 6, 2012

to gain skills in program development and implementation at the primary and secondary levels of prevention. Described by the students as a “total immersion” experience, they were quickly recognized for their clinical skills by other volunteer staff and were often asked to help intervene with campers who were exhibiting challenging behaviors. MVYATA hopes to continue this relationship with the University of Pittsburgh in welcoming occupational therapy students to participate annually at Camp Watakamini. n

San diego cAlifOrniA
april 25–28, 2013

plAn TOdAy fOr 2013!

References
1. Pennsylvania Department of Education. (2012). National school lunch program. Retrieved from http://www.portal.state.pa.us/portal/server.pt/ community/national_school_lunch/7487 2. Blum, R. W., Beuhring, T., Shwe, M. L., Bearings, L. H., Sieving, R. E., & Resnick, M. D. (2000). The effects of race/ethnicity, income, and family structure on adolescent risk behaviors. American Journal of Public Health, 90, 1879–1884. 3. Escarce, J. J. (2003). Socioeconomic status and the fates of adolescents. Health Services Research, 38, 1229–1234. 4. American Occupational Therapy Association (2008). Occupational therapy practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62, 625–683. doi:10.5014/ajot.62.6.625 Pamela Toto, PhD, OTR/L, BGC, FAOTA, is an assistant professor at the University of Pittsburgh’s Department of Occupational Therapy. Mary Lou Leibold, PhD, OTR/L, is an assistant professor and the academic fieldwork coordinator at the University of Pittsburgh’s Department of Occupational Therapy. Sam Boardman, Maggie Corcoran, Kourtney Heichel, Kate Schramm, and Rachel Simon are graduates of the University of Pittsburgh’s Master of Occupational Therapy Program.

Bring your family and visit ocean life at Sea World, stroll the beautiful Pacific Coast, and see pandas at the zoo. Shopping and dining are all within walking distance of the convention center and hotels.
AC-116 AC-116

21

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. September
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.

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

CEonCD™

NEW! Ethics Topic—Duty to Warn: An Ethical Responsibility for All Practitioners, by Deborah 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

Baltimore, MD

Johns Hopkins University and Kennedy Krieger Institute at the Johns Hopkins Medical Institutions. Email: cmenet@jhmi.edu or details and online registration are available at: http://www.hopkinscme. edu/Coursedetail.aspx/80029240 or by calling the Johns Hopkins Office of CME at (410) 502-9636.

Exploring Shoulder Dystocia and Neonatal Brachial Plexus Injury: Updates on Prevention and Treatment. The second symposium presented by

Sept. 9–10

CEonCD™

October

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

St. Louis, MO

Envision Conference 2012. Learn from leaders in

Sept. 12–15

San Diego, CA

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.

Denver, CO

Sept. 15–25

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 deficits 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 8–10, 2013. Contact visAbILITIES Rehab Services: www.visabilities.com or (888) 752-4364, Fax: (205) 823-6657.

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

Oct. 12–14

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™

Ethics Topics—Moral Distress: Surviving Clinical Chaos, by Lea Cheyney Brandt. Complex nature

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 Charlotte, NC, September 15–25. 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

of today’s 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

Ongoing

CEonCD™

Clinician’s View Offers Unlimited CEUs

Let’s Think Big About Wellness, by Winnie Dunn.

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

courses as you want. Approved for AOTA and bOC CEUs and nbCOT for PdUs. www.clinicians-view. com 575-526-0012.

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, AOTA Members: $68, nonmembers: $97. http://store .aota.org/view/?SKU=4879

Internet & 2-Day On-Site Training

CEonCD™

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

Newton, MA

resa A. May-benson, Scd, OTR/L, FAOTA. Gain 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 modulation and discrimination problems. Lecture format, small group discussion, and case presentations will be used to reinforce learning. Geared toward intermediate level OTs, PTs, SLPs and OT and PT assistants. 1.2 CEUs available. Also coming up: Write On! Oct. 14, 2012; SI Treatment Intensive: Refining Praxis Intervention for Children with SPD, Jan. 20–24, 2013; and Spiral Foundation Symposium: Early Identification of SPD and Related Diagnosis, March 21-23, 2013. Registration for all courses available at www.thespiralfoundation. org. Contact Maribeth Conway at 617-923-4410 ext. 231 for more information.

Sensory Integration Assessment & Intervention for Children with Autism. Presented by Te-

Sept. 21–22

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.

Framework supports practitioners by providing a holistic view of the profession. Earn .3 AOTA CEU (3.75 nbCOT PdUs/3 contact hours). Order #4829, AOTA Members: $73, nonmembers: $103.00. http:// store.aota.org/view/?SKU=4829

Exploring the Domain and Process of Occupational Therapy Using the Occupational Therapy Practice Framework, 2nd Edition, by Susanne Smith Roley and Janet V. DeLany. Ways in which

Online Course

ACROSS PRACTICE AREAS

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

CEonCD™

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

ASSESSMENT & EvAlUATION

Self-Paced Clinical Course

Syracuse, NY

Eval & Intervention for Visual Processing Impairment in Adult Acquired Brain Injury Part I. This
intensive updated course has the latest evidence

Sept. 29–30

CEonCD™

Occupational Therapy and Home Modification: Promoting Safety and Supporting Participation, edited by Margaret Christenson and Carla Chase.

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

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).
AUGUST 6, 2012 • WWW.AOTA.ORG

22

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 individual’s 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 master’s 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. Veteran’s 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 master’s 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 Wyoming’s 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 27

School of Medicine & Health Sciences Department of Occupational Therapy

OT PRACTICE • AUGUST 6, 2012