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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: Tracy Hammond Advertising Assistant: Clark Collins
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 Sharon Kurfuerst: Chairperson, Administration & Management Special Interest Section Teresa A. May-Benson: Chairperson, Sensory Integration Special Interest Section Lauro A. Muoz: 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
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.
Buyers Guide
FEATURE
DEPARTMENTS
News Capital Briefing Practice Perks
The End Game: A Call to Action Guidelines for Documentation
Neuromuscular Electrical Stimulation and Task-Specific Training After Stroke: Putting Evidence Into Practice
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16 19 20 21 26
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Jessica J. Bolduc, Kristin Brewster, and Sheila Reid report on the effects of neuromuscular electrical stimulation on remediating lost muscle control for a client poststroke.
3 6 7 8 9 15
In the Classroom
Updates From Twitter, Facebook, Pintrest, and OT Connections Highlights From the ACRMASNR Annual Conference Continuing Education Opportunities
Evidence Exchange: Writing a Critically Appraised Paper Developing Inexpensive Self-Wipe Toilet Aids Breaking New Ground: Reflections on Bringing the Profession to India
p.9 p.7 p.11
Employment Opportunities
Discuss OT Practice articles at www.OTConnections.org in the OT Practice Magazine Public Forum. Send e-mail regarding editorial content to otpractice@aota.org. Go to www.aota.org/otpractice to read OT Practice online. Visit our Web site at www.aota.org for contributor guidelines, and additional news and information.
OT Practice serves as a comprehensive source for practical information to help occupational therapists and occupational therapy assistants to succeed professionally. OT Practice encourages a dialogue among members on professional concerns and views. The opinions and positions expressed by contributors are their own and not necessarily those of OT Practices editors or AOTA. Advertising is accepted on the basis of conformity with AOTA standards. AOTA is not responsible for statements made by advertisers, nor does acceptance of advertising imply endorsement, official attitude, or position of OT Practices editors, Advisory Board, or The American Occupational Therapy Association, Inc. For inquiries, contact the advertising department at 800-877-1383, ext. 2715. Changes of address need to be reported to AOTA at least 6 weeks in advance. Members and subscribers should notify the Membership department. Copies not delivered because of address changes will not be replaced. Replacements for copies that were damaged in the mail must be requested within 2 months of the date of issue for domestic subscribers and within 4 months of the date of issue for foreign subscribers. Send notice of address change to AOTA, 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 AOTAs Membership department for $16 each for AOTA members and $24.75 each for nonmembers (U.S. and Canada) while supplies last.
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AOTA News
Editorial Panel, which oversees code development, agreed to establish an internal workgroup to discuss possible changes to the PM&R Codes. For more, visit www.aota.org/practitioners/ reimb/coding/cpt-codingchanges.aspx. for January 15 to 19, 2013, at the University of North Carolina in Chapel Hill. For more on TIGRR, visit www.aota.org/ news/announcements. reviewing issues such as essential health benefits, the Medicaid eligibility expansion, and the creation of health insurance exchanges. AOTA will continue to work with state occupational therapy associations to advocate for the profession as health care reform implementation moves forward. The call was recorded and is available at www.talkshoe.com/tc/28233.
ow occupational therapy is paid for, described, and understood is bound up in the use of Common Procedural Terminology (CPT) codes. In October, AOTA provided the CPT Health Care Professionals Advisory Committee (HCPAC), part of the American Medical Associations coding process structure, with a draft coding proposal to elicit feedback from member physician and nonphysician advisors. Following the presentation by AOTAs advisors to the HCPAC, and that committees recommendation that a Physical Medicine and Rehabilitation (PM&R) Workgroup be formed, the CPT
OT PRACTICE DECEMBER 17, 2012
he deadline for submitting motions to be considered at the Representative Assembly (RA) Spring Meeting is January 1, 2013, so theres still time to draft motions. Specific instructions on how to write motions may be found at www. aota.org/governance/ra. Contact any of the RA officials or your representative(s) for advice on whether your idea should be a motion and to discuss appropriate topics and issues for policy changes. For the names(s) of the officials or your representative(s), go to the Members section of AOTAs Web site and click on Get Involved/Governance, then Representative Assembly for the RA Roster. Alternatively, you can call AOTA at 800-SAY-AOTA (729-2682), ext. 2103, or contact Laurel Radley at lradley@aota.org for assistance.
a O ta B u l l e t i n B O a r D
OUTSTANDING RESOURCES FROM
Using the Occupational Therapy Practice Guidelines for Adults With Stroke to Enhance Your Practice
(CEonCD) J. Sabari Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). ourse participants will learn key considerations for occupational therapy intervention, depending on whether the client is in the acute phase after stroke, the rehabilitation phase, or the phase of continuing adjustment. Findings from published research that guide best practice in occupational therapy intervention with the stroke population are presented. $68 for members, $97 for nonmembers. Order #4845. http:// store.aota.org/view/?SKU=4845
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 enhancement 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, which is essential to everyday life. $89 for members, $126 for nonmembers. Order #1173B. http:// store.aota.org/view/?SKU=1173B
Resources
Tips on Toys
anta isnt the only one who should have a list and check it twice this holiday season. Encourage your clients to take a look at AOTAs selecting toys tip sheet when considering buying toys to help facilitate development during play. To see AOTAs complete list of tip sheets, visit www.aota.org/consumers. Youll find How to Pick a Toy: Checklist for Toy Shopping in the Children and Youth section.
Industry News
Occupation-Focused Intervention Strategies for Clients With Fibromyalgia and Fatiguing Conditions
(CEonCD) R. R. Taylor Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). his course presents several evidence-based strategies for managing fibromyalgia and other fatiguing conditions, such as chronic fatigue syndrome. Biomechanical intervention strategies, common assistive devices, and occupationfocused interventions that can address the multifaceted symptoms and needs of these populations are presented. $68 for members, $97 for nonmembers. Order #4839. http:// store.aota.org/view/?SKU=4839
H. S. Gabai his text lays the foundation for occupationbased practice and addresses the contextual issues of working within the acute care setting. Research covers key aspects of how diseases affect the human body, including the cardiovascular, nervous, and endocrine systems. It features color illustrations of the human bodys systems and functions, as well as tables delineating the signs and symptoms of various diseases. Highlights also include orthopedics and musculoskeletal disorders. $109 for members, $154 for nonmembers. Order #1258. http:// store.aota.org/view/?SKU=1258
Bulletin Board is written by Amanda Fogle, AOTA marketing specialist.
he first module of the Part C training curriculum has been launched. The Basics of Early Intervention leads off the curriculum on the 2011 Part C regulations of the Individuals with Disabilities Education Act. It gives users a training resource on the eight basic steps of early intervention, important acronyms to know, key definitions, and more. The module is available at http:// nichcy.org/laws/idea/legacy/ partc/module1.
Go4Life E-Cards
oes your friend (or client) need encouragement to keep exercising? Go4Life, created by the National Institute on Aging, has an e-card for that, so get ready to hit the send button. For more, visit http://go4life.nia.nih.gov/ stay-in-touch/send-e-card.
Intersections
n Jennifer Bogenrief, AOTAs manager of Reimbursement and Regulatory Policy, recently attended the National Association of Rehabilitation Providers and Agencies Fall 2012 Conference in Las Vegas, Nevada.
DECEMBER 17, 2012 WWW.AOTA.ORG
Questions? Call 800-SAY-AOTA (members); 301-652-AOTA (nonmembers and local callers); TDD: 800-377-8555
She participated in the skilled nursing facility work group. n Susan Lin, ScD, OTR/L, AOTAs director of Research, attended a colloquium at the National Institutes of Health campus in Bethesda, Maryland, commemorating the National Institute of Child Health and Human Developments 50th anniversary. n Amy Lamb, OTD, OTR/L, FAOTA, AOTAs vice president, spoke about the Affordable Care Act at a seminar at St. Joseph Mercy Hospital in Ypsilanti, Michigan. n Sandra Schefkind, MS, OTR/L, AOTAs pediatric coordinator, recently attended the OCALICON Conference in Columbus, Ohio, and spoke about AOTAs efforts in helping children with autism get the therapy they need. Schefkind also attended the Association of University Centers on Disabilities conference in Washington, DC, where she spoke about early signs of autism and AOTAs efforts in the Learn the signs. Act Early campaign.
n Terry Olivas-De La O, COTA/L, ROH, Susan Burwash, MSC, OT, Anita Hamilton, Karen Jacobs, EdD, OTR/L, CRE, FAOTA, Helen Rushton, MBA, MCOTSS, and Marilyn Pattison, OT, MBA, recently participated in a podcast organized by Family Success by Design, Inc., in recognition of occupational therapy around the world. To listen to the archived show, visit www.blogtalkradio.com/search/ latino-role-models-success/. n Occupational therapy students at Quinnipiac University in Hamden, Connecticut, recently visited the United Nations to learn about human rights. For more, visit www.quinnipiac.edu/ news-events/ot-students-learnabout-human-rights-at-the-un. n Elizabeth Skidmore, PhD, OTR/L, associate professor in the Department of Occupational Therapy at the University of Pittsburgh, was awarded the School of Health and Rehabilitation Sciences 20112012 Deans Distinguished Teaching Award as an exemplary educator, who masterfully integrates professional knowledge (neuroscience and neurorehabilitation), interpersonal knowledge (human interactions), and intrapersonal knowledge (reflective capacity and ethics) in her teaching. n Jennifer Stenga, a first-year occupational therapy student at a joint program between Creighton University and the University of AlaskaAnchorage, has won a $7,500 Dr. Pepper Tuition Giveaway scholarship. Applicants created a 1-minute video explaining how they will make an impact in their community or even in the world for a chance to win either $2,500 or $100,000 in tuition. n Debra Young, MEd., OTR/L, SCEM, ATP, CAPS, has been appointed to the Home Builders Association of Delaware 2013 Board of Directors. Andrew Waite is the associate editor of OT Practice. He can be reached at awaite@aota.org.
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Earn .7 CEU (8.75 NBCOT PDUs/7 contact hours). This new CE course presents supplementary content from chapters in The Occupational Therapy Manager, 5th Edition (Order # 1390C), and provides additional applications that are relevant to selected issues on management. The course focuses on 6 specific topics with individual learning objectives, and it is strongly recommended that participants read the selected chapters prior to studying the topics. Order #4880. AOTA Members: $194, Nonmembers: $277
CE-258
c a p i ta l B r i e f i n g b
t presstime, Congress had yet to take substantive action to address any of the significant challenges it faces before the end of the year. Previous Capital Briefings have discussed the fiscal cliff so often covered in the news, including expiring tax provisions, mandatory cuts to discretionary spending through sequestration, and a series of expiring Medicare provisions that would result in a cut of more than 26.5% to all Medicare providers paid on the fee schedule, including occupational therapists and occupational therapy assistants. All told, the Congressional Budget Office expects the policy changes facing Congress to have an economic impact of nearly $750 billion in 2013 alone. Among the many financial issues Congress must address that are of immediate importance to occupational therapy practitioners are the Medicare fee schedule and the outpatient therapy caps, which account for a comparatively paltry $26 billion for next year. Because of the vast challenges Congress faces, and the many stakeholder groups competing for members attention, it is critical for practitioners to continually draw the attention of Congress to the devastating effect the scheduled 26.5% cut would have on seniors access to care, and how the therapy cap would deny medically necessary care to more than 700,000 Medicare beneficiaries who need therapy beyond the cap. In this political and budgetary environment, the problem of the cap looms larger than ever. Extending the exceptions process is expected to cost just under $1 billion for 2013 in a year when any additional spending is looked upon with skepticism and the cap seems insignificant compared with
the projected impact of sequestration. Thus the need for continued and passionate grassroots advocacy. Rehabilitation advocates from the provider and consumer communities must work together to spread the word about the cap and draw the attention of Congress to this issue. Just last week, AOTA partnered with the American Physical Therapy Association; the American Speech-Language-Hearing Association; the Consortium for Citizens with Disabilities; and a host of consumer advocacy organizations, including the Parkinsons Action Network and the National Multiple Sclerosis Society, to conduct a Virtual Hill Day that reached every Congressional office in Washington. The message was simple: Extend the exceptions process and ensure access to rehabilitation services for Medicare beneficiaries. AOTAs Federal Affairs staff continue to meet with key Congressional staff in both the House and Senate to pave the way for the policy necessary to extend the exceptions process, but the pressure must be maintained on Congress to act before the end of the year. Because the size and scope of the year-end package under consideration is expected to be enormous, there is a good chance that the only major action achieved in 2012 will be to push larger decisions down the road into 2013. But
in the clinic
he everyday and very essential task of toilet hygiene can also be very embarrassing for clients when they need someone to assist them with it. Because I have found that clients frequently report that commercial toilet aids are too expensive for them and often are not even effective because of their particular functional limitations, I was inspired by an article in the July 25, 2011, issue of OT Practice on Performing Single Subject Research Designs in Practice1 to apply the systematic method of a single subject research design to fabricate and test an inexpensive self-wipe toilet aid with two clients. My project eventually proved successful, as it allowed me to apply lessons learned from one client to the next. My research question was, What are the functional limitations preventing the client from being independent in toilet hygiene? The factors I identified as limiting effective toilet hygiene included inadequate shoulder, elbow, and hand active range of motion (AROM) because of acute injury and/ or chronic disease, including obesity.
n Carmen
n Renee
epending on the extent of damage from stroke, the neural mechanisms within a clients brain can potentially be reorganized, allowing motor skills to be relearned.1 One potential aid to recovery is neuromuscular electrical stimulation (NMES), a physical agent modality that helps stimulate paralyzed or paretic muscles affected by stroke. The stimulation has been shown to aid in remediating lost muscle control.2 There are varying applications for NMES, such as a neuroprosthesis (e.g., Bioness), and various triggered NMES units (e.g., biofeedback with electrodes).2 Typically, electrodes are placed over the desired muscles to be activated and the unit is programmed to deliver an electrical current to facilitate muscle contractions. How NMES
Occupational therapists report on the effects of neuromuscular electrical stimulation on remediating lost muscle control for a client poststroke.
is applied depends on the desired outcome; for the case example discussed in this article, the goal was to have a flexible application to accommodate high repetitions of various functional tasks while incorporating a task-specific training (TST) approach. When considering motor learning, it appears that unless people work actively to achieve a task, NMES is unlikely to affect upper-extremity function at the activity or participation level.2 For this reason, NMES was combined with TST for a client who had sustained strokes. Combining NMES with TST uses real-life task training with the goal of reacquiring a skill, using high repetition of functional tasks.3 Principles of TST state that tasks should be challenging and progressively advanced or adapted with common basic objects, involve active participation and problem solving, target the area of deficit, be practiced randomly, and be meaningful and novel.3 Task shaping involves advancing the challenge of the task by altering one of the following object characteristics: shape, size or weight, texture, surface, or rigidity. Clinicians can use various strategies to help facilitate client learning, including providing verbal
With neuromuscular electrical stimulation, electrodes typically are placed over the desired muscles to be activated, and the unit is programmed to deliver an electrical current to facilitate muscle contractions.
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feedback, coaching, modeling the task for the client, and encouraging the client to continue with the task.4 Based on evidence and expert opinion, criteria for using NMES and TST with a client were a score of at least 10/60 on the Modified Fugl Myer Assessment of Motor Recovery for the Upper Extremity (mFMA-UE)5; at least 10 of active wrist motion, no contraindications for NMES56; and the ability to follow two-bstep commands, participate in problem solving, and give consent to the intervention after reviewing risks and benefits.
Assessment Modified Upper Extremity (UE) Fugl Meyer*1112 Box and Block test*
Post-NMES Measures, Rehab Day 41 87/108 (39/60 UE) MCID** is 10% of total score change13 Right48 blocks/minute Left2 blocks/minute (modified) (norm: R: 66 blocks/minute, L: 64 blocks/minute) MCID**: 7 blocks12
CLIENT PROFILE
Mr. H was a 74-year-old right-handed white male who lived with his wife in rural New York. He was retired, on disability and, prior to this recent stroke, independent with basic activities of daily living (ADLs), and he and his wife together completed instrumental activities of daily living. He was showing signs of mild dementiafor example, difficulty managing money (e.g., balancing a check book, paying bills on time). His medical history included two previous mild strokes (no residual effects), coronary artery disease, hypertension, obstructive sleep apnea, hyperthyroidism, glucose intolerance, and a history of smoking. Mr. Hs occupational profile reflected a new diagnosis of acute right thalamic hemorrhagic stroke, resulting in left hemiparesis, decreased activity tolerance, decreased standing balance, dysphagia, and dysarthria. Without use of his left hand, Mr. H struggled with basic ADL tasks that required bilateral arm use. He felt that if he could gain function of his left hand, he could regain some independence and feel less of a burden on his family.
CAHAI -7*
Unable
Grip strength
Right77# Leftaverage 5.5# (norm: R: 75.3# 21.5# L: 55# 17#) MCID**: L hand 13.64#12
Motor control
Rightwithin normal limits LeftBrunnstrom level 4=Spasticity decreases, synergistic movements predominate15 10 of active wrist extension motion, and trace finger and thumb movement
Rightwithin normal limits LeftBrunnstrom level 6=Coordination and movement patterns near normal, but trouble with more rapid complex movements15 Wrist extension to neutral, full wrist flexion, and thumb and finger opposition Setup assistance with grooming; minimal assistance with upperbody bathing and dressing, with the client using both hands; moderate assistance of one person for lower-body bathing and dressing using both hands; minimal to moderate assistance with toileting needs using both hands
Self-care
Maximal assistance with grooming, bathing, and dressing, with the client unable to use his left hand for assist
*Psychometrically strong, standardized outcome measures **MCID = minimal clinically important difference
full use of his left hand to be able to complete self-care tasks with both hands. His occupational therapy plan of care included standard interventions using sensorimotor, rehabilitation, and biomechanical frames of reference for ADL retraining, activity modification, neuromuscular reeducation, and client and family education.7 By rehabilitation day 20, Mr. H had 10 of wrist extension, which fit our evidence-based criteria for potential enhanced functional recovery through NMES and TST. Occupational therapist and first author Jessica Bolduc, MS, OTR/L, obtained
Mr. Hs consent and medical approval, and selected tasks with him for TST during NMES intervention.
Careers
had not yet heard of occupational therapy in 1950, when Kamala Nimbkar wrote my father. I was a 17-year-old girl interested in studying mental health, and Mrs. Nimbkar was an American who had moved to India to marry one of my fathers friends. She was trying to start the first occupational therapy school in India, and she wanted to know if I would be interested in moving to Bombay to enroll. She sent the syllabus for the program and explained that it would be a new subject that very few people in India would have heard of. My father was familiar with Bombay, so he felt comfortable sending me there, and I was soon to be 18, so it was a good time for me to leave the house. So, in 1950, I left my home in Hyderabad to join the occupational therapy training program in Bombay. There were six of us in the classthree girls, three boys. Our training program covered basic medical subjectsanatomy, physiology, psychology, psychiatry, general medicine, surgery, and pathology. The clinical areas were general medicine, psychiatry, pediatrics, tuberculosis, and the infirmary. As part of our clinical training we worked at various city hospitals under Mrs. Nimbkars supervision to start occupational therapy services. The occupational therapy school was affiliated with the
OT PRACTICE DECEMBER 17, 2012
King Edward Memorial Hospital, so all of the medical training was conducted by the senior medical staff at the hospital. We also received lectures on setting up occupational therapy departments and administration strategies. Then, in 1952, I got a scholarship for the London School of Occupational Therapy. In London, occupational therapy was already established and was recognized as a complementary aspect of health care service. Occupational therapy services were provided soon after the acute stage of the illness as an integral part of the treatment process! As a result, London offered me opportunities to work in inpatient and outpatient units and demanded a good grasp of theoretical knowledge and adaptability of therapeutic technologies. The focus was on activity analysis, self-care, activities of daily living, and household tasks linked to a persons independence and job skills. After such comprehensive training for 3 years in London, I returned to India to become Mrs. Nimbkars assistant at her occupational therapy training school. My favorite thing became crafting devices so people could be more independent. There was one woman who had hemiplegia, so, naturally, she could not walk. So it was then a question of how to give her mobility so that she can go from one
Origami
Rebecca Lipnick
a square from a rectangle and encouraged to make their own paper squares from magazines, wrapping paper, newspapers, or wax paper. Origami is an appropriate intervention, not only in pediatric settings, but in virtually any setting. It can serve as a means of improving hand and finger strength, fine motor dexterity, visual spatial skills, and directionality, as well as of facilitating use of higher-level thinking functions such as memory, sequencing, and following directions. Origami engages multiple senses and can be adapted to a variety of disabilities and settings. Origami activities can be easily graded without increasing the complexity of the model, by simply decreasing the size of the paper squares used. Smaller paper requires increased dexterity and precision, and closer visual attention to detail. Heavier weight paper will increase resistance, but it tends not to fold as easily and may be frustrating. Manipulating the paper to execute folds provides practice in fine motor dexterity and requires using graded finger movements to make fine adjustments to correctly align edges of the paper. Bilateral use of hands, crossing midline, and strength are also addressed through the folding process. Descriptions of folds involve directionality and spatial relations. Higher level executive functions are tapped by this activity. The client can plan and then recall steps, sequence, and extrapolate (What will it look like if we unfold it?). Following directions is a critical element of origami. Yet one of the wonderful characteristics of paper folding is that errors can often be corrected on the original piece of paper.
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rigami (a combination of the Japanese words for fold and paper) has been used in educational settings in Japan and Europe for many years.1 In the first half of the 19th century, Friedrich Froebel, the founder of the kindergarten system, discussed the use of paper folding as an active means of engaging in learningpart of a classification of activities that he called occupations.2 Origami has been used in school settings as a means of encouraging exploration and the creative process while facilitating eye-hand coordination and dexterity. More recently, there has been a revival of the art form, especially for promoting and understanding mathematical processes.34
APPLICATION TO THERAPY
Among the relevant applications to occupational therapy, the Miller Function and Participation Scales (M-FUN), for example, uses an origami item to assess fine motor accuracy, motor planning, and sequencing in children 3 to 8 years of age.5 The items can be quickly scored, and the child can take the object home. I have used origami as an intervention with children in various settings and with a wide variety of conditions for more than 30 years. It has consistently been one of the best received and most frequently requested activities. An unexpected benefit of this intervention has been parent and caregiver involvement. Parents almost always ask for a piece of paper so they can perform the activity with their child. They often report trying it at home. In the school setting, students frequently ask for extra paper to take home. Students can be taught to make
that may have gone undetected. These settings provide increased opportunities for interaction and socialization with peers without disabilities. Origami adapts well to many other settings, including rehabilitation,7 mental health, home heath, acute care, and elder care. When origami is provided in a large group, it is essential that the model being taught is well known to the instructor. Large-size paper that has been prefolded makes it easier to demonstrate the model and for students to see the steps. It is possible to begin a session with body foldingfolding arms to left and right sides, or folding diagonally, by reaching with the right or left hand to the opposite foot. This activity uses gross motor movement, works on directionality, and may allow the clients to increase their level of alertness prior to performing the actual paper folds.8
CASE ExAMPLES
Inclusion. Origami was used in an
inclusion setting in a fifth grade classroom. Only one student in the classroom received occupational therapy, although five other students were in special education. When origami was introduced, the class could not complete a model involving five steps. In the course of one semester, with origami presented seven times, the students could name and execute basic folds (including inventing the names hotdog fold for a book fold and taco fold for a diagonal fold) and complete a six- to seven-step model, including multistep folds. The classroom teacher indicated that the students were doing better with visual tracking activities and logical thinking. Three years later, all the special education students from that class were seen in a large group setting in which origami was one possible activity.
Every student from the inclusion setting chose the origami activity and executed several models, using smaller and smaller paper and recalling the steps after one demonstration. Oppositional defiant disorder. Brendon was a 13-year-old eighth grader with oppositional defiant disorder and attention deficit hyperactive disorder. Brendons treatment goals involved completing assignments, increasing self-control, and accepting directions from adults. During one session, he was asked to sort the directions for origami models from two origami-a-day calendars. He did not want any assistance and quickly sorted the pages, establishing categories on his own and asking only for clarification. He sorted out duplicates and asked if he could have them. He returned to the occupational therapist the next week, having done many of the models and asked for help with the bases he couldnt do without specific directions. When complimented on his work, he actually gave the occupational therapist a grudging smile! Mental retardation. Michael was a 10 year old with a qualifying disability of mental retardation. He had poor social skills, difficulty with short- and long-term memory, and low self-esteem. In a group occupational therapy session, an origami model was presented. The model involved 8 steps to create the base form and 11 additional steps to complete the model. Michael was interested and engaged
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throughout the session. Three weeks later, the same group of three boys asked to do the same model. The treating occupational therapist indicated that while there was origami paper available, she did not have the instructions and could not recall them. Michael insisted that he knew how to do it. Michael not only recalled each step, but he was able to explain and demonstrate the process to the other boys in the group. He was extremely proud when he left and would often remind the occupational therapist that he had done it.
f O r M O r e i n f O r M at i O n
British Origami Society www.britishorigami.info Origami: The Art of Paper Folding www.origami-resource-center.com The Ultimate Origami Book Morin, J. (1998). The ultimate origami book. Philadelphia, PA: Courage Books, Running Press.
3. 4.
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SUMMARY
A challenge facing many occupational therapy practitioners is finding the means of engaging clients through activities with an occupational relevance and making such activities interesting. Origami can be a powerful element of an occupational therapy toolbox. It is a fun and engaging activity that addresses numerous occupational skills and can be applied to numerous disabilities and a wide variety of settings. It appeals to a wide range of ages and is conducive to group and family participation. Origamis very simplicity is one of its strengths, as it can be done almost anywhere and at any time with minimal preparation. Even specialty paper is not required. It should be considered by occupational therapy practitioners searching for motivating activities for clients of all ages. n
8.
University of Surrey Roehampton. Retrieved from http://www.friedrichfroebel.com/books/weston. pdf Pearl, B. (2008). Math in motionOrigami in the classroom. Yardley, PA: Math in Motion. Pope, S. (2002). The use of origami in the teaching of geometry. Proceedings of the British Society for Research into Learning Mathematics, 22(3), 6773. Miller, L. J. (2006). The Miller Function and Participation Scales (M-FUN). San Antonio, TX: Harcourt Assessment. Hanft, B., & Shepherd, J. (2008). Collaborating for student success: A guide for school-based occupational therapy. Bethesda, MD: American Occupational Therapy Association. Wilson, L. M., Roden, P. W., Taylor, Y., & Marston, L. (2008). The effectiveness of origami on overall hand function after injury: A pilot controlled trial. British Journal of Hand Therapy, 13(1), 1220. Williams, M. S., & Shellenberger, S. (1994). How does your engine run? A leaders guide to the alert program for self-regulation. Albuquerque, NM: TherapyWorks.
Rebecca Lipnick, OTR/L, has 30 years of experience as a pediatric occupational therapist in acute and critical care, outpatient, and school settings. She currently works as a school-based occupational therapist on the Navajo Reservation in New Mexico and is enrolled in the Masters Degree in Occupational Therapy Program at Quinnipiac University in Hamden, Connecticut.
References
1. Kasahara, K. (2004). The art and wonder of origami. Hove, East Sussex, United Kingdom: Apple Press Sheridan House. 2. Weston, P. (2000). Friedrich Froebel: His life, times & significance. London, United Kingdom:
References
1. Birkenmeier, R. L., Prager, E. M., & Lang, C. E. (2010). Translating animal doses of TST to people with chronic stroke in 1-hour therapy sessions: A proof-of-concept study. Neurorehabilitation and Neural Repair, 24, 620635. 2. Hayward, K. S., Barker, R. N., & Brauer, S. G. (2010). Advances in neuromuscular electrical stimulation for the upper limb post-stroke. Physical Therapy Reviews, 15, 309319. 3. Davis, J. Z. (2006). Task selection and enriched environments: A functional upper extremity training program for stroke survivors. Topics in Stroke Rehabilitation, 13, 111 4. Taub, E., Uswatte, G., King, D. K., Morris, D., Crago, J. E., & Chatterjee, A. (2006). A placebo-controlled trial of constraint-induced movement therapy for upper extremity after stroke. Stroke, 37, 10451049. 5. Gladstone, D. J., Danelles, C. J., & Black, S. E. (2002). The Fugl-Meyer assessment of motor recovery after stroke: A critical review of its measurement properties. Neurorehabilitation and Neural Repair, 16, 232240.
6. Houghton, P. E., Nussbaum, E. L., & Hoens, A. M. (2010). Electrophysical agents contraindications and precautions: An evidence based approach to clinical decision making in physical therapy. Physiotherapy Canada, 62, 2638. 7. Pendleton, H. M., & Schultz-Krohn, W. (2006). Pedrettis occupational therapy practice skills for physical dysfunction (6th ed.). St. Louis, MO: Mosby. 8. Gowland, C., Stratford, P., Ward, M., Moreland, J., Torresin, W., Van Hullenaar, S.,Plews, N. (1993). Measuring physical impairment and disability with the Chedoke McMaster Stroke Assessment. Stroke, 24, 5863. 9. Hsu, S. S., Hu, M. H., Wang, Y. H., Yip, P. K., Chiu, J-W., & Hsieh, C. L. (2010). Dose-response relation between neuromuscular electrical stimulation and upper-extremity function in patients with stroke. Stroke, 41, 821824. 10. van Halteren-van Tilborg, I. A. D. A., Scherder, E. J. A., & Hulstijn, W. (2007). Motor-skill learning in Alzheimers disease: A review with an eye to the clinical practice. Neuropsychology Review, 17, 203212. 11. Sandford, J., Moreland, J., Swanson, L. R., Stratford, P. W., & Gowland, C. (1993). Reliability of the Fugl Meyer Assessment for test motor performance in patients following stroke. Physical Therapy, 73, 447454. 12. Woodbury, M. L., Velozo, C. A., Richard, L. G., Duncan, P. W., Studenski, S., & Lai, S. M. (2007). Dimensionality and construct validity of the Fugl Meyer Assessment of the upper extremity. Archives of Physical Medicine and Rehabilitation, 88, 715723.
13. Lang, C. E., Edwards, D. F., Birkenmeier, R. L., & Dromerick, A. W. (2008). Estimating minimal clinically important differences of upper-extremity measures early after stroke. Archives of Physical Medicine Rehabilitation, 89, 16931700. 14. Gowland, C., Stratford, P., Ward, M., Moreland, J., Torresin, W., Van Hullenaar, S.,Plews, N. (1993). Measuring physical impairment and disability with the Chedoke McMaster Stroke Assessment. Stroke, 24, 5863. 15. Teasall, R., McClure, A., & Murie-Fernandez, M. (2012). Motor recovery post stroke educational supplement. Retrieved from http://www.ebrsr. com/~ebrsr/modules.php
Authors Wanted! Are you interested in writing for ot Practice? See our guidelines at http://www.aota. org/Pubs/Publish/ 40400
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@4stephy Attended my first #AOTA meeting. So proud to love my profession and join others in supporting its growth! @AOTAInc #OccupationalTherapy @AOTAInc 14 Nov Friends war injury inspires NJ Occupational Therapist Kristin Perelli to create home for wounded vets. Video: http://ow.ly/figfB @OT_Advocacy Quality sleep means quality peace. #OccupationalTherapy @Zainy07 13 Nov As an #occupationaltherapist I jus gotta say.....lifes not about being occupied but about doing things that make ur heart go boombaroomboom! @Anna Haertling 13 Nov One of my tweets was pinned on @AOTAIncs Pinterest on a Top #Conclave12 Tweets list! #flattered @AOTA News & PR 6 Nov Fast-growing jobs that dont require a 4-year degree. Occupational therapy assistant on the list, via @HuffPost http://ow.ly/f3UbS
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Embrace your chaos blog. An OT with a lot of great ideas. 1 like 31 repins embraceyourchaos.com
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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.
sues 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
CEonCD
Everyday Ethics: Core Knowledge for Occupational Therapy Practitioners and Educators, 2nd Edition, by AOTA Ethics Commission and presented by Deborah Yarett Slater. Foundation in basic
January
Phoenix, AZ
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 Memphis, TN, March 919, 2013. 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.
FRACS, PhD; Elisabet Hagert, MD, PhD; John D Lubahn, MD; Alexander Y. Shin, MD; Scott W. Wolfe, MD. For info, contact HRF at 610.768.5958 or hrf@ handfoundation.org; or visit our website at www. handfoundation.org
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
Ethics TopicDuty to Warn: An Ethical Responsibility for All Practitioners, by Deborah Yarett Slater, Staff Liaison to the Ethics Commission.
Ongoing
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.
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
CEonCD
February
Jackson, MS
Evaluation and Intervention for Visual Processing Deficits in Adult Acquired Brain Injury, Part I. Faculty: Mary Warren PhD, OTR/L, SCLV, FAOTA.
This updated course has the latest evidence based research. Participants learn a practical, functional, reimbursable approach to evaluation, intervention, and documentation of visual processing deficits in adults with acquired brain injury from CVA and TBI. Topics include hemianopsia, visual neglect, eye movement disorders, and reduced acuity. Also New Orleans, LA, March 910, 2013. Contact www.visabilities.com, call 888-752-4364, of fax 205-823-6657.
Shoshana Shamberg, 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.
Ethics TopicsOrganizational Ethics: Occupational Therapy Practice In a Complex Health Environment, by Lea Cheyney Brandt. Issues that can
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 TopicsMoral Distress: Surviving Clinical Chaos, by Lea Cheyney Brandt. Complex nature
March
distance learning course is designed for those working with individuals who present with limitations in daily function due to visual/cognitive/perceptual impairment. Specific topics related to evaluation and interventions include poor awareness, visuospatial deficits, apraxia, neglect, memory loss, attention deficits, executive dysfunction, agnosia, etc. See www.columbiaot.org for more information. Instructor: Glen Gillen, GG50@Columbia.edu.
Improving Function for Those Living With Cognitive & Perceptual Impairments. This self-paced
of todays health care environment and results in increased moral distress for occupational therapy practitioners. Earn .1 AOTA CEU (1.25 NBCOT PDUs/1 contact hour). Order #4840, AOTA Members: $45, Nonmembers: $65. http://store.aota.org/ view/?SKU=4840
CEonCD
Official documents and materials that support OT concept of wellness, interdisciplinary literature, and models from other disciplines. Earn .25 CEU (3.13 NBCOT PDUs/2.5 contact hours). Order #4879, AOTA Members: $68, Nonmembers: $97. http://store .aota.org/view/?SKU=4879
This course is designed to train OTs in objectively assessing the impact of cognitive perceptual impairments (e.g., neglect, agnosias, spatial dysfunction, apraxia, body scheme disorders) on ADLs and mobility, highlighting our unique contribution to this practice area. Limited enrollment. AOTA CEUs. Contact: Glen Gillen at 212-305-1648 or GG50@ Columbia.edu.
CEonCD
April
Surgery and Rehabilitation of the Hand: With Emphasis on the Wrist. Sponsored by Hand Rehabilitation Foundation and Jefferson Health System. Hands-on workshops, panel discussions, surgery demos and anatomy labs compliment didactic sessions. Pre-conference 3-day tutorial; new 1-day pediatric pre-course available. Honored Professors: Pat McKee, M.Sc., OT Reg.(Ont.), OT(C); William W. Walsh, MBA, MHA, OTR/L, CHT; Gregory I. Bain,
OT PRACTICE December 17, 2012
community mobility issues are complex and changes in independence are life-altering. This comprehensive SPCC gathers researchers and clinicians in a team effort to offer expert guidance in this developing practice area. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3031, AOTA Members: $259, Nonmembers: $359. http://store. aota.org/view/?SKU=3031
NEW! Driving and Community Mobility: Occupational Therapy Strategies Across the Lifespan, edited by Mary Jo McGuire, MS, OTR/L, FAOTA, and Elin Schold Davis, OTR/L, CDRS. Driving and
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: $103.50. 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
CEonCD
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 is-
tional 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
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. Occupa-
21
CALENDAR
ASSESSMENT & EvAlUATION
Occupational Therapy and Home Modification: Promoting Safety and Supporting Participation, edited by Margaret Christenson and Carla Chase.
Education on home modification for OT professionals and an overview of evaluation and intervention and detailed descriptions of assessment tools. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3029, AOTA Members: $259, Nonmembers: $359. http://store.aota.org/view/?SKU =3029
quired professional reasoning and ethics for making final recommendations about the capacity for older adults with dementia to drive or not. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4842, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/?SKU=4842
sional Reasoning: The Responsibility of All Occupational Therapists, by Linda A. Hunt. Re-
Continuing Education Sensory Integration Certification Program by USC/WPS Los Angeles, CA: Course 1: Jan. 25, 26, 27, & Feb. 2, 3, 2013 Boston, MA: Course 3: Jan. 31Feb. 4, 2013 London, ON, Canada: Course 4: Jan. 31Feb. 4, 2013 For additional sites and dates, or to register, visit www.wpspublish.com or call 800-648-8857
D-6252
CEonCD
The Short Child Occupational Profile (SCOPE), by Patricia Bowyer, Hany Ngo, and Jessica Kramer.
Introduction of SCOPE assessment tool and description of documenting child motivation for occupations, habits and roles, skills, and environmental supports and barriers. Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). Order #4847, AOTA Members: $210, Nonmembers: $299. http://store. aota.org/view/?SKU=4847
public awareness strategies on expertise in transitioning early childhood development into occupational engagement in natural environments. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3026, AOTA Members: $259, Nonmembers: $359. http://store.aota.org/view/?SKU=3026
Early Childhood: Occupational Therapy Services for Children Birth to Five, edited by Barbara E. Chandler. Federal legislation in OT practice and Continuing Education
Treatment2Gos
CEonCD
Collaborating for Student Success: A Guide for School-Based Occupational Therapy, edited by Barbara Hanft and Jayne Shepherd. OT collab-
Only $549.00
Structured, semi-structured, and general clinical interviewing and set of norms and communication strategies that can maximize accurate, relevant, and detailed information. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4844, AOTA Members: $68, Nonmembers: $97. http://store.aota. org/view/?SKU=4844
orative practice with education teams using professional knowledge and interpersonal skills to blend hands-on services for students and system supports for families and educators. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3023, AOTA Members: $259, Nonmembers: $359. http:// store.aota.org/view/?SKU=3023
Thermal & Electrical Agents AOTA Approved course Meets most state requirements This fantastic interactive movie course retails at $599.00. Save $50.00 for a limited time. Use Promo Code: OTPAMS
CEonCD
CEonCD
Model of Human Occupation Screening Tool (MOHOST): Theory, Content, and Purpose, by Gary Kielhofner, Lisa Castle, Supriya Sen, and Sarah Skinner. Information from observation, interview,
Autism Topics Part I: Relationship Building, Evaluation Strategies, and Sensory Integration and Praxis, edited by Renee Watling. Content
chart review, and proxy reports to complete the MOHOST occupation-focused assessment tool. Earn .4 AOTA CEU (5 NBCOT PDUs/4 contact hours). Order # 4838, AOTA Members: $125, Nonmembers: $180. http://store.aota.org/view/?SKU=4838
from Autism, 3rd Edition to expand OT practice with children through building the intentional relationship, using evaluation strategies, addressing sensory integration challenges, and planning intervention for praxis. Earn .6 CEU (7.5 NBCOT PDUs/6 contact hours). Order #4848, AOTA Members: $210, Nonmembers: $299. http://store.aota. org/view/?SKU=4848
Continuing Education
CEonCD
Neurorehabilitation Self-Paced Clinical Course Series, by Gordon Muir Giles, Kathleen Golisz, Margaret Newsham Beckley, and Mary A. Corcoran. Includes 4 componentsthe Core SPCC, and
Autism Topics Part II: Occupational Therapy Service Provision in an Educational Context, edited by Renee Watling. Second in 3-part CE series with
3 Diagnosis-Specific SPCCs. Core SPCC: Core Concepts in Neurorehabilitation: Earn .7 AOTA CEU (8.75 NBCOT PDUs/ 7 contact hours). Order #3019, AOTA Members: $91, Nonmembers: $128.80. http:// store.aota.org/view/?SKU=3019. Diagnosis-Specific SPCCs: Neurorehabilitation for Dementia-Related Diseases (Order #3022 http://store.aota.org/ view/?SKU=3022), Neurorehabilitation for Stroke (Order #3021 http://store.aota.org/view/?SKU=3021), and Neurorehabilitation for Traumatic Brain Injury (Order #3020 http://store.aota.org/view/?SKU=3020). Each: 1 AOTA CEU (12.5 NBCOT PDUs/10 contact hours), AOTA Members: $129.50, Nonmembers: $184.10.
content from Autism, 3rd Edition addressing OT practice within public school systems and early intervention through elementary years and transition process. Earn .6 CEU (7.5 NBCOT PDUs/6 contact hours). Order #4881, AOTA Members: $210, Nonmembers: $299. http://store.aota.org/view/?SKU= 4881
CEonCD
Assessment and Intervention Assessment & Intervention Training 2-day hands-on workshop (1.6 CEU)
Two Days of Hands-On Learning (1.6 CEU) 2008 Conference Schedule
NEW! Autism Topics Part III: Addressing Play and Playfulness When Intervening With Children With an Autism Spectrum Disorder, edited by Renee Watling. Third of 3-part series with content
CEonCD
Using the Occupational Therapy Practice Guidelines for Adults with Alzheimers Disease and Related Disorders (ADRD) To Enhance Your Practice, by Patricia Schaber. Evidence-based
perspective in defining the process and nature, frequency, and duration of interventions and case studies of adults at different stages of Alzheimers disease. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4883, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/ ?SKU=4883
from Autism, 3rd Edition. Provides topicsCore Concepts, Formal and Informal Assessments, Intervention Planning, and Tying It All Togetherto incorporate the occupation of play into both evaluations and interventions with children with autism spectrum disorders. Earn .6 CEU (7.5 NBCOT PDUs/6 contact hours). Order #4884, AOTA Members: $210, Nonmembers: $299. http://store.aota. org/view/?SKU=4884
CEonCD
Determining Capacity to Drive for Drivers with Dementia Using Research, Ethics, and ProfesOT PRACTICE DECEMBER 17, 2012
issues of autism in adulthood and knowledge and tools to advocate health and community participation of young adults and adults on the autism spectrum. Earn .3 AOTA CEU (3.75 NBCOT PDUs/3 contact hours). Order #4878, AOTA Members: $105, Nonmembers: $150. http://store.aota.org/view/?SKU =4878
Young Adults on the Autism Spectrum: Life After IDEA, by Lisa Crabtree and Janet DeLany. Critical
For complete training schedule & information visit Host a Beckman Oral Motor Conference in 2009! www.beckmanoralmotor.com For Hosting info call (407) 590-4852, or email info@beckmanoralmotor.com Host a Beckman Oral Motor Seminar! Host info (407) 590-4852, or info@beckmanoralmotor.com D-6253
San Francisco, CA Feb & Dates: Upcoming Locations 29-Mar 1 Burlington, January 14-15 Fayetteville, AR NC Mar. 1112, 2013 Houston, January 28-29 Stafford, TX TX Mar1819, 2013 McAllen, TX Apr. 4-5 Mobile, AL February 2223, 2013 Chicago, March 11-12 Atlanta, GA IL Apr 12, 2013 San Antonio, March 19-20 Lexington, KY TX Apr89, 2013 Charleston, SC Apr 25-26 Morganton, NC March 2122, 2013 Tampa, FL May 2-3 Montery, CA NY Jul 17-18 Manhattan, April 45, 2013 Peck, Beach, VA Sep 2013 Virginia MI April 1112, 20-21 San Antonio, TX May 2324, 2013 Morganton, NC Sep 25-26 Chicago, August 1617, Houston, TX IL Oct 10-11 2013 Columbia, SC Oct 16-17 Hartford, CT September 78, 2013 Sacramento, CA Oct 24-25 Seattle, WA October 56, 2013 Orlando, October 2425, San Antonio, TXFL Nov 14-15 2013 For additional info and to register, 2013 Columbia, TN November 12,visit www.beckmanoralmotor.com
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eMplOyMent OppOrtunities
Faculty
Faculty
About Our Department UWMs Department of Occupational Science and Technology (OS&T) is comprised of internationally recognized faculty and staff with expertise in both traditional and emerging areas of practice relevant to occupational therapy. With 12 full-time faculty positions and 4.25 full-time academic staff positions, the department offers entry-level OT degrees, an interdisciplinary PhD in Health Sciences and certificates in therapeutic recreation, ergonomics, and assistive technology and accessible design. The OT graduate program is rated in the top 25% in the United States. The Rehabilitation, Research, Design, and Disability (R2D2) Center and the Center for Ergonomics have been developed to provide in-depth interdisciplinary research opportunities. Application Procedure: Applicants must apply online at http://jobs.uwm.edu/postings/10835 and submit electronically a) a cover letter with a statement of the candidates teaching interests and experiences, b) a curriculum vitae detailing educational background, work experience, and courses taught, and c) a list of three professional references with contact information to include telephone number, mailing address, and e-mail address. Review of applications will begin February 1, 2013. The names of those applicants who have not requested in writing that their identities be withheld and the names of all finalists will be released upon request. The state of Wisconsin will require a criminal background check. The University of Wisconsin-Milwaukee is an affirmative action, equal employment opportunity employer. Web sites for the university and this position are found at http://uwm.edu/chs and http://jobs.uwm.edu/postings/10835. For the UWM Campus Security Report, go to http://cleryact.uwm.edu or call the Office of Student Life, 118 Mellencamp Hall at (414) 229-4632 for a paper copy.
F-6250
EMPLOYMENT OPPORTUNITIES
International
The successful candidates must: ave a bachelors or masters degree in occupational H therapy from a recognized institution. e registered with the Supplementary Medical B Professions Council of Hong Kong (Part 1 of Register) NoteApplication for registration can be made through the Occupational Therapists Board of Hong Kong (Web site: www.smp-council.org.hk/ot/english/index.htm) Closing Date: Sunday, January 6, 2013 Please go to http://recruit.esf.edu.hk for more details and submit application online. For further enquiries, please contact the vice principal, Mr. Robert Szorenyi, at robert.szorenyi@jcsrs.edu.hk. I-6249
Northeast
west
School-based OTs-IL
Special ed agency seeks licensed full/parttime OTs for job in Aurora. Competitive salary, excellent benefits, pension, mentoring. New grads welcome. Contact Mary Kolinski, Northwestern Illinois Association, 630-402-2002. Fax resumes to 630-513-1980 or email mkolinski @thenia.org. Web site: www.thenia.org EOE South
Occupational Therapists
Multidisciplinary pediatric practice seeking occupational therapists on a full-time and part-time basis in Los Angeles and San Fernando Valley. Competitive pay based on experience. Generous benefit package for full time employees. Independent contracting available. Job Description: Provide OT services to clients in clinic, home and schools. Participate as a member of the interdisciplinary team of speech pathologists, occupational therapists, BCBAs, behaviorists, educational therapists, early interventionists and child development specialists. Graduates from an accredited Occupational Therapy program, current certification by AOTA/National Board for Certification of Occupational Therapy. California State Licensure. Must have 2+ years experience. Strong assessment, treatment planning, communication/organizational skills, knowledge of and interest in working with children and adults. Speech, Language & Educational Associates 16500 Ventura Boulevard, Suite 414 Encino, CA 91436 818-788-1003 FX 818-788-1135
S-6259
west
Phoenix, Tucson, & Burbs 602-478-5850/480-221-2573 Schools, 16 wks off, 100% Paid: Health, Dental, Lic, Dues, CEU-$1,000,401K, Hawaii/Spanish I trips Jobs@StudentTherapy.com
ARIZONA OTs$65,000
M-6230
W-6239
Buyers Guide
2013
OccupatiOnal therapy
Register at www.aota.org/conference
experiencing great opportunity as we expand in evidencebased research and practice. But we also face serious challenges in health care legislation and public awareness. As we take our place as leaders in the profession and as skilled providers of excellent practice, research, and education, the more opportunities will arise and the more challenges will be met. The AOTA Annual Conference & Expo is the most dynamic gathering for occupational therapy professionals each year. Stimulating Presidential and keynote addresses, hundreds of focused educational sessions, exceptional speakers, valuable connections, and an Expo brimming with state of the art products and opportunities are all under one roof in San Diego. This is your chance to
flourish!
AC-116
A must-read book for occupational therapy professionals and students to consider cognitive intervention strategies as critical to promote occupation-based, client-centered care and everyday participation in a fuller life!
Each model includes (1) a theoretical base; (2) intervention, including evaluation procedures, assessments, and treatment methods; (3) individual and group treatment case studies that illustrate the intervention process; and (4) research supporting the evidence base of the model or parts of it. Chapters feature learning objectives and review questions.
ISBN: 978-1-56900-322-0
BK-244
for a free information kit including costs, exclusions, limitations and terms of coverage or visit us at www.aotainsurance.com.
NOTE: Plans may vary and may not be available in all states.
P-6180
Call 1-800-503-9230
* Underwritten by Liberty Insurance Underwriters Inc., a member company of Liberty Mutual Insurance. 55 Water Street, New York, New York 10041. May not be available in all states. Pending underwriter approval. ** Underwritten by Hartford Life and Accident Insurance Company and Hartford Life Insurance Company, Simsbury, CT 06089. *** Underwritten by The United States Life Insurance Company in the City of New York. **** Underwritten by Veterinary Pet Insurance Co. (CA), Brea, CA; National Casualty Co. (Natl), Madison, WI. Administered by Marsh U.S. Consumer, a service of Seabury & Smith, Inc.
CA Ins. Lic. #0633005, AR Ins. Lic. #245544 d/b/a in CA Seabury & Smith Insurance Program Management
AG 9561 55464, 55827, 55991, 55992, 55828 (10/12) Seabury & Smith, Inc. 2012