Occupational Therapy Jobs | Occupational Therapy Work
By an allied health world contributing writer
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What are some examples of the types of clients occupational therapists may work with?Between 30-45% of occupational therapists work in pediatrics with children with autism, developmental delays, cerebral palsy, brain and spinal cord injuries just to name a few. In working with children with autism, the occupational therapist helps them develop functional skills to become as independent as possible. For example, the occupational therapist can use sensory information to engage the child in play activities, improve motor coordination, increase the variety of food textures in his/her diet, and develop effective social skills to interact with peers appropriately. In addition, children with autism often have difficulty in attending to a teacher in a classroom, are easily distracted, may have trouble participating in group activities, and may have behavioral problems. Therefore, the OT helps the child learn to function in a school environment by helping him/her learn to write, use a computer, complete homework assignments, listen to the teacher’s lesson or instructions, follow routines, and participate in a group. The overall goal of the occupational therapist is to help the child succeed in the classroom and be able to carry out his or her daily activities independently.
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Other populations include people with neurological and orthopedic disorders such as those who have had strokes, traumatic brain injuries, spinal cord injuries, and multiple sclerosis. In working with a client who suffered a stroke, the occupational therapist would start by reviewing all of the life activities that this person needs to be able to do. The activities could include grooming and hygiene activities, being able to manage his/her home, being able to go out into the community independently, and returning to work or school. The occupational therapist would also look at the cognitive, mental, and social skills that were affected by the stroke and may work on remediating those problems. For example, it is very common for stroke survivors to lose function in one side of their body so the OT would work with the individual on regaining function of their arm and hand so that they are able to engage in productive activities.
Occupational therapists also work in mental health settings with individuals who have mental health problems such as schizophrenia, bi-polar disorder, and depression. In these settings, occupational therapy is often provided through a group process of engagement in meaningful activities or occupations such as crafts, gardening, and meal preparation. This promotes attention, memory, problem-solving, sequencing, task persistence and completion as well as communication, social interactions, regulation of emotions and behavior according to expectations and demands, and sharing in their accomplishments. In addition, the occupational therapist and other members of the mental health team may plan community outings, which help the individuals utilize their skills and adapt to the demands of different contexts.
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What are common interventions occupational therapists use with their clients?The interventions used in occupational therapy are client centered since the therapist is trying to use purposeful and meaningful occupations within the environments in which people participate in order to get them to the highest level of function. Part of what makes the field of occupational therapy unique is that in addition to the specific approaches for intervention, purposeful activities and meaningful occupations are used as a therapeutic medium to accomplish goals and outcomes. So, occupation is both a therapeutic means as well as a goal with an outcome.
In a school setting, for example, the occupational therapist may work with children to help them improve fine motor skills so they are able to cut with scissors and grasp and release objects. To accomplish this the occupational therapist may use specific play activities that work on underlying components such as posture control, strength, and using both sides of the body in a coordinated way. Examples of these activities include climbing on certain equipment, ball activities, lacing activities, and making things out of play dough.
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For an adult who has suffered from a stroke, the occupational therapist may engage the individual in a cooking activity in the clinic kitchen, which can address various aspects of functioning including memory, sequencing, using both sides of the body, and visual-motor coordination. This would be an effective treatment if cooking is a meaningful activity to the client; and it could also work toward an ultimate goal for the individual to be able to prepare a meal independently at home. If the client does not enjoy cooking, it would likely not serve as a therapeutic activity for that individual as there would be reduced interest and motivation.
Occupational therapists also use specific techniques based on theories or models of practice such as Sensory Integration (SI) and Neurodevelopmental Treatment (NDT) that require advanced training. These may include specific ways to use one’s hands to facilitate movement patterns or postural control, or to design activities that provide a particular level of intensity, duration, frequency of sensory input to promote an adaptive response. Occupational therapists may fabricate a splint to promote a functional hand position, or implement specific techniques to facilitate an oral-motor pattern for chewing. A high chair may be adapted to provide appropriate positioning and support for an infant during mealtime. If an individual has physical impairments, such as limited use of one side of the body, the occupational therapist may teach certain strategies or incorporate adapted tools or materials to compensate for the impairment.
There are also specialized hand clinics where occupational therapists work with individuals with carpel tunnel syndrome or those who have fractured their hand. They may use activities, or tools such as hand grippers or therapy putty with different exercises to help the client regain hand function and strength.
Why are the individuals occupational therapists work with referred to as “clients” rather than “patients”?The American Occupational Therapy Association produced a document titled “Occupational Therapy Practice Framework: Domain and Process, 2nd ed.” that uses the term “client” to refer not only to an individual but also a group or population. The only time “patient” is used in occupational therapy is when referring to those in medical settings, or in documentation required for reimbursement by insurance or Medicare since it follows a medical model. The medical model is very narrow, and occupational therapy serves people in so many different settings, and not just people who have disabilities or impairments. In school settings the terms “student” or “client” are used. In pediatrics and early intervention, “client” is used unless describing those individuals in a children’s hospital. Many occupational therapists work with healthy people in the workplace (i.e., ergonomics) and in the community (i.e., lifestyle redesign). Therefore it is misleading to refer to “patients” as the norm in this industry.
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