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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

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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