Florida Occupational Therapy Association by fota.janine

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Florida Occupational Therapy Association Spring 2019

Leadership Development Program OT Month

Free FOTA19 Registration Member Survey FOTA19 Call for Papers Deadline Sponsors & Exhibitors

Contents 3

From the Editorâ&#x20AC;&#x2122;s Desk

The Expanding Role of OTs in the School Setting

From the President Quarterly update of news and events

Unleashing the Synergy between Occupational Science and Occupational Therapy

Myra McDaniel and Lela Llorenz Scholorship Winners

Meet The SIS Team

Claudia Allen and the Cognitive Disabilities Model

FOTA19: Enabling Occupation; Supporting All People, Populations and Communities Updates and Deadline on Call for Papers, Exhibit Information & registration information

The Executive Order and OT Implications: The Rising Suicide Rate in Babyboomers and the Role of Occupational Therapy HILLDAY19 Updates and photos from Hill Day which took place in January OT Month Take our member survey and you win a FOTA19 Conference Registration!

Advertisers 14

Motivations, inc.

Keiser Unitversity

South University

What has the Florida Occupational Therapy Education Consortium been up to?

Congratulations to the FOTA The Myra McDaniel Endowed Scholarship Award Winner Sarah Gaies, OT Graduate of the University of Florida (pg. 23)

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focus EDITOR IN CHIEF Kurt Hubbard

CREATIVE DIRECTOR Janine Silvaroli

CONTRIBUTORS Annette Bullard Ricardo Carrasco Brent Cheyne Mariana D’Amico FLOTEC Kurt Hubbard Kimberly McKinney Anjali K. Parti Janine Silvaroli Mirtha Whaley

CONTACT FOTA 1133 Bal Harbor Blvd Suite 1139 • PMB 200 Punta Gorda, FL 339506574 info@flota.org

DISCLAIMER: All photos and articles are property of Florida Occupational Therapy Association.

Kurt Hubbard editor-in-chief

From the Editors Desk: Hello FOTA members. Welcome to the Spring 2019 issue of FOCUS. I am happy to report that FOTA was well represented at the AOTA conference in New Orleans. The next issue of FOCUS will capture some of these exciting highlights. This issue will contain many timely topics of interest as well as some scholarly information from the Special Interest Chairs. For those interested in disseminating YOUR knowledge, please consider submitting your work for consideration to this year’s FOTA Annual Conference. The theme for 2019 is “Embracing Occupation: Supporting all people, populations, and communities,” and will be held November 16-17 at the Renaissance Orlando at SeaWorld. The goal of this conference is to offer a variety of topics with an emphasis on timely techniques and evidence. The call for papers is currently open through July 15th for professional posters, short courses, workshop, & SIS conversations that matter. In addition, the FOTA Leadership Development Course will be held on June 8th, 2019. This event will be hosted on campus at Keiser University, Jacksonville - Occupational Therapy Assistant Program, & virtually at Nova Southeastern University, Tampa - Doctorate of Occupational Therapy Program. So as you can see, there is a lot going on at FOTA and we are happy that you are part of it… Kurt K. Hubbard, PhD, OTD, OTR/L, FAOTA Editor, FOTA FOCUS Newsletter fota.focus@gmail.com kkhubbard55@gmail.com

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from the president

On behalf of the entire FOTA Board and Leadership, I wish all of our members a HAPPY OT MONTH – April 2019!! Here is your FOTA news updates from the President: Elections: March was an election month for our association. There were two candidates running unopposed for positions: • Vice President: Debra Misrahi (incumbent) • Treasurer: Jordan Powers The election took place March 4 - March 30 by electronic ballot, and congratulations to our newly elected FOTA Leaders! Thanks to the Nominations Committee headed by Pauline Kelley and to Janine Silvaroli, Association Coordinator, for assisting them. Conference: Conference is November 17 - 18. We will return to our beautiful venue at Renaissance Orlando at SeaWorld® with our 2019 Theme: Embracing Occupation – Supporting All People, Populations, and Communities. We have our vendor prospectus and Call for Papers posted on our website: • Call for Papers • Exhibitor Information

Our Call for Papers Submission deadline is July 15, 2019

in school. Three takeaways so far as per Anita:

Governmental Affairs (GA): Hill Day 2019, January 22, was a great success through the efforts of our GA Co-Chairs, Kelly Uanino and Sharon Rosenberg. Thanks to all that attended. FOTA members met with 16 different representatives during rolling office visits. We educated these folks on OT and our role with a particular focus on the opiate crisis and Medicaid reimbursement. Also discussed during our legislative meetings were the topics of OT in mental health in schools and telehealth.

Their three big takeaways so far:

February 19th there was a Department of Health (DOH) meeting that Anita Berry of Corcoran & Johnston (FOTA’s Lobbying Firm) attended – to address needs of children in public school system. The meeting was held by the School and Public Services Ad Hoc Advisory Committee working on a white paper on mental health

1. Workforce issues – trouble finding qualified providers, and ones willing to work for less reimbursement in the school system 2. Privacy issues – HIPAA and FERPA 3. Telemedicine – beneficial to addressing the issue but not all schools have access to the technology Anita is reaching out to DOH to see how FOTA can be involved and provide recommendations. The Florida Legislative Session began March 5th and will continue through at least 60 days. Our GA Committee and Lobbying Firm continue to work tirelessly monitoring the developments as bills come through committees to be presented for voting on the floor of the House

focus • Spring 2019 and Senate. More updates to follow as session progresses. Membership Promotions: A promotional video was finalized in January, and is circulating on social media and on our website. Andre Johnson, our Members Concerns Chair, has announced that Milly Panel and Mary Ellen Berkely are new members of the Membership Concerns committee. Welcome to our leadership team! Winter FOCUS Edition: An ongoing round of thanks to Kurt Hubbard, and all the contributing SIS Chairs, for the outstanding quality of the FOCUS newsletter. The winter edition was our biggest and best ever and special kudos to Janine Silvaroli for her design and technical assistance on the newsletter.

Regional Reps: Joining Dana Dixie as our new Regional Reps Coordinator is Stephanie Carlo, who will serve as the new Regional Rep for Region 7. Thanks for taking a leadership role Stephanie! Leadership Development: The Leadership Development Committee is planning an event continuing education seminar on leadership for June 8th Keiser University, Jacksonville and Nova Southeastern University, Tampa. Leadership Program Nominations opened March 8th and are open self-nomination or nomination of colleague or student by April 5. More information Mark Your Calendars: The June Face-to-face meeting of FOTA –Saturday, June 15 at Nova Southeastern University Tampa.

Developing agenda items for the Face-to-Face Agenda for June include: 1. Budget Approval 2. B y l a w s A m e n d m e n t s – Leadership Standing Committee and others? 3. Strategic Plan 2019 – 5-Year Plan Approval 4. Transition of Officers, President, Treasurer, VP 5. Meeting with our Lobbyists 6. Annual Reports from Officers, Coordinators and Chairs Looks like it will be a busy FOTA year moving forward! Brent Cheyne, OTD, OTR/L FOTA President president@flota.org

FOTA is focusing on emerging leaders in Florida. Inspire – OT leaders in clinical, academic and management venues will identify the skills that OTAs need to effectively lead on the job, in their careers, and for their profession. Interact - Talk with OT peers and experienced practitioners in breakout sessions designed to reveal leadership qualities within. Keynote Speaker Kurt Hubbard, PhD, OTD, OTR/L, FAOTA , former President of FOTA. Expand - Gain knowledge about the mission and initiatives of the Florida Occupational Therapy Association (FOTA), and the ways OTs & OTAs can grow their leadership skills within their state

Saturday, June 8th, 2019; 8:30-4:30pm

Keiser University Jacksonville OTA program and Nova Southeastern University OT Program 6 CEU Course for $60.00, entry-level student rates $20.00 Acceptance to the program will be announced at the end of April! Good luck to all who applied.

Call for Papers Deadline July 15, 2019

FOTA19: Embracing Occupation Supporting All People Populations, and Communities

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Call for Papers

Exhibit.Sponsor

Deadline July 15

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1 & 2 day options for all

In an effort to provide higher levels of learning at FOTA19 we will show preference for those submissions who meet our theme and provide intermediate and advance courses. If you presented a beginner course last conference, perhaps you can elevate your proposal for a higher level of learning.

Exhibitors may choose 1 or 2 day options. There are many advertising options available. Choose to be a SPONSOR and increase your advertising power and showcase your business across multiple platforms. Check out all the new sponsor options this year.

Spring 2019

14 CEs available over 2 days Early Discount expires Oct 19. Prices increase $25 after deadline Keynote Speaker & more advance course options for practitioners. Box Lunch & Beverage included

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The Executive Order and OT Implications: The Rising Suicide Rate in Baby Boomers and the Role of Occupational Therapy Anjali K. Parti, OTD, OTR/L Gerontology Co-Chair Annette Bullard, COTA, Gerontology Co-Chair At the Florida Occupational Therapy Association (FOTA) conference in 2018, Anjali Parti and Annette Bullard hosted a Conversations that Matter that was very well attended, many OT practitioners voiced an interest in doing more for mental health in the VA setting. We have decided to re-visit this important topic due to President Trump’s recent Executive Order signed March 5, 2019. Here is some information on the order and what the order entails:

health approach to suicide prevention further by identifying key integrations and connections across the federal government and communities that can be used to save Veterans’ lives.”- VA Secretary Robert Wilkie

“As the largest integrated health care provider in the nation and a leader in developing innovative mental health and suicide prevention strategies, the Department of Veterans Affairs (VA) is uniquely positioned to co-chair this effort with the White House,” said VA Secretary Robert Wilkie. “Veterans suicide is a national public health issue that affects communities everywhere, and this executive order is a national call to action. We are committed to saving Veteran lives, but just as there is no single cause of suicide, no single organization can end Veteran suicide alone,” Wilkie said. “We must work side by side with our partners at all levels of government — and in the private sector — to provide our Veterans with the mental health and suicide prevention services they need. This executive order advances the public

1. Develop a comprehensive national public health roadmap outlining the specific strategies needed to lower effectively the rate of Veteran suicide, with a focus on community engagement,

Executive Order Task Force Agenda Within 365 days of the date of the order and working with a variety of representatives from across both the public and private sectors, the task force shall:

2. Design and propose to Congress a program for making grants to local communities, which will increase their ability to collaborate with each other, integrate service delivery and coordinate resources to Veterans, and 3. Develop a national research strategy to improve the coordination, monitoring, benchmarking and execution of research in the field of Veteran suicide prevention. The Issue at Hand:

A growing baby boomer suicide rate! ‘Suicide at any age is a tragedy for the individual, his or her family and friends, and the communities of which they are a part. At a population level suicide is also a major public health problem, accounting for over 34,500 deaths each year in the United States and an estimated one million or more worldwide (Yeates, Van Orden, & Caines, 2011). According to the National Institute of Mental Health Suicide is the 8th most frequent cause of death of Americans ages 55-64. The World Health Organization calls for a coordinated action to reduce suicides worldwide. “This report is a call for action to address a large public health problem which has been shrouded in taboo for far too long” (World Health Organization, 2014). The first WHO report on suicide prevention reports that suicide rates are highest in people 70+ and women are twice as likely to die by suicide as men. In 2016, the highest suicide rate (19.72) was among adults between 45 and 54 years of age. The second highest rate (18.98) occurred in those 85 years or older. (American Foundation for Suicide Prevention, 2018)

What Does this Mean for Occupational Therapy? With this new governmental support, maybe our implementation of more mental health approaches to our veteran

focus • Spring 2019 1. Use the ‘Interest Checklist’ and the Meaningful Activity Participation Assessment to assess what is valuable to a client, compared to how physically or mentally they can engage in those activities can assist OT’s in prioritizing, grading and/or adapting valued occupations. Information revealed by use of the checklist may also assist OT’s in reviving once utilized activities to replace activities that engagement in is no longer possible. By ensuring engagement in valuable occupations we ensure engagement and value of life and thereby contribute to suicide prevention. 2. Utilize the COPM and Beck Depression Inventory in your evaluations. 3. Refer your client to a list of resources for mental health counseling in his/her area and be a true advocate for this and not just a messenger. 4. Continue to identify preferred tasks which bring fulfillment and collaborate with caregivers and family and friends. 5. Collaborate with nursing homes, assisted living facilities, hospitals, and local Council on Aging and local support groups to brainstorm on potential funding or easy ways to identify signs/ symptoms of suicidal ideation that come along with depression. 6. Look for local ‘Mental Health First Aid’ courses to better identify signs/symptoms of mental distress and how to properly assist in case of an emergency. 7. Review your workplace’s policies and procedures on what to do should someone report suicidal intent. 8. Speak with your therapy manager and team to see what the department can/should do should a patient express suicidal intent or ideation in a treatment session. 9. Identify a treatment goal that can consistently target preferred tasks and occupations and focus on this as much as possible in your sessions. 10. Finally, focus on your client’s social isolation and what that means for the client’s functionality with ADL/IADL and help identify ways to incorporate community re-integration into your treatment planning patients in the VA or in other settings will receive additional support. Many Occupational Therapy professionals see first-hand the effects of aging in the baby boomers in the state of Florida. Florida being the sunshine state is one of the states where many baby boomers wish to retire. Many OT practitioners often practice in the geriatric setting because of prevalent job opportunities and a rising need of the community for OT services. The Occupational Therapy profession is unique in many ways one of which sets our profession apart is that, the whole person is considered during treatment. 9

This fact makes us uniquely qualified to assist with suicide prevention with our patient/clients. In their article ‘Suicide in Older Adults’ Conwell, writes that ‘suicide needs to be understood as a developmental process to which risk and protective factors contribute in defining a trajectory to suicide over time.’ His article sets a perfect stage for Occupational Therapy professionals to intercept what Conwell describes as a trajectory toward suicide. Consistent use of the training OT’s receive in mental health can begin to change the course, from tragedy

to successful redefining purposeful life engagement, despite challenges. In conclusion, it is very important for those of us treating the geriatric population to be mindful of the most important item in our treatment planning and processes; the mental health of the client. It would be prudent to advocate for our skill set and discuss scheduling and reimbursement matters with our workplace administrators for support. Support to spend more time on focusing on signs and symptoms of depression, consulting with mental health providers, and taking an interdisciplinary approach with our nursing, physical, and speech

focus â&#x20AC;˘ Spring 2019 therapy peers would be a step in the right direction. The strength of Occupational Therapy is focusing on the psychosocial well-being of all clients and ultimately their ability to safely participate in functional and preferred activities. We must be mindful of ensuring our clients feel the quality in their quality of life in order to feel fulfilled and prevent risk for suicide.

References *

(2017) Suicide Statistics. Retrieved March *

American Foundation for Suicide Prevention.

2017) Suicide. *

Office of Public and Intergovernmental Affairs.

01, 2018

(2016, September 01). Office of Public and

Eakman, A., Carlson, M., Clark, F. (2010).

Intergovernmental Affairs.

The Meaningful Activity Participation

Assessment: A Measure of Engagement in Personally Valued Activities. *

National Institute of Mental Health. (May

Model of Human Occupational Theory

World Health Organization (Sept 4, 2014). First WHO report on suicide prevention.

Yeates, C., Van Orden, K., & Eric, C. (June 2011) Suicide in Older Adults.

and Application. (2018). Modified Interest Checklist.

FOTA19: Hotel Reservations & Booking Website Renaissance Orlando at SeaWorldÂŽ 6677 Sea Harbor Drive Orlando, Florida 32821

Use this link to make, modify and cancel hotel reservations online, as well as take advantage of any room upgrades, amenities or other services offered by the hotel. This will ensure you get the FOTA rate for your stay. The FOTA rate is $179.00/night +12.5% tax. The resort fee is $25.00/night but has been waived for FOTA.

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FOTA Hill Day: January 22, 2019 Brent Cheyne, OTD, OTR/L FOTA President FOTA Hill Day in Tallahassee, FL, January 22 at the Capitol Building, 2nd Floor Rotunda at 8am. We were joined by our lobbying firm, Corcoran & Johnston (C&J), to establish a presence with legislators in the rotunda, promote an awareness OT on the hill, as well as engage in sitdown meetings individually with specifically selected legislators at their offices as arranged C&J. Our objective was to raise awareness of the distinct value of OT in serving Floridians, and addressing specific issues of access to care, protection and promotion of OT practice across our state. We hope many OTs join us for Hill Day in the years to come. Part of your membership dues go to ensure that FOTA as skilled advisement from our lobbying firm on strategies to promote and protect OT in Florida. FOTA relies on membership support to advocate successfully. More

members are needed to increase our ability to influence change. Thanks to OT Students from FAMU and OTA Students from Keiser University provided a positive presence and enthusiastic representation for the future of Occupational Therapy in Florida. Students and faculty attended some meeting with legislators, toured the House and Senate Chambers, and mingled with the leaders coming and going in the Rotunda. A student poster presenting research on the important issue pain management through OT was presented near our FOTA tables. Informational Brochures were available for all that came by our area. The FOTA Governmental Affairs Co-Chairs, President, our Lobby Firm--Corcoran & Johnston, and Members had 16 different legislators and their staff over the course of

a full-day schedule. We discussed issues important to the practice of OT and the service to our clients over several talking points including the Opioid Crisis, Pain Management, Mental Health in Schools, Medicaid, and Telehealth Practice. Our meeting included leaders on important health policy, and human services committees. We thank them for a receptive discussion about OT in FL. I have included some pics of my hand-held schedule and talking points from the day of meetings. • Hill Day Schedule Legislator Office Visits • Hill Day Talking Points A huge thanks to Anita Berry, our Lobbyist for Corcoran and Johnston, for providing great guidance and insight on legislation being filed for this coming session, and to our fearless FOTA Governmental Affairs Co-Chairs, Sharon Rosenberg and Kelly

focus â&#x20AC;˘ Spring 2019 Uanino for leading the charge in framing the relevance and awareness of OT issues in FL. As President of FOTA, I was impressed with the number of connections and discussions we were able to have on Hill Day 2019. It was an effective and productive day of advocacy during our day-long schedule of office meetings with over 16 legislators. Thanks to our OT Clinicians and Faculty who attend office meetings with legislators, and for our discussions on building a better organization through increased membership, communication, messaging, and developing more value for members in OT. Of course, the number one value of OT membership is our advocacy efforts through the Governmental Affairs Committee and investment in lobbying consultation through event such as Hill Day. Keep in mind our Advocacy efforts are a year-round process and we would love more help and individuals with knowledge on the issues to help us out. Part of your membership dues go to ensure that FOTA as skilled advisement from our lobbying firm on strategies to promote and protect OT in Florida. FOTA relies on membership support to advocate successfully. More members are needed to increase our ability to influence change. The 60-day Legislative Session will convene on March 5, 2019, with interim committee weeks being held in December, January and February. The following is a brief overview of work done since the last legislative session and legislative priorities we expect to work on throughout the upcoming session. State Health Plan Coverage Following the 2017 addition of occupational therapy as a covered benefit under the state employee health plan we will work again to protect the language within the budget so the benefit remains. 12

Opioid Abuse Epidemic We have begun discussions with a coalition of other health care providers, including massage therapists, acupuncturists, chiropractors and physical therapists, on legislation to promote alternative treatment options for pain management. Medicaid Reimbursement In March 2018, we arranged a meeting with Medicaid leadership at the Agency for Health Care Administration (AHCA) to discuss reimbursement challenges for occupational therapists. Since then, we have had ongoing conversations around CPT codes and access to occupational therapy. We will be continuing this work to better ensure adequate reimbursement levels. We also arranged a meeting directly with leadership of the Florida Association of Health Plans to help improve communication between providers and health plans. In addition, we have been in communication with the Department of Health regarding the CMS transition to managed care. In September 2018, DOH awarded the CMS contract to Wellcare Staywell. The contract award has been contested by South Florida Community Care Network. Patients were intended to transition on January 1, 2018, but that process has been delayed until the contract contest is resolved. We have relayed the concerns of occupational therapy providers regarding the lack of communication throughout the transition and have been informed that additional information will be provided to patients and providers once the contest is resolved. We will be following up with DOH to arrange a direct conversation

between FOTA and CMS regarding access to occupational therapy services. Mental Health in Schools Last Session, significant legislation addressing mental health access in schools was passed in response to the Parkland shooting. We have had ongoing conversations in regards to how occupational therapists can assist in providing mental health services in schools. Legislative leadership has not yet determined if they will re-visit the issue in the 2019 session, however we seek to be prepared to weigh-in on the issue if legislation is filed. Telemedicine We anticipate the legislature will again attempt legislation addressing the practice of telemedicine in Florida. We will work to ensure whatever legislation is introduced and potentially passed, includes occupational therapy as a health care practice that can be delivered through telemedicine.

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Leading the way We are so blessed to have an amazing team of volunteers to help steer FOTA! Thank you Sharon Rosenberg, Brent Cheyne and Kelly Uanino

Showing our True Colors Did you get your I’m for OT Shirt?

Our Government Affairs team provided T-shirts (for purchase) for the event and they sure looked great! I’m for OT!

Gudiance at Hill Day Anita Berry, Lobbyist for Corcoran and Johnston (center) and to FOTA Governmental Affairs CoChairs, Sharon Rosenberg (left) and Kelly Uanino (right)

Building a better organization Thanks to our OT Clinicians and Faculty who attend office meetings with legislators and brought forth many great ideas for our bright future. 13

Members of FL APTA and FOTA received a 15% discount on our Location Courses. Select “association rate” # 114 Donatelli's Shoulder Mechanics of with Lab Robert Donatelli PhD, PT, OCS

# 329 Pediatric NDT Intensive Handling Techniques Gail Ritchie, OTR, C/NDT DoubleTree by Hilton, Orlando, FL April 13-14, 2019

Warner Robins, GA Innovative Therapy Concepts June 8-9, 2019 # 179 The MEEKS METHOD® Management of Spinal Pathology: Alignment for Osteoporosis, Spinal Stenosis, Scoliosis, Back Pain

Sara Meeks, PT, MS, GCS, KYT

Hampton Inn Perimeter, Atlanta, GA July 26-27, 2019 # 330 Sensory Systems: The Effect on Postural Control … Understanding and Incorporating Sensory Strategies in NDT Treatment

DoubleTree by Hilton Orlando, FL October 26-27, 2019

Gail Ritchie, OTR, C/NDT Brenda J. Lindsay, PT, C/NDT

# 206 Innovative Stroke and Neurological Rehab Treatment Approaches J.J. Mowder-Tinney PT, PhD, NCS

Celebration, FL Advent Health Celebration November 21-22, 2019

AdventHealth, Winter Park, FL November 15, 2019

# 320 BRAIN GYM ® Susan Owens, MS, OTR

# 237 Stroke Recovery Toolbox: Clinical Strategies & Assessments Stephen Page, Ph.D., M.S., MOT, OTR/L, FAHA

Atlanta, GA Hampton Inn Atlanta-Perimeter Ctr September 13, 2019

St. Vincent's Medical Ctr Riverside Jacksonville, FL September 14, 2019

# 213 Visual Rehabilitation & Neuro Handling After a Neurological Incident … Concepts for Function

# 256 Brain & Concussion Rehab

Tampa General Hospital, Tampa, FL May 4-5, 2019

Baptist Hospital of Miami, FL April 27-28, 2019

AdventHealth, Winter Park, FL June 6-7, 2019

Eli Day PT, MPT,ATP, cNDT

Michelle Mioduszewski, MS, OTR/L

Submitted to CE Broker FL PT and OT

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For information visit: www.motivationsceu.com 14 admin@motivationsceu.com

Spring 2019

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OT Month

We want to hear your voice! As an OT, you are part of a vitally important profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities. Your holistic and customized approach to evaluations, interventions, and outcomes help a child with disabilities participate in school and in social situations, assist a person recovering from injuries to regain skills, aid an older adult to stay as independent as possible, and offer the specialized support and services to people of all ages and in all circumstances that only occupational therapy can provide.

Log in to FOTA and take our member survey to win a FOTA19 Conference Registration or FOTA T-Shirt. We are asking that our members complete a survey. This is a quick 5 minute survey. Drawings to take place May 3, 2019. Share your OT Photos with us on Facebook and help promote our profession. Visit our Facebook page and submit photos of OTs in action! Please give a description and i will post that as well. Thank you for your support of FOTA! FOTA OT Month Poster: Download our OT Month Poster and place it in your workplace! Send to friends & colleagues.

Happy OT Month!

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What has the Florida Occupational Therapy Education Consortium been up to? Improvements with you in mind.

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The FLOTEC website is undergoing a ‘virtual facelift’ just for you, because everyone benefits from fieldwork education.

Student supervision provides you with an opportunity to give back to the Occupational Therapy profession

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Student supervision ensures longevity of our profession

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Student supervision allows you to pass on quality skills

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Student supervision allows you to earn continuing education and professional development units

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Student supervision provides opportunities to achieve professional development goals

The FLOTEC members have been working hard to improve fieldwork education and it has begun with our website. The website will soon be more colorful and user friendly just for you the fieldwork educator. The website will provide resources, course registration, helpful links and information to assist with fieldwork education on a more colorful and user-friendly platform. FLOTEC specializes in assisting fieldwork educators and will be continuing to offer our Fieldwork Educators Certification course. Additionally, this fall you will be able to attend one of our newest courses on Evidence Based Practice, which will be offered at the FOTA conference. Soon FLOTEC will be offering courses on topics such as Ethics, Communication and Legal Issues, to benefit and develop fieldwork educators. Remember when you were a wide-eyed student and benefitted from someone who provide you with fieldwork supervision? Now as a professional you can benefit again in multiple ways. •

Students bring fresh ideas and some of the latest research to fieldwork setting

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Students provide the challenge of professional growth with answering questions, explaining techniques treatment rationale

Watch for our website changes made specifically to help you continue to benefit from fieldwork education while achieving professional growth. “We are here to support and help you as a Fieldwork Educator. Our members are a consortium of OT Academic Fieldwork Clinical Educators from across Florida. FLOTEC is dedicated to promoting the academic and clinical aspects of Occupational Therapy Education Fieldwork and current practice.”

KEISER UNIVERSITY

Occupational Therapy Assistant Program

At Keiser University You Receive a Hands-On Learning Experience Occupational Therapy Assistant program prepares

students to work as occupational therapy assistants under direct supervision of a licensed occupational

therapist. Students learn the therapeutic use of occupations which include self-care, work and

play/leisure activities in order to maximize

independent function, enhance development, prevent

disability and maintain health. Intervention strategies

may include adaptations to a task or environment or compensatory approaches in order to facilitate

clientsâ&#x20AC;&#x2122; achievement of maximum independence.

www.keiseruniversity.edu Keiser provides an environment in which students demonstrate ethical behaviors, critical thinking skills and commitment to lifelong learning as required of a competent healthcare professional.

This program is available in the following Florida campuses: Daytona Beach, Fort Lauderdale, Fort Myers, Jacksonville, Melbourne, Miami, Orlando, Pembroke Pines, Tallahassee, Tampa, West Palm Beach

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The Expanding Role of OTs in the School Setting Kim McKinney MPT, MOT, OTR/L FOTA School Systems SIS chair supports, and problem solving with the student support teams.

Recently, Gloria Frolek Clark and Pam Stephenson presented an online Member Appreciation class on the “Distinct Value of Occupational Therapy in Todays Schools.” In the presentation they discussed the changes in the role of therapists when it comes to students in the school system. In the past, our services have been reserved primarily for students who have an IEP. Occasionally, we may have been asked to assist in a limited role with students who are on an MTSS plan. With the implementation of Every Student Succeeds Act (ESSA) of 2015, our role has shifted. One of the changes with ESSA is the use of specialized instructional support personnel for ALL children in the district. What does this mean for OTs in the school setting? Through ESSA, OTs can take a greater role in school and district wide supports. This may look like a different role in the MTSS process. AOTA (2010) supports the use of OTs in all three tiers of the MTSS model. OTs can assist with universal screenings, data collection reviews, teacher 18

The presenters discussed the continuum of OT in the school system. In this model, OTs have a role with supporting 4 different areas in the process.

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School Wide Action Ideas: •

Vo l u n t e e r f o r B u i l d i n g Committees

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Assist with building-wide professional development or training programs (anti-bullying, PBIS, mental health, lifting/ transferring students)

District Wide Stakeholders: • •

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Administrators (Superintendent, Principal, SE Director) School Personnel (Teachers, Nurse, Custodian, Bus Drivers, etc.) Parents (PTO) Team members (Curriculum, Playground)

District Wide Action Ideas: • • • •

Volunteer for District Committees Curriculum Committees Data analysis for results of District Grants (anti-bullying, PBIS District-wide Training (e.g., mental health, health and wellness, literacy, motor development, self-regulation)

Classroom Level Stakeholders: •

Teachers

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Paraprofessionals

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Other team members & service providers

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Parents & volunteers

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All students in the class

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Classroom Level Action Ideas:

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Consider co-teaching at specific times, or during specific activities

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Collaborate to identify opportunities to embed strategies/ activities throughout the day e.g. yoga or movement breaks

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Coach staff on implementation and expansion of strategies

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Offer an in-service on the expanded role of OT e.g. EIS, (RtI, PBIS)

School Wide Stakeholders: •

Principal

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School Personnel (e.g., Teachers, Nurse, Paraprofessionals, Custodian, Bus Drivers)

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Parents (PTO, volunteers)

Team members (504 teams, IEP teams, GE Building teams)

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Individual Level Stakeholders: •

Teachers

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Paraprofessionals

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Other team members & service providers

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Parents & volunteers

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Individual students (e.g. with IEP, 504)

Individual Level Action Ideas: •

If using primarily a pull-out model, explore ways to support individual students in context in the classroom, or other parts of the school environment such as the cafeteria, or during recess

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Work collaboratively to set up and review data collection systems as part of progress monitoring

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Review your explanation of schoolbased OT – does it reflect full scope of practice/opportunity?

Studies show that collaboration within the school district has a positive effect on all stakeholders. In an AJOT article, Howell et al (2017) found that “occupational therapists who successfully collaborate with educators and related service providers in schools and EI will generate better outcomes for children and will improve the value of occupational therapy”. This is a great time as OTs in the school setting to look at what our strengths and passions are. We can use them to collaborate and be part of the teams that support children, teachers, schools, and families. ESSA has opened the door for the focus to switch from individual student progress to support outcomes for all students. What role will you play?

Resources for support can be found here. AOTA is looking for stories on the distinct value of working with children and youth. Please submit your story to AOTA. AOTA Practice Advisory on Occupational Therapy in Response to Intervention. (2010). Retrieved from. Frolek Clark, G., & Stephenson, P. (2019). Presentation: Distinct Value of Occupational Therapy in Today’s Schools. AOTA. Howell, D., Myers, C., O’Brien, S., Schneck, C. (2017). Interprofessional learning about therapy teams in schools and early intervention. AJOT, 71. doi:10.5014/ ajot.2017.71S1

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focus • Spring 2019

Unleashing the Synergy between Occupational Science and Occupational Therapy Ricardo C. Carrásco, PhD, OTR/L, FAOTA Mariana D’Amico, EdD, OTR/L, FAOTA Abstract

Keywords:

Occupational science evolved from Yerxa’s work (1989), and gained global influence in studying humans as “occupational beings,” (Glover, 2009). Since then, conversations have occurred about the relationship between the science and the profession of occupational therapy.Wilcock (2005) suggested that occupational science informs occupational therapy by investigating restorative capacities of occupational participation. Conversely, Hocking & Wright-St. Clair (2011) proposed that the occupational therapy profession provides insight to investigations from practice, which in turn contributes to occupational science. This article offers a historical and contemporary insight of what might be a synergic relationship between the basic and applied sciences that can benefit both, as well as those other professions such as anthropology, among others that engage in occupational studies. Exemplars will illustrate possibilities of this symbiotic relationship and provide a better understanding of the utility of occupational science, which ultimately should benefit consumers of the health care and other professions.

occupational science, occupation, occupational therapy, basic science, foundations, applied science Background This is the second in a series of articles with the intent to share information to occupational therapy practitioners and others who can find enlightenment from occupational science. This article proposes that there might be a synergistic relationship between the basic and the applied sciences (occupational science and occupational therapy, respectively), and how the synergy can benefit both, and other disciplines that engage in and consume occupational science research. The purpose of occupational

Hocking & Wright St. Clair, 2011; Hocking,

2014; Kristensen & Petersen, 2015). As a

direct result of these scholarly products, occupational science has seen the evolution of the science itself, but also the development of graduate and

undergraduate programs, and proliferation of literature in fields that include, but not limited to anthropology, anthropology, architecture, economics, education, engineering, geography marketing, occupational therapy, psychology, public health, sociology, and in occupational science itself. As in the evolution of new disciplines, mechanisms of differentiation can result Doctoral research group using harvested cortisol salivary samples to study the in conflict and refinement effect on anxiety after active engagement by students in ikebana or Japanese flower (Abbott, 2001, pp. 21-33). arranging. This is a good example of how occupational science can inform the This differentiation may also practice of occupational therapy. (left) Dr. Gustavo Reinoso, Assistant Professor, Dr. cause paradigm shifts that Kristine Cinco, (Alumnus, 2016) and Dr. Shannon Conn Taylor (Alumnus, 2016). (right) science since its beginnings in the emanate from conversations Dr. Gustavo Reinoso

‘80s has always been to produce knowledge about occupation to inform occupational therapy (Clark, et al, 1991, p. 301, Carrasco, 2018). Occupational science has continued to do that with scholarly explorations on the construct of occupations in studying humans as occupational beings, (Glover, 2009;

focus • Spring 2019 revolving around whether or not occupational science informs occupational therapy, or vice versa. This can lead into mapping new directions for occupational science and occupational therapy through mutual productive interactions between science and application. Scholarly Beginnings Occupational Science

Occupational science evolved from the need that echoed beliefs and values on occupation identified by the founders of the occupational therapy profession and by several occupational therapy leaders such as Reilly (1974, 2840), Fidler (1981, p. 568), and Gilfoyle (1984, 575-576) or Meyer, (1922). Occupational science provides the research platform that can help sustain and improve the practitioners’ utilization of occupation as an effective medium for intervention. In 2012, Pierce proposed a “promise” of occupational science and described four levels of research that is applicable to study aspects of human occupation. These research levels are descriptive, relational, predictive and prescriptive. Descriptive research aims to describe occupation and is the foundation for the other levels (Pierce, 2014b, 1318), such as a study that describes the experiences of loneliness and the daily occupations of adults with intellectual disability (McVilly et al., (2006). The second research level or relational research combines research from other disciplines with the construct of occupation (Pierce, 2014d, 8187). This allows for interprofessional collaboration with professions such as anthropology, sociology, andpsychology or others such as the study by Simões & Santos (2016) which examined the quality of life of individuals with 22

and without intellectual disability by describing their daily occupations. Of the four levels, the least developed is the third level or predictive research. Pierce (2014c, 181-184) describes it to identify patterns of occupation across groups of individuals, and therefore expands on theories derived from descriptive research. Of the four levels, prescriptive research relates the most to occupational therapy, and can provide scholarly work with systematic studies for the practice of occupational therapy (Pierce, 2014a, 249-252). Ramsey (2011) illustrated prescriptive research in an exploratory study of occupational therapy practitioners in community settings. Occupational science research also refines the capacity to measure outcomes and assess the occupational needs of individuals across the lifespan and the spectrum of conditions and diagnoses, including the well population. Occupation includes all essential functions that people use on a daily basis. As Meyer (1922, 1977 (AJOT)) stated, engagement in occupation structures peoples’ day and prevents mental illness. Building habits, routines and roles has long been the intervention aspect of occupational therapy to promote health. Across cultures, occupational science research can open doors on the transmission of tradition in familiar places through apprenticeship, and in doing so, interpreting centuries old traditions and relating them to

contemporary practice. 23-34).

(Smith, 1998,

Occupational Science in Practice Occupational science terminology has become part of occupational therapy. Since the early ‘80s, occupational therapy verbal or printed scholarly products have included words that were occupational science in origin: occupational dysfunction occupational disruption, occupational development, co-occupations, dark occupations, occupational reconstruction, occupational engagement, occupational justice, occupational termination, occupational development, occupational wellness, occupational deprivation, occupational adaptation, occupational chaos, occupational exploration, occupational balance, occupational choice, occupational storytelling, among many. Occupational science provides the research platform that has a strong potential for sustaining and improving the practitioners’ utilization of occupation as an effective medium for intervention. It also refines the capacity to measure intervention outcomes and assess

focus • Spring 2019 the occupational needs of individuals across the lifespan and the spectrum of conditions and diagnoses, including those of the well population or even organizations and societies. Occupation includes all the essential functions in which people engage on a daily basis. As Meyer (1922, 1977 (AJOT)) stated, engagement in occupation structures peoples’ day and prevents mental illness. Occupational science investigates the basics of occupation. It explores all aspects of occupation: form, context, meaning, purposefulness, relational aspects, beneficence or detriment. Through this knowledge OTs can better understand the clients’ narratives and needs, and anticipate their futures collaborating with clients, and providing guidance for clients’ achieving their goals from therapy. This understanding of the individual and their necessary and chosen occupations can assist OTs to promote occupational balance on an individual basis according the needs and configuration of each person’s life.

culturally meaningful roles, habits and routines, and adapting to both the human and non-human environments. There is an intimate relationship between occupation and people’s identity, individually and socially. Occupational participation whether civically, spiritually, socially, at work or home are important aspects of an individual’s life, constructing one’s worldview whether small or large. It is in doing that humans become, belong, and be who individuals perceive themselves to be. Humans meet their own expectations and those of the communal circles in which they live, their family, neighborhood, city, town, country, ethnically, etc. Sharing aspects of our occupations with others builds community and expands perspective. Occupational science can help the occupational therapy practitioner elaborate on these concepts for best practice. Therefore, it is essential that occupational science and occupational therapy work synergistically for individual, societal and organizational health.

Author Notes Ricardo C. Carrásco, PhD, OTR/L, FAOTA and Mariana D’Amico, EdD, OTR/L, FAOTA respectively are Director & Professor and Associate Professor at the Entry-Level Doctor of Occupational Therapy Program, Nova Southeastern University, at their brand-new Tampa Bay Regional Campus in Clearwater, FL. Dr. Carrasco serves on the FOTA Board of Directors as the Coordinator of the Practice Standing Committee and Chair of the Occupational Science Special Interest Section. Correspondence concerning this FOTA FOCUS article should be addressed to Dr. Ricardo C. Carrásco, Department of Occupational Therapy Doctorate Program, 3632 Queen Palm Drive, Nova Southeastern University, Tampa, FL 33619. email: rc1265@nova.edu

Exemplars from Real Life Scenarios Exemplars in this section illustrate possibilities of a synergistic relationship between occupational science and occupational therapy. The intended outcome is to provide better understanding of the utility of occupational science to inform practice and thereby provide benefits to consumers of health care and the profession. Building habits, routines and roles has long been the intervention aspect of occupational therapy to promote health. As Reilly (1962 W & S 211 or Slagle lecture) stated, “That man through the use of his hands as they are energized by mind and will can influence the state of his own health.” Thus, doing is part of being, becoming and belonging in some echelon of society incorporating 23

Ricardo C. Carrásco, PhD, OTR/L, FAOTA, FOTA Practice Standing Committee Chair and SIS Occupational Science Chair

Mariana D’Amico, EdD, OTR/L, FAOTA

focus • Spring 2019 References: Abbot, A. (2001). The Chaos of disciplines in Abbot A. Chaos of disciplines (21-33). Chicago: University of Chicago Press. Carrasco, R. C. (2018). Occupational science in our midst: Journey of sharing, living

and engaging in the science. FOCUS Newsletter. Fall 2018, 6-8. Clark, F., Parham, D., Carlson, M. E., Frank, G., Jackson, J., Pierce, D., & Zemke, R. (1991) Occupational science: Academic innovation in the service of occupational therapy’s future. American Journal of Occupational Therapy, 45, 300-310. doi.10.5014/ajot.45.4.300 Fidler, G. (1981). From crafts to competence. American Journal of Occupational Therapy. 567-573. 35. 9. Retrieved from: http://ajot .aota.org on 09/25/2018. Gilfoyle, E. M. (1984). Transformation of a profession. American Journal of Occupational Therapy. 575-584. 18, 9. Retrieved from. Glover, J (2009). “The literature of occupational science: A systematic, quantitative examination of peer-reviewed publications from 1996-2006”. Journal of Occupational Science 16 (2): 92–103. Hocking, C., Jones, M., & Reed, K. (2014). Occupational science informing occupational therapy interventions. International Handbook of Occupational Therapy Interventions. 26. 127-134.

Hocking, C. & Wright-St Clair, V. (2011). Occupational science: Adding value to occupational therapy. New Zealand Journal of Occupational Therapy, 58(1), 29-35. Kristensen, H. K., & Petersen, K. S. (2016). Occupational science: An important contributor to occupational therapists’ clinical reasoning. Scandinavian Journal of Occupational Therapy. 23:3, 240-243. DOI:10.3109/11038128.2015.1083054. McVilly, K. R., Stancliffe, R. J., Parmenter, T. R., & Burton-Smith, R. M. (2006). ‘I get by with a little help from my friends’: Adults with intellectual disability discuss loneliness. Journal of Applied Research in Intellectual Disabilities, 19(2), 191-203. Meyer, A. (1977). The philosophy of occupational therapy, Reprint from 1922. American Journal of Occupational Therapy, 31. (10), 639-642. Pierce, D. (2012) Promise, Journal of Occupational Science, 19:4, 298-311, doi: 10.1080/14427591.2012.667778 Pierce, D. (2014). Occupational science for occupational therapy. Thorofare, NJ: Slack, Inc. Pierce, D. (2014a). Occupation in practice. In Pierce, D. Occupational science for occupational therapy. (249-254). Thorofare, NJ: SLACK Incorporated. Pierce, D. (2014b). Occupational science research describing occupation. In Pierce, D. Occupational science for occupational therapy. (13-22). Thorofare, NJ: SLACK Incorporated. Pierce, D. (2014c) Predictive research in

occupational science. In Pierce D. Occupational science for occupational therapy, (181186). Thorofare, NJ: SLACK Incorporated. Pierce, D. (2014d). Relational research in occupational science. In Pierce, D. Occupational science for occupational therapy. (8190). Thorofare, NJ: SLACK Incorporated. Reily, M. (1962). 1961 Eleanor Clarke Slagle Lecture: Occupational therapy can be one of the great ideas of 20th century medicine. American Occupational Journal of Occupational Therapy. 16 (1). 87-105 Simões, C. & Santos, S. (2016). Comparing the quality of life of adults with and without intellectual disability. Journal of Intellectual Disability Research, 60(4), 378-388. doi:10.1111/ jir.12256 Smith, R. J. (i998). Transmitting tradition by the rules: An anthropological interpretation of the iemoto system. In Singleton, J. Learning in likely places: Varieties of apprenticeship in Japan. Cambridge, UK: Cambridge University Press. Wilcock, A. (2005). Occupational science: Bridging occupation and health. Canadian Journal of Occupational Therapy 72 (1): 5–12. Yerxa, E., Clark, F., Jackson, J., Parham, D., Pierce, D., Stein, C., et al. (1989). An introduction to occupational science, A foundation for occupational therapy in the 21st century. Occupational Therapy in Health Care, 6 (4), 1-17.

Congratulations to the FOTA The Myra McDaniel Endowed Scholarship Award Winner Sarah Gaies, OT Graduate of the University of Florida Provided through The American Occupational Therapy Foundation (AOTF) The Myra McDaniel Scholarship: Scholarships awarded to students in good standing attending an accredited occupational therapy educational program located in the state of Florida. Must be a member of the Florida Occupational Therapy Association.

Congratulations to the Lela Llorens Endowed Scholarship Kerissa Acetta, Unversity of Arkansas. Also funded through seed money provided in 2017: Awarded to Candidates who have shown outstanding leadership in the Student Occupational Therapy Association on their campus and as a member of the Black Occupational Therapy Association and/or Caucus on their campus, in their state, or at the national level. Find out more about Scholarships 24

focus â&#x20AC;¢ Spring 2019

Meet your SIS Team!

PSC Coordinator

Administration

Dev. Disabilities

Education

Fieldwork Education

Ricardo C. Carrasco,

Michael Steinhauer,

Kathleen Frahm,

Kurt K. Hubbard, OTD,

Linda Struckmeyer,

PhD, OTR/L, FAOTA

MPH, OTR/L, FAOTA

MBA, OTR/L

PhD, OTR/L, FAOTA

PhD, OTR/L

Gerontology Co-Chair

Health/Wellness

Home & Health

Mental Health

Anjali K. Parti,

Annette Bullard, COTA

Marcia Hamilton,

Amanda Kotolski,

Mirtha Montejo

OTD, MSHS, OTRL. BCP

Ph.D, OTR/L

Whaley ,PhD, OTR/L

OTD, OTR/L

Occupational Science

Physical Disabilities

Research CO-SIS

Research Co-SIS

School Systems

Ricardo C. Carrasco,

Kristin Antolino,

Annemarie Connor,

Sarah Fabrizi,

Kim McKinney

PhD, OTR/L, FAOTA

MOT, OTR/L

PhD, OTR/

PhD, OTR/L

MPT, MOT, OTR/L

Sensory Integration

Technology

Work Programs

Gustavo A. Reinoso,

Rick D. Davenport,

Regina Bonynge,

PhD, OTR/L

OTR/L, CWCE, CEAS

focus • Spring 2019

Claudia Allen and the Cognitive Disabilities Model Mirtha M. Whaley, PhD, MPH, OTR/L, Chair Mental Health Special Interest Section On February 25 of this year, occupational therapy lost a leader of our profession, a pioneer who worked tirelessly since the late 1960’s with a group of committed therapists, on behalf of individuals who experience the challenges of mental illness. Originally working through Claudia K. Allen, MA, OTR, FAOTA the Allen Cognitive Network (ACN), several of the founding members have more recently formed the Allen Cognitive Group to promote and support use of the Allen’s Cognitive Disabilities Model (CDM). Their work helps us understand how mental illness and other conditions affect the global functioning of the brain, making it difficult to successfully meet the demands of a task and the task environment. Claudia’s work, originally based on Piaget’s theory of sensorimotor development, evolved over a period of more than forty years, undergoing several iterations and refinements. The 5th and most recent iteration was introduced in 2007 with changes to the administration of the Allen Cognitive Level Screen (ACLS) and the Large Allen Cognitive Level Screen (LACLS), and a shift to information processing. Through the years, the CDM changed its objectives, moving from a disability model focused on remediation at the level of the individual, to one highlighting the individual’s remaining abilities and facilitation of performance and safety through changes to the task and the individual’s contexts, to provide a “just right challenge.” 26

Through Claudia’s work, we came to understand a number of issues. Among these, are the cognitive challenges of mental illness and dementia, and the early difficulties posed by the latter, which affect functional performance and safety but are frequently undetected. Claudia helped us maintain “occupation” central to our interventions and gave us the language to both understand and explain how cognitive impairments affect functional cognition, impacting safe performance and engagement in valued roles and occupations. For all she contributed, she received the Eleonor Clarke Slagle Lectureship Award in 1986 and was recognized in 2017 as being one of 100 most influential individuals in occupational therapy. But, acceptance of the Cognitive Disabilities Model at the practice level has been slow and fraught with many myths, misconceptions, and frequently with doubt…if not disdain. Many of those myths and misconceptions are alive and well today, although the CDM is very much aligned with the World Health Organization’s definition of disability and function, and with the Occupational Therapy Practice Framework. The CDM can be used with a number of populations and in a variety of practice areas, including rehabilitation settings. However, adopting it in practice should be done with intention and care, in order to preserve its fidelity. The following are recommendations for correctly implementing the CDM in practice: 1. Reach out to a practitioner who is knowledgeable about the CDM. Several of us, myself included, became authorized instructors through a series of workshops with Claudia Allen. Additionally, there are a number of reputable videos recorded by the Allen Cognitive Group, which are useful learning tools. My personal advice is to

focus • Spring 2019 avoid student videos, which are frequently inaccurate. 2. Make sure to obtain the right tools to implement the CDM in your practice. At minimum, these should include: a. The ACLS and the LACLS (leather lacing screening tools), the latter in particular, if you work with older individuals who may have difficulty with vision or manual dexterity. b. The standardized assessment manual, Manual for the Allen Cognitive Level Screen-5 and the Large Cognitive Level Screen by Claudia K. Allen, Sarah L. Austin, et al. This manual steps you through each part of the process, including information as to when and how to provide cueing and verbal support, and how to assign a score. c. The manual you will need for “translating” the score obtained from the ACLS or LACLS, Understanding Cognitive Performance Modes: Version 1.3, by Claudia Allen, Tina Blue, et al. Note that the single score obtained with the leather lacing is meaningless, if not translated into functional performance using this manual. 3. Understand that the score obtained using the ACLS or LACLS was never intended to stand alone, but to be verified with another assessment such as the Routine Task Inventory-Expanded or the Allen Diagnostic Manual-2 (ADM2) if you’re lucky enough to have access to the manual and supplies for the craft activities. 4. Be patient, learning and becoming comfortable administering the assessment and using the CDM takes time, but it is worth it. In closing, I would like to share some of the myths, misconceptions, and misuses of the CDM which have entered my radar through my years in practice. Are any of these familiar? 1. The Allen Cognitive Disabilities Model is outdated – well, no…it has had several updates, and will not be outdated unless someone deems that information processing has become useless or that sensorimotor stages are not real. 2. You can observe a client doing ADLs and determine their cognitive status. No, not really. ADLs are overlearned, and observation of performance of a familiar task is never a good measure of cognitive function, unless there is a challenge introduced requiring new problem-solving 3. You can carry on a conversation with a client and know whether or not they are cognitively intact. Hmmmm…no. Social and conversational skills are not a good measure of functional cognition 27

4. My facility can’t afford to purchase all the ADM materials, so we use the same craft in place of the ACLS or LACLS to get a score. H m m m … the ADM was intended to validate the score on the leather lacing, not the other way around. Additionally, selection of a single task of the ADM is not a substitute for the proper use of those assessments and will give you inaccurate information as to your client’s cognitive function. 5. There is no research to support use of the model. Hmmm… not true, but I’ll let you do the looking 6. The MMSE is a better measure of cognitive function. Okay, I have a problem here. For starters, the MMSE gives you a score but doesn’t really tell you what it means, nor does it translate it into functional performance, and the MMSE is not sensitive to mild cognitive impairment (the ACLS and LACLS are). Additionally, it has been my experience that many clinicians administer and score the MMSE improperly. Our practice has grown very complex, with demands for accountability, productivity, and outcomes of care. Not assessing an individual’s functional cognition places the burden on the client, and far too frequently we determined the client is manipulative, not motivated for treatment, or not a good candidate for rehabilitation. Conversely, assessing functional cognition places the burden on the therapist to have accurate information about the client to develop a reasonable treatment plan. I found that using the CDM allowed me to meet my clients where they were and to deliver treatment that was clientcentered, occupation-based, and had realistic goals. I challenge you to try. As for me, I am grateful for Claudia’s work and thankful that I was able to learn from her. 1987 Eleonor Clarke Slagle Lecture: Allen, C. (1987). Activity: Occupational Therapy’s Treatment Method. The American Journal of Occupational Therapy,41(9), 563-579.

EXECUTIVE BOARD President: Brent Cheyne, OTD, OTR/L president@Flota.org Vice President: Debra Misrahi, DrOT,OTR/L dpmotr@aol.com Treasurer: Kathleen Frahm, MBA, OTR/L frahmk@bellsouth.net Secretary: Elise Bloch, Ed.D., OT/L ebloch@nova.edu STANDING COMMITTEE CHAIRS: Governmental Affairs: Kelly Uanino, OTRL, CLT-LANA & Sharon Rosenberg, M.S., OTR/L GovAffairs@Flota.org Member Concerns: André Johnson COTA/L, BHS anjohnson@keiseruniversity.edu Practice SIS: Ricardo Carrasco PhD, OTR/L, FAOTA rc1265@nova.edu Regional Reps:Dana Dixie, OTR/L ddixie@southuniversity.edu Conference Convener: Tia Hughes, DrOT, MBA, OTR/L tia.hughes@adu.edu AOTA Rep (FL): Dr Edwin Myers, OTD, OTR/L emyers@fgcu.edu REGIONAL REPRESENTATIVES: Region 1 North West: OPEN Region 2 Sylvia Young, OTR/L

sylvia.young@tmh.org

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juliewOTR@outlook.com

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krathgeber@usa.edu

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