April is OT Month!

Demystifying OT and Celebrating its Distinct Value

Occupational Therapy is a unique profession that is often misunderstood. This is in-part due to the fact that the role of the OT can vary significantly among treatment settings and populations. But it is also because many OTs don’t have a concise “30 second elevator speech” that clearly defines the profession.

Case in point: Whether working with children, adults, or geriatric populations, the primary role of Physical Therapy is to addressmovement including gait/ambulation, strength, balance, pain management and tissue healing through physical means. This definition fits across treatment settings whetherthe PT is treating in the home, school, hospital,acute or subacute care, or outpatient settings.

However, when we consider OT across the lifespan and various treatment settings, the focuscan greatly differ as evident in the table below:

Early Intervention (0-3)Development of reflexes, motor skills, sensory processing, feeding skills, play
School-aged childrenTactile sense, visual/spatial organization, handwriting, social skills, participation in school
AdultRegaining self-care skills after injury or illness
Mental HealthCoping strategies, habit, routines, rituals, values, goals, decision-making
Productive Agingchronic disease management, driving, dementia care, fall prevention, home modifications, self-care management, physical rehabilitation
Work and IndustryErgonomics, functional capacity assessment, employment readiness skills, community integration

While the overarching theme is activities of daily living (ADL), this manifests differentlyacross populations. Simply describing the role of OT as ADL training could mean almost anything, including the areas of treatment focus for PT. After all, bed mobility, transferring and walking all ADL. Therefore, “ADL” does not entirely identify the unique role of OT. So how do we define OT with one definition that fits all patient populations and all treatment settings?

Let’s start by clarifying what OT is not:

OT is PT for the upper bodyPT and OT address the whole body
OT is a service that helps people find jobsJob skills is a component of OT but not job finding
OT is for fine motor skills development and PT is for gross motor skills developmentFine motor skills development can be a component of OT treatment

Consider the analogy of an athlete. Regardless of the sport, most athletes undergo two types of training:

1)Cardiovascular endurance and strength training and

2) Sport specific training

  1. The cardiovascular endurance and strength training would be very similar regardless of the sport. Most athletes will typically train by running and/or cycling, and resistance training. This is PT.
  2. Sport specific training on the other hand would be very different for every type of athlete. A tennis player might work on serving, a swimmer might work on breathing technique, and a basketball player might work on free throws. All are examples of sport specific training, and all are very different. This can be compared to OT.

So what is OT? Therapy focused on overcoming dysfunction by acquiring or rehabilitating specific skills or tasks that allows a person to engage or participate in meaningful activities of daily living.

Now that we have helped to demystify OT, let’s consider OTs unique value within the medical model. OTs who practice in acute and sub-acute, inpatient settings, may experience that OT is viewed as an ancillary service to PT and not as a stand-alone discipline. Transfers and gait distance is considered a standard measure for insurance coverage determination. However, there is often little consideration made for activities that require skills beyond the use of a walker; like toileting or item retrieval from floor, closet, drawer or cabinet. The ability to perform these seemingly basic tasks can determine whether or not patients eat a nutritious meal, maintain hygiene and skin integrity, or even pick up life-saving medication that has been dropped on the floor.

As OT practitioners witness these day to day challenges of our patients, we are charged to be change agents who advocate and for the needs and rights of those we serve. A basketball player will never achieve greatness in the sport by running and strength training alone. Shooting, passing, dribbling and actually playing the game is necessary for true mastery of basketball. Conversely, OT allows patients to “play the game” and master the sport of living!

Let’s celebrate OT Month by sharing with others the distinct value of Occupational Therapy.

Melinda Butler, OTD


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