What is OT?
 

Occupational Therapy is skilled treatment that helps individuals achieve independence. Services include:

• Customized treatment programs aimed at improving abilities to carry out activities of daily living
• Comprehensive evaluation of home and job environments and recommendations on necessary adaptation
• Assessments and treatment for work performance skills
• Recommendations and training in the use of adaptive equipment to replace lost function
• Instructions to family members and attendants in safe and effective methods of caring for individuals

• people with work related injuries
• People who have had a stroke or heart attack
• People with arthritis, multiple sclerosis or other serious illness
• Children with birth injuries, learning problems or developmental disabilities
• People with mental health problems
• People with substance abuse problems and eating disorders
• People with burns, spinal cord injuries, or amputations
• People with broken bones or other injuries from sports, fall or accidents

•  Safe feeding of the patients
• Proper nutrition of patients
• Positioning
• Adaptive silverware or glasses
• Alternative communication equipment
• Memory tools
• Sequencing, problem solving and motor planning

• Arthritis
• Orthopedic (hip and knee replacements, fractures)
• Paralysis
• Burns

• ASHA defines 12 roles of a Speech-Language Pathologist in swallowing, but does not state they are the only professionals qualified to provide dysphagia assessment, evaluation and treatment.
 Feeding vs. swallowing
Feeding – getting the food into the mouth, manipulation of the bolus (chewing) and the oral stage
Swallowing – the oral pharyngeal and esophageal stages including swallow reflex and airway protection.
• Varies in settings
• Tends to be that the OT treats feeding more than swallowing
• Can be that the OT is the primary professional in dysphagia management
• Type and degree of education regarding swallowing
• Very basics provided in school
• Can attend continuing education courses to receive more training
• Typical types of responsibilities
• Adaptive feeding
• Adaptive seating/positioning
• Sample Goals
• Positioning:  Resident will learn to position self in (bed/wc/chair) for feeding activity with ___ assist or independence.
• Step Sequencing from hand to mouth:  Resident will bring utensil from plate to mouth with ___ assist/independence.

• Used to assist a person in dressing, feeding, housekeeping and other home management activities,

 caring for children, grooming , etc.
• List of  SOME adaptive equipment:

     sock aid    plate with guard   bathmit
    dressing stick   nonskid mats   scoop dish
     reacher    long plastic straws  weighted wrist cuffs
     buttonhooks   pan stabilizer   long handled bathsponge
     weighted silverware  lever for doorknobs  utensils with cuffs
     nosey cups   electric scissors   spray can adapters
     rocking knife   writing aids   mats and bars in tub
     swivel spoon   telephone clip holders  soap on a rope
•  Work Simplification:  any technique used to make a clients life or work easier

 Includes techniques such as:
      always plan ahead
      use proper work heights
      use carts to transport groceries, laundry, etc.
      use time and energy saving equipment (electric razor, electric mixer, etc.)
      organize work centers and storage areas
      use strategies for simplifying care of young children
      incorporate any adaptive equipment as needed
      use proper positioning at all times
      find a natural pace that fits your work the best
      use relaxation techniques, both mental and physical

LINKS

• American Occupational Therapy Association

Equipment For Improving Independent Living
 

REFERENCES

CMS Therapies, Dysphagia Manual; OT Role/Responsibility

Class notes from CD 5530:  Swallowing Disorders in Adults and Children.  Summer 1997.  Appalachian State University. Boone, NC.

 “Knowledge and skills needed by Speech-Language Pathologists Providing Services to Dysphagic Patient/Clients”  American Speech-Language-Hearing Association Task Force on Dysphagia.  Adopted November, 1989.

Pedretti, L.W. & Zoltan, B., 1990.  Occupational Therapy:  Practice Skills for Physical Dysfunction.  The C.V. Mosby Company.  St. Louis, Missouri

“What is Occupational Therapy?”, 1994 brochure from The American Occupational Therapy Association, Inc., Rockville, MD

Occupational Therapists Consulted:

•  Brenda Kennell, MA, OTR/L, Professor at Lenoir-Rhyne College, Hickory, NC
• Mary Rinas, OTR/L, Menorah Park Center for the Aged, Beachwood, OH
• Lyn Wyble, OTR/L, Thoms Rehab, Asheville, NC