Delivery Of Occupational Therapy Services Research Articles

From individual to inclusive: exploring the spectrum of service delivery models in occupational therapist—teacher collaborations

AbstractCollaborative practice between teachers and occupational therapists is promoted as best-practice to support the inclusion of students with disabilities in mainstream classrooms. However, interprofessional practice across the disciplines of education and health is complicated, and success is mediated by personal, professional, and system factors. This qualitative ethnographic study used shadowing, contextual conversations, and interviews to explore collaboration between teachers (n = 11) and occupational therapists (n = 10) in mainstream primary schools (n = 10) in three Australian states to better understand how context impacts practice. Findings reveal that collaborative practice is influenced both by the model of occupational therapy service delivery employed as well as professional differences between teachers and therapists. A move from itinerant to embedded models of service delivery may support collaboration and help bridge differences between professionals through improved communication and mutual professional development.

Occupational Therapy Practice Guidelines for Autistic People Across the Lifespan.

Occupational therapy practitioners need evidence to support interventions that promote subjective well-being among autistic people and their families through optimal engagement and participation in occupations. These Practice Guidelines are informed by systematic reviews to expand knowledge of interventions that promote access, inclusion, engagement, and optimal participation in occupations that are meaningful to autistic people. Our intent was to foster occupational therapy practitioners' clinical decision-making and reasoning when working with autistic people and their care partners. These Practice Guidelines were developed on the basis of four systematic reviews, supporting evidence and literature, along with continued revisions and integration through an iterative and collaborative process. A total of 98 articles were included in the systematic reviews, which are the foundation for practice recommendations in these guidelines. Forty-eight of the systematic review articles were used to inform the clinical recommendations included in these Practice Guidelines. Strong to moderate evidence indicates the need for multidisciplinary, goal-oriented interventions to support autistic people in different contexts. Although there is only emerging evidence in the inclusion of autistic people's strengths, interests, and perspectives to guide occupational therapy interventions, such practices can enhance the delivery of neurodiversity-affirming and trauma-informed practices. In addition, evidence is needed to support participation in activities of daily living (ADLs) for autistic youths. We recommend the use of strengths-based language to describe autistic people and the use of environmental adaptations, care partner education, and coaching to enhance occupational therapy service delivery. Plain-Language Summary: The literature is sparse regarding neurodiversity-affirming and trauma-informed practices for autistic youths, as well as for participation in activities of daily living (ADLs). These Practice Guidelines provide new information on positive mental health development; self-determination; ADLs, instrumental ADLs, play, and leisure occupations for children, adolescents, and adults; person-centered planning for adolescents and adults; and rest and sleep. Information on health management is also provided. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel etal., 2021; Kenny etal., 2016). However, we respect the use of person-first language and have made a conscious decision to include research articles that have used this language.

Experiências vividas por cuidadores em terapia ocupacional por meio de telessaúde no meio de uma pandemia

Abstract Within the context of the COVID-19 pandemic, telehealth was seen to be a viable and alternative solution to provide occupational therapy services in the Philippines. This phenomenological study aimed to describe the lived experiences of Filipino parents and carers in receiving occupational therapy through telehealth for their children with disabilities. We interviewed 10 participants who were considered primary carers of a Filipino child with disabilities undergoing telehealth during the COVID-19 pandemic situation. An interpretative phenomenological analysis involving double hermeneutics was employed to analyze the interviews that yielded four themes: “dimensions of telehealth in occupational therapy”, “reinforcing family-centered occupational therapy”, “emphasizing an occupational therapist’s advocacy role”, and “telehealth in occupational therapy–today and tomorrow”. Our findings suggest that in order for telehealth to be a sustainable service, it should be seen not merely as an alternative in the occupational therapy service delivery process. Although telehealth remains to be an evolving concept and practice within health services, telehealth must be practiced within the principles of family-centered care approaches, interprofessional collaboration, and health accessibility and equitability. This study hopes to facilitate intersections between service providers and service users to cultivate a shared goal of bringing together experiences that will inform a more contextualized occupational therapy and telehealth practice at the tail-end of the pandemic. In conclusion, telehealth in occupational therapy shall not be an alternative, but an integrative tool that occupational therapists can maximize to transform occupational therapy access and equity.

Experiences of ‘virtual’ occupational therapy service delivery in Wales

Introduction: COVID-19 accelerated the implementation of virtual working at pace, which carries the risk of missed opportunities for shared learning across organisations and services. This study therefore investigated the experiences of ‘virtual working’ among occupational therapy (OT) staff and students in Wales. The objectives were to establish the meaning of virtual working for occupational therapists (OTs), identify the perceived advantages and disadvantages of the technologies used to support virtual working and explore the specific contextual factors that impact on service delivery. Method: An online questionnaire was completed by 191 registered and unregistered OT staff and students working in Wales, and 11 semi-structured interviews were conducted in a convergent mixed methods design. Results and Findings: The questionnaire data confirmed that the use of virtual working has increased and impacts all areas of service delivery. The semi-structured interviews identified three themes: the art of OT, keeping doors open and looking forward. Conclusion: Virtual working can improve access to services, but one size does not fit all and its use in person centred care should be carefully considered. Virtual working should not compromise high quality service provision and the risks of virtual working to staff’s mental and physical health needs to be considered.

Patient Consumerism and Its Influence on the Future of Occupational Therapy.

The cost of care is shifting to the individual in the form of high-deductible health plans and health savings accounts. The public demands and expects innovation in health care and health delivery and is using quality and cost data to make purchasing decisions. Public expectations for convenience are demonstrated in the use of walk-in clinics, telemedicine, and other technologies. As a result of the responsibility for paying and managing one's own health, consumerism involves a curated approach to selecting health services. This Health Policy Perspectives column examines how consumerism influences health care policy, in particular occupational therapy service delivery. Issues that consumerism creates include (1) a lack of publicly shared cost and quality data about occupational therapy; (2) confusion in measurement of client-centered care, patient satisfaction, and patient experience; (3) inadequate incorporation of patient shared decision-making throughout the occupational therapy process; and (4) payment model restrictions in service delivery. Occupational therapy practitioners must help consumers learn, through patient shared decision-making, that occupational therapy is evidence based and produces desired outcomes, thereby both improving the quality and lowering the cost of health care. Occupational therapy practitioners must advocate for lower cost and convenient service options in the community through an array of technologies. Practice scholarship of the clinical doctorate in occupational therapy must focus on conducting consumer research related to patient experience; enhancing service delivery through quality improvement; and innovating practice for new sites and methods of service delivery, including the use of technology.

Current Practice in Occupational Therapy for COVID-19 and Post-COVID-19 Conditions.

The onset of the pandemic highlighted the need for a review of rehabilitation practices to ensure coordinated, effective, and efficient services for people affected by COVID-19. This paper reports on a global survey highlighting the delivery of occupational therapy services to people with COVID-19/post-COVID-19 condition (PCC) and makes recommendations to facilitate quality service delivery for this population. An online cross-sectional descriptive survey was developed and distributed to the global occupational therapy community via member organisations and communication channels of the World Federation of Occupational Therapists to collect information for this study. The survey obtained qualitative and quantitative data from respondents who were occupational therapists or occupational therapy assistants regarding (i) demographic characteristics, (ii) work experience with persons with COVID-19 and PCC, (iii) modes of working, (iv) education and training, (iv) occupational therapy intervention provided to persons with COVID-19 and PCC, and (v) the perceived quality of the occupational therapy services provided. Findings indicate that respondents provided a range of occupational therapy interventions for people affected by COVID-19/PCC aligned with evidence-based practice guidelines. While respondents identified a strong role for occupational therapy and generally rated their services as effective, issues related to the accessibility of their services impacted quality and user satisfaction. The study highlighted the need to advocate for access to occupational therapy to facilitate engagement in desired and needed occupations for COVID-19 survivors. Other recommendations emerging from the findings include the need to develop, disseminate, and use research evidence for guiding services for people with COVID-19/PCC, create quality service standards, and ensure the availability of necessary resources and supports such as referral pathways and screening criteria, availability of staff, training, personal protective equipment, and assistive devices and technology.

Parent Satisfaction With a Telehealth Parent Coaching Intervention to Support Family Participation.

COVID-19 catalyzed telehealth practice creating opportunities for clients and providers to discern best applications. Parent satisfaction with services supports partnership within therapy processes, potentially augmenting outcomes. We examined parent satisfaction levels and experiences with the telehealth approach of a parent coaching intervention for families of children with special health care needs (CSHCNs). We used a mixed-methods descriptive design. Fifteen parents completed the Telehealth Usability Questionnaire (TUQ) and a semistructured interview. We analyzed TUQ ratings using descriptive statistics, and we thematically analyzed participants' telehealth experiences. Parents found telehealth useful, easy to use, effective, reliable, and satisfactory. Parents described that telehealth addressed needs conveniently, enhanced parent-provider communication, and fostered shared parent involvement. Telehealth appears to be a satisfactory occupational therapy service delivery approach for parents of CSHCN. Findings build preliminary evidence for understanding for whom telehealth is well suited, supporting determination of relevant, fundable telehealth services.

Occupational Therapy and COVID-19: How the Transition to Telehealth Has Affected Outcomes for Children: A Systematic Review

ABSTRACT This systematic review aimed to evaluate the evidence for the outcomes of telehealth occupational therapy service delivery versus traditional in-person service delivery for children during the peak of the COVID-19 pandemic. Using three academic databases, a search string including the following keywords, telehealth, occupational, and child, returned 825 articles. Five articles were selected for full-text review after screening and employing the inclusion/exclusion criteria. A quality appraisal was completed, leaving two articles in this systematic review. Researchers found that moderate evidence supports the use of telehealth to disseminate occupational therapy service delivery. Researchers also found substantial evidence that supports the use of telehealth in overall satisfaction with services compared to traditional in-person therapy services. This systematic review confirms that telehealth has improved access to occupational therapy services. Further research needs to be conducted on the efficacy of specific interventions in the telehealth setting.

A Depiction of Handwriting Intervention Guideline for Children with Handwriting Difficulties in Malaysia

Handwriting skill is the major occupational therapy intervention executed by occupational therapists who are working with children. This article aims to describe a newly developed handwriting intervention guideline for occupational therapy service delivery in Malaysia. The handwriting intervention guideline is set up to be applicable for children aged four to nine years. The guideline is presented to support children with handwriting issues in terms of handwriting readiness and writing criteria specifically on capitals, lowercase, and numbers. This article provides a description of the handwriting intervention guideline such as the rationale of this guideline, content structure, and activity modules to guide clinical practice. The guideline has been implemented on a group of children with pre- and post-measures. The outcome findings are demonstrated to show the viability of the guideline to be used by occupational therapy practitioners. This depiction of handwriting intervention guidelines is expected to assist occupational therapy practitioners in conducting handwriting intervention for children to suit our socio-cultural background and educational system.

A review of occupational therapy services within an acute public tertiary hospital in KwaZulu-Natal, South Africa

INTRODUCTION: The provision of occupational therapy services in providing a minimum essential service in public health institutions in South Africa are currently guided by a quality control measure by the National Department of Health. AIM: To review the occupational therapy services in an acute, public tertiary hospital from 2015-2019 and to compare this with the expectations of these services in a tertiary hospital to identify potential gaps in service delivery. METHOD: A single site, retrospective quantitative audit from 2015-2019 was completed at one tertiary hospital. Patient-related and occupational therapy service data were included. 18579 patient entries were captured. The analysis included descriptive and inferential statistics of mean, standard deviations, frequency tables, percentages, and ANOVA. RESULTS: Findings indicated a consistent decline in the mean values of, the number of therapists attending to patients, number of patients, assistive devices issued, total time of patient units and consultations, total time spent on ward rounds, clinics, and meeting attendance. The number of student therapists attending to patients, splints, pressure garments and issued wheelchairs showed an increase in trend across the reviewed years. CONCLUSION: Inadequate human resources and budget systems are potential gaps in occupational therapy service delivery in an acute public tertiary hospital.

Occupational therapists' perspectives on the impact of COVID-19 lockdowns on their clients in Gauteng, South Africa - a qualitative retrospective study

INTRODUCTION: In March 2020, the South African government responded to the threat of the COVID-19 pandemic by issuing a national lockdown, calling a halt to all non-essential services and movements, including most occupational therapy services. Occupational therapy clients had no access to treatment during this time and may have experienced occupational injustices. AIM: We explore occupational therapists' perceptions of the influence of COVID-19 lockdowns on rehabilitation clients in Gauteng, South Africa. METHODOLOGY: We analysed secondary data collected in July 2020. The original qualitative study assessed occupational therapists' perceptions of the influence of COVID-19 on their service delivery. Sixteen occupational therapists participated in asynchronous on-online focus group discussions. The therapists worked in public and private settings in Gauteng. This study focussed on the influence of COVID-19 lockdowns on clients as perceived by occupational therapists. All data relating to the influence of COVID-19 lockdowns on clients were extracted from the original dataset using ATLAS. ti and then thematically analysed using deductive reasoning. RESULTS: Five themes emerged from the data. Occupational therapists felt that clients had altered clinical presentation due to infection prevention and control measures (Theme 1). Therapists also felt that the quality of services was negatively impacted, which was detrimental for clients (Theme 2); that their clients experienced occupational injustice due to disrupted services (Theme 3) that vulnerable populations experienced the greatest challenges (Theme 4) and that clients' experienced positive impacts or benefits during the COVID-19 lockdown (Theme 5). CONCLUSIONS: In future pandemics, decision-makers need to carefully consider the impact of disrupted service delivery for occupational therapy clients, especially vulnerable populations. A syndemic approach is recommended for occupational therapy service delivery during a pandemic. Tailor-made recommendations that are needed for vulnerable populations in South Africa are proposed.

Official Documents Available From the American Occupational Therapy Association

Official documents and professional policies are approved by the AOTA Representative Assembly and undergo scheduled review and approval by the Representative Assembly Coordinating Committee (RACC). These documents are used by the Association and its membership to guide education, practice, advocacy, and policy on behalf of the profession. The documents are a valuable resource for occupational therapy practitioners and provide a solid grounding in the profession for students, consumers, and external stakeholders.Items in bold are new for 2022 and are available in this supplement to the American Journal of Occupational Therapy. Official documents are periodically reviewed, and documents may be superseded by newer versions or rescinded. A complete list of the most current documents is available at https://www.aota.org/practice/practice-essentials/aota-official-documents.Guidance documents provide comprehensive perspective and guidance on topics that shape advancement of the profession and its future direction. ▪ Guidelines for Documentation of Occupational Therapy (2018)▪ Guidelines for Occupational Therapy Services in Early Intervention and Schools (2017)▪ Guidelines for Reentry Into the Field of Occupational Therapy (2020)▪ Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services (2020)▪ Occupational Therapy Practice Framework: Domain and Process, 4th Edition (2020)▪ The Practice of Occupational Therapy in Feeding, Eating, and Swallowing (2017)▪ A Descriptive Review of Occupational Therapy Education (2016)▪ Scholarship in Occupational Therapy (2022)Position statements present an official stance on the provision of services, practice of occupational therapy, or role of occupational therapy. They are developed in response to a professional issue, concern, or need. ▪ COE Academic Terminal Degree (2022)▪ Assistive Technology and Occupational Performance (2016)▪ Autism Spectrum Disorders Across the Life Course and Occupational Therapy Services (2022)▪ Cognition, Cognitive Rehabilitation, and Occupational Performance (2019)▪ Continuing Professional Development in Occupational Therapy (2016)▪ Driving and Community Mobility (2016)▪ Fieldwork Level II and Occupational Therapy Students (2018)▪ Importance of Collaborative Occupational Therapist-Occupational Therapy Assistant Intraprofessional Education in Occupational Therapy Curricula (2017)▪ Importance of Interprofessional Education for Occupational Therapy (2022)▪ Importance of Primary Care Education in Occupational Therapy Curricula (2017)▪ Inclusive Environments: Home, Work, Public Spaces, Technology, and Specialty Environments (2022)▪ Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice (2017)▪ Occupational Therapy and Complementary Health Approaches and Integrative Health (2016)▪ Occupational Therapy Doctoral Capstone: Purpose and Value (2022)▪ Occupational Therapy Fieldwork Education: Value and Purpose (2022)▪ Occupational Therapy for Children and Youth Using Sensory Integration Theory and Methods in School-Based Practice (2015)▪ Occupational Therapy in the Promotion of Health and Well-Being (2019)▪ Occupational Therapy Scope of Practice (2021)▪ Occupational Therapy Services for Individuals Who Have Experienced Domestic Violence (2017)▪ Occupational Therapy Services in Facilitating Work Participation and Performance (2017)▪ Occupational Therapy Services in the Promotion of Mental Health and Well-Being (2016)▪ Occupational Therapy’s Commitment to Diversity, Equity, and Inclusion (2020)▪ Occupational Therapy’s Perspective on the Use of Environments and Contexts to Facilitate Health, Well-Being, and Participation in Occupations (2015)▪ Occupational Therapy’s Role in Case Management (2018)▪ Occupational Therapy’s Role in Medication Management (2017)▪ Occupational Therapy’s Role in the Neonatal Intensive Care Unit (2018)▪ Occupational Therapy’s Role With Chronic Conditions (2022)▪ Philosophical Base of Occupational Therapy (2017)▪ Philosophy of Occupational Therapy Education (2018)▪ Role of Occupational Therapy in End-of-Life Care (2016)▪ Role of Occupational Therapy in Pain Management (2021)▪ Physical Agents and Mechanical Modalities (2018)▪ Role of Occupational Therapy in Primary Care (2020)▪ Role of Occupational Therapy in Wound Management (2018)▪ Telehealth in Occupational Therapy (2018)▪ Value of Occupational Therapy Assistant Education to the Profession (2019)▪ Vestibular Impairment, Vestibular Rehabilitation, and Occupational Performance (2017)Professional standards describe and define minimal standards for practice, continued competence, and other professional behaviors. ▪ AOTA 2020 Code of Ethics▪ Standards for Continuing Competence (2021)▪ Standards of Practice for Occupational Therapy (2021)Societal statements are written in the form of public announcements and identify a societal issue of concern; state how the issue affects the participation of individuals, families, groups, or communities in society; and may offer action to be taken by individuals, families, groups, or communities. ▪ AOTA’s Societal Statement Denouncing Conversion “Therapy” (2022)▪ AOTA’s Societal Statement on Disaster Response and Risk Reduction (2017)▪ AOTA’s Societal Statement on Community Violence (2022)▪ AOTA’s Societal Statement on Gun Violence (2022)▪ AOTA’s Societal Statement on Health Disparities (2013)▪ AOTA’s Societal Statement on Health Literacy (2016)▪ AOTA’s Societal Statement on Livable Communities (2016)▪ AOTA’s Societal Statement on Stress, Trauma, and Posttraumatic Stress Disorder (2017)▪ AOTA’s Societal Statement on Youth Violence (2016)▪ Specialized Knowledge and Skills of Occupational Therapy Educators of the Future (2009)

Elizabeth Casson Memorial Lecture 2022: Optimising performance, clinical and economic outcomes in occupational therapy service delivery

The rise in health and social care costs has prompted a critical look at the way health and social care services are managed and delivered. There has been a significant change in assessing the performance and evaluating the outcomes of services. Where once only performance outcome data related to service efficiency were required, now evidence of clinical effectiveness and cost-effectiveness is demanded. When evaluating the outcomes of service delivery, it is important to measure performance outcomes (related to service efficiency), clinical outcomes (related to service effectiveness) and economic outcomes (related to cost-effectiveness). This lecture examines the interdependent relationship between performance, clinical and economic outcomes in service delivery which is underpinned by strong leadership, the application of various service improvement strategies and collaborative research between managers, clinicians, researchers and health economists, with patient and public involvement. Service improvement strategies based on practice-based and research-based evidence will be suggested to optimise performance, clinical and economic outcomes. My lecture concludes that occupational therapists should adopt these service improvement strategies and conduct clinical researches and economic evaluations to develop an efficient, effective and cost-effective service which can meet the client’s needs by using allocated resources and is value for money from a commissioning perspective.

Application of the ICF and OTPF-4 to Conceptualize the Dual Diagnosis of COVID-19 and Stroke: Implications for Occupational Therapy Practice in Acute and Inpatient Rehabilitation

There is mounting evidence that the vascular manifestations associated with COVID-19 are linked to ischemic strokes. The emergence of patients with both COVID-19 and cerebrovascular accidents (COV-CVA) has created a need to adjust occupational therapy service delivery for inpatients with this dual diagnosis. This clinical perspective paper conceptualizes COV-CVA as a health condition using the International Classification of Functioning, Disability and Health Framework (ICF). The Occupational Therapy Practice Framework-4 was used to guide clinical considerations and recommendations for the evaluation, intervention, and discharge planning of patients with COV-CVA.

Addressing Pelvic Floor Dysfunctions in Older Women

Women’s pelvic health has become an emerging practice area for occupational therapy in recent years. The National Institute of Health (NIH) reports that 24% of women in the United States are impacted by pelvic floor disorders (2008). As the general population ages, older women’s health has become a pivotal topic for occupational therapists to include as part of a comprehensive plan of care. Occupational therapists must acquire deeper knowledge related to pelvic pain and urinary incontinence. Developing a deeper understanding of the types of pain and urinary incontinence in older women facilitates efficacy and efficiency in the delivery of occupational therapy services for these women. Evidence strongly supports the interdisciplinary approach between biomechanical and psychosocial interventions to address pelvic health issues in a holistic manner.

Official Documents Available From the American Occupational Therapy Association.

Official documents and professional policies are approved by the AOTA Representative Assembly and undergo scheduled review and approval by the Representative Assembly Coordinating Committee (RACC). These documents are used by the Association and its membership to guide education, practice, advocacy, and policy on behalf of the profession. The documents are a valuable resource for occupational therapy practitioners and provide a solid grounding in the profession for students, consumers, and external stakeholders.The Representative Assembly adopted the RACC Standard Operating Procedures, Attachment A, at the fall online meeting in November 2020. As a result of this motion, the types of official documents have been renamed and are categorized and described below.Items in bold are new for 2021 and are available in this supplement to the American Journal of Occupational Therapy. Official documents are periodically reviewed, and documents may be superseded by newer versions or rescinded. A complete list of the most current documents is available at https://www.aota.org.Guidance documents provide comprehensive perspective and guidance on topics that shape advancement of the profession and its future direction. Guidelines for Documentation of Occupational Therapy (2018)Guidelines for Occupational Therapy Services in Early Intervention and Schools (2017)Guidelines for Reentry Into the Field of Occupational Therapy (2020)Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy Services (2020)Occupational Therapy Practice Framework: Domain and Process, 4th Edition (2020)The Practice of Occupational Therapy in Feeding, Eating, and Swallowing (2017)A Descriptive Review of Occupational Therapy Education (2016)Scholarship in Occupational Therapy (2016)Position statements present an official stance on the provision of services, practice of occupational therapy, or role of occupational therapy. They are developed in response to a professional issue, concern, or need. Academic Terminal Degree (2017)Assistive Technology and Occupational PerformanceCognition, Cognitive Rehabilitation, and Occupational Performance (2019)Complex Environmental Modifications (2015)Continuing Professional Development in Occupational Therapy (2016)Driving and Community Mobility (2016)Fieldwork Level II and Occupational Therapy Students (2018)Importance of Collaborative Occupational Therapist-Occupational Therapy Assistant Intraprofessional Education in Occupational Therapy Curricula (2017)Importance of Interprofessional Education in Occupational Therapy Curricula (2015)Importance of Primary Care Education in Occupational Therapy Curricula (2017)Mental Health Promotion, Prevention, and Intervention in Occupational Therapy Practice (2017)Obesity and Occupational Therapy (2013)Occupational Therapy and Complementary Health Approaches and Integrative Health (2016)Occupational Therapy Fieldwork Education: Value and Purpose (2016)Occupational Therapy for Children and Youth Using Sensory Integration Theory and Methods in School-Based Practice (2015)Occupational Therapy in the Promotion of Health and Well-Being (2019)Occupational Therapy Scope of Practice (2021)Occupational Therapy Services for Individuals Who Have Experienced Domestic Violence (2017)Occupational Therapy Services in Facilitating Work Participation and Performance (2017)Occupational Therapy Services in the Promotion of Mental Health and Well-Being (2016)Occupational Therapy’s Commitment to Diversity, Equity, and Inclusion (2020)Occupational Therapy’s Perspective on the Use of Environments and Contexts to Facilitate Health, Well-Being, and Participation in Occupations (2015)Occupational Therapy’s Role in Case Management (2018)Occupational Therapy’s Role in Medication Management (2017)Occupational Therapy’s Role in the Neonatal Intensive Care Unit (2018)Philosophical Base of Occupational Therapy (2017)Philosophy of Occupational Therapy Education (2018)Role of Occupational Therapy in End-of-Life Care (2016)Role of Occupational Therapy in Pain Management (2021)Physical Agents and Mechanical Modalities (2018)Role of Occupational Therapy in Primary Care (2020)Role of Occupational Therapy in Wound Management (2018)Scope of Occupational Therapy Services for Individuals With An Autism Spectrum Disorder Across The Life Course (2015)Telehealth in Occupational Therapy (2018)Value of Occupational Therapy Assistant Education to the Profession (2019)Vestibular Impairment, Vestibular Rehabilitation, and Occupational Performance (2017)Professional standards describe and define minimal standards for practice, continued competence, and other professional behaviors. AOTA 2020 Code of EthicsStandards for Continuing Competence (2021)Standards of Practice for Occupational Therapy (2021)Societal statements are written in the form of public announcements and identify a societal issue of concern; state how the issue affects the participation of individuals, families, groups, or communities in society; and may offer action to be taken by individuals, families, groups, or communities. AOTA’s Societal Statement on Disaster Response and Risk Reduction (2017)AOTA’s Societal Statement on Health Disparities (2013)AOTA’s Societal Statement on Health Literacy (2016)AOTA’s Societal Statement on Livable Communities (2016)AOTA’s Societal Statement on Stress, Trauma, and Posttraumatic Stress Disorder (2017)AOTA’s Societal Statement on Youth Violence (2016)

Occupational Therapy Service Delivery Among Medicaid-Enrolled Children and Adults on the Autism Spectrum and With Other Intellectual Disabilities.

Rates of occupational therapy service utilization among people with autism spectrum disorder (ASD) or intellectual disability (ID) have not been explored in population-based samples. To describe occupational therapy services delivered to Medicaid-eligible persons younger than age 65 yr identified as having ASD, ID, or both and to evaluate demographic factors associated with occupational therapy service utilization in this population. Retrospective, case-control, cohort study using claims records from Medicaid Analytic eXtract files (2009-2012). Data from all 50 states and Washington, DC. Beneficiaries identified as having ASD only, ASD+ID, or ID only who were younger than age 18 yr (N = 664,214) and ages 18-64 yr (N = 702,338). Outcomes and Measures: We analyzed Current Procedural Terminology® and Healthcare Common Procedure Coding System procedure codes, Medicaid Statistical Information System type of service codes, and Center for Medicare & Medicaid Services provider specialty codes. Only 3.7% to 6.3% of eligible adult beneficiaries received occupational therapy; in contrast, 20.5% to 24.2% of children received occupational therapy. Significant predictors of service use varied by group; however, differences by race-ethnicity, eligibility on the basis of poverty, and geographic location were observed. Among children, the most frequent billing code was for "therapeutic activities" (43%-60%); among adults, it was "community/work reintegration training" (29%-39%). Billed procedure code patterns do not consistently reflect the unique occupational focus that occupational therapy providers deliver to people with developmental disabilities. Disparities in occupational therapy receipt warrant further attention to understand the social and structural factors affecting service delivery. What This Article Adds: Occupational therapy services paid for by Medicaid are used more frequently by children with ASD and ID than by adults with these diagnoses. Greater understanding of the intersectional factors that drive service delivery and disparities is needed.

Higher Frequency of Acute Occupational Therapy Services Is Associated With Reduced Hospital Readmissions.

Hospital readmissions are associated with poor patient outcomes, including higher risk for mortality, nutritional concerns, deconditioning, and higher costs. To evaluate how acute occupational therapy service delivery factors affect readmission risk. Cross-sectional, retrospective study. Single academic medical center. Medicare inpatients with a diagnosis included in the Hospital Readmissions Reduction Program (HRRP; N = 17,618). Data were collected from medical records at a large urban hospital in southeastern Wisconsin. Outcomes and Measures: Logistic regression models were estimated to examine the association between acute occupational therapy service delivery factors and odds of readmission. In addition, the types of acute occupational therapy services for readmitted versus not-readmitted patients were compared. Patients had significantly higher odds of readmission if they received occupational therapy services while hospitalized (odds ratio [OR] = 1.18, 95% confidence interval [CI] [1.07, 1.31]). However, patshients who received acute occupational therapy services had significantly lower odds of readmission if they received a higher frequency (OR = 0.99, 95% CI [0.99,1.00]) of acute occupational therapy services. A significantly higher proportion of patients who were not readmitted, compared with patients who were readmitted, received activities of daily living (ADL) or self-care training (p < .01). For patients with HRRP-qualifying diagnoses who received acute occupational therapy services, higher frequency of acute occupational therapy services was linked with lower odds of readmission. Readmitted patients were less likely to have received ADL or self-care training while hospitalized. What This Article Adds: Identifying factors of acute occupational therapy services that reduce the odds of readmission for Medicare patients may help to improve patient outcomes and further define occupational therapy's role in the U.S. quality-focused health care system.

Standards of Practice for Occupational Therapy.

This document defines minimum standards for the practice of occupational therapy. According to the Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF-4), occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations (i.e., the client) for the purpose of enhancing or enabling participation. . . . Occupational therapy services are provided for habilitation, rehabilitation, and promotion of health and wellness for clients with disability- and non-disability-related needs. These services include acquisition and preservation of occupational identity for clients who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. (American Occupational Therapy Association [AOTA], 2020c, p. 1).

Integrated Services or Pullout? Factors Influencing School-based Occupational Therapy Service Delivery Models

ABSTRACT Historically, school-based occupational therapists have used more pullout than integrated therapy. Recent trends for therapy provision in regular classrooms may be a catalyst for changing practice patterns. This study examined current school-based Occupational Therapy delivery methods and perceived barriers to integrated services. Mixed methods. School-based occupational therapists (n = 61) and occupational therapy assistants (n = 2) in Colorado and Utah. Therapists completed an online survey. A subset of therapists (21 occupational therapists, 1 occupational therapy assistant) were interviewed. Descriptive statistics described survey data, with correlations calculated between potential moderator variables and the amount of integrated services. Interviews were coded for themes. Therapists provided 40% of services in an occupational therapy area (pullout services). Therapists favored integrated services for some children but reported the following system barriers to its use: lack of education and training for integrated services, meeting individual student needs, perceived high caseloads and workloads, the variability in the school environments and the relationships and attitudes within the schools. Therapists reported more use of integrated services since previous studies but continue experiencing barriers to its use as a primary service model.