Occupational Therapy, Simply

In the burgeoning field of medicine and the allied health professions, there are many avenues for a career-minded professional to embark upon. At the same time, coupled with the ever-increasing advancement of technology and pharmacology, the health professions are becoming ever more technical and arcane in their methods. While the field of Occupational Therapy (OT) may certainly use much of this newer technology enabling clients to perform in their daily occupations, Occupational Therapy Assistants (OTA) and Occupational Therapists (OTR) can perform many interventions through much simpler methods. At its core, the field of Occupational Therapy is about using everyday activities (occupations) to facilitate health and well-being.

To summarize OT in a very basic nutshell, people learn better and recover faster when the following criteria are met: doing activities they love that are meaningful and being motivated to perform these activities through patterns of frequent use. As an example, I am much more motivated to develop my core strength by gardening as opposed to doing crunches or sitting on a wobbly ball. A child may be more motivated to develop a similar core strength by playing a game while propped up on their elbows and prone on a mat instead of gardening. I can tell you from personal experience that playing with Legos is much more fun for a ten-year-old than adding sulfur to the garlic or weeding the potatoes.

While there is much to be said for theory, research, and frames of reference, all important in their own right, I strongly advocate that the most basic and unique premise of OT is task analysis. Succinctly, task analysis is exactly what it sounds like. A particular task is broken down into all possible constituent parts from the simple physical mechanics to the more nebulous idea of cognition and awareness and even extending into the broad and diffuse implication of contexts, such as one’s culture. An example may be in order. Let us examine writing a letter to grandma thanking her for the wonderful loving kindness she offers in a cruel and heartless world . . . or for that $500 she was kind enough to let you borrow. Task analysis would dissect the act of writing into a number of factors including such items as shoulder stability and strength, fine motor control, visual scanning of the paper, the endurance it takes to sit up straight, cognitive ability to form sentences, syntax abilities, letter formation and recall, awareness of predicting word length, ability to focus on the task, and a whole host of other abilities many of us take for granted when completing something rather simple. This is task analysis: looking at everything that goes into even the simplest task.

From this, an OTA can derive interventions. Let us generate an example by way of a child named Eustace. (I’m sure that name will be stylish within 20 years.) Eustace does not like writing in school because it is difficult and boring. After testing and observation, we see that his pencil grip is not the most effective or efficient. He, like yours truly, has a “thumb wrap” style of writing, which causes his hand to fatigue easily. It is plain to see that Eustace has not fully developed the most advanced fine motor grip, “the tripod grasp”, and he has been sent to OT in order to improve his writing speed and letter formation. An OTA (Edwina) sees Eustace three times a week and is working on developing both hand strength and endurance along with correcting Eustace’s grip style. Edwina knows that Eustace loves construction machines, so she instigates a game of “crane” using a pair of tongs and wooden blocks. Taken out of context, this may look like simple play to most, but OT practitioners will see the development of hand motor skills, motoric separation, shoulder stability and strengthening, trunk stability, coordination and a raft of other beneficial influences that will assist in the development of requisite musculature for the surprisingly complex task of hand writing.

During the course of our education to date at Maria College, we OTA students have been repeatedly told, “Anything we do can be therapeutic, as long as you understand why you are doing it.” With enough knowledge and training, this becomes closer to the truth with each passing day.

As we OTA students approach our semester of field work, our minds are beginning to break down activities, analyze actions and tasks, and notice things that were otherwise unapparent a mere semester ago. By understanding tasks in detail and considering all of the work that goes into any given moment of activity (even sleep!), task analysis rewards us with ways to better ourselves and the lives of our clients.

For me OT is about helping others help themselves. Our goal as therapists is not to treat the client, per se, but rather to design a treatment for the client who then treats themselves and enjoys doing so. That is OT.

Guest Blogger and Maria College OTA Student Ian Schneider

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