FAQs: "What is an occupational therapist anyway???"

I do sincerely apologize to my blog readers for the very long break in blog entries. First came the holidays, then when the new year began I became very busy because I began a new job. I still am working full-time at the job I’ve had, but I’ve taken on an additional part-time job. In addition to my work at a pediatric therapy center (through which I work at a clinic every weekday afternoon/evening and am contracted out to a public secondary school two mornings per week), I am now also working two mornings per week at a special needs school. There, I work primarily with children in the school's preschool program. It has been a great experience so far, but it has taken a few weeks to acclimate to my new much busier schedule. So, once again, apologies for neglecting my blog.

I realize that a lot of my blog readers are not occupational therapists themselves. A lot you readers are people who do know me in real life, and kind of sort of know what it is I do, and have heard me try to explain it, but as readers who ARE fellow OTs know, summarizing what we do in any kind of concise way that can lead to any real understanding of our profession is almost impossible! I’ve been told many of my blog entries so far has contributed to my non-OT readers’ understanding of what OT is and what pediatric OTs do. So I decided to expand on that and write a blog entry giving my best description of my profession to help with my readers' understanding. I’ve decided to do it as a “FAQ”. These are real questions I’ve been asked when I’ve said to someone that I’m an occupational therapist. Most of these questions I’ve heard several times, as has basically every OT I know! Here are my answers.

The OT Slogan

Question: Is an occupational therapist someone who helps people find jobs?

This is one all OTs hear rather often, and always produces a collective groan from the OT community. A very common misconception is the meaning of the word “occupation.” In colloquial language an "occupation" refers to someone’s job, but an “occupation” refers to more than just a job. Occupations are what people do to occupy their time that is meaningful to them, and/or required of them. For you, your occupations likely include: activities of daily living (ADLs) (ex: dressing, eating, bathing and toileting), instrumental activities of daily living (IADLs) (ex: cooking, cleaning, pet care, and child care), your job, driving and/or navigating public transportation, and what you do for fun (such as participating in hobbies or meaningful leisure activities). Occupational therapists assist when people are unable to participate in, or have difficulty successfully participating in any of their occupations because of various barriers (including disability, disease, injury or mental health issues).

Question: What is an occupational therapist? What does an OT do?

Occupational therapists are professionals that assist their clients to overcome barriers to performing their daily occupations. This may involve assisting clients to: develop or improve necessary component skills for successful performance in their occupations; develop compensatory methods in the process of developing the component skills, or when these skills cannot improve (such as in the case of a permanent disability affecting the ability to develop the skill); adapt the task to accommodate for the client's current abilities; adapt the environment to promote the client's success; and most commonly occupational therapist use a combination of some or all of these methods for each client. An OT's overall goal with a client is to help him or her to become as independent and functional as possible, participate in meaningful occupations, and experience a high quality of life.

Question: What does an OT do with kids? Kids don’t have jobs!?

Children don’t have jobs, but children DO have occupations, For children, common occupations are: participating in ADLs (dressing, eating, bathing, toileting); being a family member and functioning within his or her family environment; playing/engaging in leisure; and being a student. Barriers to being successful in childhood occupations that pediatric occupational therapists treat include:

• Sensory integration/processing issues
• Developmental delay or disability
• Gross motor delays
• Fine motor delays
• Muscle tone abnormality
• Poor endurance
• Retained primitive reflexes
• Learning disabilities
• Cognitive impairment
• Physical disabilities
• Acquired injuries
• Behavioral issues
• Attention/focus difficulties
• Motor planning or praxis difficulties
• Visual perception and/or visual-motor integration difficulties
• Psychosocial issues

Question: Occupational therapy? Is that like physical therapy?

This is a question OTs get all of the time, likely because physical therapy has more mainstream recognition and most people understand the basics of what PTs do, but many people have no idea what OTs do. For those that can recognize a difference in the professions there is a stereotype that PTs rehabilitate from the waist down, and OTs from the waist up. Another stereotype that is out there is that PTs address gross motor skills, and OTs address fine motor skills. While these stereotypes aren’t entirely unfounded, they’re not entirely true either. Occupational therapy (OT) and physical therapy (PT) are both considered “related services” and often work in similar settings and with similar populations, but we are very different professions with different theoretical bases. Physical therapy rehabilitates a client when there is a physical problem that exists. Although OTs do that too, our treatment is always directly related to daily life functioning and ability to participate in daily occupations. OTs never have clients perform non-function based exercises merely for the sake of making a body part stronger or more flexible. We may do similar exercises as PTs if there is a physical problem limiting the client’s participation in their occupations, but the exercise will always only be a “warm-up” to working on a specific activity or developing or rehabilitating a specific skill required for the occupation. While both our professions help clients function, OTs treat all aspects of the person we are treating, not just the physical. Often we have overlapping caseloads (such as people who have had strokes or children and adults with physical disabilities). However, there are many settings where there is rarely overlap in cliental, for example OTs don’t often have a role a lot of strictly orthopedic situations where overall daily life functioning is not affected (such as a sprained ankle), and PTs don’t generally have a role in mental health or other barriers to occupation that don’t require physical rehabilitation.

The Occupational Therapy Domain

There, in summary are my answers to “OT FAQs”. Hopefully this contributed to my non-OT readers’ understanding a bit!