Occupational Therapy

Occupational Therapy (OT), helps people regain, develop and build skills that are important for independent living, health and happiness. Through the remediation of one's performance limitations and the incorporation of compensatory strategies and assistive technology, OT enables individuals to engage in the Skills for the Job of Living. If you have trouble performing daily activities because of limitations in areas such as arm and hand use, thinking, or seeing, OT may be able to help you.

Activities of Daily Living (ADLs) are tasks a person performs everyday to maintain their independence. These include:

• Bathing
• Grooming
• Toileting
• Dressing
• Feeding
• Sexual Expression
• Transfers
• Community: Mobility & Leisure Activities
• Functional Communication (writing, typing, using the phone)

Other ADLs one might not consider, but are important parts of life nonetheless, include home management and parenting.

Many disabilities can effect how someone performs these skills. Occupational Therapists often work with individuals on any or all of these activities so that they obtain or regain greater independence. Assistive technology, adaptive devices and compensatory strategies can be evaluated and utilized to assist one in reaching this goal.

Please see the Assistive Technology section of our site for detailed information on the Assistive Technology Program at WWRC.

Please email us if you would like to receive a list of manufacturers the Occupational Therapy department has found useful, including manufacturers of items directly related to OT, as well as everyday items that can be used to assist in improving everyday functions and tasks. It's all about problem solving!

In today’s society, many individual’s lives involve children. Opportunities arise to interact with children either by virtue of having children, remarriage, extended family commitments, or social situations. Childcare has historically been a part of a comprehensive occupational therapy program. Obtaining the necessary skills and making adaptations to carryout childcare responsibilities may deem a challenging process, but will prove to be beneficial in maintaining this life role. At Woodrow Wilson Rehabilitation Center (WWRC), we began to see the need for adaptive parenting to be a larger, more routine part of our activities of daily living program.

Occupational therapy will provide a variety of services to address parenting as an activity of daily living. These services may include the following:

• An initial evaluation to determine the extent of the parenting role
• Instruction on adaptive holding, feeding, diapering, and playing techniques
• Education on safe and effective adaptive childcare equipment
• Information on legal rights of parents with disabilities and advocacy
• Provision of useful resources and literature on childcare in your own community
• Finding accessible housing for you and your child

The Occupational Therapy Childcare Program can be accessed in several ways. First, clients are introduced to the program during their inpatient rehabilitation stay. Second, clients can access the program as an outpatient. This can be done on a one-day basis or they can arrange to stay at WWRC’s family cottages or at the Switzer Building, which is an on-grounds lodging facility. Third, clients can receive a home-visit to further determine needs. We have also had the opportunity to work with home health therapists and nurses after the initial evaluation for further practice of skills necessary for adaptive childcare. Continuing education workshops may be arranged through the Occupational Therapy Department.

The ability to access one's community is essential to enhancing independence and social opportunities. A person's disability can make community access more challenging. Occupational Therapists can assist individuals in gaining greater community involvement.

Re-entry into one's community may include accessing:

• Banks for money management
• Stores and malls for shopping
• Medical facilities for appointments
• Social establishments for leisure
• Salons and barbers for hair care

Individuals who are residents on the Short Term Rehabilitation Unit and / or Supportive Living Services have the opportunity to participate in weekly outings in the community. Outings in the past have included trips to the movies, local restaurants, shopping centers, bowling lanes and sporting events. In addition, therapists may also accompany a client individually out into the community during a treatment session if this goal is included in their rehabilitation program.

Many of us take for granted being able to turn on a light or change the channel on a television. People with disabilities often have difficulty with many of these tasks. Occupational Therapy offers evaluations and training in the use of electronic aids to daily living (EADLs). EADLs range from simple to complex adaptations that provide a way to do things like turn on lights, appliances and small electronic devices. EADLs often allow individuals with disabilities to independently control their environments.

Following an accident or injury, the ability to perform activities of daily living can be significantly diminished. Cognitive deficits may not always easily be seen, which can make them hard to understand by clients, as well as family members and friends. As part of a comprehensive program at Woodrow Wilson Rehabilitation Center (WWRC), occupational therapy addresses the unique cognitive needs of each client and evaluates the impact that these deficits have on the ability to perform routine activities. Specific clinical evaluations or observation of the client in a variety of settings during different times of the day can be used to determine the frequency and severity of the cognitive problem.

Examples of cognitive areas that occupational therapy may address are:

• Awareness of the environment and passage of time (orientation)
• Ability to remember directions while preparing a meal
• Maintaining attention during a work day
• Limited insight into unsafe behavior at home or in the community
• Determining the best solution to a particular problem
• Difficulty organizing thoughts during conversation
• Planning out your daily schedule
• Delay in initiating familiar activities such as dressing or eating
• Ability to perform simple calculations for balancing a checkbook

Occupational therapists can assist the client in utilizing helpful strategies to compensate for memory loss or difficulty with problem solving. Suggestions can be provided to help individuals organize information or increase motivation. By focusing on these areas, an individual can work on maximizing their level of independence and quality of life.

Often after an injury or illness an individual will need temporary or permanent modifications to their home, school, or work place, so that they can be more independent. Some individuals may have simple needs such as rearranging furniture and removing throw rugs. More complex needs may be identified such as building a ramp, widening doorways or replacing a tub with a roll-in shower. A visit to a person's home is frequently completed during an individual's treatment program, if this need is determined. Referrals can also be made for this service alone.

In some circumstances, an Occupational Therapist completes a home visit and consults primarily with the client and family. There are other situations when additional team members are called upon such as a Rehabilitation Engineer, Physical Therapist and Case Manager depending on the client's needs and their environment.

Occupational Therapists work with individuals to assist them in regaining or obtaining greater independence in managing their home. Assistive technology and adaptive equipment can be incorporated to reach this goal. Utilization of compensation strategies may also be beneficial to reach greater independence.

Home management tasks can include:

• Clothing care
• Cleaning
• Meal planning / preparation
• Safety awareness
• Household maintenance
• Lawn care

It is not uncommon for a disability to have some impact on the use of one's arms and hands. Occupational Therapists can complete a comprehensive assessment of the movement, strength, sensation and coordination of the upper extremities (arms and hands). If indicated, therapy can be provided to improve the amount, strength and quality of movement; promote stability and increase functional use. Other treatment methods may focus on education regarding compensatory strategies, taping, splinting, casting, edema management and pain management.

Specific upper extremity programs include:

• Prosthetics
• Orthotics
• Tendon Transfer Consultations
• Functional Hand Evaluations / Treatment

Everyday activities are effected by how well we see. If vision is impaired, then these daily activities may become more difficult. Often visual problems are only thought of as visual loss or blindness. There are additional visual components that may effect everyday tasks.

These include such things as:

• Acuity (ability to see clearly)
• Scanning / Pursuits (ability to move eyes side to side, up and down)
• Depth Perception
• Contrast Sensitivity
• Double Vision (ability to see singular items verses seeing double)
• Peripheral Vision
• Ability of the eyes to work together
• Visual Field (ability to see things all around you)
• Color Perception (ability to see colors)

The Occupational Therapists at WWRC work in collaboration with behavioral optometrists in the assessment and treatment of visual impairments. They provide visual training exercises as well as suggest alternative solutions / techniques for areas of difficulty. There are potential adaptations that can be used to promote improvements in visual abilities and allow the person to become more independent. Suggestions for changes in the environment that will increase safety and independence can also be given.

For more information on visual deficits, check out lighthouse.org.

Kelly Lum
Occupational Therapy Director

Kay Buchanan
Mary Breister
Adaptive Driving Program