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Occupational Therapy

University

Introduction to the Degree in Occupational Therapy. Source: Wikipedia (CC BY-SA 4.0).

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Definition, objectives, and history of occupational therapy

  • WHO Definition: Techniques and methods to prevent disease, restore functionality, and achieve independence.
  • Objectives: Reintegration in professional, mental, physical, and social spheres.
  • Axes of occupational science: Form, function, and meaning.
  • Egypt (2000 B.C.): Use of games and recreation for melancholy.
  • Classical Greece: Use of music, literature, and exercise (Hippocrates, Pythagoras, Seneca).
  • 1250-1700: Study of movement, rhythm, and energy expenditure (Descartes, Bacon).
  • 1425: First descriptions of occupational therapy by Father Murillo in Zaragoza.
  • Philippe Pinel: Use of manual labor for discipline and morale in patients.
  • 1780: Tisot classifies occupational exercise into active, passive, and mixed.
  • World War II: Official recognition of Occupational Therapy as a profession.

Historical evolution of Occupational Therapy in the United States

  • Origin: late 18th century and early 19th century with moral treatment
  • Benjamin Rush (1745-1813): recommended exercise, work, and music for mental health
  • Golden age of moral treatment: between 1840 and 1860
  • Arts and crafts movement: emerged after the economic crisis of 1860
  • Approach for the mentally ill: "room occupations and activities for the disabled"
  • Approach for physical disabilities: "manual training and occupational training"
  • World War I: appearance of "reconstruction aides"
  • World War II: creation of training programs due to high demand for therapists
  • World War II: transition toward a more mechanistic paradigm
  • 1917: Founding of the NSPOT (now AOTA), consolidating Occupational Therapy

History and key figures of Occupational Therapy

  • Adolf Meyer: mental illness as a problem of adaptation and work-leisure imbalance
  • Susan E. Tracy: pioneer in instructor training and first author of a book on the subject
  • Herbert J. Hall: classified occupations into remedial and entertainment
  • Eleanor Clarke Slagle: mother of the profession; founded the first professional school in Chicago
  • William Rush Dunton Jr.: father of the profession; published the first complete text and founded the first society (NSPOT)
  • Edward Barton: first to coin the term Occupational Therapy
  • Gail Filder: introduced psychodynamic theory and non-verbal expression
  • Mary Reilly: introduced the study of play as exploratory learning
  • Elizabeth June Yerxa: criticized the reductionist model; focus on individual choices
  • Catherine Trombly: developed the occupational performance model
  • Anna Jean Ayres Baker: discovered sensory integration deficit in children
  • Ayres Baker's instruments: Southern California Sensory Integration Tests (1972), Postrotary Nystagmus Test (1975), and Sensory Integration and Praxis Tests (1989)

Historical evolution of Occupational Therapy in Great Britain, Chile, and Spain

  • Great Britain: William Tuke introduced self-control and occupations as treatment.
  • Great Britain: Brabazon Project (1898) in Scotland for the useful use of hands.
  • Great Britain: Sir Robert Jons established orthopedic centers after World War I.
  • Great Britain: Margot Fulton was the first certified therapist in 1925; first school in 1930.
  • Chile: María Cristina Ríos (1961) was the first occupational therapist.
  • Chile: Beatriz Wade disseminated the discipline and the occupational therapy workshop.
  • Chile: The Chile 21 and Chile 5000 agreements created physical medicine centers.
  • Chile: Own Curriculum (1972) based on the Minimum Standards of the World Federation of Occupational Therapy.
  • Spain: Father Menni (1877) applied medico-moral treatments.
  • Spain: Workplace Accident Law (1900) and the creation of the IRPIT (1922).
  • Spain: National Workplace Accident Fund (1933) for rehabilitation.
  • Spain: Rehabilitation recognized as a medical specialty in 1969.
  • Spain: National School of Occupational Therapy founded by Oñorbe Garbayo, Ruiz García, and González Sánchez.
  • Spain: Mercedes Abella (WHO) developed the first curriculum for occupational therapy education.

Historical evolution, foundations, and fields of intervention of Occupational Therapy

  • ENTO Foundation: 1964
  • Move to the Provincial Institute of Rehabilitation: 1971
  • WFOT Recognition: 1970
  • Rehabilitation technicians in ONCE: 1984
  • University studies (RD 1420/1990): 1990
  • Homologation of Diploma degree (BOE 290/1995): December 5, 1995
  • User-centered practice: seeks control and active participation
  • Occupation-centered practice: requires systematic evaluation of priorities
  • Evidence-based practice: use of research to predict outcomes
  • Acquired brain injury: includes stroke, trauma, degenerative diseases, and spinal cord injury
  • Swallowing and communication disorders: of functional and neurological origin
  • Areas of intervention: include mental health, geriatrics, pediatrics, oncology, and palliative care

Occupational Therapy in Oncology, Geriatrics, Education, and Orthotics

  • OT Objective: Development, maintenance, and recovery of bodily, psychological, and social functions.
  • Pediatric oncology: Cognitive deficits in 40-100% of survivors.
  • Specific deficits in brain tumors: Attention, memory, processing speed, visuospatial capacity, and executive functions.
  • Reference models in oncology: Human Occupation Model and Neurodevelopmental model (techniques such as Psychomotricity).
  • Geriatrics (independent): Focus on prevention, healthy lifestyles, and capacity training.
  • Geriatrics (dependent): Focus on enhancing remaining capacities and environmental adaptation.
  • Education: Facilitating the teaching-learning process and adaptation to the school environment.
  • Orthoses: External devices to modify the neuromusculoskeletal system.
  • Orthosis materials: polyform, aquaplast, ezeform, x-lite, turbocast, and casts.

Types of orthoses, intervention tools, and reference frameworks in Occupational Therapy

  • Stabilizing orthoses: maintain fixed position
  • Functional/dynamic orthoses: allow movement with an elastic element
  • Corrective orthoses: treat skeletal deformities
  • Protective orthoses: align injured limbs
  • Orthoses: unique and non-transferable technical aids because they are custom-made
  • Cognitive stimulation: improves memory, attention, language, calculation, and orientation
  • Psychomotricity materials: balance islands, cones, smooth balls, flat hoops
  • OT functions: include SI assessment, ADLs, functional adaptation, orthosis design, and vocational guidance
  • Frameworks of reference: scientific foundations (not practical tools) that must be combined
  • Primary frameworks: Physiological (biological) and Psychological (behavioral)
  • Applied frameworks: practical strategies for physical and psychosocial dysfunctions
  • Key models: MOHO, Occupational Adaptation, Health Action, Australian, Canadian, Quadratic, AOTA, Allen, Ecological, Occupational Performance, Kawa, and Multicontextual

MOHO Assessment Instruments and Occupational Therapy Code of Ethics

  • PVQ: Observational motivation assessment in children aged 2 to 7 years
  • PVQ: Scale composed of 14 indicators
  • COSA: Occupational belonging self-assessment for children aged 8 to 13 years
  • SCOPE: MOHO-based assessment for individuals aged 0 to 21 years
  • SCOPE: Identifies patterns of strengths and challenges for intervention planning
  • AMPS: Assesses motor and processing skills in adolescents and adults
  • AMPS: Assesses balance, mobility, coordination, strength, and organization
  • ACIS: Observational communication assessment in 3 domains (physical, information, and relationships)
  • ACIS: Scoring scale from 1 (deficient) to 4 (competent)
  • WFOT Code of Ethics: Based on non-maleficence, beneficence, autonomy, and justice
  • Personal attributes: Integrity, reliability, judgment, and loyalty
  • Continuing Education: Ongoing training based on the best possible evidence
  • Advocacy: Ethical development of the profession at regional, national, and international levels

Paradigms and Historical Evolution of Occupational Therapy

  • Pre-paradigm: Context of the Second Industrial Revolution (1850-1914)
  • Foundations of the pre-paradigm: Moral treatment, Arts and Crafts, and Pragmatism
  • Adolf Meyer: Established the philosophical foundations and the holistic vision of the human being
  • Mechanistic Paradigm: Influenced by Logical Neopositivism and the biomedical approach
  • Mechanism: Reduction of Occupational Therapy (OT) to medicine and palliative techniques
  • First Crisis: The demand to explain health through neurological and anatomical mechanisms
  • Second Crisis: Loss of the meaning of occupation in daily life (1960s-70s)
  • Occupation Paradigm: Interpretative and psychosocial approach (second half of the 20th century)
  • Mary Reilly: Return to occupation as the core axis of the discipline
  • David Nelson: Differentiation between Occupational Form and Performance
  • Kielhofner and Burke: Proponents of the Model of Human Occupation
  • Canadian Model: Includes Spirituality as a nuclear factor
  • Social Paradigm: Focus on community OT, Human Rights, and political perspective
  • Theory of Occupational Nature: Proposed by Ann Wilcock

Flashcard preview (6 of 40)

  1. 01

    According to the WHO, what is the primary objective of occupational therapy regarding individual independence?

    To achieve the greatest possible independence and reintegration in all aspects (occupational, mental, physical, and social).

  2. 02

    In occupational science, what is the unit of analysis and the focus of practice?

    Occupation.

  3. 03

    In occupational science, what does the 'function' of occupation study?

    How it influences physical health and life satisfaction.

  4. 04

    In what year was Occupational Therapy recognized as a profession?

    During World War II.

  5. 05

    Who first described treatments through occupational work or labor therapy in 1425?

    Father Murillo (Hospital Real y General de Nuestra Señora de Gracia, Zaragoza).

  6. 06

    In the history of occupational therapy in the US, what treatment gave structure to the profession in the late 18th and early 19th centuries?

    Moral treatment

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