OTA 100 - Ch. 2 History of OT

Question 1

ACA

Answer 1

Affordable Care Act/ObamaCare; 2010. Addressed rising cost of healthcare, shortage of providers, and lack of insurance availability. To lower govt spending on healthcare by decreasing ER visits/increasing preventative care. Sets clear rules for insurance co’s to prevent fraud/abuse. Funds scholarships/loan repayment for health-related professions. Funds community health centers. AOTA still advocating for OT to be covered, as it qualifies as preventative care/quality of life.

Question 2

AOTA

Answer 2

American Occupational Therapy Association. NSPOT became AOTA in 1921 and has been since. (Publishes AJOT since 1947.)

Question 3

Americans with Disabilities Act 1990

Answer 3

ADA; 1990s; Provides civil rights to disabled; equal access to employment, transportation, public accommodations, government, and telecommunication. OTs consult private and public agencies to meet guidelines.

Question 4

Benjamin Rush

Answer 4

US Quaker, first physician to institute moral treatment practices after Tuke and Pinel’s work.

Question 5

Balanced Budget Act of 1997 (BBA)

Answer 5

Passed to reduce Medicare spending, create incentives for managed care plans, and limit fee-for-service payment and programs. Caused practitioners to broaden horizons beyond traditional practice. Community based programs, etc. Caused upswing in job market for OTs.

Question 6

Herbert Hall

Answer 6

Considered a founder of OT as profession. Harvard Med School physician who adapted arts and crafts movement for medical purposes/treatment. Worked with invalid patients providing supervised crafts to improve health/financial independence. Occupation as therapy for people with nervous/mental disorders called “WORK CURE.” Early president of Natl. Society for Promotion of OT (1920-23).

Question 7

Centennial Vision

Answer 7

Adopted by AOTA in 2017 (100-year OT anniv.). Emphasizes evidence-based practice and value of diversity in clients/practitioners.

Question 8

Civilian Vocational Rehab. Act

Answer 8

1920; Provided federal funds to states on 50-50 matching basis for vocational rehab services to civilians with physical disabilities. Assistance with gaining employment. OTs provided prevocational and rehab services.

Question 9

Deinstitutionalization

Answer 9

Neuroleptic drugs arrived in mid-1950s, and as psychotic behavior became controlled with drugs, more people were discharged (deinstitutionalized). Led to development of community mental health programs, and more requirement for OTs.

Question 10

Education for All Handicapped Children Act of 1975

Answer 10

Established right of all children to free and appropriate education, regardless of disability. Includes OT as related service. Required individualized education program (IEP) for each child.

Question 11

Thomas Kidner

Answer 11

Friend of George Barton; fellow architect/teacher. Established presence of OT in vocational rehab and TB treatment. Developed system of vocational rehab for disabled Canadian vets of WWI. Constructed institutions for disabled. Designed hospitals in CA and US for treatment of TB.

Question 12

Gary Kielhofner

Answer 12

Developed Model of Human Occupation (MOHO) as grad student at USC. Published 19 textbooks and 150 journal articles; developed model that would allow OTs at all levels to better address important client issues. Provided profession with evidence to support occupation-based practice and tools to evaluate clients. Remained visionary and scholar; promoted field of OT.

Question 13

List the Founders of the Profession of OT:

Answer 13

• Herbert Hall
• George Edward Barton
• Dr. William Rush Dunton Jr.
• Eleanor Clarke Slagle
• Susan Tracy
• Susan Cox Johnson
• Thomas Kidner

Question 14

Habit Training

Answer 14

Re-education program to overcome negative habits, construct new ones, with goal of restoring/maintaining health. 24-hour program, involving all hospital personnel. Slagle developed this method in 1912.

Question 15

Handicapped Infants and Toddlers Act

Answer 15

Passed in 1986 as amendment to Ed. for All Handicapped Children Act. Includes children 3-5 years old, and early intervention from birth to 3. Increased OT services provided to children and in schools.

Question 16

Medicare

Answer 16

Enacted in 1965, increased demand for OT. 65+ or permanently disabled receive assistance in paying for health care. Covers OT in inpatient setting, limited coverage for outpatient (kind of a drawback). 1988 legislation permitted direct reimbursement for OT services.

Question 17

Individuals with Disabilities Education Act (IDEA)

Answer 17

Renaming of Educ for All Handicapped Children Act; 1991. Requires school districts to educate disabled students in least restrictive environment; incorporate with students without disabilities. School district to provide assistive tech/services.

Question 18

Technology-Related Assistance for Individuals with Disabilities Act of 1988

Answer 18

Addresses availability of assistive tech devices and services to disabled. OTs involved in providing these services.

Question 19

Social Security Amendments

Answer 19

1983, Reagan passed these to change health-care payment; level of payment based on diagnosis-related groups (DRGs), which caused changes like shortened acute care in hospitals, and increased need for long-term care facilities/home health services.

Question 20

Prospective Payment System (PPS)

Answer 20

Part of Medicare, created by Social Security Amendments; nationwide schedule to delineate what govt would pay for inpatient stay of Medicare patient. “Fixed payment” system.

Question 21

Reconstruction Aides

Answer 21

WWI need for OTs increased with reconstruction movement; rehab soldiers injured in war; showed increased need for OT-related treatment due to US Army’s influence with these aides, even overseas.

Question 22

Soldier’s Rehabilitation Act

Answer 22

1918; established program of vocational rehab for soldiers disabled during active duty; OTs helped them adjust to civilian life; Helped them return to productive living.

Question 23

Reductionistic

Answer 23

View that humankind is reduced to separately functioning parts; Medicine viewed this way in postwar period, counter to holistic approach of OT.

Question 24

Arts and Crafts Movement

Answer 24

Led by John Ruskin and William Morris in England. Opposed to machine production; sought to restore ties between work and worker; high standard of craftsmanship; using hands leads to health.

Question 25

Eleanor Clarke Slagle

Answer 25

Mother of OT. Student of social work; studied curative occupations; 1912, asked by Adolf Meyer to direct OT dept at Henry Phipps Psychiatric Clinic in MD. There, developed “Habit Training.” Later in Chicago, started workshop for chronically unemployed and first professional school for OTs, Henry B. Favill School of Occupations. Her home was first hq of NSPOT. Served each office there, and AOTA now has an award named after her.

Question 26

George Edward Barton

Answer 26

Architect in London who studied under William Morris (arts and crafts movement). Went to Boston and founded Boston Society of Arts and Crafts. After personal experience with disabling conditions, he wanted to improve plight of convalescents. Opened Consolation House in 1914, using occupation (arts/crafts) for treatment.

Question 27

Adolf Meyer

Answer 27

Swiss physician, came to US in 1892; became prof of psychiatry at Johns Hopkins Univ. Point of view became the philosophical base of OT. (Holistic, psychobiological approach, meaningful activity promoting health)

Question 28

National Society for the Promotion of Occupational Therapy (NSPOT)

Answer 28

Founded in 1917 in NY, and considered birth of OT as a profession. Included Barton, Dunton, Slagle, Cox Johnson, Kidner and Isabel Newton. Object to study/advance creative occupations; gather news of progress in OT; encourage research. (Later became AOTA.)

Question 29

Rehabilitation Act of 1973

Answer 29

Came after civil rights movement of 1960s; disabled people exerted influence on rehabilitation legislation. Act emphasized priority service for most severely disabled; individualized written rehab program (IWRP); set of standards by which rehab services could be assessed; included civil rights/nondiscrimination prohibitions for disabled.

Question 30

Rehabilitation Movement

Answer 30

After WWII, 1942-1960, VA hospitals expanded and employed OTs; developed rehab depts to serve veterans with disabilities.

Question 31

Susan Cox Johnson

Answer 31

Designer and arts/crafts teacher from Berkeley. Became director of occupations at Montefiore Home in NY; there showed occupations as uplifting, improving mental/physical health. Later taught at Columbia.

Question 32

Susan Tracy

Answer 32

Nursing instructor involved with arts/crafts mvmt and use of occupations. Hired in 1905 at Adams Nervine Asylum in Mass., where she developed occupations program. Wrote first book on OT: “Studies in Invalid Occupations.”

Question 33

William Rush Dunton Jr.

Answer 33

Father of OT. Psychiatrist. In 1891, became physician at Sheppard Asylum in MD; incorporated arts/crafts treatment in early 1910s. Known for his writings on OT and was president of NSPOT for 21 years.

Question 34

Moral Treatment

Answer 34

Movement based on philosophy that all ppl are entitled to consideration and compassion; using purposeful activity to make existence more bearable. Credited to Philippe Pinel (french physician) and William Tuke (english Quaker/merchant).

Question 35

World War I

Answer 35

Influenced profession of OT with creation of reconstruction aides, who became greatly needed, and who showed validity of activity as therapy and linked OT with physical disabilities.

Question 36

OTA Events of 1958

Answer 36

• Mildred Schwagmeyer became assistant director of education at AOTA; most knowledgable on OTA.
• First 3-month educational program for OTAs in psychiatry

Question 37

Important events of OTA history:

Answer 37

1958: First 3-month educ prog for OTAs in psychiatry
1958: Mildren Schwagmeyer joins AOTA; most knowledgeable on OTA
1967: AOTA holds first COTA meeting at conference
1977: First COTA certification exam
1991: COTAs participate on AOTA exec board
1998: First COTA member votes on AOTA exec board

Question 38

Laddering (what and when?)

Answer 38

Laddering= Advancing career based on experience rather than returning to classroom.

1971-AOTA adopted resolution for COTAs to advance (to OTR) this way (Career Mobility Program).
1973-First group endorsed to take exam in 1974.
1982-Laddering stopped.