January / February / March • Issue 1 • 2013
March/ April • Issue 9 • 2008
communiqué
CROR
THE
Illinois Occupational Therapy A ssociation
In this issue:
• Research Update
Learn about the
Intentional Relationship
Model Clearinghouse
on Page 10.
• Student Voice
Read about Brittany
Davis’ fieldwork in an
early learning center on
Page 6.
• Clinical Spotlight
Chana Goldstein
discusses working in the
Chicago Public Schools
on Page 8.
Self Catheterization
Reclaiming Independence
Catheterization is not one of the first
be expected that they would be able to selfADLs that comes to mind when we think
catheterize at the regular potty-training age,
of basic self-care. Yet, it is an important
between 2-3 years of age. I realized that there
issue for special populations, especially
was no way that a patient could master selfthose with neurogenic bladder dysfunction.
catheterization independence until the patient
I was first introduced
was independent in
to self-catheterization
his or her other ADLs.
intimately when I began
In addition to ADL
to staff the spina bifida
independence,
an
It brought the youth’s need for
(or myelomeningocele)
occupational therapist
independence... to the forefront.
clinic
at
Shriners
must also address the
Hospitals for Children–
following functional
A light bulb went off and a new
Chicago.
Working
areas before selfinpatient self-catheterization
with the spina bifida
catheterization can be
population
allowed
achieved: bathroom
program took shape.
me to see how an
transfers, fine motor
occupational therapist
function,
pinch
could be a crucial team
and grip strength,
member in evaluating a child’s readiness for
visual perception, perceptual motor skills,
self-catheterization. Early in life the parents
stereognosis, sitting balance, and cognition
performed scheduled catheterizations, just
(specifically sequencing and problem solving).
like dressing or bathing their children.
In the clinic, I observed that catheterization
Children with spina bifida are typically
was a source of deep stress for some patients
delayed in their ADL independence by an
and their caregivers, especially if the child was
average of 2-5 years. Therefore, it should not
“
A story about hope and
working in pediatrics on
Page 15.
• Introductions!
Meet the people
who bring you this
newsletter, starting on
Page 11.
”
…Continued on Page 7
• Reflection
Rachel Galant
Co-director of Rehabilitation
Shriners Hospitals for Children
H
ow Will You Celebrate OT Month?
April is OT Month! We are looking for your stories. Please send us some innovative ways that you plan to
celebrate or have celebrated in the past and we will showcase them in the next issue.
…Continued on Page 3
ILOTA Board
The Illinois Occupational Therapy
Association of Illinois is the official
representation of the OT professionals in the
State of Illinois.
ILOTA acknowledges and promotes
professional excellence through a proactive,
organized collaboration with OT personnel,
the health care community, governmental
agencies and consumers. advanced
Research
President
Peggy Nelson
Bylaws: Position Open
Office Manager
Jennifer Dang
Secretary
Lisa Iffland
Archives: Ashley Stoffel &
Kathy Priessner
Director of Finance
Lisa Mahaffey
Continuing Education Co-Chairs
Catherine Brady and Kim Bryze
CE Approval Chairs
Katie Polo & Mark Kovic
Reimbursement Chair
Nancy Richman
Conference Coordinator
Anne Kiraly-Alvarez
Professional Development Coordinator Lisa Castle
Director of Advocacy
Rachel Dargatz
Public Policy Coordinator
Kylene Canham
Director of Membership
Position Open
Retention Coordinator
Susan Quinn
Activation Coordinator
Position Open
Recruitment Coordinator
Position Open
Director of Communication
Carolyn Calamia
Website Coordinator
Position Open
Newsletter Coordinator
Carrie Nutter
Networking Coordinator
Position Open
AOTA Representatives
Robin Jones
Page 2
The Communiqué
The mission of the Communiqué is to inform Illinois Occupational Therapy
Association (ILOTA) members of current issues, trends and events affecting the practice of
Occupational Therapy. The ILOTA publishes this newsletter quarterly. ILOTA does not sanction or promote one philosophy, procedure, or technique over
another. Unless otherwise stated, the material published does not receive the endorsement
or reflect the official position of the ILOTA. The Illinois Occupational Therapy Association
hereby disclaims any liability or responsibility for the accuracy of material accepted for
publication and techniques described. Deadlines and Information
Articles and ads must be submitted by the last day of the month prior to the month of
publication. Contact the ILOTA office for more information and advertising submission forms:
P.O. Box 4520
Lisle, IL 60532
Phone: 708-452-7640
Fax (866) 459-4099
Website: w w w.ilota.org
ILOTA Newsletter Editorial Committee
Carrie Nutter • Mara Sonkin • LaVonne St. Amand
Newsletter design by Holly DeMark Neumann
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Don’t forget to renew your membership online at
www.ilota.org!
Celebrate OT Month
January
/ March
• Issue
1 • 2013
August/ February
/ September
• Issue
3 • 2008
President’s Address
Peggy Nelson
Positioning ILOTA for Success
As we continue to learn of
new legislation that influences service
delivery of Occupational Therapy
across all practice areas, our association
continues to identify resources to help
navigate strategies for success. Our
mission continues to demonstrate a
strong statement of our purpose and
initiatives to support the practitioners
in Illinois.
(continued from page 1)
Mission of ILOTA:
The Illinois Occupational Therapy Association (ILOTA)
is the official representation of the Occupational Therapy
profession in the state of Illinois. ILOTA acknowledges
and promotes professional excellence through a proactive,
organized collaboration with Occupational Therapy
personnel, the health care community, governmental
agencies, and consumers.
With the sunset of our Practice Act soon approaching in 2014,
there have been several committees established to discuss key
components. These committees review the current language
of our Practice Act and provide recommended revisions to
guide us into the next ten years. Examples of this include
updating the definition of educational requirements and
inclusion of language to position our profession for success
with the continued progressive use of technology in practice. This draft is then sent to the Illinois Department of
Professional Regulation for review and feedback before a Bill
is created. Once approved by the Department, a Bill will be
created and opened for Senate/House and public comment. Please check our ILOTA website for continued updates. Additionally, in order to continue to serve the practitioners
throughout Illinois, we continue to recruit volunteers to help
us achieve our organizational goals. We hosted our first ever
ILOTA orientation program on February 16, 2013 at the
Rehab Institute of Chicago for current and incoming board/
committee members. This orientation program will be
offered annually at our state conference to provide ongoing
support for members interested in serving in a committee or
board position. As you reflect on your profession for the year,
please consider how you can work with us to strengthen our
organization throughout the state. Visit our website today at www.ilota.org, or contact us at
office@ilota.org for additional resources, up to date listings of
opportunities related to open positions on the ILOTA board,
or how you can participate in the association. You make all
the difference!
Here are just a few ways that you can help the Illinois
Occupational Therapy Association ( ILOTA):
• Join or renew your membership for ILOTA
• Join the board or a committee
• Write an article for the Communique newsletter or
recommend an individual or topic
• Help plan the state conference or volunteer on site at
the event
• Make a donation (all sizes are welcome and helpful)
• Organize a networking or educational event
• Encourage organizations to advertise in the Communique or through ILOTA e-mail blasts
• Spread the word about the benefits of being an active
member in ILOTA
We appreciate that many of you are also members of the
American Occupational Therapy Association (AOTA)
and are supportive of the state and national Political Action Funds (PACs), mentor students, peers and co-workers, engage in lobbying, organize events and advocate for
our profession and share knowledge about and passion
for OT in so many ways! Let the momentum continue and
inspire each of us in 2013!
Peggy Nelson, President of ILOTA
Page 3
Photo
Opinions
What inspires you about
working in pediatrics?
We value our colleagues’ opinions and views! In each issue we will ask a different question.
Some may be thought provoking and some may be more whimsical, since as OTs we face both
serious concerns and opportunities for creativity. We will feature responses and photos from different
clinicians or students in each issue. If you have an idea for a question or would like to be considered
for a future issue, please contact us.
Habilitation vs. Rehabilitation
I have the pleasure of working with both adults and children in my
practice at Edward Hospital. Pediatrics is an interesting practice area
due to the fact that often it is habilitation instead of rehabilitation.
Children are very easily engaged in their occupational roles as friend,
family member, or student. I really enjoy helping children choose
activities that are both therapeutic and Fun.
Jen Matern OTR/L
Edward Hospital
Strengthening Roles
Photo Opinions
If you would like to be
featured in Photo Opinions or know someone
who would, please contact Carrie Nutter at
codycheq@aol.com
Page 4
I work at Aspire Children’s Services with children who have
developmental delays and disabilities and with their families. Working in
a community-based, non-profit agency has given me the opportunity to
build strong relationships between children, families, and communities. I
think one of my most important roles as a pediatric OT is to help children
succeed at being themselves as well as to support families’ understanding
and enjoyment of their child. I often tell my fieldwork students, “It
is not my goal that a child learns new skills to play and interact with
me as the OT. It is more meaningful for a child to play and interact
with his/her parents, siblings and peers.” Beginning my career in early
intervention provided me with a framework of using everyday activities
within natural environments throughout the OT process. At Aspire, I’m
able to carryover these ideas into my work with children of all ages by
occasionally seeing children in their homes, schools and communities,
instead of only at a center. Another benefit of my position is being part
of a multi-disciplinary team. This team approach promotes collaboration
and learning, and it encourages taking all of a child’s developmental
components into account when determining interventions. I enjoy
sharing OT’s unique perspective of not only looking at building skills,
but also striving to build relationships and strengthening roles through
participation in occupations.
Collaborating with team members, then hearing the teachers
report successes in the classroom or when a student no longer needs my
support. And, of course, the high school peer tutor who says they too
want to be an OT when they graduate. Each new success is a step in the
direction of increased independence and awareness….and I love being a
part of that!
Ashley Stoffel, OTD, OTR/L
Aspire
What inspires you
about working in pediatrics?
Pediatrics brings a sense of satisfaction
My entry into the world of pediatrics was quite by chance, a friend back in Singapore
informed me that a position was available to work as a mobile occupational therapist for an
organization that was advocating for children with physical disabilities to be included into
mainstream education. Needless to say, I left adult psychiatric and physical occupational
therapy areas for pediatrics. As soon as I immersed myself in pediatrics, I realized that I
was able to apply everything I learnt from psychiatry to hands in this area of specialization.
Advocating for the needs of these children has never stopped and it varies from one child to
the other. The job satisfaction that comes with this line of work is that as an occupational
therapist we approach our work by being family centered. The child’s and families needs are
acknowledged and we work towards the goals that are formed with the family and child. The joys of being a pediatric occupational therapist is when the child can enjoy play
and is able to engage with other children their age. As a pediatric occupational therapist I am
able to make the necessary sensory or motor adaptations for them to function at the fullest
potential both at school, home and in their play or sport. The smile and the acknowledgement of a child being able to accomplish an act/goal that was previously unattainable is just precious.
The sense of empowerment by the child and family makes this line of work just so much more
enjoyable and satisfying.
Kavitha N Krishnan MS OTR/L
University of Illinois
Pediatric Team
Destined to become a Pediatric OT
Michelle Schmidt , OTR/L
I knew I was destined to become a Pediatric OT at the age of 13 when I met a COTA at
my high school. I was a peer tutor in P.E. class and Ms. Jennifer was the COTA working with
the student I was a buddy for. She piqued my interest in what she was doing, invited me to come
observe her at other times during the day, and then helped me locate information on becoming
an OTR. The rest is, as they say, history. While I have spent time in almost all of the other
fields that OT offers, I always kept coming back to pediatrics. A few years ago, I returned to my
passion – working in the school system. Being a school occupational therapist has its challenges
and rewards; but is worth every minute! I love working with children of every age! Starting
with the young pre-kindergarten students who are learning and growing at such a fast pace, to
the students getting ready to transition out of high school into the next phase of their lives, and
all those in between. As a school therapist, I get to be a jack of all trades - creating, fabricating,
constructing, making something out of nothing, etc. - with every day bringing new challenges
and successes. While I thrive on the challenges of each day with scheduling, keeping tasks fresh and
interesting, meetings, reports and such, the successes are what make it all worthwhile. Such as
the smile of a student the first time they master a task or the student who doesn’t want to go back
to class because they love what they are doing. Collaborating with team members, then hearing
the teachers report successes in the classroom or when a student no longer needs my support. And, of course, the high school peer tutor who says they too want to be an OT when they
graduate. Each new success is a step in the direction of increased independence and awareness….
and I love being a part of that!
Page 5
Student
Voice
Communiqué
Student Voice
If you would like to be
featured in Student Voice
or know someone who
would, please contact LaVonne St. Amand at
lavonne.stamand@yahoo.
com
Page 6
Brittany Davis, OTS
Lincoln Land Community College
I Hear, and I Forget. I See,
and I Remember. I Do, and I Understand.
In the Occupational Therapy Assistant
Program at Lincoln Land Community
College, Level I fieldwork takes
place in community settings,
not in healthcare settings, as
is the case with many other
occupational therapy education
programs. Instead of shadowing
an
occupational
therapy
practitioner and observing
occupational therapy, Level I
fieldwork is focused more on
gaining professional behaviors
with both other professionals
and the clients. My experience
on Level I fieldwork took place
at the Cordelia Dammon Early
Learning Center in Springfield,
Illinois. Cordelia Dammon offers programs
that help preschool children develop skills
that will enable them to be successful in
kindergarten. It also equips the children with
skills to be life-long learners. Throughout the
weeks that I was there, I was able to enhance
my professional behavior through working
and playing with the children while also
aiding and discussing the students with the
teachers.
Concurrently with Level I fieldwork, I was
also taking an occupational therapy theory
class for mental health. Some of the topics
covered in that class were very much related to
my time at the Early Learning Center. Several
students that I had the pleasure of interacting
with had different diagnoses and conditions
such as aggression, autism, attention deficit
disorder (ADD), and attention deficithyperactivity disorder (ADHD). During
the mental health class, I was taught how to
interact with children that had these specific
diagnoses. I found this class to be very helpful
for my role as a “helper” in the classroom.
Some of the concepts that I was taught and
was able to apply at the Early Learning Center
with the students included using very brief
and direct instructions for children with ADD
and ADHD , as well as ensuring that there
are minimal distractions, in order to more
successfully perform activities. While working
with the students on coloring activities or
reading activities, I was able to apply these
concepts. For example, one of the students
had a very short attention span and was
very distractible; therefore, while giving him
directions, I had to be quite direct with him
to keep his attention. When he would start
to look away from the activity, I would have
to say his name in a rather loud
voice to get his attention back
to the activity.
I found it interesting to see how
the teachers and other faculty
members applied the same
concepts while interacting with
the children. The classrooms
were very organized and labels
were placed in each area, such
as “cubby area”, “reading
books” or “kitchen area”. Each
child’s cubby was labeled with
the child’s name and his or her
photo. The class agenda was
the same every day with recess
first, then restroom and drink time, snack
time, an OT session, and music time was last.
Having the schedule the same every day helps
the children to develop routines, which is an
important part of the learning process. As the
teacher would go over the agenda every day,
she would call on students to help her complete
small tasks, such as counting the days of the
month, counting the number of students
present, or figuring out what day of the week it
is. If one of the students was having a difficult
time completing the task, the teacher would
walk them through it. For some of the students
that had ADD or ADHD, some of these tasks
seemed quite difficult, so the teacher had to
implement some of the concepts such as saying
short, direct statements and minimizing
distractions. Aggression was another topic that I had
the opportunity of learning about in the
mental health class. This information was very
valuable to me because some of the students
had aggressive behavior. One of the students
was often caught kicking, hitting, and yelling
at the other students as well as the teachers.
When the student would become both
physically and verbally aggressive I would
remember what I learned during the mental
health class when aggressive behaviors were
discussed. First, I would explain to the student
that hitting and kicking is not allowed and
it is not nice to hit or yell at others. I would
explain this in a very clear and serious voice
to keep his attention. The teachers would also
avoid punishing the student because it would
…Continued on Page 11
January / February / March • Issue 1 • 2013
Self-Catheterization (continued from page 1)
getting close to teenage years. In these cases, it was a task
that parents did not want to continue doing for their child
for the rest of their lives, and it was a limiting factor in social
interaction and confidence for the child. And yet, in other
families, parents were content to continue doing this for
their child, and the child was unconcerned. Some caregivers
had to go to their child’s
school to perform his/her
catheterization once or
twice per day. To help youth
understand the benefits
of
self-catheterization
independence, I would
ask them questions that
included, “Do you ever
want to have a sleepover
at a friend’s house? Do
you want to live on your
own one day? Do you
Anatomical dolls allow practice and
play while skills are being learned. always want to have to ask
mom or dad to help you
with your bathroom needs?” It brought the youth’s need for
independence with catheterization to the forefront.
A light bulb went off and a new inpatient selfcatheterization program took shape. Starting in 2007, we
began scheduling rehabilitation admissions primarily for
self-catheterization training after brief screenings in clinic to
see if youth were appropriate. Several families were on board
with the idea, and we admitted about 13 patients over the
course of 5 years. Each child was identified in clinic as a good
candidate for catheterization training (ie. independence with
most ADLs, appropriate cognitive skills, youth and parent
desire to learn) and participated in a 3-5 day hospital stay with
twice daily occupational therapy (OT) services and nursing
team teaching. Occupational therapists utilized flash cards,
teaching dolls, anatomy review, and achievement charts, and
provided aids (ie. mirrors, lower extremity positioners) to
the children as needed. We also employed readiness activity
skills that included fine motor strengthening, dexterity,
perceptual motor, visual perceptual, ADL, and bathroom
transfers training.
Most children were able to complete steps of selfcatheterization to a greater extent by the end of their
inpatient stays. Being in the hospital overnight allowed
them to put their new skills to use 24-hours a day, while the
children received a lot of support from therapy and inpatient
nursing. But to really confirm the outcomes, I decided to do
a retrospective chart review. Thirteen charts were reviewed.
The average age was 11.2±2.4, and there were 3 male and 10
female participants. Data was collected prior to training, at
discharge and at a clinic follow up.
Results
Prior to training, 54% of participants were completely
dependent for catheterization and 36% were dependent with
catheter insertion but helped with pre-catheterization tasks.
One participant continued to be dependent at discharge
and follow-up due to anatomy and dependence in lower
body self-help skills. At discharge, 31% of participants
required assistance with catheter insertion and cues for precatheterization tasks and 62% were independent except for
verbal cues.
At clinic follow-up (average 6.5 months), one participant
required assist with catheter insertion and cues for precatheterization tasks, 23% of participants were independent
with catheter insertion with occasional cueing, and 62%
were completely independent with all aspects. Fifty percent
of participants used a mirror in bed to complete the task.
Seventeen percent performed it in bed without aids, 17%
used a toilet and mirror, and 7% used a toilet with no aids.
The results indicate that utilizing a combination of
intensive inpatient hospital stay and OT intervention allows
most participants with SB to make excellent progress in selfcatheterization independence. And participants maintained
or surpassed their level of independence at follow-up.
Until recently, Shriners Hospitals did not bill 3rd party
payers. We had a lot of flexibility in caring for our patients
in an inpatient setting without
concerns over insurance coverage.
Due to the economic downturn,
the hospital system had to turn to
dependence on 3rd party payment,
even though we continue to care for
children without regard to patient
or family ability to pay. With the
onset of insurance authorization,
many of these patients now need to
be seen on an intensive outpatient
basis for self-catheterization
Games and tools assess
training.
and improve fine motor skills
The results of this study have
and memory
been presented as a poster at
3 different conferences in 2012: The 2nd World Congress
on Spina Bifida Research and Care in Las Vegas, ILOTA
conference in Naperville, and Howard Steel Conference:
Pediatric Spinal Cord Injuries and Dysfunction in Orlando.
About the Author
Rachel Galant is co-director of rehabilitation at Shriners
Hospitals for Children – Chicago and can be contacted at
rgalant@shrinenet.org. The Shriners Chicago unit specializes
in orthopedics, spinal cord injury, and cleft lip & palate. If
you would like to refer a patient for this specialized medical
care or therapy services, please call 773-385-KIDS (5437).
Page 7
Clinical
Spotlight
Communiqué
Clinical Spotlight
If you would like to be
featured in Clinical Spotlight or know someone
who would, please contact LaVonne St. Amand at lavonne.stamand@
yahoo.com
Page 8
Clinical Spotlight
When I was graduating from high school
and deciding on a career path, I knew that I
wanted a couple of things for my future life. I
knew I wanted a job in the medical field, and
I knew that I wanted to have time to have a
family. When researching possible jobs in the
health care field that matched these criteria, I
came across OT. First and foremost, the OT
profession offered the ability to help people
with a wide variety of diagnoses. Second,
with the wide range of job possibilities, OT
offered the option of part-time hours or school
placement, which would allow me to balance
home and work.
When I graduated ten years ago, I was
offered two jobs on
the same day: the first,
an outpatient clinic
and the second, Beard
School, a school for
children with severe
autism or E/BD. With
limited
experience
working with kids with
Autism and torn as to
what to do, I called
Kim Bryze, my peds
fieldwork
supervisor
and
an
unfailing
source of wisdom. She
recommended
that I take the job
at Beard because the
self-contained programs in Chicago Public
Schools tend to be “hidden little gems.” On
her guidance, I accepted the position at Beard,
uncertain as to what to expect, and was lucky
to find it a perfect fit.
The kids I met upon my arrival at Beard
were not simply Autistic. Many of them had
already failed in other programs that were
less restrictive and had more access to regular
education peers. Their level of cognitive
functioning or the severity of their behaviors
had made it impossible for them to learn in
a classroom larger than eight children with
three adults. Working with these kids was
physically and emotionally demanding, and
unfortunately, in many cases, it took time to
see any results.
However, one of the special things about
working at a small self-contained school is
being a part of a team. Being an itinerant school
therapist can be a lonely role and a challenge for
any new therapist trying to learn from others. Beard houses two full time psychologists, two
full time social workers, 3 speech language
pathologists, a behavior therapist and some of
Chana Goldstein MS, OTR/L
Chicago Public Schools
the best and most dedicated teachers I have
ever met. We collaborate with each other
daily about behaviors that we observe, and
each discipline brings its own knowledge set
into interpretation and treatment. Working
together so closely allows us to build a plan
that takes into account the focuses of each
professional and treat the whole child. I have
learned so much from each of these individuals
and making myself part of a great team has
made me better.
When I started at Beard, the model used
in treatment was a pull out model in which
kids were removed from the classroom for
their OT sessions, which often focused on
fine motor tasks, and transitioned
back into the classroom following
treatment. Over the years, the
other therapists and I realized
that this nonintegrated approach
to therapy kept us from really
getting to know the students. We
would sit in IEP meetings and
hear descriptions of the child’s
behaviors that we had never seen
in our short weekly sessions. As
a related service, we felt that OT
had to shift to a more integrated
model. We started working
in the classrooms, and it was
not long before teachers started
approaching us with concerns far
beyond handwriting. Teachers
also began including us in curriculum and
IEP development. Interactions with parents
increased as well, and we became an even
more integral part of the child’s education. Today, this integrated approach to
treatment is going strong. I assign myself to
each room for a large block of time. During
that time, I assist with arrival and departure
routines, toileting, snack, circle times, one
on one box times, and of course, direct OT
sessions. Consultation with the teacher fits
naturally in the day. For example, if a sensory
modification is required to increase a child’s
attention and participation, I can implement
those strategies in the moment. No time
is wasted waiting for the teacher to track
me down, describe the behavior, and begin
the trial and error process that comes with
building any sensory diet. In addition to one on one and small group
treatment, I also run groups in each of my
classrooms. Running groups with the whole
class, including those not on my caseload,
also allows me to quickly target children
…Continued on Page 9
January / February / March • Issue 1 • 2013
Clinical Spotlight: Chana Goldstein (continued from page 8)
who need services before they fall too far behind as well as
engage the kids in a more playful way. Each of my teachers
and I collaborate on the type of activity best suited to the
students. We choose groups that will challenge the children’s
abilities as well as tap into their interests. I can connect
with the kids during a fun activity more than I can during
handwriting drills, which is especially crucial with kids with
Autism who struggle to make connections with others. I
run fine motor groups that usually include a sensory based
craft paired with a writing task. The crafts may include
coloring salt to make a beach poster for summer, melting
crayons onto wax paper to make a tree changing colors in
the fall, mixing shaving cream with glue to make a puffy
snowman in the winter, or paper mache to make a football
pinata for the Superbowl. I also do sensory motor groups
designed to increase body awareness and to provide input to
increased overall organization prior to tablework activities. I use several homemade sensory games like sensory dice, a
fishing game with different sensory activities on each fish,
and movement cards similar to yoga. I run fine motor
board game groups that also work on social interactions. Interactions between peers can be unpredictable and ever
changing making it especially difficult for kids with Autism. Board games allow interactions that are unchanging and easy
to anticipate making it an easy place to facilitate successful
peer interactions while still working on motor skills in an
enjoyable way. My favorite groups are my cooking activities
that incorporate sensory activities and self-care tasks. Food is
so motivating that most kids are more engaged in a cooking
group than they would be in another fine motor task even
if it includes the same challenging tasks. It also gives an
opportunity for picky eaters, as many children with Autism
are, to engage with new foods in the hopes that they may be
willing to try something new.
In a system always short on funds, it can be a struggle
to obtain the resources needed. I have written many
grants over the years to ensure that I have the supplies and
resources necessary to make these experiences available to
the kids. Chicago Foundation for Education and Donors
Choose are some of the organizations that provide simple
grants to people working in education. I am grateful to these
organizations for making it possible for me to provide these
activities, and I feel that these groups have increased the level
of engagement I have with the classroom and the kids. Being a school based therapist with this difficult
population has given me more than I could ever have given
them. I get to work in the child’s natural environment, see if
my interventions generalize to other areas, and work towards
that end. My job also gives me a creative outlet so many
jobs do not offer. I get to color, melt crayons, and play with
playdoh. I do yoga, play catch, and ride around on scooter
boards. I have even had the opportunity to bring my favorite
pastime, cooking, into my day. There is immense joy in
some small things we take for granted in typical kids like a
successful toilet training, self feeding, and figuring out how
to put together a craft to match a model. Working so hard
towards these goals makes the feeling of accomplishment
even sweeter. However, the most rewarding part of my job
is making the parents see the value in these small things as
well. Being a parent of a child with Autism can be so frustrating. The amount of work required to meet the child’s needs are
immense and the appreciation and reciprocity given from a
child with Autism may be very limited. Additionally, the
world often judges rather than supports parents of children
with Autism. Because Autism often lacks any outward
physical signs, people may conclude that parents of children
with Autism are simply “bad parents” who are incapable of
controlling their children when out in public. As an OT, I
can work with a child on so many areas and occupations, and
it allows me to be strength based with the parents, sharing
the child’s potentially hidden successes instead of merely the
deficit areas. If I can make a parent feel good and proud of
their special needs child even for a moment then that is my
greatest reward.
Three years ago, the struggle against Autism hit home. One of my five children was diagnosed with Autism at age
two and a half. While no one can say they are happy to
have a child with a disability, I cannot help but feel that it
has made me a better therapist and given me “street cred”. It is easy to fall into a pattern of giving parents so many
ideas of things to do at home to maximize function without
considering the extra stress that it may put on the parents. I now understand the struggles that parents are facing, and
I am familiar with the battle to incorporate therapeutic
interactions within a busy home routine. I, too, have figured
out how to juggle kids, homework, therapies, and running
a house into my schedule and try to share these successfully
tried strategies with parents.
My time at Beard has made me see that the future of
OT is in making ourselves an indispensible part of the
team working with a child. This includes supporting the
other members of the team and taking on jobs that do not
initially seem to be our domain for the greater good of the
team and therefore, the child. Occupational therapy can
encompass so many occupations of childhood, and we must
be open minded as to our role in treatment. We cannot
allow ourselves to be put in a small box as the person who
works on fine motor deficits, the person who does sensory
activities, or the person who works on dressing. We are all
of those things, but we are also a whole lot more. Our role
in treatment and as a team member is only limited by our
imagination, and we can work in conjunction with other
stakeholders to broaden our scope and treat the whole child. In that way, Occupational Therapy can remain a strong and
important service in the future.
People ask if it is hard to work with this population all
day, only to leave and battle the same issues at home, and
I understand their concern. The physical and emotional
demands, as well as the constant changing nature of its
presentation, make Autism a difficult battle to fight, but it’s
my battle and I love it.
Page 9
Research
Update
Intentional Relationship
Model Clearinghouse
Research Update
If you would like to be
featured in a Reseaerch
Update or know someone
who would, please contact LaVonne St. Amand at lavonne.stamand@
yahoo.com
Page 10
Renee Taylor, PhD. at the University
of Illinois at Chicago, UIC, has established an
intentional relationship model, IRM, Clearinghouse. The IRM Clearinghouse is expanding research, communication, and resources
for occupational therapists. The intentional
relationship model “explains how components
of the client-therapist relationship interact and
can be enhanced in the face of everyday challenges to that relationship” (Taylor, 2008).
At UIC, Dr. Taylor has established a
Clearinghouse with multiple features such as a
ListServ and webpage to disseminate her model. The IRM Clearinghouse ListServ functions
to provide a communication link between
those who are researching, studying, and using therapeutic communication and use of
self. The IRM ListServ will share educational
strategies for teaching topics related to use of
self and client-therapist communication, gain
support from shared anonymous client dilemmas and topics regarding use of self, share
research projects involving IRM and obtain
consultation, and learn to use and access IRM
assessments for education, research, and clinical use.
The IRM webpage will serve as a center for resources, products, and articles to help
educators, practitioners, researchers and students’ best utilize the therapeutic use of self.
The webpage will also include tools that may
assist an individual use the intentional relationship model.
In addition to the creation of the IRM
Clearinghouse, Dr. Taylor is also expanding research on the intentional relationship
model. This research is to expand evidence on
IRM and validate assessments that evaluate
IRM principles. Current studies include one
conjunction with Hwei-Lan Tan and Esther
Baily Zubel, OTS
University of Illinois at Chicago
Research Assistant
Tai at National University
Hospital Rehabi litat ion
Center in Singapore and Dr.
Taylor’s doctoral student
SuRen Wong.
This
study
evaluates the
client-therapist
relationship and client-student therapist relationship. The relationship is being measured
through the Clinical Assessment of Modes
Client Version, CAM-C, before and after
therapy in addition to the Clinical Assessment
of Modes Therapist Version, CAM-T. Both
the CAM-C and the CAM-T are undergoing
reliability and validation studies at UIC.
The Department of Occupational
Therapy at UIC has joined with the University of Illinois Medical Center, UIMC, to work
on both reliability and validation of CAM-C
and CAM-T and providing research on clienttherapist interactions and perceived participation. This study is aimed to begin in early
August.
To Join the IRM Clearinghouse ListServ please email “SUBSCRIBE IRM” to listserv@listserv.uic.edu. For more information
on the IRM Clearinghouse please email irm.
clearinghouse@gmail.com or visit our website
at https://www.uic.edu/IRM.
Reference:
Taylor, R. (2008). The intentional relationship: Occupational therapy and use of self.
Philadelphia: F.A. Davis Company.
Wanted: Research Studies
We are interested in hearing about research projects. These can be projects facilitated by students,
clinicians or professors in academic or workplace settings. You are welcome to summarize research
that has recently been presented in publications or at seminars or poster sessions at conferences.
If you have recently completed a project, we would love to hear from you so we can showcase the
results. Remember, research is important. It helps to validate our work and inspires us to look into
innovative ideas. All articles short or long are accepted and enjoyed.
If interested, please contact codycheq@aol.com!
January / February / March • Issue 1 • 2013
Meet the Communiqué Committee!
Carrie Nutter
Hi. My name is Carrie Nutter. I’ve been a member of the Communique
newsletter team since 2007 and the editor since 2010. I received my
B.A. in Psychology and M.S. in Management of Public Services from
DePaul University and my M.S. in Occupational Therapy from Rush
University. I currently work as an OT full-time at Chicago Public
Schools and part-time in the hippotherapy program at Freedom
Woods Equestrian Center. Besides school-based therapy, I also have experience working in
hospital, long term care, outpatient and home settings. Prior to a
career in occupational therapy, I worked in social service management. I value the human-animal bond and have taken courses on animalassisted therapy, hippotherapy and rehabilitation to help animals with
debilitating conditions. I volunteer with special events for numerous animal rescue/welfare groups.
My interests include animals, vegetarianism/veganism, horseback riding, tennis, party planning and writing. I reside
in Lincoln Park (city condo) and Carol Stream (suburban house) with my husband, George and our 13 ½ year old
Greyhound, Grayson and 6 year old long-haired cat, Monet. Thank you to everyone who has helped make the
Communique the success it is and I look forward to hearing from even more of you in 2013!
…Continued on Page 14
Student Voice (continued from page 6)
increase the aggressive behavior. Instead, they would sit
him in the time-out chair until the aggressive behaviors
stopped. The student would then join the other students.
In addition, during the mental health course, I was taught
how to choose activities depending on diagnoses and
certain behaviors. As a result, during play-time, I helped the
aggressive student choose an activity that would allow him
to get some aggression out while not being violent. When
the student started being mean to other students, I asked
him if he’d like to make “cookies” using play dough. This
activity allowed the student to use repetitive movements in
order to roll the dough into a ball. These repetitive motions
seemed to really calm him down. After the student had
played with the play dough without the presence of other
students for a bit, I invited some of the other students to join
us. Without becoming aggressive or violent, the student sat
side by side with the other children.
Though my Level
I fieldwork did not
take place in an
occupational therapy
setting, I feel that
I gained a great
deal of knowledge
and experience in
interacting with both
professionals and the
students. I was also
able to truly apply
the concepts that I had learned in class to my experience
at the Early Learning Center. Not only was my experience
extremely enjoyable, it was also very beneficial to me as an
occupational therapy assistant student.
Page 11
Photo
Opinions
What inspires you about
working in academia?
We value our colleagues’ opinions and views! In each issue we will ask a different question.
Some may be thought provoking and some may be more whimsical, since as OTs we face both
serious concerns and opportunities for creativity. We will feature responses and photos from different
clinicians or students in each issue. If you have an idea for a question or would like to be considered
for a future issue, please contact us.
Training Future Occupational Therapists
I enjoy educating students about fieldwork and witnessing
how students blossom and grow into professional occupational
therapists. Students go through an amazing transformation from
the time they enter the program at orientation to the time they leave
fieldwork and emerge as competent occupational therapists. It is
exciting to see the changes which occur during Level II fieldwork
when students apply what they have learned in school and translate
it into occupational therapy practice. As an Academic Fieldwork
Coordinator, I realize this transformation is often facilitated by the
fieldwork educators who willingly give of their time and expertise to
educate the next generation of occupational therapy practitioners. I am fortunate to be able to collaborate with a great group
of fieldwork coordinators and educators. I often have the added
bonus of collaborating with former students who become fieldwork
educators. It is always extremely gratifying when former students
contact their schools because they “want to take a fieldwork
Minetta S. Wallingford, MHS, OTR/L student”. It is very rewarding to be part of this dynamic circle of
Assistant Professor, Academic
training future occupational therapists.
Fieldwork Coordinator
Midwestern University
Witnessing the Joy in Discovery
Photo Opinions
If you would like to be
featured in Photo Opinions or know someone
who would, please contact Carrie Nutter at
codycheq@aol.com
Page 12
People ask me if I miss working with patients, and I say, “yes,
but being a faculty member allows me to be part of a similar process
with the students. I observe them learning and growing and going on
to pursue their goals, and I know I am a part of that experience”. After
almost 25 years at UIC, I still get butterflies before the first day of class,
and choked up on graduation day. Teaching is the next best thing to
having children, a chance to influence the future. It is powerful – helping
to shape the next generation of therapists. Knowing that what you teach
them may get passed on as they interface with future clients, families and
colleagues; being there to witness their joy in discovery and those “aha
moments”; having them come up to you many years after graduation and
tell you that something you taught them stuck with them and helped
them over a rough spot. I love being a teacher and feel very fortunate that
I am in a place like UIC where I can learn and grow and have my own
“aha moments” on a continual basis. Being part of a teaching/learning
community has enriched my life and I encourage all practitioners and
students to consider walking down this road at some point in the future.
Gail Fisher
University of Illinois Chicago
What inspires you about
working in academia?
Working with the disability community to overcome barriers
As a practicing clinician in Southwest Louisiana, I was always interested in the question
of “what happens next?” Why do some people flourish and some flounder upon community
re-entry? Critical to these questions were issues of equity in service and resource allocation. My qualitative research with people with disabilities who are facing major life transitions has
highlighted that access to supportive resources is foundational to people’s abilities to live and
participate in the community. Negotiating care and coordinating services are not, however,
skills that are typically addressed in rehabilitation. I do research that helps to understand
the barriers to care and social services that people with disabilities experience and to develop
strategies to help people overcome these barriers. I believe that by working collaboratively
with the disability community we can harness existing strengths and knowledge to develop
practical solutions to these problems. I am currently working on two community-based participatory research studies with
the Health Policy Team at Access Living (a local center for independent living) to examine
barriers to primary care among Medicaid beneficiaries with disabilities and cancer screening
among women with disabilities. We are working to developing community-driven models
of patient navigation to help people overcome these barriers to care. I do research because I
believe health is foundational to occupation and because I believe that navigating the social
service and healthcare systems are vital occupations that enable people with disabilities to live
their lives to the fullest. Susan Magasi
Assistant Professor
University of Illinois - Chicago
Sharing passion with OT students
I am honored to be an occupational therapy educator. Thanks to my mentors and the
teachers who came before me, I understand the awesome significance that occupation has in
expressly shaping people’s lives. I believe in the healing power of occupation and appreciate the
art and the science that is involved in viewing an individual’s engagement in occupation as both
a therapeutic modality and an outcome of our interventions. Being an OT educator has given
me the opportunity to share this passion with OT students. I feel privileged to have a hand in
shaping my students’ clinical reasoning. I enjoy supporting them as they begin to appreciate the
intricate details of occupational therapy theories and how they can collaborate with their clients
to help them fulfill the roles that are meaningful to them. I particularly love preparing students
to work in the area of pediatrics. I enjoy witnessing the transformation that many students make
from seeing children merely as “kids” to viewing and respecting them as individuals who have
their own set of values, interests, and beliefs. I am grateful for the opportunity to prepare the
next generation of occupational therapists. My greatest hope is that my students will go on to
hold fast to the core values of our profession, advocate for their clients, and carve out new roles
for us in emerging areas of practice.
Susan Cahill
Assistant Professor
Midwestern University
Page 13
Communiqué
Meet the Communiqué Committee!
LaVonne St. Amand, MPH, OTR/L
Hello, I am LaVonne St. Amand and have been working with the Communiqué
newsletter team since 2008. I have more than 45 years of experience as a healthcare
professional presenting teaching and consulting in the areas of strategic planning,
business development, program development communications and marketing to
business professionals and healthcare graduate students.
My undergraduate degree in Occupational Therapy is from Eastern Michigan University
and my graduate degree in Administration and Business is from University of Hawaii.
I have been fortunate enough to work in all traditional venues for Occupational Therapy
and also take our unique skills and perspective into the business world to advocate and
educate as well as having my own consulting practice. I recently retired as Asst. Professor and Academic Fieldwork
Coordinator for Midwestern University.
I have been a life time advocate for the rights and access for the disabled community demonstrated through my community
outreach, personal and professional activities throughout my life receiving recognition from a number of organizations. I
sit on several boards and has been active in the volunteer community for various organizations. My career has provided
me with being a guest speaker, writing and being published for a number of Occupational Therapy and business venues
nationally. My personal passions are animals, nature, and paying forward in any way that presents itself.
Mara Sonkin, OTR/L
My name is Mara Sonkin. I have been an Occupational Therapist since 2007
and part of the ILOTA communique for two years. I completed my undergraduate degree at Valparaiso University in Psychology
and then continued on to receive my MOT at Midwestern University. I am lucky to have worked in acute care, sub-acute and outpatient settings. At this time I am working in the acute care setting focusing on critical care. I also spend time working in outpatient performing cognitive and visual
rehab. I enjoy working with a variety of clients and have developed a strong
passion for working with stroke patients. I recognize the strong component
of psychosocial factors involved in stroke recovery. I am part of multiple
groups that promote social involvement and education for stroke survivors. Other interests outside of Occupational Therapy include tennis, traveling, hiking, theater, and cooking. It is an honor
to be part of such a wonderful profession that has such a strong impact others. I am looking forward to continuing to
be involved in the OT profession and part of the Communique team. It has been a wonderful experience.
Page 14
January / February / March • Issue 1 • 2013
A Seed of Hope…
Sitting in my car in front of their house for the first
time, I reviewed the reports—again. I had never heard
of his diagnosis before I looked it up, an autoimmune
disease that is degenerative and typically very quickly
progressing. I held my breath in thought for a moment,
and went to meet my new client.
His mother and grandmother greeted me and
introduced me to Chris. He was a beautiful blue eyed,
brown haired, 5 month old little boy, with no motor skills
or awareness to note and very low muscle tone. Tearfully,
Mom told me, “His condition has been stabilized by
medications. But… the doctors say that he will always be
a vegetable.” As Grandma watched, I held him, rocked
him, ranged his limbs and provided tactile input to his
skin.
With all of the earnestness in my soul, I looked each
one in the face and said: “I can’t tell you that the doctors
are wrong. I can only tell you that we are going to try.”
It was the glimmer of hope that the family was
craving. Their relief was visible as tension fell from their
brows and shoulders. Someone was going to try. “That is
all we ask for.”
I cried with the family that day. I cried with them
more times that I can count over the months working
together.
Chris’s family was full of love in doing the home
programming with Chris and diligent in being present
for therapy sessions. One particular summer day when
the sun was shining, I arrived to find that Grandma
had laid-out a blanket under a shade tree and littered
it with the bright and squeaky toys that had started to
gain Chris’s attention. Thoughtfully, she added a glass
of ice tea for me. Realizing that the change in setting,
sensation, and sunshine were good for him, the family
wanted Chris to be able to have time outside too. We all
‘played’ outside that day.
After about 7 months of working together, the
family informed me that they would soon be moving to
Kentucky for family reasons. We started to cry together
again, as they delivered the truly tragic news: Kentucky
Early Intervention would not accept evaluations and
reports from Illinois Early Intervention and would not
open a file on Chris until they were actually living in
Kentucky. This information would most likely mean
at least two months without any therapy for Chris. A
shift to private therapy, even for two months, wasn’t an
affordable option.
To help, I put together a large binder with progressive
home programming to hopefully get them through the
therapy lapse. Each of his therapists did. And then, on
my last day with the family, a magical moment happened,
Natalie D. Loewe, MS, OTR/L
which left an indelible
print on my soul. The memory remains
burned in my mind,
in the same fashion my
own children’s births
are.
I was talking with
Mom and Grandma,
saying goodbye, and
glancing at Chris as he
sat contentedly in his swing. His pacifier dropped out
of his mouth and onto the tray. He reached down, felt
around until he found the pacifier, picked it up, turned it
around and put the correct end of it into his mouth, and
happily continued to suck on it, his baby-cheeks puffing
in and out.
I could feel the tear tracks as I turned to his family:
“I don’t know how far Chris will be able to go, but that
is not a vegetable.” And we cried together one last time.
I think of Chris often, and wonder how he is doing,
what he is able to do now, and even whether he is still
living, as it has now been about 9 years since I last saw
him. There were so many things that made this family
special. He continues to be one of the youngest children
that I have worked with through Early Intervention. He
continues to be the lowest functioning child that I have
ever worked with. His family was magnificent in their
love, patience, diligence and hope for Chris. When it
came time to discharge Chris, there was still so much
left to do and so many questions… that was hard for me.
I met Chris during my first year as an Occupational
Therapist, and he is the big one that sticks with me.
Usually when I discharge a child, I have an idea of what
the prognosis will be for future development and course
of therapy and such. With Chris, I just didn’t know. Still
don’t know. I know that I made a difference for that
family though. It is very possible, likely even, that another
therapist could have gone in and helped Chris to make
the gains that he did. But it wasn’t another therapist. It
was me. And I believe that as much as I helped the family
gain skills to help Chris, I believe that the biggest, most
important thing that I gave that family was hope.
Hope for growth.
Hope for relationship.
Hope for a meaningful life for Chris.
Page 15
Submit Articles to the Communiqué Each issue of the Communique seeks to highlight areas of Occupational Therapy Practice. We appreciate our
readers’ wide-ranging experiences. Each issue features a different theme:
Jan/ Feb/March: Education, Research, Pediatrics
April/May/June: Gerontology, Home Health, Low Vision
July/Aug/Sept: Physical Disabilities, Hand Therapy, Driving Rehabilitation
Oct/Nov/Dec: Mental Health, Work Hardening, Ergonomics
Do you have an article that does not fit the themes already listed? Send it. We welcome articles from diverse and
novel perspectives.
Article Guidelines:
• Articles should contain title, introduction, body, summary, and references when appropriate.
• Theme articles might include photos and/or graphics.
• Articles should be approximately 300-1000 words. • Authors are requested to submit a professional biography, maximum 35 words.
• Passport type photos are recommended for author photo.
• All work should be original work. If work submitted is not original, one must have written permission from
the original author to place specific item in Communique publication. Please use quotes when quoting
others and give credit to original authors.
• Please give credit to individuals who collaborated to complete article (e.g.- those helping with research,
providing background information, helping write article,etc.).
• For the next issue, articles should be submitted by May 15!
SUBMIT ARTICLES TO: codycheq@aol.com
The Communiqué editorial committee reserves the right to edit any material submitted.
Page 16