| 05/01/2012 | |
| NEWSRoom | |
Q&A with Barbara A. Smith, MS, OTR/L, Occupational Therapist at Challenge Unlimited/Ironstone Therapies in Andover, Massachusetts |
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Barbara Smith is an OT specializing in pediatrics and hippotherapy. She has a BA in English from the State University of New York at New Paltz and a master's degree in occupational therapy from Tufts University in Boston. Barbara works at Challenge Unlimited/Ironstone Therapies ( http://www.challengeunlimited.org/ ) working with special needs children. She also writes articles, conducts seminars and is working on her third book. You can learn more about Barbara's work by visiting www.RecyclingOT.com. Q: Can you tell us about your educational background? A: I earned a BA in English during the 1970s before having ever heard of occupational therapy. I serendipitously discovered that I liked working with developmentally disabled adults and later earned my master's degree at Tufts University Boston School of Occupational Therapy. I earned subsequent certifications in sensory integration and hippotherapy that reflect my areas of interest. Q: What motivated you to become an occupational therapist? A: Working at a small residential facility for developmentally disabled adults after college introduced me to the world of human services. The facility was not therapeutic, but rather more like a warehouse. After six months I found a different job as "house parent" to nine men who were being moved out of the infamous Willowbrook State School in New York. The poor living conditions had been widely publicized and the deinstitutionalization movement was growing. At this job, I learned through trial and error how to teach daily living and social skills while creating a home complete with dogs and a garden. I later worked at an ARC day habilitation program where I created activity analyses for teaching ADLs. I think that I was an OT before knowing what the profession was! I applied to graduate school to gain the theoretical knowledge and experiences that, of course, opened many career doors. Q: Can you give a brief description of the different OT settings you've worked in over the years? A: I actually had the pleasure of working in community residences and day programs while writing my thesis. However, my first job after becoming an OT was in an early intervention program. I had no experience working with children, let along such young children with complex conditions. I learned a lot on the job but think that it is better for a more experienced therapist to work in the EI setting. After having a baby, I worked in school collaborative and public school settings. I also worked for several years at a state school with very involved developmentally disabled adults—completing that circle started many years earlier. My current job doing hippotherapy offers opportunities to be creative and be with animals outdoors—all while having fun with young children. Q: As an author, can you talk about your books and the writing process? A: For me, writing, giving seminars and even updating my Facebook page are all facets of sharing and teaching about occupational therapy strategies. It all began when I realized that the activities I created while working at Hogan Regional Center in Danvers, Massachusetts should be shared. The result was my book The Recycling Occupational Therapist—titled as such because I created so many successful activities out of the boxes, bags and bottles that most people throw away. I wrote From Rattles to Writing: A Parent's Guide to Hand Skills because I recognized that many of the children referred for OT evaluations simply needed better and more early sensorimotor experiences that prepare children for the demands of kindergarten. I wrote a parent friendly book that explains typical child development (with a focus on hand skills) and what parents can do to promote it. Activities and strategies described in my books were developed over many years but I have to also give much credit to my publisher and editors who helped me to organize and explain concepts to readers who don't have child development backgrounds. Q: Typically what are your day-to-day responsibilities as an OT? A: I only work one day a week doing clinical work where my responsibility is to evaluate and treat children with a variety of diagnoses, while using the horse as a treatment tool. The rest of my busy week is spent writing articles, doing interviews, and preparing for and giving seminars. I stay on top of the latest OT innovations by writing book reviews and blogging about workshops. All of this helps me as I work on my next book about autism and hippotherapy. Q: What types of patients/diagnoses do you encounter most frequently? A: I had been working in the area of low vision home care but stopped because referrals were few and far between. Most of the low vision patients had macular degeneration. All of my other clinical work has been with children or adults with learning or developmental disabilities. My pediatric clients are very young and many do not have diagnoses yet. But I would say that many are on the autism spectrum, a few have Down syndrome or other genetic disorders and some have more complex physical disabilities due to a neuromuscular disorder such as cerebral palsy. Q: Can you share a memorable story about your profession? A: The first one that pops into my mind happened before I became an OT. As I mentioned, I lived with nine men who had spent all of their lives living in an institution and being treated like children. I encouraged adult clothing and occupations and threw out the Mickey Mouse lunch boxes! My husband had given one of the men magazines with pictures to enjoy in private. One day the resident came downstairs with the centerfold opened to show the social worker, exclaiming that he found a picture of me! We all had a good chuckle, but I want this story to show the importance of recognizing that people with disabilities are whole—and need to have all aspects of occupation addressed—including uncomfortable subjects such as sexuality or aging. As OTs we can impact a person's quality of life from birth until death. I think that is a very powerful concept. Q: Are there other areas of interest for you as an OT, either clinically or educationally, that you plan to pursue? A: That's a good question. Unexpected events have always driven the direction of my work. My young adult son has Asperger's syndrome, so I feel especially connected to the community of special needs parents and the topic of helping adults achieve independence and self-esteem. Perhaps in the future I will find a niche consulting as an autism specialist but for now I love giving OT seminars and writing books that will reach many parents and professionals. I am an occasional guest lecturer at the local community college. I would love to teach a course in pediatrics or developmental disabilities if such an opportunity opened up near home. Q: What do you like most about your job? What do you dislike most? A: I only do hippotherapy once a week, but it is still physically demanding, especially when working with children who need much physical support in order to sit. I have been at this current job for six years and have tweaked changes in my hours and staffing so that I work during the least busy time, with excellent volunteers and my favorite aged clients (i.e. 2-4 year olds). I love seeing their skills and confidence grow and I often hear their first words. Hippotherapy enables parents to view their children as capable human beings who can ride a horse rather than as primarily a disabled child who needs to be shuffled to various therapies all week long. For many children, this is the highlight of their week! Q: Are you currently involved with any research projects? Are there any projects or other areas of interest that you would like to be involved with? A: I am not involved with any research projects. I have considered getting a PhD, but I am enjoying my current career path. There is a need for hippotherapy research, especially in terms of its impact on sensory processing disorders. Much of the past research has focused on how riding improves the client's strength, coordination and gait. That is all important but I am excited by how movement (on or off the horse) can be used to improve engagement, visual attention and hand use in children on the autism spectrum. I am addressing this in my next book. Q: Do you feel that the role of occupational therapists has changed over recent years? A: I think that the role of OT is always evolving as healthcare facilities, insurance companies and the government seek cost savings. Therapists may feel compelled to meet certain goals that allow discharge, even though additional therapy might make the patient stronger, safer and more independent at home. It seems that there are greater numbers of children with diagnoses of ADHD, autism and sensory processing disorders being referred for occupational therapy. OTs have the important role of teaching parents and educators how to integrate sensorimotor strategies into the home and classroom. Starting this model early in preschool may decrease the number of children on IEPs down the road. I see and like the trend of OTs providing services in the classroom rather than only pull-out services. The most skillful OTs are so discreet that the students don't know who the "SPED kids" are and then they can all benefit from the interventions. Q: What do you feel is of the greatest concern to OTs today? A: Another great question. The educational requirement of entry level OTs is now master's level; perhaps it will someday be a PhD. There are also expanding opportunities to specialize in areas such as sensory processing disorders, low vision or hippotherapy. We are a profession dedicated to developing our skills through extensive training and mentorship. So, it concerns me when I see people who are not therapists providing interventions that have traditionally been performed by allied healthcare professionals such as, for example, sensory based learning programs. I am concerned that insurance companies will seek out less expensive providers who lack our expertise. Q: What is the most important thing you've learned over the course of your career? A: Providing skillful and effective treatment is important, but I have learned that my relationships with parents are also critical in terms of impacting a client's life. Twenty-five years ago I worked with a mother who had a very disabled 2-year old who lacked head control, speech and hand skills. I felt that I had little to offer in terms of helping this child gain skills—until the social worker explained how important it was for me to adore this child. I started to focus more on talking about how cute he was, admiring his outfits, his beautiful blue eyes, and the warm relationship between mother and child. I am occasionally told that I am the best therapist the parent has ever met, even at times when I hadn't seen as much progress as I had hoped. Some parents simply want the therapist to mainly validate their parenting skills and that their severely disabled child is lovable. This therapeutic use of Self is one of the best, free, readily available tools in the OT bag of tricks. Q: What advice do you have for others thinking of entering occupational therapy? A: Get as much experience as possible in the type of healthcare setting you think you might enjoy and observe the good and the bad aspects of the work environment. Is the OT overwhelmed, happy, fulfilled, respected or frustrated? If possible check out a variety of settings. I knew that I wanted to work with people with developmental disabilities before entering school and I really disliked working with medically ill people in hospitals. So even if the potential OT dislikes one setting, another may be perfect. The wonderful thing about occupational therapy is that there are so many options. Q: If you could sum up your job in one word, what would it be and why? A: Fun. I came up with this word immediately because when I am happy and having fun so are my clients and that's the first step in helping them to learn and develop to the best of their abilities. |
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