4/26/18

OT’s Distinct Value

Distinct Value: Occupational therapy’s distinct value is to improve

health and quality of life through facilitating
Occupational Therapy participation and engagement in occupations, the
meaningful, necessary and familiar activities of
in Mental Health everyday life.

Tina Champagne, OT, OTD, FAOTA

Occupational therapy is client-centered, achieves
April 2018
positive outcomes, and is cost-effective.

(AOTA, 2015)

cc: Nina Matthews Photography - http://www.flickr.com/photos/21560098@N06

OT Practitioners & OT Process Distinct Value in Mental Health

• Identify gaps
• Practitioner • Inform policy, state and federal regulations
• Research
• Consultant Client
Activity &
Factors
Occupational
Demands • Publish
• Researcher • Educate
• Advocate • New roles for OT, including funding
• Administrator • Leadership roles in administration, consultation,
Environmental &
and direct care across MH settings
• Educator Contextual
Demands
• Practice guidelines
• MH: communities of practice, SIG, SIS, mentorship

National Initiatives & Distinct Value International Mental Health Initiatives

Trauma-Informed Care: Model of Care
Examples of national initiatives in mental health:
• Appreciation for the high prevalence of traumatic
– Restraint & seclusion reduction
experiences among consumers
– Trauma informed care
• Building bridges initiative
• An understanding of the profound neurological,
– Recovery movement
biological, and social effects of trauma and violence
– Positive mental health promotion

• Care that recognizes and addresses trauma-related

issues, is collaborative, supportive, and skilled
(NASMHPD, 2003-present)

1
 4/26/18

The experience of being human is embedded

in the sensory events of our every day lives.
- Dunn, 2001
Without understanding the basic principles of how
the brain develops and changes, we cannot expect
to design and implement effective interventions.
Bruce Perry, M.D.

cc: jeronimoooooooo - https://www.flickr.com/photos/76109285@N02

Sensory Modulation Program

– Therapeutic Use of Self
• Verbal and nonverbal communication
• Assessment & Intervention Planning
– Sensorimotor Activities & Strategies
– Sensory Modalities
– Sensory Diet
– Environmental Modifications
– Caregiver Education

(Champagne, 2003, 2006, 2008, 2010, 2011)

www.ot-innovations.com

Research Hypothesis

Children with developmental trauma

often have
trauma-related symptoms &
sensory processing difficulties
that impact occupational participation

(Champagne, 2011; WORK Journal)

2
 4/26/18

Research Method Sensory Integration & Praxis Tests (SIPT)

1. Space Visualization (SV)
Population: • Gold Standard 2. Figure-Ground Perception (FG)
• Exploratory pilot study 3. Manual Form Perception (MFP)
• Volunteer convenience sample from Cutchins Programs for Children & 4. Kinesthesia (KIN)
Families in Northampton, MA • -Created & Initially Researched by: 5. Finger Identification (FI)
• N= 9 (ages 6-12) • Dr. A. Jean Ayres (1989) 6. Graphesthesia (GRA)
• Ages 4-8:11 7. Loc. of Tactile Stimuli (LTS)
8. Praxis on Verb. Command (PrVC)
Assessments: 9. Design Copying (DC)
• OT administered: (2 OTs certified in sensory processing): 10. Constructional Praxis (CPr)
• Sensory Integration and Praxis Test (SIPT) 11. Postural Praxis (PPr)
• Clinical Observations of Motor and Postural Skills 2nd Ed (COMPS) 12. Oral Praxis (OPr)
• Bruininks-Oseretsky Test of Motor Proficiency 2nd Ed (BOT-2; Fine Motor Composite) 13. Sequencing Praxis (SPr)
• Caregiver completed: 14. Bilateral Motor Coord. (BMC)
• Sensory Profile 2 15. Standing & Walking Balance (SWB)
• Short Child Occupational Profile (SCOPE)
16. Motor Accuracy (MAc)
• Clinical Therapist Administered:
17. Postrotary Nystagmus (PRN)
• Child Dissociative Checklist, Version 3 (CDC)
• Trauma Symptom Checklist for Young Children (TSCYC)

Clinical Observations Bruininks-Oseretsky Test of Motor Proficiency 2nd Ed (BOT-2)

of Motor and Postural Skills (COMPS)
– Authors: Bruininks & Bruininks(2005)
• Significant motor and postural skill problems were present in 7 out of 9 • Age range: 4-21
participants (scored less than zero) = 78%
• 6 out of 9 (67%) had below or well below average for composite scores
• Patterns of primary difficulty noted in:
• Finger-to-nose • Fine Motor Composite:
• Prone extension • Fine manual control: Fine motor precision & fine motor integration
• Asymmetrical Tonic Neck Reflex (ATNR) • Manual coordination: Manual dexterity & Upper limb coordination
• Supine flexion

Authors: Wilson, Kaplan, Pollack, Law

• Based on Ayres Clinical Observations
• Age range: 5-15

SCOPE Summary:
Occupational Skills, Performance, & Participation Individuals that have been
traumatized need to
Volition:
• Expression of enjoyment: 6/9 67% have experiences that directly
• Response to challenge: 6/9 67%
Habituation: contradict the emotional
• Response to transitions: 5/9 56%
• Roles: 5/9 56% helplessness and physical
Communication & Interaction Skills
• Conversation: 5/9 56% paralysis that accompany
Process Skills
• Plan and make decisions: 4/9 44% traumatic experiences.
• Problem Solving: 5/9 56%
Motor Skills: (Bessel Van der Kolk, 2004)
• *Note 2 of the 9 children scored all 2’s in all areas of motor processing
• Energy/endurance: 5/9 56%

3
 4/26/18

Mindfulness Through the Senses Sensory Soothers

• Comforting, nurturing, relaxing

Grounding & Distraction Techniques Rhythm, Music, Movement & Arts

• Facilitate reality orientation and to distract from

and/or reduce negative thinking, flashbacks and suicidal
thoughts/behaviors, SIB
– Strong smells
– Strong tastes
– Hot balls/sour candy/lemons
– Chewing gum
– Cold cloth to face/Hold or eat ice
– Movement/exercise
– Pacing
– Weighted modalities
– Tapping/beanbag tapping
78
21

Novelty, Creativity & Exploration Create & Use :Safe Place

4
 4/26/18

PromOTing Recovery AOTA Resource Examples

Safety, stabilization & recovery-oriented care: • AOTA Societal Statement: Stress, Trauma & PTSD
• Preparatory, purposeful and occupation-based - https://www.aota.org/~/media/Corporate/Files/AboutAOTA/
OfficialDocs/Soc-Stmt-PTSD-fin.pdf
interventions
• OT in PTSD:
– http://www.aota.org/-
Building the capacity for: /media/Corporate/Files/AboutOT/Professionals/WhatIsOT/MH/Facts/PTSD
%20fact%20sheet.pdf
• Increased resiliency
• OT in Polytrauma:
• Development – http://www.aota.org/about-occupational-
• Occupational participation therapy/professionals/rdp/occupational%20therapy%20in%20polytrauma.
aspx
• Health & wellness
• OT’s role in Restraint & Seclusion Reduction:
• Quality of life – http://www.aota.org/-
/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/MH/Facts/Restra
int%20fact%20sheet.pdf

Contact Information:

Tina Champagne, OTD, OTR/L, FAOTA

Email: tina@ot-innovations.com
Web Site: www.ot-innovations.com

Networking:
Facebook Group: OT Innovations
Twitter: @TChamp13
Twitter: @OTInnovations
OT Twitter Chat: #OTalk2US
Pinterest: TChamp13

28