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LCFS Glossary*
* Unless otherwise noted all entries are from the Medicare Glossary

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Significant Points - Occupational therapist assistants generally must complete an associate degree or a certificate program; in contrast, occupational therapist aides usually receive most of their training on the job. Occupational therapists are expected to delegate more hands-on therapy work to occupational therapist assistants and aides. Employment is projected to increase much faster than the average, reflecting growth in the number of individuals with disabilities or limited function who require therapeutic services.

Nature of the Work - Occupational therapist assistants and aides work under the direction of occupational therapists to provide rehabilitative services to persons with mental, physical, emotional, or developmental impairments. The ultimate goal is to improve clients’ quality of life and ability to perform daily activities. For example, occupational therapist assistants help injured workers re-enter the labor force by teaching them how to compensate for lost motor skills or help individuals with learning disabilities increase their independence.

Occupational therapist assistants help clients with rehabilitative activities and exercises outlined in a treatment plan developed in collaboration with an occupational therapist. Activities range from teaching the proper method of moving from a bed into a wheelchair to the best way to stretch and limber the muscles of the hand. Assistants monitor an individual’s activities to make sure that they are performed correctly and to provide encouragement. They also record their client’s progress for the occupational therapist. If the treatment is not having the intended effect, or the client is not improving as expected, the therapist may alter the treatment program in hopes of obtaining better results. In addition, occupational therapist assistants document the billing of the client’s health insurance provider.

Occupational therapist aides typically prepare materials and assemble equipment used during treatment. They are responsible for a range of clerical tasks, including scheduling appointments, answering the telephone, restocking or ordering depleted supplies, and filling out insurance forms or other paperwork. Aides are not licensed, so the law does not allow them to perform as wide a range of tasks as occupational therapist assistants.

Training, Other Qualifications, and Advancement - An associate degree or a certificate from an accredited community college or technical school is generally required to qualify for occupational therapist assistant jobs. In contrast, occupational therapist aides usually receive most of their training on the job.

There were 161 accredited occupational therapist assistant programs in 2003. The first year of study typically involves an introduction to healthcare, basic medical terminology, anatomy, and physiology. In the second year, courses are more rigorous and usually include occupational therapist courses in areas such as mental health, adult physical disabilities, gerontology, and pediatrics. Students also must complete 16 weeks of supervised fieldwork in a clinic or community setting. Applicants to occupational therapist assistant programs can improve their chances of admission by taking high school courses in biology and health and by performing volunteer work in nursing care facilities, occupational or physical therapists’ offices, or other healthcare settings.

Occupational therapist assistants are regulated in most States and must pass a national certification examination after they graduate. Those who pass the test are awarded the title “Certified Occupational Therapist Assistant.”

Occupational therapist aides usually receive most of their training on the job. Qualified applicants must have a high school diploma, strong interpersonal skills, and a desire to help people in need. Applicants may increase their chances of getting a job by volunteering their services, thus displaying initiative and aptitude to the employer.

Assistants and aides must be responsible, patient, and willing to take directions and work as part of a team. Furthermore, they should be caring and want to help people who are not able to help themselves.

* U.S. Department of Labor

Significant Points - Employment is projected to increase faster than the average, as rapid growth in the number of middle-aged and elderly individuals increases the demand for therapeutic services. A bachelor’s degree in occupational therapy is the minimum educational requirement; beginning in 2007, however, a master’s degree or higher will be required. Occupational therapists are increasingly taking on supervisory roles. More than a quarter of occupational therapists work part time.

Nature of the Work - Occupational therapists (OTs) help people improve their ability to perform tasks in their daily living and working environments. They work with individuals who have conditions that are mentally, physically, developmentally, or emotionally disabling. They also help them to develop, recover, or maintain daily living and work skills. Occupational therapists help clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. Their goal is to help clients have independent, productive, and satisfying lives.

Occupational therapists assist clients in performing activities of all types, ranging from using a computer to caring for daily needs such as dressing, cooking, and eating. Physical exercises may be used to increase strength and dexterity, while other activities may be chosen to improve visual acuity and the ability to discern patterns. For example, a client with short-term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decisionmaking, abstract-reasoning, problem-solving, and perceptual skills, as well as memory, sequencing, and coordination—all of which are important for independent living.

Therapists instruct those with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, in the use of adaptive equipment, including wheelchairs, splints, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop computer-aided adaptive equipment and teach clients with severe limitations how to use that equipment in order to communicate better and control various aspects of their environment.

Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners arrange employment, evaluate the work environment, plan work activities, and assess the client’s progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the work can be successfully completed.

Occupational therapists may work exclusively with individuals in a particular age group or with particular disabilities. In schools, for example, they evaluate children’s abilities, recommend and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities. Occupational therapy also is beneficial to the elderly population. Therapists help the elderly lead more productive, active, and independent lives through a variety of methods, including the use of adaptive equipment.

Occupational therapists in mental-health settings treat individuals who are mentally ill, mentally retarded, or emotionally disturbed. To treat these problems, therapists choose activities that help people learn to engage in and cope with daily life. Activities include time management skills, budgeting, shopping, homemaking, and the use of public transportation. Occupational therapists also may work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders, or stress-related disorders.

Assessing and recording a client’s activities and progress is an important part of an occupational therapist’s job. Accurate records are essential for evaluating clients, for billing, and for reporting to physicians and other healthcare providers.

Training, Other Qualifications, and Advancement - Currently, a bachelor’s degree in occupational therapy is the minimum requirement for entry into this field. Beginning in 2007, however, a master’s degree or higher will be the minimum educational requirement. As a result, students in bachelor’s-level programs should complete their coursework and fieldwork before 2007. All States, Puerto Rico, and the District of Columbia regulate the practice of occupational therapy. To obtain a license, applicants must graduate from an accredited educational program and pass a national certification examination. Those who pass the exam are awarded the title “Occupational Therapist Registered (OTR).”

In 2003, entry-level education was offered in 38 bachelor’s degree programs, 3 postbaccalaureate certificate programs for students with a degree other than occupational therapy, and 86 entry-level master’s degree programs. There were 48 programs that offered a combined bachelor’s and master’s degree and 5 offered an entry-level doctoral degree. Most schools have full-time programs, although a growing number also offer weekend or part-time programs.

Occupational therapy coursework includes physical, biological, and behavioral sciences and the application of occupational therapy theory and skills. Completion of 6 months of supervised fieldwork also is required.

Persons considering this profession should take high school courses in biology, chemistry, physics, health, art, and the social sciences. College admissions offices also look favorably at paid or volunteer experience in the healthcare field.

Occupational therapists need patience and strong interpersonal skills to inspire trust and respect in their clients. Ingenuity and imagination in adapting activities to individual needs are assets. Those working in home healthcare services must be able to adapt to a variety of settings.

* U.S. Department of Labor
OCCUPATIONAL THERAPY - A therapy, treatment, or instructional support provided by an occupational therapist to the child, family, and/or pertinent members of the child's environment. Occupational therapy helps develop adaptive or physical skills that will aid in daily living and improve interactions with a person's physical and social world. It focuses on developing functional skills related to sensory-motor integration; coordination of movement; fine motor skills; self-help skills (dressing, self-feeding, etc. ...)

* Our Special Kids.Org
OPPERANT BEHAVIOR* - A term from behaviorist learning theory that refers to behaviors that "operate" on or produce an effect on the environment. Walking, talking, hitting, and reading are examples of operants. Operants are different from respondent or reflexive behaviors.

* www.childrenwithchallenges.net
OPPOSITIONAL DISORDER* - The covert display of underlying aggression by patterns of obstinate, but generally passive behavior. Children with this disorder often provoke adults or other children by the use of negativism, stubbornness, dawdling, procrastination, and other behaviors.

* Our Special Kids.Org
ORGANIZATIONAL DETERMINATION - A health plan's decision on whether to pay all or part of a bill, or to give medical services, after you file an appeal. If the decision is not in your favor, the plan must give you a written notice. This notice must give a reason for the denial and a description of steps in the appeals process.
OSTEOARTHRITIS* - Arthritis is a general term that describes inflammation in joints. Osteoarthritis, also called degenerative joint disease, is the most common type of arthritis. It is associated with a breakdown of cartilage in joints and commonly occurs in the hips, knees and spine. Also, it often affects the finger joints, the joint at the base of the thumb, and the joint at the base of the big toe.

* WebMD Medical Library
OTHER HEALTH IMPAIRED* - Having limited strength, vitality or alertness because of chronic or acute health problems, such as a heart condition, tuberculosis, rheumatic fever, nephritis, asthma, sickle-cell anemia, hemophilia, epilepsy, lead poisoning, leukemia or diabetes, which adversely affect a student's educational performance. Autistic students should be included in this category.

* Our Special Kids.Org
OUT OF NETWORK BENEFIT - Generally, an out-of-network benefit provides a beneficiary with the option to access plan services outside of the plan's contracted network of providers. In some cases, a beneficiary's out-of-pocket costs may be higher for an out-of-network benefit.
OUT-OF-POCKET COSTS - Health care costs that you must pay on your own because they are not covered by Medicare or other insurance.
OUTPATIENT CARE - Medical or surgical care that does not include an overnight hospital stay.
OUTPATIENT SERVICES - A service you get in one day (24 hours) at a hospital outpatient department or community mental health center.


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