Episode Transcript
[00:00:00] Speaker A: Hi, I'm Maggie.
[00:00:00] Speaker B: And I'm Nicole. Welcome to the DAC Dyslexia and Coffee Podcast. We're so happy you could join us. We're both moms and dyslexia interventionists who want to talk about our students and children. What dyslexia is, how it affects our kids, strategies to help and topics related to other learning disabilities will also be covered in this podcast.
Parents are not alone, and we want to give voice to the concerns and struggles we are all having.
This is a safe place to learn more about how to help our children grow and succeed in school and the world. Grab a cup of coffee and enjoy the conversation.
[00:00:36] Speaker A: Hi, everybody. Welcome to episode 73 of Dyslexia and Coffee Podcasts. We're going to start this episode like we have all of our other episodes, with the concept of the week. So the concept of the week is our opportunity as practitioners to kind of peel back the curtain a little bit and let everyone into an interventorship session. We like to teach about things that either we would teach directly to our students and or the things that we would be teaching to their parents and the kind of greater community.
So today's concept of the week is occupational therapy.
Occupational therapy helps people of all ages develop, recover, and maintain skills for daily living and working, called occupations.
This helps them live more independently and more fully.
[00:01:32] Speaker B: Yes. So welcome to episode 73.
We decided to make this episode Ask an Occupational Therapist or ot.
So Maggie's going to be asking the questions, and I'll be trying to answer them.
[00:01:47] Speaker A: My favorite kind of episode.
This is my favorite kind of episode. I get to sit back and ask these questions, you know, and really this episode, the idea for this episode really came up at work with one of our other practitioners who works for us. Her son is seeing an occupational therapist, and she was really kind of like, wow, I can't believe all the things that an occupational therapist really does. And I really do feel like this is such a field that is misunderstood and kind of just not even misunderstood, but not even really understood at all.
[00:02:29] Speaker B: A lot of people think we get people jobs. Yes.
[00:02:33] Speaker A: The word occupation. Yes. Yeah. Thinks. Think like vocation, right? Yes.
[00:02:39] Speaker B: That's what people think we do, but I really don't.
[00:02:44] Speaker A: That's not it.
So my first question for Dr. Nicole Boynton, who is an occupational therapist, is what is the difference between occupational therapy and physical therapy?
[00:02:59] Speaker B: We get that question all the time. And most people think we are like physical therapy.
[00:03:04] Speaker A: Yes.
[00:03:05] Speaker B: But basically occupational therapy, we focus on enabling people to do meaningfully Daily, meaningful, daily activities. Right. So dressing, cooking, even working.
And we do that by adapting the task, we adapt the environment.
We improve strength, we improve mobility, we improve range of motion. We do mental health intervention, and we do cognitive intervention, which is back to our topic of the week. Right.
[00:03:35] Speaker A: Yeah, yeah.
[00:03:36] Speaker B: So our scope of practice is very broad, which I think that makes it hard to define, which. And it looks at really a lot of different ways that we can specialize.
[00:03:48] Speaker A: Yeah, I think. Yeah, that kind of. Like, what is the difference between physical therapy and occupational therapy? I think a lot of people's experience with both of those kinds of therapy comes, like, after an injury or as we watch, like, aging family members.
[00:04:10] Speaker B: Right, right.
[00:04:10] Speaker A: We hear like, oh, yes, they're in physical therapy and occupational therapy. And I think it is hard to understand for the general public. You know what? Really, what. Where does kind of one specialty begin and then the other one kind of. And so, like, while there's lots of overlap.
[00:04:29] Speaker B: There is some differences.
[00:04:30] Speaker A: There are some differences.
[00:04:33] Speaker B: So physical therapy, they concentrate more on the physical function like mobility, strength, range of motion, and they make sure that the body can move better. So they're really focused on the body and the body's recovery. Well, we look at more the broad picture of, yeah, the body is included in our area, but we also look at mental health, cognition, and the environment, which physical therapists don't typically.
[00:05:04] Speaker A: Yeah. Because it's really a lot about, like, adaptive funk, adaptive functioning.
[00:05:09] Speaker B: Correct.
[00:05:10] Speaker A: So, yes, you're concerned with, let's try to improve these movements, but also.
Okay, what actually has to happen for this person?
What do they have to be able to do? And then how do we get to that place?
[00:05:29] Speaker B: Yes.
[00:05:29] Speaker A: By strengthening the body and also adapting environment where not. Not so much with pt, Correct.
[00:05:39] Speaker B: Yeah. Yes. Yeah.
[00:05:41] Speaker A: Sometimes I hear.
[00:05:42] Speaker B: And this is.
[00:05:44] Speaker A: You're going off script.
[00:05:46] Speaker B: We do that a lot.
[00:05:47] Speaker A: Sometimes I hear kind of the generalization that while a physical therap therapist is concerned mostly with, like, the gross motor function, where an occupational therapist is concerned mostly with the fine motor function.
How do you feel about that generalization?
[00:06:08] Speaker B: Well, I mean, it's a generalization. Right. Honestly, if the fine motor and the gross motor impact, an OT can use do either and they can do both together.
But, like, more of the mobility that you traditionally see with physical therapy, that's more of a gross motor. Sure.
Aspect. But we're looking at the whole person. So depending on what their need is.
[00:06:34] Speaker A: Yes.
[00:06:34] Speaker B: We couldn't do either or both.
[00:06:37] Speaker A: That's really interesting.
Leads me kind of to our next Question, which is, what areas could an.
[00:06:47] Speaker B: OT be working on?
Oh, that's a big question because we're everywhere, which is kind of funny because people don't realize that, but we can work in many different environments.
Our background where we originally started was in one of the early wars, occupational therapists. We went and did functional tasks with veterans, and that's where OT started.
So mental health was the forefront of where we were and where we want to still be.
But we also can work in hospitals, we work in acute care, we work in skilled nursing facilities, home health, outpatient practices, maternal baby care. We do a lot of lactician coaching, we do schools, ICU, NICUs for little babies, driving, work environments. I mean, really, we can work anywhere. Yeah, because anywhere you live, you have an occupation or work or go. Right, Right. So that's where we end up. Right.
[00:07:59] Speaker A: I mean, I think that that makes a lot of sense and I think it's kind of.
I think our listeners will find that interesting. Oh, actually, the broad scope, you know, the OTs that I know, well, that's what kind of leads them to.
A lot of them have kind of more of a specialty underneath that really large umbrella. Because that is such a broad scope that.
[00:08:32] Speaker B: Right.
[00:08:33] Speaker A: Most of the occupational therapists that I know have kind of like a sub specialty or several. Right, exactly. Careers are long, and so there's a lot of ways that people can go exactly. Within the realm of occupational therapy, but it often leads to like a subspecialty.
[00:08:54] Speaker B: Exactly. Which is why people get confused too. Right. Because those specialties are very specialized. Yes.
[00:09:02] Speaker A: I think, like the one that comes to mind for OT is like the hand therapists. Yes, exactly. That's a really specific narrowed down. And I think that might be too, where some of like the fine motor generalization comes into mind, because. Definitely. Yes, that would be. You know, the hands are really complicated. Yeah. And if you have a hand injury.
[00:09:26] Speaker B: Right.
You need your hands for everything.
[00:09:31] Speaker A: Bathing.
[00:09:31] Speaker B: Exactly. Working, taking care of kids, taking care of your pets. Yeah, all sorts of things.
[00:09:37] Speaker A: So. And people who have like a skill, like either a skilled trade or, you know, surgeons who work with their hand, like if they injure or musicians.
[00:09:49] Speaker B: Exactly.
[00:09:50] Speaker A: Right. Like, that's. That's why that specialty, I think, is so one big. I think it's one of the ones that is well known.
[00:09:58] Speaker B: Yeah.
[00:09:59] Speaker A: And it's pretty intensive therapy because if you're trying to get back to doing something you could do before injury.
[00:10:08] Speaker B: Exactly.
[00:10:09] Speaker A: That's gonna.
It's gonna take a minute.
[00:10:13] Speaker B: Right.
[00:10:13] Speaker A: Yeah.
[00:10:14] Speaker B: We also work on like physical deficits, like after stroke.
[00:10:18] Speaker A: Yes.
[00:10:19] Speaker B: Environmental concerns. We do a lot of home modifications adaptations.
You know, there is a specialty area in home modifications where you can get certified and you can actually redesign rooms so that it's more functional for the person.
Mental health interventions.
We do a lot with community mobility, community health incontinence training, which people are like, what? But yeah, that's us. Because what is it?
It's activity of daily living.
[00:10:55] Speaker A: Right, Absolutely right. It impacts your ability to. I mean, function.
[00:11:00] Speaker B: Exactly.
[00:11:01] Speaker A: And it infects falls.
[00:11:03] Speaker B: There's lots of reasons.
[00:11:04] Speaker A: Yeah, yeah, definitely.
[00:11:05] Speaker B: And then in the. For kids, developmental disabilities, executive functioning is a big area that we do work on and people are a little shocked about that.
[00:11:14] Speaker A: Yeah, I think that is said.
I mean, I know, right?
But I think, I think that was probably as I started working in special education and I started working with occupational therapists.
That's a huge overlap. Right. My background is in special education. Threat in my background in training.
I was never really introduced to OTs until I was actually working in the field. And I think that's a real shame because there's a lot to offer. I think from the collaboration mindset where special ed teacher is coming from is a slight. Like a slightly different hat.
[00:12:03] Speaker B: Correct.
[00:12:03] Speaker A: Even though we're working on the same thing. And I think both of those kind of brains together really, really help a kid.
And I think, you know, it's a real shame that there's not a lot. At least in my prep program there wasn't a lot of like, actually these are all the things that an OT can do and like they might be a good collaboration tool for you as you're trying to design instruction.
[00:12:34] Speaker B: Right.
[00:12:35] Speaker A: Or specifically executive functioning.
[00:12:38] Speaker B: Exactly. Yeah.
Another thing we work on is memory. Like a lot of MOTs work in memory care.
[00:12:45] Speaker A: Yep.
[00:12:48] Speaker B: Vision, we can get certified in vision specialists, learning disabilities, what we do. Right.
School based therapy, home health care, where you go into the home, make sure people are safe, able to take care of themselves.
Fall intervention, we actually do swallowing, which depending on the state, sometimes it's speech therapy, sometimes it's ot, sometimes it can be both. So it's kind of interesting that we're overlap with speech in that area a little bit.
Sleep intervention has been a big one.
Motor skills, we do teach assisted technology.
Sensory processing is a really big area for OTs.
So really anything that involves what you do in your life, like hobbies, to jobs, to school, to being able to take care of yourself.
Yeah.
[00:13:48] Speaker A: Why do you think it is that so many People really don't understand occupational therapy.
It's a big field. It is a big ultra, and it's a big umbrella.
So you think you get a bigger piece of the pie in terms of what people know about it?
[00:14:06] Speaker B: You would think. Yes, but no. I think one area is we're really not good at marketing ourselves.
Like, we know a lot of doctors that don't even know what we do. And honestly, they should know what we.
[00:14:21] Speaker A: Do because they're prescribing it.
[00:14:23] Speaker B: Right. They prescribe it. Yeah.
You know, I also think we don't get in front of the community and advocate for ourselves as much.
You know, we tend to be the givers, and I think sometimes we just feel like we shouldn't.
I don't want to say boast, but we don't, like, say, hey, look at what I can do.
[00:14:46] Speaker A: I can do.
[00:14:47] Speaker B: Right.
[00:14:47] Speaker A: Like, insert yourself kind of thing. Even though, like, hi, we're already here.
[00:14:50] Speaker B: Yeah, we're here.
[00:14:51] Speaker A: Sure.
[00:14:52] Speaker B: But we don't do that. And I think that's one way that we need to start stepping up as a whole group of a progression. Right.
And also, our scope of practice is really broad, and so listing everything we do is really difficult.
[00:15:08] Speaker A: Yeah, it is.
[00:15:10] Speaker B: Yeah.
[00:15:11] Speaker A: It's almost like those specialty groups have a better chance of marketing, you know?
[00:15:19] Speaker B: Yes.
[00:15:19] Speaker A: Even though. Yes. It's one field.
But I understand why, like, the hand therapists get their. I guess, do. Right, Right. People understand what they do. It's kind of. It's a discreet bucket.
[00:15:36] Speaker B: Exactly.
[00:15:37] Speaker A: That they do.
Or like people. The OTs, who help people recover from injury, too.
[00:15:43] Speaker B: Same thing.
[00:15:43] Speaker A: Like, I think people do understand.
Oh, they're trying to adapt this so that I can xyz.
[00:15:50] Speaker B: Exactly. You know.
[00:15:52] Speaker A: Right.
[00:15:52] Speaker B: You usually see them in the hospital or right after the hospital, and they're there for a little while and then they disappear.
[00:15:58] Speaker A: Yep.
[00:16:00] Speaker B: But they can also reappear for other things.
[00:16:03] Speaker A: Oh, definitely. Yes.
[00:16:04] Speaker B: Yeah. Yeah.
[00:16:05] Speaker A: It's just kind of interesting.
So what would a typical visit with an occupational therapist.
[00:16:17] Speaker B: Yeah, I mean, we are, you know, a profession that we do an assessment when we first see you.
We find the strengths and the weaknesses and then ask the client their goals.
We're very holistic in our approach.
And then we make a plan with the client.
So, you know, and then we would do, like, let's say they're there because they can't do something at their job. Then we would break down and do an activity analysis, which we're one of the only, I think, professions that knows how to do. That, sure. Like we were taught in school how to break down an activity into all the little parts so we can see what is going to be a challenge.
[00:17:03] Speaker A: Where are we going to get the hang ups?
[00:17:05] Speaker B: Right. Yeah, yeah.
And then what we do is we strengthen, we improve the mobility, we adapt or we modify the task so the person can participate in that task.
So that's kind of how we break it down.
And then depending on why they're there, we might go to another goal or another task, depending on what's been impacted by whatever happened or what is interesting.
Right?
[00:17:32] Speaker A: Yeah. Whatever has led them to.
[00:17:35] Speaker B: Right.
[00:17:35] Speaker A: Seek occupational therapy.
[00:17:38] Speaker B: Exactly. Yeah.
[00:17:41] Speaker A: I think that is helpful to have a better, broader understanding of what actually is occupational therapy.
How would one, like seek an occupational therapist? Like, if you're listening to this episode and you're like, huh, I feel like there's some discrete things that would be helpful either for your own self or something your child is struggling with.
What would be a good way to go about seeking occupational therapy?
[00:18:22] Speaker B: There's many ways.
The easiest way is usually to go to your physician because they're supposed to order it. Yeah. So Wisconsin is a direct service state, which means we don't have to have a physician order, but the insurance companies make us have a physician's order. Even though we legally could see you without a physician's order.
[00:18:51] Speaker A: I believe speech language is that way as well.
[00:18:53] Speaker B: Yes.
[00:18:54] Speaker A: This state anyway.
[00:18:56] Speaker B: And so is physical therapy in the state? Yes, this is kind of.
There are a few states that are like this.
I think more and more states are trying to turn over to that.
[00:19:05] Speaker A: Sure.
[00:19:06] Speaker B: Because, you know, to make it more accessible for people.
[00:19:10] Speaker A: And it clogs up the physicians.
[00:19:12] Speaker B: Correct. Like, well, yeah, if I have to go to my physician first and ask for this and that's an appointment that maybe somebody who was really sick could have used. Correct.
[00:19:22] Speaker A: And you're talking about fully licensed people.
[00:19:24] Speaker B: Correct.
[00:19:25] Speaker A: Can make an assessment and say, yes, you do need our services. No, you do not need our services.
Here's some other recommendations.
[00:19:33] Speaker B: Exactly. Yeah. And we are licensed by the state.
We do have a national board where we have to take a national test when we graduate. So I mean, we have to pass that in order to get credentialed as a registered occupational therapist or an occupational therapist assistant. We do have assistance, which is the only thing that they cannot do is an assessment by themselves.
But they're just as knowledgeable in breaking down the tasks and being able to make goals and implement them.
So I mean, there's definitely changes are really slow, especially with laws and all that stuff.
[00:20:18] Speaker A: The power the insurance companies have as well.
[00:20:20] Speaker B: They have a lot.
[00:20:21] Speaker A: They have. I mean, they have the power to, you know, deny what they're gonna deny. Unfortunately, that's just the way the current. The system works.
[00:20:37] Speaker B: Right.
[00:20:37] Speaker A: Real unfortunate. In a pinch.
Are there ways around that? Like, let's say, you know, in a private pay situation.
[00:20:49] Speaker B: Yeah. Then you don't need to.
Then you just have to follow the licensure laws. You don't have to follow the insurance regulations. I guess.
Because if you're private pay and you're not using your insurance company anyways.
[00:21:04] Speaker A: Yes.
[00:21:04] Speaker B: Then it's not a big deal. Because in states especially like Wisconsin, you can still see you do the assessment, do the intervention, and just kind of move on from there.
So it just really kind of depends. The really cool thing is Wisconsin is part of. So there's a national occupational therapy compact that is being put into place the first four states which have started it, and Wisconsin should be on there pretty soon.
But you can then apply for a state that's in this compact, and if you're online and doing virtual therapy, you can be in that state because you're.
[00:21:48] Speaker A: Technically licensed in that state. That's pretty cool.
[00:21:51] Speaker B: So that's brand new. And yes, we fought really hard in Wisconsin to get on that.
And I'm really excited to be part.
[00:22:01] Speaker A: Of that because, you know, sounds like the accessibility there is a lot greater because it's. If you're in a telehealth situation. Right.
The next available therapist lives in Michigan.
[00:22:17] Speaker B: Exactly.
[00:22:18] Speaker A: You know, you can.
[00:22:19] Speaker B: Or let's say the specialist of something that you want to do is in another state. You can use them if they're part of that compact.
Because, you know, not everybody can be a driving specialist or a lactician specialist. And we all know, based on the research, telehealth is just as effective as being in person for most things.
[00:22:44] Speaker A: For most things, yeah. That's pretty cool. Interesting.
Well, that's interesting.
[00:22:51] Speaker B: That is interesting. Yeah. My favorite kind of episode. I know. Just kind of giving us some knowledge.
[00:22:57] Speaker A: I like to just ask some questions and learn some things. It's a really good day to be me.
[00:23:09] Speaker B: So, Maggie, what is happening beyond the snakes here?
[00:23:12] Speaker A: Oh, my goodness.
Okay, so as we record this, it is mid January, and interestingly enough, it's gonna be, like, 50 degrees outside today.
[00:23:25] Speaker B: I know. Which. For one day.
[00:23:28] Speaker A: For one day. For one day, it's gonna get, like, real cold.
I mean, any day, like, the sun is actually out.
[00:23:35] Speaker B: Yes.
[00:23:36] Speaker A: I'm looking out our window currently. And it's a clear blue sky and it's sunny and it's gonna be 50 degrees in the middle of January.
I'm really pleased and I feel like that's a great date. I just trying to appreciate the little things.
And I feel like a 50 degree day in the middle of January is not a little thing. That's a great.
[00:23:59] Speaker B: It is a.
[00:24:00] Speaker A: When you live here.
[00:24:01] Speaker B: Yes.
[00:24:02] Speaker A: I mean, context for people who do not live here.
Negative 25 degrees in the middle of January is not unusual. Is not unusual.
And 75 degrees higher.
[00:24:19] Speaker B: Right.
[00:24:19] Speaker A: Like I'll take it. So that's. I'm just.
[00:24:24] Speaker B: Unfortunately, tomorrow will be about 25 degrees colder. Colder.
[00:24:29] Speaker A: And we'll be out in about that day trying to lose transportation.
[00:24:33] Speaker B: So. Yeah, it's supposed to snow a little.
[00:24:36] Speaker A: Yeah. But Today, today it's 50 degrees and sunny. So I'm just gonna put my pin in that right now.
[00:24:45] Speaker B: Today.
[00:24:46] Speaker A: What's going on for you, Nicole?
[00:24:48] Speaker B: Yeah, so we, I guess over the weekend we had a sleepover for our son's birthday party, which is actually in December, but usually it's right by Christmas, so we usually don't celebrate it until January. Yes. So instead of three children, we had six children at our house.
[00:25:03] Speaker A: Sure did.
[00:25:04] Speaker B: We sure did.
[00:25:05] Speaker A: Two of them were mine.
[00:25:06] Speaker B: They were so cute and they were so good. And yet I'm so exhausted, I can't even.
I'm still recovering and it's Tuesday.
[00:25:20] Speaker A: They had the best, best time. They were so excited and boy, did they sleep well Sunday night.
[00:25:28] Speaker B: So. Hey, there we go. There we go. Just send them to my house and I'll make them sleep.
[00:25:33] Speaker A: It'll be my turn next time.
I'll take them anytime.
[00:25:37] Speaker B: Anytime.
[00:25:41] Speaker A: Well, thank you everybody for listening. Please follow us on social media and reach out if you have any questions or you would like us to discuss the topic. If you do like our show, be sure to follow and rate our show on your favorite podcast player.
This is how we really get to reach more listeners and then we get to help our families. So thank you, everybody.
[00:26:01] Speaker B: Thank you.
