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Among the nation’s five largest cities, Chicago has put aside the smallest portion of its looming pension obligations,  according to a study issued this year by the Pew Charitable Trusts. Its plans were funded at 36 percent by the end of 2012, city documents say. While federal regulators would step in if a corporate pension fund sank to that level, unfortunately,  they have no authority over public pensions.

Given the recent Detroit bankruptcy, the Chicago teacher pension crisis is now national news.    As  therapists who live and or work in the greater Chicagoland, we thought that you may want to read the entire front page article on this problem   as seen in  yesterday’s New York Times   (http://www.nytimes.com/2013/08/06/us/chicago-sees-pension-crisis-drawing-near.html?ref=todayspaper&_r=0).

This problem is likely to touch many Chicagoans either directly or indirectly as well as  all residents of the State of Illinois.   Becoming  better informed about the problem is good place for all of us to start.

 

New Research Challenges the Conventional Wisdom that Minority Students Dominate Special Ed

Special education research is usually a rather dry affair, with almost no one reading the findings other than special educators, special ed teachers, and special ed academics.  A paper published last year has drawn a larger audience because it appears to upend decades of accepted wisdom in the field.    The issue at hand is whether black and Hispanic students are overrepresented relative to their demographics in special education programs.  This has been the conventional wisdom for some time, so a comprehensive study that shows that it is actually white students who are overrepresented in special ed today was bound to garner widespread attention.   As with almost all race-related topics in the US today, there is a tendency to argue the points with more heat than light.   My goal in this blog is to do the opposite.

In 2015, education professors Paul L. Morgan and George Farkas published a peer-reviewed analysis stating that there is clear bias in the way students are identified for special education. But the bias went in an unexpected direction, they said: By their calculations, black and Hispanic students are universally underrepresented compared to their white peers in a variety of categories, including emotional disturbance and specific learning disabilities, such as dyslexia.   Their findings are directly opposite of the conventional wisdom that special education programs are dominated by blacks and Hispanic students.

The paper was not the first time that Morgan, of Pennsylvania State University, and Farkas, based at the University of California, Irvine, had published those sort of findings but this particular study got national attention once it was the subject of an editorial in The New York Times.  A new debate over these findings has come to the fore.     In April of this year, the journal Educational Researcher published a point-counterpoint between the paper’s authors and its critics.   Ironically, this controversy started just as the U.S. Department of Education was collecting comments on its proposal to fix the previously widely held belief that too many minority students are identified for special education.  Under the Individuals with Disabilities Education Act, states are required to monitor districts’ educational placement of students with disabilities for signs of overrepresentation.  Even though the federal monitoring requirement has been around for nearly 20 years, states have identified only a tiny fraction of districts for overrepresentation problems. The Education Department has therefore proposed a new set of standards that would result in more districts being identified, with a comment period that ended May 16.  But according to this new research, the idea of  minority overrepresentation in special education may not be based on sound evidence at all.  If minority students are actually being denied the services they deserve, then Morgan and Farkas contend thatthe Education Department’s efforts could be harming the students it means to protect.  “The simple policy [federal officials] should do is stop talking about over placement. That’s such a modest suggestion. “We should simply stop this harmful push that is just completely against the evidence,” said Farkas. “We have replicated [our findings] so many times, in so many ways, that it really can’t be questioned at all.”

Why are Morgan and Farkas’ findings so different from other research?  In their study, the researchers looked at a national sample of children who entered kindergarten in fall 1998 and were surveyed periodically through 8th grade. That sample of children is different from the child-count data that are collected by the federal office that oversees special education.  Unlike the child-count data, their sample data include a wide-ranging set of additional demographic variables including information on the child’s academic achievement and on his or her behavior, as observed by teachers.  Morgan and Farkas used that additional information to make the children as similar to one another as possible. What they found is that for students who demonstrated similar levels of academic achievement and behavior, the minority students were less likely than their white peers to be enrolled in special education. “The right way to read the research is, if we look at kids who display a similar level of need, who is more likely to get help?” Morgan continued. “Amongst children displaying the same level of need, white children are more likely to get services. That, to me, seems like an inequity.”

This new data also appears to mirror other public-health research, which suggests that minority students, particularly African-Americans and Hispanics, are less likely to have access to medical care and are diagnosed with certain disabilities, such as autism, at older ages than their white peers. Some in special education have found the research compelling. “It helped me congeal a number of impressions that I’ve had over the years,” said Michael Gerber, a professor of education at the University of California, Santa Barbara and a leader in the field of special education, disabilities, and risk.

But agreement with these findings is far from universal.  Amanda L. Sullivan, an associate professor at the University of Minnesota who has conducted extensive research on special education disparities, said that Morgan and Farkas’ work is an “interesting addition” to the field, but cannot be taken as the last word on the subject.  She contends that the Farkas and Morgan sample size for students with disabilities is very small, but they’re using those findings to suggest that underrepresentation is universal. Her own research has found that minorities are both underrepresented and overrepresented in some categories, and that identification varies not only by disability category, but by region. “You have a nationally representative sample, but they’re averaging across the entire country with these findings. And we do feel that region matters,” she said.

I think that our best roadmap for the future lies with a combination of Farkas and Morgan’s research with Dr. Sullivan’s.   The matter of minority overrepresentation vs. underrepresentation is importantly influenced by cultural and regional contexts.   Given the state of many of our nation’s inner city schools, it is not surprising that a black or Hispanic student showing the same academic/learning characteristics is less likely to be referred for special ed than their white counterparts.   The unfortunate truth is that the academic norms expected by teachers and parents alike in an inner city school is going to be lower, and perhaps considerably lower, than those same stakeholders in more privileged school districts.    As unsavory as it may be, it makes common sense that school districts with lower achievement norms probably find it much more difficult to accurately identify students who are struggling primarily because of learning issues that require special education when many of their non-special ed peers are struggling in school because of nutritional, familial, and sociological obstacles.  So I believe that Farkas and Morgan do make a compelling case that inner city kids with learning issues are not going to be identified less accurately than students in better school districts.

What is the solution to this dilemma?   It is raising academic performance in inner city schools to the point where learning disabilities can be more easily identified as the reason why students  are falling behind.

 

Robert Hoyt, Ph.D.

President

Allied Health Professionals, LLC

Technology Innovations Are Creating New Opportunities for Physical Therapists

From vibrating posture sensors and gait-correcting shoe insoles to popular movement tracking devices like the fitbit, there have been a number of exciting advancements and trends in PT technology. These innovations offer new opportunities for improved diagnosis, treatment, and outcomes.

New Apps

Smartphone and tablet apps for physical therapy professionals and patients are a growing trend. Many apps are inexpensive—or even free—and provide handy resources like physiotherapy glossaries, exercise videos, orthopedic diagnosis tools, clinical tests, and even 360-degree visual anatomy. Other apps, like PTGenie, are designed to assist patients with their home exercise programs (HEPs). With printable and emailable exercises, pictures, protocols, and evaluation forms, these intuitive apps help clinics save time and money while improving patient compliance.

Exoskeletons Are No Longer Science Fiction

The Berkeley-based company Ekso Bionics broke new ground in rehabilitation services and gait training when it developed the Ekso suit—an aluminum and titanium exoskeleton that helps patients suffering from varying degrees of paralysis or hemiparesis with movement. The suit helps facilitate patient progress with progressive step modes and enforces normal biomechanical alignments and gait patterns. Even more impressive, patients typically start walking during their first session with the Ekso suit.

Once the therapist “buckles in” the patient, he or she can choose from three walk modes. The first mode requires the therapist to actuate steps with the simple push of a button, while the second and third modes give control to the patient, who can actuate steps by using the buttons or shifting his or her body weight. Designed to meet the needs of busy therapists, the Ekso suit does most of the work, allowing the therapist to assist many patients in a short amount of time.

Robotics that Dramatically Improve Patient Progress

Rehab therapists are increasingly able to use rehabilitation robots to speed recovery for patients with such neurological impairments as traumatic brain injuries, strokes, and cerebral palsy. Practice makes permanent, and in PT, practice—repetitive movement—is key to recovery. Robots increase the number of repetitions performed by PT patients; in fact, a robot can help a patient perform ten times the number of repetitions in a normal one-hour session.

You’ve probably heard of anti-gravity and underwater treadmills, but get ready for Lokomat, a robotic treadmill that allows patients who suffer from neurological conditions to engage in task-specific repetitive movement, thus helping them regain or improve their ability to walk. (Rusk Pediatric Physical Therapy department in New York is already using this cutting-edge treadmill.) To use this innovative piece of equipment, the therapist suspends the patient over the treadmill using a harness. Then, the therapist fits the patient’s legs into the treadmill’s robotic legs. A computer then personalizes the pace of the treadmill and measures the patient’s response and progress.

From Gaming to Rehab

Over the last few years, more and more therapists have started incorporating the Nintendo Wii into treatment plans and HEPs. Wii games use motion-sensitive controllers and repetitive movements similar to the exercises performed in physical therapy. As a complement to traditional PT modalities, Wii-Hab—as it’s come to be known—is a proven way to better engage patients in their recovery and ease the burden of PT in clinical settings. The benefits of Wii-Hab extend to home exercise programs, too, because patients are more likely to participate in their HEP if they enjoy it.

Telemedicine is a growing trend in the physical therapy space and—again—video game technology has laid the groundwork for advancement. Companies like Canada’s Jintronix and San Diego’s Reflexion Health used pre-existing gaming technology to create web-based therapy programs founded on evidence-based practice. Reflexion Health’s Rehabilitation Tracker program provides prescribed patient-specific instructional videos, coaching, educational materials, and exercises. The program not only allows therapists to monitor patient performance and track patient progress in real time, but also enables them to physically see their patients performing the exercises using the Kinect camera.

Effective PT will continue to involve a strong, motivating rapport between the patient and the Physical Therapist.  What is striking about the new advances in robotics and bionics is that bond can be strengthened by the faster and strong recoveries that this equipment provides.   Patients who are energized by faster and perhaps strong improvements leads to far better patient experiences and improved outcomes.    Some may argue that the risks of technology innovation in general is as great or even greater than the benefits they provide, but in the area of physical therapist is it quite clear that the growing number of  new tools are a godsend for patients and allied health professionals who treat them alike.

Robert Hoyt, Ph.D.

President

Allied Health Professionals

Recent Innovations in Speech Therapy

As in all areas of medicine, exciting new advances are being made every day. In this blog, I will recap some of the most intriguing and exciting new developments going on in the field of speech pathology today.

The Role of Cerebral Blow Flow in Stuttering
The first innovation is research being done at Miseracordia University in Pennsylvania on the potential role of cerebral blood flow in stuttering Dr. Tellis, Professor and Chair of the Speech-Language Pathology Department there, is using the principles of physics to propel his research. Tellis told Advance for Speech & Hearing: “We use noninvasive methods, near-infrared spectroscopy and diffuse correlation spectroscopy, which map transcranial recordings to derive changes in oxy- and deoxyhemoglobin concentration from tissue absorption changes, as well as changes in cerebral blood flow. The methods are so noninvasive they can be used on children and infants.” In layman’s terms, this means that we may be close to identifying differences in the blood flow and concentration of individuals who stutter and those who speak fluidly. Tellis’ research seeks to identify differences in the blood flow and concentration of individuals who stutter and those who speak fluidly. The results may be able to “improve diagnoses and treatment for those with communication disorders.”

Spreading the Word
With 160 million blogs as of 2012, there certainly is a blog for everything and that includes speech language pathology. Experienced providers, students, and researchers are writing on everything from games to help autistic children to the use of technology in the industry. If you’re looking for a new resource on the latest and greatest innovative happenings in the field—or maybe just a laugh from someone who gets it—you’ve got plenty of blogs to choose from. Here are just a few:
Crazy Speech World
If I Only Had Super Powers
Olivia SLP
Pathologically Speaking
SpeechSnacks
Speech Peeps

WebPT is an excellent source for great SLP blogs and websites. Check out this list of the best speech-language pathology blogs from A to Z, or their list of 100 great SLP websites.

Spanning the Globe
Most people think of globalization in terms of international trade, but this example shows how electronic communication is spreading the impact of speech therapy to countries that have historically offered little or no help to their children and adults with speech disorders. On her first volunteer visit to Vietnam (as part of Operation Smile),Charlotte Ducote, PhD, CCC-SLP, head of the Division of Communicative Disorders at the Ochsner Clinic in New Orleans, “fell in love with the country,” according to Advance for Speech & Hearing. Over her next 18 visits, Ducote learned that the people of Vietnam have little to no access to speech-language pathology services, but they did have access to the Internet (in cafés). As a result of this discovery, she and fellow speech language pathologist Giang Pham, assistant professor in the Department of Communication Disorders at the University of Massachusetts, Amherst, created a website to improve speech therapy access in Vietnam. Through the site, users can access information in Vietnamese on topics important to the field. Drs. Ducote and Pham also offer to answer questions and consult through a “contact us” form.
Preserving the Voices of our Most Talented Singers
Robert E. Hillman, PhD, CCC-SLP, Co-Director and Research Director of the Center for Laryngeal Surgery and Voice Rehabilitation at the Massachusetts General Hospital, has developed an ambulatory device that unobtrusively monitors daily voice use, similar to existing heart monitoring technology. The device includes a penny-sized miniature accelerometer, which mounts on the user’s throat, above the sternal notch and below the larynx, and measures vibrations for up to one week. When the user speaks, a corresponding cell phone application records the vibration and transmits the data to the clinic for pitch, volume, and duration analysis. Hillman explains: “Once we know what patients are doing wrong, another app lets us set the device to remind them not to do those things using the vibration mode on the cell phone as biofeedback.” Who is currently benefiting from the high-tech biofeedback loop? Along with Co-Director Steven M. Zeitels, MD, FACS, Hillman has worked with many famous performers, including Julie Andrews, Adele, and Steven Tyler of Aerosmith. “Singers are 500 times more likely to develop a voice disorder than anyone else,” Hillman says. However, because “a lot of the common voice disorders are related to how people use, misuse, or abuse their voices,” there are other professionals who may also benefit from the device, including teachers, clergy, salespeople, lawyers, and healthcare workers.

These are very exciting times indeed for speech therapy innovations. We are now exploring how cerebral blood flow may create a major breakthrough in the treatment of stuttering. Modern communication technology is disseminating a cornucopia of new games, techniques, and approaches in the blogosphere around the world. Smartphone-based biofeedback techniques are teaching our greatest singers how to preserve their voices for the pleasure of us all. And, best of all, this is surely just the tip of the iceberg for the accelerating advancement of speech pathology.

Robert Hoyt, Ph.D.
President
Allied Health Professionals, LLC

Top Expert Offers 6 Reforms to Fix Illinois’ Deficit Crisis

Despite their spectacular fiscal failure, lawmakers in the Land of Lincoln are showing little sign of progress in breaking the deadlock, now nine months past the deadline. Since then, Republican Gov. Bruce Rauner has been holding out for a package of business incentives and changes in collective bargaining laws that a Democratic-controlled legislature wants no part of.

The state’s controller, Leslie Munger, has estimated the backlog could top $10 billion by the time the current fiscal year ends in July. That money that will have to be made up in next year’s budget, which is technically due July 1.  “The bottom line is the state cannot go bankrupt and we cannot print money,” Munger told reporters last month. “Taxpayers are going to have to pay this bill.”    Fears that Chicago’s large property tax increase last year is only the tip the iceberg may be one explanation why Chicago was the only one of our 20 largest cities to have a population decline.

The implications of more people leaving the state is ominous–without structural reforms to our budget mess, we face a vicious downward spiral with fewer taxpayers footing ever larger tax bills.  On April 11, 2016 the credit rating agency Fitch cut Chicago’s rating by two notches to BBB-, one step above junk status, citing the recent court rulings. And other credit agencies are warning of further downgrades to Illinois’ credit, already the lowest of the 50 states.

Even though many believe that Governor Rauner and Speaker Madigan will be forced to agree on some kind of budget compromise after the November election, it will do nothing to address our current enormous deficits and growing pension liabilities.   A mid-April article by Donna Arduin published in the Illinois Policy Institute is both timely and important for the state’s future.  Ms. Ardiun, a partner in Arduin, Laffer & Moore Econometrics, is one of the nation’s most successful veterans of state budget management and tax reform.  She has served as budget director for four different former governors who, after getting her long-term policy changes passed, all consistently received high marks on the Cato Institute’s fiscal report cards during her tenures with their administrations.

Ms. Arduin’s 6 recommendations for Illinois are:

A stronger balanced budget requirement

According to the National Conference of State Legislatures, 43 states including Illinois, require a governor’s proposed budget to be balanced, 40 states require the state legislature to pass balanced budgets, and 37 ensure that budget deficits cannot be pushed off into the next year.

Illinois’ constitutional requirement for a balanced budget, however, is full of loopholes and has become meaningless.   A strong bipartisan effort is needed to put real teeth into this law. 

Biennial budgets

Nineteen states, including Indiana, Kentucky, Minnesota, Ohio and Wisconsin, pass a state budget every two years instead of every year. In addition to eliminating the potential for protracted budget fights every year, this timeframe would allow lawmakers to pass budgets in nonelection years, which would minimize delays for political purposes.

Importantly, governors and legislatures have more time to focus on policy reforms, which are often instrumental to long-term solvency, in nonbudget years. Several states with two-year budgets have AAA credit ratings, and they tend to outperform other states economically and to be more fiscally stable. 

Reasonable pension protection

Some state constitutions protect government employees’ already-earned pension benefits. Illinois courts have ruled that the state’s constitution not only protects already-earned pension benefits, but also those that government workers have not yet earned. That carries a high price tag for taxpayers and squeezes out spending for core government programs and services.

Illinois should amend its constitution so it can reform government workers’ unearned  retirement benefits going forward. In the meantime, the General Assembly can pass several reforms that would help reduce the impact of the state’s pension crises. 

Professional revenue and spending assumptions

Illinois’ constitutional balanced-budget language gives the General Assembly the ability to make revenue and spending assumptions, which essentially allows politicians to make unrealistic or inaccurate assumptions about how much money the state will have to spend. Those tricks were in clear view when legislators passed a 2015 budget they conceded was out of balance the day it was signed. The 2016 budget that Rauner vetoed did not even balance on paper. 

Other states prevent midyear deficits with official revenue- and expenditure-estimating conferences. Conferences consist of economists and budget professionals from the executive and legislative branches with the advice of external experts and national economic forecasts. The governor and legislature are required to use official estimates for revenues and spending programs, as well as official estimates for proposed spending reforms and revenue changes. 

Ending bill backlogs and building a rainy day fund

Illinois should enact a budget-stabilization mechanism that serves to pay down any unpaid bills and creates a rainy day fund. Such a program would require the General Assembly to set aside a portion of any revenues over and above expected revenues for use to pay down the state bill backlog.

After eliminating the backlog, the state would dedicate half of above-trend revenues to a rainy day fund. The state could only make withdrawals from the fund in fiscal or health and safety emergencies. 

End mid- and late-year budget fights and uncertainty for providers

Other states’ laws give the governor authority to declare fiscal emergencies in the event of unforeseen lower revenue or higher expenditures. Even official estimating conferences may not foresee a national economic crisis such as 9/11, or a natural disaster.

In some states, the governor can adjust the budget’s spending plan in order to fix a mid-year problem without legislative approval if the legislature is out of session. In other states, the governor can send the legislature a plan to address a fiscal emergency through expenditure reductions or use of the rainy day fund. In these cases, a joint committee of the legislature must be given a defined period of time to make changes to the proposal or it becomes law.

Arduin, Laffer & Moore Econometrics has only been hired by Republican governors thus far.   With a Republican governor, all of us must petition Governor’s Rauner to hire that firm as an important step in the right direction.  For those of us whose livelihoods and families are tied to Illinois, the stakes could not be higher.

 

Robert Hoyt, Ph.D.
President
Allied Health Professionals LLC

Strong Interview Skills Land You the Allied Health Job You Want

In our last blog, we talked about the importance of a strong resume for getting the best job possible.   But a great resume only gets your foot in the door—being an equally great interviewer is essential to actually getting that job.   The first step to becoming a very strong interviewee is to practice your answers to the questions most commonly asked.   These links will give you a nice range of questions that you might be asked:

Each of these sites offer something a little bit different, so looking at all of them would serve you well in preparing well for a job interview.    As good as all this advice is, in our experience the what makes you go from a good to a great interviewee is simple but profound:  role playing. Impressing the interviewer certainly requires strong answers, but the truth is that what you say ends up less memorable than how you say it.    As a clinical psychologist, I am certain that these factors will end up at least as important as your answers:

  • Personal appearance – Looking your best tells the interviewer that you respect the institution and the job and you also respect yourself.  Is your outfit professionally appropriate but still has some style?   Getting an interviewer to feel good about you starts with you feeling that you look like a million bucks!
  • Body language – If your body language conveys honesty, self-confidence and conviction, then even answers where you are not sure what you want to say can still be impressive. The most important things to concentrate on are your posture, making eye contact, and smiling at appropriate times.  If the interviewer smiles back, it’s working.  If he or she never smiles and appears cold, shift to a more serious but equally confident approach.
  • Listen as well as you talk – In your role playing, practice answers that are clear and concise and make sure to pause enough to give the interviewer comfortable ways to break in. Even if you are saying interesting things, if the interviewer feels like they could not get a word in edgewise, they will recall that frustration more clearly.
  • Tone – Making a strong impression involves coming across as serious, articulate, and relaxed.   Even great responses without this quietly confident tone can fall flat.

The best way to get this just right for an interview is to role play with friends, family, or professional recruiters who know how to be both supportive and honest.  One last words to the wise—practice to the point where you feel natural, but not to the point where you might come across as too scripted.

Robert Hoyt, Ph. D

President

Allied Health Professionals LLC

OTs, PTs, and SLPs, Great Resumes get Great Jobs

The job prospects for Allied Health Professionals are among the best for individuals in the U.S. in the coming years. According to the Bureau of Labor Statistics, from 2014 to 2024, the number of occupational therapy jobs in the U.S. will grow by a 27%. Employment of physical therapists is predicted to grow 36% between 2012 and 2022, and speech and language pathologists will grow by 21% over the same period . Since the Bureau of Labor Statistics projects 7% growth for all professions over this same time period, it is clear that the expanded health care coverage through Obamacare plus rapid growth in rehabilitation services needed for the aging U.S. population has created the demand for OTs, PTs, and SLPs. This means attractive pay, scheduling flexibility, and professional security down the road-all leading to professional gratification.

One might think that the importance of a well-crafted resume is less important now that hiring is so strong. Actually the opposite is the case. The best hospitals, schools, and other facilities have been attentive to the need to prove measurable results from allied health treatments, and client satisfaction is now essential to an organization’s reputation. A resume that stands out can make the all the difference between landing a job that you just tolerate and a job that you’ll love! Richard Poulin has done a very nice job articulating the differences between an ordinary and an exceptional OT resume (Poulin blog). In this blog, I will expand upon his ideas to make them applicable to PTs and SLPs as well. I promise you that working on these ideas yourself and perhaps getting the right kind of coaching will be more than worth your while.

A “typical” resume lists the special treatments you have learned, skills you have acquired, clinical populations that you have treated, and assessment tools that you have used. This kind of resume is fine in terms of conveying key professional facts about you, but it does show how you stand out from your peers. An exceptional resume, on the other hand, is about showing what makes you special—it shows what you have done which go above and beyond professional norms. A great resume tells a story of what special value you will bring to your employer and your patients or clients. This is what Richard Poulin calls resume accomplishments–an accomplishment is something for which you deserve a bonus. Whether you actually got a bonus or not is not relevant. Your most important accomplishments demonstrate highly valuable skills: leadership, initiative, problem-solving, process improvement, etc. as well as your clinical and technical skills. In our company’s experience, few resumes articulate such accomplishments. Before we submit a therapist’s resume, we coach them line by line on how to transform a solid but undistinguished resume into one that packs a punch. By going over professional experiences in detail, we find time and time again that someone has wonderful vignettes that they thought were either not appropriate or relevant to add to a resume. After we work with them, they come to realize that these examples are actually the most interesting and informative for the employer.

Richard Poulin gives solid examples of the kind of accomplishments you need to make a resume special (Poulin blog). It would absolutely serve you well to study his examples carefully, but in our experience at Allied, we have found that coaching (regardless of whether the therapist is a new grad or highly experienced) gets a creative dialogue going that fleshes out more ideas of great things to go into the resume than that person came up with on their own. We offer job candidates for contract placements resume coaching, Even those that don’t take us up on our job offers often find our resume reviews helped them land the perfect job and they let us know their appreciation.

The other half of going from an average to an outstanding job candidate is strong interviewing skills. That will be the topic of a future blog.

Robert Hoyt, Ph.D.
President
Allied Health Professionals LLC

Occupational Therapy Month is a Good Time to Focus on How OT helps Kids

Some people may think that occupational therapy is only for adults; kids, after all, do not have occupations. But a child’s main job is playing and learning, and occupational therapists can evaluate kids’ skills for playing, school performance, and daily activities and compare them with what is developmentally appropriate for their age group.

According to the American Occupational Therapy Association (AOTA), in addition to dealing with physical well-being, OT practitioners can positively impact psychological, social, and environmental factors as well.  According to the AOTA, kids with these medical problems might benefit from OT:

When one looks at specific examples of how an Occupational Therapist can improve children’s lives, the impact is obvious:

  • — help kids work on fine motor skills so they can grasp and release toys and develop good handwriting skills
  • — address hand–eye coordination to improve kids’ play and school skills (hitting a target, batting a ball, copying from a blackboard, etc.)
  • — help kids with severe developmental delays learn basic tasks (such as bathing, getting dressed, brushing their teeth, and feeding themselves)
  • — help kids with behavioral disorders maintain positive behaviors in all environments (e.g., instead of hitting others or acting out, using positive ways to deal with anger, such as writing about feelings or participating in a physical activity)
  • — teach kids with physical disabilities the coordination skills needed to feed themselves, use a computer, or increase the speed and legibility of their handwriting
  • — evaluate a child’s need for specialized equipment, such as wheelchairs, splints, bathing equipment, dressing devices, or communication aids
  • — work with kids who have sensory and attentional issues to improve focus and social skills

Although both physical and occupational therapy help improve kids’ quality of life, there are differences. Physical therapy (PT) deals with pain, strength, joint range of motion, endurance, and gross motor functioning, whereas OT deals more with fine motor skills, visual-perceptual skills, cognitive skills, and sensory-processing deficits.  These are certainly equally important when relevant, but quite different in what new skills are learned from each of these allied health professional disciplines.

Since 2007, to become an OT, one must complete a master’s degree program (previously, only a bachelor’s degree was required). An OTA (Occupational Therapy Assistant) is only required to complete an associate’s degree program and can carry out treatment plans developed by the occupational therapist but can’t complete evaluations.

All occupational therapy practitioners must complete supervised fieldwork programs and pass a national certification examination. A license to practice is mandatory in most states, as are continuing education classes to maintain that licensure.

Many people think that occupational therapy done at school versus a children’s clinic or a private pediatric practice differ in what kind of treatment is conducted.  This is actually not the case.  What makes the difference is the sophistication and skills of the OT doing the therapy, and not the setting where it occurs.

This is absolutely an allied health professional that deserves to be honored every year.  The interventions they offer can result in the difference between a happy and well-adjusted child who keeps getting better and an very unhappy one who actually may get worse as a result of mounting untreated issues.

Robert Hoyt, Ph.D.

President

Allied Health Professionals LLC

Budget Impasse Continues into Second Year: Do the Governor and State Legislators have no Shame?

On February 17, 2016, Illinois Governor Rauner proposed a FY 2017 budget even though no FY 2016 budget was passed. A compilation of the extensive damage inflicted on children’s services alone was recently updated by the Fiscal Policy Center of Voices for Illinois Children, an organization that is trying to publicize how many programs have been severely impaired over this past year (Fiscal Policy Center). That enormous list is just the tip of the iceberg. A Feb. 5, 2016 Moody’s forecasts trouble not just for Illinois’ public universities’ finances in the short-term, but for their very existence going forward. This report was released just days after Chicago State University declared a state of financial emergency which will allow it to take extraordinary cost-saving measures including laying off tenured faculty. Chicago State, which has 4,500 students, had cautioned earlier that it would have to close, possibly next month. The reason? The state budget impasse has left it with no state funding for over a year.

Presenting a new FY 17 budget without addressing the failure to pass a FY 16 budget reflects just how tragically dysfunctional Illinois politics have become. In his budget address on Feb. 17, Rauner offered the Democrats, who control the General Assembly, two choices:

  1. Pass some of his Turnaround Agenda (this program include term limits, a property tax freeze, local control of collective bargaining, tort reform, workers’ compensation reform that makes workers prove an injury was primarily caused on the job, and legislative redistricting reform). In exchange, Rauner will work with Democrats to create new revenue to close a gap of $3.5 billion or
  2. give him extraordinary budget authority to create and balance the budget on his own with
    cuts only.

The Governor’s proposal and the negative response from House Speaker Michael Madigan and Senate President John Cullerton — the two Democratic leaders of the General Assembly – is largely the same as last year. But there is one major difference – 2016 is an election year. By this summer, Democrats will pull out the stops on efforts to convince the voters that the only way to break the budget impasse is to elect enough Democratic legislators to override a Rauner budget veto. The Governor and the Republican party will make an equally intense pitch for electing Republican majorities to the Illinois State Senate and House as the only viable way to replace the impasse with a fiscally responsible budget.

The problem is that the odds of this being resolved by political realignment is close to zero. Our best hope is that Republican voters insist that Rauner compromises or he will be a one term Governor and that Democrats protest loudly about their representatives needing to meet the Governor in the middle.

Illinois voters are angry and confused as to why our politicians are willing to let our state be the laughing stock of the nation. If this continues, here is the extreme solution I propose:

In 2018, every single Illinois voter must vote for the challenger and not the incumbent. If Rauner, Cullerton, and Madigan all lose their jobs, the newly elected officials will get the message “the jig is up” loud and clear. If we do not fire the politicians accountable for this mess, then we lose our right to complain as Illinois becomes a significantly undesirable place to live and work.

Please register your objection to this travesty of political dysfunction. I urge you to write or call the Governor and you statement representatives to let them know that this is your intention. Today, that is as easy as googling their names for your state district.

Robert Hoyt, Ph.D.
President
Allied Health Professionals LLC

Allied Health Professionals Make a Major Difference for Cancer Patients

Founded in 1884, Memorial Sloan Kettering (MSK) is not only the oldest, but also one of most highly regarded cancer research and treatment centers in the world.  It has also been a longstanding leader in using allied health professionals as a critical part of their oncology treatment teams,

The Sillerman Center for Rehabilitation, is MSK’s 22,000-square-foot, state-of-the-art facility located in midtown Manhattan. This facility has personal treatment bays, as well as a spacious gymnasium with state-of-the-art equipment.  The advances that they have made at Sillerman in managing the effects for chemotherapy, radiation therapy, and post-surgical recoveries from cancer for both children and adults make this facility a model for oncology treatment elsewhere in the country.

Sillerman’s rehabilitation staff includes physical therapists, occupational therapists, and physiatrists (physicians who specialize in rehabilitation medicine).  They collaborate with other medical staff to improve our patients’ well-being. Their team has expertise in therapeutic exercise, neuromuscular training, pulmonary rehabilitation, and other techniques for improving quality of life. They also provide important educational resources to patients and their families.

Physical therapists work with oncology side effects like decreased strength and range of motion, difficulty walking, decreased balance, neuropathy (numbness, pain, or muscle weakness), fatigue, scar tissue adhesions and radiation fibrosis.

Vestibular rehab is a particularly specialized focus for PT at Sillerman.  Patients undergoing cancer treatments sometimes experience persistent dizziness or a loss of balance due to inner ear problems.  These physical therapists are specially trained to develop a set of exercises and activities to retrain patients in how to regain their equilibrium. Patients who undergo vestibular rehabilitation are less likely to fall which reduces the risk of additional medical complications.

Another thing that physical therapists at Sillerman treat are problems caused by cancer treatments that damage what is known as the muscular floor of the pelvis. This can cause pain in the pelvis, back, sacrum, or tailbone; urinary or fecal incontinence; or an inability to enjoy intimate physical relations.

Sillerman’s occupational therapists focus on daily activities such as dressing, bathing, eating, preparing meals, and managing the home after treatment. They also teach the patient and their caregivers how to use devices that can make these daily activities easier. They are also skilled at identifying and addressing social and environmental issues that may be causing you trouble.

Certain cancer treatments (usually surgery and radiation therapy), may affect a patient’s ability to swallow, speak, or hear. While these side effects are most common for patients with head and neck cancers, people with other types of cancer may also experience these functional problems following treatment.  Like the other allied health specialists on staff, the Speech and Hearing therapists often get excellent results because of their exclusive focus on cancer-related issues.

I strongly believe that research currently being conducted at MSK will prove a fairly obvious fact—cancer patients have far better rehabilitation outcomes and post-treatment quality of life when they work with allied health professionals who specialize in the problems by nearly all cancer treatments and some cancer surgeries.  To get a fuller idea of the range and breadth of the highly specialized rehab programs offered at Memorial Sloan Kettering through Sillerman, please visit their website:  MSK cancer rehab.   I am sure that other well-known centers like MD Anderson, Mayo, and the University of Chicago are working hard to develop the kind of OT, PT, and SLP oncology sophistication that they possess at the Sillerman Center.

 

Robert Hoyt, Ph.D.

President

Allied Health Professionals LLC