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This occurrence is known as:Search Results - Web resultsKlinefelter Syndrome (for Parents) - Nemours KidsHealth“””” Boys who have Klinefelter syndrome are born with it. It's also called XXY because they have an extra X chromosome in most or all of their cells. ... to a successful pregnancy, the baby will have the XXY condition in some or all of his cells””””, kidshealth.org › parents › klinefelter-syndrome .- -KidsHealth / for Parents / Klinefelter SyndromeKlinefelter SyndromeReviewed by: Judith L. Ross, MD. , en españolSíndrome de KlinefelterQuora required LINK: Klinefelter Syndrome .“””” What Is Klinefelter Syndrome? ~ Klinefelter syndrome is a fairly common genetic condition found in males only.Many boys with Klinefelter syndrome — also known as XXY syndrome — have no signs or symptoms, and some don't even know they have it until later in life.The XXY condition that causes Klinefelter syndrome can't be changed, but medical treatment and working with therapists can help a boy's development and help lessen the condition's effects. Even without treatment, most boys with Klinefelter syndrome grow up to live productive, healthy lives.What Causes Klinefelter Syndrome? ! Boys who have Klinefelter syndrome are born with it. It's also called XXY because they have an extra X chromosome in most or all of their cells.Usually, a person has 46 chromosomes in each cell, divided into 23 pairs, which includes two sex chromosomes. Half of the chromosomes are inherited from the father and the other half from the mother.The chromosomes contain genes, which determine an individual's characteristics, such as eye color and height. Boys typically have one X chromosome and one Y chromosome, or XY, but boys with XXY syndrome have an extra X chromosome, or XXY.Klinefelter syndrome is not caused by anything the parents did or did not do.The disorder is a random error in cell division that happens when a parent's reproductive cells are being formed.If one of these defective cells contributes to a successful pregnancy, the baby will have the XXY condition in some or all of his cells.Some boys will even have more than two X chromosomes (XXXY or XXXXY, for example), which increases the risk of severe symptoms and other health concerns.When a boy is born with the XXY condition in only some of his cells, it's called mosaic Klinefelter syndrome. Often, boys and men with this condition can have milder signs and symptoms than others with the XXY condition.What Are the Signs & Symptoms of Klinefelter Syndrome?Not all boys with Klinefelter syndrome will have noticeable symptoms. Other boys can have symptoms that are physically apparent or problems with speech, learning, and development.Babies with Klinefelter syndrome typically have weak muscles, reduced strength, and quiet personalities. They also can take longer to do things like sit up, crawl, walk, and speak.Compared with other kids their age, boys with Klinefelter syndrome might have some or all of these symptoms:a taller, less muscular bodybroader hips and longer legs and armslarger breasts (a condition called gynecomastia)weaker bonesa lower energy levelsmaller penis and testiclesdelayed or incomplete puberty (some boys won't go through puberty at all)less facial and body hair following pubertyWhat Problems Can Happen? Klinefelter syndrome typically causes a boy's testicles to grow at a slower rate than those of other boys. It also prevents the testicles from producing normal amounts of sperm and the hormone testosterone.Testosterone affects the way a boy develops both physically and sexually. Low hormone levels and problems with sperm production make it difficult or sometimes impossible for a boy with Klinefelter syndrome to father a child later in life.Many boys with Klinefelter syndrome show symptoms related to their development of social and language skills. They may have trouble paying attention. A lot of boys learn to talk late or have trouble using words to express their emotions. They also can have trouble with things like learning to spell, read, and write.Socially, they tend to have quiet personalities. They rarely cause trouble and are often more helpful and thoughtful than other boys. They're often shy and sensitive, and many are less self-confident and less active than other boys their age.Most boys aren't likely to have major health problems, but the condition can bring some other challenges later in life. Klinefelter syndrome puts males at greater risk of breast cancer, some other cancers, and some other diseases like type 2 diabetes, varicose veins and problems with blood vessels, problems with sexual function, and osteoporosis (weak bones) later in life.Most boys with Klinefelter syndrome can have sex when they become men, usually with the help of testosterone treatment. However, problems with their testicles prevent them from making enough normal sperm to father children.The vast majority of men with Klinefelter syndrome are infertile and can't father a child the usual way. Options for becoming natural parents are limited, but fertility researchers are working on new treatments. By the time a child with Klinefelter syndrome is ready to become a dad, there may be new options available related to the extraction of sperm from the testicles.How Is Klinefelter Syndrome Diagnosed? Since Klinefelter syndrome can be hard to notice, many parents don't know their son has it until he grows up or shows delays in puberty. Sometimes, parents who are worried about their son's development consult a doctor, and the diagnosis reveals Klinefelter syndrome. This can help, because the earlier a boy is diagnosed with Klinefelter syndrome, the more effective the treatments usually are.To diagnose cases of Klinefelter syndrome, doctors usually begin by asking about any learning or behavior issues and examining the boy's testicles and body proportions.There are two main types of tests used in the diagnosis of Klinefelter syndrome:Hormone testing, which is usually done by taking a blood sample to check for abnormal hormone levels.A chromosome analysis, or karyotype, which is usually done on a blood sample. This test checks the number of chromosomes to see if the XXY syndrome is present.How Is Klinefelter Syndrome Treated? There's no way to change the XXY condition if a boy is born with it, but treatments can help relieve some of the symptoms. As with many conditions, beginning treatment early can greatly increase its effectiveness.Testosterone replacement therapy (TRT) works by increasing a boy's testosterone levels into the normal range. Additional testosterone can help a boy with Klinefelter syndrome develop bigger muscles and a deeper voice, as well as promote the growth of the penis and facial and body hair. It can also help improve bone density and reduce the growth of a boy's breasts. Testosterone therapy cannot increase the size of a boy's testicles or prevent or reverse infertility, however.Educational support services can help boys and teens with Klinefelter syndrome keep pace in school. Many benefit from extra assistance when it comes to schoolwork. If your son has Klinefelter syndrome, let his teachers and school nurse know about his condition and see what kind of support is available. He may be eligible for an individualized education plan (IEP) or 504 education plan, which both can provide accommodations for kids with special needs.Speech therapy and physical therapy can help boys with Klinefelter syndrome learn to speak, read, and write better, or improve muscle strength and coordination. Other forms of therapy include behavioral, mental health, and occupational therapy. These can help improve low self-confidence, shyness, and delayed social development.Looking Ahead Because boys with Klinefelter syndrome can have problems with schoolwork and sports, they may feel like they don't fit in with other kids their age. They're more likely to have low self-esteem, which can make things harder socially and academically. But by the time they're men, most will have normal social relationships with friends, family members, and others.If your son struggles in school or has trouble making friends, talk to your doctor, school principal, or school counselor. Counselors and therapists can give boys practical skills to help them feel more confident in social settings. And many schools provide educational services or accommodations that can help your son succeed””””, Klinefelter Syndrome .Reviewed by: Judith L. Ross, MD, Date reviewed: September 2017

Original Question:**What are some ways to test at home to determine if a second grader could have a reading disability such as dyslexia?**Honestly, if you have a suspicion there may be an issue, there likely is. Its estimated that between 10 and 20% of the general population have some degree of dyslexic processing. This fact seems to reflect the reality that the vast majority of children receiving special education services are dyslexic.You can formally request a screening through the child’s school (it is your right under Federal Law (Right to an Evaluation of a Child for Special Education Services)). Even if your child attends private school, your local school district is on the hook to do the screening.That said, even if your child gets categorized with an SLD (specific learning disability) it doesn’t necessarily mean they will receive services. If your child is advancing within the mean at grade level (but perhaps below the rate you might expect given their intelligence), schools are resistant to providing services like a reading specialist.Teachers and administrators may also be likely to resist screening in 2nd grade/suggest that its too early to screen the child in second grade as “kids develop reading at different rates and there is a big difference in second grade.”It is (somewhat) correct, non-dyslexic early readers and writers often make mistakes like reverse letters when they write, or make incorrect substitutions, and can lack the hand strength and dexterity to write recognizably, but not to the same degree or with the consistency that a dyslexic will.It's also important to keep in mind that (as research suggests) dyslexia isn’t just one thing. The symptoms that manifest in one person can vary greatly, and there can be a wide range of symptom severity among people. However, there are some tell-tale traits and patterns you can observe.A difficulty with acquiring the foundational skills required for learning acquisition, they can include:* Inability or difficulty pairing letters with their sounds (P makes a “puhh” sound vs B making a “buhh” sound)* Difficulty remembering letter characters “B and b” and their letter relationship. (picture of a B) = “that is a b.” The same goes for sequencing letters in the ABCs without using “the song.” EG: Knowing that “C” comes after “B,” but before “F.” You can see the same things with numbers and number relationships.* Difficulty associating the sounds of words with the letters they start with, end with or contain. This problem (known as phonemic awareness) is a defining characteristic among people with dyslexia. Challenges with recognizing phonemes (letter and letter combinations and their sounds) can show up as difficulty matching words that rhyme. EG: (picture of a book) which word starts with the same sound as the picture? “Took, call, look, bat, bat.”* Consistent misspelling of common words they should know or do know.* If the child does read, odd/strange replacements of words in the context of a sentence that look similar but don’t make sense, or sound similar but have a different meaning or sound.* Low reading comprehension or reliance on pictures to describe what happened in a passage.In spoken language, the child may also reverse the words in a phrase or use odd phrasing or tense in describing something “I TV watched” or “He teach’ed me” or “he had the table on top of him” (he was under the table).In daily life, the child may struggle with determining their left and right and also be extremely disorganized and loose things easily.There are many, many other ways dyslexia can manifest, and it is detectable at an early age through a variety of methods. Keep in mind that the screening the child receives at school will not be a formal diagnosis, and is used only to determine eligibility for services based on performance and observation. The school can’t formally diagnosis anyone, and they typically avoid doing more than the absolute minimum required by law. School personnel will also avoid giving you any advice besides what is mandated legally as part of the formal IEP and screening process. The goal of the school district is to do as little as possible while meeting the legal requirements defined by the Federal and state government. They will not suggest screening proactively until and unless your child is clearly failing and falling behind grade-level expectations. By then, a gap has opened up that can take years (if ever) to make up because first, second and third grade are foundational. Getting intervention as early as possible is the best way to mitigate those problems.A more effective but more costly process would be to have your pediatrician refer you to a pediatric neurologist or developmental psychologist who can provide a more precise evaluation and documentation to establish the rights to either services or accommodations than what the school will provide. These independent evaluations can sometimes be covered/justified under insurance, and can happen outside the school year, but can be prohibitively expensive for many families ($3500 +/-).Keep in mind that you are your child’s best advocate and that the buck starts and stops with you. Most good schools and teachers will work with you, but they won’t drive the effort. You would be surprised how little many trained, very experienced teachers know about dyslexia and learning differences generally.The more you educate yourself on what dyslexia is (and is not) as well as what your child’s rights are under the law, the easier it will be to effectively advocate on their behalf.The process doesn’t have to be adversarial, in fact, most teachers and administrators want to help, but they represent the interests of the school district first and foremost, and there are limited resources (both time and money) to go around. Frontline teachers often have to manage a classroom with more than 25 children. Its nearly impossible to tailor instruction to the needs of every student. Getting services at school (if necessary) is a good start, but the challenges of dyslexia may require more work for you and solutions that are broader than what the school can offer.The light at the end of the tunnel is that dyslexics have some fantastic advantages to go with the negative traits. If you are interested in those too, I’d recommend the books Dyslexic Advantage and The Gift of Dyslexia as good starting points.

An occupational therapist works systematically with a client through a sequence of actions called the occupational therapy process. There are several versions of this process as described by numerous scholars. All practice frameworks include the components of evaluation (or assessment), intervention, and outcomes. This process provides a framework through which occupational therapists assist and contribute to promoting health and ensures structure and consistency among therapists.The Occupational Therapy Practice Framework (OTPF) is the core competency of occupational therapy in the United States. The OTPF framework is divided into two sections: domain and process. The domain includes environment, client factors, such as the individual's motivation, health status, and status of performing occupational tasks. The domain looks at the contextual picture to help the occupational therapist understand how to diagnose and treat the patient. The process is the actions taken by the therapist to implement a plan and strategy to treat the patient.Occupational therapists work with infants, toddlers, children, youth, and their families in a variety of settings, including schools, clinics, homes, hospitals, and the community.Assessment of a person's ability to engage in daily, meaningful occupations is the initial step of occupational therapy (OT) intervention and involves evaluating a young person's occupational performance in areas of feeding, playing, and socializing daily living skills, or attending school.Occupational therapists take into consideration the strengths and weaknesses of a child's underlying skills which may be physical, cognitive, or emotional in nature, as well as the context and environmental demands at play. In planning treatment, occupational therapists work in collaboration with parents, caregivers, teachers, or the children and teens themselves in order to develop functional goals within a variety of occupations meaningful to the young client. Early intervention is an extremely important aspect of the daily functioning of a child between the ages of birth-3 years old. This area of practice sets the tone or standard for therapy in the school setting. OT's who practice in early intervention develop a family's ability to care for their child with special needs and promote his or her function and participation in the most natural environment as possible. Each child is required to have an Individualized Family Service Plan (IFSP) that focuses on the family's goals for the child. It's possible for an OT to serve as the family's service coordinator and facilitate the team process for creating an IFSP for each eligible child.Objectives that an occupational therapist addresses with children and youth may take a variety of forms.For example:Providing splinting and caregiver education in a hospital burn unit.Facilitating handwriting development by providing intervention to develop fine motor and writing readiness skills in school-aged children.Providing individualized treatment for sensory processing.Teaching coping skills to a child with Generalized Anxiety Disorder.Consulting with teachers, counselors, social workers, parents/ caregivers, or any person that works with children regarding modifications, accommodations, and supports in a variety of areas, such as sensory processing, motor planning, visual processing sequencing, transitions between schools, etc.Instructing caregivers in regard to mealtime intervention for children with autism who have feeding difficulties.In the United States, pediatric occupational therapists work in the school setting as a "related service" for children with an Individual Education Plan (IEP).Every student who receives special education and related services in the public school system is required by law to have an IEP, which is a very individualized plan designed for each specific student (U.S. Department of Education, 2007).Related services are “developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education,” and include a variety of professions such as speech-language pathology and audiology services, interpreting services, psychological services, and physical and occupational therapy.As a related service, occupational therapists work with children with varying disabilities to address those skills needed to access the special education program and support academic achievement and social participation throughout the school day (AOTA, n.d.-b). In doing so, occupational therapists help children fulfill their role as students and prepare them to transition to post-secondary education, career, and community integration (AOTA, n.d.-b).Occupational therapists have specific knowledge to increase participation in school routines throughout the day, including:Modification of the school environment to allow physical access for children with disabilitiesProvide assistive technology to support student successHelping to plan instructional activities for implementation in the classroomSupport the needs of students with significant challenges such as helping to determine methods for alternate assessment of learningHelping students develop the skills necessary to transition to post-high school employment, independent living or further education (AOTA).Other settings, such as homes, hospitals, and the community are important environments where occupational therapists work with children and teens to promote their independence in meaningful, daily activities.Outpatient clinics offer a growing OT intervention referred to as “Sensory Integration Treatment”. This therapy, provided by experienced and knowledgeable pediatric occupational therapists, was originally developed by A. Jean Ayres, an occupational therapist.Sensory integration therapy is an evidence-based practice that enables children to better process and integrate sensory input from the child's body and from the environment, thus improving his or her emotional regulation, ability to learn, behavior, and functional participation in meaningful daily activities.Recognition of occupational therapy programs and services for children and youth is increasing worldwide.Occupational therapy for both children and adults is now recognized by the United Nations as a human right which is linked to the social determinants of health. As of 2018, there are over 500,000 occupational therapists working worldwide (many of whom work with children) and 778 academic institutions providing occupational therapy instruction.Health and wellnessAccording to the American Occupational Therapy Association's (AOTA) Occupational Therapy Practice Framework, 3rd Edition, the domain of occupational therapy is described as "Achieving health, well-being, and participation in life through engagement in occupation".Occupational therapy practitioners have a distinct value in their ability to utilize daily occupations to achieve optimal health and well-being. By examining an individual's roles, routines, environment, and occupations, occupational therapists can identify the barriers in achieving overall health, well-being, and participation.Occupational therapy practitioners can intervene at primary, secondary, and tertiary levels of intervention to promote health and wellness. It can be addressed in all practice settings to prevent disease and injuries, and adopt healthy lifestyle practices for those with chronic diseases.Two of the occupational therapy programs that have emerged targeting health and wellness are the Lifestyle Redesign Progra and the REAL Diabetes Program.Occupational therapy interventions for health and wellness vary in each setting:SchoolOccupational therapy practitioners target school-wide advocacy for health and wellness including bullying prevention, backpack awareness, recess promotion, school lunches, and PE inclusion. They also heavily work with students with learning disabilities such as those on the autism spectrum.A study conducted in Switzerland showed that a large majority of occupational therapists collaborate with schools, half of them providing direct services within mainstream school settings. The results also show that services were mainly provided to children with medical diagnoses, focusing on the school environment rather than the child's disability.OutpatientOccupational therapy practitioners conduct 1:1 treatment sessions and group interventions to address: leisure, health literacy, and education, modified physical activity, stress/anger management, healthy meal preparation, and medication management.Acute careOccupational therapy practitioners conduct 1:1 treatment sessions, group interventions, and promote hospital-wide programs targeting: leisure, stress management, pain management techniques, physical activity, healthy food recommendations, and medication management.Community-basedOccupational therapy practitioners develop and implement community-wide programs to assist in the prevention of diseases and encourage healthy lifestyles by: conducting education classes for prevention, facilitating gardening, offering ergonomic assessments, and offering pleasurable leisure and physical activity programs.Mental healthThe occupational therapy profession believes that the health of an individual is fostered through active engagement in one's occupations (AOTA, 2014). When a person is experiencing any mental health need, his or her ability to actively participate in occupations may be hindered. For example, if a person has depression or anxiety, he or she may experience interruptions in sleep, difficulty completing self-care tasks, decreased motivation to participate in leisure activities, decreased concentration for school or job-related work, and avoidance of social interactions.Occupational therapy practitioners possess the educational knowledge base in mental health and can contribute to the efforts in mental health promotion, prevention, and intervention. Occupational therapy practitioners can provide services that focus on social-emotional well-being, prevention of negative behaviors, early detection through screenings, and intensive intervention (Bazyk & Downing, 2017).Occupational therapy practitioners can work directly with clients, provide professional development for staff, and work in collaboration with other team members and families. For instance, occupational therapists are specifically skilled at understanding the relationship between the demands of a task and the person's abilities.With this knowledge, practitioners are able to devise an intervention plan to facilitate successful participation in meaningful occupations. Occupational therapy services can focus on engagement in occupation to support participation in areas related to school, education, work, play, leisure, ADLs, and instrumental ADLs (Bazyk & Downing, 2017).Occupational therapy utilizes the public health approach to mental health (WHO, 2001) which emphasizes the promotion of mental health as well as the prevention of, and intervention for, mental illness. This model highlights the distinct value of occupational therapists in mental health promotion, prevention, and intensive interventions across the lifespan (Miles et al., 2010).Below are the three major levels of service:Tier 3: intensive interventionsIntensive interventions are provided for individuals with identified mental, emotional, or behavioral disorders that limit daily functioning, interpersonal relationships, feelings of emotional well-being, and the ability to cope with challenges in daily life. Occupational therapy practitioners are committed to the recovery model which focuses on enabling persons with mental health challenges through a client-centered process to live a meaningful life in the community and reach their potential (Champagne & Gray, 2011).The focus of intensive interventions (direct–individual or group, consultation) is engagement in occupation to foster recovery or “reclaiming mental health” resulting in optimal levels of community participation, daily functioning, and quality of life; functional assessment and intervention (skills training, accommodations, compensatory strategies) (Brown, 2012); identification and implementation of healthy habits, rituals, and routines to support wellness.Tier 2: targeted servicesTargeted services are designed to prevent mental health problems in persons who are at risk of developing mental health challenges, such as those who have emotional experiences (e.g., trauma, abuse), situational stressors (e.g., physical disability, bullying, social isolation, obesity) or genetic factors (e.g., family history of mental illness). Occupational therapy practitioners are committed to early identification of and intervention for mental health challenges in all settings.The focus of targeted services (small groups, consultation, accommodations, education) is engagement in occupations to promote mental health and diminish early symptoms; small, therapeutic groups (Olson, 2011); environmental modifications to enhance participation (e.g., create sensory-friendly classrooms, home, or work environments)Tier 1: universal servicesUniversal services are provided to all individuals with or without mental health or behavioral problems, including those with disabilities and illnesses (Barry & Jenkins, 2007).Occupational therapy services focus on mental health promotion and prevention for all:encouraging participation in health-promoting occupations (e.g., enjoyable activities, healthy eating, exercise, adequate sleep);fostering self-regulation and coping strategies (e.g., mindfulness, yoga);promoting mental health literacy (e.g., knowing how to take care of one's mental health and what to do when experiencing symptoms associated with ill mental health).Occupational therapy practitioners develop universal programs and embed strategies to promote mental health and well-being in a variety of settings, from schools to the workplace.The focus of universal services (individual, group, school-wide, employee/organizational level) is universal programs to help all individuals successfully participate in occupations that promote positive mental health (Bazyk, 2011);educational and coaching strategies with a wide range of relevant stakeholders focusing on mental health promotion and prevention; the development of coping strategies and resilience; environmental modifications and supports to foster participation in health-promoting occupations.Productive agingOccupational therapists work with older adults to maintain independence, participate in meaningful activities, and live fulfilling lives. Some examples of areas that occupational therapists address with older adults are driving, aging in place, low vision, and dementia or Alzheimer’s Disease (AD).When addressing driving, driver evaluations are administered to determine if drivers are safe behind the wheel. To enable the independence of older adults at home, occupational therapists perform fall risk assessments, assess clients functioning in their homes, and recommend specific home modifications. When addressing low vision, occupational therapists modify tasks and the environment.While working with individuals with AD, occupational therapists focus on maintaining the quality of life, ensuring safety, and promoting independence.Geriatrics/productive agingOccupational therapists address all aspects of aging from health promotion to the treatment of various disease processes. The goal of occupational therapy for older adults is to ensure that older adults can maintain independence and reduce health care costs associated with hospitalization and institutionalization.In the community, occupational therapists can assess older adults' ability to drive and if they are safe to do so. If it is found that an individual is not safe to drive the occupational therapist can assist with finding alternate transit options.Occupational therapists also work with older adults in their homes as part of home care. In the home, an occupational therapist can work on such things as fall prevention, maximizing independence with activities of daily living, ensuring safety, and being able to stay in the home for as long as the person wants. An occupational therapist can also recommend home modifications to ensure safety in the home.Many older adults suffer from chronic conditions such as diabetes, arthritis, and cardiopulmonary conditions. Occupational therapists can help manage these conditions by offering education on energy conservation strategies or coping strategies. Not only do occupational therapists work with older adults in their homes, but they also work with older adults in hospitals, nursing homes, and post-acute rehabilitation. In nursing homes, the role of the occupational therapist is to work with clients and caregivers on education for safe care, modifying the environment, positioning needs, and enhancing IADL skills to name a few.In post-acute rehabilitation, occupational therapists work with clients to get them back home and to their prior level of function after a hospitalization for an illness or accident. Occupational therapists also play a unique role in those with dementia. The therapist may assist with modifying the environment to ensure safety as the disease progresses along with caregiver education to prevent burnout.Occupational therapists also play a role in palliative and hospice care. The goal at this stage of life is to ensure that the roles and occupations that the individual finds meaningful continue to be meaningful. If the person is no longer able to perform these activities, the occupational therapist can offer new ways to complete these tasks while taking into consideration the environment along with physical, psychosocial, and physical needs. Not only do occupational therapists work with older adults in traditional settings they also work in senior centers and ALFs.Visual impairmentVisual impairment is one of the top 10 disabilities among American adults.Occupational therapists work with other professions, such as optometrists, ophthalmologists, and certified low vision therapists, to maximize the independence of persons with a visual impairment by using their remaining vision as efficiently as possible.AOTA's promotional goal of “Living Life to Its Fullest” speaks to who people are and learning about what they want to do, particularly when promoting the participation in meaningful activities, regardless of visual impairment.Populations that may benefit from occupational therapy include older adults, persons with traumatic brain injury, adults with the potential to return to driving, and children with visual impairments. Visual impairments addressed by occupational therapists may be characterized into 2 types including low vision or neurological visual impairment. An example of neurological impairment is a cortical visual impairment (CVI) which is defined as “...abnormal or inefficient vision resulting from a problem or disorder affecting the parts of the brain that provide sight”.The following section will discuss the role of occupational therapy when working with the visually impaired.Occupational therapy for older adults with low vision includes task analysis, environmental evaluation, and modification of tasks or the environment as needed. Many occupational therapy practitioners work closely with optometrists and ophthalmologists to address visual deficits in acuity, visual field, and eye movement in people with traumatic brain injury, including providing education on compensatory strategies to complete daily tasks safely and efficiently. Adults with a stable visual impairment may benefit from occupational therapy for the provision of a driving assessment and an evaluation of the potential to return to driving. Lastly, occupational therapy practitioners enable children with visual impairments to complete self-care tasks and participate in classroom activities using compensatory strategies.Adult rehabilitationOccupational therapists address the need for rehabilitation following an injury or impairment. When planning treatment, occupational therapists address the physical, cognitive, psychosocial, and environmental needs involved in adult populations across a variety of settings.Occupational therapy in adult rehabilitation may take a variety of forms:Working with adults with autism at day rehabilitation programs to promote successful relationships and community participation through instruction on social skills.Increasing the quality of life for an individual with cancer by engaging them in occupations that are meaningful, providing anxiety and stress reduction methods, and suggesting fatigue management strategiesCoaching individuals with hand amputations how to put on and take off a myoelectrically controlled limb as well as training for functional use of the limbAs for paraplegics, there are such things as sitting cushion and pressure sore prevention. Prescription of these aids is a common job for paraplegics.Using and implementing new technology such as speech to text software and Nintendo Wii video gamesCommunicating via tele-health methods as a service delivery model for clients who live in rural areasWorking with adults who have had a stroke to regain their activities of daily livingAssistive technologyOccupational therapy practitioners or OTs are uniquely poised to educate, recommend, and promote the use of assistive technology to improve the quality of life for their clients. OTs are able to understand the unique needs of the individual in regard to occupational performance and have a strong background in activity analysis to focus on helping clients achieve goals. Thus, the use of varied and diverse assistive technology is strongly supported within occupational therapy practice models.Travel occupational therapyBecause of the rising need for occupational therapy practitioners in the U.S., many facilities are opting for travel occupational therapy practitioners—who are willing to travel, often out of state, to work temporarily in a facility. Assignments can range from 8 weeks to 9 months, but typically last 13–26 weeks in length.Travel therapists work in many different settings, but the highest need for therapists is in home health and skilled nursing facility settings.There are no further educational requirements needed to be a travel occupational therapy practitioner; however, there may be different state licensure guidelines and practice acts that must be followed.According to Zip Recruiter, as of July 2019, the national average salary for a full-time travel therapist is $86,475 with a range between $62,500 to $100,000 across the United States.Most commonly (43%), travel occupational therapists enter the industry between the ages of 21–30.Occupational justiceThe practice area of occupational justice relates to the “benefits, privileges, and harms associated with participation in occupations” and the effects related to access or denial of opportunities to participate in occupations. This theory brings attention to the relationship between occupations, health, well-being, and quality of life.Occupational justice can be approached individually and collectively. The individual path includes disease, disability, and functional restrictions. The collective way consists of public health, gender, and sexual identity, social inclusion, migration, and the environment.The skills of occupational therapy practitioners enable them to serve as advocates for systemic change, impacting institutions, policy, individuals, communities, and entire populations.Examples of populations that experience occupational injustice include refugees, prisoners, homeless persons, survivors of natural disasters, individuals at the end of their life, people with disabilities, elderly living in residential homes, individuals experiencing poverty, children, immigrants, and LGBTQI+ individuals.For example, the role of an occupational therapist working to promote occupational justice may include:Analyzing tasks, modifying activities, and environments to minimize barriers to participation in meaningful activities of daily living.Addressing physical and mental aspects that may hinder a person's functional ability.Provide intervention that is relevant to the client, family, and social context.Contribute to global health by advocating for individuals with disabilities to participate in meaningful activities on a global level. Occupation therapists are involved with the World Health Organization (WHO), non-governmental organizations and community groups, and policymaking to influence the health and well-being of individuals with disabilities worldwideOccupational therapy practitioners’ role in occupational justice is not only to align with perceptions of procedural and social justice but to advocate for the inherent need of meaningful occupation and how it promotes a just society, well-being, and quality of life among people relevant to their context. It is recommended to the clinicians to consider occupational justice in their everyday practice to promote the intention of helping people participate in tasks that they want and need to do.Occupational injusticeIn contrast, occupational injustice relates to conditions wherein people are deprived, excluded, or denied opportunities that are meaningful to them.Types of occupational injustices and examples within the OT practice include:Occupational deprivation: The exclusion from meaningful occupations due to external factors that are beyond the person's control. As an example, a person who has difficulties with functional mobility may find it challenging to reintegrate into the community due to transportation barriers.Occupational apartheid: The exclusion of a person in chosen occupations due to personal characteristics such as age, gender, race, nationality, or socioeconomic status. An example can be seen in children with developmental disabilities from low socioeconomic backgrounds whose families would opt-out from therapy due to financial constraints.Occupational marginalization: Relates to how implicit norms of behavior or societal expectations prevents a person from engaging in a chosen occupation. As an example, a child with physical impairments may only be offered table-top leisure activities instead of sports as an extracurricular activity due to the functional limitations caused by his physical impairments.Occupational imbalance: The limited participation in a meaningful occupation brought about by another role in a different occupation. This can be seen in the situation of a caregiver of a person with a disability who also has to fulfill other roles such as being a parent to other children, a student, or a worker.Occupational alienation: The imposition of an occupation that does not hold meaning for that person. In the OT profession, this manifests in the provision of rote activities which does not really relate to the goals or the interest of the client.Within occupational therapy practice, injustice may ensue in situations wherein professional dominance, standardized treatments, laws, and political conditions create a negative impact on the occupational engagement of our clients.Awareness of these injustices will enable the therapist to reflect on his own practice and think of ways in approaching their client's problems while promoting occupational justice.Community-based therapyAs occupational therapy (OT) has grown and developed, the community-based practice has blossomed from an emerging area of practice to a fundamental part of occupational therapy practice (Scaffa & Reitz, 2013).Community-based practice allows for OTs to work with clients and other stakeholders such as families, schools, employers, agencies, service providers, stores, day treatment and daycare, and others who may influence the degree of success the client will have in participating. It also allows the therapist to see what is actually happening in the context and design interventions relevant to what might support the client in participating and what is impeding her or him from participating.Community-based practice crosses all of the categories within which OTs practice from physical to cognitive, mental health to spiritual, all types of clients may be seen in community-based settings. The role of the OT also may vary, from advocate to consultant, direct care provider to program designer, adjunctive services to the therapeutic leader.EducationWorldwide, there is a range of qualifications required to practice as an occupational therapist or occupational therapy assistant. Depending on the country and expected level of practice, degree options include associate degree, Bachelor's degree, entry-level master's degree, post-professional master's degree, entry-level Doctorate (OTD), post-professional Doctorate (OTD), Doctor of Clinical Science in OT (CScD), Doctor of Philosophy in Occupational Therapy (PhD), and combined OTD/PhD degrees.Both occupational therapist and occupational therapy assistant roles exist internationally. Currently, in the United States, dual points of entry exist for both OT and OTA programs. For OT, that is an entry-level Masters or entry-level Doctorate. For OTA, that is an associate degree or bachelor's degree.The World Federation of Occupational Therapists (WFOT) has minimum standards for the education of OTs, which was revised in 2016. All of the educational programs around the world need to meet these minimum standards. These standards are subsumed by and can be supplemented with academic standards set by a country's national accreditation organization.As part of the minimum standards, all programs must have a curriculum that includes practice placements (fieldwork). Examples of fieldwork settings include acute care, inpatient hospital, outpatient hospital, skilled nursing facilities, schools, group homes, early intervention, home health, and community settings.The profession of occupational therapy is based on a wide theoretical and evidence-based background. The OT curriculum focuses on the theoretical basis of occupation through multiple facets of science, including occupational science, anatomy, physiology, biomechanics, and neurology. In addition, this scientific foundation is integrated with knowledge from psychology, sociology, and more.In the United States, Canada, and other countries around the world, there is a licensure requirement. In order to obtain an OT or OTA license, one must graduate from an accredited program, complete fieldwork requirements, and pass a national certification examination.Theoretical frameworksA distinguishing facet of occupational therapy is that therapists often espouse the use of theoretical frameworks to frame their practice. Nonetheless, many have also argued that the use of theory complicates everyday clinical care and is not necessary to provide patient-driven care.Note that terminology differs between scholars. An incomplete list of theoretical bases for framing a human and their occupations include the following:Generic modelsGeneric models are the overarching title given to a collation of compatible knowledge, research, and theories that form conceptual practice.More generally they are defined as "those aspects which influence our perceptions, decisions, and practice".Person-Environment Occupation Performance ModelThe Person Environment Occupation Performance model (PEOP) was originally published in 1991 (Charles Christiansen & M. Carolyn Baum] and describes an individual's performance based on four elements including environment, person, performance, and occupation. The model focuses on the interplay of these components and how this interaction works to inhibit or promote successful engagement in occupation.Occupation-Focused Practice ModelsOccupational Therapy Intervention Process Model (OTIPM) (Anne Fisher and others)Occupational Performance Process Model (OPPM)Model of Human Occupation (MOHO) (Gary Kielhofner and others) MOHO was first published in 1980. It explains how people select, organize, and undertake occupations within their environment. The model is supported by evidence generated over thirty years and has been successfully applied throughout the world.Canadian Model of Occupational Performance and Engagement (CMOP-E)Occupational Performances Model – Australia (OPM-A) (Chris Chapparo & Judy Ranka)The OPM(A) was conceptualized in 1986 with its current form launched in 2006. The OPM(A) illustrates the complexity of occupational performance, the scope of occupational therapy practice, and provides a framework for occupational therapy education.Kawa (River) Model (Michael Iwama)The Biopsychosocial ModelThe biopsychosocial model takes into account how disease and illness can be impacted by social, environmental, psychological, and body functions. The biopsychosocial model is unique in that it takes the client's subjective experience and the client-provider relationship as factors to wellness. This model also factors in cultural diversity as many countries have different societal norms and beliefs. This is a multifactorial and multi-dimensional model to understand not only the cause of disease but also a person-centered approach that the provider has more of a participatory and reflective role.Frames of referenceFrames of reference are an additional knowledge base for the occupational therapist to develop their treatment or assessment of a patient or client group. Though there are conceptual models (listed above) that allow the therapist to conceptualize the occupational roles of the patient, it is often important to use a further reference to embed clinical reasoning. Therefore, many occupational therapists will use additional frames of reference to both assess and then develop therapy goals for their patients or service users.As with the conceptual models discussed above, these frames of reference are used infrequently in routine clinical practice, and often obfuscate clinical decision-making. ,Biomechanical frame of reference. The biomechanical frame of reference is primarily concerned with motion during occupation. It is used with individuals who experience limitations in movement, inadequate muscle strength, or loss of endurance in occupations. The frame of reference was not originally compiled by occupational therapists, and therapists should translate it to the occupational therapy perspective, to avoid the risk of movement or exercise becoming the main focus.Rehabilitative (compensatory)Neurofunctional (Gordon Muir Giles and Clark-Wilson)Dynamic systems theoryThe client-centered frame of reference this frame of reference is developed from the work of Carl Rogers. It views the client as the center of all therapeutic activity, and the client's needs and goals direct the delivery of the occupational therapy process.Cognitive-behavioural frame of referenceEcology of the human performance modelThe recovery modelThe sensory integration framework is commonly implemented in clinical, community, and school-based occupational therapy practice. It is most frequently used with children with developmental delays and developmental disabilities such as autism spectrum disorder and dyspraxia.Core features of sensory integration in treatment include providing opportunities for the client to experience and integrate feedback using multiple sensory systems, providing therapeutic challenges to the client's skills, integrating the client's interests into therapy, organizing of the environment to support the client's engagement, facilitating a physically safe and emotionally supportive environment, modifying activities to support the client's strengths and weaknesses, and creating sensory opportunities within the context of play to develop intrinsic motivation. While sensory integration is traditionally implemented in pediatric practice, there is emerging evidence for the benefits of sensory integration strategies for adults.ICFThe International Classification of Hearing, Functioning, Disability, and Health (ICF) is a framework to measure health and ability by illustrating how these components impact one's function. This relates very closely to the Occupational Therapy Practice Framework, as it is stated that "the profession's core beliefs are in the positive relationship between occupation and health and its view of people as occupational beings".The ICF is built into the 2nd edition of the practice framework. Activities and participation examples from the ICF overlap Areas of Occupation, Performance Skills, and Performance Patterns in the framework.The ICF also includes contextual factors (environmental and personal factors) that relate to the framework's context. In addition, body functions and structures classified within the ICF help describe the client factors described in the Occupational Therapy Practice Framework.Further exploration of the relationship between occupational therapy and the components of the ICIDH-2 (revision of the original International Classification of Impairments, Disabilities, and Handicaps (ICIDH), which later became the ICF) was conducted by McLaughlin Gray.It is noted in the literature that occupational therapists should use specific occupational therapy vocabulary along with the ICF in order to ensure correct communication about specific concepts.The ICF might lack certain categories to describe what occupational therapists need to communicate to clients and colleagues. It also may not be possible to exactly match the connotations of the ICF categories to occupational therapy terms. The ICF is not an assessment and specialized occupational therapy terminology should not be replaced with ICF terminology.The ICF is an overarching framework for current therapy practices.Global occupational therapyOccupational therapy is practiced around the world and can be translated in practice to many different cultures and environments. The construct of occupation is shared throughout the profession regardless of country, culture, and context. Occupation and the active participation in occupation are now seen as a human right and is asserted as a strong influence in health and well-being.As the profession grows there is a lot of people who are traveling across countries to work as occupational therapists for better work or opportunities. Under this context, every occupational therapist is required to adapt to a new culture, foreign to their own.Understanding cultures and their communities are crucial to occupational therapy ethos. Effective occupational therapy practice includes acknowledging the values and social perspectives of each client and their families. Harnessing culture and understanding what is important to the client is truly a faster way towards independence.The World Federation of Occupational Therapists is an international voice of the profession and is a membership network of occupational therapists worldwide. WFOT supports the international practice of occupational therapy through collaboration across countries. WFOT currently includes over 100 member country organizations, 550,000 occupational therapy practitioners, and 900 approved educational programs.The profession celebrates World Occupational Therapy Day on the 27th of October annually to increase visibility and awareness of the profession, promoting the profession's development work at a local, national, and international platform.WFOT has been in close collaboration with the World Health Organization (WHO) since 1959, working together in programs that aim to improve world health.WFOT supports the vision for healthy people, in alignment with the United Nations 17 Sustainable Development Goals, which focuses on "ending poverty, fighting inequality and injustice, tackling climate change and promoting health".Occupational therapy is a major player in enabling individuals and communities to engage in "chosen and necessary occupations" and "the creation of more meaningful lives".