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On Pygmalion and sensory integration research
Occupational therapists have been attempting to improve research on sensory integration by adopting more strict fidelity standards and by using Goal Attainment Scaling as an outcome measure.  Three years ago I blogged about an SI effectiveness study and expressed some concerns on the research design - you can read about that at http://abctherapeutics.blogspot.com/2011/01/new-study-on-si-effectiveness-but.html.A new study has been published by Schaaf et al (2013) and can be accessed online in full text at http://link.springer.com/article/10.1007%2Fs10803-013-1983-8/fulltext.html  However, one major difference is t...
Source: ABC Therapeutics Occupational Therapy Weblog - December 3, 2013 Category: Occupational Therapists Tags: autism evidence-based practice sensory integration Source Type: blogs

On beehives, planetary motion, and reasons for not writing reports sooner.
Autumn clings tightly to these late November days like the last remaining leaves on the trees.  Looking out into my front yard I see that bee hives and abandoned birds nests also populate the branches of trees.  I know that the leaves fall and they fertilize the earth and feed the trees for the Spring.  I have been wondering if the bees re-populate their hives, or if the birds recycle their nests.  I have to look into that.Why is it that my immediate impulse was to remove these remnants of the Spring and Summer?  In my mind I was waiting for it to be cold enough so that the bees would be torpid.&nb...
Source: ABC Therapeutics Occupational Therapy Weblog - November 18, 2013 Category: Occupational Therapists Tags: OT practice philosophy Source Type: blogs

Reasons to pause when discussing a "sensory processing disorder" construct.
The Sensory Profile is an assessment tool that purports to measure sensory processing abilities (Pearson Education Inc., 2008); there are versions for infant/toddlers, school aged children, and adolescent/adult populations.  The tool has been used to document the incidence of a "sensory processing disorder" construct (Ahn, et. al., 2004; Ben-Sasson, et. al., 2009).  To date, although many scientists recognize that children can have difficulties with processing sensory information, this diagnostic construct has been rejected and is not considered as a distinct clinical entity (AAP, 2012).   For more in depth ...
Source: ABC Therapeutics Occupational Therapy Weblog - October 29, 2013 Category: Occupational Therapists Tags: OT practice sensory integration Source Type: blogs

Written testimony for public hearing on EI fiscal agent implementation
Although I was initially planning to present oral testimony for the upcoming public hearing on EI fiscal agent implementation I have decided to present written testimony.  My ideas on this differ a little from other providers who very understandably are stressed by the notion of billing because of how difficult this process has been.  I think that a correctly implemented plan as outlined here would be the best solution. Here is what I have submitted:+++++++++++++++++++++++++++++++ My name is Christopher Alterio and I am an occupational therapist and private practice (small business) owner in Western New York. Th...
Source: ABC Therapeutics Occupational Therapy Weblog - October 18, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

Evidence update: Pediatric fecal incontinence and best practices for intervention
Almost seven years ago I wrote a blog entry on pediatric fecal incontinence which is archived here.  In that review I briefly discussed psychological and physiological and regulatory factors that might contribute to the problem.  The evidence at that time indicated that dietary, activity, and cognitive behavioral interventions were most likely to be successful in helping families.I also discussed a common occupational therapy mythology that sensory processing factors such as preference for deep pressure stimulation might contribute to fecal retention.  There has never been any evidence to indicate that this ...
Source: ABC Therapeutics Occupational Therapy Weblog - September 28, 2013 Category: Occupational Therapists Tags: parenting evidence-based practice sensory integration OT practice Source Type: blogs

Are NYS Medicaid audits improperly destroying care systems?
Follow up to earlier post: http://abctherapeutics.blogspot.com/2013/03/how-citizen-participation-impacts.html++++++ New York State Medicaid regulations are a dizzying and complex ruleset that most providers in good faith attempt to follow in their care of people who are Medicaid recipients.There is an appropriately strict set of rules that most people don't disagree with because naturally we want our State monies to be distributed appropriately and we certainly don't want people fraudulently gaming a reimbursement system.Undoubtedly, there are examples of fraud and abuse that require strong auditing response and hopefully ...
Source: ABC Therapeutics Occupational Therapy Weblog - September 26, 2013 Category: Occupational Therapists Tags: Disability rights policy health insurance Source Type: blogs

The influence of William Morris and the Arts and Crafts Movement on Occupational Therapy
n.b. ongoing series related to a study of George Barton, founder of the Occupational Therapy Profession. By my reckoning, it is probably impossible to conduct a study of an event without studying the context in which that event occurred.  Here I suspect that occupational therapy colleagues reading this will understand the bias of the author as he attempts to become a historian.  As clinicians we have well established practice frameworks like the P-E-O model (Law, Cooper, Strong, Stewart, Rigby, & Letts, 1996) that explicitly state that the behavior can’t be separated from its contextual influences. Additi...
Source: ABC Therapeutics Occupational Therapy Weblog - September 19, 2013 Category: Occupational Therapists Tags: history Source Type: blogs

When the fishing is good but the catching is bad.
I personally always fished with worms, or occasionally newts - but I am no fisherman and my knowledge of this occupation is restricted to the things a young boy would gain by spending summers casting into the Hudson River more for a way to commune with friends than for the sport.  Back then it never really mattered what we caught or even if we caught because the occupation was directed toward the social experience.  Besides, there is nothing worse than having to get a river eel off of your line.  Gross.Anyway, I was preparing a lecture and the concept of 'emerging practice area' ran across my radar screen.&n...
Source: ABC Therapeutics Occupational Therapy Weblog - September 7, 2013 Category: Occupational Therapists Tags: OT Education philosophy evidence-based practice OT practice Source Type: blogs

NYS Early Intervention Program makes up more rule changes as they trip along
Here is an illustration for providers in the NYS Early Intervention Program that clearly illustrates the selfish orientation of thinking that is driving decision making on a central level at the Bureau of Early Intervention.Exactly two months and two days ago, the Bureau of Early Intervention instructed providers to "accept claim amounts proposed by the insurer as payment in full from the insurer for the claim which are lower than the State-established EIP rate."  Although they explained that this would not impact payments from escrow in the short term, we explained that accepting these payments in this way would be...
Source: ABC Therapeutics Occupational Therapy Weblog - August 29, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

New York State Early Intervention: Roadmap through the end of 2013
My email box is flooded from colleagues asking about the NYS Early Intervention program - so I thought I would lay out the likely path toward the end of 2013 so people can plan appropriately for what lies ahead.I also have a roadmap through 2014 and 2015 which will be published as a part of this series.  Stay tuned. Fall, 2013: The already stressed EIP will continue to come apart at the seams.  Payments to providers will continue to be excruciatingly slow and complex.  Even more providers will leave the system creating even longer waiting lists for children and families.There will be no immediate 'fix' becau...
Source: ABC Therapeutics Occupational Therapy Weblog - August 24, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

Understanding Common Core Standards in two short videos.
Here is everything you need to know about Common Core standards in two short videos: Enjoy! (Source: ABC Therapeutics Occupational Therapy Weblog)
Source: ABC Therapeutics Occupational Therapy Weblog - August 19, 2013 Category: Occupational Therapists Tags: parenting Source Type: blogs

Early intervention providers: Look the 'Gift Horse' in the mouth please.
I received this in email today:Dear Colleague:The NYS Department of Health (Department) is offering a one-time State safety net payment to Early Intervention providers, and will not proceed to implement the Preliminary Escrow Payment (PEP) proposal due to insufficient county participation.  State safety net payments will be calculated as seventy-five percent of the value of claims submitted to insurers, with the exception of the medical assistance program, in the period April 1, 2013 through July 29, 2013 for which no known payment or denial has been received.  The State safety net payments will be recon...
Source: ABC Therapeutics Occupational Therapy Weblog - August 15, 2013 Category: Occupational Therapists Tags: policy health insurance Source Type: blogs

Note to politicians: Grandstanding on important policy issues does not win votes.
All press is not good press.  Especially when people get distracted from what the primary issues are.In tonight's Capitol Confidential post there is a report that is headlined: "Therapists want to get paid, Tedisco sees 'War on Women.'"The headline I would like to see is: "Children go without important therapy as NYS decimates Early Intervention Program."A parallel example recently was the announced closure of O.D.Heck.  This announcement generated conversation about the plight of union jobs.  What got lost in the shuffle was the important human rights policy of de-institutionalization and the very real fact...
Source: ABC Therapeutics Occupational Therapy Weblog - August 14, 2013 Category: Occupational Therapists Tags: policy health insurance Source Type: blogs

George Barton: Birth and early influences.
George Edward Barton was born on March 7, 1871.  That is a rather dry fact about one of the important founders of the occupational therapy profession - so what can be done to help give it context?Context provides dimension - and if we want to learn a little about George Barton it might be helpful to know a little about his history.  His parents lived in Boston, Massachusetts.   His father was Edward H. Barton, the Secretary and Treasurer of the South Boston Savings Bank.  His mother was Rebecca Duncan (Boynton) Barton.It was difficult to find other information about George Barton's parents, but a rather...
Source: ABC Therapeutics Occupational Therapy Weblog - August 10, 2013 Category: Occupational Therapists Tags: history Source Type: blogs

NYS Early Intervention botches billing for commercial insurance too
Today we received notification that some of our early intervention families have been sent our payments for the services we provided to children.  The payments are not supposed to be directed to the families - they are supposed to be directed to the providers or to the State for processing.Based on our private billing experience as an outpatient clinic, it is uncommon for insurance companies to send reimbursements directly to enrollees, but it happens.  Most of the time when the insurance company does this the family hands the checks directly to us.  Unfortunately, some people don't understand what the check...
Source: ABC Therapeutics Occupational Therapy Weblog - August 9, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs