Occupational Therapy: A Brief History

Occupational therapy (OT) celebrated its centennial last year, but what is OT and what is its history? According to the American Occupational Therapy Association (AOTA), OT enables “people of all ages to live life to its fullest by helping them promote health, and prevent – or live better with – injury, illness, or disability.” Occupational services usually include individualized evaluations, during which the patient, their family, and the occupational therapist determine the person’s goal; customized interventions to improve a person’s ability to perform daily activities and reach their goals; adaptive equipment recommendation and training in its use; and an evaluation of the outcomes to make sure that the goals are being met or make changes to the intervention plan.

OT and the War Years

OT has an extensive history and has evolved over the last century. Although John Ruskin and William Morris were credited with the creation of the Arts and Crafts Movement of the 1860s, which served as the creative basis of OT, it was in 1917 that OT grew as a profession out of the Moral Treatment Movement, which focused on seeing people as more than their disabilities. It was during this time that reconstruction aides were being used to aid soldiers injured during World War I (WWI). The Soldier’s Rehabilitation Act of 1918 helped to create a program for injured soldiers to participate in rehabilitation after the war. At the same time, Eleanor Clark Slagle, known as the mother of OT, was teaching classes on OT at the Hull House to anyone interested in helping with war rehabilitation.

The Great Depression halted the growth of the OT field until 1939, which included a decrease in practitioners. However, there was an increased need for OT during World War II (WWII), during which emergency courses allowed occupational therapists (OTs) to be trained in order to help in the rehabilitation of soldiers returning with service-connected injuries. Shortly after WWII, the Rehabilitation Movement began and was a time of growth in healthcare and this growth continued until 1960. During this time period, OTs were increasingly employed in rehabilitation areas and the women who worked as OTs during WWII were considered commissioned officers in the military.

Impact of Legislation on OT Services

As the field of OT grew, so too did improvements in technology related to prosthetics and the use of wheelchairs. In 1965, Medicare was created and it helped increase the demand for OTs since selected OT services were now covered by Medicare. Ten years later, the Education for All Handicapped Children Act of 1975 not only gave free and proper education to all children regardless of disabilities, it also included OT as a special education service and OTs began to support children in public schools.

The Science of OT

The 1980s brought new models of treatment including the Model of Human Occupation founded by Gary Kielhofner in 1980 which is an evidence-based model whose goal is to explain the science behind occupational therapy. During the 1990s, OTs were engaged by organizations to help meet their responsibilities under the Americans with Disabilities Act of 1990, using science-based methods to assist with workplace evaluations and accommodations to support employees, volunteers, and customers with disabilities. OT fields of practice also expanded in areas such as community-based programs, health promotion for older individuals, and prevention. The 1990s also saw new and innovative technology in many areas of practice, from utilizing computer activities as part of interventions to identifying technology solutions for home, work, and school. The 21^st century brought further technological advances that OTs use, not only as interventions, but to train their patients in newer assistive technologies, including apps that can be downloaded onto a tablet that can be used as part of therapy for fine motor skills, for example.

Congratulations to OTs for an exciting first 100 years! We look forward to seeing what you do in the next 100 years.

If you would like more information on occupational therapy, please contact NARIC’s information specialists by calling 800/346-2742, chat, or email.

Sources:

1. Occupational Therapy Celebrating 100 by the American Occupational Therapy Association, Inc.
2. 100 Influential People by the American Occupational Therapy Association, Inc.
3. What is Occupational Therapy by The American Occupational Association, Inc.
4. The Evolution of Occupational Therapy Through the Years, St. Catherine University Online OTA Program.
5. Anderson, L. T., & Reed, K. L. (2017). The History of Occupational Therapy: The First Century, Slack Incorporated.