Occupational Therapy -> Activities of Daily Living / Self-care

Activities of Daily Living / Self-care

Occupational therapists help individuals become as independent as possible in daily tasks required to take care of one’s own body. An occupational therapist may provide adaptive equipment/seating, modified steps of the task, therapeutic activities/exercises to address the skills needed for a specific task or training to caregivers to increase the individual's independence, participation, and safety.

Minor focus areas

Reference links

  • Interventions Within the Scope of Occupational Therapy Practice to Improve Activities of Daily Living, Rest, and Sleep For Children Ages 0–5 Years and Their Families: A Systematic Review 2
    research.aota.org     Author: Gronski and Doherty - Feeding and eating, toileting, rest and sleep. Behavioral approaches, parent and caregiver education, and contextual intervention. Interdisciplinary care, family coaching and education, and behavioral approaches within the professional scope of occupational therapy to improve the functional performance, routines, and quality of life for young children and their caregivers. Benefits of these interventions include improved falling and staying asleep, more frequent child-initiated toileting, and fewer negative mealtime behavior. Citation: Meredith Gronski, Meghan Doherty; Interventions Within the Scope of Occupational Therapy Practice to Improve Activities of Daily Living, Rest, and Sleep for Children Ages 0–5 Years and Their Families: A Systematic Review. Am J Occup Ther March/April 2020, Vol. 74(2), 7402180010p1–7402180010p33. doi: https://doi.org/10.5014/ajot.2020.039545
  • Occupational Therapy Interventions For Children and Youth With Challenges In Sensory Integration and Sensory Processing: A School-Based Practice Case Example 0
    research.aota.org     Author: Gloria Frolek Clark; Renee Watling; L. Diane Parham; Roseann Schaaf - This case demonstrates the use of evidence-based strategies in school-based occupational therapy for a student with ASD and sensory processing difficulties whose occupational therapy evaluation identified specific challenges in the school routine that affected his occupational performance and participation. This case emphasizes the need to implement the following evidence-based evaluation and intervention procedures: - Conduct a comprehensive evaluation that includes screening all areas of occupation, record review, interviews, observations during natural routines, and assessment tool use (when applicable). - Use evaluation findings to hypothesize why participation challenges occur. - Work with the team to identify the student’s needs and create collaborative student IEP goals to address these needs (not therapy-specific goals). - Provide occupational therapy services that reflect the distinct value of occupational therapy in school settings. - Gather frequent quantitative data to determine the effectiveness of the intervention.
  • Occupation- and Activity-Based Interventions to Improve Performance of Activities of Daily Living, Play, and Leisure For Children and Youth Ages 5 to 21: A Systematic Review 2
    research.aota.org     Author: Laverdure and Beisbier - Strong evidence indicates that engagement in occupations and activities, practice within and across environments, and coaching and feedback improve participation and performance in ADLs and functional mobility. Moderate evidence supports the use of collaborative goal setting, modeling, and guided participation in play and leisure. Moderate evidence also supports technological interventions for ADL, play, and leisure performance. Collaborating with clients and caregivers on the development of goals and intervention plans Providing caregiver training in the implementation, carryover, and transfer of occupation- and activity-based interventions in meaningful contexts Providing training and feedback to support client initiation of and engagement in occupational tasks and routines Embedding occupation- and activity-based interventions in natural routines, contexts, and environments and with naturally occurring social partners (e.g., caregivers, peers) Guiding and structuring occupation- and activity-based intervention and considering the use of technology (e.g., video modeling, virtual reality, and video game training interventions) to support and reinforce occupational participation and performance Instructing caregivers in the structured practice and provision of coaching and feedback on ADL skills in home and community settings. Citation: Patricia Laverdure, Stephanie Beisbier; Occupation- and Activity-Based Interventions to Improve Performance of Activities of Daily Living, Play, and Leisure for Children and Youth Ages 5 to 21: A Systematic Review. Am J Occup Ther January/February 2021, Vol. 75(1), 7501205050p1–7501205050p24. doi: https://doi.org/10.5014/ajot.2021.039560
  • Effectiveness of Pediatric Occupational Therapy For Children With Disabilities: A Systematic Review 1
    www.ncbi.nlm.nih.gov     Author: Iona Novak and Ingrid Honan - A. Parent partnership within an occupational therapist intervention is effective and worthwhile Occupational Therapists embrace the principles of family-centered care (Hanna & Rodger, 2002), where the parent is the decision-maker and the expert in knowing their child, and the therapist is a technical resource to the family. B. Activities-based, ‘top-down’ interventions deliver bigger gains. Numerous occupational therapy interventions exist, aiming to improve motor, behavioral and functional outcomes (Fig. 3), affording many choices to families and clinicians. The greatest number of effective green light interventions was at the activity level of the ICF, indicating that daily life skills training using a ‘top-down’ approach is a strength of the occupational therapy profession.
  • Milestone Moments 1
    www.cdc.gov     Author: Centers For Disease Control and Prevention - These developmental milestones show what most children (75% or more) can do by each age. Subject matter experts selected these milestones based on available data and expert consensus.
  • Therapy Co-Treatment Scenarios and Documentation - Harmony Healthcare International (HHI) Blog 1
    www.harmony-healthcare.com     Author: Kris Mastrangelo, OTR/L, LNHA, MBA - PT and OT appear to be a natural pairing because of the treatment crossover in neuromuscular and orthopedic deficit remediation. However, patients also benefit from co-treatments with SLP and OT, for interventions such as self feeding. During these types of therapeutic collaborations, OT can address postural alignment, positioning, adaptive equipment, and the motor sequence of self feeding, while the SLP addresses bolus size, rate of presentation, and any specific strategies identified to reduce the risk of aspiration; such as chin tuck swallow, or multiple swallows per bolus. Examples of appropriate goals in support of co-treatment follow: Patient will demonstrate self feeding skills with setup assistance x 4/5 consecutive sessions x 14 days, while applying swallow safety strategies with minimal verbal cueing. Patient will demonstrate lower body dressing skills with minimum assist while maintaining standing balance in order to complete the task safely in preparation for return to ALF.
  • Autism Spectrum Disorder and Other Development Disorder 1
    www.who.int     Author: World Health Organization - Psychosocial interventions that are effective in reducing core symptoms and improving adaptive skills and functioning are available, but they are very resource intensive. Increased evidence on affordable service delivery models and effective and scalable capacity-building approaches are required. Interventions mediated by parents and other non-specialist providers have the potential to significantly increase access to care.
  • Pathological Demand Avoidance: Symptoms but Not a Syndrome 0
    pubmed.ncbi.nlm.nih.gov     Author: Jonathan Green 1, Michael Absoud 2, Victoria Grahame 3, Osman Malik 4, Emily Simonoff 5, Ann Le Couteur 6, Gillian Baird 4 - In our Viewpoint, we reviewed the current literature and conclude that the evidence does not support the validity of pathological demand avoidance as an independent syndrome. Nevertheless, the use of the term highlights an important known range of co-occurring difficulties for many children with autism spectrum disorder that can substantially affect families. We explore how these difficulties can best be understood through an understanding social, sensory, and cognitive sensitivity in autism spectrum disorder, identification of frequently occurring comorbid conditions, and assessment of how these problems interact within the child's social environment. Pathological demand avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent.
  • Nurturing Care For Early Childhood Development 1
    www.who.int     Author: World Health Organization - Your loving care as a parent is what a child needs to be healthy, wellnourished and safe. • Communicate early and often, starting even before your baby is born. It will help you build a warm and loving relationship. • Make time to play with your child and engage them in your daily chores. You will help your child to learn, be happy and thrive. • Remember that feeding times are periods of learning and love – talk to your child while feeding and make eye-to-eye contact. • If you feel sad and unable to respond joyfully to your child, seek help from your health care provider
  • Joint Guidelines For Therapy Co-Treatment Under Medicare 1
    www.aota.org     Author: The American Occupational Therapy Association (AOTA) The American Physical Therapy Association (APTA) The American Speech-Language-Hearing Association (ASHA) - Co-treatment may be appropriate when practitioners from different professional disciplines can effectively address their treatment goals while the patient is engaged in a single therapy session. For example, a patient may address cognitive goals for sequencing as part of a speech-language pathology (SLP) treatment session while the physical therapist (PT) is training the patient to use a wheelchair. Or a patient may address ADL goals for increasing independence as part of an occupational therapy (OT) treatment session while the PT addresses balance retraining with the patient to increase independence with mobility. Co-treatment is appropriate when coordination between the two disciplines will benefit the patient, not simply for scheduling convenience. Documentation should clearly indicate the rationale for co-treatment and state the goals that will be addressed through this method of intervention. Co-treatment sessions should be documented as such by each practitioner, stating which goals were addressed and the progress made. Co-treatment should be limited to two disciplines providing interventions during one treatment session.
  • Your Child’s Early Development is a Journey 1
    www.cdc.gov     Author: Centers For Disease Control and Prevention - Skills such as taking the first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Children reach milestones in how they play, learn, speak, act, and move. Click on the age of your child to see the milestones:
  • Variables Related to Successful School-Based Practice 1
    www.nbcot.org     Author: Case-Smith, Jane.  - Three themes were identified: "Finding the key" described a procedural reasoning process in which the participants searched for the underlying reasons for each student's behaviors and performance. "The whole child" emphasized the importance of the student's psychosocial core and described the therapist's use of interactive and conditional reasoning to form supportive relationships with their students. Because each participant valued the student's vision of a new self, she was able to help the student achieve new social roles and improved self-esteem. "Whose success is this?" told of the importance of a cohesive team, which included the parents, to the child's success. The child's achievement of important life goals and success as a student seemed to be the result of a team effort to which occupational therapy contributed.
  • Scope of Occupational Therapy Services For Individuals With Autism Spectrum Disorder Across the Life Course 1
    research.aota.org     Author: Copyright © 2015 By the American Occupational Therapy Association, Inc. The American Journal of Occupational Therapy, 2015, Vol. 69(Supplement_3), 6913410054p1–6913410054p12. - Occupational Therapy practitioners work collaboratively with individuals on the autism spectrum, their families, OTHER PROFESSIONALS, organizations, and community members in multiple contexts to advocate for and provide a range of needed resources and services that support individuals' ability to participate fully in life (Case-Smith & Ambersman, 2008; Kuhaneck, Madonna, Novak, & Pearson, 2015; Tanner Hand, O'Toole, & Lane, 2015; Watling & Hauer, 2015a; Weaver, 2015). According to a study conducted by the Interactive Autism Network (2011), occupational therapy ranks second to speech-language pathology as the most frequently provided service for individuals with autism throughout the United States.
  • Medicare Guidelines For Group Therapy 1
    www.asha.org     Author: The American Speech-Language-Hearing Association (ASHA) - Medicare Benefit Policy Manual, Chapter 15 230-Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology A. Group Therapy Services. Contractors pay for outpatient physical therapy services (which includes outpatient speech-language pathology services) and outpatient occupational therapy services provided simultaneously to two or more individuals by a practitioner as group therapy services (97150). The individuals can be, but need not be, performing the same activity. The physician or therapist involved in group therapy services must be in constant attendance, but one-on-one patient contact is not required. The Medicare Benefit Policy Manual does not establish a specific restriction on the use of group therapy, particularly as it pertains to the size of the group. In the absence of such guidance, speech-language pathologists must refer to the LCD developed by their MAC to determine any such restrictions. LCDs may be accessed through the Medicare Coverage Database.
  • Occupational Therapy Practice Guidelines For Children and Youth Ages 5–21 Years 2
    research.aota.org     Author: Cahill and Beisbier - Collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence. Activity- and Occupation-Based Interventions to Support Activities of Daily Living, Instrumental Activities of Daily Living, Play and Leisure, and Rest and Sleep -Parent, school, and community involvement should be supported throughout the course of intervention, and pediatric services should be provided in the natural context of the child’s or youth’s routine and environments. -Engagement in daily occupations should remain the central focus of goals and intervention. Practitioners should use manualized programs that have clear activity- and occupation-based strategies as opposed to those that are solely focused on performance skills or client factors. -Practitioners should collaborate with clients and caregivers to establish meaningful occupation-based and achievable goals and use intentional strategies to maintain a collaborative relationship throughout the therapy process. -Consistent caregiver training and instruction should be provided to promote carryover, and the power of the caregiver to effect change and support the child should be emphasized. -Practitioners should follow up with children, parents, and teachers and provide ongoing coaching and feedback on performance. They should provide opportunities for collaborative problem solving and model strategies for ongoing problem solving in the home and community as new challenges arise. -Skills-based interventions should incorporate peer, family member, and practitioner interaction. -Small-group service delivery methods provide an opportunity for increased motivation and modeling. -Practitioners should explore interactive technology interventions, especially with clients with ASD and ADHD. The use of technology can be coupled with skills training and other evidence-based interventions. -The evaluation and occupational profile should include consideration of the quality of rest and sleep. -Rest and sleep should be addressed to enhance health and well-being and increase performance and participation in meaningful occupations. Activity- and Occupation-Based Interventions to Improve Mental Health, Positive Behavior, and Social Participation -Activity- and occupation-based interventions should be implemented to address the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. -Practitioners should use group service delivery models when providing intervention to children and youth with or at risk for mental health concerns. -Sports activities should be used to develop social interaction skills. -Practitioners should incorporate meditation practices and blogging when attempting to foster positive feelings about self in children and youth. -Manualized yoga programs or less structured yoga games and poses should be used when addressing the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Activity- and Occupation-Based Interventions to Improve Learning, Academic Achievement, and Successful Participation in School -Practitioners should incorporate peer support, such as peer tutoring and peer-mediated interventions, into occupational therapy interventions and provide services in typical school environments to promote social participation and academic performance. -Practitioners should emphasize the use of activity- and occupation-based approaches to improve learning, academic achievement, and successful participation in school. -Therapeutic practice should be favored over sensorimotor approaches for the development and remediation of handwriting and literacy skills and performance. -Weighted vests should be used with caution. Citation: Susan M. Cahill, Stephanie Beisbier; Occupational Therapy Practice Guidelines for Children and Youth Ages 5–21 Years. Am J Occup Ther July/August 2020, Vol. 74(4), 7404397010p1–7404397010p48. doi: https://doi.org/10.5014/ajot.2020.744001
  • How An SLP and OT Collaborate Long-Distance - The ASHA Leader BLOG 1
    leader.pubs.asha.org     Author: Stephanie Sigal, MA, CCC-SLP, Michelle Bonang, OTR/L - As speech-language pathologists, we all experience stories of working as an interdisciplinary team. In this story, co-treatment brought us together and keeps us in touch today. Our relationship naturally affected us professionally, but personally as well. This story shares some of my adventures—I’m Stephanie Sigal, an SLP in Manhattan, with my friend and colleague Michelle Bonang, an occupational therapist in Vermont. Together, we teach each other invaluable skills.
  • PROMOTING PHYSICAL ACTIVITY THROUGH SCHOOLS: POLICY BRIEF 1
    www.who.int     Author: World Health Organization - Physical activity is good for hearts, bodies and minds. Regular physical activity can improve physical fitness; improve heart, vascular and metabolic health, and bone health; and reduce adiposity in children and adolescents (1). Being active can also improve cognitive function, including academic performance and mental health, and can reduce symptoms of depression and anxiety (1). In contrast, too much sedentary behavior can be unhealthy; it increases the risk of obesity and poorer fitness and cardiometabolic health and can affect sleep duration
  • Pathological Demand Avoidance: Exploring the Behavioral Profile 0
    pubmed.ncbi.nlm.nih.gov     Author: Elizabeth O'Nions 1, Essi Viding 2, Corina U Greven 3, Angelica Ronald 4, Francesca Happé 5 - This study is the first to use standardized measures to explore the behavioral profile of children receiving the increasingly used label PDA. It represents the first clear evidence that children fitting the PDA description display severe impairments across multiple domains. Comparisons between behavior in PDA and two putatively overlapping groups, ASD and CP/CU, revealed levels of peer problems and autistic-like traits in PDA comparable to ASD.
  • Changes In American Children's Time - 1997 to 2003 1
    www.ncbi.nlm.nih.gov     Author: Sandra L Hofferth - According to research by Sandra Hofferth, children between six and twelve years of age spend an average of just under three hours per week on housework (and almost 14 hours per week watching television!). While it’s important that children not have to shoulder adult-size responsibilities, pitching in by helping with household chores won’t hurt them and may even help them.
  • The Rehab Therapist’s Guide to Co-Treatment Under Medicare - Recommended Co-Treatment Guidelines Based On CMS’s Regulations. 1
    www.webpt.com     Author: Brooke Andrus, Ryan Giebel PT, DPT, OCS, CMTPT/DN - There is one important point to keep in mind, courtesy of joint guidelines for co-treatment created by the American Speech-Language-Hearing Association (ASHA), the American Occupational Therapy Association (AOTA), and the American Physical Therapy Association (APTA): Therapists billing under either Part A or Part B should only provide co-treatment if the purpose for such treatment is to enhance the quality of care the patient receives. Practitioners should never co-treat simply because it is logistically more convenient to do so. If the therapists believe co-treatment is the best way to help the patient progress toward his or her goals, they must clearly document that rationale within their notes. Finally, therapists should not provide therapy in more than two disciplines during a single session Medicare Part A Co-Treatment Rules If, during a single treatment session, a patient receives therapy from two different practitioners working in two different disciplines (e.g., PT and OT), both therapists can bill for the entire treatment session separately. Each treating therapist, however, must ensure the length of time billed as co-treatment is equal in each other’s accounts. Medicare Part B Co-Treatment Rules If two therapists provide treatment—whether that treatment includes the same or different services—to a single patient at the same time, neither therapist can bill separately for the full session.
  • Leveling Up Regulatory Support Through Community Collaboration 1
    pubs.asha.org     Author: Amy C. Laurenta and Jacquelyn Fede - While behavioral intervention methodologies and societal expectations for masking remain prevalent, in recent years, there has been a greater emphasis placed on understanding the underlying factors contributing to problematic and challenging behaviors. Furthermore, there has been greater recognition of the need to address those underlying factors as the primary areas to target for effective intervention that can actually help autistic individuals navigate their environments in school and as they transition out of school and into the real world (Prizant et al., 2006a). To provide this type of ethical, efficient, and sustainable support, it is imperative for clinicians to understand emotional or energy regulation as a developmental construct and then to understand its relationship to challenging behaviors.
  • What to Know About ADLs and IADLS 1
    www.verywellhealth.com     Author: VeryWell Health - Here is a basic guide to ADLS (Activities of Daily Living) and IADLS (Instrumental Activities of Daily Living).
  • Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation For Children and Youth: A Systematic Review 2
    research.aota.org     Author: Cahill, Egan and Seber - Productive occupations and life skills, sports, and yoga addressed mental health, positive behavior, and social participation for children and youth with and at risk for mental health concerns. Moderate-strength evidence suggests that yoga can be used to address mental health, positive behavior, and social participation of children and youth. Low- to moderate-strength evidence suggests that productive occupations and life skills training can be used to address mental health, positive behavior, and social participation. Moderate-strength evidence supports the use of play and creative arts. Activity- and occupation-based interventions should be implemented to address the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Practitioners should use group service delivery models when providing intervention to children and youth with or at risk for mental health concerns. Sports activities should be used to develop social interaction skills. Practitioners should incorporate meditation practices and blogging when attempting to foster positive feelings about self in children and youth. Manualized yoga programs or less structured yoga games and poses should be used when addressing the mental health, positive behavior, and social participation of children and youth with or at risk for mental health concerns. Citation: Susan M. Cahill, Brad E. Egan, Joanna Seber; Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation for Children and Youth: A Systematic Review. Am J Occup Ther March/April 2020, Vol. 74(2), 7402180020p1–7402180020p28. doi: https://doi.org/10.5014/ajot.2020.038687
  • Parents' Experiences of Professionals' Involvement For Children With Extreme Demand Avoidance 0
    pubmed.ncbi.nlm.nih.gov     Author: Emma Gore Langton 1, Norah Frederickson 1 - Parents felt positive about practitioners who had listened to their experiences, made efforts to understand the child, and provided or arranged for help. Parents found involvement most helpful when it resulted in comprehensive assessment, appropriate intervention, practical advice and management strategies, and a focus on the well-being of all family members. The overall ratings of helpfulness are encouraging, and the specific feedback about what is most helpful could be of value in shaping services.
  • Nurturing Care For Early Childhood Development 1
    cdn.who.int     Author: World Health Organization - Your loving care as a parent is what a child needs to be healthy, wellnourished and safe. • Communicate early and often, starting even before your baby is born. It will help you build a warm and loving relationship. • Make time to play with your child and engage them in your daily chores. You will help your child to learn, be happy and thrive. • Remember that feeding times are periods of learning and love – talk to your child while feeding and make eye to eye contact. • If you feel sad and unable to respond joyfully to your child, seek help from your health care provider.

Activity List(s)

Visual Schedule Cards

Related Disorder(s)

  • Post-traumatic stress disorder - Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.
  • Neurological Conditions - Types of neurological conditions may include: Alzheimer’s Disease, Dementias, Brain Cancer, Epilepsy and Other Seizure Disorders, Mental Disorders, Parkinson’s and Other Movement Disorders, and Stroke and Transient Ischemic Attack (TIA).

Assessments

Goal Bank

  • Jody will follow a daily sensory and movement diet with age-appropriate preferred regulatory activities 10 minutes per day, min 4 times per week, with visual and 50% verbal cues, to improve active participation at home and school, 80% of the time. 0
  • With individually tailored behavior and sensory regime, Jake will apply learned strategies to accept sudden changes in his schedule, exhibiting acceptable behavior in 4 /5 opportunities, with visual cues, and 50% verbal cues as reported by teachers, and parents. 0
  • Milo will demonstrate functional grasp and release of eating utensils (spoon and fork) during lunchtime meal, in 4 /5 trials, in 6 months. 0
  • While sitting with peers, Theodora will identify 2 possible sensory-motor strategies to use to decrease anxiety during lunchtime in the cafeteria, in 4 /5 days in the week, in 6 months. 0
  • With a visual schedule, bullets of activity expectations, and sequence predictability, together with multimodal communication opportunities (verbal, AAC, pics, typing, gestures), Jody will engage in purposeful activity with fading modeling in 4 /5 opportunities across the school settings to improve engagement and participation and to actively advocate for adaptation of the same environment to better match her needs, in 6 months. 0
  • Following an individually tailored supportive regiment, Lolla will apply learned strategies and tolerate standing in line with tolerable behavior with visual cues and 50% verbal cues, in 5 /5 opportunities as measured by teachers and/or family report. 0
  • Margaret will complete fine motor tasks (such as cut on the line, trace, connect items, copy forms) with 70% accuracy in 4 /5 work samples, with 25% verbal cues, as per teachers observation, in 6 months. 0

Organizations

Organizations who selected this major focus area as their top area of expertise.

  • Kids N Play OT

    Kids N Play OT

    Private Practice
    1 employee

    Kids N Play OT, LLC is in Portland, Oregon

Therapists

Therapists who selected this major focus area as their top area of expertise.

  • Krystan Inman

    Krystan Inman

    Full-time Therapist COTA

    I work with kids with Autism Spectrum Disorder, Developmental Delays, Sensory Processing Disorder...

  • Jodie Hillier

    Jodie Hillier

    OTA COTA
  • Maya Gonzalez

    Maya Gonzalez

    Intern STUDENT

    I am a first-year doctoral student of Occupational Therapy and part of the inaugural cohort. I gr...

  • Jenna Chafin

    Jenna Chafin

    Full-time Therapist OTR/L

    I specialize in working with kids with different developmental coordination issues including Dysp...

  • Morgan Watts

    Morgan Watts

    Full-time Therapist OTR/L

    I completed my occupational therapy program at Spalding University in Louisville, KY. I enjoy wor...