1. Occupational Therapy 1940 - 1969
By Genevieve Cyrs, Claire Kelly, Allie Taylor, & Patricia Wong

2. The 1940s Changes in Occupational Therapy Education
World War II- increased demand for OTs
Changes in Occupational Therapy Education
The Structure and Focus of Occupational Therapy
Medical Advancements
Important Individuals: Clare Spackman, Helen Willard, Wilma West

3. World War II Large numbers of injured soldiers Women working/

4. Growth in OT schools Accreditation
Expansion- 1947: USC introduces first Master’s Degree program
Revision of Essentials for accreditation
1943: More flexibility in areas of therapeutic training
1949: Increased biological sciences requirement

5. Occupational Therapy Move away from Arts & Crafts Movement
Positive attitude towards work
Patients are motivated through personal interests & material goods
Goals:
1. Meet person’s interests and abilities
2. Use activity with physical/mental objective

6. Medical Model Disability is deficiency or abnormality
Disability is negative
Disability is in the individual body
Remedy for disability-related problems: cure or normalization
Change strategy: surgery, medication, medical technology and intervention
Agent of remedy: the professional
Independence seen as individual physical, cognitive, and mental ability to perform and capacity to make decisions
(Willard & Spackman, p. 871)

7. OT Practical Design
Medical model & influence on field of occupational therapy
Self-repair activity discounted in favor of conceptions in psychology, physiology and anatomy
Redefinition of mission & emergence of a new paradigm 7

8. Advances in Medicine Antibiotics- penicillin and streptomyocin
Vaccinations
Improvement in healthcare quality
Federal government funds research and passes laws regarding delivery of healthcare
Life expectancy increases

9. Wilma West
Head of orthopedics occupational therapy at the Walter Reed General Hospital

10. Helen Willard & Clare Spackman

11. 1947: Publication of first OT textbook

12. IT’S QUIZ TIME!

13. The 1950s
Post-war Effects
Social Context: Women’s Roles, Civil Rights Movement
Polio Epidemic
The Structure and Focus of Occupational Therapy
Treatment of Mental Health
WFOT
Important Individuals: Dr. Howard Rusk

14. Post-war Effects
Baby boom
Economic prosperity

15. Women’s Roles Housewife- ideal of femininity Discouraged from working
Continued to work, mostly in low paying jobs (“pink-collared work”)

16. Civil Rights Movement early 1950s
Korean War- desegregation of armed forces
1954: Brown v. Board of Education- Supreme Court rules segregation unconstitutional, desegregation of schools
Non-violent protests
Civil disobedience
: Rosa Parks and Montgomery Bus boycotts

17. Poliomyelitis Known as Infantile Paralysis
Most cases of polio are symptom-free
When the virus enters the blood stream, it attacks the CNS
causes muscle weakness & paralysis of the legs
Bulbar polio affects nerves responsible for breathing, swallowing and speech

18. Polio in the Media

19. “Plague Season” In 1952, there were 57,000 cases of polio in the US
Targeted children from 5-9 years old
21,000 permanent paralysis
3,000 deaths
1955: the Salk Vaccine is distributed in mass quantities
Children of the 1950s are today’s baby boomers

20. OT Practical Design The Mechanistic Paradigm emerges
More Freudian-based psychological treatment of patients
Disability viewed as abnormal expression of repression within
Incorporation of neurological knowledge into practice 20

21. OT Methodology Change
Practice of splinting and prescribing adaptive devices flourished
Discrete analysis of requirement needed for activity
Emphasis on the patient returning to healthy functioning
Respect for objective measurement and scientific precision gained
Functional knowledge related to internal processes and body structure applied

22. Dr. Howard Rusk
Established the Institute of Rehabilitation and Physical Medicine
Wrote and gave speeches about expanded idea of rehabilitation
Increased medical and public knowledge of physical and occupational therapy

23. Working with Mental Patients
Do not work on causative factors of behaviors—correct symptoms
Do not stress activity over relationship with patient
Use graduation & persuasion to overcome distasteful habits
Select tasks within ability level to assure success
Give patient choice of activity
Develop patient’s sense of responsibility
Hold “community sing”

24. Video
Mental Health Rehabilitation in 1950s

25. World Federation of Occupational Therapists
Founded in 1952
1959: WFOT entered into relations with WHO
Mission:
To promote occupational therapy as an art and science
To develop and use occupational therapy worldwide
International cooperation

26. WFOT Focus Program Areas: Education & research Standards & quality
International Cooperation
Executive programs
Promotion & development

27. WFOT 1952
USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark

28. WFOT 1969
USA • United Kingdom • Canada • South Africa • Sweden • New Zealand • Australia • Israel • India • Denmark •
Belgium • France • Germany • Netherlands • Norway • Philippines • Portugal • Switzerland • Venezuela

29. 1950s OT changes
1956: Certified Occupational Therapy Assistant (COTA) position created
1958: Pi Epsilon Theta founded at UNH

30. IT’S QUIZ TIME!

31. The 1960s
Social Context: Civil Rights Movement Continues, Women’s Empowerment
The Structure and Focus of Occupational Therapy
Medicare/Medicaid
Important Individuals: Gail Fidler, Mary Reilly, Wilma West, Elizabeth Yerxa, A. Jean Ayres

32. Civil Rights Movement
Presidents Kennedy and Johnson set tone by making civil rights a priority of their administration
Nonviolent protests continue
1960: sit-in protests
1964: Civil Rights Act passed- outlaws discrimination based on race

33. Women’s Liberation Movement
1964: Civil Rights Act- outlaws sex discrimination
Empowerment of women
More educated
More economically secure
More willing speak up about their ideas

34. OT Practical Design
Occupational therapy clarified in accordance with the medical model
Pathological conditions better understood
Use of technology to intercede with dysfunction increased 34

35. OT Practical Conflict Field in conflict
Occupational therapy had turned from holistic foundation toward concrete scientific rationale
Interventions mechanized, losing meaning in favor of achieving purpose

36. Call for a new Paradigm?
Occupational therapy valued with respect to conformity with the medical model
Many therapists had difficulty adjusting to the approach of the medical model
Practitioners not united
A realization that the profession needed to ameliorate its differences was recognized

37. Wilma West President of AOTA from 1961 to 1964
Wanted to address changing needs of society and adapt OT accordingly
Wanted OT to have a new role of “health agent”
Founded American Occupational Therapy Foundation (AOTF)

38. Mary Reilly Active in the 1960s Re-evaluation of mechanistic model
Advocated a more interdisciplinary approach

39. 1960s Changes More work with pediatrics and developmental delays
Beginning of de-institutionalization
Working to integrate formerly institutionalized clients into society as independent and productive members

40. Medicare/Medicaid
Established in Inpatient occupational therapy services covered

41. Elizabeth Yerxa
“the scientific attitude is not incompatible with concern for the client as a human being but may be one of the best foundations for acting upon that concern”
Advocate of client choices

42. Gail Fidler
Wanted to recognize the professional commitment to learning, critical thinking, and creativity
Advocated teaching more than just technical skills

43. A. Jean Ayres Developed sensory integration approach
Influenced by Piaget

44. Influences from the 40s-60s that we see today
Occupation-based therapy
Client has choices
De-institutionalization

45. IT’S QUIZ TIME!

46. Thank you!
Any questions?

47. References
Abrams, R.M. (2006). America transformed: Sixty years of revolutionary change, New York, NY: Cambridge University Press.
Cole, M.B. & Tufano, R. (2007). Applied theories in occupational therapy: a practical approach. Retrieved from
Dunton Jr., W. R. & Licht, S. (1957). Occupational Therapy: Principles and Practice (2nd ed.). Springfield, IL: Bannerstone House.
Fidler, G. S. & Fidler, J. W. (1954). Introduction to Psychiatric Occupational Therapy. New York City: Macmillan Publishing Co.
Fidler, G. S. & Fidler, J. W. (1963). Occupational Therapy: A Communication Process in Psychiatry. New York City: Macmillan Publishing Co.
Gilbert, J. (1981). Another chance: Postwar America, Philadelphia, PA: TempleUniversity Press.
Gillon, S.M. (2007). The American paradox: A history of the United States since Boston, MA: Houghton Mifflin Company.
Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s
occupational therapy (11th ed., pp ). Philadelphia, PA: Lippincott Williams & Wilkins.
Hammel, J., Charlton, J. Jones, R., Kramer, J., Wilson, T. (2009). From disability rights to empowered consciousness. In Crepeau, E.B., Cohn, E.S., &
Boyt Schell, B.A. (Eds.), Willard and Spackman’s Occupational Therapy (11th ed). ( ). Philadelphia: Lippincott, Williams & Wilkins.
Kearney, Pamalyn. (2004). The influence of competing paradigms on occupational therapy education: A brief history. Retrieved from
Kielhofner, G. (1992).  Conceptual Foundations of Occupational Therapy.  Philadelphia: F.A. Davis Co.
Marcus, R.D., & Burner, D. (Eds.). (1972). America since New York, NY: St. Martin’s Press.
Reilly, M. (1985). The 1961 Eleanor Clarke Slagle Lecture: Occupational therapy can be one of the great ideas of 20th century medicine in AOTA
(Ed.), A Professional Legacy: The Eleanor Clarke Slagle Lectures in Occupational Therapy, , (pp ). Rockville:
AOTA. Retrieved from

48. References
The American Occupational Therapy Foundation. (2009). Mission, Vision, Goals, & Strategic Plan. Retrieved from
The History of Occupational Therapy. (n.d.) Retrieved from
Willard, H.S., & Spackman, C.S. (Eds.). (1954). Principles of Occupational Therapy (2nd ed.). Philadelphia, PA: J.B. Lippincott Company.
Willard, H. S. & Spackman, C. S. (1963). Occupational Therapy (3rd ed.). Philadelphia: J.B. Lippincott Co.
Photographs/Video:
Gordon, D.M. (2009). The history of occupational therapy. In E.B. Crepeau, E.S. Cohn, & B.A.B. Schell (Eds.), Willard and Spackman’s occupational therapy (11th ed., pp ). Philadelphia, PA: Lippincott Williams & Wilkins.