A STUDY OP THE OCCUPATIONAL THERAPY PROGRAM OF AIDMORS CONVALESCENT HOME ATLANTA, GEORGIA A THESIS SUBMITTED TO THE FACULTY OF THE ATLANTA UNIVERSITY SCHOOL OF SOCIAL WORK IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK BY THEODOSIA RUSSELL JOHNSTON ATLANTA, GEORGIA AUGUST 1948 il TABLE OF CONTENTS Chapter Page I. INTRODUCTION 1 Purpose of this Study 4 Scope 4 Method of Procedure 4 II. THE HISTORY AND DEVELOPMENT OF OCCUPATIONAL THERAPY.. 5 III. THE HISTORY AND DEVELOPMENT OF AIDMORE 13 IV. THE OCCUPATIONAL THERAPY PROGRAM OF AIDMORE 21 V. SUMMARY AND CONCLUSION 31 APPENDIX 35 Schedule • 3 6 BIBLIOGRAPHY 38 CHAPTER I INTRODUCTION "An organic disability becomes an actual disability only when the individual senses a defect and feels a consciousness of that defect reflected in his environment."^ If we look around us, we see many fine persons who have some physical handicap which we fail to note after a first acquaintance because their engaging personalities erase their physiques from our minds. If we acquaint ourselves with the childhood of these individuals, we would perhaps find that they as children received the kind of love, attention and understanding which enabled them to take advantage of opportunities and substitute for handicaps. At one time or another, most normal children go through a period when they feel lonely, bitter and suspicious because of physical attributes which make them appear different from other children - a long nose, chubbiness, gawkiness or large ears. The personalities of these children are not permanently damaged, however, because these handicaps are not sufficient to cause continuous frustration, or because the children, in time, acquire a sense of values in which slight differences do not matter.2 ^Georgia Ball, "Case Work With Crippled Children," The Family. XX (April, 1939), 267. 2 Ibid. 1 2 The sense of difference which the crippled child feels and the loneliness which he may experience are liable to result in a serious maladjustment of the personality if he is not given the type of understanding to which all children are entitled. An element of very great importance in all Institutions where crippled children are cared for is the general atmosphere. Recovery for many of these patients who have suffered much pain, is dependent upon their states of mind. It is because of this that modern, properly conducted orthopedic schools, convalescent homes, hospitals or sanita¬ riums have the atmosphere of hope, good will, cheery laughter and essential comfort. In addition to sunlight, fresh air and general pleasant surroundings, toys, amusement books, companionship and instruction in occupational therapy is available to the greatest possible degree. Here the child is furnished with companions of his own age and able to compete with him in games and sports as adequately as his handicap will permit. As a result, during these years of his life, rarely reminded of his handicap, the child develops a healthy normal psychology.^ The instruction provided in the various occupational and recreational arts have physical as well as vocational value. It trains one in the use of muscles which might otherwise remain dormant. Some of the industries which these children may ■^Henry Abt, The Care, Cure and Education of Crippled Children (Ohio, 1926), p. 45. 3 be instructed in are sewing, lace making, chair caning, burnt woodwork, knitting, crocheting, leather work, basketry, making artificial flowers and pottery. Recreational activities may include folk dancing, checkers, lasso-throwing, marbles, shuffle-board and pitching horse-shoes. All activity must be approved by a qualified physician. The spastic, who lacks control of normally voluntary muscles, receives more than mere happiness from playing with blocks or stretching the cord on a shuttle. In addition to assurance that he can play like other children, he is being taught to grasp: he is developing muscular coordination. The girl whose leg is withered as a result of infantile paralysis and who cannot walk because of a contracted tendon at the back of her heel is having that tendon stretched by operating the pedals on the weaving machine.^ As a result of the intrusion of occupational and recreational therapy in the programs of institutions for crippled children, "pallid frail children find themselves becoming robust and delight in using their new found strength and muscular power in games and contests in which they believed they would never be able to engage."1 2 Moreover, these practices, like surgery and physiotherapy, have become a necessary part of the regimen of the better 1Ibid., p. 46. 2Ibid. 4 institutions for crippled children all over the country. Purpose of the Study This study has undertaken to analyze the extent to which occupational and recreational activities are used by Aidmore, how effective they have been in giving to the children emotional as well as physical relief and the areas in which they have proved least effective. Scope Consideration has been given the physical equipment, the provisions for education and organized recreation, and the attitudes of the therapists with regard to the program during the year 1948. Method of Procedure Visits were made to the institution for purposes of observation and interviewing members of the institutional staff. Schedules were employed in the latter instance. Pertinent literature was perused. CHAPTER II THE HISTORY AND DEVELOPMENT OF OCCUPATIONAL THERAPY Occupational therapy as such is still a relatively new profession. "in 172 A. D. the Greek philosopher Galen made the statement, ’employment is nature's best physician and is essential to human happiness.'"1 For hundreds of years physicians have acknowledged the benefit of the employment of arts and crafts for the diversion of the sick. It has been variously called "work cure," "ergotherapy," and "diversional occupation." Only during the past decade has it taken its place as a definite form of medical treatment, like drugs, diet, or massage, prescribed by a doctor and administered by a specialist. Not until 1914 was it called occupational therapy.2 Susan Tacy in 1910 published a book on invalid occupations designed for the instruction of nurses, but despite the fact that it embodied many principles followed today it contained no hint that it might, at any time, engage specialists in its •3 application. ‘'"Edith M. Stern, "The Work Cure," Survey Graphic Magazine, XXVIII (April, 1939), 282. 2Ibid. 3Ibid. 5 6 The United States is really a pioneer in the field of occupational therapy. The term was first used by Dr. George E. Barton at a conference of social workers in 1914- but at the time caused no real sensation in the medical world. In 1908, the Chicago School of Civics and Philanthropy offered a course for the training of occupational therapists in the care of the mentally ill. Prior to that time the same school had given occupational training to nurses as a sideline, but their training was not as adequate as it is today and many of the trained had little technical knowledge*^ The actual birth of occupational therapy as a profession occurred very suddenly in 1918, when the A. E. F. sent out a call for women workers to provide bedside occupation for sick and wounded soldiers. As a result, the Walter Reed hospital published monographs with charts showing patients' improvement after workshop. From that time on, the prophecy of Dr. Thomas W. Salmon, chief consultant in Psychiatry in the A. E. F., has begun to be fulfilled step by step. He stated that, "someday, occupational therapy will rank with anesthesia in taking the suffering out of sickness and with anti-toxin in shortening its duration."2 Another great stimulus towards the growth of the profession was provided by the depression which followed the war, when work-starved hands found comfort in the crafts ^Ibld., p. 285. 2Ibid. 7 and other therapeutic arts. The recognition of occupational therapy as one of the valuable skills of medical science brought about the establishment of many training schools in various sections of the country. Now the American Association of Occupational Therapists stands guard, so that 0. T. R. (Registered Occupational Therapist) carries with it the same kind of guarantee as R. N. (Registered Nurse).1 Occupational Therapy is a type of medical treatment that must be prescribed by the physician according to the needs of the patient. Physically its function is to increase muscle strength and to improve the general bodily health; mentally its function is to supply, as nearly as possible, normal activity through vocational projects and pre-vocational studies and training. A given regimen of occupational therapy must be prescribed by an orthopedic physician and its progress watched and guided by the therapist, who is well versed in 2 methods and procedures. The tenm "occupational therapy" and "occupational rehabilitation" are often confused. Although they do sometimes overlap, each is a separate and distinct service. The former aims simply to "occupy the patient with some sort of task that 1Ibld. p Helen S. Willard, "Occupational Therapy - A Relatively New Profession," Occupations, The Vocational Guidance Magazine, XVII (January, 1939),293. 8 will aid in restoring him to health."^ Thus it does not have a vocational significance, although pre-vocational training may be part of the therapist's duties. Occupational rehabilitation, on the other hand, is the "work of adapting and training the handicapped person for an occupation in which he may be able