On the job: pediatric occupational therapist
This month I spoke with Ann-Marie Fallon Villasana. She’s self-employed, but she’s also contracted with healthcare agencies as well.
Q What are the duties of a pediatric occupational therapist?
A As healthcare professionals, we help people perform whatever “occupies” their lives. The word “occupational” doesn’t refer to work or jobs, but rather what “occupies” your day—whatever you spend time doing. So that could include developing skills for eating, writing, leisure activities, even sleeping.
Q I was wondering about that. When you said that you work with kids, I couldn't imagine your trying to help them return to “work.” So, when we see soldiers on TV who are relearning how to walk, are those occupational therapists they’re working with?
A No, those are physical therapists. Their jobs are similar but not really the same. They might help a soldier relearn how to walk, which can be a huge job on its own—an occupational therapist can then help him make adjustments, sometimes finer adjustments, in getting through his day.
We try to help people, usually with a condition or disability, regain or build up to his or her best functioning level. We talk about goals: Do you want to return to work? Figure out how to modify your home? In my case, I work with very young children, from birth to 3 years old. So while I’m working with them, I’m also making sure that their parents, grandparents, daycare staff, caretaker—whoever spends time with them—can also work with developing their skills.
Q So, in your case, how do you get clients?
A Oh, many places—the Children’s Developmental Services Agency [in downtown Durham], daycares, Head Start programs, physicians, family, friends of the family, and Lincoln [the Lincoln Community Health Center]. I’m fluent in Spanish and work with most of the Spanish-speaking families. Nowadays newborns and babies are tested for all sorts of things, and when they don’t seem to be progressing compared to babies their age, they are assessed. Often it’s a caseworker who evaluates the child and determines if he or she needs occupational therapy.
Once I get a client, we work in the home setting—but we can also work in daycares and Head Start programs, too. The therapy is extremely individualized, because each child is different. We figure out ways to help the child, and sometimes the parents help come up with clever solutions. In one case, the mom was having a hard time feeding her child. The child couldn’t sit up well, and his mom had a hard time holding him up and then spoon-feeding him. The parents came up with the idea of using soft materials to “harness” the baby’s head, and then his mom was able to feed him. Some child have limited strength or control over their hands, so we sometimes get adaptive devices or aids to help.
A child’s “work” is to play, so if the children can’t grasp or manipulate tools and if he has sensory problems (like many kids with autism) or communication issues, I work with the family to find solutions and then provide the kind of treatment to help the child.
Q I’m not trying to get in your business, but I’m wondering how you get paid. I guess I really want to know if everybody who needs your services can get them.
A Well, yes. One thing I’m really thankful is that in this country Medicaid covers “early intervention therapy services.” There are lots of ways to negotiate payment—some of my clients who aren’t eligible for Medicaid pay in cash, some make monthly payments. It varies.
Q So if a young person decides that this might be a field to go in to, would advice would you give?
A First, the most important element is having an interest in people, and wanting to help them. If you don’t have patience, flexibility, and empathy, this is not the job for you! But I would say that, starting as early as high school, you should study and read up on development, disease, health care, assistive technology, and adaptive devices. Pay attention to stories in the news about people playing one-handed golf and finding ways around their challenges. Learn about them. There is a desperate need for more minorities and men. Right now most practitioners are white and women. This job pays very well.
Durham Tech has a certified occupational therapy assistant (COTA) 2-year program. They work under the supervision of occupational therapists—they provide therapy but they can’t do assessments.
But to be an occupational therapist you have to have a master's degree in occupational therapy or occupational science. You can get your bachelor’s in recreational therapy, psychology, or some related subject. There are master’s programs at UNC–Chapel Hill, East Carolina University, and Winston-Salem State University.
You can also become a specialist in things hand therapy, geriatrics, and sensory integration. And there are so many places that use occupational therapists—schools, including the public schools; hospitals; nursing homes; substance-abuse clinics; Head Start, preschools, and daycare centers; and of course, the client’s home.
Q What do you like best about being a pediatric occupational therapist?
A Every day is so different than the day before! I get to work with people who are motivated by love, and I get to be really creative. I might have a session all planned out, and when I get there, the child is having a mood or isn’t interested. Then I have to find a work-around. I really enjoy my work!