OCCUPATIONAL THERAPY

1870 1923 A doctor who used making crafts as a medical tool therefore incorporated the ideas of the arts and craft movement into treatment (2)

Occupations

59 of 100 patients improved, 27 were much improved, and 14 received no relief (arts and crafts)

Handweaving, woodcarving, metalwork, and pottery (rec therapy)

WOODWORKING
Woodworking is the process of building, making or carving something using wood.

Introduction
Wood has provided some of our most basic human needs- heating and cooking, weapons, shelters, sports equipment, musical instruments, sculptures used in religious ceremonies and for decoration, and transportation such as bridges and railroad ties. Woodworking encompasses a vast number of crafts: house building, furniture making, chip carving, making wood blocks for printing, whittling, toy manufacturing, wood sculpturing and making of small wooden containers for storage.

Materials Historically, woodworkers relied upon the woods native to their region, until transportation and trade innovations made more exotic woods available to the craftsman. Woods can be sorted into three basic types: hardwoods typified by tight grain and derived from broadleaf trees, softwoods from coniferous trees, and man-made materials such as plywood and MDF. Typically furniture such as tables and chairs is made using solid stock, and cabinet/fixture makers employ the use of plywood and other man made panel products.

Frequency of Use
Seven out of ten therapist use woodcraft at some time. Cabinet making, furniture making and other woodcrafts are commonly employed treatment methods in work-hardening units. Wooden kits are a common project in mental health treatment.

Assessments
Formal assessments that include woodcrafts are the ffg: 1. Work Adjustment Program it has 3 tasks: sorting/packaging, assembling mimeographed sheets and manufacturing objects that are made mostly of wood such as bookshelves or furniture. It is rated on a scale of 1 to 6 on such work skills and attitudes as attendance, motivation, dressing and grooming.

2. Jacobs Prevocational Skills Assessment there is a section called carpentry assembly. The client is asked to name the tools and requested to use the tools to put screws and hammer and a nail. It is recorded on a checklist in relation to their coordination, perceptual-motor and cognitive performance.

3. Diagnostic Test Battery This battery may take several weeks to complete. The woodwork is the last of 5 subtest in this assessment, wood project to be assembled is checkerboard. The project assesses perceptual function, cognitive skills, planning and discrimination.

4. Build-a-Farm Assessment this assessment does not formally use wood as do as the others. Wood is included among other materials such as styrofoam, clay and construction paper, w/c are presented to a small group of children or adolescence with instruction to build a farm. The childs interpersonal skills are assessed by this process.

5. Interest checklist This assessment is simply asks the clients to rate their own interest-casual, strong or none in 80 different activities. There are several categories that might include woodcrafts: manual arts, model building, home repairs and woodworking. The clients/ patients responses on the checklist are then used as a basis for discussion of leisure use

Therapeutic Applications
Physical Dysfunction
In Carpentry- ROM in the hand, finger flexion and thumb opposition and adduction and gross grasp can be achieved in doing this activity. Also many shoulder movts are needed here like flex, extend, IR, ER and scapular retraction. Hand drilling, sanding, hammering and chip carving flexion and extension of the elbow. Weights- can be added to increase resistance and improve strength. Gravity or adaptive equipment can be used to decrease resistance. For weak grip woodworking tools can be built up with foam and padding. Note: For pxs with diminished sensation, diminished circulation or immune response need to be supervised carefully as it is easy to scrape skin or hit a finger or thumb in woodworking.

Mental Health Wood projects give a real feeling of accomplishment which is tied to Self-esteem. Gradability from simple to complex provides for the wide range of functional level founds in mental health pxs. Enhance interpersonal interaction used in group activity by use of small, simple and pre-cut kits. Patients need to share tools, glue and containers to finish. It also assess the course of deterioration or recovery in a pxs cognition by illustrating deficits in perceptual- motor fxn, motor planning, problem solving, judgment, memory and attention span.

Pediatrics
Hammer and peg toys develops eye-hand coordination, muscular control and object manipulation. Constructing wooden blocks Sex role differentiation at age of 3 years occurs, masculine identification with wood can be positive. Wood working with hammer and scrap wood at age of 4 years old children envision complicated ideas but have difficulty carrying them out, this activity stimulates Creativity. Small, odd shapes and sizes of wood at age of 5 years, the child begins to count and discriminate sizes and shapes, woodworking is a natural way to use numbers in measurement and comparison of shapes. Note: Wood should be checked for splinters before using it with children. Woodworking from plans and drawings is too difficult for most children so they need constant one-on-one attention.

Geriatrics Adaptations are needed for pxs with diminished memory, vision, hearing and increased pain. Precut kits are advisable because often have only a few steps.

Leatherwork

-also known as Leathercraft, is the practice of making leather into craft objects or works of art, using shaping techniques, coloring techniques or both.

Leather is our most ancient fabric. Some of these are made of leather to name a few, shoe, belt, hat, garments, wallet, notebook covers, holsters, etc. An important visual construct that many OTs use to attempt to understand human behavior is Maslows Hierarchy of Human Needs. It represents the idea that our basic needs control our behaviors. If our needs are physiological, they are at the survival; if these needs are unmet, we are then unable to attend to needs higher up on the hierarchy. Using Maslows hierarchy, we can think in a hierarchical way about how leather was used as needs were met.

Introduction

Frequency of Use
Many therapist use leatherwork with their pxs once (1) per week or more; some use it daily. In the past, Leather was often used to make adaptive devices such as slings and splints for patients.

Assessments
Leatherwork is part of the following formal occupational therapy assessments: 1. Allen Cognitive Level Test which uses uses a leather lacing task to determine into which of (6) cognitive levels a patient fits. The screening tools are designed to provide an initial estimate of cognitive function.

2. Diagnostic Test Battery in w/c patient chooses a background pattern to engrave or tool on leather. Findings from this part of the assessment have to do with tactile perception, coordination, making and following plans, self-perception and affect.

3. Jacobson Prevocational Assessment has a section called leather assembly. The client is asked to assemble a simple leather key ring following a demonstration by the therapist.

4. Neuropsychiatric Institute (NPI) Interests Checklist - Gathers data about a person's interest patterns and characteristics. It asks the px to rate his or her interest as casual, strong or none, in 80 activities.

Tools
Rotary Punch

Leather Awl

Strap Cutler

Skife

Thonging Chisel

Lacing
Lacing is a particularly important part of leatherwork for OTs because its performance may indicate strength, motor planning, visual-perceptual ability, sequencing ability, tactile perception and frustration tolerance. Variety of stitches are: running stitch, whip stitch, single cordovan lacing and double cordovan lacing.

Therapeutic Application
Physical Dysfunction Leathercraft is gradable from simple to complex. Leatherwork offers opportunities for physical disabled pxs who have problems in UE strengthening and endurance. Strengthening is achieved by gradually increasing the amount of force neede to perfrom the action. Slings, mobile arm supports and the lacing pony can assist weakened joints and muscle. Increases tactile perception for patients who have sight-impairment as px works on design, the impression and contours can be felt with the fingers.

Mental Health Easy projects such as link-belt kits or simple lacing can easily completed by lowfunctioning patients. Leathercrafts addresses such common problems in mental health: concentration, self-esteem, attention span, memory, visual perception, fine motor coordination, decision making and the need to express unconscious feelings in a safe and structured activity.

Pediatrics Leatherwork is seldom used by younger, acute care, physically disabled patients. Older children and teenager are most likely to use leather. It can be used to evaluate coordination and attention span. It also used to sublimate anger through hammering for angry children. Leatherwork is avoided for any children who is hypersensitive to sound or touch.

Geriatrics Strength is an important consideration for leatherwork as the elderly diminished vigor. Because many of the tools could cause cuts and bruises, so the thx must be observant of the pxs coordination and visual perception.

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