Occupational therapy practitioners prevent illness, remediate disability, and restore health by enabling participation in meaningful occupations. During World War I, the first occupational therapists, called “reconstruction aides,” treated soldiers who were suffering from wounds and battle neurosis.1 These early occupational therapists were teachers, secretaries, and artists that contributed to the war effort abroad. To promote healing, the aides used occupation-based activities to engage the mind and hands of patients. They taught handicrafts and vocational skills to distract the injured, increase physical activity, and improve morale (Figs. 78–1 and 78–2).2 This philosophy was captured by Mary Reilly in her 1962 Eleanor Clarke Slagle Lecture, “Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.”3
Two soldiers engaging in occupation-based activities. This photograph illustrates the early origins of occupational therapy. Source: Basket weaving for physical therapy (Reeve 000286), National Museum of Health and Medicine. https://www.flickr.com/photos/medicalmuseum/3305085454. Accessed September 27, 2018.
Soldiers using meaningful occupations to assist their rehabilitation. This figure illustrates occupational therapy's foundation in occupations. (Source: Physical and occupational therapy on the porch at Walter Reed (Reeve 000773), National Museum of Health and Medicine. https://www.flickr.com/photos/medicalmuseum/3305093988. Accessed September 27, 2018.
In 1917, occupational therapists formed their first professional association, called the National Society for the Promotion of Occupational Therapy (NSPOT). The founding members, including doctors, nurses, architects, and a psychiatrist, were instrumental in the development of occupational therapy as a profession. They were dedicated to building a role for occupational therapy in the health care community and establishing an organization that would expand the profession. In 1923, NSPOT changed their name to the American Occupational Therapy Association (AOTA), with Eleanor Clark Slagle as the first executive director.4 When the United States joined World War II in 1941, the expertise of occupational therapists was directed toward the war effort. The increased need for occupational therapists, especially in military hospitals, expanded occupational therapy services to include a broad range of physical and mental conditions.5
Between the years 1950 and 1969, occupational therapy became more technical and specialized. During this era, occupational therapists entered pediatric practice to address the needs of children with polio, cerebral palsy, and sensory processing conditions.4 Several legislative influences have shaped the profession of occupational therapy. For example, the creation of Medicare and Medicaid and passage of legislation such as the Americans with Disabilities Act, Individuals with Disabilities Education Act, and Affordable Care Act have resulted in new occupational therapy programs and services in outpatient, inpatient, community, and school-based settings.6–10 During the 1970s, 1980s, and 1990s, the profession embraced a more holistic practice, expanding beyond the hospital and into ...