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Affordable Care Act/ObamaCare; 2010. Addressed rising cost of healthcare, shortage of providers, and lack of insurance availability. To lower govt spending on healthcare by decreasing ER visits/increasing preventative care. Sets clear rules for insurance co's to prevent fraud/abuse. Funds scholarships/loan repayment for health-related professions. Funds community health centers. AOTA still advocating for OT to be covered, as it qualifies as preventative care/quality of life.



American Occupational Therapy Association. NSPOT became AOTA in 1921 and has been since. (Publishes AJOT since 1947.)


Americans with Disabilities Act 1990

ADA; 1990s; Provides civil rights to disabled; equal access to employment, transportation, public accommodations, government, and telecommunication. OTs consult private and public agencies to meet guidelines.


Benjamin Rush

US Quaker, first physician to institute moral treatment practices after Tuke and Pinel's work.


Balanced Budget Act of 1997 (BBA)

Passed to reduce Medicare spending, create incentives for managed care plans, and limit fee-for-service payment and programs. Caused practitioners to broaden horizons beyond traditional practice. Community based programs, etc. Caused upswing in job market for OTs.


Herbert Hall

Considered a founder of OT as profession. Harvard Med School physician who adapted arts and crafts movement for medical purposes/treatment. Worked with invalid patients providing supervised crafts to improve health/financial independence. Occupation as therapy for people with nervous/mental disorders called “WORK CURE.” Early president of Natl. Society for Promotion of OT (1920-23).


Centennial Vision

Adopted by AOTA in 2017 (100-year OT anniv.). Emphasizes evidence-based practice and value of diversity in clients/practitioners.


Civilian Vocational Rehab. Act

1920; Provided federal funds to states on 50-50 matching basis for vocational rehab services to civilians with physical disabilities. Assistance with gaining employment. OTs provided prevocational and rehab services.



Neuroleptic drugs arrived in mid-1950s, and as psychotic behavior became controlled with drugs, more people were discharged (deinstitutionalized). Led to development of community mental health programs, and more requirement for OTs.


Education for All Handicapped Children Act of 1975

Established right of all children to free and appropriate education, regardless of disability. Includes OT as related service. Required individualized education program (IEP) for each child.


Thomas Kidner

Friend of George Barton; fellow architect/teacher. Established presence of OT in vocational rehab and TB treatment. Developed system of vocational rehab for disabled Canadian vets of WWI. Constructed institutions for disabled. Designed hospitals in CA and US for treatment of TB.


Gary Kielhofner

Developed Model of Human Occupation (MOHO) as grad student at USC. Published 19 textbooks and 150 journal articles; developed model that would allow OTs at all levels to better address important client issues. Provided profession with evidence to support occupation-based practice and tools to evaluate clients. Remained visionary and scholar; promoted field of OT.


List the Founders of the Profession of OT:

• Herbert Hall
• George Edward Barton
• Dr. William Rush Dunton Jr.
• Eleanor Clarke Slagle
• Susan Tracy
• Susan Cox Johnson
• Thomas Kidner


Habit Training

Re-education program to overcome negative habits, construct new ones, with goal of restoring/maintaining health. 24-hour program, involving all hospital personnel. Slagle developed this method in 1912.


Handicapped Infants and Toddlers Act

Passed in 1986 as amendment to Ed. for All Handicapped Children Act. Includes children 3-5 years old, and early intervention from birth to 3. Increased OT services provided to children and in schools.



Enacted in 1965, increased demand for OT. 65+ or permanently disabled receive assistance in paying for health care. Covers OT in inpatient setting, limited coverage for outpatient (kind of a drawback). 1988 legislation permitted direct reimbursement for OT services.


Individuals with Disabilities Education Act (IDEA)

Renaming of Educ for All Handicapped Children Act; 1991. Requires school districts to educate disabled students in least restrictive environment; incorporate with students without disabilities. School district to provide assistive tech/services.


Technology-Related Assistance for Individuals with Disabilities Act of 1988

Addresses availability of assistive tech devices and services to disabled. OTs involved in providing these services.


Social Security Amendments

1983, Reagan passed these to change health-care payment; level of payment based on diagnosis-related groups (DRGs), which caused changes like shortened acute care in hospitals, and increased need for long-term care facilities/home health services.


Prospective Payment System (PPS)

Part of Medicare, created by Social Security Amendments; nationwide schedule to delineate what govt would pay for inpatient stay of Medicare patient. "Fixed payment" system.


Reconstruction Aides

WWI need for OTs increased with reconstruction movement; rehab soldiers injured in war; showed increased need for OT-related treatment due to US Army's influence with these aides, even overseas.


Soldier's Rehabilitation Act

1918; established program of vocational rehab for soldiers disabled during active duty; OTs helped them adjust to civilian life; Helped them return to productive living.



View that humankind is reduced to separately functioning parts; Medicine viewed this way in postwar period, counter to holistic approach of OT.


Arts and Crafts Movement

Led by John Ruskin and William Morris in England. Opposed to machine production; sought to restore ties between work and worker; high standard of craftsmanship; using hands leads to health.


Eleanor Clarke Slagle

Mother of OT. Student of social work; studied curative occupations; 1912, asked by Adolf Meyer to direct OT dept at Henry Phipps Psychiatric Clinic in MD. There, developed "Habit Training." Later in Chicago, started workshop for chronically unemployed and first professional school for OTs, Henry B. Favill School of Occupations. Her home was first hq of NSPOT. Served each office there, and AOTA now has an award named after her.


George Edward Barton

Architect in London who studied under William Morris (arts and crafts movement). Went to Boston and founded Boston Society of Arts and Crafts. After personal experience with disabling conditions, he wanted to improve plight of convalescents. Opened Consolation House in 1914, using occupation (arts/crafts) for treatment.


Adolf Meyer

Swiss physician, came to US in 1892; became prof of psychiatry at Johns Hopkins Univ. Point of view became the philosophical base of OT. (Holistic, psychobiological approach, meaningful activity promoting health)


National Society for the Promotion of Occupational Therapy (NSPOT)

Founded in 1917 in NY, and considered birth of OT as a profession. Included Barton, Dunton, Slagle, Cox Johnson, Kidner and Isabel Newton. Object to study/advance creative occupations; gather news of progress in OT; encourage research. (Later became AOTA.)


Rehabilitation Act of 1973

Came after civil rights movement of 1960s; disabled people exerted influence on rehabilitation legislation. Act emphasized priority service for most severely disabled; individualized written rehab program (IWRP); set of standards by which rehab services could be assessed; included civil rights/nondiscrimination prohibitions for disabled.


Rehabilitation Movement

After WWII, 1942-1960, VA hospitals expanded and employed OTs; developed rehab depts to serve veterans with disabilities.