The Movement Path

Occupational therapists posit that there are seven senses: the five you know, plus vestibular and proprioceptive. The vestibular system, rooted in your inner ear, relates to balance and spatial orientation. Proprioception—a function of muscles, tendons, and joints—relates to the movement and positioning of your body, “knowing where your body is in space,” as Kendra Phillips (née Mendez) ’09, OTD ’19, describes it.

Phillips is a graduate of AIC’s Post-Professional Occupational Therapy Doctorate (OTD) program, established in 2017 to meet an industry demand for doctorally prepared OT professionals. (The Bureau of Labor Statistics projects employment of occupational therapists to increase by 18%—or, to add 23,700 jobs—between 2018 and 2028 as the youngest of the baby boomers age into senior citizenship.) She entered the program in its first year and was one of the four members of its inaugural graduating class.

The low-residency OTD program at AIC was designed for working professionals; most of the coursework consists of distance learning. While in school, Phillips was pregnant with her third child and working full time as a school-based occupational therapist in the Holyoke Public Schools system, her job since 2016.

A determinant in her decision to enroll in AIC’s OTD program was faculty like Tina Champagne, MS, OTR/L; Allison Sullivan, DOT, OTR/L; and Christine Helfrich, PhD, OTR/L, FAOTA. “They’re pretty much famous in the OT world,” Phillips says, “not just in Massachusetts.” Champagne has published two books on sensory modulation; Sullivan’s “Impact of a Fieldwork Experience on Attitudes toward People with Intellectual Disabilities” was published in the American Journal of Occupational Therapy in 2017; and Helfrich publishes prolifically on the topic of mental health.

Phillips says the other doctoral programs she considered lacked the theory courses AIC offers, “and that’s a huge component of OT, especially if you’re going to go and teach. I think if you don’t have that, you’re really missing something.” One such course, Occupational Therapy and Legal, Ethical, and Policy Issues, required her and her classmates to individually advocate publicly for or against an OT-centric healthcare bill that they felt especially strong about. Phillips chose H.R. 1757, the Trauma-Informed Care for Children and Families Act of 2017, an amendment to a number of existing laws to, in part, provide trauma-related training for school-based personnel and healthcare providers. She promoted the bill on WTCC, 90.7 FM, Springfield Technical Community College’s radio station.

“Now, that’s something I would never have done before that,” she says. “I really got out of my comfort zone.”

Occupational therapy is ideologically rooted in the late-nineteenth century and the Arts and Crafts Movement, which advocated for working with one’s hands to counteract what its proponents considered to be the dehumanizing effects of industrialization.

Phillips (center) with Holyoke Public Schools colleagues Alissa Izzo (right) and Noel Sherman (left), on a 2019 episode of WGBY’s Connecting Point, discussing the movement path she helped develop at H.B. Lawrence School.

George Edward Barton, an architect who lost part of his left foot to frostbite and contracted tuberculosis while surveying land in Kansas, coined the term occupational therapy in 1915. (The rehabilitation method had previously gone by many names, including “work cure,” “therapeutic activity,” and the antiquated “invalid occupation.”) Barton became a fervent advocate and, with five others, founded The National Society for the Promotion of Occupational Therapy—now called The American Occupational Therapy Association (AOTA)—two years later.

Occupation, in the sense of the word that the profession uses, refers not to one’s job but to everyday activities like, say, brushing one’s teeth. “We generally don’t think about our daily occupations,” reads an informational brochure from the AOTA, “until we have trouble doing them.” In the event of such trouble—be it the result of an accident, injury, disease, or condition—occupational therapists incorporate patients’ activities into their rehabilitation. This is occupational therapy’s curative function.

In the early-twentieth century, practitioners used occupational therapeutics almost exclusively curatively. It wasn’t until nearly a half-century later that the preventive benefits of occupational therapy became a focal point of the profession. In a 1962 article in the American Journal of Occupational Therapy, Mary Reilly, an OT educator at the University of Southern California, wrote that “the use of [one’s] hands, as they are energized by mind and will, can influence the state of [one’s] own health.”

Reilly’s assertion, and the echoes of her colleagues in the field, influenced the AOTA’s redefinition, in 1969, of occupational therapy as “the art and science of directing [one’s] response to selected activity to promote and maintain health, to prevent disability, to evaluate behavior and to treat or train patients with physical or psychosocial dysfunction.” (Emphasis added.)

The movement path that Phillips helped develop at H.B. Lawrence School in Holyoke draws from both the curative and preventive aspects of occupational therapy. Also called a “sensory walk,” a movement path is a designated area—in Lawrence’s case, an otherwise lightly trafficked hallway—with prompts for students to perform varied physical activities to aid in their academic progress.

The movement path at Lawrence includes prompts that affect vestibular (e.g., walking in a figure eight) as well as proprioceptive (jumping, push-ups) inputs. Another prompt asks students to walk chronologically on floor decals of the letters of the alphabet. “They’re practicing their letters and they’re getting a structured movement break,” she explains. “They really need those breaks throughout the day. Even adults do. I’ve found it very helpful for a lot of the students.” At the end of the path, students are prompted to take a deep breath—a mindfulness practice.

The pilot program at Lawrence saw such success that movement walks will soon feature in all of Holyoke’s public schools. “I’m super excited about that,” she says. “I think it will be very helpful for a lot of the students.”