1700-1899 (Pre-History)

During the late 18th century, changes in how people

with mental illness were viewed resulted in more humane
treatment in Europe and US. A belief regarding this change
was that these people were creatures of reason and therefore
must be treated with compassion. Moral treatment
influenced the development of therapeutic communities and
engagement in productive activities.

1900-1919 The “Great War” happened and resulted to millions of

deaths and disabilities of soldiers. The War Department of
American Expeditionary Forces requested for mobilized
plans for the care of the soldiers whose conditions require
rehabilitation.

During the time when US entered the war several

treatments and programs were established for training
occupation workers. The need for occupation workers had
received significant drive from the mental hygiene
movement, reforms in mental health and for the patients
recovering from physical injuries or chronic diseases.
Because of the large amount of casualties, US anticipated a
need for several facilities and rehabilitation workers and
eventually establish reconstruction aides. Occupational
Therapists provided handicrafts and assisted with
orthopedic patients but also worked with those having
psychiatric problems. Then AOTA was formed and provided
wise advocacy for the recruitment of high-quality trainees.
1920- 1939 The early part of this ear was focused on treating and
reconstructing the wounded soldiers of the war and this
provided more employment for occupational therapists. The
AOTA became an effective organization for promoting the
profession through its network of members, annual
meetings and the publication of a journal under 3 different
names between 1917 and 1925 at which the association
gained 900 members. Eleanor Clarke Slagle found creative
ways to continue promoting the field through networking
women’s clubs and the establishment of the national office
in New York. Members of the association continue to grow
and the association continue to prosper.

In 1935, the accreditation of occupational therapy programs

was initiated by the American Medical Association. Many
positions for occupational therapist were created.
Occupational therapists adopted goniometry and began
adapting tools and equipment to enable patients to gain
strength, endurance and range of motion while doing crafts.

1940-1959 World War II created increased in the demand of

occupational therapist. This time occupational therapy grew
and changed because its focus shifted from from the use of
arts and crafts toward rehabilitation techniques based on
scientific methods. Occupational therapist imported some
techniques from the physical therapists and they used some
activities of daily living, ergonomics and vocational
rehabilitationfor therapy. Occupational Therapist now then
became involved in prosthetic training
1960-1979 The American Occupational Therapy Foundation (AOTF) was
established to advance the science of the field and improve
its public recognition. The practice of occupational therapy
was focused on the rehabilitation of the soldiers in the post-
World War II where mechanistic paradigm emphasizing
neuromotor and musculoskeletal systems and their impacts
on function were used. A. Jean Ayres expanded the work of
the Bobaths and used neuroscience to study the perceptual
motor issues in children and develop and apply the theory of
sensory integration. Because of these influences on practice
shifted form the holistic mind-body occupation-based
philosophies to those with bottom-up approaches focusing
on the underlying source of the problem, often with
emphasis on reflex integration and motor function.
Education for all Handicapped Children Act ( PL 94-142,
1975) expanded the scopes and areas of occupational
therapy.

State professional association continued their lobbying for

1980-1999 legislative acts and licensure to regulate the practice of
occupational therapy and increase the public safety,
visibility, and legitimacy of the profession. During this time,
emphasis was placed on research,efficacy, and defining the
scope of practice for occupational therapist. AOTF hired a
full time director and began a series of programs to advance
research and education. This led to the creation of the
journal Occupational Therapy Journal of research in 1980.
National Board for Certification in Occupational Terapy was
also created.

In 1997, the individuals with Disabilities Education Act

Amendments were signed into law providing strength and
accountability for the education of children and adolescents
with disabilities. Occupational therapy was one of the
specialized services provided for under this Act. The
provisions for rehabilitation services in the law gave rise to
an increase in therapists practicing in the school system such
that by the mid-2000s, education and early intervention was
the area with the highest number of practicing therapists
(AOTA. 2006)

In Canada, the government funded programs to increase

independence of older adults; in the early 199os, a 30-
month project began to emphasize health prevention and
promotion in occupational therapy (CAOT, 1993
2000- Present Occupational therapy practice continued to be influenced by
federal and state legislation and policy changes aimed at
achieving cost containment and increasing quality. CMS and
(AHRQ) began to exert influence on health care practices
and research by linking clinical studies of effectiveness to
reimbursement through its Effective Health Care Program
Hospitals experienced pressures to reduce patient lengths of
stay in order to contain costs so the types of procedures
offered to inpatients began to focus more on those needed
for discharge. More therapy was offered on an outpatient
basis or in the home as part of home health services.

Conceptual models are examined and challenged by the

growing numbers of professionals internationally. Kawa
Model was developed. It offered a different but culturally
relevant view of occupational therapy through the lens of
Asian Pacific and other collectivist cultures.
The AOTA and the AOTF published the Research Agenda for
Occupational Therapy, recommended by a joint panel of
occupational therapy scientists serving the two
organizations (AOTA/AOTF Research Advisory Panel, 2011).
It emphasized the importance of providing a strong
infrastructure for supporting research in occupational
therapy that will demonstrate the efficacy of services.
Wars abroad resulted in significant and challenging injuries
for many survivors. Who impelled innovations in military
occupational therapy and called attention to the need for
services to reintegrate soldiers sustaining blast injuries that
resulted in trauma.
In occupational therapy education, the growth of clinical
doctorate programs escalated during the period. Educational
programs also increased, offering a significant portion of
curricular content to be delivered over the Internet. This
trend accelerated with the growth of online social
networking and the development of new digital learning
technologies and the advent of mobile wireless smartphones
and tablet computing devices.