I am also one of the "lurkers"...but I do have a topic of discussion I would 
like to hear some opinions on.  I am an OT in the LTC setting and I have 
always had a passion for working with those with cognitive disability 
(Dementia - all types, head injuries, some forms of mental illness, etc...) 
At any rate, I have always incorporated into my treatments( for residents 
with these and other disabilities with cognitive effects), some of the 
cognitive type goals.  Sometimes I will use the ACL as part of my testing 
and measurement, but not always.  Here is my topic I would like some 
discussion on:  I am noticing that more and more OT's are referring their 
clients with these issues to the SLP.  Now I know, or am assuming that this 
is part of their practice area as well.....but I am concerned that so many 
OT's do not touch this area.  I was trained back in the early 80's (yes I am 
one of the"old" therapists) and this has always been an integral part of OT 
practice area.  I am concerned that we are turning it over to Speech to take 
as their sole domain......remember when OT's used to do the majority of 
dysphagia (also an 80's practice area!)  In my area, SLP's are hard to come 
by right now and many are getting huge prn rates (which I don't begrudge) 
however, why should they pay an SLP to come in at $60 an hour when I have a 
staff OT that could provide the same treatment?  Am I off base on this?  Are 
we shying away because the goals are not "functional" enough?  Maybe someone 
could also enlighten me on which areas possibly that a SLP could do that an 
OT would not be able to cover.......I'd love to hear some of your thoughts 
because I am getting ready to "retrain" my therapists in how to address 
cognitive disability.     Terrie O. 



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