Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, October 14, 1993 TAG: 9310140193
SECTION: VIRGINIA PAGE: C-1 EDITION: METRO
SOURCE: LAURA WILLIAMSON STAFF WRITER
DATELINE: LENGTH: Long
David Robbins "talks" to his fifth-grade teacher at Back Creek Elementary School by pointing a light on his head at a series of letters, numbers and phrases programmed into a computer on his wheelchair.
If David can't point, he can't speak. He is a quadriplegic with cerebral palsy, a disorder that prevents him from controling anything but his head.
But operating the "liberator" that connects David to the rest of the world often proves challenging. David needs somebody to train him - twice a week - to succeed.
The state guarantees him that help. Only David hasn't been getting it lately.
Neither have dozens of students in the Roanoke Valley who need occupational therapy to master the physical obstacles that make learning difficult. Some, like David, rely on the service for problems as critical as basic communication. Others, like 9-year-old Jessica Swanson, her muscles weakened by muscular dystrophy, need help learning to move a pencil properly.
Jessica and David - like many others - have seen their services cut from twice a week to once every other week because of a shortage of physical therapists in the Roanoke Valley. Therapy Associates, the company hired by a regional special education board, lost two of its occupational therapists this spring and has had a hard time replacing them.
"There's a very definite shortage of occupational therapists," said Therapy Associates owner Scott Stephens, who spent nearly a year negotiating a contract with one recently hired employee.
Therapy Associates provides occupational therapy to 38 of the most severely disabled students in Botetourt, Craig, Franklin and Roanoke counties and the cities of Roanoke and Salem. Under a separate contract, it provides the service to 49 additional special education students in Roanoke County.
Stephens said he believes he will have the problem under control by the end of the month, when a second therapist will be coming on board. But turnover at small, private companies like his runs high - particularly in Southern and rural areas - and parents worry about the problem recurring.
"People won't stay," said Roanoke County parent Ann Cranwell, whose 9-year-old son needs help writing because the right and left sides of his brain don't communicate well.
In her son's first year of occupational therapy, he was treated by three different people, Cranwell said.
She wants the Roanoke County school system to hire its own occupational therapist, a proposal being studied by the county's special education advisory committee.
But if companies such as Therapy Associates are having a tough time hiring therapists, the school system won't find it any easier, said Eddie Kolb, director of pupil personnel services and special education.
"They will be just as short for the schools as for private practice," he said.
Advances in medical technology, along with federal laws that require public schools to provide more services to handicapped students, have created an increasing demand in recent years for occupational therapists nationwide. Colleges and universities, facing ever-shrinking budgets, have been slow to respond by creating or expanding programs to train people in the field.
There are 44,000 registered occupational therapists and 11,000 certified assistants in the United States, said Howard Holland, a spokesman for the Washington, D.C.-based American Occupational Therapy Association. That's 25 percent too few, he said.
Of those, 1,025 therapists and 100 assistants live in Virginia. A registered therapist can both evaluate and treat clients. Assistants can treat clients under the supervision of registered therapists but cannot make evaluations.
Rural areas - such as Southwest Virginia - find it particularly difficult to attract occupational therapists. Because they are in such demand, said Holland, new graduates have their pick of jobs - and most pick jobs that take them to the Northeast.
Many go for the higher salaries, which range between $30,000 and $40,000 for entry-level positions.
When rural areas do attract occupational therapists, said Stephens, many prefer to work with adults, where the pay can be higher and the stress reduced. His company sends five therapists to six school divisions - some hours apart - where they treat 10 or 11 students each day.
Holland said others simply choose to settle near the colleges at which they have earned their degrees, many of which are located near New York and Boston.
There are roughly 150 programs across the country offering degrees in occupational therapy. About 80 produce registered therapists; the other 70 graduate certified assistants.
For years, Virginia had only one program for training occupational therapists, at Virginia Commonwealth University's Medical College of Virginia. That program graduates slightly more than 40 registered therapists each year, said Craig Nelson, an associate professor.
It was recently joined by Shenandoah University in Winchester, which started a three-year program in August, said Barbara Chandler, the director of clinical education. The school, which will also produce registered occupational therapists, enrolled 37 students, who will graduate in 1996.
But Kolb and others hope their problems will be alleviated by a new program at Roanoke's College of Health Sciences, which will graduate its first group of 15 certified occupational therapist assistants this spring.
"There's hope," he said.
In the meantime, parents like Denise Swanson have gone outside the system - and into their own pockets - to keep their children from falling behind.
Kolb said he would ask the regional board and the county to reimburse them, because Virginia law requires the services called for in each child's educational plan to be provided by the school system.
"It's a problem," he said, "and we're trying to solve it."
Memo: ***CORRECTION***