# Occupational Therapy Foundations > Occupational Therapy notes on foundations: the philosophy of occupation, the OT process, history since 1917 and Indian training at KEM Mumbai. - Canonical URL: https://prepelephant.com/topics/allied/occupational-therapy/ot-foundations - Exam / course: Allied Health · Subject: Occupational Therapy - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Occupational Therapy Foundations", PrepElephant, https://prepelephant.com/topics/allied/occupational-therapy/ot-foundations ## Direct answer Occupation — everything people need, want and are expected to do — is both the subject and the treatment medium of occupational therapy. The profession enables participation across the lifespan by adapting the person, the occupation or the environment, working through a structured process of assessment, goal setting, intervention and review, always anchored in purposeful activity rather than isolated exercise. It was formally founded in the United States in 1917, reached India in 1950 when the first training school opened at KEM Hospital, Mumbai, and is represented today by the World Federation of Occupational Therapists (WFOT) and the All India Occupational Therapists' Association. ## What you must remember - Occupations, per the Occupational Therapy Practice Framework, span activities of daily living, instrumental ADLs, health management, rest and sleep, education, work, play, leisure and social participation. - Founding: the National Society for the Promotion of Occupational Therapy, 1917, USA; William Rush Dunton is called the father of occupational therapy and Eleanor Clarke Slagle its mother — a standard viva pair. - India: the first OT training school and centre opened at KEM Hospital, Mumbai, in 1950, founded by the American-trained therapist Kamala V. Nimbkar; the All India Occupational Therapists' Association (AIOTA) is the professional body. - WFOT was constituted in 1952; World Occupational Therapy Day falls on 27 October. - The OT process: referral and screening, assessment (occupational profile plus analysis of occupational performance), goal setting, intervention, re-evaluation and discharge — taught as a loop, not a line. - Intervention approaches: create or promote, establish or restore, maintain, modify (environment or task), and prevent. - Core skills unique to the profession: activity analysis and synthesis, therapeutic use of self, and environmental adaptation. - Practice settings: acute hospitals, rehabilitation units, mental health services, schools, industry and ergonomics, community and home-based programmes. ## The OT process on one referral A 28-year-old mason sustains a T12 complete paraplegia in a fall and is referred six days after surgery. Assessment begins with conversation, not instruments: the occupational profile records that he is the family earner, lives in a house with an Indian-style squat toilet, and values cooking for his daughter — the occupations that matter to him, not the ones a checklist guesses. Formal measures follow: functional independence in transfers and grooming, a Canadian Occupational Performance Measure in which he rates his top problems, and home-visit observations of the narrow bathroom doorway. Goals are negotiated and written SMART — independent bed-to-wheelchair transfers with a sliding board within three weeks, supervised rolling and dressing within two. Intervention then works from every angle at once: he practices the transfers (establish), the family is taught to assist safely (maintain), a commode chair and a ramp are planned for the doorway (modify), and pressure-care education protects his skin (prevent). At four weeks the same scales are re-administered — the COPM performance scores rising from 3 to 7 — and discharge is planned around community follow-up. Every step of that loop is examinable, and every step begins from occupation, not impairment. ## How the exam frames it The examiners' favourite contrast is occupational therapy against physiotherapy: physiotherapy works primarily on impairment — strength, range, movement — while occupational therapy works on participation — getting life done — and the safest answer names both and the overlap honestly. "Occupation" itself is the classic trap: it means all meaningful daily doing, not employment, so a homemaker or a child is fully "occupied". Purposeful activity (goal-directed, chosen) must be separated from diversional activity (leisure for enjoyment), and one-mark questions regularly ask for the founding year, the father and mother of the profession, or where Indian OT began — 1917, Dunton and Slagle, KEM Hospital Mumbai 1950. ## Frequently asked questions ### What does "occupation" mean in occupational therapy? All purposeful activities a person needs, wants or is expected to perform — self-care, work, play, leisure, sleep and social participation — not just paid employment. ### How does occupational therapy differ from physiotherapy? Physiotherapy targets impairment and movement; occupational therapy targets participation in daily occupations, using activity and environmental adaptation as treatment. ### What are the steps of the OT process? Referral and screening, assessment (occupational profile and performance analysis), goal setting, intervention, re-evaluation and discharge planning. ### Who founded occupational therapy, and when? The National Society for the Promotion of Occupational Therapy in 1917; William Rush Dunton is regarded as the father and Eleanor Clarke Slagle the mother of the profession. ### Where did occupational therapy training begin in India? At the Occupational Therapy Training School and Centre, KEM Hospital, Mumbai, in 1950, founded by Kamala V. Nimbkar. ### What is therapeutic use of self? The deliberate use of one's personality, communication and rapport as an intervention tool — planning interaction to enable the patient's engagement.