Bridging the generation gap

Two current UND occupational therapy students learn how their moms also graduated from UND’s OT program together three decades ago.

It’s amazing what a Christmas card can do.

Visiting her parents at her childhood home in Mapleton, N.D., over the holiday break last year, third-year occupational therapy student Olivia Dobrinz was looking through the greeting cards that her mother Lia had posted on the farmhouse’s front foyer.

Then Olivia froze.

“I was like, ‘What’s my friend Sydney doing in this card?’” Olivia recalled with a laugh, turning to smile at her mother. “I said, ‘Mom, I take classes with her.’”

“I said, ‘Oh, that’s Darla Johnson’s daughter Sydney,’” Lia replied. “Darla and I trained together at UND. So I asked ‘Is Sydney in OT too?’”

Sure enough, Sydney Johnson was – and is – an occupational therapy doctorate (OTD) student alongside Olivia at the UND School of Medicine & Health Sciences in Grand Forks. And, yes, the two students’ mothers – Darla Johnson and Lia Dobrinz – were also OT classmates at UND in the 1990s.

Small world

After a few excited – and amazed – texts and emails, the four current and future OTs had figured it out: Despite starting in physical therapy, Olivia had switched her major to OT in her first year at UND. Soon thereafter she learned that she was on the same floor of the same residence hall as Sydney – whom Olivia had started noticing in her pre-OT classes. And both trainees had, as Sydney put it, spent their childhoods “learning about OT” from their moms.

Small world, indeed.

“We would go to my mom’s office work parties and play in the sensory gym at her facility,” remembered Sydney, who is in the middle of a pediatric outpatient fieldwork placement at the Altru Health System Performance Center in Grand Forks. “So I decided to go to UND. Olivia was actually roommates with someone I knew from high school, so we all became friends.”

Years earlier, Elk River, Minn., native Darla had met Fargo-Moorhead native and former pre-med student Lia at UND around 1989. Back then, UND’s Department of Occupational Therapy, which celebrates its 70th anniversary in 2024, offered “just” a Bachelor of Science degree in OT, which both Lia and Darla took home in 1993. (UND replaced its BSOT degree with a Master of Occupational Therapy degree in 2000 and the MOT with an OTD degree in 2019.)

After graduation, Darla ended up back in south-central Minnesota and Lia ended up back on the North Dakota side of the Red River Valley. Both are still practicing in the profession: at Sanford Health in Fargo and Mercy Hospital in Coon Rapids, Minn., respectively.

“I’d grown up with a friend who had a spinal cord injury, and it was neat to see how independent he was and lived a completely normal life,” Lia said of her decision to explore OT as a college student. “I kind of found my niche in that area, I guess – growing up with this friend. I wouldn’t have known that he was paralyzed from the waist down. He worked every day, drove, did everything independently. It was a cool, inspirational thing, and I was able to see how impactful OT could be in a lot of ways for a lot of people.”

Then and now

That impact has only grown since the 1990s. As Darla explained, the expansion of OT across the therapeutic spectrum this century means that she and her colleagues are a much larger piece of the patient care puzzle than they were when UND’s OT program was founded in 1954.

Of this there is no better example than autism diagnoses.

“One of the big changes in the field and probably in our culture is the change with autism diagnosis,” said Darla. “We had very minimal training in the 1990s – just a brief touch on sensory integration. For my very first job, I saw one person with a diagnosis of autism. Right now, autism accounts for 80% of the kids who walk through the door in our clinic.”

Sitting alongside her mother, Sydney nodded, explaining how central autism training is to the current OTD curriculum.

“Yeah, classroom and fieldwork,” Sydney added. “I learned a lot of those sensory things with autism early. And I’m assuming that even in your fieldwork training you didn’t have that.”

Also missing from her educational experience a quarter century ago was feeding intervention, Darla continued.

“There’s often a comorbidity of autism and feeding difficulties,” she said. “Feeding aversion and picky eating with limited diets. I see many of those kids, and also see kids with feeding difficulties who were born prematurely and have a G-tube placement. I see them when they’re around two years old, and we work on getting them to eat orally. Those kids born prematurely didn’t survive at 25 weeks in 1994. That’s a huge change.”

What has also likely changed since Lia and Darla graduated, said Olivia, is the amount of research and evidence-based intervention training ongoing in OT programs, UND’s included.

“There was more of a psychiatric component at that time at UND,” added Lia. “That’s a very important component of what we do, but I appreciate that it’s gotten away from that a bit, allowing you to explore other avenues to get in more neuro-physical disability training as well.”

These changes in OT education – which follow changes in both research and clinical practice, noted both Darla and Lia – have meant a greater acceptance of the profession today, relative to 70 years ago.

“It’s a more respected profession,” quipped Lia. “There’s a lot more collaboration and working with the other providers to have the best outcome in the rehab setting – the team approach. That’s what we’re realizing as health systems, and even with insurance companies. The new norm is helping keep our clients as independent as we can. We were at the cutting edge of that as OTs. That concept has exploded and really shined a positive light on our profession. It’s very collaborative now, and I appreciate that.”

Resisting the parental instinct

This shift in the culture of health systems, never mind society at large, means Lia and Darla both had to deal with challenges that their daughters could hardly image today. That’s exactly why it’s sometimes difficult for the moms to step back and let their daughters learn the profession their own way.

But not too difficult.

“It’s not really that hard,” shrugged Sydney of having an OT mom while she’s in an OT training program. “We talk about what assessments we like. I ask her if they use certain assessments at her clinic and then if there were some that she’d never heard about. But I had minimal education on feeding interventions coming into my fieldwork, so I was able to ask my mom a lot of different questions about different interventions and what to look for and different things to do.”

“Sydney does a good job of saying ‘Okay, Mom, I got it. I’m learning all of this in school,’” acknowledged Darla, who along with Lia keeps up with advances in OT through continuing education programs. “She does a good job of setting boundaries.”

Lia agreed, adding that having a daughter in OT now helps her learn more of what’s current in the profession.

“It’s a fine line, because you want to allow them the opportunity to experience this themselves and grow and learn from it, and not just constantly be whispering in their ear,” admitted Lia, who works with UND OT students at Sanford and has lectured at UND to discuss occupational therapy and driving rehabilitation. “It’s been exciting for me as a mom to watch that happen. I try to not offer feedback unless she reaches out for it, and I’m learning from her as well, because the field is constantly evolving.”

Next gen

Because the profession continues to evolve, both daughters expect to specialize in fields different from those of their mothers. Sydney hopes to end up in pediatric therapy in the nature-based setting (the focus of her senior capstone project), or perhaps pursue travel OT.

“I would like to experience new things, places, settings and then probably end up somewhere around Minnesota,” she said. “Or maybe even practice in a rural setting. Wyoming or Montana would be cool.”

And instead of focusing on driving interventions for adults like her mom, Olivia expects to explore orthopedics or pediatrics in an urban setting, to “see where that takes me.”

For their part, both Lia and Darla are still satisfied with the training they received at UND, and the current state of UND’s OT program, which they get to absorb – 30 years after their own graduation – through their children.

“It’s been fun to see the UND program I love grow, especially now that it’s included in the med school and that interprofessional paradigm,” Lia mused. “Back when Darla and I went to school, we were in the old Hyslop building, above the pool. Everyone in class would be like, ‘Why does my head hurt?’ It was the chlorine. So, it’s been neat to see the wonderful environment there now, and the beautiful facility. It’s awesome.”

“We used to hang out together both in and outside of the classroom,” added Darla of her and Lia’s UND experience. “We spent Halloweens together and did the dress-up thing with the department. It was fun. And I’m glad to hear that hasn’t changed.”

Or if it has changed seventy years into its run, the moms imply, UND’s Department of Occupational Therapy has only gotten better with age.