Charting a new course for OT education at WashU

Lenin Grajo, PhD, OTR/L, incorporates the principles of diversity, equity, inclusion, justice and anti-racism into the curriculum

by Stephanie Stemmler • November 18, 2022

Grajo teaches first-year students how to effectively design survey and questionnaire rating scales in the Research Designs and Use of Data course.

The Program in Occupational Therapy is undergoing some fundamental changes in the way the Program and the curriculum meet the needs of the next generation of occupational therapists. In the middle of these changes is Lenin Grajo, PhD, EdM, OTR/L, the Program’s new director of the Division of Professional Education and associate director of Diversity, Equity and Inclusion.

Grajo, a dynamic personality who says that being an educator is the “primary core” of his whole self, is focused on how to better embed principles of diversity, equity, inclusion, justice and anti-racism into the Program’s curriculum design. “I want to see how this can be better reflected in every single course that is offered and in the methods we use in teaching,” he says. “The people we serve are diverse and rapidly changing, and health-care practitioners are not often ready for that. We need to do better to prepare our students for the diversity that is inherent in our communities so that we can reflect equity, inclusion and anti-racist principles in the care we provide.”

He offers several examples. Where we may brush our hair in one specific fashion, it’s not the same for people with different hair textures, different cultures or different backgrounds. Religious practices influence occupational choices. Child-rearing practices are affected by culture and other influences. The ways in which we work and participate in home activities are different. Simply put, occupational therapy (OT) practices should consider the diversity of the human population and the human experience. To do that, Grajo says, “We need to teach, innovate, impact practice and then lead.”

His timing in joining Washington University School of Medicine is perfect. With the debut of the new Community Experiential Learning Center in the Program in Occupational Therapy, Grajo’s focus is on advancing the curriculum so that students will engage immediately with faculty as well as the community not only to provide clinical services, but also to identify, research and develop novel methods, tools, metrics and programs that enhance health and overall well-being and reflect diversity, equity and inclusion.

Grajo comes to WashU from Columbia University College of Physicians and Surgeons in New York where he served as Director of Post-Professional Doctor of Occupational Therapy Programs and Associate Professor of Rehabilitation and Regenerative Medicine. “It was a small but innovative program in that it was the only doctoral program in the country focused on functional cognition,” he says. “It inspired me to do more to impact practice and lead.”

His journey started in the Philippines. Challenged by his aunt who raised him (whom he calls his mother) to follow a passion for education and a meaningful skilled career, he envisioned going to college to become an elementary school teacher. His aunt encouraged him to pursue studies in OT, and Grajo soon was accepted into the University of the Philippines to study OT. By age 21, he owned a private pediatric OT practice with colleagues in the Philippines and was asked to return to the university after earning his bachelor’s degree to become a member of the faculty.

Recognizing that he could combine an OT career with an academic career focused on children and education, he applied to Harvard University to earn a master’s degree in education with a focus on child development and psychology. “I moved here with two suitcases, mainly filled with books and shoes, and $80 in my bank account,” he says. “Throughout my days in college, I only had one pair of shoes that I wore until there were holes in the soles and I could feel the water seep in when it rained. As my career progressed, my shoes became a symbol for my hard work; step by step, it’s been a journey that is an homage to my mother, who lit that spark for education in me.”

He focused on early childhood education, with his research delving into literacy interventions for children with learning disabilities such as dyslexia. After graduation, he moved to Austin, Texas, to take a position as a pediatric occupational therapist in private practice. Soon after, a colleague mentioned a doctoral program at Texas Woman’s University School of Occupational Therapy in Dallas. “I started the program in 2011 to continue my research on advancing the role of OT in literacy,” Grajo recalls. “After completing just one semester, I saw that Saint Louis University had a faculty position open in their Occupational Science and Occupational Therapy program.” He applied, was offered the job, and spent the next several years teaching in St. Louis while traveling back and forth to Texas to earn his doctoral degree. After designing an assessment tool to measure children’s literacy for his dissertation, he was more passionate than ever about education and ways to create and enhance curricula in the OT field. The chance to move to New York to help design the OT curriculum at Columbia University was the next logical step.

It was during the recent COVID-19 pandemic, however, when Grajo took a hard look at his career path. Feeling isolated in a 650-square-foot apartment with two cats and a dog and eager to take on new leadership roles in OT education, he started to explore options. One came in an email direct from Lisa Connor, PhD, executive director of the Program in Occupational Therapy at Washington University School of Medicine. Under Connor’s leadership, the Program was undergoing fundamental and exciting changes to its clinical practice, research and education programs. Did Grajo, Connor asked, want to be a partner in developing this new era at a nationally ranked OT program?

“In my first interview, I realized how everyone was focused on advancing the field of OT in new and dynamic ways,” says Grajo. “I wanted to be a part of that.”

He hit the ground running by participating in and initiating meetings months before he officially joined the Program in July 2022. Mirroring the university’s push to reimagine how to incorporate diversity, anti-racism and justice in health care, Grajo already has partnered with other faculty to update the curriculum. He also is mindful that underrepresented groups comprise 23% of the student population in the Program. “Yes, we want to increase that diversity among students, but even more important, we need to ensure that all of our students graduate with the understanding and critical thinking necessary to ensure that OT clinical care mirrors the diversity around us. As Dr. Connor reimagines the entire Program, we can be pioneers in how we develop the educational components that achieve that goal.”