Out and About

The name “Christine Berg, PhD, OTR/L, FAOTA” is synonymous with the word “community” in the Program in Occupational Therapy. She teaches the Promoting Population Health through Community Partnerships course to master’s and doctoral students each year, oversees the clinical/community practice course sequence, establishes community-university alliances to benefit the underserved or un-served.

Berg came to the Program in 1987 when her husband, John, was named assistant to the chancellor at Washington University. Her career up to that point had been that of a community-based occupational therapist (OT) working with adults and children with mental, developmental and physical disabilities. During the mid-1970s, these populations were being reintegrated into their communities from segregated health institutions and OTs like Berg were charged with helping them transition into their communities. Looking back, she notes one significant difference in how she would approach facilitating a similar transition now.

“At the time, OTs didn’t necessarily connect these populations to community agencies already in place that could have provided services to assist with this transition to community process. We stayed within the medical community,” recalls Berg. “Connecting people with community agencies that can support their health care needs is something we as OTs can do to foster a longer range continuum of care. These are extremely vital partnerships that contribute to overall public health and community participation.”

As an educator, Berg understands how vital these community partnerships can be to students interested in becoming clinical practitioners.

Evolution of the Community Health course

In the mid-2000s, the Program began to incorporate courses that covered how occupational therapy could be utilized to strengthen community health promotion and prevention programs for persons with disabilities and their networks. The Community Health and Occupational Therapy course examined community health and education practices in occupational therapy for groups, communities and populations. Under Berg’s guidance, the course evolved into a service-learning model where students were matched to community sites to use their developing community practice skills in real world context.

“The course was designed from the belief that the best practice to educate OTs offers students opportunities for authentic, in-context learning along with practice, reflection and mentoring,” explains Berg. “It’s a mutually beneficial relationship, as students benefit from service-learning in these settings and the community sites gain fresh new perspectives and strategies from OT needs assessments and program plans, which address the individual health challenges of the agencies.”

In 2013, this community health emphasis evolved into the Community Health and Participation clinical/community practice track offering with self-directed learning experiences under the guidance of a Program faculty member. “The clinical/community practice track was the result of a curriculum change to offer students the opportunity to work directly in the community on projects that impact populations in need of OT services such as people with low vision, mobility and chronic health conditions,” says Berg.

Mentored by Berg and an agency supervisor, students provided a capacity-building service to the organization by performing a needs assessment in a focused area, collaborating with staff, and developing and delivering a program. The intent was to provide the agency with materials and a process that they could implement to enhance their ongoing programs. At one point, Berg had multiple students at multiple agencies throughout the St. Louis area, and she evaluated the impact of these individual projects and the service delivery of the agency.

“I began to ask, ‘Are there agencies out there with projects that could support more than one student to increase the impact?’ Collaboratively, our students could further broaden the programming and services offered to the community through the agency,” says Berg. The result was Berg connecting with two local agencies – Beyond Housing and United 4 Children.

Directly impacting the community

Beyond Housing is a community development organization that works in the 24 municipalities that send children to the Normandy School District, which is among the poorest and most underserved districts in Missouri. They focus resources where they can have the greatest impact in all of the areas that make up a thriving community – education, housing, health, employment readiness and access and economic development. Beyond Housing partners with United 4 Children to implement Programs Achieving Quality (PAQ), an early learning quality improvement project in collaboration with early childhood centers located in the Normandy School District. Through PAQ, students are engaged in the Move2Learn initiative, which encourages physical activity with a focus on infants and toddlers. Student projects complement the Move2Learn program.

“Currently, one student is looking at fostering movement through reading books. Reading books is considered a sedentary activity, so how can we build movement into this common early childhood routine? Another student is exploring communication outreach to parents on building routines at home to get kids moving,” says Berg. “Other projects involve designing lesson plans that include environmental support such as space, materials and portable equipment. By facilitating physical activity in early childhood programs, we can help children establish lifelong habits of physical activity that could reduce obesity and promote healthy development.”

The agency collaboration is having positive results all around.

"The partnership between Washington University, Beyond Housing and United 4 Children is an innovative way to work toward ensuring children develop on target physically, which directly impacts their continued progress in other areas of development. By creating a team approach between child care professionals, volunteers, child development coaches and even families, we are fostering an environment that is truly providing the holistic approach to supporting children that is so important,” says Elisa Zieg, MA, program development officer of United 4 Children. “One infant teacher had a child who struggled to sit on his own, even though developmentally that was a skill he should have. By working with the OT student, the team was able to come up with fun activities to encourage the child to sit on his own.”

“Having the OT students in the early childcare centers provides a little break in the day for the teachers and it’s exciting for children to see a new face in the center, especially one that is going to be there for a semester or two,” shares Casey Locey, early childhood resource coordinator for Beyond Housing. “The OT students help the teachers learn new activities to get the children moving and new ways to use the materials in the classroom to promote fine and gross motor skills. The teachers can then incorporate those techniques into the daily classroom activities, and they become habit for the center. Most importantly, the children’s brains and bodies are being developed and shaped in healthy ways … and they don’t even know it because it’s fun!”

Looking ahead

Berg is continually seeking new ways to engage students who are passionate about community. For years, she has been personally involved in the Civic Scholar Program through the Gephardt Institute for Civic and Community Engagement at Washington University. When an OT student approached her about wanting to look at a broader regional issue, Berg began developing the Civic Engagement track, modeled after the Gephardt program.

“After hearing him describe his interest in preventing gun violence, it just didn’t fit within one agency so I began to explore who I could connect him with in the community. This track allows students to look across several agencies at the big issues in our community such as poverty, racial disparity and homelessness, and how we as OT can participate in finding solutions,” says Berg. “He is learning about the issues, his role as a therapist and how gun violence impacts the OT profession and the clients we serve. It’s a broader way to learn about community health.”

Berg sees even more community opportunities for students by collaborating interprofessionally on projects with other Washington University programs and departments. During the summer, Berg worked with senior lecturer Jennifer Ingram of the Sam Fox School of Design & Visual Arts. “We have eight teams consisting of one OT student, one fashion design student and a person with a disability to design clothing that fits their lifestyle and accessibility needs. The students meet with their client three times to discuss wardrobe needs and activities, design universal options and sketch clothing with fabric choices for them,” says Berg. “Currently, there is no store-based retail market for clothing for people with disabilities, only specialty websites. That’s the kind of ‘out of the box’ thinking our profession can explore. Potential community partners to foster participation for our clients could be lawyers, architects, engineers and even fashion designers. The possibilities are endless … so stay tuned!”