Fellow Laura Cohen

Laura J. Cohen, PT, PhD, ATP

Born:

Entry into the AT Field: 1986

I am a physical therapist who started work in an inpatient rehabilitation facility. At my first job I recall sitting around a large conference table with the entire rehab team of ~ 20 people and everyone turned to me when the question was posed "What equipment does Mrs. or Mr. Jones need to go home?" I remember thinking I did not know I was the one who had to make that decision - I best learn more about this. That is when I began to learn that there was a whole world of technology and options for my patients. I also quickly learned that when someone told me I cannot get "that" for my patient because it was not covered that I could challenge that successfully with appropriate rationale and justification. When I found RESNA I was so excited to find "my people".

I always say that my entire career in AT evolved by accident- being in the right place at the right time. Working in a heavily managed care environment I was increasingly frustrated with the difficulties I had obtaining the technology I was recommending for my patients. I quickly learned to seek guidance from colleagues. One of my first educational experiences in the field of seating and mobility was a Regional RESNA Seating and Mobility Conference in Phoenix, AZ. Jessica Presperin Pedersen was the keynote speaker and Janice Hunt Hermann and Dave Dilli were the conference coordinators. This conference was a pivotal point in my career inspiring me to continue and focus my practice in seating and mobility. With guidance from Janice and Dave and their experience with their AT clinic at Good Samaritan Rehabilitation soon after we opened the Assistive Technology Program of Tucson at Tucson Medical Center, the first AT program in Southern AZ.

While traditional PT proved to significantly help the people I worked with I found myself asking - what happens when they go home? How do they function and participate the rest of the time? Can they return to their prior activities and prior level of functioning? It occurred to me if I could obtain assistive devices to accommodate and compensate for mobility impairments when the person was not in the clinic that would have a much longer term impact on that person 24/7. Using an assistive device- wheelchair or scooter did not minimize the benefits or need for PT but augmented it! By matching the person with the proper technology they could engage in a more active and independent life during and after rehabilitation.

While there are a number of colleagues that have inspired me and supported my learning, Jean Minkel has generously provided mentoring, guidance and coaching since early on in my career. I consider Jean a treasured long-time friend and attribute much of my career success to her wise counsel. Over the past 25 years Jean guided me on everything from direct patient care questions, building a productive full service AT program and seating clinic, serving on my doctoral dissertation committee, creating and sustaining a successful private consulting practice and carrying forward the next generation of work of the RESNA PSB. I am grateful for all of the time and support Jean has invested in me and hope to pass that generosity on moving forward.

I find that AT in general serves to level the playing field for all players. Given the proper tools potential is limitless. I have seen this with the people who I have worked with to provide seating and mobility services and find this direct work the most rewarding. While my career has moved me somewhat away from direct patient care services, I strive to work to ensure that people with disabilities have continued access to the complex rehab technology that they need to live active and productive lives. I believe that public policy can responsibly provide appropriate technology and services to the people who need it. There remains a lot of work to do in order to put in place the checks and balances in the form of public policies and best practices. It is time to professionalize the field of Rehabilitation Technology and develop a qualified workforce to meet the growing demand. My work focuses on ensuring that people with disabilities have continued access to the technology that they need and that there is a qualified and prepared workforce to provide the AT related services to meet the needs of the public.

Almost all of my most memorable successes in the field relate to individuals who I have worked with to provide independent mobility. The look of joy and amazement on the face of a person who has never had an opportunity to independently move themselves is priceless.

As Chair of the RESNA Professional Standards Board, I had the distinct honor of working with a tremendous group of dedicated professionals from the PSB, Certification staff, and numerous RESNA volunteers. Together we worked to modernize the RESNA Certification Program: consolidating the ATP and ATS certifications, updating the Assistive Technology Professional Certification, establishing the Seating and Mobility Specialty Certification and moving to computer-based testing.

The frustration of navigating the funding and reimbursement process sometimes seems unending. I recently had a patient pass away waiting to obtain the power wheelchair he needed so that he could move out of a nursing home. It broke my heart to know that the power wheelchair was a covered benefit that he could not get access to due to red tape. I have committed a great deal of time and effort towards advocacy work. I recognize that it is not sustainable to fight each battle person by person. It is the system that needs to be fixed for everyone. That is where I have channeled my efforts.

The field of AT has evolved to a recognized specialty area of clinical practice with a well established voluntary certification program that has gained international recognition. While still young in evolution the field continues to progress and we are beginning to see the development of Clinical Practice Guidelines and position papers. While there is still plenty more to do I am pleased to see the progress we have made towards professionalizing the field of AT.

The wide range of AT available has been the most significant advance to the field over the past 25 years. When I first started there were very few options available for the patients I saw. Advances made "custom" products available to the few that were fortunate enough to work with rehab engineers who could fabricate became more readily available to all through multiple manufacturers. Today if you can think of it you can find someone who can make it for you. The problem that limits our success is access. Still today, not everyone can gain access to the technology that exists. My work involves challenging the access issues through public policy.

Opportunities abound for us to advance the field of RE and AT. It is time for our field to mature. We need to develop mechanisms to bring new people into the field and academically prepare the next generation of AT Professionals. We need to be at the table of health care reform showing the impact of AT on the lives of the people who use it, how AT plays a pivotal role in ensuring people lead active healthy and productive lives, how AT Professionals can help to lower health care cost and contribute to keeping people out of institutions and active in the workforce.

Over the years I have served numerous roles within RESNA. I first got involved early on with the Quality Assurance Committee, Publications Committee and Education Committee and then as Professional Development Coordinator for RESNA developing the Fundamentals of Assistive Technology curriculum. I have served in many capacities including Chair of SIG-09 - Seating and Mobility, and Chair of the RESNA Professional Standards Board. I am currently appointed to the Government Affairs Committee and the Editorial Board for Assistive Technology. It is through my involvement with RESNA that I have created an international network of colleagues. All of my activities within RESNA have contributed to the success of my career and private practice.

Certification. With focus and investment of resources, RESNA has the potential to develop and be the repository for professional educational materials to support the AT Professionals in the field and prepare those interested in developing their expertise.

People first. What we do is all about the people. Keep function, independence and participation as the focus. Act professionally and be fiscally responsible. Rather than fight each barrier one by one let's work together to make a system that will work best for most. We spend so much of our life working it is important to find a career that is fun, challenging and rewarding. I am lucky to have found one I love, I hope you do to!