Irene Zhang, Occupational Therapist, LIH Olivia’s Place Shanghai

Zhang Yan (Irene Zhang)

Irene is a Hong Kong-registered occupational therapist. She has a Bachelor of Science in Occupational Therapy from Hong Kong Polytechnic University and a diploma in Rehabilitation Science from West China Center of Medical Sciences, Sichuan University. She has worked with adults and children in rehabilitation center, hospital, and school settings. Her clinical interests are in working with children with a variety of special needs, including sensory processing difficulties, handwriting difficulties, ADHD, ASD, dyslexia, Down syndrome and cerebral palsy.Languages: English, Mandarin, Cantonese

Why did you choose to work at LIH Olivia’s Place?

LIH Olivia’s Place is the pioneering service provider in China that offers world class, multidisciplinary pediatric therapy services. In addition, I was attracted by the mission to make high standard therapy universally available in China.

Why did you choose your field?

After having worked with adults with disabilities, disaster victims, and children with special needs. I found I was really enjoying teaching children new skills while playing with them. Pediatric occupational therapy offers me the opportunity to enjoy every minute of my life and meanwhile fulfill my career aspirations.

What are some of the most rewarding experiences you have had in your chose profession?

After regular visits to a welfare center for a year, all bed-bound children now have adaptive chairs and a daily routine to access these chairs. The quality of life for these children has changed and the staff at the center have started to understand how important a positive attitude and praise are for teaching and training children.

What’s your favorite thing about living in China and working at LIH Olivia’s Place?

The not very fast-not very slow pace of living in Shanghai and the international environment and culture compatibility at LIH Olivia’s Place.

What would you like to be doing in 5 years’ time?

Besides personal professional development, as a pediatric OT working mainly with expatriate families in Shanghai currently, I would like to contribute as much as I can to promote a holistic occupational therapy service to children with special needs all over China. This would include visiting more local schools and extend OT service in local schools and establishing long-term relationships and regularly visiting two more welfare centers.

The Speech-Language and Psychology teams at LIH Olivia’s Place Shanghai have recently made the exciting transition to digital assessment administration for many formal assessments.  Since LIH Olivia’s Place opened in 2010, we have been committed to using leading industry standard assessments and to safeguarding the intellectual property of the assessment authors and publishers. This has always meant dealing with a number of challenges to ensure that test materials from international assessment publishers could be readily and consistently available. The opportunity to explore another way of maintaining our high standards while we continue to grow in China, while protecting the integrity of the assessments themselves, was exciting to us.

The decision to change from paper-and-pencil test formats to the use of iPad and computer-based testing was no easy task. Our teams had to consider the ease of use for children and parents, comfort levels with necessary technology, and the learning curve of new administration techniques. However, after trials by our speech and psychology staff, it was clear that these formats would be of significant benefit to the families we serve and our clinicians. Once a struggle because most assessments must be purchased outside of China, digital assessment platforms will allow LIH Olivia’s Place clinicians to immediately access the most up-to-date versions of some of our most widely used tools. They will also allow us to stay immediately informed of any changes or improvements in the tests we use.

Digital administration is now offered through several assessment publishers and LIH Olivia’s Place will migrate to digital platforms as they become available and well-tested. One of these platforms is Q-Interactive, offered by Pearson, the publisher of many of the most reputable and evidence-based tests. It can be used to both administer and score tests that are traditionally given by examiners in a paper-and-pencil format. Using the digital version of the assessment, testing takes place on two iPads using an app called Assess. The first iPad is used by the examiner to access the test administration instructions, score and record responses, and control visual stimuli. The person who completing the assessment uses the other iPad to view and respond to stimuli. Q-interactive can also generate summary information for assessments administered on the iPads.

Pearson has conducted substantial research to ensure that the use of its digital system does not detract from the quality of assessments administered. Prior to inclusion in the Q-interactive library, each new type of subtest underwent an equivalency study to evaluate whether scores from digital testing were interchangeable with those scored from paper-and-pencil testing. Results of these studies support the validity of Q-Interactive as a method of administration for all tests included.

The transition to digital assessment is an intensive process. While familiar with the paper and pencil versions of these tools, our clinicians have undertaken additional training to solidify their competency in each assessment they will be administering with the new systems.  Clinicians and families at LIH Olivia’s Place Shanghai will be the first to use these advanced digital platforms, other LIH Healthcare clinics and hospitals can anticipate having access to this technology and specialized training in the near future.

Physical therapists ZiLi Wang and Ilija Dimitrovski gave staff at LIH Olivia’s Place Shanghai a workshop on managing workplace postures, including short assessments for staff with work or sports related pain. The health of our clinicians and support staff is very important, as having a pain-free body allows us to perform at our best.

Staff learned about the basics of core muscle strengthening to help maintain proper posture, and how to manage their works pace. Specific problems, such as neck, back, and shoulder pain were individually addressed, with the physical therapists showing their assessment flow – from asking subjective questions to the actual physical examination. Suggestions for exercises to relieve neck stress and stretch the neck and shoulder muscles were also given and demonstrated.

Here are a few of the exercises that were included:

Neck Extension: This exercise helps relieve pain from the neck after too much time spent looking down at laptops or paperwork.

Tuck your chin in and slide your whole head backward. Slowly extend your neck as you look up. Slowly right your head, then repeat the movement 10 times. Do not repeat this exercise if it worsens your pain!

Neck Muscle Stretches: These exercises help stretch out the neck muscles on both sides.

Look down and turn the head slightly (45 degrees) to either side. Take the arm on the side turned to, and gently pull the head down. Maintain the stretch for 30 seconds.

Core and Back Exercise: This is a general exercise that can be used to improve core strength and back stability. If it is too difficult to maintain, do only the legs or arms component.

Kneel down so that your back is flat and your knees and shoulders are flexed to 90 degrees. Slowly raise up one leg and at the same time raise the opposing arm, keeping your back flat. Hold the posture for up to 1 minute. Repeat using the opposite limbs.

LIH Olivia’s Place is thrilled to announce the addition of Dr. David Cifu and Dr. Denise Challis to our Techinical Advisory Board, joining our standing members who have recently committed to continued service: Dr. Ao Lijuan, Professor Jean Deitz, Professor Sharon DeMuth, and Dr. Henry L. Lew.

We warmly welcome our new Technical Advisory Board members and thank each of our continuing members who have renewed their commitment to our organization. Each shares the vision, mission, and values of LIH Healthcare and brings the kind of creativity, energy, and commitment that LIH Olivia’s Place needs to build on what we have accomplished together over the last several years. Their distinctive knowledge, experience, and expertise in rehabilitation will support our efforts in increasing our impact on China’s rehabilitation services.

Ao Lijuan, MD

Dr. Ao is the Department Chairperson of Kunming Medical University’s Rehabilitation Medicine Department. She is also the Vice Chairperson of the China Association of Rehabilitation Medicine, the Secretary General of the Yunnan Provincial Association of Rehabilitation Medicine, the Chief Physician in the Rehabilitation Department of the Second Affiliated Hospital of Kunming Medical University, the Chief Medical Officer of the Yunnan Disabled People’s Federation Rehabilitation Hospital, and on the editorial boards of multiple medical journals. Dr. Ao has made very significant contributions to the development of rehabilitation medicine, physical therapy, occupational therapy and speech and language pathology in China. Among other things she has been instrumental in starting the first degree programs in these three latter fields. Dr. Ao has a passionate commitment to the development of pediatric therapy in China, assessment of children with cerebral palsy, and methodology for treatment.

Denise Challis, MA., MB., Bchir., Msc., DCH., FRCPCH

Dr Challis has specialized in neuro-pediatrics over the past 44 years, having trained in the Universities of Cambridge and London. She consulted at The Portland Hospital, London, England, until autumn 2015. Her specialism was in the assessment and treatment of children from all over the world with neurological conditions, including autism, cerebral palsy, epilepsy, neurodegenerative diseases, and a wide range of congenital disorders. Her continued special interests include the holistic management of the care of children with complex, chronic disorders from initial assessment, particularly using the Griffiths Mental Development Scales (GMDS). She lectures regularly in the UK and abroad, particularly in China, partly to facilitate the growing use of assessment in diagnosis and provision of therapy for children with disabilities Dr. Challis is presently a Consultant Pediatrician specializing in Neurodevelopment and Neurodisability. She is the Past President of the Association for Research in Infant and Child Development. She is also a member of the Member of the British Paediatric Neurology Association and the British and European Academies of Childhood Disability.

David Cifu, MD

Dr, Cifu is Chairman and the Herman J. Flax, MD Endowed Professor (tenured) of the Department of PM&R at the Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia. He is also Chief of PM&R Services of the VCU Health System and Founding Director of the VCU-Center for Rehabilitation Sciences and Engineering (CERSE). He is the Senior Traumatic Brain Injury Specialist for the U.S. Department of Veterans Affairs. He has been funded on 39 research grants of over $130 million, including currently serving as Principal Investigator of the VA/DoD $62.2 million Chronic Effects of Neurotrauma Consortium (CENC). In his more than 25 years as an academic physiatrist, he has delivered more than 500 regional, national, and international lectures, published more than 200 scientific articles and 65 abstracts, and co-authored or edited 31 books and book chapters. He is also the Past President of the American Academy of PM&R (2007-8) and Editor-in-Chief of the 5th Edition of Braddom’s Physical Medicine and Rehabilitation textbook (2015).

Jean Deitz, PhD, OTR/L, FAOTA

Dr. Deitz was a professor in the Department of Rehabilitation Medicine, School of Medicine, University of Washington (UW) for 30 years. During her tenure at the University, she was involved in curriculum design, development, implementation, and evaluation; taught undergraduate, masters, and doctoral level courses; served as Graduate Program Coordinator for the Department; mentored graduate students in occupational therapy, physical therapy, prosthetics and orthotics, and education; chaired the committee that developed the UW interdisciplinary PhD program in Rehabilitation Science; was the principal investigator or project coordinator for numerous federally funded grants related to either program development or research; and was elected to the UW Graduate School Council.

She has published extensively with a focus on pediatrics, measurement, and assistive technology. She has 80 research publications in peer-reviewed journals and has contributed chapters to major textbooks in her field. Nationally, she served as an American Occupational Therapy Foundation (AOTF) Regional Research Consultant and chaired the AOTF Research Advisory Council;served on the National Advisory Board for Medical Rehabilitation Research (National Institutes of Health); and was on the editorial boards of peer-reviewed journals appropriate to her field.   Her primary awards include American Occupational Therapy Foundation Academy of Research; Fellow of the American Occupational Therapy Association; Lifetime Honorary Membership in the American Academy of Orthotists and Prosthetists (in recognition of her leadership in helping them move their educational programs to the master’s level); and two American Occupational Therapy Foundation Meritorious Service Awards (2003 and 2008).  The latter was for being an “effective and articulate advocate for the relationship among occupation, participation, and health”; and for sharing a “wealth of knowledge” and an “interdisciplinary perspective, as both a scholar and teacher.”

Sharon DeMuth, PT, MS, DPT

 Dr. DeMuth developed the clinical pediatric physical therapy curriculum in the Doctor of Physical Therapy program at the University of Southern California (USC) where she taught for 16 years until she retired in 2013. Her contributions to the Division of Biokinesiology and Physical Therapy were recognized with the Division Tribute Award in 2014. Dr. DeMuth especially enjoyed supervising students in providing care for children and families in Fit Families (the pro bono clinic at USC) and at volunteer sites in Mexico. She has continued volunteering as a clinician and teacher of physical therapists and orthotists caring for patients with cerebral palsy and polio internationally. Prior to teaching at USC she served as a clinician, and supervising therapist at Boston Children’s Hospital and Children’s Hospital of Los Angeles as well as acting director of physical therapy at the Children’s Hospital of Philadelphia. Dr. DeMuth directed the Los Angeles collection of normative data for the Test of Infant Motor Performance, a multi-center NIH funded research project with Suzann Campbell, PT, PhD, to develop a new test for evaluating motor performance in infants born prematurely. She was also co-lead investigator on the Pediatric Endurance and Limb Strengthening Study (PEDALS) that evaluated the effect of a stationary bicycling intervention on strength and endurance in children with the spastic diplegic form of cerebral palsy. She has served as the co-chair of the education committee and as the chair of the nominating committee of the Pediatric Section of the American Physical Therapy Association. She was recognized for her service to the Pediatric Section with the G E “Bud” DeHaven service award, one of the sections highest honors. Dr. DeMuth was an article reviewer for the journal of Pediatric Physical Therapy. She has written chapters on orthopedic pediatric physical therapy in two texts and has published abstracts and articles in peer reviewed journals on idiopathic scoliosis, cerebral palsy, orthotic practice and wound healing using electrical stimulation.

Henry L. Lew, MD, PhD

Dr. Lew is a board-certified physician in Physical Medicine and Rehabilitation (PM&R) in the USA. He completed his PM&R residency training and Traumatic Brain Injury (TBI) fellowship at the University of Washington in Seattle, Washington. Dr. Lew served as Clinical Assistant Professor of PM&R at Stanford University School of Medicine, Associate Professor at Harvard Medical School, and currently holds two Professor appointments, one at the University of Hawaii School of Medicine, and the other at Virginia Commonwealth University School of Medicine.Dr. Lew has been awarded multiple federal and state grants to study the diagnosis and rehabilitation of brain injury, with emphasis on promoting evidence-based clinical practice. He has published more than 120 scientific articles, 10 book chapters, and authored 3 textbooks (Electromyography, Polytrauma Rehabilitation, and Braddom’s Textbook of PM&R, as Associate Editor, with Dr. David Cifu as the Editor).  He has been recently appointed as Chair of the Education Committee for the International Society of Physical and Rehabilitation Medicine (ISPRM).

For inquiries about our Technical Advisory Board, please contact Dr. Jie Zhang., Director, LIH Healthcare Training Division