OT in Native American Communities

In late September I had the opportunity to attend the opening of the Smithsonian National Museum of the American Indian in Washington DC. This was a very special event with Indian people from the northern parts of Canada to the tip of South America sharing their traditions, life experiences and arts. The mall was full of Indian music, dance, story telling and art. If you get to Washington, DC, in the near future, make sure you visit this beautiful living-history museum.

I am fortunate to live in a state with great cultural diversity. Fifty-five percent of our second-year students represent minority cultures. Currently we have six Native American students enrolled in our program. Almost 9 percent of the population in New Mexico is Native American (2000 Census). This percentage is second only to Alaska, with 15.6 percent of the residents being American Indian or Alaskan Natives.

Besides the Navajo Nation, which covers parts of four states (New Mexico, Colorado, Utah and Arizona), there are two Apache tribes and 19 pueblos that are mainly located along the Rio Grande.

Having Indian students in our program has enriched the learning experience for everyone. For the past few years I have taken classes to Jemez Pueblo, located in a beautiful Red Rock Valley. Marie Shije, a soon-to-be graduate, has invited each class to her grandmother's house to participate in the village Feast Day in November.

After watching impressive dancing by the two different clan groups, we go to Marie's grandmother's home to feast on a meal of multiple delicious traditional dishes. It is an honor to be able to both observe this special community event plus enjoy the warmth of Marie's family. Most of the pueblos are open to having outsiders visit their communities during the Feast Days. They are events you will not forget!

Because many Indian people live in rural areas and are widely dispersed, services for people with disabilities can be challenging. I have worked for 10 years in a program called Indian Children's Program (ICP). This is a community-based program that provides services to Native American children who have developmental disabilities. I work with families in their own communities, and this often involves evaluating a child and locating needed services.

We also provide technical assistance and training for providers working in programs like Head Start, BIA and other schools, and early intervention. This tri-state (New Mexico, Utah and Arizona) program is funded by the U.S. Department of Health and Human Services through Utah State University.

The Navajo Nation covers 27,000 square miles, with about 130 clans. According to the 2000 U.S. Census, 298,197 individuals claimed Navajo ethnicity. Of the 180,000 residents residing on tribal land, 168,000 are Navajo enrolled members, with the remaining being non-members who reside and work within the Navajo Nation.

The median age of the Navajo population is 22.5 years (2000 Census). Services for children with disabilities are provided by the Indian Health Service, Division of Developmental Disabilities, and school districts.

There are currently eight occupational therapists practicing within the Navajo Nation. One of my early mentors, Dr. Noelani Hong, is working in Window Rock, the capital of the Navajo Nation, for her second year. She moved from the lush beauty of Hawaii to the desert beauty of Arizona. She is employed by the Navajo County Special Services Consortium (NCSSC) and has been assigned to cover all six schools in the Window Rock Unified School District.

Noe's role and responsibilities as an OT include evaluation, screening, serving on IEP teams, consultation and direct service to students with special needs. Noe states, "I have grown very fond of the Navajo people. They are industrious, reflective, respectful and resilient. They have a strong sense of identity and harmony with the universe. It is an honor and a privilege to be immersed in the daily occupations of the Navajo people.

"Their lives weave a rich tapestry of spirituality, ceremony, family and community. Creative challenges serve to sharpen any OT's clinical reasoning when working here.

"There are opportunities for embracing diverse ways of viewing the meaning of occupation."

You may contact Noelani at Inquiries regarding employment in Navajo or Apache County school districts for OTs, PTs and SLPs, may be directed to NCSSC at

It is a pleasure to live and work in New Mexico, the Land of Enchantment. The rich cultural diversity enriches our lives. If you have not had a chance to visit our beautiful state, make sure you put New Mexico on your travel list!

Terry K. Crowe PhD, OTR/L, FAOTA, is the founding director of the occupational therapy program at the University of New Mexico (UNM) and a professor in the department of orthopedics in the UNM School of Medicine. She has worked in Bangladesh and Mexico and traveled in 38 countries around the world. She can be reached at

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