Thank you..

Thank you..

Friends and Colleagues …

This is embarrassing.

Embarrassing and presumptuous.

So first let me start by saying… This was not my idea.

In building a blog audience… or a following of any kind, I’ve been schooled on the art of outreach.

Be accessible.

Be visible.

Be real.

Be present.

A lot.

None of the above directives felt particularly comfortable, as social as I may appear.  In truth, when I’m working, I’m working.  I’m buried in my computer in the solitude of my office/kitchen/patio/deck, feverishly creating content.  

Or as my husband, Steve, likes to say, ‘Intellectual property.’

Launching a business, developing an evidence-based program, writing, editing and sometimes designing my own graphics is a solitary occupation.  In fact, it is a pre-occupation in that it preoccupies every waking moment of my life.

When I’m thinking about how to describe the concepts, strategies and or materials that support the Size Matters Handwriting Program, I’m not thinking about the fact that I’ve essentially been sitting alone for endless hours with uncombed hair and nary a bathroom break.  

Instead, what I’m thinking about is how to best describe this concept-driven approach in as compelling a way possible so that you want to bring it into your practice.

That said… My handlers (and that includes the mentors, managers, colleagues, employees and family members) have said that selling is as much about the person as it is about the product.  They continued that getting someone excited about the program may start with them becoming invested in you.  That people do not want to be hit over the head with product pitch after product pitch but would instead feel connected to the product if they felt a personal connection to the author.  To which my response was… Really??

So first of all… I want to acknowledge all of you.  If you have read this far, you demonstrate the curiosity and stick-to-itiveness that distinguishes our profession as relentless problem-solvers in search of the root of behavior.  

If there were any better rationalization for this undertaking… let me know.  For now, that would be it. 

We are an awesome composite of like-minded health care workers whose common theme is our value of unique needs, contributing variables, and individual journeys.

And with that justification, I’m going to share MY journey.

But on the outside chance that you think that I think I’m singularly important enough to think that you think… (was there enough thinking in this process??) … my story is unique; I must humbly disagree.  In retelling my story, (and you should know that is a much longer version of this in my memoir entitled Me.  Not Me.), I learned that everyone has a story.  And every story is interesting and special and powerful and worthy.  This just happens to be my story.

My journey

  • How did I reach this point in my career?
  • Who were the influencers who shaped my decisions?
  • What were the obstacles that challenged and redirected me?
  • Why did I develop?

Secondly…I want to applaud all of you.  You are the future.  You are doing awesome work by examining the nuances of behavior, activity, motivation, different treatments, discrete variables in treatments and more.  But on the chance that you dare to minimize the gravity of what you have just accomplished, let me give you have a little perspective…

When I started out… and this is almost 40 years ago, we weren’t doing research.  We were an INTUITIVE group and inherited an INSIGHTFUL DIRECTIVE that valued purposeful activity and success experiences as the road toward FEELING COMPETENT and ACHIEVING INDEPENDENCE.  

But aside from the collective wisdom of generations of brilliant OTs, we had not proven our assumptions as much as we had lived them.

And that was what caught my attention.  


I was always a doer 

Not only did I enjoy working with my hands, but I needed to work with my hands.  Creating… engaging,… task completion…  These all felt personally satisfying and VITAL for my self-esteem.  I had been living the OT credo well before I’d even heard it.

Like many of you, my career path wasn’t a straight one.  I actually started this journey as an art major.   In fact, from 6th through 9th grade, I took the C bus down Broad Street from Cheltenham to Center City every Saturday, passing Temple University… later to become my alma mater for both my Masters and Doctorate… to take adult classes at the Philadelphia College of Art.

By Junior High, my mother decided I couldn’t make a living in art and found Occupational Therapy.  That turned out to be a perfect marriage of my interests and my talents.  When I applied to schools, (and back then, you applied as an incoming freshman into OT programs,) I got into Sargent College within Boston University.  

This was my first time living away, and frankly, I was not very good at taking care of me.  But I was good at school.  So good, that a friend said to me, “Bev, you’re too smart to be an OT.  You should be a PT.”

Now being insecure, I panicked at the idea of going all through school just to be considered an arts and crafts teacher.  So, I switched into PT and got a PT fellowship that summer here at Temple University Hospital.

In a word… I hated it!!  I am not a PT.   Don’t get me wrong.  PT is a noble profession, but for me, it was too formulaic.  I was an arty free spirit.  I loved the inventiveness, the infinite possibilities, the science and the art… especially the art… of OT.  

Ultimately, I transferred to Penn, one of the first OT programs in the country.    The year I graduated they started phasing it out though.  When it came time for my Master’s and later my Doctorate, I chose Temple. (That’s their slogan!)

But before we jump to the present, let me take you on the journey.

Working in Pediatrics was always my goal.  But in the 70’s, unless you worked in a traditional setting like a hospital or rehab clinic, the opportunities to work with kids, let alone make a living working with them, required multiple contracts, multiple settings and lots of wear and tear on your car.  

There was one exception—the St. Edmond’s Home for Crippled Children a residential school in Rosemont.  (That’s what they called it in those days.)  There, my second year out, I became Director of the OT department.  Don’t get too excited.  It was a department of one!!  

But it was a marvelous opportunity to hone skills on organization, treatment planning, severe lifelong disabilities and public relations.  Interestingly, as a way to help me remember everyone’s treatment plans, I had a 12-foot bulletin board installed in my room onto which I color coded everyone’s goals for the week.  (Remember… this was way before HIPAA!!).  Yellow was for Gross Motor.  Red was Fine Motor.  Blue-Perceptual Cognitive.  Green- Personal-Social, including Self Care.  I even color-coded the cabinets with blue/green/yellow and red stickers on the boxes, so the volunteers knew how to pitch in. 

As it turned out, the nuns found my board to be a great teaching tool for all the visitors from whom they were hoping to get donations.  OT was a MUST SEE stop on the tour, after which, I assume, they all wrote checks!

St. Edmond’s was followed by the Crozer-Chester Medical Center, where I developed the out-patient pediatric program, worked their burn unit, did home care, bedside treatments the hand center…

Funny story.  During my physical disability’s internship at Grady Hospital in Atlanta, my supervisor wrote, “Bev will probably be a great OT one day… but not in hands!”  For all my art talents, I could not seem to align my outriggers with the correct angle of pull.  I was much more accurate with pencils and paper!!

That was followed by an assortment of contracts, sometimes as many as six at a time.  

I became the OT consultant for clients leaving Pennhurst, the state institution closed in the 1970’s for inhumane care.  The residents were moved into group homes in Philadelphia, Montgomery, Delaware and Bucks counties.  Approved for only one visit a month, I needed to leave behind a realistic program that the non-professionals would be able to implement.  Recalling my success at St. Edmond’s, I created a color-coded calendar system in which the staff would pick two activities a day among the yellow, red, blue or green options.  It was so simple and easy to track—all they had to do was write the name of the ‘game’ on the calendar.  Two years later, and a few years after I left, they were still following the program.

Other jobs included a State Hospital in Doylestown, a Habilitation Center in the Northeast, a Community Center in Berwyn, Kencrest in Southhampton, Easter Seals all over the place (I was their coordinating consultant), a sheltered Workshop Wynnewood, and home care everywhere else.

Quick aside…  I invented drinkable yogurt.  30 years ago, I discovered, that if you put a straw in vanilla, coffee or lemon, you could slurp it up on your way to the next contract.  You couldn’t use fruit ones because they would clog up the straw.  Such a missed opportunity!!


When I decided to focus on school populations, I serviced more than 15 school districts and visited more than 60 different schools, sometimes as many as 7 in a day.  Now those were the days before security.  I could park by a back door, run to the classroom, do my little magic in the hall, the closet, the stage, the cafeteria… return the student to his classroom, blow kisses to everyone… (that may have just been me).  

Eventually, the caseloads got so large that I had enough work in one school district alone.  I stayed there for 16 years until a second district made me an offer I couldn’t refuse.  But in all these years, my passion for effectiveness and efficiency, along with my art background, and the ever-pressing need to GET RESULTS found me creating materials to better serve my students.  

Included in these materials was an approach to teaching handwriting for which I was having tremendous success.  FYI… if any of you chose to go into school-based practice, you will be flooded with handwriting referrals.  OTs report that anywhere from 65 to 75% of their caseload has to do with handwriting.

Over the years, these materials and my programs became more extensive and inclusive, more colorful and measurable, reflective of the Practice Framework,… and during these years, when I’d share them with my colleagues, they’d say, “Bev, you should market this stuff.”  And I would say, “How do you do that?  I’m a therapist.”

So when Temple began its DOT program with a specialty track in Entrepreneurship, I enrolled.  I am delighted to share with each of you today that I am not only an experienced OT, but also President of this company… Real OT Solutions… which you probably figured out already if you made it this far on our website!  ROTS made its debut at AOTA in 2010, here in Philadelphia.  

At this point in time, our products, are in every state in the country and 4 continents.

A large part of that growth was a direct result of becoming comfortable with public speaking.. but that was not a straight shot either.  

Gaining some confidence after several wrap-ups presentations including my capstone during my doctoral studies, I volunteered to present 2 50-minute short courses at the Pennsylvania Occupational Therapy Association annual conference.  One was called “Want Fast, Real and Lasting Changes in Handwriting?  The other was called “Real OT Solutions to school-based practice.”  In truth, after applying I panicked and tried to withdraw.  FYI… conference organizers don’t look kindly upon these requests after their brochures are printed!!

A few months after the conference, I received a phone call from a gentleman asking if I’d like to be on the national stage.  

First thought…

As a matter of fact, I would!! 

Second thought…

Is this a scam??

It turned out that Frank Koontz… a former teacher, principal, and program developer extraordinaire… developed workshops for the Bureau of Education and Research, a seminar company with over 200 presenters and 40+ years of success… based in Seattle.  (I think they peruse state conference brochures looking for someone who has a topic compatible with their philosophy.). 

Frank gave me a theme and asked if I could develop a course around it: Practical Strategies for Increasing the Effectiveness, Efficiency and Impact of your School-based Occupational Therapy practice.  (BER loves explicit and long titles!). That first year, I travel the country teaching full day workshops on Practical Strategies to increase one’s effectiveness and efficiency, as well as how to take control of the explosion of handwriting referrals.

And after the second such effort, Frank took me out to dinner.  He’d sat through my entire presentation and took elaborate notes. “It wasn’t until the 12-minute mark that you engaged the audience, Bev. I want you to try to do that sooner. I have a suggestion. On slide 8, you could do this activity…”  And he proceeded through practically every slide on my presentation.  Engagement ideas. Polisher tricks.  Graphic enhancers.  Audience pleasers.  I took seven pages of notes.

By no small miracle, I made the grade. My course evaluation scores were high enough that I was asked to return the following year. My second outing of that year Frank was again in my audience. At dinner he reviewed my entire presentation… again. I took five pages of notes.

The next year, I had incorporated every suggestion Frank made.  I thought he would be so pleased.  Three pages of notes.

The following year… Two pages. My fifth year, I said to Frank “Do I ever actually get there? “And if that point Frank said, “Bev that was a fantastic presentation.  There is nothing else I would suggest.“

And at this point in time, I do feel that I am a skilled and confident presenter… And I totally credit Frank Koontz for showing me how.

But again…I’ve leaped ahead.   


It was one thing for me to have tremendous success with something I created

the Size Matters Handwriting Program.  And lest you think that we are not aware of the innuendo in our name… Size Matters… we do get a number of hits on our website for people looking for something entirely different!

But… it is another thing entirely for it to be proven.  

After I graduated, I remained in touch with my teachers and mentors, one of whom was Beth Pfeiffer, a brilliant educator, researcher and now tenured faculty.  And I’d say to her, “Beth, if you ever have any students looking for a study, I would so welcome it.”  While I knew that the Size Matters needed to be researched, I also knew that I couldn’t be the one to do it.  Even I would accuse me of bias!!

So a couple years after I left, Beth reported that there were two interested OT students.  We are ecstatic to report that the results from the largest study ever done on handwriting were published this past summer in the Occupational Therapy Journal of Research, and that we achieved significance at a .001 level comparing the pre and post test scores.  

That was the first.  Since then, there are a number of studies on Size Matters in various stages of IRB approval, implementation, analysis, discussion or submission.  

But it all leads me to confess… I never saw my career path reaching these heights.  It was a collision of necessity, opportunity and timing.  

My gratitude to Temple for enabling me to realize my dreams is beyond words.  

To Beth, for championing the research and publication, guiding the development of our Fidelity Manual and methodology, tireless professional and scholarly role model, my eternal thanks.  

To Roger Ideishi, friend, champion of accessibility in the performing and fine arts for all people, and now Director of the OT program at American University, my sincerest thanks for including me as a colleague and honoring me with Temple’s Distinguished Alumni award.  

To my husband, Steve Moskowitz, who wants me to be all that I can be, you are forever my prince and hero.  

And to Sam, you are my inspiration.

And to all of you… my OT family….

Know that you have chosen well.  

On multiple counts.  You will have bright, fulfilling and exciting futures.  Stay informed.  Stay connected.  Join POTA or your state organization!!!  Pay your AOTA dues, too.  I call these the costs of doing business and protecting this most awesome profession.

Contribute.  Research.  Present.  Write.  


Try on many different hats.  

This is just your beginning.  I look forward to coming back in 45+ years (as long as I’ve already been practicing!!) to hear where your journeys have taken you!!

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