Mary Lawlor ScD, OTR/L, FAOTA
Associate Chair of Research and Professor, joint appointment with the Keck School of Medicine of USC, Department of Pediatrics
Room: CHP 222C
Mary Lawlor is known for her work in the areas of pediatric occupational therapy, maternal and child health, family-centered care, interdisciplinary models of service delivery, and ethnographic research. She graduated magna cum laude from Boston University in occupational therapy and received her master’s degree in Education from Harvard University. She earned her Sc.D. in Therapeutic Studies from Boston University, and is a Fellow of the American Occupational Therapy Association. She was most recently principal investigator for an interdisciplinary longitudinal ethnographic research project funded by the NIH National Institute for Child Health and Human Development. The study involved African-American children with special health care needs, their families and the practitioners who serve them. She has also received grants from the Maternal and Child Health Bureau, the U.S. Department of Education and the American Occupational Therapy Foundation.
Dr. Lawlor’s interests are in examining the meanings of illness and disability in family life, the social nature of therapeutic experience and cultural influences on health care and developmental processes.
Doctorate of Science (ScD)
in Therapeutic Studies
1989 | Boston University
in Systems Theory, Introduction and Application
1977 | Boston University
Master of Education (EdM)
1975 | Harvard Graduate School of Education
Bachelor of Science (BS)
in Occupational Therapy
1972 | Boston University
Solomon, O., & Lawlor, M. C. (2018). Beyond V40.31: Narrative phenomenology of wandering in autism and dementia. Culture, Medicine, and Psychiatry, 42(2), 206–243. https://doi.org/10.1007/s11013-017-9562-7 Show abstract
Research on autism spectrum disorder (ASD) and on Alzheimer's Disease (AD) and other types of dementia describes a behaviour called 'wandering', a term that denotes movement through space lacking intention or exact destination, as when a person is disoriented or not self-aware. In the U.S., 'wandering' in both ASD and AD has been examined mostly from a management and prevention perspective. It prioritizes safety while primarily overlooking personal experiences of those who 'wander' and their families, thus limiting the range of potentially effective strategies to address this issue. Communicative challenges faced by many people diagnosed with ASD and AD further obscure the experiential, existential aspects of 'wandering'. This article reflects an increasing concern of social science scholars interested in whether and how the conceptual and practical strategies to address 'wandering' are informed by the situated experiences of people with cognitive and developmental disabilities and their families. We examine 'wandering' at the intersections of personal experience, family life, clinical practice, public health policy, and legislation, as a conceptually rich site where notions of personhood, subjectivity, intentionality, and quality of life powerfully and consequentially converge to impact the lives of many people with ASD and AD, and their families. We draw upon critical autism studies describing how attributions of personhood, subjectivity, intentionality, rational agency, and moral autonomy of people with ASD have been contingent upon the norms and conventions governing movement of the human body through space (Hilton, Afr Am Rev 50(2):221-235, 2017). When this movement is deemed aberrant, the person may be construed as irrational, a danger to self because of a lack of self-awareness, and a danger to others because of a lack of empathy. These attributions put the person at risk of being excluded from the considerations and, more importantly, the obligations of the 'moral community' to ensure that he or she has a 'good human life' (Barnbaum, The Ethics of Autism: Among Them but not of Them. Indiana University Press, Bloomington, 2008; Silvers and Francis, Metaphilosophy 40(3/4):475-498, 2009). Using ethnographic, narrative phenomenological (Mattingly, The Paradox of Hope: Journeys through a Clinical Borderland. Berkeley: University of California Press, 2010), and medical humanities (Charon, JAMA 286:1897-1902, 2001; Narrative Medicine: Honoring the Stories of Illness. New York: Oxford University Press, 2006) approaches, we examine multiple perspectives on 'wandering' in ASD and AD across narrative discourse genres, institutional contexts, and media of representation. We argue for an extension of the prevention and management view to focus not only on safety but also on what phenomenologist Merleau-Ponty (1962) called "having a world" (p. 146). The analysis is intended to inform clinical practice, policy and public health efforts to enhance understanding of first and second person perspectives on 'wandering' in order to improve the participation and quality of life of people with ASD and AD who 'wander', and their families.
Solomon, O., Angell, A. M., Yin, L., & Lawlor, M. C. (2015). 'You can turn off the light if you'd like': Pediatric health care visits for children with autism spectrum disorder as an interactional achievement. Medical Anthropology Quarterly, 29(4), 531-555. https://doi.org/10.1111/maq.12237 Show abstract
Substantial scholarship has been generated in medical anthropology and other social science fields on typically developing child-parent-doctor interactions during health care visits. This article contributes an ethnographic, longitudinal, discourse analytic account of a child with autism spectrum disorder (ASD)-parent-doctor interactions that occur during pediatric and neurology visits. The analysis shows that when a child with ASD walks into the doctor's office, the tacit expectations about the visit may have to be renegotiated to facilitate the child's, the parent's, and the doctor's participation in the interaction. A successful visit then becomes a hard-won achievement that requires the interactional and relational work of all three participants. We demonstrate that communicative and sensory limitations imposed by ASD present unique challenges to all the participants and consider how health care disparities may invade the pediatric encounter, making visible the structural and interactional processes that engender them.
Lawlor, M. C., & Mattingly, C. F. (2014). Family perspectives on occupation, health, and disability. In B. A. B. Schell, G. Gillen, & M. E. Scaffa (Eds.), Willard & Spackman’s occupational therapy (12th ed., pp. 150-162). Philadelphia, PA: Lippincott Williams & Wilkins. Full text
Solomon, O., & Lawlor, M. C. (2013). "And I look down and he is gone": Narrating autism, elopement and wandering in Los Angeles. Social Science & Medicine, 94, 106-114. https://doi.org/10.1016/j.socscimed.2013.06.034 Show abstract
'Wandering' and 'elopement' have been identified as common in autism, affecting half of all diagnosed children ages four to ten, yet families rarely receive advice from practitioners even after the fact. Family perspectives have been missing from the literature as well as from public health and policy debates on how and when to respond to this problem. The problem of 'wandering' and 'elopement' reveals a complex intersection of larger issues encountered by families of children with autism. To consider these issues, this article examines 'wandering' and 'elopement' from the perspectives of African American mothers of children with autism, an underrepresented group in autism research. We consider how the mothers experience these behaviors and the response to these behaviors by professionals, such as service coordinators and law enforcement personnel working within various jurisdictions that become involved with the problem. We analyze the mothers' narratives about 'wandering' and 'elopement' drawn from ethnographic interviews that were collected between October 1, 2009 and August 31, 2012. These interviews were part of a larger project on disparities in autism diagnosis and services that followed a cohort of 25 four to ten-year old children. Drawing on narrative, phenomenological and interpretive traditions, we trace the mothers' developing understandings of 'wandering' and 'elopement' over time, and show how these understandings become elaborated and transformed. This article provides a nuanced, moment-to-moment and longitudinal picture of the mothers' experiences of 'wandering' and 'elopement' that enriches the cross-sectional view of large-scale surveys about the problem and contributes unique insights at the family and community levels. Implications for professional awareness, clinical practice and service provision are also suggested.
Jacobs, L., Lawlor, M. C., & Mattingly, C. F. (2011). I/We narratives among African American families raising children with special needs. Culture, Medicine, and Psychiatry, 35(1), 3-25. https://doi.org/10.1007/s11013-010-9196-5 Show abstract
This paper examines a statistics debate among African American caregivers raising children with disabilities for insights into the work of "African American mothering." Using ethnographic, narrative and discourse analyses, we delineate the work that African American mothers do—in and beyond this conversation—to cross ideological and epistemological boundaries around race and disability. Their work entails choosing to be an "I" and, in some cases, actively resisting being seen as a "they" and/or part of a collective "we" in order to chart alternative futures for themselves and their children.
The articles in the Special Issue, "Rethinking Autism, Rethinking Anthropology," provide a ground for demonstrating substantive contributions to understandings of autism and mark the dilemmas and tensions inherent in anthropological approaches. Comments explore the ways in which authors attend to demarcation of the social world, establishment and negotiation of expertise, juxtaposition of autism as a phenomenon of interest and as an exemplar of sociality, and management of structured and improvisational approaches to the study of engagements in real life. The dilemmas and tensions that are briefly described here are only a partial list of still uncultivated spaces where autism and anthropology can–should–do meet.
Lawlor, M. C., & Mattingly, C. F. (2008). Understanding family perspectives on illness and disability experience. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard & Spackman’s occupational therapy (11th ed., pp. 33-44). Philadelphia, PA: Lippincott Williams & Wilkins.
Clark, F. A., & Lawlor, M. C. (2008). The making and mattering of occupational science. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard & Spackman’s occupational therapy (11th ed., pp. 2-14). Philadelphia, PA: Lippincott Williams & Wilkins.
Lawlor, M. C. (2003). Mothering work: Negotiating healthcare, illness and disability, and development. In S. A. Esdaile & J. A. Olson (Eds.), Mothering occupations: Challenge, agency, and participation (pp. 306-323). Philadelphia, PA: F. A. Davis.
Mattingly, C. F., & Lawlor, M. C. (2003). Disability experience from a family perspective. In E. Crepeau, E. Cohn, & B. Schell (Eds.), Willard & Spackman’s occupational therapy (10th ed., pp. 69-79). Philadelphia, PA: Lippincott Williams & Wilkins.
Neville-Jan, A. M., & Lawlor, M. C. (2003). Managing appearance: A qualitative study of adults with spina bifida. European Journal of Pediatric Surgery, 13, S1-S11.
Lawlor, M. C. (2003). The significance of being occupied: The social construction of childhood occupations. American Journal of Occupational Therapy, 57(4), 424-434. https://doi.org/10.5014/ajot.57.4.424 Show abstract
The purpose of this paper is to explore theoretical and developmental foundations for interpreting children’s engagement with activity in the typically social worlds of childhood. Drawing upon longitudinal ethnographic data, I argue for the need to reframe the study of childhood occupation to the study of “socially occupied beings” as a means of enhancing our understanding of children’s experiences. The focus is on childhood experiences that are socially constructed through adult and child co-created action sequences. The unit of analysis is constructed around a child or children, their adult partners in action, the social world of engagement, and the cultural context. The interpretive focus is on acts and actors, acting in a socially constructed world. Two microethnographic examples are provided; the first relates to an observation of a mother and her children playing in a hospital corridor and the second to an occupational therapist and child engaged in jointly constructed activity within a therapy session. These segments illustrate pragmatic and conceptual understandings of the interconnectedness of social relatedness, intersubjectivity, social action, and engagement. Further development of theoretical and research models is needed to capture the essence of children as socially occupied beings, doing something with someone else that matters.
The purpose of this paper is to analyze ways of perceiving, knowing, and being with others while engaging in qualitative and ethnographic research. As occupational therapists acquire research expertise and embark on research trajectories, they bring their clinical legacy into the research arena. The ability to conduct qualitative and ethnographic projects may require a reconfiguration of the clinical gaze of occupational therapists. This transformation is complex and also involves acquiring and adopting a stance that alters relational and interpersonal processes and results in new ways of seeing and being. I draw upon experiences in training, mentoring, and supervising therapists who embark on ethnographic research, as well as my own research practices, to illustrate points of intersection and divergence between the clinical gaze and ethnographic lens. Artistic metaphors are also used to highlight aspects of the interactional and intersubjective processes intrinsic to ethnographic practices. I argue that ethnographers are continually evaluating and negotiating their stance in the field. The clinician who becomes an ethnographer faces unique challenges to his or her stance in the midst of moment to moment encounters as well as over time in the course of prolonged engagement.
Mattingly, C., Lawlor, M., & Jacobs-Huey, L. (2002). Narrating September 11: Race, gender, and the play of cultural identities. American Anthropologist, 104(3), 743-753. https://doi.org/10.1525/aa.2002.104.3.743 Show abstract
This article considers the September 11 tragedy as an event that has created a powerful experience—an astonishing and unthinkable "breach" from the expected and routine—that has riveted the American public and provoked personal storytelling. September 11 and its aftermath have provided an occasion for rethinking and reworking cultural identity. We explore how September 11 and subsequent events have been experienced, constructed, and narrated by African American women, primarily from working-class and low-income backgrounds. These stories, and the commentaries and discussions that surround them, provide vehicles for these women to ponder what sort of social contexts they inhabit, within what sort of subject positions they are placed, and how these may be shifting in light of the attacks and America's "War on Terrorism".
This article explores a paradox—the simultaneous cultivation and suppression of "healing dramas" by pediatric rehabilitation therapists. Dramatic moments are defined as ones in which the routine exercises and treatment activities of therapeutic practice are transformed into narrative plots. These improvisational plots involve multiple characters, risks, suspense, and above all, a heightened sense that something is at stake. Experience itself becomes the focus of attention for the patient. Based upon ethnographic research in Chicago and Los Angeles, this article offers an anatomy of two such moments, investigating not only how healing dramas are constructed between patients and healers but how and why institutional discourses and practices invite their abandonment.
Lawlor, M. C., & Mattingly, C. F. (2001). Beyond the unobtrusive observer: Reflections on researcher-informant relationships in urban ethnography. American Journal of Occupational Therapy, 55(2), 147-154. https://doi.org/10.5014/ajot.55.2.147 Show abstract
Ethnographic research involves the creation and ongoing renegotiations of relationships between researchers and informants. Prolonged engagement contributes to the complexity as relationships deepen and shift over time and participants accumulate a substantial reservoir of shared experiences. Reflections about the relationships we have co-constructed with informants in several research projects have contributed to our identification of several critical aspects of building and maintaining researcher–informant relationships in cross-cultural research. Aspects of relationship work specifically related to conducting ethnography with children, within the communities in which researchers live, and within the practice of occupational therapy are discussed.
Mattingly, C., & Lawlor, M. (2000). Learning from stories: Narrative interviewing in cross-cultural research. Scandinavian Journal of Occupational Therapy, 7(1), 4-14. https://doi.org/10.1080/110381200443571 Show abstract
This paper argues for the importance of eliciting stories when trying to understand the point of view and personal experience of one's informants. It also outlines one approach to eliciting and analyzing narrative data as part of a complex and multi-faceted ethnographic study. The paper draws upon ethnographic research among African-American families who have children with serious illnesses or disabilities. However, it is not a report of research findings per se. Rather, it is primarily a conceptual paper that addresses narrative as a research method. Features that distinguish a story from other sorts of discourse are sketched and current discussions in the occupational therapy and social science literature concerning the importance of narrative are examined. The heart of the paper focuses on a single narrative interview and examines what we learn about the client and family caregiver perspective through stories.
Mattingly, C. F., & Lawlor, M. C. (1998). Illness experience from a family perspective. In M. E. Neistadt & E. B. Crepeau (Eds.), Willard & Spackman’s occupational therapy (9th ed., pp. 43-53). Philadelphia, PA: Lippincott.
Lawlor, M. C., & Mattingly, C. F. (1998). The complexities embedded in family-centered care. American Journal of Occupational Therapy, 52(4), 259-267. https://doi.org/10.5014/ajot.52.4.259 Show abstract
The recent movement toward family-centered care, which has been propelled by the implementation of the Education for All Handicapped Children Amendments of 1986, poses considerable challenges to professionals trained in client-centered models of service delivery. These challenges are compounded by the fact that our understanding of family-centered care lags considerably behind our attempts to implement responsive and efficacious services. When practitioners include family members more integrally as collaborators in pediatric treatment, their perceptions about families and the nature of the therapeutic experience is affected. In this article, we present a number of critical dilemmas that are based on data drawn from ethnographic research, descriptive studies, and training seminars we conducted with pediatric practitioners and parents of children with special heath care needs. These dilemmas highlight the complexities involved in building effective partnerships among all the key players, the influence of multiple cultural worlds on everyday practices, and the need to provide supports to practitioners for the emotional and social dimensions of practice. Implications for practice and future research are presented.
Lawlor, M. C. (1994). Development of a standardized telephone interview instrument. OTJR: Occupation, Participation and Health, 13(4), 1-13. Full text
Lawlor, M. C., & Guynes, D. (1994). Related settings: Design — improving the quality of physical rehabilitation. Journal of Healthcare Design, 6, 103-112. Full text
Lawlor, M. C., & Cada, E. A. (1994). The UIC Therapeutic Partnership Project. Final report. Washington, D.C.: Early Education Program for Children with Disabilities, US Department of Education. Full text Show abstract
This interdisciplinary inservice training project at the University of Illinois at Chicago was designed to improve early childhood occupational and physical therapy services by developing, implementing, evaluating, and disseminating a comprehensive training model. The competency-based program was designed to address the developmental needs of practitioners, from foundational skills to advanced practice competencies. The program allowed therapists who were working to remain in the provider pool while enhancing their skills. Participants collaborated with project faculty and clinical supervisors in developing individualized learning contracts. Foundational Level therapists enrolled in a lecture series and completed an extensive supervised practicum. Training at the Enrichment Level included completion of a continuing education program involving didactic sessions and videotape case analyses. Advanced Level training addressed highly specialized competencies that required practicum experiences supervised by qualified practitioners. Follow-up activities for participating therapists included seminar meetings emphasizing faculty and peer review. Appendices contain competency statements; a parent advisory committee report; the Individual Learning Plan; various evaluation forms; a reprint of an article by Mary C. Lawlor and Elizabeth A. Cada titled "Partnerships between Therapists, Parents, and Children"; and results of a survey of 276 occupational and physical therapists in Illinois. A participant's guide titled "Forming Partnerships with Families" is also provided. It includes information and exercises for a self-paced, video-based course dealing with the family, interpersonal relationships, the multidiscilinary conference meeting, and development of the Individualized Family Service Plan. The participant's guide is accompanied by three videotape recordings.
Munoz, J., Lawlor, M. C., & Kielhofner, G. (1993). Use of the Model of Human Occupation: A survey of therapists in psychiatric practice. OTJR: Occupation, Participation and Health, 13(2), 117-139. Full text
Lawlor, M. C., & Cada, E. A. (1993). Evaluation of an innovative product: Easy Street Environments, Inc. OT Practice, 4(3), 1-18. Full text
Lawlor, M. C., & Cada, E. A. (1993). Partnerships between therapists, parents, and children. OSERS News in Print, 5(4), 27-30.
Lawlor, M. C. (1991). Quality assurance in pediatrics. In B. Joe (Ed.), Quality assurance in occupational therapy (pp. 18-23). Rockville, MD: American Occupational Therapy Association.
Lawlor, M. C. (1991). Historical and societal influences on school system practice. In A. Bundy (Ed.), Making a difference: OTs and PTs in public schools (pp. 1-15). Chicago, IL: The University of Illinois at Chicago.
Lawlor, M. C. (1991). A conceptual framework for quality assurance. In B. Joe (Ed.), Quality assurance in occupational therapy (pp. 7-17). Rockville, MD: American Occupational Therapy Association.
Niehues, A., Bundy, A., Mattingly, C. F., & Lawlor, M. C. (1991). Making a difference: Occupational therapy in public schools. OTJR: Occupation, Participation and Health, 11(4), 195-212. Full text
Lawlor, M. C. (1991). Evaluating the impact of technology and innovative products within the clinical setting. OT Practice, 2(2), 74-86. Full text
Lawlor, M. C., & Henderson, A. (1989). A descriptive study of the clinical practice patterns of occupational therapists working with infants and young children. American Journal of Occupational Therapy, 43(11), 755-768. https://doi.org/10.5014/ajot.43.11.755 Show abstract
This investigation was designed to gather descriptive data on the clinical practice patterns of occupational therapists working with infants and young children. One hundred nineteen therapists entered the study, and 118 completed the interview, yielding a response rate of 99.4%. The therapists were highly experienced, with a mean of 9.47 years working in pediatrics. The school setting was the most common type of facility in which therapists served infants and young children and accounted for 37.3% of the sample. The majority of the respondents (67.8%) were members of formally identified teams. Although 80.5% ofthe therapists served very young children (aged birth to 12 months), no therapists served this population exclusively. Considerable variability in models ofservice provision, team structures, and assessment and treatment practices were found. Additionally, there was a lack of consensus on the unique contributions of occupational therapy and diverse opinions regarding the importance of selected frames of reference. Implications of the findings on professional initiatives to enhance practice are discussed.
Lawlor, M. C. (1989). [Human development for occupational and physical therapists]. Physical and Occupational Therapy in Pediatrics, 9(2), 141-142. https://doi.org/10.1080/J006v09n02_10
Ostrow, P. C., Lawlor, M. C., Joe, B. E., & Johnson, M. (1988). Efficacy data brief: Intensive multidisciplinary rehabilitation of stroke patients increases independence, decreases living costs, study shows [Review of Stroke: Does rehabilitation affect outcome?] (3).
Ostrow, P. C., Lawlor, M. C., Joe, B. E., & Johnson, M. (1988). Efficacy data brief: Outpatient stroke therapy improves functional ability, reduces deterioration, investigation suggests. [Review of remedial therapy after stroke: A randomized controlled trial] (3). American Occupational Therapy Association.
Ostrow, P. C., Lawlor, M. C., & Joe, B. E. (1988). Efficacy data brief: Research supports efficacy of sensory integration procedures. [Review of sensory integration theory: Affect or effect] (3). American Occupational Therapy Association.
Ostrow, P. C., Lawlor, M. C., Joe, B. E., & Johnson, M. (1988). Efficacy data brief: Use of splints and pressure garments in related to decrease incidence of contracture and surgery in burn patients. [Review of ten years of experience in managing patients with burn contractures of axilla, elbow, wrist, and knee joints] (3). American Occupational Therapy Association.
Lawlor, M. C. (1987). Improving occupational therapy services through quality assurance: A study of patient referrals. In J. Bair (Ed.), Occupational therapy in acute care settings: A manual (pp. 9-17, 9-28). Rockville, MD: American Occupational Therapy Association.
Henderson, A., Lawlor, M. C., & Pekoski, C. (1986). Pediatric occupational therapy: Challenges for the future. Boston, MA: Boston University.
Lawlor, M. C. (1984). Occupational therapy services through quality assurance: A study of patient referrals. Rockville, MD: American Occupational Therapy Program.
Lawlor, M. C., & Zielinski, A. (1983). Occupational therapy. In G. Thompson, I. Rubin, & R. Bileaker (Eds.), Comprehensive management of cerebral palsy (pp. 181-191). New York, NY: Grune & Stratton.