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Overcoming Barriers by Doing Things Differently.

A barrier is often described as a circumstance or obstacle that prevents access or progress. Participation occurs through involvement in a meaningful occupation. For an individual with a physical disability, barriers to participation often stem from the physical environment or from problems that exist in body structures and functions. In the field of occupational therapy, intervention aims to create, or facilitate, opportunities to participate in meaningful occupations. Common treatment approaches used to enable participation include remediation of skills, compensatory strategies, and adapting or modifying the task or environment. The specific approach that is employed will differ depending on the unique needs and preferences of the individual. Although individual outcomes may differ, the best possible approach often requires learning how to do things differently. "Notwithstanding, a man without hands--or who cannot use them--is still a man. He not only is able to fabricate and use his own tools, but he can also enjoy and create artistic objects, aesthetically speaking" (de Oliveira, 2016, p. 285).

Tom Yendell, an artist based in the United Kingdom, provided the cover art for the Summer 2018 issue of The Open Journal of Occupational Therapy (OJOT) (see Figure 1). "Silk Flowers" is a mouth painting made from acrylic on silk. Tom was born a bilateral congenital amputee at the shoulder level due to exposure to the drug Thalidomide. Originally developed in 1954, Thalidomide was promoted as a "wonder drug" and prescribed for a variety of conditions including headache, insomnia, and morning sickness. Ultimately, Thalidomide would be linked to a wide spectrum of impairments in newborn babies, including bilateral limb deficiencies. The devastating effects of Thalidomide on the developing fetus were not revealed by pharmaceutical companies until 1961. By this time, approximately 12,000 children had been born with impairments caused by exposure to the drug. Of the approximately 2,000 births linked to Thalidomide that occurred in the United Kingdom, Tom was one of only 466 babies who survived (Triggle, 2010).

Born in 1962 in Hampshire, England, Tom was the youngest of five children. Immediately after his birth, a nurse swiftly removed Tom from the delivery room. Tom's parents, Jack and Margaret Yendell, were given no explanation. Ultimately, they had to wait 6 weeks to see their newborn son. Tom remained at the hospital until his first birthday to allow doctors to study the effects of Thalidomide. Tom's nurses described him as a wonderful and happy baby (Alexander, 2012). Once discharged from the hospital, Tom fit right in with his four siblings who were all very eager to meet him.

Jack and Margaret wanted Tom to learn how to do things for himself, so they treated him no differently from their other children. Tom's siblings were instructed not to do everything for him. "They did not go easy on me," said Tom. Although he did things differently, Tom developed skill using his toes just as his siblings used their hands. Tom followed the typical developmental milestones of early childhood. As an infant, he used his feet to play with his toys and to hold a baby bottle for self-feeding. At 12-months of age, he could sit on the floor and push to standing using only his legs. Shortly thereafter, Tom took his first steps. By the age of 4, Tom learned to ride a tricycle by controlling the steering with his knees. By the age of 5, he also demonstrated proficiency in self-care out of necessity. "My parents were busy raising five kids and running a bakery," said Tom. "I did not want to wait for help, so I learned how to get dressed on my own. I wanted to get on with things." He had little trouble keeping up with his siblings. Tom grew up believing he could do anything.

In the 1960's, the increase in congenital amputations caused by Thalidomide sparked research and the development of powered limb prostheses in the United Kingdom (Childress, 1985). Following the advice of doctors, Tom was fitted with his first pair of prosthetic arms at the age of 4. The arms presented with a hook on one end and an artificial hand with posable fingers on the other. A small cylinder filled with carbon dioxide gas was attached to a shoulder harness at the center. Three times a year, Margaret took Tom to a specialist for instruction on how to control the arms. Tom found wearing the arms was more of a hindrance than a help, as he still relied on his feet to complete everyday tasks.

"It encumbers you more to do things this way," he said. Eventually, Tom's gas-powered arms were replaced with realistic looking cosmetic arms. Outside of a few practical jokes, Tom had little use for his new arms. He knew he could do things better with his feet. "The arms are not functional. They are for society," he said. At age 14, Tom gave the arms up for good. "Until they make an artificial arm that works as good as yours, I don't want it," he said.

When Tom entered primary school, he was the only child who had a disability. "The teachers did not know how to treat me," he said. "I was happy to sit in the back of the classroom and do as little work as possible." When Jack and Margaret learned about Tom's lack of progress, they enrolled him at a local boarding preparatory school. Tom admits he was never really interested in academics. One of his favorite features at the school was an outdoor swimming pool. When Tom was first learning how to swim, he wore a special pair of polystyrene water wings that were attached with Velcro straps. On one occasion, Tom's older brother took him to the pool to swim. "He didn't want to bother putting the wings on me, so he pushed me in," said Tom. "I learned to swim without a device very quickly!"

When Tom was 11 years old, Jack and Margaret enrolled him at Lord Mayor Treloar School, a specialist school for children with disabilities. The curriculum would provide Tom with a sound education while enabling him to become as independent as possible. Treloar's also provided several specialty services, including physiotherapy, occupational therapy, and speech-language pathology. Administrators tailored the class schedules based on the strengths of each individual student. "It's one of the greatest schools in the world," said Tom. "There is nothing that compares to it." Unlike his previous school settings, Treloar's knew how to challenge Tom. "It was one of the best things that ever happened to me," he said.

Tom demonstrated an interest in drawing and painting at a very young age. Enrollment at Treloar's also proved to be very influential for Tom's future career as an artist. Tom's art teacher, Mr. Alan Wilde, quickly became a mentor for Tom. "He was the most laid-back teacher that you would ever want," said Tom. "He was very unorganized, unprepared, and a fantastic artist." When Tom entered Treloar's, he was too big to sit on the table. His teachers required him to sit at a desk to write and draw like the rest of his classmates. To adapt, Tom learned to write and paint with his mouth. Mr. Wilde quickly recognized Tom's artistic talent and worked to develop his abilities. "He encouraged us to try everything from ceramics to painting landscapes."

When Tom graduated from Treloar's in 1980, Mr. Wilde's support was influential in his decision to further his education. Tom completed a foundation year at Hastings College of Art before transferring to Brighton Polytechnic to pursue a degree in expressive art. At Brighton, Tom immersed himself in drawing, painting, art history, drama, and photography (Alexander, 2012). Tom enjoyed his studies at Brighton; however, by the end of the year, he yearned for greater independence. As a Thalidomide beneficiary, Tom was able to purchase a car that could be adapted with foot controls. With greater mobility, Tom was free to explore the larger community and all it had to offer. He decided to join a Physically Handicapped and Able-Bodied (PHAB) youth club. Through the provision of fully accessible activities, PHAB creates opportunities for people with and without disabilities to enjoy life together. Tom greatly enjoyed his experiences with PHAB and decided to get involved.

With a new-found affinity for volunteer and charity work, Tom took a sabbatical year from Brighton. He became a youth club leader for PHAB, and he volunteered to organize a fundraiser for a local charity called Creative Young People Together (CRYPT). During this same year, Tom received some unfortunate news. His mentor, Mr. Alan Wilde, had passed away unexpectedly. When Treloar's asked Tom to take over Mr. Wilde's art classes until the end of the school year, he was glad to help. After some self-reflection, Tom decided he needed to prove to himself that he could live on his own. He purchased a small house and learned how to complete the cooking and household tasks independently. Tom's determination and desire for independence empowered him to forge ahead during a difficult year. Helping others in the community provided motivation.

When Tom returned to Brighton, he focused his energy on photography. He was able to operate the camera controls with his feet; however, finding the best angle proved difficult. When a tripod mount led to similar disappointing results, the technical staff at Brighton came up with an innovative solution.

They built Tom a light weight shoulder harness with an adjustable camera mount that enabled him to access the viewfinder and peer through the lens. With the camera mounted close to his face, Tom could use his chin to control the exposure, timing, and shutter button. Tom produced enough quality work over the semester to build a professional portfolio. His collection of work would soon prove beneficial. After graduating from Brighton with a degree in expressive arts, Tom gained employment as a full-time photographer for Business in the Community, a nonprofit business incubator based in London. His assignments consisted of taking pictures of entrepreneurs who recently started their own businesses. As Tom learned the personal stories of his clients, he became intrigued with the idea of becoming his own boss someday.

During his tenure at Brighton, Tom continued his volunteer work with PHAB. While attending a social event one evening, Tom met Lucy, a fellow art student. The pair felt an immediate bond and their relationship blossomed quickly. As a youth leader, homeowner, and traveling photographer, Tom maintained a very busy schedule that left him little free time. Although life was hectic, he always made time for Lucy. During one special visit, Tom proposed to Lucy during a trip to the local market. After the engagement, the couple began making plans for their future. Tom set out to find a larger house with space for a family and a proper art studio. He found a house with the qualities he was looking for; however, it left much to be desired. The house was old and in desperate need of renovation. "Even so, I thought it was beautiful," said Tom.

Tom realized that to become a self-employed artist, he would need to find more time to paint. Home renovations needed to take place before Tom could access his art studio, so he decided to leave his job as a photographer. Tom and Lucy wanted to renovate the home themselves; however, Lucy's academic schedule limited her availability. True to form, Tom completed much of the work on his own by doing things differently. He wore a pair of wooden clogs that were easy to remove should he need to work with his toes. Tom attached various tools to his clogs including a blow torch, scraper, wire brush, and a paintbrush (Alexander, 2012). While Lucy was away, Tom balanced a schedule filled with home renovations, painting, and charitable works. With more time and a dedicated space, Tom continued to improve his skill as an artist.

While most mouth and foot painting artists use one method or the other, Tom is unique in his ability to paint with both his mouth and feet. As a child, Tom began painting with his feet but transitioned to mouth painting when he enrolled at Treloar's because it gave him more control. Tom's preferred medium for mouth painting is acrylic on silk. His technique was derived from the Batik style of painting often used in India and Asia. Tom begins by drawing a sketch on paper and then placing it underneath a piece of silk. Next, he traces an outline of the image on the silk with gutta, a rubber-like substance made from latex. Creating a boundary is necessary to keep the paint contained in a designated area. After the gutta has dried, the silk is stretched over a wooden frame and placed on an easel. Using his feet, Tom unscrews the caps from several paint bottles before moving them to a table top one by one. Holding a paintbrush between his teeth, Tom fills the boundaries with color to bring the picture to life. Tom has also explored painting with other mediums. "The Car Dump" (see Figure 2) is a mouth painting made from pen and watercolor. Most of Tom's paintings come from his imagination. "Very rarely do I start painting and know what I am going to do," he said. "A blank canvas inspires me."

When foot painting, Tom works from a seated position with the canvas on the floor in front of him. First, he creates a basic sketch directly on the canvas to use a guide. With his feet, Tom removes the caps from several tubes of acrylic, then squeezes several dollops of paint onto a palette. Holding a credit card between his toes, Tom mixes the perfect shade. He paints along the edges of the frame first with a traditional long handled brush. Using the credit card once again, Tom adds color and texture to the surface of the canvas with sweeping strokes of his foot. While remaining fixed in his chair, Tom spins the canvas 180 degrees with his feet. It does not seem to matter if the canvas lands right-side up, upside-down, or sideways, Tom will continue to paint from any angle. "Floral Explosion" (see Figure 3) is a 3 x 3 ft painting made from acrylic on canvas. Regardless of the method or medium, Tom's appreciation for color and shape is evident. "I am not a fine artist. More of a graphic designer really," he said. Over time, Tom's determination and hard work began to pay off. As Tom's body of work grew, so did his confidence in his ability to gain membership in the Mouth and Foot Painting Artists (MFPA).

Founded in 1957, the MFPA is an international self-help organization of nearly 800 artists who paint without the use of their hands ( Anyone who has lost the use of their hands and can paint with their mouth or feet is eligible to join. One of the primary objectives of the organization is to help artists earn a regular income. Members sell their original works through a publishing house that creates tangible products, such as greeting cards, calendars, and wrapping paper. The MFPA has historically maintained high standards for membership that require a certain level of expertise. Therefore, most members enter the organization at the student level. Scholarships are available to help students advance their level of skill. This is necessary to become an associate or full member of the organization.

In 1986, Tom submitted samples of his work for evaluation by the MFPA. He was thrilled when he learned he had been accepted as a member of the organization. "This was one of the best moments of my life," said Tom. Membership would come with many benefits and opportunities, including continuing education, a regular income, and recognition as a professional artist. To show his appreciation, Tom looked for ways to give back to the MFPA. He had an idea to establish a permanent gallery that could be used to display paintings, hold art exhibitions, and sell products. With support from the MFPA, Tom found the perfect location, an old antique shop near Treloar College. In 1992, the Selborne Gallery became a reality. Outside of serving as curator and resident artist at the gallery, Tom continued to give back to the MFPA as an unofficial mentor to potential students considering new membership. He became known as someone who could answer questions and give advice. Tom also gave talks on the MFPA complete with demonstration of his own techniques (see Figure 4). Tom organized art exhibitions and artist workshops around the world. In 2002, he designed a mobile exhibition trailer to serve as a traveling gallery at county shows and civic events. Over time, Tom's creative energy and organizational skill greatly benefitted the MFPA. In 2013, Tom was recognized with a promotion to the MFPA Board of Artists. As a world-renowned mouth and foot painter, Tom is a living example of how barriers can be overcome by doing things differently.

Tom's credo in life is "try everything." He leads by example through his world travels and participation in activities, such as scuba diving, cycling, horseback riding, and snow skiing. "I don't let anything stop me," he said. Today, Tom continues to use his artistic abilities and charitable works to inspire others. His latest project aims to empower people with disabilities to travel the world. The project, titled Flat Spaces, offers a totally accessible holiday home that sleeps up to six people and has ample space for three to four wheelchairs at one time. The home is equipped with an emergency call system, adjustable height worktops, and a ceiling hoist for transporting guests from one room to another. During the planning stages, Tom employed specialists from Treloar's and the MFPA artists as consultants. "I'd like to build them all over the world," he said.

In the field of occupational therapy, the specific treatment approach employed will differ depending on the unique needs and preferences of the individual. Tom Yendell advocates for allowing people with disabilities to do things their own way. As a young child, Tom learned to use his toes the same ways others used their hands. With practice, he gained proficiency to participate in meaningful activities, including writing and drawing. "We give too much when it comes to providing aids and adaptations," said Tom. "You adjust" The few aids and adaptations Tom uses in his daily life include a camera stand, foot steering controls to drive his car, and a dressing stick. "I still use one every day to pull my trousers up," he said. Tom believes learning to do things differently is the best way to empower people with disabilities. Through his art and charitable works, Tom applies his creative energy, organizational skill, and determination to inspire others to live life to the fullest.

DOI: 10.15453/2168-6408.1552

Related Links:

* Visit the OJOT Gallery for more of Tom's work: occupationandartist/

* Tom Yendell's Website:

* Flat Spaces:

* Mouth and Foot Painting Artists (MFPA):



* Physically Handicapped and Able Bodied (PHAB) Clubs:

* Tom Yendell Art on Facebook:


Alexander, M. (2012). Here for a purpose. The inspiring story of the artist Tom Yendell. United Kingdom: Mouth and Foot Painting Artists.

Childress, D. S. (1985). Historical aspects of powered limb prostheses. Clinical Prosthetics & Orthotics, 9(1), 2-13. Retrieved from

de Oliveira, J. V. G. (2016). Art and disability or disabled artists are victorious in at least two senses. International Journal of Innovation and Research in Educational Sciences, 3(5), 283-287.

Triggle, N. (January, 2010). "Apology to thalidomide survivors". BBC News. Retrieved from

Jennifer Fortuna

Western Michigan University,

Caption: Tom Yendell

Photo courtesy of Ray Massey

Caption: Figure 1. Summer 2018 Cover of OJOT.

Caption: Figure 2. "The Car Dump" by Tom Yendell.

Caption: Figure 3. "Floral Explosion" by Tom Yendell.

Caption: Figure 4. Tom Yendell mouth painting.
COPYRIGHT 2018 Western Michigan University, Department of Occupational Therapy
No portion of this article can be reproduced without the express written permission from the copyright holder.
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Author:Fortuna, Jennifer
Publication:Open Journal of Occupational Therapy
Date:Jun 22, 2018
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