OTS 122: YOUR QUESTIONS, JAYSON'S ANSWERS
- Jayson Davies M.A. OTR/L
- Apr 16, 2023
- 37 min read
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Welcome to the show notes for Episode 122 of the OT Schoolhouse Podcast.
Welcome to a special episode of the OT Schoolhouse Podcast, where we celebrate OT Month and the anniversary of the OT Schoolhouse Podcast!
We're excited to bring you an episode packed with valuable insights as Jayson answers questions submitted by our listeners.
Tune in as we cover various topics related to OT, such as creative contests for school-aged students, strategies to help parents prepare for changes in their child's OT services, sensory checklists, and tips for becoming a more confident OT practitioner.
We'd like to extend a big thank you to all those who submitted their questions and helped make this episode possible. So sit back, relax, and let's dive in!
Listen now to learn the following objectives:
Learners will identify how to help build confidence as a new practitioner
Learners will identify strategies to help parents prepare for dismissal from OT services
Learners will identify how to utilize The Sensational Brain Sensory Checklist with a general Ed classroom
Guest Bio
In 2017, Jayson founded the OT Schoolhouse website and now supports school-based OT practitioners via courses, conferences, and the OTS Collaborative community.
With experience as both a contracted therapist and an "in-house" employee for two distinctly different districts, Jayson has had the opportunity to appreciate the differences between both small-rural and large-suburban districts.
Recently, Jayson has put forth his efforts toward supporting therapists interested in tiered intervention, collaborative programming, and managing their workloads.
Quotes
“Start with one student and one teacher and build from there - find a student who is mastering skills in the OT room but needs to generalize” - Jayson Davies, M.A. OTR/L
“Don't fake it till you make it. Instead, believe it till you achieve it” -Jayson Davies, M.A. OTR/L
“If you have a student focusing on handwriting, try to find a way to incorporate daily support…even a 5 minutes check-in could have better outcomes” -Jayson Davies, M.A. OTR/L
Resources
Episode Transcript
Expand to view the full episode transcript.
Amazing Narrator
Hello and welcome to the otschoolhouse com podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host. Jayson Davies class is officially in session.
Jayson Davies
Hello, fellow occupational therapy practitioner, welcome to episode 122 of the otschoolhouse com podcast. So happy to have you here. I'm your host and fellow school based OTP Jayson Davies, and today you are tuning into a special ot month edition of the otschoolhouse com podcast. Ot month and the anniversary of the otschoolhouse podcast occur right around the same time each year. So to celebrate, I like to host a special Q and A session where I answer some questions directly from you, the listener. So this episode is that special episode. Today, we have about 10 listener submitted questions that I'm going to do my best to answer, and we have questions from Meredith, from Ruth, Amy and more. We also have a special audio question about sensory screenings and checklists that I'm going to play for you from Lori and give my best answer for that one. Just one more thing before I dive into the questions. You may hear me mention the otschoolhouse com collaborative today, or OTS collab, for short. So I just wanted to let you know what that is. In case you haven't heard of it yet, the otschoolhouse com collaborative is our brand new community for school based ot practitioners. Here at the OT school house, inside the collaborative, we host live aota approved professional development courses. We collaborate with one another during team meetings, and we host a research and resource library directly in the community specific to school based OT. If that sounds like something you could benefit from in your career, be sure to check out the community at otschoolhouse com slash collab with that said, let's go ahead and dive into our first question of the day. This one comes from Meredith and is a great first question for ot month. Meredith wants to know if I have any fun contest for school age students during ot month. Apparently, she was thinking of maybe a shoe tying game or something like that, but she just wanted to get my ideas on the matter. So first of all, Meredith, I'm sorry this episode's coming out a little bit later in OT month, but maybe you still have time to fit it in, or maybe save it for next year. So first off, I love this idea. I love this question, and to be brutally honest, I had never thought about doing something like this before, but I really love the idea. And you know, you could do this just for the classes that you frequent most, or you could take your own time, if you have any, of course, and go out during lunch or go out during recess and host a little competition out during that time. I'm thinking something along the lines of Minute to Win It. You know, whether it's like little short one minute games that several people can play at a single time. For example, I remember at, I believe it was an OT of California Association event that we played Minute to Win It, and we had people that had, like, tissue boxes that were strapped around their their waist with a rope or whatever, with a bunch of ping pong balls in the tissue box, and they had to, you know, shake and groove and to try and get the ping pong balls out of their their tissue box, another little minute to win it game. And again, each of these games is just a one minute long, or typically one minute long game, though, so they're very short. You know, you don't have to have a lot of attention to do them. Another one was basically who could wrap up their partner in TP the fastest and so these don't have to be very, you know, super structured games per se. Now, before you go ahead and pick out a game, what I might do is actually reach out to your teachers, reach out to your administrators, and maybe bounce some ideas off of them, because they might give you some things that their students are struggling with that they would like you to incorporate. You know. They might say, Yeah, you know, shoe tines kind of tricky for some of our kids. It'd be great if we gamified it and made it fun for them. Or they might say, you know, we have a bunch of kids that are struggling with opening a milk box, and you could somehow work that into it or something. So, so, yeah, you know, talk to the teachers, you may find that mental health concerns or social skills are some of the concerns, and maybe you can work some of that in there as well. But I think it would be great to kind of collaborate with the administrators with the teachers on this because it is also kind of opening up yourself to that team and letting them know that you want to support them as much as you want to support the kids in what you're doing for this little ot month Shindig. So again. Meredith, fun question. Thank you so much for submitting that and yeah. Keep on going for question number two, Ruth has a question about changing services for a student. More specifically, she wants to know what are some steps to take or strategies to use to help a parent prepare for changes in their child's ot services. Specifically, she wants to know more information about dismissing a student from ot services. Now this is always a I was going to use the word tricky, but I think the right word is actually more it's a sensitive time, and we have to be mindful of not only what we are thinking in the moment at this IEP or before the IEP and after the IEP, but also what the other people on that IEP team are thinking or have beliefs about during that time. When we're trying to dismiss the student, we need to think about the teacher's feelings and thoughts toward the student, the administrator's feelings and thoughts the district as a whole. But also the parents, right? This parent has a huge emotional attachment to the student, and everything, everything that surrounds that student, and that includes the IEP, the services within IEP, the goals within the IEP, everything that makes up an IEP. So when it comes to time to change services, to redo, services to terminate, dismiss, whatever you want to use, but to remove those services from a student's IEP, we need to be sensitive to all of that, and I'd like to say that that process starts way before the IEP is even coming up where you want to dismiss students. In fact, I will often tell people. In fact, I tell people this in my A to Z school based ot course, that dismissal of a student should actually start on day one, when you are reporting your evaluation results for the very first time for that student. So at their initial onset of occupational therapy, you should already be talking about dismissal. Be talking about how we are hoping to be able to dismiss the student from ot services after maybe one, two or three years, and talking about the purpose of OT to support education, and that at some point that student's education will no longer need OTS to support that education. So dismissing shouldn't just be something that sprung up on a on a parent in the IEP meeting when they're expecting. You know, for things just to continue on the status quo, we need to almost eliminate that status quo, like staying on ot services. Maybe that shouldn't be the status quo, and how can you go about changing that? Well, one I just mentioned right starting dismissal, way back when you first even onboard a student to occupational therapy services, but then at all the other IEPs between those two, the onboarding and the dismissal IEP so every year you're kind of bringing that back up. And you can even kind of phrase it like, Hey, Mrs. Smith, you know, whenever I do an evaluation or at all these annual meetings, I always have to weigh, you know, where the student is and should they be dismissed? Should they continue on? Should we change things up a little bit? And this is what I ultimately came across. That way, every time that they're meeting with you, they see that you are actively considering all the different options and that you're not just going with All right, time to continue, time to continue, or just when that meeting comes up for dismissal, all of a sudden, it's time for dismissal, right? So we want to, we want to leave option on the table. I guess you could call it now, of course, maybe you haven't been doing that, maybe you haven't been talking about dismissal from the onset of services. So what can you do from from now on? I would say, start slowly. When it comes to these IEP meetings, it is not usual that you decide the day of the day before, maybe not even the week before that, you're thinking about dismissing a student from ot services. So as soon as you start to think, hey, this student might be ready for dismissal from OT, I would communicate that with the team, both the parent as well as other team members, like the teacher, the administrator and whoever else, maybe even the speech pathologist that communication could be in the form of a phone call, which it probably should be. But you can also use other opportunities to to share this information. In fact, one opportunity that you have about every three or four months is the progress on goals. Now, if you're doing progress on goals which you should be, and you're taking data which you should be, then you can use those progress on goals to actually show the parent. Hey, this is the data that I'm seeing in OT we are making progress to goals two, three and five, or whatever it might be. Here's the data. Data. And you know what Johnny's doing? Great if he continues at this rate, we may be discussing dismissal from ot services at the upcoming IEP. Now I get it. Some people are going to say, Wait, Jayson, you want me to actually, like, give them the heads up so they can go get a lawyer and advocate to come to the meeting to fight me on this. I mean, if you want to take it that way, sure, but I take it as the way as you are kind of leading them, you're scaffolding the parent up to understanding that their parent or that their child no longer will need ot services, and that that is a good thing, not a bad thing. Now, what you will need to make sure of as you lead up to the IEP is that you fully understand all the concerns from all parties on the IEP team, so you can make sure that they have been fully addressed. Then you also want to make sure that any accommodations that are on the IEP or that need to be on the IEP are ready to go, and that the teacher and any other support staff can implement those accommodations without you needing to be there. That way, when you walk away, when you are dismissing yourself from that student's IEP, everything is in place for the student. And I think the last thing that I will add to this topic is that remind the parent that ot can always be added back onto an IEP, if need be, be straight with them. Let them know that it will likely need to be an evaluation to add the student back on. Right? You just don't add services back on. But let them know you know the IEP is a living document, and that at any moment, a teacher, a parent, anyone can make a referral for an OT evaluation. Hopefully, if you do all of those, or at least some of those, it should lessen the quote, unquote blow for the parent and make life a little bit easier for everyone you, the student, the parent, the entire IEP team. So Ruth, thank you for the question. I really hope that helps you, as well as everyone else that is listening today to this special ot month edition of the OTS podcast. All right, next up, we are diving into the topic of sensory we had several sensory questions, so we're going to kind of go through this. We have questions about a sensory checklist, about sensory fidgets, about just general sensory and so we're going to dive through these. There's three or four of them, but we're going to start with an audio question. Laurie was so kind to leave me an audio question, so I'm going to play that for you right now and come back and answer it in just a moment. So have a listen.
Lori Flynn
Hey, I've been, I'm an OT in the schools as well, and I've been, recently been asked, actually, more and more, I'm being asked to look at kids with sensory concerns in the gen ed classroom. And I started using the sensational brain sensory checklist, which makes it really easy to see if this is an over responder, an under responder, sensory seeker. And I wondered if that is sufficient. And your thoughts on that.
Jayson Davies
Lori, thank you so much for your question. Thank you for leaving us a voicemail so we could play it here on the podcast. And also, thank you for kicking off. What is going to be the sensory section of this podcast episode? We have three, I think, questions about sensory and we're going to start by talking about this sensory checklist and my thoughts on that. So let's dive into it. When I first heard your voicemail about a sensory checklist, it reminded me of a conversation that myself, Leanne and a few others in the otschoolhouse com collaborative have been having about the sensory profile, the SPM and all the different sensory checklists and standardized assessment tools that we commonly use as school based OTS. And this conversation actually revolved around the psychologist using a sensory profile before the occupational therapist even comes on board. And so when I heard you asking about this sensory checklist and using it kind of as a screening tool, it kind of clicked with me a little bit, and I wanted to share kind of our conversation that we were having there, and what I might do here. Now I'm going to talk first about that other conversation inside our collaborative and that is that the psychologist is actually using the SPM to gather some data to determine if the OT needs to be more involved. Now if that's going to happen, the psychologist should definitely be more trained in understanding the SPM and how to actually grade it, and what those outcomes of the SPM actually mean, so they can pass it off to the OT, or choose not to pass it off to the OT. Now in this case, where you're talking about using the sensational brain sensory checklist, which we'll link to in the in the comments or in the show notes, so that you. And I'll find that here, but using that kind of as a screening tool, per se, before a student even has an IEP, or at least has ot on on the IEP, if they already have an IEP. Now, if that's the case, this is the way I would go about it. I would actually provide that questionnaire to the teacher, and I would say, Hey, Mrs. Jones, can you please fill this questionnaire out in relationship to the student you have in mind? I don't need to know the student's name. I don't need to know all the different concerns. I just want you to kind of fill this out in relationship to the teacher so I can provide you some general guidelines. All right, that's how you can get potentially around this without having to do a full evaluation. This is, in a way, tier three RTI. You're getting some specific information about a child, but it's not leading to the point where you necessarily need to do a full evaluation. So after the teacher completes that form for you and they give that back to you, you can kind of look at it right. This sensory checklist isn't standardized. It's simply designed to provide you with information or behaviors that the teacher is seeing the student exhibit. Now, based upon the sensory checklist, you can provide the teacher with some general strategies, and when you provide those general strategies, you should also provide some sort of data sheet that the teacher can use to track if those those strategies, those sensory strategies, behavioral strategies, whatever strategies that you are asking the teacher to implement if they work now, if they work within, you know, the next full or six, eight weeks, then there is no Need to move forward with an evaluation. However, if they don't work, then you may need to do a evaluation to really identify what areas of sensory processing skills are impacting those behaviors, or whatever type of sensory behaviors we are seeing. Okay, so again, I would identify this as a tier three strategy. You don't necessarily need to know who the student is. You are simply providing general strategies based upon the checklist form the teacher has filled out. Now if it doesn't work, then you would go beyond that to do a more comprehensive evaluation so you can actually identify what areas within sensory is impacting that student's behavior and functional skills, but with this checklist, you're not going to be able to really get that. You need more standardized assessment tools, more observations, more pulling the student out and working with them one to one to really understand the sensory processing skills or the deficits that the student needs specific, targeted intervention with to actually implement that type of occupational therapy beyond what we can do with this skills checklist. All right. Cool. Now that brings us to Amy's questions. So you got three in there, three in one here, most of them, or two of them pertain to sensory at least that's the way that I'm I'm taking it, and I'll explain in just a moment. And the other is about push in versus pull out. So let's start with the two sensory questions, and then we'll go into the push in model versus pull out model. Her first question is, how do we prevent us from becoming the quote, unquote stuff people? And I'm taking this as we provide a lot of sensory stuff to the teachers, or at least, I think that is where Amy's going with this question. Now the straightforward, blunt part of my brain is just saying, Well, don't give the teachers stuff then, right? But obviously it's not that simple. What I mean is, don't make it as easy. When teachers come to you asking for something, for example, they may come ask you for a weighted vest or a yoga ball that a student can sit on, or a sensory fidget item, right? They may come with all different types of things, and typically, they're coming to you because this is a hot topic. Of course, sensory is a hot topic. It continues to be a hot topic, but just because it is a hot topic doesn't necessarily mean that the teacher understands the research behind it and the strategies behind how it is supposed to work, or what limitations it might have, or how not to use it, because it could potentially harm the student in the future. Now, Amy's second half, or, I guess, second third of her question is, what's the real T on the use of weighted vests for sensory issues? And that's important here. There is research that goes both ways on weighted vests. There's research that is being put out by OTS per se that kind of shows either no significant improvement with the use of weighted vest for sleep and attention. And then there's others that are saying, yes, there is some benefit to using a weighted vest for sleep and attention. Then there's other research put out by, you know, psychologists, ABA, therapists, that are saying, No, you know what? Some. Sensory vest, there's no change in behavior, and some of them have even linked a negative change in behavior with the use of sensory vest. So unfortunately, I can't give you just like a straightforward answer yes sensory vest or no sensory vest. What I can do is point you in the direction of the aota choosing wisely campaign, where they do actually state this, and I really do appreciate that they did this. They have a statement that says, don't provide sensory based interventions to individual children or youth without documented assessment results of difficulties processing or integrating sensory information. So what does that mean? When we break that apart, it means that we shouldn't actually be providing sensory strategies, whether it be sensory integration treatment or a weighted vest or yoga ball or anything kind of simplistic like that, the stuff, right, without doing any valuation. So that's how we can get away from just giving teachers stuff, sensory stuff, right? We say, okay, Mrs. Jones, or Mr. Jones comes to us and says, Hey, I need a sensory vest for Jason. You seen him in the classroom? You know, he needs a sensory vest, a weighted vest, whatever it might be. And your response can then be, okay, okay, Mr. Jones, I hear you. I understand what you're saying. Unfortunately, you know, the governing body of occupational therapy says, I need to do an evaluation before I can provide this sensory based intervention for that student. Now, yes, you are giving yourself more work. You have to do an evaluation, but to be honest, that's a good thing. We need to stop trying to eliminate work by doing interventions without any evaluation. Instead, we need to advocate for ourselves to have more time to do those evaluations and treatment, to make sure that we're implementing good evaluations and treatment. So the next time that a teacher comes to you and just says, Hey, I need sensory stuff. Say, hold on. You know what? It's one thing if you want to provide your student with something, and you can call it a toy, you can call it a fidget, you can call it whatever you want to call it. That's okay, but it's not going to come from me until I do an evaluation to actually determine if the student is going to need this. Is this the most appropriate sensory item to work for your student? Yeah, I'm taking a long pause there, because we should really think hard about that. We shouldn't just be handing out stuff. We need to be doing an evaluation, especially when it pertains to a single student. Now, again, we can kind of potentially say, Okay, some of these things might work with some of your students. Here are a few things, you know, just kind of try and see what works as a general strategy. But when we're talking about one particular student, we need to do that evaluation. And that now brings me to the final question that Amy had, and that was how we can start to move from a pull out model to a push in model. And I'm gonna give you the same tips that I give all the school based ot practitioners that take my A to Z school based ot course. And that is to start small, find one student that is currently on a pull out model service that you know is doing pretty well. They're meeting their goals in that pull out model environment, and now talk to the teacher and say, hey, you know what Johnny's doing so well with improving his executive functioning skills, for taking notes, for handwriting, whatever the goal is. You know, Johnny's doing super well with that in the pullout model. But I'm hearing from you that we're not quite getting that into the classroom yet, and that right there is your opportunity to say, All right, we're going to move Johnny from a pull out model to a push in model, and just do it with one kid, just Johnny. Don't Don't worry about Sarah, don't worry about Elise, don't worry about Brian, just worry about Johnny first. And getting into the classroom with Johnny, that's going to be your opportunity to learn a little bit what it feels like, the planning that it might take to do that push in. And it's also going to give the teacher an opportunity to see what you can do, what progress you make with the child, being in the classroom, being in their academic setting with the student and the teacher. From there, you might be surprised, because if the teacher sees you doing great work in the classroom, you're gonna have other teachers starting to come to you and asking you if you can go into the classroom with Brian, with Sarah, with Elise, because they're gonna see that progress that you make. The other thing that I would also potentially recommend is that, if you have the time and the opportunity to do it, is to do an in service, do an in service for maybe grades K through two, the teachers on their professional development day, and share with them what a push in model might look like, and how you know during a push in model. So it might not just be beneficial for the student that you're there to see, but maybe all the other students that the teacher has some concerns about, and how you can provide co teaching with the teacher to maybe implement some handwriting instruction, or how you can come into the classroom and provide some generalized sensory strategies and introduce them to go noodle or some other type of video that they can use in the classroom to promote sensory regulation or even mental well being. All right, so start small. Start with one student and one teacher, and then grow from there. Don't try and just say, You know what, I'm going to move my entire caseload to push in. That is an easy way to fail. Don't do that unless you're really confident. Yeah, I recommend starting small and growing from there. So Amy, thank you for your trio of questions. I hope I was able to weave those all in together for you, and I hope that makes sense, if not, you know, reach out to me. I'd love to help you out some more. All right, so this next question comes from Tiffany. And Tiffany, thank you for your question. I'm going to synthesize it a little bit. It is a little on the long side, but I got the general feel, and I'm going to share that, and then we'll dive into an answer. So Tiffany shares that she is a relatively new occupational therapy practitioner. She's got about one year of experience as a school based OT. And you know she has some days where she's feeling great and others days where she's just not feeling so confident. A lot of us have those days. You have those days beyond your first year. It does happen. Don't worry about it. Like I'll get more into that in a moment, but just know that everyone has those days going a little bit further, Tiffany shares that sensory seems to be that area that most gets her feeling less confident, right? Maybe imposter syndrome creeps up on her when there's a student that needs some sensory intervention or some sensory supports, and that's kind of what her question revolves around. Hence why it's kind of in our sensory segment of this podcast. She really loves working in the schools. She loves working with the teachers, the parents. She loves the otschoolhouse podcast. Thanks for sharing that, Tiffany. But she needs some support within sensory so that she can feel more confident in her role. So the first thing that I want to say is, don't use the saying, fake it until you make it. Instead, use the saying, believe it until you achieve it, because you do have a lot of great skills. Maybe you're not feeling so great in the area of sensory, but you understand sensory a little bit. If you don't fully understand it, there's places to get more training in that. And eventually you will get to a point where you do feel like you pretty much understand sensory now, as soon as you start to understand sensory, things will change, and you'll have to get more education. You know, that's why we have to get 12 hours or so of professional development every year. But don't beat yourself up, you know, 10 years in, and sometimes I still feel like, wait a second, this just changed. You know, like, what was common practice 10 years ago is not common practice anymore because there has been new research, new growth. So I would definitely recommend that you look out for either a mentor in your district that understands sensory that you look into other forms of education, like at the otschoolhouse com collaborative, where we have professional development every month, and in fact, just, you know, shameless pitch here in May, we're having a course from Kelly altright all about sensory perception in the schools and how sensory reactivity and sensory perception impacts school participation. So something like that might be a great idea. I would also recommend that you find a course, if not the one I just mentioned, a course that revolves around school based practice, because you can go and take a long certification program like the class C or the full STAR program, and yeah, you'll get a lot of information, but maybe only 25% of it will be super relevant to what you're doing in the schools. Or you can go and take one piece of their course, one piece that is specifically relevant to school based OT and that's where I would start. I know the star Institute in Colorado has actually one particular sensory course geared towards school based OTPs that might be worth looking into. One type of course that I would actually avoid is any course that pits sensory versus behavior. I would avoid that like the plague, unless within the description it clearly says, haha, sensory versus behavior. That's a joke. Of course, sensory and behavior go together. Because, you know, you can't weed out sensory and behavior fully. They, of course, interact and they impact one another. So anyone who tells you that you can completely weed out sensory versus behavior, just I recommend, don't believe in them. So yeah, definitely find a course that addresses sensory. It relates to school based OT, you know, the last 10 minutes of this podcast have probably helped you already tremendously, and the next question is probably going to help you as well, but find something that's a little bit more structured. Again, we have a course coming up in May, all about sensory in the schools, and there are other courses available to you. And then again, just believe it, until you achieve it, you have so much education. One year into your profession, you are not supposed to know everything. That's why we have professional development and continuing education. You will continue to learn, and you will continue to feel like you don't know everything, because things change, and then you will learn some more. So just be confident you're doing great, and yeah, we'll continue to support you here on the otschoolhouse com podcast. All right, this final sensory question comes from an anonymous certified occupational therapy assistant, and she wants to know how she can support her OTRS to address sensory and self regulation. In addition, she asked for any guidance and Data Research published information stating that a child needs to be able to self regulate before being able to learn and decrease behavior. So I actually had to kind of dive into this a little bit. I wasn't too familiar with any particular research that you know, kind of blatantly said, Yes, you need to be able to regulate before you can learn and behavior. Now, I think the OT side of us, you know, kind of understands, right. We're trying to find that optimal arousal level, as we often call it, for a student to learn, right? If their engine is running too high, or if their engine's running too low, then it's not a great place to learn. So I did a little bit of research into it, and as I say, engine high, engine low. We did an episode a few weeks ago with one of the creators of the Alert program, and they keyed into a lot of research. So you might want to go back and listen to that episode and view the show notes, because they shared a lot of a lot of research related to self regulation. Now, I did do my own little homework into this, and I did find an article in the Open Journal of Occupational Therapy from Rhonda Lynn Whitney, and it's titled, self regulation as a key factor in protection against the harmful effects of adverse childhood experiences, critical role for ot effects of adverse child experiences. Anyways. So it's looking at the adverse experiences of aces, or the adverse effects of aces, and we often include that one of the adverse effects of aces, often is behavior and self regulation and the ability to learn, and if we're using self regulation or CO regulation to offset those adverse effects of adverse childhood experiences, then that is kind of in a way, saying, Yeah, we do need to address the self regulation in order to Address behavior and and learning itself. So I would definitely check out that article. I will post a link to that as well as all the other research that I mentioned so far in the show notes. But I would, you know, download that, keep it in your file, keep it available, so that way you can have it when you need to explain something to your OTR. You know, I would also show or share with your OTRS, what other ot practitioners are doing. Share with them different school based OTs, whether it be on Instagram or research articles or the otschoolhouse com podcast or other places where sensory is a key feature within the school based occupational therapy realm. Now, I know there is a lot of kickback. When you bring up the word sensory integration, people like to claim one of two things. They either say a there's no research behind it, which is complete nonsense, because there's probably more research into sensory integration, whether it's good or bad, there's more research into sensory integration in the field of OT than most other areas within OT. You know, that used to be a case for concern back in the 90s, but there has been so much research since gene airs all the way up to, you know, this year. So there is research related to sensory integration and sensory practices in general that you can find. The other concern that's often brought up is that, okay, there's research, but it doesn't pertain to school based OT, and that one's hard to argue with a little bit, because most of the research that is done is so much more than one time a week for 30 minutes like the protocol that they use is more than likely three to five days a week for one hour sessions, and we can't match that in school based OT. So that is often a hard part to combat when people use that argument because they're kind of correct and. Sensory integration hasn't really been studied in a school based setting. There have been some research, you know, like we talked about weighted vest earlier, as to whether or not weighted vest work within a school setting. But there hasn't really been a lot related to sensory integration, and actually using more that clinic style model with swings and whatnot in the schools, and there we go. There's another situation that people often bring up is we don't have swings, we don't have bolsters, we don't have all the stuff that you often see in a clinic in a school based setting. And to be fair, you know you can't expect every single school to have a sensory integration clinic. I have seen school districts where sometimes they will actually bus a student from one campus to another campus after school for a sensory integration style treatment that they have a lab kind of at that school site. But we can't even expect that like that's really a lot, especially for smaller districts, districts where schools are spread out by, you know, 20 plus miles and stuff like that. So it's hard to, you know, get some people to come around, but I would continue to talk about it, make sure that you're noting it within your notes when you do sensory interventions, and how you are seeing that your sensory intervention interventions are impacting the students. And, you know, sometimes sensory can be like a four letter word to some people, and it's often because the research that has developed, it's developed slowly. It hasn't always been consistent. The protocols haven't been administered consistent. And I know the people that are within Si, you know that has been a pain in their side for years, and so much so that they now have a fidelity measure to say whether or not you are actually implementing sensory integration or not. And so now the research that's coming out now follows that fidelity measure. So the research is getting better. So keep, keep you know, finding that research, sharing that research, and then implementing what you know to be best practices within sensory and documenting that for your OTRS. One other resource that may be helpful for you is actually episode 26 of the otschoolhouse com podcast, if you haven't listened to it already, and that is with Olivia Martinez Hauge, and we talked about the polyvagal theory and how sensory and behavior are just really linked together. So I would definitely check that one out as well. Now we have a question from Joan, and Joan has a question about handwriting, so we're kind of moving away from the sensory part of this episode, and moving toward the handwriting part, of course, there had to be a handwriting section, and she's asking about handwriting strategies for students within third grade or above, you know, those outside, I guess, of that typical K through two handwriting kind of focus group. And she wants to know, you know, once you get to third grade, can you still work on handwriting? And you know, if a student is still showing mixtures of uppercase and lowercase letters, should we continue to work on it or not? So here's my simple answer to that, no. There's no research that says a student cannot make progress on handwriting after the third grade, or after the second grade, after the fifth grade, whatever it may be. And I've had a lot of handwriting specialists on the otschoolhouse com, like Dr Beverly Moskowitz and Cheryl Bragman. And you know, these people have handwriting programs, and they all tell me the same thing, that, yes, a student who is older can still learn to improve their handwriting skills. And I truly believe this, mostly because I believe in the growth mindset. I never believe that we can stop learning something, even if a student has a disability. I believe that they have the ability to continue to learn something, it might take longer. They might need to do it in a different way, to learn it in a different way. But yes, they can learn it, and that is what the specialists that I've talked to are telling me. And if we are going to work on handwriting, we might need to reframe our thoughts about it, because, again, the research, just like the sensory research when it comes to handwriting, the research isn't usually a handwriting program once a week for 30 minutes. It's usually a handwriting program four times a week for 1520, minutes. And unfortunately, we often default to one time a week for 30 minutes for OT and then we say it doesn't work. Well, maybe, instead of saying it's not working, maybe we need to say it's not working because I'm only seeing the student one time a week for 30 minutes, or it's not working because the student's only practicing handwriting one time a week for 30 minutes. And when you reframe it that way, whether it be in an IEP or to a teacher to a parent, then you can start to. Think about, okay, well, what if we change what our handwriting instruction looks like, and that's where you get to be creative. That's where you get to say, You know what? Instead of me pulling out this student for 30 minutes one time a week, what if instead I meet with the teacher 15 minutes a week to provide the teacher with some strategies that they can do all week long with the student for handwriting, or what if I work with the student five minutes in the morning, three days a week? Now I know that's like chaotic, right? You may not even be at a school three days a week, I get that, but I'm just saying this is where we need to be creative a little bit. If you're in an IEP, you might have parents that are open to working on handwriting at home, and so you're more like a teacher giving homework out to a parent, and that is okay, too, as long as the IEP team agrees on it, you can give out a home program now, getting the parent to actually make sure that they follow through with it, that's a Different story, but you can try it. You know, it may work better than one time a week for 30 minutes, even if they're only doing it a few times a week. And that is kind of the point here. You got to get creative about how we are implementing programs when it's not working one time a week for 30 minutes. All right? So, yes, I definitely think that students can improve upon their handwriting at later ages. I think we just need to get creative in the way that we are implementing said programs. And now for question number eight, I believe we are on from Laura. And Laura wants to know, can a diagnosis of dysgraphia only be given by a OTR in the school special education team, or outside ot clinician, or who is the one that is giving a dysgraphia diagnosis? To answer this question, I'm actually going to tease an upcoming episode that I had with Penny stack. Penny is actually the founder of dyslexia RX, not dysgraphia, but dyslexia RX, and she made a good point during that episode. And like dyslexia, dysgraphia is a specific learning disability, and that's where it actually falls within the DSM. And so as you know, specific learning disability is a qualifying criteria within special education that said special education, whether it be an OT, an educational psychologist, the speech therapist, we are not making diagnoses. Neither is any ot outside of a school based realm. We might make a treating diagnosis, you know, kind of a theory that we have that we want to work with, but technically, it would be someone like a neurologist, who would make that diagnosis of a specific learning disability, and they might tag onto that an area of dysgraphia within specific learning disability or dyslexia under a specific learning disability. So no, OTs are not making diagnoses. Neither is anyone on the special education team that would be coming from a medical doctor. We are making kind of a treatment diagnosis or a treatment theory, and we're working with that, but we're not making the actual diagnosis. Okay, we are now down to our final three questions for today's special episode, and this one comes all the way from India, from B santoshini, and she has a question about, if an autistic child receives early intervention or special education services, is it possible for them to be involved in normal school for their higher studies, and the answer is just 100% true. Now not every student will get to that point, but it is absolutely possible for a student to receive special education services early on in the career, or even later on in their educational career in high school, and then go on to college and be successful in college. Or, you know, they could even have special education from grades one through three, then exit from special education for grades four, five and six, and then they're back on special education for the rest of their, you know, educational career that is totally possible. Everything on an IEP is up for changing, and even then, an IEP only goes up until a student either graduates or exits out of the educational system at age 22 so at that point they would no longer have an IEP. They could potentially still have a 504 because five oh fours are not tied directly to public education. They're tied to any program that receives federal funding, which often includes colleges. So a college could put a 504 plan in place for a student. That's not out of the realm. So yeah, to answer your question in the most simple terms, yes, it is possible for a autistic student. To receive early intervention, special education services, and then go on to participate in regular education for the rest of their educational career and beyond, all right? And that brings up Gina's question. Gina, thank you for submitting a question. Gina asks, Can you please go over RTI ideas now? RTI, if you know me, is one of my favorite things within education, because it allows us to be more proactive, as opposed to reactionary when it comes to supporting students. And it's so important to me that I dedicated an entire episode to RTI and occupational therapy that is back in episode 42 of the otschoolhouse com podcast. So I definitely recommend checking that out. Now RTI, sometimes people will refer to RTI as MTSS, they are slightly different, but they're both tiered intervention models, and they have three different tiers, tier one, tier two and tier three. Tier one is often referred to as whole district or whole school or even whole grade level support training, providing teachers with the first best instruction. So tier one examples could be providing an in service for an entire school on proper body mechanics, for sitting in a chair while doing work. That could be something that is supporting teachers so that they can support all of their students. Or it could be something about handwriting. It could be something about self regulation, and how you can, you can get students moving to improve their self regulation and improve their ability to work on schoolwork like that. Could be an in service and a tier one intervention. When you get to tier two, I like to say that tier two is about supporting individual classrooms. So even though you just did an in service about how all the teachers need to make sure that their students have, you know, good posture in the classroom, well, maybe one teacher is still having difficulty with that. So they might come to you and say, Hey, I know you just did this in service, but I'm still having some difficulties with, you know, a handful of my students sitting in their chairs. Can you just come take a look? And then you go, you take a look, and then you provide strategies, not to the individual students, but to the teacher then to implement. So maybe you tell the teacher, well, hey, you have some kids who their chairs too big. I recommend reaching out to the custodian to find some smaller chairs. Or you have some students that are rocking back and forth in their chair, you can even provide them with a idea for a rocker chair. And you and the teacher together can propose to the principal, hey, can we get some rocker chairs? It will benefit some of our students without necessarily needing an evaluation, and it would be then up for the teachers to ultimately decide who gets that rocker chair, not you. Once you go beyond that, you go to tier three, which is often supporting either a small group of students identified by the teacher or possibly an individual student through what is commonly referred to in Southern California as an SST, a student study team. It might be called something else in your area. It's almost like an informal IEP, and the team being the teacher and maybe the parent and maybe the administrator might just be those three people come together to discuss ideas and how they're going to take data to see if the student's improving within educational standards and what to do if the student doesn't actually make improvements. So as far as the OT, you could potentially sit on that team meeting as a consultant. So you're not evaluating the student, but you're listening in to say, You know what? Here's some general strategies that you could try and then, kind of like what we referred to earlier in this episode, if the student doesn't make improvements with those general strategies, then maybe you need to do something more specific, and that's where an evaluation might come into play. So yeah, that's RTI at tier one in services, and you can do an in service on just about anything. I would definitely talk to your teachers and ask them what they need help with, and then create an in service about that. At tier two, you're going to listen to one, maybe two specific teachers and ask them or listen for how they need additional support. And you're going to support them by providing them with strategies, or maybe even co teaching something like a handwriting lesson or a self regulation lesson per se. So that would be tier two, and tier three gets more specific, individualized and or with a small group. So you could kind of do a center in a kindergarten classroom where all the kids rotate through your center to work on fine motor skills or whatever it is that they need support with, thanks again, Gina for the question, and best of luck with RTI. And that brings us to our final question in this special ot month Q and A edition of the OTS podcast. And this question comes from Natalie. Natalie actually wants to ask. If I can do a full podcast on something, but I'll see what I can do here. She wants to know if I can do a podcast on how to work in stressful classroom environments, particularly with teachers that aren't collaborative or open to learning. Could you discuss behavioral management in classrooms and schools and the OT role? Now, I think we've already kind of hit this a little harder earlier in this podcast episode, but a few other things that I want to add is that teachers don't just want to be told what to do. They want to be shown what to do. And this has actually been shown in research. I think I even did an episode on this a few months ago, but it was all about modeling and how teachers actually want to see you model what you are recommending that they do in the classroom. So getting into the classroom actually modeling, showing them the strategies that might work, as opposed to just telling them that can help with getting into the classroom and supporting the students in there in a collaborative way, in services I just mentioned those that's a good way to kind of building rapport with the teachers, so that they might be more interested in having you come into the classroom within the otschoolhouse com collaborative, we actually just had a wonderful course from the occupational therapy practitioners behind mindfulness in motion, and they talked about helping the staff to better understand their own sensory preferences and triggers, and that way they can self identify when something is triggering them in the classroom, and so that they may not overreact when something is going on within the class, right? The last thing we need is a student triggering an adult, and in response, that adult triggering the student, and it just goes back and forth, back and forth, so the better the adults understand their triggers, the better that they can respond and calm down and use those co regulation type of strategies within that presentation, from mindfulness in motion, Danielle and me also explained the Four main functions of behavior, being sensory escape avoidance, attention and access. And I think that is something that you know, ABA therapists understand. OTs, I think are starting to better understand it, but teachers may not fully understand that yet, and so helping them to understand the sensory escape, attention and access type of causes for behavior. Again, you're going to further build your rapport with that teacher. You're giving them education that will support them and they might see how beneficial you are to their program and become more open to learning and collaborating with you. So to wrap that up, I would definitely recommend the course that we have within ot school house collaborative. You can access that if you become a member today, or anytime it is a replay within the OT school house collaborative, and we'd be happy to have you there. And yeah, you can, you can learn from there today with the registration in the OT school house collaborative. All right, well, that is going to wrap up this very special ot month edition of the otschoolhouse com podcast. Thank you so much for listening. I really appreciate every single person who, well, not only you know, submitted a question, but all of you for listening today. You know, we get 1000s of OT practitioners that listen to the otschoolhouse com podcast every single week, every month, and it just blows my mind that you want to be a better ot practitioner, that you want to better serve the students that you work with. And I just, you know, applaud you. I appreciate you for doing everything you can to support the students and the teachers that you serve. So thank you so much for being here. Thank you so much for listening to this. You know, 5455 minute long podcast on your commute while you're at the gym, whatever it is, I appreciate you. You know, I just love that we get to come together every other week to learn together. So I appreciate you. I love you. Have a great rest of your ot month. Celebrate advocate and yeah, just enjoy your month. I will see you next time on Episode 123 of the otschoolhouse podcast, take care. Bye.
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