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Welcome to the show notes for Episode 138 of the OT Schoolhouse Podcast.
As a school-based Practitioner, have you ever thought about exploring alternatives to traditional pull-out sessions?
If you're looking to expand your scope of practice, increase work efficiency, and provide more individualized services in the least restrictive environment, tune into this episode.
Jayson dives into the benefits of working with students in their natural context, the different service models available, and how to implement them effectively. He discusses many areas from individual and group sessions, to collaboration and consultation with teachers and aides. Listen to learn more!
Listen now to learn the following objectives:
Learners will identify ways to support students in the general education and least restrictive environment
Learners will identify ways to build rapport with teachers
Learners will understand the importance of natural context
Learners will understand how to transition to different service models
Host 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
"Although it's difficult to collaborate, it makes it even more difficult to collaborate when we are constantly using pull out services."
— Jayson Davies, MA, OTR/L
“Teachers appreciated, when occupational therapy practitioners modeled sensory and behavioral support strategies for the teachers and aides."
— Jayson Davies, MA, OTR/L
“It gives you some flexibility, to work on those skills, that you may need to do in a group or a pull out setting and then it gives you the other two sessions to generalize them into the classroom.”
— Jayson Davies, MA, OTR/L
“If we are sharing our knowledge with a student, and the teacher and or the aide, then they can work together when we are not in the room, and that is what leads to consistency.”
— Jayson Davies, MA, OTR/L
Resources
Sisti, Mary K. MA and Robledo, Jodi A. Ph.D. (2021) "Interdisciplinary Collaboration Practices between Education Specialists and Related Service Providers," The Journal of Special Education Apprenticeship: Vol. 10: No. 1, Article 5. Available at: https://scholarworks.lib.csusb.edu/josea/vol10/iss1/5
Episode Transcript
Expand to view the full episode transcript.
Jayson Davies
Hey there, school based OT practitioners what is happening and thank you so much for being here today. Whether this is your first episode, your 138 episode, or anywhere in between there thank you so much for tuning in today to better yourself as a school based occupational therapy practitioner. My name is Jayson Davies and I'm a school based OTs down in the Southern California area. And I'm just so happy to be here with you today. This episode is actually coming as a result of a recent presentation that I gave to a SELPA down here in Southern California. Shout out to Antelope Valley and Santa Clarita SELPA. Down in the Los Angeles area. I just presented this like two days ago. And I thought to myself, You know what I needed to actually record a podcast episode about this very topic. And what this topic is about today, as you probably saw in the title is moving away from defaulting to one time a week, 30 minute pull out sessions. And the reason for that is because that is basically the most restrictive environment that we can provide a service in other than a student being in a residential placement or away from they're away from their home school or even outside of their district potentially. So I wanted to talk about this because well, a Ida says that we need to support students in the general education and least restrictive environment as much as possible. And also because we are in a very unique position as school based occupational therapy practitioners, in the sense that we are one of the few occupational therapy providers, not just school based OT providers, but all OT providers that have the ability to actually work with our clients in their natural context. And I don't think we take advantage of that nearly as much as we should. So today, my goal for this episode is to kind of help you see other ideas out there, besides just that pull out individual session, to give you some different types of models that you can use to support your students so that we can start seeing them in the least restrictive environment. Now, I want to, you know, kind of pre load this, if you want to call it with the idea that I don't believe that every student needs to be seen in the classroom, I believe that there are many circumstances where the pullout environment is the best case to see a student. However, I don't think that we should default to that, I think we should almost flip it around and default to consoles and move away from consoles as necessary, moving to a more restrictive environment, eventually getting to again, that pullout environment. So let's go ahead and dive in. We're going to start with what a pullout model is the pros and cons of it. And then we'll start moving to a less restrictive environment, and talk about how we can provide more services in that less restrictive environment. All right, stay tuned.
Amazing Narrator
Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies, class is officially in session.
Jayson Davies
All right, let's discuss those individual pullout services that may or may not make up a bulk of your caseload. For a long time, they absolutely did make up a bulk of my caseload. And this isn't like a new concept. This is something that has been going on for a long time. And partially that is because occupational therapy is relatively new to special education or education as a whole. Yes, it's been over 50 years now. We're right around 50 years if I can do my math, right, but we're still relatively new. And when occupational therapy first started getting into the schools back when EHA was first introduced in 1975, through 77, the medical model of occupational therapy went to school. Occupational therapists and occupational therapy assistants were used to that one to one model seen a student directly in a arena where they could control it and when they are when we I should say as occupational therapy practitioners moved into the schools. That's what we knew. So that's what we provided. Even today, one to one individual pullout services are often referred to as a medical model style of services. As I mentioned, I don't necessarily agree with that because I do think that there is a place for one to one pullout services and school based occupational therapy. And here are some Some of the reasons why the biggest pro and probably the main reason that most of us have often defaulted to pull out services is because A, we get to control that environment, right, a student is coming to our OT closet, our OT room or OT, cupboard, whatever it might be. But it's ours, we have the ability to manipulate that environment to work on skills. Secondly, the reason that I think we default to this is because being in that personalized one to one setting, it allows us to work on specific skills that, to be honest, are quite difficult to work on when we are in the classroom. You know, in the classroom, we can really work on generalization, we can really work on maybe some social skills, we can work on that planning an organization. But in a pullout setting, that's where we have the opportunity to potentially do some hand under hand hand over hand hands on in general type of skills that sometimes are needed. It allows us to manipulate the environment which we can't necessarily do or can't easily do in the classroom environment, at recess, and so forth. So There absolutely are some pros to having therapy in your own designated space. Some of the other reasons that may not be the best of reasons why we often use a pullout setting is because, to be honest, that's what we know. That's what we're taught in occupational therapy school, we're taught how to see students or clients in general, one on one, we are not really well taught and OTs goal, how to support people in their natural environment, that's just hard to actually like set up. If you think about OT schools, they often have a clinic, what happens in clinics, people come to the clinic, it's not very often that OT students are going out and supporting people and their natural context, like we would be if we're going into the classroom to support a student. In addition to that pull out sessions are typically easier to plan, you don't have to collaborate with a teacher to make sure that you're going in during the time that a student will actually be working on a skill that their goal is related to. Like when you're scheduling, it's easier to schedule students one on one in a pullout setting than it is to schedule having to go into a classroom, it's just easier to plan these pullout sessions. Now, that may not be the best reason to continue doing pullout sessions all the time. But it is a common reason like I have been guilty of that. And then right along the same lines with that, it's also easier to take data on our goals in the pullout setting, right? We can manipulate the environment, we can change with the work, we can track data really easily. The more we move into the classroom and try to track data in the classroom, it does get more tricky, primarily because it takes more planning and more initiative on our part to make sure that we're going into the classroom again, when we can actually see the occupation or the goal that we are trying to see. So those were some of the things that maybe facilitate us doing a pullout model type of service. But that doesn't mean that there aren't some cons to providing that type of service. And I've got a few things listed here. And I want to share them with you. Because one of my biggest things about why I prefer to not do a pull up model when I can, is because although it's difficult to collaborate, it makes it even more difficult to collaborate. When we are constantly using pullout services. The only opportunity you really have to collaborate with a teacher, if you are doing or if you're conducting pullout services with a student is maybe in the hallway passing, which isn't a great time for collaboration, maybe the one minute while you're waiting for the student to get up and come to you so that you can go to the polls setting or on your way back to classroom. Maybe you have a second to talk to the teacher. But that's not really collaboration either. So in general, I find that the more that we are pulling students out of the classroom, the less we are collaborating with the teacher, whether it be in the classroom or consulting with them at another time. So that's the first one pullout services limit collaboration. Also, in regards to pullout services, I believe that there is a false belief that weekly pullout sessions are evidence based. Now I want to start with this. Think of the last research article that you read, whether it was found to be effective or not effective. What was the frequency and duration of the service provided? Was it one time a week for 30 minutes? Was it one time a day for an hour as many studies often Are wasn't one time a month for 30 minutes. We don't see a lot of studies within the world of occupational therapy, whether it be through the Asia act or other journals where it replicates what a school based occupational therapy service frequency might actually look like. So we see something that looks promising and research. But if you look deeper, the reason it looked promising is because there are providing services every day for an hour, or three times a week for maybe even 30 minutes. Like that is kind of doable in a school setting for some people, but for many of you, you're like, wait, what, three times a week? 30 minutes? Yeah, I know, you just can't fathom that. Right. So I think that we do see this research out there, where we're seeing articles say, I don't want to mention any programs. But there's programs out there where they've been research based, but oftentimes it is more than the frequency that we have the capacity to provide, in schools, at least the way that our case loads are currently built. And in line with that same idea, two of my favorite authors, Mindy Garfinkel and Francine Surya have come out with research and guidance for school based occupational therapy practitioners like us. And they're actually noting that best practice guidelines are indicating that providing services and contextually based settings such as classrooms are more effective for children, that actually comes from their 2020 article, they have several articles, they're all definitely worth a read. But I think that's true. A lot of the research that we're getting similar to the frequency and duration, not necessarily lining up with what we might do in a school, most of the research is also being done and more of that, quote, unquote, medical model style, where it's a lot of one on one individual type of services, as opposed to maybe getting into the classroom. That said, we are seeing that when occupational therapy practitioners are getting into the classroom, we are having positive results within the research. And I'll talk a little bit about that more when we get to that section. So the final point that I want to make before we move on to some alternative models, is that if we continue to kind of default to this one time a weak individual pullout service for a majority of our students, then to an extent, we are not providing an individual educational plan, we are providing a prescribed general individual plan. I mean, I don't even know what to call that the IEP is designed to be individualized. And if we're providing the same 30 minutes once a week pullout service for every student, then it is no longer individualized. Right? I get it like every individual service is individualized, yes. But if every single student is receiving the same service, frequency and duration, and in the same setting, it doesn't look that way on an IEP. It also prevents us from even considering providing services and the least restrictive environment. And I get it, it is hard to provide services in the classroom in a collaborative way. Maybe in the kindergarten classroom as a group, I get it, that is tricky. But we're not going to get any better at it unless we start doing them. Alright, so that is my 10 minute soapbox on pull out individual services and maybe why we should start to consider alternative services. That brings us to our first alternative model from a pullout individual service, which is a push in individuals service. Individual pushin services are absolutely one of the most difficult services to implement with good achievement and good outcomes, I find it is just hard, it takes a lot of planning, you really need to have good communication with the teacher to make sure that your schedules align so that when you go into the classroom, to actually work on a handwriting goal, they're actually working on something related to writing. Or if you're going into the classroom to work on a sensory processing goal to make sure that you know, they're actually doing something where you can implement some of those various accommodations or sensory brakes or whatever you plan to do. It can be overwhelming because you don't have any control over the environment really. And when you come into the classroom, you've got to bring all the tools that you need. If you don't bring all the tools then you're probably gonna have to say, Oops, excuse me, I'm gonna go run back to the OT room and grab something. Push in individual services are tricky. One of the biggest objections to push on services that I have heard from other OT practitioners and I've even experienced from myself is how is what I am doing as a push in individual service, different from a eight different from a special education aid working with a student. And it took me some time to kind of really understand this and figure it out for myself and be able to share it. But the truth is, is that you are very different from an aide, you have a lot of knowledge that that aide does not have a paraprofessional who has been in the schools a long time and has worked with other OTs and SLPs, and PTs, you know, they have a lot of knowledge, and they might have some of that knowledge that you do. But at the end of the day, your brain works a lot differently than a paraprofessional, you have the ability to really break down tasks and build them back up, you understand the just right challenge very well. And when we talk about collaborative services here in a little bit, we're going to talk about building up the capacity of those paraprofessionals and the teachers that we work with. But in this role as a individual push in type of service, we are really going into the classroom and focusing on that student, we're not necessarily trying to support the teacher and understanding exactly what we're doing or supporting the aid and understanding what we're doing, we're really there for the student. A lot of times this can be used for generalizing skills that have been maybe mastered and the pull out setting, maybe you're going into the classroom to generalize those skills. Personally, I prefer collaborative type of services over this pushin model, they are similar in a way because you are going into the classroom. So I'm actually going to cut myself off here and postpone a lot of what I have to say about getting into the classroom for when we discuss collaborative type of services. All right, let's go ahead and talk about the next one, which is groups. Group therapy can be wonderful. It can be provided in a pullout setting similar to what we were just talking about, or it can be provided in the classroom setting. One of my favorite ways to provide groups in the classroom setting is by pushing into younger grades like preschool, kindergarten, and maybe first grade when they're still doing some of those centers, you can kind of ingrain yourself naturally in during center time. And the students who need occupational therapy services can come to you for one of your services. If you want to do this more in an RTI model, you can go into a kindergarten classroom, you can set up shop at a particular table, and multiple groups can rotate to you whether or not they have OT services. That's how groups in a classroom can be used as an RTI model. I'm not going to spend as much time on groups as I did on that pullout individual services. But I do have a few pros a few good things that that can come out of groups and why we might want to use them. And I'll list those off here and talk just a little bit about them. One is that they can be a very efficient use of time. If you have a large caseload. And you go and actually look at that caseload, and maybe turn a few of those individual services into maybe four groups, you can take 10 individual half hour sessions and maybe turn it into four individual half hour sessions. So you just went from 1030 minute sessions, which is five hours to 430 minute sessions combined, that altogether is two hours. So it can save you a lot of time. But to do that, it can take some time for planning and figuring out which kids to put together. I definitely recommend starting with kids in the same classroom that maybe have similar style goals. If you have a few kids in the same third grade classroom that have handwriting goals, maybe that's a good group. If some of them have maybe behavior related to sensory processing goals, that could be another good group to put together. Which leads me to another wonderful aspect of groups. And that is the peer interaction and modeling that can occur during groups. Children are very observant. And we should know this as occupational therapy practitioners, right, we recognize the importance of play, because during play kids learn to watch others and learn from others about how to play and develop those social skills and how to learn all type of other skills, motor skills, physical skills, everything comes from play for children, or a lot comes from play for children. So I think that that is something that's very important and valuable. And that is definitely something that you can mention in an IEP, when you're saying, hey, I want to group Johnny and Susan, because, you know, Johnny has these strengths and I think Susan might kind of pick up on those or vice versa, and they might be able to support one another Try it out. If it doesn't work, you can always have an addendum and change it up. But, and yes, I have had to do that before where I made a group thought it was gonna be great and it wasn't. So we changed it up. But give it a try. Let's give Johnny and Susan that opportunity to learn together, be together interact together and learn from one another. If it doesn't work, we can change it up. But let's give them that opportunity. A moment ago, I mentioned how I had a group and it just didn't work. And I had to break it up. And that leads me to my main con for having group therapy sessions. In some cases, you might have one student and a group of two or three that just demand your attention. Or maybe they demand the attention of their peers and the group. And that can make a group very difficult. And when that happens, you have to make a decision as to whether or not this is the right group? Would the group be better off? If you split up a group of three into a group of two with the other receiving individual services? Or with maybe taking one of those students and putting them into a separate group? Would that be better? The point here is that when you're looking at groups, you can't just look at their skill level, you can't just look at their age, you also have to take into account the dynamics of that group, will they work together or will they not work well together. And you may not know that until you try. The last point that I want to make about group therapy sessions is that they should be a real group, as opposed to three simultaneous individual sessions. Yes, it's nice to save time and all by grouping kids together. But let's not group them together only for time sake, we shouldn't be working with Billy on fine motor skills, Susan on coping skills. And I don't know Jeremiah, on visual motor capabilities like this should be a true group session, they should be working on a similar task. Maybe that task is graded differently for each of them. But they should all have similar goals and plays and be working together. Part of group therapy that's so important is that social impact that social interaction that occurs between all three are all two of the students that are in that session. So let's just try not to group kids together for the sake of saving time, let's group kids together because it's actually going to benefit them and the goals that they are working on. All right, now we are moving to an even less restrictive model of occupational therapy services. And that is collaboration. Many therapists and schools and districts and people in general will use collaboration services interchangeably with consultative services. And I don't find that to be the best use. I distinguish them with purpose. And I'm going to break that down for you right here starting with collaboration. When I'm talking about collaboration therapy services, I'm talking about working with both the teacher and the student, I'm not going to get into consultation, but just to kind of show the difference. Consultation is working only with the teacher and not with the students. So going back to collaboration type of services, there are a lot of benefits here. First, collaboration typically occurs in the classroom or in the natural context, collaboration rarely occurs in the OT room away from the students natural environment, that is one of the biggest pros. The other two real positives for collaborative services really go hand in hand. It's capacity building and consistency. And let me break that down here. When I'm talking about capacity building. I'm talking about your ability as an occupational therapy practitioner to build capacity within both the student and the teacher in the natural context. When you are able to support both the student and the teacher in the classroom, or maybe an aide and the student at recess or in the lunch room. That is what allows the consistency. Because if we are sharing our knowledge with the student, and the teacher and or the aide, then they can work together when we are not in the room and that is what leads to consistency. Too often, a student will come to us in the pull up model, we work on something, let's call it letter A, they go back to the classroom, they never work on letter A until the next time they come and see us but if we're going into the classroom, and we're working on handwriting or we're going into the classroom, we're working on selecting coping skills or implementing coping skills or implementing organization skills. Then that student is seeing how it works in the classroom. That teacher or the aide is also seen how it can work in the classroom and they He can implement that same exact process, that same exact skill, that same exact intervention throughout the week and beyond. Now, collaboration does take some time to implement, it is time consuming. And it often requires planning before the actual service itself. If you are going to put collaboration on an IEP, you might also need to put consultation on the IEP in order to have that time to work with the aide or the teacher prior to the collaborative service. I know it sounds difficult, and it can be a little difficult to get used to. And the biggest objection that I often hear from this is that, oh classroom staff, teachers and aides, they won't carry it over. They they just don't, they won't carry it over. And I don't think that that is quite accurate. I don't think that they're actually being given the best opportunity to carry things over. Because a lot of us are using a consultative model where we tell the teacher we tell the aide as opposed to a collaborative model, where we show the aide or the teacher how to do things. And we do that on a regular basis, not a once a month basis. We're actually in there with them on the front lines, showing them how to complete that intervention. And yes, I have some research to support this. I went outside of the world of occupational therapy literature, and I jumped into the world of education literature. And I found inside the Journal of special education, apprenticeship and 2021. A article from sisty and Robledo, where they actually did a survey of special education teachers and found that teachers appreciated when occupational therapy practitioners modeled sensory and behavioral support strategies for the teachers and aides. In fact, they even said that they really appreciated it, as opposed to when we use the pullout model, because they liked to see the strategies that we were working on, they wanted to implement whatever we did throughout the rest of the week. And they actually were like a little put off by the pullout model services, because they didn't know what we were doing. They didn't know how they could help them that way. They really appreciated it when the therapist got into the classroom, model those supports, so that they could then carry it over for the rest of the week, the rest of the month, and so on, and so forth. So collaborative services, in general, getting into the classroom, working not only with the student in the classroom, but also with the teacher right there or the aide right there too, so that they can model and complete what you're doing throughout the rest of the week. They don't need to be right next to you the entire time the teacher, I mean, but it would be nice if you kind of do something and pointed out to them. So they remember that right? Like we can't just do something and expect them to always be watching us and then implement it, we have to do it, explain what we did, or vice versa, explain what we're going to do, and then do it. And then make sure that they understand it so that they can move forward. All right. And that brings us to consultation services, I alluded to consultation services a minute ago, consultation, unlike collaboration is supporting only the teacher. A lot of times consultation can be used in the event of implementing assistive technology or another accommodation, where you can teach the teacher how to implement it, and then they can do it themselves, maybe you don't actually need to be working with the student consultation is the least restrictive type of service because it involves having absolutely zero contact with the student themselves. The student doesn't have to feel any pressure about this outside person coming in to work with them and having their peers wonder who and why this person is working with them. It prevents you from having to say, Oh, I'm just a helper in the classroom and trying to hide who you are. So in that sense, consultation is really nice. But it is also difficult. You have to have a good rapport with a teacher or an aide to make it work. Consultation is a two way street. It is not a one way street. And there have been times in my past where I thought you know what consultation would be great. But then I also think like about the teacher and who I would be consulting with and maybe we don't have that best report, and maybe a different service would actually be better than consultation. It is absolutely okay to take dynamics like that and use them when you're trying to figure out what type of service to implement. If you're not going to be able to you know, use a consultation to its best impact, then maybe try something else like that is okay as long as you have a reason for it, and that you can still provide the service that's going to help the student make progress, meaningful progress toward their goal. All right, so that covers just about all the different types of services that you can have as a school based occupational therapy practitioner, we started off talking about individual pullout, then we talked about individual pushed in, then we talked about groups, which can be both a pullout or a pushin model. And then we went on to talk about collaboration and then consultation. Now, I want to discuss one more thing before we wrap up this episode. And that is about mixing it up. And using multiple models here, not just console, not just pull out individual services, but potentially mixing it up, you may be familiar with a three to one model, some people use something like a two to two model, I really like that one. Some people like to have weekly services, and then add an additional console to the services. So let me explain how these models work. Starting with the one you may be most familiar with, if you read some of the research, and that is the three to one model, the three to one model has definitely been looked at within research, I don't know that it has actually been compared to maybe a weekly direct service. But what the three to one model is, is basically setting up a month into four weeks, like most months are and saying during those four weeks, I'm going to do one service, one time a week. And then for the fourth week, I'm going to do something different, hence the three to one model. So in a month, with four weeks, the first three weeks, you might provide a direct individual pull out service, and then the fourth week, maybe you're doing a consultation, hence, three to one, get it now, that is one alternative model. And it allows you to kind of get the best of both worlds, you can see the student individually in a pull up model. And then maybe on week number four, you're actually consulting with the teacher, or maybe you're collaborating and getting into the classroom a little bit. Or maybe you're seeing the student in a group, whatever it might be. Some districts also use the three to one model where the three are services. And then the one week is actually completely free from services, where it allows the therapist an opportunity to spend time with evaluations, RTI, maybe the entire related service programs don't have services that week, so that they can focus on IEP s that week, or whatever it might be. To be honest, I'm not a big fan of that. Because then like what if you do have a student that needs services every week, then you're like the only one that's not using the three to one model because you have five kids that needs to be seen that week. But anyways, that is kind of the essence of the three to one model. And to support this claim about the three to one model, and the Journal of Occupational Therapy, schools and early intervention. So ruya and Garfinkel. Again, this is a 2018 article, they said that practitioners felt the three to one model supported their use of differentiated service delivery, that was contextually based expanded their scope of practice, increased work efficiency, and was heavily influenced by stakeholder support. So those are some good key benefits of the three to one model that can't be denied. Right? Again, I don't think that there's research out there that compares like the three to one model to a two to two model, which I'm going to talk about in a second to a full on one time a week, 30 minute session model, but it is something out there and a lot of people are using it. That then brings me to the model that I really do like and prefer, which is a two to two model. This is one of my go to models and similar, you know, similar concept of the three to one model, except two to two. So 5050 split. And you can do this with any type of service model, you could have two group sessions and to individual sessions, you can have to individual pull out sessions and to individual push in sessions, or to pull out group sessions and to collaborative sessions. I really liked this model because it gives you some flexibility to work on those skills that you may need to do in a group or a pullout setting. And then it gives you the other two sessions to generalize them into the classroom. Again, this is one of my go twos. And to give you a little example of how it can progress over time. I've had a student where my therapy services progressed like this, the first year that I was working with them that I tried this model, I had a one to one pullout service with them for two times a month and a pullout group service with them two times a month. So we would alternate between individual service and group service individual service group service so that way we'd work on a skill one on one, and then we could work on that same skill in a group. The following year we transition to twice a month group services in He pulled out setting and twice a month collaborative services in the classroom setting. This gave us the opportunity to again, work on some skills in the small group, and then transition and generalize them into the classroom setting. I really liked this model, it has worked wonders for me. No, I don't have any data on it. But it's just something anecdotally that I saw really helped many of my students. The one other MCs method that I have used in the past as well is adding a consultation to students IEPs, were also had weekly individual services, or really any type of weekly services, whether it's collaborative group or individual, I'd like to add that extra consultation, because in most cases, I was already doing it. Like it's very rare that we don't actually consult with a teacher about a particular student, even if it's five minutes in between seen to other students, typically, we are talking to a student, in person or via email to help them right. So I just formalized it by putting it on the IEP. So what did that look like on the IEP I had two separate service lines. And this goes for the three to one model, the two to two model or this model, I had two separate service lines. One was one service and the other was a separate service. It was that simple like that is possible, you can do that. It's not something unheard of, it's okay for occupational therapy, to have two separate service lines on the IEP. All right to bring this all back together. And to wrap up this episode number 138. Those are the primary service models that we use in school based occupational therapy, maybe you've gotten creative and use something a little different, I really hope you have because I think we need to try different things. And maybe they fail, but at least we tried it. Now if you're sitting listening to this episode and saying to yourself, Man, like 85% of my caseload is pulled out the other 15% is console like it's all or nothing or one or the other, right. And maybe you want to try some of these other type of models. A I encourage you to do that. And be I just want to say starts low. Like you don't have to transition all of your students from pull out individual all to like push an individual or collaboration, like over the next year, right? Take it slow, audit your caseload, take your caseload one night and grab some wine or a drink, whatever, and just look it over and just, you know, put a tally mark by the students that you think hey, you know what? I'd like to try it with those students like three, five, maybe 10 students, you think to yourself, What if I actually pushed into that that kids classroom? What if I supported them in the classroom instead of in the OT room, right? Like, that's how you can start doing this, you don't need to just jump full in, just start with a few a few kids. And on top of that, maybe even think about the teachers, right? Like what teachers do you know, that would be on board with this. The last thing you want to do is go gung ho with this, and then find out that the teachers are like, Excuse me, what are you doing in my classroom? Right? So maybe find three kids that are in a teacher's classroom that you have a good rapport with, and start there. Don't make this hard on yourself, like make it nice and easy, by picking out the students that you know will likely be successful if you're supporting them in the classroom, because of your rapport with that teacher and because of your ability to support those students. All right, that is going to wrap up episode 138 of the OT schoolhouse podcast. I hope this helped you. I hope you may be, you know, hit rewind a few times because of some of the things I said actually made you think if they did, that is wonderful growth happens when we are questioning our own beliefs and whatnot. So I'm glad that you were able to find this podcast helpful. I did mention some research articles in this episode, and I have them all linked, you can just check out OTSchoolHouse.com slash episode 138 If you want to learn more about those articles. Likewise, if you would appreciate more support directly from myself, please check out the OT schoolhouse collaborative. The OT schoolhouse collaborative is our private membership, where myself and other school based occupational therapy practitioners come together to help us all implement best practices. We have professional development within the collaborative. We have mentorship from myself and others in the collaborative. We have a gold bank, we have resources and research all available for you inside the OT schoolhouse collaborative. So you can check that out either using the link in the show notes or by heading over to OTSchoolHouse.com slash collab. I hope to see you over there and no matter what I hope to see you in the very next episode of the OT schoolhouse podcast, take care and I'll see you next time.
Amazing Narrator
Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now, head on over to OTschoolhouse.com Until next time, class is dismissed.
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