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OT School House Podcast Episode 53: AAC with The Fannypack Therapists

On this episode of the OT School House Podcast, Jayson welcomes to the show the wonderful minds behind @TheFannyPackTherapist to talk about their specialty, Augmentative and Alternative Communication. Annabeth Knight, OTD, OTR/L & Mara Jonet, MA, CCC-SLP have presented at conferences nationwide on the collaborative approach to evaluating and implementing AAC devices fro children. In this podcast episode we focus on that collaborative process and the role of the OT. We also talk about why AAC devices are sometimes under utilized and how to prevent users from abandoning their device. Links to Show References: Follow Annabeth and Mara on Instagram: @TheFannyPackTherapist Follow Annabeth and Mara on their brand new Fanny Pack Therapist website! AOTA Position paper on Assistive Technology (Members Only) ASHA Position Statement on Access to Communication Services and Supports The Communication Bill of Rights (NJC) Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments regarding our podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 53! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

OT School House Podcast Episode 52 - Research Review: How Teachers & OTs Perceive School-Based OT

Have you every felt unappreciated by the teachers at your school? Well, listen to this episode to learn what a small research study has to say about the way teachers and OTs perceive Occupational Therapy and therapists in the schools. Dr. Bolton and Jayson will talk about this and more in Episode 52 of the OT School House Podcast! Links to Show References: Article: Occupational Therapy Role in School-based Practice: Perspectives from Teachers and OTs Help Jayson by Donating to Big Brothers and Big Sisters Freebies! Be sure to subscribe to our website now & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments regarding our podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 52! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Top Tips For New School-Based OTs From the OT School House Community

The world of school-based occupational therapy is unique and different than any other setting. We are medical professionals in a world of education. You could say that we are “the odd man out”. As occupational therapists, we are educated to support a medical model. However, when we cross over to school-based therapy, our framework and foundation must shift to an education model. Because of this, I feel like school-based OTs spend an insane amount of time educating parents, faculty, and staff about our role in the school system. Since we are initially trained in the medical model, if a therapist is just starting in the school system as a brand new graduate, or if an OT practitioner is transitioning into the schools after 20 years in inpatient rehab, the simple idea of starting in a school-based model can be daunting and terrifying all at the same time. So, when Jayson prompted the community to share a tip for new practitioners on Instagram, there were almost a hundred helpful comments from experienced school-based OT practitioners. Clearly, therapists are more than willing to give advice, especially related to areas and situations where they wish someone would have told them how to (you can fill in the blank). As we dove into the comments more, several themes surfaced and we wanted to take some time to share and expand on these words of wisdom. Tip #1: Build relationships with everyone on campus “Make sure your admin know who you are” @Theaccommodationstation (Alexandra)​ “Make friends with the custodian! You never know when you’ll need to borrow tools/hardware or have them rig something up for you!” @Theeverydayot (Sarah)​ “In addition to making friends with the building secretaries and janitor, befriend the gym teacher…Also, don’t forget to provide support to the ‘specials’ teachers (art, gym, music, and computer). These teachers a lot of time get little support and aren’t quite sure how to meet students’ needs. Art and gym are often great classes to push in to for OTs.” - @Raejean84 (Raejean) Each school you walk into is a family. Each member has its role and place, and no one wants to be left out. In all the years I have been in the schools, I cannot count the number of times I have borrowed the janitor’s hammer to “fix-up” a student’s locker to increase accessibility, or the number of adapted scissors (usually the loop scissors) I have given to art teachers for our students in special education classrooms to use while in their classroom. These are all things that can help build relationships within each of your campuses. No one is too great or too small to be involved. When you ask for that hammer, be genuine while you ask how their day is going. Take a second to see what the cafeteria monitor’s favorite TV show is. When you take the time to build these relationships across the entire campus, you can bet that they are going to reciprocate that relationship and take an interest in you. Tip #2: Take time to build rapport “Always start with building rapport with your clients, you’ll be able to more effectively meet your goals once your students have a solid trust in you and your relationship!” - @Kidscopinglab (Dr. Meryl & Shae) The phrase “It takes a village to raise a child” can definitely apply here. Taking some time to build rapport with each of those individuals can help bring the entire team together. It can be simple things, like asking about their day, or offering to check supplies of adapted paper so they never run out. It could mean taking some time to sit in on the IEP meeting they told you about last minute, or adapting and integrating parent strategies into the classroom setting. Once you take this time to build rapport with the team, it becomes easier for them to help you as well if you get into a difficult situation. Tip #3: Do not be afraid to ask questions “Don’t be afraid to ask questions #yr2schoolCOTA” - @Haepi_ft (Elisha)​​ “Ask questions! Ask where the bathroom/gym/nurse’s office is rather than wandering around until you find it…Ask for help, Ask what people mean by acronyms- you get smarter and better at your job when you ask clarifying questions than when you pretend to know what people are talking about” @Michellemarie5 (Michelle) This is where the previous rapport building and building relationships can come in handy. If you have taken the time to build rapport and relationships on your campuses, they are going to be more likely to help you. It can be embarrassing to ask simple questions about the location of the bathroom or where room 204 is. If you take time to build relationships, the teachers and staff are going to be more than willing to help you. They know you care. Tip #4: Reach out for training and in turn, train others “Take advantage of all the mentorship you can get. Watch and learn” @Tarradp (Tarra)​ “Do a lot of training. Train those teachers, push in, and present, present, present. You have too many kids to see all alone so instill help in the staff. Collaborate constantly.” - @Kidsviewtherapy (Theresa) “Collaborate and create alliances with your case carriers and specialized academic instruction teachers, They will be your eyes and ears for your students everyday even if you physically can’t be on the school campus.” @Mamawells329 (Christine) “Push in to the classroom, let the teachers see you working with the students. It will help create rapport with the teachers and buy-in for interventions you want to implement. Also makes sure what you might be working on in a pull out session transfer into their everyday environment” @Ashmenzies (Ashley) Take a second to think back to your entry-level OT curriculum. What was one of the tools your professors or instructors would use to help teach concepts? Teaching others! Once you have received some training or some correction, take the time to turn around and apply it. This could be through training a teacher on a strategy you are using with a student or discussing a new strategy with a coworker or colleague. This can also help you build collaborative teams and alliances within your different campuses. If you have access to other OTs, maybe see if they can come and observe you or sit with you through your first IEP meeting. They can help you point out things about yourself that you may not pick up on. It could be little things like “your posture appeared very closed and uninviting” to “when you are talking with the parent, a different way to phrase that would be…”. Do not look at it as a colleague trying to pick apart everything little thing you do, but as an opportunity to grow and learn as a therapist. Listen to Episode 45 of the OT School House Podcast for even more tips! Tip #5: Find your own organization strategy so you can be flexible “1. Using electronic documentation as much as possible and find some sort of way to keep track of IEP dates. 2. Try to avoid bouncing back and forth between schools.” - @Yoursch00lot (Amanda) “I recommend making yourself a checklist of all the things that need to be completed before/after IEPs (data collection, teacher consult, scoring goals, drafting goals, documentation, etc.).” - @Sarahbeeot (Sarah) “Before IEP meetings observe the child in class, talk to the teacher, and call the parents." - @Wootherapy (Meghan) “Be kind to yourself. Figure out a schedule that allows you to spend the most time with your kiddos and supporting staff.” - @Mornings.with.an.ot.mom (Danielle) “Be flexible! Write everything in pencil because it will change. Also, give yourself some grace to make mistakes and take long on things. The first year is DIFFICULT and so you need that year to learn the rhythm and routine of the school year.” - @hopemccarroll (Hope) Everyone is going to have their own way to keep organized. Jayson, for instance, keeps items electronically. He even offers you resources for free to help with organization when you subscribe to the OTschoolhouse.com email list. I, however, do not keep up with items well if I keep them online or electronically. I have forms that I keep in one binder and have dividers for each campus. I have had systems in the past where I had a binder or folder for each campus. I think you need to figure out a system that works best for you that is going to help you stay organized. Also, I keep a paper planner and write out a schedule every single week. I take it as an opportunity to cluster treatment sessions on the same campus and look at moving sessions if I have an IEP meeting or additional staff meeting on the campus a different day of the week. I do this knowing that my schedule will change during the week, but I can easily keep track of the sessions I need to move and reschedule when changes come. And that is not an “if changes come” but “when they come”. Tip #6: Document everything “If it’s not documented, It never happened!” -Elisa Wern Documentation is everything. Documentation is not just for treatment sessions but, it is also for everyday tasks and conversations as well. If an incident happens, document it. A consultation with a teacher or conversation with the parent, document it. If you attended an IEP meeting or staffing, document it. You really should do this for a number of reasons: First, It becomes part of the child’s running record and chart. Even IEP meetings can help document recommendations made about service time so another therapist could look at it and see the progression over time. Second, this can also really show the time it takes to be part of a child’s case. Districts are always looking for documentation related to how you spend your time during the day. This is a great way to document that. It is hard to quantify a conversation with a parent or how long consultation meetings with teachers actually take. This is a way to keep track of that. And finally, if you are ever questioned about how you spend your time, you are able to pull your own documentation records and see exactly what you did because you documented it. Tip #7: Advocate for yourself “Advocate for the children but most importantly YOURSELF.” @OTwithKenzie (Kenzie) “Change takes time. You will see many things you are not ok with. Focus on the things you can change.” - @mornings.with.an.ot.mom (Danielle) In the school system, advocating as an occupational therapist could look many different ways. Maybe it is advocating for additional OT staff or for help on a campus or two because you are behind on treatment sessions or piled with evaluations. You may also choose to advocate for additional programming on a campus because of a trend you are seeing related to the mental health and anxiety in the children on that campus. You may also advocate for additional training and help on a particular case. Do not be afraid to be honest with yourself and others about your needs. Many of the educational service centers and AOTA have tons of resources, but you may not always know how to access those. It never hurts to ask! Although you may feel alone in this endeavor of school-based therapy, know that you have access to a plethora of other school-based therapists virtually that you can also rely on for additional advice. There are many Facebook groups, podcasts (such as the OT School House Podcast), blogs, and Instagram accounts (including all the people who are quoted in this article) that can all be used as resources to build your own therapy community. Do not be afraid to put yourself out there and to build that community! Have a great first year! Author Bio: Hope McCarroll has been an occupational therapist since 2011. Her primary area of focus has been school-based occupational therapy services. She recently made the leap to academia and is currently core faculty at University of St. Augustine for Health Sciences. Hope continues to practice as a pediatric occupational therapist while teaching occupational therapy students. #Organization #SchoolbasedOT

Sensory Integration in Schools: Its more than just sensory tools...

The term“Sensory” has hit schools and hit them big. Many school districts are building their own motor labs complete with swings, trampolines, and squeeze machines (I can’t recall the technical term for these but that is essentially what it is). School administrators are promoting these rooms to teachers and parents with occupational therapy being highly recognized in the promotion of "sensory" within the school setting. Yet I have felt there has been something lacking in the implementation of sensory tools and rooms that would justify pulling students from their educational curriculum to participate in "sensory" activities. I have noticed little connection between the use of these rooms and tools to research or sensory integration theory. Students with excellent gross motor skills leave their academics in order to come to motor lab and receive “input to organize their sensory processing”, yet the people bringing them there have very little if any background in occupational therapy or sensory integration theory. I don’t believe that the needs of students should be neglected; however I do think it would be wise to pause and consider what school is for and how we can truly support our students with sensory processing difficulties in their educational needs. Sensory integration and sensory based strategies were never intended to be a "one-size fits all model". Like occupational therapy itself, sensory integration is intended to be highly individualized to the child, environment, and occupational performance. I have to admit I have never been a big fan of sensory integration in school-based practice. I have found that implementing true sensory integration based strategies, evaluation, and therapy is difficult to do with my limited schedule and skills set. Evaluation of how children process and integrate sensations from their environment is difficult and requires specialized knowledge and training. When evaluating sensory processing within the school based setting is important for the occupational therapist to consider more than what tool could be trialed. Assessment should also include how sensory processing difficulty is impacting functional performance beyond the apparent "sensory-related behavior". Two more questions when addressing sensory the school-based practitioner may want to ask should include: What are the demands of the classroom environment? How will the child meet the demands of given classroom activities. If the student is fidgeting frequently its important to also observe how this impacts his classroom performance and his ability to meet classroom demands. This will impact what strategies you utilize and how you go about implementing them. It is not enough to merely provide a tool based on this observed behavior as that could end up being counter productive or ineffective. Giving the Sensory Processing Measure or Sensory Profile can provide important information; however it is also important to conduct classroom observations and other clinical observations of the child in order to truly determine what approach will be effective. Staff interviews and having classroom personnel collect data on the observable sensory-related behaviors is also necessary and can help the occupational therapist best fit their approach be considering the needs of the classroom in conjunction with the needs of the child. I recognized my own limitations in regards to sensory integration when I recently fell into the “easy button” sensory tool approach myself. I provided a student who had a diagnosis of autism with a “chew tool” due to his teacher reported sensory needs and history of having had this particular strategy used in the past with reported success. Without having conducted an observation or worked with him directly I caved to the pressure of providing the tool on a trial basis. The student chewed so extensively that he went through three of them in a very short period with little change in his maladaptive behaviors (i.e. his grabbing and pulling hair, pinching staff, and squeezing faces). I should note that he had access to a variety of sensory-based tools including a therapy ball, headphones, weighted vest, thera-band, and multiple squeezable fidgets. I decided that prior to providing the 4th "chew tool" I would conduct classroom observations to determine what was impacting his classroom performance and gain a better understanding of how his sensory processing was preventing him from meeting the demands of his environment and expected task performance. Once I put on my occupational therapy hat and observed the student in his classroom a series of "Aha" moments began to occur to me!The first thing I decided to build a profile of the student. He was a student with Autism who demonstrated behaviors related to a very high excitement level I would even say his behaviors appeared anxious and ones of discomfort (he was observed to grimace and squint frequently). He seemed highly sensitive to every bit of stimuli in his environment. He also demonstrated significant difficulty communicating his needs. Communication appeared to be slow, and in short phrases and words. This student also appeared to scan the room by moving his entire head and body versus utilizing scanning and tracking skills. The second part of classroom observation included observing during non-preferred activities during which his maladaptive behavior was more likely to occur. I then observed two separate moments when the maladaptive behavior occurred. Both occurred during the reading and writing center on two separate observations. Prior to both behavior incidents another student had acted out by falling onto the floor and yelling at the same center. It should also be noted that I had reviewed his previous assessments and reading and writing is a largely non-preferred task for this student as well as his biggest area of deficit. The third part of the evaluation was how the student coped or attempted to cope with the environment and task demands given his sensory processing difficulties. Prior to the behavior incident the student attempted move away from his acting out classmate and the teacher had prevented him from leaving. She required that he first told her what he wanted before he was allowed to get up and access his headphone. Being that he was already distressed he was not able to communicate this and eventually grabbed her hair and face. In observing these moments it became clearer that a "chew tool" was not going to be the answer. What the teacher had told me was sensory based due to the lack of tools (i.e. she wanted a trampoline in her classroom and more chew tools) was in fact sensory based; however it would not have been made better with use of those tools. I also discovered after interviewing staff that this student had been moved from his previous years’ class into his current placement. This classroom had new staff, teacher, peers, higher demands and was within a very different environmental structure with less freedom or free time than he had been used to. To top it off, he had been in his previous class for three years. The teacher and aids knew how to anticipate his needs and scaffold his environment in order to prevent these behaviors; therefore his behaviors and previous sensory seeking had nearly disappeared before this change. Given this student's high sensory sensitivity he required more support to reduce sensory input during challenging tasks, incorporating more sensory breaks where he could escape or reduce the sensory input he was receiving as well as highly structuring his classroom tasks experiences. Based on my observations and interviews we were able to collaboratively come up with a plan to address this student’s needs. Conducting these observations is imperative to appropriately utilizing the models in sensory integration and it can be difficult to adequately perform these observations and interviews but I would argue that it is also necessary in order to provide sensory integration based strategies within the classroom setting. Luckily I work in a school district who is interested in keeping our caseloads manageable so that I have the time to perform these very important job duties. I have worked in other districts where I was fighting to just keep afloat so observations such as these were not easily conducted. It is easy to become complacent or so overwhelmed that we end up offering sensory-based tools as easy buttons, but we need to remember that that this is not sensory integration and often times it is also not evidence-based. I'm not trying to downplay the power of fidgets or wiggle seats and I'm definitely not advocating for the removal of these tools, but I am encouraging us as occupational therapists working in schools to remember that sensory integration theory is different from the tools. It is out job as the occupational therapist to assess what the students needs are and how that is impacting classroom performance. When we look to simplify sensory into a tool or strategy it can lead to a wider misunderstanding and misinterpretation of sensory integration. Like sensory integration itself, occupational therapy is difficult to describe and by its very nature complex in its evaluation and implementation. I say we embrace this complexity in both occupational therapy as well as sensory. We need to do the work of advocating for sensory integration in schools by embracing and teaching the complex nature of both sensory integration and school-based occupational therapy to the school personnel, parents, and administrators of the schools we service. What are you doing to promote appropriate use of sensory integration based tools within the classroom? Do you feel you have adequate knowledge and skills to tackle student needs in this area? What would you like more training in? For more reading on use of sensory integration in school settings check out the links to references below: Choosing Wisely Q & A: Renee Watling on Sensory Intervention and Assessment Building Competency in SI: Evidence-based Guidelines for Occupational Therapists using Ayers Sensory Integration Occupational Therapy for Children and Youth Using Sensory Integration Theory and Methods in School-based Practice. (2015). American Journal of Occupational Therapy, 69, 1-20. Retrieved November 14, 2018, from https://ajot.aota.org/article.aspx?articleid=2442686. Thank you for reading! When we all work together we can promote occupational therapy in schools as well as throughout our communities! :) Abby #SchoolbasedOT #Sensory #Development #IEP #Goals

Top 10 blogs for School-Based Occupational Therapy Practitioners

Hello, As some of you may know, we are celebrating our first full year of blogging here at OTSchoolHouse.com this month. What a year it has been. The last 12 months have been full of excitement, accomplishments, and just the right amount of anxiety... As we mark this celebratory month, I wanted to give some credit to our favorite blogs that inspired us to start the OT School House Blog. The occupational and physical therapists behind the blogs I am about to introduce to you have been leaders in the therapy blogging world. They blog consistently, are active on social media, and some of them have even been featured on the OT School House Podcast. (Hopefully, the others will join us soon) Each of them has a unique place in the occupational therapy bloggersphere and many provide exceptional value through blogs, books, videos, and other resources. It would mean a lot to me if you scrolled down and found at least one that speaks to you and subscribe to their email list. If you enjoy the OT School House blog and podcast, you will without a doubt enjoy the following blogs. I do want to quickly note that some links on this page to the other blogs may be what is called an affiliate link. This simply means that if you find their content amazing and happen to purchase a product from them, at no additional cost to you the OT School House receives a small commission. So let's get started! In no particular order, we have... 1. PocketOT.com The Pocket OT, aka Cara Koscinski, has been blogging for over 10 years and her website is the ultimate go-to resource for anything sensory and interception. Along with well-written blog posts, you will find a series of web-based courses she offers as well as several books she has authored, including her newest book, "Interoception". Interoception is all about understanding what your body is trying to convey to your brain, and in this book, Cara shares how you can help children better understand what their bodies are telling them. So, be sure to check out the Pocket OT website! 2. TheInspiredTreehouse.com The Inspired Treehouse is a fun website developed by an OT, PT duo. Claire Heffron, OTR/L, and Lauren Drobnjak, PT, blog about developmental milestones, sensory processing, and how to push into the classroom. They also have a few online courses for purchase including the "Pushing into the Classroom: Practical Strategies for Pediatric Therapists" webinar which is designed to help therapists understand how to successfully help students in a push-in model. You can check out that course and their blog Here! 3. YourTheapySource.com YourTherapySource.com is a one-stop shop for therapists, teachers, and parents. With multiple blog posts a week and countless free and paid resources, it is easy to get lost in all the fantastic content. This is the one website on this list without a name and face go with the website and that it because they have a team of professionals bringing you tons of content. They even have a page where they list professional development opportunities. Check out all that they have to offer at YourTherapySource.com 4. TheOTToolBox.com The OT Tool Box, formally known and Sugar Aunts, was started by 3 sisters who all had an interest in creating fun, sensory rich activities for kids. Since the switch to the OT Tool Box, one of the sisters has taken a majority stake in creating the content on the website. Collen is an occupational therapist by trade, but she now stays home to be close to her 4 children. At the OT Tool Box, Colleen now releases a blog at least once a week it seems like and she has plenty of other brilliant worksheets and resources available for purchase. Check her blog out at theottoolbox.com 5. MissJaimeOT.com Miss Jaime is an OT from Long Island, New York and she everywhere when it comes to pediatric and school-based OT. Not only does she treat student in schools, but she also provides therapy outside of schools and is an advocate for change in school-based OT. You can learn more about that in her Facebook group, "USA School-based Occupational Therapists Looking for a Change" Check out her blog and "Motor Mondays" where she demonstrates how just about anything can be used to facilitate motor skills at Missjaimeot.com 6. YouKidsOT.com Cindy, the Australian based occupational therapist, is the blogger and creator behind YourKidsOT.com Although I have not yet had the chance to meet her in person, I have seen her actively engage with her followers all over social media. In fact, she is currently running a monthly competition on Instagram where she asks therapists to post pictures of their best pictures using a tool or strategy of the month (October is clothed pins). With over 4 years worth of blog posts, she has a blog and activity for just about everything. Check Cindy's blog out at YourKidsOT.com 7. AdaptAndLearn.com Adaptandlearn.com has become my go-to blog for all things Assistive Technology and OT. Alescia is ATP certified as well as a Handwriting Without Tears specialist. Her blog posts make adapting everything from playing to planning and to handwriting easy for any OT. She not only reviews physical products, but she also shares her top recommendations for IOS (Apple) devices and Google Chrome extensions. Be sure to check out AdaptandLearn.com if you are looking for some AT tips. 8. GrowingHandsOnKids.com I think this was the first pediatric OT blog I ever came across. I was immediately blown away by what Heather had to offer. She has been blogging for nearly 10 years about child development, DIY projects and sensory processing. If there is a skill you need help with finding an idea for, this COTA has got your back! Her love for Montessori education and OT has driven her to share her ideas with the world through this blog. Check her out at GrowingHandsOnKids.com. Oh, and I did I mention she is an Author? Check out her books Here! 9. TheAnonymousOT.com The Anonymous OT has been providing her candid thoughts on pediatric occupational therapy since 2013. Being anonymous has given her some leeway to go a bit further than anyone else out there when it comes to speaking the truth. Don't get me wrong, she is justified in everything she says. In fact, we enjoy her blog so much that she will be on episode 16 of the OT School House podcast! Be sure to tune in as we "unveil" The Anonymous OT. Along with the blog, she also has some resources available for free and for purchase to assist in treatments. Check out what's happening over at TheAnonymousOT.com 10. OTRobert.Wordpress.com Robert Constantine loves vision! And that is an understatement! Although he doesn't blog as frequently as the rest of the blogs I have listed here, his content is second to none when it comes to understanding vision and ocular motor skills. If I had a vision related question, this is the man I would seek out answers from. He currently provides trainings through PESI, but we were lucky enough to have him join us on Episode 15 of the OT School House Podcast. Be sure to have a listen. He is so passionate about what he does and drops so much knowledge in this 1-hour podcast. Bonus Blog: Sorry, I just couldn't contain myself to just ten OTPotential.com Sarah Lyon may not be a pediatric OT, but she is the owner and face behind OTPotential.com. Since 2012, Sarah has built up a repertoire of blog posts ranging in all areas of occupational therapy. She or a guest writer typically release a new blog once or twice a month about new opportunities for OTs at all abilities. One of her most prominent blog articles is titled "6 Steps to the Right OT Job" where she walks you through the process of finding and securing the OT job of your choice. She also has plenty of books and resources for sale at great prices. I highly recommend you check out her website at OTPotential.com Alright, there it is! The preferred occupational therapy blogs of the OT School House, beside ours of course. But, I would be a fool to not recognize these 11 pages for what they have put together, accomplished, and provided to other OTs like me. Thank you to each of them and thanks to each of you for checking out this list of amazing blogs. I hope you will check out their blogs, as well as ours. Be sure to also check out our podcast during your commutes. You can find the OT School House Podcast on Apple Podcasts, Spotify, Google Play, or wherever you listen to podcasts! Have a great day, Jayson #SchoolbasedOT

Responsible Social Media Use

This time last year, the OT School House did not exist. It was still an idea brewing within conversations between Abby and I. We knew that we wanted to start a blog and we had an idea to start a podcast, but other than that, we had no idea how to get started. We began to meet at Starbucks every Tuesday night and research how to build a website and what the cost would be as we knew we would not be making money off the blog anytime soon. We also looked into creating social media accounts which included taking pictures and videos we could share for the world to see. After all, what OT doesn't love to follow other OTs on Instagram and Facebook to see what free and inexpensive ideas they can use. But before we started posting pictures onto social media, we knew we had to be careful about what we posted. Not only pictures but also the content we shared, whether it be our own, or another's popular post. The thing about having a website and media accounts that people follow closely is that you put yourself out on the line. Just like almost every other OT out there, Abby and I are both nationally certified via NBCOT and licensed in the state of California. And as I am sure you are aware of, your state's practice act not only governs the skilled treatment you provide but also how you conduct yourself. So naturally, as much as we wanted to build the OT School House, we also wanted to make sure that we were not putting our credentials at risk. So we made sure to look at the California practice act along with NBCOT, HIPAA, and FERPA regulations since we work in public schools. Through that process, this is what we have found that we thought you may be interested in knowing. NBCOT: Practice Standards The NBCOT Practice Standards consists of 4 sections including 1) Practice Domains, 2) Code of Professional Conduct, 3) Supervision, and 4) Documentation. We will dive into the Code of Conduct in just a second, but for school-based OTs I want to provide a quote from the standards here just in case you haven't revisited the NBCOT standards in awhile: "The IDEA requires occupational therapists to: 1. Write a report of the evaluation the OT conducted;

2. Provide information and recommendations for students’

Individualized Education Program (IEP) plans;

3. Write service plans for students, considering: disability, medical

diagnosis, contraindications to therapy;

4. Help develop IEP goals and determine equipment and personnel/

assistance needed to meet therapy goals;

5. Prepare periodic status reports; and

6. Write a report when students discontinue therapy. The law does not specify how long therapists must keep

documentation. The OTR or COTA should discuss the documentation

retention policy of their supervisor or employer." This, as you can see, breaks down the required documentation for school-based OTs. It's amazing what you find when you are looking for something completely different. I underlined "Help develop IEP goals" because I think this proves that goals should be collaborative and not just "OT goals" NBCOT: Code Of Conduct NBCOT's code of conduct incorporates 9 principles that are completely understandable and justified. Principles such as not practicing while intoxicated and following state laws headline the code. Also included though is principle number 1 which states that we will provide accurate and timely information to NBCOT such as our certification registration every 3 years. For the purpose of the OT School House, principle 8 was the one that popped out to me the most. Principle 8 states: "Certificants shall not electronically post personal health information or anything, including photos, that may reveal a patient’s/client’s identity or personal or therapeutic relationship." This, of course, was important because we knew we would be posting social media images. And this principle follows HIPAA guidelines in stating that we may not post identifying pictures. So next we looked at NBCOTs Practice Standards. California Practice Act State Occupational Therapy Practice Act Now we couldn't go through every state's practice act for obvious reasons, but the California Practice Act is pretty thorough and is the one we must abide by. Although I won't go into detail because it is state specific, some key points shared in the practice act include: - Ethical Guidelines

-Legal state definitions of "OT" "occupational therapist" "occupational therapy assistant" and more.

-Disciplinary actions should the board feel that ethical guidelines or other areas have been abused.

-Service delivery standards

-Supervision standards. Be sure to look up your state's practice act every now and then to update yourself on the happenings of OT in your state. In California, ours was amended just last month thanks to OTAC and several other key players. HIPAA (Health Insurance Portability and Accountability Act of 1996) Now, I'm sure just about every OT, if not every OT, has taken a workplace course on HIPAA. It tends to be one of those yearly online trainings that we all must take as a way to protect the school district, hospital, or wherever else from liability should protected information be released without consent. In a nutshell, HIPAA exists to protect our clients' identity being connected with any one of the following related to that patient: - a past, present or future physical or mental health or condition,

- the provision of health care to the individual, or

- the past, present, or future payment for the provision of health care to the individual, This is directly related to the OT School House in the sense that you will not hear us on the podcast use a students name. If we use a name, you can rest assured that it is a pseudonym. It is too easy for someone listening to find out what schools I work at for me to even risk using a real name of a student. Likewise, you will not find any pictures on our website or social media pages that identify a student that we work with for the same reason. And that brings us to... FERPA (Family Educational Rights and Privacy Act) Not all OTs are required to follow FERPA guidelines. This is specific to OTs and OTAs that work in public school systems and are required to protect student educational records. Where HIPAA prohibits OTs from sharing medical information on a student, FERPA prohibits the sharing of educational related material such as if a student is receiving special education services. Some information, known as directory information (such as a student's name, grade, and phone number) can be shared for specified reasons such as use in a yearbook or when a district contracts with a photographer for class photos. With that said, at the individual level, we should not be sharing this information with just anyone. Educational records can be maintained in any form, print, picture, audio, etc. So just about any form of documentation collected by an educational agency or representative of that agency that relates specifically to that child can be deemed as an educational record. To me, FERPA is not as straightforward as HIPAA and I wish I better understood FERPA as it relates to special education. The way I try to follow FERPA as best I can is by following HIPAA guidelines for all educational information as I already do related to medical information. Conclusions on our findings As I said, the reason we set to look up all of this information is because we wanted to make sure we were not posting written, pictorial, or video information that would harm our students, you readers, or put ourselves at jeopardy. I forgot to mention earlier, but you should also check your employee handbook to see what your district policies are for posting pictures of work related material on your personal social media platforms. This goes for any type of sharing or social media, be it at a conference, on Reddit, facebook pages or even "closed" groups, or Instagram (This is where I get the most worried by what I am seeing). Through this process, we realized that if we followed HIPAA guidelines across the board in regards to sharing information, we (and you) should be okay. Of course, I am not a lawyer and I want to warn you that my limited research does not make me an expert in any of these guidelines. If you are worried that what you are posting or seeing on social media, you may want to reach out to your state's licensing board for more clarification. So here is our list of 5 guidelines when it comes to posting on social media. 1. Do not use names! Neither student's name nor adult's names should be used to protect identity. You could get permission to use an adult's name, but I just try to stay clear of it. 2. No names, date of births, ID numbers, the name of a school, or any other identifiable info should be in your post. 3. No faces in pictures! We opt to go further and only take pictures of work samples. 4. Do not state what services a student may receive or for what condition. 5. Give credit when reposting. This one is not in the guidelines, but we hope it would be common sense. Whether sharing one of our photos or someone else's, please give them credit. #SchoolbasedOT

How to: Video Tutorial of How to Use DoubleTimeDocs.com

Hey there, Ever since the interview I conducted with Jason Gonzales from DoubleTimeDoc.com (watch it here), I've received some questions about how the Double Time Docs report generator works. One person went so far as to say she felt like it was cheating. But that was only because she did not understand how the website helps you to organize your thoughts. She later expressed that she would try out the free 7-day trial. As occupational therapists, we of course all feel a sense of responsibility when it comes to our reports. And after all, it is our practice license on the line and we want to do the best for our students. So that's why I wanted to write this blog and record the video below that shows exactly I used the DoubleTimeDocs.com software to write an OT report for Ariel from The Little Mermaid. No really, I did. You can even read the full report generated by DTD here Be sure to use promo code OTSH20 to get 20% off your first purchase First off, here are the 3 specific reasons I recommend using DTD. 1. Double Time Docs help you to remember every area that should be addressed in a school-based OT (or PT now) evaluation so you don't leave anything out. Sure, you could choose to leave out whether or not the chair is at an appropriate height for the student, but you won't forget to with this software because it asks you under the "Motor skills" section. 2. The time it takes to build and revise a template. I have spent hours upon hours writing my original template and updating every time I like something in another OT's report or when a parent advocate decides to focus in on one specific sentence for some odd reason. With DTD, I have faith the co-founders, Jason and Scott, will keep the template up to date as trends change over the years. They even have a place for users to submit recommendations. 3. The time to write a report... even with a good template. Even after you've got your template down, you still have to spend time scrolling through and replacing lines with words for each student. DTD makes this simple because you don't have to scroll and search. And you definitely do not have to worry about having the wrong pronoun or, even worse, the wrong student's name in your reports because you are starting each report from a clean slate. Alright, now that you've heard my 3 reasons why I recommend using doubletimedocs.com, I want to share with you this video that shows exactly how to get started with your free 7-day trial and write your first report. The video is about 20 minutes long, but I am sure you will feel comfortable using their website after watching it. On a mobile device? Watch the video on Youtube. Here's the link to view Ariel's full report written on DoubleTimeDocs.com Then, get your free 7-day trial! Well, that's all I have for you all today. I hope you enjoyed the video and feel comfortable in trying out this new program to help save you time and maybe even from some undue anxiety. See you next time, Jayson #OTassessment #OTreports #SchoolbasedOT

A Discussion On Writing School-Based OT Evaluations (Webinar)

This evening, I did something that a year ago I never would have imagined. Below is a replay of a Live Facebook Webinar that Jason Gonzales of DoubleTimeDocs.com (Affiliate Link) and I conducted on the OT School House Facebook page.


In this 60+ minutes webinar, Jason and I reviewed some of the regulations and guidelines that we should all keep in mind when writing evaluations. Jason also provides some data he has collected on how long the average assessment takes and together we offer some solutions to help decrease the time it takes for you to complete your evaluations. So please, feel free to watch the video. Also check out Jason's website DoubleTimeDocs.com to learn more about how to simplify and cut down your writing time. Be sure to get your free 7 day trial and use promo code FALL18 to get 20% your order for a limited time. Quick note: If your school/site has Facebook blocked, this video may not work. But don't worry, this video will still be here later tonight while you enjoy your bottle... I mean, glass of wine. Cheers! Enjoy the video! On a mobile device? Watch the video on Facebook! #Reportwriting #OTreports #OTassessment #SchoolbasedOT

Get Organized for the Upcoming School Year: Tips for the School-based OT

I must confess first of all that organization and I have a long and sorted history. I am often jealous of coworkers who are meticulously organized (Jayson!) as I have often felt that I am missing that gene. My disorganization has been an ongoing struggle starting in grade school with my desk and backpack. I was the student with random crumpled papers crammed into the back and objects falling out onto the floor. As a result organization is one of those areas I have researched and tried to improve as it is necessary to working in a school district. Here are the 10 tools and tricks I use to keep my hot mess somewhat together. 1. Create the simplest system that you will maintain regularly in order to form a new habit. As OTs we often look at student's habits and routines. I decided to use the same approach with myself. In order to create a new habit you have to be able to start and maintain that new behavior for a period of time consistently. This allows your brain to create a new pathway that as it is used will become more automatic. If your organization system is too involved you will not be able to maintain it. Keep whatever system you decide to use simple. For example I keep track of students treatment times, annuals/triennials/assessments/equipment/master schedule/treatment log etc. all in one planner. I found that using multiple binders for all these things was not simple enough a system for me and I couldn't maintain it. Keeping a daily journal or log of everything in one spot helped me to create a new habit ​2. Make time weekly or biweekly to organize your desk, files, notes, etc. Make time each week to organize and clean out your desk, OT school bag, desktop, email, and files. This will help you to keep track of what you need to get done and keep a clear work space. I had an overwhelming workload at my previous position and I found this difficult to make time for but it is necessary. Scheduling this time in the office will help you clear clutter and get more productive. I also experienced far less anxiety when things were put away. 3. Take time to organize your email and desktop folders I tend to hoard emails. I leave my inbox full most of the time. It can be stressful however to open up emails and see hundreds in there and scrolling through emails can take time. Take time to set up folders on your desktop and email it will save you time later when you want to review or remember what someone asked for! 4. Keep a daily paper planner, log, or journal Presently most districts do not have easy electronic documentation and well, if you're like me most of the day I'm running from classroom to classroom so jotting notes down in a planner became a life saver. I take a simple planner with daily pages and times in order to write down what I was doing when. Some examples of what I would include would be treatments, COTA supervision, teacher collaboration, groups, equipment, and meetings. This way when I go to write notes at the end of the day or the next morning I can transcribe my daily journal/log without missing anything. The log is simple enough I can fit it into my OT bag and travel with it more easily between schools. In my planner/log I also pre-list annuals, triennials, and track my 60 day timelines. If its something I see every day I'm not likely to forget. There are three other notebooks I keep as well as a daily log. A phone conversation notebook that I keep by my desk phone, an IEP meeting notebook, and a staff-meeting notebook. These seem to be the three things I want to be able to remember. I mistakenly had these all in the same notebook in the past, but this became super confusing. I use my planner mainly for tracking treatments, assessments, equipment list, teacher conversations, meeting times, and anything else I’m doing during the day. Essentially I have tried to create a journal of each workday in the school year that I can reference as need be. 5. Create a priority list at the end of each day with 3 "Must do" items for the next day. Setting your intentions for the next school day the afternoon before will help you get your mornings rolling. Get those top 3 difficult tasks off your plate first! I have always had issues with anxiety and procrastination. I have found that knocking out the difficult tasks first thing can lead to greater focus during the day as I am not wasting brain power on worrying. 6. Schedule times to check and respond to email and keep work email OFF OF YOUR PHONE! Scheduling email checks for noon and 4pm each day will allow you to keep your morning priorities productive and your inbox clear. I found the when I’m overly connected with emails on my cell phone I’m not being as present as I could be with the students. If there is something dire you will likely get a text or a phone call. Scheduling email times can also help you keep your inbox clear. 7. Keep your car and school bag organized and cleaned out regularly Ok so this is a seriously difficult thing for me to do. Random crayons have been melted to my car seats and tempera paint has ended up on the seat of my pants. I have had to remind myself to throw things out! If I haven’t used it I need to get rid of it. Organizing my school bag allows me to come up with new treatment activities and plan other options when treatment plans were maybe too easy or too hard. Make sure your tools frequently used are accessible. I have found to that when my bag is organized the students love looking to see what all is in it. I presently use a scrapbooking bag with lots of pouches and clear zipper pockets so you can see all the fun things. Larger Items are stored in the middle section. Items that are larger I can balance on top (i.e. scooter boards etc.). 8. Remember to plan Try to plan your treatments in an organized way. I have been guilty of planning on the fly (which if your school bag is organized and ready to go isn't so bad) but I have found that when looking at student progress keeping treatments consistent planning is important! A strategy I have found useful is to make student work folders preplanned worksheets that monitor the goal that the student can use at each treatment session. I make sure I have enough handwriting paper, cutting activities etc. in there to cover multiple sessions. Planning out this way allows for better progress monitoring than treatment notes and random work samples. Hopefully when it comes time for the annual you will then be able to have a series of work samples that easily demonstrate progress because you clearly had a plan. 9. Take a few minutes to clean at the end of the day When you make your priority list take 15 minutes to clear your desk or work area by putting things away. This will help you start fresh the next day and help your mind end your school day. I found myself constantly obsessing over the work I had to do every night and this helped my brain be somewhat done with work so that I could enjoy my evenings and personal time to reset. 10. Remember to be kind to yourself this school year This is probably one of the most important things I've learned on my unorganized journey. If you’re like me and become disorganized easily be kind to yourself and take a few hours to get it sorted. Getting organized is a form of self-care you need to keep so you can be more productive. The students will pick up on your vibes as well so being kind to yourself will bring that same kindness to the kiddos you work with particularly the disorganized ones. Hopefully some of these tips and tricks helped! Remember to keep it simple as organization is a tool to help things be less stressful and keep you a productive OT or COTA! What organizational tools do you use? How is it you are staying put together for this upcoming school year? Have a happy and great start to the new school year! Thanks for stopping by! Abby #Organization #SchoolbasedOT #Goals #IEP

A Back To School List From a School-based Occupational Therapist (PDF included)

This past week my wife and I were browsing through our local Target. I am a school-based occupational therapist and my wife is a now a 4th-grade teacher. Neither of us work in the school district we, or this target, reside in. So given the fact that we both work in education, you can imagine our excitement when we found this setup at Target (pictured) and realized that each teacher at the nearby schools had a handout for needed school materials. Literally, each teacher, from each school had a handout in those little slots noting what students in their class would need. And while yes, I know, schools should be providing all the materials (hence, a FREE and appropriate public education) the reality is that teachers (and OTs) need help sometimes. So yeah, I thought that was super cool. But it also got me thinking... What if OTs got to make a back to school list for parents to have? What would I put on my list of supplies Target puts out as Mr. Davies' list of occupational therapy supplies for your child. So, I posted this picture to Instagram and asked @Target if I could put a list of OT supplies together for them including many items children could use to succeed in schools. I can assure you, @Target did not respond... But some of you did! A few of you raised your hands, using emojis of course. So then I started making a list and here it is. Keep in mind, this is not for any 1 age group... Mr. Davies' List of OT materials to help kids succeed in school Three different types of pencils Small or broken crayons A fidget (not a toy) Accordion file folder Something appropriate to chew Stickers Stylus Earplugs Words of encouragement Box Wiggle cushion See our curated Amazon shopping list with these items Click Here (Amazon Affiliate link that supports the OT School House) Some of these, of course, seem obvious to you who are OTs and special education teachers, but others may not. So I'm going to do two things below. First, I'm going to explain why each made the list. And then at the bottom of the post, you can download a cheat sheet of this list to do with as you will. So let's get started. #1 Three Different Types of Pencils Why 3 different types of pencils? Because you never know which one is going to work for a kid. Some kids do great with a small pencil, others prefer fat pencils. Who am I to judge. As adults we all have our preference, so why shouldn't our students. I am a believer in the idea that we all gravitate to what works for us. Hence, let your student have options and see what works for them. Here are 3 pencils you may want to try out. (Click on the picture to view on Amazon) #2 Small or Broken Crayons Now, I love the look and smell of a brand new box of crayons as much as the next person. But sometimes we just have to break 'em. Crayons that are broken into small pieces, or just small in general, help children on the verge of developing in-hand manipulation skills and functional a pencil grasp. So the next time you see broken crayons about to be thrown out, grab those suckers and let the kids go crazy with them. Break some regular crayons or check out these tiny crayons. #3 A Fidget (not a toy) A toy is something a child actively engages with. It not only entices their hands but also their mind. A fidget, on the other hand, keeps the hand or hands busy with minimal exertion from the mind. Sometimes a fidget can even soothe the mind without even consciously trying to do so. Think of that coin in your pocket that you sometimes mindlessly flip in your pocket or the pen you click aimlessly at your morning meeting. If your student may need a fidget, check out these "fidgets" on Amazon. #4 Accordion File Folder This is one for the kids who have some difficulty organizing their papers and homework. If you know a student who's binder really does look like the dog chewed it up, this may be something worth trying out. Find one that fits into the student's backpack and can be opened without having to take it out. Then, work with your student to label each section in a way that makes sense to the child. Here's one from Amazon: #5 Something Appropriate To Chew On Many kids are soothed by chewing. Chewing can work like a fidget, except it occurs in the mouth as opposed to the child's hand. Some kids wear chewable necklaces while others prefer to chew on straws. I have frequently advocated for students to be able to chew gum at school. Sometimes, just providing the student with a crunchy snack can help. Either the teacher or the parent can provide these snacks. Here are a few things on Amazon you might try with your students: #6 Stickers! Stickers have so many uses! They with with everything from assisting preschoolers in refining their pincer grasps and bilateral hand skills to helping first graders with spacing between words. You can check out the entire post I wrote for more ideas on why stickers are so amazing and how you can use them to help your student(s). Check out these Emoji stickers! #7 Tablet Stylus Every time a child uses a tablet, we have the opportunity to reinforce their use of a pencil by using a stylus. So many schools are putting iPads into the classroom, but they are are not looking at the fine motor side effects of using a tablet. I'm seeing too many kids using their middle finger when using a tablet as opposed to their index finger. Then when they go to pick up a coin, they use their middle finger for that as well. That makes it more difficult for them to manipulate that coin or other small items. By using a stylus, you prevent children from developing poor habits through tablet use. Check out these styluses: Here are some apps you may want to try out as well! #8 Earplugs Let's be honest, there are a lot of loud noises at school. Be it the teacher, the proctor, or the bell installed back in the 80's, these things can hurt little ears. Even if it doesn't damage the physical structure of the inner ear, the noises can be very disruptive to a child's focus. They are simple and discrete; for the right student, they can make a world of a difference. Some teachers and schools will even allow students to listen to music during independent work time. #9 Words of Encouragement The best thing about this one, it's free. Or at least it can be. I saw this idea years ago and I think it's too simple for any parent not to do it. Just write down a few words of encouragement on a colorful paper and stick it in your child's lunch pail. You can even "batch process" several of these weeks in advance. Make it more interesting by making a game out of it. While it may not help a student focus more in class the moment they read it, feeling loved has never hurt a child's ability to succeed. Here's some from Amazon if you'd like to save some time of need some for the days you are in a rush. #10 Box or Stool Have you ever gone into your student's classroom and noticed that they cannot reach the floor with their feet when seated properly in their chair. You likely take quick note of this without diving any deeper into the effects of this. From my years of experience, students who cannot touch the floor are more often wiggling in or rocking their chair, half sitting-half standing in their chairs, out of their seat completely. While a correctly sized chair an desk is the best fix for this problem, it is often hard to come by in public schools. A quick fix can be a small step stool or solid box of some kind that the student can rest their feet on to feel stable in their chair. When in a jam, you can even use this box: Or you can purchase a small foot stool like this one: #11 Wiggle Cushion If your child still likes to move around a lot even with his/her feet stable on the ground or a box, you may want to try a Disc'O'Sit air cushion or wiggle cushion as I often call them. This air-filled disc is easy to fill with a pump and can withstand most kids playful attempt to pop it. More importantly, it allows students to get their movement in while staying in their seat. It is ideal for the student that appears to be lost in space, but can then answer any question when called on. Plus, it's easy to move to the floor during circle time. Just be sure that once you put it on the chair the child can still reach the floor. And of course, you can find it on Amazon! Just click on the picture. Sum It Up! Alright, that's my 11 item list that I would suggest every parent look into for their student, even if they don't receive special education services. Nothing is crazy expensive and most teachers would be okay with them in the class so long as the student does not misuse them. You can see every item Here on our Amazon list. Interested in having this list on a one-page handout? Download it here! No email needed for this freebie. If you'd like more freebies that we have to offer, sign up here! When you sign up, you'll receive 3 more free resources and receive periodic emails from us about more free stuff when it becomes available. Thank you all for checking out this post. If you feel I missed something on my list, comment below. I'd love to hear your thoughts. Take care and I hope you have a great start to the school year! -Jayson Learn more about Jayson on our About Page #Organization #Play #CommonCore #FineMotor #SchoolbasedOT #handwriting

Piecing Together the Alphabet Soup that is PDUs, CEUs, and CAUs

One Does Not Simply Earn PDUs, or CEUs... or CAUs... or whatever other names you can call professional development units... Yet, as Occupational therapists, all of us are required to keep up with our state licensure and/or our national certification with continuing education and professional development. In the school setting, as well as within our profession, it is most important that when we are providing services we are utilizing evidence-based practices in order to utilize the most up to date and effective strategies with the populations we serve. This can be a daunting task at times and often I default to looking for the stamp of approved provider status from AOTA in order to ensure my professional development is on point and that my hours will count toward licensure; however is this the ONLY way to obtain professional development that can go toward licensure? The governing bodies that require proof of professional development or continuing education can make earning professional development feel like an inconvenience. These state governing bodies (i.e. The Board of Occupational Therapy in California), American Occupational Therapy Association, and National Board for Certification of Occupational Therapy work together in order to regulate and ultimately legitimize our profession. By providing standards in continuing education and research, occupational therapists are to work with efficacy and consistency throughout multiple states and can be recognized by public school systems, government bodies, and insurance agencies as a viable and necessary service provider. Although professional development can at times seem daunting (particularly if you have put off earning those CEUs to the last minute) and be a pain to keep track of, it is an extremely important and necessary to growing our profession and maintaining our standing within the education and medical fields. It separates what we do from other professions that may not have the same regulatory bodies and agencies and even promotes appropriate salaries and pay by giving supporting evidence and value to what we know works. I actually encourage all people to join their state occupational therapy organizations as well as our national organizations such as AOTA, because they do contribute so much to the profession that has promotes and advocated for occupational therapy within not just the medical setting but within the public school setting as well. Why is professional development so confusing? Let’s explore the ever-changing and confusing world of professional development in occupational therapy by first reviewing the many names given to professional development by the different regulatory bodies that manage certification and licensure. The National Board for Certification in Occupational Therapy (NBCOT) provides a Certification Renewal Activities Chart that lists Professional Development Units (PDUs) and Competency Assessment Units (CAUs). AOTA recognizes both Professional Development Units and Continuing Education Units in the form of contact hours (where 0.1 CEU is equal to 1 contact hour or PDU). NBCOT looks at 1 contact hour equaling 1.25 PDUs if provided by an AOTA approved provider. As for Competency Assessment Units (CAUs), NBCOT seems to have moved toward using this term because they allow us to earn units through not only the traditional courses, but also through activities that many may not consider traditional professional development. Some examples include volunteering, providing in-services, publishing or review published studies, and others that you can find on this chart of approved CAUs from NBCOT. I have found this chart to be extremely useful in determining which activities are recognized toward professional development as well as the max number of units allowed for each type of professional development. It was truly surprising to learn that quite a few activities outside of the typical classes and seminars may be used toward renewal of your NBCOT certification and state licensure. While I have typically defaulted to only looking for the AOTA approved provider courses as my main means of continuing competency activity in the past, it was eye-opening to recognize the number of activities that can be utilized for licensure renewal and certification renewals was extensive and quite well-rounded. So don’t sell yourself short in taking credit for the awesome extra things you’ve been doing in your practice! Check out NBCOT’s Navigator tool and your state’s licensure requirements and then take advantage of the opportunities for a well-rounded professional development portfolio. Professional Development can come in many packages. While knowing that you are getting a certain vetted level of continuing education by looking at AOTA approved provides you with security in most states will accepting your continuing education, it is not the only form of professional development. It is the responsibility of you as the occupational therapist seeking renewal to know your requirements and track these appropriately. Development of your portfolio in professional development can lead you to new and exciting job opportunities. Utilizing the NBCOT navigator tool and self-assessment tools can provide you with clear career goals and a means of monitoring your continuing education, competence, and development within your specialty area. If you are attempting to become an expert in your area, utilizing tools such as the Navigator can provide you with a means to find the gaps in your knowledge and fill in those holes with continuing education that can designate you as an expert in your field. This can assist in making you desirable to school districts, prepared for interviews, or even open up other opportunities for you promote occupational therapy and your skills. The OT School House, myself, and Jayson have decided to embrace professional development and the opportunities it provides in order to enhance our own personal practice by bringing you blog posts and the OT School House Podcast. Starting the OT School House has lead to both of us developing a greater understanding of occupational therapy practice within the school setting, as well as giving us an opportunity to bring other school-based occupational therapists a resource for the development of their professional portfolios. With that said, we are now bringing the opportunity for you to earn professional development directly from OT School House Podcast! In fact, you can earn .75 units of professional development right now simply by listening to Episode 6 of the OT School House Podcast about commonly used assessments in school-based OT. After you listen, simply visit the show notes and order you professional development certificate of completion. You be directed to take a short quiz that shows you listened to the podcast and gathered the required knowledge. Then, we will send you a certificate of completion. Simple as that! Thank you for stopping by. We hope you now have a better sense of what is required of you to keep the your license valid. Still have questions, feel free to email us! Hope to see you again soon! Abby Parana P.S. here are some links to established online continuing education providers that we fully support. They range in price and some provide the OT School House with a commission when you use our link or promo code “OTschoolhouse” MedbridgeEducation.com (Link) Medbridge has over 150 courses related to school-based OT practice on an easy to use website. Use Promo code: OTschoolhouse to get your first year of unlimited courses for $200 versus the $250 advertised rate. The OT School House does receive a small commission for any OTs who sign up to use Medbridge with our promo code. OccupationalTherapy.com (Link) Occupationaltheapy.com has over 70 School-based related courses that you can watch, read, or listen to earn continuing education all for $99 a year. Use the link above to help the OT School House earn a small commission when signing up. This helps us to keep bringing you excellent content. PocketOT.com (Link) PocketOT is a fantastic blog and resource from long-time Occupational Therapist Cara Koscinski. Not only is she an OT, but she also has children of her own with special needs. she is a great resource and you may even see her name in the conference brochure at your next AOTA conference. OT School House is an affiliate for PocketOT as well. #SchoolbasedOT #Tier1RTI

What is the Sensory Integration and Praxis Tests (SIPT)

The use of Ayres' Sensory Integration and the Sensory Integration & Praxis Tests (SIPT) is a hot topic in school districts across the nation. More and more parents are requesting it and thus more school districts are looking for occupational therapists that can administer the SIPT and provide a sensory integration model of therapy. In fact, searching for School-based OT jobs on Edjoin.org you will often find a description that looks a little like this: So what are your options when it comes to gaining knowledge about sensory integration? If you have worked in a pediatric setting of any kind, you have no doubt picked up at least some sensory-based strategies as well as some theory on SI. The University of Southern California Sensory Integration courses cost thousands of dollars and at conferences such as AOTA, you can attend seminars to get small snippets of sensory integration techniques from various OTs. And a google search of "what is sensory integration" yields an endless amount of professional organizations that attempt to provide the definition in a way that parents will want to seek it out for their child. Not to say that parents shouldn't seek SI out, but it is not exactly the information an OT might be looking for. As far as the Sensory Integration and Praxis tests goes, in this post I wanted to give you a brief overview of the 17 (yep, 17) individual tests that make up the SIPT While long and exhaustive, I must say I appreciate how the SIPT is composed of individual tests that are each norm-referenced. Unlike the BOT-2 where you get a standard score for a group of tests related to visual-motor integration, the SIPT provides you with a score for each separate test. The 17 tests that make up the SIPT 1.Space Visualization This first test reminds me of a toy you might find on Amazon. It consists of 2 plastic form boards with a peg that can be moved so that only a certain form can fit correctly into the form. for each form board, there are 2 corresponding forms (an egg shape and diamond shape) with a hole in each shape for the peg to fit into when correctly placed into the board. On this test, you record the accuracy of choosing the correct form, the hand used by the child to pick up the form, and the time taken for the student to pick which form they think will fit. As you can likely imagine, this test looks at a child's ability to visualize in their head which form will correctly fit. It is also measuring, however, the ability to cross the midline and unofficially the handedness of the student. 2. Figure-Ground Perception Similar to other visual perception tests commonly used, the figure-ground test looks at a child's ability to find the pictures/shapes hidden within a larger picture. The student is instructed to identify the 3 out of 6 options that are hidden in the larger picture. Along with accuracy, the time to process each answer is also recorded for this test. 3. Standing and Walking Balance Just as the name indicates, this test looks at a child's ability to balance in various static and dynamic positions with their eyes open and then closed on most items. A wooden dowel (shaped like a tine speed bump) is used as a way to measure balance on a stationary raised object. Much of sensory integration is based upon the proprioception and vestibular senses, both of which assist us every day to stay on our feet or seated upright in our chair. 4. Design Copy This is the SIPTs version of a visual motor integration test such as the Berry VMI. What I really like about the Design Copy test is how it's scaffolded. The child starts by connecting dots in a horizontal and vertical line on a dot plane, then the dots from the stimulus image disappear. Finally, all of the dots disappear and the drawing becomes even more intricate. This test is graded on several "should have (SH)" and "should not have (SNF)" factors including line deviation, mirror or flipped drawings, and where the child starts the drawing. Think of it as objectively measuring all the nuances that you take notes on while watching your student try to draw the overlapping pencils on the BOT-2 5. Postural Praxis One of the more fun test, but also more difficult to grade, is the postural praxis test. During this test, the assessor assumes a not so normal position, and the child aims to mimic the body position they see in front of them. A child is given full credit if the correct position is assumed in 3 seconds or less, partial credit if within 7 seconds, and no credit beyond that. This test can reveal much more than you would think. 6. Bilateral Motor Coordination You likely do this one with your kids already, but here it is standardized. In this test, the student mimics your 4-8 steps bilateral drumming patterns. After your done with the hands, move on to the feet. This assessment is based upon a 3-point scale; incorrect, approximately correct, or correct. 7. Praxis on Verbal Command As the name suggests, this test is looking at how the child responds to you giving them a 1-2 step verbal direction. An example is "Put the back part of your feet together and your toes apart." For this test, you simply grade whether it was correct or not, and how long it took to get there (up to 15 seconds). 8. Constructional Praxis This test and the Postrotary Nystagmus test are the two tests I think people most associate with the SIPT. The constructional praxis test includes a prebuilt "fort," for lack of a better word, and the blocks needed to recreate that fort. The assessor then helps the child to get started with the building and then allows the child up to 15 minutes to complete the structure. This is probably the most difficult test to score as you have to measure each of the 15 blocks against 8 different criteria. Grading this block fort is an assessment in itself for an assessor. 9. Postrotary Nystagmus A classic part of the SIPT, the Postrotary Nystagmus test involves spinning the child on a spin board 10 times over a period of 20 seconds with their eyes open. after ten turns, you look at and time how long the nystagmus reaction occurs. For the SIPT, the norm reference for how long this reaction should occur after being stopped is 10 second with a small room for error. Precaution: It a child has a history of seizures, you may not want to administer this test. be sure to complete a chart review and/or ask the child's doctor for any precautions. changes in light while spinning can cause the onset of a seizure. 10. Motor Accuracy For this test, the child traces over a black line that spans over a construction sheet sized paper (11"x17" I think). The line is wavy in nature and it does not cross at any time like a figure-8 does. The child attempts the task first with their dominant hand, and then again on the backside of the sheet with their non-dominant hand. This test is scored by the time it takes to complete the task, and by using a rolling measuring tool to see how frequently the child stayed on the black line or within a given area. It's always interesting to compare the dominant hand trial versus the second trial. If they look the same, it's probably not a good sign... 11. Sequencing Praxis Similar to the Bilateral Motor Coordination test, on this test the child mimics your hand "clapping" sequence. This time, however, each step builds upon the previous step. For example, I clap twice then the child claps twice. Next, I clap twice then knock the table, child mimics. Now I clap twice and knock the table twice... and so on. This continues on until it becomes a 6-step process. Along with full hand gestures/taps, this test goes on to include finger taps as though you were typing. Ex. index, middle, index. 12. Oral Praxis Another fun one, in this test the assessor does something with their tounge, lips, teeth or combination of those and the child mimics. Two examples include "put tongue in left cheek" (assessor does this then child mimics) and "smack lips" Score as an incorrect (o), poor quality (1), or well executed (2). If you have already, please give your eyes a break from reading this. If you have read this far, you may like to know that I produce a podcast with my partner in crime, Abby Parana, all about Pediatric OT. You can find it here or on iTunes. Be sure to subscribe so you get all future episodes Alright, back to the SIPT. 5 more to go 13. Manual Form Perception The Manual Form test is a clever one. With their eyes occluded, the child is first asked to find a shape described by yourself. After that, they are to feel a shape with one hand and find that same shape with their other hand. Some shapes are very different, while others are very similar. The hardest part for you on this test is holding the folder to block the child's vision while timing them. Good luck. 14. Kinesthesia Another clever one with the child's vision blocked. The child starts with their index finger on point "A". You then move their hand and finger to point "B" then back to point "A". It is then their job to try and move their finger back as close as they can to point "B" on their own volition without looking. You find out a lot about a child's body awareness through this test. This is something you could do in just a few seconds without the SIPT and I don't use it nearly as much as I should. 15. Finger Identification Again, with the child's vision occluded, the assessor taps on one or two fingers of the child's hand and then the child identifies which finger or fingers were touched. This is simply scored as a "0" or a "1" if correct. We are mostly checking to make sure the tactile system in all okay here. 16. Graphesthesia For this test, you draw a design on the back of the child's hand with your finger while the child cannot see. You then see if the child can recreate the design with their own finger. So you occlude the child's vision while you draw the design, then they are allowed to look while they draw the design. Designs vary from a straight line to a simple star. 17. Localization of Tactile Stimuli And the last one, LTS! For this test, we use a special pen to mark a spot on the child's arm or hand with their vision occluded and then they touch that spot with their vision still occluded. Again, this gives you a good insight to the child's body awareness. WOW, that was all 17! This is not a short set of tests by any means. On the few occasions that I have given the SIPT, it has taken two-to-three sittings of at least an hour each. That is the main reason I don't use it more frequently. The scoring is also time-consuming and requires a computer software and USB key to get the final results. The best administrators of the SIPT say they can get it done in a single 90 sitting. Of course, it really depends on the child as well. To wrap this up, I am SIPT certified and I completed the WPS/USC training about 4 years ago. It has since been discontinued. USC now offers a series of courses that can be taken in southern California, but they are costly. I recommend them if you are interested in getting a deep dive into sensory integration. I hope this intro to the Sensory Integration and Praxis Tests gets you interested in learning more at least. If you have any questions, feel free to email me! Until next time, Jayson #OTassessment #SchoolbasedOT

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