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Using Holistic Circus in Occupational Therapy Feat. Jill Maglio: OTSH Podcast Episode 60

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 61 of the OT School House Podcast. In episode 61 of the OT School House Podcast, I have a fantastic conversation with Jill Maglio, OTR/L, on how she incorporates her passion for circus in her everyday therapy practice. We will talk not only about how she uses circus in here day to day therapy with kids, but also how she has made a living helping people around the world with circus. Learn more about Jill and how she uses circus by listening to episode 61 of the OT School House Podcast! In addition to listening to the OT School House Podcast episode, you can also watch Jill provide a lesson on Juggling to Jayson to see what a treatment session using circus may actually look like. Check it out here! You can also contact Jill at jillmaglio@circusaid.com to gain more circus skills training and ideas for your occupational therapy sessions or to join one of CircusAid’s social development projects working with marginalized communities OT + Circus — CircusAid Links to Show References: HolisitcCircusTherapy.com Circus Aid Instagram Learn Poi at Home online Course CircusAid Website * some of the links above are affiliate links meaning I receive a small commission when you use the links at no additional cost you. 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! 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

2020 Review & 5 Resolutions For Any School-Based OT: OT School House Podcast Episode 60

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 60 of the OT School House Podcast. In episode 60 I am looking back at what I learned from 2020 and sharing what you can expect from the OT School House in 2021. We will also review 5 new years resolutions fit for any School-Based OT and one special announcement. Links to Show References: A-Z School-based OT Occupationaltherapy.com medbridgeeducation.com learnplaythrive.com MsJaimeot.com * some of the links above are affiliate links meaning I own a small commission when you use the links at no additional cost you. 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 59! 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

When to use Screenings in School-Based OT: OT School House Podcast Episode 59

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 59 of the OT School House Podcast. In episode 59 of the OT School House Podcast, I'm sharing with you the who, what, when, where, why & how of screenings in the school-based OT setting. Whether you are a brand new OT or a seasoned School-Based OT, the likelihood that you are using screenings and the subsequent opportunities to their full potential is unlikely simply because it is not something we are trained in. I hope this podcast can inspire you to move forward with supporting more students that just those who are on an IEP. So please listen to learn how. Links to Show References: Sheryl Eckberg Zylstra, Beth Pfeiffer; Effectiveness of a Handwriting Intervention With At-Risk Kindergarteners. Am J Occup Ther 2016;70(3):7003220020. https://doi.org/10.5014/ajot.2016.018820 Check out the A_Z School-Based OT course - The Comprehensive course for OTs in the the school-based setting. Use Promo Code oct50 to get $50 off before Oct. 23, 2020 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 59! 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

Occupational Therapy in Preschool: OT School House Podcast Episode 58

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 58 of the OT School House Podcast. In this episode of the OT School House Podcast, I have a conversation with Amanda Speights, OTR/L about what occupational therapy looks like in a preschool. She works in a model preschool and I work in a preschool, not sure I would call it a model preschool =P Anyways, in this episode we talk about the what the goal is for working with preschoolers, the referral and assessment process, and why we think it is important to collaborate with the preschool teachers to serve our students. Links to Show References: Visit Amanda's website at AmandaTheOT.com 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 57! 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

Telehealth Platforms, Evaluations, and Ethics: OT School House Podcast Episode 57

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 57 of the OT School House Podcast. In this second episode of the 2-part teletherapy series, I discuss the pros and cons of the most popular telehealth platforms being used by public schools districts and some tips on how to use both Google Meet and Zoom. I then go into what a school-based occupational therapy evaluation may look like through a telehealth model. We will look at what assessments tools may or may not be possible. And finally at the end, we will discus ethics as they relate to telehealth and how to ensure that you are providing equitable services. View the first episode in this teletherapy series at otschoolhouse.com/episode56 Earn a certificate for 2 hours of professional development by listening to episode 56 & 57 and purchasing the Professional Development Podcast Course! Links to Show References: Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: Designing a user-expe rience. Work. 2019;62(1):125-131. doi:10.3233/WOR-182847 Telehealth in Occupational Therapy. Am J Occup Ther 2018;72(Supplement_2):7212410059. https://doi.org/10.5014/ajot.2018.72S219 AOTA Back to School Resource page Criss M. J. (2013). School-based telerehabilitation in occupational therapy: using telerehabilitation technologies to promote improvements in student performance. International journal of telerehabilitation, 5(1), 39–46. https://doi.org/10.5195/ijt.2013.6115 Sarsak HI. Telerehabilitation services: a successful paradigm for occupational therapy clinical services? . Int Phys Med Rehab J. 2020;5(2):93?98. DOI: 10.15406/ipmrj.2020.05.00237 Osmo attachment for the iPad (turn your iPad into a document camera) (Link supports the OT School House Podcast) 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 57! 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

Telehealth Guidance, Practice, & Research: OT School House Podcast Episode 56

Press play below to listen to the podcast Welcome to the show notes for the Episode 56 of the OT School House Podcast. In this episode of the OT School House Podcast, I share guidance, research and practical strategies related to providing telehealth occupational therapy services as a School-Based OT. We will look specifically at AOTAs guidance on telehealth, state laws to be mindful of, and the considerations to be mindful of when providing OT services via a teletherapy model. I also provide a few of my favorite teletherapy treatment ideas and how I have been adapting them. This is the first in a 2-part series on teletherapy. View the second episode in this teletherapy series at otschoolhouse.com/episode57 Earn a certificate for 2 hours of professional development by listening to episode 56 & 57 and purchasing the Professional Development Podcast Course! Episode 56 of the OT School House Podcast is sponsored by Learn Play Thrive View the free Learn Play Thrive webinar by clicking the image below Links to Show References: Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: Designing a user-expe rience. Work. 2019;62(1):125-131. doi:10.3233/WOR-182847 Telehealth in Occupational Therapy. Am J Occup Ther 2018;72(Supplement_2):7212410059. https://doi.org/10.5014/ajot.2018.72S219 Wallisch A, Little L, Pope E, Dunn W. Parent Perspectives of an Occupational Therapy Telehealth Intervention. Int J Telerehabil. 2019;11(1):15-22. Published 2019 Jun 12. doi:10.5195/ijt.2019.6274 OT School House Instagram A-Z School-Based OT Course 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 56! 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 55: Back To School Plans During a Pandemic - Part 2

Press play above for the unedited audio and visual version of the podcast. Press play below to listen to the edited version of the podcast (audio only). Or click on your preferred podcast player link! On this special event episode of the OT School House Podcast, Jayson welcomes to the show occupational therapists, Jaime Spencer, OTR/L, and Billy Hatridge, OTR/L

In this episode, Jayson, Jaime, and Billy discuss what the looming return to the 2020-21 school may look like in our districts and how we are planning for them. We discuss how evaluations, treatments and IEP meetings will all be very different, even from how they were at the end of the 2020 school year. We also spend some time advocating for our profession and a workload model in schools. Above, you can watch the full, unedited Facebook video or you can listen to the audio only version on the OT School House podcast using the player at the top of the page or where ever you listen to podcasts. Links to Show References: Visit Jaime's website at MissJaimeOT.com Check out Billy's website at TheOTDad.com A-Z School based OT Course - An original OT School House Course created and taught by Jayson on almost every aspect of School-Based OT. USe promo code "backtoschool" for 10% off! Also referenced in this episode: Google Meet Zoom Microsoft Teams 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 55! 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 54: Back To School Plans During a Pandemic

Or click on your preferred podcast player link! On this special event episode of the OT School House Podcast, Jayson welcomes to the show occupational therapist, Olivia Martinez-Hauge, MFTA, OTR/L, and occupational therapy assistant, Cait Bowen, COTA. You may remember Cait from Episode 44 of the OT School House Podcast.

In this episode, Jayson, Cait, and Olivia discuss what the looming return to the 2020-21 school may look like in our districts and how we are planning for them. We discuss how evaluations, treatments and IEP meetings will all be very different, even from how they were at the end of the 2020 school year. Above, you can watch the full, unedited Facebook video or you can listen to the audio only version on the OT School House podcast using the player at the top of the page or where ever you listen to podcasts. Links to Show References: Follow Cait Bowen on Instagram: @Cait_the_COTA Check out Olivia Martinez-Huage's website at OliviaMArtinezHuage.com Also referenced in this episode: The WooTherapy Blog (Highly recommended) Google Meets Google Meets Zoom Microsoft Teams 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 54! 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 53: AAC with The Fannypack Therapists

Or click on your preferred podcast player link! 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

Or click on your preferred podcast player link! 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.

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

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