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Hey there! As OT practitioners, we understand IEPs. I mean, we have to. You can't get through a school-based OT job interview without knowing at least the basics of an IEP. But 504s are different. I don’t think I knew what a 504 plan was until my second year in the schools, and it was probably an additional year or two before I was actually included on a 504 team. While IEPs follow a pretty standardized structure outlined by federal law, the landscape of 504 plans is notably varied. Across the country, districts seem to interpret what constitutes 504 plan interventions very differently, resulting in a wide range of approaches and practices. In this article, we’ll address the similarities and differences between these plans. I’ll also share insights and strategies from my experiences providing OT services under both an IEP and a 504 plan. Overview of 504 Plans and IEPs 504 plans and IEPs both serve as guiding documents that delineate the unique needs and accommodations for students with disabilities. And while both aim to ensure equitable access to education, they operate under distinct legal frameworks. A 504 plan, governed by Section 504 of the Rehabilitation Act of 1973, caters to students whose disabilities “ substantially limits one or more major life activities ” but do not necessitate specialized instruction. On the other hand, an IEP is mandated by the Individuals with Disabilities Education Act (IDEA) and must be tailored for students with specific disabilities who require specialized educational services. OT Significance:  OT practitioners can support students under both a 504 plan and an IEP. Eligibility Criteria Understanding the eligibility criteria for these plans is muddy, even on the best of days. For a student to qualify for a 504 plan, their disability must significantly impede major life activities such as learning, walking, or concentrating. This definition lacks the specificity outlined by IDEA, leaving the idea of who can benefit from a 504 plan ambiguous, at best. In contrast, eligibility for an IEP (not just OT services on an IEP) is well documented in IDEA  and requires that a student must be identified as meeting one (or more) of 13 different disability criteria. In addition to meeting the disability criteria, the student must also be identified as needing specialized instruction to access and benefit from their educational curriculum. Eligibility for school-based OT services is not explicitly outlined by IDEA or Section 504. Scope of Services The scope of services offered under 504 plans and IEPs are often very different. Whereas IEPs usually include accommodations, modifications, specialized instructional supports, and related services, 504 plans will frequently only include accommodations for a student. While uncommon, it is not unheard of for districts to provide services (in addition to accommodations) to students on a 504 plan. As an OT practitioner, you may be asked to limit your 504 plan recommendations to accommodations and reserve services for students who qualify for an IEP. This is one of the many situations in which you might learn a lot about your personal ethical boundaries OT Assessment Process In the assessment realm, OT practitioners play a role in evaluating students' functional abilities and determining the most appropriate interventions. To understand the OT assessment process as it relates to IEPs and Section 504, you need to consider several factors, including: IDEA Section 504 provisions your State OT Practice Act The OT Practice Framework (OTPF-4) Regarding IDEA and 504 Plans, the statutes have similar requirements for what an evaluation must look like. Information must “draw from a variety of sources” and “all significant factors related to the student's learning process must be considered.” Likewise, sources may include “aptitude and achievement tests, teacher recommendations, physical condition, social and cultural background, and adaptive behavior” (“Protecting Students with Disabilities,” 2023) I obviously cannot discuss every state practice act, but by looking at the OTPF-4 we’ll get a good sense of what is required of an OT evaluation. The OTPF-4 notes that prior to providing OT services, OT practitioners need to have a solid evaluation to guide the intervention process. It also outlines the three primary aspects of an OT evaluation. Those are: The development of an occupational profile An analysis of occupational performance, and A synthesis of the evaluation data So, to answer the question of how 504 plan OT assessments differ from IEP OT assessments, my answer is that they don’t - or at least the process should be the same. Sure, the outcomes of a 504 plan assessment may be different from those of an IEP assessment, but that doesn’t mean that you need less data to come to your conclusions. There will likely be some occasions when you are asked to evaluate a very specific area of need for a 504 plan. In that case, your evaluation may be more targeted than others, but the process and how you arrive at your recommendations will remain the same. You can learn more about what school-based OT evaluations should look like here. Want to learn more about OT Evaluations? Sign up for the A-Z School-Based OT Course to help you better understand how to complete an OT evaluation. You'll get access to my evaluation document template to improve your evaluation write-ups! Intervention Process Traditionally, interventions for students with a 504 plan revolve around providing accommodations such as preferential seating, extended time on tests, assistive technology to facilitate equal access to educational opportunities, etc. In addition to the accommodation(s) put in place, consultations with team members may be required to ensure they are implemented with fidelity. In contrast, an IEP frequently includes weekly, monthly, and/or less frequent consultative services in addition to accommodations. However, as I noted above, 504 plans can include consultative or direct services. Likewise, OT practitioners can suggest accommodations to an IEP team without implementing any service—although I recommend at least a consultative service when first implementing accommodations. I hope you are starting to see how entangled and gray 504 plans and IEPs genuinely are. It is because of this that I see more and more districts bypassing 504 plans and going straight to an IEP. Documentation I’ll keep this section short and sweet. When it comes to documentation, the answer is to ALWAYS DOCUMENT!!! Whether the student has an IEP, 504, is on MTSS, or any other program with an acronym that only educators know, document everything - Evals, notes, progress, sessions… everything! Conclusion As I hope you have gleaned from this article, IEPs and 504 plans intersect in complex ways. 504 plans are not “accommodation only” plans. And IEPs do not always have to include OT services. When it comes to the OT assessment and intervention pieces, I have come to acknowledge that there are more similarities than there are differences. What really seems to separate them out are the pieces that OT practitioners have less say in - such as how the student qualifies for one or the other and details in the paperwork. No matter what kind of plan you are supporting, I know OT practitioners are always going to be on the side of supporting the student. And so long as you do that, you’ll just about always do the right thing. What are your experiences like with 504 plans and how do they compare to IEPs? Please share this article on LinkedIn and share your thoughts. I would love to hear what you think. Thanks for having a read, 👋 Jayson Resources Occupational Therapy Practice Framework: Domain and Process—Fourth Edition.  Am J Occup Ther  August 2020, Vol. 74(Supplement_2), 7412410010p1–7412410010p87. doi:  https://doi.org/10.5014/ajot.2020.74S2001
Protecting Students With Disabilities. (2023).  Ed.gov . http://www.ed.gov/about/offices/list/ocr/504faq.html
Sec. 300.8 Child with a disability - Individuals with Disabilities Education Act . (2018, May 25). Individuals with Disabilities Education Act. https://sites.ed.gov/idea/regs/b/a/300.8

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 147 of the OT Schoolhouse Podcast. Do you think AI can revolutionize school-based OT? In this episode, join expert guest Teresa Fair-Field as she explores innovative uses of artificial intelligence that are reshaping the way OTP's support students and clinical decision making.  Discover the collaborative efforts between clinicians and tech experts in developing predictive AI, and learn how these advancements can generate treatment plans and improve communication. This episode is great for any school-based OT who wants to stay up to date, and utilize technology to enhance evidence-based practice and ultimately enrich student outcomes. Listen now to learn the following objectives: Learners will recognize the ethical considerations of AI use.
Learners will understand the role of occupational therapy in supporting neurodivergent students in physical education settings.
Learners will identify strategies for integrating AI into clinical decision-making, IEP development, and treatment planning. Guest Bio Teresa Fair-Field, OTD, OTR/L Clinical Assistant Professor of Occupational Therapy Baylor University Teresa Fair-Field, OTD, OTR/L, Clinical Assistant Professor of Occupational Therapy at Baylor University since 2021, affiliated with Early Markers, a Seattle-based startup focusing on machine learning and infant motor development. Their NIH-funded work aims to create an app for AI-supported early screening, parent coaching, and education. Teresa specializes in neurological development across the lifespan, including early intervention, infant motor skills, and neuromotor conditions. Quotes "AI is a family of computer systems... aimed at solving problems that could include learning, problem solving, decision making, pattern recognition."  – Teresa Fair-Field, OTD, OTR/L “All of the ethical responsibility is on the user to sort of normalize. I use this tool in the same way that you would have used Microsoft Word embedded grammar checks.” –Teresa Fair-Field, OTD, OTR/L “You kind of have to assume if you are entering details, that they are going on a computer somewhere that you don't have control over. So that's why it's really important that you're sort of cutting and pasting things and that those things don't have explicit information in them.” –Teresa Fair-Field, OTD, OTR/L “That's the biggest hurdle. It's not the integration. It's connecting the existing systems we already have.” –Teresa Fair-Field, OTD, OTR/L “Evidence based practice is reading the research, learning about the research, taking what you know about the patient, what you know about the environment, the school…and deciding for yourself whether or not that research actually makes sense for your case.” – Jayson Davies, MA, OTR/L Resources 👉 Chat GPT 👉 Hippocratic AI 👉 Early Markers 👉 Consensus AI 👉 Magic School AI 👉 Copilot AI 👉 Gemini AI 👉 Occupational therapy in the Fourth Industrial Revolution 👉 https://www.youtube.com/watch?v=7l5Fjl8dilI&t=1 Event replay Link 👉 Get in touch with Teresa  Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hello and welcome to the second episode of where we are diving into school based occupational therapy and artificial intelligence. In this episode, I am joined by Teresa Fairfield, an occupational therapist who is on the forefront of incorporating AI into the profession of OT. As the Chief Clinical Officer of early markers, a company that is using AI to develop a home based mobile app to detect early risk indicators for cerebral palsy. It is pretty crazy, I definitely recommend checking it out. You can learn more about it over at early markers.com . In addition to her role at early markers, Theresa has an extensive background in pediatric OT. And as a Clinical Assistant Professor of Occupational Therapy at Baylor University. I've known Teresa for almost 10 years now, it's hard to say that like 10 years ago feels like yesterday. But she has done so much. And I've just watched her career developed over the last 10 years. And when I found out that she was working with early markers, I was just kind of blown away because I never heard of an OT working alongside of a quote unquote, tech startup. So very cool to have her joining us today. This episode is a very special one in the sense that it was originally recorded live on YouTube back in March of 2024. This year, if you're listening to it recently, because of that, you might hear us refer to some listener questions near the end of the episode. If you would like to watch the episode on YouTube, we have added a link to the show notes over at OTSchoolHouse.com slash episode 147. You're getting the same content here. It'll be a little bit more edited here because it's not live. But if you want to have that picture with the audio, you can head on over to YouTube and find it there. And one last thing before we get started, did you know that you can earn professional development hours for listening to the OT schoolhouse podcast? Yep, that's right. Members of our OT school house collaborative community can earn unlimited certificates of completion by listening to the OT school health podcast and displaying their learned knowledge with a simple quiz. To learn more about otisco House collaborative and just start earning your professional development hours for the podcast episodes. You already listened to head on over to OTSchoolHouse.com slash collab that OTSchoolHouse.com slash co LL. A B. And with that, let's dive into how AI may revolutionize school based OT in the future and the impact it is already having today. Stay tuned.    Amazing Narrator     Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here's your host Jayson Davies. PLAs is officially in session.    Jayson Davies     All right, I see the chat is working. The chat is definitely popping up. Hello, hello, I am refreshing the YouTube page just to make sure we are good over here it is good. And we are just gonna go ahead and get started. I see so many people here. I think we had 40 people or 48 people waiting and just before we go, but I see Billy I see March. Thank you for being here. Christy KALLIOPI, a member of the OT School Health Collaborative, thank you so much for being here. Really appreciate you all. And as you note today is all about school based occupational therapy and the use of AI and school based occupational therapy. This is a very special Live episode of the OT school health podcast. And in case you're wondering, a replay will be available both right here on YouTube where you're watching it now. And we will also be releasing this as a podcast episode for the OT schoolhouse podcast as its own separate thing probably in about a month or so. So stay tuned for that if you want to catch it again, in audio format in between schools number one, two and three. So with that, let me go ahead and we're going to dive right into it. I'm going to introduce my fellow colleague here. And I'm actually going to bring her on the screen right now. So we can bring her on you can all meet Theresa and the threes with Ella was not I actually met Teresa several years ago now in the middle of a sensory integration and practice test course. Going through the USC WPS program when it was still a thing. She was just a friendly, friendly hello friendly face and we went through like four classes together over the span of a year. got lunch several times you haven't just had a good time learning together just like we are doing today. And so if I can really briefly introduce Teresa to you all. Teresa is a Clinical Assistant Professor of Occupational Therapy at Baylor University. She's been in that role since 2021 and is affiliated with early markers, a Seattle based company pewter vision startup whose work in machine learning and infant motor development is building an app based tool to provide AI supported early screening together with parent coaching and education. So and kind of see why we have her on today. She is like with this, she's working alongside this AI base program to basically support infants and infant motor development. The smartphone app is poised to improve screening access to areas underserved by skilled early interventionist, and over her nearly 30 year career. Teresa has specialized in neurological development through the lifespan to include early intervention, and infant motor skills, as well as neuro motor conditions, adulthood and neurodegenerative diseases. And she's also certified. Once again, that's where I met her as well. So, Teresa, how are you doing today?    Teresa Fairfield     Oh, very excellent. It's nice to have so many people that are interested in the AI space. And you know, it's an exciting topic. So let's get started. Yeah,    Jayson Davies     you know, and this is definitely something that is exciting. It's extremely new, we're kind of like you're saying like the wild west of AI, it's, it's a OTA has not even had time to kind of publish any sort of guidelines. As many of you know, I participated in an EO TA, forum, chat, whatever you wanna call live with them about a month ago. And that was just so awesome. We had four of us on, on there to just kind of talk about what we're seeing. And the world of AI and I kind of was the pseudo school based OT, therefore, that it's just amazing, we're seeing so many different use cases of AI. And I think that's just kind of the best place to start here. Today, we'll get into some q&a, everyone, for if you're listening, we'll do some q&a later. But we're going to start this off by just letting Teresa share a little bit about what she has seen within the realm of AI. So with that threesomes share a little bit, just kind of what you've seen out there with AI and occupational therapy in general.    Teresa Fairfield     Absolutely. So to begin with, let's just talk about what AI is, and maybe places that were already using AI and might not even know about it, that's probably a good place to start. So AI is a family of theater systems really, that's aimed at solving problems that could include learning, problem solving, decision making all kinds of pattern recognition on a on a high level. And it includes things like branches of AI like predictive AI, which is where you're using tools to actually predict an outcome or such as, you know, scanning data and seeing, you know, can we predict a specific outcome based on these large format data streams, or what what we as consumers are probably more familiar with, which is generative AI, and that is AI that is, has been trained on resources that generates data that is similar to but not identical to those resources. And those are things like chat TPT, and some things that I know that you've played around with. So in that sense, we have both sides sort of represented, and that, you know, my research in early intervention is really the predictive AI can we use an AI tool to identify those infants that would benefit from a full occupational therapy assessment or a full team assessment by early interventionists? So, you know, it's it's in nobody's interest to replace the team with AI assessment bots. However, we do know that we have a pipeline issue in the field and, you know, identifying the infants that you know, would benefit that are missing their milestones that have a certain number of motor markers that would likely qualify could help really unclog that access issue. And when we started out this work, it was shortly around the time when I met you, Jason around 2014 2015. We were using tools like Well, at that time, it was the camera that was on your Microsoft Xbox that was you know, detecting humans in play and and our team used some of those same tools to you know, begin research and say, Okay, can you know that was designed with a certain use case being adults being, you know, in the gaming world, and can we use that same technology and see if it can Identify an infant or a child and because that was sort of, you know, not a use case it was designed for and turns out, it performed beautifully. But it didn't resolve the issue of access, because of course, not everyone had a at that time, not everyone had an X Box in their home. And but, you know, the technology that was running on that planet, nobody has an Xbox, you know, Kinect in their home now, because, you know, the technology that was available then is now available on everybody's smartphone, even older smartphones are capable of, you know, producing body pose imaging, that can, you know, detect an infant and what the infant is doing with hot with very high accuracy. So, so that being said, there's, you know, there's this space of AI, but there's also this space of digital health, which is, you know, related can be aI informed, but you know, not necessarily as explicitly research or documentation, but how do we use data to solve some of Healthcare's challenges? So that's where it's really exciting and really fun to talk about.     Jayson Davies     Yeah, and I think most of us when we think of AI, right, we think about what you mentioned that I've talked about, which is mostly chat, GPT. Maybe what's it, what's it called copilot I think, is the one that Microsoft is officially going with, or Gemini for Google, we think about, you know, interacting with a chatbot. But you've opened the door. Like, there's so much more to that with machine learning, I want to I think we're gonna spend most of today talking more about like chatGPT, because I think that's what's accessible. But before we dive really into that, the other side of things, are you seeing any of that in school based OT as of right now, or in any pediatric OT for that sense, other than the project that you're working on?    Teresa Fairfield     Well, not necessarily in the clinical space, because again, we're working on validation. So the tool is built, we've looked at hundreds of infants, we're doing what's called supervised machine learning. And that means that you and and we had OTs be early intervention OTs involved with what's called setting the ground truth. So you observe 1000s of video snippets, you label them, and then essentially train the computer, what you as a clinician are observing. So in that sense, you can label it both quantitatively as well as qualitatively if we think about aspects of motor skills, we have both quantitative and qualitative data points in any motor activity. And so by training that label set, then you can deliver it to videos and content that it has not seen before. And it can, you know, detect those same movements, those same motor markers on the untrained data set. So but really, when we talk about that predictive AI, I think the important part for clinicians is to understand that clinicians are the ones doing that work in association with the programmers and software engineers, because, you know, they know the code, but they don't know what they're looking at. So it's very much a collaborative exercise. And really, all the things that we'll be talking about have even the even the GPT so a GPT is a generative stands for generative pre trained transformer. So you know, you are you are again, you are giving it data to learn from and then asking it to generate something new from that. And that's where the and there's many GPUs that do that, including ones that are specifically focused on medical health issues like Hippocratic AI is a health GPT. And it's been trained using actual nursing and and health care providers. So that it's not just programmers that are that are delivering this content. It's not just and I think it's important to kind of pull back the curtain and make sure that people know that a there's seats at the table if you're interested in this work, because they need us to produce a product that's relevant. And they need our insights in terms of understanding what the problem is that we face.    Jayson Davies     Yeah, yeah. And I'm just trying to think of some like use cases and throw some out for me like obviously, I think people understand the GPT is because we can use those to generate goals. We can use this to generate we'll talk more about this but goals or treatment plans evaluations help us to write up notes and all that good stuff but the others side of it, what do you see as some pie in the sky 10 years from now activities that that will be supporting us on a daily, weekly basis. Just you don't need to go into detail, but just, you know, things that we know of already today?    Teresa Fairfield     Absolutely, I think, you know, I think that what it makes possible is for us to be spending our time on not only where we want to be spending our time, which is clinical decision making, and you know, but it's a nice decision support tool, in terms of, you know, how do I triage this issue, and that, you know, kind of materially comes in to some of those workload caseload discussions that I know you have on your platform quite a bit in that, you know, not just what can we take off of our plate, as you know, we're spending more time doing activities that are not value added direct to the client, but also, what becomes possible in terms of things that we haven't thought about yet. And that's some of the conversations that I've had in the digital health community is, you know, we don't have you know, calls going out to families, we don't have like, there's a lot of sort of connection between school and home or clinic and home or environment at home, like there's a lot of connection that doesn't exist, because we don't have the ability to, you know, perform that ourselves. And that's where we can look at a chatbot. And, and, you know, the language support is really, really taking a giant leap forward. And, you know, we can expect that, you know, all of those gaps in communication could potentially be closed.    Jayson Davies     All right, I have a hypothetical for you, how long would it take me potentially today? Or I don't know, if it's not possible today, to potentially create something where I upload a student's writing sample and AI is able to, quote unquote, graded on legibility, based upon maybe letter size, spacing, placement, all that good stuff. Is that something that could probably be produced with a GPT? today?    Teresa Fairfield     Yeah, yes, and certainly with, you know, certainly with image detection, now, your GPS that you're using, don't have that sort of image databank. But, you know, again, if you train it here is the, the range of typical, then whether it's handwriting or motor milestones, a computer's going to be able to, you know, very closely identify, here is your normative band. And we already have that with our OT assessments that, you know, they're moving towards, you know, look at the PDMS. Three, it's, you know, it's all online scoring. So, you know, and the, and the bot three coming out soon, near you within the next few years near you, is all computerized scoring. And so it's really a very tiny jump before you'd be able to just scan in sheets and, and receive data. And in that sense, like, the, you know, I saw a chat, I saw a comment pop up about clinical reasoning. And, of course, we're going to spend a lot of time talking about that, as well as the ethics of some of these scenarios. But, you know, again, we already have the it's not the actual delivery of the counting the number of below line letters like that is not where our skill is necessary. You know, that is a very mechanical tasks that can be performed by, you know, a trained individual of any variety to say, Okay, how many, you know, mixed case letter formations do we have in this student sample, that's not where the skill exists, the skill is in, you know, all of the aspects that affect handwriting, everything from you know, seating, postural control, you know, all of those things, and, and similarly to some of the conversations, you know, even looking at vestibular equipment, like the swing is not the OT, the OT brings the OT, this swing is just a tool. And you know, anybody can put the kid in a swing and they're not performing OT. So I think it I think it requires us to really focus in on our clinical reasoning skills as well as perfect our ability to communicate them.     Jayson Davies     Yeah. Yeah, that's funny that you bring that up the whole idea that like, yeah, AI can score an assessment, but so can just about anyone who can read the manual and go through, like, especially standardized assessment and tells you exactly what to say, right? Like, I mean, we can put a ruler over the circle and see if the circle is cut like, you don't need to be an OT to determine if it's cut within one quarter inch of a line. And that can save us a lot of time time that we could be spending with teachers spending with parents spending with kids, giving them the information that they need, or, or walking them off a cliff because AI told them something wrong. We need to clarify a little bit. But yeah, there's so many generative are so many, so many ways to utilize this to give us more time, honestly, which is which is very important. Let's talk about ethics, not just necessarily related to school based OT, but just in general, what are some things that maybe we should be very aware of when it comes to AI as it currently is today?     Teresa Fairfield     Absolutely, certainly, I think the and as an educator, there's a lot of and talking with other educators, there's a lot of initially sort of reactive response to how do we keep our students from using this. And that's really not a sustainable approach. Because it's a tool, it has the ability to improve your quality of life as a clinician, and as a student, and, and again, like, equity in the space is important too. And so, you know, I feel like AI is is has the ability to bring us to bring so many good ideas to the forefront. But but really the the onus is on us, as individuals to declare that we've used AI and you can, you know, you can submit a manuscript to a peer reviewed journal, you can give it a draft, you can and you can indicate and are expected to indicate where AI has been used in the development of that manuscript. So that's already happened in the American Medical Association Journal, where, you know, it is assumed that with these large language models, we have the ability to improve our sentence structure, we have the ability to, you know, look for sort of holes in our argument, and then buttress them. And it's important to understand that our results are still our results. Those are things that, you know, we achieved based on our human in invention and innovation. And if we use a large language model for refinement of our results section, and we declare that, you know, that is widely acceptable within within evidence based practice. So again, the AI is not generating data, that's, that's outside of its role. But it does have the ability to, you know, as, as Amy's mentioning, in the chat, it does have the ability to improve the professional writing voice and you know, assist you as the author from taking something from potentially unpublishable, to to publishable levels. And it's, it's a declaration and again, we as all of the ethical responsibility is on this on the user to sort of normalize, you know, I use this tool in the same way that you know, you would have used Microsoft Word embedded grammar checks 10 years ago.    Jayson Davies     So but what if we get out of the idea of formal manuscripts and whatnot, what if we're talking about our daily treatment notes or an evaluation that we're completing, whether it's school based or in a hospital, we use chat GPT, just because we gave it the bot scores, and it was able to summarize that a little bit quicker, honestly, than we could do you think at that point? Is it becoming a norm to say, you know, what, this report includes AI generated content, or is this separate from manuscripts?    Teresa Fairfield     Well, I think I think that's where we probably should go in the sense that if you and again 510 years ago, if you were using the online scoring software of the bot, it produced a report for you. Yeah, from your data alone. So you know, and we did that all the time. You could print short form reports, you could print long form reports after only having having given it the bot data. Now, the issue is, it's very clear that you didn't write that, right that's coming from the bot A company from the assessment company. So and I think the challenge, I never really used a lot of those reports because they weren't parent friendly. They weren't parent centric, they weren't at an appropriate reading level for the parent. And again, you can use the large language module model AI to, to set whatever reading level you specify, which has, you know, an incredible opportunity for health literacy. But it's still the onus is still on the therapists to ensure understanding to provide education to provide generalization and relevance. But again, it really starts to shape. What is the skilled service? The skilled service is the assessment? It's not necessarily the manual scoring. And it's the interpretation of the results.    Jayson Davies     Yeah, absolutely. And, you know, this is something that this is why we're having the discussion, because this isn't set in stone yet. AI has only I mean, chat GPT opened the doors like a year and a half ago. So this is all new, a OTA is still trying to figure out where to go with guidance. At the OT school house, I'm definitely using AI. And I know many OTs are someone mentioned in the chat earlier, one of the tools that they use as magic school.ai , which is its AI designed for teachers really, and related service providers, but it's really more geared to our teachers and admin, but I know that OTs are using it for the same purpose. I don't think anyone fully knows how to quote unquote, site AI out of maybe the more formal manuscripts, like people are still trying to figure that out. The same way that everyone tried to figure out what to do when Google took over the road. Like, you know, this is a tool that we are trying to use. Now, we obviously need to talk a little bit about HIPAA. In the schools, we also have FERPA which is basically just the educational version of HIPAA. But what are some things that we should know in relationship to AI? When it comes to HIPAA and or FERPA? Could they kind of go together?    Teresa Fairfield     Absolutely, I think it's important to understand how large language models work and the computer is, if you test it, it does not give you any revealing information about how it has learned what it has learned. So in that sense, and that's why there's some gray area around some of the lawsuits that have already come into chat GPT and other large language models, because it is like if you ask it, if it knows this, or if it knows a particular thing or a particular person, you know, there's filters in place that say I you know, I am not able to do that I do not provide that information. If you ask it about you know Winnie the Pooh characters, or to write a story involving Winnie the Pooh, you can detect that it's probably heard of Winnie the Pooh before, that it's been trained on a Winnie the Pooh story. But it's not in the sense that you can Google a specific name and sort of deep dive and find out more information. It doesn't give you specific information about an individual a case. That being said, does it have the official stamp of HIPAA or FERPA approval? I don't think so. But you're you know, you shouldn't be feeding it client specific data anyway. What you should be using it for is describing the scenario. I am a school based occupational therapist, I am working with a client that's six years old with the following challenges. Here's what I have, in terms of findings, you know, helped me write a summary paragraph or a concluding paragraph helped me develop notes for my IEP meeting. Like it can do all of those things. But you have to set up the scenario. It's not so easy. And I think one of the challenges is that we go into Google and we put four or five search terms up there, and we expect magic to come out. And you know, it's a garbage in garbage out system. So if you, you know, the more time you have sort of describe the scenario and what you what you want it to do, and the better better your outcome better your output.     Jayson Davies     Yeah, yeah, right. We'll get into that crystal. We're going to get into goals in a little bit. We're trying to do more of an overview first, and then we're going to really dive into the special Perfect. So I really do want to ask you, because I know the HIPAA FERPA ethical areas is the main. I mean, it's the main holdup for a lot of reasons, right? Like, I think that OT practitioners are the most ethical people in the world, to be honest. And like, we really want to make sure that this is safe for us and our clients. And so when we are using AI, say, I'm using chat gptc, I'm using copilot What should I assume? is the default to them keeping data? I mean, like, if I type in a student's name, is that name going to be in there forever? Is it going to learn off that name? Do we not know, do we know? Like, what should we assume I guess when we're using AI, as far as data collection,    Teresa Fairfield     I think anytime you put something into your system, you should assume that you have lost control of that information. I think that's just sort of standard practice now. And that's why that's why a lot of like, I just listened to a Male Clinic speaker, and they have set up and they're working a lot in the area of mobile health. But they have identified that in order to do that. And they're they're working on relationships around the world with clinics on every single continent. But as a result, they are saying we are only using our own data, our own internal data, they are not sending it out, they are not sharing it, they have locked it down and what they call a behind the glass model. So you know, you can look it on their data, but it's not coming. And it's not leaving the system at all. So I think you know, I think it's reasonable to expect. And again, I have a presence on the Internet, you can Google me and things pop up. And you know, I think I think a lot of us do, particularly when we're working in these innovative spaces, but you have to kind of assume that if you're entering details that they are going on a computer somewhere that you don't have control over. So that's why it's really important that you're sort of cutting and pasting things, and that those things don't have explicit information in them.     Jayson Davies     Yeah, and I mean, I go as far as just using pseudonyms, I just default to using John for everything. Like John is a fourth grader who can do all this, please help me with John. So that's one way to definitely do it. I know some programs, I'm assuming magic AI or magic school AI but I know ever, ever ability I believe it's called, they were able to basically partner with Chet GPT and certify that they have HIPAA compliance. And what that meant was that they can basically guarantee that the input that you the inputs you give it are not being trained extra. I don't want to say it wrong, but I can guarantee stored Yeah, it's basically been deleted. And so there is a way to go about making sure that you do use a HIPAA compliant or a FERPA compliant, I believe FERPA is more difficult because I don't think there are like FERPA, it's a government agency that just doesn't do a whole lot. But if something's HIPAA compliant, you can almost kind of assume that it's FERPA.     Teresa Fairfield     The higher, stringent, yeah, and no, and one way around that and one way, and then of course, in our research, we're using videos of infants. So we have been up one side and down the other with the IRB around security of the data safety of the information. And one way that you can do that is that all of the the identifying information stays local on the device, ie local on your laptop or your smartphone, and none of it actually gets transmitted to the cloud, or it's encrypted by the time it goes to the cloud. So that in our situation, when the parent takes the video of the infant, the video stays on the parents phone, along with you know, 4000 other videos, the parent has taken up their infant, but when they're what they're uploading to, in our case, Amazon Web Services is just the data, just the data around the movement. There's no video showing the child's image, there's no protected health information of the child's name or date of birth. So it's all sort of, you know, locally processed, and that's another thing that mobile health companies are focused on is how to do more sort of processing on the device itself. So that the only thing that goes out is encrypted data that cannot be He tracked back to an individual.     Jayson Davies     Yeah, I mean, I know that's I think that's part of the reason that I know, what's his name the same ultimate? No, I don't know, the guy who owns Chet GPT, like he is trying to mass produce a bunch of the chips that are required for AI, because it's just computers are going to are going to need those chips in order for us to process AI, I think in the future, which, yeah, it sounds crazy. But anyways, we've mentioned ethics, we mentioned HIPAA, FERPA, all that good stuff. Are there others? Or are you seeing other challenges or misconceptions surrounding AI that are maybe preventing? Not just OTs, but just in general healthcare use of AI? And is there anything that we can work to overcome?    Teresa Fairfield     I think, you know, all of the people that are with us today live, all of the people that are going to be watching this recording are, I think, absolutely in the right place to be on the forefront of this because, you know, you're here to find out more. And certainly, there's early adopters, and then there's, and then there's people that we're bringing along behind us that you know, when this is on everybody's phone, then they'll begin to start and pay attention. But But I feel like, again, there needs to be more presence in OT there needs to be. But there's so much sort of interdisciplinary focus on these issues that I think learning more keeping your ear out. One thing that's interesting is that, when you're thinking about what is possible in the healthcare system, one thing to be aware of is that it might be possible, but one of the biggest challenges within the system is how they communicate with each other. And currently, they don't. And so that's one of the biggest issues is that if you show up at an ER in another country, they don't have access to your Fitbit data, your provider doesn't have a way of moving your, you know, heart rate information easily into your medical chart. The EMR companies are not speaking with each other. And so we tend to think that these things are possible. And they are but it's still extremely siloed, where these things are taking place. And so a world where all of this data is available to improve our lives as practitioners as well as consumers of health care. We're just not there yet. And that's the biggest hurdle. It's not the it's not the innovation. It's connecting the existing systems we already have.     Jayson Davies     Interesting. Interesting. All right. All right. Let's dive into being more specific about school based IoT we've kind of touched the surface, but let's dive into it here. I'm using I'm using AI I know many other people have already mentioned they're using AI, what are some of the most common uses that you're hearing of school based OT pediatric coachees? Using AI? I'm assuming primarily GPS. But yeah, what I just list them off.     Teresa Fairfield     Absolutely, I would say primarily the large language models, because again, that is some of the heaviest lifting of our job is writing goals, updating materials, some of the EMRs. And the and the IEP software have really restrictive sort of textboxes and really restrictive. And so you know, it's really a helpful tool in that regard. There isn't a lot of innovation in pediatrics in some of the predictive modeling. Again, ours is really unique focused on infants, but there's not a lot of it, that is looking at, like you described, just automatic scoring of, you know, fine motor work or work products of, of the child. And again, that's only one tiny little thing that OTs are doing, but gosh, if it were easier, it would be a big game changer, right. But, you know, they're not being designed with a pediatric population in mind. And so, I think the, I think the text generating solutions are going to be the most high value because again, think about how many times you would even just like having an outline. I need an outline to provide a teacher some, you know, self regulating activities. And, you know, all these scenarios in which, you know, you could produce really customized sorts of content for teachers, for parents for, for other, you know, conference submissions, you're, you're still needing to provide all of the data that goes into those. But but, you know, I think that's really going to alleviate some of our biggest pain points.     Jayson Davies     Yeah. I mean, to be to be like, I don't know, I'm waiting for the day that WPS says, Here's a $10 monitor, it's probably closer to $100 month subscription to access our WPS bot that has all the data on all of our assessments. And you can ask it anything like I know it's coming. I'm sure that in the works of it, it's got to be. But yeah, I think that like for me, we have what's called the OT school house, goal bank, and I'm absolutely using AI to take my goals. And based upon my goals that I have used over time, and even goals that others are submitting, were saying, Alright, AI, here's the goal, please turn it into a template. And it's turning that into a template. So now we're using it as a goal being and from there, I can say, Okay, well, if this is my goal, what might a baseline on an IEP look like for this for this goal? And so now it's creating a draft baseline. And from there, I can ask it, okay, well, what about accommodations? What accommodations might be able to support a student with this goal? What type of services might be able to support a student with those goals? And, you know, just like with everything else, I mean, you think about evidence based practice, right? Evidence Based Practice is not going out, finding the research and replicating the research, that's research, evidence based practices, reading the research, learning about the research, taking what you know about the patient, what you know, about the environmental school and all that, and deciding for yourself whether or not that research that evidence actually makes sense for your case. And I think we all obviously, you have to read anything that comes back from Ai, with a grain of salt for the exact reason you said, right, like, it doesn't have all the knowledge that we think it might like, it hasn't read everything on the world. I know, it's read a lot. But it hasn't read everything just quite yet. So yeah, that's just one example that I can think of, for school base, Oh, Jesus, the goals.    Teresa Fairfield     Absolutely. And and very similarly, like, if you have any ethical quandaries, about using an LLM to generate your goals, it's the same process as using a goal bank of you know, here's all and, you know, I did that for years, here's goals I've already written, and saving myself some time, you know, you reflect or you, you know, copy and paste, and then modify, you know, like those sorts of old school techniques we've been using for years. And do you need as a therapist to modify, if you're taking this description of what a sensory seeker means and, and sort of translating it for another child, and another scenario and another SPM score? Absolutely. But it's a very similar process of, you know, taking a goal bank or, or, you know, finishing a document that you felt really proud of, and saving it for later as a template. And, you know, this is very much like that, where you're, you know, needing to sort of reduce your sort of cognitive load, if you will, as a school based therapist, because, you know, the things you need to be responsible for are tremendous.    Jayson Davies     yeah, yeah. So, so, when you're using when OTs Kobe Sochi, right, they just had a full day of seeing clients and whatnot, and how can they remain that maybe they're jumping on chat up to you to ask you for some support with treatment strategies, they want to plan their next week treatment plan? How can they ensure that interventions are remaining client centered and individualized for each student?    Teresa Fairfield     Um, I think that's, you know, I saw I'm, I'm paying as much attention as I'm able to the chat, but that was one that was one thing that I saw earlier is you can't just give it demographic information. You can't just say you have a child and a diagnosis and expect it to know what that child looks like. Because, you know, again, there's other aspects that are client centered that it will not provide. And so you know, the more sort of context that you can add or that you can come up with, including, you know, in preparation for this. Today, I gave chat GPT for some, some prompts about coming up with a treatment activity of a four student group focused on social skills. And, you know, here's the reading level, I want it to be about three minutes. And so, you know, we're focused on basic social skills with, you know, around the prompt of what are you doing this weekend. And, you know, it produced line by line script that, you know, the students could practice with each other in sort of a skit sort of way in terms of roleplay. And I think, you know, even just taking that activity, which I just kind of threw up there to play with, it just shows you, you know, things that you could produce, I've seen a lot of things happening in the social stories, absolutely. Like, you know, the that content, it's easy to, it's actually the most fun part of social story building, to which I've done a lot of to do, you know, take the pictures or the video snippets to actually work with the child and family over what those what social stories are necessary or, or with the teacher and in school base cases, and then have have the large language model just punch out what you know, what script needs to accompany that. And the, you know, language generating tools are incredibly they're improving at an incredible rate. They currently like all of the text to speech still still sounds a little bit robotic. But I just listened to some this weekend down at Stanford, and it's pretty undetectable.    Jayson Davies     Yeah, yeah, it's, it's pretty amazing where we're going. And so I do want to definitely keep time for some q&a. And so I kind of want to get into some quote unquote, maybe rapid fire. If you were working on this right now. And you had chat CPT open, what would you do? Alright, so situation, you're working on an evaluation, you've got some data in front of you, you are working on maybe your interpretations at the end of your result? How are you going to ask Chet GPT? For some support?    Teresa Fairfield     Me? Are you asking the chat?    Jayson Davies     No, you I want to I want to know this. Yeah. So what what might you I mean, everyone can, everyone can play a long Feel free?    Teresa Fairfield     Well, what I would what I would do, first of all, is I would upload a de identified sample of something that I had already written. Right, this is me, this is this is how Theresa sounds when she writes a report. And you know, these are some of the contents you can and then you can you ask it to use that as the model. So then it takes everything that is learned, but it's specifically just learned from you individually. And I think that's an important part. Since you know, you want it to sound like you. And then you I think a good place to go would be to describe what you're trying to achieve. And it's the same thing I would tell my students actually, who's the audience for the work? Yeah. Is it a teacher? Is it a parent? What's the reading level? What's the vocabulary? Are there any terms that need defining you could kind of assume that that chat would know a lot of these terms because of the model that's been trained on. But if there's any, any sorts of vocabulary or jargon that you're using? Obviously, you can't give it any direct quotes, you'd be doing some of that editing. afterwards. I find when I'm doing that sort of thing, even just having a text to start with, it's much faster, it's much easier to edit something, then start with a blank page.    Jayson Davies     Yeah, I have found that especially I don't know, I use chat. GPT. Mostly I don't use copilot or Gemini, but I found that chat. GPT likes to use the word Delve, I delve into something so if you see the word Delve, I would question if it's a I like that's just my personal I don't know, maybe your kitchen something else. But either way you need to edit whatever it gives you you need to edit it, you need to make sure it actually sounds more like you what Theresa said was a great idea by uploading your own work to it, it is being trained on you or on your words. But still, usually you got to edit it just a little bit. Alright, so that was evaluation.     Teresa Fairfield     But do you want to do you want the prompt I actually gave Chad GPT?    Jayson Davies      I mean, if you want to go for it.     Teresa Fairfield     It says I am an occupational therapist working in the school system. I'm working with a group of 15 year old students with Level Two autism that have difficulty with appropriate social communication. I'm interested in setting up a roleplay activity where peers will read a script that models the appropriate interactions between students. I'd like you to provide the script for a group of four teenage students with a third grade reading level. The scenario should involve the four teens sitting at the table at lunchtime, asking each other what they like to do on the weekend. The scenario should take about three minutes, please provide the script.    Jayson Davies     Yeah. And I just, I just also put up a chat comment up here from Heather. And it should be easier to read now that I change the formatting. But this is basically what Theresa just did. She gave it a role. She gave it context, she gave it action, she gave it formats and constraints, you really want to do that. I mean, a lot of us just want to give it a quick sentence and and expect it to give us something amazing. And that's just not the way it happens. I mean, like, it's almost like trying to tell you to do an evaluation as an 18 year old before you have any OTs experience, and then telling you to do an evaluation, once you have the training, what's your taking OT 5015025035040 Those classes now you have much more information available to us. So yeah, absolutely got it. Gotta make sure we prompt it. Alright, so that was a little bit about evaluations, and also a little bit of treatment planning there. What if you wanted to let's see, what if you wanted to find out a support that might be helpful for a student? How might you interact with AI?    Teresa Fairfield     In that case, I would provide some similar to, you know, what just got posted? What's the what's the context? What's the length? What's the complexity? How many steps? For example, you know, one thing that I haven't tried, but I am excited to see some folks in the in the chat that have already hopped over and tried it for the first time, How fantastic is that? Glad to have you jumping in the pool. And, you know, again, you can just use name, you can just use a placeholder, you you can you know, the but again, the ideas come from you. And that's where if you give sort of an idea, it could come up with some ideas, the relevance of those ideas may not be that helpful. But I think for like student centered, like, here's where you can use it. to buttress your, you know, let's say you're not so skilled on the pokey Milan characters. You could ask the you could ask the chat to generate a game involving five Pokemon characters, and, you know, three rules that could be played in 10 minutes or less. And again, you're providing the bumpers on that activity. But you know, think about your time savings if if pokimane is not your jam, by asking sort of those specific sorts of questions.     Jayson Davies     Yeah. All right. We're gonna dive into some q&a Right after this last question. But I just kind of want to prompt everyone. Thank you so much for being here. First of all, we are going to actually post into the chat a link to get a certificate of attendance for being here. So stay tuned for that. But I want to ask you for one thing, and that is to please let me know in the chat, what you most want to learn about AI now that you've attended today, like what is the one thing that you wish that you could snap your fingers, and tomorrow, you would just know how to do please leave that in the chat for us. And with that, I'm going to ask Teresa, if you could snap your fingers. And tomorrow a tool was built for you related to AI. What would that be? Hopefully related to OT but who knows?    Teresa Fairfield     Yes, I think you know, again, my vision for the project that we're working on is is so huge. And we've done so many focus groups with parents and early intervention. I know some of you are working with littles as well. And there's so much opportunity for also sort of supporting the clinician and the parent with like a micro konsult. And so my vision is that, you know, that parental sort of anxiety or caregiver anxiety around development is resolved with a combination of machine learning insights, a beautiful parent education platform, and an entire, you know, team at armada of occupational therapists that could, you know, provide sort of micro consults support that puts in a meaningful way to really resolve some of our, you know, equity and access issues around early intervention. And, you know, as we know, even as school based therapists you're, you're seeing kiddos later on, after that early intervention window is closed. And, you know, what, what if? What if they had access to all three years of Birth to Three services? Like, what would their school experience look like?     Jayson Davies     Yeah, yeah, I kind of already mentioned mine earlier. So I won't go too much into it. But it'd be like a tool that just literally can tell me the exact legibility of this writing, and then also some strategies to move forward. But to whoever just gave us a thumbs down and then change it to a thumbs up. Thank you, I appreciate you, and to anyone else who wants to give us a thumbs up. Thank you so much, I appreciate it. Alright, so I've got some questions here. And feel free to also add a few more to the chat, we might have time. The first one that I want to cover is, which AI platform might you recommend for getting started, we've talked a lot about chat, it's up to you is that is that your go to?    Teresa Fairfield     That's my go to I have decided personally, that chat for subscription is is worth my investment. As a clinician, I feel like you know, certainly try around with the free tools and see you see what might be possible. And then you know, there are a you can have in terms of a free trial, you can compare what three and 3.5 gives you what four gives you. And keep in mind, there's also a bandwidth issue, sometimes you'll come to it and it will sound really impaired in terms of this response. And then And then, you know, and again, keep in mind that this is essentially a crowdsourcing issue, we're all going to one well, and when more of us are trying to get our problem solved, it can get a little murky in there, but but play around and again, keep in mind, it is a computer, the more you give it in terms of guidance, the more it's going to help you out.    Jayson Davies     Yeah, exactly. I found that I mean, you really have to learn how to prompt and a lot of people are asking for prompt goals or for prompting help. So we'll have to come up with something for that. But crystal asks, Does it write goals? And I want to get your take on? I don't know if you've used it much to write goals. I obviously talked a little bit about earlier, but your concept on that?    Teresa Fairfield     Yeah, I think I think it can write goals. Again, if you give it parameters, and you know, maybe maybe a nice supplement. Jason, you and I are talking about more ways to intersect on this content. So I think something that would be fantastic is to provide some more sort of prompt specific support. And maybe you know, some case study resources that you can put out to your, your members and subscribers about you know how to begin shaping this tool for themselves.    Jayson Davies     Yeah, yeah, definitely. I've got another question here from Amy. Amy. Thanks for joining us, a alumni of the OT school house Podcast. I'm trying to put it on the screen right now self determined kids shout out finding research articles that I need on a particular topic. Have you explored anything with that? I've used consensus, which is an app out there. What have you used?     Teresa Fairfield     Yeah, I think that's I think it's great. The issue is that there's still these products still need funding. So you know, all of the all of the places that we get our articles still need financial support. So libraries are getting them and they're paying for them. And you know, you still have to go to your library and chat GPT will not help you get out behind a paywall. It is absolutely blocked from providing, can it help write code, it can absolutely help write code, but it will not help you write code to get behind a paywall. So it does have some ethical boundaries for itself as well.    Jayson Davies     You know, that's interesting, because I'm a big daily listener of the podcast, and they've had journalists talk about this exact topic. And while they couldn't get it to, like, recreate the article, well, I should take that back. Someone did, but then they shut it off because of that. But one way that people were getting around it was saying write me an article about this topic in the voice of said journalist, and it didn't know that journalist voice and it knew what that journalist knew. So then it just recreated a journal that was very, very similar, but yeah, very interested in how things are working.    Teresa Fairfield     I would say though, that anything it would create does not have the peer reviewed rigor of something that's actually published in the journal and that's, you know, the names the the hallmark of evidence based practice is the peer review process, not just the writing one.    Jayson Davies     Yeah, yeah, absolutely. All right, well, it is 359 My time Here in California, I think we're just about to wrap up unless there was any pieces of the comments that maybe you wanted to address really quickly before we say goodbye to everybody.     Teresa Fairfield     Um    Jayson Davies     I know they were going by fast. So    Teresa Fairfield     I only got a sense of them. But you know, what I love is that it's an active community, and they're generating great ideas and support for each other. That's absolutely fantastic. And, you know, I hope to be back again at some other point in the conversation.    Jayson Davies     Yeah, thank you so much. And Marcia, to answer your question about consensus. It's basically AI for research, you type in a question, and then it searches research for your answers, and will cite the research that is giving you an answer based off of so yeah, there are so many tools out there. Like I feel like we just need to put together a cheat sheet on different tools. Maybe we can get that together in the near future. But yeah, thank you all everyone so much for being here. Really appreciate it. We had over 400 people registered for this 200 People nearly that attended today. Obviously AI and school based OT AI and OT in general, it's just a huge thing we are on or we are in the very beginning phases of this. Be sure to look out for information for myself for information from Teresa about a I really quickly Theresa, if anyone wants to get in touch with you learn more about you find you somewhere on the interweb without asking chat GPT where can they do that?    Teresa Fairfield     You can you can Google me Like I said, I am known to the internet. And I am available at Teresa underscore fair hyphen field@baylor.edu .    Jayson Davies     Yes. Geralyn called you TFF. I don't think people will find you that way. But maybe we are calling you TFF or T fields. I like T fields. All right. Anyways, Teresa, thank you so much for joining us. Thank you, everyone, for joining us so much, really appreciate it. And we'll see you next time on the T schoolhouse podcast. Take care, everyone. Good night.  All right, and that is going to wrap up this very special episode with Theresa Fairfield. Thank you all so much for listening, I really hope you appreciate this. I hope that this episode helped you to kind of understand AI as a tool as opposed to something that we should fear and is going to take off or take over all of our jobs. In fact, I was just looking up an article. And it's actually in the Canadian Journal of Occupational Therapy from 2018. So several years ago before AI was really a thing. And they can talk about how how AI isn't really a threat to overtake the role of occupational therapy practitioners. However, AI is going to make it harder for many of our clients that people that we work with on a daily basis to keep up with some of the work demands. And I think this is going to be huge for our youth today, they're really going to have to learn how to use AI, the same way that so many of us had to learn how to use Microsoft Word, learn how to use Google Drive, and how to use Google search terms of find what we wanted to find what we needed to find to get through our daily lives over the last 20 years. And I really think that that is important. We can't just you know, ignore it. We need to embrace it and figure out how we are going to use AI in practice the same way that we might use Google or we might use Google Drive Microsoft Word Canva all those tools that we do use every day. So thank you again, so much for listening. And if you would like to earn your certificate of completion for listen to this podcast, be sure to check out the OT schoolhouse collaborative. That's at OTSchoolHouse.com slash Code Lab. Thank you so much, and we'll see you next time. Take care.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed.  Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! 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 Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 146 of the OT Schoolhouse Podcast. Imagine a school environment where every student, regardless of their abilities, can actively participate in physical education. How can we, as occupational therapists and educators, work together to turn this into reality? In today's episode, we are joined by Faith Newton, an occupational therapist based in England, who is passionate about inclusive physical education (PE) for students with special educational needs and disabilities. In this episode, Faith will discuss the school-based occupational therapy system in the UK and how it compares to models in the US. She will also explore universal design principles and strategies for making PE more inclusive for all students. Tune in to learn more! Listen now to learn the following objectives: Learners will Identify the key components of an inclusive PE program for children with special educational needs and disabilities (SEND).
Learners will understand the role of occupational therapy in supporting neurodivergent students in physical education settings.
Learners will understand how to conduct an activity analysis for common PE games like dodgeball to identify sensory, physical, cognitive, and emotional demands. Guest Bio Faith Newton is a Children's Occupational Therapist and founder of School OT. She has worked with schools, parents and children since 2013. She is also the author of 'Inclusive PE for SEND Children' and has two neurodivergent children. She is passionate about making schools more inclusive. Quotes “People talk about the positive emotions that come with sport and that's definitely the case. But there's also can be a lot of negative emotions” -Faith Newton, Occupational Therapy MSc (pre-reg) "My approach, really with universal strategies is things for the whole class and it's not changing the person, it's changing the environment and the occupation." -Faith Newton, Occupational Therapy MSc (pre-reg) "My approach is what's good for kids with SEND is good for all kids." -Faith Newton, Occupational Therapy MSc (pre-reg) "How can you make it better for everybody? The kids with no diagnosis, the kid that’s struggling, and the kids that do really well, it can just maximize their chances, if they have choice and enjoyment." -Faith Newton, Occupational Therapy MSc (pre-reg) “For so many of our kids, there's so much else going on. It's not automatic, it's really challenging. So awareness is really key.” -Faith Newton, Occupational Therapy MSc (pre-reg) “Inclusion is a Journey…none of us are perfect…making it manageable, the just right level of challenge for them.” -Faith Newton, Occupational Therapy MSc (pre-reg) “I think the schools don't ask, and we don't ask them. So it's kind of like nobody's thinking about it.” -Faith Newton, Occupational Therapy MSc (pre-reg) “If we're going to help these students be included into general education, physical education, then we should probably also be supporting the people that are gonna make that possible, like the teachers and the aids.” -Jayson Davies, MA, OTR/L “We're all part of a team together and we all need to support one another.” -Jayson Davies, MA, OTR/L Resources X @FaithSchoolOT Faith's Website Susan Bazyk Initiatives Mim Project Amazon- Inclusive PE for SEND Children: A Practical Guide for Teachers Faith Media Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hello, everyone and welcome back to another episode of the OT schoolhouse podcast. As you may have heard me talk about on the podcast before, one of my favorite people to work with on an IEP team are the adapted physical education teachers, they just seem to understand occupational therapy, and they are always up for collaborating. Shout out to Joanne who listens to every episode of the otisco Health podcast, even though she's now retired. It was fantastic working with you. Thank you for your support, and I hope you're enjoying your walk this morning. But I also recognize that many OT practitioners, maybe like yourself, don't have an AP counterpart to rely on when it comes to supporting students during physical education. That's why today we are joined by faith Newton and OT based in England to discuss inclusive physical education for students with special education needs and disabilities, aka send students that was a new one for me. Faith is passionate about supporting students to fully participate in PE and even wrote a book on the topic, we'll be sure to link to that in the show notes in case you're interested. My discussion today with faith focused on two different areas. First, we're going to dive into occupational therapy in the schools and what that looks like in the UK as compared to models in the United States. Faith provides insight into how OT services are structured and delivered across different contexts. And I will warn you is very different from what we have over here in the States. Second, we're gonna dive into strategies for making PE more inclusive and accessible for all students. Faith is going to share universal design principles that can benefit all learners. And together we are going to explore targeted and individualized supports for how OTs can support and collaborate with PE teachers to support again, all students to fully engage in physical education. I'm excited to share with you faith expertise in this area today. Thank you so much for joining. And stay tuned. We'll be right back with faith Newton.    Amazing Narrator     Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies. PLAs is officially in session.    Jayson Davies     Welcome to the OT school health podcast. Babe, how are you doing today? Good. Thank you. Yes. Thank you so much for joining us. This is definitely a topic that I've always been interested in. Like, you know, I'm a very much especially growing up very much into sports. And in California, we actually have, we have related service providers that work in the schools called adaptive physical education teachers. But I know that isn't necessarily common. And so I'm excited to talk to you today about occupational therapy in the world of physical education. And that is just something that you're so passionate about and can't wait for you to share. This is going to be a fun one. So I hope you're excited. Oh, yeah. Yeah, it's quite funny, because I was not supported at all. So we come from the opposite sides. We experience funny how that works. But I mean, at the end of the day, you know, now we're older, we're occupational therapy practitioners, it's all about supporting the students and supporting them and what they enjoy. And many, many students love PE, even if it's not necessarily always the sport side of PE, there's other aspects of PE, and we'll talk about that. But yeah, let's dive into it. And the first thing that people listening might have noticed is your accent. We usually have a US based therapist on here. So let's start with there. Where are you joining us from today?     Faith Newton     Sure. I'm in Gloucester, in England. So it's about 40 miles south of Birmingham.     Jayson Davies     Alright, I know that I have no idea where it is. I know, I could not find it on a map. But I heard hear of it, you know, some bridgerton language in there and all that fun stuff. So yeah, so you're, you're in the UK. And you know what I don't want to get into to the school base. So to cite first, I definitely want to ask you how it's different there versus in the States. But before I do that, how did you get into the role of occupational therapy and where are you currently practicing in the world of OT?     Faith Newton     Sure. So I got into it. My mom has cerebral palsy. So I was kind of aware of OTs and I guess just disability really growing up. It's just kind of part of my life. And then somehow, yeah, I think I was about 16. And we have like a week's work experience in the UK when you're 16. And so I asked a local hospital if I could go into work experience, and it was awful. It was like, literally just given that commode. Sorta Do you know what? Yeah. Yeah. commodes, and like getting people on a net of the bath, but like, really fast, you didn't get to know anybody. And a 16. He was just like, I'm not doing this with my life. But I knew there was more to it. And I thought, Okay, I'll come back later. Because I've done some reading and I knew it was good. It just like was feeling not quite right then So I did an English Lit degree, and then worked in Afghanistan for a few years for an NGO. And while I was there, I went to a clinic with kids with CP cerebral palsy like my mom. And they didn't really have anything. And I was just like, I really want to help and be able to make a difference to kids disabled kids. So then I kind of looked at training and went back to university. So that's kind of how I got into it. And now I'm kind of at a crossroads. Actually, I'm doing some school based it work privately. And I'm about to set to kind of pivot my business slightly to do like online kind of telehealth with parents and your, your divergent children. And PDA. Kids. So pathological demand avoidance,    Jayson Davies     okay. Yep. Yeah, that's a very hot topic, or that acronym. I've been hearing that more and more and more lately, PDA. And, you know, the first time I heard of it, PDA is not what I thought of pathological demand avoidance. But yes, definitely a growing area of need to support parents and everyone in that realm. So yeah,     Faith Newton     yeah. And my son has PDA. So it's kind of very close to my heart. And the reason for pivoting is really, he's not a school at the moment. So I kind of need to be based more from home. So I kind of adapting it, and realizing that hopefully, I can be a big blessing to a lot of families who are just kind of stuck, and I've lived it, I've got the personal and professional experience.     Jayson Davies     Fantastic. Yeah, I think you'll be able to, I mean, like you said, You've lived it a little bit, plus, you had the occupational therapy side. So you'll really, really be able to support a lot of parents and maybe even some teachers and other families that are supporting students with PDA. So awesome. You mentioned when you're kind of talking about what you've done as an OT, school based OT, but you also kind of said it as a private practice, which is interesting, because in the States, we often think of school based OT as one thing and private practice as more the clinical side of things. So, yeah. Oh, really. So yeah, I would love for you to share with us just what school based occupational therapy looks like in the UK, because we have primarily a listenership of US based, although we do actually have a fair, fair amount of listeners in Australia and in the UK. So I would love to learn more about what it looks like in your neck of the woods.     Faith Newton     Sure, so, and not 30 with children is with the NHS. So it's free. NHS being the National Health Service. Yeah, so we fund it through our taxes, but it's free at point of delivery. There's also a very long waiting list. That's kind of downside. So I worked for an NHS clinic, I guess you'd call it for four years. And so the doctor or the school would refer to us, we would see the child's impairment in the clinic. And then I would also go into school to do some assessments and intervention in the school. But I would go to 2530 different schools kind of walk up for an hour, hi to the teacher, hopefully get 10 seconds to pass over any information and then be on to the next one. Yeah, you guys are way ahead of us for school based OT. So basically, about four or five years ago, NHS were like, oh, we should think about school, like school based entity. And we've got like this tiered model that the Royal College of OTs in the UK have kind of pushing. So you have like the universal provision, which would be class targeted and then individual. And they're trying to get people to do more of a universal provision. But that kind of looks like maybe one training a term for school, or maybe being in a school a bit more, but there's not a lot of it. So yeah, there's not many people kind of doing private school based it either. So I think I just I've not met anyone else who does quite what I do. So     Jayson Davies     yeah, yeah. So sorry, I think I kind of cut you off a little bit. But the three different tiers in the United States, we call it under RTI or MTS s and have tier one, which tends to be universal tier two more targeted interventions. And then tier three might be what some consider that special education, others consider it just more targeted, but not yet special education. Is that pretty similar to the model that you would be using?    Faith Newton     Kind of first the Yeah, the individual was that tier one or tier three?     Jayson Davies     That'd be the top the tier three.     Faith Newton     Yeah, the top tier, the top tier is one on one doesn't matter if it's special educational mainstream. It just means one on one. As opposed to a group or the class     Jayson Davies     that makes it so simple. Like I just because you're in the States, no one can figure out what your three really is and how it's separate or the same as special education. I wish we could just make it nice and straightforward, right? Tier one universal tier two groups, tier three individual like boom, that that would be nice and easy. Yeah. All right. Well, at least we kind of know what we're working with. Now here, we both have this tiered intervention type of system, which is great. Before we kind of move on. I do want to ask you, so you said that you worked for a clinic funded by NHS, basically, the way it worked, right?    Faith Newton     Wasn't NHS clinics. So, okay, I mean, actually making that we had a building that kids were coming to with a sensory integration room, but most of my day was spent kind of out of the clinic going into schools and homes. Okay,     Jayson Davies     so then I do want to ask you, because here in the States, a lot of school based OT practitioners are employed directly by the school, or maybe by a contract agency that's being contracted to work with a specific school specific district or county, it sounds like this is very separate in the sense that you work at an NHS clinic, how? I guess the question is, is how does the school and the NHS clinic work together? Or do they? Does that make sense?    Faith Newton     It depends on the individual therapist, so like, my manager was really big on, you phoned the school, you don't just speak to the receptionist, you asked to speak to the Senko, who was the special education needs coordinator who was responsible for overseeing, or the kids with special needs to speak with them kind of explain, you know, the referral or get their perspective and opinion? So that's what I would try and do in reality, sometimes, it was kind of you were kind of at the school. And so Oh, yeah, we know you can there you go, any kind of leave going? Because you're not paid, you know, they're not paying for you, I think, I think that does make a difference. Because now when I'm doing independent work is because the head teacher wants me the same code wants me, and I'm talking about the whole school priority. And I'm talking about inspections and their ratings and how we can improve everything. And it's completely different from kind of the doctor wrote a letter, so I have to come into the score.     Jayson Davies     So is that how it typically would work at the NHS clinic, as a doctor writes a letter saying, hey, this student or this kid needs OT and then from there, you decide whether or not you're going to see the student in the clinic, or if you're going to try and go into the school.    Faith Newton     It can be the GP, it can be another health professional. And depending on the trust, it can be a Senko as well. So sometimes a school is referred that individual pupil, but then they may have to wait six months, one year, two years to be seen. Wow. And my, my NHS organization was really good, because we got to treatment, but several of them is assessment only, and then kind of a handout.     Jayson Davies     Yeah, wow. You know, things just change from state to state. And then of course, from country to country, it's just amazing to see how things are different. And it's funny that even earlier, you know, you mentioned how the states are quote unquote, like, farther advanced or further along when it comes to school based OT practice or OT services, because I kind of see other states. In fact, Canada is one of those where they don't necessarily have the same model as us. But they're really gung ho about the the RTI MTSS type of model. And so I almost see them as being more advanced than us. In some ways. You know, the grass is always greener on the other side, I guess they could say, right, so it's interesting how that works out. So well. Very cool. So now that we have this kind of picture of the system that you were working in, I'd love to hear more about the real reason we're here, which is physical education. And you wrote a book about this, uh, you know, so much more than, than I could ever think of, and we're gonna dive deep into that. So why don't you first introduced to was the concept where did this concept for the book come from?    Faith Newton     Yeah, so I was on maternity leave about almost four years ago. And I was listening to a webinar about how to write a book, I think I was a bit bored afternoon, I need some brain stimulation. And I thought of a book that's going to be all about the whole of OT for schools. And then I quickly realized that was huge and not going to work. So I decided to break it down focus on movements, and I was going to have one part on pa one part on classroom environment and movement, and one part on playtime or recess. And then when I started outlining it, I just thought no, this is three books, actually. And I just literally sat in cost a coffee shop, and kind of just thought which way should I go for and went for PA. Mainly because I emotionally because I had a hard time with PA. I think there's something there and it's really overlooked. It's an area that, you know, on IEP s are kind of our equivalent is hardly ever mentioned. And so I went onto Facebook because I'm part of some parents support groups. And I just said to them, can anyone tell me about their child's experience of PA and the replies I got just kind of compelled me to write it. Because suddenly they the opposite of what you're saying? It wasn't my child loves pa it was they hate it. It's for living, how they're hiding and the toiler. They're not going to school that day. It was so painful and difficult for them. And I was just I need to make it better. I wanted to get that.     Jayson Davies     Yeah. Wow. So so the title of the book is inclusive PE, physical education for sent s e n d children. And that, again, is another term that we're not familiar with here. I looked it up. And so I know super simple, but I'll let you explain.    Faith Newton     Yeah, so sound is special educational needs and disabilities. And in the UK, there's a kind of all this documentation around it. But it's split into four categories. It's split into physical and sensory communication, interaction, cognitive and learning, and emotional, mental and site emotional, social and mental health. So children are meant to fit into one category. But we all know kids sort of into boxes, and they often merge into software. So yeah, yeah.     Jayson Davies     Wow. So So you decided to take on inclusive physical education for students with disabilities? And where did you go from there? It sounds like you had some experience within school based OT, if we want to call it that, for lack of a better word for the system. What did you know about PE? Did you have experience with supporting kids in PE? What made you feel like you could take on this book?    Faith Newton     Yeah, well, I had you lots of impostor syndrome. And lots of days, I cannot write this, I'm not sporting, I'm not a PE teacher. I just kept coming back to you know, I'm not a PE teacher, and I'm not sporty, and the T the educators, and that is their back and their expertise. But I'm an OT. And I just kept coming back to I'm an OT, I get the environment and I get the occupation I've seen it to offer. And I just kind of kept that as my angle. And I really wanted to bring the voice of the child and family into it. So from the Facebook kind of chats with their concern, after interviews, I've got quotes all through the book from children and parents, because I really wanted their voice to be heard. So once I found the structure of their voice, base, and then I briefly kind of explained to say, I didn't know DC do dyspraxia, I kind of say, what is it? How common is a? What are some of the kind of challenges, what are some of the strengths and strategies, and once I kind of had that structure, it just kind of flows? Yeah, I had a bit of experience supporting kids with PA. But to be honest, a lot of strategies work outside of PA, it's just PE puts them in a spotlight. So teamwork or group work happens in the classroom, that with pa it's kind of really public, really high stakes. And the same with the sensory environment that I've worked with all the time. You know, in PA, you've got kind of, I don't know the smell of aftershave or body odor, or you've got a whistle as you've got light. So it's all the sensory stuff, but magnified?     Jayson Davies     Yeah, yeah. I mean, and I feel like there's a lot more to PE than just the sports to that can also be very difficult for kids, especially kids who are on the spectrum or who have DCD and whatnot. And so what are some of the other factors that go into PE aside from just the physical aspect of PE that students can often have difficulties with?    Faith Newton     Yeah, I mean, there's so many so yeah, like I said, with a sense categories as four categories, you know, physical was one of them. So for a lot of students, the team element is really difficult. You know, if you struggle with maths, your teacher might say, and you might not put your hands at merch, but not everyone's witnessing, you get it wrong. In pa you know, if you're playing particularly a kind of more sport, and you're the one that causes your team to miss the goal, or you can't hit the ball and all 30 Kids are watching you. There's a lot of potential shame, humiliation, people talk about the positive, you know, emotions that come with sport, and that's definitely the case. But there's also gonna be a lot of negative emotions. And just the kind of nonverbal communication is huge. So if you think about something like do you have Dodgeball?     Jayson Davies     Dodgeball? Yeah, one of my favorites,     Faith Newton     okay. So if you think about dodgeball, you know, your attention is meant to be split in so many ways. You've got balls hurtling everywhere, you're trying to like not knock into the wall, not knock over your team may not crash with a ball, jump dodge, kind of. There's so much going on. And actually in the book, I've got two chapters where I just do an activity analysis on dodgeball, and getting changed for PA There's about 20 to 30 different elements. And that's not even all of them for each one. And so and also just emotional regulation. So, you know, you're out you have to sit on the bench. So how do you feel? And, you know, if you kind of have a stress bucket that's already very full, it can spill over easily that might trigger you to have a big reaction. And then with OT, the other thing is the kids that are the worst get sent out the quickest. Right? So the kids that are really good gets loads of practice, and the kids that are bad get sent out. It's just about that.     Jayson Davies     Yeah, that's absolutely correct. And that's not just dodgeball. I mean, there's other instances where, where the same thing, right, in baseball, if you strike out a lot, you're only getting three pitches, and you're back on the bench and, and you're not as good. So maybe the coach benches you you're not playing out on the field, so you're not getting any better. And of course, the kids that are getting hits getting on the basis are going to excel. Yeah, absolutely. Correct. Yeah, very cool. So absolutely, it's definitely more than just physical education. And you really illustrated some of that social emotional, some of the difficulties with processing emotions, you know, having to be on the bench for a certain amount of time. And I'm sure you could go on and on, you talked a little bit about, right, like changing in the PE room, there's so much just in that aspect alone, a lot of therapists, I think, when it comes to the schools, sometimes we are quick to just miss the need to work on working on some ADLs, because we don't necessarily see it as a school related activity. But when it comes to PE, there's a lot of ADLs and getting ready for a PE session. So there's just so much there.     Faith Newton     Yeah, there's loads and like managing transitions and preparation. So for instance, my son was due to go swimming with his class, slightly local pool. But we were only told like four days beforehand. And he's got a lot of sensory sensitivities. And so we tried to put a plan together, but it didn't get passed on to the teachers. And so he came home from swimming, then I'm never going again, they made me have two showers, I hated it. And fortunately, he has not to that pool, he's not coming back, but he has gone back to other pools. But had we been told 234 weeks in advance, going to meet with the teachers and prepare for Brittany, it would have gotten so much better. And you know, little things like that are really simple, but they just take a bit of thought around preparation and transition and all this kind of thing.    Jayson Davies     You mean planning ahead of time    Faith Newton     I was talking scores I've got a lot of but yeah.    Jayson Davies     yeah, it's hard. Alright, so I kinda want to bring two elements that we've already discussed together. You know, you talked a lot about the difficulties, the concerns that students have had difficulty with within PE. And we also talked about that tiered model. And so I want to kind of maybe take it one tear at a time about how an occupational therapy practitioner might support students with PE. So if we kind of start at the base level, right, universal strategies, tier one, what are some things that you've had success with, using tier one strategies to support students and maybe even the PE teachers themselves?    Faith Newton     Yeah, so I think that my approach is what's good for kids with Sen is good for all kids. So instead of saying, because I don't know about the states, but we have kind of at least 16% of kids in any school that have special special needs, guys, and it's growing year on year. And so trying to say to the teacher, here's a list of recommendations for Bobby and Mohamed and Jack, and you know, they can't do it. But actually, if I'm saying to them, can you pick one thing from my book, one thing I'm going to try this week, so maybe, can you show a video clip of the game to give instructions visually and verbally, instead of just trying to tell kid in a noisy kind of field, or Hall, you know, as one thing they can do that can make it better for lots of kids. So my approach, really, with universal strategies is things for the whole class and it's not changing, the person is changing the environment and the occupation. So it's really focused on that. It could be you know, for kids who are colorblind, and a lot you might not know they're colorblind, just being careful the equipment, you have the color of your combs, the you know, the visuals that you have things like that. So that will kind of be which is what my book is all about with these these universal strategies. How can you make it better for everybody? The kids with no diagnosis, the kids are struggling. And you know, the kids that do really well it can just like maximize their chances if they have choice and enjoyment, you know, use of all those things.     Jayson Davies     Yeah, absolutely. So That's tier one or universal strategies. And we're gonna come back to that, because I want to challenge you in that one just a little bit. But let's move up to tier two or more that targeted approach. So now you've given the teacher some universal strategies, but maybe there's some kids, I'm assuming at least a few kids now are still struggling, what might you do to support the teacher in the kids?    Faith Newton     Yeah, so I have done kind of small groups, kind of like gross motor skill groups before and kind of, you know, really tried to work with the skills and then you can kind of use like, coop model and like, teach that to staff as well how to kind of really, you know, help them problem solve and understand feedback. And a lot of it is confidence. I've also done some sensory integration work with kids, and suddenly, they're able to kind of go on a slide go on a swing, and because they get in that movement, and they're going on high, so that can kind of translate to the P context as well. And then more for like, participating in trying out things.     Jayson Davies     Yeah. So in that case, would you be working with the students during physical education during their PE time, or would it be during potentially different time during the school day or?    Faith Newton     different time of the day. So I also have done like a whole class screenings. In fact, one day, I was in the junior school. So that's like, ages, one, eight till 11. And I was in the playground for the whole day in like February or something. And each class had PE outside, and I was kind of screening the whole class. And I'd pick out you know, five or six kids, write them down the next slot, the next slot, and then follow that up with one or one assessment. And then we started playground intervention. So I kind of came up with gross motor kind of activities to help them develop, train the teaching assistants, and they did it a break time.    Jayson Davies     Very cool. So your that? Yeah, I mean, there's research about that. I don't have them off the top of my head. But I've read several researchers research about that. I think Susan basic actually has a entire program all about making recess, and lunchtime and more friendly. I know, the comfortable cafeteria is one program, but I think she has a recess program as well. So yeah, I think we can definitely support not just teachers, but also the the aides that are out there during recess or during morning time, or whatever it might be. So yeah,     Faith Newton     yeah, that's a bit of both weeks, I looked at, you know a lot about the environment. So did a playground audit, I did staff training. But then also, we had that kind of group that was specifically kind of working on the gross motor skills intentionally. So I spent the next really awesome,     Jayson Davies     great, so from universal strategies to more of a group model. And then when it gets to the individual tier, how has that looked for you? or what have you had success with when it comes to directly working on some of the skills that might be utilized during physical education time?     Faith Newton     Yes, so it's probably been some of the kind of basic things you know, catching, throwing kind of confidence with that thing about kind of on the motor planning aspects of things. I don't think it's a very polite module, typically with OT, here, and so I wouldn't often kind of be alongside them in a PLS. So when I was doing the one on ones, it will kind of be a different time, I kind of regretted that a little bit, because you're not in the right environment. I mean, it stops a student being self conscious that you're kind of working with them one on one. But we all know that when you have a child in a quiet one to one environment, and is completely different from in a class of 30, with all the distractions, or the noise, or the emotions, and how it should translate often wasn't around to say, and then quite quickly, at least for the NHS, either kind of finish my block of sessions. Or if the school was paying me, they'd want me to kind of be on to the next shooter. So yeah, I've got less experienced with individuals. And budgets are really, really stretched at the moment in schools in the UK, we've got the cost of living crisis, we've got kind of Scotland roofs fall again, it's kind of chaos. And so saying to schools, these are things you can do that are very cheap or free for the whole class is kind of where things are out here. Really. So I guess the books kind of responding to kind of the political environment as well.     Jayson Davies     Yeah, yeah. And you know, you're right, right. When you do something one on one, it's very different from doing it in the classroom or out on the PE pitch or whatever. But at the same time, a lot of a lot of stuff that you do in the clinic. If you're working on dyspraxia if you're working on social emotional skills, you know, the hope in the plan is that it does translate over it. Yeah. And hopefully that tied together with some of maybe the targeted or universal strategies that can make a difference out there     Faith Newton     there's definitely a space for one to one. Definitely. I think there's just been so much focus from it, and scores on wants have won. And I've seen some of the downsides that I've kind of gone a bit the other direction. And personally, for my son, he had a lot of one to one interventions and adaptations, and it wasn't enough. And again, we've kind of got a national crisis, really, of so many children who can't access school. And then they all like your divergent, autistic, and the environments, you know, the uniform policy that we have, and the attendance awards that we have, and then locking the toilet and putting all these things and making it really hard for our kids to access. So I'm kind of coming at it from that direction as well.     Jayson Davies     Yeah, yeah. I know, your book is really aimed more toward the teachers and the parents that are trying to support their students in the school. But obviously, it's for therapists as well. And I don't know, in my experience, I find that general education, PE teachers are not always the most open to ideas from related service providers, like OTs and whatnot, they tend to kind of think like, this is my space, you know, that Johnny's doing fine, like, don't worry about I'll take care of Johnny's mentality. I know that's not true for every PE teacher. But I want to ask you like, what are some general strategies maybe that have worked for you to kind of getting them on board a little bit? And just find as OTs right, we can't just go in and give them more work to do we have to be careful about it. And so I want to ask you, maybe some strategies that have worked for you to kind of get the PE teachers on board a little bit.    Faith Newton     I think increasing awareness is like the first thing, you know, they have to see the need. And they do see the need, you know, that people have said to me, I know their students struggling, but I don't know what to do to help them. And that's kind of across the board, particularly in primary where they teach every subject and P might not be their specialism, but they have to teach. I'm always kind of very validating that I know you've got loads to do I know you're pulled in every direction. And that's Yeah, so I think awareness. I think when I've had the opportunity to do training, either webinars or in schools kind of CPD, and I show them or I get them to do an activity analysis in groups of things like dodgeball, suddenly, they're like, I had no idea. I had no idea how complicated it was. And I always compare it to driving a car. Like when you start driving, you're like, Man, the clutch and the indicators and the mirrors, and it's completely overwhelming. And then you know, now you're chatting away, you're planning your dinner, and you're like, Oh, I've arrived. And I've talked to them about how, you know, when it becomes automatic, it's easy, but for so many of our kids, there's so much else going on. It's not automatic, it's really challenging. So awareness is really key. And a lot of people said the kind of stories in the book have been really helpful. And then just saying to them, you know, inclusion is a journey. None of us get right. None of us are perfect. But pick one thing, one thing that can help and may be WhatsApps embedded in a few weeks, pick the next thing, you know, and just make it really small and really simple. Like, yeah, could you share that two minute video? Could you make sure you don't just have red and green cones? Could you make sure when you put kids in groups, you keep them in groups for half a Term or Term? You're not changing all the time? You know? Yeah, yeah. So just kind of kind of almost OTs, it making it small, making it manageable, the just right level of challenge for them. And I try to encourage people to kind of be in community and kind of talk to other teachers about find out the forums.     Jayson Davies     Yeah, yeah, absolutely. I like to say, right, we're not a school based OT practitioners, our clients is definitely more than the student, right? Like the teacher is our client, the parents are often the client, the age, everyone on that campus is really part of the team and I use the word client, but really, it's just that we're all part of a team together. Right. And, and we all need to support one another. So absolutely.     Faith Newton     What I was gonna say is, I think I, I kind of own my expertise, which I've been really surprised that they've really appreciated like, oh, you get this, you get that? And I've kind of made sure to be like, you guys know the curriculum. You guys know how to teach it? I don't you know, so like, we're both experts in different ways. We both have different things to bring. Well, you know, I didn't know everything they didn't ever think they might you say together with be that team?     Jayson Davies     Yeah, yeah. So earlier in the in the podcast, I mentioned a PE Adapted PE, and like I kind of alluded to earlier, I have come to the realization that APS do not exist everywhere. And I'm assuming you're shaking your head right now. So it's not happening in the UK either. So before you kind of started to support the students within PE Do you know of anyone that was doing that? This or is there another professional that was doing this at all?    Faith Newton     Yeah, that's a good question. I mean, well, we have current national bodies, kind of like youth sport trust. And we have P associations and inclusion is very much on their agenda. And like I know, for instance, are trying to think I think there's a cerebral palsy charity, that have like a online module about gymnastics and behavior adapt things. So there is definitely training and support. But it's not being from OTs. Yeah, it's been from maybe special school teachers or PE experts that have done some training and sand. And a lot of it's probably been with quite physical disabilities. So we do have things like, you know, bochur, kind of sitting down, or adaptive sports, they nearly always take place outside of school to kind of be an evening group or for adults. And my focus kind of in the book is really kind of those neurodivergent students rather than kind of, you know, kids with CP or Danlos Syndrome or different things.     Jayson Davies     Yeah. Yeah. different needs. Yeah, I just think it's interesting, because when I think about a PE expecially, and I think about my experience as a school based occupational therapy practitioner, I rarely get a concern about a student's ability to access B, not because it's not there. It's just because it's not typically the focus, right? Like everyone's so focused on math, everyone's so focused on reading, legible handwriting, that the other things just kind of take a backseat to it. And I don't know, especially if you're in an area where adaptive physical education doesn't exist, I don't know of anyone that would raise their hand and say, Yeah, I can support this student out of PE. I know, I've worked at a high school. And we had one student who was in a lifeskills classroom with autism, and he wanted to be on the baseball team. And so luckily, I had no part of this, but the teacher really stepped up. And she knew the baseball coach. So got the baseball coach involved, and he got to go to the games, or at least the home games and be a part of that. And it was really great. And it just had me really thinking like, we have really limited our scope. In most school based occupational therapy positions to handwriting, visual motor skills within the classroom, fine motor skills in the classroom, maybe we get out to recess, or maybe we get out to the lunch room to help out there. But very rarely is physical education even addressed at all. So I just, I just love that you're, you're looking into this. I think that's all.    Faith Newton     Yeah. And I think you'll I mean, it's gonna say in my experience, I think the scores don't ask, and we don't ask them. So it's kind of like nobody's thinking about it. And yet, there's kind of, you know, it'd be quite polarizing. So I've talked a lot about the difficulties that kids can have with PE, but for other kids, it's the best class of the week, you know, maybe because if we're dyslexic, and you know, the readings really difficult and challenging. But actually, they're amazing at dancing, for instance, and I find some stats when I was researching my book. And it's like, one in three people in performing arts are dyslexic, but only one in 10 of the population. So there's loads of dancers who are just dyslexic, they're brilliant, and they're dyslexic, and they bring their strengths. And the same with ADHD, there's almost double the amount of athletes and baseball players that have ADHD than the population. Because the risk taking impulsivity, the ability to take in loads all at once, it's perfect, that's what you need to accept. So part of my work is also talking to teach about the strengths of, you know, kids are kind of different conditions on your rare types, and helping them thinking of how to include some of these things. And how do we talk about long models, you know, talking to the class, you know, about Tiger Woods, or you know, but a different kind of sports people on who are dyslexic or have DCD or autistic? Because that's not talked about either. Really?     Jayson Davies     Yeah. Yeah. It's so interesting. And you also include the word inclusive within the book. And which brings me to a whole nother mindset that I've experienced time after time again, here, especially in the States is on our IEP, which I think we talked about, you're familiar with an IEP here in the States, right. On the IEP, we are often trying to help a student mainstream or be more included in with general education peers. And a lot of times the first class in quotes, if you want to call it that, the first class that it student is mainstreamed into is physical education. So a student might be in a self contained special day class for the entire day. But the first classroom that they get to go out or not classroom but period that they get to go out and spend Time with their general education peers is often that PE class. And yeah, I guess it's you know, it's because it's seen as, quote unquote, being easier than math reading all the other areas. And it's interesting, I never thought about it in this Limelight before, like from the point of view that we are, we're putting so much emphasis on PE as being at the place of inclusion, or at least the first point of inclusion for so many students. Yet, we're not doing anything about it to actually make it inclusive. I mean, maybe an aide is going out there with a student or I don't know, but yeah, we just need to if we're going to help these students, be included into general education, physical education, then we should probably also be supporting the people that are going to make that possible, like the teachers and the aides and whatnot. So yeah, I really love that you're doing this.    Faith Newton      And it doesn't take very long to be the slowest, or the one who misses all the hits, before you start thinking I'm rubbish at sport, I don't like pee, I can't do this. And we still kind of have I mean, I use the terms only I'm not very sporty, we still kind of have this language. But you don't have people saying, this is a quote from another podcast. But somebody said, you know, you wouldn't say oh, they're the non writers, you know, they're not very righty, they're the writers, because we just expect all students to write, but we have this and we think, you know, you practice you get better. But we don't always have this growth mindset with PA, we kind of, you know, so the kids will get better. And often the kids who struggle, participate less engage less, and things that can be really, really helped with that are given students voice and choice. Because if they can find something they enjoy, they could be more motivated, more engaged. And often schools are kind of asking kids, you know, what kind of activities do you want to try and try to bring that in as well to kind of bridge that gap?    Jayson Davies     Yeah, yeah. Again, it's so important, but it gets so little, it gets so little thought, I think when we're sitting on these teams with ours, or with teams, with, with speech therapist with teachers with maybe even the PE teacher for lucky to have them in a meeting in a team meeting, there's just so little thought about physical education, because there's so much emphasis on the other areas. And, you know, there's a reason that PE and recess are really built into the school day, because a lot of that gives students a, a break from the academics or it gives them the ability to build up some of their confidence, like you were talking about, it gives them the ability to do things with their hands, with their legs, with their feet, gross motor, all that good stuff. But as you mentioned, if a kid's not really succeeding in that, are they still getting the benefit that breaks and recess and physical education activities can actually give them and I think that's huge, you know, and I really think that we need to be more mindful that and bring that into the IEP, us and bring that onto our team meetings and really discuss, you know, how was the student accessing that physical education? So definitely,     Faith Newton     yeah. And it can have a lifelong impact. So one mother I interviewed said, she's never set foot in an exercise class in her life, because she hated PA, and it's impacting her house. And so we're not just thinking about, you know, today, tomorrow, next week, next year, we're thinking about people's health their entire life. This is a public health issue. And we're perfectly placed as OTs to, you know, this is our area that we need to speak out and be involved in this.     Jayson Davies     Yeah, yeah, absolutely. I'm trying to figure out how to phrase this question because I want OT practitioners that are listening to this podcast, you know, feel inspired, feel like, hey, I want to get out there and support my students who are going out to PE I want them to be included with PE I want them to actually feel like they can achieve with PE. And so I guess for you that the question is is like, where to start with this, you know, if they've never really talked to a PE teacher, if they've never written a goal for physical education, if they've just never had the idea to really support a student within the Feds physical education realm? Where do you think that they should get started with?    Faith Newton     I would if you can observe and a class as I would like, speak with, I don't know if you do have like a special needs coordinator     Jayson Davies     equivalised, a special education teacher or they might have a case carrier for the for each student.     Faith Newton     within mainstream.     Jayson Davies     Usually there's a case carrier for each student. So that case carrier kind of oversees everything.     Faith Newton     Yeah. So whoever the relevant member of staff is, whether it's the head of PA or the kind of case carrier, but kind of find out you know, what's the plan for that term, you know, what activity what sport they're working on, and I will be doing an activity analysis you know, I'd be sitting down thinking okay, here's all the sensory demands of physical the cognitive and emotional mental health and then kind of match that up to either your one student or the handful of students you know, struggling and fit okay. Is To the sensory, Is that causing the most problems? You know, is it the kind of cognitive communication, and then just kind of have a handful of really quick wins, you know, you want, you want the kids to experience success, the teachers and you, because if you get quick wins, you're gonna get people on board for change. So like I said, it might be thinking, okay, you know, what, kids with ADHD are really struggling. So let's ask for a little bit more repetition. And let's make the motor planning a bit more explicit, the teacher is going to say, you know, to hit this, you need to bend your arm here, put your foot here, you know, talk it through, and that takes what, two minutes, or it might be, you know, thinking about team selection, or partner selection, and just trying to change that. And again, what is free, it takes one or two minutes, but it can make a difference. And then you could get feedback from the students, you know, about what they find difficult. What's helped them as well.     Jayson Davies     Yeah, you know, I, I've realized that you've said these terms more than I think they are said in most of the podcasts that I record. And that's task analysis and activity demands. And these two terms are something that like our bedrock to occupational therapy, and I honestly don't think we use them enough. Because I really think that can be advantageous to us, I really think that these are terms that we can use to really show what we can do. And so I do want to ask you, like, How could someone use a task analysis to maybe get their foot in the door with supporting students? And PE?    Faith Newton     Yeah, I think, I think kind of surprises me, because I just take it for granted. But every training I've done with teachers, wow, just amazing. This is a task analysis. So yes, I think having that conversation with the staff and just saying, you know, in my experience, lots of students struggle with PA. And it's usually because it's either the physical demands or sensory, the cognitive, you know, go through all of that, and say, you know, have you experienced that? Have you experienced, you know, kids sitting out not being fully engaged? Do you have any idea why, and just so you know, part of my job, I will say, I'm a detective. My job is to figure out, like, what was the issue and figure out why is it the sensory? Is it the cognitive? Is it the physical? And what do we do about it? And that's my job. You know, you're teaching 30 kids, and my job is to watch and figure out what's going on? And kind of, yeah, I'm pixelings.     Jayson Davies     Yeah. Yeah, I love that. I think that that is definitely something that we should do more of. And I think it could be a one on one, like, I think you're kind of alluding to just a one on one with a teacher. But you could also do this, you know, for the entire PE team maybe have if there's multiple PE teachers, or maybe for the first grade team, because they also have to do their own PE even though they're not a PE teacher, but really just take a common activity, like what you did with the locker room, or if it's younger grades. The game of dodgeball we talked about that earlier, and just kind of breaking that down and really showing teachers what's actually involved when it comes to playing dodgeball. And it's not, this is definitely not exclusive to PE Right. Like, we could probably get through to teachers, when we're talking about handwriting if we go through.    Faith Newton     Yeah, this week at a training, I wrote all the demands of handwriting, and they were just like, wow, this is crazy. And it's the same thing like the car, you know, it's and then I explain why for some kids, it needs to be typing, because you take away so many demands, that I think we understand ourselves. So in the UK, we have these like consultants who come into schools, and they're paid like the big bucks, basically. And they come and advise on whole school improvement. But we can do that. So I meet with the head teacher on the same call and say, you know, what are your top school priorities? And there will be handwriting or, or bullying or how theater, you know, they'll be something in there that we say, you know, that's my domain, and I can help you with that. I can help you with that Ponce. I can help you write that curriculum. So I think even how we position ourselves we're underselling ourselves a lot because we're kind of reducing our scope. But I just really encourage people to be like, we do know our stuff. And you know, we're the only ones that get the environment and the occupation. And the person. Yeah, we're the only ones that get all of that. And in looking across physical and emotional, you know, not just like physios. We're looking across it. But teachers don't know that because they just see us doing one on one handwriting, maybe or scissor skills.     Jayson Davies     Yeah, shout out to the PEO model there. You know, we absolutely can like and I know now a few therapists that are doing that shout out to Danielle Emile rip mindfulness in motion here in California. They're doing that and you know what they have? They are occupational therapy practitioners, but they are purposefully rebranding themselves as Educational Consultants. They are educational consultants with a background I'm in occupational therapy. And in that way, they are bringing mindfulness to classrooms to support all students. And they are doing full school trainings. They're doing full district trainings there. They're also going into individual classrooms and doing trainings. And I absolutely think that, that that's 100% accurate, like we are selling ourselves short. Like, I could probably list off like 10 different trainings that a therapist could do right now, like starting with breaking down behavior. Like, right, there's just so many trainings that we can do as OT practitioners. And you don't have to try and make the big bucks, right? Like you can do this for two teachers at your school. You don't have to try and make this a business model. But I think if you are actively starting to try and train your teachers outside of one on one therapy time and working with your administrators to say Hey, can I have 35 minutes with teachers and just give a straight to the point training for them? It's going to benefit all the kids in so many ways. And I think that's awesome,    Faith Newton     is it I've been asked to speak to university students, trainee teachers, so I've lectured to them. And I've been I went to was asked to speak at the Youth Sport trust conference, and to the whole room is full of spotty people in a tracksuits with their trainers. And I'm there, like the only person that's not from that background as the OT, and they want to hear what I have to say. But I've been quite careful to try to use educational language. So you know, I've read up on the government policies, I kind of I read the Ofsted reports, I tried to immerse myself in educational language, and I don't I don't talk to them about PII, I don't talk to them about activity. I mean, I don't really use this analysis, I say, you know, this is OT, but then I tried to very much kind of talk in their world swell. And I've, yeah, I've had the best reception for the book has been from teachers. It's been great.     Jayson Davies     That's awesome. That's awesome. And bringing it back to your book, as we kind of wrap things up here, I really want to ask you like, what is your aspiration for the impact that your book will have? Not only within the OT community, but just in general? Like, if you could have that pie in the sky goal for your book, their aspiration? What is that     Faith Newton     just be to make things better for like the individual kid. You know, like we talked, I want it to impact a lot of people, but it comes down to the one. And I interviewed one mom, and she said that her son from reception to year four, used to roll around during PA and when it's really bad to eat dayss It was that bad. She moved into a new school. And within a few terms, he was on the sports team for the school. And that is the impact that is the difference that inclusion and that it can make. And that's what I want to happen for lots of children and philosophy teachers to give they want they want to do it, but they don't know how to give them that confidence. And no one really,     Jayson Davies     yeah. Fantastic. I think that's the I think that's one of the things at all, you know, school based OTs, we don't go into it for the money, we go into it to make a difference in those individual kids lives. So yeah. And to finally wrap things up here I, of course, I want to say thank you. But I also want to give you the opportunity to share where anyone can learn more about your book, where's the best place to go to learn more and potentially purchase your your inclusive PE incent children book.     Faith Newton     Yes, it's on Amazon. That's the main place. So it's a physical paperback. And it's on Kindle. And Kindle Unlimited. It's on kind of, you know, the status sites on the UK, lots of different sites. And then my website, which is school ot.co.uk . I have like a free strategy sheet you can download. So that's got strategies from the book. And I've also got blog posts on there and different resources for OTs and teachers and reviews of the book and information about as well.     Jayson Davies     Awesome. We will definitely be sure to link both of those the Amazon as well as your website. And yeah, faith just one more time really want to say thank you so much for coming on and sharing about how OTs can support students inclusivity within physical education. It's been a lot of fun.     Faith Newton     Thank you, Jason. It's been great.    Jayson Davies     All right, that is going to wrap up episode number 146 of the OT, schoolhouse podcast. Thank you so much to faith for coming on and just sharing what occupational therapy looks like in the UK and sharing how it could look like in order to support all students in the physical education realm. There is so much more to PE than just the physical side of PE you know, there is that social emotional aspect. There are the ADL components of dressing in and out for PE just so much more than actual playing the sports right learning the sports learning all the social nuances that go into it. So I hope you appreciated this podcast episode with faith noon. Be sure to also check out her book if that's something that you're interested in. It may also be worth purchasing for the PE department at your school site. Who knows. But with that, thank you so much for tuning in. I really appreciate you being here and we'll see you next time on the OT schoolhouse podcast. Take care.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now head on over to OTs schoolhouse.com . Until next time, class is dismissed.  * Transcript generated by AI and may not reflect the actual words spoken by the host and guest. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 145 of the OT Schoolhouse Podcast. Have you thought that optimizing your practice with efficient goal banking strategies might be helpful?  In this episode, we explore a range of goal banking options, from simple PDFs to advanced spreadsheets, to help you streamline your process.  Join us as Jayson shares his journey and a practical six-step plan to create and utilize your personalized goals. Jayson also introduces the concept of templating goals and even offers a glimpse into the AI-powered solutions for creating reusable, searchable goals. Don't miss out on this insightful episode to help you in your daily school-based practice! Listen now to learn the following objectives: Learners will identify the purpose and benefits of creating and using a goal bank for school-based OT
Learners will understand the process of templatizing goals and customizing criteria and accommodations Learners will be able to apply strategies for organizing and categorizing goals to create their own goal templates. Guest Bio In 2017, Jayson founded the OT Schoolhouse website and now supports school-based OT practitioners via courses, conferences, and the OTS Collaborative community. With experience as both a contracted therapist and an "in-house" employee for two distinctly different districts, Jayson has had the opportunity to appreciate the differences between both small-rural and large-suburban districts. For over five years, he has been helping therapists implement proactive tiered interventions, support IEP teams with goals and services, and feel more satisfied with the job they are doing as school-based OT practitioners.  Quotes "I want to help you either, overcome that stopping point of yourself creating a gold bank that you can actually use and/ or help you find a gold bank that you can use."  -Jayson Davies, MA, OTR/L "I also wanted the goals to be ready to plug and play. AKA, I wanted them to be a template, easy to copy those goals really quickly."  -Jayson Davies, MA, OTR/L "if you're looking for a reason to become familiar with using artificial intelligence, AI, this may be the perfect opportunity."   -Jayson Davies, MA, OTR/L “Using that filter button can definitely make your life much easier, once it actually comes time to use this goal bank.  -Jayson Davies, MA, OTR/L “After building and beginning to use your goal bank, you may find that some goals lend themselves to other factors that you commonly use.” -Jayson Davies, MA, OTR/L Resources 👉 OTS Collab- Goal Bank
👉 ChatGPT- AI
👉 TeachersPayTeachers Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hey there, and welcome to episode 145 of the OTs schoolhouse podcast. Thank you so much for being here. My name is Jayson Davies, a school based occupational therapy practitioner based in Southern California. To start off this podcast, I have a very simple question for you. Have you ever tried to create and use a goal bank yourself? And if you did try, the follow up to that question is, did you find that process so frustrating that you just decided to give up on it somewhere in the process, maybe you inserted like five goals to a spreadsheet and just got so tired of it, you stopped or maybe you got 20 goals in there, and you actually started to use it. And then the end of the school year came and you just never went back to using it the next school year? Well, if that's you, it's also me too, we have something in common, I have started a gold bank at least three separate times. And it's also something that I've wanted to do a long time over here at the OT schoolhouse, is to create a gold bank that everyone can use. And that's exactly why in this episode, I want to help you to either a overcome that stopping point of yourself creating a gold bank that you can actually use. And or help you find a gold thing that you can use and don't have to necessarily recreate the wheel because you already have it available to you. And you can skip the building step and just get to the point where you use the gold Bank, which is so much easier. And it saves us a lot of time, the hard part is actually creating the gold thing. So that's what we're going to discuss today. And maybe you're like many of the occupational therapy practitioners that I surveyed over on my Instagram page, where people said that they loved the idea of the goal bank, but they never found one or they're never able to create one that just worked for them. Take Amy for example. She said she loves them. But she doesn't always have the time to use them. Or Jackie Gabby and many others who said they just haven't found the right one yet. And that's why today I want to talk to you about how to create and or find a gold bank that you will actually use. We'll talk about the qualities of a goal bank and what that can include how to build your own, and even a little extra something at the end about how you can access that goal bank that I have now created at the OT school house for you. So stay tuned. Let's Cue the intro and we'll be right back.    Amazing Narrator     Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies, class is officially in session.    Jayson Davies     All right, welcome back. First things first, before you start creating or looking for a goal, I think there is one main thing that I think everyone should do. And that is to identify your need and your desires for actually creating and using a goal bank. What is the purpose of this goal bank is it to save you time is it to give you ideas that maybe you wouldn't have thought of without having this gold bank in front of you, is it to maybe even build upon further than just the goal bank to include accommodations and other strategies that often go along with a goal, there's so many different reasons that you might want to create a goal bank time, of course, been a big one. But if you're going to create a gold bank, you will spend a lot of time creating that gold bank to get to the point where it's going to save you time. So I'll start by saying that there are a ton of gold banks out there, some are free, some are paid. Some you can even copy and adapt, while others are more fixed like a PDF, right? You can't adapt a PDF unless you kind of go through a lot of work. But some are actually more flexible, like a spreadsheet, right, you can go into the spreadsheet, and maybe you can adapt that spreadsheet. Of course, if the spreadsheet is locked, or if it belongs to someone else, and you only have to access, then that's a little bit more tricky. Maybe you can make a copy of it. But then maybe you're missing out on missing out on the benefit where when someone adds a goal, you no longer get that because you're using a copy of it instead of the original. So that's why I say it's very important to start by identifying what you want out of the goal bank. So to do that, I want you to just ask yourself a few simple questions. Nothing crazy, right? Here they are. Do you want a list of 100 all encompassing goals that you may never use? Or maybe you only use five or 10 of them? Or do you want a set of just 25 goals that you frequently use and you know, work for you? Those are the ones that just you use, right? You find yourself using the same goals over and over and over again. And you don't necessarily need a large list. Do you care if the goal bank is searchable? Do you want to be able to just hit Command F or Ctrl F on your computer and say handwriting and all the handwriting goals come up or is that not a factor for you? Do you care whether or not you have the ability to update a goal. Do you Want to be able to say, hey, you know what that goal was great a year ago, but now not so much. Let me update a little bit. Again, if it's a PDF goldbank, you might not be able to do that. But if it's a spreadsheet that you have access to that you can manipulate, then of course, you would be able to do that. And then finally, the last question, and this was a big one for me, and I alluded to this a minute ago is do you want it to go further than just goals, a lot of gold beings will list like a grade level and a bunch of goals, or maybe a Common Core State Standard, and a bunch of goals or a topic of handwriting and a bunch of goals. But it stops there. There's nothing else to go beyond the goal. So once you select a goal, you don't have anything to build on, you have to kind of build on it yourself. However, it is possible. And we'll talk more about this in a bit, that you might find that if you use a handwriting goal regarding legibility, or regarding maybe sizing or spacing, or whatever that handwriting goal might be, then there might be common accommodations that you use, or common treatment strategies that you use, or maybe common pull out versus in class interventions that you use, and you can kind of build those into your goldbank. So that you don't necessarily need to think about them again. So that's something to consider when you're thinking about what you want out of your gold bank. For me, personally, there were three things that I really wanted out of a gold bank, if I was to use it. And to be honest, these are kind of lofty, and might have prevented me from actually really getting started with my gold bank or not started but really completing my gold bank, I kind of lost interest because it was hard to get to these three things. Well, technology has advanced a little bit. And that's why I've been able to achieve this. But I always wanted a gold bank that was easy to navigate. And also had a search feature, right? Like, I know how to use Command F on my computer really well. And I want it to be able to just say Command F executive functioning, boom, here's all my executive functioning goals, I wanted that I also wanted the goals to be ready to plug and play, aka, I wanted them to be a template or I wanted to templatized them so that I can just Command C copy those goals really quickly, pull it over to the IEP command P paste that goal right there. And then all I have to do is find wherever name is changed the student's name, and then find where date is changed the date and maybe update the criteria a little bit, I didn't want to have to pull out a goal that had a name already built into it and a incorrect date. And then fear that, oh, if I don't change that name and date, then you know, I'm gonna have Sarah's name and Johnny's IEP, and the date and the goal is not going to reflect the IEP date. I don't want that right. So I wanted something that was ready to plug and play. And finally, as I was discussing a little bit earlier, I wanted the ability to include information beyond the goal. Like once I found my desired goal, I kind of wanted to already have some information in there to build upon. So if I'm going to use this organizational executive functioning goal, than I already want to have some strategy that I know, or some accommodations that I've used in the past that I know work that I can just really quickly hey, these accommodations, I should add those to the IEP while I'm adding the goal, because these accommodations will likely support the student, or at least I should consider those accommodations. So in this way, I was able to move forward beyond the goal by instantly having that goal in front of me, rather than having to sit down say, okay, how am I goal? Now? What should I do about accommodations? Now, what should I do about treatment strategies, from here on out, I already have those built into my goal bank, and that's what I want it. So once you have that idea of what you need, what you want, what you desire, out of an occupational therapy, a school based occupational therapy goldbank, then it's time to move to step number two. Step number two is one of two things or maybe combination of both. It is either a find the bank that suits your needs, and desires that you want, or getting started by creating your own. Personally, I find that a lot of therapists start by trying to create their goal bank, it's exactly how I started and maybe you've done the same thing. And then we try we get going and then we say You know what, I'm just gonna go on to Teachers Pay Teachers are going to Facebook or wherever, and find an existing goal book. And then we do that right. Like we go on to Facebook, we find a free one on one of the the school based Oh T websites or not websites, one of the Facebook groups for school based occupational therapy, and we find this goal, think and if we're lucky, we find one that you know, has a has a decent amount of goals, and then we start to use it and then we just realized it doesn't have all the things that we wanted. And that flips us back to saying you know what, I'm going to create my own. And it's kind of a reverse cycle, right? Like it's almost a form of procrastination, right? Like we want the goal being so bad, but we don't necessarily want to do the work and we're scared to do the work. But we just want the goal bank and so the next thing you know, we've tried three are four different gold beings only to use each one for like a week, and then move on to the next one or just completely give up. It's funny how that works, because at the end of the day, we often go back to creating our own gold bank. So if we're going to try and create our own gold bank, where do we start? For this first step, I actually want to break it into two separate steps and bear with me, you'll see why. Because oftentimes, our brain tries to do two things at once it tries to like do a brain dump. And then it also tries to organize that brain dump at the same time. And I just want to separate those two processes out. So for you, what I want you to do is if you're getting started, sit down, you know, give yourself at least 30 minutes to work on this, if not more, and just go through past IEPs that you have, and just copy and paste, copy the IEP pasted into a, a single column on a Google spreadsheet or whatever your spreadsheet of choice is. Just go through find all the goals that might be related to occupational therapy, not even, you know, you're not even trying to think like, oh, is this an OT goal or not an OT goal doesn't matter if it's something that you may use, just copy and paste it, whether you wrote it, whether the SLP wrote it, whether the teacher wrote it, the education specialist, whoever wrote, It doesn't matter if it's related to occupational therapy, grab it and put it in your spreadsheet. Once you have a list of maybe 2030 goals, whatever it might be, you've gone through, and you're finally getting tired of that part of it. Now you can go back and do some of the organizational process, we're not going to start the template part of it yet, we're just organizing it, maybe you're going to read through those 20 goals a little bit more carefully to determine if they relate to OTs. If not, delete it. For the ones that do relate to OT in the next column over, I just want you to categorize it, label it as a handwriting goal, label it as an executive functioning goal, label it as an organizational goal, a visual motor goal. Even if you want to add grade level, you could like this is a preschool a very defined preschool goal, sensory goal, whatever it might be, just use a separate column the next column over and if you know how to use spreadsheets pretty well, I recommend making it a drop down. So you can just like quickly click on it and click the right one. Or if you know a sensory just hit S and century will come up, right. But you want to start to give each goal a category. So at this point, you've got two columns on your spreadsheet, you've got one column with the actual goal itself. The next column has the category that that goal fits into. While you're adding the category if you want to maybe you add a third column to add a specific grade level for each of the goals, if you know that there are some that you use for a particular grade level, if you want to add something else here, go for it to help you categorize them. But we're going to get into even more categorization in a bit, I don't want you to get too bogged up with trying to make it perfect right now. Because if you do that, it might be overwhelming. And then you might just never use the goal. And we don't want that. Alright. So once you've got your goals there, you got some categorization done. Maybe you do 20 goals into the bank. And then you categorize them and another 20 and categorize them to, you get however many goals you want. Now it's time to go back and actually start turning those goals in to a template. So this is a kind of multi step process here. But just work with me because this is the part that I think really makes a goal or this step. And the next step are really the parts of a goal bank that make it actually user friendly. So that way, once you actually have your goal bank, you're more likely to actually use it, rather than give up on it. So let's start with templatized. Seeing the goals, what we're going to do is go one by one each goal. And you can either sit down and do this all at one time. Or you can kind of do this as you go right like when you're sitting down for an IEP and you're going to use Goal number 10. Well, maybe when you use Goal number 10, before you use it, you just turn it into a template and then use the template. And then next time we're Johnny, you have gold number 18 that you want to use, and then you do it then hope that makes sense. But when you're templatized the goal, you're going to do two primary things. You're going to remove the old students name if it is there, and you're just going to replace it with a capital and a me all capitalized, easy to find. It just blares out at you, when you copy this, go to the IEP, you're going to see name and you're just going to know I need to switch out the name. The other thing that you want to do is remove the date and replace that again with a just capitalized da te so that way you know I need to change the date here. Or you can just change all the dates to instead of by 1119 2025 or something like that, you can just change it by the next students or by the students next annual IEP, then you don't have to worry about changing the date in the future at all your choice and kind of depends on how your district likes to have the date within the actual goal itself. So in addition to the name and the date that you want to change out some other things that you might see in some goals that you want to turn into a template, as opposed to leaving it, the way that they are, are any accommodations, you know, some goals, you might list out accommodations that the student might have access to, while trying to attempt or trying to complete that goal accurately. So you can just like change it to accommodations, so you know, to go in and put the accommodations specific to that student, or also the criteria, sometimes we change the criteria, right, maybe we don't always want 80%, maybe we don't always want four out of five trials, or four to five trials in a given session or something like that. So if you want to change that out, you can also change that, you might just change it like to a number sign slash number sign. So that way, you know to go back in and change the number signs to whatever number it's supposed to be, or just like a blank space percentage, so you know that you need to put a percentage in there. So by doing this, you're just creating a template. That way, when you grab the goal put into the IEP, you know that you have one, two, maybe three things that you just need to update very quickly, right? Yes, this step is time consuming. But as I mentioned just a moment ago, it's also the step that's more likely to make you actually use the goldbank. Quick like pro hacker tip here, if you are familiar with or if you're looking for a reason to become familiar with using artificial intelligence, AI, this may be the perfect opportunity, chat GPT if you like give it one of your old previous goals that has the name that has a date in it, and you just say, hey, chat, GBT, I would want you to take this goal, and turn it into a reusable template without the name without the date. But make sure that you like put something in its place so that I know I need to put the name and date there, it will likely just do that for you. And you could potentially just kind of say, Hey, do that now again, but do it for these 20 goals. And you just feed it the 20 goals. And it might just turn them all into a template for you. Now with AI, it's all about how you prompt it. So it might not be perfect, you might have to play around with a little bit. But again, if you're looking for an excuse to actually start to learn how to use AI, this might be the perfect opportunity is definitely something that I have used. So there you go. All right, one last note before moving on to the last step. And that when you're going through and templatized your goals, you can kind of do it in one or a few of these manners. You can either a sit down and just templatized all the goals all at once or, you know, do 10 Here, 10, tomorrow, 10 The next day until you get them all done. Or you can commit to creating a template for each goal the next time you use that goal. Now, I will say there's a benefit to that aspect as opposed to doing them all at once. Because you're going to start to realize what goals you use more frequently. And if you've gone, you know, three months, six months, and you see goals that aren't templatized dead, that might be a sign that maybe it's time to delete or archive those goals because you're just simply not using them. So that is one of the nice pieces about you know, making sure that you're going to create the template each time you actually use a goal instead of just doing them all at once. Because then you only you're templatized in the goals that you actually use. And you can clean out the ones that you are not using. And of course you can use a combination of those two, maybe you know, your top 10 most frequent goals. So you just do those top 10 Right off the bat. And then you leave the rest for a templatized them as you go type of strategy. All right. Okay, we now have a list of goals, we have those goals categorized to some extent by maybe sensory handwriting, visual motor, fine motor, whatever it might be, we have now started to templatized those goals. And this next step, which was very important to me, and maybe it's not as important to you, and maybe you want to skip it, that's okay. But I wanted to improve searchability I know my goals pretty well. And I wanted to be able to find them very, very quickly. So what that meant for me was actually giving each goal its own name, a very specific name, a unique name, a name that you would not find anywhere else on the page. That way, I know that if I want my handwriting legibility goal that I just type in really quickly, HW legibility and it pops up. Or if I want my executive functioning turn in homework assignment, then I know that I can just type in turn in homework and it's going to pop up. So I put that into a new column. In fact, I usually move that column to the very, very far left of my spreadsheet, so it's like the first One, just super easy to navigate a little bit. That way I can use Command F or control f, if I'm on a Windows device and just really quickly find that goal, I want to make sure that each goal has a very unique name. Now, going a little bit further than this, you can, I mean, this is your gulping. So if you want to do it a little bit differently, go for it, you could give each goal a unique emoji, or maybe you use emojis to categorize them a little bit. Maybe you color coat goals by category or color coat them by grade level or whatever it might be. The other thing that I recommend doing is finding the very first row the top row of your spreadsheet, and using the filter button, so you just you highlight the very first row at the very top, and you go into the settings, or sometimes it's right there on the top homescreen bar. And it's a little filter, and it looks like a filter. And by doing that, it's going to make each of your columns, the ability to like, rearrange your entire spreadsheet based upon that column, whether it's, you know, by alphabetical order by most recently created, or whatever it might be. But using that filter button can definitely make your life much easier once it actually comes time to use this goal bank. And to be honest, hopefully, by now, you've gotten far enough along in the step that you are already starting to use this goal bank, you're not still just creating it, you're actually utilizing it. Again, this is your goal bank, especially if you're creating it. So find what works for you, and use what works for you, right, like only you know what works for you. All right, at this point, your goldbank is very usable, it's searchable. It's got goals that are templatized. It's got categories that make it easy to find things, maybe you've added some emojis or you've color coded it into a pretty functional goal bank. However, as I mentioned earlier, for me, I wanted more than this, I wanted to have kind of the next steps once I know my goals. And so that brings me to what I'm calling like this Pro feature bonus, and that is adding extra features. After building and beginning to use your goal bank, you may find that some goals lend themselves to other factors that you commonly use. For example, you might know that every time that you use a organizational turn in homework goal, you commonly use the accommodation of giving the student additional time having the student be able to email the assignment into the teacher. Whatever accommodations you might use, you might also realize that your treatment strategies might be somewhat similar, or at least you might have some go to treatment strategies that you commonly use when addressing this goal. Maybe there are some other strategies that you commonly use, or maybe you recognize that your baseline in the IEP with the goal is always the same for this goal. And so you just have a template for the baseline that again, all you have to do is switch out the student's name, and what they're currently able to do in regards to that goal. You're not having to reinvent or retype out the entire baseline. So these are all things that you can actually start to build into your goal bank. While you're going, I wouldn't recommend doing this upfront, like as you are organizing your goals. But this is definitely something that you can do. As you start to see, hey, I'm using, like 10 goals really frequently. And when I use those 10 goals, I'm using a similar baseline. And when I use a goal, I'm using similar in class strategies or similar pullout strategies, similar accommodations, so on and so forth. And I really call this like the Pro feature bonus part of your goal bank. Because when you're starting to do these, when you incorporate these features to your bank, you're going be on what a goldbank typically encompasses and you're actually beginning to develop a personalized therapy protocol for each goal, right. Like, you know, if I'm putting in this, this goal for a student to maybe sequence a full paragraph, well, you might already know what your next five sessions might look like with that student because you really understand what that goal means. And, of course, it might look a little different every student's a little bit different, but you have a gist of what your next five sessions or your next three sessions might look like, based upon what has worked in the past. We are creating evidence by using our own strategies and way by reusing our strategies, we can start to create evidence and you can start actually, if you really wanted to, within your goal bank is taking data as to what strategy actually works and what doesn't, and then manipulating the goal bank based upon your data. Yeah, I know getting a little over the top here with the goal bank. This is much more than I think most people think of when they think of a goal bank, right? Like we think of a goal bank. We just think of a long list of goals. Oh Hopefully we can search for those goals. But nonetheless, a long list of goals, but here we're adding more and make it a protocol, as opposed to just a gold bank. And that brings us to the final step, the whole purpose of putting this all together. And that is utilizing a gold bank, right? If you're keeping track, this is step number six here, and steps one through five, we're all about creating a goal bank so that we could get to step six, of course, you know, maybe you're not doing step five, or you're adding additional features. And even by time you get to step four, even three to some degree, you already have a gold bank that can actually be utilized. But once you've got all five pieces together, and you get to, to step six, this is where it gets really fun. Because now that you've done all that work, you can really start to utilize your gold bank. And rather than taking you more time to use your gold bank, it's actually taking you less time to find goals, and start to implement those goals. I definitely recommend if you're using Google Sheets, or some web based application to to use or to create your goal bank, then you definitely want to bookmark it and pin it to your browser so that it's just always there, right, you want it to be one click away. That way. At the end of the day, when you don't have students and you're ready to work on IEP goals, you can just really quickly bring those up and boom, they are right there. If it is more of a computer based system, a software on your computer, like maybe your your Microsoft spreadsheets might be depends on which version you have, then just make it a shortcut on your desktop. That way, again, it's very easy to add, you can just even leave that spreadsheet open all the time. So it's even easier to get to. The other thing you might need is actually a sticky note on your computer to remind you to actually use the goal bank. Or maybe if you have a checklist that you kind of use for every IEP, like, you know, for every IEP, you need to input your present levels of performance, your IEP goals, and whatnot, right your services, maybe you just add to your IEP checklist that you use each time, check goldbank for IEP goals, simple as that, just a quick reminder to make sure you're actually using this goal bank that you put so much effort into. And then once you're using it, don't forget to update it, right, like you don't need to update it every day, every week. But as you go along, you're gonna start to see what goals you use and what goals you don't use. If there's goals that you are using frequently, maybe you categorize those a little bit more by adding a star emoji and a far right column or a far left column to make them easy to find. Maybe you do something else, maybe you add more of those additional aspects to, again, to make your life easier if there are goals that you're commonly using, then you are also commonly writing baselines, putting accommodations in place and whatnot. So you can add those to your template. If there's goals that you're not using, right, like maybe there's goals that are just way down at the bottom of your list, and maybe they haven't even been templatized at you haven't used them in a long time. Maybe you're keeping track of what goals you actually use or don't use and which goals are effective or not effective? I don't know. But you can start to trim those out, right? As I mentioned earlier, do you want a list of 100 goals that you only use a few of or do you want a very condensed goal bank that you know what's there and you can easily find what you want. That's a personal decision. And maybe what you want now might be different from what you want in the future. And that's why I wouldn't necessarily delete those goals, I would just create a new tab or a new sheet within your spreadsheet that you would archive them so that way you can just copy the entire row, or cut out that entire row and move it to your archive. So they're still there if you ever want to go find them, but they're not in your way when you're trying to find the goals that you know that you want. Alright, so that is the six steps to creating and utilizing your own goal bank. And if you actually know maybe you went the route of finding your own goal bank, maybe you found one, you can kind of depending on how it works, you could potentially go through the other steps with that gold link that you found and make it your own. Again through steps two through six right you can personalize it a little bit by categorizing it but it all depends on how you have access the gold bank that you found. So as a quick recap, those six steps really quickly are to identify your needs and desires for goldbank. Gather your goals. Organize your goals and assign attributes to make your goals easy to find. Add extra features if it makes sense for you. And then the most important step use your goal being man I know that I have started at least three gold banks and I use them for maybe a few weeks then the end of the school year came and I just never went back and found them. I don't want that to be the case for you. I want you to build a gold bank. or find a gold bank that works for you that you will use over and over again, to actually save you time. And it's also for that reason that I want to introduce you to the OT schoolhouse school based occupational therapy gold bank. The steps that I laid out here steps one through six are the exact steps that I use to create the OTs schoolhouse gold bank that is now available at OTSchoolHouse.com slash gold bank. Now I have designed this OTs schoolhouse gold bank. Now I might be biased here because I designed it myself. But I really think that the OTs schoolhouse gold bank is really like the most premier gold bank right now because it's got everything that I've already listed or mentioned in this podcast episode. So far. It's designed to be an interactive and growing collection of OT and collaborative IEP goals explicitly designed for people like you and me school based OT practitioners. Plus every month, we add new goals based upon our members request. So if there isn't a goal already in the goal bank that our members want, then we go ahead and we build it out for them because we want the goals that you want to be there when you want them. For each goal, we don't just include the goal template. We also include a template for writing the student baselines, tips for monitoring progress on the goal, accommodations to support student success in class strategies to support student progress toward their goals, pull out strategies to further support student progress on their goals. And now we're even starting to add in common core standards that each goal could apply to so that way, if your administrator says hey, how does this goal support the students academics, you can say, Oh, well, this goal actually supports Common Core standard 2.2 Second grade or whatever that might be. And they'll be like, Oh, okay, cool. That sounds awesome, right. So that's why we're starting to incorporate the Common Core standards into each goal. As part of the goal bank, we also have this really cool AI feature that you get access to as a member. And I created this AI form to help you craft your own goals. In the case that you really want something more specific to your students case. And the way that it works, it's pretty simple. There's like five inputs, I think it is you input like the student's first name, you input the functional area that you want your student to improve in, and you also input like their current baseline where they're currently performing related to that functional skill. Once you do that, it's going to do its work. And it's going to spit out six different goals, the first three goals are actually going to be very specific to the information that you gave it. And then the other three goals, I've given it a little bit of creative freedom to kind of go above and beyond to maybe give you an idea for a goal that you weren't thinking about. So it gives you six goals, three that are very specific to what you want three, a little bit more creative goals to kind of, you know, maybe give you a little extra boost of adrenaline or a little boost of energy to add something else. All right. It's a really cool tool, and I can't wait for you to use it. So if the OT schoolhouse goldbank sounds, you know, just really interesting to you. And something that might make your life a little bit easier there in your school based occupational therapy role, I would love for you to check it out over at OTSchoolHouse.com slash goldbank. And of course, I'll post the link to that in the show notes for you to easily find but OTSchoolHouse.com slash gold banks pretty easy there, boy, yeah. And since I really appreciate everyone for listening to the OT, schoolhouse podcast, and I really appreciate you for listening all the way to the end, please use the promo code podcast to get your first month completely free. I really think you'll enjoy this. We've tried to make this just like super helpful, super, super user friendly. And again, it's going to grow with you. And so if you get in there and you love, you know all the goals, and there's one goal that maybe isn't there that you hope was would be there. Just use our request form. Let us know what your request is. Maybe you want a goal specific to I don't know, I don't know accessing lunchtime, or getting from one class to another. I don't think we have a goal in there. Right now. Maybe it'll be in there by the time you get there. But let us know if there's something that you would like to request. All right, well, that is going to wrap up this episode of the OT schoolhouse podcast all about binding creating and utilizing a school based occupational therapy goldbank I really hope that this episode helped you. I hope that if you decide to take us up on the free month of using our gold bank, I really hope that helps you and and please let me know, you know, shoot me an email or once you get into the gold bank itself, you can actually send me a direct message and just let me know did it did it help you out? And if not, why not? And if it did, let me know why we've gotten a lot of great feedback so far. And we're gonna continue to improve this. This goldbank For for all the school based OT practitioners out there, and I really hope it helps you. Also if you create Did your gold bank and you just absolutely love it? I would love for you to let me know what you love about your gold bank and why you love it. And maybe the process that you took, was it similar to the process that I took? Or was it a little bit different? If that's you've hit me up on Instagram, Instagram, or maybe Facebook and just send me a message about what you did the steps that you took to create your gold bank, and why you love it so much. I'd love to just give you some kudos and maybe even throw a shout out your way on the OT school house social media platform. I'm always looking for people doing awesome things. Love it. And who knows, maybe we'll have you on the podcast to talk about your goal bank. I would love nothing more. All right. Well, thank you again, so much for tuning in. This was episode number 145. I appreciate you. I appreciate you being here. And yeah, we'll see you next time. Take care. Bye.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed.  * Transcript generated by AI and may not reflect the actual words spoken by the host and guest. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 144 of the OT Schoolhouse Podcast. Dive into the OT Schoolhouse Podcast's latest episode, where Jayson welcomes Amy Crosby, whose innovative application of the Kawa Model in education is cultivating an oasis of calm for educators amidst the tempest of school day chaos.  Join us as Amy reveals how a simple yet profound shift in supporting teachers can ripple into improved classroom dynamics and personal well-being, backed by her engaging workshop results.   Don't miss out on this insightful journey through the lens of the Kawa Model to cultivate professional and personal fulfillment for you and the teachers you serve.  Tune in, and let's navigate the turbulent waters of education together! Listen now to learn the following objectives: Identify and describe the core concepts of using the Kawa model to support teachers as introduced by Amy Crosby in school-based occupational therapy.

Recognize the environmental and personal stress factors in educational settings that were highlighted during the workshop.

Recall the strategies for stress reduction taught in the workshop, including deep breathing and thought reframing. Guest Bio Amy Crosby received her Master's degree in 2003 and her Post-Professional OTD in 2023 from the Medical University of South Carolina. She has spent most of that time working with children in a variety of settings, such as school systems, acute care, private preschools/day cares, and homes. One of her favorite things professionally to do is "share the good news" by educating caregivers, teachers, and school administrators about topics within the OT scope in order to help them serve the children. Her company, Crosby Coastal Therapy LLC, has offered staff trainings and consultative services to schools and day cares for over a decade on a multitude of topics related to children. Amy has a heart for teachers and used her doctoral capstone project to pour into their social-emotional health so that they may continue pouring into their students. Resources 👉 View Amy's Capstone Project 👉 Get in touch with Amy 👉 The Kawa Model Website Highlights from the episode "As occupational therapists, it's not just about the students; we need to serve and support our teachers as well." - Amy Crosby, OTD, OTR/L "Educators are under so much pressure. It's not just about the curriculum; it's about creating an environment where both they and the children can thrive."
- Amy Crosby, OTD, OTR/L "Implementing the Kawa model within a school setting was a novel idea, but it has shown that we can have a real impact on educators' lives." - Amy Crosby, OTD, OTR/L "Understanding the environmental factors that cause stress at work can empower us to create more positive and productive learning spaces." - Amy Crosby, OTD, OTR/L "Seeing a 10% reduction in stress levels among participants affirms that the intervention we are applying has a tangible positive impact. - Amy Crosby, OTD, OTR/L "The classroom is a microcosm of the larger world, and if we can improve flow and engagement there, we can make ripples that extend far beyond its walls." - Amy Crosby, OTD, OTR/L When we teach strategies like rainbow breathing, we're not only helping teachers with stress management but also enhancing the classroom atmosphere for the children." - Jayson Davies, MA, OTR/L "We're not just occupational therapists, we are educators and advocates, and sometimes that means adapting our role to meet the needs of those we serve." - Jayson Davies, MA, OTR/L Episode Transcript Expand to view the full episode transcript. Jayson Davies  Hello and welcome to episode 144 of the OT schoolhouse podcast. I'm your host Jayson Davies, Mao TRL. That just feels so weird to say, you know, you write it at the end of your name so often or MS OTRS, or whatever it might be cotpa. But to actually say it out loud, it's just a little weird. Anyways, as you often hear me say on the podcast, school based occupational therapy is not just about serving the students. It's also about serving the teachers so that they can best support the students. After all, they are with the students a significant amount of more time than we get with our 30 minutes a week or whatever it might be so supporting the students by supporting the teachers. And that is why in today's episode, I want to introduce you to Dr. Amy Crosby. As part of her OTD Capstone, Amy had the idea to support teachers by introducing them to the column model and the associated life metaphors of the water riverbank rocks and driftwood. Through this episode with Dr. Crosby, you'll learn how Amy introduced the column model to her teachers the impact it had, and how you can even replicate this tier one strategy to support a group of teachers. If you have a deep burning desire to support teachers in order to make changes in the way that they support their students. This episode is for you. I hope you enjoy.   Amazing Narrator  Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies, glass is officially in session.   Jayson Davies  Amy, welcome to the OT schoolhouse podcast today. How are things over in South Carolina. They   Amy Crosby  are wonderful. Thank you so much for having me. I'm happy to be here. I   Jayson Davies  am so happy to have you here. We're gonna be talking about the column model. I really love the column model. I use it both like in my own practice, I use it in my business. And even sometimes it works its way out into real world applications, kind of like what we're going to be talking about today. So so that's exciting to be talking about. I gotta say, before we get started, you have some lovely decor behind you. And it's completely natural. I love the trees. I know people listening can't see it. But share with us a little bit about where you are, where you're located and the surrounding area.   Amy Crosby  Yes, I'm in the beautiful low country of South Carolina. And it's mid afternoon. It's a beautiful day today. I think it's getting up in the 60s. It's sunny, and I'm in my sunroom which is my happy place. We'll be talking about power of environment here in a little bit. And this is where I get a lot of clarity. I'm closed off so I have my parameters. But we have a lot of greenery in our yard. And yeah, it's a beautiful sunshiny day here.   Jayson Davies  I love it. Yeah, you've got nice big windows that just open up to beautiful trees outside. I just I just want to be in that room right there. And just like with a book Yeah. be so wonderful.   Amy Crosby  Thank you. You are here virtually. Yep.   Jayson Davies  Yep. All right. Hopefully we can bring all the listeners into our nice calm, wonderful South Carolina space right now. But yeah, wonderful. All right, well, let's dive into it. I, you're an occupational therapy practitioner, you just completed your doctorate last year, we're going to talk about the Kawamata, which you use to do that, in a sense. But first, just share with us a little bit about where you are in your OT world right now. I'd love to hear about that. Okay,   Amy Crosby  yeah, so I've been an OT for 20 years. And most of that time, like 15 years, I was counting I've been school based in some way. And so I'll go out I love to try new things and new settings. So I tend to go out every few years and try a new setting. And I always enjoy that. But the school tends to be my happy place. So right now I'm a school based ote full time working in a local public school district. I was part time last year while I was doing my doctorate, I was lucky enough to be part time and finish that schooling. And then started this year part time and then took on to cover someone's maternity leave. So I'm full time now. And I'm looking ahead next year like what am I going to do? Am I going to go part time again and maybe dabble in acute care? That's what I'm considering going back. I love to change it up. I really love all of the settings but right now full time school based. That's   Jayson Davies  awesome. You know, just I believe it was yesterday just posted on LinkedIn about how awesome occupational therapy is kind of for that reason, right? Like if you get tired or sick of one setting or it's just you're not happy in that setting. There's too many other settings to go try out to stick around and be unhappy. So that's completely awesome. I love that you kind of take that opportunity to go try out different places at school. Absolutely.   Amy Crosby  I love having a level two students with me. And I always will, I really will tell anyone who will listen. I have my oldest daughter is 17. So I talk a lot to her friends and the middle daughter is 15. That and then the youngest is 11. They've always been a part of my OT world, of course, but especially with the older ones, we have a lot of conversation about looking forward and their lives, what do they want to do choose something you love to do? And, you know, people who are getting, you know, young people getting ready to go to college? I really do I celebrate our career and educate them about the fact that what you just said, you can choose any setting. And then as you grow and your you know, if you're a family as you're if you have a family and your family grows, you can adjust and modify your work to match your family needs. Yeah. And yeah, it's we're so blessed that we chose this.   Jayson Davies  Absolutely. And we had this wonderful model called the column model, which I mean, it's just awesome. And, you know, you talked about that, right? I mean, our skill sets almost act as the driftwood in a way and we'll talk about that in a little bit. I'm sure, you know, our driftwood, our skills can knock down rocks and move them out of the way and open up the river for us. And we have some great skills as occupational therapy practitioners to support us in that. So let's discuss the caller model. You Ready?   Amy Crosby  Ready? All right.   Jayson Davies  So I got to ask What first got you kind of interested in the Calvo model? Did you sit in some, you know, professional development course one day where you're reading in a textbook? Do you learn it in school? What What got you interested in the column model? Well,   Amy Crosby  I did not even know about the column model, just full transparency until I was in school for this post professional doctorate. And Dr. Allama, came to one of our classes virtually, and introduced his column model, because I graduated in oh three, I think it was developed in Oh, six. So, you know, it wasn't in existence when I was in school. But he came and it just, he captivated me. He was on your show. I know. And yeah, listen to that podcast. And his just, his whole manner captivated me how gracious and humble. Yes. And in the model I just fell in love with right away. Yeah,   Jayson Davies  it was episode 126. And I remember it vividly. And he's just a very calm presence. But at the same time, like so knowledgeable if he wants to just really help with the column model. And so yeah, I remember learning it briefly in my school career. But it wasn't until I have attended a few different professional development courses that I really started to understand its true potential. So yeah, I agree. If you're not familiar with the column model out there, if you're listening, go back, listen to episode 126. We'll finish this episode first. And then go back and listen to episode 126. With Dr. awam. It's, it's a really good one. So then what made you decide to take the column model and Bridget with school based occupational therapy? Because as far as I know, no one's really done that before.   Amy Crosby  Yeah, I know. That's correct. And Dr. Obama, concurs with that. When I was starting, I reached out to him and he was my content expert for this prop my capstone project. And he said, Yeah, to his knowledge. You know, at the time of a year ago, when I did my project, there wasn't a study done using Kawa and early elementary education. But I, my classmates laugh at me, because I said that my capstone project kind of found me instead of me going to find it. I guess, like I said, the schools have always been my resting place, and teachers have always had my heart. And going into the post professional program. A lot of people to Capstone is what kind of drew them in to do that get their doctorate. It wasn't that way. With me. It was an interesting but also very intimidating because I didn't have a thing. I want to do this thing, you know, and I, so I'll go get my doctorate and I can do the thing. And that wasn't the case with me. But I just It honestly, the opportunity, you know, just for me, I was working. All the seeds were planted at all the right times just different. I took here's here's the deal, okay. For the greater part of 20 years, I've worked in schools account from a family of educators, and teachers personally and professionally, I've always had my heart. So I've done like private OT and then the private OT and daycares and private preschools. I've been the school based OT. I've done a lot of doing teacher trainings and So I've been, you know, the educator for staff teaching staff, teaching them different things in the scope of OT. And I've been a consultant role. And so I've worked. So I love working with teachers. And I took three years off before and during COVID, not due to COVID. But I took the year before COVID, we decided to homeschool our three and and then COVID happened. And we were thankful we'd already decided that, but I was there, you know, primary teacher, and I took a break from my professional OT. And when I re entered, that we went back to main mainstream traditional school. After that three years, and when I re entered my professional role, I was setting up a training with a preschool director who we've been working together for 15 years. And I went on to visit with her and we met in person, and we're so excited to see each other. And she just looked at me and said, Miss Amy, it's been, it's terrible. And that was the first seed that was planted. I'm like, wait, what's terrible. So it was just so excited to be with her and plan our next training. And she just proceeded to film in kind of on what they had experienced last year, while I was not there and hadn't experienced that, and that manner. And that was the first seed that was planted. And then as I reached out, have more conversations, and then I, you know, went to work back part time to work while I was doing my cat, my doctorate. And that that was just restated in, across the board, you know, consistently among all of my teachers. That's what I say it came to me, You know what I mean? It says, I was just going through real organically reentering the world, my professional role. I just was so discouraged and sad for them. And shocked, again, and again and again, you know, going in the classrooms and seeing there, they were just depleted. From the last three years, it really had taken like a chronic toll on them. So that was the nietos right in front of me. I mean, I didn't go looking, you know what I mean? It was just it was right there, that I was blessed to be in that position at that time, you know, with this opportunity, hey, you know, what project do you want to do, but like I said, a couple years before I, I never had a thing, a project I was dreaming up, but it just it was right there in front of me. So I was blessed to have that opportunity. And then I learned about the caller model. Yeah. It's it just, I felt that would be a nice match for the teachers. I love spreading good news, when I do trainings, that's what I feel like I'm doing is just sharing good news with them, that I want them to notice it's gonna make their life better. You know, that's what I always feel like I'm doing I'm doing a training. And I had that same feeling with the caller model. Like they need to know this, they need to know about it. If they know about it, they'll use it, you know, as they use it, it's going to help them which is going to help their students. So that's kind of how it started.   Jayson Davies  Yeah, yeah, yeah, no, and, you know, the column model is so it's so vivid, right, you have the picture of the river. And it's so easy to like, understand, even just by looking at the pictures even and so, I think that really lends itself working well. And like the the case that you're talking about with supporting teachers using the column model, I want to ask you, did you ever consider using it almost in a way with the students as opposed to the teachers? Or was it always kind of your idea? You know, what, I'm just gonna go straight to the teachers, because I can imagine also potentially using it with students.   Amy Crosby  I agree. I've focused from thus far on teachers. I just did this always, like I said, that's always when I go on a classroom, like always push in. And I'm always like, what do you need? What can you know, to the teacher? Yeah. And so I really have primarily focused on teacher teachers, the greater part of my caseload right now. I love the preschool world. So they're little, and then my older kids are moderately involved. So um, so that, you know, so that the population I'm serving right now wouldn't be able to actively, like, visualize that participant in the river, I think with all certain populations. Yeah, it'd be great. I've done it with my own children. And there's, you know, typically developing children and they've enjoyed it. Yeah. Awesome. Awesome.   Jayson Davies  Well, let's talk about the needs assessment a little bit. You already I mean, you kind of front loaded us with this kind of was right after COVID, that you're getting back into the schools starting to have these conversations with teachers. And I think we are all very well aware of the stress that came with COVID. And even kind of still continues to this day beyond COVID. And so I guess as you got started, what was the first part of your capstone project? How did you start to develop the need for it?   Amy Crosby  What we did was in the fall of 21, we did a needs assessment, and that I did I polled preschool teachers and public and private schools. And I just used REDCap survey, it was very simple. It was six questions that all had a branch. So if they said, Yes, it branched, okay, and asked them to rate they're the only one at what didn't branch was to rate their current level of stress on a zero to five, five being the most stress. And then it went on they all the things we've been talking about thus far. Has your stress increased in the last three years? If yes, why? Are there personal factors that affect your level of stress? If yes, why? The same with environmental factors? Are there strategies you use to decrease your stress? If yes, why? And would you be willing to participate in a class to learn more     call to action.   Amy Crosby  But it was interesting it and then yeah, so that's what I, that's what I did in September of 21. Prior to that, I did a literature review, you know, to dig into what the research the existing research out there, and that was interesting, because some key points from that, that are relevant, that are so relevant, or that that we know this, we already know that just to see the research, you know, in black and white is so powerful. So we already know this, but the research that students can sense their teachers stress level, and that has a negative or positive yet well, a negative that their stress has a negative effect on their learning. There was several research articles of the column model being used in interdisciplinary healthcare teams, to increase collaboration. And so, you know, based upon that, you could assume predict that it would also be successful in a multi in an AI, you know, multidisciplinary school based team to increase collaboration, which I did get to witness firsthand, you know, so it was it was interesting to do the literature review, and then to match that up with the needs assessment. And then originally, I was gonna do my project at the preschool that I spoke about earlier, where I met with the director, and she planted that first seed of what it was really like, out there, but just logistically, once we get into the the nitty gritty of planning it, it wouldn't line up with their like their half day, preschool. The teachers leave right at the kids leave, they don't have planning and they don't have teacher work days. And so we couldn't fit me in there. On a weekly basis. Yeah, gotcha. Gotcha. So I changed to the public school where I was working in, which was a beautiful, yeah. And it made the project I think more what the findings of the project more far reaching, it has 700 to 1000 students at the elementary school. And so, you know, to do it there a greater population. City there. Yeah.   Jayson Davies  Yeah, absolutely. And, I mean, I know we have a lot of OTs that work in OT practitioners that work in charter schools, private schools, but a majority of us are in that public setting. So it could be more widespread the results could be used for there. Let's talk about some of that needs assessment data a little bit. But first question is, is you know, how many teachers were you able to get to to support you with that questionnaire that you sent out?   Amy Crosby  So for the needs assessment in the fall, so they I had 29 Teachers filled it out. And for me, which was great, and I just sent it out, you know, just word of mouth. Like all my school based ote friends, please send this to your preschool teachers. My sister's a teacher, you know, everyone just kind of sent it out for me. And it was throughout the state. So I was very pleased with that. Yeah. 29 Yeah,   Jayson Davies  absolutely. And yeah, What were some of the key points that kind of came back from that? What did you learn?   Amy Crosby  So what what I learned was that, that it was really true what I thought was happening, you know that that teachers really were depleted 20 out of 29 of them reported their stress, SBN, three are higher on that scale of zero to five. So they all that triad turned on record, they're moderately to highly stressed. That same number of them said that their stress had increased in the last three years, which is what I had, you know, seen from leaving that world for those three years. And coming back, it was, it was so palpable, you know, the difference. So, the needs assessment echoed that. And when asked why hat, you know, what the question was, Has your stress increased in the last three years? If they say yes, then why. And four of the most popular answers were increased procedures due to COVID, increased demands or expectations, lack of parental support, and high teacher turnover. So, all things that we know, but just to see it in black and white and concur, that is powerful. Yeah, so absolutely.   Jayson Davies  I have a question for you, because you were doing this right after COVID? How much of this do you think you can contribute directly to COVID? versus how much of this is, you know, just how much do you feel is just the day to day stuff? COVID, or whether whether or not COVID is part of the picture? I mean, I know you didn't ask this question. But what were what was your takeaway?   Amy Crosby  I think the setting schools are, they're a beautiful place to be. And a lot of a lot of good happens there. It's there is very hard work. Yeah, that the teachers are doing every day. And you know, as as OTs, we go in and we support the child in the room, or the few children in the room, or the many children in the room. And then we leave and go down the hall to the next classroom. And my heart is that's, you know, another reason hats off to them, because the teacher is in there all day, every day. Yeah, with the students. And so I think, at baseline, it's tough. And then you throw in COVID On top of that, and it exacerbated all of the stressors. Yeah, you know, if there were behaviors before they were heightened, if there were definitely, you know, the paperwork, everything just got get amped up. aggravated. Yeah, absolutely.   Jayson Davies  I'm right on with you. On that one, I see the same thing my wife is, is an educator. And I tell her all the time, like, I couldn't be in a classroom with 30 kids for the entire day. Like I just got it. I'm very fortunate in the OT spaces, many of us are that, like you said, we can we're in with one or one or a group of kids for 30 minutes, and then we're on to the next group or individuals. So yeah, that we have it. Good. And I think it's very important for us to recognize that with teachers and understand that that is a tough situation to be in. And yeah, I think that kind of leads us to our next aspect. Because after you did do the needs assessment, where did you go from there? Did you start to find new participants for your actual workshop? Did you develop your workshop? Or where did that? Where did that lead you?   Amy Crosby  Okay, so after the needs, it says that we had decided it wasn't going to work for me to do the workshop at the preschool that I mentioned earlier because of logistics. And I was working in a public school elementary school and they agreed to be the Capstone site that was there, two to three days a week. And it's has 700 to 1000 students, and k are pre K to fifth grade. So there that became the Capstone site. And I gathered my team, my team, I gathered my my capstone population, it was 10. Teachers. Well, educators, one was a school psychologist to speech pathologist and then seven teachers, and they were all on special education, pre K through fifth grade. Okay, that those   Jayson Davies  are the typical population that most of us would be working with in any elementary school.   Amy Crosby  Yes, exactly. Yes. They were with me through the duration. It was five the whole process five weeks, and they all 10 out of 10. Were there for the the duration of the workshop. Gotcha. Okay,   Jayson Davies  so what did the what did the five weeks just broadly look like really quickly? Okay,   Amy Crosby  so what we did is we met every Wednesday. Originally, I wanted to do it for 30 to 45 minutes. But that was pie in the sky. And we had to condense it to 20 minutes. And it was it was very hard starting 10 times it was two to was like, right before it was two to 220. And people would come early, a few minutes early, but we started right at two and we ended at 220. Some lingered, because I would hang out, but IEP meeting started at 230. And the kids were out of the school by 150. So that was it. That was the one that was the one window. But um, but they would if they didn't have a meeting, we would you know, we would stay and chat. And like I said somewhat come early, but it was that hard, hard starting in time. And then I they all knew that. Our stay, I would be there again, the following day for anyone who couldn't make it. Okay. Yeah. So all   Jayson Davies  right. So before we get into some of the pre and post testing, what did the workshop actually come to look like? What was the what was the ideal message you're trying to get across? And how were you trying to get that across?   Amy Crosby  Well, it was, it was really cool how we did it, I thought about I wanted to my goal was to teach them the column model components of it, to teach it to them so that they could, you know, understand it, and they could use it to help themselves. And ultimately, then the children who, who they teach, and I thought about doing it a few different ways, I thought, originally, I was going to do like a two hour course and teach it to them. And I actually tried that I did, I tried it two different ways, which was very interesting, I tried, I did that I did a two hour course with a group of entry level doctoral students at Presbyterian College here in South Carolina. And it was very well received there. Okay, I did it also, I call it a community class. And I gathered, it was all women from ages like 13 to 70. And I guess it was eight to 10 of us, and I tried it on them. And it was it didn't work. Because and what I kind of came to understand from that experience is they just didn't have the foundational knowledge that those entry level OT students did, about all the things that I was just ready, I was throwing at them, like the components of, of the river and what they like what the riverbed stands for, and context. Like they don't know what context means, when I'm talking when we're talking about context, you know. So, from those two experiences, I realized I needed to break this down. And I wanted to give the participants time in between sessions to process everything and deal and self reflect. So I think that was a good move and unnecessary move. So we had four weeks of content, that delivery, and then the fifth week was feedback and reflection. So in the so we broke down the components of the river model each week. So week one was I just gave him a, like I said, we had 20 minutes. So most most of the heavy work of this workshop where was you know, it was done in between sessions by these individuals. But we wanted a very brief overview of like, why we're here, you know, what, what is this, you know, that I was doing my cast, and, and all of that, and a very good overview of the column model, too. So they would kind of know where we're going with this. But we focused on the water. We focused on the river water that first week. And it was, it was so fun and amazing because what we focused on I explained to them the concept, what it symbolizes our life flow. And we really dug into how balanced is our water or imbalanced is our water. And I defined for them. So this is back to those. Like when I did that community class and that OTD class. These were things that I just didn't anticipate until I had done that community class. You know, things I needed to explain like this. We're talking about balance and I explained to them, what we as OTs mean when buying occupation. You know what, why to find out Be patient to them and our context. And I had them pick, go through a week, day and a weekend day, and go through all of their occupations that they could remember, you know, all goes through every thing that they did in a day, all their occupations, and sort them in either productivity, leisure or self care. Put every occupation, each occupation in one of those categories. And, and look at that and reflect on that. So they did that for a week day and a weekend day. That was very enlightening. Because many, many, many, many, most, were out of balance, like we all are, yeah, randomly picked three, everybody, I should have said the beginning, everybody got a manual, a folder with the materials in it. And I randomly picked three of those at the end with their permission. And two of the three that I picked and looked at their inventory of their occupations, their productivity occupations, were four times that of any of the other categories. Cuz that's, that's what we know that. Yeah. I know. I mean, we know that, you know, but just to see it. And for that, you know, it's powerful, it's powerful to see it in black and white for it was for them. And for me, too, so that we call those um, theory application tasks like they did that I went through the instruction. This is what you're gonna do, you know, examples of it and defined occupation and define those three categories. And once I felt confident, they understood what they were going to do that week, you know, then they took it. And they did that on their own time that week. Another thing they did that week, that was enlightening was the Moho, the model of human occupation, that role checklist and the interest checklist. And that was powerful for them, too. Because it had them on the interest checklist. It's like two pages of, of all kinds of hobbies, you know, all kinds of hobbies from gardening to drawing, I mean, every hobby, and they go through and literally check in the I think it's like in the last five years. Was this a hobby? Would you like to get into it in the future? It hasn't just reflect on Yeah, that used to be an interest of mine. And I'm not doing it currently, what I like to do it in the future. And that was from the feedback from the participants. That was a powerful exercise as well. Yeah. So those, those three things, the Oculus sword in their occupations, during the inventory checklist and the role checklist, those were the self reflective theory, application tasks that they did that first week. Gotcha. Okay. Together. Yeah.   Jayson Davies  Yeah. So then you move on to week two, and you? What did you What was the theme for week two? And then what was the exercise?   Amy Crosby  So week two was super cool, too. This was so fun for us. And they loved it, too. They love the FaceTime. And the the fellowship? Yeah. So the week two was riverbed, our riverbed and we'd choose it. So what if so I defined context, which we as OTs, it's just kind of part of our, you know, mental framework, like it's just we just think that way, but it's not for everybody else? Yeah. So I defined context and how our personal and environmental factors comprise our context. Gotcha. Okay. And this was a super enlightening time that we had when we went over the content. And then discussions and reflections thereafter. It was very enlightening. And like you talked about where I am right now and the sunroom and the windows. One thing we did there and person that they reflected on in more depth on their own was and I had visuals to support this was I wanted them to envision their ideal office. And I wanted them to in all of the categories of sensation. I wanted them to envision what it looked like. And then I showed them examples of classrooms for them. I should have classrooms that were very visually organized and ones that were kind of a hot mess, you know, and the effect that had on them. And that generated some fun conversation you can imagine. And then we went through, what does it sound like in there? And in your ideal office? What does it sound like? You know, do you hear children? Is it better? Is it loud and chaotic? And you can't even hear yourself think, isn't totally silent year. Like, if you could just dream it up? What would your ideal office be? Where you're most available for creative work? Not where you go to get on the wheel and do rote work. But for creative Ben inspired work? You know, that was that was powerful. We went through all that, what would your seat look like? Would it be a yoga chair? Would you have a stand up desk? Would you be on a treadmill, you know, but just to get them thinking about the power of environment? Yeah. So that that was powerful for them. And we talked about their own classrooms. And they did a lot there were all of their each of their classrooms were very different per their styles and the effect that that had on them. And, and then we also, a powerful thing that we got great feedback from was are the personal factors affecting our context. And we talked about self narratives, the power of that we believe the voice we hear, most often we believe, what we what we tell ourselves most often. And so we had a lot of great discussion, productive discussion about that. And you know that, but to the model, how that affects, they really gained an understanding of how those personal factors and the environmental factors comprise our context, which is the riverbed and how that has such a direct effect on how our life flow, you know? Yeah, yeah. So that was week two. And they were just, they didn't have something to turn in, you know, to complete for week two, but to go further with creating their own dream office. And further in that way, oh, another thing we did in that week two was, they're supposed to just take some practical steps to simplify their environment. So I gave him I think it was 10 or so practical steps to simplify their environment. And it was things that we had talked about in class in our session, but stuff like minimizing your clutter, minimizing your time on social media, eliminating your news intake, minimizing your time with toxic people, you know. But yeah, that was an impactful week.   Jayson Davies  Yeah. Okay, so that was week two. Yeah. Week one was the was the Water Week to the riverbed. I'm assuming we're getting into the rocks and Driftwood here. And week three,   Amy Crosby  yeah, wave three was rocks and driftwood. So rocks are our problems, quote, unquote, our challenges, things that are difficult to us that impede our flow. And then our driftwood are the personal characteristics that can be worked for us or against us. But there's, you know, so unique to us. And so that week are in session time was, we had a case study about a teacher named Sally. And Sally had a lot in common with them. And we discussed Sally she was thriving in some areas, and then she was struggling in some areas personally and professionally. And we identified together we identified Sally's rocks, and her River and her driftwood and her river. So we did that together. And then their theory application tasks that week was to do the same one themselves. Awesome to identify some of their rocks and some of their driftwood.   Jayson Davies  Gotcha. Okay. I think we'll go with week four. And then we can when we talk about the discussion or the results, we can kind of dive into what some of their driftwood in the in the rocks were. But first let's let's talk about week four.   Amy Crosby  So week four, which is the kind of the big purpose for the kala Haleakala model can be used is to we try to identify spaces, you know, for greater flow, greater engagement and meaningful activity. And so week two we we went during our in session time, we talked about Sally our case study again, and we created SMART goals for Sally and Do you know and what was greatest since these were all special education educators and professionals, they were familiar with smart goals from IEPs. They had no trouble with that. Yeah, with creating the goal, and that was, that was very interesting, we created some for Sally together. Of course, that was easier for them than it was to create them for them for, for your own self, you know, it's easier to do that for someone else than yourself. But, um, it was interesting, because some of them just to give you an idea of where they were, and their kind of process and what they were learning. One, I was looking through some of my notes, but one, her goal was by March, so that was like, she gave herself a month that she would so five rose crochet five rose on her blanket. That was obviously a hobby that she had maybe put aside, you know, for a while. And one was, she was gonna make a list, that she would look prioritize her to do list, and just focus and complete three of the top five on her list each day, because she was getting overwhelmed. One was that she would go to the gym, she was one who realized that she was way out of balance in terms of not having any self care and her when she took inventory. So she wanted to her goal was that she would go to the gym straight from school. It was either one to two times a week, which was hard because she had a new child at home and yeah, all of that. But they were great goals aimed at increasing the flow of the river, or increasing the moving a rock out of the way a little bit or widening the riverbed, you know. But that was week four, is their theory application task was they would they create it to smart goals for themselves? Gotcha. Very cool. Yeah.   Jayson Davies  All right. Well, I think that that goes through most of the content with in the column model. So then week five was the left for some feedback.   Amy Crosby  Yes. So week five, I asked them questions about not not survey questions, not about their stress. And all of that. I asked them questions about about the workshop. Was this helpful? Do you think this is something that would be helpful to be implemented in the schools? What would you change? And what was the best part? Is there anything you would eliminate this questions like that in terms of the workshop to help me moving forward with it? You know, if it was something to offer again? Or to you know, how to modify it to make it better? Yeah. What did they all everybody loved it, we kind of it's, it's hard because really all 10 out of 10 loved what they loved about it is what makes it so hard to do, but they loved the in person aspect. Because they loved the the fellowship, like I said, the dialogue that was started there. And they love they said they loved getting together and, and talking and learning and studying something outside of what they do all day. You know, but they wish they had more time. I don't know how to fix that, you know, because of the me within that setting. I don't know how to fix that. Yeah. We talked about different ideas. They said like at a Tomorrow's a staff education day. And you know that we could do one there. But then you're back to doing it all. All at once. So anyways, it was good conversation. We didn't, it didn't end with with a nice neat answer of how to implement it. The whole workshop. pieces and parts. Yes. pieces and parts. Yes. And I think that this work, I might be getting ahead of myself, but I do think that this workshop pretty much as its outlined can can be replicated in another school with really good results. It just leaves you wanting more it does because of the content you know not and not because of the instructor or the, you know, the content? And because of the, the effects? Yeah. Because you learn things that actually do make your life better. And yeah, I do help you do help you to manage to manage in that setting to manage all of your roles. And yeah, it makes you make the time. Yeah.   Jayson Davies  So So before we get into that, so I could I do want to ask you about, you know, if anyone wants to kind of implement this, maybe some tips you have, but before that, talking about the actual pre workshop and post workshop survey, what, what were some of the key results that you found from the pre to post survey?   Amy Crosby  Okay, so one thing that we found is there was a 10%, but I'll take it, there was a reduction in overall reported stress levels. And that's powerful, because I didn't take any of their work demands off of them, you know, what I mean, I nothing came off of them, this is actually something additional inserted into their day, it was helpful, but it was work, you know, and then them having not having but choosing to make time to do the activities, that was all extra. And even in spite of all of that, there was a 10% reduction in stress levels report, when you compare the pre and post workshop surveys, there was a greater use of stress reducing strategies afterwards, compared to before, so specifically to deep breathing and thought reframing strategies. So meaning, the self narrative, changing that from a negative to a positive, and visualizing the river and the components of the river during the day. So I should have said that at the end of every session, in person, we did a stress reducing, we introduced a stress reducing strategy. And when I picked it, I picked ones that, you know, intentionally they could use in their classroom. So and they were so simple. So the first one, what two of them were deep breathing activities with a visual, and, like, one was the rainbow and they, you it's just pretty and colorful and happy, of course, but you you trace, as you trace over, it has the arrows that tell you like, you trace, left to right, and inhale. And then you get and you switch rows, you switch colors, and you come back on the exhale. And you do that through the through the rainbow. We do did that together. And then now there's rainbows and all of the classrooms, really in there calm down corners and, and stuff like that. But um, we did the deep breathing and we did a visualization. One, but I think that um, so back to the pre and pose before, in the pre survey, I think it was one of them. One person reported doing, I'm gonna pull it up. One person reported doing deep breathing, and then that went up to four and the end and the in the post survey. And then Okay, so what we found was in the pre workshop survey, one participant said she used deep breathing to help manage stress after the workshop for said they use deep breathing. That's, that's pretty impressive to me. Yeah, very positive. And before the workshop, no participants reported using reframing thought strategies, which would be like visualizing the column model as a whole or a component of the column model. Or it would also be like changing your self narrative from negative to positive, but none of the participants reported using that pre workshop, and four of them reported using it after. So those were the two biggest changes and noteworthy changes in terms of Strad energies that they use to manage the stress that I would attribute to the workshop, also. So in terms of environmental factors in the pre workshop survey, 60% says six out of 10 of the teachers reported that there were environmental factors at work that increased their stress. And then after the workshop that increased to 80%. And I think this points to an increased awareness of what environment environmental factors are. So before they knew they were stressed, but they couldn't, perhaps necessarily articulate what was causing that stress and their environment. And they, you know, through the workshop and the study of context and all of that they gained an awareness of that. Yeah. And as I   Jayson Davies  really quickly as I, as I look at your slide here, the top three factors, environmental factors in your post were staffing issues, student behaviors and paperwork, which, you know, some people don't view paperwork as an environmental factor, they might think, oh, that's more of a personal factor. That's something that I'm not good at. It takes me personally a long time to do paperwork. But in reality, that can be an environmental factor related to your specific job. It's not a you thing, it's a your job thing.   Amy Crosby  Yes, yes. Yes, there are personal factors listed were anxiety and depression that was listed both pre and post, that's not not changing, you know, we can't change that. I'm feeling overwhelmed, and being worried about children and family. So those are factors definitely unique to the person. Yeah, yeah.   Jayson Davies  All right. So at the end of the day, what are your thoughts on this just kind of in general, like, is this something that you hope to do again? Are you already doing it again? Are you still using what you learned in your everyday practice? Just kind of overall, what what were your takeaways?   Amy Crosby  So I would love to do this, again, I would have thought of a few different things. But what has happened thus far as we've kept the language going? Because you still work at the same school, right? Yeah, I'm at the same school, 10 out of 10 of us are still there. Now, eight out of 10, eight out of the two speech therapists left, eight out of 10 of us are still there, and the language is Go is definitely still go. And the deep breathing is still going, I learned that if I this is some powerful takeaways. Teachers will utilize strategies, if they can use them for the children in their classroom. Do you know what I mean? You know, like with the rainbow breathing when we that's, that's just a prime example. It helps the teachers manage their stress. But they use them immediately. Their first response was, oh, I'm printing that out for my for my classroom. And that's their buy in almost. That's my, that's my weigh in, you know,   Jayson Davies  yeah, it's funny because we, we do more for others than we do for ourselves. We want to take care of the kids that we serve. So if we do it for them, we're more likely to do for ourselves.   Amy Crosby  Yeah. Yeah. So. So that's important. When I think about reaching a teacher, I need to do it, where she or he understands that it will ultimately help the their students, do you know what I mean? Then I have their buy in. Same with strategies when we when we go in the classroom, you know, and we're like, what Johnny needs to be set up on an angle surface, and that'll help his grasp or Sally needs to have this visually blocked over here. And but but when they when the when we get buy in from the teacher because she sees the effectiveness of that strategy. You don't I mean, that's when she's going to use it. You know, so it's the same with this when she or he says that? Oh, yeah, if I learned this, and I can model it for my students, you know, I'll do it. I'll do it. But, um, so so the language has still is going. I've learned it's just reminded me of the OT, I do think that what I learned from this is it's different than when I went into OT in the schools. I didn't anticipate kind of serving teachers in this way. You know, because what we think of was school based or tea or is all of the fine motor or visual motor sensory processing strategies and services to help the student. And not I mean, I know we've always support the teacher and work alongside the teacher, and we're professional partner partners with them, but to, to serve the teacher in this way, as is a different kind of addition to our OT role that I think is, is definitely worthy of studying and highlighting and continuing to do. Yeah,   Jayson Davies  absolutely. I mean, and that's why that's one of the reasons that I am so particular, you'll often hear me there, say it here on the podcast, or my emails that we're there to serve both students and teachers is not just students, it's not just the teachers, we're really there to support all of them. And that's why I really wanted to have you on today to really talk about how you serve the teachers, because, as you mentioned, you know, way back, when we got started in that literature review, it's not new to understand that if teachers are feeling good or feeling supported, they're, you know, de stressed, then they're going to help the students improve more. And so by focusing in on the teachers here, you have probably made a big difference. I know, we can't quantify it, but you've, you've probably made a difference on those students that that have been able to learn. So that's quite, quite a feature. So quick question. Have you seen any of the teachers? Mention the column model? Use the column model, like in their classroom at all? With the kids particularly? Or Not yet?   Amy Crosby  Not directly? Now, and again, my my class, my, my classrooms that I serve are a lot of preschool and then the moderate severe classrooms. So no, not directly.   Jayson Davies  Yeah. I wonder, too. I mean, like the you said, you mentioned you worked with, like the school, Psych was part of it as both the speech therapists and I could definitely see, especially maybe a speech therapists kind of working on that during the session or something. But know that that's super cool, that you were able to get through to all the staff. Before we wrap up here really quickly, some quick tips that you might have, for anyone who might be interested in kind of running this type of a group with their teachers at their school site.   Amy Crosby  I guess my first thing I would say is, it's doable, and it's worth it. Yeah, and a starting place. I mean, we've been thinking of other timeframes, but in the day in the school day, where you can capture all of those people, and I just, if you find one, email me, because we can't find it, but it's true. You know, so I would just say start with what you have, and you don't have to have it is so much content. But a lot of it is done individually. You know, one, you just do it on your own individually in between sessions. So this is a great starting place, 20 minutes, four weeks, five, if you know for that feedback week. And it really the it's worth it, and it's doable is what I would want to say. Yeah, yeah,   Jayson Davies  absolutely. And you know, your your capstone project is available. And so anyone can go and read your capstone project for a little breakdown of how you did it. And then there's so many YouTube videos about the Calvo model. If you need to learn more about it, you can also go to column model.com , to learn more about the column model. So if you're not quite familiar with it yet, you can definitely learn more about it before you try something like this. Completely agree when it comes to working with teachers and providing like training to teachers, shorter is better, even 20 minutes is hard to get time for. So kudos to you for finding that 20 minutes, you know, for five consecutive weeks is that is definitely not easy. I do have one final question, I think. And that is in regards to the administrator. I know that the administrator was not necessarily part of your research, but the Did they have any thoughts either before or after you   Amy Crosby  completed this? They were just consistently supportive. It's one principal and two assistant principals. And they were just consistently supportive. And they would ask for updates of how my project was going. They were when I couldn't even get the question out initially to ask the principal can I I was telling her I'm in school and I've just kept you know, and before I'm gonna get up, she was like, yes, have it here. We'd love to be your capstone site. So just from the very beginning, very welcoming and encouraging and supportive. Yeah,   Jayson Davies  awesome. That's great. Well, Amy me, thank you so much for joining us today really appreciate it. I'm really looking forward also to catching up with you maybe a year from now and seeing if you've had a chance to run it back with the teachers and what they've learned or maybe find a new group of teachers to try it out. I personally would love to see you retry this with the general education teachers, and maybe if it's, maybe it's just like the first grade team, or maybe it's just the kindergarten team, whatever it might be. But I would love to see what could even even come with that. That'd be fantastic. Any final words you'd like to share?   Amy Crosby  Um, no, I just, I do think there, I do think there's little pieces of this that could be embedded in the school, that would be something else that if someone else wanted to do a workshop like this, you know, how just visuals like at the end the teachers lounge or at the water, fill up station, and visuals or have pictures of the river, like once we once you do that workshop, to have a visual on the bathroom door, there's, I have memorized this, there's the positive affirmations that are on the bathroom doors, when I see them, and so that's the power of them. So like, it works, you know what I mean? And so I think little pieces and parts along the language will stick. And then there's those visuals that you could put up throughout the school that would add another layer of keeping the culture going, you know, the kala culture going. And, and I also thought of like a water relaxation station type place where you could go and have maybe the like the dream machine, you know, the sound of a river, and the positive affirmations posted on the wall. So I think that's another layer that you could do post workshop to keep the effects going. Yeah. I would love any any questions or any communication I have. We put my email,   Jayson Davies  go ahead and share it here really quickly. And then so yeah, okay,   Amy Crosby  so it's Crosby, coastal therapy. Crosby as my last name. Coastal is along the coast. therapy@yahoo.com . Perfect. Yeah, reach out. Yeah, just chat about it. Yeah,   Jayson Davies  we'll share that on the show notes for the episode as well as a link directly to to the Cala moto website, as well as your capstone project. So anyone who wants to take a read through or ponder through it can absolutely learn more about it and reach out to you so   Amy Crosby  great. Okay, thank you very much.   Jayson Davies  Yeah. Thank you, Amy. It's been great talking. And we'll definitely stay in touch to learn more. So   Amy Crosby  thank you. I've enjoyed this.   Jayson Davies  Thank you once again, for tuning in to the OT schoolhouse podcast. And thank you so much to Amy for sharing about how she used the column model to support teachers. If you would like to learn more about the COA model, be sure to go back and listen to episode 126 of the podcast with Dr. Hugh wama. He is the founder of the column model. And we dove into all the different parts of the model from the river to the riverbank to the driftwood and the rocks and how that really can apply to school based occupational therapy. And I really think that there are more school based OT practitioners that are starting to use the column model, especially as we dive into the world of mental health. I can't wait to hear how you implement the column model in your practice. Now that you have a little bit more information. Thanks again for tuning in. I appreciate you and I'll see you next time. Take care of school base Oh T crew.   Amazing Narrator  Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now head on over to OT schoolhouse.com Until next time, class is dismissed.   Jayson Davies  Thanks again for listening to the OT schoolhouse podcast. Though to school house podcast is produced by myself Jayson Davies with support from Chandler cozy. The podcast is edited by James Endo. While we strive to provide accurate and up to date information. The content shared in this episode is intended for informational purposes only. It is not a substitute for professional advice, diagnosis or treatment. If you or a loved one would benefit from occupational therapy services, we recommend consulting with a qualified occupational therapist or health care provider for your personal guidance. The views and opinions expressed by guests on this podcast are their own and do not necessarily reflect those of those who schoolhouse. Remember your safety and well being are important, so please use discretion and seek appropriate support when implementing any strategies or recommendations discussed. If you would like more individualized support as a school based occupational therapy provider. Check out the OT schoolhouse collaborative at OTSchoolHouse.com slash collab where you can earn professional development access is our interactive gold bank and interact with myself and other school based OT practitioners I appreciate you see you next time * Transcript generated by AI and may not reflect the actual words spoken by the host and guest. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 143 of the OT Schoolhouse Podcast. Are you curious to understand how school-based OTPs can use AI? Tune in as Jayson Davies, MA, OTR/L, dives into the future of AI and occupational therapy. Discover how AI tools like Chat GPT can change your approach to evaluations, IEP planning, and beyond while ensuring ethical practice and preserving confidentiality. Whether it's creating personalized goals, drafting treatment plans, or enhancing service delivery, Jayson discusses the potential of AI to level the playing field and optimize OT services. Whether you're a tech-savvy OTP or an AI novice, this episode will educate, and inspire you to harness the power of AI in your daily practice. Listen now to learn the following objectives: Learners will identify ways in which school-based practitioners can use AI to support themselves and their students.
Learners will understand the role of AI and tools to assist in the development of treatment plans, documentation, and monitoring of student progress.
Learners will identify the importance of ethical considerations and maintaining confidentiality when integrating AI into school-based practice. Guest Bio In 2017, Jayson founded the OT Schoolhouse website and now supports school-based OT practitioners via courses, conferences, and the OTS Collaborative community. With experience as both a contracted therapist and an "in-house" employee for two distinctly different districts, Jayson has had the opportunity to appreciate the differences between both small-rural and large-suburban districts. Recently, Jayson has put forth his efforts toward supporting therapists interested in tiered intervention, collaborative programming, and managing their workloads. Quotes "AI is training computers... to have so much knowledge that they can then make decisions and craft responses on their own." - Jayson Davies, MA, OTR/L “We need to at least be familiar with it in order to make sure that when push comes to shove, occupational therapy practitioners can stand up and say, hey, I know AI and this is how I'm using AI.” - Jayson Davies, MA, OTR/L “I think it's going to help us be more organized. It's going to help us to better evaluate and understand our caseloads and our workloads.” - Jayson Davies, MA, OTR/L Resources Chat GPT
Google BARD Episode Transcript Expand to view the full episode transcript. Jayson Davies  Hey there, school based OT practitioners what is happening? Welcome to Episode 143 of the OT schoolhouse podcast. Thank you all so much for being here today. Now, as you read in the title of today's episode, we are talking about occupational therapy, and AI, specifically school based occupational therapy, and AI because that's what we talk about here, school based occupational therapy. So you might have heard, you might have even attended that about two weeks ago, I was part of an EO ta panel on AI and occupational therapy, there are about five of us and all of us have had some sort of experience using AI and occupational therapy. And I became kind of the pseudo pediatric school based therapist about AI on that panel, that panel was completely free to attend, you didn't even have to be an A OTA member. And they should be releasing the replay very soon. If it is available, you can probably click on the show notes for this episode to figure out how to get access to it. But anyways, it was a wonderful, just a fantastic webinar panel, so many knowledgeable people. And we got to dive into a lot of questions from ethics to service delivery to documentation. And it was just awesome. It blew my mind. I learned a lot and I helped a lot of people also learn a lot about AI. So I figured I'd do a follow up to that. And we would talk about AI specifically in school based occupational therapy with this podcast episode. So we're gonna go ahead and dive into the intro music. And when we come back, it's all about AI in school based OT hang tight.   Amazing Narrator  Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies, class is officially in session.   Jayson Davies  All right, welcome back to this very special episode on school based OT and artificial intelligence. Before I go any further with this discussion on AI, I first want to give a big thank you shout out to a OTA for inviting me to be a part of that panel, it really was a great time. And we found out as panelist, and as a OTA as a whole, that occupational therapy practitioners are really interested in AI. In fact, they even shared during the panel that this was the most registered webinar that they had had since like, the COVID times. And it was also the most attended webinar that they had since the COVID. Time. So AI and occupational therapy huge right now. And it's a very important discussion to be having. With that said, I don't want to assume that anyone listening knows anything about AI. So I'm going to give just a brief overview of AI from my own learning from my own perception. And then we'll go into the specifics about school based occupational therapy. So if you're already familiar with AI, hang tight, just give me like two minutes, and then we'll dive into the specifics here.   Jayson Davies  So what is AI, in the most basic sense, AI is training computers very, very strong and powerful computers, to have so much knowledge that they can then make decisions and craft responses on their own. You know, at some point, they're even like talking to one another. That's where things get a little scary. But, you know, this isn't the first time we've had a big technological shift, right? When Google first came about, that was a big change, you know, schools got scared that everyone's going to be able to copy or find answers to tests and whatnot. And that's nothing new. We're kind of living that all over again. And we'll talk about ethical concerns in a minute. But I just wanted to talk about that, you know, this is this is a similar shift. And computers are learning and they rely on a mass amount of data, like data from the entire web, or a large portion of the web, in order to craft their decisions, create responses, and to support us as the consumers using the AI. Now, here's an example about how AI has taken the search query to a new level. I think we are all very familiar with google.com , the basic Google search engine, and the way that the Google search engine works is that if we ask a question, like what is OT, it's going to provide answers from 2000 individual websites or more or less whatever might be about what OT is from that specific website. So you might get a definition from a OTA you might get a definition from Ida from NBC, OT from OT school, house, whatever it might be, but their individual responses from each of those websites and Then they encourage you to click on to go to that website to learn more, right? Conversely, Google bar or chat GPT, rather than showing you 2000 different responses, they're only going to give you one response. And it's going to be the quote unquote, perfect response based upon all the definitions of occupational therapy that it has access to. So behind the scenes in a fraction of a second, it read the OTA definition, it read the NBC OT definition or read the OT school has definition, and then it crafted a response from that. Which then leads me to this fun exercise where I asked Chet GPT, what is school based occupational therapy, it offered me a full paragraph about OT. In fact, it gave me a really long paragraph. So I asked it to short in the paragraph, which you can do. And this is what it gave me. School Based occupational therapy. OT in parentheses, involves therapists working in educational settings to support students participation in school activities, addressing challenges related to motor skills, sensory processing, attention, self care, and academic performance, ultimately promoting their success in school. I didn't make that up that is straight from chat GPT. And I'm sure that it pulled it from a various number of resources. I don't know where it got this from. It's not quoted, it's not cited. But I assume that it is sourcing it from a OTA state websites, maybe the Department of Education websites, and perhaps even the OT School House website and other school based OT, blogs and websites. I did ask it to please cite its answer. And it basically told me sorry, I can't cite. But you can learn more over at a ota.com and other occupational therapy websites. So that is how chat GPT and these other chat bots are different from Google, Google is going to give you a list of websites where you can go learn more, versus chat. GPT is going to kind of summarize everything he knows about everything on the web, and then bring it in together to one answer, you can then follow up and have a conversation with these chat bots. And it will continue to do the same thing over and over and over again, every time you ask it a question, it's going to look at its previous response that it gave you, then it's going to search the web based upon the context you gave it and find the best answer to provide you with and every time you ask a question or a follow up question. It's doing the same thing over and over and over. So if you came into this podcast, never heard of the term AI. I hope that that definition that working definition is enough to help you understand what we're going to be talking about today, with AI and occupational therapy, mostly related to how we can use chat bots to support us, as well as the students we serve. Now, there is a whole nother universe of AI and that has to do with enabling machines to operate without human interaction. And I hope and in fact, I do plan to talk more about that in the future. But for now, I don't know enough to have the discussion with you on my own. Yeah, sidenote, Robo dogs scare the heck out of me if they don't scare you, there is something wrong, but we're going to talk about how AI within technology might support students on another episode. All right. Now, for the fun part, let's have a discussion about AI and school based occupational therapy, where we are kind of today and potentially where we might go in the future. I'm going to break down the rest of the podcast into about six sections. We're going to talk about evaluations, IEP planning and writing, documentation, service delivery, program management. And yes, of course, we cannot leave ethics within occupational therapy and AI. In fact, we are even going to start with ethics in AI because I believe that school based occupational therapy or occupational therapy providers are some of the most ethical people that I know. And this is often the first question that comes up whenever I bring up AI is how is it ethical? Is it going to take over our job? Should we be using AI? Should we cite AI? All of these questions are very important and I want to start right there. But I also want to start with a slight disclaimer. AI is moving very fast right now.   Jayson Davies  So please understand that everything I say is from my perspective only. I am not aware of legislation pertaining to AI and OT AI in education or AI in general. And legislation may change the day after or years after this podcast goes live. So just keep that Have in mind that I am speaking from my personal understanding. And I am not a lawyer. So yeah, make sure you check with your district at the very least, on anything I say today. All right, so HIPAA and FERPA the two acronyms that we are all familiar with, but don't completely understand. Basically, we have to protect our students, our patients, our clients confidentiality, when it comes to AI, I am very skeptical about this. And without going too far into all the details for you and I as school based occupational therapy practitioners who either are employed by a school employed by a district employee by county and or contracted with one of those areas, you have to be very, very careful. Open AI, which is the owner of chat GPT Typically holds on to data for 30 days. Now, there are ways to go around this. But basically, you have to have an agreement with them, which your district probably doesn't have. So unless your district has said, Hey, OT team, we're all good to go, you can use AI in the same sense that you would use any other documentation application, then I would not put any names in, I would not put any date of births. And I wouldn't put social security numbers in not that we really have access to social security numbers. But what I'm saying is don't use personal identifying information within these chatbots. A lot of them are saying that they don't keep your information. But you also have to think about the outputs, right? Not just the inputs, you don't want it to keep what you're putting in. But if it's then regurgitating what you put in on the output, you got to make sure that it's also not keeping that output for their own training purposes to make their bots even smarter, and who knows where that data is going. So again, as far as I think we should be treating this as school based occupational therapy practitioners, and protecting the rights and the names and the personal information of our students, we should not be inputting any personal information into a chatbot, we can absolutely use pseudonyms. And then when we copy and paste, whatever it is that chat bot gives us over to a secure document, then we can go back and you can even use the Command F button on your keyboard or Ctrl F on your keyboard, and basically change out all the pseudonyms for the actual students name. But don't do that until you are on a secure platform, your district likely has a contract with Google in place to make sure that their Google you're at whatever email address that you have that's on Google or Microsoft, whatever it might be, they likely have a system in place that makes that secure. But that system may not be in place for using chat GPT or Google bar yet. So don't use names. Unless someone at your district someone high level at your district has told you it's okay. And that leads me to the second most common question or concern that I get when talking about AI with OT practitioners out there. And that is that people are afraid that chat GPT is going to take their job, or they're also afraid that chat GPT cannot do what they can and therefore there's no use to chat GPT to that I say two things. First, it is not taking our job. Not here not now. I can't save, you know, for 2030 years, I don't know. But I can confidently say that it's not taking our job right now. And we should actually get on board with understanding it and with using it. Because if we don't someone else will. And then we might even be more in trouble. Right? Like we don't need computer science, figuring out how to basically replace occupational therapy. No, we need occupational therapy, understanding AI so that we can have a seat at the table. We have lost seats at too many tables to lose another seat. So we need to be here. We need to understand AI. And we need to understand legislation that might come down the pipe in regards to AI. Now as far as the idea that we shouldn't use AI because AI can't do task analysis and AI just doesn't replace us and it can't replace me. I won't let it replace me. I say this, I like to think of working with a chatbot and AI chat bot in a similar manner to working with a level two student or a research assistant. Right? We can ask the research assistant just like we can ask AI to look something up for us to I look up research to look up IEP goals to look up SOAP Notes. But at the end of the day, it is you that is transferring what the AI chatbot or the research assistant is giving you on to the official paperwork, right? So at the end of the day, it's not chat GPT is license that is up for debate. If something goes wrong, it's your license and your certification. That is up for debate, right. So you need to make sure that anything you look at anything that you receive from any one of these chat bots, is actually legit, at the end of the day it is on you, you can get information from these tools. But they are that they are a tool, they're not an end all be all. And anything that you take from them should be looked at with a grain of salt, right? You cannot trust that the research that is giving you is accurate. You can not trust that it is citing works from the textbook that you thought it was because it said it did. Chat, GBT and Google bar are both known for hallucinations, which is basically just fabricating any response that it wants, because it thinks that you'll appreciate it. So a lot of times, if it does try and cite something, the citation is very wrong. And it's really easy to figure out because it'll be a clickable link, and you click on it and it goes nowhere. If that happens, it just made up that citation. Do not trust it. Go over to Google, type in the name of that article and see if you can actually find that article. If so, look at the article and find where it might have come from whatever the response was that chat GPT gave you. And I understand, you know, there's a lot of potential new terms that you're hearing right now, like hallucinations, and I'm saying chat GPT all over again, what the heck does GPT even mean? I'm just not going over that because it's too much. And this kind of all ties back to my response a few moments ago, about why we need to get on board with playing around with AI seeing how it can support us the potential dangers of AI, and start learning about it so that we can actually have a say, in how AI support OTs, rather than letting other people who know nothing about occupational therapy, dictating how AI can support occupational therapy practitioners. All right. So no AI cannot do your job. But AI can certainly help you do your job. And that's the fun part now that we're gonna dive into. All right, it is time to discuss artificial intelligence and evaluations. If you know me, you know that evaluations are something I actually enjoy. Not everyone does. But I do. And I have a list here of several ways that we can use artificial intelligence to help us with our evaluations. By helping us I mean, it could help us save more time, it could potentially help us to create better evaluations.   Jayson Davies  It can also help with interpreting our own thoughts and helping us better understand what we think we know. And potentially embedding research into our interpretations. So here's a few specific ideas that you can use right now to support yourself with evaluations using artificial intelligence. Starting with the very first part of any evaluation is collecting an occupational profile. I don't know about you, some people use different formats for collecting information for an occupational profile. If you have followed me, you probably heard me talk about the occupational profile for school based occupational therapy that I have that you can get by checking out the blog post or just subscribing to our email list. And another way that I've also collected occupational profile information is by using a form, whether this is a Google form or a Microsoft form, whatever it might be, you can send this form out to a teacher or to a parent or to both and collect information back on it. Well, once you have this form, whether or not it's a Google form, a Microsoft form, or even a handwritten form, potentially if you're using the right AI software, you could provide this information to the AI, again, using a pseudonym. So you're taking out the student's actual name, actual birthday, stuff like that, but you can use the general information to help you with developing an occupational profile, you can essentially tell it pi this is the information that I have collected from the parent from previous IEPs from the teacher, even from the student themselves. Please help to create an occupational profile, be sure to include this, this and this and it will sure enough, go ahead and provide you with an occupational profile. As I mentioned earlier, you are going to have to probably cut and paste and edit and make changes to it. But it is a starting point. Once you have done that enough times, you know, maybe you've done it 510 times, you're going to start to see a template emerge. And you're going to start to see how everything you say impacts the way that it gives you the occupational profile that you want or don't want, and you're going to make changes. And then you're going to start to see that a template emerges. And you can even ask the AI to create you an occupational profile template, which then you can give back to the AI and say, use this data, and the template that I'm providing you to create me an occupational profile. I know it's mind blown, we're going to have to do some YouTube videos on how to make this actually happen, what it looks like. But that is the first way that you can begin to use AI to support you in your evaluations. Another way that you can use AI in your evaluations is to help with comparing assessment results, you could tell the AI, Hey, Johnny scored, average, below average and average on the bot to and on the end fun, he scored in this range, this range in this range. Please help me to understand what this might mean. Now you got to be careful, because with assessments I have tested it, it is not right with assessments, it doesn't fully understand all the different assessment pieces right now. It thinks that it can great assessments, but it really can't. But it can start to help you with interpreting what it might mean, if a student is scoring average on this test, but below average on this test data it can start to do, I would be willing to bet a lot of money that very, very soon. Pearson And WPS all the publishers of all those evaluations that we use, they are going to start embedding AI into their scoring methods, they already have a lot of their tests being scored online. And can you just imagine when you punch in the raw data, it's not only going to give you a table, but it's also going to give you a narrative about what those scores actually mean. And then you'll be able to go in and add everything that you observed into that narrative to really build out a round picture. So now that you have used AI, potentially to help develop an occupational profile, now that you have provided your own observations into it, because AI can't do that, yet, that's a whole nother discussion. And now that you've also gotten some data in there, now you can basically give the AI all that information to help with potential interpretations. You can ask it for themes, you could say, Hey, I'm thinking this, does that make sense? And it might help you. I'm not saying you have to use what it gives you. I'm saying that it could potentially help you in the sense that it might give you ideas that you would not have otherwise thought about. Again, you got to take everything with a grain of salt here, but it can potentially help you. You can also ask for any additional support. Hey, based upon this occupational profile AI based upon these observations in this evaluation data, is there something that I should consider? Are there accommodations that I might want to look into? Are there specific types of therapy or different materials that I might want to consider? Is there any research related to occupational therapy and school based OT and Down syndrome that might help me to better understand where to go next? These are all the things that you can ask AI for support with. And then as you get to the end of your evaluation, you can even ask it to help you with justifying services or justifying not recommending services. I feel like I'm gonna say this 100 more times during this podcast, take it all with a grain of salt, do not just copy and paste, make sure that you're reading it, breaking it down, fully understanding it fully deciding to yourself, hey, does this make sense? Does it not make sense, does 10% Or to 60% of it makes sense. But these can help you potentially make your process a little bit faster. Not the first time, not the fifth time, probably not even the 10th time. But once you start to understand and create this process for using AI and incorporating it into your evaluation system, it may be able to help you. Again, I'm gonna say this multiple times throughout the podcast, do not use real names, do not use real birthdays, make sure you're using pseudonyms. I'm sure there are other ways to incorporate this into evaluations. In fact, I know that there are new programs coming out. I'm not going to throw out any names right now. But there are programs that are being developed and are available online right now to help with evaluations. But this is a way what I've talked about so far. This is a way that you can do it without using a program. There are probably programs out there in fact, again, I know there are that might make this process even more simple. but I'm not gonna throw those names out because I haven't tested them, I haven't vetted them, I haven't used them. So I'm just going to leave them off for now. Alright, now that we have our evaluation done, whether we used AI for assistance, or we did it the old traditional way, on our own, typed it up 10 pages, whatever it might be, without AI, that's okay, too. But once we have that evaluation, now, we can potentially use artificial intelligence to help us with planning and writing the IEP as well as a treatment plan. So here's what I mean by that. Every IEP consists of four main components that occupational therapy practitioners have to fill in, right, you have the present levels of performance, you have the new goals, the new services and the accommodations. And from my playing around with artificial intelligence, I have figured out that for three pieces for three of those pieces, you can use AI to help you, you can use it to help you with the present levels of performance, you can use it to help you actually create goals for the student, you can't really use it to help you determine services that is very much a unique area unique aspect to both yourself as the OT practitioner, and also the IEP team. And then you can also help or it can help you with the idea of incorporating accommodations. So let's start with the present levels of performance here. One way that you can use AI for the present levels of performance. And this is different, or this varies, I should say, based upon how your IEP system works and whether or not you have one giant space where you put in all your present levels. Or if it's broken down into sections, like insert fine motor skills here, insert sensory stuff here. But you can go in to, you can go into chat GPT, and say, I have this student pseudonym is blank, ages blank. These are some of his strains, these are some of his concerns. These are things that I want to make sure to include in the present levels. And then you can say, create me an IEP present levels of performance based on this information. And what it's going to do is it's going to take that information, and it's going to kind of turn it into a nice pretty present level of performance. You can even a step further here, little pro tip, I   Jayson Davies  guess you can say, hey, here's my data, turn this into a strengths based present level of performance, turn this into a deficit based present level of performance. Not that you would use that, but I'm just giving you examples, you can then say, okay, let's expand upon it, here's a little bit more information incorporate that. Or let's make it shorter. Let's make this specific to fine motor skills and create a second one that is specific to sensory processing skills. So there you go. Now you have just developed present levels of performance. And yes, you put all the data in, you told the AI chatbot exactly what your student is able to do what they can't do, and then chant GPT just made it look pretty for you in essence, right? That's pretty cool. If you agree with that. If not, maybe not. But now that you have crafted your present level of performance within chat GPT you can continue from there. And what I mean by that is you can then say, okay, chat, GPT, you have Johnny's goal. And now I want to create an executive functioning goal for Johnny that revolves around the need for organizational skills so that he remembers to turn in his homework, please chat GPT right for me. Yes, I am one of those people that talk to an AI bot and uses formalities such as please. But anyways, chat GPT, please write me three to five goals around executive functioning and organizing of schoolwork. And it will do that it's going to write you out three to five potential goals that you can choose from or that you can adapt, you can say, hey, check your pte. I don't like the way that you did that. Can you change it to this way? Can you make a strength space? Can you make the criteria 80% instead of 90%? Can you make it in four out of five trials instead of three consecutive trials, whatever it might be, but you can play around with the goals that it creates a draft for you. You can even scratch it and say, hey, those all stink, please give me five new ones. And just be creative. What might the student need from here on? Give me five new goals. And it'll do just that. This is not replacing you. This is asking for help. This would be similar to going to an occupational therapy mentor and saying, Hey, I need help crafting a goal for this student. Here's his present levels. Here's the areas that I think we need to work on. Do you have any guidance and that OT mentor saying I think I have some ideas? Try these and then you kind of having a conversation back and forth saying I'm not sure. So I hope this resonates with you because you can continue on from there either. and right, once you have the present levels of performance, once you have now developed a goal or two, by the way, you can even say, hey, chat GPT, let's make this a collaborative goal. And I want to collaborate with the teacher on this, how might we collaborate together? It'll help you with that? Well, once you have that, then you can say, alright, chat up team, are there any accommodations that I might want to consider in the classroom to help the student meet this goal. And this is kind of key, because remember, this whole conversation is one conversation with Chatrapati. We started potentially with the present levels of performance, or you might have even started with the evaluation. So chat GPT knows everything to this point, except the student's name, the student's date of birth, the student's social security number, and any other identifiable information like maybe even the school that you are at, but it has created a picture for the student, it has helped you to create an IEP for this student. And it's going to continue to help you so long as you keep texting with it in the same chat feed. Now, if you've played around with AI a little bit, you kind of are probably understanding where I'm coming from and how this would look. If you've never been inside of chat GPT or interacted with an AI chat bot, I get it, it's hard to understand. But once you get in and play around with it, you can see that it remembers everything that you have said within that one chat thread. If you open up a new trap thread, it's like having a new conversation with a brand new person who never read your plot. Never read your evaluation doesn't know the goals. But if you remain in the same chat thread, it's going to continue to remember what student you're talking about. Albeit it doesn't know the student's name. But it's going to understand all the things that you've done before. And therefore when you ask a future questions, it's going to relate back to the evaluation and back to all the other pieces that you've already done there. So now you can potentially use it to help you with developing a treatment plan. You could ask it to help you write a daily note by giving it the raw data and kind of saying, Hey, turn this into a soap note. You could ask it to create progress notes based upon all the data that is collected over the last three months because you put in data after every single session, you could say, Hey, turn this into a pretty progress note that incorporates this, be sure to say thank you to the parents at the end of the progress monitoring note whatever it might be, you can say use this template that you have developed to create a progress note, you could say, hey, I need to take data on this goal about organizing homework, can you help me create a data sheet? To do that I want the teacher to be able to quickly respond to this data sheet each morning, when the student does or does not turn in homework. All of this is possible with AI. But it takes an occupational therapy lens in order to make this possible in the way that occupational therapy needs. You have to be the one to prompt it, you have to be the one to say, Hey, I gave you a prompt, I see why you did what you did. But that wasn't right, let's change it up. Make it longer, make it shorter, add more detail, take away that detail. Make a strength base, all that stuff, you know, even down to if you want it to use person first language or if you want it to use identity, first language, those are things that you can tell the Chatbot what to do and how to act. And it's going to begin to mirror the way that you want it to respond, it's going to start to learn that you want neurodiverse language included that you want strengths based language included that you want to use identity first language, it's going to start learning that. And you know what's interesting, as I mentioned, right, if you open up a new chat thread, you can change all that. If you wanted to, you could absolutely change that. Or in Chachi PT, you can go into the settings if you have the paid version and say, Hey, I'm a strength based OT and everything that you apply to me, I want you to think about from a neurodiverse perspective, then it will know that about you. So it's going to give you information based upon kind of how it thinks you want to react, which I know to an extent is a little scary, because at what point are we saying give me what I want instead of giving me what is actually accurate. But we can also tell it, we want you to be accurate. Provide me with the research around this site, whatever you're giving me if it's research based, and if and when you realize that the chat bot is hallucinating. You can tell it you can say hey, that's not real. I clicked on the link that you gave me and it took me nowhere. It will actually you know, admit that it made a mistake and it'll ask you to saying hey, let's try this again. Let's give me another prompt. Let's see where we can go from here. All right, well, that can kind of took us through everything from evaluations, IEP planning, and writing, and straight through documentation. And now I want to talk about something that I think is really cool to think about. And I haven't really done yet. But I can see so many occupational therapy practitioners using AI as an intervention tool, not just to support our own productivity organization or whatnot, but to actually use the AI as an intervention tool. And even as an accommodation tool. Here's an example how many of us have gotten to the point where we almost want to give up with teaching a student to type because their typing is legible. But it takes them so long to go back and edit that we don't think it's really useful. Well, now AI, we could say, Hey, this is what my student typed, fix the grammar and spelling. And it can do that. And we can teach a student to do that. In fact, there are now chrome add ons that you can embed AI with. So you could just highlight the text and say, Hey, this drop down fix spelling and grammar, and it will fix that for them. I can only imagine speech to text improving with the use of AI. Imagine being able to use a common app that occupational therapy practitioners use, like snap type, where you take a picture and it just like brings the written document into an app so that the student can type or use the iPad, whatever to write on the right on the page. Imagine if you could take a picture of a worksheet and differentiate the worksheet just by saying, hey app make this more difficult. And I want to work on visual perceptual skills. So turn everything red and blue or use high contrast or something like that. That is where we are headed with AI being able to support us as occupational therapy practitioners. As I mentioned, I don't have any experience right now using AI in intervention. But that is not keeping me from being super interested in it.   Jayson Davies  I think that there are so many ways that OT practitioners can support students in using AI. And I think AI is basically the next universal design for learning. I think AI is going to level a lot of playing fields, because so long as you can figure out how to prompt AI. Or if someone can create an app that makes it so easy for people to use. It's going to bring knowledge available to everyone, just like Google did 30 years ago, gosh, is that long ago. But yeah, just like Google did. AI is going to support so many students. And I cannot wait to see how occupational therapy practitioners are going to use it. And you can bet when I start learning about how people are using it, you'll hear about it here on this podcast. So stay tuned, that's going to be fun. All right, the last area that I just want to say really quickly that AI can support occupational therapy practitioners is in an area that often goes unmanaged. And just to be honest, is completely forgotten. And that is actually the management of the occupational therapy program. I think that AI is going to start being able to help us with scheduling more efficiently. I think it's going to help us be more organized is going to help us to better evaluate and understand our caseload and our workloads is going to help us to provide data to our administrators to say, hey, look, OT is supporting our students or OTs supporting all the students in these classes. But it's not really supporting students in these classes. Here's how we might be able to improve OT services, all those things that we probably should be doing as an OT department and aren't doing AI can make it easier and can make it quicker. And to make it actually time efficient to get done. Right now to do some of those things will still take a lot of work because you have to provide the data to something like chat up at first. But in the future, I can see AI programs out there that really help school based occupational therapy practitioners, as well as all the SLPs PTS teachers, everyone that we work with, to better understand what is working and what is not working. And I mentioned it before, it's also going to help us to better implement research. We can ask it a question based upon research and it can give us an answer. We don't necessarily have to go looking for the research. So we could potentially reach out to there's one app called consensus and we can say, hey, give me ideas for using RTI as a school based occupational therapy practitioner based on research and it scours the research for RtI and school based AR T and will provide you with responses. So again, we are at the very beginning of the ah it's amazing. Yes It is scary to some extent because it can do so much. But I think that we need to, if not lean into it, we need to at least be familiar with it. In order to make sure that when push comes to shove, occupational therapy practitioners can stand up and say, Hey, I know AI, and this is how I'm using AI. And if AI were to disappear, it would be good or bad. And if AI were to continue, it would be good or bad, we need to be able to say, and see both sides of it, so that we can have an opinion on it when it matters. Right now, a OTA doesn't really have guidance on AI intervention. Neither does NBC OT as far as I know, but you know what, maybe they should. And we need to be the ones to kind of start figuring out what that should look like. So go over to open AI. And that's the founder of chat GPT. By the way, just play around with it. Just play around, ask it silly, dumb questions that have nothing to do with OD, but just play around with it. And then at some point, you'll start to feel a little comfortable. And you can ask it a question about OT, you can ask it what is school based OT? What is the research on weighted This is si applicable to school base are two questions that you want to ask and never get the answer that you're hoping for. Ask that to judge EBT and see what it says. You might be surprised you might find it a fun and might be a little game for you. But it's definitely something that I think everyone, all OT practitioners need to at least understand a little bit and need to kind of get in there, play with it, and find out what they like and what they don't like about it. All right, well, I hope you are excited to learn a little bit more about AI we are definitely going to have some more episodes here on the OT school have podcasts about AI. And if you like that If you enjoy that if you enjoyed this episode, please be sure to leave us a review on Apple podcasts or over on Spotify. Think they have something but let us know. Let us know give us a five star review and let us know what type of topics you want to hear on the OT schoolhouse podcasts. Really appreciate you listening in today. Wherever you're listening in from whether it's your car in between school one and school three. Or if you're just on your way home or at the gym. I really appreciate you tuning in. And yeah, I hope you enjoy this episode and I look forward to talking more about OT and AI with you in the future. Have a great rest of your day and I'll catch you next time on OT school health podcast.   Amazing Narrator  Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT school house.com Until next time, class is dismissed. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 141 of the OT Schoolhouse Podcast. In this episode of the OT Schoolhouse Podcast, Kelsey Kornaus delves into the world of visual impairments in students. From the importance of self-advocacy to the impact of sensory difficulties and the role of assistive technology, this episode discusses the challenges and innovative strategies for supporting students with visual impairments in educational settings. Listen now to gain valuable insights into assessment techniques, the decision-making process for residential placement, and the benefit of community support. Listen now to learn the following objectives: Learners will understand the role occupational therapy practitioners play in supporting students with visual impairments.
Learners will identify challenges and considerations in working with students with visual impairments in educational settings, including the need for specific adaptations, support for sensory difficulties, and the integration of assistive technology and universal design for learning to facilitate academic success and independence.
Learners will identify the importance of advocating for students with visual impairments in accessing necessary support and services.
Guest Bio Kelsey Kornaus is an occupational therapist with a Master's in Occupational Therapy from the University of Indianapolis. Over the past 7 years, Kelsey has been working in the school-based setting supporting students with visual impairments from ages 3-21 years old. Quotes “Typically a student with a visual impairment will prefer increased vestibular input.” -Kelsey Kornaus, MOT, OTR/L “Assistive technology really opens up opportunities for them, and especially academically.” -Kelsey Kornaus, MOT, OTR/L Hand under hand, a very important technique to use with a student with a visual impairment.” -Kelsey Kornaus, MOT, OTR/L “We don't need to know everything, but we need to know enough to be dangerous in an IEP a little bit and to provide some services." -Jayson Davies, MA, OTR/L Resources SP - 2
SPM - 2
IDEA definition of Vision Impairment
Kelsey’s Facebook group
Kelsey’s Linkedin Episode Transcript Expand to view the full episode transcript. Jayson Davies  Hey there, fellow OT practitioner and welcome back to the OT schoolhouse podcast your place for practical school based occupational therapy tips, research and professional development. I'm your host Jayson Davies. And today we have a fantastic episode about how school based OT practitioners can support students with a low vision. To help me out with that. Joining me today is the incredibly knowledgeable Kelsey Cornell's, an occupational therapist with a background in optometry and extensive experience working with students with visual impairments, particularly at a school for the blind and visually impaired. Together, Kelsey, and I hope to help you understand the role of occupational therapy practitioners and supporting students with visual impairments and their specific needs, including the use of assistive technology and universal design for learning. And before we get started, I also want to let you in on one little secret, Kelsey recently presented a full training on supporting the sensory needs of students with visual impairments inside our OT schoolhouse collaborative community. So if you enjoy this episode, which I'm sure you will be sure to check out her course inside the collaborative at OTSchoolHouse.com slash collab, we hope to see you there. And with that, I hope you enjoy this enlightening conversation with Kelsey Cronos. As we learn and grow together as a community of therapists enjoy the episode.   Amazing Narrator  Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies. PLAs is officially in session.   Jayson Davies  Kelsey, welcome to the OTs schoolhouse podcast. It is such a pleasure to have you here today. How you doing?   Kelsey Kornaus  I'm doing well. Thank you for having me excited to be joining on the OTs podcast. Yeah, you know, we've done a lot together over the years, it seems like I've known you for so long, you've been part of those costs collaborative a little bit helping out over there with presenting about visual impairments. And I'm excited to bring you on today to again talk about visual impairments and really sharing the role that OT practitioners can can partake in supporting students with visual impairments. It's gonna be a good time, I think it is I'm excited to kind of dive in and talk more about visual impairments and what we what our role is as school based OTs. Absolutely. So, you know, let's kind of start off with a little bit about your background and how you kind of fell into the world of working in the VI space. I did, yeah. So um, my OT journey was definitely that it was a journey. I did not start out pursuing occupational therapy. I actually was pursuing a career as an optometrist. And did my undergrad with a bachelor's in pre optometry was going to do pediatrics and vision therapy. And like that was, that was the plan. So went to grad school to be an optometrist, and quickly realized, like, oh, this just isn't the right fit for me. Like, it wasn't everything that I was hoping for. So I kind of took a pause on that and was figuring out like, what am I going to do next? Like, what what does this look like? Because there was really only plan A and not plan B. So it happened to be at the time that I had a family member who was going through vestibular therapy. And she called me up and she was like, You know what she's like, I think this could be like a really good combination of skills. Like I'm working with an OT, we're doing vestibular therapy, like, here's all the vision pieces, you know, why don't you kind of look into this some more, just like, okay, like, let's do that. So, did some shadowing, talk to and worked with some really great OTs and vestibular therapy world. And I was like, alright, like, OT school, like, that's the new. That's the new goal. Like, let's see where we go from there. So I was very fortunate to get into OT learn more about it. And I went to the University of Indianapolis, where I got my master's in occupational therapy. And really, the, the drive was like, Okay, I'm gonna connect my vision background with occupational therapy, like, I don't know how that's gonna happen. But like, I know, that's, that's my passion. And so after school, you know, you kind of start out get your first job, get, you know, used to everything. And after about a year of working, I got in contact with a company that was looking to place an OT at the School for the Blind in Wisconsin, which is where I'm at, and they were like, you know, we think this would be a good fit, like you've got this fishing background and yeah, I I always knew I as an OTA either wanted to go school based or peds based, and then to have the School for the Blind opportunity, I was like, well, this kind of merges everything together for me. And that was, so it just kind of all happened. I wasn't planning on it, it's kind of how that worked. And so I got into the school for the blind, and just really started to like hone my skills as an OT, working with students with visual impairments, and also learning the school based side of OT. Yeah, simultaneously.   Jayson Davies  Yeah, that's, that's a unique experience. Because I mean, to be fair, there's just not a lot of school for the blind out there. I mean, states, if you're in a smaller state, you might have one. And if you're in a larger state, they might have them but they're very spread out and right. It's not like every city has one like they do have schools.   Kelsey Kornaus  So and, and typically, it's like, you know, if you're lucky to have a school for the blind in your state, it's going to be, you know, usually located near your capital, or, you know, you're going to be serving students throughout the whole state, you aren't going to have schools in multiple locations within a state.   Jayson Davies  Yeah, yeah, absolutely. So did you were you saying that you actually started with a fieldwork placement and this and then it turned into a job? Or did you just get that as your first job out of OT school,   Kelsey Kornaus  I got it as my second job out of OT school. So the first job I was working with a company doing assisted living and memory care support, and kind of starting there just as that first grant experience, and then after a year of working there, this position at the blind school became available, and they were reaching out in trying to find qualified applicants. Yeah.   Jayson Davies  Wow. That's awesome. Because you already had that background with optometry a little bit and it just kind of worked out. Yeah, I'm sure they appreciated that background when when you came in for your interview, like not only she you know, tea, but she's got some some background and optometry that really works out. So very cool. All right. Well, as you dove into that job, you know, I want to get into the VR. I really do. But I kind of want to ask you, as you're diving into that very first job as in the school for for the blind, kind of what was that first experience? Like? Was it very shocking to you? Was it exactly what you expected? What was it like going into that position?   Kelsey Kornaus  Yeah, I would say I definitely had a thought of what it could be. And then I quickly realized, I have a lot to learn, I have a lot to kind of just experience and wrap my head around. Because initially, you know, I was kind of told like, yep, students with a visual impairment. I'm thinking, okay, low vision blindness, the thing that we that I hadn't considered was just the additional diagnoses are the additional complexities that can go with that for some students. So, you know, not only are they blind and visually impaired, but there might also be a diagnosis of cerebral palsy, or they might have a neurodivergent diagnosis. They might also be, you know, minimal communication skills. And so when you start to look at, you know, how are you bringing information into your body? Well, you might have decreased vision, but then you might also have decreased communication skills and decreased hearing, and just how all of those play into the whole student. And so that part, I don't think I was prepared for it, just the complexities that you work with, for some students. So I had to learn quickly. But thankfully, I had some great support. And, you know, great team members that I worked with to help me learn this new role. Yeah,   Jayson Davies  yeah, definitely. And I know we're going to dive in as we go a little bit further into some of those other attributes that you saw with these students. They were common with some of your students with visual impairments. But let's take a kind of a quick step back, I guess, and, and define a little bit what a visual impairment is, as it relates to schools. As everyone I think out there knows, like we're not diagnosing the school psychologist is not diagnosing. Often there's not an optometrist or an ophthalmologist on campus, this diagnosing that's happening outside, but when it comes to education in the schools, what does it mean when a school identifies a student as having a visual impairment?   Kelsey Kornaus  Yeah, absolutely. So Ida will define a visual impairment. It's an impairment in vision that even with correction adversely affects the child's educational performance. And we want to make sure that we're including both partial sight and blindness. So that's why it's important to know like, is the student considered to low vision? Or completely blind? And so that's where that visual impairment eligibility criteria comes into play.   Jayson Davies  Gotcha. And then, I'm assuming, I mean, you worked in a school for blind, so the student was already been, they already had an IEP identified them as having visual impairment. However, I do want to ask you this question. For those who aren't working in school for blind? How might a school go about identifying a student with visual with a visual impairment? Is it something that an OT is often part of? Is there someone typically specific on the IEP team that might do that? Or what have you experienced? Yeah, so   Kelsey Kornaus  in my experience, you know, if you're wanting to consider a visual impairment Diag, her eligibility criteria, there is a team that's going to get together to help determine that criteria. So typically, the members of that team are going to include a teacher of the visually impaired, and they will perform the functional vision evaluation, they're going to look at medical records, they're going to get information from that optometrist, or ophthalmologist, and they're really going to look at the educational needs, and what's impacting that student. In addition, there's also going to be an Oregon orientation and mobility specialist, the team and they need to evaluate and determine if there's going to be any orientation and mobility needs, either in the home and the school or community environments. So a child can meet criteria for visual impairment, but not necessarily need the orientation and mobility component. So not every student is going to be a white cane user, which is typically where orientation and mobility specialists are going to work with the student, some students might be in a wheelchair, and might, you know, still meet that eligibility criteria for a visual impairment. But as a part of that team, you want to get that full, comprehensive evaluation. And then oftentimes, depending on the size of the team, and what the team is considering that they might bring in, you know, occupational therapy, physical therapy, to evaluate any additional concerns, but that initial team is really looking at, you know, what are the students visual, like visual skills? Where do they fall? And then how is that impacting their educational needs?   Jayson Davies  Gotcha. And correct me if I'm wrong, but that would typically happen at the local Lea the local school, correct, right?   Kelsey Kornaus  Yes. So your local district within your state is going to do that initial evaluation. Oftentimes, if a school team needs additional support, they can contact the state's outreach team, which is often associated with your schools for the blind schools for the deaf. And then those team members can also help facilitate those services, because it's really about making sure the student has access to services to be as independent as possible.   Jayson Davies  Yeah. And, you know, just like other types of services and other types of eligibilities, you know, schools don't have all the resources to support all the students. And that's where the School for the Blind really comes into play, kind of going down that route, then would it be, I guess, that team could make that initial referral to potentially refer that student to the school for for the blind, however, it might occur later, potentially, they might try out the local Lea first, and then determine if they need to move on to school for the blind. But I kind of want to understand that process just a little bit, that you've probably experienced from being at the school for the blind, like, what does that referral process look like when a school when a student has been referred to a school for blind from an alley from a their local Lea, I guess?   Kelsey Kornaus  Yeah, correct. So oftentimes, you know, a student will be in their what I refer to as their home district, right? They've started out in their home districts, they've gotten services. And then usually, it seems to be like around middle school, is when you can see that a student might need additional supports or some really individualized opportunities and learning a bat is really well provided at the school for the blind. And so typically, what would happen is families would come they would tour, you know, they've started those conversations, maybe those le A's have connected a family with their State School for the Blind. And then if a family would like to Do we typically call that a trial placement, like, okay, um, you know, spend an amount of time in the school setting. And what's unique is you have to remember, it's also typically a residential setting. So students are coming from all over the state. So you also want to make sure like they're comfortable being away from home, that they're, you know, able to support themselves with assistance where needed. And so typically, students would do a trial placement, and then the team at the blind school would come together, kind of do like, just an IT not an evaluation, but just kind of assess the skills like where's the student at, you know, here's what's working well, for them in this environment, here's what, you know, some additional supports or accommodations that we can recommend. And then really based on, like both schools coming together, so the local Lea team comes together, the School for the Blind comes together, and just with the families in the student have that conversation about, you know, what do we think is the best placement, you know, for a student? And where can they get the services and supports that they need to continue on academically. So most of the students I worked with, we typically see them like middle school through high school. But that's not to say there isn't support for, you know, your younger students as well, those three year olds, four year olds and five year   Jayson Davies  olds. Yeah. And, you know, LEA is local districts, they, it's not like, they want to send out students to the school for a blind, I mean, they, they want to help the student and they want to try and keep the student in the least restrictive environment, which is that homeschool and, and give them the support that they that they need there. And so I can imagine you're trying to get through elementary school, and maybe they're working on teaching the student Braille with a vision teacher working on orientation, mobility, but at some point, for some students, it just becomes maybe a little too much. And they need that extra support. Yes.   Kelsey Kornaus  And then what I know from a lot of my students and having spoken with them, like there's a sense of community, there they come and they are with other students who have had similar experiences similar opportunities as them and they're like, Okay, I didn't have this in my, you know, I didn't have this community or this network. And I will say, with social media, there is a much larger community now. Yeah, and, you know, that's been beneficial for some students, but there's just this sense of, like, I'm with other students who understand what I do on a daily basis, and not have to explain it or not have to, you know, like, why do you need this support? And why do you, you know, do this or this, but, um, so I will say like, those middle school students are like, it's really great to, to have that community.   Jayson Davies  That's awesome. That's awesome. Yeah, it's so interesting, when you think about like, the least restrictive environment, and how just things have evolved over the years. And you think about trying to keep students with their typically developing peers, as Ida wants us to do. But then there is that sense of community, when students do have that alternative type of placement where they can go be with like minded, like abled peers that have shared those experiences? And it's hard to find that, that happy medium, right, like, where do we give them that opportunity to experience both experiences with peers, typically, typically developing peers, as well as their peers that have similar lives that they have? So it's hard. Yeah.   Kelsey Kornaus  And then I, you know, I'm sure for families, it's a huge decision to say, Okay, I'm gonna send my son or daughter to a residential setting five days out of seven. And, you know, also consider transportation because we had students that would come on charter buses, some would fly, depending on the distance. And so like, it's a big, you know, I'm sure it's a big decision for a lot of families and students.   Jayson Davies  Yeah, yeah. I, I would not want to have to go through that. And if I ever do like it, it will be such a big decision. And it's not just for schools for the blind to like any residential placement. Correct, right. Yeah. All right. Well, let's continue on earlier, you mentioned some secondary potential diagnoses or other conditions that students may have in addition to the low vision. Did you see themes were there common themes, whether it be in research or just in practice that you have started to see while working with students with visual impairments? What did you see on their IEPs? But also just while working with them?   Kelsey Kornaus  Yeah, so I mean, typically on an IEP or a student to be having an eligibility criteria, you're going to see somewhere along the lines that visual impairment, diagnosis or criteria. But in addition to that, I mean, there are students that have a medical diagnoses, whether that's cerebral palsy, there also might have that autism diagnosis or eligibility criteria in there as well. And then you can also have students with the visual impairment and hard of hearing. So sometimes you have like that dual deaf and hard of hearing with a visual impairment as well. And so it's really unique, like, you know, every student is going to be needing some very specific adaptations or requirements. And so it just takes like, you really just have to kind of do your digging in your homework and get to know the student. And just because the student has a visual impairment, like it's it's one visual impairment, it's going to impact them differently.   Jayson Davies  Yeah, yeah, definitely. I know, one of the reasons that you and I first started connecting and working together a little bit is because of the sensory aspect. And when we think of students with visual impairments, and also students who have hearing difficulties, like those are two very important senses that we rely on a lot in life. And so I kind of want to get into the weeds and talking about sensory with you a little bit. And we can start more broad and talk about maybe just the the difficulty with the sense of vision, and how that just impacts maybe other sensory systems a little bit. Yeah, absolutely.   Kelsey Kornaus  So I mean, we know as OTs, our sensory system is always working, right, there's always input coming in and output. And when we're working with a student with a visual impairment, research tells us that like they, that student is going to perceive sensory information differently, like their sensory system is already built and established differently, then, like a typically developing peer. And so when we, like, we want to consider all of those components. And so oftentimes, it will be, like a student with a visual impairment will tend to rely more on their hearing and their sense of touch. But at the same time, those same systems can be over responsive or under responsive. And then, depending on if it is a dual, like sensory impairment, now, what does that look like? And so in any evaluation or assessment, like it's so important to, to do that sensory assessment, that evaluation piece, and really try to understand all of those components and what that looks like. Yeah,   Jayson Davies  we know that, obviously, vision and the vestibular systems are so linked really close or so closely linked? Have you made any connections with those two systems in general, either via again, research or your own practice? Yeah,   Kelsey Kornaus  so what, what we tend to see, and research will back this up as well. But like, typically, a student with a visual impairment will prefer increased vestibular input. So oftentimes, you will see certain sensory traits that present themselves for these students, and so rocking back and forth to get that increased vestibular input, spinning in circles to get that increased vestibular input. There's just this like, crave for vestibular movement. And it comes very naturally for these students, you know, they're going to self regulate the way that works best for them. And so you tend to see those common sensory traits for a student with a visual impairment. Gotcha.   Jayson Davies  And then you also kind of mentioned, the tactile system, if I recall correctly, are there some, I guess, patterns that you might see among your students when it comes to the tactile system? Or is it just that they really need to rely on it more, um, it can be   Kelsey Kornaus  bold, there's so some students can really rely on their tactile system for information and input. And then it can be that the flip the flip side of that, where students are like very tactfully defensive, because it's a higher input system. Yeah. And so, I mean, I've seen it both ways where students can be seeking that tactile input, and then at the same time, when you're asking them to use their hands together, or you're asking them to try something new with their hands, that defensiveness or that hesitation, can be really strong as well, because what I don't know is how strongly that information is coming into their body. You know, and they can't always tell me but they can show me so we you know, we always know that that behavior you Communication. And especially for the students that have an additional communication need, like, it's very important to just be aware and be a good observer and see, you know, look to see what your students are showing you.   Jayson Davies  Yeah, I mean, I can think of many of my students that when I would work on some tactile based interventions, and you try to occlude that vision, and you know, they freak out, like, these are students who rely on their vision a lot. And, you know, granted, I know that the students with low vision, you know, they've, over the years they have been become accustomed to not being able to visually see, but I can still imagine, right, like, you ask them to put their hand on something, and they don't know what it is. Yeah, like, whether it be slime, sand or whatever, there's gonna be some hesitation every single time not yes, when you occlude their vision, because, yeah,   Kelsey Kornaus  yeah, absolutely. And it's also really important that when we're supporting a student's tactile exploration, that we're using hand under hand technique. And what that allows, is, so like, my hand is the OT with guide the student's hand. And then it's my hand, typically interacting with whichever sensory support or item that we're using, and then it allows the student to take their hand away, if they're feeling uncomfortable. And then typically, they'll come back and they'll be like, Oh, okay, like, let's see what's going on, like, and I'll always ask a student, like, Can my hands help your hands? And I'll kind of wait to see like, okay, yep, they're interested, like, I can give them some additional assistance. So hand under hand, very important technique to use with a student with a visual impairment. And the difference being that is if we go to hand over hand, the student have now lost that autonomy, they've lost that sense of control. And so we're now forcing them to do something that they may or may not want to participate in. So that's definitely one of those key aspects for, for any OT, like switching to that hand under hand technique. Yeah.   Jayson Davies  Visual Impairment working with students with visual impairment or not the hand under is so important. And kind of what I where my mind was going. As you're speaking, there was the safety net to that offers the student, especially if you're doing some sort of tactile activity, right, your hand being the first hand to touch the slime, as opposed to their hand, being the first hand assistant slime, so they feel safe knowing that you're not asking them to touch anything that you yourself are not putting your hand on as well, your hands gonna be touching whatever it is, before their hand might be touching it. So yeah, a little bit of that safety as well. And   Kelsey Kornaus  then just describing like, what I'm feeling. So is it slimy? Is it rough? Is it smooth, like giving them those descriptors, because that's also part of early Braille skills? is learning difference in textures and using those hands together? Gotcha. Yeah.   Jayson Davies  All right. Well, I want to ask you a question about assessments. I know now you are working at a more traditional school based occupational therapy position, even though you had several years with the VI program. So I want to ask you a little bit about the difference in your assessments, how might your assessments be a little bit different when you're working in that VI setting, or maybe they're exactly the same. But what does an assessment look like when you're actually whether it be a try, or whatever it might be, or you're using additional or different tools.   Kelsey Kornaus  So really, it's going to be quite the same as it would be for traditional school based OTs. We want to look at that top down approach, we want to do that comprehensive occupational profile, because we're going to learn a lot of information about the student observations for me were the most helpful those skilled observations in the classroom in those different settings. And for me, like I need to see a student in multiple academic settings. So like how they interact in daily living skills versus how they're going to act in science class, and what's it like to be in the lunch room, which can be very overwhelming for a lot of students, and then also relying on those teacher and caregiver questionnaires to get some of that additional information. And that also helps me determine like, you know, what, what are we seeing what are the concerns for an evaluation, making sure that we're not missing a key piece of information. And then always, for me doing that sensory assessment as well. So that can be the sensory profile to or the sensory processing measure to it's just, if we're going to use those standardized assessments. We're now using them and on standardized method because they're To my knowledge very is not yet that like standard sensory assessment for a student with a visual impairment. But it still gives really valuable information. And that's information that I want to be able to share with the team. Yeah. So that when we are looking at programming and accommodations and modifications, we have that information.   Jayson Davies  Yeah, I want to ask you this, because it is very common right to use the SP or the SPM. Although that is going to be completed by a teacher and or a parent and or an aide, and they both include a lot of vision questions. So, you know, we also kind of have to be a little mindful, right? And would you cross out vision questions? Would you preface the Completer? Whoever is completing that form, like, Hey, don't worry about these questions? Or would you just kind of leave it as is and go with it? Or?   Kelsey Kornaus  Yeah, it's really interesting, because it's gonna depend on who's scoring it? Yeah. I mean, who is administering it? And then it also depends on like, does that student have some vision? Sure. Are they completely blind, so like, you kind of have to tease out that piece a little bit as well. I think for me, like, I always just requested that they fill it out to the best of their ability to like, fill out all those sections. And then when it does get to that vision area, like, I'll look to see what's been filled out or not filled out, and kind of go from there. Because, you know, we know that vision is one of those primary senses. So when we're looking at these assessment tools, like it's often very much intertwined with other areas. And so, for me, and this was just in my practice, like, I'm gonna get as much information as I can, but I don't want to skew someone's interpretation. Like, I don't want to say don't fill it out, or like, don't do it. Because maybe there's something there that is helpful. Like, to me data is data, like all data is helpful information.   Jayson Davies  Yeah. Yeah, one way or the other, it's going to help that is true. I was just, I was just thinking about, like, if you're giving that to, especially if it's like a parent, I could see them some there are probably some parents out there that would almost be offended, potentially, by some of the questions that are asked on there. And that's, I don't know if you've ever experienced anything like that. Or if you've ever had a parent addressed that at all, like I personally   Kelsey Kornaus  have not had that experience. And I think for a lot of these families, by the time I would see their student, they're so used to filling out these assessments, like, kind of been doing it for a long time at this point. But they wouldn't be uncommon for me, it would be great to hear a parent question, you know, like, Hey, by the way, we know, my student has a visual impairment, like, Is this really necessary for me to complete? Or, you know, it wouldn't surprise me that if there are families out there that would question that, and you make a good point. Like, I guess I hadn't really thought about it that way.   Jayson Davies  Yeah. Yeah. I mean, you never know. I mean, everyone, everyone reads things and looks into things differently. But I was just, I don't know, always think about the quote, unquote, worst case scenario, potentially, I could see someone being offended by questions related to vision when their student is is completely blind, potentially, or whatever it might be. I know, on the SPM. I don't think taking out the vision questions would impact other factors. However, with the sensory profile, each question gets scored in multiple ways. It's not just in relationship to the vision system, but also the school factors and a few other areas. So if they're not filling that piece out, or that piece isn't completed, it could impact some of the other areas. Granted, we already talked about how you're no longer using it in a standardized way. Anyways, but but still, it could impact some of the other scores. And just to know, yeah, and I   Kelsey Kornaus  know, for me, like, I tend to prefer the sensory processing measure, just because I can kind of tease out those areas and not have to rely fully on, like if the vision piece isn't there, or, or things like that, but either is going to give you valuable information. And it's going to help the team during those IEP meetings.   Jayson Davies  Yeah, yeah, I will. I'll say this really quickly. I preferred the sensory profile early on in my career, because I felt like it was so much more comprehensive, like so many more questions, you could really go back and tease out things. But as my observation skills increased, then I started to prefer the SPM. It gave me enough that I could then use my observations to kind of fill in some of the blanks. So just kind of my thoughts on that. But good point. Yeah. All right. Anything else you want to talk about in relationship to sensory before we can move on?   Kelsey Kornaus  I think we've covered a good amount at the moment.   Jayson Davies  Yeah, yeah, definitely. I think that's a very good start, and I Again, you know, this is an introduction to working with students with visual impairments. This is definitely not the end all be all, there's always more to learn. And if this is catching your ear, if you're listening today in this kitchen, you're here, set up a Google Scholar alert for vision impairment and sensory and you know, you might, you might be surprised, and you might learn some new information every time a new article comes out. So that is one way to keep the learning going. Let's move on to another very important topic in the area of visual impairment. And that's assistive technology. But what's been your experience with assistive technology while working with students who are blind or visually impaired?   Kelsey Kornaus  Great question. So I was very fortunate to work with assistive technology specialists, teachers of the visually impaired that were doing that additional piece as well. And what we know for students with visual impairment is that assistive technology really opens up opportunities for them, and especially academically, provides tools and supports that they can use in their, in their daily lives. And what is also really great about that is, you know, for most students, just, you know, having their smartphone in their pocket, you know, that provides so much assistive technology, and opportunities for them. So, you know, I get really used to listening to voiceover super common, like VoiceOver is on every computer, every output device, and then, but also like, allowing them access to more of like, their curriculum, and, you know, using, you know, whether, whether it is that laptop with additional supports put on it, or that Chromebook, assistive technology really is a beneficial piece for a lot of students with a visual impairment.   Jayson Davies  Gotcha. And so what role did you play in assistive technology? Were you evaluating? Were you hoping to implement? Were you doing all the above? What was your role? Yeah, so   Kelsey Kornaus  for me, I definitely fell under the piece of helping to implement. And so going into that assistive technology class, so our students were fortunate to like, have that as part of their school day and part of their schedule, but going in and like helping with a typing program, going in and helping students learn to access their smartphone going in, and then helping those students use that as a technology in the classroom setting. And so there was, there was a time where I was kind of pushing into the math class. And every student would have a different form of assistive technology. And, you know, even a brailler is considered that assistive technology piece to me, because it's another form of output and support. And so, like, we might have some students on a brailler, some students using their laptops, another student is going to use like both of those combined. And so just really making sure that like, once a student grasp the foundational skills of whatever their assistive technology is, and then helping them to implement that across those school environments.   Jayson Davies  Yeah, absolutely. And that's great that you had the opportunity to help to implement that in the fact that they have their own like, specific class dedicated to assistive technology, which is, I mean, heck, every high schooler could use a class like that, I think. Just go ahead. Yeah,   Kelsey Kornaus  well, and I will say like, it's dependent too on like the school because I've been talking to other OTs that are in those residential school settings. And, you know, not not every program can have a designated Assistive Technology instructor or someone to like, have those supports daily for students. And so, again, it was just a really great team working together.   Jayson Davies  That's awesome. I want to ask you about the team and the differences of the team. But first, I want to while we're on assistive technology, I want to ask you a question. This might challenge you a little bit. And that is based upon your experiences in that classroom, that environment that is really set up for students with VI M, with visual impairments to succeed. What piece of equipment do you feel like could be implemented on every school campus as a piece of universal design for learning for students that would help both students visual impaired students as well as just all students on campus? Is there something that you feel like that would be so awesome if every single third grade classroom in America had   Kelsey Kornaus  right that is a great question and that really does like kind of stretch my thinking a bit. And so what I would say for that piece is really helping honor su against requests, when they're asking for, like lighting is a really easy one, that's a universal design. Like, for a student with a visual impairment, they might need task lighting, they might need the overhead lights to be shut off. And then just allow for more natural lighting to come through the windows. So that can be like a really easy universal design that is easy to implement, you know, in a school setting, and also just having the opportunity for high contrast colors. So if a student with low vision is having having difficulty seeing the items around them, like something simple, like a black backdrop with bright colors on top, so whether that's orange or yellow, or red, so I think really like an easy universal design would just be access to high contrast colors, and then having the lighting opportunities or change in lighting.   Jayson Davies  Yeah, yeah. See, I mean, they're not they're not difficult. They're, they're relatively simple things that can be implemented, it does take some training and you know, giving people that knowledge, but relatively simple thing.   Kelsey Kornaus  Yes. And like other simple accommodations that work well, for a lot of students is just letting them, you know, wear a ball cap in class and letting them have their kids up, which now that I've switched into that more traditional school based setting, like all day long, I hear teachers say like, oh, take your hoods off, take your hats off, like don't wear those. And then coming from a vision background, I'm like, Well, that was just really common. Like, it was really common to see a kid go down the hallway with their hood on and their hat on, because like that is an accommodation for them. Or it can be it can be one of them. Yeah. So it's just been interesting to hear or like, see the differences between the settings. And honestly, like a student is going to know what works best for them. And oftentimes, it's just giving them the space to tell you and to self advocate like, Hey, Miss coffee, like I came in your room today? And can we shut the lights off? And? Or like, this is bothering me today? Like, can we adjust it? And like yes, we can. And that self advocacy piece is so important for students to learn early and in us. And I think if we're not careful, like it kind of comes across as, like a complaint almost for some adults. And so just being mindful, like the student knows what's best for them. And you can help support that.   Jayson Davies  Yeah, you know, I think that goes back to Gosh, I'm forgetting the name. Right. But but the quote that I think many of us have heard before about education, right? Students do well, when they can, like, exactly. And then they know what they know what works for them. And so we need to give them that that space, that ability and that awareness to you know, have that mindset to take opportunities to try things that work well for them and to share that and express that with people that are in their education system. So yeah, love that. All right, you know, we have so much that we can go over. And I think we're going to kind of start to wrap up with this question. It's a two part question. And kind of getting out a little bit of the differences between what you might see at a typical school, and then are your homeschool versus a school for the blind. And you've mentioned several of these people already, but I kind of want to give you the opportunity to kind of go at it with this one question. And we'll start with thinking about a homeschool. Most commonly what services what specialists are available to students with visual impairments. In a typical district, I know it changes from district to district, but what are some of the more common services you might see at a at a home district?   Kelsey Kornaus  Yeah, so typically, and also legally, we want to keep in mind that like students are allowed access to specialists. And so most oftentimes, like you're going to see in, in that home district, like they're going to have access to a special education teacher, they're going to have access to an OT PT, a speech and language pathologist. And then you know, if the team determines that it's necessary, you know, then access to a teacher of the visually impaired and orientation and mobility specialist and, and those two specialists know their jobs incredibly well. Like I love working with a teacher of the visually impaired. It's just like kind of working with another OT colleague, they are just very specialized, like in that visual impairment piece. Very knowledgeable. So if you're in a district, and you know a student has a visual impairment like be be searching out and connecting with that teacher, the visually impaired, especially as an OT Because oftentimes, in a district that student is going to see that TBI maybe once a week um You know if they're lucky and that TBI is going to be traveling to multiple locations, and then same thing with an orientation and mobility specialist, so not every student with a visual impairment is going to require an orientation and mobility specialist. However, like they're another key member of the team, and so you're going to want to connect with them, you're gonna want to talk with them. Because where you come in as the school based OT is being able to help kind of like facilitate what the students learning with those specialists and helping them embed that into their school environment. And then, what what could be different is if the student ends up in that residential setting, or at a school for the blind is, at least in my experience, like those services for TBI and Owen M, are occurring at a more frequent rate, because they're being housed in the same building. So, you know, instead of those specialists traveling to the school or multiple schools, and trying to split their time, like, at least in my experience, like the TBI is, and the UNM specialists are typically designated like to that school. And so then also, like, students get a chance to work in a group setting more. So I mean, typically, I'm gonna say there's maybe one or two kids that might have a visual impairment, and then, you know, in a district or, like, you know, there'll be split grade levels or different schools. And so, again, it allows for that, like, peer interaction and that peer support. So really, I mean, those key team members that I would hope would be on everyone's team, you know, would be the TVI. And the Owen M specialist, for sure. And if that's not the case, like it's your job to help advocate for the student as well, because it could just be that your team isn't familiar, or it could be that they don't really work with a lot of students with a visual impairment, you know, in their district. So making sure like, I will often say to families, like I would like to help advocate for your student, and like, could we reach out to these specialists?   Jayson Davies  Yeah, and a lot of time, an individual district and individual Lea won't have those service providers on staff, because it is so infrequent that they have students with visual impairments. And oftentimes, once they, once they identify students having a visual impairment, either A, they might contract with what we call in California SELPA, or the county or the state to bring in some of those services. Or they might go the route of a residential placement. Those are kind of two different options. Right? Correct. What about vision therapist? I know that has been something that has come up in my own practice, and others have reached out to me asking like, what is the role of a vision therapist? How does OT and vision therapy overlap or not overlap? What's been your experience?   Kelsey Kornaus  Yeah, that's such a great question. Because they actually had TB eyes and Oh, nm specialists come to me and asked me that exact question. Like, what is, you know, vision therapy versus vision rehab, you know, what's OTs role? What does that look like? And I want to be very respectful to vision therapists and optometrists that have done the education to provide those services. And because I've worked as the vision therapist previously, so like, for me, it's really important to give credit where credit is due. And so I will say this, like a, for me, a vision therapist is working in conjunction with a most oftentimes a developmental optometrist. They have specific trainings, specific resources, that intervention is weakly it's intense. There's home programming, it is very specific. Okay. So, vision therapy, to me has has its place under under Optometry. Okay. I want to be respectful of that. Yeah, that is not to say that an OT cannot support vision rehabilitation. So that's where this kind of changes a little bit. And so I do believe and fully support OTs role in vision rehab, and then also working with a student's visual system, especially in the schools like as it relates to academics. And so yes, we as school based OTs can support vision, we can support tracking, we can support, you know, vision, and eyes teaming together through different intervention strategies. And so to me, like vision therapy, and and vision rehab are very distinct. Yeah. And so is like working with visual impairments. So you could say, based on ideas definition that a student qualifies with a visual impairment because they have convergence insufficiency. You know, that's also a possibility. Yeah. But then like, we also have to keep in mind the place of vision impairment as it relates to low vision and blindness.   Jayson Davies  Yeah, yeah, absolutely. Thank you for thank you for explaining that a little bit. Because it's something that that comes up in IPS more frequently, it seems like, especially if you're in more urban suburban areas, I think. And I've never had a bad experience with the vision therapist, I just honestly didn't know what their role was necessarily compared to what my role was. And I know, I was doing a lot more in the classroom type of things, a lot of accommodations correct. And it seemed like they were doing a lot more pull out working on, like, really understanding the eye movements. And I don't know that there was as much emphasis on education that maybe I was putting on, like, the education seemed like they're doing a lot more exercises, as opposed to that would help in all aspects, not just education. So practice, yeah. Okay. All righty. Well, before we wrap up here, I want to give you the opportunity to share just maybe one tip for occupational therapy practitioners that let's just let's just kind of say maybe they recently had a student that was placed on their caseload or they evaluated a student and vision impairment. Just the overarching advice for for occupational therapy practitioners out there. Yeah, I   Kelsey Kornaus  mean, this is broad. It is broad, but I will say like, as school based OTs, like you have the skill set, you have the training, you have the knowledge, it can be intimidating at first. But I really want to empower you to know that you have the skill set, you know, you you are keen observers, you are really great at the task analysis, you know how to provide that just right challenge for students. So you have the ability, and then when you have questions like reach out to your team members, like reach out to the teachers of the visually impaired, reach out to your orientation and mobility specialists. And I mean, feel free to reach out to me, I'm happy to help.   Jayson Davies  Sounds great. Well, thank you so much, Kelsey, for coming on and sharing so much information related to supporting students with visual impairments as an occupational therapy practitioner, it's been very helpful. I know a lot of us will never have the opportunity to work in a school for the visually impaired. But we never know when we might come across a student with visual impairment on their IEP in our local district. And so it's always helpful. We don't need to know everything, but we need to know enough to be dangerous in an IEP a little bit and to provide some services. So thank you so much, we really appreciate your time and look forward to keeping in touch.   Kelsey Kornaus  Thank you so much.   Jayson Davies  And that's going to wrap up episode number 142. Thank you so much for tuning in to this very, very special episode. It's not often that we get to talk about working with students with low vision. But I know there's several of you that work in schools for for those who are visually impaired or blind. And even if you don't, there's a very high likelihood that you will have one, two, or maybe a handful of students with visual impairments at your public school. So I really hope this helps you. And if you are looking for all the resources that Kelsey didn't mention today, be sure to head on over to OTSchoolHouse.com slash episode 142 to find all of those resources, and to potentially even connect with Kelsey. Kelsey is such a wonderful person, as both a friend as well as an occupational therapy practitioner, and I'm so happy she was able to come on and share this knowledge with everyone today. And again, she does have a course now on the OT school house collaborative network. And you can go learn more about that over at OTSchoolHouse.com slash collab. As I said earlier, we would love for you to be our newest member inside the OT school house collaborative. So thanks again for listening and I hope to see you in the OT schoolhouse collaborative. Until next time.   Amazing Narrator  Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! 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 Schoolhouse Podcast

Hey there! In school-based occupational therapy, we often find ourselves navigating a complex landscape of tools and interventions, each with its own set of benefits and drawbacks. One tool that has captured the attention of educators and therapists alike is GoNoodle . I first found out about GoNoodle back in 2015 while observing a student, and I will admit, I thought it was absolutely fantastic. However, as GoNoddle has become more popular and grown into a pseudo-replacement for PE in elementary schools that do not hire PE teachers, the everyday use of GoNoodle has become slightly concerning for me. Maybe you have felt the same way. At first glance, GoNoodle appears to be a game-changer for advocates of movement in the classroom. It offers a treasure trove of interactive videos and activities designed to provide students with short breaks and engaging movement experiences. The colorful characters and catchy tunes make it a hit among kids, and teachers appreciate the opportunity it provides for students to release pent-up energy. It seems like the perfect solution, a win-win for both students and educators. However, as you dig a bit deeper, especially when addressing the unique challenges of students with motor planning difficulties, the relationship with GoNoodle becomes more complex. While it undeniably has its merits, it's crucial to recognize its limitations, especially when it comes to being used in classrooms where students have difficulties with motor planning. In this article, we'll explore why you might not  want to recommend GoNoodle to some teachers and why individualized therapy is still the key to helping students develop motor plans for everyday activities. Understanding Motor Planning Difficulties Motor planning difficulties and dyspraxia can significantly impact a student's ability to plan and execute coordinated movements. Per Mailloux et al., 2023 , A. Jean Ayres “theorized that praxis requires sensory perception, integrated with cognitive and motor functions.” As such, challenges related to motor planning are highly individualized, and they play a fundamental role in a student's overall development and independence. Whether it's buttoning a shirt, effectively using a pencil, or even learning the newest dance craze, motor planning is at the core of these actions. Dyspraxia from a Sensory Integration Perspective From a sensory integration point of view, it's essential to understand the senses that have a direct link to dyspraxia in order to understand better how it impacts students. Here are the key sensory integration-related factors linked to dyspraxia: Sensory Modulation:  Some students with dyspraxia may struggle with sensory modulation, leading to heightened or diminished sensitivity to sensory input. This can affect their ability to plan and execute motor actions accurately.
Body Awareness:  Dyspraxic students might have challenges with proprioception, the sense that helps us understand where our bodies are in space. This can make it difficult for them to plan and coordinate movements effectively.
Vestibular Dysfunction:  Problems with the vestibular system, which controls balance and spatial orientation, can also contribute to dyspraxia. Students may experience difficulties in activities that involve balance and coordination.
Tactile Perception:  Sensory sensitivities and limited feedback from tactile receptors may impact motor planning. Some students may avoid, seek out, or incorrectly interpret certain tactile sensations, affecting their willingness or ability to engage in activities that require fine motor skills - especially when their vision is occluded.
Because a child with dyspraxia can be impacted by any combination of these difficulties (and others), our evaluation of a child’s needs revolving around dyspraxia is so important. A well-addressed evaluation allows us to provide tailored interventions that address sensory processing difficulties alongside motor planning challenges. The Appeal of GoNoodle Let's start by acknowledging the appeal of GoNoodle.com . It offers a variety of engaging activities and videos that provide students with a much-needed break from their daily routines. Many students benefit from the movement, fun, and sensory engagement that GoNoodle provides. And the truth is, for 90% of the student population, GoNoodle is great! Challenges for Students with Motor Planning Difficulties However, when it comes to students with motor planning difficulties, GoNoodle falls short and may even cause more problems than solutions for teachers and students. Many of the activities and movements used in GoNoodle videos can be very challenging for students with motor planning difficulties, leading to frustration and anxiety rather than an optimal learning level of arousal. The fast-paced nature of GoNoodle activities can limit students from making progress and may even deter them from wanting to engage in future physical activities. That is why it is crucial to recognize that what works for one student (or even 30 students) may not work for another, especially when motor planning is a significant hurdle. The Need for OT So, what's the solution for students with motor planning difficulties? Individualized therapy and collaboration with the teacher are the missing pieces of the puzzle. These students do not need teachers, peers, and staff encouraging them to “Keep trying” or to Keep up. Instead, they need tailored interventions designed to address their specific motor planning challenges, Individualized therapy sessions can focus on breaking down motor tasks into manageable steps, providing ample practice and repetition, and gradually increasing complexity as students progress. These sessions help students develop motor plans for everyday activities, fostering their independence and confidence. In a similar manner, collaboration with teachers and other staff can help to identify easy-to-implement accommodations and potentially alternative methods for helping the student achieve individualized academic and functional expectations. Where to start? Here's what you can do to help educate teachers about the limitations of GoNoodle and explore alternative strategies for your students on campus: Informing Teachers:
Communicate with teachers about the specific motor planning challenges that some students may face. (This makes for a great in-service!)
Provide information about the sensory integration aspects of motor planning difficulties, helping teachers understand the root causes and sensory sensitivities involved.
Alternative Strategies within the Classroom:
Encourage teachers to have children lead exercises slowly : This approach allows each student to set a pace that suits their motor planning abilities, reducing anxiety and frustration.
Promote peer support: Teachers can encourage students to support one another in the classroom. Pairing a student who excels in motor skills with a peer who struggles can create a supportive environment where students learn from each other.
Acknowledge differences and provide alternative movements: Emphasize the importance of acknowledging that not all students can perform the same movements. Teachers can offer alternative movements or exercises that accommodate students with motor planning difficulties.
Use mindfulness and relaxation techniques: Incorporating mindfulness activities can help reduce anxiety and improve focus, benefiting students with motor planning challenges.
Collaborative Problem-Solving:
Foster collaboration between OT practitioners and teachers to brainstorm and implement classroom strategies that address motor planning difficulties.
Encourage open communication, where teachers can share observations and concerns, and OTs can provide insights and suggestions based on their expertise. By working closely with teachers and providing them with insights into the challenges some students face, you can help create a more inclusive classroom environment for all students - even the ones not on your caseload. The classroom may even enjoy exploring alternative strategies that allow every student to participate in the classroom movement breaks. Wrap Up In conclusion, my relationship with GoNoodle is one of love and frustration. While it has its merits as a sensory support tool, it may not effectively address the motor planning difficulties that some students face. This is especially true in classrooms where there may be several students with motor planning difficulties. So, the next time you are considering recommending GoNoodle to a teacher, or you see a classroom full of kids struggling to keep up with the beat, take a step back and ask yourself if there is a better way to support the needs of those students. GoNoodle is an easy solution, and in many cases, it is the best solution. But in our world of supporting students with various needs, there may be better solutions available. Thanks for having a read, 👋 Jayson

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 141 of the OT Schoolhouse Podcast. How can the strategic use of color and contrast in writing programs not only capture children's attention but also foster a focused environment for handwriting tasks?
In this episode of the OT Schoolhouse Podcast, guest Helene Lieberman discusses her journey of developing a program, seeking feedback from colleagues, and making adjustments based on their input. The program features high-contrast laminated pages to reduce distractions, helping children with low vision and attention deficit disorder focus on writing tasks.
Join us as we explore the intersection of program development, collaborative feedback, and the pursuit of effective interventions! Listen now to learn the following objectives: Learners will understand the process and challenges involved in developing a program for school-based occupational therapy.
Learners will identify the potential impact of creating evidence-based programs and interventions in school-based occupational therapy, including the benefits of pairing with academics to conduct formal research projects to evaluate the efficacy of interventions.
Learners will identify the challenges and strategies for managing and collecting program data for multiple students in a school-based setting, and learn about the importance of keeping careful records and monitoring progress during therapy sessions.
Guest Bio Helene Lieberman MS, OTR/L received her Bachelor’s Degree in Occupational Therapy from Boston University, Sargent College of Allied Health and a Master’s Degree in Family Support Studies at Nova Southeastern University. She is NDT Trained in Pediatrics, trained to implement Interactive Metronome and IM Home systems, ILS and SIPT Certified. For the past 34 years she has worked in a variety of settings including hospitals, schools, outpatient clinics, Intermediate Care Facilities and home health. Helene is the creator of BlackBack Writing to teach shapes, letters and numbers and is developing writing paper to teach the proper alignment of letters. Quotes “Take pictures and keep a file and see if you notice a difference… and keeping it in a secure place.” -Helene Lieberman, OTR/L “Let's say if you have a problem and you solve it with a good idea, other people probably had similar problems and are looking for something to solve that problem.” -Helene Lieberman, OTR/L “Research in 2022…learners who struggle with handwriting also tend to struggle with keyboarding.” -Jayson Davies, MA., OTR/L “Research shows that when writing is done, there is an increase in literacy as well, whether it's letter recognition, whether it is, their reading, also memory is increased.” -Helene Lieberman, OTR/L Resources Right write stylus
App - Writing wizard
App - Letter School
Learning without tears
Free sample of BlackBack Writing Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hello and welcome to episode 141 of the OT schoolhouse podcast, your go to resource for practical strategies and professional development in school based occupational therapy. I'm your host Jayson Davies. And in today's episode, we had the pleasure of speaking with Helene Lieberman, and experienced occupational therapist and creator of the black back handwriting program. In this episode with Helene will explore topics like using high contrast writing programs to address handwriting difficulties, practical ways to integrate sensory activities and specialized writing programs into school environments, and even the challenges and triumphs of developing and implementing an innovative handwriting program within your own school based occupational therapy program. If you're a school based occupational therapy practitioner looking for evidence based strategies to empower your students with diverse learning needs, then this episode is for you. Enhance your knowledge of effective reading interventions and sensory activities and gain valuable insights from Helene's extensive experience. Now, enjoy the intro music and tune in to gain valuable tips and inspiration for enhancing your OT practice in the school setting.    Amazing Narrator     Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here's your host Jayson Davies. PLAs is officially in session.    Jayson Davies     Helene, welcome to the OT, schoolhouse podcast. So glad to have you. How are you doing today?    Helene Lieberman     I'm doing well. Thank you. How are you?    Jayson Davies     I am wonderful. Thank you for asking. And I'm excited to talk to you, you know, the holidays are coming up. But when this airs, the holidays, we will be in the past. But I would love for you to share to get us started a little bit about your background and experience as a school based occupational therapy practitioner.    Helene Lieberman     Okay, so I graduated many, many years ago in 1988. And I've worked in a variety of settings, school bass being one of them. And I really enjoy the school based setting because you do see a variety of children. And you get to interact with the teachers where they really need to have their work that we're doing an OT applied. So, but before that I worked in outpatient, I worked in a rehabilitation unit for pediatrics. I did homecare early intervention. So a little bit of everything. Awesome.    Jayson Davies     I have a question based on your experience with being in an outpatient clinic was that pediatric? Yes. All pediatrics. Okay, gotcha. Was there anything in particular that you felt was helpful as you moved into the school based OT realm from that clinic based realm?    Helene Lieberman     I guess. Pediatrics has pediatrics. And maybe the goals change to turn the goals to a more school based educationally related goal. But a lot of it carries over I didn't really feel that there was much to learn except maybe how to do an IEP. That was a bit of a learning curve and dealing with some of the parents, the IEP, but an outpatient, you're dealing with parents all the time and other family members. So I think that was good preparation. But I really think it was an easy transition.    Jayson Davies     Yeah, I for me, I never worked in a clinic setting, but I did a lot of fieldwork hours at a pediatric clinic. That's how I got into OT. And the biggest takeaways are differences. I guess, for me, that I noticed was the session length, a lot of times in a clinic, you have a full hour with a student versus in school based OT right? We're often that 30 minutes, sometimes even less. And then also with clinic basis, the frequency two, sometimes kids will be in a clinic, three, four times a week, oftentimes at least twice. Versus in school based OT we're kind of lucky if we get that 130 minute session. And so that was the big takeaway for me.    Helene Lieberman     Yeah, that is a bit of a difference. But I was lucky enough to work in a school where we were in house, there were four occupational therapists within the school. So even though they might have been on the schedule, once or twice a week, we were able to see them more frequently and just go into the classroom. So it was a really nice setting to work in.     Jayson Davies     Great. Well, we're gonna dive into the content for today. And just a little teaser, you have developed an entire hand writing program. But before we get into that, I want to kind of get into the why and even a little bit about the how that came to be. And so to kind of get started with that section of the episode, I guess, what made you decide you know what, I need to develop a hand writing program what was wrong? What did you see that just kind of drew you to it?     Helene Lieberman     Well, I would say I Other kids and I worked in a preschool for our children on the spectrum. So I would say 95% of the IEPs had a writing goal, whether it was just drawing a line or first letter of their name or something I'm related to writing. And there are quite a few of the children on my caseload, who really just didn't want to have anything to do with writing, it became very difficult to motivate them, even if we weren't using writing tools and trying to use some of the other, you know, components that had to do with writing. Maybe that would be good. But as soon as you brought out a writing tool that related to the goal, and we had to take data on it, it became very stressful. So parents wanted the goal still on their IEP. So I'm like, Okay, we got to figure out a way to make this happen. And I guess there are certain programs we're using, and I'm not saying any of them back, because I really think there's value in every single program, it just really depends on the person you're using the program for. And not every program works for everyone. And that's why occupational therapists really need to have a huge bag of tools in order to accommodate whoever comes onto your caseload. So that being said, I was having trouble meeting goals on the IEPs. And I was like, I need to do something else, because I need to get this done. And I gotta figure out how to do it. And we're creative, as OTs so started coming up with other things.    Jayson Davies     Absolutely. And I it's been a little while since this episode, aired that I'm about to talk about what we had an episode with Susan Cahill. And she talked a little bit about creating your own evidence. And one of the important pieces of creating your own evidence is actually using a set program. You know, if we're just kind of coming up on the fly with a with a session, every single week, you're not necessarily creating evidence, because there isn't really a standardized tool that you're using, or even an unstandardized tool that you're using. And so it sounds like you decided, You know what, I need to create something. So it's all kind of put together into a nice, clean, little bundle. I'm sure it wasn't that at first. But that's kind of what it came to be right.    Helene Lieberman     Yeah, I was doing things session by session and child by child initially. But once I saw that something was working, I actually did the same thing with certain children. And I kept doing what I was doing with other children. And then I started seeing a more positive outcome with some of the new things I was doing. So then I realized I was onto something.    Jayson Davies     Gotcha. Okay, I want to ask you a follow up question to this. But to kind of give some context for everyone just briefly describe the premise of the back black writing or get right back black or black back.      Black, it's a black background, basically. So that'll help them remember it. So what I noticed is that the basically, I started noticing, and it was a Halloween project that we were doing. And I used a black piece of construction paper. And I was using white papers and white Q tips in order to make a skeleton figure and some of the children really gravitated towards that children who were very interested in doing a lot of arts and crafts, the fine motor kind of things. So I just thought that was interesting. And then I took a piece of white paper, and I put it vertically on the black construction paper. And the kids started coloring on the white paper. And I was like, oh, that's, that's interesting. And then I turn the paper and there was a horizontal line. And then I started cutting strips and making different shapes. And I noticed that the kids weren't very interested in that. So the preschool was a preschool for children on the autism spectrum. There were some children who also had Attention Deficit Disorder, I also had a few children who had low vision in addition to a diagnosis of ASD, obviously, the children with low vision definitely took towards it. So that was the first concept of just making the black background and the white image and then I started thinking of how are they going to learn to write small because I had that piece of paper from the top of that construction paper to the bottom. So they started making it smaller and smaller so they can learn more about the coordination after the formation of doing whatever it is they were doing. So I just started with the shapes first and then I started cutting a lot of paper and making letters and then go this is and copying it and then eating up the toner on the on the don't tell them that was me. Who did that and making copies and so I said you know what this seems to be working and then I finally this is after a few years now we're told Parking, I had a graphic artist work with me to make it into a program that was then sent to a printer and laminated. So the program itself is letters, upper and lowercase is one, program numbers zero through nine. And all the prewriting shapes that we do. And each program has six sizes except for the letters which just change, but we'll talk about that later. So starting from a larger size, going down to the size of why ruled paper, there is only one image on the page. So there is no numbered pages, there are no pictures identifying if you have a see, there is no car, there's nothing else for the child to do. When they work on the whitespace. They see what they're doing. When they start working in the black space, there's no feedback, so becomes very errorless, where they want to go back and work in the white space to see what they're doing. And there's no other distraction on the page for them to talk about everything. But what is needed to be done.    Jayson Davies     Yeah, great. And so, again, high contrast, you really brought down the focus level, right? You're drawing their focus into exactly what you want them to be doing nothing else to distract them. Of course, we can't control everything around them in the room. But on the paper, we're focusing them into that one letter one number one shape that we want to focus on. Exactly. All right. And so you said that all came from a Halloween Halloween concept idea. Now, before you develop this idea of putting white paper or white color on a black background, I want to ask whether other ideas that you tried that maybe you found weren't as successful?     Helene Lieberman     I would say I mean, other programs that we use are just generally writing on paper using a lot of sensory media to do writing using different types of writing tools, crayons, markers, dry erase boards, chalkboard, Clay, wicky, sticks, everything else that you know, I could think of that would interest the child?     Jayson Davies     Yeah. And I mean, those are types of things that we use every day. But I guess why did you? I'm sure you still use some of that. But ultimately,    Helene Lieberman     I use it all. Exactly, right? Yes, I love all of it.    Jayson Davies     So why focus on the program, as opposed to some of those other tools, or I mean, you said you still use them. But what made you decide like those weren't enough.    Helene Lieberman     It was really the distraction factor. That's what it really was. And I still will use block back along with other programs, again, depending on the child, and there are so many wonderful writing programs out there. But a lot of times to get somebody's attention, and interest in focus. This is how I felt I needed to start because a lot of children were overwhelmed. Whether it was by all the images on a page, or the page looked very busy and confusing, or the page was part of a notebook like a bound notebook. And the child thought that they would have to do the whole notebook, even though you would say just one page, it just became the anxiety started to increase before we even got to do the activity. Yeah. So it became that became a barrier as well. So the this program is laminated pages, but it's there are three holes for our whole time. So you can put them in a binder. But I usually take it out because if you start presenting the binder, I had the same type of reaction where it became a heightened anxiety. So that's where I started. Just just keep it simple. Very simple.    Jayson Davies     What about technology? I know one of my go twos was using an iPad. I liked using a stylus with apps like writing wizard or letter school. What about did you use those and kind of?    Helene Lieberman     I did and sometimes it's successful sometimes it's not depends on the child. I always lock the iPad when I do apps. And I love the the right, right. Stylus Yeah. only works with the proper grip pretty much. And even though I'd lock the iPad, some kids did well with it. Some kids kept trying to press the button to change the app. Yeah. And that became a focus of theirs and they were not happy that they couldn't change what was on the iPad.    Jayson Davies     Right. Follow up question to that one of the biggest difficulties I had with the app and I wanted to know if you had it, too, was carryover from an app onto papers. That's something that you noticed as a difficult thing to overcome.     Helene Lieberman     Not so much. I always go to paper. Even with the black writing I go to write Killer paper also right after, when I use apps, I was good at paper after because that's more most of the kids are gonna end up writing. And of course, there are some kids who end up using typing and, you know, apps for communication. But I always go to paper.    Jayson Davies     Gotcha. Cool. And kind of on the line to that technology side, I'm sure at some point in your career, you have had this debate in your head, just as most of us have, why not go to typing for our students who are struggling, even if it's, you know, early on, why not go to that next use technology,    Helene Lieberman     because research shows that when writing is done, there is increase in literacy as well, whether it's letter recognition, whether it is their reading, also, memories increased when children are writing. So that's important. And I think the aspect of writing is really something that started drawing pictures. And then leads, of course, to the literacy and being able to express yourself. And it's not just the writing, it's the legibility of it. There's research that shows that students who write messy, get poor grades, even if maybe they wrote the correct thing, sometimes teachers don't want to bother with it, sadly. So they end up getting downgraded on their papers. And then they become more upset and unfocused and their self confidence decreases. So I think it's important thing to write, not every class is going to have the technology. And not every school district is going to go to technology right away are provided. And some families don't have the means for that as well.     Jayson Davies     Yeah, you know, you sent in some, you sent him some slides that we were able to prepare for, for this interview today. And one thing that really struck me with this, you had you actually cited this as a research from, I believe it's more mo HR in 2022, that learners who struggle with handwriting also tend to struggle with keyboarding. And this really struck a chord with me because I have never had nice penmanship. And so I have always tried to focus a little bit on typing. And even at the age of 35, I think I am now my typing speed is probably still slower than a today's seventh grader, like I am terrible at both. And so like I fit right into that study, which I just thought was kind of interesting.    Helene Lieberman     Yeah, I thought that was very interesting, too, because you would think, if it's the legibility and the writing, they could type. But again, when you think of the sub skills for typing, you still need to visually scan the keyboard, you still need to be able to have dexterity in your fingers. So there are things that you need for writing that you will need for typing.    Jayson Davies     Yeah, and even if you're trying to be more fluent with typing if we want to say same thing with writing, like for me, I've always struggled to Farpoint copy effectively with a pencil, because I don't I personally feel like my tactile awareness is not greater, maybe it's a little bit of probe, but like I have to look down at what I'm writing with a pencil like otherwise, I'm just going to be all over the page. And that same skill is also used very much in typing right to touch type, you rely on a lot of tactile feedback, a lot of muscle memory per se of knowing where all the keys are and so I think like you said, there's a lot of overlaps when we really think about it between handwriting and typing. So     Helene Lieberman     Yeah, I have to look at the keyboard when I type I cannot I think that's the only class I failed in high school was typing.    Jayson Davies     I mean, I'm going to completely admit that I still log into typing club every now and then to practice my own typing skills. i Yeah, that's how bad that is. All right. But but still kind of like for real on typing the keyboard because I know that it is something that people can move on to and I definitely have and I want to get your take on this for me and I honestly don't remember where I read this I want to say it was in like maybe the etch manual or something like this but it was something like we should it move kids over to typing until they have reached at least 15 words per minute and and maybe all of us have our own separate kind of criteria for students when to move to tyffyn But what did you kind of use if you were you know, transitioning to typing what did you kind of use to gauge whether or not that would be okay for a student?    Helene Lieberman     I because I live in Florida third grade is a big year and I don't know you know if your state so Third graders a big year, where they have to often write more sentences and essays. And if their writing is so difficult that they're not going to write much, because it's a struggle. And they don't have somebody to write their thoughts because, you know, they don't have that, that accommodation, usually by third grade.    Jayson Davies     Yeah. Yeah. I don't know if it's by third grade that like, we need to make that decision here, at least, but not make the decision. I understand what    Helene Lieberman     cutter drive I'm like, let's start the typing and see what what happens is going to stick better. Is it going to be more successful?    Jayson Davies     Yeah, and this is the perfect transition to the next kind of topic I wanted to talk about which was common core, because, as you know, like there is no real handwriting in common core goals. Like it says that they will print but it doesn't say like, to what degree and the same factor I think unless I'm wrong, you can tell me the same thing with typing. Like it says the kids will type but it doesn't really gauge like, what that exactly looks like.    Helene Lieberman     Exactly. There's no standard on the typing or the writing, I think it says, For the writing it says from a model. So they might be looking at what the teacher does. And what I call is drawing a letter. So the letter in the end might look like the teachers letter, but the formation is maybe not proper. And that eventually starts slowing down the child and their writing, if they're not using a efficient way to form the letter. And in the Common Core, there's a lot of not handwriting requirements, but writing requirements in terms of writing essays, or writing creative thoughts or writing a paragraph or so the writing is there, but the handwriting pieces not.     Jayson Davies     Yeah, and and I kind of understand why because I think that they tried to left it more broad as a way to understand within society that we are moving to a digital age. And if they put in there, that the child will hand write a paragraph or hand write an essay, then people will come about and say, Well, what about typing? So I think that being a little more broad opens that up. But go ahead,    Helene Lieberman     but I don't think the states put anything in I know our state doesn't put anything in there. Either. The Common Core can be interpreted differently by the states and we know different schools. Counties also do their own thing. And some counties do put in handwriting as part of their core curriculum, and some do not. Actually, some teachers just do it on their own because they understand the importance of it whether their district has it or not.    Jayson Davies     Yeah. And that reminds me that I believe California, just think it was California just signed into law that they're bringing back cursive, like cursive was gone for how many years? And it's still, like you said, I don't think her sister mentioned in the broad, Common Core, but as you mentioned, right states can potentially put some into it. And I think California has made that decision. They're going to put cursive back in. So yeah.    Helene Lieberman     Yeah. So it depends on you know, and there are some states, of course, you don't even have a core curriculum, but that's a whole other. Right. That's all thing. But and the private schools, of course, are different than public schools, private schools can do their own thing. Actually, more private schools, from what I've seen, and when I've heard I don't have any research or data on this. But I have heard and seen that private schools, have handwriting curriculums versus or have more handwriting curriculums that a public school does. And I don't know if that's because they have the funding, or the parents are demanding it or I'm not exactly sure what it is.    Jayson Davies     Who knows, but yeah, yeah. While we're on the common core subject, how do you feel we talked a little bit about Common Core how lacks the handwriting lacks hyping? But aside from that, what have you heard from teachers, from principals from other occupational therapy practitioners, as far as how common core is impacting their day to day with students?    Helene Lieberman     What I've heard is that a lot of teachers are teaching to the test. That is what I've heard. And then for occupational therapists, that the teachers want the therapist to do the homework or whatever the assignment is, that they need to do in the therapy session so that they can keep up with the curriculum, even if it's a push an activity, like, Okay, this is what we're doing. Now. That makes sense, of course, you know, we're pushing it and this is what we're doing. But even if they're pulling out, like, can you do this, they can't miss whatever it is that they're doing, and I think I understand the need for test taking, but I think that's sometimes takes over the learning process.    Jayson Davies     Yeah, absolutely. I mean, I definitely have had teachers kind of say, Hey, can you work on this homework in your pullout setting or whatever, like, and we started To have actually, principals, and I know this isn't uncommon, we were being directed to not pull out kids during a certain time, because that was core instruction time. And that gets really hard because now your time to see kids has been shrunk even more with an over impacted, you know, caseload and it's struggling.    Helene Lieberman     I have that problem actually, right after this. I'm going to see a kid in the schools, it happens to be a private school. But because their day is so busy, I cannot see the child till the end of the day. Yeah. So they're pulled out for the last half hour. When I'm not allowed. Nobody's allowed in the classroom either. Oh, wow. All right. So I get the child like the last half hour or the day, and then the child stays a little bit extra. And then the family comes to pick the child up. But it became like, well, there's just no room in our day for OT. Yeah. And if it wasn't for the parent pushing, I don't think they would allow it at all. The parent is a very good advocate for that child.    Jayson Davies     Yeah. Yeah. It's there's a lot of restrictions being put on everyone. And it's not just OT, right. Like, it's everyone's speech, teachers, principals. It's everyone, right? It's just making everyone's job a little bit more, more difficult. Right?    Helene Lieberman     There's only so many hours in a day.     Jayson Davies     Exactly, exactly. And then you try to put 60 Kids in, you know, to a matter of a 32 hour work week, it just gets impossible. I kind of want to circle back because we did go off tangent A little bit. But those were important conversations. And now bring us back because I want to ask you, how did common core understanding Common Core or not understanding Common Core at the time? How did that impact the route that you took with black back with the writing program?    Helene Lieberman     I'll be honest, I had no clue about common core, before I started looking into it. So I was looking as to what the schools are requiring for handwriting. And that's when I started talking to some of my teacher friends. And they were the ones who were telling me that there is nothing required. And then I started looking into it. And I found this similarities. So yeah, so I was very clueless, except for my own children. I knew there was a curriculum and a common core. But other than that, as an OT, I really never delved into it, and I should, and I feel we should be in the school system, you know, be more aware of it. So I admit, I was totally unaware until I started looking at well, what are schools to for writing, you know, how do they, you know, get the kids to write.    Jayson Davies     So as you were looking into your school, like, what, what were your teachers doing? What were other therapists, like? What were they doing? if they    Helene Lieberman      Okay, so in other school that I was working in, actually we use, I'm learning without tears, which I do love. I love it. And I incorporated a lot. There's a lot of wonderful things in terms of sensory and movement. And it's a wonderful curriculum. The only issue I had is that some of the children were very distracted by some of it. Again, great curriculum evidence, not for everybody. So I found pairing this, but yeah, there was a curriculum. And actually, the OTs went into the classroom, usually once a week to do a center that every teacher had the materials and incorporated some of the songs into their circle time. So it was it was very successful.     Jayson Davies     Gotcha. Okay. So they were using the students that were being referred to you then at the time, they were already getting some sort of handwriting instruction. Yes. Okay. Yes. Because a lot of times as occupational therapy practitioners, right, we get the handwriting referral, and then we ask what's been done? And the answer is just like, regular instruction, there's no further program in there. So that's nice to know. That    Helene Lieberman     yeah, it was wonderful.     Jayson Davies     Awesome. Okay. So that's kind of where your school was at, at the time when you thought of blackpack writing. Now, as it started to progress, as you started to see students, you know, it was working for students. At what point did you start to kind of look into more research to kind of maybe adapt it based on research a little bit.  Um, so it was looking at some of the research of like, just colors and writing and just in general colors. I found a lot of stuff on media marketing, low vision, you know, things that didn't have to do with writing. I did find one study that was done in Germany. I believe it was in Germany, with children who had attention deficit disorder, and they were given color choices of paper. And they found that the children wrote more, but they their theory was that it was the child's choice like Oh, I love pink, I'm going to write on pink versus white. So they were talking about giving the children color choices as paper. Now we know that there's like the overlays the colored overlays that are helpful. But there was nothing that talked about changing. Now I've worked with children who have low vision, where they and I can't remember the name of the machine for the life of me. But it's a machine that if you put the book under, and you could flip the background. Oh, so I think I know what you're talking about. I don't know the name of it. But I had a student who I believe had that.    Helene Lieberman     Right. So if they're reading a book, you put the book under, and then the light is on top, and then they're knobs and adjustments, so you could flip the color. Oh, do they really?     Jayson Davies     Well, I mean, I was working with a high schooler, you can imagine a high schooler having that on his desk and a general education. Yeah, yeah, we just have iPads.    Helene Lieberman     Right. So the the low vision, you know, piece was, you know, important too. And that's where a lot of the research was, but nothing that had to do with writing and changing the color. And I saw somebody doing research, please.    Jayson Davies     Yeah. And you know, it's interesting, because that is something that we see we see the overlays a lot in occupational therapy. And I want to say there is some research around it for reading, but I don't know about writing exactly for reading. And then in the writing space, I think every occupational therapy practitioner just about is familiar with a high rate paper that has that yellow, highlighted area, I created a paper that's called gray space, paper and other one with color, and it was just using gray. So I mean, that is not uncommon, within the OT world, especially to use colors on paper as a visual cue. So, but there isn't a lot of research from what you're able to find. It sounds like I couldn't find any research in terms of writing.  Interesting. All right. If anyone out there wants to take my gray space paper and do some research, I would be happy to print out as much as you want. I'm just throwing that out there. I'm sure Holly would be happy to if you use a black bag.     Helene Lieberman     Yeah, definitely now that there are more entry level doctoral programs out there. Most students do need some sort of capstone project. So if any of them are listening, or if somebody knows somebody who needs a capstone project, I guess you can get in touch with either of us. And I'm happy to have them doing. I'm doing some research now. And so far, not much. So last school year, we didn't have a very large sample size, we had one classroom, and we did four kids for six weeks of the school year, and then another four children for the second six weeks. So there really wasn't a lot of evidence or significance, I guess, is the word. Limited learning I'm learning. And this year, I'm doing a whole classroom. So there are nine children in the class. And it's a pre K four class. So those children will all be going to kindergarten next year. And there is a another classroom in the same school. So that class is not getting the block back program. Gotcha. So we can make a little bit more of a comparison. And hopefully, we'll see something.     Jayson Davies     Yeah. Yeah. So this is your first Oh, this will be like your second time doing research. Officially.    Helene Lieberman     It's part of it's under the same umbrella. It's under the same IRB. Okay. Yeah. But yeah, I took a stab at research, you know, I think, I think it's important to do as a clinician, don't do it a lot. I think we need guidance to do it, or at least I needed guidance to do it, because I'm not an academic. So it's, I think it'd be great for clinicians to pair with academics to, you know, we're seeing things in the clinic. And, you know, we want to make sure that it's working, so we need to have some research on it.    Jayson Davies     Yeah, absolutely. That's awesome. In fact, I think we had an entire episode way back and like, I want to say it's Episode 11, or 13, where we talked with a school based occupational therapy practitioner about like incorporating research into school. And I know it's not easy. So I just want to give you kudos because you've got to go through the district board. You've got to get an IRB, it is not simple.    Helene Lieberman     I'm doing it in a private school because of difficulties with a public school.     Jayson Davies     There you go.     Helene Lieberman     Yeah, it was very, very difficult to do with the public school system.     Jayson Davies     Yeah.     Helene Lieberman     But you got to start somewhere.    Jayson Davies      Yep. Yeah. And some people start with their own kids. Like, I mean, just it's right, you start somewhere, but actually taking that step back. Yeah, we dove into the research that you're kind of working on now. But you must have done some of your own like, even if it wasn't written down some of your own like little internal studies, per se, individual case study. So share a little bit about that, like, Well, what did you do before the official IRB stuff?    Helene Lieberman     So I think I mentioned this before, I don't know if I did, where I had some of the kids on my caseload use the black bag program. And some of the other kids just do whatever I was doing before and nothing different. And I noticed that the data was better for the children using block back. So it was very unofficial and it was more are like my little data sheets checking? Yeah, that's, that's about it.    Jayson Davies     You can get I recently, gosh, I think it was an article posted a few weeks ago, I talked about some of the things that we should be doing as OT practitioners that we honestly don't have time for. And one of them is kind of program management and taking data on our own program. At school based occupational therapy practitioners, we're very good at taking data on an individual student presenting that data on that individual student at said child's IEP. And then we do it again, for students to 355. But we are never able to take that step back to see as a whole, our 50% of our 55 kids actually making progress toward their goals are 75% making progress or their goals. 25%. And and I don't know if you have the opportunity to do that, probably not just because it's so difficult. But that's great that you were at least able to kind of look at some of the kids who were getting the program and some of the kids who weren't and just kind of anecdotally, you know, keeping in your mind and a little checklist that it was working.    Helene Lieberman     Yeah. So it's you have to be very mindful of it. Because, as you know, sometimes days get really busy.    Jayson Davies     Yes, yes, absolutely. So how long did you actually use the program, kind of or the the prototype, I guess you want to call it where you were just printing out things before you decided, you know, what, this is something that is really working, and I need to make this known to other people.    Helene Lieberman     Great questions. So I think, like, for a couple of years, I was doing it on my own. And I have to say I was a little shy thinking everyone's gonna think it's weird, or just doubting myself as to this and the theory I had. But now just looking back on it, I see when I go to conferences, and people are looking at it. They're like, wow, this is so simple, but so effective. So in the beginning, like I said, I was a little shy about it. So took I did it a few years on my own. Then like I said, I got sick of copying everything. So I found a graphic artist to do it. And I used it on my own. And then finally, I got the guts to speak with a printer.   to actually print it in bulk. And, you know, okay, I'm going to do this. And if I if fails, and everyone says it's a dumb idea, then okay, but at least I tried. So it finally got printed in early 2020. And I was probably doing this for at least eight years before that, I would think using what I did on my own. Yeah. And I finally got it printed. And it came to my house in huge pallets. And it was about, yeah, it was a lot. And it was in March of 2020. And I was supposed to show Yep, exactly. showcase it at that a OTA in Boston, I had a booth.     Jayson Davies     Okay, Oh, no.     Helene Lieberman     Yeah, so we had a lot of stuff in our garage for a long, long time. And eventually, you know, I brought it out. But I would say I was shy at the beginning to do it. You know, it's anything new, you have to put, of course, a lot of work into it. And I was still working full time. So I would try to do something on my free time. And then my free time got eaten up by something else. So but now I'm doing it a little bit more. And it it has been well received. So I would say since about 2011 2012. Maybe    Jayson Davies     working on a long time in the works.     Helene Lieberman     Yeah. Yeah.    Jayson Davies      Fantastic, though. That'd be I mean, and you think about right where you are right now, like you're starting out with really selling these I know you've you've already, you've sold some it's not like you haven't sold one, you know, you've sold some they're going out. But even if you never did that there's so many kids that you were able to work with using this program. That I mean, you helped a lot of kids with this program without ever selling a single copy. Right? Like, that's awesome. And now moving forward to think about it. Like all those years of development of you working with it, figuring out what worked, what didn't work, and now others are going to be able to use that to help countless individuals with the program. That's pretty cool to think about. Right?     Helene Lieberman     Yeah. I mean, I think that's one of the reasons we become therapists. And we have a desire to be, you know, to make an impact on somebody, and hopefully, maybe people.     Jayson Davies     Yeah, yeah, definitely. All right. I want to kind of take a step back within the development phase, because this was a question I had, and I probably could have asked it a few questions ago, but I often get asked, Hey, Jason, I'm typing out some worksheets for handwriting, what typing style or what typing fonts should I use? And so I'm sure you have had Have things to look into and kind of trialed out a few things and what do you? What did you try allowed? I guess? Or what did you learn? And what did you end up using?     Helene Lieberman     Um, again, to be honest, I can't remember the font. But if I would go back and do it, I think I'd go to Comic Sans. Why is that? I think it's very easy to read. I think the letters are likely the way we write them. And I just think it's easy on the eye also.     Jayson Davies     Yeah. Yeah. That's smart. I personally, on my website, I use Poppins. Okay. And the sole reason that I use Poppins or not the sole reason, but honestly, there are many that I actually like better. But I use Poppins because of the lowercase a, it actually makes a lowercase A the way that we write it as opposed to    Helene Lieberman     Comic Sans. Yep.     Jayson Davies     Yeah. Yeah. So     Helene Lieberman     that one,    Jayson Davies     don't know how to describe it. I don't even know how to write it if you ask me to. But yeah, it's amazing how much emphasis we put on fonts, whether it's on a website, or even the way that we personally write things. I mean, I've had students and I'm sure you have had to where you ask them to write letter A. And they write that other style a and like, you don't even almost recognize it as an eight you're like, Wait, that's not a that's like a D. And then you actually look at it like, Oh, you're writing the a that you probably see typed out on the iPad every single day or right or reading,    Helene Lieberman     right? And I always accept it. I mean, it's it's a it's an A, it's an A, I think it's harder to write than the other way.    Jayson Davies     I agree. And it throws you off when the first time you see it, like you don't see it every day. You don't see kids writing. That's not usually so    Helene Lieberman     you know what we're talking about drawing the letter. That's what happens. Often when children are not taught. They're looking at it, they understand it's an A, so they're just copying what they see. Which is smart.     Jayson Davies     Yeah, yeah. I mean, that's what we do in life. We copy that's how we learn.     Helene Lieberman     Exactly. That's how I make my.    Jayson Davies     Yeah, yeah. Wow. All right. Well, before I'm trying to make sure that we covered everything about like that, though, how and the why you got here, we obviously cover the why a lot about Common Core. And we discovered or we talked about how you learned a lot about how there wasn't necessarily a program ingrained. And so you started to develop this program to work alongside potentially learning without tears or other programs. Was there anything else that you want to share about kind of the how you develop the program?    Helene Lieberman     Um, I, I did send things to my OT friends. To try out.    Jayson Davies     Yeah, freebies, everyone loves freebies.     Helene Lieberman     Yeah. That was another little, like, pilot testing sort of thing. Try let me know what you think of it.     Jayson Davies     Yeah. That's important    Helene Lieberman     Yeah. And so I guess piloting it. And     Jayson Davies     what were some of the feedback that you felt? I mean, everyone, it's hard to give negative feedback to a friend. So was it all positive?    Helene Lieberman     Definitely too much ink. Okay. Too much into print out? That was for sure.     Jayson Davies     Yeah.    Helene Lieberman      And actually, over the years, part of the feedback was six sizes is too much.     Jayson Davies     Okay,    Helene Lieberman      so our second printing of the letters, which should be in my garage, on a pallet, hopefully, by the end of the week, is has only four sizes as opposed to six. And the other feedback that the eight and a half by 11. Size is too large for portability, especially for school therapists. Because it was heavy. No joke, it was 10 pounds.     Jayson Davies     Oh, wow.     Helene Lieberman     Yeah, it was a lot. And I always kept it in an uppercase binder and a lowercase binder. And I always would just pull what I needed. But other people who go to schools further away, and they need to have, you know, everything they can just pick and choose for the day. So I don't know what the weight is going to be. I could let you know when I get it. But this is going to be five by seven.     Jayson Davies     Okay,     Helene Lieberman     the letter sizes aren't changing, just there's less background of the black. And I have done prototypes of it. And people say that that should be better.    Jayson Davies      a little bit easier to handle and use    Helene Lieberman      Yes. Easier to manage in terms of size and carrying around and storage. For sure. Yeah.     Jayson Davies     Awesome. That's gonna be great. I'm sure. Like I would like I said earlier, I'm sure it's gonna help a lot of therapists, a lot of kids out and, and hopefully teachers and parents too, right. Like this isn't necessarily unique to to therapists.    Helene Lieberman     No, actually, teachers really love it in their centers, because they're laminated and they're like, Okay, you can do this. It doesn't require any explanation. And the teachers do a lot of sensory stuff on there, too. And it can be cleaned. So they're like, Oh, this is so easy, and teachers have a hard job. So giving them something easy.    Jayson Davies     It's good, right? You've been instead of asking as always There's always something that key into a teacher, right? The more you can give them, especially if it's a physical product that they can use. Yeah. You mentioned sensory, we kind of touched on that a little bit and OTs are creative, but what have been some of your favorite sensory activities to use alongside the cards?     Helene Lieberman     I would say wicky sticks is really good paint. I've emptied a nail polish bottle. Yeah, it's the nail polish. Well, I don't know if you polish your nails often enough, but the way just seems at the top seems to give me a great grasp and like, oh, and it is kind of interesting. emptying it out and cleaning out and paint and nail polish bottle. What is it wicky sticks. I've done food on it also pretzels, like, stick pretzels, and in circle pretzels and licorice and sticky things and skill.     Jayson Davies     playdough slime, all that fun stuff? I'm sure.     Helene Lieberman     Yeah, I've actually put it under let's say shaving cream. And the kids have to? Oh, yes. So they have to find the letter under there.    Jayson Davies      Like a sandbox or shaving cream sample?     Helene Lieberman     Yeah, just cover it in something and they have to use their hands to clean it off to find what's under there.    Jayson Davies     All right, for those of us who don't do our nails on a weekly basis, or monthly basis, or yearly basis? I as hearing you say that, is it easy to get off? Like because it dries right. So    Helene Lieberman     I still with paint, I take off the nail polish?    Jayson Davies     Oh, I get what you're saying you're not using nail polish using the polish?    Helene Lieberman     Yeah, actually, I've tried nail polish. If you get it right away, it comes off, it gets a little tougher. But Magic Eraser pretty much can take off anything eventually.     Jayson Davies     True.    Helene Lieberman     and the nail polish just chip off also. So    Jayson Davies     however, I imagined paint is a lot cheaper than nail polish.    Helene Lieberman     It's definitely cheaper and easier. And if the kids get it on their skin, it's much more washable.     Jayson Davies     Yeah, yeah, definitely. And if you have girls on your caseload, they might start painting their nails instead of doing the activity. That's the whole, we're trying to not distract them. But anyways. Awesome. Well, that's great to hear that, that you're moving forward with changing it up a little bit based upon feedback and making it available for everyone. And you just provided some sensory strategies and other activities that the people can try out if they do decide to use something like this. Alright, so that's kind of the program, I want to ask you kind of about supporting other occupational therapy practitioners who maybe have an idea out there, like this took you you already talked about like a decade or so to really kind of have the idea, have multiple ideas, put those ideas into your own practice and various ways and then eventually get to the point where you printed something out. And now you're selling it. OTs have so many ideas like we are constantly adapting a pencil or changing up a stylus or taking keys and moving them around on a keyboard, whatever it might be. So for OTs out there who have maybe tried a few things, do you have any suggestions for them as to you know, maybe one day could be a program? Where should they start?    Helene Lieberman     I think if you have a good idea. Or if you have, let's say if you have a problem, and you solve it with a good idea, other people probably had similar problems, and are looking for something to solve that problem. So I would think that it could be something that's a marketable, I think, talking to other colleagues and asking if they'd have the same problem and ask them to try the new method that you've figured out. And does this work for you? Sometimes it's a one off thing that just works for one child. And I think not being, I guess, scared of the ideas that you have, and being nervous that it's going to be looked at as Oh, that's a strange idea. But if it works, it works. It's not a strange idea.     Jayson Davies     Yeah, yeah. And I think a lot of times as an occupational therapy practitioner, we think, Oh, this was just for one kid. Like, we do it just for one kid. But if it works for one kid, it's very likely that it will work for many kids and the on the kids that you can potentially provide service to or even provide whatever that is to the teacher, the parent, there are likely others out there who may benefit. And so that's where, you know, reaching out to people talking to the teachers. Hey, is this helpful to you? I think that's a great idea.     Helene Lieberman     Yeah.    Jayson Davies     And then what about if they wanted to start getting some data on their product or their idea? Where would you suggest that they started? Not? Not necessarily, obviously, I want to say not necessarily using an IRB, you know, style data, but how do you recommend that they just start getting some anecdotal data?    Helene Lieberman     I would just say use your caseload, use your caseload and keep careful records of what you've done. So In a therapy session, tried to take pictures is something that I did without, of course, the child's face in it, you know, try to take pictures and keep a file and see if you notice a difference, whether it's in hand position or quality or whatever it is that you are, you know, working on, and keeping it in a secure place. And then really looking at it from quarter to quarter. And seeing if it makes a difference than trying maybe on another group of kids. And again, keeping your own anecdotal data, you know, writing it down, and then see if you find a pattern in something.    Jayson Davies     Awesome. Awesome. Well, thank you so much for sharing. Helene, this has been wonderful. We talked about like kind of the problem with handwriting in schools. And then we kind of talked about kind of the why and what you developed and how you developed it on. And then, of course, just kind of going over a little bit about helping anyone out there who may want to develop a program at all. Before I let you go, I obviously want to ask you about where people can learn more about yourself and the blackpack writing program.     Helene Lieberman     Okay, so actually, I'm meeting with someone tonight, to construct my website, I went spin a my next dream, I'm getting a website, it'll be called Black back. riding.com . I already have the name, but I don't have the website so they can look for that I am on Instagram, and Tiktok. And I have a Facebook page, and I will send those to you so they can look it up, I put up handwriting ideas. If somebody is using the program, I'd love feedback, especially if it's positive. You know, that's always good. But you know, negative too, because you learn from absolutely everything. You know, it's not just about you know, positive, you got to take, take it all in. So that's what I'd say the Tick Tock Facebook and Instagram and soon website. And if somebody's interested in getting a free download of blackpack, I did send you a link. So somebody can try it out and get a free download sample. And remember to have toner in your machine in your printer when you do that,    Jayson Davies      yeah, yeah, that's that's a it does take up some toner. So follow up to this really quickly. Maybe we should have talked about this earlier. But what about using the black back program as a PDF on an iPad? Is it similar? Or is it very different?    Helene Lieberman     So interestingly enough, it hasn't worked that I've seen. Okay, but I was just talking to somebody who wants to do an app with black back. And so that's something I'm thinking. Yeah, I mean, I guess you could,why not?     Jayson Davies     Yeah. Yeah. I mean,     Helene Lieberman     you're not gonna get like on some of the other apps, when you write on it, you're not going to get the same kind of results. But it's still good practice.    Jayson Davies     Yeah, yeah, absolutely. So very cool. Well, Helene, thank you so much for sharing all of your information with us your wisdom, really appreciate it. And again, I know that the black bag handwriting program is gonna help a lot of people out there. So I will put all the links to all the different things that we talked about today, everything from the right rate stylist to the different apps that we talked about to of course, your website, your Instagram, your Twitter, and all that over on the show notes at OTSchoolHouse.com slash episode 141. So that'll be an easy place to go find all of it, including that free sample of the black back handwriting program that you can get for yourself. So thank you so much. Really appreciate you being here.     Helene Lieberman     And thank you for having me appreciate the opportunity.     Jayson Davies     Absolutely. Thanks.     Helene Lieberman     All right, have a great day. Bye.    Jayson Davies     One last time, a big thank you to Helene Lieberman for coming on and sharing her experiences as a school based occupational therapy practitioner, and as the creator of the black backhand reading program. If you'd like to learn more about Helene and this program that she has created, be sure to check out the show notes at OTSchoolHouse.com slash episode one for one. And also if you really enjoy and just love occupational therapy and school based occupational therapy, be sure to check out our community for school based occupational therapy practitioners at OTSchoolHouse.com slash collab where we have over 100 school based occupational therapy practitioners, learning and growing together to be the best school based OT practitioners they can be. We would love to have you as our newest member and grow together. Thanks again for tuning in. We'll see you next time.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OTSchoolHouse.com Until next time, class is dismissed.  Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! 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 Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 140 of the OT Schoolhouse Podcast. In this episode, Lori Flynn is delving into multiple different aspects of understanding ADHD, creating personalized teaching plans, developing visual schedules, and fostering a supportive environment for every child. She also discusses the challenges and the practical strategies that can assist. You'll be equipped with some tools to create a positive and inclusive learning environment.
Join us as we explore these valuable insights and work towards making a real difference in the lives of these students! Listen now to learn the following objectives: Learners will understand the environmental Impact on ADHD Symptoms
Learners will identify the pivotal role of individualized interventions in addressing the unique needs of students with ADHD.
Learners will identify the overlap between sensory processing difficulties and ADHD, and distinguish between sensory interventions and breaks for children with ADHD.
Learners will identify the need for collaborative support and individualized teaching plans for children with ADHD, and understand the importance of integrating visual aids, recognizing strengths, and providing clear accommodations for optimal support. Guest Bio Lori Flynn is a practicing school-based occupational therapist, certified ADHD practitioner, and parent coach.
She is the founder of OT4ADHD.com , a website dedicated to providing school-based professionals with effective, evidenced-based strategies that facilitate improved classroom participation and performance for children with ADHD.
Her knowledge and passion surrounding ADHD is shaped by extensive ongoing continuing education and lived experience. Quotes “Teachers do well when they can.” -Lori Flynn, OTR/L “The children who do not have the hyperactivity piece… they're not being identified.” -Lori Flynn, OTR/L “I am not focusing on automating writing when they're older, because the speed in which the class is moving is so much faster than any type of game that I can ever build for that child.” -Lori Flynn, OTR/L “No, he doesn't need to try harder. He needs to try differently, because that's not going to work for him.” -Lori Flynn, OTR/L “For any accommodation that I am going to put on to that page, I'm going to make sure that there's a plan to actually incorporate that accommodation.” -Jayson Davies, MA, OTR/L Resources BRIEF checklist WISC-V Conners 4th Edition Chadd Visit Lori's website for QR codes to support the most common classroom issues. OT4ADHD website Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here's your host Jayson Davies, class is officially in session.    Jayson Davies     Hey there and welcome to episode 140 of the OT schoolhouse podcast your dedicated resource for practical strategies and actionable insight in the world of school based occupational therapy. I'm your host Jayson Davies, and I am so happy to have you here as we dive into the world of ADHD today. In this episode, I am thrilled to introduce you to Laurie Flynn, a highly experienced school based occupational therapy practitioner with over two decades of expertise out of need. Laurie has devoted much of the last several years to understanding and supporting the unique needs of students with ADHD in the classroom, making her the perfect guest for today's enlightening discussion. Like many of you, Laurie has seen a dramatic increase in the number of students refer to her due to concerns stemming from a student's ADHD. As a result, she took it upon herself to learn everything she could about ADHD from all perspectives, attending conferences, reading, online courses, everything. Now she's ready to share some of what she has learned with all of us. In today's interview, Lori and I will first discuss ADHD and some of the common areas of concern relative to ADHD. After that, I asked Laurie to walk us through a case study of sorts to provide valuable insights and strategies for evaluating and effectively supporting students who exhibit traits associated with ADHD. Specifically, we'll explore the impact of the natural environment on ADHD symptoms and its influence on standardized testing, assessment tools and evidence based strategies for supporting students with ADHD, including the use of the whisk to assess cognitive proficiency and working memory. And finally, we'll also discuss practical tips for fostering strong collaborations between OT practitioners, teachers, parents, and students to create environments conducive to academic success for students with ADHD. As an OT practitioner, evaluating and providing effective services to students with ADHD is crucial. By walking through the evaluation and discussing therapy interventions with us, you will gain practical insights and tools to tailor your intervention plans and accommodations that are conducive to the success of students with ADHD in the classroom. So get ready to use that 15 Second rewind button as Laurie dropped some serious knowledge today, and tune into the complete episode to equip yourself with the knowledge you need to support your students. Let's go. Lori, welcome to the OT, schoolhouse podcast. Thank you so much for being here. How are you doing today?    Lori Flynn     I'm doing great. Thank you for having me.    Jayson Davies     Yeah, I'm so excited. You know, I mean, it's probably been about half a year now maybe even a little bit more that I've started to see these posts to show up on my Instagram feed. And they're all about ADHD and how we can support students as occupational therapy practitioners in in school, those with ADHD, and I just love what I'm seeing. So I had to reach out and yeah, I'm looking forward to this. I hope you are as well.    Lori Flynn     I am that's great. I'm glad it reached you.     Jayson Davies     Yeah, yeah, definitely. Right. Like, that's what's really cool about social media, you know, it's, it's, we can get out there and share our, our message with the world. And I guess like the first thing I want to get started with is where you are as an OT today, and kind of how you got started with this Instagram with OT for ADHD.    Lori Flynn     Wow, all right. I am still I'm a practicing school based OT in New York in a teeny tiny school. And I started well, it's I've been practicing for 22 years. So I'm gonna say about half of my practice ago, I started seeing such an increase in students with ADHD, just in general. And then they were the kids that just weren't generalizing. They weren't generalizing what we were doing in our sessions, and back to the classroom. And now I started a long time ago. So it was pull out was the only way. I started doing OTs, which I have to, you know, evolved. But at the time, it bugged me that I just couldn't figure out why. So I started researching just on my own and doing some continuing education on each user tried to figure out that piece why they were one child in my room and a totally, totally different child in the classroom. And it would throw me so it really just started becoming something that I was upskilling on on my own for no other reason.     Jayson Davies     Yeah, that's awesome. I mean, that's I think that's how a lot of us get into a specialty area right like, we start a little abroad and then something starts to start to hit us in one way or another. And for you, it was, you know, seeing more students with ADHD and you just kind of went off and ran with that. I want to ask you then, for you, what was your preferred method for learning more about ADHD? Was it reading research articles? Was it buying books? I know you just went to a conference. But was that kind of what you did at first? Or how did you get started?     Lori Flynn     At first I was I'm a real big reader. I was reading books. And then I was reading research articles. And then I was, I laughed, because I was like, I'm not fun at parties anymore. I read the citations on the research article, and then read those articles. And that's becoming what I do at night. And I was like, oh, because there was no OT, ADHD information. I mean, what I had I exhausted in a day. There really just, it was not.    Jayson Davies     I love that you brought that up, because I still feel that way. Like, is that true?     Lori Flynn     And it is better. Okay, Canada, I get more out of Canada, even though it is true. When you do if you just like, go on a OTA and you research and you do all the journals. I mean, what you come up with is, is so on usable? It's like one woman with horseback riding and she had ADHD and let's write a research article. I can't use that in this. Yeah. So it was really missing. So I had it, I had to go outside of the OT field. And I think Russell Barkley historic there, I think everybody starts there. He's like, the king of ADHD research. And he just retired. And I've read everything appears. And then I just, it just keeps going. It was it was like a rabbit hole that I went down and just have never come out of. And it's been many years.    Jayson Davies     But right I mean, your your most recent Instagram post, as of today is a picture of a bunch of books from from the conference you just attended. So obviously, nothing has changed in regarding to your reading habits.    Lori Flynn     And I only did that because I did the same picture the year before. So I'm like, that's gonna be my leaving picture every year. Back of books on the hotel bed because they didn't fit in my suitcase. That was the problem I had last year. Not this last one. But the one before I had to leave, I usually travel with a pillow. I had to leave my pillow behind to get the books home. Because I had so many. And I had a carry on.     Jayson Davies     That is funny. That's good.     Lori Flynn     Sure. I love space.    Jayson Davies     All right. So somewhere below in Euro Deborah. All right. Well, now, as you mentioned, right, ADHD, and OT, we know that we can support students with ADHD. But as you mentioned, there's not a lot of resources out there. However, you are kind of taking on that role right now with your Instagram with your website. And so I'm excited to dive into that. But I want to ask you, you know, you had students, you started to see more students with ADHD. But was there one specific moment that just like dawned on you, hey, I need to do this. I need to be the one to create these resources for the students, for the teachers and for other occupational therapy practitioners.    Lori Flynn     Oh, yes, it was. It was one very specific moment. Well, I had already been studying and it was just on my own and I was just applying it with my own students. So it wasn't, you know, I was alone. Occupational therapists, like many of us are I just work with myself. You know, my speech therapist is my buddy and I just do my job. And I was at a CSE meeting for one of my students, one of my very favorites, but they're all my favorites. But this one I just bought. And we're at the CSE meeting and the teacher is we're talking about right handwriting because the handwriting it just sticks and you know, this child was done. This was he was in third grade. And the teacher, we were talking about the gains is made and she says, Well, he can write neatly when he tries. And I actually lost it. At this point, I had learned so much that it became dangerous. I had too much knowledge, and I lost it and I've never 22 years like I've never lost it at the CSE meeting I behave. And I snapped and it wasn't even because she said, and I just started lecturing. I didn't do anything really crazy. I just was lecturing and like without knowing your audience and the parents were there lecturing. But it was It wasn't because she said he can try harder. I got used to dealing with that every day. It was that she was a brand new special ed teacher, brand new that just came out of school. And I went home and I emailed and apologized. And then I opened a website. First I Googled how to open a website. Then I opened the website because they said I am going to just tell all the teachers like I have 44 teachers in my school like what you know, that's not even going to help and look Mic 44. And this one is just someone has to tell these teachers like they need this information. They don't know. And I just started just putting I opened up an Instagram, I made it OT for ADHD, I mean, there's no creativity, you could tell in that moment, I was just like, what could it be called OT for ADHD, good, the fo r was taken. So I just use the number for, like, this was all done in a moment. And I just start posting like one a day. And just things, anything that I just thought people should know. And I, from there, I just keep doing it every day, I'm shocked that I kept it going. But people were really grateful for the information. And I was dripping it in bite sized pieces, like a piece, just one little piece of information rather than these giant books that I was reading. So it really came out of anger, which so many wonderful things to do. But that's how I started it.    Jayson Davies     Yeah, I love it. I mean, as kind of scroll through your Instagram, right, you have like tip number one or tip for this. And it's just a very nice bite sized piece of information that you can take, kind of put it into your heart, maybe create a little mantra about it if you need to. But it's something that you can start to implement very quickly. So I love that I think we have all been in an IEP meeting or a CSE meeting where someone has said that right? Like, oh, he can write his name when he wants to, he can write when he wants to he can behave when he wants to he can whatever when he wants to. And I know every OT practitioner dies a little inside when we hear that because we know like we understand where that person is coming from whether it's a teacher, a parent, even another OT practitioner, but we also understand using a holistic lens, how almost inappropriate it sounds is almost like a four letter word for us. Right? Like, that's just hard for us to hear. And so, as you mentioned, you've heard that countless times. And so I'd love for you to kind of take us into the moment like how does that really make you feel? And what are you hearing when someone says that?    Lori Flynn     Well, kids do well when they can. So I mean, I think we all know Ross screen and kids do well when they can these, these students are just so misunderstood. And they want to do well. And they don't even know how to do well. They don't know why they're not doing well. And I hear it from preschool teachers. There is not a preschooler in the world that doesn't want to do everything. Well. I mean, it's like, I do it, I do it. That's what preschoolers say, let me do it.     Jayson Davies     Yeah,  Right.     Lori Flynn     So it just the fact that it's mistaken for a will based condition is actually the most damaging thing that is what creates the secondary complications with ADHD. And that is what really I think fuels my passion for it. Because there are so many things out in the world that OTs help people participate in perform, and that we don't have control over. You know, if someone has hemiplegic arm, I can, I can help them, but I can't prevent more damage from their arm. But with ADHC the humans in the context of this child's life actually have the power to prevent just by their own beliefs. And it is really just we have we have more power in the schools and more control. And I say we I mean teachers over the outcomes than we even know. So if we knew we would all do better, because I did have one post that said, teachers do well when they can. They don't know. Yeah, they don't. And when they find out they're like, huh, I see what you mean now, but it takes a little while. But once they know, then they know. And yeah, makes it changes the the entire prognosis for the child?  that's a lot of power.    Jayson Davies     Yeah, and we're gonna get into a little bit more about strategies here in maybe 20 minutes or so. But I kind of want to dive into those challenges of what, what we see what teachers see. And I don't I don't want to over generalize. I know every student with ADHD is different from every other student with ADHD. But I'd like to ask you, what are some of the common functional difficulties that you see students with ADHD having as it relates to, you know, progressing and participating in education    Lori Flynn     in school? Wow. It's very prevalent. So you're looking at about one in 10. So that's two to three in every single class. And he is extremely heterogeneous. I mean, extremely. You can have two kids sitting next to each other and they appeared to have And incredibly opposite profile. And they both have ADHD, and comorbidities or CO occurring conditions with ADHD, change the whole picture. So you have a boy with primarily inattentive, impulsive presentation, ADHD, and dyslexia is going to have way different challenges than a girl that's also twice exceptional, and has ADHD and is just inattentive, they look totally different, but it's the same thing. So the challenges are really all over the market what, what ADHD really is, is a neuro developmental difference of self regulation and executive function. So it touches everything in school, and executive functions develop throughout the entire school, they don't fully develop into your mid 20s. And there's a great variance with executive functions to begin with. So little kids with ADHD are the kids that a lot of OTs are approached about, they look like they have sensory problems, they have self regulation problems, their transitions are the worst possible thing. They're melting down emotional dysregulation, you're seeing that in the younger grades. And then hyperactivity for children who are hyperactive, you'll see that and you know, they can't stay seated. And then you see a ton of internal distraction and rumination and more of that emotional anxiety dysregulation. And then as they get older, that hyperactivity decreases in adolescence, and there's like a studies of this the progression, and it kind of goes inside. So then it's more in your head. And then you're seeing the disorganization the difficulty with time, then they're talking more about that the teachers, so really depends on the age and stage, and what else what other conditions are present as far as their challenges, but it is, it's all over the map. And and the children who do not have the hyperactivity piece, are the ones you really do have to worry about.     Jayson Davies     Why is that?     Lori Flynn     Because they're not being identified. The stereotypical bouncing first grade boy that's always got an October birthday, and he's a lefty. I don't know why, but it's just always that profile. That to be a study, that guy gets help. That guy, you know, the teacher is like, what is going on, you know, he's hanging from the ceiling, he gets help, but the one that is in the corner, and it doesn't have to be a girl, a lot of females have, that are late diagnosed adults, you know, we're quiet, they are not a problem. You're teaching a class of 20 to 30 kids, the quiet kid is not your problem, like you're not even paying attention. And they're struggling. And no one knows they're struggling. And that that becomes anxiety and depression later on the untreated piece. So we really need to be very careful when we're looking at children that are struggling, and disorganized and forgetting things and having that very inattentive presentation, but that aren't a problem and then are having emotional problems, they really need to be looking at what's going on with these, these kids.     Jayson Davies     Gotcha. Great. Thanks for sharing that I based upon kind of your response to follow ups here. Take them one at a time. You started with that very first kid that really got you going. You mentioned how people were saying, Oh, he can write when he wants to. Obviously ADHD is not a motor disability, right. However, I think we have all experienced kids with ADHD who struggle with writing. You mentioned a little bit about self regulation, emotional regulation when it comes to ADHD executive functioning. Where's the connection between ADHD and handwriting? Why are us why is it that UC students who have poor handwriting have ADHD.     Lori Flynn     So the connection between ADHD and handwriting, which is like, super fascinating, and you'll jump right into the rabbit hole with me is working memory. It's working memory, and it's huge. So the entire writing process is governed by working memory. There's a triangle picture the triangle between transcription which is handwriting and spelling, and then written expression like where you're taking all your thoughts and you're making an an order an essay out of it, sees everything, sentences, everything, it all plays on that working memory. You have to be able to hold things in mind before you can transfer them to long term schemas. graphemes phonemes all that it's called ortho graphic. I can't organization it's so that working Memory governs writing. It governs handwriting governs learning the letters. And then it governs being able to write words and sentences. And working memory is indicated as being one of the things that the developmental difference in the prefrontal cortex impacts. So the reason why children with ADHD have difficulty with handwriting, maybe the motor piece, but it's really, that we do a really good job at helping with that as therapists. That's what I was seeing. I was like, Oh, I motor skills are fine with letters in isolation. As soon as you have to put those letters together and start moving across the page. They're gone. And I was like, it's a sequencing sequencing thing. Now, it's a working memory thing. And working memory is limited in the neuro typical adult, to three to four pieces of information at a time. It's not very big. Yeah. Typically, in a student with ADHD, it's like one, it's like one piece of information at a time, one step, then give them the next step. And it's, most of the help is compensatory in nature. So when they're saying he needs to try harder, I'm like, No, he doesn't need to try harder. He needs to try differently, because that's not going to work for him. And that is, it's a huge wow moment for teachers, they really do understand that working memory piece. And if you're like a research, person, burnin, burn injure, she's the best.    Jayson Davies     just had that off the top of your head, you know, working memory for injure?    Lori Flynn      I do actually.     Jayson Davies     I love it. I love it. No, you know, that resonates with me, I've sat in so many IEPs, where I try and break that down for parents and teachers, right? I don't think I've ever actually said the words work in memory. But kind of like you said, right? Like you use the word sequencing or something like that. And you try to help parents and teachers understand that writing is so much more than just putting letters on the page. And, as you mentioned, we can hold three, four, maybe five things in our brain at a time, kids much less. And when you really break down the tasks of writing. If you don't know how to spell the word, the t h e, you don't know how to put it on paper before that every single letter is like 18 steps from the brain to the pencil to the paper. And we sometimes have to help parents to understand that and teachers to understand that which is it's hard. But it's something that we sometimes need to speak up in an IEP and tell them about     Lori Flynn     Yes, and if they haven't automated, so if they automate their writing, if they automate letter formation, which typically they're supposed to by third grade, automate those letter formation, so then they can use them to learn, you know, you're not reading, you're not learning to read and write, you're writing, reading and writing to learn. So if they're not automated, each one of those letters are an actual task. So you could have two or three, and then you're done, you're overloaded. And once your working memory is overloaded, you're nothing else is getting in I, in one of the post, they made it like a iPhone battery. Like when it's iPhone memory, when it's full, it's full. Nothing else is getting in. So when you overload that working memory, with non automated tasks, the other things aren't getting in. You're not ignoring them. You're not not listening. They're just not getting in. And it's like when you walk into a room, you're like, Why did I come in this room? Like that's gone? Whatever the reason was, it's gone, because it never got in. So you go back to where you came from. And you look around, and then that same thing. Well, we spark what it was that you went into the other room for. So that's why the writing, and it's, it's great.    Jayson Davies     Sorry, Laurie, as soon as you started talking about the iPhone memory, my brain went to I keep getting emails from Apple saying I have 10% left on my iCloud storage. And my brain was full at that point. But no, really, though. Let's continue on. So we talked a little bit about that handwriting, that motor piece and working memory being such a big part of handwriting. I think that's important, right? Because a lot of I mean, I think we've all Yeah, we've all been in a conversation where people whether it's an OT a teacher, someone else thinks like all OTs do is motor and sensory, but working memory is definitely something that we can touch on. And we'll come back to that in a moment. But I do want to ask that other question that I had was about sensory. Is there a sensory component to ADHD? Again, you talked about self regulation, executive functioning, but you didn't mention that sometimes. Someone might approach you thinking it's a sensory difficulty sensory processing difficulty. So is there a tie is there not a tie? Talk to me?     Lori Flynn     So children with sensory processing difficulties and ADHD there is a huge overlap. They can have both. But ADHD is a developmental difference in the prefrontal cortex of the brain sensory processing is not the same. When we use sensory integration, that doesn't help ADHD. But you are going to have lots of people with ADHD that also have difficulty processing, you know, sensations. And they're also highly sensitive, they have poor, so you know, selective attention skills. So they're taking in a ton of input, and then having difficulty regulating the input. So it is, everything is sensory, everything is behavior, you know, so it's very hard. But you can't say, oh, I'm going to put them you know, in an SI gym, and that's going to help his ADHD, because it will not help his ADHD. But when I go into a classroom, and the child's highly distracted, and I give them sound blocking headphones, that's technically a sensory intervention, but I'm giving it to that child to block distractions. For so it's for a different reason, or a cushion. Because when students with ADHD sit on the move and stick cushions, they get to move, and they do better when they can move. But it's not because he's sensory seeking. It's because he has ADHD. So sensory is almost like a symptom of, you know, the side effects of ADHD. But they but they have to be distinguished because there are studies out there that say, occupational therapy does not work for ADHD in the schools. And yep, I actually wrote to the person that did the study, because it was so inflammatory. And it was they gave the student weighted vests and the therapy ball. Right? Those were the two interventions that they did a research study on. And they didn't, that was it. And then they called that those two pieces of equipment without any training, they just kind of like gave these kids, they call that OT, that's not OT yet, it wasn't FIU Sorry, I was really mad about the study. And it was just it was wrong to do that. So, so we have to be careful, like, this is why I am using this. So if they do, they're extremely, you know, co occurring, especially sound sensitivity. I see that quite often. But the reason for using equipment, or for taking a break, it's not it's not a break, because he's sensory seeking, it's a break, because he needs a reset as executive functions and change environments so he can re engage. So it's, it's the same but different. If that makes sense.    Jayson Davies     Yeah, yeah, absolutely. No, I don't want to almost for the rest of the podcast, honestly, it's it's I think we might kind of go about it as a case study per se. And I want to start with that in the sense that if you receive a referral for a student who's maybe having some difficulties with handwriting, maybe some behavioral concerns, no real diagnosis, and you think that, you know, ADHD may or may not be a factor. does that manifest within your evaluation? Does your evaluation look a little different? Or I guess, like, what are you looking for in your evaluation? And how do you look for that information?    Lori Flynn     So my evaluation has changed greatly not even because of this research, just because of the new direction of OT my evaluation is, is very functional based. Now, I could care less what the bot says like that is really as no part of what I'm doing in the school and little part like I do kind of curious, but that's about it. I look at what it is, what the problem is in the classroom, what what is, what is the expectation? What is the procedure, the procedure and procedures are everything in school, and if you look at there's 40 of them, right? 40 procedures, these kids have to know in a classroom, like they have a procedure for sharpening a pencil for coming in. There's just procedure procedure procedure. That's how they run, it's you. You have to have them.     Jayson Davies     Yeah,    Lori Flynn      that's how good classrooms run on their procedures, and which ones are a difficulty. And then I go back to why. And I look at the student, you know, developmentally, I look at I do the occupational profile, I look at executive functions because there's no getting around them. They're in everything. And I could use depending on the age I could use a standardized tests, I use informal, I use interview, and then I look at what it is that I see clinically which I've been doing this a long time. So it's kind of unfair, compared to someone brand new, but clinically, I can see alright, this child might be having difficulty with let's say visual processing or fine motor or sensory or executive function. And then I would go a little deeper to try to uncover there. And then the ADHD piece is usually pretty obvious to me only because 70% of my caseload has 80 So I just I, you know starting to be like okay, to the point where I'm like, why is everyone have like it just me I'm like, what I do, but it is that it's a 70 70%. It's 80% of children with ADHD have another condition. It's rare for someone to just have ADHD all by itself. So they're on my caseload mainly because they had difficulties with difficulty with fine motor development. And you know, I'm working on that with them, or Developmental Coordination Disorder, that's, that's a big one that likes to go hand in hand. And those two together, very motor skills are very difficult for these kids really difficult. And then I go from there, and I'm all about, let's get them doing it. Let's get them doing it. I'm strength based, you know, let's get them doing it in a way that works best for them. Because this is lifelong. And the American Academy of Pediatrics, that chronic care model is not, you know, let me spend the next six years of my life working on these fine motor skills, I am changing the occupation, I'm changing the task, I'm matching the child to the expectation, and I'm saving their self esteem. And I think that's what OTs are supposed to be doing in the schools, but we forget, especially me who was trained with performance components, like it was, you know, back in the black and white days, it was a long time ago. And I would go in and say, Okay, what are the performance? What are the breakdowns? What are the weaknesses, let me fix them. But it won't generalize, because the working memory, and it needs to be in the classroom, and you need to match the kid. So it does, I totally went off tests there. But it's, it does it really,     Jayson Davies     really fun. I want to challenge you here, then, because you put some emphasis on working memory. And as you know, not everyone listening has the 22 years of experience as you do. And the bot doesn't give you working memory, the SPM doesn't give you working memory. So if I may, maybe one or two things that you kind of do specifically to look at working memory.    Lori Flynn      Alright, so even more interesting observation in the natural environment. So have you ever had a child that you take them to your room to evaluate them, and they do amazing. I mean, they're all of the standardized testing is like off the charts. And we're like, I saw this child function in the classroom with my own two eyes. But on paper, this is a superstar. That is what we're dealing with, with ADHD, because your context in the novelty of the one to one environment sparked everything, and they are running at their tippity top best. And they are, they are remembering, they're answering questions. They can do everything on all of your tests. But then you put them in the classroom, and it's gone. Because they're overloaded, and they can't perform in that context. So you get more from your observation. And you get more from when it comes to executive functions, because you can't really test them outside of the natural environment, because you're in a different environment. So that right there, the demands and expectations are totally different. would be like the brief. The brief is a standardized test that you can email the teacher, for some reason I get those back like instant. Sometimes you have to chase teachers down for, you know, for checklists, this one I guess it's just such a friendly format to fill it out. And we boom, I never it's never been even a day they get right back. Party Connect has it like where it's like a queue global type thing. So the brief works great, and it will give you different scales about the working memory.     Jayson Davies     Okay.    Lori Flynn      And I steal from the school psychologists from the whisk. And his I have never I spend more time I think I read I think I read his report when he does really study it.    Jayson Davies     Reports Oh, yeah, I love like reports available.    Lori Flynn     I'm at the point where I'm like, I'm not testing them to the SEC reports done because it gives me so much information as to where the strengths are, where and you're always gonna see the working memory is low cognitive proficiency as well. processing speed may be low, the coding, that's all that that piece there. So when you see that on the psych report, it's also it's a piece of the puzzle.    Jayson Davies     Can you say that one more time, you know, for everyone,    Lori Flynn     the WISC five, there's actual there's actually studies. I'm such a visual person, like I'm actually looking at the picture of it. In my head, I want to show it to you and I keep forgetting we're on the WISC five you're gonna see lower scores in coding, processing speed, which is the cognitive proficiency area of the wrist, and the working memory, you're going to see those lower than everything else. So the child might be like in the most of my students, I actually charted them, like 99th percentile in the whole thing. And then there'll be in the 40s     Jayson Davies     Oh, wow.     Lori Flynn     So in that, which nobody would say that's a disability. But oh, Have you noticed there's a little glitch in the sub tests and like, Oh, that's not a glitch, that is exactly what we're seeing in the classroom. And it's that cognitive proficiency, they're not able to apply their intelligence in the moment. And it's, it's very interesting. And they actually the WISC five takes out those the coding the working memory, the processing speed, to get it to get the I know, I don't want to say it's crystallized intelligence is another word for it to get a different intelligence score, that's usually higher, because it brought that down. And they'll use that for students that have ADHD.  Interesting. Good to know when something new. All right. That's right. All right. So now, if you've done your evaluation, you started to, you know, tease out some of these items. Before we get into the intervention side, I actually want to ask you about the IEP or the CSC meeting itself. Everyone should know if we've worked in the schools for you know, six months or longer, we can't go into an IEP and say, Hey, your student has ADHD. Right? So how do you present to a parent, especially if it's a student who hasn't been identified as ADHD? How do you kind of present that to them and say, These are the types of things that we want to work on? Because can't use ADHD? So how do you how do you word that, I would never say to a parent, it is not my, it's wrong of me. My school psychologist can do that all he wants. But they do, they'll give him the Conners if that's a concern, and they'll take the Connors which is a ADHD screening to the pediatrician,     Jayson Davies     okay,    Lori Flynn      because nobody in the school would diagnose someone with ADHD. But they would say we are concerned with his ability to attend to this that the other thing, he's an attentive this is we're showing all this, you may want to bring this to pediatrician. But to be totally honest, I don't even care if they have an ADHD diagnosis, it does not change anything I'm going to do for that child. Because whether or not they're identified, which I do believe it's very important to be identified with that, even just just to know it does put a name to what's going on, depending on the age and for the parent, I'm going to work on whatever the thing is in the school, they're having difficulty performing whether or not they have ADHD, it just lets me know that I'm going to have to use a little bit of a different type of intervention. So I'm still working on the same goals, I just know that I am going to work in the classroom rather than out of the classroom, I need to be at the point of performance, I need to have much more teacher and parent buy in than I would. And I need to be looking at a strength based, very protective, very lifelong, build my own skills type practice, rather than like let's, you know, teach, play these games makes our finger muscles stronger, and go. And they need to know that when they're little I am going to automate those writing skills like you've never seen, I'm going to really focus on automation more than anything, because I want that off their plate. I want to there's a lot to know as an OT. So it's not that I'm going out there and treating all the kids with ADHD I actually don't treat ADHD I treat a student so they can participate and perform in their school environment, whether they have ADHD, dyslexia, you know, lefties with October birthdays, they're all you know, it doesn't matter. It doesn't the fact that I have like branched out more, and I help train parents and teachers, but that's the only way it really matters. Otherwise, it just changed the way I approach my intervention. Because they have more information.    Jayson Davies     Yeah, great. I love that, that that's    Lori Flynn     mind blowing.    Jayson Davies     Yeah, you know, it's something that, again, if we've been in the schools for more than a few weeks, then you've been told by someone like OTs do not make diagnosis is I mean, we diagnoses we don't make diagnosis, even outside right? of schools. But we have to be very careful not to make diagnoses, we also have to be sometimes very mindful of not making a referral, right. Like, we can't say, hey, you know, there's an OT that specializes in ADHD on first and a street, you know, go check them out, we have to be careful about that as well. So yeah, thanks for sharing a little bit about that. Yes. Now, let's move on to that next piece. Right. So you have this data, you've talked to the IEP team about needing to provide some supports, there's many routes that we could go from here, right, you talked about how you're going to treat differently based upon your information. What are some things that you might consider, let's just dive into considerations, not what you would do, but what are you going to consider as you develop your service model type of plan.    Lori Flynn     So I'm at the IEP meeting for this new student. Yeah, right. So I would be the accommodation shins become to even ever be at the year at the initial CSE meeting, and everyone's gone over their reports, right. And it's always running very long when every single person's going over to initial, and then you get to the end, and they're like, did any accommodations? And they seem, I don't know, it always just seems like an afterthought like or did and so I started reading all this, like any account, especially for the younger kids that don't have testing really any accommodations, people throw it at preferential seating and focus redirect, that's where I go, Whoa, let's go back because we need to make this environment match this child. So most of what I do in a CSE meeting is get really crystal clear on accommodations, and how exactly they're implemented. And in New York, we have like this box for management needs. And that thing is, it is like bulleted down half a page from me. Rather than it was it just would be like, Sally has poor fine motor skills, she needs help. Like, it's not like that anymore. Um, because this is what is going to help this child. So that's the big difference. To see is I put a lot of I'm very mindful about the accommodations, but more so about the implementation guidance, because what does refocus and redirect me? What does preferential seating mean? I people actually think it means they get to pick their seat like that. Is you better? No, that's not what that means.    Jayson Davies     No, no, I'm just I'm going on because I love where you're about to go. Because I do the same thing. I mean, I have half a page of accommodations. But for any accommodation that I am going to put on to that page, I'm going to make sure that there's a plan to actually incorporate that accommodation, because too often, you put an accommodation onto a page. And then a year later you come back for the IEP team meeting. And someone asks, How has this been accommodated? How has this been implemented? And everyone looks at each other? Like, did you do it? Did you do it? Who was the one who taught him how to use speech to text? He was the one who taught him how to use that feature on the test. Right? So So what do you do then?     Lori Flynn     So I don't do a half a page accommodations. I keep my accommodations small. And they really I have data to prove everyone because we have to remember these are a big ask have teachers accommodations. And I basically in with the younger kids, where it's one classroom teacher in their class, but if you think of middle school, high school, they have hundreds of students with hundreds of accommodations. So you have to be very careful. It's the implementation guidance, like you're saying the plan, that is a half page, like you know, exactly. If I put an accommodation on an IEP, you know, how to how to exactly how to provide that accommodation, there is no question that you're not wondering where that this child should sit, sit in a classroom. You know, what, where, and you know, why? Do you know exactly why, and I think that's super important. Because when you know why you're going to do it, we're likely to do it.     Jayson Davies     Yeah,     Lori Flynn     yes. And then the child is going to accept it, because kids hate being other. So it accommodations really are very important thing that get very, you know, swept over. And that that's, and I also know most I don't know, T has to go and do this. This is my own craziness. But I work in one small district. So I know who the teacher is, there's only two there's a choice, you have a 5050 shot for next year. So I know who the teacher is. And I write out a cheat sheet for each one of my students with all their accommodations. And like ways I do it like at the CSE meeting, like as we're talking, like what's working for this student now. And being that I know that teacher and I know how they teach. And my kid just had that teacher I know exactly what they do. And I think this is because I'm in a small space. I give them a IEP cheat sheet, I call it or the 504 cheat sheet for school starts that has made I tell parents to do that for their own children. Because it has made such a difference to have it just bulleted this works. This works. This works. This is what I mean, this happens when you do this. This is great. And the teachers it really does help open collaboration with them because they're like, Thank you. You know, I have 4040 IPS three like this was so nice. I could just so often read the IP legally but like I can apply it immediately. So that that helps have a question    Jayson Davies     then because I consider this I don't think I've ever actually done it. But basically to create a an IEP goal for an accommodation to be implemented. Now. I don't think I've done it that specific. I think I have done some like self advocacy goals right where the student will access accommodations. on AP or something like that, but nothing specific to an accommodation is that something that you might do, or because you're doing this cheat sheet for teachers, you haven't needed to do it,    Lori Flynn     I've written well, if you're going to use an accommodation like speech to text, I really do hope you have a goal. Matching that one, because you need the child needs to know how to use speech to text with a certain level of fidelity for to being, you know, anything even close to helpful. So they are, I will always have a goal. And that I will put the accommodations that the child has access to speech to text, not that they have to use it, because that means they have to use it, you have to be very, it's the legal document. So have access to, and then they will be trained as a goal. And they can use use it when they have a certain fidelity at home school. But I have never, outside of the self advocacy, I when I've written a goal that was like the child will choose from a visual choice board, like, you know, three out of three, like where to take a break in the accommodation break, like that type of tying together the goal and the accommodation. But I've never been so specific, like the child will tolerate their accommodations and use them. But you know, self advocacy, and that's so important. But I do have a funny, I do have a funny, 504 story. Saying that. So I had been working really hard on self advocacy with a certain student. And they kind of took it too far. Like they really own their 504 Like, this was like their cake. And I was always happy. You know, they're using their 504. And they're always talking about their 504. And they got in trouble. That the kid was at a sleepover and got in trouble. And the one kid got his phone taken away. But the other child, you know, supposedly nothing happened to him, you know, because he had a 504. So he had trouble with his parents. Wow, that's over. Yeah. He said, Well, he didn't get grounded, because he has a 504. I was like, Whoa. You guys have taken the 504 way too far. So, you know, ADHD is your it's not your fault. Right? It's your responsibility. ByVal floors are not about what you can't do. They're about what you can do and how you can do it. So it took a I learned that the hard way. I'll never forget that.     Jayson Davies     You know, and if I recall, you're only you only have to live by the 504 rules if you're getting federal funding. So where are those parents federal funds? I want some of that federal funding. Right now. All right, cool. So we've talked a little bit about accommodations, I kind of also want to talk to you about environmental factors, and maybe some things that you might consider, aside from the accommodations, just general environmental adaptations that you may recommend to a teacher potentially.    Lori Flynn     So the first and foremost best environmental factor in a classroom, a couple. Alright, so visual schedule, visual schedule is like a, like a magical wand of help for just everybody. If I can go into the classroom, and I see, I can walk into a classroom, and I know what I'm supposed to be doing. Right now, at this moment, without talking to anyone I can look around and know that that child's going to really thrive in that classroom. Because this teacher is has a very structured classroom teaching, you have a visual schedule, you know what's coming up next, you know what you're supposed to be doing now. And the I love the ones that use the slideshow, it's like agendas, like oh, you know, it's math you need and then the I mean, you do it once, and you have it for the rest of your life, you just have this thing going, that is an amazing environment. But these students do very well in structured explicit environments. flexible seating is dreamy, and, but they can they can function without flexible seating, but I don't think they can function without the visual schedule. If a child has difficulty holding things in mind, and everything is being told to them verbally, these children really, really struggle with that. And that's all they they mean, most brilliant child you have in the room and they you said put my name and then you said put my last name and they only put their first name like that. All that verbiage isn't getting through. So to have things externalized essentially steps to all the procedures and routines. That is where we're going to see it's I call them visual schedules, but the visual schedule of where now later what I need, and it's just always visible. So if you get distracted, you come back, do you know where you are?    Jayson Davies     Gotcha. So making it easy for the child to find what they're supposed to be doing in the Moment.     Lori Flynn     Yeah. And what's coming next? And what's coming next takes a lot of the anxiety away.    Jayson Davies     When you're saying visual schedule, I think of like, literal pictures. Do you think it needs to be to that extent? Or depending on the grade? Can it be just like a, you know, words? And like, what? How do you sort that out? Or do you prefer one or the other?    Lori Flynn     I prefer the pictures. For a couple of reasons. The pictures give us a visual image of what done looks like. So that's very hard to imagine, if you're having difficulty holding things in mind, like, what does done look like? So when you have the pictures, you're able to almost children with ADHD have difficulty with episodic memory and future thinking because of that, that working memory. So it's hard for them to picture anything besides now, everything is now is now or not now. That's where they're living. So giving them the actual vision of the future, which is like the done product. What's next, in the picture form really, really helps it scaffolds learning. Yeah, do I want like the little peck icon of like, you know, math with the little numbers? Nope, you know, but a picture of the math books that they're supposed to have would be amazing. Because now they're going to build that visual memory    Jayson Davies     you're honest Canva and many other tools make it way too easy now to have to rely on specific programs.     Lori Flynn     And I could use video or canvas like the best thing ever    Jayson Davies     educators free account all you have to use your your work ID or your work email, and you should get a free Canva. Like the full thing, not the not the mini mini Canva. The full canvas software. So yeah, absolutely.    Lori Flynn     A picture of the desk, clean your desk. Right? Clean. It's time to clean desks is one thing in words and let's talk they're a great we can read. We know clean desks. But if you have a picture of what a clean desk looks like, you have solved the world's problems there. Because you're helping so many kids like Oh, stack the books there like that. It's just, we're not all aware of how many steps a clean desk really is, even though most teachers think that's a step. So with the picture, exactly.    Jayson Davies     like, yeah,    Lori Flynn     yeah. So yes, it's very different.    Jayson Davies     Yeah. All right. So you I think you said that there might have been another environmental factor that you really liked to look into, you talked about the visual schedules, you're kind of on the fence, it sounds like you might have more than one. So I wanted to see if there was one more that you wanted to talk about in relationship to the environment, setting up the environment for success.     Lori Flynn     Setting up the back was, well, it's really more in the human context, it's the understanding piece. So it doesn't the environment, we need to expect that a child with ADHD is going and it's impulsive, is going to be impulsive. So when they come in, we are anticipating impulsive impulsivity. And we're anticipating the roadblocks and we're anticipating and setting up the environment with friction, you know, using it to and from, they talk about choice architecture, right? Like that's a consumer thing where they put you know, the grocery store has all like the junk food on the outer eye, the inner aisles, it's that you could do that with the classroom, it's the same thing you want to nudge children to make the right decisions. You don't want to have cupcakes sitting on the counter next to an impulsive child and then expect them not to eat the cupcakes like that come up, like but that type of stuff, just pointing it out, like let's, you know, put them here, put that here and nudge, nudge them and decrease the overload. So I always say like, the Plan B is the roadblocks when you look as the adult in charge of that child. And you look around for for those you're expecting. You really do set them up with success. So that's the big one is the just structured environment that is, you know, has I call choice architecture like it is nudging the kids like they don't have you don't put their supplies across the room. You put those supplies right at the desk, you any they're gonna if they're going to get a pencil they are not coming back like you cannot like the pencils are sharpened and ready to go like and that you're going to save that lesson just by having those pencils there. Do not allow that unsharpened pencil No, you're losing them that period like that type of thinking process and you need to have that by accepting. No I accept this student is going to be distracted. I'm ready. Let's do this.    Jayson Davies     We've all we've all seen that kid that takes 15 minutes to sharpen a pencil. Why? Yeah, yeah,     Lori Flynn     the bathroom trip.    Jayson Davies     Oh, yeah,    Lori Flynn     my OT room is near the bathroom. The OT room is near the bathroom. And I you know, it's fun looking. And I'm fun and the kids come wandering in. And I'm like, where are you supposed to be, the bathroom? Jump for a minute?     Jayson Davies     Yeah. All right. So we've covered some accommodations, some environmental aspects, structure pneus of the classroom. Now, let's talk about the actual services, you've dropped a few hints in regard to some things that you might key in on in regards to providing services for your students who, who who have ADHD or are struggling with some executive function and what not. But what are some things that you're going to consider very important when it comes time to choosing the type of services you're providing?    Lori Flynn     So depending on all the different factors, right, so they're, they're having difficulty. So I, again, I don't treat any type of diagnosis, right I treat the student is having difficulty with let's say, he's having difficulty with written expression and organization. It's just like, what everyone's having difficulty with that a treat. So I could work on written expression in organization in my room, but that is not going to help them in the classroom with 25. Other kids, they are going to be very well organized in my tiny room with just me, and they're going to be very well written in that extremely individualized novel, like totally speaking to their special interest writing prompt I give them it's going to be the best thing ever, because I know how to, you know, get the engagement. So I, you really need to be pushing in, which I know is so hard. But working with the student at the point of performance, anything outside that that point of performance is now going to say they need help in the now because time is now or not now, they need the help now. And they need it in the natural environment. So a lot of my sessions, I've learned this hack is that I put it, this all depends on your school and your IEP coordinator what it is they change like daily. So I put like, one in one out on the IEP services and the IEP. But it used to just put various locations. And then because they were they don't want that anymore because of the torque. So now I do one in one out. And because I there are some things, I still need to go back and skill build a little bit that I can't do in the classroom with everybody else. And it and so that one in one out, really, really helps me or does the three to one model, like the three times a month     Jayson Davies     three times? Yeah, I like to I call the one in one out that you're talking about I call it two to two because I think of in a month. So I call it the two to two model to kind of like the three to one models in a month. I called to to to one in one out one in one hour kind of going back and forth. So yeah, but yeah, I like that model. A lot.     Lori Flynn     Yeah. And if you need to be in more, you're okay, you don't have to go out because it's least restrictive. And I always put group because I do want them to do things with other people. But if I, if we need to work on something privately, you know, we could be individual. And then once a month, teacher console time that I vote that's on the IEP for every one of my kids, because I'm done. I'm done. I need the time to talk to the kid to dictate to the teacher. And I can make the time by doing that the teachers can't. So if I don't put it there, we're not talking. It's very interesting.     Jayson Davies     Laurie, you just became my best friend. No, I completely advocate for that as well having that extra console on there. Because if it's not on there, then really it's not required. And if it's not required, it's not going to happen. So,yeah,     Lori Flynn     and I've gotten subs for my teachers, so they can consult with me.     Jayson Davies     Oh, wow    Lori Flynn      that's how you make best friends with a teacher? Yeah. Like, I'm not gonna take their problem, I get them a sub. Can I have a sub for this period? We need to really work together on this, of course, and someone gives them a sub and then it's not taking away. There's little strategies that are there to help them. That's our job. We are there support? Where support?     Jayson Davies     Yeah, and again, if you don't want that on the IEP, if you don't put that on the IEP, it might be that much more difficult to get us up. I mean, it's hard to get us up in general, but at least if you've got console on your IEP, and you can tell your administrator Hey, I've got eight kids that I need to console with this teacher for then then you can justify potentially that sometime. Yeah,    Lori Flynn     we have. I mean, and a lot of schools have really, I'm going to say that in the past five years. I've seen a movement for more of the collaborative team model. Just in even just my tiny school like where we have like bi weekly to In meetings for like a classroom that has a lot of students with speech OT needs VC needs, and we all meet as a team. And that's talk about it. That's like a game changer. It really puts everyone on the same page. It's really amazing. So the more we see that I think the more it's going to be, well, of course, you need console time with the teacher, like it would be ridiculous not to have it, where it was like, What Why do you need that? What do you mean? And, you know, I have worked, where I never spoke to the teacher until the annual review. And then I would leave the annual review and go, Wow, I didn't know that about so and so I wish I would have talked to this teacher sooner. Do that a couple of times. And you you learn how important it is. But it's hard to to advocate in the system. But it really is a great model. And it's once a month. So if you have multiple kids, you just put in two slots into your schedule, and you can you wind up being able to see all the teachers like on a revolving basis.     Jayson Davies     Yeah, yeah, absolutely. All right. Let's, let's take, maybe Lori's time back a few years before her schools weren't so collaborative, and you weren't meeting with the teachers all the time. And you were just starting to push into the classrooms. That's hard, right? For those who are not yet pushing into the classroom? Do you have just one or two tips to kind of get started with that to make it a little bit easier to start having a productive session in a classroom?     Lori Flynn     So, teach the whole class that's going to teach the whole class, you do something fun. And the kids like you, you get the buy in of the teacher? In that moment. You're doing stuff for the teacher, you're helping the teacher, I have walked into a push them where they were reading a story, and I stood and watched. You know, the teacher read the kids a story and dying inside like, Oh, I'm not this is like, I can't this is wrong. Why am I here? Yeah. This but you know, things like that happen, move that time, you know, to a better time. If you can, otherwise, then that's not someone you could be pushing in with, it doesn't work. But if you could, so I would teach a handwriting lesson. I did like 10 weeks of kindergarten portions, where I just do like fine motor stuff. And then I was kinda like, I'm helping my student, but everyone else around and given the teacher tips, you build those relationships, they are begging you to come in next year, it's no longer a question about is it pushing? They're like, Well, what time is my IoT push in time? It's not. And it it just helps you share and I made a do not go on right do not go on was like a blocker for a kid that was going ahead and this math. So I said, Well, let's get something like very physical was the piece of paper laminated and they put it in like a bookmark. And when he got to the donut that said do not go in. And it was full sheet, he knew to stop. And it said you can and gave him some choices of what else to do. I didn't make one I made 25 laminated 25 of them and handed them to the teacher. Because everyone in the class use that because every one of the class goes on. So it became she still has it years later, she still uses it, I love it. And that's how you get like you you're you're going to someone's home, look at it that way, like your mom never go empty handed. That's funny, you're going to someone's home, you ask you don't tell them, you know, you're not the expert in that classroom. You inspire you don't instruct, and you teach the whole lesson, then you have to develop a relationship like, like everywhere else. And it really does help with the push in. It does not work when you walk in and say I have to push them with this kid, this is the time I'm coming. Oh, no, you need to do this change this to that it just they that will not work.    Jayson Davies     Agreed. You reminded me of your stop sign paper. They use that for all types of things. Like I remember taking a standardized test. And you'd get to the end of the math section and there'll be a big page there. Stop. So this isn't like it's something that is specific to working with a student with a disability. These are very common, I mean, maybe not common, but they're very usable strategies that work for all kids, not just for a student with a disability.    Lori Flynn     And a lot of things for ADHD are because we're all going to suffer from poor executive function some days. Because sleep sick, sleep deprivation, if you're sick, you're drunk. You have no executive functions. So they actually have an app you could put on your phone so you don't drunk dial people. I mean, you allow the ADHD research to come across these things. So like they are blocking the impulsivity of a person who's intoxicated, therefore lost their inhibition, which is that executive function skill, so they don't drunk, dial their boss and lose their job in the morning. And it's the same concept of what I'm doing. I'm helping someone with poor inhibition. So you aren't going to see these things being very, you know, mainstreaming type nothing. So odd in other two that help? That helps a lot. Yeah. So often, often, when they're given universally, universally, they help a lot of kids, because you're gonna see difficulties with working memory and inhibition and emotional dysregulation with a lot of different things in the classroom. So it does work really well universally.     Jayson Davies     All right. Well, our time is going by very quick, and we are kind of running out of time. So I have like two more questions that I really want to dive into. And for those listening, who have kind of struggled with getting maybe the support from others on campus, to support those with some of those, some of that event, executive functioning difficulties, self regulation, difficulties, they're really known as the handwriting specialists, the handwriting teacher, whatever it might be, what kind of tips might you have for them to kind of move on from just being the motor handwriting therapist,    Lori Flynn     I would well apply this knowledge to where you are, so you're innovating inside the box. So if you are working on handwriting with a student, and that is what others expectations are of you. Take a look at that handwriting from the lens of executive function, take a look at the inhibition and the working memory, and the cognitive flexibility that's needed in the you know, any written output, and then share that information with the people around you, and say, Okay, I'm gonna support this piece for that student's handwriting because of their ADHD. So you're innovating inside the box exactly where you are in your lane that people are expecting. So it's not disappearing, like you're breaking out and doing a new thing. Like you're, you're still doing your thing, which you're just doing it in a much more informed way. And that is you build slowly from there, because it will work. And people be like, Hmm, now, can we generalize that to something else, and then you slowly step up, in a way don't do anything radical, it doesn't work. To innovate inside the box. That's what, that's what I always say, like, just stay where you are, but go up a step. If you don't communicate with your teachers, send them an email once in a while, like go up a step.     Jayson Davies     Yeah.     Lori Flynn     And I think that's really where you need to start. And then just share, I share a lot and they ask, like, Would you like me to send you some information about this? And if the teacher says, Yeah, you send us some one page, never more than one page, it's not being read. If it's more than one page, like literally one page.    Jayson Davies     Be careful. It can't even be an attachment because attachments won't get open. It's just got to be right there email. Yeah.    Lori Flynn     And you have to go learn marketing, like you have to have an attention grabber. Teacher, but they're busy. And there's so many of these. And they and, you know, most teachers are awesome people. They're teachers, they they're, they dedicate their lives to teaching children, we have a lot in common with them. But you just have to look at it from there and validate their point of view. And a lot of times when I do talk to teachers, I don't look at it. from the student's point of view. I approach it from the teachers point of view. So okay, what's the difficulty little Sally is I don't know who Sally is. But Sally's having in the class, wow, she must be how do you teach with her disrupting you like that? I literally validate and then look at it, like how do I get Sally to stop disrupting the teacher? And I just go about it in a way that validates them. And, you know, teacher recruitment is the term for teacher recruitment increases.    Jayson Davies     There you go. There is a golden nugget, if there was one for the episode. And there's been a lot of golden nuggets in this episode. I have to come back to one. You mentioned something earlier about automation of writing. And I didn't ask it in the moment because I wanted to continue on. But I know there's people out there listening, that wanted me to ask this question. You mentioned before third grade, you're really going to focus on that automation of writing. What about beyond third grade? Are you still focusing on automation of writing? Or are you using accommodations? Or what are you thinking about for those students who are in fifth, sixth, seventh, maybe even high school that have an automated writing?    Lori Flynn     I am not focusing on automating writing when they're older, because the speed in which the class is moving is so much faster than any type of gain that I can ever Build for that child. If I sat there and practice everyday handwriting with them, there's obviously a reason they're not automating it. And I'm not going to fix it in time. Not to say I would never I, I still want them writing is to want them saying their names, I still want them making lists. But I do not expect them to use their writing to learn. And there's a real big difference I expect them to write, but not to learn from what they're writing. I want them to use a way that works for them. So whether it be verbal speech to text typing, fill in the blanks, any type where I'm going to reduce the, the demands on that learning activity, because if that writing is not automated, it is in the way of learning. So I'm not going to use something that makes learning harder to learn. And when I put it that way to the team, it makes a lot of sense, like, oh, well, writing is very hard for him. Why would we add writing to geography, you know, so I removed the writing, so we could focus on the geography, but I don't ever stop them from writing. But in the older grades, their grades like wishy washy, right, so it depends where we are third grade, but like fifth grade and up, I am not working on making that child's handwriting any neater, because the more plans they have are automated. They may be incorrect, but they're automated, and they may be ineffective and make things harder, but they're their motor plants. Like you can see that in a handwriting sample, if you look at like a D, and it's written the same, upside down backwards way, the whole thing across, that's an automated D, try to change that D now, so think about geography, they're thinking about D, that you're impairing their ability to learn.    Jayson Davies     So and trying to make them take notes is just making the situation worse probably.    Lori Flynn     And think of the working memory and cognitive flexibility, and alternating attention, demands of taking notes, take out the visual piece, even just those cognitive demands of taking notes. And if you have difficulty with those demands, are you learning anything? Or are you just copying stuff? So in today's technology, we're like I can't. And I have to say I really haven't seen a lot. They are giving the kids the stuff now in the older grades because it's on the classroom. That's amazing.    Jayson Davies     Yeah, like, I mean, that's why I love podcasts, I can hit rewind, I don't have to worry about taking notes, I can go back and listen to it again. That's why right now, today, we are recording this session using what's called otter AI. So that way, we can go back and check the transcript. I don't have to take notes again, here, like notes is hard for me. And I figured that out sometime during my life. And I just stopped taking notes during class, I just listened. And that was more beneficial for me. I know that isn't for everyone. But that was definitely something that helped me was just understanding that I'm the exact opposite. I have to write it down or it doesn't go on my brain. So I can't listen to anything like I am holding myself back from writing notes. So but the fact that we know as adults, how we learn best, you know, taking some time to honor our students and figure out how they learn best and then advocating for them as an occupational therapist was kind of a huge part of your job. And they listen, when when we you know, the people and I know a lot of a lot of therapists have difficulty with parents that are like no, he needs to you need to work on his handwriting. His handwriting is horrifying. I can't even read this, when you explain it to them that, you know, he's gonna focus on Dean. So the geography, they get it. But no one's ever said that to them. All they see is and that problem with handwriting is such a visible difficulty. Like it's right there in your face. And people judge handwriting, they judge your intelligence by your handwriting. So I get it being very important. But we're talking about learning not handwriting, I mean, the purpose of school, the purpose of this classroom, and thank goodness for technology, then the technology is really going to help so many of our kids, and it's just getting better and better and oh my goodness. All right, Laurie? Well, it has been a real pleasure. But before I let you go, I want to ask Where Can anyone interested in learning more about you and more about using occupational therapy to support students with ADHD? Where can they go to learn more?    Lori Flynn     Well, I have the website which is www dot OT for adhd.com . And there's tons of free everything on there posts and ADHD fact sheets and and then I was going to make a little thing for the listeners of this where we could QR code. I was kind of throwing it around QR code, just like direct articles for certain issues. Like the issue was sitting or the issue with handwriting or the issue with I can't even think of all the issues there's lots of issues. But when I say issue is because there's not the candidate It's not the environments together, it's an issue. So I'm gonna put that www.ot">up@www.ot for ADHC/school.    Jayson Davies     I think it's gonna be OT for adhd.com/ot  schoolhouse, so her website and then add an OT schoolhouse at the end. And that will take you there. And if it's even easier, you can just head on over to OTSchoolHouse.com/episode 140 will have all the links there for you as well. So everything that we talked about, we'll put it right there for you. So you can find it easily. So, Laurie, one more time. Thank you so much. I really appreciate having you here today. And I look forward to definitely staying in touch because I know you have so much to share. And we just touched the surface of it today. So thank you.    Lori Flynn     Great, thank you.    Jayson Davies     All right, and that is going to wrap us up for episode number 140 with Laurie Flynn, be sure to check out all the resources from this episode over at OTSchoolHouse.com slash episode 140. And also be sure to check out Laurie over on Instagram at OT the number four ADHD, you won't regret it. She has so much valuable info there. And I know she's only going to continue to add even more value for every occupational therapy practitioner looking to support students with ADHD. All right, well, thank you so much for listening in today. I really hope you appreciate it this episode with Laurie Flynn. And once again, Lori, thank you so much for joining us. If you're listening to this episode over your holiday break, I hope you're having a wonderful break. And if you're listening to this and other time Well, thanks for joining us really appreciate you being here. And if you enjoyed this episode, I would love for you to give us a review over on Apple podcasts, Spotify, wherever you listen, five stars is wonderful. Or you know, just click that copy link and share it with a friend who would enjoy this episode. That means even more. So thanks again for tuning in. And we'll catch you next time on The OT Shoolhouse podcast. Take care.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed.  Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 139 of the OT Schoolhouse Podcast. Ever wondered about the transformative power of child-led methods in creating inclusive and empowered learning environments for students with special needs? Dr. Amy Coopersmith is here to share with us how students receiving special education experience occupation deprivation and the important role of child-led decision-making and planning in occupational therapy. Through her own personal examples and strategies she shows how these approaches can help foster independence and self-advocacy ultimately unleashing these students' potential. Tune in to hear more about many strategies such as the use of choice boards, self-monitoring, and the "Captain Me" program. Listen now to learn the following objectives: Learners will understand the significance of establishing a least restrictive environment for children with disabilities to enhance their autonomy and learning opportunities.
Learners will identify the importance of educators and occupational therapists actively listening to children, aiding them in formulating personal goals, and distinguishing between internally-driven and externally-imposed objectives to foster independence and empowerment.
Learners will explore practical strategies for engaging children in decision-making, planning, and goal-setting within occupational therapy sessions, aiming to cultivate self-determination and independence. Guest(s) Bio Dr. Amy Coopersmith, OTD, OTR/L; MA Ed, is a self-determination advocate with over 30 years of experience as a pediatric occupational therapist and teacher. As a school-based therapist in New York City, she worked as a clinician, evaluator and supervisor serving over 100 schools. Amy noticed that the child-led teaching methods she used during her years as an educator made a big difference in children’s lives. She implemented those ideas as an occupational therapist and found that children made faster progress and demonstrated greater motivation and engagement using these methods. Author of the Self-Determination Strategies Toolkit and the Captain Me program for young children, Amy strives to teach practitioners and educators how to implement evidence-informed strategies to promote children’s autonomy. Amy earned her doctorate from Temple University in 2022, and she continues to present at national conferences, mentor practitioners, and develop new materials to translate research into effective practice Quotes “IEP goals are important, but what's most important is that they understand goals that are important for themselves." -Amy Coopersmith, OTD, OTR/L, MA, Ed “We need to be aware of ways we can help boost their confidence and help them achieve some level of competence at things they're good at, so that they have a positive experience with learning.” -Amy Coopersmith, OTD, OTR/L, MA, Ed “When they create today's plan. It's their plan, they own it. And so I think that's a very powerful message to the child.” -Amy Coopersmith, OTD, OTR/L, MA, Ed "Boredom allows students to become more advanced in their imagination, and their imaginative play.” -Jayson Davies, MA, OTR/L Resources COSA
Captain Me
Self-Determination Strategies Toolkit
Canadian Occupational Performance Measure  (COPM)
Captain Me Music on Spotify Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hey there, and welcome to episode 139 of the OT schoolhouse podcast. Thank you so much for being here. But even more importantly, today, I want to thank you for taking what you learn in the OT school health podcast, and putting it in to action. I recently had the opportunity to meet some of you all at occupational therapy conferences, both here in California and in Colorado. And it was just awesome. What I loved most about that was that while you all loved OTs Coolhaus podcast so much, you didn't come up saying, oh my gosh, Jason, I loved episode 38. Or oh my gosh, Dr. So and so it was awesome. Or oh my god, Jason, I just love everything you say it was more about? Jason, thank you so much for this, you've allowed me to do this, some of you have moved to a workload approach. Some of you have began getting into the classroom and collaborating more, some of you are just simply getting into school based OT as a result of listening to the podcast. And that is what matters so much to me. And when I hear that, it just makes my robe like I love hearing that. You're not only listening, but you're actually taking action. So just thought that was so cool. And I just want to thank you for listening. You're the real MVP, right? Like, I'm here sharing some of this, but you're the one actually out there, putting it into action. All your kids, all the teachers, everyone on campus, you're the MVP to each of them. So thank you so much for listening. But also thank you so much for putting it into action. All right, onto today's episode, I think you'll agree that every profession has its own language, right? Call it what you want niche terms, jargon, whatever it might be. Every profession has its language. Teachers use terms like curriculum standards, grades, behavioral referral, things like that. Bankers use terms like underwriting liquidity and hedging things that I still barely understand. Every profession has jargon. And of course, occupational therapy is no different. And that jargon becomes even more specific when we niche down from occupational therapy as a whole to school based occupational therapy. You know, we may use words like fine motor, visual motor praxis, vestibular, proprioception, sensory, eye, hand coordination, motor control, right? These are all things that you probably say, on a daily basis. But there's a lot of terms out there that maybe we should be using a little bit more, because after all, these two are pillars and facilitating independence during school and beyond. Some terms that I'm talking about here are occupational justice, self determination, empowerment, and autonomy. Luckily for us, I found the perfect person to come on and talk a little bit about these terms. Today, I have the privilege of introducing you to Dr. Amy coopersmith. Amy has over 30 years of experience as a pediatric and school based occupational therapy practitioner in New York. And prior to that she worked as an educator, so she knows a thing or two about supporting students. Amy will share a little bit about her experience in just a moment. But today, Amy is here to share with us how students receiving special education services experience occupation deprivation, and how using a child led methodology can support student autonomy and self determination. That way they can begin to harness their independence and advocate for themselves. So let's go ahead and cue that intro. And when we come back, we're going to talk about some of the things that are limiting occupational justice within our students and how we can support self determination to promote student independence. We'll be right back.    Amazing Narrator     Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies. PLAs is officially in session.    Jayson Davies     Amy, welcome to the OT, schoolhouse podcast. How are you doing today?     Amy Coopersmith, OTD, OTR/L, MA, Ed     I'm great. And I'm so happy to be here with you.     Jayson Davies     Yeah, you know, we've been connecting a few times over the last month to month now. And it has just been a pleasure to get to know you. And I'm excited to have you share a lot of your information with everyone who listens to the OT schools podcast. So thank you for being here.    Amy Coopersmith, OTD, OTR/L, MA, Ed      Yes. And I'm excited to because as you know, this is my favorite topic, and I'm looking forward to our discussion.    Jayson Davies      Yeah. And you know, part of the reason that we originally connected was because you have this inspiring program called Captain me. And you know, we may get into that a little bit. It's not the exact reason we're here today. But I think that's just so cool that in your current journey, where you are right now in your OT, your OT world, your OT career, you've taken this chance to create something not just for other occupational therapy practitioners, but for students and that's exactly what we're going to be talking about today is helping students with self determination. So before we get into that, I want to give you an opportunity to kind of share a little bit about yourself, and maybe not all the ways you got to where you are today, but kind of where you are in your OT journey.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Sure, I guess it was about 30 years ago, I started working as a teacher of health and physical education. And I used a child led approach, it was what I was taught as part of my graduate degree. And I noticed that the students responded amazingly, that these were sometimes troubled youth and very difficult neighborhoods. And they were middle school students who are kind of known for being oppositional. And they were so motivated, and I'm all of five foot two. And some of them were, you know, six feet tall with mustaches. And I sometimes wondered how that experience was going to go. But because I was giving them a chance to leave their own learning, they really pursued that with a vengeance, and were very motivated and engaged. So fast forward 10 years, when I became an occupational therapist, I started using the same child lead techniques. And I found that the children were again, very, very motivated, very engaged, really focused on the purpose for their being with me during our sessions. And then when I became a supervisor, I noticed that other people were not using these techniques. So I said, Well, I'm the supervisor, why don't I share it with them. And I started giving workshops and having other occupational therapy practitioners try out these techniques. And they all reported back with case studies and experiences, where children who were previously not engaged, they were disengaged, and not really getting with the program, all of a sudden, they were excited and motivated to be there. So that was the beginning of my journey. And now, fast forward another 20 years. So I no longer work in the schools directly. But I've started giving workshops and programs, such as Captain me, because what I find is that people all want to do this, everybody wants to try and have children lead their learning it we know that's best practice, it's client led, that's what we were all taught to do. The question is, how, how can people fit that into a 30 minute session. So that's why Captain Mia was born. That's why some of my other programs are have you know, have been created to make it easier for OT practitioners, and streamlined and efficient to work it into one's daily life.     Jayson Davies     I love that. That is you said something really key there. You know, we all know that child led child driven type of therapy is the right way to do it. But we're not necessarily explicitly taught how to do that. So I'm excited. Maybe we can dive into that. Just a little bit today.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Sure.    Jayson Davies      Yeah. So as we get going here, you know, I think you've shared with me in the past a little bit about some research, and I'm sure you'll bring it up today. But you've shown the research, or I should say research has shown that children with disabilities have fewer opportunities in school to gain independence and self advocacy skills compared to their peers. Why do you think that occupational injustice exists? And what has some of the research concluded?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right, so it's absolutely something that has happened for years, but it's become much more crystal clear, more recently, that this is occurring. And I did some research as part of my doctoral studies. And what I learned from all the readings I did is that there are a few factors and there's probably more, but I'm just going to tell you what I found out, which is there are three things. helicopter parenting is a big problem. Special ed reform is also a problem. And also busy, hectic life and academia pressures, those kinds of things in schools. So those three, we've got the academic high academic standards, the helicopter parenting that I mentioned, you know, these are huge areas that our problem. So I'll go through each three of the three if that's okay with you.     Jayson Davies     Yeah, yeah. And I think sports also plays into that. But yeah, go ahead.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right. So I'm in no particular order here, and there's no hierarchy. It's just these three factors all play into the learned helplessness and the deprivation. So first of all, special ed reform. Special ed reform is something that actually some of the younger OT practitioners might not even be so aware of, because it's been around for a while. Oh my goodness, at least 50 years. But I'm old enough to know what it used to be like, which is when children were in specialized schools, and they were separated from their general education peers, and there was just very little interaction among the different children who had different needs. So, now a lot of neurodiverse children are included in the main mainstream education setting, which is a great thing, this is what we want it, what the problem is that some people didn't anticipate some of the side effects, some of the other factors that were going to arise out of that. So one of the things that happened, and many people might relate to this is that there are paraprofessionals, or teachers aides, who help children kind of keep up in the school setting, because they're now in general education classes, or they are in collaborative teaching where some of the children are considered Gen Ed and some of them have special needs. So they're in these settings where they have to keep up. So to keep up these aides are assisting children. Sometimes they're over assisting children, and they actually do the work for them. And then that's just been, you know, when I've witnessed that, I get almost horrified to see that the the aid is doing all the work for the child. So when that happens, the message we are giving the child is that they're not capable. And so the deprivation that's happening, there is all children struggle when they learned child struggle, when I learned even to this day, at my age, when you're learning something, there's a learning curve, and it takes a while. But when we take that opportunity away from the child, because we're helping them all day long, they never have that experience of what it's like to work towards something and struggle with it a little bit, and then finally achieve it because somebody's doing it all for them. So there's actually not a lot of research in this area. But the research that I have found, Kansas State did some research on it, and noted that this was a big problem, that when these teachers aides and support professionals are coming in and helping, sometimes they're taking away opportunities from the child to learn.     Jayson Davies     Yeah, so and I've seen that too, in the schools and before we move on to the next ones, and maybe you're not even quite ready to get there yet. But I want to ask you about faith plans, because I don't think schools put faith plans in place enough when we are putting a one to one eight in place, or maybe a small group Aiden plays. And I mean, I'll be straight up in IEP is I've kind of said, Okay, if we're gonna put this person in place, what's the end game here? What are we actually aiming for? Because I think that's what's missing a lot of times when a paraprofessional is put in place for a student,     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right, and to me, but we always talk about the least restrictive environment, we want children to be in that least restrictive environment whenever possible. And in my opinion, having a paraprofessional or a teacher's aide, sitting next to a student is the most restrictive environment, because they are blocking the child from so many opportunities to interact with their peers to make their own mistakes and learn from them. You know, all of these things are not happening. And so yeah, I there are no fake plans in my setting that I'm aware of. The only thing is each year at the IEP meeting, they reevaluate. And also, in my experience, parents often don't want to let go of the teacher's aide or paraprofessional because they believe that that's what's keeping their child in that general education setting. And they're afraid, and I have so much compassion. I know how fearful I had a child who had some special needs when you know, she's an adult now, but I know how scary that can be to think that your child may struggle and suffer. And so you want to give them all those supports. The problem is too much support ends up being a problem. So, yes, and the fake plans, in my experience do not exist.     Jayson Davies     Yeah, and that's absolutely what I see. It's not often we have a paid plan, it's often that I will bring it up. But that doesn't necessarily mean that it ever actually gets put into plays. And I just feel for especially the parents, right, like the student doesn't necessarily know better, but I do feel for the parents who know that they're going to show up to an IEP and be told, Hey, we're going to take away your child's one to one aid, or we're going to evaluate to take away your child's one on one aid or we're not blank. Parents are often blindsided at an IEP about this and we could go on a whole nother podcast about talking about that. But yeah, it is what it is right now and it's something that definitely needs to be addressed. So, before we move on to the other Joe, when asked in relationship to special education reform, was there anything else you wanted to talk about?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Well, I think I covered it in a nutshell. I just think that I want to stress that I don't think there are there any people out there that are trying to harm children. I mean, the the paraprofessionals that I worked with, were just stellar. They were wonderful human beings. And even, you know, if I look at across the board at the teachers, the school administrators, that he's trying to help children, the problem is there's so many pressures coming from other areas, that sometimes it becomes overwhelming. And people take the easy path, which is to help the child and I'm putting up air quotes here, help the child because sometimes they really need the help they need is to struggle a little and figure something out themselves.     Jayson Davies     Yeah, yeah. Or at least have a service that's going to help them do something as opposed to do it for them. And from the occupational therapy perspective, if you're in this situation, I just want to say, you can support that paraprofessional II mean, you may not be able to put the faith plan in place on your own, you may not be able to take off the paraprofessional off the IEP. But you can support that paraprofessional to better understand the just right challenge and to help them to help the child and a more in a way that's actually going to support the student's long term abilities as opposed to just helping them get their spelling test done today.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right. And, you know, our long term goal with these children is for them to have a wonderful future. So we're not just looking at if they were able to do today's assignment, we want to see long term High School and post high school, are they able to make a life for themselves? And so if every problem is solved for them, and every assignment they do is helped in order to completion by another person? How are they going to the lesson they're learning is that throughout their life, someone's always going to come to their aid. And that's really what we don't want to see. Because that's going to hold them back in the future.     Jayson Davies     Yeah, yeah. All right. Well, let's dive into the helicopter family. You mentioned three sped reform, special education reform, helicopter families are helicopter parents, and academics. Let's talk about helicopter families.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right. So helicopter is actually very much aligned with what I just discussed, that this is when parents and families are hovering, they're looking out for every possible danger looking out for every possible that it's kind of being a obsessively controlling of a child's schedule. Now, this has happened for a few reasons. There are articles, over the internet, scholarly articles, books, there's actually an organization called Free Range kids, where they teach parents how to kind of let go a little bit because this is an epidemic. And part of it is the fear that is struck in the hearts of parents, when they see television news reports about horrible things that are happening around the world. So they don't want to let their children out of their sight. And when I was growing up, my mother would open the door and say, Come back when it's dark, and I didn't see her all day long. And somehow I survived. And you know, my friends, and I figured out how to get things done that we wanted to, and we managed to keep safe. But there are so many frightening news reports out there. And you just don't see parents doing that anymore. So we can't change that overnight, that whole culture that hold mindset, that's not going to change overnight. But what we can do is be mindful of it, and try to provide children with opportunities that might be missing, because parents are hovering and because there's that fear out there. So what can we do rather than just overscheduling every minute of their day, and controlling everything they do? What can we give them, you know, maybe let them ride a bike with their friend down the block to a park. And, you know, I've even heard of parents silently following and hiding behind a tree to check on their kids, but you know, at least to let them have these opportunities to know what it's like to be on their own rather than to be controlled at all times. So that, again, is something that impacts learned helplessness and occupational deprivation.     Jayson Davies     Yeah, absolutely. And there was just one thing I wanted to add to that. It's an article that I read once upon a time ago, and I couldn't cite it if I wanted to, I don't know, I could probably find it. But it's always stuck with me. And that is that we need to give children students the opportunity to feel boredom. And then oftentimes the most helpful play if we want to call play helpful is when they have the opportunity to become bored because it forces them to go through that planning process to create something new to not be bored anymore. It forces them to figure out How a ladder can be something completely different. I don't know, maybe it turns into a hopscotch board, I don't know. But anyways, boredom allows students to become more advanced in their imagination and their imaginative play. And so I just thought that that's something that kind of relates with that helicopter parenting     Amy Coopersmith, OTD, OTR/L, MA, Ed     100%. And if a child never has a moment's free time, because they're scheduled for after school activities, and play dates, and all kinds of events, there never is a chance for boredom. And a little anecdote, I have a friend who was very impoverished when he was growing up, and the only toy he had was a broken vacuum cleaner. And he learned how to make that vacuum cleaner into 1000 different toys, and grew up to become an advertising executive who specialized in props and learning how to create props. Because that was what he did for his entire childhood was with this old vacuum cleaner, and it was in those moments of boredom had nothing to do you know, so it does stimulate the creativity for sure.     Jayson Davies     Wow. Amazing what childhood leads you to? It's it's quite interesting. All right, we've talked about reform and helicopter parenting and families. What about those academic demands?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right. So children are, as I mentioned, now included neurodiverse children from all walks of life are included in general education settings. And we know that the US government, the New York State, I'm from New York State, and all the state governments have guidelines, regulations, you know, Core expectations for different grades, and different age levels. And administrators and teachers are very aware of that. And so they are teaching to make sure that children reach those milestones. And the problem is that we know that many of the neurodiverse children that we work with, are not capable of reaching a particular mindset milestone at a particular time, it might take them longer, they might take a winding route instead of a straight path. And so those academic demands are making it difficult, if not impossible, for children to do that kind of learning that happens at your own pace, they're being pressured to hurry up and learn. And I don't know about anybody else. But when somebody pressures me to hurry up and learn something, I don't react well to that, I need to do it in my own time, and figure things out on my own.    Jayson Davies     I'm right there with you, right, like, I'm like, don't, don't try to put this false box around me, like, don't fit me into this false box, I will do what I want to do on my time. And I will try my best to support you. But don't try to fit me in this box, because that's just not going to make me want to do it. So yeah, right there with you. And I'm sure our students feel similar sometimes.     Amy Coopersmith, OTD, OTR/L, MA, Ed     And, I want to just throw something else in here, when I was studying to for my physical education and health master's degree, they required me to learn a new sport that I had never learned before. So I knew I'm certainly not a team sports kind of person. That's not my background. So I said, I'll try my hand at tennis. And so I signed up for tennis lessons, and it was an absolutely excruciating experience. And I've always been, you know, someone who's kind of at the top of the class, I things came pretty easily to me as a student, for the most part. Well, learning tennis did not come easily to me. And I knew that I was not a good student, I was very aware of that. And it was a painful experience. And I think that that's something that I've become very aware of that when because we have such a range of children now in one single classroom, there are going to be those children who are aware that they're not able to keep up. And that is such a painful experience for so many children. So we need to be aware that of ways that we can help boost their confidence and help them achieve some level of competence and things they're good at so that they have a positive experience with learning.     Jayson Davies     Yeah, yeah, absolutely. All right. Well, that was, you know, three very important ideas, topics around maybe why students are having fewer opportunities to gain independence. talking specifically to school, we discussed how paraprofessionals can kind of be an impact to this. But what other ways are you seeing occupational deprivation among students within special education?    Amy Coopersmith, OTD, OTR/L, MA, Ed      Well, a lot of the students who we see in special education come from difficult personal backgrounds. It could be that they're a family that recently moved to this country. It could be that they are impoverished. They could have you know, a medical condition where other kids are bullying them, there's so many things that can happen with the children who we see that are outside of what we're actually seeing in the IEP. It's just the, you know, I learned problem based learning as part of my OT training, and Problem Based Learning looked at the whole child. And when we look at that whole child, we can see so many different things that might be impacting their experience in school. There was one child who went into his classroom, they called me in because he was hiding under the desk and refuse to come out. And he was on my caseload. And I had to try to figure out why, because he was always a very, you know, friendly child. And I found out that his parents signed him over to his grandparents, because they felt overwhelmed, and they lived down the block. So he would see every day on his way to school, he would pass his old house where his parents lived. And it just got to the point where he couldn't deal with it anymore. And he hid under the desk, he just he shut down. That was it. And I mean, that's a very extreme example of what we often see in the schools. But there are so many things that can interfere with a child's ability to, you know, participate fully with their peers, and our children who we see have probably a dozen more challenges than the kids who are just in general ed, and are kind of going about their daily lives, or they might have physical things that are holding them back, I had one child who had a hemiparesis. And he wasn't able to put his chair on the desk at the end of the day, when all the other kids could. So that, you know, he was very aware, again, that there were things that he couldn't do. And so there are all these things that hold our children back from fully participating in a session. And there are things that we can do to change that story to change that mindset to help them feel better and do better.     Jayson Davies     Yeah, yeah, absolutely. And I kind of want to, I kind of want to go off that example that you just kind of shared. And we can go off other examples to potentially as we talk, but the students that you just mentioned with hemiparesis, and not being able to put his desk up on his chair, right, like, there's two ways to kind of go about this, well, there's more than two, but the two that come to my head are a we can figure out a way to accommodate the activity, support him and getting that chair up on the desk in some way or the other is a separate opportunity in which maybe you can go through self determine not necessarily self determination, but being able to have the social skills to get help and being able to ask for help and the willingness to reach out to other people. And so I want to give you that opportunity to share a kind of which route might you go, or there's probably many right answers to that, but down that route of helping him to ask for help. Where would you go with that?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Well, I think it's important for at one of the lessons in my captain meet program is about we're all different. There isn't a single person on this planet who doesn't have some kind of problem with some aspect of their function. Even if you look at the gold medal, Olympic athletes, there might be some area that's difficult for them. So we all have that. And I think when children are aware that it's not just them that everyone has things that are difficult for them to do, then they don't feel so isolated. And I often taught that to a whole class. So that as a matter of fact, every year for the last 20 years, even after I left the school and became a supervisor, I went back every year for Career Day. And I always went to classes and taught the children about what an OT practitioner does, and how we help everyone participate. And then they start to learn about how, you know, we do sensitivity exercises so that they understand that, you know, things happen, you might break an arm, you know, just a general ed child might break their arm, and then they have to learn how to do something one handed. And so when they start to see that this is something that all people experience, then that one child who's struggling sees that they're not alone. The other thing that I like to do is to give that child a leadership opportunity, because there's usually something that they're very good at. They're always sometimes we just don't know what it is yet. But there's always something that a child is going to be good at. And when we can give them that opportunity to shine, then the area that's difficult for them becomes less important. It's not hovering over the in their brain that Oh, I can't do this. I can't do this because they know that there's something that they're admired for that they're being celebrated for and so it becomes more of a balanced picture in their life.     Jayson Davies     Yeah, yeah, that's great. Again, there are so many routes that you could take with that. But I think if you're empowering that student, then you're going in the right direction. So, yeah, one of the things that you talked about special education reform, and one of the things in special education for the for the past 50 years or so has been IEPs and elicit Least Restrictive Environment LRE, you mentioned that earlier, as well. How do you think even just the idea of a student having an IEP can impact their occupational justice and their ability to participate in everyday school activities?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Well, I think that that can be a really impactful situation, it can impact them in so many ways. And I think for every child, it's going to be different, you know, it for a child who has an IEP, and then they're in there in a classroom with all children who have IEP s, it's going to be very different than a child who is in a classroom where there's only a couple and no one else does have that IEP. So I think it's just a situation where the OT practitioner can be mindful of how that child perceives themselves, and how their classmates perceive themselves and each other. So I think that when a child can take part in their IEP development, and set their own goals, which is a huge priority for me, to help children select and set their own goals, that can be a big support for all children. And that's for children without IEPs, too, that's but especially when a child has an IEP, they can learn about what is a goal, and then they can learn how to set their own goal and learn the difference between a goal they set for themselves, and a goal that someone else set for them. And then kind of analyze I mean, of course, you know, some of our children may have some difficulty with cognitive challenges. But we can help point out that, of course, the the IEP goals are important, but what's most important is that they understand goals that are important for themselves. And then when they kind of come to terms with what's important for themselves, and feel good about that, then they can start looking at their parents and teachers who are highlighting goals that they think are important. And this is one of the reasons why I love the child occupational self assessment, which is the Moho tool that's used for children to help them, you know, identify what's important to them and what they're good at. And it's such an affirming kind of assessment, because it doesn't judge the child in any way. It doesn't give a score based on what you know how well they did. It's just informing the child and everyone around them, what they find important in their life, and what they think is difficult or easy for them to do. And I think it's a great vehicle for us to teach children about the importance of finding goals that are meaningful to them.     Jayson Davies     Yeah, I want to ask Ashley, can you dive a little bit further into that evaluation, because I've always considered using the copm when it comes to helping a student identify a type of goal. I know technically, the copm I believe was kind of created more for the adult population. It sounds like, do you know I guess my question is, do you know if this is kind of a drawl from the copm? is a completely different?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Yeah, I'm sure they're very aligned. And honestly, I'm not as familiar with the copm. I learned about it and OT school. But because I have spent 20 years working with children, I just always drifted towards the cosa, you know, the child occupational self assessment, but the Cosa is, I'm guessing I would have to look back at the copm. But it's, what they're doing is they have, it's very cute. When you look at it, it's a page with smiley faces and sad faces. And for the younger children, what they're asked to do is either to circle if they're writers, if they're not a writer, they then they can point or indicate their answer to the practitioner who's administering the assessment with them. So the main thing is we want them to be able to identify what's important, you're looking at two things. What is most important to me, and what am I good at? Okay, so if a child is good at something, and it's really important to them, that's not really a goal area because they're already good at it. And it's important to them done. We're done. With that, okay, now the next one is, if something is they're not good at it, and it's not important to them is that really something that we certainly don't want to start with that, because that's not going to be motivating. So if writing an essay is not important to a child, and they know they're not good at it, it's not a great area to start. But the area that we do want to start is when a child is very motivated, they really want to do something, and they have trouble doing it. That is a goal area that we want to focus on, especially in the beginning. And the child is asked what is important to them, and what is most important to them. So if they can find if the assessment professional finds something where the child says this is very important, or it's the most important thing of all, and it's difficult for me, that is an area, that's a great place to start for goal setting. Absolutely. And you know, there was one child, he was in fifth grade. And he highlighted to his OT practitioner, that he wanted to learn his name, address, and he knew his name, but he wanted his address, his phone number, and there was something else, I'm trying to remember his name and address his phone number. And I can't remember the third thing, it doesn't matter. It's irrelevant, but let's just start with the name and address, okay, he wanted to remember his address and his phone number. And he couldn't, and he was embarrassed because he was in fifth grade, maybe it was his email address or something. So it was some other thing. He couldn't remember these things, it was just difficult for him, he had a learning disability. And so that was what he highlighted on his assessment that he that was really important to him. And it was difficult. And so his OT practitioner made that with him, they collaborated and made that a goal, and watching him go through that process of learning it. And he was so good at it by the end. And the practitioner made him talk about why it was important to him. And I think that's so meaningful. When we can ask a child, why is this important to you what, what makes you want to do that, and then it forces the child to kind of dig a little deeper and think about why it's so meaningful to them. And to hear him talk about how when he goes to high school in college, if he ever gets lost, he's going to know how to ask for help to get Yeah, you know, something so basic, and he figured that out on his own, and it was a great thing to see.     Jayson Davies     Yeah, and you know, that's a very common goal, right to be able to identify and write down your personal information. But typically, the importance of that goal is not coming from the student, it's coming from the parent, it's coming from the teacher. And what the coasts allowed you to do was to identify that that was something meaningful to the student, which I really love, I really appreciate that. And it's something I want to look more into. Just for everyone listening, I just went to the Moho website. And this is like a $40 evaluation, I think you can reuse it. So it's very cheap, very easy to access to access, and will give you a lot of information about the student, we often talk about using a student interview for an occupational profile as part of your evaluation tool. Well, using the Cosa might be, you know, a good way to get that interview done. So thank you, Amy, for sharing that.    Amy Coopersmith, OTD, OTR/L, MA, Ed      Sure. And I think it's important to note that the version that you usually see online has all the smiley faces, but there's another version for older students that just has words. So if you feel like it's too juvenile for some of your older students, you can, you know, access the version for older students.     Jayson Davies     Awesome. Yeah. And you're right, like you don't think these are things that you don't necessarily think about, like, even when you're trying to build rapport with the student, there is that idea behind it, that you're trying to focus on these goals that have been identified by someone that's not them. So ultimately, you can build rapport for 1015 20 minutes, three days, three weeks, but you're still going to be asking the student to potentially work on something that they don't enjoy. And so if you can, if you can get them to work on their own goals, I think that is 100% the right way to go about it. I have a question for you, when it comes to those goals? Do you tend to actually use those student goals on the IEP? Or are they a little separate?    Amy Coopersmith, OTD, OTR/L, MA, Ed     It's a tricky situation, because often we inherit a child's goals from a previous year, you know, we're not necessarily the one crafting the goals. And even if we are it might not come to later in the year. So I consider it a starting point. What I usually suggest to people is start when you're starting to build rapport with that child, let them set their first goal and help them craft the goal so that it's easy for them to achieve it. So that you know and when I say a goal, I'm not talking about an annual goal, something that's you know, within two or three sessions that they can achieve and feel good about it and have a little check off that they did it. And you usually don't need any fancy prizes when it's something that they chose for themselves. Just like we don't need prizes, when we have a goal to work out at the gym, when we do it, we just celebrate because we're so happy that we did what we set out to do. And so that's what we want to see for children. And then once they've had some experience of success, and they're feeling good, then perhaps we can look at the IEP goals with them. And say, now, we worked on a goal that you were really excited about. But we also need to look at some of the goals that your teachers and family think are important for you. So which one would you like to work on first, and let them have a voice in that process? So that it's not just someone telling them? Here's what we are working on? It's that these are the things that we need to work on together to have a successful year at school? What would you like to do first? How would you like to work on it? Where when all those kinds of factors?    Jayson Davies     Yeah, great. And I know, we kind of went off on a tangent on here with goals and talking about the coast a little bit. But I think that's so important when we are talking about supporting student occupational justice, like giving them the opportunity to have choices to solve problems potentially. And so I want to kind of go down that line, because I think this is part of that solution that you often discuss when it comes to occupational injustice is choices and product and choices and opportunities to solve problems. So how do you use choices and supporting students in solving their problems to support occupational injustice?    Amy Coopersmith, OTD, OTR/L, MA, Ed     Right, so children in general education generally have many, many choices available to them. They, you know, when they wake up in the morning, I'm here visiting my grandchildren right now. And when they woke up, they picked their own clothing, they decided what they wanted to eat for breakfast. And if it's not what they want, they're usually quite vocal about it. But a child with a disability may have some difficulty with that, they might not be as verbal as their general education peers, they, the parents, you know, might have a lot going on in terms of trying to get a child ready in the morning. So they might have picked up the clothes for the child the night before, and dress them rather than letting the child do it themselves. And I am not judging that in any way. It's just a reality. It's very difficult for parents across the board. And then when you have a child who might have difficulty getting ready in the morning, your main goal is getting them out the door by 7:30am, or whatever time you need to leave and get them to that school program where they have to arrive. So thinking about their you know, process of choice making, and that sort of thing is not in the for the front up front part of your mind in the morning when you're getting ready for school. So what I usually suggest to parents, is let them make the choices the night before about what they want to wear, you could look up the weather report together and say, Oh, it's supposed to be rainy and chilly, what do you think would be a good outfit to wear tomorrow morning. So it being planful can help that situation, rather than the parent having to make all the decisions for the child. So it's a difficult situation. But with thinking ahead of time, and being planful, we can build in these opportunities for choice making. And the same thing happens at school. In classrooms, very often, children have assignments, and they have to hurry up and get it done by a certain time. And so there aren't necessarily a lot of choices built into their day to day life. We can't impact the curriculum, or if we can, it's very slight, because we're, you know, we're not involved in curriculum development in school districts at this point, there might be a few of us who do that, but it's a very small minority. So what we can do is we can influence teachers and school administrators, by being role models by showing them how we can give children choices by showing them how much better children do when they are provided with options that are meaningful for them. And this is not a surprise country's I'm not I'm not sure if I'm getting all the details correct, because I don't have the research study in front of me. But in Finland, they were something like number 50 Out of the 50 Western countries who were part of a research study, they were the lowest country in terms of academic achievement. And the committee in the government said we are going to do something about this and change it and they completely changed their school system. completely change the curriculum to make it child lead. And right now I'm not sure what number they are. But for a while they were number one that I think they might have dipped to number two, but they it just completely reversed the whole trend of that lack of learning that was going on. And so we know that giving children these options and these opportunities makes such a difference.     Jayson Davies     Yeah, yeah, definitely. And I want to kind of just continue on with that a little bit, you know, the How to and as occupational therapy practitioners in the school, we work with several different levels, if we want to call it right, there's the individual student that we might work with, we might work with a small group of students, a classroom all the way up to a whole school, and sometimes even an entire district, right? For occupational therapy practitioners listening today. And they're like, Hey, I kind of want to start supporting a little bit of self determination. Starting with just like an individual student, we talked a little bit about goals, but is a one, you know, that quick win that you can provide to an occupational therapy practitioner listening to support self determination and their students.    Amy Coopersmith, OTD, OTR/L, MA, Ed      Right. So Oh, my goodness, there's so many goodies from my little goodie bag that I could pull out. But I'm trying to think of if there was a number one thing. I, of course, you know, as I mentioned, I think the Cosa is a great place to start. One of the things that I always used to do. And this was taught to me by a fellow practitioner, and I'll tell you a little story about an interesting turn of events that happened with this. I always had children write today's plan at the beginning of every session, it was shown to me when I first became an occupational therapist in New York City, a by a colleague who mentored me, and I did it for a few years. And then I kind of stopped doing it. And I said, Why did I stop doing this? It's brilliant. So I'll just explain what it is, it's so easy. It's just a little piece of paper that says on the top, today's plan, number one, number two, number three, that's it. And then the child comes in. And in one or two words, they have to fill in those three blanks. This is of course, if they're a writer, if they're not a writer, then you want to give them choice sports, which I'll talk about in a minute, because that's my my other goodie that I'd like to share. So today's plan you want, I always would tell them, we have to do something that's a warm up activity that's going to get get us ready to learn what we want to work on and in our session together. So I would let them pick, what are they going to do. And sometimes there would be pictures on the wall. And they point to which one they wanted to do. Or maybe there was a little index card box, and they could leave through the index box and look at an activity they wanted to do. Or sometimes they just knew they had a favorite activity, they wanted to jump on the mini trampoline. So whatever it might have been, so they write that down. Or you could use a picture icon or a choice board. So that's number one. Number two is what goal are we working on. So that I use goal cards a lot with children. So they often knew right up front, the goal card they have today is working on, you know writing their letters, or it's working on, you know, if it's a child that usually child children don't pick writing their letters as their first goal. So it might be learning to play catch with their friend, something like that. So that would be number two. And then number three is something really fun that they love to do that, you know, we often think of it as the reward, but I don't think of it as a reward, I just think that we all tend to want to always, you know, do something that we enjoy. So that would be the end of their session. So those three things would be on today's plan. When the child takes two or three minutes to write that out, we are teaching them planning is very important. And we're teaching them that we need to structure our time so that we achieve things that we want to achieve. And what it does for you is it helps you learn about the child's priorities. You can see so much of how they're thinking. There's certain amount of problem solving that goes on during that today's plan, as they're thinking about what do they want to work on? And let me find the pencil and the papers, who knows I would let them go scout out what they needed. And where are they going to sit and write it. And the little anecdote that I was going to tell you about is that I always do this at the beginning of every session. And one day I brought the child into the OT area, and the phone rang in my room. So I answered the phone. And when I came back, I walked to the middle of the room and said, Okay, let's do our warm up. And he said, Wait, Mrs. C, we didn't do today's plan. And I that was so fantastic to me, because it meant that he had internalized that process. Even though I forgot about it. It was important to him that he set his plan for the session. And I think that that's a very powerful tool.     Jayson Davies     Yeah, and I mean, it's something that is we all do it to some extent and even if it's just in our head, all all of us are trying to put together a game plan for the day or even if it is just for an individual session. And I think that is important for other students to work on as well.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Right. And what happens is many of the children we see with disabilities are shuttled from one activity to the next to the next all day long. And it's like they sit there passively waiting for someone to tell them what's what's expected. When they create today's plan. It's their plan, they own it. And so I think that's a very powerful message to the child.     Jayson Davies     Yeah. And it gives you opportunities to, you know, once you're done with step one, you're not saying to them, Hey, do you remember what step two is? You're saying, hey, what was step two, and they know to go back to their plan and look for it, you're not necessarily prompting, it just opens the door for more ways to, to focus on that transition aspect that we that we work on so much with our students? So? Yeah,     Amy Coopersmith, OTD, OTR/L, MA, Ed     absolutely. And I'd love to talk about choice boards too, because I was torn between today's sports, choice boards are just the most fantastic way to help every level of child, you know, it's a very kind of compact little menu of choices that they can choose from. And you know, how who doesn't love a menu, you go to a restaurant, you get to pick whatever you want to do, you know, and so a choice board is telling the child that their decision that or is that what they want matters. And that's what a so that's when we're talking about occupational deprivation. When a child's choices don't matter, day after day, week, after week, they internalize that message like, well, I don't count, I just have to do what everybody else tells me to do. But once you have that choice board, and they can pick something that's meaningful for them, that really changes the kind of story in their head and in everybody's head. So choice boards can be so many different things, you can look that up on Pinterest, on the internet, there are just choice boards galore. But the main categories of choice board are just black choice boards, where there might I usually say there shouldn't be more than three. So you would have a board where there's three little squares, and a child can fill in the three squares with their choice. So let's say the choice for today is which warm up are we going to do. And the child can either draw a picture of three different warm ups that they like, and this is this is not the warmup activity itself, this is something you do in a session unto itself, where you're asking the child, let's think about warm up activities that you like. And then they put down the three choices of what they enjoy. And then, so they either draw it, they could cut out pictures from a magazine and glue it in, which includes a lot of skills that we want kids to work on. Or that there can be a search on the internet, if you have internet access in your school, and you can supervise as the child is surfing to find different warmup activities they like, or for children who struggle with these things, we can have a pre populated choice board. And that can be put together by contacting. First of all, you can try to ask a child if they're able to express themselves either using a communication board or, or some way that they can indicate. Or if that's not possible, you can ask the teacher what they noticed the child is gravitating towards, they might have a favorite iPad game, you know, something that you maybe they see them dancing around when the music teacher comes in. So dancing might be one Warm Up option. So there's a lot of ways that we can get that from either the teacher or their family to find out what it is that they enjoy. And then we pre populate the board, and then say which one would you like to do today? And that's always the question is, once they've made that choice board, then you want to run it off and have multiple copies, because you don't want them scribbling on it. And then you never have it again, you want to make sure it's blank. So that you know without writing on it, and even you can put dates on it, and then use it over and over again in multiple sessions.     Jayson Davies     Yeah, yeah, I like that both the creating your list and using a choice board just to better understand what the student actually enjoys. And you know, I was thinking about a sensory diet, right? Like a lot of us are implementing a sensory data with very little input from a student. We know that spinning will help them but we don't actually ask them if they enjoy spinning, and I'm just using that as an example. But I think you could use a choice board in that same type of experience, right? Like, we know we need to get some vestibular input in well, let's give a few choices. So that we can identify what activities to get that vestibular input in the child prefers and we are naturally allowing that that student to make choices in relationship to their sensory data. either sensory plan or, or whatever you want to call it. So there's so many uses for it.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Absolutely. And I think we also need to listen, not just to what they say. But really, I think one of the one of the things that has been expressed to me from people who've taken classes with me is that it changed their understanding of their role as an OT practitioner, that we're not just there to come up with a treatment plan and administer it to a child, we're there to help the child get ready for a successful future. And what's the best way we can do that we can listen to them. Because by administering something to them, we're imposing our own ideas on them. But when we listen to them, that's they're expressing what they want for their future. And so, you know, if we can let them make those kinds of decisions, we're giving them this enormous gift for their future.     Jayson Davies     Yeah. All right, I have two more questions, kind of in the same realm that we've been talking, you know, we were just talking more about working with an individual student. But what about working with a teacher, you know, even if it's just a quick tip for teachers, you know, they're seeing their students is always needing a teacher just comes to you and says, like, my students are always needing cues, always even verbal cues. Like they can't do more than one thing at a time. What's your kind of your one or two go to recommendations for teachers to try out?     Amy Coopersmith, OTD, OTR/L, MA, Ed     Well, I've had some very positive experiences with children having doing self monitoring, which again, puts the onus on the child. And when I say puts the onus on them, they love it. So it's not like we're giving them a burden, we are not, they love monitoring their own progress. So when a child has repeated questions over and over, it might be something that can be managed through a self monitoring process. And it's so easy to implement this, it just takes a little bit of planning, but it's not that difficult. It's basically a, you can do it with a group, a small group or with a whole class where the children might be aware of either given a blank form, and it has on it, you know what want to do? So let's say they want to the teacher has an assignment where she wants them to do a paragraph with an illustration about Aesop's Fables. I'm just making it up. Okay, so what are maybe they're going over a fifth fables. So you know, there are certain things that they're going to need to do, they're going to need to draw a picture, they're going to need to either write a sentence or a paragraph about the table that they read and what it meant. Okay, so let's say the child keeps asking for help. Like, I don't know what I'm supposed to do, I don't know what what how am I supposed to write it, they can write those things as points, like actions that they need to take, I need to find my crayons, find my blank paper from my folder that's in my cubby, open it up and take out the sheet and start coloring my picture. Okay, so that's all on their paper, or it can be a picture icon, it doesn't have to be all those words, it could just be a picture icon, on their self monitor and for. And so the teacher can say, Go get yourself monitoring form. And once they see that form, it reminds them of what they need to do so that instead of the teacher being the one who is cueing them, the form is queued. And they've written the cues themselves, so that that cue they're giving it to themselves, and then they go down list on that form. And there always has to be a date on top of each column, so that over time, they can check off what they were able to do. Maybe different components, draw the picture, write the sentence about Aesop's fable sign my name, you know, letters are sitting on the line, whatever the different criteria are, that the teacher wants, and the child can now analyze, did, were they able to do that? And again, for children who have challenges doing this, they might need the paraprofessional or the occupational therapy practitioner to assist them with analyzing how they did. But the point is that they're doing the analyzing, it's not the teacher saying you didn't do this, and you didn't do that. But you did that right? No, let them figure it out for themselves. And that can really help boost their confidence, boost their actual ability and reduce the amount of cueing that a teacher needs to do on a day to day basis.     Jayson Davies     Yeah, well, you know, as I'm sitting here listening, I'm really you know, I've seen it it's not something that I haven't seen, but I'm just recalling how different a self contained classroom is from your more typical general education classroom, not just in the content that they're being taught. But even just the routines, how there's so much different, you know, if you walk into most general education classrooms, you're going to see first thing in the morning, writing down the agenda routine for the day, at the end of the day, you're going to see them writing down their homework for the day, you're going to see them creating checklists for themselves. And those are things that you don't necessarily always see in more of a self contained special education classroom. You know, they're trying to focus on the writing their name, address, phone number, collect, we kind of mentioned earlier, to some extent it it's teaching the road skills, as opposed to teaching them the planning skills that general education students get every single day, when they're writing down their agenda, checking off their homework and whatnot. And I think that is something that we can definitely have conversations with our our special education teachers, and just, you know, teachers always talk to sorry, excuse me, but teachers always talk about like, my students aren't independent. And well, if we're not teaching them to be independent, they're not going to become independent.     Amy Coopersmith, OTD, OTR/L, MA, Ed     And in my opinion, that is a form of occupational injustice and deprivation, that they aren't given those opportunities. And so we can have an influence. I call this a grassroots approach. Like I said, before, we can't change the US Department of Education from our little school, okay. But we can change it from the ground up, you're right, we can from the ground up, when people start to see that these things work. It changes people's perspective over time. So I think it is worthwhile doing and when you have those successes, I had a couple, what really turned my head around was when I started teaching this because as I mentioned, I was doing this myself. But when I started teaching it to OT practitioners came to me and said, we'd like to share a case study with you. During our annual end of year meeting, we used to have these nowadays, they tend to be virtual, but before the pandemic, we had these in person meetings where we would have 300 people or 250, people show up in a giant auditorium. And we would have an end of the year meeting. So they said, Can we share this case study? I said, go for it, I'd love it. And what they found was that using that self monitoring approach that I mentioned, and the questioning approach, asking the child to make choices, changed this one child's entire trajectory. So I'll just tell you how it started out. It was two practitioners. One year, it was the child was in kindergarten, and he started out he was only he couldn't recognize or write any letters at the beginning of kindergarten. And by the end of kindergarten, he was able to write three letters. Okay. So it took him an entire year to learn three letters. In September, they switched, the he now was with the second OT who was in that building, the other OT, and she tried the techniques I just described, where he got to choose what letters he wanted to learn, he got to choose where he wanted to learn them how he wanted to learn. He did his own chart, and he would write down which letter he was going to do on what day and check off when he did it. And he learned all the other 23 letters in three months. So he his learning just sped up. Now, of course we don't know is that is partially from maturity, there may be other factors. But they were so excited because they knew this child, and they knew how he was struggling. And he just leapt forward and was now participating along with his fellow students. So I think that's just one example of how powerful some of these tools can be.     Jayson Davies     Yeah, yeah, that's great. And, and, of course, now we've already mentioned it a few times, you've taken a lot of your experience and turned it into a program Captain me. And I want to give you just a quick opportunity to share a little bit about that as we start to wrap up.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Sure. So Captain Me was developed as a pandemic project, which was a pure joy, because as you know, we were pretty much all stuck indoors. And, you know, kind of struggling and floundering trying to figure out what we were going to do with ourselves while we were isolated. So I was very fortunate that I was taking these long walks and, and trying to figure out how I was going to spend my time in isolation. And I have a musical background and I decided to create some songs that would help children remember different aspects that were important to develop their own autonomy. So as I would walk down the street, I was singing these little songs into my phone's voice recorder. And when once I had about 12 songs and the topics were on goal setting, self monitoring, problem solving, planning, and how to clean up the mess and get organized, you know the things that we see on a day to day basis with children. So I'm fortunate I come from a showbiz family and I have, I had family members who helped me produce this and turn it into 12 Interactive Video programs. And they're only about five to six minutes each, because I wanted something that OT practitioners and educators could use in a very short amount of time. You know, we all know that it's important for children to be independent. But how are we going to do that when we've got IEP goals and documentation and all kinds of other pressures on ourselves. So we can't spend a whole session, you know, just asking children a million questions and, and going off on tangents, we've got to stay focused. So these 12 Very brief lessons that have interactive moments within them are meant to streamline the process and make it easier for OT practitioners to incorporate self determination in a very efficient manner. And to get some support, the OT practitioner can pick which aspects are most important. So if you know that a child you're working with is very upset, every time they make a mistake. There is a lesson about making mistakes and how to handle that. Okay, and it features a puppet. So the puppet is the one who makes mistakes, the puppet is the one who struggles. And so they watch this puppet go through his challenges and his frustration. And then the video pauses, and the OT practitioner has a chance to talk to the child and say, What happened to copy the puppet? Why was he upset? What do you think happened? What should he do to fix his problem? What would make his situation better? And so then the video resumes and they see how Cappy resolved his problem? And then it goes to the next stages. What would you do? If you were in that situation? How would you help resolve a problem like that. So it's very quick. And then there's a song for each lesson that they can go sing on their own. And my hope is that children will start singing it now I've been visiting my grandchildren, and they have been singing the songs all weekend with me. So I know, children liked the songs, they're fun songs, and just a little pointer, if anybody is interested, they can find all the songs free of charge through any music app. But you just have to have the list of the names of the songs. So I'll make sure that we can share that. So that if if any of your listeners want to listen to the song, they can do it very easily. And those can be sung, you know, at any time with a child to just reinforce the positive message about their own abilities about their ability to overcome difficulties. And they can just sing that song to make themselves realize that they are worthy and that they're good at these different topics.     Jayson Davies     Yeah, definitely, we'll have to post a link to Spotify or whatever, wherever it's best way to find it. But yeah, I love how you just like we've been talking about all day to day right choices and self monitoring. And it sounds like that's kind of what you've embedded into these videos, pressing pause, letting kids make choices, pressing play, again, pressing pause, letting them self monitor about, you know, if they were in the situation, you know, what would they do? What how would they feel and whatnot. So yeah, I think that that is absolutely wonderful. So thank you.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Yes, thank you,    Jayson Davies     Amy, thank you one more time, Amy for coming on the podcast, where's the best place for people to learn more about you and maybe the captain me program.     Amy Coopersmith, OTD, OTR/L, MA, Ed     So everyone can go to Captain me kids.com . And that's where the captain me program lives. And I'm in the midst of launching a new website. But everyone who goes to Captain me kids will go to the new website, because I have another program called the self determination strategies toolkit that highlights 10 different strategies that are basically everything we talked about today, but just encapsulates each strategy in a very brief manner, to help practitioners kind of focus on these different strategies and how to make them work best. So those will both live in the new website, which happens to be called self determined  kids.com . But right now, and then that will be in the next few weeks that we'll be launching. But right now everybody can just go to Captain me kids.com And you will see all the songs there. The different topics and people can reach out the email is listed right there on the website. And feel free to reach out with any questions.    Jayson Davies     It was great. Thank you so much, Amy. And we'll definitely post all the links to those resources in the show notes so that they are so easy to find. Thank you again. And we look forward to staying in touch.     Amy Coopersmith, OTD, OTR/L, MA, Ed     Yes, thank you so much. I enjoyed our time together.    Jayson Davies     All right, that is going to wrap up episode number 139 of the OTs schoolhouse podcast. Thank you so much to Dr. Amy coopersmith, for coming on sharing her knowledge and inspiring us a little bit to I think move beyond the fine motor and sensory processing skills, then think about that self determination piece and how we can encourage choice making and let kids don't learn to make their own decisions. You know, if we don't facilitate that, and if the teachers are not facilitating that, and if the parents are not facilitating that, they're never going to get that. I mean, how good is it if they can have rote skills, but then they can't make their own decisions in the future. So once again, thank you, Amy, thank you to you for tuning in listening and taking something from this episode and putting it into your practice. maybe today, maybe tomorrow, whenever it might be. Thank you. If you enjoyed this episode with Dr. Cooper Smith, she recently provided a one hour professional development course right inside of our OTs schoolhouse collaborative community. If you'd like to learn more about that course and more about the OTs schoolhouse collaborative community, you can do so over at OTSchoolHouse.com slash collab. We have professional development every single month over there. We have a gold bank, and we have a community of school based OT practitioners that want to support one another. If you're looking for professional development, mentorship and guidance, the OT school house collaborative is the perfect place to be. All right, well, that's gonna wrap us up today. Thank you so much for tuning in. And we'll see you next time on the OT school house podcast.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed.  Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! 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 Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 138 of the OT Schoolhouse Podcast. As a school-based Practitioner, have you ever thought about exploring alternatives to traditional pull-out sessions? If you're looking to expand your scope of practice, increase work efficiency, and provide more individualized services in the least restrictive environment, tune into this episode. Jayson dives into the benefits of working with students in their natural context, the different service models available, and how to implement them effectively. He discusses many areas from individual and group sessions, to collaboration and consultation with teachers and aides. Listen to learn more! Listen now to learn the following objectives: Learners will identify ways to support students in the general education and least restrictive environment Learners will identify ways to build rapport with teachers Learners will understand the importance of natural context Learners will understand how to transition to different service models Host Bio In 2017, Jayson founded the OT Schoolhouse website and now supports school-based OT practitioners via courses, conferences, and the OTS Collaborative community. With experience as both a contracted therapist and an "in-house" employee for two distinctly different districts, Jayson has had the opportunity to appreciate the differences between both small-rural and large-suburban districts. Recently, Jayson has put forth his efforts toward supporting therapists interested in tiered intervention, collaborative programming, and managing their workloads. Quotes "Although it's difficult to collaborate, it makes it even more difficult to collaborate when we are constantly using pull out services." — Jayson Davies, MA, OTR/L “Teachers appreciated, when occupational therapy practitioners modeled sensory and behavioral support strategies for the teachers and aides." — Jayson Davies, MA, OTR/L “It gives you some flexibility, to work on those skills, that you may need to do in a group or a pull out setting and then it gives you the other two sessions to generalize them into the classroom.” — Jayson Davies, MA, OTR/L “If we are sharing our knowledge with a student, and the teacher and or the aide, then they can work together when we are not in the room, and that is what leads to consistency.” — Jayson Davies, MA, OTR/L Resources Therapists’ perceptions of the 3:1 Service Delivery Model Article Caseload and Workload: Current Trends Article Toward Participation-Focused School-Based OT Article A Sensory Integration Intervention in the Schools Article Sisti, Mary K. MA and Robledo, Jodi A. Ph.D. (2021) "Interdisciplinary Collaboration Practices between Education Specialists and Related Service Providers," The Journal of Special Education Apprenticeship: Vol. 10: No. 1, Article 5. Available at: https://scholarworks.lib.csusb.edu/josea/vol10/iss1/5 Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hey there, school based OT practitioners what is happening and thank you so much for being here today. Whether this is your first episode, your 138 episode, or anywhere in between there thank you so much for tuning in today to better yourself as a school based occupational therapy practitioner. My name is Jayson Davies and I'm a school based OTs down in the Southern California area. And I'm just so happy to be here with you today. This episode is actually coming as a result of a recent presentation that I gave to a SELPA down here in Southern California. Shout out to Antelope Valley and Santa Clarita SELPA. Down in the Los Angeles area. I just presented this like two days ago. And I thought to myself, You know what I needed to actually record a podcast episode about this very topic. And what this topic is about today, as you probably saw in the title is moving away from defaulting to one time a week, 30 minute pull out sessions. And the reason for that is because that is basically the most restrictive environment that we can provide a service in other than a student being in a residential placement or away from they're away from their home school or even outside of their district potentially. So I wanted to talk about this because well, a Ida says that we need to support students in the general education and least restrictive environment as much as possible. And also because we are in a very unique position as school based occupational therapy practitioners, in the sense that we are one of the few occupational therapy providers, not just school based OT providers, but all OT providers that have the ability to actually work with our clients in their natural context. And I don't think we take advantage of that nearly as much as we should. So today, my goal for this episode is to kind of help you see other ideas out there, besides just that pull out individual session, to give you some different types of models that you can use to support your students so that we can start seeing them in the least restrictive environment. Now, I want to, you know, kind of pre load this, if you want to call it with the idea that I don't believe that every student needs to be seen in the classroom, I believe that there are many circumstances where the pullout environment is the best case to see a student. However, I don't think that we should default to that, I think we should almost flip it around and default to consoles and move away from consoles as necessary, moving to a more restrictive environment, eventually getting to again, that pullout environment. So let's go ahead and dive in. We're going to start with what a pullout model is the pros and cons of it. And then we'll start moving to a less restrictive environment, and talk about how we can provide more services in that less restrictive environment. All right, stay tuned.  Amazing Narrator     Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies, class is officially in session. Jayson Davies     All right, let's discuss those individual pullout services that may or may not make up a bulk of your caseload. For a long time, they absolutely did make up a bulk of my caseload. And this isn't like a new concept. This is something that has been going on for a long time. And partially that is because occupational therapy is relatively new to special education or education as a whole. Yes, it's been over 50 years now. We're right around 50 years if I can do my math, right, but we're still relatively new. And when occupational therapy first started getting into the schools back when EHA was first introduced in 1975, through 77, the medical model of occupational therapy went to school. Occupational therapists and occupational therapy assistants were used to that one to one model seen a student directly in a arena where they could control it and when they are when we I should say as occupational therapy practitioners moved into the schools. That's what we knew. So that's what we provided. Even today, one to one individual pullout services are often referred to as a medical model style of services. As I mentioned, I don't necessarily agree with that because I do think that there is a place for one to one pullout services and school based occupational therapy. And here are some Some of the reasons why the biggest pro and probably the main reason that most of us have often defaulted to pull out services is because A, we get to control that environment, right, a student is coming to our OT closet, our OT room or OT, cupboard, whatever it might be. But it's ours, we have the ability to manipulate that environment to work on skills. Secondly, the reason that I think we default to this is because being in that personalized one to one setting, it allows us to work on specific skills that, to be honest, are quite difficult to work on when we are in the classroom. You know, in the classroom, we can really work on generalization, we can really work on maybe some social skills, we can work on that planning an organization. But in a pullout setting, that's where we have the opportunity to potentially do some hand under hand hand over hand hands on in general type of skills that sometimes are needed. It allows us to manipulate the environment which we can't necessarily do or can't easily do in the classroom environment, at recess, and so forth. So There absolutely are some pros to having therapy in your own designated space. Some of the other reasons that may not be the best of reasons why we often use a pullout setting is because, to be honest, that's what we know. That's what we're taught in occupational therapy school, we're taught how to see students or clients in general, one on one, we are not really well taught and OTs goal, how to support people in their natural environment, that's just hard to actually like set up. If you think about OT schools, they often have a clinic, what happens in clinics, people come to the clinic, it's not very often that OT students are going out and supporting people and their natural context, like we would be if we're going into the classroom to support a student. In addition to that pull out sessions are typically easier to plan, you don't have to collaborate with a teacher to make sure that you're going in during the time that a student will actually be working on a skill that their goal is related to. Like when you're scheduling, it's easier to schedule students one on one in a pullout setting than it is to schedule having to go into a classroom, it's just easier to plan these pullout sessions. Now, that may not be the best reason to continue doing pullout sessions all the time. But it is a common reason like I have been guilty of that. And then right along the same lines with that, it's also easier to take data on our goals in the pullout setting, right? We can manipulate the environment, we can change with the work, we can track data really easily. The more we move into the classroom and try to track data in the classroom, it does get more tricky, primarily because it takes more planning and more initiative on our part to make sure that we're going into the classroom again, when we can actually see the occupation or the goal that we are trying to see. So those were some of the things that maybe facilitate us doing a pullout model type of service. But that doesn't mean that there aren't some cons to providing that type of service. And I've got a few things listed here. And I want to share them with you. Because one of my biggest things about why I prefer to not do a pull up model when I can, is because although it's difficult to collaborate, it makes it even more difficult to collaborate. When we are constantly using pullout services. The only opportunity you really have to collaborate with a teacher, if you are doing or if you're conducting pullout services with a student is maybe in the hallway passing, which isn't a great time for collaboration, maybe the one minute while you're waiting for the student to get up and come to you so that you can go to the polls setting or on your way back to classroom. Maybe you have a second to talk to the teacher. But that's not really collaboration either. So in general, I find that the more that we are pulling students out of the classroom, the less we are collaborating with the teacher, whether it be in the classroom or consulting with them at another time. So that's the first one pullout services limit collaboration. Also, in regards to pullout services, I believe that there is a false belief that weekly pullout sessions are evidence based. Now I want to start with this. Think of the last research article that you read, whether it was found to be effective or not effective. What was the frequency and duration of the service provided? Was it one time a week for 30 minutes? Was it one time a day for an hour as many studies often Are wasn't one time a month for 30 minutes. We don't see a lot of studies within the world of occupational therapy, whether it be through the Asia act or other journals where it replicates what a school based occupational therapy service frequency might actually look like. So we see something that looks promising and research. But if you look deeper, the reason it looked promising is because there are providing services every day for an hour, or three times a week for maybe even 30 minutes. Like that is kind of doable in a school setting for some people, but for many of you, you're like, wait, what, three times a week? 30 minutes? Yeah, I know, you just can't fathom that. Right. So I think that we do see this research out there, where we're seeing articles say, I don't want to mention any programs. But there's programs out there where they've been research based, but oftentimes it is more than the frequency that we have the capacity to provide, in schools, at least the way that our case loads are currently built. And in line with that same idea, two of my favorite authors, Mindy Garfinkel and Francine Surya have come out with research and guidance for school based occupational therapy practitioners like us. And they're actually noting that best practice guidelines are indicating that providing services and contextually based settings such as classrooms are more effective for children, that actually comes from their 2020 article, they have several articles, they're all definitely worth a read. But I think that's true. A lot of the research that we're getting similar to the frequency and duration, not necessarily lining up with what we might do in a school, most of the research is also being done and more of that, quote, unquote, medical model style, where it's a lot of one on one individual type of services, as opposed to maybe getting into the classroom. That said, we are seeing that when occupational therapy practitioners are getting into the classroom, we are having positive results within the research. And I'll talk a little bit about that more when we get to that section. So the final point that I want to make before we move on to some alternative models, is that if we continue to kind of default to this one time a weak individual pullout service for a majority of our students, then to an extent, we are not providing an individual educational plan, we are providing a prescribed general individual plan. I mean, I don't even know what to call that the IEP is designed to be individualized. And if we're providing the same 30 minutes once a week pullout service for every student, then it is no longer individualized. Right? I get it like every individual service is individualized, yes. But if every single student is receiving the same service, frequency and duration, and in the same setting, it doesn't look that way on an IEP. It also prevents us from even considering providing services and the least restrictive environment. And I get it, it is hard to provide services in the classroom in a collaborative way. Maybe in the kindergarten classroom as a group, I get it, that is tricky. But we're not going to get any better at it unless we start doing them. Alright, so that is my 10 minute soapbox on pull out individual services and maybe why we should start to consider alternative services. That brings us to our first alternative model from a pullout individual service, which is a push in individuals service. Individual pushin services are absolutely one of the most difficult services to implement with good achievement and good outcomes, I find it is just hard, it takes a lot of planning, you really need to have good communication with the teacher to make sure that your schedules align so that when you go into the classroom, to actually work on a handwriting goal, they're actually working on something related to writing. Or if you're going into the classroom to work on a sensory processing goal to make sure that you know, they're actually doing something where you can implement some of those various accommodations or sensory brakes or whatever you plan to do. It can be overwhelming because you don't have any control over the environment really. And when you come into the classroom, you've got to bring all the tools that you need. If you don't bring all the tools then you're probably gonna have to say, Oops, excuse me, I'm gonna go run back to the OT room and grab something. Push in individual services are tricky. One of the biggest objections to push on services that I have heard from other OT practitioners and I've even experienced from myself is how is what I am doing as a push in individual service, different from a eight different from a special education aid working with a student. And it took me some time to kind of really understand this and figure it out for myself and be able to share it. But the truth is, is that you are very different from an aide, you have a lot of knowledge that that aide does not have a paraprofessional who has been in the schools a long time and has worked with other OTs and SLPs, and PTs, you know, they have a lot of knowledge, and they might have some of that knowledge that you do. But at the end of the day, your brain works a lot differently than a paraprofessional, you have the ability to really break down tasks and build them back up, you understand the just right challenge very well. And when we talk about collaborative services here in a little bit, we're going to talk about building up the capacity of those paraprofessionals and the teachers that we work with. But in this role as a individual push in type of service, we are really going into the classroom and focusing on that student, we're not necessarily trying to support the teacher and understanding exactly what we're doing or supporting the aid and understanding what we're doing, we're really there for the student. A lot of times this can be used for generalizing skills that have been maybe mastered and the pull out setting, maybe you're going into the classroom to generalize those skills. Personally, I prefer collaborative type of services over this pushin model, they are similar in a way because you are going into the classroom. So I'm actually going to cut myself off here and postpone a lot of what I have to say about getting into the classroom for when we discuss collaborative type of services. All right, let's go ahead and talk about the next one, which is groups. Group therapy can be wonderful. It can be provided in a pullout setting similar to what we were just talking about, or it can be provided in the classroom setting. One of my favorite ways to provide groups in the classroom setting is by pushing into younger grades like preschool, kindergarten, and maybe first grade when they're still doing some of those centers, you can kind of ingrain yourself naturally in during center time. And the students who need occupational therapy services can come to you for one of your services. If you want to do this more in an RTI model, you can go into a kindergarten classroom, you can set up shop at a particular table, and multiple groups can rotate to you whether or not they have OT services. That's how groups in a classroom can be used as an RTI model. I'm not going to spend as much time on groups as I did on that pullout individual services. But I do have a few pros a few good things that that can come out of groups and why we might want to use them. And I'll list those off here and talk just a little bit about them. One is that they can be a very efficient use of time. If you have a large caseload. And you go and actually look at that caseload, and maybe turn a few of those individual services into maybe four groups, you can take 10 individual half hour sessions and maybe turn it into four individual half hour sessions. So you just went from 1030 minute sessions, which is five hours to 430 minute sessions combined, that altogether is two hours. So it can save you a lot of time. But to do that, it can take some time for planning and figuring out which kids to put together. I definitely recommend starting with kids in the same classroom that maybe have similar style goals. If you have a few kids in the same third grade classroom that have handwriting goals, maybe that's a good group. If some of them have maybe behavior related to sensory processing goals, that could be another good group to put together. Which leads me to another wonderful aspect of groups. And that is the peer interaction and modeling that can occur during groups. Children are very observant. And we should know this as occupational therapy practitioners, right, we recognize the importance of play, because during play kids learn to watch others and learn from others about how to play and develop those social skills and how to learn all type of other skills, motor skills, physical skills, everything comes from play for children, or a lot comes from play for children. So I think that that is something that's very important and valuable. And that is definitely something that you can mention in an IEP, when you're saying, hey, I want to group Johnny and Susan, because, you know, Johnny has these strengths and I think Susan might kind of pick up on those or vice versa, and they might be able to support one another Try it out. If it doesn't work, you can always have an addendum and change it up. But, and yes, I have had to do that before where I made a group thought it was gonna be great and it wasn't. So we changed it up. But give it a try. Let's give Johnny and Susan that opportunity to learn together, be together interact together and learn from one another. If it doesn't work, we can change it up. But let's give them that opportunity. A moment ago, I mentioned how I had a group and it just didn't work. And I had to break it up. And that leads me to my main con for having group therapy sessions. In some cases, you might have one student and a group of two or three that just demand your attention. Or maybe they demand the attention of their peers and the group. And that can make a group very difficult. And when that happens, you have to make a decision as to whether or not this is the right group? Would the group be better off? If you split up a group of three into a group of two with the other receiving individual services? Or with maybe taking one of those students and putting them into a separate group? Would that be better? The point here is that when you're looking at groups, you can't just look at their skill level, you can't just look at their age, you also have to take into account the dynamics of that group, will they work together or will they not work well together. And you may not know that until you try. The last point that I want to make about group therapy sessions is that they should be a real group, as opposed to three simultaneous individual sessions. Yes, it's nice to save time and all by grouping kids together. But let's not group them together only for time sake, we shouldn't be working with Billy on fine motor skills, Susan on coping skills. And I don't know Jeremiah, on visual motor capabilities like this should be a true group session, they should be working on a similar task. Maybe that task is graded differently for each of them. But they should all have similar goals and plays and be working together. Part of group therapy that's so important is that social impact that social interaction that occurs between all three are all two of the students that are in that session. So let's just try not to group kids together for the sake of saving time, let's group kids together because it's actually going to benefit them and the goals that they are working on. All right, now we are moving to an even less restrictive model of occupational therapy services. And that is collaboration. Many therapists and schools and districts and people in general will use collaboration services interchangeably with consultative services. And I don't find that to be the best use. I distinguish them with purpose. And I'm going to break that down for you right here starting with collaboration. When I'm talking about collaboration therapy services, I'm talking about working with both the teacher and the student, I'm not going to get into consultation, but just to kind of show the difference. Consultation is working only with the teacher and not with the students. So going back to collaboration type of services, there are a lot of benefits here. First, collaboration typically occurs in the classroom or in the natural context, collaboration rarely occurs in the OT room away from the students natural environment, that is one of the biggest pros. The other two real positives for collaborative services really go hand in hand. It's capacity building and consistency. And let me break that down here. When I'm talking about capacity building. I'm talking about your ability as an occupational therapy practitioner to build capacity within both the student and the teacher in the natural context. When you are able to support both the student and the teacher in the classroom, or maybe an aide and the student at recess or in the lunch room. That is what allows the consistency. Because if we are sharing our knowledge with the student, and the teacher and or the aide, then they can work together when we are not in the room and that is what leads to consistency. Too often, a student will come to us in the pull up model, we work on something, let's call it letter A, they go back to the classroom, they never work on letter A until the next time they come and see us but if we're going into the classroom, and we're working on handwriting or we're going into the classroom, we're working on selecting coping skills or implementing coping skills or implementing organization skills. Then that student is seeing how it works in the classroom. That teacher or the aide is also seen how it can work in the classroom and they He can implement that same exact process, that same exact skill, that same exact intervention throughout the week and beyond. Now, collaboration does take some time to implement, it is time consuming. And it often requires planning before the actual service itself. If you are going to put collaboration on an IEP, you might also need to put consultation on the IEP in order to have that time to work with the aide or the teacher prior to the collaborative service. I know it sounds difficult, and it can be a little difficult to get used to. And the biggest objection that I often hear from this is that, oh classroom staff, teachers and aides, they won't carry it over. They they just don't, they won't carry it over. And I don't think that that is quite accurate. I don't think that they're actually being given the best opportunity to carry things over. Because a lot of us are using a consultative model where we tell the teacher we tell the aide as opposed to a collaborative model, where we show the aide or the teacher how to do things. And we do that on a regular basis, not a once a month basis. We're actually in there with them on the front lines, showing them how to complete that intervention. And yes, I have some research to support this. I went outside of the world of occupational therapy literature, and I jumped into the world of education literature. And I found inside the Journal of special education, apprenticeship and 2021. A article from sisty and Robledo, where they actually did a survey of special education teachers and found that teachers appreciated when occupational therapy practitioners modeled sensory and behavioral support strategies for the teachers and aides. In fact, they even said that they really appreciated it, as opposed to when we use the pullout model, because they liked to see the strategies that we were working on, they wanted to implement whatever we did throughout the rest of the week. And they actually were like a little put off by the pullout model services, because they didn't know what we were doing. They didn't know how they could help them that way. They really appreciated it when the therapist got into the classroom, model those supports, so that they could then carry it over for the rest of the week, the rest of the month, and so on, and so forth. So collaborative services, in general, getting into the classroom, working not only with the student in the classroom, but also with the teacher right there or the aide right there too, so that they can model and complete what you're doing throughout the rest of the week. They don't need to be right next to you the entire time the teacher, I mean, but it would be nice if you kind of do something and pointed out to them. So they remember that right? Like we can't just do something and expect them to always be watching us and then implement it, we have to do it, explain what we did, or vice versa, explain what we're going to do, and then do it. And then make sure that they understand it so that they can move forward. All right. And that brings us to consultation services, I alluded to consultation services a minute ago, consultation, unlike collaboration is supporting only the teacher. A lot of times consultation can be used in the event of implementing assistive technology or another accommodation, where you can teach the teacher how to implement it, and then they can do it themselves, maybe you don't actually need to be working with the student consultation is the least restrictive type of service because it involves having absolutely zero contact with the student themselves. The student doesn't have to feel any pressure about this outside person coming in to work with them and having their peers wonder who and why this person is working with them. It prevents you from having to say, Oh, I'm just a helper in the classroom and trying to hide who you are. So in that sense, consultation is really nice. But it is also difficult. You have to have a good rapport with a teacher or an aide to make it work. Consultation is a two way street. It is not a one way street. And there have been times in my past where I thought you know what consultation would be great. But then I also think like about the teacher and who I would be consulting with and maybe we don't have that best report, and maybe a different service would actually be better than consultation. It is absolutely okay to take dynamics like that and use them when you're trying to figure out what type of service to implement. If you're not going to be able to you know, use a consultation to its best impact, then maybe try something else like that is okay as long as you have a reason for it, and that you can still provide the service that's going to help the student make progress, meaningful progress toward their goal. All right, so that covers just about all the different types of services that you can have as a school based occupational therapy practitioner, we started off talking about individual pullout, then we talked about individual pushed in, then we talked about groups, which can be both a pullout or a pushin model. And then we went on to talk about collaboration and then consultation. Now, I want to discuss one more thing before we wrap up this episode. And that is about mixing it up. And using multiple models here, not just console, not just pull out individual services, but potentially mixing it up, you may be familiar with a three to one model, some people use something like a two to two model, I really like that one. Some people like to have weekly services, and then add an additional console to the services. So let me explain how these models work. Starting with the one you may be most familiar with, if you read some of the research, and that is the three to one model, the three to one model has definitely been looked at within research, I don't know that it has actually been compared to maybe a weekly direct service. But what the three to one model is, is basically setting up a month into four weeks, like most months are and saying during those four weeks, I'm going to do one service, one time a week. And then for the fourth week, I'm going to do something different, hence the three to one model. So in a month, with four weeks, the first three weeks, you might provide a direct individual pull out service, and then the fourth week, maybe you're doing a consultation, hence, three to one, get it now, that is one alternative model. And it allows you to kind of get the best of both worlds, you can see the student individually in a pull up model. And then maybe on week number four, you're actually consulting with the teacher, or maybe you're collaborating and getting into the classroom a little bit. Or maybe you're seeing the student in a group, whatever it might be. Some districts also use the three to one model where the three are services. And then the one week is actually completely free from services, where it allows the therapist an opportunity to spend time with evaluations, RTI, maybe the entire related service programs don't have services that week, so that they can focus on IEP s that week, or whatever it might be. To be honest, I'm not a big fan of that. Because then like what if you do have a student that needs services every week, then you're like the only one that's not using the three to one model because you have five kids that needs to be seen that week. But anyways, that is kind of the essence of the three to one model. And to support this claim about the three to one model, and the Journal of Occupational Therapy, schools and early intervention. So ruya and Garfinkel. Again, this is a 2018 article, they said that practitioners felt the three to one model supported their use of differentiated service delivery, that was contextually based expanded their scope of practice, increased work efficiency, and was heavily influenced by stakeholder support. So those are some good key benefits of the three to one model that can't be denied. Right? Again, I don't think that there's research out there that compares like the three to one model to a two to two model, which I'm going to talk about in a second to a full on one time a week, 30 minute session model, but it is something out there and a lot of people are using it. That then brings me to the model that I really do like and prefer, which is a two to two model. This is one of my go to models and similar, you know, similar concept of the three to one model, except two to two. So 5050 split. And you can do this with any type of service model, you could have two group sessions and to individual sessions, you can have to individual pull out sessions and to individual push in sessions, or to pull out group sessions and to collaborative sessions. I really liked this model because it gives you some flexibility to work on those skills that you may need to do in a group or a pullout setting. And then it gives you the other two sessions to generalize them into the classroom. Again, this is one of my go twos. And to give you a little example of how it can progress over time. I've had a student where my therapy services progressed like this, the first year that I was working with them that I tried this model, I had a one to one pullout service with them for two times a month and a pullout group service with them two times a month. So we would alternate between individual service and group service individual service group service so that way we'd work on a skill one on one, and then we could work on that same skill in a group. The following year we transition to twice a month group services in He pulled out setting and twice a month collaborative services in the classroom setting. This gave us the opportunity to again, work on some skills in the small group, and then transition and generalize them into the classroom setting. I really liked this model, it has worked wonders for me. No, I don't have any data on it. But it's just something anecdotally that I saw really helped many of my students. The one other MCs method that I have used in the past as well is adding a consultation to students IEPs, were also had weekly individual services, or really any type of weekly services, whether it's collaborative group or individual, I'd like to add that extra consultation, because in most cases, I was already doing it. Like it's very rare that we don't actually consult with a teacher about a particular student, even if it's five minutes in between seen to other students, typically, we are talking to a student, in person or via email to help them right. So I just formalized it by putting it on the IEP. So what did that look like on the IEP I had two separate service lines. And this goes for the three to one model, the two to two model or this model, I had two separate service lines. One was one service and the other was a separate service. It was that simple like that is possible, you can do that. It's not something unheard of, it's okay for occupational therapy, to have two separate service lines on the IEP. All right to bring this all back together. And to wrap up this episode number 138. Those are the primary service models that we use in school based occupational therapy, maybe you've gotten creative and use something a little different, I really hope you have because I think we need to try different things. And maybe they fail, but at least we tried it. Now if you're sitting listening to this episode and saying to yourself, Man, like 85% of my caseload is pulled out the other 15% is console like it's all or nothing or one or the other, right. And maybe you want to try some of these other type of models. A I encourage you to do that. And be I just want to say starts low. Like you don't have to transition all of your students from pull out individual all to like push an individual or collaboration, like over the next year, right? Take it slow, audit your caseload, take your caseload one night and grab some wine or a drink, whatever, and just look it over and just, you know, put a tally mark by the students that you think hey, you know what? I'd like to try it with those students like three, five, maybe 10 students, you think to yourself, What if I actually pushed into that that kids classroom? What if I supported them in the classroom instead of in the OT room, right? Like, that's how you can start doing this, you don't need to just jump full in, just start with a few a few kids. And on top of that, maybe even think about the teachers, right? Like what teachers do you know, that would be on board with this. The last thing you want to do is go gung ho with this, and then find out that the teachers are like, Excuse me, what are you doing in my classroom? Right? So maybe find three kids that are in a teacher's classroom that you have a good rapport with, and start there. Don't make this hard on yourself, like make it nice and easy, by picking out the students that you know will likely be successful if you're supporting them in the classroom, because of your rapport with that teacher and because of your ability to support those students. All right, that is going to wrap up episode 138 of the OT schoolhouse podcast. I hope this helped you. I hope you may be, you know, hit rewind a few times because of some of the things I said actually made you think if they did, that is wonderful growth happens when we are questioning our own beliefs and whatnot. So I'm glad that you were able to find this podcast helpful. I did mention some research articles in this episode, and I have them all linked, you can just check out OTSchoolHouse.com slash episode 138 If you want to learn more about those articles. Likewise, if you would appreciate more support directly from myself, please check out the OT schoolhouse collaborative. The OT schoolhouse collaborative is our private membership, where myself and other school based occupational therapy practitioners come together to help us all implement best practices. We have professional development within the collaborative. We have mentorship from myself and others in the collaborative. We have a gold bank, we have resources and research all available for you inside the OT schoolhouse collaborative. So you can check that out either using the link in the show notes or by heading over to OTSchoolHouse.com slash collab. I hope to see you over there and no matter what I hope to see you in the very next episode of the OT schoolhouse podcast, take care and I'll see you next time.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now, head on over to OTschoolhouse.com Until next time, class is dismissed.  Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! 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 Schoolhouse Podcast