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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. 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 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 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 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 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

Hey there! As the holiday season approaches, I think now is the perfect time to pause and reflect on the many reasons we, as school-based OT practitioners, have to be thankful. While there's no doubt that our profession can be demanding and challenging at times, there's also a wealth of fulfillment that comes with being a school-based OT practitioner. I figured I would keep it lighthearted today as I share ten reasons why we, as school-based OT practitioners, should feel an extra dose of gratitude during the holiday season. As my dad likes to say at the Thanksgiving table, "There's always something to be thankful for." So, let's look at some of the things we can be thankful for every day. Seeing Students in Their Natural Environment One of the most beautiful aspects of our role is the opportunity to work with students in their natural environment—the school. We get to observe, evaluate, and provide treatment to students where they spend most of their day, allowing us to truly understand their challenges and progress on a deeper level. It's a privilege we should cherish. Our daily interactions with students in the busy hallways, lively classrooms, and on the playground provide invaluable insights that go beyond what can be gleaned from a clinical setting. We witness not only their academic struggles but also their social interactions, sensory sensitivities, and emotional highs and lows where it matters most to them. This depth of understanding allows us to tailor our interventions to their unique needs and foster progress that matters to each student. Supporting More Than Just Students While our primary focus is on our students, our impact often reaches much further. We have the unique privilege of supporting teachers, aides, and other school staff in creating inclusive and effective learning environments. Displaying our expertise in fine and gross motor skills, sensory integration, and executive functioning in the classroom benefits all educators striving to meet the diverse needs of their students. Collaborating with teachers to implement strategies that make learning accessible to all is such a rewarding aspect of what we do. Whether we're recommending a shift in the classroom seating to accommodate sensory sensitivities or providing recommendations for inclusive physical education activities, we contribute to the overall success of the school community. Our ability to support not only our students but also the educators who work tirelessly to provide quality education is indeed something to be thankful for. Empowering Entire Classrooms Our influence doesn't stop at individual students; it often extends to positively impact entire classrooms and sometimes even entire schools. The strategies we implement can enhance classroom dynamics, routines, and accessibility, benefitting every student. Through RTI strategies, we can help set up sensory-friendly classroom spaces, provide guidance on efficient classroom organization, and contribute to the creation of an educational environment where all students can thrive. This ripple effect on the entire school community is a testament to the holistic impact we can have and a reason to be profoundly thankful. Enjoying Extended Holiday Breaks Yep, It had to be said. We enjoy a perk that many envy—extended holiday breaks that align with the academic calendar. Lucky for us, these breaks offer a well-deserved chance to recharge, spend quality time with loved ones, and return to our duties with renewed energy and enthusiasm. I hope you are enjoying a holiday break of your own as you read along today. Never a Dull Day While you may not be able to count on being invited to the IEP as the school OT, one thing is for sure - it's anything but dull. Our work is dynamic, diverse, and ever-evolving. Each day brings new challenges, new faces, and new opportunities for growth and learning. From conducting assessments to collaborating with colleagues and providing direct services to students, there is a constant flow of activity. We are problem solvers, adaptors, and educators, and our diverse responsibilities keep our profession exciting and dynamic. Embracing the unpredictability of each day and the learning that comes with it is something to be thankful for. Serving Students Who May Not Otherwise Have Access to OT This is one that I hold near and dear. In our role, we often have the privilege of reaching students who might not have access to occupational therapy services elsewhere. This is especially true for students from underserved communities, in rural areas, or those with limited resources. Knowing that our early interventions can be life-changing for these children is a source of immense pride and gratitude. We have the opportunity to bridge gaps in access to essential services, ensuring that all students, regardless of their circumstances, have equal opportunities to succeed. It's a reminder of the profound impact our work can have on the lives of those we serve. Contributing to Inclusive Education You can't spell inclusion without OT… Wait, you can??? I get confused at times because OT practitioners always seem to be at the center of advocating for and implementing inclusive practices! Whether we are recommending collaborative services to the IEP team or providing education to the teachers and staff we support, we always seem to have inclusion in mind. By advocating for inclusive practices and supporting educators in their efforts, we foster an environment where students with various abilities learn side by side, benefiting from shared experiences and opportunities. The dedication to making inclusive education a reality is indeed something to be celebrated and thankful for. Variety of Students One fascinating aspect of our profession that keeps us engaged and continually learning is the wide variety of students we encounter. Each student is unique, presenting their own set of challenges and opportunities for growth. From working with a child with sensory processing difficulties to helping another improve their fine motor skills or learn to use assistive technology, this diversity keeps our work intellectually stimulating. We constantly have to expand our knowledge and hone our skills to meet the unique needs of each student. This variety not only keeps us on our toes but also reinforces our ability to think critically, adapt to different situations, and apply our expertise in creative ways. It's an ongoing learning journey that enriches our professional lives and gives us reason to be thankful for the constant growth it offers. Witnessing Progress and Milestones Few experiences in our profession are as rewarding as witnessing the progress and milestones achieved by our students. It's in these moments that the true impact of our interventions becomes evident. Whether it's a child mastering the letters in their name, improving their ability to follow along in art class, or gaining confidence in their social interactions, these milestones are a testament to our dedication and expertise. We fortunate to be able to share these moments with the students we serve, and that's something to be thankful for. Advocating for Students Like inclusion, advocacy is woven into the fabric of our role as school-based OT practitioners. Maybe it's because we always have to advocate for ourselves. But for whatever reason, every OTP I know tirelessly advocates for the unique needs of their students, ensuring they are recognized and supported within the educational system. We also know how important it is for students to be able to advocate for themselves. If there is an advocacy goal on a student's IEP, I'd be willing to bet it was the OT who wrote it. It's just something we always consider in helping our students achieve. Our advocacy also extends to fostering strong partnerships with parents, caregivers, and other professionals. Our ability to effectively communicate the needs of our students and collaborate with various stakeholders is a cornerstone of our profession. It's a reminder of our role as advocates, educators, and catalysts for positive change in the lives of our students. Wrap Up As we head into the holiday season, I encourage you to take a moment to reflect on the multitude of reasons you have to be thankful for in your role as a school-based OT practitioner. We have a pretty unique and rather fantastic job filled with diversity, dynamism, and meaningful moments. Our ability to see students in their natural environment, support not only students but also teachers and staff, empower entire classrooms, enjoy extended holiday breaks, embrace the dynamic nature of our work, and serve students who may not otherwise have access to OT is a testament to the uniqueness of our role. So, as we gather with friends, family, and our other favorite people, let's remember the profound impact we have on the lives of our students and the countless reasons we have to be thankful as school-based OT practitioners during this holiday season. Plus, you can use these as examples when you have to explain to your Uncle Bob what you do as a school-based OT practitioner for the tenth time. 😉 Enjoy your break, 👋 Jayson

Welcome back to another installment in our series dedicated to the tools and techniques that shape our practice in school-based occupational therapy. Today, we're zeroing in on a cornerstone of our work that is often overshadowed by more talked-about areas like sensory processing or fine motor skills: visual perception and visual motor integration. As you well know, these skills are not just 'nice-to-haves'; they are essential for our students' academic achievements and day-to-day functioning. Whether it's decoding text in a reading assignment, copying notes from the board, or participating in a physical education class, the ability to accurately perceive visual information and translate it into coordinated motor actions is vital. In this article, we'll dive into the assessment tools and processes that are our go-to resources for evaluating these skills. These aren't just diagnostic instruments; they're communication tools that help us articulate our students' needs to teachers, parents, and IEP teams. By the end of this guide, you'll have a deeper understanding of each tool's strengths and limitations, empowering you to choose the most appropriate assessments for your students and to advocate more effectively for the services they need. Understanding Visual Perception and Visual Motor Assessments As an OT practitioner, you've likely found yourself in an IEP meeting trying to explain the importance of visual perception and visual motor skills to a room full of educators and parents. These skills are often misunderstood or inappropriately lumped into one category. Yet, they are foundational to a student's ability to learn and interact with their environment effectively. Visual perception involves the brain's ability to interpret and make sense of visual stimuli, such as shapes, colors, and patterns. Visual motor integration, on the other hand, is the coordination of visual perception and motor skills. This is where the rubber meets the road, so to speak, in activities like handwriting, cutting with scissors, or catching a ball. Too often, educators (OTPs included) are too quick to label a problem as “visual-motor” rather than dig deeper to find the root motor or perception difficulty. As school-based OT practitioners, we're in a unique position to assess these skills and translate our findings into actionable insights for teachers, parents, and other members of the IEP team. The assessments we choose serve multiple purposes: they help us identify specific challenges a student may be facing, guide our intervention planning, and provide a quantitative measure that can be tracked over time to gauge the effectiveness of interventions. But choosing the right assessment tool isn't always straightforward. Each tool comes with its own set of advantages and limitations, from the age range it's suitable for to the specific skills it measures and the time required for administration. That's why it's crucial to be well-versed in the range of available assessments, understanding not just how to administer them, but also how to interpret the results in the context of a student's overall occupational performance and participation in school activities. Below, I'll break down some of the most commonly used assessment tools for visual perception and visual motor skills, providing you with the information you need to make informed decisions in your practice. We'll cover everything from the basics of each tool to tips on administration and interpretation, as well as the benefits and limitations as we see them in our day-to-day practice. Let’s do this! Visual Perception Assessment Tools As school-based OT practitioners, we know that visual perception is more than just "seeing" — it's about understanding and interpreting what is seen. The tools explored below can help us identify the unique challenges our students face, whether it's distinguishing shapes in math class or understanding spatial relationships in a physical education setting. Note that some of these tools also include subtests that measure visual motor skills separately from the subtests that measure visual perception skills. However, I have placed the assessment tool here based on what I feel it measures best - visual perception skills. TVPS-4 (Test of Visual-Perceptual Skills) Brief Overview: Evaluates visual-perceptual abilities across seven domains, including visual discrimination, visual memory, and spatial relationships. Subtests: Visual Discrimination, Visual Memory, Spatial Relationships, Form Constancy, Sequential Memory, Figure-Ground, and Visual Closure. Age Range: 4-18+ years Time Needed: 25-45 minutes Administration Format: Multiple-choice Benefits: Comprehensive assessment of visual-perceptual skills, useful for targeted interventions. Limitations: Requires controlled testing environment and does not assess visual motor skills. Click here to learn more about the TVPS-4. MVPT-4 (Motor-Free Visual Perception Test) Brief Overview: Assesses visual perception without motor involvement. Subtests: Visual Discrimination, Spatial Relationship, Visual Memory, Figure–Ground, Visual Closure. Age Range: 4-80+ years Time Needed: 25-35 minutes Administration Format: Multiple-choice Benefits: Motor-free, suitable for a wide age range. Limitations: It may not capture subtle difficulties and does not assess at visual motor capabilities. Click here to learn more about the MVPT-4. DTVP-3 (Developmental Test of Visual Perception) Brief Overview: Comprehensive look at both visual perceptual skills and visual-motor integration. Subtests: Eye-Hand Coordination, Copying, Figure-Ground, Visual Closure, Form Constancy, Visual-Motor Speed Age Range: 4-10 years Time Needed: 20-30 minutes Administration Format: Paper and pencil Benefits: Comprehensive, includes both motor-reduced and motor-enhanced subtests. Limitations: Limited age range, but that leads to our next tool, the DTVP-A Click here to learn more about the DTVP-3. DTVP-A:2 (Adolescent & Adult Version) Brief Overview: Tailored for adolescents and adults. Subtests: Similar to DTVP but adapted for an older age group. Age Range: 11-74 years Time Needed: 20-30 minutes Administration Format: Paper and pencil Benefits: Age-appropriate for adolescents and adults. Includes both a VP and a VM component. This tool is a favorite of mine when working with students in high school. Limitations: Limited to adolescent and adult populations. Click here to learn more about the DTVP-A:2. Visual Motor Assessment Tools Visual motor skills are where perception meets action. These skills are essential for tasks that require coordination of visual perception with fine and gross motor skills, such as handwriting, cutting, and ball skills. The following tools are designed to assess these integrated skills. Note that some of these tools also include subtests that measure visual perceptual skills separately from the subtests that measure visual motor skills. However, I have placed the assessment tool here based on what I feel it measures best - visual motor skills. PDMS-3 (The Peabody - Eye-Hand Coordination Subtest) Brief Overview: Focuses on eye-hand coordination. Subtests: Eye-Hand Coordination Age Range: 0-5 years Time Needed: 5-10 minutes Administration Format: Manipulatives Benefits: Suitable for very young children, relatively quick to administer once you get used to it. Limitations: Limited to eye-hand coordination. Limited age range, as well. No activities that directly assess perception. Click here to learn more about the PDMS-3. VMI-6 (Beery-Buktenica Developmental Test of Visual-Motor Integration) Brief Overview: Assesses the integration of visual and motor skills. Subtests: Visual-Motor Integration, Visual Perception Test (Supplemental), Motor Coordination Test (Supplemental) Age Range: 2-100 years Time Needed: 10-15 minutes Administration Format: Paper and pencil Benefits: Widely recognized, strong psychometric properties. Limitations: May not capture full complexity. I have also found that many school psychologists use the VMI. So check in with your school psych before deciding to use the Berry VMI. Click here to learn more about the VMI. WRAVMA (Wide Range Assessment of Visual Motor Abilities) Brief Overview: Assesses visual-motor skills, visual-spatial skills, and fine motor skills. Subtests: Drawing (VMI), Matching (VP), Pegboard (Motor Coordination) Age Range: 3-17 years Time Needed: 15-25 minutes Administration Format: Requires manipulatives and paper and pencil Benefits: Wide age range, assesses multiple domains. I sometimes prefer the WRAVMA over the VMI when I am working with younger students. It is a little more relatable with the pictures and activities. Limitations: Requires multiple manipulatives. Click here to learn more about the WRAVMA. BOT-2 (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition) Brief Overview: The BOT-2 is a comprehensive motor assessment with various subtests that can provide insights into a child's visual-motor skills and, to some extent, visual perception. Subtests Relevant to VP and VM: Fine Motor Precision, Fine Motor Integration, & Manual Dexterity Age Range: 4-21 years Time Needed: Varies depending on the number of subtests administered; each subtest can take between 5-15 minutes. Administration Format: Manipulatives and paper and pencil Limitations: I know... it doesn’t use the term “visual motor” in the title or as a subtest, but the BOT-2 absolutely looks at VM skills. It just calls them “Fine Motor Integration.” As such, you may need supplementary assessments for a comprehensive understanding of these skills. Click here to learn more about the BOT-2. Informal Assessment of Visual Perception and Visual Motor Skills While formal assessments provide standardized data and are essential for diagnosing specific issues, informal assessments offer a more flexible approach that can be tailored to individual student needs and classroom environments. These assessments are particularly useful for capturing a holistic view of a child's abilities and challenges. Observations Classroom Activities: Observe the student during typical classroom activities like writing, cutting, or drawing. Look for signs of difficulty in tasks that require visual-motor integration or visual perception. Playground/Gym: Observing a child during physical education or free play can provide insights into their gross motor visual-motor skills, such as hand-eye coordination in ball games. Teacher and Parent Interviews Questionnaires and Interviews: Questionnaires and Interviews can be used to gather information from teachers and parents about a child's performance in daily activities that require visual perception and visual-motor skills. IEP Meetings: Use these meetings as an opportunity to discuss any concerns about a child's visual perception or visual-motor skills and learn more from the other adults working with the student. Task Analysis Handwriting Samples: Analyze a student's handwriting for signs of visual-motor difficulties, such as inconsistent letter formation or poor spacing. Functional Tasks: Break down everyday tasks that the student finds challenging, such as tying shoelaces or using scissors, to identify specific visual-motor or visual-perceptual difficulties. Scaffolding: Provide varying levels of support during a task to see how much assistance the student requires for successful completion. This can help identify the specific skills that need to be targeted in intervention. Error Analysis: Examine the types of errors a student makes during visual-motor or visual-perceptual tasks to understand the underlying challenges. By integrating both formal and informal assessments into your practice, you can develop a more comprehensive understanding of a student's visual perception and visual-motor skills, leading to more effective and individualized intervention plans. You've assessed the student. Now what? 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! Assessing Beyond Functional Skills Visual perception and visual-motor skills are just one piece of the puzzle when it comes to a child's academic performance and overall well-being. Often, these skills are intertwined with other areas of development, such as fine motor skills, executive functioning, and even social-emotional skills. Therefore, a comprehensive evaluation often requires us to look beyond just visual perception and visual-motor skills to understand the whole child. This might involve assessments in one or more of the following areas: Fine Motor Skills: Assessing a student's ability to use and coordinate small muscles in the hands and fingers to perform precise movements required for handwriting, opening containers, and more. Executive Functioning: Assessing skills related to organization, time management, planning, and self-regulation to address challenges that impact task initiation, focus, time management, and assignment completion. Functional and Independence skills: Assessing students' ability to perform daily living tasks, such as dressing and grooming, to enhance independence and functional participation. Sensory Processing: Evaluating how students perceive and respond to sensory information to develop strategies for managing sensory challenges and promoting engagement in school activities. Social-Emotional Skills: Assessing students' social interactions, emotional regulation, self-awareness, and coping strategies to enhance social skills, self-esteem, and emotional well-being, fostering positive relationships and school engagement. By considering these additional areas and employing comprehensive assessment approaches, we can address the diverse needs of students and support their holistic development, functional participation, and overall well-being in the school environment. The Wrap Up Visual perception and visual motor skills are integral to a child's academic and daily life success, and as school-based OT practitioners, we are uniquely positioned to assess and intervene in these areas. From formal assessments like the VMI, TVPS, and DTVP, to informal methods such as classroom observations and task analysis, we have a wide array of tools at our disposal. Each tool comes with its own set of benefits and limitations, and the choice of assessment should be tailored to the individual needs of each student. Thank you for joining me in this deep dive into visual perception and visual motor assessment tools. I hope you've found this guide useful in enhancing your practice and supporting the children who rely on your expertise. Until next time, keep doing what you do best—making a difference in the lives of your students. 👋 Jayson PS. If you appreciate this article, be sure to join our email list below to know when the next helpful article related to school-based OT becomes available. Get my Evaluation Report Template and start feeling confident knowing you conducted a solid school-based OT evaluation. Sign up for the A-Z School-Based OT Course to help you better understand school-based OT and create systems to ensure you are giving each student your absolute best.

Written by Jaivin Anzalota, Creator of ELLA.KIDS In the ever-evolving landscape of education, technological advancements continue to reshape the way students learn, and educators instruct. One area where technology has made significant strides is in the development of artificial intelligence (AI). AI is not only changing the way educators manage their classrooms but also how they cater to the unique needs of individual students. One promising application of AI in education is the creation of personalized social stories, a tool that school-based OT practitioners can leverage to ease transitions, teach calm-down strategies, and, more broadly, support students. In this article, we will explore the capabilities of AI and introduce a new tool called Ella, which empowers OTPs to craft personalized social stories for students more efficiently than ever before. The Power of AI in Education Artificial intelligence is a field of computer science dedicated to creating systems that can perform tasks typically requiring human intelligence. These tasks encompass problem-solving, pattern recognition, language understanding, and more. AI systems can analyze vast amounts of data, recognize trends, and generate insights, making them invaluable tools for enhancing various facets of education. Five Ways AI Can Be Used Today in Education 1. Adaptability: AI enables educators to tailor lessons and activities to the individual needs and learning styles of students. By generating alternative questions and activities, AI can enable educators to adjust lessons with little effort. 2. Efficiency: AI-driven automation reduces administrative burdens on educators, allowing them to focus more on actual teaching. Grading, scheduling, and data analysis can all be streamlined with AI tools, saving educators valuable time. 3. Accessibility: AI can enhance accessibility for students with disabilities. Text-to-speech and speech-to-text applications, for example, assist students with reading and writing difficulties. 4. Engagement: AI-powered interactive tools, such as virtual reality simulations or gamified learning platforms, can make learning more engaging and immersive for students. 5. Personalized Stories: AI-powered personalized social stories can play an important role in helping students transition smoothly between activities, adapt to routines, and reinforce essential calm-down strategies. Ella: AI-Generated Social Stories Ella is an AI-powered tool developed specifically for school-based therapists and educators that streamlines the process of crafting custom visual stories with remarkable speed and efficiency. Ella's power lies in its simplicity and effectiveness. With just a few inputs, school-based OTPs can quickly generate tailored visual stories for their students. Let's take a closer look at how Ella operates: 1. Customization: Ella allows OTPs to create specific stories about a student's routine, upcoming events, or challenging transitions. These stories may include the student's name, age, likeness, and the activity or situation. 2. AI-Powered Content Generation: Once the basic information is provided, Ella's AI algorithms get to work. They analyze the input and generate a personalized social story that is easy to understand, following social story best practices. 3. Visual Support: Ella's stories are rich in visual elements, making them highly accessible to students, including those with various learning challenges. Visual aids help students better comprehend and internalize the information presented in the story. 4. Fast Results: Unlike traditional methods of creating social stories that can be time-consuming and labor-intensive, Ella generates these stories in about a minute, using any device with a Web browser, allowing OTPs to focus more on their students. See this example story: Sam's calm-down strategies at school: Movement breaks, quiet space, Yoga breaks, and quiet fidget toys. The story was created for Sam, a 7-year-old boy with red, messy hair. Positive Impact on Students The application of AI in the creation of personalized social stories has the potential to significantly benefit students in various ways: 1. Reduced Anxiety: Transitioning between activities or adapting to new routines can be anxiety-inducing for many students. Personalized social stories, created with Ella's help, can mitigate this anxiety by providing a clear and comforting narrative. 2. Improved Understanding: Visual aids in social stories make it easier for students to understand the expectations and steps involved in a particular activity or routine. 3. Enhanced Communication: Social stories can be used to improve communication skills, allowing students to express their needs and feelings more effectively. 4. Independence: By using social stories consistently, students can become more self-reliant in managing transitions and routines, promoting independence and self-confidence. Incorporating AI-powered Social Stories in Occupational Therapy For occupational therapy practitioners working in schools, incorporating AI tools like Ella into their practice can be a game-changer. Here are some steps that OTPs can take to integrate AI-driven personalized social stories into their work: 1. Training and Familiarization OTPs should practice to become proficient in using AI tools like Ella. Familiarity with the software's features and capabilities is essential to maximize its potential. 2. Collaboration Collaboration with educators, speech therapists, and other specialists is key to ensuring that personalized social stories align with students' overall support plans. 3. Customization OTPs should input accurate and detailed information into Ella to ensure that the generated social stories address the specific needs of each student. While a story title like "Sam can calm down" will produce an accurate narrative, a more specific title like "Sam can calm down using X, Y, Z strategies" will be more personalized. 4. Regular Assessment OTPs should regularly assess the effectiveness of the social stories and make adjustments as needed. This ongoing evaluation ensures that the stories continue to meet the student's evolving needs. Looking for mentorship on when and how to use social stories in school-based OT? Become a member of the OT Schoolhouse Collaborative, where you can ask me any questions you have about social stories, sensory processing, and other school-based OT topics. You'll also get access to our growing library of AOTA-approved courses, resources, and research that we have built for school-based OT practitioners just like you. The Future of AI in Education As AI continues to advance, its impact on education is only expected to grow. AI-powered tools like Ella are just the beginning of a transformative journey that promises to make education more accessible, personalized, and effective. The possibilities are vast, from AI-driven tutoring systems to adaptive learning platforms that adjust content in real-time based on student performance. School-based OT practitioners are well-positioned to embrace these advancements, integrating AI tools into their practice to provide even more targeted and effective support for students with diverse needs. By doing so, they contribute to a more inclusive future for education, where every student can thrive. In conclusion, AI in education, exemplified by tools like Ella, is changing the way occupational therapists support students in their transitions and routines. These AI-generated personalized social stories hold the potential to reduce anxiety, improve understanding, and enhance independence for students, making it an invaluable addition to the toolkit of school-based OTPs. As technology continues to evolve, the role of AI in education will only become more significant, offering exciting opportunities to improve the lives of students and educators alike. Thank you for reading, and be sure to check out Ella.kids to create a social story for the student you are thinking of right now. Cheers, 👋 Jaivin and Jayson Get my Evaluation Report Template and start feeling confident, knowing you conducted a solid OT evaluation. Join the OT Schoolhouse Collaborative membership to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best.

In the dynamic realm of school-based occupational therapy, daily session notes are both a nuisance and a blessing. These notes serve a multifaceted purpose, acting as a tangible record of student progress, a conduit for communication with teachers and parents, a means of demonstrating the effectiveness of your interventions, and, in the most unfortunate cases - a way to cover your own behind when everything hits the fan. As they say, if it's not documented, it never happened. For that reason, in this essay, we'll delve deep into the world of daily session notes, exploring the why, how, and what so you can streamline your documentation process and elevate your ability to document what you practice. I'll also show you a few examples you can use to craft your own note template in the style you prefer. Let's get started. Table of Contents Section 1: Why Do School-Based OT Practitioners Need to Take Notes? Section 2: Options for Note Types (examples) Section 3: How to Decide Which Note-Taking Model Is Right for You Section 4: Tips for Implementation Section 1: Why Do School-Based OT Practitioners Need to Take Notes? To get started, you need to understand the why behind taking notes. I mentioned a few reasons in the intro, but I want to cover each of these reasons more so you recognize the importance of each. Tracking Student Progress Daily notes allow you to show a longitudinal view of each student's journey, helping you to identify and share with the team trends and patterns in the student's development. This insight is invaluable for tailoring interventions and demonstrating progress over time. You may embed your data directly into your note or use a separate data collection form to track the data before narratively adding the data to your notes. Demonstrating Effectiveness Detailed notes are also your proof of efficacy. They show the direct impact of your interventions on a student's functional abilities. This can be instrumental when justifying your role and services to administrators, parents, and other stakeholders. On the flip side, your notes can also be used to show why a student may NOT have made progress. They may have had a lot of absences, or perhaps the teacher prevented you from seeing the student. Whatever the cause, your notes are the place to document it. Regulatory Compliance Daily notes help ensure compliance with federal and state regulations and Medicaid billing. They provide a clear record of services rendered, which can be crucial in audits or reviews. Every state operates differently, so check in with your supervisor for what is required in your notes. Cover Your... Behind And if those reasons are not enough to get you to complete your notes, this one should be. Your notes are your most valuable defense when someone claims that you or the district has done something improper. Whether someone claims you never saw the student, that they don't believe the student's progress, or anything else, your notes can be your best friend. If you don't take notes, or you take poor notes, they can also be your worst enemy. Section 2: Options for Note Types Now for the fun part (well, as fun as talking about notes can be). Let's explore the various note-taking models available. Here are five options: SOAP Notes (Subjective, Objective, Assessment, Plan) SOAP notes are a comprehensive model organized into distinct sections. The Subjective section captures information provided by students, teachers, or parents. The Objective section contains measurable data and observations. The Assessment section summarizes your professional evaluation, while the Plan outlines future interventions and steps. SOAP Note Example: Subjective: While walking to the OT room, the student shared that she was having a rough day and that her hand was tired from writing a 3 paragraph paper in class earlier. When asked what she does when her hand gets tired, Sarah noted that she sometimes takes breaks and shakes her hand to relieve the pressure. Objective: During the session, the therapist observed that Sarah used a very tight grasp on a writing tool but relaxed her grip when writing on a vertical surface. Assessment: After writing on a vertical surface for 5+ minutes, Sarah had no complaint of hand fatigue. In fact, she wanted to continue the story she was working on. Plan: In the next session, I will introduce a slant board to see if this has the same effect on Sarah's tiredness during writing activities. If helpful, I will consult with the teacher to determine if a slant board may be appropriate to use in the classroom. My Take on SOAP Notes: SOAP notes are comprehensive and tend to be longer than other formats. If you are new to school-based OT, consider starting with SOAP notes to ensure you hit on every crucial piece of the treatment session. As you become more experienced, you may move on to something like DAP notes, which can be quicker. DAP Notes (Data, Assessment, Plan) DAP notes focus on data collection, assessment, and planning. The Data section records qualitative and quantitative data and progress. Assessment summarizes your analysis, and Plan outlines future strategies. DAP Note Example Data: Sarah reported having a rough day and hand fatigue. She mentioned using breaks and hand-shaking to relieve hand pressure. Observation: Sarah had a tight grasp on the writing tool but relaxed her grip when writing vertically. Assessment: Sarah's hand fatigue was non-existent when writing on a vertical surface - even after 5+ minutes. She desired to continue the activity, indicating increased comfort and reduced fatigue. Using a vertical surface appears to be an effective strategy for Sarah. Plan: Introduce and monitor the impact of the slant board on Sarah's hand fatigue during writing activities. If the slant board proves helpful, consult with the teacher to assess the feasibility of using one in the classroom. My Take on DAP Notes: DAP Notes are quick and efficient. They omit the "Subjective" piece, but as you can see in the example, you can add any subjective notes into a DAP note's "Data" section. My notes tend to look like a narrative version of DAP notes due to saving space on a page. If you write your notes directly into an online system, you may not need to worry about spacing, and listing your thoughts out may be a perfect solution. Goal-Oriented Notes In goal-oriented notes, the primary focus is on the goals and objectives outlined in the student's IEP. These notes track progress toward these specific goals, making them particularly valuable for IEP reporting and compliance. Goal-Oriented Note Example Goal: - Improve Sarah's hand comfort and reduce hand fatigue during writing activities. Objective: - Sarah reported a rough day and hand fatigue. - Observation: Sarah exhibited a tight grasp on the writing tool but relaxed her grip when writing on a vertical surface. - After 5+ minutes of writing on a vertical surface, Sarah showed no signs of hand fatigue and expressed a desire to continue the activity. Progress Towards Goal: - Sarah's ability to write without hand fatigue improved during the session. - The introduction of the vertical surface appears to be a successful strategy. My Take on Goal-Oriented Notes: This template fits the school-based OT model well, given the direct commentary on the student's goal. However, if you have multiple goals, you may have to add a similar note for each goal you work on that day. I wouldn't say I like that the "Plan" piece is missing in this note type. If I were to use this template, I would add a "Plan" section to the note. It isn't necessary, but it makes my life easier when planning my next sessions. Checklists These notes use predefined checklists or flowcharts to structure your documentation. They provide a systematic and efficient way to record information. Checklists ensure that you cover all necessary points during your note-taking. I don't have an example of this for you because checklists tend to a) take up a whole sheet of paper or b) are built-in to an online system. I have used strict checklist versions for notes in the past, but I was not a fan. They are just too rigid and never have the checkboxes you need. That leads to frustration while completing your notes and trying to fit a sentence or two wherever it will fit on the page. Hybrid Notes Hybrid notes offer flexibility. They allow you to combine elements from different models to tailor your documentation to your needs. This can be especially useful when a student's needs are multifaceted and don't neatly fit into a single model. While I'm not fond of checklist notes, a hybrid version incorporating a checklist with some space for narrative notes can work well. The checklist section can be used for some basic info (like where you saw the student and for how long), while the narrative section allows you to include your DAP section. Want more help crafting the perfect note template? Become a member of the OT Schoolhouse Collaborative, where you can ask me any questions you have about school-based OT. You'll also get access to our growing library of AOTA-approved courses, resources, and research that we have built for school-based OT practitioners just like you. Section 3: How to Decide Which Note-Taking Model Is Right for You The question now is, how do you choose the note-taking model that aligns best with your practice? Here are some factors to consider. Nature of Students' Needs: Consider the specific needs of the students you work with. Some note-taking models may be better suited for particular types of interventions or conditions. If you have a diverse caseload of students with different needs, you'll want to use a template that allows for flexibility. If you work on similar skills with many of your students, then a checklist may work out well. Institutional Requirements: Your school or district may have specific documentation standards or templates you must use. Ensure that your chosen model aligns with these requirements. Personal Documentation Style: Reflect on your personal preferences and documentation style. Some practitioners may find certain models more intuitive or comfortable to work with. To make an informed choice: Conduct a Self-Assessment: Reflect on your practice and preferences. Consider the factors mentioned above. Trial and Error: Experiment with different models to see which feels most natural and effective for your daily note-taking. Which one allows you to provide the most relevant info without taking up half of your day to complete? Seek Feedback: Consult with colleagues or mentors who may understand which model best suits your specific context. Flexibility: Remember that flexibility is key. You can adapt your note-taking style as needed and may even choose different models for different students based on their unique needs. Get my Evaluation Report Template and start feeling confident, knowing you conducted a solid OT evaluation. Join the OT Schoolhouse Collaborative membership to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best. Section 4: Tips for Implementation Creating a structured system for note-taking is a vital step in optimizing your school-based occupational therapy practice. To help you establish an efficient routine, consider implementing the following tips: 1. Schedule Time on Your Calendar: Allocate dedicated time on your calendar for completing session notes. Treat this time as non-negotiable and prioritize it. Consistency in scheduling note-taking sessions will help ensure that you stay up-to-date with your documentation. 2. Create a Template: Develop a note-taking template that aligns with your preferred documentation style (SOAP, DAP, etc.). A well-structured template can significantly reduce the time and effort required to document each session. Customize it to include essential sections and prompts relevant to your practice. 3. Use Snippets for Commonly Used Phrases: Consider using text snippets or shortcuts for commonly used phrases and sentences. Many word-processing software and note-taking apps allow you to create and use shortcuts, saving you from repeatedly typing the same information. This is especially handy for phrases like "student demonstrated improvement in..." 4. Explore Technology with Google Forms: If you prefer a digital approach, explore using technology like Google Forms for note-taking. Google Forms allow you to create customized forms with fields for each section of your notes. Responses are automatically organized, making it easy to review and store information digitally. 5. Prioritize Efficient Documentation Tools: Invest in efficient documentation tools that align with your workflow. If you prefer handwriting notes, consider digital pens and tablets that can convert your handwritten notes into digital text. For digital note-takers, explore note-taking apps that offer templates and organization features. 6. Consider Voice-to-Text Software: If typing is time-consuming, explore voice-to-text software. These tools allow you to speak your notes, which are then transcribed into text. This can be a quick and convenient way to capture your observations and assessments during sessions. 7. Regularly Review and Update Templates: Periodically review and update your note-taking templates. As your practice evolves or you encounter new challenges, adjust your templates to ensure they reflect your current needs. Templates should be dynamic and adaptable. Conclusion If you read all the way to this point, first and foremost, thank you. I appreciate you spending your time here learning how to improve yourself as a therapist. I hope you found this post insightful, and I hope it helps you develop a strategy for getting your notes completed efficiently. Now, be sure to put one thing you learned from this post in action today. Then, please share this post on your social media page to help other school-based OT practitioners. Thanks again for reading, and I hope you have a great day! Until next time, 👋 Jayson

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

As an occupational therapist for over a decade, I have witnessed the growing importance of addressing executive functioning (EF) skills in school settings. Executive functioning skills, such as planning, organization, working memory, and cognitive flexibility, play a vital role in a student's ability to succeed academically and participate effectively in daily life activities. Every educator addresses executive functioning to some degree. However, as school-based OT practitioners, we have a unique opportunity to assess and address EF challenges to support our students' overall well-being and success. In recent years, the focus on assessing and addressing executive functioning within the school-based OT practice has gained momentum. With a deeper understanding of the impact of Executive Functioning deficits on student performance, we can create more targeted and effective intervention plans. This essay aims to provide school-based OT practitioners with an overview of structured and unstructured executive functioning assessment tools used in the schools. These tools can help us gain valuable insights into a child's EF skills and guide the development of tailored intervention strategies. I. Understanding Executive Functioning (EF) Before delving into the assessment tools, let's first explore what executive functioning entails. Executive functions are a set of cognitive processes that enable individuals to plan, organize, initiate, self-monitor, and complete tasks successfully. These skills are essential for problem-solving, time management, emotional regulation, and flexible thinking. Children with EF challenges may struggle with following instructions, organizing their school materials, managing time, and adapting to changes in routines. Addressing these challenges early can significantly impact a child's academic success and overall development. Just imagine how difficult it may be for students to complete an assignment if they need help remembering where they placed the instructions. Per Havard University's Center on the Developing Child, three brain functions impact one's executive functioning. They are working memory, mental flexibility, and self-control. Working memory pertains to the ability to temporarily store and manipulate information in the mind. Mental flexibility is a term used to describe the ability to adapt and adjust to new situations and ideas. The concept that different rules apply to other settings would fit under mental flexibility. Self-control refers to one's ability to set priorities and resist impulses. These are all skills you have likely worked on with your students and you can likely conclude how these functions could positively (or negatively) impact a student's ability to succeed in a classroom. Here are a few items that come to my mind: Learning and completing the classroom morning routine Following written or verbal instructions to complete an assignment Understanding and accepting that rules may be slightly different in class than they are at recess Tuning out a peer while the teacher is speaking Using a planner to note down the agenda and homework for the day Remembering to complete the homework once at home. II. The Importance of EF Assessment in School-Based OT Practice: As is the case with other skills we support, assessing executive functioning skills when warranted is crucial in developing targeted intervention plans. By identifying specific EF strengths and weaknesses, we can set realistic goals for our students and monitor their progress over time. Effective assessments can help us tailor interventions to address individual needs and promote meaningful growth in EF skills. A. The Brief-2 (Behavior Rating Inventory of Executive Function, Second Edition): Based on my experiences, the Brief-2 is the most commonly used assessment of executive functioning skills by school-based OT practitioners. The Brief-2 relies on rating scales from parents, teachers, and the child. It offers insights into various EF domains, including working memory, inhibition, emotional control, and more. By comparing results from multiple raters, we can gain a comprehensive view of the child's executive functioning skills in different settings. The ten domains of EF addressed include: Inhibit: The ability to stop or delay a response when necessary, showing self-control. Shift: The capacity to move flexibly between tasks or situations, demonstrating cognitive flexibility. Emotional Control: The regulation of emotions and responses to emotional situations. Working Memory: The ability to hold and manipulate information mentally to complete tasks efficiently. Initiate: The ability to begin a task or activity independently without undue hesitation. Organization of Materials: The capability to manage and arrange one's belongings and work materials effectively. Plan/Organize: The aptitude to set goals, create plans, and carry out the steps required to achieve them. Self-Monitor: The skill of self-monitoring one's performance and adjusting strategies when needed. Task Monitor: The skill of self-monitoring during tasks or activities to ensure they are completed accurately and efficiently. Task Completion: The capacity to carry out tasks to completion in a timely and accurate manner. Additional Information concerning the Brief-2: Age Range: 5 to 18 years. (Self-report form: 11-18 years) Completion Time: 10 to 20 minutes per form (teacher, parent, and self). Pros: Multiple perspectives from parents, teachers, and the child provide a holistic understanding. Helps identify specific areas for targeted intervention planning. Cons: Subjectivity from raters may influence results. This is not a task-based assessment. All information is based on reports, which can be skewed. Limited to older children and adolescents, not suitable for younger students. Several helpful resources related to the Brief-2 can be found here. B. The CKTA (Children's Kitchen Task Assessment): The CKTA, Children's Kitchen Task Assessment, is a functional and real-life task-based assessment sometimes used by school-based OT practitioners to evaluate executive functioning and adaptive skills. This assessment involves observing the child's performance while they engage in a cooking task to make dough for playing. The CKTA provides insights into a child's ability to plan, organize, and problem-solve during a common IADL. Domains Assessed: The CKTA focuses on executive functioning skills related to cooking activities, as well as adaptive skills required for independent meal preparation. The assessment looks into the child's ability to follow multi-step instructions, manage time, and organize materials during the cooking process. Additional Information: Age Range: 8 to 12 years. Completion Time: 15 to 30 minutes. Pros: Utilizes a functional, real-life task to assess executive functioning in a familiar context. Offers a practical understanding of a child's EF skills during a daily activity. It can be engaging and motivating for children, making it easier to elicit their best performance. Cons: Requires access to a kitchen or suitable cooking environment, which may not be available in all school settings. Limited to assessing specific EF skills related to cooking activities and may not cover all EF domains. The CKTA may not apply to students who do not have cooking as part of their education plan. While the assessment is free to download, you will need to obtain the required materials. Learn more about the CKTA here. C. The Weekly Calendar Planning Activity (WCPA): The Weekly Calendar Planning Activity (WCPA) is a performance-based assessment that uses the concept of creating a schedule to assess executive functioning. The task involves following and organizing a list of 18 (youth version) appointments or errands into a weekly schedule while keeping track of rules, avoiding conflicts, monitoring the passage of time, and inhibiting distractions. The WCPA is a tool that OT practitioners could use with high school students to understand EF skills better and plan an intervention for supporting organizational goals. Domains Addressed: The WCPA is designed to assess executive function domains such as attention and working memory, cognition, and executive functioning through an occupation-based task. Additional Information: Age Range: 12-89 years Completion time: Approximately 20-30 minutes Pros: The WCPA is a performance-based assessment that can provide information about both EF skills and the ability to complete a complex scheduling task. It is appropriate for use with adolescents and young adults. The time that it takes to complete the WCPA is reasonable within a school setting. Cons: Requires the student to have functional writing skills. Not suitable for younger students. Narrow in its scope due to only looking at EF skills related to one particular task. Learn more about the WCPA here. D. The WCST (Wisconsin Card Sorting Test): The WCST, Wisconsin Card Sorting Test, is a widely recognized and used standardized assessment tool to assess cognitive flexibility and problem-solving abilities. It requires the child or adolescent to sort cards based on different criteria and adapt to changing rules during the task. It's like playing Solitaire, except with cards designed to be slightly confusing. Domains Assessed: The WCST measures the child's ability to adapt to changing conditions, switch mental sets, and problem-solve during the card sorting activity. Additional Information: Age Range: 6 years and older, including adolescents and adults. Completion Time: 20 to 30 minutes. Pros: Offers a standardized, objective measure of cognitive flexibility and problem-solving. Provides valuable information about a child's ability to adapt to changing rules and mental set shifting. Widely recognized and used in neuropsychology, allowing for comparisons with normative data. Cons: It may be challenging or frustrating for some children, leading to potential performance-related stress. Limited to assessing specific aspects of executive functioning and may not capture the full range of EF skills. Click here to learn more about the WCST. E. The NEPSY-II: The NEPSY-II is a comprehensive assessment battery used to evaluate various cognitive domains, including executive functions. It provides valuable insights into EF, attention, language, memory, and sensorimotor skills in children. To be frank, I have not heard of OTs using the NEPSY-ll in school-based OT. It seems to be more commonly used by psychologists than OT practitioners. However, as an OT, you may be able to extract data from the tool if your school psychologist has administered it. Domains Assessed: The NEPSY-II includes the following subtests: Executive Function and Attention Language Memory and Learning Sensorimotor Visuospatial Processing Social Perception Several of the six subtests assess executive functioning skills such as inhibition, attention, cognitive flexibility, and working memory, among others. Additional Information: Age Range: 3 to 16 years. Completion Time: 45 minutes to several hours, depending on the number of subtests. It may take longer while you become familiar with the assessment tool. Pros: A comprehensive assessment covering multiple cognitive domains, including executive functions. Helpful in identifying developmental delays and cognitive impairments impacting EF. Cons: Administration time may be lengthy, which could pose challenges in busy school schedules. Requires specific training or expertise to administer and interpret the results accurately. There are reports that this assessment is challenging to administer. More info about the NEPSY-II can be found here. You've assessed the student. Now what? 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! IV. Informal Assessments of EF Skills While standardized assessment tools like the Brief-2, CKTA, WCST, and NEPSY-II offer valuable insights into executive functioning, school-based OT practitioners can also use informal methods to gather relevant information. These informal ways can provide additional context and complement the formal assessments: A. Observations: School-based OTs can observe students during classroom activities, transitions, and free play to note how they manage time, follow instructions, and plan tasks. Identifying behaviors such as impulsivity, difficulty switching between tasks, or lack of organization can offer clues about a child's executive functioning abilities. B. Work Samples and Classwork: Reviewing a student's completed assignments, classwork, and homework can reveal patterns of organization, attention to detail, and task completion. Analyzing the quality of work, consistency, and ability to follow multi-step instructions can provide valuable insights into EF skills. C. Interviews and Collaborations: Engaging in discussions with teachers, parents, and the student can offer a broader perspective on the child's executive functioning in different settings. Collaborating with educators and support staff can help identify strategies that have been successful or challenging for the student. D. Checklists and Questionnaires: Using informal checklists or questionnaires focused on executive functioning skills can provide a quick overview of strengths and challenges in specific areas. These tools can be adapted or created to address the individual needs and circumstances of the student. E. Self-Reports and Student Feedback: Allowing students to self-reflect on their executive functioning abilities through age-appropriate discussions or questionnaires can provide valuable self-awareness and insights. Encouraging students to share their experiences and perspectives can help develop a more holistic understanding of their EF skills. Assessing Beyond Executive Functioning While executive Functioning skills are a crucial focus of school-based occupational therapy, it's important to note that we address a wide range of areas that contribute to students' overall success and participation in the school environment. While EF assessment tools provide valuable insights into working memory, flexible thinking, and self-control, they do not capture the full scope of an OT's expertise and intervention strategies. Here are a few additional areas in which we assess: Fine Motor Skills: Assessing a student's ability to use and coordinate small muscles in the hands and fingers to perform precise movements required for handwriting, opening containers, and more. Self-Care and Independence: Assessing students' ability to perform daily living tasks, such as dressing and grooming, to enhance independence and functional participation. Visual Perception and Visual-Motor Skills: Evaluating how students interpret and use visual information for motor planning and coordination, supporting academic performance. Sensory Processing: Evaluating how students perceive and respond to sensory information to develop strategies for managing sensory challenges and promoting engagement in school activities. Social-Emotional Skills: Assessing students' social interactions, emotional regulation, self-awareness, and coping strategies to enhance social skills, self-esteem, and emotional well-being, fostering positive relationships and school engagement. By considering these additional areas and employing comprehensive assessment approaches, we can address the diverse needs of students and support their holistic development, functional participation, and overall well-being in the school environment. The Final Word Incorporating informal methods of assessing executive functioning skills alongside standardized assessment tools can enhance the school-based OT practitioner's ability to develop tailored intervention plans. By leveraging observations, work samples, interviews, and student feedback, OTs can gain a more comprehensive understanding of a child's EF strengths and challenges in real-life contexts. Emphasizing a collaborative and holistic approach will empower school-based OTs to better support students in developing vital executive functioning skills for academic success and daily life activities. So, do you use any of the assessment tools mentioned above? Let me know by sharing this post on your favorite social media app and tagging @OTSchoolhouse. Until next time, 👋 Jayson Get my Evaluation Report Template and start feeling confident, knowing you conducted a solid OT evaluation. Sign up for the A-Z School-Based OT Course to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best. Additional 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 Jeri Hahn-Markowitz, Itai Berger, Iris Manor, Adina Maeir; Impact of the Cognitive–Functional (Cog–Fun) Intervention on Executive Functions and Participation Among Children With Attention Deficit Hyperactivity Disorder: A Randomized Controlled Trial. Am J Occup Ther September/October 2017, Vol. 71(5), 7105220010p1–7105220010p9. doi: https://doi.org/10.5014/ajot.2017.022053 Heidi Cramm, Terry Krupa, Cheryl Missiuna, Rosemary M. Lysaght, Kevin C. H. Parker; Broadening the Occupational Therapy Toolkit: An Executive Functioning Lens for Occupational Therapy With Children and Youth. Am J Occup Ther November/December 2013, Vol. 67(6), e139–e147. doi: https://doi.org/10.5014/ajot.2013.008607 Kristy Rocke, Paige Hays, Dorothy Edwards, Christine Berg; Development of a Performance Assessment of Executive Function: The Children’s Kitchen Task Assessment. Am J Occup Ther September/October 2008, Vol. 62(5), 528–537. doi: https://doi.org/10.5014/ajot.62.5.528 Nikki Williamson Weiner, Joan Toglia, Christine Berg; Weekly Calendar Planning Activity (WCPA): A Performance-Based Assessment of Executive Function Piloted With At-Risk Adolescents. Am J Occup Ther November/December 2012, Vol. 66(6), 699–708. doi: https://doi.org/10.5014/ajot.2012.004754 Joan Toglia, Christine Berg; Performance-Based Measure of Executive Function: Comparison of Community and At-Risk Youth. Am J Occup Ther September/October 2013, Vol. 67(5), 515–523. doi: https://doi.org/10.5014/ajot.2013.008482 Claudia List Hilton, Kristina Cumpata, Cheryl Klohr, Shannon Gaetke, Amanda Artner, Hailey Johnson, Sarah Dobbs; Effects of Exergaming on Executive Function and Motor Skills in Children With Autism Spectrum Disorder: A Pilot Study. Am J Occup Ther January/February 2014, Vol. 68(1), 57–65. doi: https://doi.org/10.5014/ajot.2014.008664

Last month, I shared the most common fine motor and handwriting assessment tools in school-based OT. However, we all know that fine motor is only one piece of the occupational therapy evaluation puzzle. Another piece to the evaluation puzzle is sensory perception and integration. As school-based OT practitioners, we understand and appreciate the challenges of assessing sensory processing skills in children. It can be a complex and multifaceted area that requires specialized training and expertise. No one tool is always going to be the right piece. However, it is also a crucial aspect of our work that can significantly impact a child's academic and social success. That's why I put together this post to introduce you to five assessment tools that can help you assess sensory processing skills. Let's dive in. Assessment Tools for Sensory Processing in School-based OT There are several assessment tools that school-based OT practitioners can use to evaluate sensory processing concerns in students. Today we will touch on the most commonly used and discussed sensory tools. You will likely be familiar with some, while others may be new to you. Sensory Profile 2 The Sensory Profile 2 is a standardized assessment tool that evaluates sensory processing patterns across multiple contexts. It measures the child's responses to sensory stimuli and provides information about how they process and respond to sensory input. The tool is administered through a questionnaire completed by parents, teachers, or other caregivers familiar with the child's behavior in different settings. Published: 2014 Age range: Birth to 14:11 years An adolescent/adult version is also available for ages 11+ Administration time: ~20 minutes for the teacher or caregiver Pros: Provides a comprehensive evaluation of sensory processing patterns across multiple school-related contexts as observed by a teacher. The tool includes a "School Companion" form that can be used to collect data from a student's teacher. Cons: Results may be influenced by teachers' or caregivers' perception of the student's non-sensory related behaviors during testing. Since it is a checklist, all results are based on someone's perception of a child rather than the child's ability at a given moment. I find the paper/pencil version of the tool to be challenging to score. The digital version alleviates this tremendously. Sensory Processing Measure-2 The Sensory Processing Measure (SPM-2) is another standardized assessment tool that evaluates sensory processing patterns across multiple contexts. It is similar to the SP-2 in that it also measures the child's responses to sensory stimuli and provides information about how they process and respond to sensory input. Likewise, the tool is administered through a questionnaire completed by parents, teachers, or other caregivers familiar with the child's behavior in different settings. Published: 2021 Age range: 4 months to 87 years Administration time: 15-20 minutes Pros: Very similar to the SP-2, except it takes less time to score. It may yield fewer data points about a child below the surface scores than the SP-2. I like to use the SPM classroom form in my evaluations. I will sometimes send the "home form" to the parents if I feel that it is necessary to gather more data. Cons: Similar to the Sensory Profile, results may be influenced by teachers' or caregivers' perception of the student's non-sensory related behaviors during testing. Since it is a checklist, all results are based on someone's perception of a child rather than the child's ability at a given moment. Sensory Integration and Praxis Tests (SIPT) The Sensory Integration and Praxis Tests (SIPT) evaluate multiple aspects of sensory integration and praxis, including tactile perception, visual perception, motor planning, and more. The SIPT consists of 17 tests that assess different aspects of sensory integration and praxis. The test is administered by a trained professional in a one-on-one setting. Published 1989 Age range: 4 to 8:11 years Administration time: 2-3 hours for the whole set of tests Tests include: Space Visualization; Figure Ground Perception; Standing Walking Balance; Design Copying; Postural Praxis; Bilateral Motor; Coordination; Praxis on Verbal Command; Constructional Praxis; Post-Rotary Nystagmus; Motor Accuracy; Sequencing Praxis; Oral Praxis; Manual Form Perception; Kinesthesia; Finger Identification; Graphesthesia; Localization of Tactile; Stimuli Pros: Provides a VERY comprehensive evaluation of multiple aspects of sensory integration and praxis. The SIPT has long been called the "Gold Standard" of sensory assessment tools due to its thoroughness and the research base supporting it. Cons: Lengthy administration time may make it difficult to use in busy school settings. I can attest to this. As a SIPT-Certified therapist, it would take me 3 hours to conduct. That is partly due to needing to use the tool more to become accustomed to it. It just wasn't the tool I used for every evaluation. Scoring can also be challenging and requires training to interpret with accuracy. Evaluation in Ayres Sensory Integration® (EASI) The Evaluation in Ayres Sensory Integration® (EASI) builds on the SIPT's research base and evaluates multiple aspects of sensory integration. Through 20 individual 5-10 minute tests, the EASI aims to measure the core constructs of Ayres Sensory Integration, including tactile perception, visual perception, motor planning, praxis, and more. Release date: 2023, by the Collaborative for Leadership in Ayres Sensory Integration (CLASI) Age range: 3-12 years old Time to administer: Approximately 2 hours Pros: Provides a comprehensive evaluation of multiple aspects of sensory integration. This is the closest tool to the SIPT and is based on Ayres Sensory Integration®. The EASI is also designed to be open access and available to OT practitioners with the required training. The training is a costly one-time investment, but the testing kit, forms, and scoring software are affordable. In fact, you can 3D print some of the tools, and the test forms are free to print. Cons: Like the SIPT, the EASI's lengthy administration time may make it difficult for some school-based OTs to use. OTPs must complete Modules 2 and 3 from the Collaborative for Leadership in Ayres Sensory Integration (CLASI) to be trained in administering and using the EASI. This could also be noted as a "pro" given the knowledge you will have after completing the training. Structured Observations of Sensory Integration SOSI-M The Structured Observations of Sensory Integration (SOSI-M) aims to evaluate a student's sensory processing patterns in real-time during a structured observation. The practitioner observes the student's skills and behaviors during specific activities and records what they see using a structured form. Published: 2021 Authored by: Erna Imperatore Blanche, PhD, OTR/L, Gustavo Reinoso, PhD, OTR/L, and Dominique Blanche Kiefer, OTD, OTR/L Age range: 5 to 14 years Administration time: 20-40 minutes to complete the 14 sets of administered items. Pros: Provides real-time evaluation of a student's sensory processing patterns. The SOSI-M can be used with the COP-R, a behavioral observation tool, to gather behavioral data related to sensory processing. I have yet to use this tool, but it does intrigue me. Cons: I have yet to use this tool, but I imagine it would take some training, given it is an observation-based assessment. While you do not need specific training to purchase the SOSI-M, you will likely need to be trained in what to look for as you complete the observations. You've assessed the student. Now what? 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! Additional Notes on Completing Evaluations It is important to remember that more than one assessment tool is needed to gather a comprehensive evaluation. To ensure that an OT evaluation is comprehensive, it should include an occupational profile, observations in the natural context, standardized and/or unstandardized assessment tools, and a synthesis of all of the data. You should also assess beyond just sensory processing skills to get a holistic view of the student's abilities and needs. Assessing Beyond Sensory Processing While sensory processing skills are a crucial focus of school-based occupational therapy, it's important to note that we address a wide range of areas that contribute to students' overall success and participation in the school environment. While sensory assessment tools provide valuable insights into sensory sensitivities, perception, and praxis, they do not capture the full scope of an OT's expertise and intervention strategies. Here are a few additional areas in which we assess: Fine Motor Skills: Assessing a student's ability to use and coordinate small muscles in the hands and fingers to perform precise movements required for handwriting, opening containers, and more. Self-Care and Independence: Assessing students' ability to perform daily living tasks, such as dressing and grooming, to enhance independence and functional participation. Visual Perception and Visual-Motor Skills: Evaluating how students interpret and use visual information for motor planning and coordination, supporting academic performance. Executive Functioning: Assessing skills related to organization, time management, planning, and self-regulation to address challenges that impact task initiation, focus, time management, and assignment completion. Social-Emotional Skills: Assessing students' social interactions, emotional regulation, self-awareness, and coping strategies to enhance social skills, self-esteem, and emotional well-being, fostering positive relationships and school engagement. By considering these additional areas and employing comprehensive assessment approaches, we can address the diverse needs of students and support their holistic development, functional participation, and overall well-being in the school environment. The Final Word To wrap this up, assessing sensory processing skills is crucial to help us identify areas of strength and concerns during our evaluation. As mentioned above, several tools are available to help with this process. The SPM-2 and the SP-2 are likely the most commonly used tools in schools due to their ease of use and time to complete them. If you do use the SP-2 or the SPM-2, be sure to include observations of sensory processes in your evaluation report - especially if the tool indicates a sensory processing concern. The SIPT, EASI, and SOSI-M provide OT practitioners the ability to obtain much more data related to a student's sensory processing and integration abilities than the SP and SPM-2. However, they require more time and additional training to administer and interpret. It is up to you to decide if you have that time and want to pursue the necessary training. It is worth reaching out to your employer for support if you do want to explore this further. I was very fortunate that a district I worked for paid for me to get SIPT certified. And while I may have used the SIPT sparingly, the knowledge I gained from the courses will stay with me forever. I hope this article helps you as you decide what tool or tools you will use and purchase at your school sites. Thank you so much for reading, and I will see you next time. 👋 Jayson Get my Evaluation Report Template and start feeling confident, knowing you conducted a solid OT evaluation. Sign up for the A-Z School-Based OT Course to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best.

It is well established that fine motor skills are crucial in students' school activities and academic performance. In 2020, Caramia et al. established that "Students spent between 37.1% and 60.2% of the school day performing fine motor activities, with handwriting accounting for 3.4%–18.0% of the day." This data comes from a study where the researchers observed kindergarten, second, and fourth-grade classrooms. They also found that transitions accounted for about 20% of the day, but we'll save that for another time. As school-based OT practitioners, we know that there is more to the occupation of education than handwriting, but it is also fair to say that fine motor and handwriting concerns make up a large part of our referrals. Since there is such a high rate of referrals for fine motor and handwriting concerns, you will likely need a few assessment tools on hand to assess these skills. This blog post provides an overview of common fine motor assessment tools used by school-based OT practitioners, categorized into tools that assess handwriting skills and those with a broader focus on fine motor skills. Let's start with handwriting-specific tools. Fine Motor Assessment Tools for Handwriting Assessing handwriting skills is a vital aspect of school-based occupational therapy, as proficient handwriting (or a reasonable and effective accommodation for handwriting) is essential for students' written expression and academic success. Several assessment tools have been specifically designed to evaluate handwriting skills, providing therapists with valuable insights into a student's legibility, speed, pencil grasp, and letter formation. The Minnesota Handwriting Assessment (MHA), Print Tool, Evaluation Tool of Children's Handwriting (ETCH), and Test of Handwriting Skills-Revised (THS-R) are widely recognized tools that assist OT practitioners in assessing and addressing handwriting difficulties in students. Here are some of each tool's characteristics, along with some pros and cons of each tool. Test of Handwriting Skills-Revised (THS-R): Completion time: Approximately 25 minutes Age range: 6 years to 18 years 11 months Pros: Assesses both manuscript and cursive handwriting skills (although I never used the cursive tool) Provides norm-referenced scores for legibility, form, alignment, and size Tests writing without lines so you can get an idea of the student's ability to maintain level writing Cons: Limited age range - may not be suitable for older students. Does not assess fluency of handwriting Scoring of each letter can be tedious until you understand the patterns (like gaps = a score of 1, and overshoots = a score of 2) Pro Tip: The THS-R is identified as a test of "neurosensory skills," not as an assessment of handwriting. However, it does function as a functional writing assessment and national norms for scoring. Minnesota Handwriting Assessment (MHA): Completion time: Around 15 minutes Age range: Grades 1 and 2 Pros: Norm-referenced tool Evaluates letter formation, legibility, speed, and pencil grasp Provides a comprehensive analysis of handwriting skills Cons: Extremely limited age range Easy to administer, difficult and time-consuming to score Pro Tip: Check the desk height and other environmental factors prior to starting. That goes for all of these tools. Print Tool: Completion time: A few minutes to administer & 10 minutes to score Age range: Preschool through 6th grade Pros: Assesses letter formation, sizing, spacing, and overall legibility Provides a clear profile of a student's handwriting strengths and areas for improvement Ties in with the Handwriting Without Tears writing curriculum Cons: Does not assess the speed or fluency of handwriting Pro Tip: Learning Without Tears offers free handwriting screening printouts on their website at LWTears.com Evaluation Tool of Children's Handwriting (ETCH): Completion time: Around 15 minutes Age range: 6-12 years Pros: Evaluates multiple components of handwriting, including letter and number formation, alignment, spacing, and pencil grip Offers specific guidelines for intervention based on identified areas of difficulty No cost to purchase scoring handbooks - They allow you to make copies when you purchase the tool. Assess both individual letter legibility AND word legibility Cons: Takes a moment to learn the scoring, but is on par with other handwriting assessment tools. Pro Tip: Jayson's preferred handwriting assessment Fine Motor Assessment Tools with a Broader Focus While handwriting is crucial, occupational therapists also recognize the importance of assessing overall fine motor skills beyond just handwriting proficiency. Fine motor skills encompass a range of abilities, including hand-eye coordination, dexterity, and motor planning, which significantly influence students' functional independence in various school-related tasks. That is why I will often pair one of the handwriting tools above with one of the tools below. When I do that, I can draw more conclusions as to whether it is fine motor skills or something else impacting a student's handwriting. Assessment tools such as the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), Peabody Developmental Motor Scales, Second Edition (PDMS-2), and Miller Function & Participation Scales (M-FUN) provide a broader perspective on fine motor development and offer valuable insights into a student's fine motor skills and other skills such as gross motor skills, visual-motor integration, and motor planning abilities. Here is some info on each of those: Miller Function & Participation Scales (M-FUN): Completion time: Approximately 30-45 minutes Age range: 2 years through 7 years 11 months Pros: (Jayson's preferred tool for this age range) Assesses fine motor skills, visual perception, visual-motor integration, and motor planning Provides a comprehensive profile of a child's functional motor abilities Scoring tools that help you guide treatment planning. Cons: Limited age range Longer administration (and set-up) time compared to some other assessment tools The test books and scoring books can get expensive Pro Tip Make lots of copies of the origami fish and dog The pros outweigh the cons, in my opinion Want to hear why I prefer the M-FUN over the BOT-2? Check out this episode of the OT Schoolhouse Podcast! Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2): Completion time: Varies depending on the subtests administered Age range: 4 through 21 years Pros: Evaluates fine motor skills along with other motor abilities Provides a comprehensive assessment of fine motor proficiency Cons: Lengthy administration time for the complete test Pro Tips: The recommended minimum interval for reassessment is three months. I typically administer the Fine Motor Precision, Fine Motor Integration, Manual Dexterity, and Bilateral Coordination subtests. The Upper-Limb Coordination subtest can also be helpful at times. Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI): Completion time: 10-15 minutes Age range: 2 years through adulthood Pros: Assesses the integration of visual and motor skills Provides norm-referenced scores for visual-motor integration abilities Cons: Has been shown to not necessarily correlate with handwriting skills Pro Tip: The VMI is sometimes used by non-OT professionals, so ask your school psychologist if they are using the VMI before you both attend the IEP with the same assessment. Peabody Developmental Motor Scales, Second Edition (PDMS-2): Completion time: Varies depending on the age of the child and the areas being assessed Age range: Birth through 5 years Pros: Assesses fine and gross motor skills Provides a comprehensive assessment of fine motor skills, including grasping, manipulation, and visual-motor integration Offers both standardized scores and age equivalents Cons: Limited to the age range of birth through 5 years Will soon need to upgrade to the Third Edition Pro Tip: Take some time to familiarize yourself with the scoring booklet and tasks. There are many materials, and it takes some time to get used to knowing which task to start with due to the need to find the student's baseline. You've assessed the student. Now what? 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! Assessing Beyond Fine Motor Skill While fine motor skills are an essential focus of school-based occupational therapy, it's important to note that occupational therapists address a wide range of areas that contribute to students' overall success and participation in the school environment. While the previously discussed assessment tools provide valuable insights into fine motor development, they do not capture the full scope of an OT's expertise and intervention strategies. Here are a few additional areas in which school-based OTs assess and intervene: Sensory Processing: Evaluating how students perceive and respond to sensory information to develop strategies for managing sensory challenges and promoting engagement in school activities. Self-Care and Independence: Assessing students' ability to perform daily living tasks, such as dressing and grooming, to enhance independence and functional participation. Visual Perception and Visual-Motor Skills: Evaluating how students interpret and use visual information for motor planning and coordination, supporting academic performance. Executive Functioning: Assessing skills related to organization, time management, planning, and self-regulation to address challenges that impact task initiation, focus, time management, and assignment completion. Social-Emotional Skills: Assessing students' social interactions, emotional regulation, self-awareness, and coping strategies to enhance social skills, self-esteem, and emotional well-being, fostering positive relationships and school engagement. By considering these additional areas and employing comprehensive assessment approaches, school-based OT practitioners can address the diverse needs of students and support their holistic development, functional participation, and overall well-being in the school environment. We will soon post blogs about tools you can use to assess these other areas in school-based OT, so stay tuned. The Final Word These fine motor assessment tools are important resources for school-based OT practitioners to evaluate and address students' fine motor skill needs. Using the standardized assessment tools mentioned above, practitioners can obtain valuable information about students' handwriting and fine motor abilities. It is always important to note that standardized assessment tools only give you a snapshot of data in a controlled environment. Always pair standardized assessment tools with observations and other assessment data to form a comprehensive evaluation and treatment plan. What are your preferred fine motor and handwriting assessment tools? Share this post on social media, and let me know which assessment tools you prefer to use when assessing students with fine motor concerns. See ya next time, 👋 Jayson Get my Evaluation Report Template and start feeling confident, knowing you conducted a solid OT evaluation. Sign up for the A-Z School-Based OT Course to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best. References: 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 Sierra Caramia, Amanpreet Gill, Alisha Ohl, David Schelly; Fine Motor Activities in Elementary School Children: A Replication Study. Am J Occup Ther March/April 2020, Vol. 74(2), 7402345010p1–7402345010p7. doi: https://doi.org/10.5014/ajot.2020.035014