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Want to earn 11 hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 73 of the OT School House Podcast. Today, we are going to talk about 10 things that you can do right now, at the end of this school year, to make NEXT school year a little bit easier. Some of these are going to be pretty straightforward and you may already be doing some of them. But some of these are going to be a little bit more reflective in nature. I'm going to ask you to go a step deeper with me and think about how you can make your next school year better by wrapping up this year in an organized manner. It's just you and I today, so let's jump in to it! Links to Show References: A-Z School-Based OT Course Back To School Conference - Aug. 27-29, 2021 Edjoin.org Episode Transcript Download or read a rough edit of this OT School House Podcast episode Amazing Narrator Hello and welcome to the OT School House podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies. Class is officially in session. Jayson Davies Hello, and welcome to episode number 73 of the OTs school house podcast. My name is Jayson Davies and I have to get this episode started with one thing, it's gonna be May! Alright, it actually already is May, but I'm recording this in April. So it's not quite there yet. So the N'Sync - Justin Timberlake meme was just blaring in my head right now. So enjoy, that is the one time you're gonna hear me sing since like, I think I sing in like Episode Two or something like that, I think I Rapped. But anyways, it may not happen again for a while. Welcome to May, with may comes the end of the school year is coming soon, some of you are going to wrap up this school year, this month, right at the end of the month. Others will potentially go into June a little bit one week, two weeks at most, probably three weeks. And then you have extended school year, right. So we're going to talk about that, we're going to talk about 10 things that you can do right now, at the end of this school year to make next school year a little bit easier. Some of these are going to be pretty straightforward. And many of you are probably already doing many of these things already. But some of these are going to be a little bit more reflective in nature. And I'm going to ask you to kind of go a step deeper and thinking how we can make next year better. Alright, so again, real quick, we're gonna go over 10 different items that you can do right now, or at the end of this school year, to make life easier when we come back in August or September whenever your district comes back. Alright, so stay with me, let's go ahead and do this. It's just me and you today. So let's get started. Alright, so let's go ahead and get started with the first of 10 things that you can do right now in the month of May, maybe June to make your life easier when we come back in the fall. These are in no particular order, I'm just going to go through and list all 10. And we'll see how long we go for. All right. So here's the first one. When it comes to assessments, you want to try and get any assessment that had the assessment plan signed 30 days or more before the end of the school year, you want those assessment plans wrapped up, you want to have that assessment done, you want to have the report written. And I know it's not completely in your control. But if you can even have the IEP, that is even better assessment plans that may have been initiated within 30 days of the school year, you can potentially wait on those until the beginning of the next school year. By all means if you have time to get them done, get them done. Because we all know that the beginning of a school year is hectic with scheduling and whatnot. And so if you can get those assessments done, do so. But there is a little bit of a leeway at the beginning of the school year, you have about 60 days depending on what state you live in, in order to get those assessments done. So if you use 30 days, and you don't get it done at the end of the school year, you still have 30 days at the beginning of the next school year. Now, I know you might be wondering what about if the student goes to extended school year is that part of the 60 days, typically No, that is not considered part of the normal school years. That's extended school year. And so he is why days would not count in regards to the 60 days timeline that you have to complete an evaluation. In addition to getting all the assessments done that were initiated prior to the final month of the school year, you also want to make sure that you document all of the assessments that did come in potentially in the final month of the school year, those are going to be assessments that you need to get done or whoever is the OT at that student's new school or at that school, maybe you're no longer there, those IEPs those assessments are still going to get held within the first 30 days of school initiating back up. So be sure they're documented. And also be sure to document anything that you actually did toward that evaluation. Maybe you already sent out a questionnaire to the teacher, maybe you already sent something out to the parent, maybe you already had a conversation with the parent, be sure to document whatever is done. So whoever picks it up after you or even you at the beginning of the next school year has that information ready to go. Jayson Davies Alright, on to the second tip, and that is to ensure that every student has had an annual and a triennial meeting if needed. Now, I know this may not completely following you as an occupational therapist, you are not typically a case carrier for any of your own students. Typically it is the speech therapist and or the case carrier, the special education teacher that is the case carrier and in all fairness, technically, yes, it is their job to make sure that all the animals and triangles happen when they're supposed to happen. But we all know that life happens. They get busy and maybe something slipped their mind if any of you Students, and this only takes a minute to check, just go back and look at your students, if any of them haven't had an annual, be sure to send an email to the case carrier and say, Hey, you know what, remember Johnny? in your class, we never had a meeting for him this year. Or maybe we had a an amendment earlier in the school year, but we never actually had an annual let them know. Likewise, are there any triangles that you were expecting to come up and didn't happen? Again, let the teacher know, say, Hey, you know what we need to do an evaluation, it's due now. And, you know, maybe you don't get it in by the end of the school year, but at least you help them to remember, hey, we need to get this done right at the beginning of next school year, which kind of goes back to the first tip that we had, get those evaluations done that you can, why is this important that you help out with this? Well, you know, you just want to be a good team player and you want to help everyone else out, you want to do what is right by the kids, what is helpful for the teachers as well as for your administrator, you want to be there to support them. And you know, Ida as well as every state says the IEP must be done every year. And a triennial if the team decides to do full testing needs to happen every three years. So make sure that you're being a team player and helping everyone out, it only takes a quick minute to kind of go down your caseload and just in your mind, say, Yep, we had that annual Yep, we have that annual. And you might have to check your IEP system if it comes to a name that you're not sure about. But it doesn't take too long. And it can really help. If you have your own documentation system in place, you might already haven't marked whether or not the child had an IEP. So that makes it really easy. And it's very helpful for the teachers when you're able to provide them with the assistance that they might need. Alright, so the third item on my list of 10 things you can do right now to make next year easier comes to the treatment and treatment notes side of things. As you're wrapping up your final treatments, maybe the last two or three weeks, your your final one or two sessions with a kid, I want you to just to write a little bit longer of a note than your typical Daily Note, you can do it as part of your daily note, or maybe even do it as a separate note in your own private journal, where you have access to it. So when we come back in September, whatever it might be, you have a little extra, a little something that reminds you, Hey, this is what I did the last few sessions in May or June. And also this is what my plan is when we come back from break. So start off this note, maybe again, just the last one or two notes that you're going to do with the kid for for this school year. Start off the note with in May or June the student dot dot dot, what did you guys do in May or June, and then go into in August or September, OT needs to focus on this. This is just going to help your brain have a little kickstart come August to jump back in and to know alright, yes, with Johnny, we were working on visual spatial skills. And we wanted to work on now in the new school year up in the game a little bit making things a little bit more difficult. And maybe we're now working on integrating those visual spatial skills in with some other functional school activities such as copying from the board or cutting out more complex shapes. If you'd like you can also add some data in with that extra note or just be sure to note where the data is so that you can access it next year when the IEP comes around. Alright, I believe that brings us to number four now. And number four is to update your caseload or workload document, whatever you call it, and add any necessary notes about the students. So if you already have an Excel spreadsheet or a Google Sheets file for your entire caseload, go ahead and just make sure you have a column at the far right that has notes. And what you're going to go through is just look at each student and look at the grade level, maybe look at Jayson Davies the classroom that they're in and kind of anticipate what may happen. Any moves that could potentially happen over summer, and then add notes based on that. Johnny sixth grade. Oh, well, since he's in the sixth grade, he's probably going to be transitioning. I don't know where yet, but he's going to be transitioning. Jennifer, she's in the sixth grade as well. But in this note, I can add that I know she's going to such and such Middle School. Alright, such as such middle school that OT there is Jessica. I'm going to make sure that I need to send this file for I think I said Jennifer was the name I gave the good need to send Jennifer's file over to Jessica. Things like that will help you again, make September a little bit easier. Other things that you can also add there is just notes about maybe things the kid might have mentioned such as, Hey, Mr. Davies, I think I might be moving over the summer. Well, we may not be certain about that. But that is something that we can put in the notes. Just to keep in mind. Hey, when we get Back in September, I need to see if that little kid is still here. Or if he's gone, if he's gone, I need to make sure I send an email to special education to let them know, Hey, he's gone. Can you help me figure out where he went. So I can send the file to wherever he might be. Other notes that you might want to add, or any conversations that were important during IEPs, or with the teachers such as a, maybe john is getting pretty close to being exited from OT or special education services in a hole. So maybe in September, or maybe give it an extra month, and maybe October, let's look into asking for an evaluation to see if they still need services. Or maybe you know that the parent is going to want to have a meeting at the beginning of next year. Right that in there a note to sell, Jonathan's mom loves to have a meeting every August when we come back to school. So you know, it's going to be there, just mark it down. So you have that little reminder. All right, on to number five. Number five is a fun one, it's a little more engaging, and it has the potential to make a huge change in the way that you see students over the course of your lifetime as a school based occupational therapist. So if you haven't done this already, maybe you don't do any RTI right now, I just want you to reach out before the end of the school year to one teacher, maybe two, if you're feeling really ambitious, with just one teacher, the one that you work the most with the one that knows the most about OT that gets it the understands what you do with the kids and ask them, How can I support you next year? That's it, how can I support you next year, maybe you can make a lunch date out of it or something but sit down or shoot them an email and say, Hey, I just want a moment with you. I want to I want to have a chat with you. But I want to make sure that you're kind of, you know, ready to have a conversation. So maybe set up a time don't just do this over a casual meeting in the hallway, set aside some time to ask this teacher? How can I support you next year? What can I do to not just help one kid in your classroom, but what can I do to support you and your entire classroom next year, you'll be amazed where this might go, the doors that it will open, the opportunities for collaboration will just they'll just open. Like I don't know what else to say. But they will open opportunities will present themselves when you make an opportunity to support a teacher. Again, only start with one, maybe two if you're feeling really ambitious. But I always tell occupational therapists start small. Start with just one teacher, maybe you get to one in August. And maybe you get to a second teacher in December. And before you know it next school year and the 2022 school year, or whatever that might be when you're listening to this podcast. Who knows maybe you'll have four or five teachers by then. But you want to start small? How can you support one teacher next year to support their entire class? Who knows, you might find out that they really need help with their students handwriting, you might find out that another teacher or the same teacher really wants help with teaching their kids how to use text to speech or speech to text. Maybe they want to work on an emotional regulation program with you. Maybe they really want you to come in and provide sensory brakes a few times a week so that they can learn how to do them on their own. It's just amazing what can happen when you ask a teacher how you can support them. So if there's one thing you take away from this podcast, I know we're only on number five, there's still five more items I want to get to. But this is the one I want you to take away from this. Reach out to a teacher and ask them how can I support you in your classroom next year. That's it. I almost want to stop the podcast right now just and with that, but we'll keep going. Before we do though. I want to take a quick break. And I just want to say hey, you know what, if you are enjoying this podcast, if Jayson Davies you're enjoying what I'm saying we've gone over five things already. Go ahead, jump on Instagram real quick. Shoot me a fist bump, a high five something in a DM. And I'll be sure to get back to you. And so I know that you're listening, and I know you're enjoying all this content. All right. I want to do more solo episodes like this, but I want to hear that you guys are all enjoying it. All right. So send me a quick dm and yeah, let's go ahead and keep going. All right, number six, collect and document any materials you might have given out this past year. I've been doing this for a while I know things get lost. And they go from being the OT departments sit and move cushion to teacher A's move and sit cushion. I get it. They don't have a lot of funding. They are more than happy to accept anything that we're willing to give them. And sometimes we never get it back. So here's what you need to do. Create an Excel spreadsheet, Google Sheet, whatever you use your weapon of choice, I guess I could say and you're going to mark down a few different things. You're going to go into the classroom and you're going to grab the item you're going to mark down what is the item so give it a name you Might even give it a color so that you kind of know exactly what you want it is even you can mark it, get a sharpie and mark it item three C. And then you can write down on your spreadsheet, item three seat, whatever that is. Then add also, where did it come from? What classroom? Did item three c come from? What student or students? Did that item support this past year? And yes, it's totally okay for one item to support several students, maybe not in COVID time so much. But typically, yes, something can support more than one student, maybe there is a yoga ball in the classroom and several students throughout the day, use it to roll on it, it's important to mark this down. Because if maybe two of those students transition to middle school, but three of the students that used it are still in the elementary school. Well, now, we can't get that ball to just one or the other classroom, we may have to ask special education for support and providing a ball to both the elementary classroom as well as the middle school classroom, if it's still relevant. Also ask the teacher for any feedback on how it went and how it was used. What exactly were they using that yoga ball? or whatever it might be for? Were they rolling it over the kid? Are they having a kid roll over the over ball was the kid sitting on the yoga ball during work? When was each kid using it? All of that is important because again, when you go back to special education, and you say, hey, I need another yoga ball. They're gonna ask why? Why do you need another item? Well, you see, Johnny and Stacy moved on to middle school, while Don Carlo and I don't know, I'm blanking, I've used too many names today. We'll go with Amanda are still in elementary school. And look, they were both using it for this and this, but now they're in different classes. So it'd be really helpful if there is one in each classroom, because they both need it for different reasons. You may also want to add, was it too big or too small? Was it just right? I feel like I'm reading Goldilocks to you right now. We want to have the just right material in place. So we need to know this past year. Was it just right? Or do we need to alter it when we get that item back out at the beginning of next school year. I already mentioned to note down if a student's going to be moving, you might want to also note that down on your caseload sheet Hey, students move into middle school. By the way, item three C was for that student in the classroom. So just let whoever the OT is at the middle school or if it's still yourself. Just a little reminder, hey, an item may or may not be going or coming with that student. You also want to mark on your cheat sheet if we want to call it that where the item is stored. So mark down item three, see, this is what it is, this is who it's for. This is how it benefited them. This is what the teacher said about it. Oh, and by the way, it is stored in the closet by the door. because too many times things get moved, or they get lost. And we just don't know where they are. So at least if something gets moved, it's not your fault you put down where you put it, and maybe someone moved it over summer, well still have to track it down, potentially. But at least you know where it should have been and you haven't documented. Now I'm sure there's a lot of other information you could add to this form. But I don't want to make your life too complicated. Yes, we want to be ready for September. But we also don't want to be over exhausted from this year. So I recommend actually making a Google form and sending it out to the teachers, letting them fill out as much of the information as they can first. And then you go back in and add some of the specifics to occupational therapy, and such like where the item is stored. And maybe a few other parts that I said there. But if you prefer a pencil and paper go with it that way. If you like Google Forms, feel free to create a simple Google form that helps you out. Jayson Davies Alright, number seven here is very simple only takes a few moments to do but it actually can help you quite a bit. And that is scheduling. I don't expect you to create your schedule for next year. I don't even expect you to have any idea about your schedule for next year. But if you know anything about your schedule, let the teachers that you will be working with know just a little bit. This doesn't need to be anything specific. It might just be as simple as Hey, Mrs. so and so. Mondays worked great at this school. I plan to keep Mondays going next year, or Hey, Sunday's Sundays, what is the Sundays or Hey, Mondays don't work this year was really tricky for me. I felt Mondays were not great, because they're just too many holidays on Mondays and I need to see your kids consistently, whatever it might be. Let them know that way when someone else reaches out to them about Mondays next year. They already have in the back of their mind. You know, I'm not sure about Mondays, Mrs. Amanda Oh already claimed Mondays for OT, let me check in with her, before I get back to you on if switch therapy would be good for Mondays or not. Again, you don't need to let them know exactly what good you're going to see at what time or what day. But if you can give them a general idea, you'd be surprised at how well they do and kind of blocking off that time for you. If you don't know at all, that's okay, you can skip this. But if you do know, it's great that you can do it. Which kind of brings us now to our final three tasks that you can do now to make next year easier. These last three are more reflective, to make yourself better, and to potentially even consider where you should move on from here. Alright, so number eight. Number eight is to reflect on how you were able to handle your caseload this past year. How did you do with handling the fluctuation in kids from the beginning to the end of the school year? How did you deal with the fluctuation of evaluations? Did you note High Times and low times or fast times in slow times? Who knew I could get some rhyming in today. But take a good hard look at that evaluation list that you compiled up over the year, take a look at how many kids came in or left your schools. When referrals came in, when referrals didn't commit, did things pick up in January, or were they slow all the way up until May and then all of a sudden you got a bunch of referrals in May. Typically, I see an uptick right at the beginning of the school year. And then another uptick right after Christmas break or winter break. That's what I typically see. But that may be different at your school. So kind of track that a little bit. Also take a moment to do a little self evaluation of your skills. How did you feel as an effective or ineffective occupational therapist this year? Did you feel like you were able to get items met? Get goals met with your students? If so, why? What helped? What skills Did you have that really supported you in that? Or maybe for a part of your caseload? You didn't feel competent? You didn't feel like you have the skills? Or maybe you didn't feel like you have the time mark that down? What was it that prevented you from being the best occupational therapist that you could be and helping the most students that you'll get help? You can even take that a step further. And once you're done with this little reflection, go ahead and just do a quick Google search. How can I get better at sensory? How can I get better at promoting handwriting? How can I get better at RTI, just Google that and you're going to come up with tons of resources, your districts going to be more likely to support you in some sort of training, if you can kind of give them a reason why that training is going to be beneficial for you. If you can share with them and say, Hey, I felt really good going into 90% of my classrooms. But these 10% of kids that I see, it was a real struggle for me this year, because I just don't have the training and autism or whatever it might be that I really need to have in order to support those students. Likewise, if you're looking back at the year, and you look back at your calendar, and you realize, man, it was really tough getting through the month of February and March, because I had so many evaluations in January, well then share that with your OT team. share that with your administrator, share that with the people that actually can do something to help you out. It's one thing if you share your trouble with your administrators or your team, and nothing happens, it's a complete other thing. If you're having difficulty and you don't ask for help. People can only help us if they know we need help. And so I want to encourage you to go back, look at your calendar and see. Realistically, look, Jayson Davies did you survive that month? Did you get all the students in that you needed to get in for the month of January and February if those were your tough months? If not let people know. You know, maybe nothing happens this year. But maybe next year is also tough and you let them know at the end of next year. And then the year after that's also tough. And you'll have to know the year after that. Well, hopefully over time, it will start to get better because people are going to hear Hey, you know what, Jessica, she's a great OT. But every year she's asking for one thing, a little bit of help with her caseload. Well, maybe over time, they'll be willing to listen to you. All right. So go back, look at your calendar and see how things went. And along the lines with reflecting on your caseload. I also want to ask you to reflect on the difficult times that you had within IEPs themselves. Where did you get tripped up? Did you have a struggle with writing the IEP itself? Did you have a struggle with actually presenting your assessment results in your goals and your services within the IEP? Maybe it was more of questions that you were asked by a parent or a teacher and those just Were you off? What was it this year? That kind of caught you off guard? Was there a theme? Was it a bunch of small little things? What was it that got you tripped up? And then again, just like in step number eight, or Item Number eight, I guess I can call it. What can you do about that? Where can you look to make IEP s a little bit easier for you? Heck, maybe it was simply that you just weren't getting invited to the IEP is? Well think about that. dissect that break it down. What can you do to ensure that next year, your teachers Remember to invite you to the IEP is, what can you do to maybe get your IEP done a day earlier to have your goals, your services, everything into the IEP IEP system one day early? That way, maybe you're not getting emails from the case carrier to get it all in? Or what can you do about when you're at an IEP and you have everything just set? Right? And then someone asked you a question that just throws you off your game? Like why do you think it's sensory, not behavior? In the moment, I know that can be a really tricky situation to handle. Even if you are really good at understanding sensory, that can still be an in the moment difficult question to answer. So make a plan plan for that to happen next year. What can you do now, to make that question easier, come next year, attending the back to school conference, or the A to Z school based OT course, you can never go wrong with one of those options to make you a better school based OT. But there's so many other courses out there that you can look at as well, I just want you to get the training to help you in your career as a school based OT. Alright, and that brings us to our final item for this podcast today. And you know, this is a tough one to talk about. Because I know there's some of you out there that you felt like this year, just flat out sucked. I'm not gonna sugarcoat it, you just, it was hard. I mean, even without COVID going on, you might have really struggled this year through COVID. On top of that, and I know some of you don't even want to be a school based OT anymore. And you're listening to this podcast, because you want me to convince you to stay here. And yes, I want you to stay here. But I also want you to be in a school based OT job that supports you. So this might be the time if things are really that bad. This might be the time to start opening up your search to look elsewhere. So what does that mean? And where do you go? I would recommend starting by reaching out to friends that are occupational therapists, speech therapists teachers in other districts and asking them what it's like in their district. And do they know of any OT positions that might become available in the next few months? Right now in May and June. This is the time that schools are hiring for August and September. There are jobs out there, I know it can be few and in between in some parts of the country. But you have to go online and you have to find where educational type of jobs are posted. Out here in Southern California and most of California in general, we use a website called Ed join Ed join.org. And that's where you can find most educationally related jobs, teachers, OTs, etc. However, I know that's not always the case, you might have to go directly to the districts in your surrounding area, look on their website, they might have a tab specifically for careers check there, I have not really found some of the larger job boards to be very helpful. But you never know in your area, maybe that's the place to check. Also check in with your state board of occupational therapy or your state Occupational Therapy Association. Jayson Davies Sometimes they will have a job board that you can look up jobs in the area, I really do want all of you to stay within the school based OT career, I don't want you to leave school based OT we need you, you are a OT that has dedicated themselves to learning more about school based OT, and it will be a huge loss for me as well as your district. If you leave the fields, I really want you to stay here. And I really want you to find a job where you're going to be supported and feel like you belong there. So if that isn't the position you're in right now, it's okay to look elsewhere. I'm going to be very honest with you right now, that website I was just telling you about Ed join.org out here in California. That is like therapy for me, I go on that website, at least probably like once a week just to look what's out there just to see what school based OT jobs are out there. You know, it's nice just to know, hey, if something really popped up that just like shouted at me like, hey, I want to go there. Well, at least I know about it. I don't want to miss that opportunity. But if you don't at least know what's out there, then you're going to miss application and you're never going to know and you're going to be stuck in a job that maybe doesn't feel right for you. I really hope that you are at the perfect job right now that you Love it that you want to stay there forever. But I know that's not the case for everyone. So that is just another option. All right, well, that is the 10 items that I wanted to cover today to think about right now to make next year as well as all subsequent years a little bit easier on yourself as a school based OT. I hope you've learned a little bit from these 10 items. I hope it will make your life a little bit easier. But please, if I miss something, if I forgot something, let me know shoot me a DM on Instagram. Leave me a review down in the apple podcast app or use a simple email carrier pigeon probably won't work. But any other form that you had to get a hold of me. Let me know what I missed so that I can help more OTs share the knowledge that you have and how to make every year successful year. Thank you so much for tuning in to today's episode and cheers to a fantastic end of the 2021 school year and a blessing of a 2021 22 school year. Take care. Amazing Narrator Thank you for listening to the OT School House 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to earn 11 hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 72 of the OT School House Podcast. Today, we are focusing on the activities children participate in during education in 3 specific grade levels as we discuss a recent brief report published in the American Journal of OT. The report is titled Fine Motor Activities in Elementary School Children: A Replication Study and was published in January of 2020. Together, we are going to discus what percentage of the day students spend completing various fine and gross motor activities. Links to Show References: Sierra Caramia, Amanpreet Gill, Alisha Ohl, David Schelly; Fine Motor Activities in Elementary School Children: A Replication Study. Am J Occup Ther 2020;74(2):7402345010. https://doi.org/10.5014/ajot.2020.035014 View the original 1992 article by Cermak & McHale Transcript Download the Transcript or read the episode below! Jayson Davies 00:01 Good morning, everyone. Welcome to the OT School House podcast. This is episode number 72. Now I can't believe we're 72 episodes in, this is going to be one that really helps you understand the role of occupational therapy in the school. And to do that we're going to have a discussion about a recent journal article from the American Journal of OT, the article that we're going to be looking at is titled Fine Motor Activities in Elementary School Children, A Replication Study. This is actually as the name suggests a replication study from a study back in 1992, a long time ago. All right, so almost 30 years ago, that is, I think, when this study was actually done, it was around 2015, maybe 2017. They said 25 years had passed since that previous study. So we're gonna jump all in to that in just a moment. But first, let's cue the intro music. Amazing Narrator 00:54 Hello, and welcome to the OT School House podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. here's your host, Jayson Davies, class is officially in session. Jayson Davies 01:11 Welcome back to the show. Again, I say this several times. But I just love that intro music. It gets me going. You know, I just realized a moment ago in the intro, I said, Good morning. But it's morning right now, and I'm recording this but I know for you this may be in the evening, maybe you're on your way home from work. I don't know what time it is. So I'm just gonna say this real quick. Good morning. Good afternoon, and good evening, because I don't know when you might be listening to this. But I am super glad you are here. really appreciative of you learning from this podcast and trying to improve yourself as an occupational therapist through the OT School House podcast. So let's go ahead and get started with our journal of discussion. Jayson Davies 01:50 As occupational therapists, we know that education is listed as one of the nine occupations categorized by AOTA in the OT practice framework, which of course is that like, Holy Grail document of the OT profession. And as a whole education consists of all the education that we as humans participate from our very first day of preschool, perhaps maybe even before and all the way through our adult life. So I mean, from pre K, all the way through to maybe, I don't know, I'm still learning about finances and stock trading or not trading any more and more investing long term investing, but we are always learning right now you're learning through this podcast. And so education is a huge part of our life. Today, we're focusing on the routines children participate during education in three specific grade levels. As we discuss a recent brief report published in the American Journal of Occupational Therapy. The report is titled fine motor activities in elementary school children a replication study, and was published in January of 2020. But like I think I said earlier, I believe the study was actually completed back in 2017. Jayson Davies 03:50 The first two authors Sierra, sorry, I'm going to try to say your name as best as I can see our Sierra Caramia and Amanpreet Gil were assisted by Alisha Ohl and David Schelly, I believe it is in observing and coding activities of students in grades kindergarten, second, and fourth grade. Jayson Davies 04:11 As I mentioned before, this was a replication study. So real quickly, I want to talk about the original study that was completed in 1992. By McHale and Cermak. that study was completed. Again, way back before technology was really a thing in public education. And in 1992, they observed second, fourth and sixth graders and found the students spend anywhere from 31 to 60% of the school day, engaging in fine motor activities with most of that time, being on paper and pencil tasks. Again, they didn't look at technology because in 1992 technology looked very different. I'm not sure even laptops were around yet in 1992. So everything was big, bulky, and definitely not a touchscreen. Likewise, new legislation has also been put in place Jayson Davies 05:00 It has changed general education and special education in general. In the past 30 years Ida has been renewed, and the No Child Left Behind Act, as well as other acts have increased the amount of testing required in public education. I'm sure you all have seen this more testing, less time actually spent on teaching students it seems like right. So whether you love or hate Common Core, it has to be known that it has changed education. For the time being, things are very different, whether you like that they teach one math skill set, how to multiply and 18 different ways, or whether you really dislike that they do that either way, you can't deny that common core has changed education today. Now, this study is not a true replication study. Like I said earlier, they changed the grades a little bit. And they also wanted to look a little bit more broad since education has changed. They looked at three different grade levels, kindergarten, second and fourth. But it did change. Remember, they had second, fourth and sixth grade in the original study. They also had a slightly more general research question, and that is, what are the motor and technology demands of elementary school, that was their overall goal. But they did kind of break it down a little bit more than that. They hypothesize that with an increased emphasis on testing, it was likely that the number of minutes spent on fine motor activities would decrease. They also imagined that technology may replace some of the time spent handwriting. So let's talk about the participants of this research study. The study included three elementary school classrooms with about 20 students per classroom, and a small college town in New York. The reason I mentioned that is because this is a small study, this cannot really be generalized for everyone. You know, again, demographics were very specific, a small town in New York, they didn't find elementary schools across the nation. It was just one school, and three classrooms. So it wasn't a very big study. The two principal authors on this study, I mentioned them earlier, they took terms of observing the three different classrooms and took detailed notes after some initial training, I'm not going to go into all the training, but they did actually train, how to take notes for the study. Before going into the classroom. They each observed the kindergarten class one day, and then one author observed the second grade classroom for two days. And the third author observed the sorry, not the third author, the second author observed the fourth grade classroom for two days. While in the classroom, the observers noted the time that each activity began as well as what time it ended. So they could keep track of how much time the students participated in that activity. If there were multiple activities going on, they notated both activities going on, or all three activities that were going on, because that's kind of what the study required. They would do this, for instance, maybe if there were centers going on. And one group of students were at one table doing math, and another group was at another table using the iPads or whatever that might be what they didn't really calculate. They might have noted it in their notes, but they weren't really trying to calculate were behavioral outbursts, or instances where maybe one student did something out of the norm. They're trying to look at the entire group as a whole, or as smaller groups per se. They didn't want to calculate time for a student who maybe got sent to the principal's office or maybe had to go use the restroom. They didn't mark that as a group activity, right? They're looking at the larger group. Alright, so now the best part, the part that everyone looks forward to hearing on this type of a podcast where we look at a journal, and that is the results. Jayson Davies 08:57 After coding all of the data that was taken all the notes that the two authors looked at, they came up with 10 activity categories that were developed, based upon the coding by all four of the authors, they all had to have consensus on each minute of the day, fitting into one of these 10 categories. They didn't go in with these 10 categories, these 10 categories were developed based upon the notes that they were taken. So, here is the 10 categories that they looked at. fine motor, non academic content, fine motor, academic content, academic no fine or gross motor involvement, non academic content, no fine motor or gross motor involvement. Alright, I know those repetitive the next few are not as repetitive computer or other technology used by students leisure or academic, unstructured, gross motor activity, structured gross motor activity, handwriting transition time and dining. I really actually liked that they looked at the transition time and the dining. I'm going to get into that Jayson Davies 10:00 Little bit more in a second. They also developed a fine motor and gross motor composite that included those 10 activities and kind of broke it down or put all the ones that belong to fine motor and the fine motor composite, and those that fit the gross motor activities into a gross motor composite. I'm not sure they explain that very well, in the article, actually, I was a little confused. But when I did the math that kind of add it all up. Sure enough, all the activities that kind of revolved around fine motor, including the computer and technology used by the students was put into the fine motor composite, they did describe well, that transition time, they actually split that time up 25% of the transition time went into the fine motor composite, while 75% of the transition time went to the gross motor composite. And that was again, based upon the notes that they took. They found that 25% of the time with the transition time students were doing fine motor tasks such as opening and closing their backpack, opening books, closing books, getting out papers or doing something that required fine motor use. The other 75% of the time might be walking from class to recess or from recess or lunch or whatever it might be. So again, 25% of transition went to fine motor 75% of transition time went to gross motor. So what did that fine motor and gross motor composite look like? Let's go ahead and start with the fine motor component. They found that kindergarten students spent about an average of 145 minutes a day, or 37% of their school day on fine motor activities. second graders spent 198 minutes, which is about 50% of their day on fine motor tasks. And fourth graders spent 20 sorry, not 20 235 minutes, or 60% of their day on fine motor activities. In comparison, the gross motor composite stayed relatively similar, while the fine motor composite grew, like I just said, from 37% in kindergarten up to 60%. in fourth grade, the gross motor composite remained between 25 and 28% of the day, so it didn't change a whole lot like the fine motor composite did. Now I know you all want to know how much of the day did students spend with handwriting tasks, you know, since that's what most of our referrals tend to be for? Well, they found that kindergarteners spend only 3.4% of their day on handwriting, that's only about 13 to 14 minutes, which I actually think that might make some of you kind of happy because I know you like to see kindergarteners doing things other than writing. So some of you may be a little happy about that some of you might be well that's it, but 13 to 14 minutes, that's it for kindergarteners, spending time on writing, second graders jumped up to about 17.8% of their day. And then fourth grade, just another small jump to only 18% of their day, which is about 75 minutes per day spent on handwriting in the fourth grade. Surprisingly, to both the researchers and myself. students spend on average about 20% of their day, just in transitions, transitions alone, they didn't note dining being a surprise to them. But to me, it was 10% of the day was spent on dining. So perhaps that's a little bit of breakfast, maybe an afternoon snack or recess time snack. And then of course lunch. You know, when you actually look at a school day, you sometimes forget about those periods outside of the academic time, you know, you forget about how much time is really spent in recess and how much time is spent in the cafeteria. And you know, that's important for us as OTs because we don't just look at education, we look at the independence within the entire educational environment. And that does absolutely include both recess and the cafeteria. The authors were also expecting the time spent with technology to be higher than it actually was. It came out to be below 5% for kindergarteners and second graders, and at just under 14% for fourth graders, the researchers actually thought that these numbers were quite low. They were expecting technology to be more incorporated based upon the studies that they had looked at previously before getting into the classroom that looked at how much technology was being used in the classrooms. So they were actually quite surprised that it was so low under 5% for the lower grade kids and at only 14% for those fourth graders. And as I mentioned earlier, that technology use was included within the fine motor composite because well I don't know about you, but I do see most technology use as being a fine motor activity, whether it's typing or drawing on an iPad with or without a stylist, that tends to be a fine motor activity. Jayson Davies 15:05 So one final comment in regards to the numbers. I know every OT is always interested about recess, we kind of have this whole kids need recess mentality, which is absolutely necessary for the students, right? Well, under the category of unstructured gross motor activity, kindergarteners were found to have 38 minutes of unstructured gross motor activity. second graders were found to have 13 minutes. And fourth graders were found to have 16 and a half minutes. So we see this pretty high number relatively high number and kindergarten, and then it goes down for second graders, and then it increases back up. For fourth graders, I found that a little interesting that it dips down so low for those second graders. But they didn't quite have a reason for this. But it was interesting just to see that fluctuation of high low, and then backups lately as students get older. Alright, so let's go ahead and talk about the author's hypothesis and their conclusions. The author's hypothesis that there would be less fine motor demands now than in the past back in 1992, that was actually found to be inaccurate, students are still engaging in a similar amount of fine motor activities throughout the school day as they did back in 1992. However, it does appear that less time is spent on paper and pencil fine motor activities. In 1992, it was reported that 85% of fine motor activities involve paper and pencil tasks. And the current study, however, showed that pencil and paper tasks range from a mirror. And I say mirror because this is in comparison to 85%, a mere 17.8 to 37.4% of the time, the author's attribute this to curricular changes over time, such as the implementation of Common Core State Standards, which really put an emphasis on group activities, and sometimes getting away from those more traditional paper and pencil tasks. Overall, the authors were slightly surprised by how much of the day children engage in fine motor activities, and not just the fine motor activities that we can think of like handwriting or using scissors, but also all the fine motor activities that go into transition time. And the time spent with dining, and even potentially some time spent with outside of the classroom with technology, and even potentially at recess or leisure time. Those are all fine motor aspects that sometimes aren't thought about in the school. Remember, we're not in the schools as occupational therapists, just to support what students do directly in the classroom for academic tasks, we're there to help them be independent in their entire educational environment. And that does include other areas. All right, I may have gotten a little bit ahead of myself and shared most of my takeaways already. But I do have one more, one more that I really want you to take away from this article. And that is that I'm surprised that all grade levels spend more time on fine motor manipulation tasks than they do on fine motor paper and pencil tasks. That means they're spending more time with zippers, and manipulating their food, and manipulating items for counting, or maybe using scissors or glue. Other activities that are not pencil and paper, maybe they're also spending more time typing with a keyboard or using an iPad. I know the author's showed that that number was relatively low compared to what they thought it might be. But other studies are potentially showing that it is higher than what they saw in this study. All of those activities that they spend one to maybe five to 10 minutes a day on, they all add up. And so kids, you know, they spend two minutes a day using the zipper, they spend 10 minutes a day using a computer, they spend five minutes a day opening and manipulating maybe their lunch pail. But that all adds up to so much more time than what they actually do spend on paper and pencil activities. Jayson Davies 19:11 So I guess what I'm trying to convey is that if you're going to go share this article with a teacher or program specialist and administrator, or maybe even another occupational therapist, really the key point is that there is more to school than just handwriting, there is so much more that OTs can do to support students outside of that traditional. This is how we write our letters, thinking of OT that I think used to be so prevalent. We are moving on from that there's so much we can do have a really good evaluation that shows those other areas where the strengths and where the weaknesses are. So that you can say in that IEP, Hey, you know what, yes, handwriting might be an area of concern, but there's other areas of concern. And that's what a strong evaluation does for us. Jayson Davies 20:00 Now, I wasn't planning to plug this in here. But since I just kind of mentioned it, if you are having some struggles with your evaluations and conveying your assessment results at an IEP, I definitely recommend looking into the A-Z School-Based OT Course, which you can find at OTschoolhouse.com/a2z That's my course where I dive into basically nine different modules about how to be a school based OT and we absolutely do cover evaluations and conveying your results at an IEP. So go ahead and check that out if that would be of interest to you. Jayson Davies 20:36 Alright, and with that said, thank you so much for listening to the OT School House podcast. Please remember, if you haven't already, subscribe or follow this podcast so you don't miss any future episodes. We have a great guest coming on next week to talk a little bit about ADHD and sensory processing. You won't want to miss that one. So be sure to subscribe or follow. With that. Take care. Have a great week, and we'll see you next time on the podcast. Amazing Narrator 21:03 Thank you for listening to the OT School House 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to earn 11 hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 71 of the OT School House Podcast. In today's episode, we have Dr. Kelly Mahler on to introduce us to Interoception. Very few people have ever heard of interception and even less know what it means. This may even be the first time you hearing the word interoception. Well, whether it is or is not, you're going to want to listen to this episode. Dr. Mahler is a true genius when it comes to interoception and she has so much to share with us today. Press play to learn how you can assess your client and understand whether or not they have difficulties with interoception. Links to Show References: Kelly-Mahler.com Episode Transcript Download or read a rough edit of this OT School House Podcast episode Jayson Davies 00:00 Alright, let's see if I can do this. interoception, interoception interoception. That actually wasn't too bad, better than when I practiced it. Anyways, today we are talking about interoception and we have Dr. Kelly Mahler on to talk about it. Very few people have ever heard of interoception and of course, even less know what it means. I can only imagine what they might think when they first hear the word. And maybe this is your first time hearing the word interoception. Well, whether it is or isn't, maybe you've heard it several times, you're gonna want to stick around for this episode. Dr. Mahler is a true genius when it comes to interoception. And she has so much to share with us today, like little tidbits on how you might even be able to look at your kid and understand whether or not they have an interoception difficulty. Alright, so stick around, put your phone in your pocket, it's time to enjoy the OT school house podcast. We'll be right back after the intro. Amazing Narrator 00:53 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 is your host, Jayson Davies. Class is officially in session. Jayson Davies 01:10 Hello, hello and welcome back to this episode of the OT school house podcast where we are doing a deep dive into interoception with Dr. Kelly Mahler. We're going to get into this pretty quickly I'm going to go ahead and introduce Dr. Kelly Mahler and then we will go ahead and get started. So I am excited for this. I hope you are as well. Dr. Mahler has served kids and adults as an occupational therapist for 18 years. She is the winner of multiple awards, including the 2020 American Occupational Therapy Association, AOTA emerging and innovative practice award and a mom's choice gold medal. She is an adjunct faculty member in the Department of OT at Elizabethtown College in Pennsylvania, and is actively involved in several research projects pertaining to topics such as interoception, self regulation, trauma and autism. Kelly is an international speaker and the author of eight different resources for interoception and kids with autism. So we are very fortunate to have her without any further ado, here is Dr. Kelly Mahler. Jayson Davies 02:12 Hey, Kelly, welcome to the OT school health podcast. How are you doing today? Dr. Kelly Mahler 02:16 I'm doing good, Jayson. Thanks. How are you? Jayson Davies 02:19 I'm doing fantastic. I am loving it here in Southern California. We have some springtime weather and it is just amazing. Remind me again. Where are you located? Dr. Kelly Mahler 02:28 I am in Hershey, Pennsylvania. And so I'm very jealous that you're having spring already have snow on our ground. Although I think it's like 40 degrees today. So hey. Jayson Davies 02:40 Nice. So I mean, you're in Hershey, Pennsylvania, obviously that is known for being like the birthplace of Hershey, right? Dr. Kelly Mahler 02:47 Yeah, that's right, like so on good days. You can smell chocolate in the air. And our streetlights are in the shapes of Hershey Kisses. Like, it's like the sweetest little place on earth to live. Jayson Davies 03:01 That's awesome. And have you been like a lifelong Hershey Pennsylvania resident? Or how's that work? Dr. Kelly Mahler 03:07 So I grew up in the next town over. It's called Elizabeth town, Pennsylvania. So my whole family still lives there. And so we're very close to help with lots of babysitting and you know, being a big part of my family's life. But we're also a little bit closer to like the Hershey Park amusement park and lots of good restaurants and stuff like that. Jayson Davies 03:28 Well, I had no idea there was an amusement park. Dr. Kelly Mahler 03:31 Oh, yes. My daughter's think that every small town has or has an amusement park, which is obviously not true. Very handy to have it in our back yard. Jayson Davies 03:42 That's awesome. Yeah, I missed when we used to have like community fairs in my old town. And now like, it doesn't happen anymore. You know, that little Carnival just never. They don't do it anymore, miss those. But all right. Well, I am so glad to have you here. As you know, I actually recently attended a training that you did, actually, last week, it was a two day six hour training or so. And it was great. So much practical information for school based OTs. But unfortunately, I know not everyone has the opportunity to hear you speak to that manner. And so I'm just excited to have you here today. So how did you become? What's your background in the OT world? And how'd you get where you are now? Dr. Kelly Mahler 04:18 Yeah, so I always knew that I wanted to work in pedes. Um, and when I got out of school, I graduated OT school in 2002. So I'm in my 19th year in the biz. And I didn't get a pedes job right away. It took me a few months, but I finally landed my first job and it just happened to be in school based OT. So I've been that's been the biggest part of my job ever since as being a school based OT. And I really love it. I've worked in so many different niches like I've been in like I've been the like primary OT for a whole school district. I've also worked in Pennsylvania, we have intermediate units, and so those are like staffing for a variety of different special education classrooms out there. So I've been in IU classrooms. And then I've also which came in super handy six years ago, I started contracting with a cyber school. And so I was hired originally to provide OT school based OT services to the cyber school students that were not benefiting from telehealth the telehealth model. So I got to go into their homes and provide OT in their educational setting, which was their health, which was such a different experience for me as a school based OT because I didn't have such interaction with families. So you know, we have a little bit, but like, I was immersed in a family culture, and it was so exciting. And then as I got to know these students, sometimes we did a hybrid model where we were doing work in the home. And but then I was also doing supplementing with a telehealth model. So I got my feet wet with telehealth before all of this COVID. So I just have always been really passionate about working with school aged children. I've done preschool school age, and I do have some young adult clients now as well. Oh, wow. Jayson Davies 06:07 Yeah, you know, that's interesting. I mean, so many things that you said, I have questions I could go on just on that alone. But the last thing you said is having some young adult clients, and I've been getting a lot of questions. One is about interoception. And another one is, what do I do with, you know, those in between students, the transition periods, students, the high schoolers and the young adults? What do I do with them. And so I think that's a growing area for OT. Obviously, that's not exactly what we're here to talk about today. But I think it's going to be a huge emerging area for Occupational Therapy. Dr. Kelly Mahler 06:39 I agree with you. And I think sometimes as a pediatric OT, it can be really intimidating to start working with adults, because you feel like maybe you don't have the skill set. But when we're talking about especially like the clients, I'm serving their neurodivergent clients, and honestly, it's this, they need the same things that I do with my school based clients, it's just done in a slightly more mature way. And working with those adult clients helps me to better understand my younger clients that don't have the insights yet, like so it has been like such a blessing to my career. Jayson Davies 07:15 That's awesome. Great. I love that idea that you were actually able to see the kids that maybe telehealth wasn't working for. Because as I'm kind of looking toward telehealth, obviously, we've all been doing telehealth the last year, and you know that there's some kids that just don't benefit from telehealth as they would from in person. And so that's cool that you were able to find a program where they understood that and then worked with you to actually go into the house to to provide that service, that must have been really a really great opportunity. Dr. Kelly Mahler 07:42 Great opportunity. Yeah. eye opening for me what families really go through on a day to day basis. Jayson Davies 07:49 Nice. Alright, so we are here today to talk about interoception. And I think the first question I should ask is, what is it because I know not everyone has been well just, I guess heard this term even. So what is interoception? Dr. Kelly Mahler 08:05 So interoception is our eighth sense. So it's just like all of our other senses where we have like, for example, our sense of vision, each sense, we know has a set of receptors and you know, this is OTs, right so your sense of vision, your receptors are your eyeballs pulling in information about all they see it outside of your body. So interoception works exactly the same way as all the other senses has a set of receptors pulling in sensory information. This time the information is being pulled from the inside of your body. So intro receptors are working. You have these receptors, first of all located extensively throughout your body. So you have them in all of your major organs. So you have interceptors in your heart and your lungs and your stomach and your bladder, your colon, your skin, your muscles, you have like very extensively almost everywhere. And these interceptors are pulling in information about how all of these different body parts are feeling like what is the condition of these body parts. So I usually give the example of your stomach like so you have interceptors the lining of your stomach pulling in information about how your stomach is feeling so is your stomach like does it feel gassy? Does it feel nauseous? Does it feel cool? Does it feel empty? You have like that tingly butterfly feeling in your stomach. And so just like all of the other senses, these interceptors pulling in all of this information travels up pathways in our spinal cord in an area of your of our brain called the insula. So what we know is the insula uses these incoming interoception messages as clues to your emotions. So if you go back to the receptors in the lining of your stomach, maybe your stomach like feels crassly or empty then your insula can use that as a clue that you feel hungry. Or if your receptors your interceptors in the lining of your stomach. Get That like, picks up that you have that little little butterfly or tingling feeling that maybe your insula uses that as a clue that you are anxious or nervous. So interoception is the sense that gives us information about how our bodies are feeling. And it provides this very tight body emotion connection. Jayson Davies 10:21 Gotcha. And I'm going to ask you about that body emotion connection just a little bit. But I want to ask is the insula, it's been like 12 years since I took an anatomy physio class, is that this same part of the brain where all the all the senses kind of go through or is that more specific to this interoception? Dr. Kelly Mahler 10:40 It tends to be more specific to interoception, and it is nicknamed the interoception center of the brain. However, like I think we have so much to learn. But I know that smell activates the insula, which kind of makes sense. I think all of our senses change the way our body feels. So like when you're listening to a certain song, it changes though it can change the way your body feels. So all of our senses are interconnected. And interoception is not something that's separate. I also was just reading some research that the certain vestibular input activates your insula. But in traditional like neuroscience literature, the insula is really known as the primarily is processing interoceptive information. Jayson Davies 11:26 Wow. Okay, so know that insula, perfect. You mentioned research a little bit, where are we at in terms of research for interoception? Dr. Kelly Mahler 11:36 Great question. We are in the infancy stage, like newborn J. Two, if you compare it to all of the other senses, and interestingly, there's a guy named Sir Charles Sherrington. And he defined interoception, back in the early 1900s, he wrote this paper, and he defined two senses. He wrote about something called proprioception, and something called interoception. Read he won a Nobel Peace Prize for his work. Yeah, everyone's like, oh, sir. Charles Sherrington, your idea on proprioception is so brilliant, right, and proprioception took off. And everyone's like, your work on interoception is so strange, we're just gonna ignore it. Over 100 years later, it was largely ignored until a brilliant neuroscientist named not named Dr. Boyd Craig. Key started studying interoception in his lab, and he was really able to give a lot of definition to the system and put a lot of research behind it. And then all of a sudden, people realize, like, holy cow, like this is a really important sense. And it does exist. And so since 2002, research has begun to emerge, and it is just exploding right now. Like the interoception. field is on fire, in neuroscience. In OT, it's getting there. I mean, there are new studies coming out almost daily. Jayson Davies 13:10 Gotcha. And actually, the reason I asked you that, partially because you mentioned it, but also I wanted to know, are there any norms established at all for interoception? Dr. Kelly Mahler 13:18 Yeah, not yet. So we know very little on the development of the interoceptive sense, we know that it's present from birth. Like if you think about like, most infants, from day one, they are equipped to notice discomfort in their body, right. And they, they're noticing that discomfort because of their interoceptive sense. So they noticed discomfort, their urge to cry, and then that is when the caregiver hopefully steps in and tends to their needs. And so from day one, we know that interoception was present. We don't know like what that developmental trajectory should look like in typical norms yet, do we need that information? It would be very helpful. But yeah, like I said, we have a lot, a lot to learn about interoception, especially from a practical application standpoint, and that's like where I want us. I mean, I'm biased, but I want us to step in and start figuring all this out, because we are the experts of performance and function and development. Jayson Davies 14:24 I have a question, but then you said something. So I have a different question. And that is, you want OT to be in the forefront of interoception. Well, who right now is in the forefront of interoception and what are they doing that we might not be doing? Dr. Kelly Mahler 14:38 Well, right now, the people on the forefront of interoception are neuroscientists, some medical practitioners and they're really trying to understand interoception from like a brain-based level or you know, neurology level. And like I said, very little work is being done on the practical application. By like, so how does interoception truly impact a whole wide variety of functional areas. And so that is where I see us as OTs to come in, take this really rich body of neuroscience, and help it to become more practical in a way that nurtures our students abilities to flourish and thrive. Jayson Davies 15:28 Yeah, definitely. That's great. Obviously, as OTs, we really have that plaque, that practical application in the real world, so that'd be great. The other thing that I was I was thinking, as you were talking last time, was that you're talking earlier about his stomach, and you know, whether or not you're hungry, whether or not you're sick, you need to use the restroom, whatever that might be. But in terms of when a baby is hungry, sick, whatever, they cry, they don't give us a different type of cry, necessarily, maybe your mom and you can, you can determine the different cry, right, but they just cry doesn't matter what their stomach feels, they just cry. So that kind of leads me to my next question, which is, you mentioned two very different terms. And those terms were implicit and explicit interoception. I think that kind of talks about that a little bit. Dr. Kelly Mahler 16:19 Yeah. So the interoception system has two main arms or categories or whatever you want to call them two main pieces. And so the first is what you said, implicit interoception. And that side of this sense is happening beneath our level of consciousness. It is all of the things that are happening in our body, that are helping to regulate our body to helping to strive for homeostasis, like that's it here, there's a word from blasphemer pass. So interoception is our sense of homeostasis. And so our interoceptive system, it notices when there's a certain change in the tissues in our body, and it activates a series of responses in order to help that homeostasis process happen. So these are things that we're not ever really thinking about, like, we don't wake up in the morning, and we're like, wow, like my livers releasing a lot of enzymes today, like it's happening, right. But then we also have the other side of interoception that you mentioned, and that's the explicit side, and that is the side of interoception, that reaches our level of consciousness. So like, we noticed when our body feels cold, and that's what urges us to regulate, like, maybe we put a blanket on or a jacket, or we go inside, or maybe we notice like a growling stomach. And that's what urges us to want to regulate to eat to help restore that comfort with our body. So there's two different arms of interoception always at work, always striving for that state of regulation. Jayson Davies 17:58 Gotcha. And so again, I already asked you about norms, you know, we know that even babies have that sensation of something's going on, but they aren't able to kind of put a, I don't know, maybe a brainwave to what that actually means. And then you have that ability to actually put something to it, you use the term, I believe it was called interoceptive. Awareness is that kind of when you link the implicit and explicit together Dr. Kelly Mahler 18:21 interoceptive awareness is typically referring to the explicit size so that the process that reaches our level of consciousness and interoceptive awareness involves our ability to notice a body signal. So we noticed the growling stomach, but then we also have to be able to connect that feeling or that body signal to the emotion like we know that when our stomach growls, it means I'm hungry, or when my heart races, it means I'm anxious. So being able to notice the body signal and then give it meaning is what interoceptive awareness can be defined as. Jayson Davies 18:58 Gotcha, perfect. So you have spent a lot of time in the schools. And I'm sure you've experienced great opportunities in school. I'm, I'm also assuming that you probably have experienced some pushback in the schools. When it comes to interoception. And the schools, how do those really tie together? Dr. Kelly Mahler 19:17 Well, there's a lot there's many, many different ways. So I think I should talk about probably the number one way and interoception has such an influence on so called challenging behavior. Yeah, so I prefer to call it regulation, but it's, um, I know that it's still and that's the pushback that I get still to this day, and 19 years and and challenging certain behavioral approaches. But if you are not understanding the way your body feels, when you're not understanding your emotions, you are not equipped to regulate those feelings and emotions independently. And what does that look like? It looks like major dysregulation all referred to by others I don't understand referred to as challenging behavior. Jayson Davies 20:06 Gotcha. So behavior is one way, does it also impact actual functional output of handwriting using scissors, other occupations on the playground and stuff like that? Dr. Kelly Mahler 20:16 Yeah, so intersection has been linked to a wide variety of aspects of our life. So it has been linked to body awareness and motor imitation, and all different kinds of self care, like sleep and dressing. And I mean, so many different I could just spend like probably the next hour listening, of course, that intersection has been found to influence in some way. It even influences social participation and our ability to understand how other people are thinking and feeling. I mean, it's so vast the influence that we're just now starting to understand how big of a deal interoception is, for a lot of our students. Jayson Davies 20:59 Gotcha. And when you started to introduce the idea of interoception into your school, I mean, I can just imagine you sitting on an in an IEP and just bringing up this, how many syllables and just interoception, like six syllables, and people just looking at you like, what the heck are you talking about? How did that go when you started to introduce it into your school? Dr. Kelly Mahler 21:21 Well, my schools already knew me as having very wild idea. I was challenging the norm. But I know and like, if you ever created this word into inception, it's not very sexy, like, I wish it were. And I was like, ooh, tell me more. But it's not right. Once you start to, like, really explain to people what interoception means, and you relate it to their own life and their own experience, like, so if you're like asking them tell me how you know, when you it's time for you to eat, or how do you know when you know, you need to go to the bathroom, or whatever it is, it's always comes back to, it's based on the way my body heals. And our bodies are designed to feel uncomfortable like that discomfort is important, because that serves as our urge to act and our urge to regulate. And so if that urge is missing for our clients, or it's confusing for our clients, or students, then it that that's where the dysregulation the breakdown comes from. Jayson Davies 22:23 Gotcha. So I'm just still trying to think of like how you got into with this school. And so when you're in the school, you're in the IEP. Now you've mentioned interoception, you say you want to work on this. Now, kind of where do you go from there with a student? Once that student? Yeah, you say I have some some concerns with this? Where do you go from there? Dr. Kelly Mahler 22:45 Well, I also try to tell and explain to the school how incorporating interoception would be a benefit of them to them. So whether it How is it going to benefit the classroom teacher? Well, if we're really actually addressing the deeper reasons behind why the student is having a hard time regulating or whatever it is in the class, then we can help them to see the benefits of what it is we're recommending. So I always try to bring it to and directly speak to whoever the stakeholders are in the room, like the administrator, how is it going to benefit the administrator like, you know, all the different players in the room and try to speak to, you know, their buy in. And then once they start to see that I still have to work hard at getting certain schools on board. And sometimes I just need to, you know, the proof is in the intervention and seeing the amazing gains that the students can make, then helps the school get on board. And I'm sure like, I mean, I'm probably no different. Like, I always pick that one teacher that loves OT so much. And I'm like, Hey, I'm gonna pick a student in your room, and we're gonna do this together. And then they start, like, create the buzz for you, right? Jayson Davies 23:53 Finally. That's one of the things I teach in my course. Yeah, exactly what you just said, One, know, your stakeholders who you're talking to know what their goals are, because they're the people that have the decision making power. You know, as OTs, we don't have a lot of decision making power, we need help from above. And then the other thing Yep, start with one teacher. Just start with one. If you can get one on board, you'll be amazed by what can come with that. So Dr. Kelly Mahler 24:18 yes, absolutely. And honestly, there's so many caregivers and people starting to learn about interoception like the schools have to get on board because especially if they're living in a if you're in a district that has a high degree of legal issues happening and due process and all that kind of stuff like you have to you have to know about this, because those savvy parents and caregivers are becoming educated and are starting to ask and push with us in schools. Jayson Davies 24:48 Yeah. So I'm going to ask you what I think it might be a little bit of a tough question and I think people out there would like to hear your answer. What about because I know OT the field can sometimes be split on a few ideas. What about the OT that says, you know, what? Does interoception really belong in schools? And you've already given some great examples as to why but what do you say to someone who's maybe a little skeptical about it, whether it's an OT, maybe a teacher, but obviously the audience here is OTs. Dr. Kelly Mahler 25:18 Why? Well, I would encourage you to think about how interoception is either impacting or supporting your student's ability to participate in the school. And we do know, like we mentioned that interoception in the research has found to influence so many aspects of participation. And so if your student is having a breakdown in participation, it is our job as the OT in the school, to think about all of the different whys and all of the different factors that are limiting that participation. And interoception is not always the main piece, it's just a small piece that we're missing. And when we incorporate it in enhances all of the amazing things that we already have in place. Jayson Davies 26:01 Absolutely. I knew you'd have a good answer for that. Great. All right, on to the next question. And that is, what concerns are red flags, perhaps should OTs look for during their file review and the evaluation that may lead you to think hey, I need to look more into this student's interoception? Dr. Kelly Mahler 26:19 Yeah, I mean, number one, that whole aspect of regulation piece, so like, if they're really struggling to manage their anxiety or frustration, or boredom, I definitely would, that sets off a curiosity in my brain, like, I need to look at their underlying interoception. If you're putting regulation supports in place, like you're using a specific curriculum, and they're memorizing the curriculum, or they're memorizing your coping strategies, and they cannot use them in the moment, that is a huge red flag to me. Like, they have to know, notice how they're feeling in the moment in order to realize, Oh, it's time for me to use the coping strategy that might have taught me or Oh, that's like, where I'm at in this, like, whatever, on my my five point scale, like, so if they're memorizing the things you're teaching, and but they're not using them in the moment, I would be suspect of that. But then there's a whole other variety of participation factors you can look at such as like, are they having accidents in the school like toileting accidents? Or are they like, are they the student that is either sprinting down the hallway last minute, because they're like, Oh, my gosh, I have to pee, you know, it's an emergency, or are they the student that is seeking out the bathroom all the time? Because they're confused about the way their body feels? Also, like looking at their feeding habits, their drinking? their sleep? So many different factors? For sure. Jayson Davies 27:40 Yeah, and I think you're right on as well. What side of sensory integration? Or how does sensory integration sensory processing play in with interoception? Dr. Kelly Mahler 27:51 That's an area we don't know a lot about yet. We know that interoception is the eighth sense. So it is not something that's working all on its own. And it you know, works alongside of all of our other senses to help us navigate the school or the day our daily routines. But exactly what that looks like. Jayson Davies 28:11 No, sure. Yeah. Yeah. because like you said earlier, you know, we have our five regular senses that everyone knows, and those do come from external stimuli. But similar to interoception, proprioception and vestibular, obviously, as OTs we know, come from more that internal stimuli are muscle stretching, and the whatever canal inside of our ears, that's not an external stimuli. And interoception is obviously in a similar so I would kind of think that those three specifically would be tied a little bit more closely together. Dr. Kelly Mahler 28:42 Yeah, I would agree with you, for sure. I can't wait to see what we learn and then next. Jayson Davies 28:48 And you're going to be right at the forefront of it. So all right, I want to continue on a little bit. You just talked about, you know, some red flags, self-regulation, being some concerns, behavior, being some concerns, being able to even just like putting types of issues as concerns. Where can therapist go from there? Alright, the teacher came to them, they have these concerns, or you're seeing these concerns, in your observations? Are there evaluations available? Dr. Kelly Mahler 29:13 Good question. And as you know, for my course, like this is a big dilemma. And the intersection feels like no one can agree on the best way to assess interoception. I do have an assessment tool called the Comprehensive Assessment of interoceptive awareness. And I'm going to be the first to admit that it is nowhere near perfect. It was just I created it for myself as a school-based OT because I needed a formal structured way to assess this new thing we were talking about and to justify why I wanted to include it in the supports that I was providing. It's not standardized, but it is really this assessment tool is so enlightening. When you administer it, you get such amazing qualitative feedback from either this Didn't themselves or sometimes we give it to like a school staff person, like someone that knows the present well to try to get as much information about their, their interoceptive experience, and it can be quite enlightening and give us insight that we might not have considered before. Jayson Davies 30:17 Gotcha. And is that part of your manual online? Dr. Kelly Mahler 30:20 Um, yeah, and do the assessment is available through a different publishing company, it's autism, Asperger's publishing company, and it's available through their website and through the current publisher. Jayson Davies 30:33 Alright, and I always put together show notes. And so I will be sure for everyone listening out there that I will find the link to it. And I'll put on the show notes if you want to find where you can get that. Alright, so we do the evaluation, we have this type of tool, aside from that actual evaluation, kind of what do you do just when you're working with a kid and you just have that little concern? Maybe you call it a screening? Or they're just some questions that you like to ask the kid or like the parents? Are there specific questions that you tend to lean toward? Dr. Kelly Mahler 31:02 Um, well, some of the questions from the interviewer that's a part of the assessment tool, I could give you some of your listeners now. And it's like, they're kind of fun questions to play around with. But like, I would just start asking the student, I mean, these are for the students that I'm supporting that have like the cognitive and communication abilities to answer some interview questions, I would just start by asking, like, tell me about like, like, what does your body feel like when you're hungry? or What does your body feel like when you're sleepy? And then I would start moving into like, some aspect of emotions, like, tell me about what your body feels like when you're excited? And then what does your body feel like when you're anxious? Or whatever emotion words would be a match for their age? and just see, like, are they like in touch? Like, Are they aware of any internal signals? Are they able to connect to those internal signals to the meaning? What is their inner experience? Like, I promise you that you will hear sometimes some very surprising insights, and things that will probably shift your ability to understand the student a little bit better, and then provide more targeted support for that learner? Jayson Davies 32:08 Yeah, and you mentioned, sorry, go ahead. Dr. Kelly Mahler 32:11 If they like, if I'm asking you those questions station, you're like, I have no idea. Like, I don't know how my body feels like, then you're like, oh, okay, like, it's too far forward thinking of me to be giving you coping skills, and regulation strategies to seek out on your own or a help card or a brake car, like you don't notice those need that feeling that need in your body, like, I need to rewind a little bit and help you to understand your body better, before you're ready to and equipped to use those strategies that I might have been doing a little bit too far ahead. Jayson Davies 32:46 Yeah, that's perfect. I was just gonna ask you to kind of elaborate on that just a little bit. Because I agree, you know, sometimes we jump two steps ahead, and we have to back up. And so for that kid, I know, this isn't the training to go six hours, I do not have you for that long. Nor do I wish for any podcast the last six hours long, I'm not Joe Rogan. But I would love to just kind of maybe hear one thing that you might do with a kid who is having that difficulty putting, I'm hungry with an upset stomach, or that feeling of an upset stomach. Dr. Kelly Mahler 33:21 So we always start like we're trying to build what we call body emotion, action connections. And it that is in line with the way that neuroscience currently says that self regulation develops. So the body peace comes from being aware of our body signals. So being aware of tight hands or hot skin or racing heart or growling stomach, and then we begin over time to learn what those what those sensations or body signals mean, like. So when my fists are tight, that's a clue for me that I feel frustrated or when my stomach growls, that's a clue for me that I feel hungry. So we start at the body level first. And we just want to help our students start noticing body signals within different parts of their body. And we do so we have tried to chunk this down and make it as easy as possible because it can be very overwhelming for many learners and students to start to notice and understand body signals. So we start with one body part at a time. And so like, sometimes we start with hands and we notice all the different ways your hands can feel. And we do it during like a lot of like fun and playful activities, helping them to notice the way their hands are feeling, understanding those body signals, and then we move on to a different body part. So over time, we're slowly building to their ability to check in and notice their entire body and understand their entire body. And you know, from the course like we are always emphasizing like there are no right or wrong interoception experiences, which is what I kind of like about this work because we're not coming in telling someone that they need to fix something like they're not doing any thing wrong. And I feel like sometimes we give that accidental message and some of the supports that we use in the schools. And so what we're trying to do with this work is to just help our students to discover self discover their own inner experience, or validating their own experience every step of the way. Because what your body feels like when you're hungry is different than what my body feels like when I'm hungry. Like what your what your hands feeling when you're squeezing a stressful is definitely what my hands are feeling when I'm using a stress ball. So we're honoring and validating each person's unique experience. And we're just trying to help our students to understand their own experience. Jayson Davies 35:40 Absolutely. That's awesome. So I have a question. And it comes straight from all the listeners and followers of the OT schoolhouse podcast. They always want to know, how do you incorporate it into a goal? How do you make an IEP goal? You know, as a school based therapist, IEP goals are like, that is the thing, you have to have an IEP goal, because then you can't have services without an IEP goal. So how do you incorporate interoception into an IEP goal? Dr. Kelly Mahler 36:06 So whenever a district is willing, I am always advocating for not having an interoception specific goal, I want to look at interoception as one of the supports that we're using to help to foster growth towards a participation based goal, a function based goal, like I don't personally, like really care if a student improves their interoceptive awareness. Like I want to know what was the like, the functional gain from that, right? Like if you just develop your ability to notice your heart rate, and nothing else, like what's the meaning of that, like you like if that helps you to become more aware of when you when you grow anxious, and you're starting to then seek out a coping skill on your own, and then you're able to stay in class longer, or participate in math class, or whatever it is, then that is amazing. So I try to never ever write interoception based goals, and help schools to see that this is just a support that we're providing your students in order for them to meet their function and participation based goals. Now, that being said, I have had some pushback from a few districts and I have agreed reluctantly to write it an interoception based goal that I like, I'll do whatever I need to help my students get the support they need. But that's not ideal. Jayson Davies 37:31 Yeah, I understand. We all want to try and make collaborative type of goals and participation, you know, in the classroom types of goals, and to make a goal where you know, maybe Little Johnny will be able to identify that he needs to use the restroom or something like that would be a very interesting goal on an IEP, then in that case, you're trying to collaborate with the teachers and have the teachers create this goal. Where do you then? Because I'm kind of in the field, you know, if you don't document it, it never happened. Are you writing then a treatment plan? And in that treatment plan, you're kind of writing how you're going to work on interoception? Does it go into the notes of the IEP? Does it go somewhere on the IEP? Or how do you do that? Dr. Kelly Mahler 38:12 Well, it really depends on your situation. Sometimes I put them in the SDI, like if I know like I want a student to have access to a body check chart, like that's just a strategy that we have, then I will put like something like that in SDI. But like I won't put them usually in a specific goal. Okay, you Jayson Davies 38:32 said SDI just elaborate on that because terms go crazy when you move from district to district, county to county state to state? Dr. Kelly Mahler 38:39 Yeah. Okay. So in Pennsylvania SDI stands for specially designed instruction. And it's like a list of things that we have in the IEP that once they get in that list, and the school is legally mandated to provide it. They're like if I put access to body check chart in the SDI is and that's something that feasibly should be happening. And we do have to, like, even specify the duration. So I could say, like, one time a day, or a five times a week, or whatever it is. And then hopefully, and I don't try to be like as highly specific law, but I'll say access to a variety of interoception supports, and then I'll put in parentheses, for example, the bar chart, or you know, whatever it is that we're recommending, and then we'll put the duration and that's like, a wish list kind of duration. That's supposed to be happening. But, and I do try to write those it definitely with support and collaboration of the classroom teacher. Jayson Davies 39:37 Yeah, and for anyone listening, every single IEP has that section. It just is called something different. It might be called your accommodations section or your instructional strategy section. But yeah, you can add accommodations or whatever it might be into that area. And that's a great example of what you might put in there. Alright, so we're going to wrap this up pretty shortly but this entire talk you have been mentioning your work and where interoception might be headed in five to 10 years. So with that, I have to ask, what are you working on? Or what are who are you working on with what? Oh, my, Dr. Kelly Mahler 40:13 okay, well, I have a lot of intervention based research going right now we want to make sure that I have the the interoception curriculum, which is our like framework for building interoception. And I use that all the time in the schools. But we want to make sure that what we're telling people and recommending to people is evidence based, and that we can come to the table, especially as OTs, we are notoriously bad. I putting evidence behind our interventions. And I do not want to continue that streak. So we are working so hard we are in year five, we have amazing outcomes through all of the work. So that's a big passion project right there of me doing all of that research with colleagues. And yeah, that's what I think the one of the biggest things, we're always working on new intersection resources to help people practicing in a variety of places. And we have new online courses that we're always trying to kind of push the bounds on new topics. Yeah. So we're just having a lot of fun with everything. Jayson Davies 41:16 Awesome. And so with that, then where Can everyone go to find out more about you? I know you have some free resources available. So where can people find those? Dr. Kelly Mahler 41:24 Yeah, so we have so many free resources on my website, it's at tele dash mahler.com. So my last name is spelled Mahler. So it's Kelly-Mahler.com, which I'm sure you'll put in the show notes. Jayson Davies 41:38 Absolutely. Yep. Of course, wouldn't miss it. Great Dr. Kelly Mahler 41:42 There's tons of free videos, printables. blog posts, you name it. It's there free resources. Jayson Davies 41:49 Yeah. And for anyone listening, if you ever have the chance to go see Kelly, whether it be live on zoom, be sure to take that opportunity. We spent, I don't know how many people were on that about 300 or so. Yeah, yeah. And so it was fantastic. We were on zoom. But if you eventually can see her live, I'm sure that'll be coming up here hopefully soon. Be sure to take advantage of it. Because you can use interoception not just you don't have to be the interoception occupational therapist. And I think some people get a little bit like, Oh, my gosh, I have to use whatever I just learned. And I'm actually gonna let you speak to this in a second is how important is it not to just use interoception? in your practice? Dr. Kelly Mahler 42:36 Yeah, it is only a small piece of what it is we do as OTs. It's a it's a really big missing piece right now. But it but it is a small piece of what it is we do. Jayson Davies 42:46 Yes. And so Kelly has so much on interoception, but she also has so much of good occupational therapy knowledge just in general. So be sure to go check her out. And with that, I want to ask you, do you have any other information that you want to share or anything like that, that I don't know, just anything for that therapists that might be looking into interoception Dr. Kelly Mahler 43:06 Yeah, I don't know, just I would just start with the free stuff and learn a little bit more about interoception. Think about how it could be impacting the students that you serve. And it has completely shifted my ability to support my students, especially the dysregulated ones in a more meaningful way. And it really falls in line with what we believe in as OT is because it's a process of validating another person's experience. It's not us coming in and telling someone what their experience should be like and how to act, quote, unquote, more typical, like it's really honoring who they are as a person. And that's what I think I love most about science. Jayson Davies 43:42 Great. Well, thank you so much for joining us today and I look forward to keeping in touch to see where you go with interoception. That'll be great. Dr. Kelly Mahler 43:49 Thanks, Jayson for having me. Jayson Davies 43:51 Definitely take care. Alright, and that wraps up this episode of the OT school house podcast. I really do hope you enjoyed that conversation with Dr. Mahler. She is just so knowledgeable when it comes to interoception and so many other areas. Be sure to check out the show notes for this episode, as well as her website Kelly-Mahler.com. To learn more about her and check out the resources she has, some are free, some are paid, but they are all wonderful. With that take care and have a great rest of your day. See you next time. Bye. Amazing Narrator 44:26 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to earn 11 hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 70 of the OT School House Podcast. Whether you trained in the USA, Greece, India, or anywhere else in the world to be an OT, this episode with Ushma Sampat is sure to teach you several valuable lessons on understanding cultural differences, systematic biases, and how to be a better school-based OT! Ushma is a now a private practice owner in the Bay Area of California where she see clients in their natural setting, including kids in school. But to get to this point, she had to learn so much. This is not an episode to skip! Links to Show References: WorldofOT.com Ushma on Instagram World of OT on Facebook Episode Transcript Download or read a rough edit of this OT School House Podcast episode Amazing Narrator 00:01 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 is your host, Jayson Davies. Class is officially in session. Jayson Davies 00:18 Hey there, welcome to the OT school health podcast. My name is Jayson Davies and I am a school based occupational therapist in Southern California. I am so excited to be here with you today. I am actually really excited today for two reasons. First and foremost, you are about to hear a wonderful conversation between myself and Ushma Sampat, who is a private practice owner up in the Bay Area of California. However, she was a school based occupational therapist for five years, and she has so much to share with us today. This is honestly been one of the best conversations I've had in a long time, so you will not want to miss this. The second reason that I am excited is much shorter. And that is just because summer is coming and I love summer. I completely feel like Olaf right now the snowman. So anyways, we're gonna keep this intro pretty short. We're gonna dive right into it. Please, please listen all the way through. This is an amazing episode. Put your phone in your pocket. You don't need it. Just press play. Let it go. Here is Ushma Sampat. Good morning, Ushma! Welcome to the OT schoolhouse podcast. How are you doing today? Ushma Sampat 01:27 I'm well, thank you for having me here. I'm excited. Jayson Davies 01:30 Thank you. Yeah, I'm excited to have you here as well. I mean, we both have a course for school based occupational therapists. So I'm excited for for everyone, all the school based OTS out there to get to know you a little bit further. So that's gonna be fun. Ushma Sampat 01:44 Thank you. Jayson Davies 01:45 Well, we have several topics that we would like to get into today. But first, I want to start off by asking you about your current practice, you own a private practice up in the Bay Area in California, right? Ushma Sampat 01:56 Yeah, World of OT serves children and the whole world. So we serve families, schools and other professionals. And we do so through direct services, concepts, and an online course, as you mentioned, for fellow OTS who are new to the school system. Jayson Davies 02:12 And so how do you work in the schools through the world of OT? Ushma Sampat 02:16 So I work with kids in in variety of ways. So firstly, because I provide services in the child's natural environment, I'm seeing some of my private kiddos in the school. I also provide console services to early headstart and Head Start preschool programs. But that's another way I'm connected with the education system. Jayson Davies 02:38 I thought I actually thought that you contracted with the school directly, but you're actually seeing private kids in the school. Is that did I hear that? Right? Ushma Sampat 02:47 Yeah, that's one. And then the other is also contracted by a private school, in the school system. Jayson Davies 02:54 Gotcha. I actually want to dive into that, then a little bit is how that works. When you have a client that is a private client, but you're asked to go into the school or work with them in the school. What does that look like? Ushma Sampat 03:06 Yeah, so it's, so when I have private kiddos that attend private schools, I work with them, just like I would with any child that I was seeing in the public system. I would, they don't have an IEP for me to go off. But I'm there because the parents primarily have concerns related to school functioning. And so what I'm doing is doing a combination of push in call out collaboration with the teachers, and kind of the whole round of things that the child might need in the school. Jayson Davies 03:43 So So how does that work? As far as the school side of it? Does the school welcome you in with open arms? Or is this a private school or public school? How does that work? Ushma Sampat 03:53 Yeah, so it's because it's a private school, it's worth kind of the teachers are glad to have me as a resource, and they're happy, you know, there's one additional brain to support them. But in private school, it does look, I mean, in public schools, it will look different. So they don't allow you to be a private practitioner come in to a public school and provide services. So with some of the families that I work with, when they are attending public schools, what I would do is collaborate with the team collaborate with the teachers as an external OT, but not really providing services for the child in there. Gotcha. So Jayson Davies 04:32 now, I want to I want to continue on this because this is very interesting to me. When you go into the private school, you're going on campus, are you going into the into the kids actual classroom? Are they pulling out the kid for you to work with them in another room? Or what does that look like? Ushma Sampat 04:48 It's both so you know, there are times when my sessions are actually pushing in. So obviously things are very different. Oh yeah, recording in the COVID world. And for right now, I'm not see any of my private kiddos in their schools. But I still do provide services to a private school where I go in person, because I'm the only OT providing services for all the kiddos at that private school that's contracted me, going back to what the services would look like for my private kiddo in the school, typically, I will push in, I'll see what the teacher is doing, you know, and get a better idea. It's more like an observation and some amount of time to observe, see work samples, touch base with the teacher, probably pull the child out, depending on what I have planned and what my goal is for the session, I might push in or pull out the child in a separate space, it might be in the playground, it might be in a separate room, it might be in the library, it might be anywhere in the school, where I could really, you know, work very much like how we do it in public schools. And then the reason I've liked the approach, even if I had to pull the child out of their classroom, but provide services in the school is because I get so many more touch points with the teachers and able to collaborate with the team where if I was only providing services in the child's home, or their natural environment, which was somewhere else, but the pain points were really coming from the school, I would be missing a whole world out there. Jayson Davies 06:18 Yeah, absolutely. For these kids, do you typically also see them at home? Or is it kind of a one or the other? Ushma Sampat 06:25 It's a combination, it is, you know, I will go so wonderful teachers provide services, wherever the child needs that I will go, you know, it could be a piano class, it could be a gymnastic class, it could be in the home, it could be in the school, it's in a local park, it will really be anywhere that I could support the team. I could support the parents and I could support the child. Jayson Davies 06:50 I really love that, like, so often I drive past like a karate studio, or like you're talking to a gymnasium or something. I just like think to myself, What if I could go to the owner of that gym and be like, Hey, I'm an occupational therapist, how can I support you? So I love that you're doing that? Ushma Sampat 07:08 Yeah, I've literally I have a music studio next door. And I've actually walked in and I said, Hey, I'm an OT. And they're like, what is that? So first, when is that I was able to educate somebody about what an OT is, and how I could be a resource, whether it was me or somebody else. But then even understanding they actually had a child that had a missing finger, and was trying to play multiple missing fingers and was learning to play the piano or something. And they said, this is perfect. We need you. And so it was just me going out there being like, How can I be of support to the community. And there was actually a need and was was just amazing. Jayson Davies 07:46 That is awesome. So I'm going to put you on the spot here just a little bit, not too much. But where is the most interesting place you have gone to treat a child or or anyone? Ushma Sampat 07:58 I want to say the gymnastics class. gymnastics. Yeah, because it was so fun to just see them out of motor planning. Obviously, the gymnastics coach, like they know everything about gymnastics, but they haven't really figured out the child's difference of learning. And they've not figured that the child's not doing it. Because of the motor learning challenges, or coordination challenges. You're expecting something but the child hasn't, doesn't have the capability of mastering at this moment. And we need to take a step back. Just being able to make them see from that different lens was just so powerful and rewarding for them. And for me, Jayson Davies 08:36 that is awesome that the last like five minutes of this podcast, we had no idea we were going to talk about that today. But I love it. Thank you so much for sharing that. Ushma Sampat 08:44 Absolutely. Jayson Davies 08:45 So let's go ahead and actually move on our first topic kind of comes out of what you and I were talking about as we were kind of planning. And you shared with me some of the inherent difficulties that you had to overcome as a therapist trained outside of the United States. And that's where I want to go. Now, let's start with a little bit about your training as an OT outside of the states, though, so then we can transition back in here. Where did that take place? Where were you trained as an occupational therapist initially? Ushma Sampat 09:13 Yeah. So I was born and I grew up in Bombay, India, and I complete my bachelor's in occupational therapy at Manipal University, which is Karnataka, a different state in India. It was a four and a half year program. And the fun part about my education was that our institute was also a hospital and had clinics attached to it all within the same campus. So universities, like for OT are not very common in India, it's typically universities look like buildings, and that's your university. But I was fortunate enough to actually go to a university that had medical programs, allied health programs, engineering, architecture, but literally everything it was actually an institute it was actually in the university. So coming back to You know, having a hospital and clinic attached to, you know, on the same campus was, was amazing because from the very first day of OT school, we were hands on in the field initially observing helping our seniors and treatments slowly providing services under supervision defined having Junior under us that we were training along the way. So I mean, it was, it was very different from what it would have been here. But I'm very thankful that I did get so much hands on experience as part of my curriculum. Jayson Davies 10:31 Yeah, because here, you get a lot of the theory, you know, two years of theory, and then you go out and do some of your field work and get that hands on experience. But it sounds like you from day one, you were in there Ushma Sampat 10:42 we were, we were in it. Initially, it was like cleaning up. And then it was giving stuff to the senior that we're providing, but you're always looking, you're thinking you're being you know, your seniors or the teachers who are providing therapy are actually asking you questions along the way to actually apply what you've been learning. So you are doing the practicals and the theory in parallel all the time. Jayson Davies 11:09 Wow, I'm sure that was difficult, but also very beneficial Ushma Sampat 11:13 to say beneficial. Jayson Davies 11:16 And so then was your first job as an occupational therapist in India? Or did you move here prior to that? Ushma Sampat 11:24 No, I moved here. So it was a double, wide. And I think I, I am fortunate that I didn't work a lot in India. So besides, you know, my four years of curriculum where I did have practical’s, along with six months of internship, other than that, I didn't have a real job. And the reason I say it was a blessing in disguise is because I had so much unlearning to do and real learning to do interesting in preparation for not only my NBC OT, but being an OT practitioner in the in the country, in the States, it is very different. Jayson Davies 12:06 Yeah. And we're gonna dive into that transition in just a minute. But I want to take a step back while we're on the topic of, of your home country, and that is to ask you a little bit about education in India. How is the education system there? Mostly public education? I know you work in private education right now. But how is public education different there from it is here? Ushma Sampat 12:26 Great question. It is very, very different. And it's interesting that you say public, because the government schools in India are not called public schools. They're usually for the financially weaker section of the society or for those who can't afford private school. But since many people publicly opt for private schools, those private schools are actually called public schools. And the public schools, as we refer to in the states are called government schools. Back in India. Jayson Davies 12:55 Okay. Interesting. Ushma Sampat 12:57 So we have different boards. So federally, like countrywide, we have three boards. So we have, you know, the cbse, board, the icse board, and then the ni o F, which is the National Institute of open schooling. For children, I mean, students that learn differently, which, you know, hasn't might have been there for a long time. I'm not quite sure, but didn't have a lot of awareness, or, you know, not many schools actually had that program. And I remember when I was in 10th, grade, my school had introduced that board as part of our school as well. Jayson Davies 13:29 Gotcha. And so if you're just driving, walking, riding a bike around India, do you see more of the government schools or the quote unquote, public schools? Ushma Sampat 13:38 public? Wow. So private? Yeah. There are fewer public schools like me, my friends, most people I know, have gone to private schools. That is the norm. And I'm talking from obviously, being in a big city, I grew up in Bombay. So I was in a bigger city in rural areas, they probably only have the option of the government schools. But I want to say that a lot more people would have attended private schools. Wow. Jayson Davies 14:09 That's very interesting. All right. Very different from here in the states for you, like have to look up where private school might be, as opposed to just seeing them everywhere. Ushma Sampat 14:18 Oh, yeah. Because I mean, you know, obviously, we have a disparity in India like economic disparity, the population is too large to even accommodate for in terms of education. So everything gets filled up, no matter what you are, you're a public school, a government school, whatever school you are, you're going to get filled up because there's just so much but yeah, like I would have, I don't my family would have never considered or it's not even considered, it's like you, you are not entitled to a government school because you're making enough to go seek education yourself. Well, Jayson Davies 14:53 okay. Well, then let's go another layer deep. What about special education, I know in some parts of the world are some parts of the world special education just doesn't exist? Some places it's up and coming here in America. I mean, it's been pretty stable for a few decades now. But what about in India? Ushma Sampat 15:12 So special needs, you know, education is only in the last century been seen as a necessity. And obviously with good reason. to dive into the stats a little bit, I pulled up some stats from an article by first crayon. In India, they're 27 million people with special needs in a population of 1.2 billion. This means that 2.2% of our population has special needs. According to the census, only 61% of children with special needs age five to 19, attend Education Institute of any sort. And those are only those we know of many cases are not reported due to misconceptions, society fears and lack of diagnosis. Well, so majority of the children with special needs don't really receive any formal education in spite of the practice of inclusive education in some schools. This is the case that children with disabilities and learning differences are segregated from the mainstream schools and other regular routines, and social activities of normal children. Jayson Davies 16:18 So is there any government laws that state schools must provide special education like there is here, Ushma Sampat 16:27 so I wasn't even aware about it. But apparently, there is a government of India has put in place an act Persons with Disabilities Act of 1995, which provides cooling and services to all children. But for most children, or some children with disabilities, these are provided in special schools. Jayson Davies 16:49 So 1995, for anyone out there who doesn't quite recall, it was in the 70s, the special education started to kind of pick up here in the States. So a 20 year difference between things getting started, but that's great, at least there is something I know a lot of a lot of countries don't have anything yet. So that's great. Ushma Sampat 17:09 It's definitely a movement, I was chatting with a couple of odd who have been practicing in the schools in India. And I came to realize that not much has changed in the last 10 years from when I left systems and processes for students to receive od services are actually not present. Though there's been some movement in trying to educate and spread awareness about od arose in the School of very individual to what the aim of that school might be, in regards to hiring you. Sometimes OTs are brought on as consultants. Other times OTs are brought on to provide group services to everyone who attends that special day program at that school. Other times, bodies are given free rein to set up their own processes and systems and do as they will, I have actually supported someone in India that was going to start working in a school and had no clue what to do. And I actually consulted with her provided her some of the, you know, some of the things that we follow over your, you know, from referral to qualifying for services or not. And beyond setting up systems, obviously, with modification that would work in India, it was such a rewarding experience to even think about it. Like, it reminded me of all the things that I could have taken for granted. The laws and systems specific to the school system to the school system in the US may seem very hard to navigate, you know, as a school based ot. But it is these very processes and systems that provide us a framework for school based work, like clarity on our role, our responsibility, how do we proceed? What do we do? Isn't it so much better, Jayson, to just have the systems to help you navigate instead of running around like a headless chicken, even if it is hard in the beginning and requires you to invest in yourself and get the support early on to hit the ground running? Jayson Davies 19:06 Absolutely. I mean, and that's not just within schools, that's also just as professionals being licensed being registered or certificated in the United States, like, yeah, it's a pain in the butt that we have to take the nbcot T and get that initial registration and then go to your state and get a license. But that's also some a job security and be it's good for the people that we serve. It ensures that we know what we're doing. And the same thing in the schools. Yes, it's a pain in the butt that you have to go through a referral process and you have 60 days to get an assessment done. But that also supports the people that we serve. So yeah, definitely. Ushma Sampat 19:43 Absolutely. Yeah. Jayson Davies 19:45 All right. Well, you actually kind of started to go in this direction. I want to encourage you to go a little bit more is talking about the difference between occupational therapy here versus occupational therapy in India. Is it very similar or and not just school based, but In general, is occupational therapy similar different? or How is it? What direction? Is it going? Ushma Sampat 20:06 Oh, great question. She said, you're so good at both occupations. And the idea and importance given to independence are very different in India when compared to the States, the influence of culture is tremendous. And you know, it's often unfortunately overlooked. In India, we have a huge economic disparity. On one hand, we have people who afford to hire health for everything. And on the other spectrum, we have those who don't have even had the financial means for the basic necessities like home, food, medical expense, leave alone therapy for quality of life. Of course, there are exceptions and people that we see the people who see the need for independence. But the attitude in the first group, which is those that can afford therapy, is largely that I don't want to trouble my loved one. And if I can afford it, I will give my family my parent, the best care by hiring someone who can help them so that they don't have to go through the pain of doing things themselves. Obviously, the attitude also changes based on the age of the loved one, right? So there's definitely been more awareness and services being accessed for pediatrics as compared to adults. And one of the most obvious reason, as I was thinking about this set comes out is India's a very populated country, and there's only room for so much. So many schools, so many colleges, so many university admissions, and so many jobs, you have to do well, and you have to ace to move on to the next thing, there's constant pressure to do better. Otherwise, someone else is going to take your place. So parents are innately wanting their kids to be the best. And if that means going to therapy, Soviet. Jayson Davies 22:03 Wow. And with occupational therapy, I think you were kind of telling me that, like, no one, correct me if I'm wrong, but very few people know what occupational therapy is there. I mean, very few people know what it is here, either. But, I mean, do you see OT clinics even around in India? or What does it look like there on the ground? Ushma Sampat 22:21 Yeah, yeah. clinics have definitely started popping up. There are a lot of otas that have actually done education Master's abroad and gone back to India to start clinics and things. So I, there are private practitioners. But obviously, what we do, and the value we provide the role we play in families, or lives of children depend on what the families I mean, even though we hear we do that, but over there is more like a private od might also just be a school od because the parents are thinking so much about the need to be educationally moving forward, like play might not be as important to a parent, ADL, maybe a maid might be able to help with or I can help with as a parent, right? Like all those things might not be there yet. So the role of 40 just automatically might have become more educationally driven, or medically based, not educationally driven. Jayson Davies 23:24 Gotcha. All right. Great. Well, I want to kind of now transition to our next section or part of the podcast where we're talking about the transition. When did you and your family decide to to move them over to your San Francisco? Right? Ushma Sampat 23:38 Yeah, Bay Area. So I was initially in Mountain View, and then we've been in San Francisco. So it's all been behavior. My husband was already living in the US. So he had come to the states to do his undergrad. And then he did his master's. And he had just about got his first job when we got married. And I moved from India to the Bay area to be with him after we got married. Jayson Davies 23:59 Gotcha. And so what was that move? Like? Were there any amazing experiences or potentially terrible experiences that really stick out in your mind? Ushma Sampat 24:08 I think I am not gonna say amazing or terrible because I am who I am today because of all the experiences that I have lived in the past. But I will say, just to think about and to give you a background of what this move might have been like, in my head. I graduated from OT school, and I got married in the beginning of March, and I moved to the stage end of March, all of the same here. Wow. So it was definitely a lot to process in a very short time. And I'm not I'm not even sure if I processed all of it then. I was 23 years old, leaving behind every human I knew on the planet. My friends and family. start a new life with my spouse in a new country. I did have some extended families mistake but these are people I probably never met before. So They were related like somebody, somebody, somebody, but I didn't know them. So it was basically like starting life from scratch. My husband, sorry, Jayson Davies 25:11 I was just gonna say I just got the idea. I don't know if you've ever done a DNA test, but I can just imagine like going through your 23andme test and just like finding a random third cousin on there, just saying, hey, hey, I'm gonna come and live by you What's going on? Ushma Sampat 25:27 Yeah, yeah, yeah. I mean, yeah, it was just a lot to process and to think of it was a big move. I, you know, it was a life changing event. I was. And obviously, my husband. I mean, the only person I knew then was my husband, and he wasn't available to sit and hang out with me. It was not like we were on a long extended honeymoon, he had to provide for the family. He had to work long hours. It was lonely, for sure. Professionally, also, you know, to think that that was personally and professionally, it was challenging, because my husband and all his friends were in the area. So no guesses there. But most people are engineers, can you imagine not knowing a single other OT in the entire country you live in? Oh, my last but not the least, in addition to all of these mixes, we have been challenges. I volunteered as an od for three years before being able to get a job as an OT. What, because I was on a dependent visa. Luckily, Visa last changed after those three years. So we have to go through a lottery system to even get a visa and the Euro went through the lottery system, laws changed. And as a dependent of a skilled worker, which was my husband, I was now allowed to get an ad, which was Employment Authorization Document that enabled me to start my private practice, a benefit that my husband still doesn't have to their state because he is an h1 b visa holder. So he can only have one job and work for somebody 40 hours a week, not even part time no matter what situation you're in. And if you lose your job, I believe you have about 60 days or 90 days to find another job or leave the country while you've been here for 15 years. And he's still in that. Jayson Davies 27:16 So for anyone listening out there real quick, you can't see my face. Ooh, schmo can see my face. And I'm just like, in disbelief here real quick. I want to stop you real quick, because there's a lot to unpack there. You had to work as a volunteer for three years before you could before basically and it wasn't even because it was just three years because laws change. But you had to volunteer. Were you volunteering as an OT? Ushma Sampat 27:39 Yeah, because I couldn't earn. So my visa situation did not allow me to earn money. And so I was, you know, I had skills. I had professional goals. Thankfully, I was in a situation that I did not need to be a provider for my family. And I could actually invest money buy in regards to money because I was traveling to the job investing all the time there. And driving back doing continuing education, learning and growing because I was at least hitting my professional goals. But I could not earn. Jayson Davies 28:18 Wow. So what kind of OT job were you doing at that point? Or so I Ushma Sampat 28:22 was at? I was at a private school. I mean, obviously, you know, how many people will really hire you, you You are an OT, but you are not allowed to work? Right? Like how are you going to explain that I'm a qualified OT allowed to be an OT, but not allowed to earn, and then actually have somebody hire you. So I was working at a private school and I was working with a couple of private families, no payment, just supporting them. Jayson Davies 28:49 Wow, that's so interesting. And then so now this kind of goes into the next area of the transition. What about NBC OT I mean, most of us, most school based OTS, most OTS listening to this podcast. Shout out to everyone who's outside of the United States. I know there's several of you. But if you're in the United States, you went through the process here you got your bachelor's, you got your masters, maybe you did your OTD you took the NBCOT t you got registered, you got licensed and you're ready to practice. What was that like for you? Ushma Sampat 29:22 We have an added layer, even over there. So we and by we I mean internationally educated otif can sit the boards to be able to sit the boards have to have an additional process completed, which is called the OT Ed process. It is basically a determination at the education that you have completed. internationally. The fee including fieldwork meets the eligibility requirements to apply for the OTDR certification exam, even if we attended a world WFOT recognized approved program. So this you know process required us to complete a lot Documentation has stuff prepared, sent out via University, one of the forms that was the most time taking was a bundle of 50 forms. Thank god they now do it online. It was physical forms that I had to fill back in but back in the day, asking us to give us details and proof on each coursework and standards and how they were met. So it was really detailed. These questions were so detailed, and one of the first questions I remember so clearly, was asking me how I learned English in whatever form that was a question about how I, my proficiency in English and how I've learned it or whatever. And to prove it? Well, given that my schooling was in English, it was hard for me to digest. And given that all of us were required to take and pass the TOEFL exam, which is a test of English as a foreign language proficiency exam, any which wave as a prerequisite for the odd process. I just felt like this was, Why are you asking me this now? Like, have I not proved to you by taking a test? that English is a language I speak where I know? Jayson Davies 31:14 You got to do both? You couldn't just say yes, I know English. And here's my background. Or let me take the test. You had to say, here's how I learned English. Oh, and now I'm going to take a test on it to prove that I know English. Ushma Sampat 31:27 Yes. So can you imagine for me having had to go through everything think how do I prove I know English? My education from pre k was English, like, what do I give you a certificate? Where do I even go? Here's my somebody is to prove that I have been educated. I mean, English right? Jayson Davies 31:46 In my head, I like if I read that question, if I was in a similar spot, I can only imagine me just saying, Hey, Mom, go get that preschool work sample that I did when I was four years old. It's all in English. And let's send that to them. Ushma Sampat 31:59 Yeah, I mean, I understand some countries do have, you know, time we education isn't a different language, but you're making them to toe fall. Why then? Are you asking them a question like that that can be perceived I completely get where they're coming from, but it could be perceived as a bias, right? Like, why are you adding that layer that we already have enough to unpack we already have enough to do? And I mean, if anything, I hope, you know, this serves as a reminder, for anybody listening and needs to hear this today, too, that our only limitations are the ones we set in our own minds. The process has never been easy for me, but I kept going. This made me resilient and taught me perseverance. And there was no stopping. Jayson Davies 32:46 Yeah, wow. And to be straight up honest, the OT world is lucky to have you in the OT room. So I'm glad you continued on and made it all the way through. Ushma Sampat 32:58 Thank you. I'm glad. Jayson Davies 33:01 So we're going to actually continue on a little bit more, because that is just part of the story, I think. So you moved here or you were going through that process, you had to kind of prove that you had training in OT, you had to prove that you spoke English and multiple ways. Was there additional training that you needed specifically for Occupational Therapy. Ushma Sampat 33:25 So I was lucky enough to be around one of the last batches, I think in 2012, they moved from if I was because I had completed my OT Ed process before 2012, I was allowed to sit the exam without a Master's, for anybody listening and who is not aware, one needs to now have a Master's to be eligible to sit the exam. But I was anyways enrolled in a post professional master's program at San Jose State University. Because that that was part of my plan. I wanted to pursue my Masters all along. So that didn't change anything for me. Jayson Davies 34:00 Okay, so But now, if someone were in a similar situation, they would have to do that Post Pro masters. Ushma Sampat 34:07 So they would have to do yeah, they would have to do a post professional masters or a doctorate because it's the entry level masters now. So anybody who wants to sit the exam, whether you be you know, you're trained in the United States or internationally, you have to have a entry level masters or opposed professional masters is the minimum requirement. Gotcha. And Jayson Davies 34:27 cannon masters from say, India or from another country, that would still suffice? Ushma Sampat 34:32 That would suffice, you would still go through the OTD process. And I would think that you would have more questions to answer and more things to prove, but it would suffice. I mean, even for me, I was at you know, odd like the process was I submit everything and they get back to me and ask me questions like this isn't clear. How did you really master this? Or these standards seem like they've not really been met through your education at the level at which we require them to be have met. So I did do certain courses I, you know, I did certain courses on occupational therapy comm like IP profits and stuff, they have questions about education. And we don't have that in India. So not, you know, my OT education did not teach me about this process, even physical or junk modalities. I remember we needed 710 I forget how many hours but I and I knew that because I started this whole process when I got engaged to my husband a year before I even moved to the country. So I started the process, I started doing all the continuing education in addition that I knew I was going to have to be, you know, that we're going to come up. And I started working on all of that the whole process of getting my odd approval took me two years. Wow. And then prepared for my NBC audience at the NBC Lt. Jayson Davies 35:46 Wow. And so what was the NBCOT experience for you like the end? Did you do that before you got your post pro? Or after you got your post pro masters? Ushma Sampat 35:55 pedrillo? Okay. Yeah, so I, I was I was enrolled in my professional masters doing my course and preparing for the NBCOT and appeared the NBCOT at the same time, okay, Jayson Davies 36:07 so that that Master's kind of helped you prepare for the NBC OT, as well as a master who's Pro's pro masters can, Ushma Sampat 36:17 maybe, but I think it's actually very different, because NBC OT has so much focus on what you would do in a particular situation more clinical, whereas my master's was more management teaching. And, you know, that focus was not as clinical. So I think NBC it was all about just reading up, you know, the typical therapy and the, you know, taking courses, you know, all of that, like just there is there wasn't a community, when I was going through aid for people who, you know, are internationally educated, going through this entire process. And obviously, me being me, I saw a gap. And I'm like, I don't have the support. I'm done with it, I will make sure I get the support and do forward for anybody who's not going through it. So I do have a Facebook group. It's a small, but mighty self sufficient community of internationally educated OTS who are trying to get through the odd process and give the boats Jayson Davies 37:15 and what's the name of that one for anyone looking? Ushma Sampat 37:17 It's called OT help for international educated OTS. And you know, we can link it up at the end of the show. Jayson Davies 37:24 Definitely. Alright, well, so that is quite an experience, believe it or not, actually, in fact, I just had someone reach out to me the other day, we get like, 5% of the listeners that come from this show come from Europe, Australia, and China or Asia region. So for anyone listening, thank you so much for listening. First of all, for anyone outside of the states, it's a blessing to have you joining us, what would be that first step recommendation that you would give, for someone listening, looking to move to the US? Ushma Sampat 37:58 It can definitely feel like a never ending process with a huge investment in terms of time and money. You know, I've heard many people in us say it is expensive. Can you imagine how expensive it could be pretty for somebody who's an international applicant, but it is worth every minute and every penny. In the end, I will add one more thing. seek support from others who have undergone this process, it will save you a lot of time and headache, instead of reinventing the wheel. I know I had to do that. And I don't wish that anybody else would have to. So reach out to somebody who's gone through the process. Jayson Davies 38:38 Well said and again, we'll make sure to link to your Facebook group in the show notes. So check that out. Alright, let's talk about school based occupational therapy. You're here you are licensed, you can work. Thank God you're not a volunteer, you're actually getting paid for your work now. How do you feel all of your experiences as an internationally trained OT impacted your current skills and preferences as a school based OT, Ushma Sampat 39:04 I feel like the OT foundational skills are so ingrained in me. And the clinical exposure and hands on approach from day one of od school has really helped me solidify my clinical reasoning skills. I remember activity analysis was given so much importance. And we often use a bottom up approach, which taught me to really dig deeper, to analyze understand why and then problem solve to support. Being an internationally educated OT, living and working in a different country made me also culturally more aware and more sensitive, partly due to the exposure, but largely due to my own lived experiences. I learned to view myself in a supporting role. Give emphasis to a team approach with the parent is the expert of the child. In the natural environment at a solid foundation, and I give all of that regard to being internationally educated and having moved to another country to work, it just opens your eyes up to so many new and different things. Jayson Davies 40:15 Yeah, and I think as an occupational therapist understanding, you know, we never truly understand the culture of other people, like we don't live in their house, we don't live in their community. We don't know that. But being aware of that, and being aware that other cultures exist, and that other people live differently than we do, is just so important. And so you've had new Ushma Sampat 40:39 Yes, yeah, they value something completely different, it might be so different, and you are no one to judge if that is right or wrong. Same, like a parent knows what's best for their child, you are no one to judge whether that's the right way or wrong way. You can guide them, you can support them, but it is their way. And their culture, the values, their habits, their routines, will determine what they find meaning in, right. Jayson Davies 41:05 Yeah, and I think you'll agree with this, too. But each classroom has its own culture as well. And so you said something very important. You said, taking on kind of a supplementary role is what you learned or what you realize. And that in itself is difficult. seeing yourself as supplemental to a classroom and knowing that that teacher is the leader in that in that the president of their classroom, and absolutely. Yeah, and so I don't know, if you want to add anything to that, just about, you know, being supplemental to the classroom. Ushma Sampat 41:39 No, I think you absolutely nailed it, we, you know, look at yourself as a resource as an support for the teachers you serve for the schools you serve for the district you serve. Think outside the box, you know, you don't have to be the main hero of the film, you can be a supporting role and still add so much value. Jayson Davies 42:00 That is a quote to remember right? You can be the supporting character and still add value, I like it. Alright, we're getting down to the last few questions, but we're gonna stay on that school based OT realm. What do you feel are some of the most or maybe the most important skill for a school based OT to acquire and build upon to be successful? Ushma Sampat 42:22 Of course, I think knowledge which is very specific to the school system, like the laws that govern school based practice, the IEP process, scope of practice, all of that is very important. I also think it's very important to set a solid process for reference. And moving on to discontinuation of services, the whole thing like how why would somebody go there? Why would somebody get services or not? Why would they get concert versus direct, right? You're really trying to get into the nitty gritty of those things, striving to be a resource for the schools yourself to an RTI approach, not only the kids on the IEP, there's another thing that is often overlooked. And having a robust workload management system to help with keeping track of multiple moving pieces at school based on these we know we have a referral coming in, we have an IEP do some other teacher has given, you know, the pre referral form we have a screening done an assessment is we have a lot of moving pieces. And that is just for one side. Can you imagine having that for multiple fights, right. So moving and looking at it, from a workload perspective, instead of a caseload perspective, would be another great skill, or another great quality to invite as a school baseball team. Jayson Davies 43:44 You know, I think you just basically wrapped up the final two questions that I had really, you know, just kind of what is some advice to a school based occupational therapist, whether they're internationally trained or trained here in the United States? I don't know. Do you have one piece of advice based upon what you just said, that they should work on? Ushma Sampat 44:04 Yeah, I think first and foremost thing is make use of the privilege of being able to see the child in the natural environment. If you look closely, it gives you so much more information that is often missed when the child is seen out of context. So that's number one, I actually have two more Jayson Davies 44:23 Go for it. Ushma Sampat 44:25 And that would be collaborate with your IEP team. They bring so much expertise to the table, which is instrumental in our decision. And next steps, you know, going back to what we talked about earlier, and the last would be remember that in addition to remediation, we as OTs are also experts in modifying the environment, adapting the activity, so that the child can be more successful. Don't forget to explore your full potential. Jayson Davies 44:56 Absolutely. Well, Ushma, this has been so much Fine, my neck is actually starting to hurt from nodding with you like everything you're saying, I'm just nodding. And you all can't see that out there listening. But I'm just like nodding this entire conversation. So I really do appreciate it. And I want to give you the opportunity to share where anyone interested in learning more about you more about the world of OT, where can they go? Ushma Sampat 45:18 Absolutely. So for anybody who's new to school based OT or interested in the school based od course, you could visit worldofot-school.thinkific.com, or the short version of that is Bit.ly/schoolOT school is all lowercase and OT is capital. You can follow me on Instagram, and my handle is worldofot. Or you can connect with me on Facebook. I'm Ushma Sampat, or visit my website and you can, you know, probably get all the information you need about me and my practice at worldofot.com. Jayson Davies 45:59 All right. And we'll be sure to link to all of those in the show notes so you can get easy access to them. So OSHA, thank you so much for coming on here. Really appreciate it. Like I said, I've been nodding this entire time. Because everything that you're saying just aligns so much with the values that I shared, the school based occupational therapist, thank you so much for sharing just about how different the culture is and what we can learn from it. You know, it's important to understand the differences. But you got to go further and understand what we can learn from that. So thank you so much. Really appreciate you coming on. Ushma Sampat 46:35 Absolutely. This was so much fun. Thank you, Jayson. Jayson Davies 46:38 Thank you. We'll have to do it again on another topic in the future. It'll be great, Ushma Sampat 46:41 Done! Jayson Davies 46:43 All right. Well, take care. Enjoy the rest of your day. And we'll see you sometime in the future. Ushma Sampat 46:49 Sounds good. Take care. Bye. Bye. Jayson Davies 46:52 One last time. Thank you so much, Ushma for coming on to the podcast. It was such a pleasure to have her on and thank you, you for listening today. This was such a great episode. I cannot agree more with everything that Ushma was saying and I hope you had a chance to learn from this conversation today. It really was a great conversation and I look forward to more in the future. So with that, until next time, I will see you later. Take care. Bye bye. Amazing Narrator 47:19 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to earn 11 hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 68 of the OT School House Podcast. In this episode we are highlighting travel opportunities as an occupational therapy practitioner, but that's not all. We will start this conversation by discussing what you need to know if you are looking into a travel therapy position as an employee for a 3rd party company. But we are also going to discus with Devon how she used a coaching model during the pandemic and what she learned from this. Links to Show References: Devon's website Occupationaltherapy.com (affiliate link) Devon's Instagram Devon's Dynamic School OT Group The Traveling Traveler Transcript Download the Transcript or read the episode below! SPEAKERS Jayson Davies & Devon Breithart Amazing Narrator 00:01 Hello and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here's your host, Jayson Davies. Class is officially in session. Jayson Davies 00:18 Hey everyone, and welcome to Episode 68 of OT schoolhouse podcast. My name is Jayson, it hasn't changed, I swear it will always be Jayson. And thank you so much for being here today. I'm excited to have you joining me. It has just been a great day, a great week, a great month at the OT School House. And I am just super excited. And I know many of you have actually shared that excitement with me because you've been emailing me and letting me know. And I just love those all of those messages of kindness of appreciation. It has just been a great time here at the OT School House. So I really do appreciate you taking a moment to listen today. Today we do have on a very special guest by the name of Devon bright heart and she is going to kind of give us all the details on what it is like to be a travel therapist. And she's also going to share with us a little bit about what she has learned throughout the last year of the pandemic and how she developed a coaching model to use during teletherapy services. Before we dive into the interview, though, I actually want to share some great news and that is that the Back To School Conference being held in August is now officially an AOTA approved course good for 11 hours, meaning that you will get a certificate if you are registered and attend for 11 hours toward your recertification or your state re licensure. This is going to be an amazing conference. I cannot wait it is 100% virtual, but it's also 100% live in the sense that everyone the presenters and myself included will be presenting live for you to interact with I cannot wait for it. Some of the amazing presenters that will be joining us for the Back To School Conference include Dr. Susan Bazyk who will be talking about her RTI program every moment counts. Olivia Martinez-Hauge, who was on the podcast a few episodes ago talking about sensory and stress, we are going to continue to build off that discussion that we had and go so much further. And another presenter that I would like to highlight right now is Meg Proctor. She is from learnplaythrive.com, and she will be discussing strategies for kids with autism. So you do not want to miss out on these presenters and more we have discussions on assistive technology and so much more. You can learn all about the conference at otschoolhouse.com/conferenc And also be sure to register now, early bird pricing is going to end at the end of April, the price will increase. So OT month is here we're gonna get through t month and then the price will increase so be sure to check it out. Now. Again, you can find all the details at otschoolhouse.com/conference With that, let's go ahead and jump into our interview. We have Devon Breithart, talking about what it's like to be a travel therapist and a little bit about a coaching model in the times of COVID and how she's going to now bring that forward as kids start to return back to school. So without any further ado, here is Devon Brethart. Hey, Devon, welcome to the OT School House podcast. How are you doing today? Devon Breithart 03:19 I'm good. I'm really excited to be here. Jayson Davies 03:21 Yeah. And I'm excited to get to know you as well. We've been getting to know each other a little bit over social media. But I'm excited to have you here on the podcast. So today we're going to talk about travel therapy. But why don't we go ahead and start off with maybe how you became an occupational therapist. What drove you to this profession? Devon Breithart 03:38 Yeah, so I feel like I have a different story than a lot of the other OTS I've met. Because I didn't actually know what OT was until I was looking at colleges. I never had any family members who received it growing up, it was just a profession that, like the rest of the world I was blissfully unaware of until I was doing college visits. And I actually thought I wanted to be an art therapist because I really liked art. And I also really liked psychology and I knew I wanted to do something kind of in the healthcare field. So I started looking for programs near me that offered art therapy and went on this great college visit to one was touring the campus enjoying myself. And then, you know, the person leading the tour was like, oh, what are you thinking about majoring in? And I was like, Oh, I heard you guys have an art therapy program. He's like, well, we don't. I was like, Oh, he said, but we do have an occupational therapy program. And I said, well, what's occupational therapy? And then he told me, and I was like, Oh, well, that's it. That's what I'm gonna be. It's funny just made sense. Yeah. Jayson Davies 04:39 So were you a big artist growing up in Devon Breithart 04:43 bits and pieces, you're in there. So I won't talk too much about this because I don't want to be like too down on myself. I was friends with a lot of really talented artists, like much more talented artists than me in high school. So I took a lot of art classes and it took a few painting classes in college too. So I wouldn't say I'm like, talented. And even now I'm like, I'm not doing any art on a regular basis anymore. But it was it was a big part of my life for a while there. Jayson Davies 05:08 Yeah, it's always fun hearing what OTS did before OT. Because I mean, yeah, I feel like a lot of people have done some form of art. I did actually film. So in high school, I did all animation. And then I took some film classes. And now I have a podcast, which allows me to kind of do some of that a little bit. Yeah, that's really cool. So let's go ahead and fast forward now a few years, what was OT life like the first few years after OT school? Devon Breithart 05:33 Yeah. So as soon as I graduated, I knew I wanted to try to get into pediatrics that was always a place that had my heart, even in OT school. And even the jobs I held before I was done with OT school. So I just started applying to different pediatric outpatient clinics near where I was, and the one that I was really interested hired me like a month before I was set to like, fully graduate and be done. And that was great for a while. And then after a few years of that, I started feeling a little stagnant and a little bored. And I knew I needed to make some sort of change. Jayson Davies 06:07 Gotcha. Okay. So then, what happened from there. So, Devon Breithart 06:12 I had always been kind of interested in travel therapy, you know, when you first graduate from OT school, there's always like recruiters, you know, they'll be at events or little like, find your phone number or email address somehow. And they'll call you and offer you a job in Nebraska that you really don't want. But they're very certain that you do want to care about it, and they keep calling. So it's always been kind of in the back of my mind, I moved around a lot as a kid and grad school, like college, and then grad school was really the longest amount of time I'd spent in one city in a long time. And, you know, after a few years of working in the outpatient clinic, and doing some early intervention, I was like, you know what I'm going to, I'm going to do it, I'm going to try travel therapy, my partner had recently gotten a remote work job. So I was like, Oh, it's perfect timing, we can take this job anywhere, I'm getting a little stagnant at work. Let's do travel therapy, let's just see what it's like. And if we completely hate it, we can always just move back. Jayson Davies 07:02 Okay, that makes more sense. Now, for some reason, in my head, I just always thought that you are a travel therapist from day one, but totally makes sense. Let's go ahead and kind of start with just a general overview. What does travel therapy even look like? Devon Breithart 07:16 Yeah, so basically, you take short term travel contracts, that can be anywhere in the United States, there are some international contracts too. But those are way more complicated, and a whole other can of worms with Visas is in that process. So mostly, it's just contracts in the United States. But there'll be for different facilities that for one reason or another, have trouble finding a qualified ot. So that could be just due to like the geographic location, it could be just like a really rural area. It could be because there's no OT schools around the area of like, California is such a huge state. And there's only a few OT schools for the entire state, like out of all the states I've looked at California has like, the highest like OT to like citizen ratio of any of the states, which I think is interesting. And you know, it's just, it just depends on the reason why they're seeking an OT and why they haven't been able to find one through traditional means. But usually, it's something like that, where they've tried, and just due to geography or whatever other reasons, they haven't been able to find one. Jayson Davies 08:13 Yeah. And so when you're saying short term, what is what is short term? Devon Breithart 08:16 So for most travel contracts, which are I would say not usually in the school system, I'm a little bit of a rarity, because I do just take school system contracts. But most of the time, they're these short term medical contracts that are usually around three months, Jayson Davies 08:28 three months to 12 weeks or so. Devon Breithart 08:30 Yep. kind of similar to like a level two fieldwork. You did three month fieldwork sessions. Jayson Davies 08:35 So what about, I mean, are there long term contract positions? And if so, have you ever done them? or What did they look like? Devon Breithart 08:42 Yeah, so the longer term contracts are most of what I do now. And by longer term, I still don't mean like, multi year or anything like that. It's usually like a school year, like so it'll be, you know, a nine or a 10 month school year contract. Sometimes you can find contracts that include EMI as well, really, you can be in the same area up to like one calendar year, like minus one day, I think, or something like that. So if you do find a district you like and you want to work for, you know, that whole year plus, yes, why that's possible. It's just when you start looking into, you know, working for that district again, the next year that it gets a little squirrely from the travel therapy perspective. Jayson Davies 09:18 Gotcha. Sorry, when you were saying, you know, one year minus a day, it just made me think of an IEP like, like an IEP right services tomorrow, and then it goes to one day before the next it is. Yeah, it's funny. So tell me then, where have you been fortunate enough to kind of go around and work. Devon Breithart 09:37 So I was pleasantly stuck in California for a few years. California is really hard to leave. I had never been there until I moved there for travel therapy. But it always been a place I wanted to go. I was always really interested in San Francisco in particular. And it just been a place that I'd never gotten to travel to like on vacation or anything like that. So I took my first contract that was in northern Cal fornia a super small town that even other northern Californians often never heard of called kelseyville. Okay, have you heard of that? No. See, there you go. And I know you're not quite in Northern California. But yeah, I would talk to people in San Francisco about it. And they'd be like, oh, I've never heard of that place. But really small town that's north of Napa and Sonoma. So kind of in that winegrowing region Oh, so beautiful. Yeah, very beautiful. The worst roads imaginable to like, get in there, because it was literally like on a mountain. But very beautiful place. Right after that. I went a little bit further south into Santa Cruz, and I was there for close to a four year actually, maybe nice place to be. Yeah, beautiful area again. I mean, it's hard not to find beautiful. You're in California. It's just a really beautiful state. Jayson Davies 10:46 Yeah. But pretty lucky. And then Devon Breithart 10:48 yeah. And then after that, I moved a little bit more up into the bay area. And I was in a district that was in Silicon Valley. Jayson Davies 10:55 Oh, that must have been interesting. Devon Breithart 10:57 So interesting. That's actually where I was when the pandemic started. So that definitely had an interesting role to play and how, how my services were delivered, and just that kind of stuff. Jayson Davies 11:06 Yes. And so how did you end up now in Seattle? Devon Breithart 11:10 So after? Well, I guess we should say during the pandemic, I was like, Oh, my gosh, am I going to keep traveling? And I get this question frequently, right, even outside of a pandemic? Or like, oh, when are you going to stop traveling? When are you going to come home? Or when are you going to settle down? And my answer is always just like, I don't know. I guess what, I get sick of it. And so far, I'm not sick of it. But during the pandemic, I was like, Oh, no, no, I really need to make decisions about if I am going to keep traveling and what that looks like and where we're going to go because it is like, you know, especially in California, we were so locked down, we weren't doing any leisure travel, like we were barely even leaving our houses for a long time there. So I was like, I really don't want to have to move during a pandemic, and especially not moved to like another state. But then it's also like, my home state is Kentucky. So the other option is like driving from California to Kentucky. So nothing, nothing really sounded like a great option. But I think that's a similar experience that a lot of people had, nothing was a good option in a pandemic. So I knew I wanted to get to Seattle eventually. And that had always been my tentative plan for the school year. And then when Seattle became like the epicenter of COVID, in the United States, like in March, the first recorded cases were in Seattle, I was like, oh, maybe I don't want to go. But you know what I ended up here. Anyways, it was, you know, it's a pandemic across the whole country. So by the time I was up here, it was bad everywhere. So gotta be somewhere. Jayson Davies 12:39 And so I actually want to use this as an example. How did you even acquire a contract while you were in California? Like, did you decide, hey, I wanted to go Seattle? Let me find a contract? Or did you say, Hey, where can I find a contract? Oh, there's a contract in Seattle? Let me go to Seattle? And how does that work out? Devon Breithart 12:59 So what most travelers do is they'll go through a recruiting agency, and those agencies are actually who acquire those contracts and help place travelers in them. It's not a situation of like your recruiter says, hey, you're going to Seattle, and you don't have a choice about it. But it is a situation of Hey, here are the available contracts we have. Are you interested in any of them? Do you want to interview for any of them? And then if it's a good fit, at the end of that interview, you can choose to go there, you can choose to sign the contract or not. So it's kind of in the middle. It's not like you're just getting assigned to a place without any input. But it's not. It's not like you can also just say, you know, I want to go to New York City and be like, right in Manhattan, because that's not always an option, either, when there's a really desirable place that has no has no trouble filling OT positions. Jayson Davies 13:43 Yeah. And so, again, kind of going off of that you mentioned recruiters, do you always go through a recruiter? Or have you ever gone where you are your own? Alright, and I can't talk right now, where you are your own contractor per se, or independent contractor, having a contract directly with a district or directly with a hospital. Devon Breithart 14:04 So I have never done just like pure independent contracting, this is something that all travelers want to know about, like, either as soon as they start traveling, or like after they take a few contracts, they start thinking, well, what if I didn't have this recruiter at all, because they are, you know, to some extent, a middleman they are taking a portion of the pay from the contract, you know, you see it and you think, Oh, I could, I could contact school districts, I could set up a contract. I could do this all on my own. And what most travelers find when they do attempt to do that stuff on their own is that it gets a lot more complicated than they had envisioned. And you know, I'm a W two employee, I get paid, like on a W two, I'm not a I say contractor, because I'm taking short term contracts. But like, in the eyes of the IRS, I am an employee of my car, my travel agency. So that makes it a little less complicated. And when you are doing that pure, independent contracting, and you're having to pay all those self employment taxes and just all the other labor that you're putting into like by In sourcing a contract, it ends up being a wash for most people. So I have never, I've never ventured into the side of like, truly, truly independent contracting for that reason. But I know a lot of people are curious about it. Jayson Davies 15:12 Yeah. And I think there's also, I mean, when you talk about independent contractor, I know that there's also people that are independent contractors, but work through a third party. And so kind of, they're in the same situation as you except it's not a W two, it's a 1099. And then they have to figure out taxes, so Yep. Okay. Very cool. So, what do you enjoy most about travel therapy? Devon Breithart 15:35 I'm, like, normally, I'll give my answer like workwise and then not work. My might not work wise answer is not a great answer right now. Because it's literally the travel. I love seeing new places, I really love food, I love going to restaurants, I love just like walking around cities. Like I just love traveling. And so to be able to have a job that allows that travel to be like, part of the job is awesome. You know, when I was working at the outpatient clinic, and I had a permanent position, that was one of the things that I was like, that was a big reason why I look to travel therapy in the first place. Because, you know, I wasn't getting a ton of vacation time. And then even the vacation time I was getting, I wasn't making a ton of money. So it's not like I could do these like big pool trips very often, because I just didn't have the paychecks to support it at the time. Whereas with travel therapy, the paychecks tend to be a little bit higher. And you know, you're already traveling just by virtue of taking the job in and of itself. So it was able to fulfill that for me really nicely. Jayson Davies 16:34 Nice. Yeah, I have heard that they tend to pay a little bit more, but that is because you're, you have to up and move your life points. And so I don't know, maybe that leads into some of the cons. I don't know, what are some of the cons of, of travel therapy? And maybe again, you want to do personal versus versus work? Devon Breithart 16:55 Yeah, I would say. I don't know, I think for me, the biggest con is like, I don't know that period of like instability, where you're like, not quite sure where you're going to go next. Because people always ask, I get a lot of questions. Can you tell, but people are always asking, like, Oh, where are you gonna go next? Where are you gonna go next. And I really don't know where I'm going to go next until like, you know, sometimes not even like a month or two beforehand. And like for some of those travelers who take like the more short term contracts that are in like outpatient clinics, or sniffs like, they don't know, until like a week beforehand, or a couple of days beforehand, like, it's a, you have to be okay with being flexible and being able to like, think on your feet a little bit. Because very often you will not know where you're going to be in a month. And that's, that's a hard space to live in for a lot of people. So I would say that part is tricky. And it's not even, it's not even for me like being able to like not make a lot of plans, because I don't know where I'm going to be where I am. But it's more that fielding those questions. And like, I don't know, just like the physical act of moving is, is such a bear. And like, luckily for me, I'm usually only moving once a year since I am taking these full school year contracts most of the time, but it's still just like, it's a lot. And I don't even move with that much stuff like we My partner and I share one car, we have a hatchback. And all of our stuff goes into that car. And if it doesn't fit, it does not come with us. But even that in and of itself is like it's it's hard to move. Jayson Davies 18:15 Oh, I bet that's gonna be tricky. And what about your partner? Does he or she have a job that they can move around? Or how does that work out? Devon Breithart 18:22 Yeah, so he's been with me the whole time. And I said earlier, you know, he had got this remote job. And I was like, Oh, this is perfect. Now we can go travel. And then you know, he actually quit that remote job like a month before I started my first contract. Yeah, of course. So that job ended up just really not being a great fit for him for a lot of reasons. And so we actually moved to California, sight unseen with me like having this travel contract job and him being unemployed and not quite sure what his next steps were. Which again, is like you have to be okay with being flexible and rolling with the punches and travel therapy because that's like situations like that just to happen. And it's it's hard to deal with that kind of stuff when you're across the country from friends or family or support systems. But my partner also has a history in education, so he worked as a substitute. Previously, he had been a pair educator for a while. So as soon as we got to California, he started working on his sub credential there. And I will tell you the sub credential in California is much harder to apply for than the sub credential in Indiana where he was previously previously working in Indiana, like they will let you sub if you were a warm body and you maybe took a college class once in California, it is like a miniature teaching license like they wanted his essay t scores, his college transcripts like all of this different stuff, just to get that sub credential. So even that was a process in itself when we first got there, but that's what he did for a couple of years. And now he is now he's actually tutoring. He has a bachelor's degree in math. So when we moved to Silicon Valley, he started working at a math tutoring center eventually moved up a little bit in red There, and now he is still working for that same company online, actually, because like public school, they also shifted all other services online when the pandemic started. So when we moved to Seattle, he was actually just able to keep that same job because he's been working online since March. So Jayson Davies 20:17 Alright, so everyone out there here, it is possible to have a partner and to be traveling. Yeah, it's possible. Devon Breithart 20:23 Yeah, Jayson Davies 20:23 let's Cool. All right. So you did mention earlier that you had you before you started traveling, you had a full time job for about two years, you were in a pediatric clinic, essentially? How do you compare the difference between not just being from a clinic to now mostly school days, but from that travel to more permanent? What? What's been the biggest difference for you? Other than, right, I Devon Breithart 20:48 mean, really, there were so many differences. I mean, just shifting from outpatient pediatrics to school in general, you know, I really thought I was gonna be okay. And like, long, long term, I was okay. But I was like, Oh, you know, I've worked in pediatric outpatient for a few years, I've got this, I'm a great therapist, I'm going to be able to pivot to schools so easily. And I don't want to say that it was impossible or incredibly hard, because I got there. And I did it. And I was proud of the work I did in that first district. But it was still like, I mean, you know, it's just such a different setting than any other pediatric setting. There are so many laws, there's so many regulations, and it's just not something that you are prepared well, for an OT school, or at least, my OT school didn't spend a lot of time on the interesting intricacies of school based practice. So I mean, that was the biggest change, by far for me was just the really narrowing down the differences between those two settings that I'd previously thought were like, fairly similar. Mm hmm. Jayson Davies 21:42 Yeah. And as you and I both know, there, there is a big difference between outpatient and school. And we'll talk more about that mentoring and some schools in just a moment. But first, you mentioned your partner, he actually had to kind of shift in the ability to get a different type of license to be a substitute teacher or whatever, in different states. Same things with OTS. Obviously, we're licensed in each state. In fact, I think Washington is even when it comes to school based OTS, I think they already have a credential program there. Yeah. But talk about that process of originally being licensed in one state, and then having to move that over. Devon Breithart 22:17 So for travel therapy, you do have to get a license in each state that you're actually practicing in. So I actually maintain a few concurrent licenses, I still maintain my Kentucky license, just because that is still my home base. And if I ever am like to go back and work, even if it's just PRN, or something like that, I want to be able to have that license. But now I also have my California OT license and my Washington OT license. And I will say for anyone who's listening to this, who's like, Oh, I want to go to California or the west coast. If you want to start traveling apply for the Washington and California license now because they are be slyke. I will my Kentucky OT license I applied for like as soon as I was done with grad school, and it was so easy, and it cost me $50. And that was it. And then of course California is is much more expensive than that. I think once you count in like getting your passport photo and getting your live scan and getting like all these extra things done. I think it was between two and $300 for my initial California license. And then of course it was due for renewal like the very next year because of the way my birthday fell. And oh, yeah, I don't have so much more expensive licenses and much more complicated processes on the west coast. Jayson Davies 23:25 Everything is more expensive here. In California, everything. An LLC is more expensive. license is more expensive gas is more expensive everything. Yo man. You talked about Kentucky being your home, is that when it comes to taxes, you typically filed taxes in your home state. So do you have to file taxes in multiple states? If that if you're getting paid for multiple states? Or how does that work? Devon Breithart 23:50 Yes, and I will say I finally broke down this year and hired an accountant. I've done my own taxes. Like since I was a teenager, I was always very proud of that. And now my taxes are complicated enough to where I'm like, okay, I I'm not the expert on this anymore. Like, there are questions that I don't know the answer to. So you do have to file taxes in each state that you're working, as well as your home state. So for me, that's Kentucky, I'll file a Kentucky return as a resident last year, I'll also file a non resident California return. And normally I would have to file a Washington State return to as a non resident, but Washington State actually doesn't have income tax. So they don't do state tax returns in the same way that a lot of other states do. But yeah, it's very common as a traveler, you know, especially if you're taking those more short term contracts, and maybe you're bopping around several different states in a year to have to file you know, the IRS, like the federal taxes and then like three or four different state returns, just depending on where you worked. Jayson Davies 24:46 Yeah. So this is my disclaimer, we are not tax attorneys or tax professionals. seek out help. Absolutely. Okay, I again, I want to get to this mentorship in a second but I'm taking advantage because you are in Washington right now. I've heard a little bit about OTS in the schools and Washington having some form of credential. I know you haven't been there long. But do you know anything about this? Devon Breithart 25:09 Yes. So in Washington state, in addition to your OT license, which is done by the Department of Health, you have to have a credential called an ESA, or educational services associate to do any work in the school system. So this is basically a credential on top of any other OT schooling, licensing anything like that, that you've done that's specific to OTS, in the school system. Jayson Davies 25:30 As a contractor, do you need that? Devon Breithart 25:32 Yes, I think there's a like, I think if you're not going to be practicing in the state for like, you can you can get around it, I think it's that if you are not going to be in the state for longer than a year, you can technically not apply for it and not do it. But once it hits that year mark, it's like you're already late. So it's like oh, like we'll give you the entire first year that you're practicing in Washington to get this credential. And then I know some travelers will probably just say, Well, I'm only going to be there nine months, so I'm just not going to apply for it. But then as soon as they want to take another contract, they're, you know, they're already going to be due to have that credential. So I wouldn't have hadn't just did mine. It's not, it's not a behemoth. Like the OT licenses, like, it's still kind of is I still had to fill out an application online on very antiquated software that was like, what, like, what high school did you go to? And I was like, Why? Why is this a question right now. But it was it was not as arduous as the OT license. Or at least it didn't feel that way to me at the time. Jayson Davies 26:31 There wasn't like any courses that you had to take or anything like that was it, Devon Breithart 26:35 I did also have to take a course with it. So it was a pretty short course. And it was just like two days, over zoom. Normally it would be in person. But since it was a pandemic, it was over zoom, there was like two eight hour days. And it's honestly, like it's a good course to take. I would recommend people take it if they're not familiar with school based practice, because it does go into a lot of the intricacies that OT schools don't go always go into. But as someone who had already practiced in the schools, just in a different state, it was a little repetitive. I was, you know, it was already a zoom, eight hour zoom call on a Saturday. So that's hard enough in itself. It was also it's also information that I mostly knew, but at the same time, I'm like this is valuable information for people that aren't yet familiar with. Jayson Davies 27:20 Yeah, be great for I mean, it'd be a great requirement or brand new school based OTS. Yeah, Washington. Right. That brings us to something that you and I are both very passionate about mentorship, and probably something you and I both lacked in our first few years as practitioners of mentorship. What about? I mean, does mentorship exist in travel therapy? Devon Breithart 27:41 So I'll say yes and no. And short answer, no, it doesn't, unless you seek it out, you'll find that a lot of travel companies will say oh, we offer mentors will place you with a current traveler who's experienced. But then a lot of times that mentorship actually looks like someone who's on the East Coast while you're on the west coast, and then the time zones never worked out, or then they leave the company or their contract ends, and they're no longer available to mentor you. And even with that mentorship, you know, anytime you take a travel contract, unless it's like explicitly stated by the facility, those places really expect you to hit the ground running like my first day of my first school based contract, like I was providing OT services, you know, it wasn't like I had a lot of time to get my feet wet. And I was also the only OT, so it wasn't, you know, like I even had this department of other more experienced school based OTS to look to it was, Hey, this is it, you're the OT for this district. They also didn't have an OT for the entire first semester of that school year. So I owe a bunch of compensatory time that I also want to pick up. So it was just kind of like, and I don't want to say, you know, this district didn't put me in a bad position. They were very supportive. The actual caseload itself was pretty low, so that compensatory time was actually manageable to make up. And they really supported me as much as they could. But they weren't OTS, so they didn't know they didn't know everything, right. Jayson Davies 28:58 Yep. So then what did you do in order to compensate for that? Did you take courses? Did you seek out friends of speech therapist or PTs that can help out? What did you do? Devon Breithart 29:10 Yeah, so I did a little bit of everything. I luckily had a really close friend of mine in grad school who had been working in the schools for several years, basically, while I was an outpatient, she was in the schools. So I leaned on her very heavily, especially those first couple months. They're just constantly calling or texting or asking questions. I also joined a lot of Facebook groups. And Facebook groups are great. And I don't want to, you know, speak badly of them because I have a Facebook group about 30. And I think it's really valuable. But at the same time, I was also like, you know, just spending so much of my time trying to wrap my brain around school based OTD like, I was doing all the school based OT work during my work day. And then I would find myself like at home or on my lunch break. Scrolling social media, I tried to do you know, like a leisure occupation. And then it turns into work because I like look at this question on a Facebook group. And I'm like, Oh, that's a good question. I should read this whole Read and then it's two hours later. And I'm like, well, I've learned a ton about school based practice, but I really probably should eat something at some point today. Um, and then courses to, you know, I really got into occupational therapy, comm mentor or membership whenever I first started travel therapy just because it was a lot easier to get online see us rather than planning where it was going to be in person. And that was helpful. So I just took all the school based courses on there I could, I leaned heavily on my school Sykes, my speech therapist, luckily, it was like a really small, close knit team, the director of special education, his office was actually like caddy corner to mine. And I was able to talk to him every day, which does not happen in large districts. So I was grateful that it was a small and supportive district that like, understood where I was coming from understood, I had experience with the pediatric therapy bit of it, but really needed some support with like the legalities and regulations part. Jayson Davies 30:52 Yeah, I had no idea that you're in that same type of similar situation. I was I was a school employee. But I was again at a smaller district, like what you're talking about this, the head psych was across the hallway from me, the director of special education was next door to me. I mean, next door in the very next office, not next door. But yeah, and it was just learning so much. Even though they weren't OTS, I was the only occupational therapist in the district. But I learned so much about special education, just from other people that had no idea really what OT was. Right. So yeah, great experience. So my next question on here, I totally blushed. I asked, Do you think school based OT is under emphasized in school based OT? That's supposed to be Do you think school based OT is under emphasized in occupational therapy school? Or when we get our, our actual credential? Devon Breithart 31:42 Yeah. And, you know, I didn't even really start thinking about this until the last couple of years, when I realized just how many therapists were in school based practice, but it's it's over 20% of occupational therapists in the US that are in school based practice. And, you know, I can't speak for every OT program across the country, obviously. But if your program was anything like mine, which it seems like a lot of people's were, you really didn't focus on school based practice. You know, I had one big pediatrics class and we had to fit outpatient and acute hospital early intervention. And then there was like, you know, a tiny little sliver where we maybe spent a week talking about IEP s and five oh, fours and that kind of stuff. It just really wasn't. It did not prepare me adequately for what, what is going to be being the only OT in a school district. We'll put it. We'll put it succinctly. Jayson Davies 32:29 Yeah. And you know, a minute ago, you also referenced occupationaltherapy.com. There's others out there. Medbridge. A few others. Can you think off the top of your head, one particular course whether it be live online, that really helped you? I know it's hard. They all blend together? Yeah. Devon Breithart 32:46 Right. I'm trying to think of a course I took in that first year, that was really helpful. Jayson Davies 32:52 And maybe it was even just a topic that you just kind of remember. Devon Breithart 32:56 You know, I think there was one that was actually about RTI, and I'm going to mispronounce her name, but it's Jean, Paula, maybe. I can't remember I might be pronouncing that wrong, or totally butchering it. There's a course about OTS and PTs getting involved in RTI in the schools. And that was really valuable. Because, you know, that was another thing that we I don't even think we touched on that in my grad school program. If we did, it was long, long forgotten, by the time I actually got to school based practice. So that one was really nice, because it helped me say like, oh, like, this isn't just like a one to one treatment kind of scenario, like you can really have more universal global support for students in the schools, which I really appreciate it. Jayson Davies 33:35 Yeah. No, I think you're spot on, though, I do think that there wasn't enough time to talk about school based OT, and I don't want to get into the whole OT D, all that good stuff. Right now, I know that's a hot topic. But I kind of feel like, if there's going to be an OT D, it should be that real specialization, like I should really go in, and I'm going to focus on school based OT or I'm going to focus on peds. outpatient or whatever it might be. That's what I think OTD should be about. I know some schools have it like specialized a little bit like that. But I don't think that everywhere. And so that's my two cents on the OTD. I don't know if you have any thoughts about it? Well, Devon Breithart 34:18 I go back and forth on it. Because it you know, on one hand, I'm like, Yeah, OTD, like, let's get like respect for our profession. That's a, you know, an easy way. Well, I don't want to say easy, because it's not easy to get a doctorate degree. But that's like a box, you can check that makes it a little bit easier to say, Well, you know, well, I'm, you know, I don't even know if I would ever introduce myself at an IEP IEP meeting and Dr. Breithart, but I could if I wanted to if I wanted to pull in that authority. But then again, I think about entry level OTG and thinking about, you know, the students who are currently in those programs, you know, you really haven't had a lot of exposure to it at all. You've had your level two fieldworks. Hopefully by the time you're working on your capstone project and working on The more doctorate level courses, but at the same time, like, there's just so much you don't know, when you don't know what you don't know that I think it's really hard to do something like very intensive in scholarship or even specialization when you just really haven't been working in the OT field, like hardly at all. So I go back and forth on OTDs or entry level OTD is at least I should say, Jayson Davies 35:20 Yeah, I get that now, because I never really thought about it from the entry level, I always kind of think it from my point of view, like, I'd be going back to get odd. And yeah, like, I know what I want to do now. Right, but six years ago, eight years ago, I don't know what I would have been doing. Heck, I didn't even think I was gonna be a school based OT. So you know, go figure. But anyways, back to travel therapy a little bit. Oftentimes, when we're not in a pandemic, we all go to these conferences, big conferences, a otaa type of conferences, and we're walking around, and there are contractors everywhere. I mean, they're always trying to get us with their pens or pencils, their squish balls, whatever, you know, the swag. What would your recommendation be to a new OT or maybe someone that's just kind of thinking about going into travel therapy? What should they what questions should they asked when they approached these contractors? Devon Breithart 36:16 You know, honestly, I would say, and I don't want this to sound mean, but I wouldn't even engage with those. I was recommending someone getting into travel therapy, because it is so salesy, you know, like people are at these conferences, they're only there for a short time, and they are like there to sell you on signing up with their travel company. And I will tell you, if you haven't already had this experience, if you give that person, your phone number or your email, they will contact you for years after the fact like I still get calls sometimes from recruiters that I have never worked with, like, never worked for their company never worked with them don't know who they are. And they call me and they asked me about doing a hospital assignment in Iowa. And I'm like, I have not, I haven't even worked with adults in like four years at this point. Like, you don't want me working in a hospital right now, I promise, like you might think you do, you really don't. So I would say if you're going into travel therapy, you know, I wouldn't really recommend connecting with recruiters at conferences like that, just because it's, it's easy to get into a situation where someone is going to be cold, calling you quite frequently. There are a lot of great resources for travel therapy online, there's a lot of great Facebook groups for that too. And especially if you have like a personal connection, or even someone you know, in your OT graduating class that went into trouble therapy, ask them, you know, ask them if they like the recruiter, if they like the agency they're working with, and try to get that personal recommendation, either from someone that you are friends with, or is at least you know, within your larger OT community, rather than just going straight to the to the booths with the squishy balls and the squiggly pens and all that kind of stuff. Jayson Davies 37:47 Yeah, I also typically find that at the conferences, very rarely are the people that are they're actually OTS or know anything about us, don't even know like what contracts they have available. And so you can talk to them, but their whole purpose is just to get your name and your phone number and your email. Yeah, like, that's all they're there for. So yeah, no, I agree with you on that. That's true. Just grab the swag and run. Yep. All right. So let's talk about this past year, obviously, we are coming around to march here shortly. And it's been almost an entire year of the pandemic, school shut down March 13. Or so depending on where you were, how have things changed for you. Devon Breithart 38:32 so I'll say I feel like I was better set up than most when the pandemic first started because I was in a district that was in Silicon Valley. And so not only did we have just a lot of access to technology, you know, most of the families around there already had a fast internet connection, or they had devices at home. And if they didn't, you know, the school district was in a really easy position to provide them with it. So that was really nice. And I recognize how lucky I was like to be in that position when the pandemic first started, because I know that was not the experience of most school based OTs across the country. Because it was in Silicon Valley. I also had like the most educated group of parents that I've ever worked with. I actually got to orient the next OT whenever I left that contract, I oriented heard all my caseload, which was nice to actually have some overlap and training someone for once. And we would have these conversations with parents where they were talking about their kids, and they were using OT language, you know, they were talking about sensory processing, they were talking about gross and fine motor skills, and they were using all the same verbiage that we would, and we would get off these calls with these parents. I'm like, they're, they know what they're doing. Like. They were also there was a high school only district. So these were parents who had kids with lifelong disabilities who had been doing it for a while, had probably had IEPs for over 10 years at this point. So they were just really familiar with their kids really familiar with their disability, really familiar with the special education system. And you know, it was just, it was very, I was very lucky to be in a district that not only had that access to technology but had this group of parents that was like, really educated and really involved with their child's education too. Jayson Davies 40:08 And I know sometimes when you're working with parents that really get it really understand everything. You have to take a different approach. Because, hey, they know a lot. And sometimes you'll be talking to them. And they're like, yeah, I already know that I already know about proprioception. I already know about vestibular. But how did how did that work for you? How did you make it work? These kids who? Let's be honest, they're, they're well off, and they have a great family life. Okay, I won't assume that. But they're doing it seems like they have parents that are supportive. So how did you change from more of a in person type of, you know, sometimes pulling a kid out to see them or even going into the classroom? What did your model turn into? Devon Breithart 40:50 So I actually didn't have a ton of students on direct service at that district, which was another thing that made the pandemic at least initially, an easier experience for me, but because they were high school students, and because most of the students on my caseload were kids with lifelong disabilities. At that point, Director services weren't really indicated for a large portion of my caseload. So I had a ton of consult students, I had a ton of students that I was collaborating with their teams. But I had like a fairly small caseload of students who were still receiving direct weekly OT support. But with those families, I was like, you know, we're gonna, we're gonna give this teletherapy thing a try. I was the only OT in that district, too. So I also had to, like research, like the laws on that, and like, how to get consent. And like, you know, do you need written consent or verbal consent, or like what is okay to do with teletherapy? Here, lots of frantic emails to the California board that time, I'm sure. But anyways, so we tried it out. And, you know, it was nice, because I already had students who had goals that were appropriate to the home setting, too, because they were high schoolers, and any kids that I was still working with directly, really didn't have pan writing goals, they really didn't have these like, kind of like entry level, fine motor poles, it was all much more functional. These were all transition age students who were looking at life after high school and what that was going to be. So it was a lot of self care skills, it was a lot of like job vocational readiness skills, I did have some students who weren't as severe, who I worked with on executive function and access to assistive technology. So it was all stuff that really lended itself pretty well to working in a completely different virtual home setting versus like working on things in a classroom. But obviously, it's still different, working on self help skills through a computer screen that it is, you know, working directly next to a person doing them. So what I really leaned into during that time was more of a parent coaching model, where I did have a parent on the other end of the call. And again, I'm very fortunate, I don't want anyone listening this to be like, well, I just, I don't have parents who will come to their students OT session. So I can't do this, I definitely don't want to make anyone feel like, you know, it's an imperfect time. And we're all just doing the best we can, it's my pleasure through this whole thing. But I did have, you know, adult support, whether it was parents or another family member, or even a nanny, like these kids, like, had a lot of adult support at home, which was really nice. And so I was really able to lean hard into that parent coaching model of actually like working with the parent and having, you know, them kind of be my hands. And like, you know, teaching them the strategies that are things that I love teaching are things that I like love helping parents and families do. And it was really, it was kind of like a return to my outpatient days in a way because I did have much more access to parents and I would have sessions where parents were just in the session the whole time, or even my early intervention, you know, kids where I was like in the home actually working on stuff. So it was really nice, in a way. Pandemic aside. Jayson Davies 43:38 Yeah. And so what do you think about this parent coaching model? is going to? Well, let's stay here, actually, first, do you think you're going to get more follow through because you're using a parent coaching model, as opposed to trying to directly work with that student over the computer? Devon Breithart 43:55 Absolutely. I had kids who over the spring, like I had this one mom, at the end of our time together Tell me, you know, I was so worried when distance learning happened, I was really just worried that my daughter wasn't going to make any progress at all. And I was honestly worried that she was going to regress, and we were going to have to spend like, all this time just catching her up. And with OT, I feel like she actually made progress. Like, I feel like she's actually doing better than she was in the fall. And I completely agreed. And she was just one of many students that I felt that way about where it was like, Oh, you have this parent, like this person who cares so much about their kid on the other end of the call, you're training them to do these strategies that they can implement everyday with the students, you know, which is what we already tried to do is school based OT with paraprofessionals and teachers, but, you know, and not to speak badly of any of our parents or teachers, but no one's gonna love your kid as much as a parent loves their kid. Yeah. And those parents are gonna have that follow through in a way that's just not always possible to be there when a kid is just at school working with a pair or teacher. Jayson Davies 44:55 Yeah, absolutely. I'm finding the same thing. Especially. I mean, like you said earlier, not every Family is in the situation to be able to do that. Not every parent can be there and give you their full attention. I completely understand that. But I have seen a lot of progress with those who were able to do that. So, yeah. Now, moving forward, as we are kind of getting to the point where some people are, are either back at school or heading back to school? How are you going to take that, and now potentially use it in your actual physical school building? Or do? Devon Breithart 45:30 I think so, you know, even as my district is looking at heading back into a hybrid model, which, you know, over here on the west coast, I think we're taking things much more slowly and cautiously than a lot of other states, I know, there are some school based oaties, who are working fully in person right now. But at least for my purposes, I'm going to be hybrid, I'm probably going to be doing some sort of remote therapy for a while, at least till the end of the school year, if not into the next school year. And maybe that's let's not even think about that yet. Enjoy the summer and pretend that it's all going to be typical. Once we returned in the fall. I think even during providing remote therapy, you know, I do have some students now who are starting to return to school buildings, and they do have a pair of their supporting them. So you know, it's similar to, you know, there, there have been OTS offering teletherapy. In schools, even before the pandemic happened, that was just the way a lot of school districts while I won't say a lot, that was the way many school districts fulfilled their OT services, you know, again, it's those rural districts are those places that you have trouble recruiting, in person OT, they'll contract with some sort of teletherapy agency that provides a OT for them. And so being able to have the skill of like coaching a parent or coaching an adult, and being able to apply that to you know, a paraprofessional, working with a student, I think that's something that I'm still going to be really able to utilize this upcoming year. And then even beyond that, you know, I don't even want to say parent coaching, but just parent involvement. I feel like I was missing out on so many opportunities to involve parents, you know, previous to the pandemic. And now, especially seeing the progress that some of my students were able to make really did have that family support. I was like, Oh, my gosh, I should have done this, like I should have, I should have been calling parents at the beginning of the year, it should have been emailing the check in more regularly, I should have been asking for more updates at home or what they were struggling with. And it's not like I wasn't doing those things, you know, I was calling parents but it was more centered around their annual IEP is coming up or they're trying to do is coming up, how's it go. And so I think just in the future, I'm going to be contacting or trying at least to reach out to parents much more regularly even when we are fully in person. Jayson Davies 47:30 Yeah, and you know, we hadn't planned to have this discussion near I mean, we're coming near the end. But I think that parents are going to be more involved than they ever have been. And education, or at least in a long time, because they have seen their kid sit in school for the last year now, they have seen what the teacher is doing in the classroom, they have seen what the OT is doing, they have seen what whatever other service is doing. And so they have a better understanding of what either A) is going great, or B) is not going so great. Ryan, so I think there's gonna be a lot more parent involvement just because of that, if nothing else, what are your thoughts? Devon Breithart 48:09 Yeah, I totally agree. And I really hope that that can be the case, because again, like from what I've seen families that do have the time to be involved, like, it's been awesome. And it's really just like, I didn't even realize like how much I miss that parent contact from my outpatient days. That was the thing that I really enjoyed about outpatient was getting to have a parent there in the session the whole time. And I don't know, there's a lot you can do at school with teachers and paraprofessionals, and speech therapist and whoever else is on the IEP team at school. But until you really have that parent involvement, it's not going to come full circle, especially as we're thinking about transition age students. And after school outcomes, you really need to have that close family involvement to make long term change. And these students Jayson Davies 48:50 couldn't agree more definitely. So as we start to wrap up, I do want to ask you, if someone's listening to this, and they're just blown away by the idea of being able to travel, provide therapy services all at the same time? What is your kind of 123 steps that they might want to start with? Devon Breithart 49:05 Yeah, that's a good question. Um, so I would just start by researching travel therapy in general, you know, there's a lot of good resources online. I have a friend Julia Kuhn, who runs a website and a blog and a Facebook group called the traveling traveler. So that's a huge group. That's a great resource. If you're just kind of travel curious, but you're not quite sure yet. You're welcome to join. And she's got a lot of really good resources on just like, you know, what is travel and like how taxes work, and like, how do you even get started? Or like, what should I ask my recruiter, all those kinds of entry level questions, um, she's a great resource for that. And then I would start narrowing down. You know, once you get some recruiter recommendations from either your friends or maybe one of those big travel groups on Facebook, I would start narrowing down where you might want to go just keeping in mind that, you know, there's not always going to be a travel contract everywhere, but just have some general ideas in mind. And then once you start getting more serious about things if you are intending to go to a place has a very arduous licensing process. Maybe go ahead and get started on that license before you actually accept the contract. Jayson Davies 50:08 Sounds great. So we're gonna wrap things up today. But I honestly just want to mention that, you know, you know, I have a course. But for anyone out there who isn't familiar with Devon, she also has a course that it's for school based occupational therapists. And so I want to give you a second to kind of talk about that. Devon Breithart 50:26 Yeah, I mean, you know, I don't want to self promote too much, because I love this podcast. And I love your course. And I know your course is a great fit for school based OTS. And I really think that we created these courses, because we both had similar experiences in the school system, and really saw that lack of education and support and mentorship when we started as coaches in the school system. So my course is called the dynamic school OT. It's a good fit for, you know, OTS who are brand new to the school system. But I've also had several more experienced OTS take the course, which I have to admit, I'll be a little transparent, always makes me like a little intimidated and a little nervous. Because I've had some OTS who have been working in the school system for like, over 20 years, or over 25 years, take the course. And I'm like, Oh, no, like, this person who is obviously so much more experienced than me like, are they going to look at this and think, Oh, I know all this, or Oh, this is silly or whatever. But honestly, all the feedback I've received has been so kind. And it really gets deep into going beyond kind of that one to one treatment and looking at RTI and looking at Universal Design for Learning. And just looking at, you know, how you can change systems within school based practice. From a more global standpoint, where it's not just, you have this caseload that's unmanageable, and you have 70 students that you're supposed to see each week, and you are just drowning in paperwork and working off the clock. If anyone feels like that, I would love to have you in my course. Jayson Davies 51:50 Absolutely, yeah, I agree with everything you just said. I've had, I've had that same exact feeling like oh my gosh, this person has like 10, 12, 15 years of experience as an OT, like, what are they going to learn from me? I've been, I've been an OT for eight or nine years. But you know what, we all have something to share. Yeah, I mean, a brand new OT is teaching one of your I mean, veterans, and vice versa. And we all have so much to share. I see so many of the updates that you're coming out with, you know, you're always working on new stuff. Kudos to you I am, I have no doubt that your course is amazing as well. So I Devon Breithart 52:24 I feel the same about yours. Jayson Davies 52:25 Thank you. So I just want to give you a second then to share if anyone wants to learn more about you, where can they go. Devon Breithart 52:33 So I am probably most active on Instagram, that account is the dynamic school ot. So you can look that up. I do also have a Facebook group, also called the dynamic school ot. So pretty much anywhere. Any social media platform, you can find me there. I do have a website as well. But that website is actually going to be DevonBreithart.com So my first and last name calm. And you will probably need to put that in the show notes. Jayson. No, my name is both first and last name are hard to spell. But I'll post blogs and just other content related to school based OT there as well, if anyone wants to check that out. Jayson Davies 53:08 Sounds great. And yeah, of course, all the all the links that we talked about will be up there, including the other. You talked about one of your friends, but by traveling travelers, we'll go ahead and throw that one up there as well. So be sure to check out the show notes for that. But yeah, I just want to again, say thank you so much for coming out of Devon, if I can say everything I'm sorry. Thank you so much. I appreciate having you on the show today. And yeah, I just look forward to staying in touch. Devon Breithart 53:32 Yeah, it was so great to talk. Thank you so much. Jayson Davies 53:34 Thank you Take care. Bye. All right, everyone that is going to wrap up Episode 68 of the OT schoolhouse podcast, I want to thank you. And I also want to thank Devon for coming on and talking about what it is to be in a travel therapy position. But not only that was so much more just talking about schools, talking about how to kind of use a more coaching model within the schools. It's just great to hear from her. And one last thing please do go ahead and check out OT schoolhouse.com forward slash conference to learn more about the back to school conference in August. Early Bird pricing that does end at the end of April. So be sure to check it out now. Take care and have a great OT month. Until next time, bye bye. Amazing Narrator 54:17 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to earn 10+ hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 67 of the OT School House Podcast. Sometimes we simply forget what average is and need a reminder. In episode 67, we are having a discussion about a recent journal article that looks at the typical handwriting abilities among second graders and compares their scores on the Evaluation Tool of Children's Handwriting - Manuscript to the teacher's subjective observations of the children's work samples. Links to Show References: Long, D. M., & Conklin, J. (2019). Handwriting Performance of Typical Second-Grade Students as Measured by the Evaluation Tool of Children's Handwriting - Manuscript and Teacher Perceptions of Legibility. The Open Journal of Occupational Therapy, 7(4), 1-14. https://doi.org/10.15453/ 2168-6408.1492 The Evaluation Toll of Children's Handwriting Transcript Download the Transcript or read the episode below! SUMMARY KEYWORDS student, legibility, ETCH, OT, score, handwriting, teachers, tool, compare, assessments, schoolhouse, criterion reference, identified, study, podcast, legible, typical, test, article, evaluation tool SPEAKERS Amazing Narrator, Jayson Davies Jayson Davies 00:00 So tell me, have you ever done this before? You're evaluating a student who's kind of on the fence for maybe, or maybe not needing occupational therapy services, and you're thinking to yourself, Hmm, I wonder how that typical third grade student who doesn't need OT would perform on this evaluation tool, or whatever age they might be. has an occupational therapist without a kid. I don't get to see typical developing kids very often. And so my mind wanders. Where would this kid score on this evaluation if he didn't need OT? Or where would he score if he did need OT ? Well, today we are going to do just that, we're going to dive into an article that looks at the evaluation tool of children's handwriting to try and figure out what some of the expectations for typical developing children are when it comes to legibility. This article also looks at what a teacher considers legible. So we're gonna dive all up into that in just a minute. But first, let's go ahead and cue the intro. I'll be back with you in just a moment. Amazing Narrator 01:05 Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started. here's your host, Jayson Davies. Class is officially in session. Jayson Davies 01:22 Alright, welcome back. My name is Jayson Davies and I am your host for the OT school house podcast. This is Episode 67. We are moving right along. And that's the same with this podcast. We're gonna move right into our journal article today. Like I said, as OTs we often see kids with special needs and sometimes we can forget what the expectations are for typical developing children. And this is important to know because we're often almost comparing the kids that we evaluate to their typically developing peers. So it's important to know what does typical developing mean, especially when it comes to handwriting because so many of our referrals do come for handwriting. So today, we are diving into the article titled handwriting performance of typical second grade students as measured by the evaluation tool of children's handwriting manuscript and teacher perceptions of legibility. This article comes from the open Journal of occupational therapy in the fall of 2019. The authors come to us from Ithaca College, they are Diane long and James Conklin. For a full citation of this article, be sure to check out the notes below in your podcast player or head over to OTschoolhouse.com/episode67. There, I will have a link for you to get access to this journal article. All right, so let's go ahead and jump right into it. We are looking at the evaluation tool of children's handwriting, you will hear me reference that as the ETCH,. And we are specifically looking at the manuscript version of the ETCH. There is a manuscript and a cursive version, we are looking at the manuscript version today. So I will use the term ETCH to reference that tool. One aspect of this article that I really appreciated was the detail in the references that they looked into the research that they actually put in before they did this study. Now, I'm not going to go into everything, because that's not what this podcast is about. But a few key highlights that I do want to touch upon is that they really did a good job at establishing the difference between a few different types of assessments, they established the difference between norm referenced criterion reference and therapist design tools. recap on that, in case you're not as familiar with that norm referenced assessment tools are tools that compare a child to their peers by looking at the percentage or standard score that a student receives. A criterion reference tool is different. And that's actually what the ETCH is, where it doesn't compare them to an actual other child. It just looks at did they hit a certain mark. So for instance, when you're talking about legibility, and the ETCH, the ETCH says that the writing is 80% legible or 90% legible. It doesn't say it's 80% legible compared to other peers. It's just giving you that that sentence, those words, those sentences, those letters are 80% legible period. Whether or not that is better than or worse than their typical developing peers or any of their peers is up for your interpretation. Just to give you a few examples, the BOT-2 the test of handwriting skills, revised THS-R and WRAVMA. Those are some norm referenced assessments. They give you scores in comparison to a large group of kids that were studied at whatever time they develop the assessment. On the contrary, the ETCH, the print tool, the SFA, the school function, assessment, those are all criterion referenced assessments. They do not compare student that you are assessing to other students of their age. Instead, these assessments simply provide you a starting point and a guide to where a student is in that particular moment so that in the future, you could potentially compare to where they were three months ago, six months ago, or however long it was ago that you gave that initial assessment. And the third type of tool that they do outline, or mentioned, at least, is a therapist design tool. And that is simply a tool that you might design to use for your own assessments that is personal to you. And you can then keep that actual work that the student did, and compare that to a later date. The author's then went into a pretty detailed review of the research behind the ETCH to look at the inter rater reliability, the test retest reliability, and even to try and establish norms for the tool as it pertains to the students age compared to the legibility and that is what kind of brings us to this specific journal article. The author's have three particular goals that they were looking at with this study, Jayson Davies 06:05 they wanted to identify the typical performance of second grade students on the edge. That's the first one. The second goal that they had was to describe whether or not gender influences scores on the ETCH. So if you're a female or a male, do you score higher or lower, typically at the same age. And then finally, the third goal that they had was to compare teachers perceptions of handwriting for second grade students with that. So they were wondering if there's a correlation between a teacher rating a student's eligibility as compared to an occupational therapist or someone completing the ETCH and rating their legibility. Real quickly, before we get to those results. Let's talk about the participants. The participants did come from a convenient sample of teachers and second grade students, all from which came from eight classrooms in four different districts in Central New York, a total of five classrooms and a high needs district as they described, and three classes from a faith based schools and other districts, there were a total of 74 kids with an average age of about seven and a half 54% were female 15% were identified as having some sort of delay disorder or disability. 13 of the kids received additional resource or special education services, and a handful received other special education services, such as OT, speech and whatnot. Alright, so I know I already mentioned the ETCH, and that it was used for this evaluation or this research, but I didn't quite mention what it is, for those of you who are not as familiar with it, maybe you use the THS or the print tool, and you haven't used the ETCH. The ETCH is a tool of children's handwriting, as the name suggests, and it consists of several sub tests that look at the legibility of a student's lowercase uppercase and numeral writing. By writing the alphabet or writing several numbers in order without a model, then it looks at near point copying through copying a sentence and grading the words as well as the letters, then you do the same thing for FAR point copying. So you write something up on the board and have them write that. After that you look at dictation, which is asking the child to write some letters that you share with them to almost create fake words. And then after that, you have them write their own sentence, and you grade the words and letters in that sentence. So that is a little rundown of the ETCH that might help the results make a little more sense when we get there. Alright, so there was one more tool and that was the tool that the teachers use to subjectively grade the students handwriting. So teachers were provided a sliding scale from 0.0 to 5.0. To rate each student's overall legibility. Based on work samples in the classroom, alignment, spacing size, they were also obtained using this same scale. The teachers were not blinded to which students handwriting they were scoring, because that would be typical during the referral process, right? A student isn't being referred by a teacher that doesn't know whose handwriting looks bad or good. They're referring a student that they have concerns with. Something I found pretty clever as it relates to this study is that the researchers provided the teachers with 10 additional work samples that were not their students to grade so that they could establish inter-rater agreement between the teachers to see if teachers kind of rated handwriting similarly, so each of the I believe it was eight teachers got the same 10 handwriting samples, just to see if teacher A B, C and D, all rated students 123 similarly, Now this may or may not come as a surprise to you, but they found that teachers did actually rate the handwriting samples pretty similarly across the board, meaning that teachers A, B, and C Did rate student one pretty similar? Alright, so let's go ahead and check out the results earlier, I gave you the three goals that the researchers aim to answer with this study. So let's go over them one by one. We'll start off with the question about gender and scores on the ETCH. I don't think it's a surprise to anyone. But with 95% confidence interval, the boys did consistently score lower than the girls. On average, the boys scored seven points lower on total word legibility, seven points lower on total letter legibility, and five points. On average, when it came to Jayson Davies 10:39 numeral legibility. Most of the sub tests hovered around those averages. However, far point letter legibility, dictation of words and dictation of letters, there was a surprisingly large gap of 10 to 16 points between the average female score to the average male score. And that brings us to the overall average scores. Remember, we're talking about second grade students with a small percentage that did have some form of additional support the resource and, and identified as needing special education services. But in general, these students scored an 84% on legibility for total letters 88% for legibility of total words, and 89% for total number legibility. And that now leads us to the final goal that the researchers had, and that is trying to predict at what score, a teacher would perceive a student's eligibility as being okay or not. Okay. And so I'm gonna kind of relate this to the scores that we just talked about the mean score for a second grade student, for total letter legibility was 84%. However, the conservative cut off recommended by the researchers is actually 77% for letter legibility, because there were students below that 77% that may still actually qualify or be identified as having illegible writing. The total word score that we had an average for before was 88%. However, the researchers recommended a score of 82% be used as the cut off, again, because some students who may score lower may actually not be identified or, or quote, unquote, fall through the cracks, potentially, if you don't use that lower cutoff. And when they looked at each of the individual sub tests, they found that the upper case legibility scores had the highest indication of predicting a teacher's overall perception of a student's legibility. So basically, that means that if the teacher found the student to have good legibility, then the student was likely to score higher on that one sub test, which is writing the alphabet, all in uppercase letters. And if the teacher identified a student as scoring low, or having limited legibility, or decreased legibility, they would likely score lower on that uppercase Alphabet Writing sub test. So what that means for the researchers is that their mean scores were in line with other studies that came before theirs. Their results were also in line with previous studies that showed that, on average girls performed better in writing than the boys did in school. And this idea of the females performing better than the males actually made them question whether or not there needs to be separate expectations for those populations, should there be different standards of legibility for males and females at the same age level? When it comes to my own personal takeaways from reading this article? I, you know, I can't help but just understand that teachers are pretty good at identifying poor handwriting. I mean, they're seeing poor handwriting as students performing less than 80% legibility on the ETCH. At least, that's what it seems like to me. I think this study also kind of reinforces that idea that I feel like most educators have that 80% is proficient, and less than 80% is not proficient, especially when it comes to handwriting. And so if you're scoring a student's ETCH, and they are hovering around that 80 percentile ranking, then that is cause for potential concern. And it is definitely caused to potentially look into it further and look at you know, visual motor, visual, spatial, and some fine motor skills to determine if there are some underlying deficits, preventing the student from scoring higher. And finally, this study also confirms why my handwriting is such a chicken scratch in comparison to my wife's, just gonna say that I now have an excuse to use when she can't read my writing. Alright, well, that is going to wrap up Episode 67 of the OT schoolhouse podcast the final episode of March 2021. Up next we have April coming up, which you know what that means it is OT month, and I'm looking forward to celebrating that with you all. Take care. Have a great rest of your March, start to April and just enjoy OT month and be sure to advocate for our wonderful profession. All right. I will see you all next time. Take care and have a great April. Bye. Amazing Narrator 15:29 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Learn more about the OT School House: Back to School Conference Here! Welcome to the show notes for the Episode 66 of the OT School House Podcast. Have you ever wondered what to do with your high school students? Did you there is such a thing as a Post Secondary Transition Plan that is required for every high school student on an IEP? If not, this is the episode for you! Today, I am welcoming to the podcast, Dr. Liz Abadiotakis, OTD, OTR/L to share with her experiences working with Post Secondary Transition Plans as part of an IEP team. Key questions to be answered: What is a Post Secondary Transition plan? When must a transition plan be put in place? What are the pieces to a transition plan? How are IEP goals similar or different from transition plan Goals? Who traditionally writes the transition plan? How can OTPs support post secondary transition? Links to Show References: Dr. Liz' Website IDEA Transition planning A Transition Guide to Postsecondary Education and Employment for Students and Youth with Disabilities AOTA Transition planning OT School House Workload Calculator Dr. Liz Summit Webinar Join AOTA.org (Starbucks affiliate) Transcript Now you can read the transcript here or download it to read later! SPEAKERS Amazing Narrator, Dr. Liz Abadiotakis, Jayson Davies Dr. Liz Abadiotakis 00:00 I know that they recently had a developmental disabilities sis open conversation, where they invited members and non members to start talking and it was about post secondary transition planning. This is definitely a population of students that oftentimes does not receive our services or if they are there, you know, consultative base, and it's hard for us as therapists to really be in the mix of the team. Jayson Davies 00:27 Hey, everyone, my name is Jayson Davies. And that was Dr. Liz Abadiotakis discussing post secondary transition planning, which is what we are going to get into this morning this afternoon, or this evening. Whenever you are listening to this podcast, we are going to dive into exactly what occupational therapists can do as students start to get older. I'm bringing Dr. Liz on to the show today, because that is one of the most frequent questions I get on social media. That is, what do I do with kids? Once they get into middle school in high school? How do I continue it? Or is it time to exit students from ot at that point? So we're going to talk about that? Exactly. In this podcast. All right. So stay tuned. We're gonna cue the intro real quick, and I'll be right back. All right. Enjoy the music. Amazing Narrator 01:14 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 is your host, Jayson Davies. Class is officially in session. Jayson Davies 01:31 Hello, hello, and welcome back for Episode 66 of the OT school house podcast. Again, real quick. My name is Jayson, I'm so excited for you to be here today. Today we are talking about the post secondary transition planning also known as PTSP. For some of you in the know, that was a new term for me, I didn't realize that it had an acronym, but it wouldn't be special education and education as a whole if it wasn't an acronym. So that is just the case. Today we are welcoming on to the show Dr. Liz Abadiotakis also known as Dr. Liz, the OT, she has a website at DrLiztheot.com, Drliztheot.com Dr. Abadiotakis has been in the OT field now for 18 years or so. And she has really found that her expertise is in supporting and educating parents, this is really a love for her. And well in that process. She found that post secondary transition planning is also a huge part of that in order to support those parents of children with special needs. So she is here to talk all about that today. Personally, I am super excited for this because this is actually the population that I initially intended to work with. Back in occupational therapy school, I actually created a program that was about incorporating film, and engaging students in general education and special education together to kind of facilitate that, that balance or those those skills and, and friendships between students with general education and within the special education population. I never quite got to the point where I got to do much of that I have a combined about two years working in the high school. So it is not an area that I feel super confident in. But Dr. Liz does this interview you're about to hear has helped me out so much to understand post secondary transition planning, and how we can continue to grow. A lot of times therapists see this high school period as a time where we should be removing ot services. Well, maybe after this interview, you might see that in a different light. And you might see a way that you can even enhance and improve the services that you provide in the high school and adult population. So without any further ado, here is Dr. Liz the OT I really hope you enjoyed this one. Jayson Davies 03:53 Hello, Liz and welcome to the OT schoolhouse podcast. I'm so excited for you to be here today. Dr. Liz Abadiotakis 03:59 I'm excited to I've been reading your emails and listening to your podcast. So I'm excited to get some information out there. Jayson Davies 04:05 I love it. Yes. And you know, this has been one of the most popular questions I have gotten what we're gonna talk about today. And that is that transition program that Post Secondary Transition stuff. And I just love it. I get questions on social media, I get questions during my A to Z course office hours. And I have limited experience in that middle school high school range. So I'm excited to what you have to say. So to get started, how about you go ahead and share with us just a little bit about your background as an occupational therapist. Dr. Liz Abadiotakis 04:38 Sure. I am primarily a school based and pediatric therapist, and I'm also a bit of an entrepreneur. So we have I started out in pediatrics at a clinic in Connecticut and moved up to be the clinical coordinator there and then moved to New Jersey once I got married to my husband. When I got here, um, besides dealing with the move and everything else, I decided why not open a private practice? That would be a great idea to some payoffs, right? So I did that with my college roommate. And we had a practice called the interactive playground and Wellness Center for about seven years, we were in schools, as well as having a sensory motor based clinic. And then, once I had my own children, I had to kind of move on from that, I went back to school to get my doctorate, and continue to be in school systems, because that worked out with my family life as well. And then, now I currently am in, again, a school system working for the Board of Education. In the teachers union, I know that's a topic that comes up a lot,as well. So I've worked actually as a contractor, as well as as an in house person. And I also now have a private practice that supports parents with one time questions or ongoing support. And that's for parents of kiddos with all different abilities. And that's via telehealth. Jayson Davies 06:07 Gotcha. So, just upon what you just said, I actually have a few questions. So I want to ask you just these based upon your responses from just there. For those of us that have never been in a clinical role, what does it mean to be a clinical coordinator of a private practice? Dr. Liz Abadiotakis 06:24 Sure. So in the I worked for center for pediatric therapy in Connecticut, which is Tara Glennon, who is one of the authors on the sensory pressing measure it was, and we, we had different levels of support there. So starting out in a clinic was really helpful, because it's primarily one on one treatments. And you have a lot of support around you, which is not always the case when you're in a school system. So we had contracts with schools. And we were also doing private therapy sessions in the clinic. So clinical coordinator was I was in charge, basically, of one of the four offices that were there. And then above me, was a clinical director. And then above that was obviously, the owner. Jayson Davies 07:13 So you were kind of in charge of making sure everyone was a doing their job, but also that people had the development that they probably needed the mentorship that they needed. Dr. Liz Abadiotakis 07:21 Yeah, so I did, I ran staff meetings and provided support, especially for new therapists around report writing. And I was actually at that point, I know, they're talking a lot with journal clubs. But one of the things that I had initiated during my time was at staff meetings, having people bring articles to the staff meeting to just review and taking turns doing that, to really just making sure that we're on top and on the cusp of what's coming up. And what is, you know, what, not only are the trends, but really what is the evidence saying that we should be doing while we're in clinic. So I think it really varies from clinic to school, because the support is there. And a lot of times what I'm hearing from therapists, because I speak as well. And what I'm hearing from therapists is that a lot of times the support isn't there, or it's there a lot for the teachers, but not necessarily that it's not necessarily specific to us. And we hear that a lot with regards to professional development days. And so there's a lot of things we can do. And we can talk about that a little bit in, in with regards to Post Secondary Transition as well. But yeah, there's definitely a big difference. Jayson Davies 08:27 Awesome. So thank you for that. Because I I've never actually been in the pediatric clinic world. And so I really honestly couldn't have told anyone what the actual role was. So thanks. And then the other question that I had is, I think this is kind of specific to more the East Coast is people working for the Board of Education. Out here, we don't have anyone really that works for Board of Education, we work for a district, we work for a selpa, which is a local education plan, they kind of support multiple districts, in a way, but what does it mean to work with the board of education? Dr. Liz Abadiotakis 09:00 Okay, so that's similar. So each district has their own board of education, and I'm in the state of New Jersey now. So that's, I worked for one Township, essentially, or one district. And then and they have that one board of education. I know even having worked in Connecticut, that they would have, like one Superintendent that covered multiple towns or multiple districts, essentially. So each state I think, is set up a little bit differently. I know even in the south, I've talked to people that they have, again, like counties that are working together to you know, to service, different towns and districts. So it kind of is a little bit different everywhere, but either you're basically getting paid through the state or no and you're able to receive the benefits that essentially the teachers are getting as well. Or you're working. You know, as a contract therapist. I know that also in New York, there was a they the occupational therapists they are trying to get into the teachers union because they were actually put into a separate you There's a big push to get them to be into in the teachers union as well. So there's a lot of different, a lot of different conversations happening within just the schools, themselves and within from state to state. Jayson Davies 10:12 So yeah, absolutely. And that's why I always tell people, I mean, it's so different from especially state to state. But even when you even kind of zoom in district, a district is different county to county, very different. So always nice to hear the lingo from different areas. I know. I mean, some people, they go to what I consider an IEP meeting, but it's called something else. And so I just like to hear from people what, what the lingo is in their area. Great. Well, thank you. So now, let's jump into the post secondary population. At what point did you decide that this is an area that you wanted to focus on? Dr. Liz Abadiotakis 10:47 Okay, so this is kind of interesting. You, I think a lot of times in Post Secondary Transition, you just fall into it. So right in a lot of things in the therapy world, you just opportunities come up and you problem solve, and you figure out whom there's a need here. And I'm going to advocate for this need. And I'm going to start supporting this need in this particular location, wherever you're working. So I had some experience in post secondary transition planning, which I feel like I should define first, Jayson Davies 11:18 that was the next question, go for it. Dr. Liz Abadiotakis 11:20 Before we move ahead, so when we talk about post secondary transition planning, we're talking about that students that are going to be graduating from high school and moving into adulthood. And that's the transition essentially, that we're talking about. And when we're talking about planning for that, we want to think about what skills will this student need in order to be successful in adulthood to obtain employment and independent living? So I feel like it really is marries itself well, to occupational therapy. And I've described it before almost as discharge planning. So some of us who have, you know, dabbled a little bit in sub acute care or acute care, you know, you when you're looking at discharge planning, you're looking at can this person care for themselves? Can they take care of their ADLs? Can they go back to work, and all of those things that you're thinking about in an acute or subacute setting is very similar to what you're thinking about in that high school setting? How is this student going to live and work independently? And how can we get them as independent as we need them to be? Jayson Davies 12:24 Yeah. And you know, what, I? I'm going to stick to my next question. But I know I want to continue to dive more into what you're just saying, When must a transition plan start to be formulated or put into place? Dr. Liz Abadiotakis 12:36 Great question. So federally, it does not need to be in place until age 16. However state to state that can vary. And so some states will say that there has to be post secondary transition planning goals in the IEP at age 14. So with that being said, there's another conversation that needs to happen. And that is that, although that's when it's legally supposed to start entering the IEP, we really need to be working on skills to prepare students for transition to adulthood a lot earlier than that. So I want we can talk more as we get into it, we could I can kind of delve into that a little bit more. Jayson Davies 13:23 No, go ahead. Go ahead, actually keep going. So what's your what's your take on that? Then? When would you start optimally start planning for that? Dr. Liz Abadiotakis 13:31 Well, there's, there's a variety of students that could benefit from this, right. So when we're talking about typically developing students that are in, you know, general education and being serviced in that way, we're still doing post secondary transition planning, right? We're trying to figure out what they're going to do after high school. And they're using tools like, I know, over here in New Jersey, we're using naviance, or one of those career planning questionnaires, and what are the students interest, and what are their personality and all of those things. And so we're always planning for transition. It's just that when we have certain students that are dealing with other learning issues, we need to support them in a different way. And so a lot of what I do, or the population that I work with is students with developmental delays. And so those are the students that are going to be able to access the Department of Developmental Disabilities Services post graduation. And so they are likely going to be staying from that 18 to 21 period where most students are graduating. So that's kind of my niche right now. But that's not to say that other therapists across the country aren't working with students that just strictly have learning disabilities that are May, you know, need a little bit more support in that transition. Jayson Davies 14:49 Gotcha. So then, can you I guess I'll start with this is what is the difference between an IEP and a transition plan or how do they work? Together, how are they separate? Dr. Liz Abadiotakis 15:02 Sure. So the plan is, essentially your planning is housed within your IEP. However, if you I do encourage people to look at ID EA, because it will specify and I talked about this actually, I have a webinar, and we can talk about that later. But I talked about the specific laws. And if you look in Ida, you will find the terminology that they're using for what kind of assessments really need to be done for students in order to prepare for that transition. And so that helps to guide you in your IEP when you're looking at what evaluations should we be doing? Um, you know, can this student take care of themselves? Can they do self care tasks? Do they have employment skills? And what is going to be the best or least restrictive setting for them when they leave? High School? So really, the planning is what ends up in the IEP plan? Jayson Davies 15:58 Gotcha. And I know that there are specific transition goals, if I'm correct, are those the same thing as IEP goals? Are they slightly different, Dr. Liz Abadiotakis 16:08 They're in a different section, probably, depending on what kind of IEP program you're using, it might be in a different section of the IEP, specifically, that states transition planning goals. However, the the IEP goals should really reflect the direction that we were looking for the student to be successful. So I know that, you know, I will talk about even to parents, and we talk at IEP meetings, how when you there needs to be a shift from working on those underlying skills and those foundational skills and really building up what the student has, which is what we're doing in elementary school, and then this shift into, okay, we've got a good foundation now. Now we need to start looking at their strengths, and what can we build on from their strengths that are really going to take them out into the world in a successful way. So the shift that needs to happen at some point, and that's different, depending on how the school system is set up. A lot of times that happens during middle school, but middle school can start in fifth grade and sixth grade and seventh grade, depending on what town you're working in. Jayson Davies 17:15 Very true. Yes. It's all over the place. All right. So you kind of started down this road about thinking where a kid might be going, you know, are they going to be graduating at the typical age of 17? Or 18? Are they going to be remaining in a adult transition program from 18 to 2122? Whatever the state allows? Or our I don't know, are they going to college? Are they going to be getting a job, whatever that might be? What are some things that you try and focus on for those transition goals? Are you looking at like making sure the student can access their future job making sure that they can access disability programs? Or what are you trying to facilitate? Dr. Liz Abadiotakis 17:57 So it's really a team effort. And you're working with the teachers, you're working with the psychologists, oftentimes districts will have a transition coordinator. And you also, of course, have the speech therapists, physical therapists, so whoever is involved in that students case, you're coming together and with everyone's evaluations, and really trying to figure out where what is going to be most valuable to the students. I talked about putting eggs in a basket, right? So if we only have you know, however, many years left, let's say five years left, and we've got these five eggs, you know, what, what basket is going to bring us the biggest yield for the students. So do they we know, considering the research, we know that self care skills and independence and self care skills can be a very good predictor of whether or not a student gets employed. So we want to make sure, first and foremost that they have, again, those foundational skills that they need that in order to be able to then obtain a job. So when I'm looking, we may be doing simultaneously self care skills. And we may also be doing pre vocational skills. At the same time. We really want to make sure that our pre vocational skills are geared towards those students interests and their abilities. Jayson Davies 19:16 Yeah, and it's interesting, because you know, we're, we're at that age, especially when you're at middle school, and everyone's trying to figure out, should I start to go to console and work my way down, because their handwriting is never going to get better? Do I need to increase services? What do I do? Kind of, do I need to stay on? Or should I back away like, Can I continue to help this kid? And so what is that mind shift that you think needs to happen as a student goes from elementary, and I'm moving toward Middle School for the occupational therapist. Dr. Liz Abadiotakis 19:49 I'm going to give you the example and you asked me earlier like how did I get into this and I did kind of fall into this now I had experience I worked at I had an internship and a community based Center, that was a post 21 program. And I also worked in a regional service center in Connecticut, that was strictly for students that had developmental disabilities. And they were out in the community and doing a lot of things already, so that I had a basis. But I had students that I hadn't seen in elementary school, when they were very young, and one in particular, one student in particular. And she came up to the middle school and had me again, so I don't see them from a period of time, because I'm like Qaeda, you know, pre K to third, and then our school district breaks up again, and I don't see them for like three years, and then they come back to me. And so when they came back up to the middle school, they were like, Where is all your fun stuff? Where is the trampoline and the swing and the math, like what is happening here? And so I was like, oh, my goodness, we have these goals. You know, we have to work on some fine motor skills, and some, you know, some other functional skills, but how am I going to make this fun for my students. And that's really how my role and transition started kind of erupting and moving into these other areas. And so I decided that in order to make fine motor skills, interesting for them, and fun for them, that we were going to make a craft store. And that this craft store was going to allow us not only to work on our fine motor skills, but also on all of our process skills in our sequencing and our casing, but also on our pre vocational skills, which gets into how we are going to manage the money for this craft store, and how we're going to make purchases and how we're going to add up our profits and figured out how much money we should spend again, and what products were successful and what products weren't. And so it became this a project that was a small project that became bigger and bigger and bigger and bigger. Jayson Davies 22:00 Wow. Yeah, cuz, you know, we always, I don't know, maybe once a year, if you're in a special education Facebook group or something like that, you always see the coffee shop idea, it pops up, like there's a school somewhere always has a coffee shop that the kids have. Right? Yeah. And you know, it's always a great idea. It's, I think it takes a lot of planning, it's, it's not just a learning experience for the kids. It's also a learning experience for the teacher, the OT the speeds everyone involved. But so that's kind of a similar idea of what you guys did, except you incorporated crafts rather than coffee. Dr. Liz Abadiotakis 22:34 Right. And so we had a coffee shop, they had a coffee shop there, I did start with crafts with the craft store. And I started that just within the OT sessions. So we were it was just an OT session, we would sell it at lunch, they had to work with a speech therapist to be able to, say their ad or like their advertising during the lunchtime, they had to, you know, their little spiel was a great up here, no connection, kind of an activity, because the students would come up and actually purchase the crafts and support their fellow students. And so that was really nice to see as well. And so it was only within ot sessions, because I needed something that was going to fulfill my goals and basically allow them to, to learn. And as my students got up into the high school, that's where they had the, what we call cafe. And so we I actually, at that point moved into the classroom, the life skills, we call that classroom with the teacher, which was really extremely helpful. And if you have the opportunity to be in the classroom with a teacher that's teaching functional skills, and share space, that can be critical. It allows for that planning time, which we don't all have, but it will happen on the fly, because you're just in the same room together. And we went on to be able to create a lot of different programs that started to look out, you know, what did she have, and I was able to kind of figure out what was missing, you know, and one of the things that was missing for our district was getting out into the community. And so not only did we have to go buy these crops, I used to go to the store and do the purchases. But we were able to end up getting busing. And so we started being able to have a reason then to go into the community that that filter back to the actual project of the craft store. And so this one little idea becomes bigger. And I think that's important for therapists to hear. Because when you talk about transition, and you can go down the rabbit hole looking for all of the information that's out there, and there's a lot but I want therapists to know that if you start with a small idea and you just start in your sessions, it can grow and you will see where it needs to grow. Jayson Davies 24:54 Yeah, I agree we actually had a, I mean, it was kind of what you're talking about. Getting out of To the community that the high school that I worked at, they would go to our den. So maybe on Tuesday, they would collect cans from the classroom cans and bottles from the classroom. And then on Wednesday, they would actually walk to our sins, they would drop out the cans and and get some money from the cans and the bottles. But more importantly, is that also on Tuesday or the Monday before they had created a shopping list. And so now in Albertsons, they're buying what they need for a meal that they're going to prep on Friday. And so that was kind of a weekly thing that they worked on meal prepping. And that was that year, I don't know, I'm not at the high school anymore. Maybe she's moved on to something. Well, right now, it's pandemic time. So nothing's happening. But yeah, I mean, it's great when you're able to get into the community. That is, that's for sure. Dr. Liz Abadiotakis 25:48 Yeah. And I think that if those programs are already up and running, that's an opportunity to say, as the therapist, instead of pulling my students out of the classroom, I'm going to push into whatever's already happening. And that was a lot easier to do in, you know, my regional service center, because they did have they had a salad bar going on, they had jobs that were already in the community. And so I didn't have to invent this new wheel, I was able to push in and integrate into that, um, we did have a, I'll tell you a funny story. We had a, we used to go out to the stores, we had vans that we could take out whenever we needed to. And we would go shopping, and our students were pretty involved. And we realized that there was a need for helping them to be able to push a cart down an aisle not run, you know, full bore 60 miles an hour, with a cart down the Costco aisle with myself. And the other otaa running after them. It was quite an experience. But we ended up going to our local Bob's at the time, which I don't know that there's very many of those left. And we actually asked them, can we have a cart we need, we need a shopping cart, and they had small carts, and they let us have one and we tossed it in the back of her Toyota, I don't even know how it fit, as we would practice with the students how to walk and stop, and just following those simple commands of walking and stopping while pushing a grocery cart in the school, so that when we went out into the community, they would have that skill to be able to go out with mom and dad. You know, and that's, I mean, that's just so simple. But again, like you went, if you push into what's already happening, you will see, you know, how you will be valuable and where your distinct value will come into play. Because you're going to be able to assess what's happening. Jayson Davies 27:35 Yeah. And, and the same thing, I went out into the community and, and with the kids, and we would walk to Albertsons. And so a lot of the things that we worked on were safety, you know, making sure that we're stopping at sidewalks not just running into the street, that we're looking both ways that we understand what signs mean. And then money when you're when you're making the purchase, you know, getting money, how to appropriately interact with the lady at the meat section and ordering things. So I'm definitely so many skills that that can be worked on, for sure. Dr. Liz Abadiotakis 28:08 I can kind of jump off on that. I know, there have been therapists also that have asked, you know, well, I can't get out or I don't have the funding. And you're saying already, you know, we've walked to whatever was, was available. And I know that I was my particular district is in a very suburban area and was rural. And so we had a community garden that was down the street. And so that was the way we actually addressed pedestrian safety, we and then we were part of the community as well again, and that was a whole nother set of three vocational skills and learning and science. And there's so many other things that that can come along. So you have to just look at what's around you. There may not be a store there. But what else is around there? Is there a library? Is there a post office is there a garden is you know, there's got to be something, you know, next to you. And if there's not, there's at least probably a street that you can cross, at least get out and do a little pedestrian safety. Jayson Davies 29:06 Absolutely. Great idea. Thanks for mentioning that. So I also want to mention the same high school that was our life skills class, just like you were talking about, but with some of our other kids, the RSP. You know, kids that aren't full day in a special education classroom. I rarely ever knew about the transition plan. And I don't know if that's the case for a lot of other OTS. They just don't like even they don't even know about the transition plan until they're in the IEP and someone is just saying here's our transition plan goals. Have you experienced this or what do you suggest an OT do if they're not really integrated in that process? Dr. Liz Abadiotakis 29:44 Yeah, I think this is a difficult area and I'll and there are conversations that are happening. I know that he recently had a developmental disabilities si Yes, open conversation, where they invited members and non members to To start talking about it was about post secondary transition planning, this is definitely a population of students that oftentimes does not receive our services, or if they are their, you know, consultative base. And it's hard for us as therapists to really be in the mix of the team, because the team at that point seems so you know, spread out because there's so many different teachers for every different subject area. And then there's the case manager as well. So it's a challenging group of students to work with, I think that we have to look at the IEP prior to the meeting happening if possible. And we have to be proactive in looking at that plan. It's, it's listed right in that IEP. So if we know it's in there, and we want to be part of that conversation, we need to be talking to the case manager in advance, we need to be looking at what what was in there last year, you know, and is there something that I can be contributing to that conversation? Jayson Davies 30:57 Yeah, and you know, I actually was just looking at aota. The other day, they had a training, just the other day, and I attended an online webinar, I think anyone who's an aota member can access the replay for free. But it was all about OTS role and transitions. And you're right, they are being proactive about it. If you go on to their website to ta.org, there is a section under the children and youth that's labeled transition. I'm looking at it right now. I haven't had a chance to really dive into see what all is there. But you are absolutely right. They are trying to put some put some focus on onto it. So what do you think? Do we kind of already go over all the barriers? Or do you think that there's other barriers out there? Dr. Liz Abadiotakis 31:39 Ah, there have definitely there's other barriers. I think people talk a lot of times about administration. And they also talk about other therapists, I'm going to be honest, I've been in a couple different conversations, I've been in conversations, I did conversations that matter at a AOTA in New Orleans. And then I also was invited to speak on a panel at Quinnipiac, for their 50th anniversary. And in both of those conversations, there were therapists mentioning that other therapists were telling them that we shouldn't be involved in transition planning. So I really felt like it's important for people to look at what it is so that it's not a topic or an area that you know that they're saying we shouldn't be involved in without having the knowledge behind it. Right. So we want to make sure that if we're going to make a decision like that, and maybe it's not right for our school system, for whatever reason that we're looking at the evidence that's out there, we're looking at what AOTA is talking about, before we start creating a barrier for our fellow professionals. Yeah, that's such a topic. But you know, we I want to make sure that therapists are getting, you know, getting the information that they need and getting it from a reliable source. I think that one of the things that a lot of therapists are nervous about or could be concerned about is that workload first caseload, right. And so how are they? How is this going to affect them? If this one therapist decides she's going to start keeping students on at the high school level? How is that going to trickle down and affect the other therapists, and there are a lot of creative ways to be able to serve as students without making that caseload overwhelming. Um, but also, we have to think about how are we advocating for ourselves, if our cases are getting too big, that's not a reason to say we're not servicing students. That's a reason to say to the administration, we need more support, and we need more therapy services. And this also came up in a couple different sessions at the at a conference. And I know that therapists, I worked with a therapist that I mentored, and there was a therapist that mentioned it at the conference as well, if you cannot fit certain students on your schedule, there have been therapists that have made lists of students and said, I cannot service these students, these students will not be being seen until you hire somebody to see them. And so at some point in time, we need to advocate for ourselves, because what is the quality of the services that we're providing? If we're completely overwhelmed? Jayson Davies 34:06 I 100% agree with what you just said. I actually at one point, and in a job, I did a caseload slash workload study for myself. I only did it over the course of I think it was three weeks. So didn't like yeah, those three weeks, I had to mark every 15 minutes what I was doing, who I was seeing and whatnot. But at the end of those three weeks, I kind of put together an Excel spreadsheet. And I showed it to my boss and said, Look, I don't have enough time in a day to see all these students. And sure enough, it took a little while, but they did bring in a contracted occupational therapist to help out. And so yeah, we can't just start decreasing services because our caseload is too high. No, we have to ask for help. And I recommend a workload, some sort of workload study if you can do it. Check it out. Dr. Liz Abadiotakis 34:58 And I believe they have a calculator now. Somewhere on the arrow to a website, there's a workload verse caseload calculator, I believe, Jayson Davies 35:04 is there. I know I created one. I haven't launched it yet. Okay. Yeah, I created one. So I'll have to launch it now with this podcast. But I was kind of waiting for the whole pandemic, because right now everyone's right, what is the caseload right now? But yeah, so I'll look for the aotea. One as well. So we'll have to figure that out. All right, well, let's look at the specific classrooms. How important is an occupational therapist understanding the curriculum for a classroom, especially if you're in like a life skills type of classroom? Dr. Liz Abadiotakis 35:37 Oh, that's very important. And I mean, that's important. We know that even at the lower elementary level, that we're, you know, a lot of therapists are more comfortable and used to, we have to know what is being taught in the classroom, in order to know, you know how we're best supporting a student, if I, if students are not getting what they need in the classroom on a regular basis, then my one time a week is not going to cut it. Because we need carryover, we need generalization. And in order to get that that needs to be happening throughout the school day. And so we have to be familiar with the curriculum, and understanding what is being taught and then know where the gaps are, so that you can then advocate for curriculum that maybe needs to be written and get involved. And that's, you know, I kind of mentioned to you before I was involved in writing curriculum in my district, we were not I was not as an occupational therapist allowed to write it on my own, which I completely agree with, because I'm not the one that's going to be teaching it. So it has to be a therapist as well as a teacher. And I've worked with several teachers to write several different curriculums, we wrote the life skills curriculum, we wrote a community integration curriculum. And we also wrote a job exploration curriculum. And so there's not every curriculum is going to fit every district. And so we've looked at other districts curriculum, and, and depending on the population of students, or depending on the number of students, because we're a smaller district, you know, your needs will be different. So you really need to look at what are the students being taught? What are the gaps? What are the strengths? And do we need to do a rewrite or an adjustment? And how can I get involved? Jayson Davies 37:22 Yeah, I think it's great that you actually, were able to work with the teacher to create your own curriculum, because I have worked with life skills, especially classes, whether they be in elementary school or high school anywhere in between, that they just don't understand the curriculum that they're being provided. They're being handed like six giant books. I know some, at least one of the popular ones is called basics. That's a, that's a popular program, I think, and, but they've never really been trained in it. And so a lot of these teachers are just kind of flying by the seat of their pants, trying to figure out how to implement this, this curriculum that a they didn't develop, be, mean, if you've been in a special education class, you you know that the curriculum almost needs to be designed specifically for that classroom, because those kids are so different, you know, you never know what one classroom of special education students is going to be similar to another classroom of special education students. So that's great. Tell me more about so you develop several curriculum. Dr. Liz Abadiotakis 38:23 Right. And I think that that's important to understand that there are curriculums out there that are written that, like you said, they're being handed to the special education teachers. And a lot of times the teachers that are in more, you know, with the more involved students, they don't have a curriculum that's already preset, which makes it their job a lot harder. But when you're being provided with this curriculum, that doesn't mean that that curriculum is set for that district, that district really needs to be tailoring it, and writing it within their own format within their own on their own letterhead within their own school community to figure out what's going to work for them. So, curriculums are written to basically say, here's what's best practice for, you know, teaching community skills, great, but we need to teach also self care skills, and you know, and other skills, and we only have one block of time, so I need to take two curriculums and meld them into one to be able to teach what needs to happen within these four marking periods. So to have a curriculum available, doesn't mean that that's how it's going to be carried out from marking period to mark wicker you really need to know, on day 17, what is this teacher teaching? You know, what are she reviewing? And that's, that's the missing piece. I think that sometimes, you know, happens. Jayson Davies 39:37 Yeah, I agree. Because it's really hard to help a classroom when you don't know what they're trying to do. And I recommend that too. That's one thing that I teach in the agency courses or my my A to Z school based OT course is you need to know what the classroom is working on. Because if you're working on one skill, and they never have the opportunity to practice that skill in the classroom, then is it gonna Are you ever actually going to meet that goal, probably Not? So yeah, no, that's very important. I'm going to ask you a question. And it's a little bit on the spot. tricky question. But I know people listening would probably be upset with me if I didn't ask this question, what might a goal that you would write, what might that look like for a student in a transition in that high school range looking to transition eventually, Dr. Liz Abadiotakis 40:21 Sure that the transition goals specifically are can be very broad. So it could be, you know, the student will be exposed to multiple career cluster areas, to you know, to decide what, you know, their areas of interest sometimes are broad, they're not as measurable, it's just for exposure, if I'm going to write a specific goal, then a lot of times, you know, depending obviously, on the level of student, there's so many different levels of students. But if you're going to look at it with regards to career interest or exploration, you can certainly write a goal that a student will be able to gather information from the internet to state three facts about a career of interest after being exposed. So you know, allow them teach them that process of how am I going to gather the information? And then and then give them a topic? Okay, you're going to look up, you know, construction worker today, can you find three facts about this job, and I have specific facts. So I usually put in my in my little parentheses, what they'd have to do, they need to know the Hours of operation, they need to know the pay. And they need to know the responsibilities and those and I want them to understand that we had a conversation, a lot of students are really interested in animal working with animals and animal science and all these things. And then when we talk about jobs, working with animals, we also talk about and I'm gonna say the word, we talk about poop, and that you have to potentially pick this up. And so, you know, as soon as they hear that, they're like, No, no, no, no, I'm no longer interested in this area. But that's why these conversations are so important, because we have they have these ideas about maybe they really want to work in an area or they have an animal at home, and they're really, you know, interested in them. But who is actually cleaning up after this animal who is actually interacting with this animal all the time to do all the caretaking. You know, that's an opportunity to say, you know, you need to start doing the caretaking. If you really will have an interest in that area, then why don't you know, that's a good way to work with families to, to try to get some skills. So we have to talk about the interest. Jayson Davies 42:21 Yeah. And so yeah, I mean, poop. Alright, anyway. He said, Would that be then a transition plan? Or would that goal or would that be an IEP goal, that's more specific goal that you made. Dr. Liz Abadiotakis 42:37 So the IEP and the transition plan, they're all in one, it's one whole big document. So your transition plan is inside of your IEP. So if you look specifically at your transition goals, it would be that this student is going to be exposed to, you know, careers of interest, or the student is going to complete, you know, an interest checklist to identify areas of interest, though, those are your exposure areas, those are your broader trickles that are going to be in your transition plan. Jayson Davies 43:07 So the goal that you made a little bit more specific. Dr. Liz Abadiotakis 43:10 And then, and then your ot goals are going to be more specific, or your my ot goals are sometimes with the teacher. So it will be OT and teacher. Right? And which we want to see more of. Yes, as you get up higher. So you're you're collaborating with the teachers to get more specific into, okay, yes, we want to expose them and they're going to be exposed, they're going to do this interest, interest inventory. But how are then we breaking that down within the document of the IEP? Yeah, so the transition goals and the IEP goal should marry to each other, they shouldn't be separate. Jayson Davies 43:42 Like that. And and going back to what you said earlier, you really need to kind of talk as a team prior to the IEP to make sure that that's happening. You can't just go to an IEP learn what the transition goal is. And then, well, I already created my IEP goals. So I'm just gonna leave it that way. You need to you need to collaborate beforehand. Definitely. Absolutely. All right. We're gonna wrap this up pretty shortly here, but I want to give you the opportunity to actually share about a time you really felt accomplished, and knew you were making a difference with a student, especially in that transition age. Dr. Liz Abadiotakis 44:11 Oh, boy, you're definitely Yeah, I think when I was able to see my students out there in the community, I know it's a different world right now. But seeing them succeed, interacting, you know, with peers, interacting with community members, I'm one of the most fun activities that we used to do is, you know, go to the mall to go shopping at holiday time. And just to allow, you know, just to step back and watch them make their own purchase, after we had practiced in class and we, you know, we reviewed all the steps and, you know, we've done all the mock situations, but to see them actually they're doing it and to see them honestly, you know, kind of referencing you vision Really, I mean, like, are you really gonna let me do this Are you really gonna just let this happen, um, and us kind of giving that reassuring look from you know, far away and then kind of completing that task, it's just, that's what makes me smile to seeing them get gained that confidence, because we've trusted that they can succeed. Jayson Davies 45:19 Yeah, I completely agree with you just going on those outings and being able to see what they really can do. Because, yeah, on the campus, you don't get to see that I mean, everything is often sheltered. And so we don't get to see that one of my favorite, one of my favorite memories is actually a kid that we had. And he was in the life skills class, but he was one of the higher functioning kids in there. And he was participating in baseball after school, he wasn't actually on the field, particularly playing, but he would go to practices, he would interact there, and he would get to go to the games and kind of hang out with the guys. But this particular instance, we were actually just out on the quad. I mean, a lot of times that life skills classes, typically kind of to themselves, but every now and then they allow some of the kids who can go out into the quad, and he was trying to figure out that high school social skills aspect. And we're doing that exact same thing, it would be me and maybe the speech therapist, and we'd be out there and just kind of, you know, standing back and watching him, like making the decisions that he makes, you know, there was a particular girl that he was interested in and kind of working on, alright, well, what's too much, you know, what, what is allowed what's appropriate at school versus what's not appropriate school, things like that. And at times, you know, I didn't think about it till just now, like, at times, we were actually working with also the general education students a little bit, to almost kind of teach them how to be appropriate around some of these kids who, who they learn a lot, they look up to the general education, students. And so teaching them about, you know, how things that you do with your general education peer might not necessarily be appropriate, with a special education here. Dr. Liz Abadiotakis 47:07 Yeah, and also allowing the kiddos to see that they, students that have different abilities can also succeed and be independent, and not to just automatically move to help them. Because, you know, I think that that's a lot of times what we'll see too, when we do those integrated, you know, activities is that they want to help their peer instead of, you know, kind of looking to see what their peer has to offer just interacting in a, you know, more typical way. And so, you know, they have to get comfortable. And that's, you know, part of the reason why it's good for them to be integrated. Jayson Davies 47:42 Yeah. I have a question. Actually, again, just popping up with questions. Now, when you go on those off campus trips, community outings? Did you ever have to explain yourself going on those community outings to an admin as to why it's important that you go on those outings? Have you ever had to do that? Or where you're Where was your administration? Were they pretty understanding of that? Dr. Liz Abadiotakis 48:06 No, I, my administration, I've been very lucky, you know, myself and the other therapists, we had really strong spatial therapists that knew about transition that were invested in, in transition we had, we played a very large role in developing the life skills, essentially program, which is what we were calling it from kind of as the students moved up, we were smaller districts. So as the need grew, you know, the program grew. And we were played an integral role in that. And when we're talking about community outings, I just want to mention, we're talking about there's two different kinds, we're talking about community based instruction, and then work based instruction or structured learning experiences. So those are two separate things, and really large components of transition programming that need to be happening for that generalization to occur. Yeah, but yeah, I know that that is a concern. I think that looking at what is your administration wanting from you? What is their bottom line? Is it you know, funding? Is it numbers or mandates, you know, know what the districts and the administration's bottom line is, so that you can justify why how are you meeting their needs, you know, it's not going to cost them anything additional. And also, you're hitting your mandates as needed. Jayson Davies 49:23 I really like how you put that because oftentimes, you know, we try to make our point. But our point that we're trying to make, our administrators just don't care about. And so you really do need to find out, what is that? What are what are the admin focusing on? What is their goals for the year? What are they really trying to focus on so that you can speak to what they're listening to so great. All right. Well, we'll go ahead and wrap this up. What other recommendations would you provide if anyone has a burning desire to find out more about transition planning or resources, you have any recommendations that they started with? Dr. Liz Abadiotakis 49:59 Sure. Of course, can I can I say my webinar. So I have a webinar, it's a two hour webinar on summit educational up summit Professional Education website, they have webinars that you can buy individually. Or if you're already an all access member, then you can certainly listen to that whenever you wanted to it was I already did it live in January. And so there's a recording already. And that's a good place to start. But of course, It has so many resources. And that's really a really good place to start. If you are feeling like you need more support in this area, though, I would reach out to your state association. As well as a OT, I know a AOTA. I'm a member of their community of practice on transition. But I'm also I work for an NGO ta New Jersey Occupational Therapy Association. I'm the secretary. And I also am the moderator of our community of practice, which I just helped to initiate that back in the fall, because we needed a lot of support considering what was going on in the world. And so if you can get involved in your state and ask for a resource, a mentor, somebody that can kind of just answer your how to questions, that's a great place to start if you don't want to go big. Jayson Davies 51:18 Great. Well, thank you for that. And then last question is Where can people learn more about you if they're interested? Dr. Liz Abadiotakis 51:23 Sure, you can go to DrLiztheOT.com where you can see my social media there, and all my other fun projects. Jayson Davies 51:30 And we will be sure to link all of this all the resources that Liz talked about today will be at the show notes. So be sure to check those out. To get easy access to all the different things that she talked about even the webinar and our website. And if I can get her social medias on there, I totally will. So check that out. But yeah, do you have any other last words that you wanted to share? Dr. Liz Abadiotakis 51:52 Just make sure it's fun. Think about what you like to do, and make it fun. Jayson Davies 51:57 Great. Well, thank you so much for joining us on the show today. I really appreciate you being here. Again, so many OTs have come to me with what do I do in high school and middle school. So this is gonna be great. I hope everyone learned so much from you today. Dr. Liz Abadiotakis 52:10 Thanks so much for having me. Jayson Davies 52:11 Great. Take care. Alright, and that wraps up today's episode. Thank you one more time to Dr. Liz for coming on the show sharing so much about post secondary transition planning. I hope you all really appreciated that. If you're in the elementary schools, maybe you don't work with this as much. But if you're in the high schools, you know exactly what this is about. And if you've had any experiences like me, there's very little ot incorporation into that transition plan. So hopefully you can now take the knowledge you have and get in there and help with that program. Also, don't forget to check out the show notes for all the links that Dr. Liz did mention. You can get those at ot schoolhouse comm forward slash Episode 66 or in the description right below in your podcast player. All right, well take care everyone. Thank you so much for listening today, and we'll see you next time. Bye. Amazing Narrator 53:03 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, thank you for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to earn 10+ hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 65 of the OT School House Podcast. In episode 65, we are having a discussion about a recent journal article that looks at school-based occupational therapists' role and capabilities in implementing a mental health tier 1 MTSS intervention. Today's article is titled The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study. This journal comes from the American Journal of occupational therapy and it was published in 2018. The research study itself occurred in 2014, and 2015, The Authors are Susan Bazyk. Luis Demirjian, Francis Horvath, and Laurie Doxsey. Links to Show References: Susan Bazyk, Louise Demirjian, Frances Horvath, Lauri Doxsey; The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study. Am J Occup Ther 2018;72(3):7203205050. Every Moment Counts Website Transcript Download the Transcript or read the episode below! Jayson Davies 00:00 Hey there, everyone. Welcome to Episode 65 of the OT School House podcast. We are doing things a little bit different today. No guests, just you and me. And a journal article straight from the American Journal of Occupational Therapy, we are going to be looking at the article titled The comfortable cafeteria program for promoting student participation and enjoyment and outcome study. And, as you likely know, I am a huge advocate for RTI and MTS s in the schools, especially when it comes to OT helping out OTs with that process. And so I'm going to share with you a little bit more exactly why we're looking at this article after the break. But first, I want to highlight the primary author of this article, Dr. Susan Bazyk. Dr. Susan Bazyk is an occupational therapist and Fellow of the American Occupational Therapy Association. She is professor emeritus of the Occupational Therapy Program at Cleveland State University where she taught for 34 years. She is the project director of every moment counts, which was launched in 2012. And the main topic of today's journal article, this multi pronged mental health promotion initiative focuses on helping all children and youth participate successfully throughout the day and academic and non academic settings. Her current efforts focus on building capacity of OT practitioners and interdisciplinary teams to do this work. longtime listeners of the OT School House podcast may recognize her from Episode 36 of the OT School House podcast when we highlighted every moment counts and the comfortable cafeteria program which we are going to dive into. Jayson Davies 01:43 Although Dr. Bazyk won't be joining us today to talk about this article, I am proud to announce that she will be speaking at the OT School House back to school conference later in August. And to learn more about this conference you can head over to OT School House.com forward slash back to school. And in case your hands and eyes are a little preoccupied right now let me share with you a little description about what she will be presenting. Jayson Davies 02:09 Dr. Bazyk knows the small moments make a big difference in how children feel and function in school. Research confirms that positive interactions and experiences such as enjoying lunch, having fun during recess. These help children feel positive and connected to school. Every moment counts as a mental health promotion initiative developed to help all children and youth become mentally healthy in order to succeed in school, at home and in the community. Participants aka you and me will learn about a multi tiered public health approach to mental health involving promotion, prevention and intervention and be introduced to every moment counts occupation based programs, not just the one we're talking about today. Comfortable cafeteria, not just the one we're talking about today, the comfortable cafeteria, but also refreshing recess, calm moment cards and making leisure matter. Jayson Davies 03:03 And while she's been on the podcast before to talk about some of those programs, I am excited to sit there and watch her present all of her knowledge that she has and how she focuses on knowledge translation to help kids throughout all school programs. If you'd like to hear from Dr. Bazyk as well at the back to school conference, be sure to head over to OT School House.com forward slash back to school to reserve your spot. Now stick with me just a moment as I cue the intro and we'll be right back to discuss the journal article. Amazing Narrator 03:34 Hello and welcome to the OT School House podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here is your host Jayson Davies. Class is officially in session. Jayson Davies 03:51 Hello and welcome back everyone. I hope that intro just put a little pep in your step I know some of you probably haven't memorized and some of you we probably even kind of novel long as she introduces myself and the podcast. I know I can't listen to it without kind of getting a little happy and and just doing that. So welcome back to Episode 65 of the OT school health podcast. Man that number is getting bigger. I can't believe it's been 65 episodes now but I'm excited to be here with you today we're doing a journal article which is a little different haven't done a journal article in a bit but I'm excited for it. I know many of you don't have the time to read articles. As much as you may or may not want to. I know you don't have the time to so I'm here to help you out with that. Again, this is an article with the primary author as Susan Bazyk, Dr. Susan Bazyk and I'm excited to share this with you so I'm not gonna really waste your time any longer. Let's go ahead and dive into it. Jayson Davies 04:47 Today's article is titled The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study. This journal comes from the American Journal of occupational therapy and it was published in 2018. Jayson Davies 05:00 Although the actual research study itself occurred in 2014, and 2015, the authors, there are four of them, are Susan Bazyk. Luis Demirjian, Francis Horvath, and Laurie Doxsey. Susan Bazyk, who I mentioned earlier is the program director at every moment counts. Louise is an occupational therapy consultant at every moment counts. And Francis and Laurie are both school based occupational therapist in the state of Ohio. Jayson Davies 05:28 Now, the reason we are looking at this article and having a discussion about this particular article is because I get so many questions from everyone on social media, in my email about how to move on from your typical fine motor and sensory based programs at ot. So many of you want to help more students. So many of you want to really see kids in the natural environment, as opposed to working with them, one on one in the OT room, the OT hallway, or whatever that might be. And so that's why we are talking about this article today. And what I want to bring to the forefront of your brain as we talk about this today is something you already know and I'm just going to, like I said bring it to the forefront of your brain is that mental health and wellness is such an area of demand right now, whether it's in an application, that was the push of a button promises to make you happier for five minutes every day, or accessing a therapist online, via again, a push of a button with mental health and wellness coming to the forefront of everyone's brains. So is it also coming to the forefront of schools. And that's what leads us to today's article as using occupations as a way to promote mental health, specifically in the natural context. And that brings us to this specific article. Before I jump into the methodologies and the outcomes of the article, I do want to briefly discuss some of the research that they found while completing their own project. And here's a few snippets of that. They found that research shows that when students enjoy lunch or when they have good friend and then when they perceive school personnel as supportive and caring for the students then more feel more connected to school. This connectedness in turn, enhances classroom engagement, academic performance, and school completion rates. That was found in an article by bloom in 2005. The authors also make a point that past research has shown that a positive cafeteria atmosphere results in children eating more of their lunch, which is great for growing kids, right. And they also have fewer behavioral problems. And it also so happens that the cafeteria is an important location for students to develop adaptive strategies for physical health and social interaction. It is a time for them to relax and take a break and socialize with their peers before returning back to their classroom. Now for students who are primarily in a special education class and have limited access to the general education classes, this is also their primary time to interact and learn from their typical developing peers. Along with recess, lunch is sometimes the only time that they have to spend with kids outside of their classroom. And the last key point that I want to bring to your attention is that at lunchtime, there is a very large discrepancy between the amount of adults to the amount of children that are in one place at a time. Typically, in a classroom, you have maybe a one to 30 ratio. Well, they found that a majority of the schools had closer to a one to 50 ratio inside of the cafeteria, so maybe one to 52 to 100, or potentially 350 kids at a time. Alright, so now let's talk about the goals that the research team had. Overall, they wanted to measure the outcomes of the comfortable cafeteria program, I'll get more into what that program Jayson Davies 08:50 looks like in just a moment. But these goals, they had three specific goals, where they wanted to measure the outcomes for both the students as well as the supervisors, and then also the therapist. So there are three goals. Let me read them here for you. First, does participation in the comfortable cafeteria program affects student perceptions of participation and enjoyment of lunchtime? Number two, does participation in the program resulting cafeteria supervisors enhanced knowledge of and perceived ability to be effective in the cafeteria? And three, what is occupational therapists overall assessment of the comfortable cafeteria program after implementation? So in order to measure that they had three different groups of participants, they had the students who were 366 in total that actually took the pre and post test. They had 18 cafeteria supervisors and for Midwestern school based occupational therapist who had been trained in every moment counts building capacity initiative. So now we get to the good part. What did they actually do? What did the therapist do? Jayson Davies 10:00 What did the supervisors do all of that? Well, I'm gonna kind of spoil the surprise right now first, you can get this entire program the cafeteria, comfortable cafeteria program at every moment. counts.org 100% free, Sue Bazyk, the director at every moment counts has it up on her website 100% free and you can get it, you can learn all about it. In synopsis, this is a six week program, in which the Occupational Therapist supports the entire school team, really, the Occupational Therapist provides education to the cafeteria supervisors as well as other relevant stakeholders. So maybe there's some parent volunteers, maybe the administrators need to kind of know what's going on. Right. So the OT provides that training, then the OT also provides a weekly embedded activities to address the weekly theme. It's a six week program, six weekly themes, though T goes in during lunchtime to do that. And then the final part of the program is kind of the maintenance part of the program. And that is when the Occupational Therapist continues to provide ongoing coaching of supervisors such as modeling positive social interactions and offering additional activities that the supervisors can then implement in the cafeteria. Without the occupational therapist. I know you want to know what those six themes are. So I went ahead and went over to every moment counts.org click on the comfortable cafeteria program. And I can tell you right now I'm just looking at the website. Those six week themes are week one kickoff, friendship, conversations, including others sensory input and healthy foods. Those are your six weekly themes. So after you are done with those six weekly themes, then you continue to work with the lunchtime supervisors on you know, an as needed basis to provide them ongoing support. Jayson Davies 11:51 Now that you know a little bit about the actual program, let's look at the assessments that they used. Quantitative data was taken one week prior in a pretest. And one week after the program post test for both the students and the supervisors. In addition, they also got some qualitative data through a group session with the students and a few of the supervisors. For the students, they use what is called a visual analog scale, I had never heard of this. But what it is is basically a small piece of paper exactly 100 millimeters in length. And when they asked the student a question, they would mark were on that paper they feel in that paper would kind of be like a Likert scale and might have some happy faces on it or something. But instead of picking only one of four options, the student can make a tick mark anywhere along the paper. So if they wanted to say they were kind of between, you know, two faces, they could do that. And then what would happen is the, the reader would then have to measure from the left side of the paper, how many millimeters from the left side of the paper, they made that mark, and that is the score. So it could be somewhere between one and 100. Because the paper is exactly 100 millimeters in length. The four questions that they asked of the students was, how much did you enjoy time at lunch? how friendly are the lunch supervisors? how friendly are the students at lunch? And how much did you enjoy conversations during lunch? I want to point something out here really quickly. Because that first question, how much did you enjoy time at lunch? They use that response to categorize students into either low enjoyers, medium enjoyers or high enjoyers. If I remember, right, it was if they marked a 25 or lower, they were considered low enjoyers 25 to 75, medium enjoyers 75 or above would be high enjoyers. Remember that because we're going to use that when we get to our results. For the supervisors. They used a 12 item five point Likert scale. That's pretty straightforward. We'll talk about the results in a little bit. And I already mentioned the qualitative part where they asked students and supervisors a few questions. They asked the students, what did you learn from the cafeteria program in a group setting? And the supervisors they asked what did you think about and learn from the comfortable cafeteria program? The occupational therapist, the four of them, were then asked to type a written reflection on for open ended questions after the program. Those four questions were what are the overall strengths of the program? What are the limitations of the program? How did the students respond to the program? And how did the supervisors respond to the program? So let's go ahead and talk about the results. Obviously, I would not be sharing this article if there weren't some great results. So let's start by talking about the students first. Remember how I had told you about how students were either grouped into low enjoyers, mid enjoyers or high enjoyers? Well, it turns out that both low enjoyers and mid enjoyers have lunch Each made statistically significant improvement on all four of the survey questions for the kids. In fact, the low enjoyers of lunch went from an average score of about five to seven on that 100 point scale, all the way up 48 points to around a 50. Like That is insane. From a five to seven, they went up, actually, it was 48 points in the post test to enjoin lunch at a rate of let's call it about 55 to 60, as opposed to five to seven in the pretest. Jayson Davies 15:38 pretest scores for the mid enjoyers hovered around the midpoint 53 during the pretest. And it went up 13 points on average to 66 in the post test, so both low and mid enjoyers are both made statistically improved are both made statistically significant increase in the amount of enjoyment that they experience from lunch after the program. No statistical improvement could be identified for high enjoyers. But that makes sense. Because if you're already above a 75, there's only so many points that you're probably going to move upward. So there wasn't any significant improvement in scores for those high enjoyers for that population. However, at the same time, there wasn't like a mass. I no longer enjoy lunchtime scores either. So there wasn't any improvement or regression and how much those high enjoyers enjoyed lunchtime. Now let's talk about the supervisors. There were three main findings when it came to the supervisors. The first is that lunchtime supervisors reported increased knowledge, skills and resources needed to supervise the kids at lunchtime. And that is great to hear, right, we want to help everyone we want it to be a win win win situation for the OT, the lunchtime supervisors as well as the kids. Next data also revealed statistically significant improvement from the pretest to the post test on items related to the supervisors ability to encourage healthy eating. So now we have the supervisors helping kids in the physical realm physical health, by encouraging them to eat healthy. And finally, supervisors better understood how to promote positive behavior and resolve conflicts in the lunchroom. How amazing is that? They feel better, they feel like they have the skills they need. And they're promoting healthy eating. And they better understand how to promote positive behavior and resolve conflicts in their realm. And finally, we have the themes that emerged from the therapist reflections. Remember, this was not quantitative. This was qualitative. And there were a few takeaways from that let me share those students enjoyed and learned from the activities is how the therapist interpreted what they saw. And they also felt that supervisors were receptive to new information and demonstrated new skills. One therapist even noted that they felt the supervisor had a better understanding of sensory processing. If you remember, right, when I talked about the six weekly themes, there was one sensory processing week in there. So that is great that the supervisors were able to take that and then apply it to where they were seeing the kids in the cafeteria. And Jayson Davies 18:25 the final takeaway that I have here from the therapist is that the Occupational Therapist did simply enjoy implementing the program and developing relationships with students and cafeteria supervisors. And again, one noted that they love how it helped them to form relationships with cafeteria staff, and students not on their caseload. I don't want to jump too far ahead to my own conclusions. But I definitely know the people that I do not know on campus, when I'm walking around, tend to be some of the noon duty aides or the staff that I don't interact with. And so I don't know a lot of the people that are not teachers on campus, especially if they're not a special education teacher, or a special education paraprofessional. Same time, I don't know students that are not on my caseload, maybe if they're in another special education classroom that I go into frequently, but definitely not a general education kid that I never see ever. So that's great that the therapist felt better about knowing all students and the staff on campus. So the key takeaways that the author makes is that data suggests that this six week comfortable cafeteria program focused on enjoyable occupations may be effective in transforming negative student experiences into positive ones. Those promoting feelings of emotional well being and developing a positive school climate. There's a key word against school climate and I know that is a topic of interest for educators, not something that comes up very often and in relationship to occupational therapy, but that is a key term for your administrators. That is something that if you mentioned It might get them listening to you. All right. So school climate keep that word in mind. This was especially true for the students who had initially said, they did not enjoy lunchtime. And then after the program, we're now moving up into that mid enjoyer, as opposed to low enjoy or for lunch. So six week program, some training, going in once a week to do a fun activity. And now, all those low, I shouldn't say all, but a lot of those low enjoyers have now moved into an area where they are enjoying lunch a little bit more. And what does that mean? Obviously, they didn't really look at, you know, do you have more friends or whatnot. But hopefully that does correlate, right. If kids are enjoying lunchtime, they're, they're probably enjoying lunchtime because they're more interactive with other children and more interactive with the supervisors in the lunchroom. So that is all great to hear. The main limitation of this study pointed out by the authors was that this is not an optimal control study, there wasn't an a group and a B group and going back and forth, to really study that. But this was a small study, and the qualitative data is still very valuable. Maybe now they can move forward with more of a quantitative larger study where they can look at this site compared to this site where the program is implemented. So hopefully, there is so much more going on. And who knows, maybe in a year from now, we will be looking at another article that has to do with the comfortable cafeteria program, and how it was a very large quantitative study within a and b cohorts. It'll be phenomenal. I can't wait for that. So my personal takeaways from all of this first, the biggest one, it is possible for OTS to complete tiered interventions within a whole school population. This is basically the definition of a tier one intervention right here, you are going in and helping the mass the large amount of kids with not that much time you're doing training, and spending a small amount of time making sure that a majority of the school has access to meaningful occupations that improve their educational outcomes. For those of you who would like to be more ingrained into the RTI or the MTS s program, I think this is definitely an article that you should have in your folder that you can show to your administrators and say, hey, look, occupational therapy can be embedded into an RTI program. And look, it even talks about school culture. This is how we can improve your school culture. Let me help you let me help the lunchtime supervisors Let me help the students I want to be a part of this school program. As I was reading this article, there was one thing that I almost wished was part of it. And that was looking at the general education population versus the special education population, and also how they co-mingled during this program, I would have loved to see how the two populations that are so often separated both physically and socially, if this program could bring them together to interact more, Jayson Davies 23:11 not only to see if it helps students in the special education classroom to develop some skills to interact with the general education peers, but also vice versa. Did it help the students who are in general education for most of the day, learn compassion and learn understanding and how to work with students and how to be friends with students who are in a classroom that's different from theirs. I would love to see something like that. If any of you are out there working on a doctoral project or your Capstone, whatever that might be, feel free to take that idea and run with it. I would love to see a project and some research about a program that really integrates the special education population with with the general education population using meaningful occupations, that would be fantastic. Be sure to send me an email when you do that. And with that, I'm going to go ahead and wrap up this discussion on the comfortable cafeteria program for promoting student participation and enjoyment and outcome study. This is again, it was a 2018 study in the American Journal of occupational therapy, be sure to check out the entire article if you would like to learn more, or check out the show notes where I will have links to both the article as well as the website that I mentioned earlier, every moment counts.org. Jayson Davies 24:31 Also, be sure to check out the back to school conference that's going to be happening in August, where the author of this study Susan Bazyk is actually going to be presenting. And you can guarantee this is part of what she will be talking about. She is all about the power of knowledge translation, which is basically the idea that we need to collaborate and so she is going to be brilliant when she speaks in August. I can't wait to have her speak, to hear her speak and to have all of you in awe as you listen to her it's going to be awesome. Check it out OT schoolhouse comm forward slash back to school is where you will find all the details. Be sure to register early because there is an early bird registration. Alright, so until next time, take care and have a great day. Bye bye. Amazing Narrator 25:17 Thank you for listening to the OT School House 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

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

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

This time last year, the OT School House did not exist. It was still an idea brewing within conversations between Abby and I. We knew that we wanted to start a blog and we had an idea to start a podcast, but other than that, we had no idea how to get started. We began to meet at Starbucks every Tuesday night and research how to build a website and what the cost would be as we knew we would not be making money off the blog anytime soon. We also looked into creating social media accounts which included taking pictures and videos we could share for the world to see. After all, what OT doesn't love to follow other OTs on Instagram and Facebook to see what free and inexpensive ideas they can use. But before we started posting pictures onto social media, we knew we had to be careful about what we posted. Not only pictures but also the content we shared, whether it be our own, or another's popular post. The thing about having a website and media accounts that people follow closely is that you put yourself out on the line. Just like almost every other OT out there, Abby and I are both nationally certified via NBCOT and licensed in the state of California. And as I am sure you are aware of, your state's practice act not only governs the skilled treatment you provide but also how you conduct yourself. So naturally, as much as we wanted to build the OT School House, we also wanted to make sure that we were not putting our credentials at risk. So we made sure to look at the California practice act along with NBCOT, HIPAA, and FERPA regulations since we work in public schools. Through that process, this is what we have found that we thought you may be interested in knowing. NBCOT: Practice Standards The NBCOT Practice Standards consists of 4 sections including 1) Practice Domains, 2) Code of Professional Conduct, 3) Supervision, and 4) Documentation. We will dive into the Code of Conduct in just a second, but for school-based OTs I want to provide a quote from the standards here just in case you haven't revisited the NBCOT standards in awhile: "The IDEA requires occupational therapists to: 1. Write a report of the evaluation the OT conducted; 2. Provide information and recommendations for students’ Individualized Education Program (IEP) plans; 3. Write service plans for students, considering: disability, medical diagnosis, contraindications to therapy; 4. Help develop IEP goals and determine equipment and personnel/ assistance needed to meet therapy goals; 5. Prepare periodic status reports; and 6. Write a report when students discontinue therapy. The law does not specify how long therapists must keep documentation. The OTR or COTA should discuss the documentation retention policy of their supervisor or employer." This, as you can see, breaks down the required documentation for school-based OTs. It's amazing what you find when you are looking for something completely different. I underlined "Help develop IEP goals" because I think this proves that goals should be collaborative and not just "OT goals" NBCOT: Code Of Conduct NBCOT's code of conduct incorporates 9 principles that are completely understandable and justified. Principles such as not practicing while intoxicated and following state laws headline the code. Also included though is principle number 1 which states that we will provide accurate and timely information to NBCOT such as our certification registration every 3 years. For the purpose of the OT School House, principle 8 was the one that popped out to me the most. Principle 8 states: "Certificants shall not electronically post personal health information or anything, including photos, that may reveal a patient’s/client’s identity or personal or therapeutic relationship." This, of course, was important because we knew we would be posting social media images. And this principle follows HIPAA guidelines in stating that we may not post identifying pictures. So next we looked at NBCOTs Practice Standards. California Practice Act State Occupational Therapy Practice Act Now we couldn't go through every state's practice act for obvious reasons, but the California Practice Act is pretty thorough and is the one we must abide by. Although I won't go into detail because it is state specific, some key points shared in the practice act include: - Ethical Guidelines -Legal state definitions of "OT" "occupational therapist" "occupational therapy assistant" and more. -Disciplinary actions should the board feel that ethical guidelines or other areas have been abused. -Service delivery standards -Supervision standards. Be sure to look up your state's practice act every now and then to update yourself on the happenings of OT in your state. In California, ours was amended just last month thanks to OTAC and several other key players. HIPAA (Health Insurance Portability and Accountability Act of 1996) Now, I'm sure just about every OT, if not every OT, has taken a workplace course on HIPAA. It tends to be one of those yearly online trainings that we all must take as a way to protect the school district, hospital, or wherever else from liability should protected information be released without consent. In a nutshell, HIPAA exists to protect our clients' identity being connected with any one of the following related to that patient: - a past, present or future physical or mental health or condition, - the provision of health care to the individual, or - the past, present, or future payment for the provision of health care to the individual, This is directly related to the OT School House in the sense that you will not hear us on the podcast use a students name. If we use a name, you can rest assured that it is a pseudonym. It is too easy for someone listening to find out what schools I work at for me to even risk using a real name of a student. Likewise, you will not find any pictures on our website or social media pages that identify a student that we work with for the same reason. And that brings us to... FERPA (Family Educational Rights and Privacy Act) Not all OTs are required to follow FERPA guidelines. This is specific to OTs and OTAs that work in public school systems and are required to protect student educational records. Where HIPAA prohibits OTs from sharing medical information on a student, FERPA prohibits the sharing of educational related material such as if a student is receiving special education services. Some information, known as directory information (such as a student's name, grade, and phone number) can be shared for specified reasons such as use in a yearbook or when a district contracts with a photographer for class photos. With that said, at the individual level, we should not be sharing this information with just anyone. Educational records can be maintained in any form, print, picture, audio, etc. So just about any form of documentation collected by an educational agency or representative of that agency that relates specifically to that child can be deemed as an educational record. To me, FERPA is not as straightforward as HIPAA and I wish I better understood FERPA as it relates to special education. The way I try to follow FERPA as best I can is by following HIPAA guidelines for all educational information as I already do related to medical information. Conclusions on our findings As I said, the reason we set to look up all of this information is because we wanted to make sure we were not posting written, pictorial, or video information that would harm our students, you readers, or put ourselves at jeopardy. I forgot to mention earlier, but you should also check your employee handbook to see what your district policies are for posting pictures of work related material on your personal social media platforms. This goes for any type of sharing or social media, be it at a conference, on Reddit, facebook pages or even "closed" groups, or Instagram (This is where I get the most worried by what I am seeing). Through this process, we realized that if we followed HIPAA guidelines across the board in regards to sharing information, we (and you) should be okay. Of course, I am not a lawyer and I want to warn you that my limited research does not make me an expert in any of these guidelines. If you are worried that what you are posting or seeing on social media, you may want to reach out to your state's licensing board for more clarification. So here is our list of 5 guidelines when it comes to posting on social media. 1. Do not use names! Neither student's name nor adult's names should be used to protect identity. You could get permission to use an adult's name, but I just try to stay clear of it. 2. No names, date of births, ID numbers, the name of a school, or any other identifiable info should be in your post. 3. No faces in pictures! We opt to go further and only take pictures of work samples. 4. Do not state what services a student may receive or for what condition. 5. Give credit when reposting. This one is not in the guidelines, but we hope it would be common sense. Whether sharing one of our photos or someone else's, please give them credit.

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