Search Results

This evening, I did something that a year ago I never would have imagined. Below is a replay of a Live Facebook Webinar that Jason Gonzales of DoubleTimeDocs.com (Affiliate Link) and I conducted on the OT School House Facebook page. In this 60+ minutes webinar, Jason and I reviewed some of the regulations and guidelines that we should all keep in mind when writing evaluations. Jason also provides some data he has collected on how long the average assessment takes and together we offer some solutions to help decrease the time it takes for you to complete your evaluations. So please, feel free to watch the video. Also check out Jason's website DoubleTimeDocs.com to learn more about how to simplify and cut down your writing time. Be sure to get your free 7 day trial and use promo code FALL18 to get 20% your order for a limited time. Quick note: If your school/site has Facebook blocked, this video may not work. But don't worry, this video will still be here later tonight while you enjoy your bottle... I mean, glass of wine. Cheers! Enjoy the video! On a mobile device? Watch the video on Facebook!

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

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

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

Hey there everyone! Between working to startup the podcast and trying to stay up to date at the school sites, we fell slightly behind on this blog post. But we’re here and the world has not come to an abrupt stop. Thank goodness. Despite not having a theme for April, this Month of OT has turned into a month of posts related to productivity and organization for OTs here, so we are going to run with it. Last week, Abby posted a great post titled “Ten Time Management Tips for the Busy School-Based OT” and this week I want to follow that up with a few more specific tips and one useful document for all of you that either travel to multiple school sites or work with multiple therapists at several school sites. Let’s jump into the first set of tips! “Prioritize your time” This one is straight from Abby’s post last week, but it’s so important that I felt it necessary to reemphasize. Being a school-based therapist is hard enough at one school, but having to deal with 2, 3, or even more school sites is just ridiculous. Most school seem to have a six and a half hour day. However, between lunch, recess, and other daily activities it can sometimes seem like the kids are hardly there at all. And it's true, you really don’t have that much time in a day to see the students. It's absolutely imperative that you know the school schedules and organize your time to take advantage of it. Here are a few quick tips to take advantage of the school schedules: See older students when the younger ones are at lunch and vice versa. Start at an early start school and end at a later start school. Drive between schools during the time when most students are at lunch. (And don’t forget to eat your lunch - likely while driving...) Make sure you have a schedule and directory for each school. Don't forget to reference to it when setting up your schedule. A school map may even be helpful at the beginning of the year. Get on each schools' email list so that you know when fire drills or other drills may occur. That way you can plan around it and even potentially be at another school site when it occurs. Going to a school site just to see one student? Call the secretary or check the web (if you have access) to see if they are even there. Check In, Check Out I got a flashback just now to Mr. Miyagi from the Karate kid while writing that. But really, This has not happened to me (and I hope it never happens to you either), but I have heard stories about therapists getting accused of not being where they were supposed to be during work hours. Being a therapist that travels between sites comes with some extra responsibility. Many people in the district trust that you are where you are supposed to be and most do not check in unless they have a reason to. You definitely do not want to put yourself in a situation where your supervisor feels they need to check in on you. Plus, it just makes all of us look bad. So please, be where you're supposed to be. With that said, be sure to check in and out of school sites. That way if anyone did feel the need to check in on you, you can prove you were at least somewhere in the district. You can’t simply rely on a teacher or secretary vouching for you. Some schools have a related service sign-in book in the front office and others have a sign-in/out for each student being seen in the classroom. Whatever the rules are, know that they are there for both you and the students' best interests. If you want a little extra security, you can even set your phone up to track when you arrive and depart from somewhere and have it logged in a google doc using the IFTTT app. This can be a little tricky to set up, but if you’d like to know more about this, email me and I will try to help you out. Caseload Management One of the hardest parts for any therapist can be keeping up to date on what kids are at what school, what do their services look like, and when are all of their meetings due. In a perfect world, the case carrier keeps you informed on much of this, but we don’t always live in a perfect world so we have to keep up our own records. Below is a screenshot from a document we would like to share with anyone who would like it. We use a very similar document uploaded to google docs so that we can access it from virtually anywhere. Then we try our best to update it right there during the IEP meeting. Although, quite frankly, it sometimes does not get updated until a pupil free day such as spring break. Not only does this document track the details of each student, but it also is used to track how many students the OT sees versus the COTA at any school site so that you can easily determine if one therapist has more or fewer students and/or weekly contact hours. The summary page of this document automatically imports data from the other “School site” pages and auto-populates to give you a summary of how many students receive different levels of service at each school site. It will also help you plan for extended school year and help when conducting a workload study to justify the need for an additional support. We have used a version of this spreadsheet for the past five years and it has really helped to keep our caseload organized year in and year out. I also make sure to save a copy of the document at the end of each school year to compare to other school years. If you think this file is something that would be useful to you and other providers at your school you can get it here by subscribing to our email list. We promise not to spam your email or sell your data. We just want to let you know when we have more great stuff for you to use. Traveling on a Schedule When I first began as an OT with multiple schools, I was almost fearful of traveling. Not the actual driving part, but the idea that I wasn’t seeing students. I felt as though I was wasting time. That was when I was only at 4 schools. Now I’m at 9! But the truth of the matter is that traveling is part of the job and we should treat it with the importance it demands. Travel takes time and if we don’t account for this time, we are bound to fall behind in our schedule. For this reason, be sure to schedule travel time into your day. Not just the time it takes to get from point A to point B, but also the time required to pack your things, check out, walk to your car, drive, check in at the new site (while saying a brief hello to the office staff) and finding/ getting set up in a room. This all takes time and is especially true for providers in rural districts as well as congested city districts where traffic can be bad. Real quick, this is also very important to track if you are in the process of, or wanting to, conduct a workload study. Workload studies are great and we are currently tracking data for our own study. We hope to bring that to you over the summer. One last thing on this topic to help you out, I promise. Be sure to track your mileage between school sites. You can either write it off on your taxes or have the district/contract agency reimburse you. In a rural area, this is well worth the time it takes to do. And That’s Just a Few There are so many other tips that could help a traveling school-based therapist and we hope to help you out with more in the future. Be sure to subscribe to our email list to get the spreadsheet from above as well as a few other free documents and stay in the know. Also check out the podcast for half-hour segments all about school-based OT. What tips do you have for our readers? Be sure to comment below so others can learn from them. Until next time, Jayson

As school-based occupational therapists, we face days that seem out of our control. Many times, I have felt my time was not my own. So, here are ten tips for busy school-based OTs who, like me, want to take back control of their time and get the most out of each school day. 1. Prioritize your time Establishing your priorities each day is probably the top tip I can give you. There will always be “fires” that pop up during the school day; however, prioritizing your day will help you to get more accomplished. I try to set time on Friday afternoons to set my priorities for the upcoming week. I tend to prioritize IEP meetings (these tend to be non-negotiable) and schedule around those meetings. Going through this list of meetings on Friday and then again briefly Monday morning helps to keep me on track. I also prefer to prioritize the most difficult phone calls and tasks for early in the morning and earlier in the week. This leads to less worry later and helps me feel accomplished. Feeling accomplished early in the day can build momentum for a better day or week. If you find that you are a worrier, try to get all difficult conversations and tasks completed early in the day/week versus procrastinating. It'll make the rest of the week so much better. 2. Learn to Say “No” This is a difficult one for me. I tend to say “yes” to everything. As OTs we want help with everything and everyone. However, there are times it may be better to say "No". I tend to think that if the quality of my work is going to suffer from saying "yes", then I should say "No" or "not yet". Your boss comes into the office and asks you to prepare an inservice or training for teachers on short notice. Do you automatically say “yes” and disregard the growing stack of assessments on your desk? Do you stop and talk to every teacher, parent, or principal who wants your opinion? I have been guilty of this and my time with students and evaluations has suffered because of it at times. If you're having difficulty with saying "No" that might be where your time is going. If someone stops you for a chat next time let them know you don't have time to talk, but that they can send you a quick email. Doing this often enough will help others value your time too and people will start emailing you versus stopping you whenever they see you. Others will not respect your time if you don't respect your own time. 3. Write a Daily To Do List Although the daily list of "To Dos" seems ongoing, write one anyway. Write one each day. Make sure that the things that are on your list are easily actionable and can be taken care of in as few steps as possible. If the task is too big to complete within a short time frame you may need to break it down into increments to be completed over multiple days so that your weekly priorities and monthly priorities can be completed. Think of your students who have difficulty with planning skills. When there is too much to complete in one short span of attention you will shut down and be more likely to not get it done. If you have that same item show up everyday or week to week, then it is time to break that down into short simple actionable steps you can complete in a day. Quick Example: Instead of adding "Assess Johnny" to your Monday's to do list, list out the steps that you can get done today in the time you have. This will help you see how much work you are really doing. Monday: Call Johnny's parents for student background Review student file Give questionnaire to teacher Observation The formal assessments and write up can hopefully wait until tuesday or another day when you've planned out your time. Click here for more on planning your assessments 4. Declutter your Workspace This is a never ending battle for me. The clutter builds and then I feel overwhelmed. Taking the time each week to “DeClutter” helps to keep my mind and desk clear to focus on the work that needs done first. Working in a cluttered environment can be time consuming as it is distracting and difficult to find the things you need. I also have noticed that when my time seems unmanageable, my workspace also begins to look unmanaged. Getting organized helps with the clarity I need for prioritizing, relieves anxiety, and increases my focus to get things done more quickly. 5. Keep a Daily Planner I like to keep a planner to write things down in. A simple planner helps me to keep track of all the little things that occur in one day. I write down quick notes such as teachers or parents I have talked to, students have worked with, meetings held, any missed visits, and priorities I have completed or need to complete. This way at the end of the day I can go back and look to see where my time has gone, what I’ve accomplished, and where and why I feel like I ran out of time. 6. Celebrate Wins Every Day I think this is key to reinforcing great time management! Keeping track of the little wins, as well as those things you are grateful for each day helps to keep your motivation going. When you see the hard work you’ve put in, you can get up and do it again the next day. And it doesn't always have to be your win. It could be a win your student had or a win a teacher had because of something you shared with them. Keeping track of your student wins or those things your grateful for at work will help you to keep a positive outlook and look for solutions particularly on days that are difficult. 7. Schedule Time for Paperwork Schedule time in the office for paperwork! Try to schedule this time on non-IEP meeting days if possible, and for a time of day you’re most productive. I am a morning person. So my paperwork time needs to be completed in the mornings because by the afternoon I am not as motivated or focused. Recognize what time of day you are most productive and do some paperwork during that time. Try hard to protect this time because record keeping is very important for school-based OTs. 8. Schedule Email Check/Response Times This is very important! It is a simple strategy to help you protect your time and helps with planning. I recommend checking email only two times a day during your work day. One time close to lunch and one time at the very end of your day. Check your email only after you have completed the most difficult tasks on your "To Do" list. This will help you to cut down on your distractions and keep you focused on the essential functions of your job. This is a difficult habit to get into if you’re anxious like I am. The worry I felt trying this technique initially was extremely uncomfortable; however the worry will subside the longer you practice this habit. Likewise, others will begin to change their expectations of you so that you can control your time. 9. Leave Your Phone in Your Bag Do this! Leave your phone in your bag during treatment and during meetings. I find this to be extremely difficult; however, checking your phone can become a distraction from the time you need to be spending with students, staff or completing documentation. Cultivating the awareness of the amount of times you check your phone during the day can be jaring when you look at how time consuming your phone can be. 10. Document as You Go, if Possible As much as you can, try to complete your notes as you work with the students/groups. I have begun taking my laptop into meetings in order to update treatment plans and update my COTA during the IEP meeting via email with what happened right in the moment. Documenting when things are fresh will lead you to more accurate record keeping and not allow notes to pile up for the end of the week. Hopefully these tips can help you feel more in control of your time. Do you do something different that helps you? Let me know what it is you do in order to keep your time yours during the school day and any tips or tricks you’ve found beneficial to your time management skills please include them in the comments below! Until next time! Abby

Hey there everyone, If you are a school-based OT or PT, please read this article to the end! This is important all who feel that they can do more for their school and/or district. If you are a teacher, administrator, parent, or any other stakeholder in special education, us service providers would greatly appreciate your support in this journey we are on by asking your legislators to support AB 2386. Please read on for more info on what that is. This past weekend, I had the opportunity to attend the Occupational Therapy Association of California (OTAC) annual Spring Symposium. I have been to several OTAC annual conferences, but this is the first symposium I have attended. It was much smaller - around 500 OTs, COTAs and OT students - and had a much more intimate feel between the luncheons and smaller total area to mingle within. One key vibe present all weekend long at the conference was the need for OTs to advocate for our profession. Not only at the state level, but also at the larger national level and the smaller individual organization level. This vibe that entranced the conference has lead me to share this with you all. The content in this article directly relates to each and every School-Based OT in California. It also indirectly relates to all School-Based OTs not in California as I know there are other states that are working on similar legislative actions or thinking about similar actions. What I am referring to is the School-Based OT and PT Credentialing Initiative, also known as Assembly Bill 2386, or AB 2386 for short. Over the recent years, OTAC has worked closely with California Assemblywoman, Blanca E. Rubio to introduce AB 2386. This bill, if passed, would slightly change the wording in the California education code (EdCode) to allow for OTs to obtain a "services credential" within public schools. Why do OTs need a service credential, you ask? Currently, in California, school districts employ OTs mostly to service student with special needs. There are some progressive districts out there that understand how beneficial OTs are too general education students as well and bring on more OTs to assist that population. However, many districts contract out for OT services from a non-public agency, such as The Stepping Stones Group. Others contract with a company like Presence Learning for online based OT services. California schools also currently have no idea how to classify OTs and PTs who work in the districts. In California, OTs and PTs may be hired on as a "Classified" staff member which puts them into the California School Employees Association (CSEA) union with almost all school employees other than teachers, SLPs, and administrators. Teachers are dubbed "Certificated" staff along with speech therapist, adapted PE teachers, and most program specialists. There are some districts that put OTs into this classification despite OTs not having a credential like teachers and SLPs do. The last most common classification of OTs and PTs hired by public schools here in California is under the "Classified Management" classification. This is what classification I am currently under in my district. The two reasons I have been told by people at my district why I am considered classified management are because 1) I don't have a teaching or other related credential and 2) the classified work/pay schedule doesn't make sense. So here's the kicker, for the first two years of working in my district, I was fine with being considered classified management. I even thought it was pretty cool to have the "management" part in there. BUT! I was stuck there! I began to enjoy facilitating IEPs (I know, I'm weird) and I became interested in program specialist and special education director/coordinator positions, but I lacked this little paper called a credential and was thus ineligible to even be considered for these positions The same is similar for nearly every school-based OT in California at this time. Despite have a similar amount of education, an OT or PT is ineligible to become - say a Special Education Director- no matter how much they know and understand about the special education system. Neither can we become a program specialist or coordinator who works on behalf of the Special Education Director. SLPs do have the option to apply for these positions because they must obtain a "Rehabilitative Services Credential" in order to work as a school-based SLP. Quick case example: Say your district wanted to create a special education coordinator of therapy services position and you were interested in this job as an OT or PT. In order to be eligible, you would first have to obtain a credential by going to school full time for 2 years including an unpaid internship. Then you would have to teach for 5 years in order to become eligible to go back to school for another year to get you Administration credential. Then, 8+ years and thousands of dollars later you could apply for that coordinator position. When AB 2386 is passed, we could essentially cut out 7 of those 8 years and the additional student loans. Not to mention, I think us OTs and PTs would make pretty darn good administrators in some of the aforementioned roles. We Need to ACT NOW! So, it is quite a big deal right now for school-based OTs and PTs here in California. OTs, PTs, and their respective California associations (OTAC & CPTA) are currently working to get this passed this year! SO WHAT'S THE HOLD UP? Two things, mostly. 1) We are not making a big enough splash in the ears of the people that have the decision-making powers (Legislators) So, now it's time to speak up if you think OTs should be credentialed within schools. Call or email your local representatives, you can find them here Once you are on their site, just click "contact" and shoot them an email. It's really simple. They may not get back to you, but someone in their office will mark down that a constituent wanted this to be passed. And every email adds up. (Not sure what to write? You can use my example below) Also, another group of legislators to contact are those on the Committee on Education. These are the legislators who will first hear AB 2386 and determine its future. Email them as well! Here is what I just sent to my Assemblyman. Feel free to copy and make it your own. Mr. Chen, I want to first say thank you for your service as part of a school board member and the Ca. Physical Therapy Board. My email today relates directly to both of these areas. My email today is in regards to AB 2386 which I hope you will support. AB2386 supports Occupational and Physical therapists being credentialed in public schools. I am a School-based Occupational Therapist that feels as though I am undervalued within the school system and I believe that I have much to offer that I cannot because I do not possess a credential. AB 2386 would change that and implement a system for which OTs and PTs would become credentialed similarly to Teachers and Speech pathologist in schools. As an OT, I attended 6 years of university schooling with many of the same core classes as a teacher, Speech Therapist, or school Psychologist, yet I do not have the same status as they do within a district. Occupational Therapists have played an instrumental role in developing today's special education and as a credentialed employee, we could do even more to support students with and without special needs. Thank you again for your openness to support OTs and PTs. If ever you should have any questions about an Occupational Therapists role within schools, you may contact me at any time. Best Wishes, Jayson Davies, M.A., OTR/L 2) The California School Employees Association (CSEA), the union that represents most non-teacher employees in the state is afraid of losing the dues a small minority of school-based OTs are paying as part of that union. To help alleviate this concern, reach out to your districts CSEA union reps and the local CSEA office and let them know how you feel about AB 2386. I have not yet reached out to my local CSEA office, but it is my intent to do so before the end of spring break. I hope you will too. It is especially important for you to reach out to them if you are not part of their union. Let them know that you would like to be credentialed and that it will have no effect on your partnership with them and the union members. Alright, well I have left you with some actionable step you can take right now, and they only take about 5 minutes. So please, if you have ever thought about the "What ifs" at work, help out and send an email or make a quick call. Thank you everyone for reading through this one. If you read all the way through, you are super awesome. Thanks again! -Jayson

Occupational therapists working within the school setting and environment receive a large amount of referrals for students due to poor or illegible handwriting. It is important for school-based occupational therapists to have a strong understanding of the complexities and processes involved in handwriting. Often times teachers and other personnel within the school assume poor handwriting is the result of fine motor, visual motor integration deficits, or an improper grasp. At times it can be any of those things; however there are often times that poor handwriting legibility is the result of multiple factors that can include attention, planning, organization, language deficits, visual processing difficulties, and/or a lack of handwriting instruction. So how do we address these other areas to improve our student's access to classroom work that requires handwriting? Anytime we are pulling students from their educational setting it is important to justify the need for the services and be sure we are supporting the child’s occupational performance in the least restrictive setting. We as occupational therapists need to be utilizing an evidence based approach when we recommend services or provide treatments for students. This means utilizing the most effective tools and efficient strategies to improve the student’s handwriting to meet the performance demands of the classroom. So, in an age of technology why is it that we are even focusing on handwriting as a skills necessary for classroom performance? Handwriting Without Tears conducted a survey in 2013 that indicated that anywhere from 23 to 58% of classroom tasks require handwriting in elementary grades K-5 indicated that handwriting is utilized frequently as a means for students to express their knowledge and convey meaning during their school day. Development of fine motor and visual motor integration skills can be refined through the occupation of handwriting. Handwriting instruction is essential as it is a necessary skill to have when participating in the classroom setting. The occupation of handwriting, it could be argued, is a form of "language". As handwriting skills develop writing becomes automatic and the student is able to express their ideas without much thought as to letter formations or even the spelling of words. Handwriting in school-age children becomes reinforcing for learning new information and is an essential component of literacy skills as often times reading and writing skills are linked. Handwriting helps to reinforce learned concepts and once habituated is the most efficient and effective tool for language expression apart from speaking. Handwriting skills are a valuable skill as an adult as well. We view good handwriting as a sign of intelligence Handwritten notes convey emotion and connection better than receiving a typed email. Writing notes can help with memorizing information or reinforcing learned information. One of the teachers I work with provides printed paper and stationary for students to write handwritten notes to each other on. This helps with communication as well as provides the students for expression maybe when they are unable to verbally communicate. Writing things by hand can allow the writer to slow down and analyze their emotions and thoughts. This is why when people journal it is often handwritten in a notebook. When we view another’s writing we are likely to make assumptions about their intelligence based on the style of writing, grammar, and spelling. Therefore, it is important for students to develop writing skills that reflect their ability level. When writing is impoverished in a student’s classroom performance in many areas. Self-esteem, behavior, and confidence can all be impacted by handwriting difficulties. Students may begin to avoid writing tasks, have difficulty attending, or act out when tasks that required handwriting are presented. It is important to address the root cause of handwriting if this is the case in order to help the student better function within the school setting. Handwriting difficulties may or may not stem from fine motor control difficulties. Some research has shown that the pencil grasp of a student may not even have an impact on the handwriting. At times it is processing, planning, and language difficulties that play a large role in the student's ability to perform classroom tasks that require handwriting. Think of those students who demonstrate functional fine motor skills but their handwriting is extremely poor. These students often times demonstrate difficulties related to executive functioning skills such as attention, planning, and organizational skills. Difficulties in executive functioning skills can greatly impact the legibility, fluidity, and speed of a child's handwriting. Once a child with or without poor handwriting becomes older handwriting legibility will decrease as the student is writing for composition and getting their ideas onto paper more so than having the focus of handwriting tasks be on the legibility or spelling of words. If the student has not had consistent handwriting instruction it is going to impact their handwriting legibility all the more and past grade 3 it becomes nearly impossible to impact handwriting legibility in most students regardless of their fine motor or visual motor integration skills. The instruction on a consistent program and practice develop the muscle memory early on in school (preK through 2nd grade) allows the student to develop functional speed and fluidity for writing. If handwriting instruction throughout these years is not implemented with fidelity and consistency students with difficulties in attention, planning, and organization will struggle all the more in performing the majority of classroom tasks as they get older as they have not developed the foundational skills. It is up to us as the occupational therapists to decide what is the best strategy for students with handwriting deficits to access the demands of school/classroom tasks. I often times do not receive referrals in time to correct poor handwriting habits and am force to come at addressing illegible writing in alternative ways. Recently I had inherited a student who had an academic IEP goal that he was having difficulty meeting. The goal was written by his classroom teacher and sounded something like this: Student will legibly write arguments to support claims with clear reasons and relevant evidence gathered from text in 4 out of 5 trials with 70% accuracy. Now I know this is not a measurable goal, but as I said I inherited this student. This goal has multiple layers and components. The students demonstrated difficulties with self-regulation, attention, and organizational difficulties. Motor skills were all functional and within the average range on the BOT-2. He had significant deficits in auditory processing as well as visual processing skills. His handwriting was illegible and he had a history of significant behavioral difficulties and anxiety related to school-environments. He had been in school inconsistently throughout his elementary age years therefore he never received consistent handwriting instruction. Parents main concern was his ability to read and write. His verbal ability was far more advance than his writing skills could convey. Parents were aggressively insistent that he improve his handwriting legibility. When I had him write the alphabet from memory he was able to legibly write each individual letter and perform near and far point copying with excellent legibility. He had little carryover of legibility when writing in classroom work or when writing from his own thoughts. How would you approach this case? Do you think his handwriting legibility could be improved? How? Would you begin keyboarding skills? Let me tell you how I addressed this. I first established a true baseline of this student's ability level when it came to overall writing skills with the classroom teacher. He was unable to form a sentence nor understand written sentence structure. He was able to speak in sentences and seemed to have a more complex understanding of ideas when he was able to express them verbally. He was also reading at a first grade level. I decided to not work on fine motor or visual motor integration skills as these appeared to be functional and average. I instead broke down the task of composing a paragraph on a topic via task analysis and introduced a linear (top to bottom and left to right) graphic organizer as well as a series of sentence frames and began to instruct the student on prewriting strategies. Once he was able to get his flood of ideas out without regard for grammar, spelling, or legibility he was able to then follow the graphic organizer and sentence frame to write sentences and a paragraph legibly onto college ruled paper with just a dotted line for letter placement legibly. It is important for occupational therapists to break down the classroom task being impacted by handwriting before jumping to motor skills, visual motor integration deficits or even sensory processing in order to understand what it is impacting the student's performance. Had I focused on self-regulation or visual motor integration/processing I would have missed that what was mostly impacting him was his ability to break down a writing task and complete each individual step. He there for would write limited ideas and phrases versus whole sentences. I believe over time the supports of sentence frames can be reduced and he will develop the independent use of graphic organizers to organize his ideas. Building capacity with him with tools and strategies for organization of ideas and collaborating with the teacher on ways to break down composition tasks to his independent ability level will give him the greatest therapeutic benefit from OT services and improve his handwriting legibility which was the main area of concern for teacher and parents. As occupational therapists we may get referrals for odd pencil grasps, poor penmanship, and difficulties with fine motor skills it is our job as the occupational therapists to look to the functional performance of the whole student. Next time you get that referral for extremely poor penmanship think outside the box. You might find that relying on those good old task analysis skills may be just the ticket! What ways are you helping your students with executive functioning skills and difficulties? What strategies have you found success with in the classroom? Please comment and share on Facebook or Twitter to keep the conversation going! Thanks for reading! Come back soon! Abby

When assessing children we are looking for areas of deficits and concern that are impacting the student’s classroom performance in order to demonstrate a need in order to provide services. Although it is important in order to establish areas of difficulty a student is experiencing it is also important that when we are assessing a student that we assess the student’s areas of strength. Taking a strengths-based approach with a student does not mean that we are ignoring or denying that a student may demonstrate areas of concern but instead are ensuring that we are focusing on the "whole-student". Recognizing students strengths can lead us to develop the "just right challenge" for our students. Working with students in the school setting to leverage their strengths and develop adaptive responses for their areas of concern can give students tools that they will not only utilize in schools but for a lifetime. This includes opportunities to develop self-confidence, advocate for themselves, and achieve self-awareness. As stated above, establishing strengths of our student populations allows us to develop the “just right challenge” that will foster growth in the deficit areas and/or an adaptive responses to those challenges. So how exactly do I promote a strengths based approach to my school-based occupational therapy practice? Well, it starts in the occupational therapy assessment report findings. I will admit that in today’s world (not just the realm of education and school-based OT) it is easy and encouraged to place a large amount of attention on our own personal areas of weakness as well as focusing on the weaknesses of others. When assessing students we can get lost in figuring out the areas of weakness or concern. Most strengths can be figured out via a simple structured interview questions of the students. What are the student's favorite classes? What do they like most about school? What are the things that they feel are good at? What is it that they want to be when they grow up? What are their preferred activities and hobbies? These are the areas that light the student up when they speak about them. During assessment I also find it valuable take note of the student's confidence on certain activities presented during classroom observations or throughout standardized testing. How was their behavior different during the class they enjoyed versus the one that was not their favorite? Did they seem confident on the timed portion of the BOT-2 manual dexterity subtest? How did that confidence improve their attention? Their overall performance? I like to make a note of this in my report because you can utilize this strength later to help boost performance skills in other areas. Taking a strengths-based approach mean providing the student with the “just right challenge”. As OTs we want to provide the child with challenging occupational activities that promote growth that help them to learn to leverage their strengths. At times during IEP prep it may be important to ask yourself “What can she do?” versus “What can’t she do that I need to work on or fix with her?” This will lead you to write more appropriate goals but also build capacity with the IEP team including the student herself. I can best describe how to do this with an example from my own practice. I had a student that was considered “very low” both developmentally and functionally. I was overwhelmed by the deficits needing to be addressed; however when I thought of what this student was good at I was able get more clarity. For example I could have focused on the deficit areas such as: she can’t write her name. She can’t trace. She can’t copy. She can’t ...she can’t…. Etc. However, I looked at what she COULD do it became much easier to establish a goal and baseline. She can hold a writing implement. She knows how to utilize a writing implement. She will color within a given boundary. She imitates simple lines and body movements. She is friendly and engaged with me and classroom personnel. She has excellent behavior and she is motivated to participate. She recognizes shapes and letters. Can work on imitating shapes or letters? Yes! That's a skill I might be able to help improve. When we look at all the ways a students may be “behind” we can lose sight of where they really are right now. When we focus on a student’s strengths we can return control to the student themselves. They learn how to utilize their strengths in order to develop adaptive responses to presented challenges as well as the self-esteem to cope with the inevitable challenges that will come their way. I have had students who refuse to participate in the fine motor activity I presented that works on their area of concern. When this happens taking a strengths based approach has helped me to provide better treatment. An example I can remember was a student with behavioral and attention difficulties who had Down's Syndrome. He seemed to only want to do the exact opposite of what I needed him to work on. The exasperation and feelings of failure with this student at times left me feeling defeated. At that moment I was solely focusing on his areas of deficit (the fine motor integration skill that he was "weak" in). I was ready to throw in the towel and say “no progress due to refusal etc. etc. etc.” When I took a step back however and thought about this student’s strengths. I realized after speaking with the teacher and pushing into the classroom that he had a sense of pride from cleaning up and being the classroom “helper”. I changed my approach to leverage this area of strength and began pairing him with another student whose ability level was slightly lower for OT sessions. My student who often refused began to model for the other student what and how to perform the activities. A bonus benefit was that his independence, self-confidence, and accuracy improved along with the skills of the other student in this OT group. Coming at this situation from a strengths-based approach allowed me to see new in-roads and opportunities I had not before. When ever I have felt “stuck” on a student or there is a lack of progress I often ask myself “Am I looking at the student’s strengths or their deficits?” If I’m looking at their deficits I will go back and take an inventory of their strengths and this more often than not leads me to new solutions and strategies I may not have tried before. Taking an inventory of strengths also gives me a more accurate assessment of the student’s present level of function, which helps me clearly define goals and next steps. I would encourage you the next time your pondering why a student hasn’t made progress or is being to take a look at their strengths and be sure you're leveraging them to their fullest capacity. While deficits may establish eligibility it is the student’s strength that is going to carry them throughout their school age years and possibly throughout their lifetime. In what ways has looking at student strengths help you develop better goals and plans with your students? How do you leverage student strengths in your school setting? How can we encourage all school personnel to focus on student strengths? Thanks for stopping by. If you feel this article was helpful please share it with your friends and spread the word about OT Schoolhouse on Facebook or Twitter! We would greatly appreciate it! Abby

Alright, So as you all know, here at the OT School House Abby and I are all about Response To Intervention (RTI) and working in partnership with our teachers. So with my partial day off due to presenting at my high school alma mater for career day, I spent part of the day digging for some research about collaboration. I searched the American Journal of Occupational Therapy (AJOT) and initially found an article from 1996... I have nothing against 20-year-old articles, but I was just looking for something a bit more contemporary today. So I dug a little further, and I came across a brand new article (2018) titled, "Effectiveness of the Co-PID for Students With Moderate Intellectual Disability". The article was put together by a group of researchers out of Israel and was aimed at looking at the effectiveness of a "Collaborative Consultation" model versus a traditional "in-service" model Article Reference: Selanikyo, E., Weintraub, N., & Yalon-Chamovitz, S. (2018). Effectiveness of the Co-PID for students with moderate intellectual disability. American Journal of Occupational Therapy, 72, 7202205090. https://doi.org/10.5014/ajot.2018.024109 The acronym Co-PID, in case you are wondering, stands for "Collaborative Consultation for Participation of students with Intellectual Disabilities". And by their account, the Co-PID Model is characterized by 3 key processes which are: 1. Freely sharing knowledge between the OTs and teachers 2. Jointly setting intervention goals and programs, and 3. Sharing responsibility for the student outcomes As soon as I read these 3 key ingredients, I was hooked. This is what I have been begging for from the admin and teachers in my district. Constant communication, collaborative goals, and the shared responsibility for goals and interventions! I'll be the first to sign up for a team that works like that! After calming down I continued reading. I was a little sad that they were not comparing this collaborative model to a direct pull-out model, but who knows, maybe that's next on their agenda. Anyways, as opposed to the traditional in-service model which for this study included a hour and a half in-service on participation and two additional 45-minute meetings spread over 4 months, the Co-PID experimental group of teachers partook in the hour and half in-service along with a workshop session where the teacher and OT basically went through a mock lesson and follow up discussion. The Co-PID group also held 45-minute consultation meetings every two weeks during the 4 month period to brainstorm activities that could increase participation. With participation being the "P" in Co-PID, it makes sense the outcomes looked at by these researchers was participation in the classroom - specifically communication, choosing, and initiating - and the transferability of these participation skills into other environments. To measure these outcomes, they used a structured observation developed alongside the Co-PID model called The Structured Observations of Students Participation in Classrooms (SOSPiC). The SOSPiC was designed to evaluate functional communication, the ability to make choices, and the ability to initiate. The SOSPiC is designed to be a 45-minute classroom observation in which the observer completes a 4 point Likert scale. The Goal Attainment Scale (GAS) and the Participation section of the School Function Assessment (SFA) were also used as part of their pre/post testing. So they went about their intervention and came to find some mixed conclusions. Between the two groups, no significant difference was found in improved communication or initiation skills. However, the Co-PID did make greater improvements in "choosing", goal progression on the GAS, and increased participation in areas other than just the classroom on the SFA. Now before I get into my own analysis of what this means to me and possibly you as a school-based OT, the study did have a few limitations that should be noted. One limitation pointed out was the design and length of the in-service group, which wasn't fully detailed in the article. In my opinion, they also had a relatively small sample size (12 teachers and ~65 students at two school sites). I also feel that it is just really difficult to complete a study at a school site. There is just so much going on that it is hard to account for external factors such as teachers and aides training experience, recess time and activities, attendance, etc. Despite these factors though, the study seems to have been completed with acceptable rigor. How Does This Study Impact Us? Well, I already mentioned this aspect, but I hope the researchers will complete a similar study with their model compared to a direct pull out model. By definition and cited in this article, students with Intellectual disabilities demonstrate poor carryover so I would be interested to see how skills carried over from OT session back into the class. Recently, we have also been having a problem in our district with IEP team members wanting us to pull a student with moderate intellectual disabilities out of the classroom to work on skills that are likely out of their developmentally appropriate range. Regarding that problem, I like that this article clearly states the importance of participation in class and other activities rather than specific skill sets. Students are school to participate in class My biggest concern with this model in relation to my district (and quite possibly yours, too) is the time constraints. Every 2 weeks the OT met individually with each teacher for 45 minutes. If you have multiple school sites that you service, you know how difficult it can be to schedule a 45-minute period when both you and the teacher would be available, especially if you have 5+ teachers to do this with. It would be a struggle, but not completely impossible in my district, I think. I think it's safe to say that I see the pros and cons of this model and will definitely be keeping it in my research binder for when I need to reference the importance of collaboration to an IEP team. I think sometimes our IEP teams (me included) still gets stuck on a deficits models rather than a strengths and participation model. It's an article like this that reminds me a student is at school to participate in his/her class, not to be pulled out for OT sessions where carryover to their classroom is minimal What about you, do you keep a research binder or journal in your workspace? Or better yet, do you reference articles in your reports or at IEPs? Let us know in the comments! If you agree with this article and subsequent analysis, please share it by clicking on your favorite social media icon below. Until next time,

Play is crucial to our development as children and I would argue an essential component to student success throughout school age years and even into adulthood. Children naturally seek play as a means of learning and understanding things in their environment. Engagement in play allows children to safely experiment, control, and practice situations that may happen in school. Parents often ask me during IEP meetings what it is that they can do for their children to improve the areas of concern I've identified in my reports. Most of the time they are looking for work that they can do at home with their son or daughter in order to help them improve their sensory processing, fine motor skills, or social skills. I have typically provided them with worksheets and handouts on sensory processing and activities they can do with the child at home. However more recently I have become inspired to take a different approach. I have given up telling parents to work on this or that skill in the home and instead have begun asking them to provide opportunities for playing. I most recently told a mother just a few weeks ago to get her daughter outside and play, building forts, playing with a ball, in the park on equipment. Anything that would be child directed could work. I provided her with information that pointed to the skills her daughter could develop through just good old fashioned play experiences. She looked at me oddly, but then agreed that she would like to be doing more of these things with her daughter instead of pushing more schoolwork on to her. School is difficult as it is and providing parents with more “homework” or practice can lead to further stress on the students as well as their families. Play is a motivating way in which to help children develop occupational performance and participation in many areas relevant to school and classroom performance. Play has the added benefit of giving both parents and their children with much needed stress relief, time to bond, and prepares your brain for learning in school more so than worksheets and handwriting practice. So Let’s explore the benefits of play experiences for learning and child development so I can make my case for less handwriting practice and hopefully less copies. Play is often conducted by children for its own sake and is described by The National Institute for Play as “ the catalyst for learning at any age”. Play is self-motivated and therefore more often therefore inherently engaging (if it were not you would not be playing!) There are two types of play structured and unstructured. I am going to be making the case for providing children and students for ample opportunities for unstructured play as I personally have seen a decline in this specific type of experience since I was in grade school. Structured play opportunities are no less important; however I will be discussing the benefits of unstructured play here. Keep your eye out for an article on structured play! Unstructured play is defined usually as child-led activity without having any specific goal or purpose. In other words “letting kids be kids”! Unstructured play during recess has been found in research to provide children with better achievement outcomes, increased physical health and better socialization skills. During unstructured play children are responsible for regulating themselves and often times will challenge themselves by taking their own self-controlled or self-calculated risks. This allows them to develop the self-control in order to achieve their goals. I can think of multiple examples from my own childhood. I had the amazing opportunities for unstructured play growing up in a small town in Pennsylvania. I lived in a small town with ample opportunities for unstructured play. My neighborhood was safe and in a small town people typically look out for each other and so my parents would allow us to leave the house on bike trips, play outside with the other kids in the neighborhood unsupervised, or go to the ballfields on our own. I was also lucky enough to live a short bike ride away from my grandparents' house where “The Hill” existed. “The Hill” was large, steep, and daunting to any elementary age kid. In our eyes a true challenge worthy of a full summer afternoon. There were trees and ropes my grandpa had left up from when he would create a Christmas light display in the winter on the steep parts. Every summer my sister and I would bring friends to my grandmother’s house to go on expeditions up “The Hill”. We would spend all afternoon using ropes, trees, and root systems in order to get to the top and return in time for dinner. There were no adults present and more often than not we would return home with ripped clothing, scrapes, and covered in dirt. Occasionally my grandma would yell up to us and we would yell down to her letting her know we were alright and that was about all the adult supervision we had and needed. Looking back as an occupational therapist I think of the skills, team building, problem solving, muscle development, and self-regulation it took in order to get to the top and return. I remember feeling this sense of achievement shared by my friends once we reached the top. It gave us a sense of confidence that was unparalleled to anything else I had experienced as a kid. It was an entirely child-directed experience and we had done it ourselves, which for many children is a rare opportunity. Many skills gained during unstructured play can be utilized within the daily lives of children. Unstructured play provides children with much needed downtime and the opportunities to make their own independent decisions and then test those choices outside of the influence of grown-ups. Some of the skills developed through unstructured play are those that occupational therapists frequently address within the school setting and can include motor skills development, self-regulation, and social skills. Children learn how to engage and control their bodies through the occupation of play, which from an occupational therapist’s perspective, is the best and most successful way they can learn these skills. Unstructured play provides an excellent opportunity for both gross motor and fine motor development. Kids can learn to develop an understanding of their own body (proprioceptive, vestibular, visual and tactile systems) through climbing, pushing, pulling, and swinging better during motivating play activities than any experiences provided in therapy (which is essentially what we attempt to create in therapy). These gross motor skills and overall strengthening lead to increase distal control for more the more refined movements of our smaller muscles. Developing core control and strength helps children to maintain sitting balance in order to engage in desktop classroom tasks that require the stability of their core to complete the fine motor work of handwriting and cutting. From an occupational therapist’s perspective, engagement in play is one of the best ways for children to develop these skills because it is done so naturally through a child-centered occupation. Unstructured play opportunities provide children the opportunities to develop much needed executive functioning skills needed for self-regulation, self-advocacy, problem solving and risk taking. In climbing the hill behind my grandmother’s house we were not just developing our sensory systems and motor skills we were also developing our abilities to adapt to change, measure risk, regulate our responses to fear (coming down often times lead to sliding on our bottoms a time or two), problem solve, and advocate for ourselves when we needed assistance. These skills are necessary to classroom performance. We were not prompted by our parents or watchful adults on the hill, but had to develop and trust our own abilities to reason through those risks, create, and execute our own plans in order to achieve a self-set goal. These are not just skills needed to succeed in the classroom, but often times are necessary in order to become successful adults. Social skills were developed through overcoming the challenge of climbing the hill with our friends. We would argue about the best routes to take, help out when someone was struggling to make it, and establish a bond through having achieved something together as a group. Adults often times will interfere with peer conflict in children and this can take away the valuable experience children gain when they learn to resolve conflicts on their own. On the hill there were no grown ups to tell us not to fight, we had to decide those things for ourselves if we were going to get to the top and back down before dinner. As children in a social group we decided the rules for our journey and learned how to advocate for our needs within the group. None of those skills could be developed as successfully or quickly with adult intervention. So I say when children get home from school in place of handwriting practice or more worksheets we get parents and students outside and playing. Unstructured play appears to be a rarity in the lives of over-scheduled students, iPads, and testing, but it provides invaluable opportunities for children to develop skills necessary for them to achieve within their lives and school setting. Playing gives a much needed break for our brains, an opportunity to engage in creativity, and a means of connecting with each other. I would encourage occupational therapists to promote unstructured play at schools and outside of schools as our students are in desperate need of these opportunities! Thank you for reading! I would love to hear your comments below. For some play activities you can incorporate in class on rainy days, check out our post "7 OT Approved Alternative Indoor Recess Ideas" Here are some resources should you want to learn more about the benefits of play: The National Institute for Play American Occupational Therapy Association Play:How it Shapes the Brain, Opens the Imagination and Invigorates the Soul by Dr. Stuart Brown (Amazon Affiliate Link) TimberNook

This time of the year, our students can get a bit antsy when the snow, rain, and wind prevent them from going outside for their play breaks. In California, we have had a dry spell this winter. Here's to hoping there's some rain coming soon. But in the Midwest and on the east coast, I know many of you have been getting pounded. With that in mind, I wanted to share with you all some of my favorite indoor alternative recess activities. Some are more up to date than others, but I think they are all better than watching a moving for 15 minutes. I mean, that's not even long enough of a time to get to the good parts... Along with the activities, I'll share some performance skills that each work on so that you can justify to others why they might want to try these activities rather than putting on a movie. Again, to be completely transparent, some of these links are affiliate links which me at no additional cost to you, the OT School House So let's just right into it. 1. Snowball Fight Two years ago my mom had my 2 sisters and I open a fun Christmas gift at the same exact time... You can imagine what ensued as all 3 of us 25+ year olds opened our own pack of snowballs. It was the most EPIC snowball fight to ever occur in a place it rarely snows. If you have frequent inside recesses, you can invest in these snowballs here. Otherwise, you can have the students crumple up some paper, preferably scrap paper. Both methods work on visual tracking and gross motor planning skills, but crumpling up the paper also works on some bilateral hand skills and strengthening. 2. GoNoodle I'm sure most of you have heard of GoNoodle by now. It's a website full of videos that can be used during alternative recesses, PE, or even cool down/warm-ups before and after a test. I especially like the Moose Tube videos GoNoodle works on so many skills. Praxis, bilateral integration, balance, imitation, social skills, Rhythm and many more. 3. Rhythm Works Integrative Dance (RWID) Looking for some dance moves that are more individualized than GoNoodle? The RWID program and the Dance In A Box flash cards (1-2-3 Dance and Hip Hop in a Box) give teachers and students the opportunity to develop their own dance routine! The cards also allow for the option to modify the moves for students who may not be able to participate fully. I recommend checking Rhythm Works out at RhytymWorksID.com I currently run a weekly group with a class of children with moderate to severe disabilities and the teacher, students, and aides all love the program. 4. 4-Corners My personal favorite as a kid, 4 Corners is an iconic rainy day game that works on more skills than you might think. The Corner picker has to rely on auditory, tactile, and even proprioceptive input from the floor vibrating through their legs to identify which corner the most students may be in. The other students roaming from corner to corner learn about to self-regulate during a rather heightened arousal level game. Social and problem-solving skills are also tested as children learn to pick the corner least likely to be picked. 5. Arts and Crafts Table With so many schools cutting back on the arts, an indoor recess can be a beneficial alternative to a movin' and groovin' recess. Slime making or letting kids create and solve their own paper mazes can be fun ways to work on fine motor, visual motor, and planning skills Oh, and don't forget that sometimes the process is more important than the product. A student who creates his own craft will typically be more proud of his/her own creation than a creation completed mostly by an adult. 6. Building You don't have to be at a STEM (Science, Technology, Engineering, and Math) School to bring in some building materials. Below are some fun building materials that can be purchased for relatively cheap considering how long they will last. They all help to build fine motor, copying, planning, and hand strengthening. Be sure to encourage your students to both follow picture directions and create their own designs. Both methods work on separate important processing skills instrumental to learning. K'nex ($31.98) PlusPlus ($7-$25) Brain Flakes ($12.99) 7. Escape Room/Box This one is for the creative teachers out there that perhaps like to build and design things themselves. Set up a scavenger hunt for your students in your room to find clues and secret keys to open a treasure box or door. Incorporate mastered academic problems or history buff clues to make it extra meaningful. Purchase this Magic Box ($11.99) to make your students feel like they just found the "National Treasure" I have not yet tried this one, but it would be fun to collaborate with a teacher to create this. If only we had rainy days here in SoCal... (Doing my rain dance right now) So that's 7 OT School House approved indoor recess activities. Of course, there are many more we could include, but I think this provides a good starting point. What do think of our games? Would you create an escape box? Let us know in the comments or on Facebook. Or share with us what your go-to indoor recess activities are or even what your favorite was growing up. Until next time,