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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

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,

Hey everyone, Continuing our "Month of Play" theme here at the OT School House, I wanted to use today's post to run through the importance of play and Mildred Parten's 6 stages of play to help refresh what OTs should be looking for in a student's ability to participate at recess and other times of play. In the third version of the Occupational Therapy Practice Framework (2017), the American Occupational Therapy Association (AOTA) used Parham & Fazio's definition of play as “Any spontaneous or organized activity that provides enjoyment, entertainment, amusement, or diversion” (1997).And over the years there have been many articles which document the importance of recess time and the play exhibited during this time. Furthermore, AOTA broke down play into "Play Exploration" - the planning and structure of play, and "Play Participation" - having the ability to access the physical environment. So as we discuss the stages of play, we will be looking at the students' ability to engage in play exploration to participate meaningfully at recess. Parten's 6 Stages of Play 1. Unoccupied Play Seemingly unorganized to an observer, unoccupied play is typically seen in infants and is a way for infants to understand the world around them. Waving their hands in front of their face, randomly clapping their hands, shaking anything that they can get their hands on; these are all forms of unoccupied play and allow for the child to learn about their environment. 2. Solitary Play The next step up from unoccupied play, solitary play is characterized by meaningful play in isolation. Where in unoccupied play the infant shook a rattle randomly, now the child is shaking the rattle with reason, perhaps to a beat. The key component here is that the child is focusing on an activity for a length of time rather than jumping from one activity to another and so on. Solitary play is typically seen in children ages 2-3 years. 3. Onlooker Behavior This phase in play is seen in younger children as well as they look toward their peers and at adults to see how they play. It may be interpreted as being shy, but this onlooker behavior is integral to learning. I like to think of this step as a data collection period for children. They intently observe to learn about concepts like gravity and social cues. 4. Parallel Play Frequently seen at about the same time as onlooker behavior, parallel play is the act of doing the same play activity as a peer, but not with the peer. For example, two children playing with their own set of Legos a few feet apart from each other, but not really interacting with each other. You may see some onlooker behaviors and imitation, but little to no social interaction. 5. Associative Play This is the beginning of socialization in play. Typically beginning to develop slightly before a child's fourth birthday, many kindergarteners enter school at this stage. Children in this stage are learning the foundations of interacting with peers. They are playing with each other and commenting on each others tower, but are not yet working together to build something or taking turns. You often have a lot of tattling at this stage because some children are okay with sharing, and others are not. 6. Cooperative Play By the end of kindergarten, most students should have reached cooperative play where they can have positive interactions with peers and play by rules agreed on by the peers (not necessarily adult provided rules...). It is through cooperative play that children learn to problem solve with peers and to "give and take" in situations where there is not necessarily a winner or loser. Relating the Stages Back to School Function Alright, so those are the most popular stages of play. While some scholars have expanded on this list on to more advanced stages of play, I feel that if a child has reached the cooperative play, they have reached a level that is functional within schools. Thus, I tend to not look beyond that during my assessments. But yes, I do assess a students level of play during my assessments if there are any social or behavioral concerns- especially if I am assessing a younger student. So what do I do? I typically will observe a full recess session and talk briefly with the teacher(s) or aide(s) who monitor recess. I often find that if an aide knows exactly the kid I'm looking for, that student is either frequently in trouble or frequently isolated from their peers for one reason or another. Both are problematic and should be looked at more thoroughly. Many times the reason or reasons for difficulties at recess can be seen by a trained eye during observations. Is the student engaging in parallel play when his/her peers are actively participating in cooperative play? Does the student have the bilateral skills required to climb a ladder or the motor planning abilities to time out when to jump the rope? A few times, I have seen a student get in trouble for pushing or shoving. I know from working with them that they are receiving speech services because they have difficulties expressing themselves. I ask more about the situation and observe the student and I come to find that this student does engage in this behavior, but it is because they do not know how to appropriately ask/tell a peer to move out of the way. This is a form of communication and is a manifestation of their disability. They should not have recess taken away. With the help of the OT and Speech provider, this situation should be used as a learning experience for the student. What Works? Recess is the best time of the day for so many students and rightly so. I think we owe it to them to make sure they all get to participate and enjoy it. So what can we do as OTs? Just like we talk to teachers about how to grip a pencil, we should be working with the recess supervisors about how to facilitate play among our students with disabilities. Some students may just need a structured and specific play task where there is one person leading the game rather than 10 students all making up the rules. A few years ago I working with a student on the Autism Spectrum and we put in place a recess jar. Every day before recess he would pull out a piece of paper that had a game on it and then give him the materials needed to play (ball, jump rope, pool noodle, etc.). Not only did this give him an idea of what to do on the playground, but it also gained interest in that game from other peers. It didn't work out every day, but it did increase overall social play interactions. Alright, so that about wraps things up. I just want to encourage you to get out on the playground and observe your students out there for a bit. You are almost guaranteed to learn something new about your students and they may even surprise you. Also, I recommend checking out the resources below. All can be accessed with an NBCOT account. Thank you for checking out this post. If you'd like to be in the know about future posts and have free OT tools delivered to your inbox Subscribe here! Hope you are having a great week! Until next time, References: Creating Effective Learning Environments EncouragePlay.com Michigan State University Extension - The Power of Play Occupational Therapy Practice Framework: Domain and Process (3rd Edition). Ramstetter, Catherine L, MS,PhD., C.S.C.S., Murray, Robert,M.D., F.A.A.P., & Garner, Andrew S, MD,PhD., F.A.A.P. (2010). The crucial role of recess in schools. The Journal of School Health, 80(11), 517. Retrieved from https://search.proquest.com/docview/757825015?accountid=143111

Hey Everyone, Welcome back to the the OT School House for our first post about PLAY! (Yay!) But before we get into play, can I share something with you real quick? January was a tough month. Somehow, the stars aligned just right, and both Abby and I got supper swamped with assessments and IEPs. In fact just yesterday, I attended 4 IEPs starting at 8:30 and ending close to 5... It's been a long day. So I must say, I am ecstatic that January is over! But looking back on January, there is one thing I found myself saying over and over again during those IEPs. That phase was "play-based education." Although, yesterday I slightly modified it to "academic based rewards" in an IEP where we were discussing the need for a student to use assistive technology. I must admit, as a team we have failed to provide this student academic experiences through play, let alone, play in itself. Even at recess, this 5th grade student with autism simply walks around the playground, occasionally moseying up onto the play structure and then paces back and forth. Since finding this out, I have spent a few recess sessions working with him on how to climb the ladder, go up the slide, and now we are working on climbing the rock wall. These activities are much more meaningful to him than copying a sentence... So anyways, I want to talk about play-based education today. As students move on from preschool and kindergarten, too often the emphasis on fun academics dissipates. This is unfortunate in general education classes, but even more so in our special education classes where many of our students are still functioning social-emotionally at a 4 year age, or perhaps younger. They may have a higher vocabulary and write slightly neater than students that are younger than them, but they may still be at a stage where they are unable to understand the importance of work and thus simply refuse to do pencil and paper work. When a student is at this stage and a teacher or therapist has a mentality that the only way a student can learn to add is though desk work, what you'll often find is an adult complaining about behaviors and a student not making much progress. And it's not fun, or beneficial for either of them. It is in this circumstance that I try to educate the teacher and IEP team on play-based education and education-based rewards. If a child can’t learn the way we teach, maybe we should teach the way they learn. -Ignacio ‘Nacho’ Estrada What is Play-Based Education? Play-based education allows for the student's inherent desire to play, drive their potential to learn. By tapping into the student's intrinsic motivation for play, we can modify their play in real time to "squeeze" in the academics. If that sounds a bit tricky, it's because it is. You have to know exactly what academic skill you are working on and then think on the fly during what could be a small group session. Here's an example. A teacher has graciously welcomed you into her classroom to collaborate with her and the other adults in the classroom for centers that last about 20 minutes. So you and a classroom aide will have a group of 5 students and are asked to work on memorizing sight words. In many classes this center may look like a fill in the missing letter worksheet or simply copying the words. In a play-based environment though. The students may use K'nex or magnetic letters to build and spell the sight words. Or, perhaps they play Hangman to discover the word. A good gross motor game would be to form the letters with your body; it could be made into a dance even. Design a dance move for each: S, K, and Y to help the kids remember how to spell sky I know, it may sound corny, but the possibilities are only limited by your (and the students') imagination. Before I move on, I want to acknowledge that play-based education does not work in all classes. There are some students who will try to take advantage of it and get out of work. In other classes, it may not be feasible with the staffing or logical with the students' learning style. That is why I don't recommend this for all classes. This is definitely something that works best for younger students and students that display delayed social-emotional skills. Academic-Based Rewards! This is pretty straight forward, so I'll make it quick. Whenever possible, the teachers and I always try to make rewards for doing academic work a more fun version of the work they complete. For instance, a student who is motivated by iPad time may get to play Writing Wizard on the iPad after completing a spelling test. The same might go for playing Prodigy on the chromebooks after completing a math lesson. If you are in a pinch and are having trouble thinking of one, might I suggest Tic-Tac-Toe with any given numbers, letters, shapes, or spelling words. It's quite surprising how easy it is to get students to write words five times correctly when it's a game. Hopefully, by using the academic rewards, your student will not only be more inclined to complete the initial task, but will also improve in academics from the rewarded activity. So, that is all I have for today. I know not every student will benefit from the two tips today, but even if only one does, it was worth writing this post about play in academics. If you enjoyed this article or any other article you have read on our site, we welcome you to sign up. We'll send you a copy of our Gray-Space adapted paper as a thank you. Simply Click Here or subscribe below. Thank you, everyone. We appreciate you visiting us! Until next time,

Hey friends, Thank you for visiting us here at the OT School House. As we continue with our January theme of handwriting, I wanted to share a list of environmental factors that could be inhibiting or even preventing your students for effectively writing in class. Before I get to the list and some supporting comments, I want to point out just why looking at the contextual environment is so important when it comes to handwriting. Can you imagine writing a 5-paragraph essay on a desk the size of a small picture frame? Now imagine writing it while relaxing in a bean bag, or even laying on the floor. These would be uncomfortable positions, right? Well, now imagine you are still trying to learn how to write your name and the alphabet and you are forced to write in these same awkward positions. It may seem counterintuitive when you think about it, but sometimes we expect our students to do this very thing without even knowing it. So without further ado, let's look at several environmental factors that often go unnoticed in class that make it just a bit more difficult for our students to write in class. 1) Student's feet do not sit flat on the ground when seated in their chair We'll start with the most frequent culprit. Too frequently I walk into a primary grade classroom and see half of the class' feet not touching the ground. If your seated right now, lift your feet off even a few inches off the ground and you will quickly see how much work it takes to stay upright. You will likely feel it in your core and some of you may even find yourself using your hands to stabilize yourself. So you can then likely imagine how the students feel when they can't touch the floor. When a chair is too big for a student you will frequently see them stand up at their desk, sit on their knees, try to touch the tips of their toes to the ground, or even put their feet on the chair in front of them to help them stabilize. I will never forget the time I saw a student move his chair over so that he could place his feet on the leg of the table. he proceeded to get reprimanded for not sitting straight at his desk. I was not assessing that student, but I had to let the teacher know why he was moving his chair. I felt so bad for the kid. Quick Fix A phone book or even a pool noodle with some theraband or pair of nylons going through it as pictured below may be placed under the student's feet to help provide support. 2) Unstable Seating Similar to not being able to touch the floor, seating arrangements without stable backs (such as a yoga balls) are great for when you want to build core strength. However, they are not so great for most students just learning to write. Do your best to provide a nice stable surface with a back and/or armrests for your students to stabilize themselves. Just like the students who can't touch the floor, these students will frequently stand or lean on the desk while working if they feel unstabilized. 3) Lefties not being able to see what they are copying (sometimes a problem for righties too) I point this out primarily for younger students who are just learning to copy letters and words. Educators often use worksheets that have a student copy a letter or word from the left side of the page onto the right side of the same page. For right handers, this is great, but for lefties their arm is often covering whatever it is that they are supposed to be copying. This can lead them to attempt to use an awkward "hook" grasp in which they flex their wrist so that they can see what is on the page. Quick Fix Provide another paper for the student to copy onto. That way, they can place the paper anywhere that best suits their needs. 4) Copying from something that that looks very different than what they are asked to write on Copying from paper with 3 lines (top, bottom, and middle dashed line) to paper with 2 lines (top and bottom) is hander for our students than one might imagine. Try to maintain consistency in the paper you use to have students copy. I also want to point out here that it can be difficult for students to copy letters that change in the way they look. Take letters "a" (vs. a) and "g" (vs. g ) for example. When is the last time you wrote either of those letters like the first version. So be mindful of the font you use if you make your own worksheets. I often find myself changing the font just for those 2 letters. The font used above to "fix" them is "Comic Sans MS" in case you need it for your next worksheet. 5) Visual & Auditory distractions In most general education classes, teachers are pretty good at keeping their room pretty quiet. On the opposite spectrum though, they also tend to have a brightly colored and visually stimulating room. For some of our students (with or without special needs), this can be overwhelming and distracting for a student who already struggles with writing. Sometimes a quiet library corner that is "closed off" to the rest of the room can add some much needed respite for students who get overwhelmed. Quick Fixes A tri-fold piece of cardboard (or recycled amazon box) or laminated manila forder "study coral" or "privacy boards" can be put up to help a student focus. 7) A desk that is too tall Have you ever seen a student whose head is barely sticking out from behind a desk. Odds are his desk is too tall and his chair may or may not be too short. Ideally, a student's desk should be at the level his/her elbows rest when seated in a correctly sized chair. While we are looking at the desk, Let's make sure their desk isn't so small or messy that there is no room to write. Organization is often a skill that needs to be taught directly in schools in order to keep those desk clear from unnecessary papers. 8) Poorly sized paper - lines to spaced out or close together For teachers, I completely understand using the same paper everyday for every student. It just takes way too much time to assess each students' specific needs for paper in the general education setting. With that being said, I would encourage the teachers out there to ask your OT for help on recommending an appropriate paper for students who struggle to size their letters, write on the line, or space out their letters and words. Feel free to also try our Gray-Space Adapted Paper! We have it in all sizes for free. Likewise, be sure that the students understands the placement of the paper. Because of the way that our arms are designed, most students benefit from tilting the paper at a slight angle with the top of the paper tilting away from the side that the student writes with (I hope that makes sense). 9) Poor lighting Simple and straight to the point, but oh so important. Until students have mastered their visual motor skills to write without looking at their hand, taking notes during a movie or in a dark classroom can be difficult for them. As the lights dim, the lines on the paper become more difficult to distinguish and you are likely to see more illegible work from your students. Try keeping half of the lights on next time you watch a movie, or provide a small reading light for the students who still need it as they get older. Some teachers are even buying these blue shades (Affiliate link to amazon) to cover their fluorescent lights in attempt to provide a relaxing atmosphere without diminishing the quality of light. 10) Temperature We covered visual distractions and lighting, but temperature can be just as important. I know many teachers have no control over this, and if you did you'd likely keep it at the just right temperature, but try your best to keep the room from getting uncomfortable. Open the door if some fresh air is needed or provide some classroom blankets if your class get excessively cold. 11) Not coming to School The most detrimental environmental factor to any students' writing by far is not coming to school. Whether it be the parents' decision or due to suspensions & expusions, we absolutely cannot have students being absent. Instruction and practice are two very different things and students need to be at school to get the instruction they need. Click here for more on handwriting instruction. Alright, so there you have it, 11 environmental factors that educators and parents can adjust in order to facilitate their students' learning and continuing to write. Did I miss anything? Please let me know below in the comments. I would also really appreciate it if you shared this article with another educator. Just click below to share this article now! Then check out what else we have to offer. Thank you again for visiting the School House, Jayson