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Press play above for the unedited audio and visual version of the podcast. Press play below to listen to the edited version of the podcast (audio only). Or click on your preferred podcast player link! On this special event episode of the OT Schoolhouse Podcast, Jayson welcomes to the show occupational therapists, Jaime Spencer, OTR/L, and Billy Hatridge, OTR/L In this episode, Jayson, Jaime, and Billy discuss what the looming return to the 2020-21 school may look like in our districts and how we are planning for them. We discuss how evaluations, treatments and IEP meetings will all be very different, even from how they were at the end of the 2020 school year. We also spend some time advocating for our profession and a workload model in schools. Above, you can watch the full, unedited Facebook video or you can listen to the audio only version on the OT School House podcast using the player at the top of the page or where ever you listen to podcasts. Links to Show References: Visit Jaime's website at MissJaimeOT.com Check out Billy's website at TheOTDad.com A-Z School-based OT Course - An original OT Schoolhouse Course created and taught by Jayson on almost every aspect of School-Based OT. USe promo code "backtoschool" for 10% off! Also referenced in this episode: Google Meet Zoom Microsoft Teams Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments regarding our podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 55! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Jayson Davies     Hey everyone, and welcome to episode 55 of the OT school house podcast. My name is Jason Davies, and I just want to say thank you. Thank you. Thank you so much for being here today. This is an exciting time for a school based OTs. We are getting back to work. I actually went to work about a week and a half ago. Is when I got started back. And you know, this is just an exciting time. We we get to go to target, and we get to find cool erasers and whatever new cool gadgets they have in that little used to be called the dollar spot. Not anymore. Now it's more like the $3 spot. But anyways, you know, this is an exciting time for us. We get to get back to work. We get to find out what our caseload looks like, what our workload looks like. We get to see what classrooms, what teachers we're working with, and even more importantly, today, we get to find out if we're working from our home or from our room on campus, and that's exactly why we are here today. This is the second part of our two part series in back to school during a pandemic with occupational therapists from around the country, and today we have on two very special occupational therapists. Actually, they're both veterans of the OT school house podcast. We have Miss Jamie Spencer from Miss Jamie OT, and we also have Billy hattridge from the OT dad. So both of them have been on the podcast before. You'll probably recognize their voices once they get going. You might even follow them on Instagram or Facebook or wherever you might follow other occupational therapists. All right, so real quick before we dive in to today's lesson with Jamie and Billy, I just wanted to really quickly and briefly let you all know that the recorded version of the A to Z school based ot course is now available at ot  schoolhouse.com , forward slash a to the number 2z and this course is going to be great. Whether you are a brand new school based OT or an experienced school based occupational therapist. This is going to be fantastic. We are going to talk about everything from RTI to the referral process, the evaluation process of a student, how to determine what goals should be included, what services, the amount of services to include. I'm going to give you a little flow chart to figure that out. We're going to go through all of that, and then after that, we're going to go through the intervention plan, how to put together an intervention plan for success so that you can help that student make progress. And of course, you can't do that without having your your data tracking and progress reports and all that good stuff. So we're going to go through all of that eventually culminating in an efficient and a ethical graduation of services from occupational therapy for a student. This is like we're chronologically following a student through the entire ot process. On top of that, you're going to receive more than 25 editable handouts and resources, such as my evaluation template, that you're free to use and manipulate as you need. And then finally, the best part of the course is that it continues on. There is no end to this course. Yes, it's eight hours of content, but after that, or even even during that, I'm going to be holding Live Office Hours on Thursdays that you are more than welcome to attend. In fact, I would love for you to attend these office hours on Thursdays. This is your time to ask questions. Since this is not a live course, I'm going to be holding these Live Office Hours on Thursdays to answer any questions that may be really about anything ot related, whether it's about coming back during a pandemic, or how to exit a student when they have below average scores on the bot. That's what this course is for. That's what those Live Office Hours are for. So if you're interested in joining me or just learning more about this course, head on over to OT schoolhouse.com forward slash a the number 2z or you can just head on over to OT schoolhouse.com and click on the professional development tab at the top, and you'll be directed to learn more about this course right there. All right, so I hope to see you potentially over there. But either way, let's get into today's content with Jamie and Billy. This is the second part of our two part series in back to school plans during a pandemic. So let's Cue the intro music, and then we will dive right into it. See you in just a second.    Amazing Narrator     Hello and welcome to the OT school house podcast. Your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.     Jayson Davies     Hey everyone, and welcome back. This is going to be a great episode. This is the second part in our back to school during a pandemic series that we're doing here at the OT school house podcast. And I want to say a special thank you so much for being here to Jamie Spencer of Miss Jaime OT and, of course, Billy hatridge of the OT Dad. Thank you so much for coming on. And let's go ahead and get started. Let's say Miss Jaime. How are you doiang this morning?    Jaime Spencer      I'm doing great. How are you doing?     Jayson Davies     Doing fantastic. And Jamie, how about you go ahead and tell us where you practice occupational therapy. And, yeah, just start with that.    Jaime Spencer     So I'm a school based occupational therapist in Long Island, New York.    Jayson Davies     Awesome. And when are you guys heading back to school?    Jaime Spencer     Well, it's the board just approved that our students aren't going to come back until September 8, so they postponed it a little bit. But the teachers, I'm not sure the exact date, to be honest, because I've been avoiding thinking about it. But we're going back a little bit earlier in order to do some training in we're going to Google. We're going to be using Google classrooms across the district, so they're bringing us back a little earlier to, you know, just ensure everything's good with COVID, and make sure that we all have the proper training and all that.    Jayson Davies     Awesome, perfect. And Billy, what about you? Tell us, sir, remind us where you're located. And just a little quick update on the district, we're going to go more into details, but just a quick update.    Billy Hatridge     Yes, I'm here in southwest Arkansas, in our OT team, we cover nine school districts throughout five counties, and so we've got a lot of variety there. And for the state, we're all looking at coming back on the 24th of August. So that's, you know, in just a couple of weeks, but that's going to be kind of staggered. But yeah, that's what we're looking as far as the timeline, the 24th.    Jayson Davies     Great. Well, this is going to be interesting for those of you who were listening to the previous episode that we did about back to school plans during a pandemic we had on Olivia and Kate Dakota, and Olivia was going back more in the distance learning model, and Kate wasn't quite sure her district hadn't given her many updates on what was going on at that point, but they were thinking maybe hybrid. I'm excited today, because I've already talked a little bit to Billy and Jamie, and it sounds like they might be going full time back. So if this is you out there an occupational therapist that is going back to the schools full time, this is the place to be right now. So whether you're watching live right now, or listening to the podcast, you are in the right place to be. So let's go ahead and get started. Billy, what were your initial reactions when you found out what the district's plans were?    Billy Hatridge     Mixed. You know, I'm eager to get back into the school and eager to get it back to work. You know, our kids have gone almost six months now without any kind of therapy. A lot of our kids anyways, we here with our clinic the way that we have two satellite clinics, and so we've been able to see some kids via outpatient during the summer, and that's helped. But it's just about getting back to these kids who have been in such a desperate need for for the service that we provide. So I'm just eager to get back into it and to stop kind of kicking the can down the road, and just figure this stuff out.    Jayson Davies     Absolutely And what about you, Jamie, what were your initial reactions when you kind of heard what was all going on?    Jaime Spencer     Well, I actually was on the committees, the reopening committees for my school district. So my school district has been really working hard to try to make sure that all the bases are covered. And we had three separate plans, you know, depending on what was going on and also for what will happen in the future. So we came up with a going back full time plan, a hybrid plan, and then a, you know, 100% remote plan. So I thought that was great, because, I mean, the parents want to go back and school teachers administrators want to go back, but if it's not safe, we can't. So I thought it was good to have that mix. My district, the elementary school, kindergarten to sixth grade are going to be going back full time, but then seventh and eighth and high school will be alternating remote and, you know, in person, and then every single child has the option to be remote 100%    Jayson Davies     Wow. Okay, so I'm just gonna start with some information from my district. They initially gave students or parents the option to either do a hybrid model, so half, you know, like two cohorts coming in two days a week, or something like that. And then a distance learning model, they found that about 75% preferred the hybrid, and about 25% wanted to go the distance learning route. What do you think that means as far as special education? And do you think that we might have more students on Special Education coming back more that are on special education, staying in the distance learning model. Jamie, it sounds like your kids might have some options. So what do you think about as far as special education and the distance learning model?     Jaime Spencer     I think in general, that most of our special ed kids are going to come back. I think the parents, first of all, feel upset that they are not special ed teachers and that their child might not be getting, you know, the full benefit of being with their teacher in person. And you know, we know the special ed teachers have bent over backwards, doing everything they can provide the proper education via teletherapy, but it's not the same as having that structure. And I. Most parents are going to be sending their kids back so that the children you know, we know our children with special needs very often, they really more than the average kid. They need structure. They need multi sensory strategies. So that's hard to provide via teletherapy, absolutely.    Jayson Davies     All right, so I want to ask, kind of going back to before. So let's talk about last school year from March until May. What did that look like for you guys? Billy, you want to go ahead and start with that?    Billy Hatridge     Yeah. So we think March the 13th was when that Friday the 13th is when everything you know, the hell mouth opened up, so to speak. But they made the announcement that, hey, we're going to be out the next week, and then the following week was spring break, and that's going to give us two weeks. We'll come back to normal. You know, we're just kind of taking a two week spring break. And then about halfway through spring break, they said, Okay, this is going to, let's kick this can down the road. Let's make open up, I think may 6 was the day, or somewhere in there, that they're going to come back. And when that decision was made, the schools who had kind of more or less just sat back and said, We're going to come back and everything's gonna be fine, we're now scrambling to figure out how to provide services. So our company, since we go to rural schools, we've already done teletherapy for speech for many years in some of our districts that we were kind of primed to kind of jump in and start doing that, and really, we only had about a 20% return rate as far as our kids who signed up for teletherapy. But that was more or less what we did was the teletherapy for the kids who, you know, had access to the internet, had access to a computer or a smartphone and but that was, again, a very small percentage of of our overall caseload.    Jayson Davies     Wow. Okay, and that, I think that's pretty similar to me. I was sending out some materials to kids. I never really heard back from them, whether or not they were doing that. I made a video for them, and then if they did it with their parent, great. But I didn't hear back from many. I probably did have about 20% or so that I was seen live for therapy. What about you, Jamie? How did the end of last school year workout for you.    Jaime Spencer     It was, I think, particularly crazy for me, because I had just come back from maternity leave, so I was just getting back into the swing of real life, you know. And then I was, I think, I was in the building for maybe five weeks, and meanwhile, so for my school district, I'm the only district employed therapist, so I don't go to every single building. I couldn't possibly I see kids in one building, and then the other three days, I do a lot of I do all the evaluations for the district. I do assistive technology, and I'm involved in the general ed curriculum, you know, doing handwriting trainings, and we just started a new handwriting program this year. So I was really busy with the teachers with that, and then all of a sudden, everything was remote. So I did when I came back from my maternity leave, my administrator said, You know what, your kids have been seeing this other therapist all year. We're not going to take, you know, take those kids and give them to you now, because they've already been making progress with her. So I didn't students on my caseload, so my year was looking really different anyway. And then to try to then go to teletherapy. Well, not teletherapy, because I didn't have direct students, but, you know, evaluations and all that other stuff, my district kind of just put everything on hold, so I didn't have any of that to do via teletherapy. I was just communicating with the teachers and keeping in touch with everybody to see if there's anything I can do to help. I was in touch with my assistive technology students and things like that, but it wasn't what it normally would have been if I had been having a regular year.    Jayson Davies     Yeah, were you doing any evaluations at all?     Jaime Spencer     I didn't do any over teletherapy. I had one that I did the day before everything shut down. I wrote it up and I sent it in and that and I but we didn't have a meeting about it, because the rest of that child's evaluations weren't completed. So everything's just been on hold. I am actually, I let my district know. I said, if you need me to do evaluations over the summer, now that the school is kind of opening, and, you know, a lot of the administrative staff are in the buildings and working, so I said, if you want and do some valuations over the summer, to get caught up. Because I can't imagine how many evals have been put off, because we do a lot, almost at least one a week. You know, I'm going in next week to do an evaluation in person.     Jayson Davies     Gotcha, Okay? Yeah, and we'll get into the evaluation a little bit more in a minute. It sounds like you said you were using Google platform for some of your things, or were you using Zoom before.    Jaime Spencer     We were we were using zoom, but now we're switching to Google.     Jayson Davies     Okay, and our district is doing the same exact thing. Not gonna lie, I was a little frustrated when I found out we weren't going to be able to use Zoom. But Billy, I think you have mentioned that your your company has an actual program for telehealth. Is that? Right?     Billy Hatridge     Yeah. They did for the speech what happened was that was the reason that platform for our speech therapist, but when we needed it for everybody, and we're looking at the cost analysis, we went with Zoom, which kind of what Jamie says. A lot of our school districts now are moving towards Google, and so I think we're on the same boat. I never actually spent, I don't think, a minute on the platform they're using for speed. We basically rolled zoom out company wide, just kind of make sure that everybody could get into it really quickly. The Zoom was really easy to pick up and run with.     Jayson Davies     So, yeah, I'm gonna miss zoom. I mean, we're on zoom right now. It's so simple to share your screen. You can give the child access to click on on your screen, as long as they're not on a Chromebook. That that was a difficult, some some difficulty with Zoom was that our district was giving out Chromebooks to kids, and apparently Chromebooks aren't as friendly with Zoom. You can't use all the futures, but I guess Google will have to want to see what happens. It sounds like we're all in the same boat there. So best of luck to everyone.     Jaime Spencer     I was actually really happy to hear that my district was going to Google. I've been begging to go to Google, just as our whole system we've been using, you know, Microsoft. So we've been using note and the one note cloud and OneDrive, and it's just really glitchy. It's been glitchy in my district, and I found a lot of the teachers weren't using it. They were using their old fashioned like shared drive on their computer, and they like, Oh, is it in there? And I'm like, No, it's in the cloud. But I think, like this, teletherapy and tele education has forced a lot of people to just embrace the technology. So I feel like going forward, it's just going to be a lot easier for me, particularly because I am in so many buildings, and I try to do out of things through technology. But if the teachers don't know how to use it, or they're not using it, then it's not as effective. So I think, personally, I'm psyched.     Jayson Davies     Yeah, absolutely. I love Google. It's just the Google meets. I tried it a few times, and it's just the way that I was using it. It it was limited in what you could do. As far as for teletherapy, that was my only concern with it. But hopefully, it sounds like they've already made a lot of upgrades to it, and like I said, I'm going to a training on Monday with, like our tech trainers, so hopefully they'll have some good tips, and maybe I can share a few different add ons throughout the week that might make it easier for people. But now let's move a little bit forward. How are you planning for the school year? Jamie, I'll let you start with this one.     Jaime Spencer     Yeah. Um, I'm not really making any major changes. I want to go in and see what things look like. Um, I I'm the only district employed person, so I don't really know who's going to be the other ot in my building, who's going to be the PT, what is their schedule going to be like? Because I think we're going to have to be in the room on different days. When I was in the reopening committees, we talked about also the cleaning in between sessions. Are we going to have to change our schedules? You know, to give allow more time in between. I mean, I don't know if you're in the same boat, Jayson, but it's like, you know, you see your child for 30 minutes, and the last five minutes you're working on skipping on the way back to class so that for the next child. And it's, I just trying to imagine adding in the cleaning and making sure that any toy that they touched is now sterilized and everything. I think that's going to be kind of the tricky part, but I haven't really done anything to prepare for it. I'm feeling like when I go in and I see what it looks like, and I look at my caseload, and I want to really work with the speech therapist too, to see what they're doing. I usually copy, you know, their schedule or whatever, however they're making it work.    Jayson Davies     Yeah, definitely make sure you get the speech schedule before you start scheduling your kids. I feel like they have so many kids, you kind of work around them a little. Yes, yes. What about you? Billy, how are things maybe changing in your planning scheme for this upcoming year?    Billy Hatridge     So for the OTs that is supervised, it's going to be kind of the same. They're going back into the school buildings that they work in. They're working, in some cases, they had and Mark, you know, give or take your kids working in some teletherapy here and there. But the big issues is, like, what Jamie said, is trying to figure out how to squeeze in those disinfectant times throughout the day, and we're going to try to really make sure that we're not using our own therapy materials as much and use the kids stuff, because the kids going to be handling it in and trying to make sure that we don't have a much cross contamination as possible. For myself, I supervise for OTs across five districts. Now, these are small, rural districts, so typical school year, I'm driving 500 550 miles a week. I'm not gonna be driving a whole lot this year. There's gonna be a lot more stuff like this being able to zoom in. In In fact, this was the one of the easiest in review seasons I've ever had, because I sat right here at my desk and just zoomed in to meeting after meeting. And I wasn't driving all over Timbuktu to make these conferences. And so it's a big thing for me, and I talked with my supervisors about this a little bit, but making sure that I'm not traveling between districts. So with these smaller districts, we're often in 234, different school buildings throughout the day. It's myself especially and trying to make sure that if I go to this elementary school, I'm really only there that day to where, if there's an issue, I'm not cross contaminating multiple districts across counties, and that's going to be the biggest issue. It was quite common for me to drive through two or three counties in a day, you know, and just sign some notes, go into a conference, test a kid, and let that be that this year it's going to be a lot more doing everything I can from home or through distance or at the office, and Skyping in, not stopping in, but zooming in Google, meet then however we're doing it. And doing supervision that way, doing note reviews that way, and just really trying to take advantage of keeping myself out as much school buildings as possible, since I do work in so many different districts.    Jayson Davies     Yeah, it's funny how Skype used to be the best platform, and now no one's using Skype. I haven't even heard of zoom, Google and Microsoft Teams is like the three go to platforms now. All right, I'm going to read this question. I don't know if you, either of you will have much input, but I want to read this. And if you do, please just chime in. Angie asks, Has anyone considered having a virtual OT and an in person ot team? If it's like hybrid learning in order to eliminate scheduling nightmare of having both you guys have any input on that one?    Billy Hatridge     Yeah, we've discussed that a little bit. Because the question is, what happens when we go into quarantine, you know, if we get exposed, if we if we get a test positive, what happens to that therapist? Do we cover for them? Do we send another person to that school to just pick up the ball and run with it? Or do they now, since they're home and stuck home, take all the teletherapy sessions so that, you know, we can utilize their downtime, and a lot of that's just going to be trying to figure it out as we go see what works what doesn't work. But we have kind of looked at that a little bit. We have a few OTs who do part time work for us, so there's some ideas there about, you know, allowing them to take the teletherapy since they are home, and have more availability. But we'll kind of see when we get in, have our numbers.    Jayson Davies     Absolutely. Jamie, did you want to say anything?    Jaime Spencer     Yeah, I don't have a team. I'm just me. So the rest of the students in my district who get occupational therapy are seen by contract therapists. So there's kind of a divide. I'm not in charge of them. They, they're they just get their caseload. And the way it was from, you know, March to June was that they were kind of scrambling a little bit to figure out. Some parents wanted to use Zoom. Some parents just wanted activities sent home. And so the therapists were, you know, I think this therapist had to work harder than ever before to get all these different wishes, and, you know, to provide all these things to go home. So I think it's going to be the same way. If we have to go back into quarantine, I'll I'll have my students, and then they'll have their students. So    Jayson Davies     Jamie, you mentioned how your role was already very different last year, because you were taking on some assistive technology, maybe a little bit more of a leadership role. It looked like are you keeping that same role or because of what's going on? Are you going to be seeing more kids this year? No.    Jaime Spencer     So my role was only different because I was on maternity leave, so I didn't have students General. My role is three days a week I do district wide stuff like leadership type things, and two days a week I see kids Gotcha. Well, that's my norm, and that's what I'm going back to. All right.    Jayson Davies     All right. This is a question that I really want to know the answer to, and this is from Colleen. She asks, Are you doing push in to the are you going to push into multiple classes? Or do you plan to go from one class to another class? Oftentimes, both of you have already talked about having multiple school sites. Are you going to be able to go from one school site in a classroom to another school site and walk into that classroom in the same day? Jamie, do you want to talk about that?    Jaime Spencer     Yeah. So for me, in my district, we do push in as a whole class in all of the special education kindergartens, so I will continue to be doing that in my building. I only see students for ot sessions in one building, I do go to all of the other buildings to talk to the kindergarten teachers about the handwriting program and first grade, and then do all of the assistive technology and all of the regular ot evaluations. So I am definitely going to try to limit my, you know, like Billy said, cross contamination, of going to too many buildings. But I think with this technology, like I'm very comfortable with technology, I want to consult with teachers via technology, and I always need to be in that building, you know, so if the teacher has questions for me or wants to talk to me, I'm hoping that there'll be a little bit more of consultation over technology to eliminate that in between buildings and in between classes situation.    Jayson Davies     Yeah, it's definitely a big change with all this technology and we have progressed, I think. Estimating, like technology has progressed 20 years and six months. I mean, it's amazing. What about you, Billy? It sounds like you might be staying home, but what about the OTs? Jason? Gonna be gone? We've already received    Billy Hatridge     some emails from our school saying, hey, you've lost your therapy room because, you know, we're making smaller class sizes. So those other kids have to go somewhere. And I get it. You know, we have an entire old music hall in one of our districts that we just use, and so we're this little corner and the rest of the classroom is empty. So that's a really underutilized space for somebody who's there maybe two or three days a week, and those schools will probably be doing a lot more, either push in or out in the hall, unfortunately, but that's going to be good, because then we don't have this contaminated therapy space where we're putting these kids in one amphitheater at the other, especially when they're from different grades or different buildings there on campus. So the question, the debate we just had, this debate yesterday, is, is it more beneficial to push in to where our students aren't going into the same room, but then if we're positive, or if we're carrying something, we're exposing 34567, classrooms in a day, and all the kids. And how do we justify that when little Bobby gets sick, but little Bobby doesn't get OT and it's just because I was sitting next to him when I was working with my client. And it's there's not really a right answer, but we're going to be conscious of that every time we go to a kid. There's no one size fits all rule to this thing, so it's just about best judgment in that time. You know, is there room for you to go and work with that kid without risking other kids who aren't even on our caseload? Is now a good time to take them into that private room? It depends on the kid, depends on the activity. So, yeah, I don't know about the push in per se, but it's not going to look like what we were doing in March, for sure, right?    Jayson Davies     Yeah, I want to kind of ask a similar question, what about small groups? Are you guys still going to be able to do small groups? Or do you even typically do small groups?     Jaime Spencer     I do a good amount of small groups, and my district spoke about ordering like dividers to put in between the kids, which I thought a good idea. You know, most of the kids that I see in a group are in the same class anyway, but I know that my my district, is trying to keep the classrooms with all the desks six feet apart. So, you know, I am going to be doing group sessions, but it's going to be, you know, a little tricky.    Jayson Davies     Yeah, it's been fun on Instagram, seeing all the creative ideas that therapists and teachers are coming up with, with how to keep desks six feet apart, keep shields up in front of their faces, so whatever their spitting isn't going anywhere, but at the same time, keep it conducive to learning, right? It's tricky. What about you, Billy? Small groups.    Billy Hatridge     We hardly ever do small groups. We're lucky enough that with the team the size that it is, we're always able to see kids one on one, with the exception of an activity that needs a group, or we're doing a cooking group with our high schoolers, those kinds of things. But I do want to touch on a point that I think both of you all have made, that all school OTs really need to understand is that the environment is going to be so much different for our students, and we as ot practitioners are the best about trying to figure out how to adapt the environment for success and for being able so that's an area that I think, I don't think a lot of OTs are quite ready for yet, but when we go back into the schools, we're going to be real cognizant of making sure they're laid out the way they need to be for all the students in the classroom, not just ours, because we're doing some wild stuff, and it's really creative in what we're doing, but We're going to have to be aware that sometimes it's not always, you know, conducive for the learning styles of our students or for their students. And we, out of all the professions, have been saying this a lot. There's no better profession to get things back to normal than ot that's what we do, right? Whether it's stroke rehab or it's special education, we are always trying to get back to function. We're always trying to get back to making things run as smoothly as possible. And so we kind of need to break away from that caseload model where it's like, these are my 20 kids, and this is the 20 hours that I work, and that's more or less what I do with my week, and start volunteering more. We're contract therapists, so a lot of times we fall into that trap of, I don't get paid to do that. So you know, y'all are on your own. That's not what we need to be doing right now. We really need to be using our services the best capacity that we can with our teachers are going to be struggling with more mental health and anxiety than usual. They're not going to know what to do. We're really good with those kinds of things, so it's not even our kids. It's the students, the teachers, the administrators that we work with and being really good at advocating the entirety of our profession, that we're not just the fine motor handwriting people, that we can do so much more that's been underutilized for years for ot but that we can really have a chance to shine here and come into the classrooms and help them set up classrooms in a meaningful way, help the teachers combat anxiety, help our students understand Mindfulness and all kinds of things that are outside of what we typically just hone in on as school based OTs.    Jaime Spencer     I just want to add, I totally agree. I just did a whole video about that Billy, about the scope of practice, of occupational therapy, and how very often we're only seen as, you know, handwriting teachers. But I think. It's, it's a hard thing to say that we need to volunteer more. I mean, I'm employed by the district, so it's different. But when I look at my contract therapist, they're already doing so much that they're not getting paid for. I think it more falls on the administration to I think it falls on us to advocate with administration about our scope of practice and that they need to utilize us for these things, not expect us to do it for free, but understand that this is part of our skills, and we would love to use them to help you. If you would add that to our work responsibility, I think that's the big key piece, because I every ot that I know works really hard. And the contract therapist, they're writing reports from home, they're making phone calls. They don't eat lunch, you know, and I think it's not right. You don't hear about teachers doing that, you know, teachers have unions that support them, and everybody knows what teachers do. But when it comes to us, we're very often underutilized. But I think a big piece of it goes back to that advocacy and US educating administrators. Use us. Please let us know before you order furniture, right, so that our kindergarten kids are not sitting in sixth grade desks. But you know, people don't realize that there's more to it than just opening the catalog and picking kindergarten furniture. My district did that, and I had like a pack, because the kindergarten furniture was not appropriate for kindergarten. It was way too big. And you know, it's those things that administrators, when you really have a good, cohesive relationship with them, you can educate them about that. But because so many OTs are not employees, they're not around long enough to that kind of relationship with their administration, right?    Billy Hatridge     That's true. I don't know about how things are in New York or California, but we're still really pushing on state level to move towards the workload model for therapists. We're still very much in the caseload model. You know, you've got 30 hours of treatment, so you're going to be working 30 hours a week. And that's not exactly how that how that works, but I think that, like you said, we're using volunteer not to kind of give our service away for free, but to advocate for what we can do. Because unfortunately, if all we do is what we're getting paid to do, they'll never pay us to do more, because they don't see the value and the other things we just say we can do, whereas if we're able to work those in, they're able to see that value. That's one of the better ways to kind of advocate to the creators that we can do more than just handwriting fears and.     Jaime Spencer     But I think on the On another note, like to play the devil's advocate. If we always do those little things extra for why would they ever pay us to do them? Either? I think we need to hit it from the top and say, Pay us and employ us and use us for these things, and it should be a workload approach, because half of one day a week should be about training the staff, or, what about self regulation, or, you know, I mean, I think that, I think that administrators like OT is not their number one concern or priority, and so it needs to be something that's coming at them from the top.     Jayson Davies     Absolutely. So I just want to share with you. You guys can't see the comments, but we have some comments. People are really appreciating what you're talking about. Olivia says, This is our time to shine. Miriam says, I agree with what both of you are saying. Tara says the same thing. I agree 100% good point. Says Miriam. I agree. Jamie says, Megan. So everyone is loving all what you had to say. This is kind of an RTI realm. And so go ahead, Jamie, looks like you have something to say about RTI. Well, I mean, we're kind of talking about RTI right now. This is tier one RTI. This is that base level education for teachers that will help every single student in the school, right?     Jaime Spencer     Yes. And, you know, with the new regulations and everything and how occupational therapy, we're now considered an S, i, s, p, we're supposed to be part of the whole team. We're supposed to be at the table, and very often, and especially in New York and Long Island. And I mean, people know I'm always like, on my soapbox about this, the districts don't hire therapists, and I'm so very blessed to be hired, but I'm so angry for the other therapists that they're not hired because, number one, I don't think that they can do the their best job, and they can't collaborate like they should if they were A team employee and a team member who's been there for years. You know, I have, I love the teachers that I work with, and I've learned so much from them, but over the years, you know, you need to kind of relationship. Or this year, we're dealing with this kind of student, and we learn from each other how to deal with that kind of problem. And the next year, we have another thing happening. And you know when you're when you're not an employee and you're not, you know, a member of the team, then you're not number one going to be as invested, and I don't blame them, but also you're not going to have the opportunity to show what you know and to shine you know. You just don't you.     Jayson Davies     Absolutely You're right. I find that I don't know out here in California, I think this is nationwide. OTs, we tend to be hired under the special education umbrella. And likewise, when we bill, we earn money for special education, and we can't bill for RTI, we that's just not what Medicare Medi Cal allows for billing. It's all for individual, small group direct services. And I think that plays a role into it, because the district does get reimbursed for what we do, and they don't get reimbursed for RtI that we might do, or trainings that we might do. And so I think that is a larger picture that has to be addressed that sometimes we don't think of. We just want to, yeah, we want to help. And so, like Jamie was saying, we offer to help, and then we're doing help, and no one knows that we're doing help. But, yeah, there's so many different sides that you have to come at it from, because there's so much going on there.    Jaime Spencer     And I think you know, administrators were once teachers, but teachers have never been administrators for the most part. So I do think that administrators do the very best that they can to look at the whole picture, and sometimes, as people who are not administrators, we might not know about their 25 other concerns that they're trying to deal with. We have our thing that we are you know, want them to pay attention to. But in my district, one thing, I mean, I feel like my administrators are pretty open minded, and I've gone to them with a lot of, you know, big ideas that they let me put into play. But one thing that we did for a while, maybe five years, was we had contract therapists pushing in to our self contained classrooms twice a week for a half an hour. And the thought behind it was that we could reduce the number of pull outs, and we could reduce the number of children who were getting occupational therapy on their IEP by providing it as a class service, which would be educating the teacher about, you know, what to look for and what to do, as well as working with all the kids. And in my building, I, you know, I'm not patting myself on the back, but in my building, that went wonderful. And I spent two days a week actually pushing in. I was in self contained kindergarten, then I went to self contained first grade, then I went to self contained third grade. And my whole day was planning, and it was a lot, because I had to plan five different sessions, different like lessons, but the teachers were very different. Some teachers I kind of pushed in with whatever they were teaching. Most of the teachers wanted me to come in with something and show them things. So in my building, we all, you know, made it work and did the best that we could for the kids, and it went great. But in the other buildings where it was contract therapists, they weren't getting paid to do the prep for these sessions, and it was, it was kind of put to them as you're going to push into that class and help in whatever way you can. You know, the teacher is not going to just stop what she's doing. So the OT can sit there. You know, it ended up in a lot of instances that the OT was trying to just sitting in the back of the room during a science lesson, like, how many times can you say this child needs this kind of pencil grip? Or, why don't we change this child's paper? It's not it what? It just wasn't working when they weren't employees. And I think again, it goes back to that collaboration, but we did have that as an RTI, you know, measure in place, and it was so great, but we didn't stick with it because it wasn't working in any of the other buildings.    Jayson Davies     All right, it's so easy to talk about RTI with the two of you, because I know both, all three of us are such advocates for all children, not just the children on our caseload. But I want to get us back to the virtual topic, and that is going ahead forward with virtual evaluations. What is the plan? Jamie, it sounds like you've thought about this a little bit. What? What are you thinking?     Jaime Spencer     So I'm the only one who does the evaluations in my district, and I was on the the RE evaluation reopening committee. There are certain tests that are easy to do via teletherapy, but there are a lot that are not. So my plan is when I go back in September to make sure that I bring my VMI forms and all the tests that I can use home with me, so that if I'm doing evaluations from home, I can mail the parent the VMI forms, but I did, you know, speak to my administrators and really advocate that our Occupational Therapy evaluations are going to look different, and we have to stop only looking at scores, because the scores, you know, these standardized tests, aren't standardized now. And you know, very often I'll do like, a visual motor assessment and then a visual perceptual assessment. But if I'm doing a visual perceptual assessment, you know, through the camera, through the lens, or even if I end it and put it on a Google slide, if we could do it, but it's not going to be the same. So I, I kind of said, we need to look at what. Going on in the classroom, what does the parents say they're having difficulty with and how can we help in terms of that? You know, in general, I think most administrators, they're used to looking at the test scores, but it's got to get away from that. If we're doing it via teletherapy.    Jayson Davies     I think everyone would like to know Jamie, if you can list a few that you are planning to use, you said the VMI, but there are there other assessments that you're planning that are pretty simple,    Jaime Spencer     yes. So I actually have a free webinar that I put together with two teletherapy experts who've been doing it for 10 to, I don't know, 20 years. That's over on my website, Miss Jamie ot.com and they taught me a lot. I interviewed them because I wanted to provide something for OTs that are, you know, kind of thrust into this world. But they said that the VMI was a good one. I like that because it's standardized from two to, you know, forever. And you you would have to mail the forms to the parent and, you know, make sure the parent knows, do not open it or do anything until we're on Zoom. And then you can provide the instructions over the camera and make sure that the child is not tilting the paper or erasing and all that other things, and then the parent would have to send it back to you so you're still scoring the actual paper, and the child is still working on the actual paper, so it is standardized in terms of the visual perceptual you know, the scores won't be standardized because we're not giving it in a standardized manner. But I don't think it would be so crazy to maybe scan the the pages of, let's say, the MVP TR or the MVP t3 and do it on Google slide and ask the student. The problem with that is, you know, you have your kids who have letter reversals, so they might say B, but they mean D. And in real life, they can point to the second one, and I know they meant B. On the computer, if that's not really happening,    Jayson Davies     you can't they're really pointing at Yeah, yeah.    Jaime Spencer     So I also think some informal measures, like the handwriting without tears, the screener handwriting proficiency, I think easy one and a good one that we can send the parent the link. They could print it out and have the child do it and send it back to us. You know, getting an informal handwriting sample is is good that certain subtests of the B OT, we could probably do, you know that the visual motor portion and the cutting portion, as long as the parent doesn't open it until we're, you know, on the camera with them, and we can still watch that's hard.    Jayson Davies     Part is you might have to mail them a red pencil, though, yeah,    Jaime Spencer     I, you know what? I, I I didn't think of that, and the scissors too, scissors too. But then then I find too. Sometimes the scissors that come with the B ot aren't, don't fit my kid. Oh yeah, I don't. I use different scissors because I want, I do to use scissors that fit, yeah,    Jayson Davies     all right. Billy red pencil, I guess they probably have something that'll work. Maybe it's green, it's all right, Billy, I'm gonna come to you, but I just want to say that, you know, that's something that we're thinking about too. I think most of our evaluations, the psychologist is going to be scheduling with the parent to bring the kid in, even though we're completely virtual teaching and virtual services. I think that kids are going to be allowed to come in for the evaluation, but that doesn't mean that they're going to be in class for an observation. I mean, we're gonna have to zoom into the teacher's Google room or whatever and do an observation. And, you know, like right now, all you can see is this little box. And so that's all I'm gonna be able to see of the student, potentially, during a classroom observation. So we're actually trying to come up with a blurb that just talks about how you know this standardized observation, or this option, not standardized observation, this test, this evaluation, was conducted via teletherapy, and therefore, I don't even know what we're going to write, but something about how this is different from the regular school environment. So, Billy, what about you? What is your plans for for evaluations? I know you are hand you are Handwriting Without Tears, certified. Are you going to be using the Print tool? Or what are you going to be using?    Billy Hatridge     Not really right now. We're just kind of employing the stop gap measures or just trying to get them tested. You know, we can look at the handwriting, we can look at some of the more specific things when we have the ability to do so and do for this formal assessment, we're very fortunate with our service model, because we have two satellite clinics that are both within an hour, 30 minutes of all of our schools. And so even when all this started back in March, parents are able to bring their kids into the clinic for a one on one sterilized environment to get tested. We had several schools making that recommendation, and so as of right now, in talking with our Las administrators, it's looking like they're going to be the kid is virtual. They're going to be sending them either to school or to one of our clinics, depending on which one's closer to the family or which one the family would be. Her and doing everything in person, as far as those, those formal evaluations. Now, you know, there will be the chance we have several who are staying home. There are several kids I know right now that aren't coming back to school in person, but these are children who would be able to participate in any kind of standardized assessment. Anyways, we're gonna be looking at manual muscle testing, range of motion, those kinds of things that it's going to be more or less walking the parent through and me kind of observing and trying to take the best guess. The truth is, with standardized testing, hardly any of my tests are standardized, because our kids aren't standardized. You know, almost every evaluation I write, I have to make some comment in there about their attention span or about their their physical capacity, right? We all us as OTs, we're all familiar with that idea that the standardized assessment don't really paint the picture, and our kids can't always participate the way that's laid out in the Administrative manual. This isn't any different. It is different, but we're used to having those blurbs in the bottom of our assessment saying, you know, it's different because of, you know, they have one arm, they're not able to sit there have these issues. So it's all about making sure everything's documented, documented properly. But as far as our team goes, it's looking like 99% will be in person.    Jayson Davies     And real quick. Jamie, I know you kind of talked a little bit about potentially bringing students in, but also virtual. Do you think you'll be doing virtual assessments now, or do you think they'll mostly be in person?    Jaime Spencer     I think if we go back to being in quarantine, then I think I can do them via teletherapy. I never have I'm definitely willing to learn and to try, because we're going back in the beginning of the year, I'll be prepared. I'll have the things that I need, and I'll bring them home with me. When school closed, it was just like, I mean, I like, I said, was on maternity leave, so I'm sleep deprived and back to work and a little crazy. I wasn't even watching the news. I'm like, what's going on? And so I didn't have anything with me, but my bag that I had that day, and prepared, but I think going forward, I will be, and I my administrators, they understand. And you know, I think that they would be, I think that they would rather have me do it over teletherapy than put it off longer,    Jayson Davies     absolutely.    Billy Hatridge     And I will say Jayson just as of right now, I do know that Arkansas Medicaid does not pay for teletherapy assessments. The re looking at that, but as of right now, there's no reimbursement in place for teletherapy evaluation. That's been the review. We haven't done any teletherapy. That might change when school gets back in and we start seeing that need, but as of right now, it's still kind of on the got to get it in person. So    Jayson Davies     I have a question follow up to that, then, how does as a contracted company, how does that affect your company, versus, because it's actually the district that's you're billing for, right, right?    Billy Hatridge     And that's been the issue we've only some of our schools have only been billing insurance or Medicaid for a few years now. So prior to that, it was just kind of the school. Of the school rule, the school rule, you know, however you want to do it, since we're paying out of our budget with the implementation of Medicaid reimbursement, it has definitely changed a lot of what we do in the schools, because now they're being more cognizant of what what those Medicaid requirements are, and making sure that things are reimbursable. Our LEAs are great. A lot of times they say, Hey, even if it's not covered, we're just going to beat the cost. Beat the cost. And you it's just got to get done, whether you know it'll be reimbursable or not. And so our, all of our administrators, are really, really great about working with the therapy team and about helping us through these hurdles. So you know, we'll, we'll kind of see, when we get back into it, how much of a need there is for virtual assessments. As of right now, I'm not seeing a real big need, but, you know, two weeks into it, if everything goes back to virtual, things might be a lot different. So    Jayson Davies     all right, in the comments, we have some questions about sensory processing. Type of evaluations, SPM, I think I might have saw the sensory profile. Are you? Do you guys use the SPM or the sensory profile?    Billy Hatridge     Yes, I use both. And those are questionnaires, and so, you know, there'll be easier to send out and kind of collect back. However, it's really important when you do those assessments, that you make note that this is during a pandemic, because that sensory processing is going to be a lot different now than it's ever been, not just because of self, you know, social distancing or the mask, but just because of the anxiety level that our our kids with sensory processing issues, are dealing with in the home and in that environment. So I've already had several that I've done, and I've had to make that comment of, you know, heightened stress, height and anxiety in the home due to, due to what's going on.    Jayson Davies     All right, I'm going to challenge you, both of you, once more, if you were having to do virtual assessments and you were going to use the SPM or the sense, well, actually the sensory profile, yeah, they both have home forms and school forms. Would you be asking the teacher to fill out the teacher school form or the parent to fill out the home form or both? What would you choose? Yeah.    Jaime Spencer     So I think I would choose the home form or both. I don't use my school district doesn't use sensory testing as part of our standardized testing. Years ago, we had an administrator that felt like we don't provide sensory integration therapy, so we shouldn't be using that assessment. What we do is sensory strategies. So that is something that we could put in, you know, our narrative. But in a case like this, with everything that's so crazy, and our kids with sensory issues really are struggling, I think sometimes it's appropriate, it really depends.    Billy Hatridge     So for me, it would depend on the but I'd be sending everything home. I'll try to get home forms as much as possible. Now, we get a 50% return rate and stuff we send home usually, so, you know, but it depends on the teacher. If the teacher has never seen this kid in person, then no, I'm probably not going to ask them to fill out a sensory questionnaire. But if this is, say, a self contained special education class, and this teacher has been working with this kid for years, then I even if they haven't seen them the last six months, I have a good idea that they're going to be a lot more aware of where the sensory processing issues are. And then again, with my documentation and the way I write up that report, make sure I denote that this is after six months of not seeing the get in person or whatever that may be,    Jayson Davies     absolutely no, definitely. I think that's spot on. We should definitely be using whatever tool our evaluation process is kind of leaning toward, and what is the school environment anymore? I mean, where are kids, and even if they are at school right now? I mean, even their home life has got to be a mess. I mean, my home life is a mess right now, and I'm a pretty, I mean, in a pretty good place, and it's still crazy. And so, yeah, that's it's going to be hard to determine what assessments to use, how to make the most of it, how to get it done. And like Jamie was saying, We're backlogged. I think everyone's backlogged a little bit. And now we're trying to figure out how to, I mean, the 60 day timeline, 45 day timeline, whatever it is in your state, is out the window right now. So right now our district is saying, focus on the new evaluations that are starting the 60 day timeline, and then try and get to the old ones, because they're already past due. Hopefully you can get to those, especially if they're tries, if their initials, we want to get those done as soon as possible. But some of the tries, maybe it's like, it's somewhat of a formality in a way, because, you know, we're not planning on changing services to a huge extent, but still got to get it done somehow. All right, I have, I think we're going to wrap this up with a kind of two questions. Kind of go hand in hand, PPE and cleaning everything. What is the plan? What is your district's plan? We talked a little bit about putting up dividers, maybe. But what are your personal plans? How are you going to make sure that things are clean in between sessions and all that good stuff?    Jaime Spencer     So my district, my district did hire, hire or buy Plexiglas for in between sessions. They've ordered face shields for all of the speech therapists. I don't know. I mean, I'm sure if I asked for a face shield, I could have one. I also bought a couple of masks that say ot on them. You know, got to promote. I think I'm going to be crazy with my Clorox wipes and just be I think what Billy said before about having the students use their own materials. I don't think my district talked about that unless I just missed, didn't, you know, didn't catch, but I think that's brilliant. So rather than have the kids using my scissors and my crayons and everything, they can bring their supply box with them when they OT and, you know, things like hand, you know, therapy putty. I'll be giving each kid their own therapy putty, that maybe I'll have a Ziploc bag for each child with the things that they use, so that that eliminates a little bit of the, you know, cleaning. But I think for the most part, I'm going to have to take the last couple of minutes of each session and just clean, clean, clean. Yeah. So    Billy Hatridge     with our team, our school districts have told us, basically, it's what your company has to do. And then our company has said, Well, it kind of depends on each school district and what they want their practitioners to do. So we're kind of in this mid zone, but ultimately it's going to be the face shield, it's going to be the mask, it's going to be gloves, making sure that we use as much of the students materials as possible, since it's already on them, and you don't have to worry about sanitizing it when they go back necessarily. I mean, you want to, but if they're going to keep using it as soon as they get back into the classroom, it's not as big of an issue as when you have a new kid coming in. He's got same stuff. I have a tackle box that I work out of. I'm probably just going to have some of those testing manipulatives that I've got to have, and not really bringing anything else into the schools with me, other than a laptop or a pen, and really trying to just minimize how much stuff I'm carrying with me, even my backpack. I go into a classroom, I sit it down on the floor, then I pick it up, put on my back to the next building. You know it's. Is another point of contact that you have to be aware of. So it's a lot of just using the students materials. It's a lot of doing more of their school based activities. So if they're working on an assignment, bring it with them. Bring as much of the stuff they're working on in school as possible. Since that's going back with them to the classroom, it's gonna look a lot different. Our sensory stuff is kind of getting locked up, you know, sand trays, big things, the therapy, the swings, ball pit, that kind of stuff is going to be a no go, which is unfortunate. We're going to have to be creative. And how we address that, I've been really pushing for my OTs to do a lot more mindfulness activities, a lot more breathing techniques, a lot more things where they can sit. We don't have to touch. We don't have to get in close proximity. Heavy work, those kinds of things, we can go out. I've got a 30 pound kettlebell that I use a lot in therapy for my for my kids, with ADD and ADHD, and that's something super easy to clean. It's just one big chunk of metal and that might find its way into the therapy room. But ultimately, it's about using as much of the student stuff as possible and to help the cross contamination, and    Jayson Davies     you can get a workout at lunchtime. I love it, Billy, good job. All right. I know I said that was the last question, but Nicole had a great question, and I just want to, we'll finish up with that. The question for Billy and Jamie is, what about progress monitoring? How are you going to how have you already done progress monitoring at the end of last school year? What did you put into those progress updates? And I think for you guys, it'll be mostly similar, because you'll be able to see the students, but if you can talk about how you did it at the end of the year, and then if it'll be any different as you move forward,    Billy Hatridge     yes, I'll jump in when we did, like, our interviews and in the year stuff, I basically had two, two scores. The first was what they had in March last time we saw them in person, were able to address it directly as it was written. And then kind of a, more or less a big air quotes here, but hypothesis of where they're falling in now based on our teletherapy sessions based on our communication with parents. You know, typically in pediatrics, we don't usually see a big change in our progress in a few weeks like you do in adult rehab, so it's usually pretty close to where they were in March, coming back in in August, we're basically starting back at zero. I've told my team we're basically taking back up, regardless of whether they've been coming for teletherapy or in person sessions during the summer, when school starts. We're back at March 13. Is the mindset I want everybody to have, and we're just going to try to pick up where we left off, and if they made progress over the time frame, great, but let's just expect to be back where we were. And the truth is, we're probably gonna have a lot of kids who regress during this time, and just making sure that in that documentation, once again, that you're that you're noting why that was whether the kid got tele therapy, whether the kid went home, whether the kid was receiving services elsewhere, what their participation was like with AMI packets, anything that you sent home, was it, like you said, I sent, I think, 32 out. I never heard back from any of them. And so, you know, I can't say what that progress was like. They have to go back to what it was March, yeah. And    Jayson Davies     what about you, Jamie, how was your progress reporting?    Jaime Spencer     I didn't have any progress reporting because I didn't have students. Oh, that's right. But I think going forward, I agree, it's going to be a fresh start. So my students that I have been working with in my building I haven't seen in a year, so I would be coming in as a fresh look anyway. And I did find out from my district that I'm going to be working with the kindergarten to third grade this year, and then the other therapist will be doing third to fifth grade. So I mean, I think I'm going to work really hard to make sure I get a baseline on every single area I can. If we do go back into quarantine, I'll have that information. Yeah, now I'll    Billy Hatridge     tell you too. I'll probably get a big resounding no from all the other OTs, but I wouldn't mind reevaluating everybody, to be honest, just to kind of figure out, because so much has happened in the last six months. Now, granted, I don't have the time to do it, but in a paradise setting, you know, just be able to reevaluate everybody. Because none of these kids are going to be where they were in Bart. None of them are going to be where you expect them to be. And we're going to have to be really aware those first several weeks of therapy that we're doing a lot of just those informal assessment that we're not jumping in and working on goals that we're just trying to get, like the baseline of all of these skills that we had been addressing and new skills, mask wearing, hand washing, you know, hygiene anxiety, there's a lot of room for us to grow out. We're going to have a lot more issues than we've ever seen, and we're just going to have to make sure that we're assessing those properly, and that every session, there's some amount of that assessment coming into it, so that we kind of get a better idea of where our kids are.    Jayson Davies     Yeah, and it's interesting, we had our official welcome back meeting yesterday with special education, and it's very interesting about how they are, what the mindset is, as far as how they are. Looking at IEPs and what the plan is, and our district, we are going to be virtual starting the school year. And as of last year, IEPs that happened from March to May, and then now going forward, they are telling us to write these IEPs as though a kid is going to be in school tomorrow. And that is not the case. I mean, that's hard to determine what we're going to put on an IEP for a for a school day when the kids not on campus. So I don't know it's going to be interesting this year. Everything from IEPs to treatment to progress monitoring, everything's going to be different. And, you know, hope for the best, plan for the worst, and we'll see where we get so I want to thank both of you so much for coming on. I actually want to give you both a quick second. I'm going to let Jamie go ahead and start. You mentioned your website earlier, but I'm going to give you a second to kind of go ahead and just just promote yourself for a second. Okay,    Jaime Spencer     so my website is Miss Jamie. Ot.com , J, a, i, m, e, and I've got a bunch of resources on there right now. I have a lot of videos on my Facebook page. I've been really focusing a lot on vision and vision within the scope of practice of school. OT, and as I said, I do have a free webinar about teletherapy. So if you're looking for more resources and more information about teletherapy, that's on my website as well. Yes,    Jayson Davies     and her emails are fantastic. She just did a great video yesterday with Robert Constantine on vision. It was fantastic. Julie. Go ahead. What about you? Share a little bit about your website? Yeah.    Billy Hatridge     So I'm the OT dad. OT dad.com , ot dad and all the social medias. And you know, I'll be honest. I was when all this started, I was like, I'm gonna have all this time to plug into my website, to plug into all these things and do all these resources. And really and truly, my priority was my three year old. And so I've spent so much more time just at home with family and really trying to focus on that since I have been in such a work mode the last several years. So it's not as robust of a resource as Miss Jamie stuff. I definitely recommend you check her out first if you're looking for those kinds of things. But no, there are good resources there, there as well, you know. And it's a lot more kind of insight on my end. But yeah, that's the okay to add on all the platform,    Jayson Davies     absolutely. All right, everyone. Well, thank you so much. Please give Billy and Jamie a thumbs up a heart. Show them your appreciation for being here. And you know what? We will see you all next time, maybe we'll have to do this again. People are enjoying it, so we'll see you all later. Have a great rest of your Saturday.    Jaime Spencer     All right. Thanks for having us, Jason.    Jayson Davies     All right. And there you have it. That was my conversation with Jamie Spencer from Miss Jamie ot.com and Billy hattridge from the OT dad.com both amazing occupational therapists, both doing great things in their respective areas. And I just want to say thank you so much again to them for coming on and taking the time to do this. I realized that one thing that I forgot to add at the top of the show was that this was actually a Facebook live video, and so that's why it might the sound quality might have been slightly lower, and you heard me saying that maybe someone was saying that they loved it, or something like that, or as asking people to give a thumbs up. That's because this was originally on a Facebook video. And so with that, I want to encourage you to head on over to facebook.com , forward slash ot school house, just like my page. That's where I do some of these live videos that I do them, and then you are there live. You can ask a question, and I'll just, I'll just answer the question there, or I'll ask whoever is a participant on our video to do to answer the question. So it works out great. I do those from time to time, and people have been loving it, so I might keep doing it. But anyways, again, thank you. Thank you. Thank you so much for listening to this episode. Listening to every single episode. Can't say thank you enough. One last time@otschoolhouse.com that's where you'll find that A to Z school based. Ot course that I talked about a little bit at the top of the show. But yeah, everything is everything is housed at ot  schoolhouse.com so check it out, and we'll see you next time on the podcast. All right, take care. Bye, bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to OT schoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Or click on your preferred podcast player link! On this special event episode of the OT Schoolhouse Podcast, Jayson welcomes to the show occupational therapist, Olivia Martinez-Hauge, MFTA, OTR/L, and occupational therapy assistant, Cait Bowen, COTA. You may remember Cait from Episode 44 of the OT Schoolhouse Podcast. In this episode, Jayson, Cait, and Olivia discuss what the looming return to the 2020-21 school may look like in our districts and how we are planning for them. We discuss how evaluations, treatments, and IEP meetings will all be very different, even from how they were at the end of the 2020 school year. Above, you can watch the full, unedited Facebook video or you can listen to the audio-only version on the OT Schoolhouse podcast using the player at the top of the page or where ever you listen to podcasts. Links to Show References: Follow Cait Bowen on Instagram: @Cait_the_COTA Check out Olivia Martinez-Hauge's website at OliviaMArtinezHauge.com Also referenced in this episode: The WooTherapy Blog (Highly recommended) Google Meets Google Meets Zoom Microsoft Teams Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments regarding our podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 54! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Jayson Davies     Hey everyone, and welcome to the OT school house podcast. I am so excited to be here with you today. My name is Jayson Davies, and today we have a very special, unique episode, actually, this past Saturday on August, 1 of 2020 I hosted an occupational therapy assistant as well as an occupational therapist, and we just went live on Facebook and talked all about getting back to school during this pandemic, what are our plans, and all of that crazy talk that could, that could go along with that. And so actually, that's what you're going to be hearing today is a recording from that Facebook Live event again on August 1 2020. Joining me on the show today will be Kate Bowen. You may have you may know her as Kate the coda on Instagram. She's just an amazing coda. Does a lot of good stuff, creates things, puts out a lot of awesome and helpful content on Instagram. And so if she's going to be here today to share about what they are doing in Michigan or how they're planning for the school year at least. We also are going to be joined by Olivia Martinez houge, and she's an occupational therapist here in Southern California, along with me, not too far away from me. But as you know, every district is a little bit different, so she's going to give her take on those districts or on her district. Sorry, all right, so that's what it is going to be, or that's who's going to be on. And like I said, we're talking about back to school during a pandemic. I just want to mention one last thing before we jump into the intro, and that is that my A to Z, school based. OT course is available once again, you can head on over to OT schoolhouse.com . Forward slash A to Z, or check out the show notes for ot school house podcast episode 54 this episode to learn more about that, but this is just something I'm so excited for. It is a go at your own pace course for a total of eight hours. But not only do you get the course, you get a ton of handouts that will help you get through your first, second, third, whatever year of a school based ot you are also with that. Not only do you get the sessions, but I'm also doing live student interactive Q and A sessions on our student Facebook interactive groups. So be sure to check that out at ot  schoolhouse.com . Forward slash A to Z. All right, so I'm going to go ahead and Cue the intro, and when I come on back, we will get started with our interview. I hope you enjoy it. And once more, here is Cait Bowen and Olivia Martinez Hauge.    Amazing Narrator     Hello and welcome to the OT school house podcast. Your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.    Jayson Davies     I love my little intro. Thank you both for joining me. I'm so happy to have you on here. Welcome to this very, very special live edition of the OT school house podcast. I want to thank everyone joining us today, but especially Kate and Olivia today. We are very lucky. We have one OTR and one occupational therapy assistant on with us today, and I have purposefully tried to find occupational therapists that are in different parts of the country because all different states have different they're not even really regulations in place. They're just kind of guidelines as far as how schools are going to return and yeah, basically, some are going back to school. Others of us are not. It looks like Olivia has her coffee or tea with her. I have mine as well. Cheers, everybody. How are you doing today? Olivia?    Olivia Martinez-Hauge     I'm doing good. I'm it's, it's a, you know, it's a Saturday, so that's always, that's always good to make it to the weekend. But I'm excited. I think this is a great idea to have OTs come together, bring their minds together. I think we're a creative bunch, and I think what what other way to sort of challenge our skills here than to create sort of the ultimate treatment plan for the kids in in our country, absolutely.    Jayson Davies     And how about you, Cait, how are you doing?     Cait Bowen     Oh, good. I've already been up for a few hours, so my coffee is gone. I feel like I need another one now.    Jayson Davies     There you go. Yeah. Is it 1030 where you are?    Cait Bowen     1130 actually, 1130 Okay, lunch time.    Jayson Davies     Right time to go to Panera or something, right? All right. So you know what? Let's go ahead and actually dive right into it. I want to start off with the first question that I think everyone wants to know, and that is, Are schools returning to campus in your area? Kate. I'll let you go ahead and and talk about that first    Cait Bowen     the question of the hour. Yeah, right. I need to start off by saying that my district has not released an official plan yet. We will find out. I believe Tuesday will be the announcement. So I don't know for sure exactly what my fall is going to look like. Districts around me have started releasing their plans, and honestly, we kind of have a mix. Some people are going in person, some people are doing all online, some people are doing a mix of both. And I'm thinking that my district is going to be doing a mix of both, where parents will have an option they can do in person with social distancing and those kind of guidelines in place, or they can choose to go online. So I'm very curious to see how much of my caseload is going to be in school or choosing to stay home, because I think that the therapy that I provide is going to be a mix of both, which is such new territory for me, but we'll kind of learn as we go, I guess. Yeah. So I don't know exactly what I'll be doing yet, but it sounds like from an OT standpoint, we will be trying to push into classrooms as much as possible. I'll have to wear a mask all day. We're sanitizing everything after each session. If we can't sanitize things, we're trying not to share things. I think that our sensory rooms are going to be closed, which is a bummer, but it's just what we have to do right now.    Jayson Davies     Yeah, yeah. And when do you guys actually start school in California? We're starting in like a week or two. Okay,    Cait Bowen     I think we're set to start August 24 we've got a couple PD days there first, and then the students will come back, I think for like two, three day weeks before Labor Day.    Jayson Davies     Okay, yep, sounds about right? And Olivia, you are actually not too far from me. You're only about 20 minutes from me. But things can change from district to district. So what are, what is Jordan's plans?    Olivia Martinez-Hauge     Yeah, I'm curious. I hadn't even asked you that. So Jordy is and the district surrounding us are all 100% virtual, starting in the fall. There was this, the discussion of the hybrid, but we are in a hot zone, so that discussion got taken off the table kind of quickly, and so we're 100% online in the fall the same    Jayson Davies     it sounds like it we things have changed over summer a few times. Yeah, we originally, I think the district really wanted to get back into in person, and then it was going to be optional hybrid, versus all online, and the hybrid was going to look like two days on for half of the class and then two days on for the other half of the class, with like Wednesday being no school day, all planning teacher or teacher planning day type of thing. But now it looks like we are starting completely all online. And despite only being 20 minutes from you. I'm in a different county from you, and as you know, California is really kind of watching things county by county. And so you guys, you're Los Angeles County, I'm San Bernardino County. And right now, we're both on California's watch list. But if one of us were to go off the watch list for 14 days, or something like that, then our district would be able to have that option to go back if we'd like.     Olivia Martinez-Hauge     Sounds so criminal,    Jayson Davies     right? But as of right now, yes, we will be starting all online. And so my question to you, actually, Olivia, then, is for us, even though we are all online. It sounds like the district is going to be requiring teachers to go on campus and actually teach on campus. What about you? Are they saying that you need to come on school? Or can you work from?    Olivia Martinez-Hauge     home? The what I know at the moment, as of 839 on Saturday, is that our unions are in negotiations still about about hours and all of the things that you know they're discussing, I believe one of the things that they're discussing is being on Campus, or that sort of thing, I know for now, we don't need to be on campus. We can do things from home. So as of right now, what I understand is that the teachers can work from home, but I. When I spoke to one of our principals, she had mentioned the opportunity for for teachers to come back to their classroom to work if it's more comfortable for them, you know, or, you know, open open up certain areas for them to work, to work in.     Jayson Davies     Gotcha. So then Kate, I want to ask you, because you're sounding like you're not sure in districts, might have the option to go back in. You go to multiple sites, right?    Cait Bowen     I have six buildings that I typically go to.    Jayson Davies     And so that's where I'm trying to figure out. As far as you know, everyone's trying to create, like, a bubble at each school site, and.    Cait Bowen      I'm breaking the bubble.     Jayson Davies     Yeah? Exactly, exactly, yeah. So.    Cait Bowen     Within the course of a week, I am in six, usually six, different school buildings. So most days it's two buildings, but I think there's going to be a day or two where I'm just in one spot, but it sounds like we're going to be trying to push into classrooms as much as we can, but they've also talked about getting us, like, like a Plexiglas barrier to go on our table with, like an opening at the bottom for us to work through. But we'll, we'll see how that goes. I have some concerns about that working for some of my kids, I get Safety First 100% but I can just see that wall being pushed at me.     Jayson Davies     Yeah, absolutely, yeah. And then I mean, yeah. And kids are going, they're used to when they work with us, they're used to having a hands on connection. Yeah, that's gonna be tricky, you know what? Before we continue on, I actually meant to ask both of you, what is the population that you are working with? Do you have a wide verse population, or does it tend to be a certain population? Kate, we're already talking, so go ahead first.    Cait Bowen     Yeah. So most of my caseload is kindergarten through sixth grade. I see kids in gen ed, and then I also have, I would say, the bulk of my population is cognitively impaired. And then I also see emotionally impaired too.    Jayson Davies     Okay, and is that mostly in general education classrooms with, like, some pull out support for special education, or at least self contained Special Education self    Cait Bowen     contained. They do spend some time in the gen ed classroom, but for the most part, they're in their own room.    Jayson Davies     Gotcha All right. And what about you, Olivia?    Olivia Martinez-Hauge     so there's just the two of us in our district. Shout out to my work wife, Amanda, who I cannot live without, and we see everybody. So we're, doing assessments at two years, 10 months or so, all the way up to having the potential of having a 22 year old. So we see everybody and special ed, general ed, everybody in between. It's just the two of us,    Jayson Davies     so a very wide range of population, all right, oh yeah, that's good, you know? I think people just want to know that. So as we're speaking, they know. And for me, I'll go ahead and update. Mine changes every now and then, and I don't think I've talked about on the podcast recently, I am mostly in two schools with moderate to severe autism classrooms. So full day for the most part. Yes, the kids are trying to or they're getting out of the special day classroom to go to general education every now and then, but it is too moderate to severe special education classrooms for kids with autism. Yeah, all right, let's talk evaluations.    Olivia Martinez-Hauge     Did not, can we not? We just ignore that completely.    Jayson Davies     We got we got it. We got to do it. We got to do it first. Let's talk about the past. March 13 was the day that we got told we are not coming back to school on March 16, or whatever it was. I don't know about for you guys, but have you were any evaluations completed in the months of April or May? No for Olivia. Kate, do you know I    Cait Bowen     don't do evaluations? Guys? Mary, you guys, listen to the podcast I did with Mary. She is like the best, so I'm not sure exactly what she did during those two months, but not sure she was doing evaluations. She's a rock star. She just, she just does her own thing. She's so great.     Jayson Davies     And for everyone out there, if you haven't listened to Episode 44 the OT school house podcast that was Kate and Mary coming on about talking about the OT ot a relationship, and how they collaborate, work together. Fantastic. Go back and listen to episode 44 but we'll, kind of Kate feel free to chime in at all through this conversation. We talk about evaluations a little bit for whatever, you know, but I'll kind of talk. To Olivia, then about that. So no evaluations. Olivia in March, April, May, Summer, nothing like that.     Olivia Martinez-Hauge     No, okay, yeah, everything paused.    Jayson Davies     Everything is, everything still paused, going forward.    Olivia Martinez-Hauge     So, okay, so, like the plans, yeah, I mean, you caught me at the like, wrong time, so yesterday, actually, it was, I think I spent a total of about three hours, three and a half hours in the assessment, like mindset. We had a webinar with an attorney group that was going to share with us, um, sort of what the newest, latest and, and, you know, I thought was was going to give us some good direction. Um, it really caused more questions than it did give us answers. What I what I think I know, is that, um, timelines have to restart again once school starts back up in the fall. And that, I guess, the bottom line is that we have to be creative in doing assessments virtually. Current sort of guideline from the state is that there should be no one on one instruction because of safety. But the lawyers then took that and said, well, they never said one to one assessment was not, you know, okay, there's that kind of open vagueness to potentially do assessments one to one, but our district at the moment is is still holding kind of strong and and wants our safety, you know, foremost. So I think that as a as a department, we're still coming together and trying to figure out the answers, what I, what I what was kind of sort of definitively said, is that standardized assessments are not standardized for telehealth or teletherapy or online, nor are they standardized during worldwide pandemic. And I think that for us, for where I am struggling in terms of my assessment protocol and my thinking when I go into assessments, my assessments are very strong in or very rich in looking at regulation and, and, And then also my question is, what is the educational environment and and what am I supporting? And so those are still questions that I'm having some difficulty with. So even if I did like a sensory profile at, you know, sent that home, I kind of have to write at the top sensory profile during worldwide pandemic. So I think it's going to take a lot of creativity on our part, a lot of discussion with the parents, which we already do so well in terms of gaining information. And I think at the end of the day, our assessments will be our best guess at what is going on and always with that filter of this occurred during COVID, and when you return back to school, I'll get my hand on you and see you in that school setting.     Jayson Davies     Yeah, and I don't want to talk to any one specific assessment in general, but I've been kind of with the mindset that, you know, if we feel that we can do the assessment over the computer, whatever that might look like, you know, sending the bot protocol in the mail to the parent, and then doing it over the over whatever zoom or whatever platform we're using, I feel Like I could do that and write in my report, you know, just like you would write, if a kid was outside of the age testing limits, you just say, Hey, I understand this wasn't standardized for teletherapy, but I felt that I could get scores that could actually somewhat reflect the child. And so I did it. It was done via teletherapy, so all the scores need to be taken with a grain of salt. But here's what it is, right? And doing any potential assessment that I can that way, I mean, are going to be like the Peabody I can imagine being very difficult to do that with, because typically you're doing that with a younger student, and so now you're going to have to instruct the parent on how to present the tools to the child versus the bot, might be a little bit easier, because you just need a red pencil.     Olivia Martinez-Hauge     Right? right, right, yeah, yeah, I Yeah. I think it's going to take some just creativity on our part and flexibility where I think, you know, some of us older Fauci. Get a little rigid in our thinking and things need to be done a certain way, or whatever. We just have to be sort of flexible and and think of things a different way. And just you recognize that this assessment took place during this time, the the the some of the more of the questions I have are like, if a tri annual comes up, and I know this child really, really well, and you know, maybe they aren't having the regulation issues that I see in the classroom, because they're at home and they're well regulated, and maybe parents create a very calming atmosphere or something, and then I don't see the same concerns. You know, am I going to dismiss this child based on on that? Those are some questions that I have in terms of, you know, yeah,    Jayson Davies     difficult for any occupational therapist to dismiss a child right now, just because there's so many changes going on, if anything. I mean, I might go to more of a consult model and try and do more of a coaching model or something like that with the parent, but I think it's going to be hard to convince any parent that now is the time to,    Olivia Martinez-Hauge     Oh, for sure. But you know, if you if you're taking sort of the letter of the law in terms of providing services or whatever, where's the area of weakness and what goal do I write or whatever? Yeah, I think it's just, you know, we'll write, and I agree. I don't think I wouldn't be dismissing anybody during this time, but, but, you know, those are some of the questions that have come up in our discussions? Yeah,    Jayson Davies     so I'm looking at the questions, and there's a few questions about Kate. I know you're not quite sure what's going on with the district. Olivia looks going completely digital. Has there been any talk, or are you just hearing whispers at all about something looking slightly different for students with special education because of their high need for education needs, their high need for the services. Have you guys heard anything about even though maybe they're on distance learning, bringing them into campus or onto campus for services or even special education, despite the rest of the population learning from home? I don't know if either of you have any, I have not    Olivia Martinez-Hauge     heard anything. No nothing. It's just, I just heard sort of rumors, whispers of the potential of having certain students come on campus a few days a week or whatever. But I haven't heard anything beyond that.    Jayson Davies     Yeah, yeah, I agree. I've heard about ideas floating that students with in special education classrooms, the SDC classes tend to be smaller, and therefore maybe social distancing will work. But you also have to keep in mind the social and cognitive disabilities and how that might be less, there might be less social distancing, despite having more space.    Olivia Martinez-Hauge     Yeah, more adults, yeah. And I don't know if I mean, you know, you can, we can go back and forth about about everything, I think, and, but one of my concerns about that is, is right? What is the potential harm that we're doing when we bring the kids back in. But, you know, we're so preoccupied with keeping them separate, are we then sort of, you know, dysregulating them, instead of regulating them by having them, having, you know, strict rules around that and you know, and then will there be behavioral modifications presented to these kids when, you know, just because for poor social, you know, I think there's a lot. And then you had mentioned Jayson earlier, early on, about how we usually have a connection with our kids, and what will be the social implication when we aren't allowed to touch our kids, and what message is that going to send to them? Connection is what we're known for, right?    Jayson Davies     So I want to talk about dive more into the treatment side. But first, Have either of you had a good win or good successes with technology? Are you guys using zoom, Google meets, Microsoft, teams and and or anything else, and what are you finding that's working for you guys?    Cait Bowen     I have to be honest, I have not done any teletherapy really. So if we go to that, I'm gonna need all the tips, because I don't know anything. It's like, totally foreign to me. I did a couple like zoom. I don't even know it wasn't a treatment, it was just more of like a Hangout with some of my students. Same kind of like talked, but there was no ot treatment happening, but that was over. Zoom, were    Jayson Davies     you, were you sending things home in the mail, or were parents coming to pick stuff up? Or what did it look like in April and May for you? Then, Kate, we    Olivia Martinez-Hauge     were emailing once a week. We were emailing parents like a list of activities that they could do. Everything was optional, so it was just more of like, if you want to do this, you may, if this is too much, it's okay. And then we just made ourselves available for parent questions and emailing back and forth, yeah, no.    Jayson Davies     I mean, we're, did you have good feedback from that?    Cait Bowen     It was hit or miss. I have some parents that I know did them, and some that I am pretty sure never opened anything, and that's just, that's just how it goes, and that was to be expected. I mean, everybody was just in survival mode for those first couple of months. And we didn't want to add another stress on top of that.     Jayson Davies     Yeah, no, I understand. And what about you, Olivia, how did March and April May kind of turn out for you technology wise? Or what were you doing?    Olivia Martinez-Hauge     Um So in our district, we're sort of, uh, mandated, or, you know, strongly suggested, to use Google. So everything's in the Google is about, called a Google Suite. I'm still learning what Google can do, but we, you know, there was a learning curve, because I had not used it before. So, so, you know, it was, it was touch and go with learning how to how to set up a Google Classroom. But since then, we've learned Google Classroom. We've learned Google Forms, which we then created, like little, little surveys or things that our kids can check off, and then it gets sent right to us. So, so we're using the Google platform and Google meet, and I, I personally have more success with Zoom, in terms of a conferencing, whatever I felt like Google meets, there's more hiccups, or it's a little bit more clunky, but unfortunately, we have to use that moving forward for meeting with parents.    Jayson Davies     Yeah, I'm kind of in the same situation. I primarily used zoom in the spring, and we just got an email the other day saying that there's going to be two trainings, one for Microsoft Teams and one for Google meets, and that we're going to have to be using those from now on. And I tried Google, the Google platform, Google meets, and I was not a big fan of it. There's a lot more limitations than there are for zoom. Yes, ever the HIPAA compliant version of zoom is $250 per person, at least, that's what they advertise. And most districts already have a contract and a business agreement with Google. And so that's probably going to be the way that it goes. And or Microsoft, yeah.    Olivia Martinez-Hauge     So if anyone from Google is listening, can you improve that platform for us, teachers and therapists?     Jayson Davies     Cait just said that teams, Microsoft, teams, is great, and that's what I'm hearing. Unfortunately, because I work in elementary schools, it sounds like elementary schools are going to be using Google and high schools are going to be using teams, which I'm like, Okay, well, now the one that I actually think is more like zoom I'm not even going to be able to use anyways, because I work with younger kids. Yeah, yeah, it'll, it'll be interesting.     Olivia Martinez-Hauge     And if may, if maybe people can share, you know, little Google tips with with whatever the Google platform. You know, I love zoom, because I feel like the screen sharing is so much easier with Google zoom, and I'm able to bring up stuff for parents to look at. You know, simultaneously. I know Google meets can do that too, but I just, yeah, it's just a little bit, all right,    Jayson Davies     let's talk a little bit about how we are getting back into treatment. So we just talked about what we've done in the past. Did anyone do summer school? E, S, Y, no, no, Kate, Olivia, did. I did too. Is basically the same thing. Olivia, I'm assuming yours was very similar with some treatments online, right? Very similar. Yeah, yeah. And I use Google Forms too as well to get feedback from parents. So once I did send them an email or something, I would have them or I tried to have them complete a Google Form to let me know how it went again, only a small handful of parents reply. To that. But let's go ahead and talk about how we are planning moving forward. Olivia, you kind of sound like you talked with the district attorneys, lawyers, people who are going to tell you exactly what to do without any experience. What do they want you? What do they want your treatments to look like?    Olivia Martinez-Hauge     So true. Um, you know, luckily we, we have a good attorney team, and they're, they're really open to listening and that sort of thing. The way that we're moving forward is based on all of the information that we received during survival mode in spring and and a little bit of summer. And so we're moving forward given the feedback from from parents, our experiences, the feedback from other providers. So, you know, I'll just tell you, like, kind of what is solid and boots on the ground, kind of stuff. So we are so what we found is that parents were in one of two camps. In in the spring, in the summer, they either wanted face to face interaction virtually, which is means that we're we're meeting with the parent virtually once a week, or once every other week, or whatever, and and we're either talking with the parent or seeing the student. So that's like one camp the other camp of parents were, I have no time, nor do I want to get on face to face with you. Send me the material, and we will do it in when we are available. So given, given those two main camps of parents, we are sending out a survey, hopefully by Monday, a survey that is asking parents to choose from option A which is face to face scheduled sessions, just like we would do in school. And those special sessions will happen as the therapist and parent determine that's Option A, and Option B is individualized resources. And, you know, individualized videos or or printables, or whatever provided for that family that the family can access when they are available during the day. So that's where we're starting, just so we can get that information, because we did our struggle this last these last few months, have been parents, maybe wanting the just the resources, but sort of afraid to tell us, like, we don't want to meet with you face to face. So there's just a lot of like, miscommunications and, you know, all of that stuff. So we're hoping with the survey, we get good, solid information, then we can plan and have materials and face to face activities and that sort of thing all planned and ready to go. By the beginning of fall, we're putting together small little packages of not expensive things, clothes pins, rubber bands, popsicle sticks, paper plates, straws, that sort of material packages that we can give to our parents. And then also, oh, and then I think we'll the plan now is to roll out a Facebook page just for our parents so that we can dump some material onto there. I mean, we're really attempting to provide as many opportunities for them to access us as possible at the same time. You know, we both have our own children, our own families that we're needing to teach as well. And so, no, we're just trying to get short everything up before the fall. But, you know, we're going to treat this much like we do a treatment session. You know, we come in with our bag of goodies and our treatment ideas, and then our kids are like, No, we don't want to do that. We're going to be ready to pivot and change and flexible. So that's sort of the plan as of now.     Jayson Davies     Yeah, So Kate, how are you expecting things to be different? I know you're very creative. Kate, Dakota has all the creative fun stuff. How are you thinking that things will be different from last term to this coming term? As far as treatments go.    Cait Bowen     I feel like. Our key words for this year are just going to be like creativity, flexibility and patience, because this is just a huge learning curve. I really have no idea what to expect if it does turn out that parents can choose between in person and online. That adds a whole nother layer to the scheduling. I feel like it was tricky to schedule before six schools, around specials, around other therapies, around core content, and now I'm adding in whether or not they're even in person or they're at home. So it's just gonna be it's gonna be wild. I think when we're in person, I'm just going to try and bring things that I can easily wipe down and a little plug if I can. Megan from woo therapy is releasing a series of blog posts where six therapists, myself included, are coming up with a list of like, 15 easily accessible, simple, cheap objects that parents could have at home or that we can have at school, that can be used in a variety of different ways. So I think I'm going to go back and look through that series and see what other people have come up with, and maybe just try and come up with, like, a small kit that each of my students can have, and then just turn on that creative part of your brain and just come up with as many ways to use those objects as you can. And I do think that's a great thing about OT is we are creative, and you can give us simple household objects, and we'll turn it into therapy. And I just think that's something that we're really good at. So it will definitely be a test of my creativity this year, and I think it will push me in ways that I've never been pushed before, but we'll just kind of figure it out as we go. I think.     Jayson Davies     Yeah, I love Megan. I was actually on the phone with her yesterday on the other side of the hill from me, so she's really not far either, sometime, but she'll appreciate the shout out. We'll definitely put a link to her to her pages. Did either of you do? Kate, it sounds like you were sending things home. Olivia, did you do any asynchronous videos where you were creating, like an activity video and sending it out to parents?    Olivia Martinez-Hauge     Yeah, during the spring, we did a lot of that we and we had parents use household items, things that were found in the house or that they would have. And then we then we would give them options like, Oh, if you don't have a straw, use a chopstick, or, you know, that sort of thing. And then, and then we created a video that would go correspond with that. And we got a lot of good feedback with parents saying, I love this. We could do it whenever it's there, it's accessible, it's on there. And then, and then, what was cute is we would get some videos back of our students, you know, doing it or trying it, or whatever. And you know, what we're always stressing is that, and I think you said this, you know, I the last thing I want to do is create more stress in the home. I want, if it's causing dysregulation, not just stop, you know, and our parents shouldn't have to be the therapist or the teacher. And so we want everything to be within that playful mindset, and, you know, just the creating connection, rather than, you know, sort of this teaching moment where you have to sit down and we've got to do but rather like, you know, here's this activity I'm suggesting it to you. If it happens in the bathtub, more power to you.    Jayson Davies     Yeah. And so, actually, I had kids who were on live, or who I was meeting with live, and some of them actually transitioned like you were talking about earlier. They're afraid to say they didn't want to do the live. And I had a few actually, that did reach out eventually, after a few missed Sessions, who said, Hey, can you just send us the activity? And so the asynchronous model became more popular as time went on. And so what I was doing is on Monday, or whatever day it would be, I was sending out an email with the materials that they would need to complete an activity, and then I created a 10, maybe 15 minute video that kind of showed what the parents could do. And I have a document camera that I borrowed from my principal, and I just basically, it was just my hands, for    Olivia Martinez-Hauge     the most part. Great idea.     Jayson Davies     So I would start the video with my face. It'd be like this right now, and I'd say, Hey, today we are going to, I don't know what's one activity I did, like pipe cleaner bracelets or something like that. I. And then I would switch over to the document camera and show them how to do it, and I would show different ways to grade it too. So I would have, like, a paper that had different colors. So that's one way that you can grade it. You can have different sizes of beads or whatnot. Someone on the comments asked about what I use Google Forms for. And if either of you want to chime in on this too, go for it. I use Google Forms a to try and ask parents what materials they had around the house. And so I would send out a Google form with just like, hey, do you have glue? Do you have this? Do you have that? And that way I knew to base my treatments around those types of materials. I also use Google Forms to then ask follow up questions about, how did this work? Do you feel like the student was able to do this, or were they not? How much support did they need? Which then does help, potentially with your progress, monitoring your progress reports. You may not be able to write specifically to the goals, but at least you can have some feedback that you know that the parents are doing the work with the students, that they're doing something with the students, so I don't know. Do either of you have any experiences with Google Forms or Microsoft forms or anything like that?    Cait Bowen     Yeah, so I'm writing down all these ideas,    Olivia Martinez-Hauge     And then Cait is gonna surpass us on, you know, yeah, look at these new Google Forms. They're dancing around.     Jayson Davies     It's gonna have templates for Google Forms, yeah,    Olivia Martinez-Hauge     um, so we use so um, one of the Google forms that was popular with our students in the spring, because we're really into social, emotional and regulation zones of regulation. So we were having our kids check in with us, tell us how they're feeling. So, you know, we used a, it's a, it's a nice, easy way for them to just click boxes. You can put pictures in there. So we had, What's that movie Inside Out pictures there for them to describe their feelings, or whatever the survey that we're sending out to parents is on Google form. And what's good about Google form, and this will be my first time, is that it generates a spreadsheet, or generate something so that it compiles the answers for you. So from there, we can just take that information and really use it in like an Excel kind of a way to organize our information.     Jayson Davies     Yeah, someone on here was asking if I had good response to Google Forms. I don't know about you, but my Google Forms responses were not great. I'm saying probably a caseload of 55 I probably had 10 to 15 a week at the most, and it kind of tapered off. Yeah.    Olivia Martinez-Hauge     I mean, it's just based on participation, and I think that, you know, parents are, I mean, for me in particular, it's, it's a struggle and a balance, to balance everything that's that's going that's going on. So it's hard. And I think What's hard is that, you know what, I'm hearing words like rigor and robust for the fall, first, for our students and for our school districts and that sort of thing, nothing has really changed from the spring. And so I'm concerned for our students that come back to this bigger and robust, you know, whatever that looks like, you know, I don't know. I think we'll be doing a lot of social, emotional now and in the future. Yeah,    Jayson Davies     Kate, I think you started to mention what some PPE personal protective equipment might look like in the school districts. What are you guys hearing you? I think you talked about Plexiglas. Have you heard about face shields, or is the district going to be requiring this? Or what are you hearing?    Cait Bowen     As far as I know right now and again, official word has not been sent out yet, but I think that staff will be wearing masks all day. So I stocked up. I got some great masks from Old Navy, 12 or something. So I just have a bunch of them. I don't know. I didn't want to wait to see if the district was going to provide them, so I just got them myself. So we'll be wearing those all day. Students will not be wearing them in the classroom, from what I understand, but once they leave the classroom, they're supposed to wear them. I'm not totally sure that'll be interesting.    Jayson Davies     I'm interested.     Olivia Martinez-Hauge     Johnny's gonna be wearing Sally's mask. Oh, yeah, yep, yep,    Cait Bowen     yeah. They're gonna be chewing on them, they're gonna be washing them. They're gonna be swapping them. Yeah, it's    Olivia Martinez-Hauge     yeah. There's gonna be, this isn't my mask. It for a half hour.    Jayson Davies     Yeah, and I mean that kind of also, things are obviously changing and so, and this goes for both of you. I know Kate, you don't sit in as many IEPs, but I mean, just how are goals going to change based upon this? I mean, priorities are changing, granted, you know, yes, academics are still important, but right now, that's not exactly what everyone's thinking about. And so I think we're gonna see a lot of different types of IEP goals and like goals. You know, we always talk about the infamous shoe Tyne goal. Is it a school based occupation, or is it not? Well, what about mask wearing? Like, is that gonna be a goal for several of our kids? Now,    Olivia Martinez-Hauge     who would have thought that we would even be talking    Cait Bowen     about wearing a mask as an IEP goal.    Olivia Martinez-Hauge     Jayson, I mean to answer your question with a question like, What is the educational environment? So is it? Is it that now my goal is for the student to make a peanut butter and jelly sandwich, because that's the, that's sort of what, yeah, that's what he needs to do at home, you know, in his educational environment. So, yeah, I don't that those are questions that I don't know the answers to.     Jayson Davies     Yeah, that would be interesting, man. I am excited to hear like, I one of Kate's like, Facebook or, sorry, not Facebook, Instagram lives in a month and a half after she's gone back live, because we're not going back live, and I don't know what that's gonna what that's gonna look like.    Cait Bowen     Wish me luck. You guys. Yeah.    Jayson Davies     All right, so we talked about a little bit of PPE. It sounds like we're not exactly sure. I think my district is going to be providing mass but they're they want you to bring your own, but they'll have them there for you. My wife's district, she is in Rowland, Rowland Heights, and they will be providing them three washable masks, and they are required to wash them. They can wear their own as well, but they're providing her with three masks, I guess. Granted, she's on optional. She doesn't have to go in, but she can go in to teach online in her classroom if she wanted to. The last thing I wanted to really talk about, and maybe I'll ask a few questions after that from the comments, is, Olivia, do you have do you have do you work with occupational therapy assistants in your district right now? Or no? No, we don't know, right? All right. So, Kate, how has the pandemic made the collaboration between you and Mary? Has it changed at all? Has it become even more important? How has that been?    Cait Bowen     I mean, you guys, know, if you listen to the podcast, I have an amazing relationship with Mary. Everybody needs a Mary in their life. She's so great. I love working with her, and honestly, I don't think how we've communicated has changed really. We've always been really open with each other and quick to email, quick to text, quick to call if something comes up and I just see that continuing into this next school year. I feel like we've just got a we call ourselves, like the dream team, the dynamic duo, plus Jody. We love you too, Jody, and we've just got a really good thing going. And I just think that that will be a real asset in this next school year.    Jayson Davies     Yeah, definitely. And it's nice to have someone just to communicate with on a regular basis. I know a lot of us occupational therapists. We might work on our own, even if there are other other occupational therapists in the district, sometimes we don't get to talk to them as much as we like. So keep up. Keep up the collaboration that always makes things a little bit easier. All right, I'm going to go ahead and bring up a question for both of you to answer. Oh, it came up and then it disappeared. It is, how are you planning schedules to work around cleaning between students. So if you are going back to live, or, let's even talk about this, I'll add to it for Olivia, who's not going back. How are you planning to schedule when kids are going to be on a zoom call with their teacher for most of the day? So for Kate, how are you planning to work around the cleaning? And then for Olivia, how are you working around kids being in a zoom classroom all day long?    Cait Bowen     So before it was just kind of like a revolving door. I would drop off a kid, pick up a kid, drop off a kid, pick up a kid. But now I think I'm gonna have to drop off a student, go back to my room, sanitize, give it a second, and then before I go and get my next student, or if I'm pushing into a classroom. I'm not exactly sure it depends on the classroom. If I'm like, going into one of my categorical rooms, I'm just going to have to wipe everything down and give myself a few minutes between students. I'm just going to have to build in that buffer time, I guess. And thankfully, we have that flexibility. Um. Okay, and we'll just have to make it our new normal.    Jayson Davies     sorry, what was that, Cait,    Cait Bowen     I think all the Clorox wipes. Yes, send them to me.    Jayson Davies     All right, so, Olivia, I'm going to ask you the question one more time, because it's because Kate answered her question, and we are trying to figure this out as well, because kids are going to be expected now to be in zoom a majority of the day with our teacher. And parents are saying that it's too hard to go from a zoom with the teacher over to a zoom with the therapist and then back into the zoom with the teacher. Are you hearing any of that? And what are your plans? Yeah,    Olivia Martinez-Hauge     so, um, Okay, a few things. So that is one of the reasons why we want parents to feel the give them the permission to say we just can't do that. And here's how we can do it, and then work with them in terms of, you know, resources and Easter ace, I can't even say that word asynchronous sessions or whatever, so, so that's one of the reasons give parents that option. The other thing that we are sort of toying around with is dropping into the classroom session or classroom platform or whatever, and then I believe, I haven't done it, but I believe there are breakout rooms where, then you can take the kid virtually into the breakout room. Is that not?    Jayson Davies     That's zoom, and I don't know, maybe teams too, but I don't think you can do that with Google. As far as I know. Maybe if some someone could correct me, I haven't used Google very much, but breakout rooms is something that is common with Zoom. I've used it there.    Olivia Martinez-Hauge     Sworn. I could have sworn our AP e provider did that. And I want to say that it happened during Google, but I don't know, but, but that is, if that is a Google thing, then that is something that we can toy Okay.    Jayson Davies     Linda, saying, Google meets does have breakout rooms.     Olivia Martinez-Hauge     Thank you, Linda. Um, yes, so, um, so yeah. I mean, that is an option, but yeah, I mean, we're gonna have to work around that those schedules    Jayson Davies     and then so follow up to both of those questions is, how will that impact your ability to see the same amount of students in a day? Well, Kate, it sounded like you said you kind of have a little bit of a buffer, a little bit.    Cait Bowen     I don't think it will affect too much. How many kids I can see in a day. We kind of have a built in buffer. Anyway, I give each of my students like a 30 minute block, but the IEPs are written usually like 20 to 30 minutes. So I could go more towards the 20 minute side, give myself time to clean before going on to the next student while still meeting their IEP requirements.     Jayson Davies     And what about you? Olivia?     Olivia Martinez-Hauge     Well, so and Jayson, I'm curious if this is the case for you too. We're kind of talking to the district and the attorneys and that sort of thing about COVID time where, maybe in the in the IEP, it says 60 minutes a week. That is not realistic to have a child, you know, on Zoom for 60 minutes. So what is the agreed upon like sort of COVID time that we can agree to that will address the concerns, address the needs within that time. So, so, yeah, I think that given that scenario and everything, I think we can see the same amount of kids or, you know, work with, with it being either face to face or or creating individualized sort of material. I think, I think, well, my time will be stretched, but well spent.    Jayson Davies     Well for me, I found that in the spring it was easier for me. I basically made every student once a week in the spring, it was too difficult to try and figure out how to plan for consults, versus how to plan for twice a month, versus how to plan for a week, and so I just made everyone weekly. And I was able to kind of do that because a lot of them wanted that asynchronous model, and so I made, I made four different videos using a document camera, and I kind of put my kids into groups. And so if a kid was in a certain group, they had these types of skills and these types of goals. They got video a, these students got video B, C. And D and so that helped, and I just sent it out weekly, because it would have been more difficult for me to figure out who to send it to this week versus who to send it to next week and all that. And so I just made everyone weekly, but with everything changing now, and I think parents are getting a little more antsy with and rightfully so that, hey, we thought this was going to be a two month thing, and now it's a six to 12 month thing. Come on now, what do you what do you want us to what do you want us to wait for? And so I don't know if that's going to have to change this fall. I want to ask you a question. Kate, about small groups have do you do small groups typically? And if so, are you planning to?    Cait Bowen     Not usually, I usually see my kids one on one, which is great. That's how I prefer to do it. But yeah, I think that will stay the same just because of social distancing. I don't think we're gonna go anywhere near small groups.     Jayson Davies     I agree with that. I was, yeah, I if we were going back to school next week, whenever we start, it would have to be all individual, in my opinion, or like you saying, pushing into the classroom, but then, as we talked about earlier, if you're pushing into the classroom, then you're exposing yourself to, let's just round and say, 20 people, and then you push yourself into another classroom at another school.     Cait Bowen     You're making me feel like a real germ spreader. I'm sorry, Kate. I'll wash my hands. I'll wear my mask.     Olivia Martinez-Hauge     We're gonna put Cait on the watch list,    Jayson Davies     but it, I mean, it's just the things that we have to worry about. I mean, hopefully, you know, everything goes well, and it's going to be interesting to see. I mean, you have a lot of the country going back, and you have a lot of the country not going back, and I'm sure there's going to be a lot of people in the government watching doing studies to try and figure out which way is the best way, and how do you calculate which way is the best way? And so it's going to be interesting. All right, let's see here. Did your asynchronous Christy is asking a question, did your asynchronous videos count toward the IEP minutes? I think that kind of goes back to what Olivia was talking about. What are IEP minutes right now? And yes, we documented it. I documented that for each asynchronous video. I kind of documented 15 minutes for emailing and whatnot. But I think I we were instructed to put it as consult. So if a student had direct minutes, then technically, no, I was not seeing that student directly. I think Heather is recommending maybe that you use a bubble suit. Cait,     Cait Bowen     there you go, just a full half mat suit,    Jayson Davies     right? So are you, for both of you, because this can happen on Zoom, or this will be our last question. Can happen on Zoom or in the classroom? Will you be doing co teaching in in a zoom classroom, in a Google meets, or in a classroom? Is that something that you think you'll continue on?    Olivia Martinez-Hauge     I think that we did not do that in the spring or summer, simply because we're just we really put off all of our sort of juices flowing with the fall. But I think that we, we are willing to try anything. I think that will be, I think for some of our students, that will be the only way for us to see them, capture them, check in on them, and that sort of thing. So, yeah, I'm and we're all we in our district, we're always, sort of, we hate being alone. So we were always, we're always co teaching, or, you know, working with our other providers. We love, we love collaborating.    Cait Bowen     Yeah, I would say possible. Really, I used to do monthly groups with the speech therapist and with the physical therapist. So I don't think that we'll be doing those anymore, which is a bummer, but we'll pick them back up when we can.    Jayson Davies     Yeah, all right, well, things are definitely going to be a little different than they ever have been before. And so I want to thank both of you. Olivia, Kate, thank you so much for coming on and doing this. I know that you don't have all the answers. I wasn't expecting you to have all the answers, and I hope no one else was. But I appreciate you guys coming on, sharing what you know, sharing about how you guys are just kind of planning for things. Really appreciate that. Please, everyone out there, please give them. A heart a thumbs up for showing them that they are here. Really appreciate that. The last thing I want to mention before we go is actually for everyone listening. This is the first of at least two back to school plans during a pandemic that we're going to be doing. So look out for another Facebook invite email about doing this again with two more therapists in different regions of the country. It's going to be great. Probably be similar questions, but who knows? Because a lot can change in a week, as we know, a lot of information changes. So thank you all for being a part of this and really appreciate it. We will see you all next time, take care. Bye. All right. I just want to thank all of you so much for having a listen to this episode number 54 with Kate Bowen and Olivia Martinez. How G really appreciate you sticking this out with us. If you would like to see the show notes, you can catch those over at ot  schoolhouse.com , forward slash episode 54 I will also have a completely unedited version of the original Facebook video that this was recorded from over there. If you'd like to watch that again. Thank you so much for visiting. I really appreciate you being here with me today. Take care. Have a great whatever day this is week, and we'll see you next time on the podcast. All right, take care. Bye, bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT School House Podcast

Or click on your preferred podcast player link! On this episode of the OT Schoolhouse Podcast, Jayson welcomes to the show the wonderful minds behind @TheFannyPackTherapist to talk about their specialty, Augmentative, and Alternative Communication. Annabeth Knight, OTD, OTR/L & Mara Jonet, MA, CCC-SLP have presented at conferences nationwide on the collaborative approach to evaluating and implementing AAC devices for children. In this podcast episode, we focus on that collaborative process and the role of the OT. We also talk about why AAC devices are sometimes underutilized and how to prevent users from abandoning their devices. Links to Show References: Follow Annabeth and Mara on Instagram: @TheFannyPackTherapist Follow Annabeth and Mara on their brand new Fanny Pack Therapist website! AOTA Position paper on Assistive Technology (Members Only) ASHA Position Statement on Access to Communication Services and Supports The Communication Bill of Rights (NJC) Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments regarding our podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 53! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript   Jayson Davies     Why is it the fanny pack therapist?    Mara Jonet     So first of all, Annabeth and I are not only great coworkers, but we're also great friends who happen to be bonded in 90s nostalgia, and we are also very similar in our treatment approaches in that you don't need tons of toys, tons of games, a heavy bag to bring to every therapy session, and you should just ditch it and use yourself. So it was kind of like, well, you don't need anything more than a fanny pack to do a treatment session. So that's how our idea of the fanny pack therapist Instagram account started.    Jayson Davies     And there you have. It. A better introduction than I could ever give to Annabeth and Mara the fanny pack therapist. You can follow them on Instagram, and they are here today to talk about assistive technology and AAC. So let's dive into our Introduction music, which everyone loves, and then we'll come back and talk about some AAC, all right, see you in a second.    Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.     Jayson Davies     Hey there. Welcome to episode number 53, of the OT school house podcast. My name is Jayson Davies, and I am your host for today. As you just kind of heard, we are here to talk about fanny packs today. No, I'm just kidding. We're actually here to talk about AAC augmentative communication. And so we are going to get into that. We have two very special guests on today. They are collaborative team, an occupational therapist and an SLP, before the Introduction music, it was Mara jonet That you were hearing talking about how they came up with the name the fanny pack therapist. And with her, is actually an occupational therapist by the name of Annabeth Knight. And together, they are part of a collaborative AAC team that works in a private practice outpatient clinic for kids. And so they are here to talk about how they work together, along with other disciplines, to have this teamwork and just come together with a parent and everyone involved to put into place an AAC device or an AAC system that just works for that student. And so they're going to talk about the assessment process, and then the ongoing process that it takes to teach everyone involved how to use that system. They're really a great team. You can just hear it throughout this interview. They're really amazing, and I'm excited to have them on this is actually the first time we're having a speech and language pathologist on the show. So that's very cool. And yeah, so I'm excited to talk about fanny packs, and I hope you are too. We'll just talk a little bit about fanny packs. But, yeah, I don't want to. I don't have any other announcements to make today, so let's just dive into it. So please help me to welcome occupational therapist, Annabeth Knight and speech and language pathologist, Mara jonet, together, they are the providers behind the fanny pack. Therapist. Hello, Annabeth. Hello, Mara. How are you doing today? Let's go ahead and start with Annabeth. How are you today?    Annabeth Knight     Doing well today. We're excited to be here, and this is our first podcast,    Jayson Davies     so awesome. And how about you, Mara? Yeah,    Mara Jonet     hello, I'm doing great today. It's been a busy day, but super excited to have a kind of a long weekend. Yeah,    Jayson Davies     I hear that that's nice. So actually, Annabeth and I were just talking about this. Annabeth and Mara run the fanny pack therapist on Instagram, at the fanny pack therapist, and they are actually engaging in the oh so popular prank, or not prank, plank, 30 day plank, it's not a contest, but challenge. How's that going for you guys? It's going well. I was    Annabeth Knight     saying before it's nice because we're kind of tag teaming it, so one of us can't get to it one day, the other one can. And I    Mara Jonet     was just gonna say we're kind of at an advantage, since we're two people so we can, we can bounce off each other and have one or the other do it so we don't have to do all days. But other than that, it's really good, and we love the purpose of it, because who doesn't want to get a little bit stronger in their body?    Jayson Davies     There you go. Yeah. I was just telling annabev, I am not one to do planks, but I will ride a bike for like, hours and hours. So that's been my exercise lately. So well anyway, let's get into it. We are here to talk about some assistive technology at but even more so the AAC collaborative process, and so I'm excited to have you with us here to talk to talk about that today, but before we get started, I always like to give my guests the opportunity to go ahead and introduce themselves. So how about we start with Annabeth. Tell us about who you are as an occupational therapist and how you got into the fanny pack therapist realm. Yeah.    Annabeth Knight     So. So I am an Occupational Therapist. I've been working for almost nine years now, which is kind of hard to believe, and I started my career. My first job at a school was at a school for children with cerebral palsy in Philadelphia, and so I kind of got thrown into the world of assistive technology and AAC, almost every single kid on my caseload used some form of AAC, and so I was on that team right away, and just had a really tremendous opportunity to learn there and to work with so many OTs and SLPs and PTs and educators who had lots of experience in that area. And now I work in outpatient pediatrics with Mara, and we have just been sort of taking on a lot of those clients who we have at our company, who have at and AAC needs and building programs for them.    Jayson Davies     Gotcha. All right. So you started in the schools, but now you are in a pediatric outpatient clinic with Mara who is a speech therapist. Go ahead, Mara, how about you introduce yourself and what you've been up to? Yes.    Mara Jonet     So like you said, I am a speech and language pathologist, and I've been practicing for a little bit over five years. And in terms of, like, my passions, I'm really just passionate about complex communication needs and AC. So I was lucky enough to kind of cater my entire graduate school around placements with students who use AAC just to really learn that area. And I have only been working in an outpatient pediatric facility, but I love it because I get to wear many different hats. I get to wear a feeding therapist hat, and then I jump into an AC session, and then I jump into a language session. So it's never a dull moment. And I just love that I get to play for my job,    Jayson Davies     right? I do like that. We get to play, but at the same time, it's got to be difficult to work on feeding over teletherapy right now. How's that going?    Mara Jonet     It's been quite interesting, but, yeah, I actually was trained in telehealth in graduate school, so I'm not super new to the world, but it is new that we are all forced into this world, but feeding therapy actually works very well because you can use more of a parent coaching model and coaching the parents through, you know, the process of eating different foods and, you know, jumping up the hierarchies of that. So it's actually been going relatively well,    Jayson Davies     awesome. What about you? Annabeth, how is teletherapy going?    Annabeth Knight     It's been going pretty well. I mean, I feel like now we're we're in it, and I didn't have experience with it beforehand. I mean, Mara was really the most experienced therapist at our clinic when we made this transition. So she, she created the transition, facilitated that, which was such a huge undertaking, and we're thankful for that. But yeah, I think that I've really enjoyed the parent coaching model as well. I think for our kiddos who use AAC, we've used a ton of that parent coaching as well, and it's really cool to see the carryover happening, and to be able to see those barriers to implementation and address them in the moment, and not just be only in the clinic with a kiddo, maybe parents there or one of the caregivers, but it's just yeah. It's been nice to Nice to facilitate that in somebody's home, even if it's virtually    Jayson Davies     Yeah. Same thing goes with school based. I mean, we're so used to working with the teacher, and now it's less work with the teacher and more so with the parent, and so it's very interesting to say the least. So kind of a nice change. I like it, but with that, I am still looking forward to going back to the schools anyways. So let's start off. We're going to talk about at and AAC. Let's first start by defining at and AAC and how they might be a little similar or not, they're definitely not interchangeable, but how they work together, yeah, so    Annabeth Knight     at is assistive technology. So I like to think of that as an umbrella term, and it encompasses a lot of different things. So it does encompass AAC, but so assistive technology is really any product, equipment or system that's going to enhance learning or a client's ability to work or participate in activities of daily living at any level. And so there's a variety of levels of technology that we'll talk about as well within within assistive technology. So it can really include anything from like a sock aid to a power wheelchair to a high tech communication system to environmental controls. So there's a lot that goes along with it, and on the speech therapy side of it, AAC is a really, a really big piece of assistive technology. Yeah.    Mara Jonet     And AC stands for augmented and alternative communication, so that is housed under the umbrella of at but AAC refers to all forms of communication other than oral speech or oral spoken language, and so any form of communication that's used to express your thoughts or your needs or your wants, your ideas, protesting things like that, any way that you do that, other than spoken language, would be AAC. Some examples would include gestures or sign language. It would also include some devices, like an iPad, if someone uses that to talk, or a communication board or picture symbols, gotcha.    Jayson Davies     And I know this is kind of a loaded question, but before we go any further, I want to just hear it. I'm assuming Mara will probably answer this is why is AAC so important for our kiddos that are nonverbal?    Mara Jonet     Yeah, absolutely. So AAC is super important because communication itself is a basic right. Everybody has the right to communicate, and in order to accommodate that, some might need access to AC. So in order to provide everyone to access to communication, that's what AAC is for. There's the national joint committee for communication needs of persons with severe disabilities, and they published a fantastic list of the communication of the basic rights, or the basic rights that all individuals have access to for communication. So that includes the right to request, the right to refuse, the right to express feelings, the right to reject something, the right to ask questions and receive responses. And one more push is communication just really allows you to participate in your daily activities and your meaningful occupations. So that's why it's important.    Jayson Davies     Yeah. I mean, it'd be hard to live in this world if you didn't have some way to communicate. So fair enough, definitely. All right, I have heard some people argue that they don't necessarily understand ot in AAC. And so before we move on any further, why is ot such an important part of AAC, both in the evaluation process and beyond?    Annabeth Knight     Yeah, so I think Mara just touched on this in a nutshell, in order to access occupation and access participation in meaningful activities you need communication, and so that's where the OT lens is really, really important. And speech language pathologists also are looking at this. They're doing a needs assessment of all of the language that a client is going to need to use throughout their day. But as OT is because we are so trained in activity analysis and really analyzing what habits, rules and routines look like for these clients. I think it's really important for an OT to be part of that process, from evaluation all the way through implementation. And another piece of it really is that the OT is focus is to do an assessment of all of the multi sensory access needs a client might have, so especially for clients who have complex medical profiles and might be accessing a communication system in a way that we wouldn't consider typical, then the OT is going to be looking at all of the motor components of that, all of the different types of access they might be using how they're going to use their vision, how seating and positioning is impacting that, and really, really focusing on energy conservation as well. Because for lots of these kids, that's going to be huge, because they we want them to be communicating all the time. But it can be energy taxing. It can be a little    Jayson Davies     exhausting. Yeah, and I know one thing that we've had difficulties with in the school is the kids having access to their device at all times during the day. I mean, it's hard to carry your I mean, how? What is the best way to carry an iPad around the entire school campus? I think maybe we can save that for a little bit. We'll come back to that. But, yeah, let's start off with the different types of AAC devices or at devices. For that matter, I often hear from my speech therapist the terms high tech, low tech, and I believe no tech. But what do you guys    Annabeth Knight     use? Yeah, I love those three. And I would add in mid tech there as well. So on that spectrum, if we start with no tech that can be broken down into Aided Language or unaided or aided or unaided systems, so unaided no tech would be things like sign language or gestures, body language, anything where you're not using and. In any specific outside tools, and then aided would be something like a picture board or using a pen and pencil to write for communication, when you're using that thing that is external in order to help with communication, low tech then is going to refer to communication boards that have symbols or that have words, and that would be something that you might be pointing to to communicate, or you're accessing with low tech eye gaze, so you're looking at the symbol or the word that you want to communicate. Or you might be doing partner assisted scanning, where a communication partner is working with you, and they're reading through your choices, and you're indicating Yes, when you get to your choice that you want to communicate. And low    Mara Jonet     tech might also refer to something just as simple as a pen and pencil so you have access to written language,    Jayson Davies     okay, so just to write something down that that's easier, yeah, yep.    Mara Jonet     So anything without technology that aids in communication would be low tech, gotcha. Okay.    Annabeth Knight     And then mid tech starts to get into those, like, single or multiple message output devices. So some people might be familiar with, like a Big Mac or a step by step. So this is where you can pre program. You can record one or several voice messages that will speak upon activation, but they're not generative. So then those high tech devices are devices that are sort of like computerized communication systems, where they are generative. You're able to access a really robust language system, and you can create unique phrases. So those are the things that we'll refer to as speech generating devices, or like a device or a talker that a kid has is typically what that high tech is,    Jayson Davies     gotcha and All right, so I hear you saying all these different types of things that we could potentially give to a child, student, parent, any person who needs some help with with communicating, but when it comes to teaching someone how to use assistive technology or an AAC device. Is there a model to follow? Or where does one start when it comes to teaching someone to use AAC? So    Mara Jonet     the most established model is thinking about it as a different language and teaching a different language. So when you think of AAC, it is another language, and children have to learn that other language, similar to how children learn spoken language. So if you think of spoken language, babies hear their parents talk, and then they'll start playing with their mouth shapes and sounds that way, and then they'll develop spoken language with words, and they're put on different meanings to different words and communicative intents, and then they'll develop and progress their language from there. So the biggest difference in that is that a lot of AUC communicators don't see their language being used. So if they don't see or hear their language being used, some adults might expect them to be using it because it's like, well, here's your support. Use it, and that's not how it works. They have to see it first in order to have any output expected. Yeah.    Jayson Davies     And I mean, I know our speech therapist often uses the term modeling, and the same way that a parent would model for a student when they're trying to read a book and trying to model that word for them that they don't know how to pronounce. You would do that? And so how would you do that? Using an AAC device?    Mara Jonet     Yeah, so modeling, or another term for that, could be Aided Language simulation, and that's a big term that we use in AAC. And so Aided Language stimulation is really where you are modeling someone's device. So you use spoken language at the same time as their device. So you might be highlighting a symbol or highlighting a word or pressing the button, if it's on a device to model that vocabulary word at the same time that you are talking, and the more AC users see that, then the more buy in to their device they might have to expect to use it. So I like to go about you just pick a few words at a time and start highlighting those on the user's communication system in addition to your spoken language. And this should be happening throughout their day, throughout their communicative environments, and throughout communication partners. So it shouldn't just be speech therapists doing it. It should also be the teachers and parents and    Jayson Davies     the OTs, yeah. Everyone involved, everyone working with that student, gotcha. And I don't know, is there a few specific words that someone tends to start with, yes and no, mom, dad, where do you tend to start?    Mara Jonet     Yeah, so where we tend to start teaching is what's called. Vocabulary. So core vocabulary is the vocabulary that makes up 80% of your daily vocabulary in in a day. So some examples might be go like, I you, they're the really high frequency words that are used all throughout your day. So where to start when teaching children their AUC devices is that core vocabulary, and that's because it's usually the most accessible, and then it's kind of the easiest to navigate when you are modeling your sentences. And they also are, they tend to be verbs and pronouns, which are the building blocks of language and more complex sentences.    Jayson Davies     Yeah, and sorry. As you're talking, I keep hearing my speech therapist in the back of my head, because what you're just starting to say is, like the type of language, and a lot of times you hear, a lot of times what's programmed into, especially the more simple devices, from what I see is I go or I want food, rather than like I would like, a full sentence, and then you have to expand that out, but you really have to start simple, Right?    Mara Jonet     Yes, you absolutely have to start simple, and you have to establish meaning or context. So you have to establish that cause and effect relationship of those words. So go might mean go to a different place. It might mean make something go. It might mean go in your car. It means a lot of different things, so you have to establish that meaning with the word, but you have to do that starting out small with just that word, but in multiple environments, in multiple contexts.    Jayson Davies     Gotcha. Great. All right, so we are going to jump into the evaluation process in just a minute. But before we do, I just want to ask, because I think when we think of AAC, we think of any person who does not have the ability to vocalize, is there any other way, or any other potential definition that I'm missing? Missing when we think about potential users for AAC, I don't know if there is other uses for AAC out there, or, you know, just populations that tend to use AAC more than others.    Mara Jonet     So anyone is a candidate for AC? I guess a candidate for AC would be someone who doesn't have all of the spoken language that they need, or if their spoken language isn't understood by others. So even if they do have spoken language, you can still use AAC. And then for those individuals who are non speaking, they also would be candidates for AAC. So there's many, many diagnoses that would benefit from AAC. We see it a lot in autism, cerebral palsy, Down syndrome, childhood apraxia of speech. There's so many different diagnoses, but it's not limited to one population or anything, so anyone who needs to communicate, who is not accessing all of their communication would benefit from AAC. Gotcha.    Jayson Davies     All right. So I love what you guys are doing at the fanny pack therapist, because you guys are working together as a speech therapist and an OT combining together. How would you guys describe the teamwork, or the collaboration that you guys use when it comes to actually completing completing an evaluation, as we jump into that aspect?    Annabeth Knight     Yeah, so I think there's a lot of there are different levels of collaboration on therapy teams that are described in the research, and this has sort of changed over time, but they're typically categorized into multidisciplinary, interdisciplinary and transdisciplinary. So I'll start by saying that we see ourselves in our collaboration as a transdisciplinary collaboration, but multidisciplinary just simply means that there are multiple professionals on the team, and they may have common goals that they're working towards, or common goal areas interdisciplinary is where there's more of that active collaboration happening. So team members are working together towards these similar goals, and then with transdisciplinary teams, there's a little bit more of a of shared roles in working towards shared goals. So there's a little bit more of that gray area between where scopes of practice are, who's taking on which pieces and so many So, much of that just depends on the. Individual experience of the professionals that are on that team. So the role that the OT takes on might be different if they're working with a an SLP who's a new grad, versus an SLP who has the same number of years of experience as them, versus an SLP who's been in the field for 20 plus years. So we definitely work very collaboratively. We do not we're not particular about who takes on which pieces necessarily. Obviously, we're always working within our scope, you know, just legally and ethically, but we rely on each other and our unique experience to be able to just meet the needs of each unique child,    Jayson Davies     absolutely and quick side question is, is it just you two typically on this AAC team, or are there other professionals or non professionals on that team?    Annabeth Knight     So I'll say first that the client and the caregivers are probably the most important people on that team. So they're always on the team. They're always the center of that team and pushing all of the goals forward and all of the priorities forward. So they are on that team where we are working currently in the program that we're working in. Our evaluations are co evaluations with an OT and an SLP. So we're sort of those main practitioners, but we do have PTS who may be on the teams of these children as well, and so we're getting input from them as appropriate. We also are working with other OTs and other SLPs outside of our outpatient practice, and so a child who is seen by us probably has an OT and an SLP in the school, and they might have one in a hospital based outpatient facility as well, potentially. And so we need to coordinate all of that care as well. Wow, that sounds    Jayson Davies     like a lot, but another thing that you mentioned was where roles can get a little blurry, and how you guys kind of have to stay in your scope. What can practitioners keep in mind to ensure that team members are not crossing boundaries getting in someone else's role? It seems like you guys, I mean, work really well together, but sometimes that's not always the case, and some people can get a little frustrated. So how do you guys kind of make sure that people are doing their own thing or their own part, I guess    Annabeth Knight     so. I think the very first thing is establishing clear and consistent, um, means of communication with that entire team. So sitting down at the beginning and saying, okay, here are these six people on this team. Here's what our goals are. Here are the needs we need to meet. Who is going to take on each of these roles, and then it can become this dynamic conversation of you know, from the beginning, I feel like I should take on this piece with seating and positioning, because I have this experience with it, and the PT is wonderful, and they're going to help out with all of the additional gross motor pieces that we need, that the child needs to work on underlying to be able to participate and to communicate. But they don't have as much experience in seating and positioning, so this, this is the person who will take on that role. I think another thing to look at is just, you know, general scopes of practice, and to go back to those, those foundational guidelines that we can look at from our regulating bodies. But also to keep in mind that both Asha and a ot a have put out either position papers or statements on assistive technology and assistive technology teams, and particularly for clients who have complex medical profiles, they put out there that there's a lot to address. And here are all of the things they'll outline, all of the things that you need to address when you're looking at evaluating for at or AAC, and they say the team has to have these competencies in order to do this well, but they don't break down who needs to take on which particular role. So there is sort of that leeway of you know if, if an OT doesn't have as much experience in working with a child with cortical visual impairment, but the SLP has 10 years of experience, and almost all of their kids have had the eye even though they're not the one addressing it, they have a lot of great input. So absolutely, it comes down to communication, yeah,    Jayson Davies     and knowing each other's strengths and weaknesses. I mean, like you said, you learn so much on the job, and so if there is a very experienced speech therapist and a not so experienced occupational therapist. There's a lot of things where you'd probably want to either default to letting the speech therapist take on that role, or especially at least asking for their help and trying to figure out what you can learn from them. So yeah, yeah,    Annabeth Knight     that's a great that was, that was me, for sure. As a new grad at the school, and I was like, I people would be looking at me for all these answers from the OT scope. And I had some answers, but I didn't have the experience with the population to to know right away and to to know the technology. So that's a big piece of it, too. That's where experience comes in, is knowing the technology and keeping up with the changes in technology. Absolutely. And    Jayson Davies     there's always things changing. Man, with technology, it's crazy. They're always new apps, new language apps on the iPad, and they all cost $100 or more and and get pricey, and just new things to learn. So all right, let's kind of break down the evaluation process right now. I know we just talked about how sometimes things get a little blurry. You kind of take on roles that you just know because you've been doing this for a while, but traditionally, Mara, what would you say are the key speech components to an AAC evaluation that you look at? So in    Mara Jonet     an AAC evaluation, a speech therapist would definitely be looking at how a child communicates their expressive and receptive communication, and kind of doing an environmental inventory to determine the needs and the wants of the family or that child,    Jayson Davies     all right, so we're all occupational therapists listening to this podcast, so we're going to need you to break that down a Little bit expressive and receptive communication. Yes,    Mara Jonet     so expressive language refers to what you are able to express or communicate. So in an AUC evaluation that most likely will not be spoken language or it will be spoken language that needs to be supplemented. So in that SLPs are responsible for looking at how a child is communicating? Are they communicating by behaviors? Are they communicating by leading your hand to somewhere they want to go? Are they crying? What are they doing to communicate their basic needs or their basic wants? And we'll also look into how are they socially interacting? Are they playing with things, or are they demonstrating that joint attention? Or do they greet others? We'll look at kind of the whole realm of communication and expressive communication, and how the child's already doing that. And then receptive language refers to what a child can understand. So we'll look at what a child is understanding. Are they able to follow directions if they have any language? Are they able to answer any questions? Are they able to identify some objects, those all relate to understanding,    Jayson Davies     gotcha. And would you actually look at their ability to use technology? Yes,    Mara Jonet     definitely. So we would in an AAC evaluation, ideally, you would have access to a variety of materials and AAC devices or different levels of technology, and you'd be looking at their interest in it, or if they will imitate anything on the device, or if they'll start using it for a function. And in AC valuation, I will be using a multi modality communication approach myself, so I might sign some words to a child and see if they are visually attending to that or interested in signing, or if they imitate any signs, but I might pull up a device that I have right next to me and kind of model some words and see if they're interested in that, or if they they use it in the evaluation, just kind of depending on The level of the child, and then one important piece is really assuming that it's with the child, is that parent interview? Because what SLPs will also do is connect, do a parent interview to conduct an environmental inventory. So what are the needs of that family in order for communication to happen, or what environments to the child does the child go to and they need access to communication. Awesome.    Jayson Davies     And so I'm just going to follow follow up with that. Then where, where do you see? I guess, what is typical responses from the parent for that. What do parents identify as places the student needs or the child sorry, needs to communicate?    Mara Jonet     We get a whole variety of that. A lot of it is basic needs, communicating that they have to go to the bathroom, communicating that they're hungry or thirsty. That's, I would say that's probably a main one, is just communicating those basic needs. But then we've also had, you know, a child with a hearing loss who has a device that can use it to go swimming. So they want some sort of communication system to go swimming, so that evaluates. Will look totally different than any well, where a child doesn't have those basic communication needs, so it looks very different. But, yeah, all parents kind of identify different areas, and it's interesting to see what the parents interests or occupations are, because sometimes they'll relate to that.    Jayson Davies     Yeah. I mean, that's unique. I never thought about swimming, but, I mean, thankfully, you know, a lot of things are becoming more waterproof, but when you said that, my brain just started moving like into sports, into like, individual sports and group sports. I mean, being able to communicate like times that you don't even realize you're communicating, whether it be verbally or visually,    Mara Jonet     absolutely. And another one that we get a lot is that they want to see their child interact and play and communicate with their brothers and sisters. If they have siblings, they want to see their child communicating like, No, I don't like that, or throw the ball over there, or something of that sort. So we get a lot of it's just a range, depending on the family and kind of where the child's communication is already at.    Jayson Davies     Yeah, I expect that would be an important one, especially when there's behaviors going on where the kid is using fist and pushing as a behavior as a way of communicating, rather than an actual device or some other form of communication?    Mara Jonet     Yeah, absolutely. So we definitely work very closely with behavior therapists and everything like that too. They're on the team, but I believe that a lot of those behaviors are communicative for some reason. Yeah, all right.    Jayson Davies     So did we touch upon all the speech areas? I mean, I know we can only go over so many, obviously, an evaluation. Every evaluation is totally different based upon the kid individualized. But were there any other areas that you wanted to touch upon?    Mara Jonet     I think we hit all of the main ones ever evaluation is so customized and different. So I'm sure I'm forgetting a million things, but I also could go into very long rabbit hole.    Jayson Davies     So no, no doubt. And I mean as as you say that I'm thinking there's probably someone listening to this podcast that wants me to ask, What technology do you use? You use an iPad? Do you use a I don't know, whatever else is out there, DynaVox, whatever, but it's so you can't give me an answer on that, I'm sure, because every kid needs something different.    Mara Jonet     Every child needs something different, and every therapist has access to different equipment. So it really depends on where or what setting you're doing that evaluation in, because at our outpatient facility, we might have access to different apps, but we don't have dedicated devices. Or at a school, you might be only able to get one trial or loaner device to do that, and sometimes you don't even have access to any of that, because that equipment is very expensive.    Jayson Davies     Yeah, absolutely, yeah. All right, so let's move into the OT side of the evaluation. Annabeth, you've already mentioned a few things, vision, seating and positioning, energy, conservation, I'm sure there's more. But how about we go over those three what area? What key area are you looking for Envision,    Annabeth Knight     yeah, so I feel like even vision can be such a broad right. So I mean, when it comes down to it, we're assessing the vision needs of AAC users the same way as we would be for any other ot client in peds. And so you can be looking at things like Visual motor skills and looking at range of motion and smooth pursuits, and the ability to visually fixate and use binocular vision, and all of those things are really important, especially if you're looking at High Tech eye gaze. You want to have a really solid foundation in this kid be able to look at all of the different icon selections on the screen. How big can that array be? How big do the symbols have to be? Or it could be, you know, things that are as simple as, how are we going to position this device so that the child can view it? What is that going to look like for a child who uses a wheelchair and needs this device mounted? What is that going to look like? And this goes into seating and positioning. But what does that look like in different different positioning systems throughout the day too. And then just looking at those more basic components of what's their visual acuity, how does that impact symbol size and how many symbols then we can have on a screen display, and if we need to have high contrast symbols, or if we need to think about the visual saliency of the symbols themselves, do we need photo symbols? Or do we need just black and white, simple stick figure symbols? Do we need symbols at all? Are we looking at just using words so there's, there's so much that goes into it. But I feel like lots of the kiddos who I used to work with and who I continue. To work with are those kids with multiple neuromuscular conditions. So lots of them do have cortical visual impairment. So then that becomes a big pivot, too, and just looking at all the components that go into that, yeah,    Jayson Davies     I mean, it's amazing just listening to you guys. I mean, just the things that come up. I mean, I know I've seen you probably have used them applications that literally just test how many items can be on a page for that student. And it's just, literally, it's a game that the child plays to determine if they need two pictures on a screen, four pictures on the screen. I'm sure you all know about that, but yeah, it's crazy. How much is out there, and that OTs and speech therapists and at team and AAC team really do have to do. It's a lot of work, and I don't think everyone understands how much goes into it, all right, so you kind of touched upon seating and positioning slightly there. I don't know if you want to talk about energy conservation, or if there's another area that's even more important.    Annabeth Knight     I think so. Energy conservation, I think, is sort of overarching. That's something that I'm looking at all the time when I'm thinking about how the child is going to access the device. And so above energy conservation, I guess, is access and what that access method is going to look like. So when we talk about alternative access methods for like, a high tech device. Let's say we're looking at things like using switches to access the device or using eye gaze to access the device. What would be more of a direct selection, then would be using your finger on a touch screen for a device? So that's what you see lots and lots of AAC users using, if they're using an iPad system, that's sort of what's typical. And OTs also have a role there too, to look at that motor control piece and determine, Okay, if we had a key guard, is that going to increase their accuracy, or if we use a stylus, is that going to be better for them than using their finger to tap for the selection, but when you don't have those skills to use your hands to be able to access we need to look at a different method, and then that is a whole lot. I feel like I could talk for hours about everything that goes into that, but it basically comes down to that activity analysis of how they're accessing communication then, so I'm asking myself questions like, what movement patterns can this child use to access a switch, or do they have the movement patterns in their ocular their ocular motor range of motion? And then are we going to work on practicing those movement patterns and refining those movement patterns to make them more successful. Or are we looking at different accommodations and additional equipment that we can use to achieve that access? So yeah, lots of, lots of the kids that I'm working with them, I'm looking at different types of switches we can use. And when you get into that, it's looking at, okay, are they going to be using a mechanical switch or an electronic switch or a biofeedback switch, and what are the pros and cons of each of those? So I think Mara may have touched on this a little bit, but the the evaluation process is really expensive, but it's very it's an ongoing process, and I agree that I don't think that everybody truly understands everything that goes into it. And Mara and I definitely feel really strongly that you need more than a two hour evaluation. Our actual evaluation that we're billing for is probably just that first day, two hours, but we're continuing to see this child ongoing, to continue to do that evaluation, because you can't see everything or analyze everything in just that two hour period of time, and then say, Okay, here's the device you need. Get out the door. Absolutely    Jayson Davies     no, that's definitely sure. I feel like we could have you come back on for another episode. Just talk about switches. And we probably have to do it on a Facebook video, because video, because we obviously need to see every switch. So maybe one day we can do that. But all right, so let's get into what are some common outcomes and recommendations after an AAC evaluation combined. You guys have we've mentioned iPads, you mentioned some switches. What else is there that's fairly common to be used?    Mara Jonet     Yeah, there. There's a ton out there. So it really just depends on the child. Everything is individualized. And part of the world of AAC is that everything has to be pretty highly customized for that individual. So ideally, after an AUC evaluation, we would like to see we would like to have enough feature matching done so that we can determine a likely access. This method for that device, and then start them on a trial of a device. One part that I don't think I mentioned in the AC evaluation part is that we're also going to kind of look at their strengths in terms of, do they have categorical knowledge, of do they know you know nature, and in nature, you would find Trees and leaves and grass, things like that. Or do they have a strength in their motor planning? Because different applications and different language systems have either like categorical organization or a motor planning organization. So we're going to kind of tease that out, and then hopefully from there we'll get some sort of solid foundation to recommend a trial of a device.    Jayson Davies     Gotcha? Yeah, I get lost in those applications all the time, and I press the back button and I feel like I'm just in a whole new world. I'm like, Wait, where am I? What is, what is the most common one on iPad to go? Or what's it called? Proloquo to go? Yeah, Proloquo to go. My guy, I the thing is my worst enemy. There's just too many things on a screen, and Proloquo to go for me, at least. But no, I totally understand that there's just, and you talked about how much it has to be individualized for a student. And I think that's just so important,    Mara Jonet     right? There is no one size fits all with    Jayson Davies     AAC, yeah. And I would just like to see, I mean, just a picture of all the different things that you have to trial with I'm sure that picture is just a overwhelming and B worth 1000s and 1000s and 1000s of dollars, because I know technology is not cheap.    Annabeth Knight     Yeah, it is. It is a lot. And we, we don't have everything yet. We sort of, we work right now in a system where we have a lot of stuff in house. But when we have a kid coming in for an evaluation, we're trying to do during that intake process, and during that consultation process, we're figuring out, do we have everything in house for them, or do we need to work with vendors in our area to get something particular in and so if it's a particular communication device, then yes, we want to get that in as a loaner beforehand, so we can do that during the initial evaluation, just get their hands on it. And that also might be looking at like, if there's a particular kind of switch that we need,    Mara Jonet     we might be purchasing that, or we might be those are a little harder to do loans with. But what I like to say is that we're resource facilitators. So not everybody is a specialist practitioner, but as generalists, we need to be resource facilitators. So even though you don't have all of the knowledge, you need to have enough knowledge of the people to go to. And that might look like, of who the vendors are, of kind of common devices. Or applications, and just to have that general knowledge to get your resources from there.    Jayson Davies     Yeah, definitely. All right, so I have a few questions from notes that I've been taking, and you don't have these in front of you, but I want to ask you about them. And the first one, I think one of you mentioned dedicated device, and what is your take on, especially when it's an iPad, having an AAC such as Proloquo to go on an iPad, and then also having other systems such as games and academic apps on that iPad,    Mara Jonet     that is a loaded question, and my answer to that is that it absolutely depends on the user, because some children might be very distracted with other things on the iPad, and they might really benefit from only that dedicated system on their iPad. However, others might need to access leisure like Facebook or the internet or something like that, and if they can do that and communicate at the same time, then it should be all accessible in one. Insurance will have a little bit of a different story for you. They only fund dedicated devices. Oh, really, yeah. So you're not allowed to put any Well, it depends, but for the most part, you're not allowed to put any other applications on    Jayson Davies     it. Gotcha so they device. So they will authorize a purchase for an iPad, but they do not want other things on there. And I'm sure they probably have their ways of preventing you from putting other things on there if they want wanted to, but that's kind of what you're saying. Is that insurance wants that device to be. Be only    Mara Jonet     for communication. Yes, insurance interesting. Generally, there's, you know, insurance is very complicated, but yeah, generally, they want to see that the device is only dedicated to communication. But we kind of believe that once a user is proficient, they should be able to kind of take control of their ownership of that device and the other features that they can use on their device.    Jayson Davies     Yeah. I mean, the last thing we want is a kid who's really understanding how to use an iPad in his communication app to be like Rambo with two iPads on his back walking around because he needs one to communicate and one to access Facebook, like you said. So, yeah, totally okay. Just to add on to that, in our school district, we're kind of going the opposite route a little bit, because we are working with mostly moderate to severe students when we're talking AAC, and a lot of times, their assistant, sorry, not their assistive technology. Their iPad has a lot of academic games on it, and it has a lot of things that are a lot more interesting than Proloquo to go and so oftentimes, I mean, we can lock things, of course, we can put Guided Access on there, but that's a pain in the butt, because then there needs to be an adult to come over to unlock their iPad so that they can go to Proloquo to go so that they can find whatever folder that they need to do and find their their words. Yeah, I don't know if you want to speak to that. I    Annabeth Knight     would argue that if all of those apps are way more exciting than communicating, then maybe the app that they're using, like maybe protocol or whatever it is, isn't the best fit for them, or they haven't had, you know, enough experience using it yet. But I think that, I mean, I'm definitely a big advocate for having additional apps on an iPad or what, even if it's a dedicated device, like if you get a dedicated system from Toby, dynavax or Saltillo, you can get other apps and access to the internet and things on those devices as well. And they interface really well. Lots of those language systems are built to interface with Facebook or Instagram or Twitter, which could be a huge motivator, but you have to have the system unlocked in order to do and I think I mean, obviously, like Mara was saying, you have to strike that balance. But if that's the really motivating activity, then we want them engaging in those activities really motivating what they want to communicate about. And I would also    Mara Jonet     add that if those applications that are super fun that they just want to play all the time, why aren't we using that and infusing their language in it? Because you can have, if you have access to your own device, you can be modeling that language the whole time. So just like when I don't know, a child doesn't speak yet. You you label what they're doing. Oh, I see you going to the kitchen. Oh, you're opening the cabinet. You can model that language on their symbols or their system, and say you're popping the bubble. That's a blue bubble, or it's obviously not that fast, but you would model that language, and then hopefully that buy in is increased.    Jayson Davies     Yeah. I mean, all it takes is time and energy. The entire team, like we talked about earlier, the entire team needs to know the application. The entire team needs to know the device, know how to model that device, and at the same time, there needs to be enough adults, especially when we're talking about school. If you have eight kids in your classroom, all using AAC, and half of them are using Proloquo, half of them are using a different system. It can be overwhelming for the teacher, especially if there's not enough staff to help and help them model it. And so I see where that can be challenging for a teacher. I mean, it's one thing for me to model it when I'm one on one with a student in the sensory room or in the OT clinic, or if you're working on language at the table, but it's hard in the classroom. So I get that. But that also leads to the next area, which is from my understanding many people, probably a large majority of them, that get a device for AAC, I have heard stop using it as soon as if they're using in the schools, as soon as they're out of the schools, it's basically got done. Or as soon as they go home, it's in their backpack. It doesn't come out of the backpack. What do you guys think about that? How big of a barrier is that? And what can we do to help overcome that? I think it's    Mara Jonet     a huge barrier, and we see that across our outpatient clinic as well. So I think that just. General term would be the buy in, the buy in from all of the team members, the buy in from the family, the buy in from the child, is a huge barrier, and the only way to overcome that is for the child to see and hear their language being used by others, so that we're back to that modeling, and that Aided Language simulation, because that's their voice and their way of communicating. And once they see that, they'll kind of take ownership and be like, oh, yeah, I can do this, and I can manipulate my environment by using communication, but it's a team approach. So the parents have to be on board, the school has to be on board, other providers have to be on board, the babysitter, the brothers, the sisters. It's a huge team approach, and I think all you can do is advocate, advocate, advocate, and really hope that your team is collaborative and kind of willing to work together.    Jayson Davies     Yeah, and based upon what you just said, I think I already know the answer to this. But what does the treatment activities, or what does treatment in general, look like after the evaluation process? Are you teaching the child how to use the device. Are you coaching people? What does it look like?    Mara Jonet     It's all of the above. It is. So in order to expect any output or language from a child, you have to have that input first. So for the first while, you are just going to be modeling before you're going to be modeling without expectation. And that's what all communication partners should be doing, modeling without expectation.    Jayson Davies     No also    Mara Jonet     we will be doing activities that are motivating for them, to get them to communicate. And might throw in a couple communication temptations, like withholding a really motivating thing and making them say go or something like that, and reinforcing that behavior that would be, or that communication that would be, something that we also do. But then a huge part of it is setting up all of their vocabulary to make sure that their vocabulary is meaningful and arranged in a way that makes sense for that individual. But then it will also be training all members and all potential communication partners on that device, how the basic navigation functions work, how to provide that modeling, how to troubleshoot the technology, pieces of it, how to program a word that they might want in it, everything. And then, if it's a really more complex communicator, the treatment will still be extended evaluation to establish maybe a switch, a switch site, or establish that motor plan of the language, yeah, yeah. For OT, I feel like that ongoing assessment and that ongoing treatment, I guess, looks very different if it's a kid with complex communication needs that have those alternative access needs, or if it's not so, sometimes the OT will have a big role in the evaluation process and then sort of drop off in terms of having direct AAC intervention.    Annabeth Knight     But for those kids with complex communication needs, when we're when we're looking at switch access, I in my sessions and doing other switch accessible activities. So it might be switch accessible games on the computer, it might be switch activated toy. Is anything that's going to continue to reinforce that motor plan, motor plan. And I'm not only looking at that primary switch site, but for some kids, we might be using two switches for access. We want to have, you know, a primary site and then a backup site as well. That sort of gets into a whole other can of worms with just having multiple methods of communication that these kiddos can use, because if their primary one isn't working, or if they're not able to access it, like Mara was saying in the pool or in the bath every single night, Oh, wow. Doesn't mean that they don't have to communicate. So we're continuing to look at those routines and determine what else we're going to do to supplement    Mara Jonet     and also, just to add, we didn't even touch on this, and this is a whole nother trail that we could talk forever about. But OTs are very knowledgeable of the sensory system and sensory integration, and a lot of the children who use AAC might have sensory needs that need. Looked at for communication purposes, or in order to get them ready to communicate, or in order to, I don't know if they have tactile defense, defensiveness, to even like access the device. So that's like a whole nother thing that the OTs would also be doing ongoing in their treatment? Yeah,    Jayson Davies     absolutely. All right, so I had one more question that I thought of while you were both talking, and I don't know how much you'll see this, because I'm sure most of your referrals are coming from parents, because, like you said, you do that environmental checklist, and a lot of times as parents saying, my kid can't communicate in this area, in the schools, sometimes those referrals are coming from the teacher, or they're coming from a psychologist and well, I mean, to put it short, we sometimes get parents that are timid of going down the AAC realm because they think it's going to hinder the vocal aspect that is very important to parents. Parents want their kids to talk. They don't just want them necessarily to communicate, but a lot of them actually have this deep desire to have them speak verbally, to hear their voice. Have you guys experienced that? And what are your thoughts?    Mara Jonet     Yes, that is not unique to the school system. We definitely get parents coming in for an evaluation of their child. Can't communicate, and that AC conversation has to be, has to happen. It it's definitely a more tricky conversation, because you are right. A lot of parents have this just desire to hear that spoken language, and so the route that we have to approach it in is kind of giving them the research. And the research is that AAC is meant to aid and augment communication so it doesn't hinder any speech development or language development. It doesn't hinder anything. It only supports it, and only allows that to grow and fosters that communication. So I like to always recommend a more multi modality communication approach, so that, yes, we can absolutely still work on spoken language. But why don't we give them a way to communicate some needs while they're working on their spoken language? And sometimes that the way of phrasing it that way supports them a little bit in in that process, and I think it's it's more of a difficult conversation of just any parent with a child of a disability, there are going to be things that are just going to have to be relearned and re imagined? Yeah,    Jayson Davies     and I'm sure you feel the same way as I do. I mean, it's not like it's hard to imagine a parent not wanting to hear their child's voice. Of course, every parent wants to hear their child, their child's voice. I would want to hear my child's voice Absolutely. And I think that can be almost, probably a little defeating knowing that your kid is four or five, six years old, and you've never heard their voice. That's got to be tough. I mean, that probably is, in itself, its own therapy that might need to happen between the parent and a psychologist, or the parent and someone, but at the same time we I'm right there with you. I like the idea that you're talking about, you know, doing, coming at it from both sides of it. And maybe, does that look like? Potentially, maybe speech therapy services once a week to work on language and another, a different service to work on the AT device, or something like that. It    Mara Jonet     could look like that, or it could look as, you know, a whole a whole session working on all those modes of communication all at the same time. Because the more modes that you give a child, the more likely they're going to pick at least one to communicate. And I think phrasing things to parents as like, I understand that, you know you want to hear the voice, but how cool would it be if you hear I love you on the device too, or something, as long as it's meaningful communication, it's just kind of relearning that, and also, you know, facilitating our resources that we have. So let me recommend a parent support group. Let me recommend someone to help you walk through the process too, that we're kind of the jack of all trades in that initial conversation.    Jayson Davies     Yeah, and like you mentioned earlier, I mean, even if you're just a resource, you are valued. Table. So by by having the supports and knowing where to refer parents to, that's important, all right. And about that, do you want to add anything? I know you were, I could see you being animated. So I know I was.    Annabeth Knight     I was just gonna say that I think that we are at a bit of an advantage sometimes in the outpatient setting, in that we can have parents involved directly in the sessions. And I know before we were talking about how this is sort of a hidden advantage of telehealth right now, is that parents are right there and so that buy in during a speech session where you are modeling spoken language and working on maybe some articulation and modeling AAC and using it when a parent can see that live happening in a session, I think it's easier for them to digest that and to understand what you mean by approaching language with multiple modalities. And those are just nice times to have those conversations too, because it doesn't just have to be a one and done conversation of like, well, this is what the research says. And so here's how we can support you. Here's some resources, but really helping them throughout that entire journey. And so in outpatient, we have that longevity, and we really we, especially for our AC users, encourage families to be involved in the sessions as much as they can be. Mara and I also take, when we're in the clinic, take lots of video of what we're doing in sessions, and we use that to give to families and to use. We'll approach it and say, like, this is for you and your family to use, so you know how to use the device. This is also for any caregivers. It's for teachers. It's for your physicians, anyone who's going to be communicating with your child. And I think that that sort of gentle approach to parent education is is valuable as well.    Jayson Davies     Absolutely no spot on. All right, great. Well, I think we got to wrap this up. We've been on here for a while. It's been great information. I love it. Thank you both for coming on. Really, really valuable stuff. I want to give you both the opportunity you guys have an Instagram page, go ahead and share what that is about and any other way, if you would like, if people have questions for you, how they can get a hold of you, if it's just Instagram    Annabeth Knight     or any other way, yeah. So I think that one of the big reasons why we started the fanny pack therapist was to be a resource like Mara was saying, We're resource facilitators, and we want to be that for our families and for other therapists. We happen to have a lot of experience in this area, and so we just get excited about a little nuggets that we can share. So on our Instagram account, which is at the fanny pack therapist, we have pretty much daily little plugs for at or AAC intervention strategies or resources or things. We've been trying out new technology, and we also have just started a blog, so we're excited about that as well. We want to have a little bit more robust information for therapists out there in the blog, and so that is available that will be live soon. And then we also have an email account where you could contact us with any questions. That's the fanny pack therapist@gmail.com and and, yeah, we're just excited. This was sort of fanny pack. Therapist is a side project that has a lot of pieces to it, and we're excited to see how it grows. We just have. We've really loved being able to create and to put things out there and to collaborate with other therapists who are doing this, we're definitely we're not the experts. We're not the only experts. There are lots of really cool resources out there and fanny packs. Big piece of it was just the 90s nostalgia that we bonded over when we first started working together.     Mara Jonet     And also just being creative and using your therapeutic use of self, we're very big advocates for using, you know yourself, as your main therapy tool, rather than bags of equipment and games and things to bring into sessions. We think that Sessions should occur naturally, and that's where AAC is facilitated in. The best is those natural communication environments.     Jayson Davies     Gotcha. Awesome. I love it. All right, guys. Well, thank you so much. Annabeth Mara, thank you so much for coming onto the show. I think there will be many, many OTs and other people, parents, speech therapists, other professionals that may listen to this episode that will find your information super helpful. Thank you for for being open to questions from other people, potentially through Instagram. It is at the fanny pack therapist on Instagram that's probably the easiest way, I think, to get a hold of them. But yeah, thank you so much for coming on. I appreciate it, and have a great rest of your evening. Thanks so much for having us. Yeah, no problem. Take care. Bye. Bye, all right. Well, one more time, I just want to give a huge thank you to Annabeth and Mara for coming on the OT school health podcast to share all that wonderful information with you. If you want to know anything more about assistive technology or AAC, be sure to check them out at the fanny pack therapist on Instagram. They also just released their blog as we are releasing this, so go ahead and Google the fanny pack therapist. I'm sure that will come up. I will also have it in the show notes, which you can click on wherever you're listening to this if you're not already on the show notes right now. Okay, so be sure to check that out. This has been episode 53 of the OT school house podcast. We will see you next time. Take care, everybody. Bye. Bye.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over To  ot   schoolhouse.com Until next time class is dismissed.   Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Or click on your preferred podcast player link! Have you ever felt unappreciated by the teachers at your school? Well, listen to this episode to learn what a small research study has to say about the way teachers and OTs perceive Occupational Therapy and therapists in the schools. Dr. Bolton and Jayson will talk about this and more in Episode 52 of the OT Schoolhouse Podcast! Links to Show References: Article: Occupational Therapy Role in School-based Practice: Perspectives from Teachers and OTs Tiffany Bolton, Brittney Stevenson & William Janes (2021) Assessing handwriting in preschool-aged children: Reliability and internal consistency of the “Just Write!” tool, Journal of Occupational Therapy, Schools, & Early Intervention, DOI: 10.1080/19411243.2021.2009083 Help Jayson by Donating to Big Brothers and Big Sisters Freebies! Be sure to subscribe to our website now & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments regarding our podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 52! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host. Jayson Davies class is officially in session.     Jayson Davies     Hey everyone. Welcome to episode number 52 of the OT school house podcast. My name is Jayson Davies, and if you're an occupational therapist that has ever felt like you're just not really appreciated in your school based ot job, you are in the right place. Today we have on a very special guest by the name of Tiffany Bolton. Tiffany recently had an article published in the Journal of Occupational therapy schools and early intervention, and the title of that article is occupational therapy role in school based practice perspectives from teachers and OTs. So we're going to get into that here in just a moment. But first, I want to ask for your help. Actually, this is coming out at the end of June, this podcast episode 52 and my birthday actually happens to be July 3. And so for this year, I thought that I would use this platform, the podcast and the OT school house, to reach out to all of you and ask for your help. I would like to set up a donation drive for the Big Brothers, Big Sisters of America organization and this organization, I did some homework before I donated myself and before I wanted to ask help from you. But the main reason that I want to support this organization, and I want to ask for your help in supporting this organization, is because I truly believe that education, whether it's about society, about academics, about social justice, social justice, if I can speak right, starts at such a young age. I think a school based occupational therapist and pediatric occupational therapist, we realize how much it matters to start young in educating our students or educating the children in our life, and whether or not you're a teacher, an occupational therapist, a parent, a babysitter, you absolutely have an influence on that child's life and who they come to be as an adult. And so especially when it comes to social justice and social equality, I truly believe that the younger we start, the bigger impact we can make, and that's part of the reason that I want to help support the Big Brothers and Big Sisters of America. And, you know, I did a little bit of homework, they have an A plus rating on charity watch, which basically means that they they do what they say they're going to do, and they are transparent. In fact, 91% of every dollar that is donated to them goes directly into their programs to support their program for big sisters, supporting little sisters, and Big Brothers, supporting little brothers. And so that's awesome. I did a little bit of research even on their CEO. I guess you could call her Pam yorio. She was the 2018 people's magazine, 25 women, women changing the world. She's been with the organization since 2014 as the CEO, and it looks like, actually, she might be stepping down soon. She's ready to move on, and they're looking for a new CEO. She's just a good leader. She even has a book about leadership. So please, if you're interested in supporting this cause, supporting me. If you've ever felt like that you wanted to give back to the OT school house, but didn't know how this is your chance. And not by supporting me, but by supporting Big Brothers and Big Sisters of america@bbs.org just go over there make a donation, and if you need even more of an incentive than that, go ahead and make a donation and send me a copy of your receipt or whatever. They email you back and I will give you $10 off your next purchase@otschoolhouse.com whether it be for a professional development course, podcast course, or for a future round of the A to Z school based ot course. All right, so again, that's bbs.org you can donate to your local chapter if you'd like, but note that that doesn't necessarily mean that the funds are going to go directly to that local chapter. So bbs.org Go ahead. Go there, make a donation. I would truly appreciate that, and let me know that you did share with me on social media, on Instagram, Facebook, at ot schoolhouse or shoot me an email. Jayson@otschoolhouse.com and when you do that, I will be sure to get you a little coupon code for $10 off your next ot school house purchase. And just like us, they are trying to figure out how to go digital too, so they understand some of our struggles. All right, so let's get into today's episode. Today's content, we are welcoming on Tiffany Bolton. She is a faculty member at the University of Missouri in the Occupational Therapy Program, and she has so much to share today. Okay, again, like I said earlier, one of the best conversations I've had in a while. Really appreciate her coming on, and we are going to talk about one of her research articles about the perceptions of OTs and teachers in school based ot so if you haven't had a chance to read this article, be sure to check out ot  schoolhouse.com . Forward slash episode 52 for the links to the article as well as if you'd like to contact her. All right. So again, here is Tiffany Bolton. Please help me welcome her to the OT school house podcast. Hey Tiffany, welcome to the podcast. How are you doing this morning? I'm good. How are you doing very well. You know, as best as we can do right now, it is what the middle of June, and I think we're all still kind of stuck at home. How has quarantined life been for you?     Tiffany Bolton     I'm a little bit crazy. So I have seven year old twins that have been home with me this whole time and still don't have anywhere to go this summer. And my husband is also working from home, although I think he is returning to his office in the next couple of weeks. So I, on the other hand, am home until, I don't know when we're teaching hybrid this fall, so probably quite a while still.     Jayson Davies     Yeah, I know. I mean, we're talking about potentially in August, going back in some sort of blended model, where there'll be like two cohorts, and some kids will be at on campus, like Monday, Wednesday. Others will be Tuesday, Thursday, and then Friday will kind of be like a day for teachers check in with all of them at home. But yeah.    Tiffany Bolton     My kids are doing that for summer school, and I have a sneaking suspicion it's a trial run for the school year. So we're doing they're doing, like, two weeks on two weeks off in the month of July, kind of a similar setup, no Friday and at home work on the two weeks off, so we'll see.     Jayson Davies     Oh, so they're just so they're there four days a week or two weeks, and then after that, they have two weeks where they're still in school, but not at school, correct? Interesting, yeah, we'll see how that goes. Yeah, yeah. So tell us about your occupational therapy career, and where you're at now and how you got there. Sure,     Tiffany Bolton     I don't have a glamorous story about how I got there. I was raised in a very rural town, and I didn't even know what ot was I you know, I selected speech therapy because I was familiar with it, and I wanted to do something related to health care. I always wanted to work with children, and it was the only thing that I really knew what it was. So in college that put me in a intro to health professions class, which was the first time that I heard about OT and I got really excited about it, and really switched to it for that reason. So I can't there was no deep meaning behind it. And then, you know, like I said, I always wanted to do pediatrics in school, though, I was surprised by how much I liked adult therapy also. So I ended up in the neuro side of the world and so, so really, the majority of my background has been in kind of complex conditions in pediatrics, but I've done a decent amount of school based therapy in the past. Right now, I currently, I'm an associate clinical professor at the University of Missouri, and I teach in our pediatric curriculum, and we do. They're essentially, they're pro bono clinics, but we really use them for teaching clinics. They're built into our didactic curriculum, and I take students with me to a preschool. So that's really more of my current school setting is a preschool setting with ot students present with me, and then we do see some outpatients that are typically school aged children that sometimes don't qualify for services at school, and so we end up being kind of a good fit for them, that is where I'm at now. So, so I do some research, although I am not research faculty, so the research part of my job is more for fun and usually clinically related. So, oh,    Jayson Davies     that's cool. Well, I'm excited because we do get to talk about a little bit of your research. Today. We're going to get into that, but I actually want to ask, how was it getting into academia and transitioning from being a clinical ot into that more academic role.    Tiffany Bolton     Um, it's hard this. That's not an easy transition. Um, a co worker of mine is actually writing a book to sort of assist with that transition, which, you know, I think there's a necessary market for that. Yeah, I, um, I actually took the role of field work coordinator when I started. And so that was, maybe, I won't say easy, because that job is not by any means easy, but I was still able to use some of my clinical contacts, and, you know, be in touch with that world and doing site visits. And so it was maybe a nice bridge for me. But I also was teaching classes as I was the fieldwork coordinator, and I found that I really loved to be in the classroom. And so, you know, as soon as the opportunity presented itself, I moved into, you know, a clinical teaching role and out of that academic fieldwork coordinator role. But I think the hardest part is that there's really no manual. There's nobody to tell you what anything is. I i. I, you know, hadn't used power. There's just a lot of things that I hadn't done for a long time as a as a clinician, that I had to dive right back into. I don't even, you know, this is kind of embarrassing, but I didn't even, we didn't have rubrics when I was a student in OT school. And now rubrics are just like standard practice and so, but it helped to as soon as I really, as soon as I took this position, I also enrolled to get my doctorate. And so I think being in in school, you know, for my doctoral degree, really helped the transition. Gotcha, it's not easy. It's not an easy it's not a snap your fingers and make it happen. Kind of a thing.    Jayson Davies     Were you, were you doing the doctorate program in the same program that you were teaching.    Tiffany Bolton     No, I we actually are still developing our post professional doctoral program. So I got my post professional doctorate at the University of Kansas Medical Center. Gotcha    Jayson Davies     very cool. All right, so we are here again talking about your article yourself. And Lindy Platner. How? Before we get into it, I just want to give you a little opportunity to share how, what role does Lindy Platner have in this? Is she your colleague at the college or?     Tiffany Bolton     No, so Lindy was a student at the time, and she was not actually my student on this research project this she was a student in either one or two cohorts younger than the students that worked on this project with me, but Lindy had a strong interest in research, and we hired her on as a research assistant for two of us in our program that were clinical faculty. So research was not our primary role, but we both engage in research and need a little bit of help to write things up and to manage the data and our with a very supportive department chair. And so he allowed us to hire her on for a couple hours a week to help us finish up a few projects. So that's really Wendy's role. She kind of helped with literature review, organizing the data. She helped with some of the charts, and it was some of the writing, so it was nice to have a little assistance there.    Jayson Davies     Awesome. Well, shout out to Lindy, thanks for helping out. All right, so this article, it was published in the Journal of Occupational therapy schools and early intervention, and the title of that article is occupational therapy role and school based practice perspectives from teachers and OTs. I just want to say that I love that you kind of went outside of the just ot realm and did go out and talk to teachers as well or get surveys from teachers. So to get started with that, what made you decide to look at the perception of school based ot from both OTs and teachers.    Tiffany Bolton     Well, like I said, I do all of my research, you know, through the University of Missouri, and so it always includes students and I, I so I'm not obligated to do that. That's actually voluntary, since I'm not research faculty. That is not something that I have to do for my job. But I really like it for a couple of reasons. I think that it's really helpful for our students to work with faculty that are not that are not strictly research based, to look at clinical issues that are out there, to hear it from a perspective, that's from someone that's not research heavy, that you know, that struggles their way through the process and has to ask for help. That's me, you know. So I think that's an important reason. And the other thing is, what I really did with this particular student group was I gave them a population that I was interested in, and we just started a lit review process. So I have to say that this project really came from a really sort of true research methods perspective, where we really did start. We had this idea. We started with the literature review, identified a gap in the literature and went from there. So that's not always the case with student projects. You know, sometimes it's like, sorry, this is the data I'm collecting right now. You have to hop in. So this one really started from scratch, and to be perfectly honest, we were interested more in the transition from preschool to kindergarten. Like I said, I run some preschool programs, so and we asked questions that gathered information about that kindergarten year in the transition to school, but we as we also asked lots of other questions, and looking at the data, we thought we had a lot more to talk about than just The kindergarten piece, and so kind of shifted and reshaped as we Funny how that happens, right? Yeah, pulled data in, and we kind of dropped that focus on the kindergarten year so much. But that's really where we came from, was this. So there's, like, a lack of both federal and state standards for what preschool curriculum should look like. Yet there's sort of a unwritten rule about what kids should look like as they enter kindergarten, um. And then if you look at common core standards, um or or other standards for kindergarten, they're so vague and they say things like, um, would it like a you know, a five year old child will incorporate research into their. You're what you know. And so schools are coming up with their own way to to interpret that, and it's leading to, you know, really drastically different expectations, I think, from kindergarten all over the place. And so we, we wanted to explore, kind of what we were hearing anecdotally mixed with what we were looking up in the research. So we have kids come in and all the time, and, you know, parents feeling like, are my kids not keeping up? And I have no idea what's going on. OT and, you know, just, I'm like, we just, let's just dig a little deeper and find out what's happening, you know. And OTs would tell us, well, I would love to do that kind of therapy, but I can't, because of this reason. And so it's kind of just a big hodgepodge of all of those things.    Jayson Davies     Yeah. So it sounds like this was a master's thesis type of thing then.    Tiffany Bolton     Yeah, so their master's programs, and we call it like their synthe synthesis project, and so yes, it is essentially like a master's thesis.    Jayson Davies     Okay, I'm actually a thesis advisor at a local university over here, so I've been doing it. I've had three cohorts now, and so I kind of understand the process a little bit more. And you're right, it is a big transition, but it's a lot of fun, because you get to kind of take these students, and you're right, it is, I feel like the students are so much more involved when they start from the ground up, and you don't just tell them what to do, and when they have a hand in developing that whole process. They just get more involved, and they feel like they take more responsibility in it.     Tiffany Bolton     They do. They were so fired up about this topic, and actually none of the three of them have an interest in pediatrics long term, but they actually won the graduate synthesis Project Award for their year because, I think, just another passion, and I really think though, because it's due to the fact that we really just sort of followed the literature and kind of let guide us, and they were really immersed in it. So yeah, it was a good experience.    Jayson Davies     Awesome. So was it just one cohort that did this entire project, or did it go span over multiple cohorts?    Tiffany Bolton     It was one cohort that that developed and pushed out the initial survey. We have them for an entire year in our research sequence, the course of a year that we worked on it. And then really though, I spent a summer kind of looking at the data after they were finished, and then the next year, Lindy kind of jumped on the project with me, and it really took on a different shape. So those initial students were really involved in sort of the development of the survey, but not really the kind of the synthesis and, you know, the analyzing the data, yeah, analyzing and that, that publication is the end result. That was really kind of more after the fact.    Jayson Davies     Gotcha All right. So as you began to look into the perceptions of OTs in schools. What did you uncover in that literature review? That kind of moved this forward, and I'm sure that those students were very helpful in that literature review. What were they finding?    Tiffany Bolton     You know, they found it was that discrepancy between so this is, this is, this is a literature review in the sense that we also looked at more, you know, federally based school websites and things like that. So it wasn't just straight research, but we found that discrepancy in how schools were were interpreting Common Core standards, which is what everyone was using at that time. And we didn't cite a lot of those, because it would have involved citing a lot of individual schools. But you can get to the school website and they have drastically different goals, you know, correlated with the same Common Core Standard, and then you start to look at the preschools, and that information is really missing. And so that was, like I said, that's the gap we went after in terms of how we developed our survey, but we realized after the fact that those questions, that we had them, and that we had all the teachers answer, there was only one question that asked, How much, you know, how many kindergarten Well, if they were the OT, how many kids of their caseload comprised of kindergarteners, and how many teachers had kindergarten experience? And the rest of them were all just sort of general school based questions. And so we eventually, sort of, you know, looked at the data and and that's kind of how the paper took shape. So it's sort of twofold, like, really the and then, and then, you know, you always have to go back and backfill with literature. And so what we found is that, you know, the number one reason for referrals is handwriting. Yet our teachers reported on there that they don't see a lot of improvement. Our OTs said that they, you know, they feel like they have a role in all of these other areas. But yet, the literature says that we're not getting referred for that, so that became sort of our new GAP, if that makes sense. Yeah. And    Jayson Davies     I actually want to dive into that in a second. But first I want to ask, what did that survey look like for both OTs and for the teachers? Was it the same? Was it different?    Tiffany Bolton     No, it was different. So um, without getting too much into the nerdy applications of Qualtrics, um. You can develop a you basically, it's like a tree. So you have they start with one question, it branches off into other directions. So if they say yes, I'm a teacher that takes them to a whole new bank of questions. If they say no, I'm an OT it takes them to a new bank of questions. What we did try to do is, you know, if we asked OTs, do you feel like you have input in these certain areas, we would also ask the teachers, would you value OTs input in these same areas? So we tried to have questions where asked the OTs, do you have input? Do you think that you should have input? And then if the teachers would value that input is really tried to how we tried to match it up so that we asked questions about the same thing. But it then made that it made sense for each profession. Gotcha, we did that perfectly. But no,    Jayson Davies     that's exactly I mean, I actually used your article to create an Instagram post, and it's been one of my most popular Instagram posts. It was just to just a reminder to OTs that teachers really do value ot Yeah, and I think that was one of the main things that I took away from reading this article. And just because we often don't feel that love in the schools, partially because we're just at so many different schools that we don't have time to sometimes have those interactions.     Tiffany Bolton     Yes, exactly. I know that was, you know, and going back to your you know what the literature led us to, I think it was part of that too. So, so because we had developed the survey for slightly different reasons, we had sort of this pot of data that we were like, Whoa, this is more than we were expecting. So when we went back, was really, I think, highlighted that discrepancy between, oh my gosh, we're only getting referred for handwriting. Yet, the teachers think that we can do all of this, and we think we can do all of this, and this could look so much different. So I think that was really a big part of it, you know, as a second with kind of the secondary data set that we found, yeah,    Jayson Davies     and I know for anyone out there listening, it's hard to, I mean, we don't want to go into each individual question that's on the survey, but I highly recommend that if you have the ability to get access to the article definitely do that. They have some great charts on there that really just break it down into the teacher and the OT perception. But let's get into that actually a little bit. Yeah, it looks like you had about 92 OTs and teachers complete the survey. What was some key points that you already mentioned a few, but what are some other key points that you're able to derive from that data?    Tiffany Bolton     Yeah, um, well, surprisingly, and this is kind of what happens when you when you talk to, sort of your, your own network of teachers and OTs. You know, as we were developing the survey, we had several teachers, look at it, we had several OTs, look at it. We interviewed some teachers, so we wanted everybody's input on it. But then, you know, you put that out there to a larger group. And so sometimes it's interesting, because I felt like what we hear from a lot of the OTs that we work with in the school based settings, that they experience a lot of barriers to being able to provide more of a consultative service, or what we consider like an inclusive service, or push into the classroom type of service, but that's not what was reported on the survey, you know. So on the survey, really, the OT said that there were no barriers, but that they still didn't do it. Do? I think that that's representative, you know, I don't know. Like I said, my own network of OTs, I think would disagree with that somewhat. So I think some of that's just we pushed it on social media, and you, you know, you have to deal with with whoever answers it, and we have a breakdown of where they were located, by state, etc. But, yeah, it's just kind of interesting. So, so that was really interesting, though. Yeah, you know, I'm actually surprised me too. So if you just look at restraint perspective, about putting my Sway on it. What it says is that the OTs are not experiencing barriers to this, but yet still prefer a more direct you know that what we call the traditional pull out type of service, that's what it says. So, yeah, just trying to stay clear. That's what that so that one was really interesting to us because we were not expecting that. We were expecting to hear a lot about the barriers.    Jayson Davies     Yeah, that's interesting. And remind me again, where most of the OTs, because it was posted out on social media and the teachers, were most of them in the Missouri area, or was it pretty spread out nationally,    Tiffany Bolton     the majority of them were in the Missouri and Illinois area, but then we had representation in quite a few other states, so it was fairly spread out with us, with definitely a concentration in the Midwest, just because of the way we put the survey out. So that was an interesting find. I think the other, really, maybe the most compelling find, were those questions that I referenced earlier, where we asked, OTs, are you involved in things like instructional methods, the classroom environment, the classroom schedule, the lunchroom environment? And we asked a lot of that and and then we also asked if they felt like they should be and so I just a huge generalization. It was. Basically, no, we're not that involved. Yes, we think we should be in that the teachers also valued it. However, I will say the teachers did not rank very high in terms of the instructional methods, but I truly believe that that's more due to the fact that I don't know that most teachers would understand what kind of input OTs could have on instructional methods. And so I, I felt like that was more of almost an error in a survey where they really weren't set up to answer that question well, but for the most part, otherwise they they basically agreed with the OTs. Yes, we think you'd be very valuable, but it's not happening.    Jayson Davies     Yeah, and that's actually one thing that I teach in my A to Z school based ot course, is about how, or just what a OT, a even defines ot as in the schools. And you know, it doesn't say in their definition that we're handwriting and sensory processing specialists. It doesn't say that at all. It says that we are to help them, help students access their curriculum in all environments, lunchroom, recess in the classroom. And so I think as OTs, it's great to see that we value that, and that even some teachers value some of that. But it's not happening. I mean, to be honest, right?    Tiffany Bolton     It's really not, you know, and I know. I just want to put this out there for anyone who's listening in more progressive schools that have achieved some of this. I know that it is happening in some places, but I still think for the most part, what I see in here at conferences, and I'm on the children and youth special interest section in a ot a, what I'm hearing from most people is it is not happening. You know, we're still being referred as the handwriting specialists, and that is the bulk of what we're doing at school. And there's so much more, you know, that I think that that we could be addressing. And I I just have to say, I do. I think ot a has some great resources on school based practice out there.      Jayson Davies     That they've really stepped up their game. Their website is really good.     Tiffany Bolton     Of the website is phenomenal. And there's a excellent section on the caseload to workload transition that could be very helpful, I think, to a lot of school based therapists.     Jayson Davies     Yeah, you kind of mentioned how that the bulk of the surveys were kind of in your area, Missouri, Illinois, but I just it's something that I often say is, you know, we have people that listen to this podcast from all over the country and all over the entire world. I've had people from China reach out to me and say, Wow, thank you. But it's crazy how different ot can look from district to district, even though they're right next door, you're one district beyond workload. One district could be on caseload. One does RTI, one does absolutely no RTI. And the more spread out you go from state to state or state to across the country, it's even more different. And it's crazy how that is so different, even though teaching often looks pretty similar, but the OT profession looks so different.    Tiffany Bolton     Yeah, we actually some. We had a few places where people were able to write in some comments, and we had some comments come in about RTI. Interestingly though, the the teachers that we worked with in development of the survey, that was not common practice for them. So you know, like you just said, it's just really different. So we really attempted to try and stay as neutral as we could, so that the information, you know, could be could be used anywhere, while recognizing that, like you said, you know, it was Midwest centric. So I know that it doesn't represent everyone.     Jayson Davies     But hey, it's a good starting point, and the research is there for everyone to read it and just to take something away from that. So one of the other little data points you had was about referrals, both the reason for referrals and the timing of referrals throughout the school year. Were you surprised by what you found?    Tiffany Bolton     Not you know, not necessarily we, I can tell you that our, you know, I mean, I guess we had maybe a slight ulterior motive with asking that question, thinking that, depending on what the data said, we could recommend, oh my gosh, well, OTs could implement, you know, maybe more preventative to your one types of services at this time of year to be more effective. And maybe it still says that, but it really was heavily in the fall semester. And so, you know, that's not too surprising. You start off that year, and it becomes really apparent who looks different from from, you know, other kids. And so that wasn't too surprising, neither was the reason for referrals, because it just supported what we had found in the literature. Found in the literature, with handwriting, by far and large, being the most, you know, dominant referral. So, yeah, that's that wasn't too shocking, yeah.     Jayson Davies     So I have a question for you. Obviously, I've only worked in a few school districts here in California, and here, IEPs happen throughout the year. You can have an IEP on the first day of school. You can have an IEP on the last day of school, even though people hate that. But I've heard in some places, they try and put all the IEPs in one point of the year. Have you seen that? Is that something that you've come across?    Tiffany Bolton     I have not come across that specifically I see. More of the it seems to be based on, really, when that initial referral exactly right? Yeah. And it just stays on that, that rotating basis, um, so, no, I have not seen that so much. I guess I could sort of see the that'd be really stressful.    Jayson Davies     I know. I can't imagine being a case carrier and saying, Hey, all your IEPs are in the month of May, or all of them are going to be in September. Like, yeah, I don't want to hold 30 IEPs, I mean, or as an OT 100 IEPs, all in one month. But I know some schools do it. I just wondering if you if you had heard any of that based upon the feedback. No, okay, that's fine. All right. So, something that I've learned as a thesis advisor is that no matter how great a project can be. It's never perfect, and sometimes you get to a point where you're interpreting the data and you just wish you would have had the ability to ask one more question after concluding this survey. Do you feel that there's any questions that you wish you would have been able to add to that survey now.    Tiffany Bolton     yes, and this one will just burn my brain for the rest of my life. I cannot believe that we did not ask the OTs if they were contracted by the school or employed by the school district, because I think it makes a huge difference in the amount of time they're able to spend at the school. You know, the way that the their ability to provide tier one interventions, I think goes up dramatically if you were employed by the school district, and we did not ask that. So we have no way to separate out if our answers, you know, were like, we have no way to group them by OTs that are contracted versus employed by the school district. And, like I said, that will, that will, like, burn my soul for the rest of my life. I there's actually somebody I've connected with on the community. Board and children and youth. I'm blanking on her first name. I think the last name is Salazar. She is currently working on an additional survey, and she's used our survey heavily to build upon hers. So in terms of, like, looking for a next step, I believe that it's in the works. She's really done her homework in terms of having people look at the survey. And I told her that question, I'm like, don't forget to ask this important please ask this question. So yeah, she she's working on kind of I've read her survey, and it's excellent, and it really takes things to the next level. She didn't build it just upon her. She used about five different sort of resources that she built hers on pretty heavily, but it really takes, like the things that we ask, to the next step. So I'm excited to read it.     Jayson Davies     Awesome. She's finished it yet, but you're absolutely right. Though, just a few days ago, I had a contract therapist reach out to me. They're like, hey, I really want to do RTI, but I don't get paid to do any time after school. Yeah, and she's like, Well, what do I do? Like, I mean, it's almost kind of that thing where you have to show your worth by working for free at some point. And I mean, if you're going to do it like an in service, you almost have to volunteer your time to do that in service and hope that they see the value of it, and then ask for some time to do stuff like that. I mean, that's my only real recommendation when it comes to that.     Tiffany Bolton     No, I could not regret it more that we didn't ask that. But I hopefully that gives somebody else a jumping off point, you know, for another, another project, to take that sort of big missing piece, and it kind of lays out a second second project pretty nicely. So.    Jayson Davies     Absolutely. So you mentioned how someone else is taking it and running with it a little bit. Do you have any intentions on following the survey up with something?    Tiffany Bolton     So not directly this survey, I actually have a completely different research project that has become a life of its own, that, you know, I've had to call in. I've partnered up with research faculty on it, because at this point, it's kind of gone beyond what what I'm able to do in my my role at work. But we are looking specifically at measurements of handwriting in their preschool population, which most OTs are like, well, they shouldn't be able to write. I agree, but the world is expecting that of them, and at this point, I feel like as OTs, we need to, we can't keep saying that developmentally, they shouldn't be writing. So instead, what we have done is we wrote a screen, not a screen tool. It's we're actually working on standardizing a tool that looks at just functional writing, so when they're not penalized for letters, they don't know how to write. There is room for error in rating the letters, but it actually looks at letters and looks at names separately, because I think most OTs we recognize that that name becomes kind of a pattern, and they might be able to write Tiffany, but then you say, write an F, and they can't write an F. So we rate names separately, and we have a way to rate each letter. And our results have been really interesting. Our participant numbers have gotten up fairly high. And so like I said, I've partnered with research faculty because at this point it's it's getting outside my wheelhouse. We have a paper submitted right now that, and we're waiting to. Back on our initial sort of stages with this. The other interesting thing that we're measuring with this is we were measuring grasp because I know that my own personal philosophy as an OT is that grasp is not overly important. So I think that, you know, at some points it is worth, you know, attempting to correct or improve, but at some point it's okay if we have an adaptive type of grasp. And so far, no matter how many numbers we add to it, we are not seeing a correlation between accuracy of writing and grasp, which is not, was not really our initial goal, but it's been a fun result. Interesting. Yeah, I mean T shirts, but.    Jayson Davies     Yeah, I mean, every now and then I I just want to go. I just get this idea that I wish I could just go in and take a picture of every single student, handwriting grasp in, like one classroom.    Tiffany Bolton     Yes, Jason did this. We took picture. We have pictures of every, oh my gosh, of everyone that we evaluated. So you are sitting on my dream.    Jayson Davies     So wait, did you just do preschool with that?     Tiffany Bolton     Then we've just done preschool so far. We did shy away from naming our tool anything to do with preschool, because we feel like it could be something down the road with someone else's help, that we could standardize, especially for kids with delays that are older, because we really are focused on, like, functional writing. So, you know, as in, we're not looking at formation, we're looking at the end result. Can I read it? So when somebody hands me this paper, can I read it? And so we felt like that can be something really helpful for, you know, our kids with disabilities that are older than the preschool age. But yes, we have pictures of everyone's grasp at three, well, either two or three different test points, depending on what phase of the study they were in. And we have done some presentations where we paired up, we showed a sample, their matching sample of grasp to or, I'm sorry, their matching writing sample with their picture of grasp. And it's, I mean, you know, it's really like poignant when you see it visually, because some of the kids with the worst looking grasp have the best looking writing and whatnot. So we did a workshop that we actually passed out pictures, and it was like a contest for some different prizes, if people could match them up based on what they were seeing. And no one could. So that's a whole different research study we're just saving.     Jayson Davies     Oh, my goodness, you're gonna have to come back onto the podcast another another day. We're gonna have to do that. Yeah, no, I wasn't gonna ask you this, but I just want to what have you learned from going through the research process, just as an OT what have you like? What are you taking away from the research process?     Tiffany Bolton     Yeah, you know, when I was a clinician, I'll be really honest and say that what I did at that point in time probably wasn't very solid research, and I think that was just lack of understanding I didn't have a strong research base in my ot program, and so reading articles was really intimidating to me. I will say, you know, continuing my education really helped with that. But I think engaging in the research process in any way that you can helps it be less intimidating, and so you can take an article and dissect it a little bit more, and you don't have to be scared of, you know, the big words that are in there that you maybe don't understand. I'm just putting that out there. This is what I tell my students. I'm like, I want at the end of the day, if you don't learn anything about the actual research we did, but you feel like you could go into your job and you know, somebody says, Hey, we're collecting data on this. Would you like to be a part of his research? And you jump on that chance, then that's a win. And so I think that, you know, what I've really taken away from it is, don't shy away from it. There's a lot of people out there that are really willing to help. Heavy researchers are eccentric, amazing people, and they like to share what they know. And so pairing up with someone, or asking for somebody to help you understand what you're looking at can be really helpful. And you know, the other piece of it, I think, from the clinical side, is collecting data is absolutely imperative. And that can look like really simple tally sheets. It doesn't have to be really complicated. One of my focuses on anything that I do is that whatever we're collecting has to be fast, because I refuse to like change my clinical process like it has to, like the research. Sometimes, researchers that help me with my data. Sometimes cringe, because my data is can be a little messy. Sometimes, like, like, Well, what about this? I'm like, I don't know. We had 35 kids to evaluate in an hour, you know. Like, that's we had to get it done, you know. So, so coming up with clean ways to collect data, simple ways to collect data, because it really can back up what you're talking about. I, you know, questions come up a lot on the community board about, you know, I know this practice doesn't have a lot of evidence behind it, but I see it happening a lot in my clinic, and my question back almost 100% of the time is what. Kind of data are you collecting on it? You know? Can you? Can you show, without a doubt, that this, that this intervention is helping? So, yeah, I think my, my key, my key takeaways from the research process are, don't be intimidated by it. Yeah, don't, you know, like, don't hesitate to reach out for help from a university, anywhere that you are affiliated with. If you've taken a student from anywhere, reach out to them and say, Hey, could you guys help us with this? Or, you know, do, do do a journal club, anything like that, and then collect data? I mean, I think those are my biggest things.     Jayson Davies     Yeah, that's a good tip. Just reach out and, I mean, yeah, the worst you're going to get is a, sorry, no, we can't do it right now. And maybe you have another program that you have an affiliate affiliation with that you can ask. So, yeah, exactly.    Tiffany Bolton     And I you know on that note, a lot of the universities will provide you with a like complimentary access to their research database. So we can provide that at our university for interested people that take our students. We they can have access to our database, so they can have all those, you know, well, like this article we're talking about today is in a is not in an open access journal, but if you were affiliated with our university, you can jump right in and, you know, get the article requested through the library.     Jayson Davies     So yeah, I mean, even this the way that you and I got connected, as a perfect example, I just reached out to you because I couldn't get access to this article that I want. That I wanted to read. I was like, Hey, I'm just gonna email Tiffany and see if she has the ability to get access to it. So thank you for that, by the way. Yeah, no problem. But yeah, I think people do get overwhelmed. They just get bogged down. I think when they're reading an article, especially when you're looking at p is greater than or less than point 00, whatever, like, all these little numbers and things that just kind of make you confused. And unless you have taken a stats class, not just taking a stats class, but probably taken one recently, because that thing is the first thing that when you graduate, I feel like the stats is the first thing to leave your brain, for sure, but yeah so, but definitely, you know, you don't have to get bogged down by those. Look at what the interpretations say. Look at the lit review, and look at also the limitations, because any good article is going to have limitations, and if they don't have limitations, then you should be questioning that.    Tiffany Bolton     Probably, right, exactly. Yeah. And, I mean, you know, with just a little bit of help, I think you can learn to recognize, you know, how large of a study it is, you know, I mean, I think there's some little key points you can, you can use to really dissect an article quickly, yeah. And really, honestly, your ot students are good at this, so have your ot students help you, right, all right,    Jayson Davies     so let's go back to your article. Last question. I just want to wrap this up and ask, what is one key point that you think school based OTs should take away from the research that we talked about today?    Tiffany Bolton     I, you know, I think based on our findings, specifically, I think it is that the teachers do value our input. They're, you know, obviously there are OTs out there that do not feel like they experience barriers to to the type of OT that they would want to provide. And so I think keeping those things in mind, you are valued, the teachers, maybe and administrators need some more education about what all we can do in a school setting. I think that's maybe a big part of it. I think some of it really just comes really just comes from lack of knowing. And don't be stuck in that rut. You know, if you feel like this is what was happening before you were there, or what other therapists are doing, there is evidence out there, and, in fact, plentiful evidence out there to support you in changing that school based role. I think that's the biggest part. Don't be afraid to change your school based role. I always tell my students, I'm like, if you go into practice willing to question, you know, everything that you're seeing, then that's, you know, that's a big accomplishment. Ask questions and and make sure you understand what's happening. So, yeah, I think that's the biggest, the biggest one. I do have to say, we purposefully sought out this journal because it pop if you go to the ERIC database, so the education database, this journal pops up in there. And so we chose it on purpose, because even though it is an OT journal, it shows up in the educators database where administrators and teachers are reading. And so that was, I was fairly adamant about using that journal for that reason.     Jayson Davies     Tiffany, you are awesome. That is, that is great that you even went that far as to find a journal that does that. Because I haven't done this yet, but my dream is to present not at an OT conference, but at teachers conferences for that very reason, because people don't know what OT is in the schools, our admin don't know, and the only way they're going to find out is if we help them. I in services are a great way to start that process, because by providing in services, you are letting the teachers the admin know what you can do, and it's coming directly from your mouth. Mm. And so you can do that through in services. And in the same way, I feel like OTs need to get out into the educational world to share what we can do, because otherwise they're never going to find out. They're not going to go Google. What can ot do in schools?     Tiffany Bolton     Yeah, I would agree, and I would have to say too in this it's in the same journal some people that I know, well, Maria ball is another person. She's written an article about a way to change school based practice that I actually cited in this article. It's excellent. And Cynthia Cliff did the same. She did her PhD, and she has she did interviews with therapists, and both articles are in the same journal, and they're excellent in terms of giving you support if you're if you're wanting to make changes in your in your school that you're in.    Jayson Davies     Great. Well. Thank you so much. This has been a fantastic just a conversation. I enjoyed this conversation. Thank you so much. I want to give you a chance if you'd like to share, where people can potentially get a hold of you if they have specific questions or just want to learn more about your research.    Tiffany Bolton     Yeah, like I said, I work for the University of Missouri ot program. My email there is my it's my last name, so Bolton TL, so my first initial and my middle initial, Bolton tl@health.missouri.edu and if you're active at all on a OT, a you'll see my name really frequently. I have another year in the position as the communications coordinator, so I'm all over the community, children and youth board, and so you can, you can find me through there as well.     Jayson Davies     Oh, and no idea about that. So are you going to be in San Diego next year, assuming everything is so if they, if.    Tiffany Bolton     we're cleared to, you know, right, be around people again, Yep.     Jayson Davies     Yeah, I sure hope so. I'm looking forward to that one that's in my backyard, basically. So I haven't announced anything yet, and I haven't even started planning, but I'm hoping to do some ot school house type of meetup gig type of thing. So, yeah.    Tiffany Bolton     that's the plan I was supposed to present in Boston. So that was, you know, not, didn't happen, obviously. So, yep, that would be the plan, cool.    Jayson Davies     Well, hopefully I see you in San Diego then next year. And yeah, thank you so much again for coming on. Really appreciate it.    Tiffany Bolton     Yeah, no problem. Thank you. All right. Take care. Bye.     Jayson Davies     All right. Thank you everyone. So much for listening to this show. I hope that you found that refreshing and just a great way to kind of start July, I mean, just to remember that OTs and teachers, we work alongside of each other, we appreciate each other, and we do so much together. It's just great to see that people are working together and that teachers appreciate us. We appreciate them. Thank you so much to Tiffany Bolton for coming on the show. Really appreciate having her on. It was a great conversation. Just really appreciate it for all the show notes. Head on over to OT schoolhouse.com forward slash episode 52 and we'll see you next time on the podcast. Take care. Bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 51 of the OT Schoolhouse Podcast. In this episode, Jayson and Dr. John Pagano talk about the assessment and treatment of children and adolescents displaying complex behaviors. Dr. Pagano shares resources that he has developed over the years that you can access for free at FABStrategies.org. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: ​ Visit Dr. Pagano's website FABStrategies.org ​ to get the freebies that he mentioned in the episode Get the FAB Strategies book at Amazon Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host. Jayson Davies class is officially in session.    Jayson Davies     Hey everyone. And welcome to episode 51 of the OT school house podcast. As always, my name is Jayson Davies, your host for the show, and today, we are going to be talking about complex behavioral difficulties and some strategies that we can use to go ahead and potentially to support these students who might have these behavioral issues. That's a good way to put it, I think, and to do that, we have a very special guest on by the name of Dr John Pagano. I'll give him a little introduction here in a moment, but first I want to share a little bit of an announcement. I actually, as I was sitting down to record this introduction, I saw an email that the OT school housed A to Z school based ot course has actually been board approved by the state of Florida as a continuing education course for eight hours of continuing education. That is awesome news for me. That's awesome news for everyone that's in the course, and I hope it's also awesome news for anyone who may be interested in taking the course. So yeah, as we finish up and or as we finish up this week, it's Friday, as I'm recording this, and I am kind of putting the end to this week. This was actually the first week of the current A to Z school based ot core cohort, and it was just a great week. We have about 100 occupational therapists meeting together, and we're going over the entire process of school based ot from the very beginning with 504 plans and SSTs, all the way through the RTI process and through evaluations, through the IEP, and even eventually to when students are ready to graduate, and how we can facilitate that process in an ethical manner. So that's kind of what I'm going through right now with those or with that cohort, and it's just been awesome. It's a big, small group, if you know what I mean, like, it's not too big to be overwhelming, but it's big enough that we all feel like we can collaborate a little bit together, and the conversations that we've been having have just been awesome. All right, so I want to go ahead and jump into today's content with our special guest, Dr John Pagano, so I'm going to go ahead and introduce him right now. So Dr John Pagano, he actually presents on what he has coined the term fab strategies. And we'll get into what fab strategy stands for in a second. He presents about these strategies internationally for therapists as well as speech therapists, physical therapists, mental health therapists all over the world on improving self regulation in children, adolescents and adults with complex behavioral, developmental and sensory processing challenges. He's been a therapist for over 30 years, and has worked in just about well, not every setting, but many settings, including the NICU Birth to Three sensory integration clinics, preschool schools, group homes and a psychiatric hospital setting. He's known for his humorous style, as you'll get to see in this episode, and he is he has a lot of his extensive background, I guess I could say in working with young adults with autism spectrum and other complex behavioral and developmental challenges. Dr pagano holds a Bachelor's of Science degree in occupational therapy, a master's in special education and a PhD in Human Development and Family Therapy, and I really think that that is key. You'll hear me talk about a little bit later, how important I think it is that for those therapists who who were able to get a bachelor's in occupational therapy and become licensed and registered because it allowed them to go on and get masters in other diverse areas, and I think that is so beneficial to our field. And I'll talk a little bit about that as we go, as we get into the interview, you'll hear that later. But more about Dr Pagano. He is certified in pivotal response treatment, neurodevelopmental treatment for children and infants, early childhood mental health, QST, sensory massage for autism. And he is also an instructor for positive behavioral support and movement based learning. All right, so that is just a lot he has done. He has done many things. I didn't even mention that he's actually the vice president of the Connecticut Occupational Therapy Association, and has several published papers with, actually, people that have been on this podcast before, and he is very involved in OT community up there in Connecticut, in the surrounding areas. So please, please, please help me. Welcome to the show. Dr John Pagano, Good morning, John. Welcome to the OT school house podcast. How are you doing this morning?     John Pagano     Great. I've listened to your podcast before, so it's really cool to be on. It, yeah, and actually,    Jayson Davies     you reached out to me in an email, and it sounded like you were familiar with one of our previous guests on the show, and tell us about that.    John Pagano     Well, I got contacted by a ot a and joined this thing we call school mental health working group, it's a bunch of us that meet together by zoom and like, write papers together, but like, have never met sometimes and Susan, two Susans have been helpful, Susan basic and Susan Cahill. I wrote a paper with Susan Cahill because it was bothering me that when I had a kid in a psychiatric hospital, I was sending him back to the public school, the principal would say, you can't give him ot in our school because he has no handwriting problems. And I was like, we do more than that. Susan Cahill is this big professor, and so her and me wrote a paper, and it's saying that the A, ot A says we can do more than handwriting. We can work on kids social skills, on helping them not punch the teacher. There's a lot of other things we couldn't do. So this way, people now have the blessing of the A ot A, that our scope of practice includes mental health, social skills, handwriting and lots of other things. That's fantastic.    Jayson Davies     So is that an Asia ot article, or is that like an A ot a paper?    John Pagano     It's an A ot a paper, but I'll send it to you, because there's so many resources at the OT a that you almost have to be a tech expert to dig out what you want in under five minutes. That    Jayson Davies     is true, that is, they have a lot of resources on their page, and you can kind of get lost if you don't know how to use their page a little bit. I completely agree. But they did read they recently redid the page, and it looks beautiful, so I got to give them credit for that. Yes, cool. And so for everyone listening out there, he's going to send me that PDF so or the link to it. So be sure to check out ot  schoolhouse.com , forward slash episode 51 to get all the resources from today's episode. All right, so you talked a little bit about that. Why don't you go ahead and give us a little bit of background into yourself as an occupational therapist.     John Pagano     Well, I'm gonna give you guys a trip in history. I'm 62 years old, and I had a sister who had Down syndrome and died of pneumonia, and when I was 14, I saw someone, and their tongues looked different. I'd never seen him before, and I felt kind of scared by him, and that really upset me. So I went into down the street was a facility where they house children with developmental disabilities, and I said, I want to be a volunteer and just like, jump into it. And this lady was trying to feed one kid, another kid was crying, so she took this little girl who had cerebral palsy and threw her in my arms, and immediately she just conformed to my arms and stopped crying. And I said, this is my thing, like, this is what I was supposed to do. So I volunteered. When I was 16, they hired me as a recreation therapist, and then when I was 18, I started ot school and got my Bachelor's in OT that's what it was in those days, and a license, and worked in pediatrics and developmental disabilities, mostly school system. And then I got a job in a clinic, and I was doing Birth to Three. I was doing clinic sensory integration. I was doing everything, and they sent me out to do our school mental health contract. We had some locked psychiatric hospitals that had adolescents in them, and the because their kids, they had to go to school, and if they had handwriting on their IEP, then they needed an OT so I went there, and they realized they wanted to cut seclusion, where they lock kids in rooms, and they wanted to cut out restraint, where they jump on kids. And everyone wanted to stop that. All the aides wanted to stop that, the superintendent wanted to stop that, and they felt that I had a role in it, so they hired me full time. I left the clinic, and I've been there for 11 years now. Let me add a second. OT, Oh, nice. So it's. Is a hospital, the only locked hospital for adolescents in Connecticut, and then I also work next door in the prt f it's like a step down unit, a psychiatric residential treatment facility for adolescent girls. And now there's two OTs. There's a new school OT, and it's a big part. They basically bought me anything I want. So I've weighted blankets, I have weeded vests, I have steamroller Deluxes, I have a punching bag, anything I want, they order for me. So, yeah.    Jayson Davies     And so you said it's for teenagers, it sounds like but it's a hospital. They still have to get their education right.     John Pagano     Right, so I also help out in the school, but I'm not technically the school therapist anymore. They contracted someone else to do    Jayson Davies     that, but that school is housed within the hospital. Yeah, within the hospital, that's a very interesting setting.     John Pagano     Then it's been a real they didn't have OT, and then they had school OT, and now they have two OTs, and their other school has OT. We got Yale adolescent hospital, to add ot once they see what we can do, they added in. In the old days, when I graduated in 81 psychiatry was a major part of occupational therapy, we started to drift away. And I think it's a shame, because we felt that if someone chopped off their hand in a meat cleaver, or someone suddenly had a spinal cord injury, it wasn't going to just be physical, it was going to have psych implications, and if you didn't know how to handle that, you weren't going to get anywhere. And I think that's still true, yeah.    Jayson Davies     Yeah. I agree. And you know what, there is a big push. I mean, in California, we have, it's called ot Occupational Therapy Association of California, and there's a few people that are really grabbing the reins on mental health and really pushing for it, and they're really trying to get people interested again in mental health, and that's, it's just great, yeah, I just really like what they're doing.     John Pagano     Since I started back in to being in that working group with the two Susan other people, I really realized that, you know, it's a lot of money I pay, like $150 a year, but they really advocate for US legally. And then I added to my bucket list that I wanted to be a part of the state association. So I called them up, and they said, Great, your vice president. Oh, wow, probably a mistake. I would suggest people start with like doing media. Did it for four years, and I met some really cool.     Jayson Davies     Oh, that's fantastic, man. Well, thank you so much for advocating for the profession. We all appreciate that. All right, so one thing that I I find really, I don't know I I just really appreciate when ot used to be a bachelor's, and I'm going to tell you why. It's because, when you meet people that are slightly older or experienced and they have their Bachelor's in OT, they always have additional credentials versus newer therapists. We had go through so much school just to get our masters or OT D, it almost limits our ability to then go out and get a masters or a doctorate in something else. So when I was looking at your information, yeah, right. And so when I was looking at your information, I saw that you have a few extra masters degrees and even a doctorate. So I wanted to ask you about those. Why did you get them? And what are they?    John Pagano     I was working as an OT in pediatrics, and I felt like I didn't know enough like about language and stuff, so I went to the local college at night and in summers, because I was a school OT and did my internship in the summers, and got my masters in early childhood special ed, they made Me take courses in speech pathology in regular ed teacher courses, and it was really, really helpful. And then they said, suddenly, they said, now you're supposed to also be able to rehabilitate the parents. I have parents who are coke addicts. I had who were intellectually disabled, I didn't know how to work with parents, so I went to UConn and got my doctorate in the marriage and family therapy program, like going three days a week, and it was really a helpful experience. I didn't become a teacher. And I didn't become a marriage family therapist. I just stayed licensed in OT but I'm really glad I did it.    Jayson Davies     Awesome. That's great. That's it. I just find it so awesome when OTs just have degrees and other things. I just think that's amazing, because I'm sure that you introduce many people in those fields to occupational therapy, and not because you were purposefully trying to, but just because you ventured out of your realm and got some education in another area. And so I just think that's really cool.    John Pagano     I really well, I don't want to get you in political trouble. I feel strongly that they shouldn't up the credentials for CODAs to make them be bachelors. That's why we got so many men and people in color who don't have much money. Because when I graduated in 81 It was outrageous. I had to go to a private college. It was $5,000 a year with room and board. My students say they play pay that for books. Now you end up with this crazy, crazy debt that I'm afraid only elite people are gonna be OTs and CODIS someday, and I don't want that. Yeah, people want people who look like them, you know?    Jayson Davies     Yeah. And I think, I think that a lot of people out there that do agree or have similar feelings that you have about that. So, yeah, I agree. I don't want to get too much into it yet, but I think that might be a great podcast for another day. But today we are actually here to talk about children, adolescents who display complex behavioral concerns. And so we're actually going to go through a little bit of assessments about how you assess. We're going to talk a little bit about the research, and then we're also going to talk a little bit about the treatment and how you go about helping these students and adolescents that you work with. So you know what? Let's start off with first, let's give a definition to complex or challenging behaviors. What are you talking about when you use that term?    John Pagano     I especially enjoy working with kids with complex behavioral challenges, not the kids who are tiny bit naughty, kids who punch, kids who spit, kids who are sexually inappropriate, because I feel it's an important part of OT functionally. If somebody can't write really, really well, they can still make it in life, but people don't want to live with someone who's violent. They don't want to have them in the workplace. It's very, very problematic functionally, if you have inappropriate behavior, and that's something that I feel we OTs are good at helping with within like two weeks, my ot students at the psychiatric hospital are as effective in treating as I am. And one time, they kind of conned me, because I have a lot of friends who are in the colleges. So they said, I said, I really think I can only handle one ot students. They said, All right, but we're gonna send four and get rid of three and pick one. And they sent four fantastic students. I said, I'm really kind of like them all. And they said, Okay, well, how about you take them all? So I did. I took four. There was just me, and what they noticed was we have this big shot doctor who works for Yale, and he did a study and found that there was more incidences of violence on the weekends when there were no OTs than during the week when my students were there, wow. And I think it's simply because we're taught to value the person. There's this ot president who said, OTs ask what matters to you, not what's the matter with you. And and I love that, because I think that's how we were taught. You know that everybody's a person. They may have a disease or they may have a mental illness, lots of people do but their person, and if you could get to what is meaningful to them, then you're going to be able to motivate them to get better.    Jayson Davies     Exactly. No, you're absolutely correct on that. So, yeah, I love that quote. I am trying to think of who I've heard it too, and I'm trying to remember which President it was, but I will look that up, and I would get that out there, someone out there screaming at me, like it is this name. I'm sure of it. Yeah. Yeah, all right, so for the purpose of today, then you talked a little bit about complex behaviors there. What? What is that ideal student that as we're talking today, or that ideal adolescent? Can you give us a picture of who we're talking about today?    John Pagano     Well, one of the reasons I went back and got my doctorate was I was taught what to do if someone has autism spectrum disorder. I was taught what to do if someone has post traumatic stress disorder, but what I get very frequently, and what I think OT is uniquely suited for, is a kid who has, say, Autism Spectrum Disorder, Oppositional Defiant Disorder, has been abused, has been in 15 different homes, and also has a lot of difficulty following directions because they have a sensory processing disorder. So they've got all four, and school didn't tell me what to do with all four, but I think it kind of gave us the foundation to figure that out. And so I think OTs are very good at that, and a traditional psychologist may not have training in developmental disabilities. When someone has a mental illness and developmental disabilities, it's a little bit of a different ball game, and that's what I think we're good at.     Jayson Davies     Yeah, no, I think you're right, and I really appreciate how OTs just look at the whole picture. And this kind of leads me to my next question is, I don't know, have you ever had the chance to work with BCBAs and behavioral therapists?    John Pagano     Yeah, a lot of times, and it's been interesting. I prefer something that's very research proven, but they're terrible marketers. It's called pivotal response training. And what happened was this ABA expert who studied with love, loss and all that was smart enough to marry a speech therapist and she became a doctor with him. They're called the kogels, and Dr and Dr Kogel developed pivotal response training, it is ABA, uses ABA, but in order to developmentally Progress people's motivation, social emotional skills and their generalizability, and I use it a lot for kids who aren't autistic but need more motivation, better social skills and better generalizability. So I don't see ABA as evil or anything, but I like better this pivotal response training brand of it, because I find that it's important to work on those An example would be, let's take motivation. If a child gives you a good answer, he tried really hard, but he didn't get it right. You reward him anyway, because you want him to become more motivated. An example of generalization and social skills is you embed a human being in the reinforcer. And it's usually what I would consider an OT activity. A kid says, jump and I jump on a bed with him so he can jump higher because I'm jumping with him and I weigh more than or he says, swing. So I push him on a swing, rather than he says, swing, and I shove an Eminem in his mouth. It's much more practical. It's the adult is embedded in the reinforcer. And you're going to, if he gives you a cruddy try, you're not going to reinforce them. But if he gives you a good approximation of saying swing and he tried his damnedest, you're going to push him anyway. Yeah, then you're going to ask for a little more. And they're very respectful to OT, obviously, to speech because the wife is a speech pathologist, and I just like that brand a little better.    Jayson Davies     Okay, and yeah, again, I'll have to put that information up on the pod or up on the research page, so that people can find more about that. One thing about about ABA is that, I think that there's so many things like you're talking about, we can do a lot of those strategies that ABA does. In fact, we already do many of those ABA strategies. What I do find, at least in the schools, is, in my opinion, I see ABA therapists often, and they're coming in now. I don't. Know how it is in Connecticut, in the schools, but in California, there are a lot of ABA therapists now coming into the schools. And in my opinion, it's often because, like you said earlier, we are seen as a, the handwriting specialist and B, because our caseload is so high that we often kind of almost push away from maybe taking on those cases that we're going to talk about today, those behavioral type of cases. But yeah, that's just kind of my two cents in it. So I want to move on to behave or sorry assessments, assessments of behavior. And so when you get a new patient, a new client, a new student, what type of assessments are you using?    John Pagano     The first thing I do is a trigger and coping strategies form, and I'll put that on your website. I adapted it from the Massachusetts safety tool, and although it's copyrighted, I give it out. I give everyone permission to use it. So it's a bunch of pictures on the first page, and you pick the three pictures that most appeal to you. So first are environmental triggers. It's something that happens, and when it happens, after it happens, you do what gets you in trouble? You cut yourself, you punch somebody, you swear at somebody. So an environmental trigger is a bunch of pictures of like I'm held to restrain. I'm told, No, which is the biggest one in the research. I'm told I can't do something. I'm told, you know, I can't do what I want. I'm tired, I'm hungry, and they circle the three pictures that are their biggest environmental triggers. The next page is their body triggers. What do they do before they punch? I make a fist before I yell at somebody. So that's my environmental trigger. Some people cry, get a red hot face, act silly, swear, so that they are identifying their warning situations and their warning body movements. A lot of times we have to figure this out for them, but you're starting to ask them about that. Then the next five pages, they have to pick three coping strategies that they're already using, and they work. And then we're going to try to expand on those. So that's a pretty much an eval I do with everybody. And the reason is, a lot of times when I get kids, their behavior is so challenging, and they've already had ot they know I can't help them, so they're not going to cooperate. So this gives you a way to trick them into showing them that you got something to offer that so things they don't know, like Thera band. I'll teach them Thera band hitting a punching bag. I'll teach them a scooter board. I'll give them a ride on a scooter board. So whenever they see coping strategies, they don't know even tense and relaxed muscles. You teach it to them as we're going along. So it gets them. I give it first. It gets them to do the assessment. Yeah, yeah. And then I give the sensory profile. Often, I'll have the short form filled out by a teacher or a parent ahead of time, because it often has things, especially if I see a kid once a month that I can eat, I can't fill it out good. So I'd rather get other people to fill it out, but they have to fill out every question. That's what you tell make your best guess. Otherwise, I can't score Exactly.    Jayson Davies     Yep. Okay, yeah. And one thing about the sensory profile, do do you use the school factors that that gives you?    John Pagano     I've been using just because I learn one thing I like, and I keep it I use the short sensory profile too. I like it for children, because it's fast and because it's reliable and valid, but also what it does now is, when he done, puts what's sensory like, I put my hands over my ears to protect my ears from sound, versus what's non sensory she doesn't like, if I call it behavior, but tantrums spitting at people, yeah, so that you have a bunch of things and you get a score of, Do they have sensory problems. Do they have behavior problems, or do they have both? Usually they have both, but it helps you to organize. Usually kids have both problems. But sometimes they don't. They just have a sensory problem. And those are the kids you get tons. Tons of them coming to your clinic in September because they hold it together in school and then beat the hell out of their brothers and sisters, it's true, so they can hold it together. Also, parents have complained that doctors give Rita Ritalin at school, but then none at home because they don't like parents. So I went to a pediatric psychiatrist. I said, Why do you do that? And he said, I do that because they won't sleep all night. It's actually a stimulant, so if I give it in school, It'll wear off by nine o'clock at night. So that's why they do it. But still, we, who are clinic therapists or even school therapists have to be sensitive that maybe we need to drop the demands at home and like, my son has five hours of homework. That's ridiculous. Yeah, I didn't get five hours of homework in the old days much.     Jayson Davies     Yeah, and I think our teachers are becoming more aware of that, and they really are telling the parents, you know, what, the demands are so high here at school. And the parents are saying the same thing, you know, he works very hard at school when he comes home, he needs a break, or he or she just needs a break when they come home.     John Pagano     And a behavioral tool that I found helpful, again, from pivotal response training is interspersed easy. So instead of giving them an hour of homework, you give them 10 minutes. And a lot of really smart teachers can give them 10 minutes of math that has all the concepts that the hour has, yeah, so they go through. And what I'll do for kids with low frustration tolerance is every other math problem will be one they already know they won't get as frustrated. So numbers 2468, 10 are new, but 1357, are things I know they're going to get right so you don't get them as frustrating.     Jayson Davies     Yeah, yeah. Completely agree with that. Okay, so you had listed a few other assessment tools that you it looks like you use, and they were behavioral, it seemed like or a little more on the behavioral side, I think the DECA, the D, E, C, A, what's that? One?    John Pagano     Is the DevRel early childhood assessment. It's a Do you have? Most of you probably do the PBIS curriculums.    Jayson Davies     Yeah, positive behavioral intervention strategies.    John Pagano     What that stuff really is about, they're different flavors, like different brands. It's scientific. But what it says is, If children have high attachment initiative and self control and low behavior concerns, they're going to do well, even if they have some neurological problems, even if they have some malnutrition, even if they have a very dangerous neighborhood they live In. So what PBIS tries to do is build up attachment, initiative in self control. So you get a score of how low is their attachment, initiative, self control. If it's two standard deviations below the mean, they're really low in Initiative, or in attachment or in self control. And it's very easy for an OT to build it up. If a kid's got poor initiative, you reinforce them for doing things for yourself. If a kid's got low self control, you have them do things like Simon Says, or red light, green light, where Simon says, Do this, do this. You want to do that. Touch your head. But if you do, you're out of the game. And when you think about behavior problems, punching somebody or swearing at somebody is a lack of motor inhibitory control, you should have kept your mouth shut. But you didn't. You said it. You should have kept your fists open, but you punched somebody with them. And so I think it's something we as OTs are very good at teaching. If attachment is something, then you have them do a special thing, just you and them. You work on your relationship, not Freudian attachment. It's attachment of using teachers and therapists the way you're supposed to use some of my kids. If, if they write two and two is five, the teacher marks it wrong, they'll slap the teacher. Well, the teachers marking it wrong because it's wrong, and you really need to learn how to accept that, that that correction.    Jayson Davies     Yeah, and that's one of the reasons that I'm trying to push more into the classrooms next year, is to help the teachers build that relationship a little bit. But I can see your mind turning in and I know sometimes in this. Podcast. We get a little bit off topic, but I want to bring that back a little bit to the decade. So is that what the DECA kind of looks at then? Is it a questionnaire, or what is it?     John Pagano     And what quick questionnaire? And it runs from preschool all the way up to 18 years old. It's something that's commonly used in the schools to mark somebody social, emotionally maladjusted. The psychologists use it, but they they call it the instead of calling it the DECA, they call it something else, but it's the same questions norm for different age. Did you say? How much in the last month did the kid do something that made adults smile or show interest in him or her? If never, that's a low attachment score for that item. Gotcha. How often did they touch adults or children inappropriately? If they very frequently did, then that's going to be a problematic score for behavior concerns and self control.    Jayson Davies     Okay, so it kind of breaks down those areas that you just described to us. Yeah,    John Pagano     and I, I kind of will, in the body of my ot of Val, talk about the very extreme scores, and then just talk about, do they have a problem in attachment, initiative or self control?    Jayson Davies     Gotcha. Okay. Cool. Thank you for explaining that you had one other one, the ASQ se.    John Pagano     questions about behavior, function, Q, A, B, F, and this, I've gotten some criticism for OTs from OTs for using but I feel it's very, very important. It gives you the functional reason that kids are misbehaving. What the research shows is, if kids are misbehaving to escape work, and every time they punch somebody, I take them out of their work and give them sensory input. I'm going to make them worse. Now, if they're the function of their behavior is sensory input, which the behavior that's also call something else. They call it non social, but it's really sensory. That's the kid with autism who's rocking because he digs rocking, rocking gives him something. So if I give him a rocking chair to rock in instead, it's going to make him better, but if he's doing it not for sensory if he's doing it to escape work, then I've got to work with my speech pathologist and figure out a way that he can appropriately tell me he wants to stop working rather than punch me. So when a kid, even if they're on a behavior program and they're and you're doing it and they're getting worse, then you need to do the Q, A, B, F, okay, and that will quickly. It's a check sheet you can do, and you can even as the OT fill it out. It's very simple questions, not not real intimate questions like the sensory profile, and it tells you, why are they being bad? Are they? But you have to get a very specific behavior. It can't be like tantrum. It's got to be punches, people. It's got to be screams. You're answering the questions for one specific observable behavior. Okay, that's a different the worst one first, something I always say, something my mother could see she's not an OT but she can get what punching is. She doesn't get what tantrum is.    Jayson Davies     Gotcha. Yeah. I mean, tantrum is a very broad term for it. Can mean very different things between this kid and that kid and and the other kid. Tantrums can look very different. So all right, I want to get into a little bit of research. You've already thrown a little bit in here and there, but in the resources that you sent me the first area that you talked about, because, I mean, maybe you need to talk a little bit about your strategies, but primarily the three areas that you focus on with research is mindfulness, sensory and then also environmental impacts on behavior. And so I want to start a little bit with the mindfulness and behavior. What research has really, has really, just like motivated you, or what research have you found? Very helpful.    John Pagano     My kind of side job is I give workshops. I give workshops for teachers. I give two day workshops with the Ri for school therapists and for occupational physical speech. I. And so when I give these workshops, what I did was and for myself personally, I developed a form I call fab strategies. Form, put it on your website, and it's got four areas, environmental adaptations, sensory modulation, that's b, c is positive behavioral support, and D is physical self regulation. So I got those four areas, and when going in, I treat I check off what do those strategies work? Because sometimes in the schools, I'm 62 they have me going out four times a year. I can't remember a kid when I see him four times a year. So when I see him the first time, I write down what strategies worked well, and I have the teacher triumph. Then when I come back, I keep the ones that worked well, and I try to add a couple more so that I can remember, so I use it as a daily data sheet, whether I see the kid weekly or monthly. And then it makes it easy to make it into a home program for teachers for next year's ot for the new school. So it's got double value, and it can be done very quickly. My biggest frustration when I work in schools is I don't have enough time.    Jayson Davies     Yeah, yeah, and then you have to really rely on the carryover. So exactly. So I saw the fab Strategies Worksheet, and so I want to talk about that research a little bit. What is the mindfulness research that has helped you to develop that fab strategies.    John Pagano     There's a lot of what I do is environmental adaptation. There's a lot of research. People will say there's no research. I'm real lucky, because my work gives me an hour a day just to do research, because we're teaching hospital so and it takes an hour day. There's so much stuff coming down. So there's a lot of evidence in environmental adaptation that what helps students learn is to highlight the curriculum that stuff you want them to pay attention to. So if they're going four plus four equals zero, they're minus thing they should have been plusing. If you take a yellow highlighter over all the pluses, you can help him to pay attention that it's pluses, and that's been proven research, proven to help children. Another is to decrease the stuff you don't want them paying attention to. So we use, there's proof. We use study carrels to help kids pay attention to their paper. If we use heavy duty walls to separate the sound or noise canceling headphones to reduce the noise level. So you want to get rid of basically all the distractions, and you want to increase curriculum related things. I might have a child read a story, and as he's reading the story, listen to that same story, he's reading on headphones, so he has auditory and visual channels. I might have the teacher have a microphone called an AV system, and the kids got one in his ear. So what the teacher saying is what he's hearing loudest, and I might use noise canceling headphones to help him to not be distracted by the other kids, or if he doesn't like wearing them, what I do is give one to the teacher, and teacher whisper to him, there's going to be a fire drill. I got your headphones. So the fire drill goes off. He's expecting it. She hands him his headphones, and he doesn't make weird sounds during the fire drill.    Jayson Davies     Yeah. And so then, have you ever incorporated some sort of yoga or meditation or anything like that into the classroom?     John Pagano     Yeah, that's the sensory modulation part. So tense and relaxed muscles, and I'll send them like one of my PDFs of what a course might look like, but tense and relaxed muscles is proven to work, but it lasts an hour when the teachers do it and the kids just slap each other. So what I have them do is just tense their face, raise their shoulders up and tense and release their hands. It's got to be a two minute exercise that the teacher could do it fast, or you could do it at the beginning of every ot session, and then move on.    Jayson Davies     Gotcha All right. Cool. One thing that I saw in here. And you already kind of talked about it, is that sensory as a reinforcer versus sensory as an actual treatment, and you had some research about that, I think, yeah.    John Pagano     It's both. And again, I'll put it on your website, but we do have a lot of good research. In fact, the University of North Carolina just added ot as an evidence based practice sensory integration, I'm sorry, as an evidence based practice for autism, people have been working their butts off these smart researchers like Lucy Jay Miller and and Winnie done and stuff, and so they have finally done the quality of research, but it's not going to change. A lot of pediatricians and a lot of behaviorists believe sensory integration is garbage, and they're going to keep saying that, even with the evidence based practice that's finally come out. So we need to know the research too, and that's why I give it to OTs fast, because you don't get an hour day to do research, but I do so I can give it to you, and that's what I think those of us who do speaking, that's our job to get the research for you guys.     Jayson Davies     Yes, and we appreciate it. I try to get some myself, too. So the practical side of things, you talked about how you see kids a lot of times, and I don't know, is it more, if we call it a pull out setting, you're seeing kids individually or in a group. But what are some of your go to strategies? Then for a teacher, you talked about your fab strategies paper. I know you have strategies on there, and everyone can get that at the show notes. But what are some of your go to strategies to give to the teacher?    John Pagano     A couple of different things. One is to optimally stable seat kids who have cruddy balance, like how to make sure that their feet are touching the floor and stuff, and how to use disco sits for kids who have good balance but are just really fidgety and that type of thing to specifically target the problem that they're having. I also find that the forms are helpful, because a lot of times when I go into a classroom, all the other kids start bothering the teacher, so I can't talk to her. So having these sheets enable you and the teacher to have a really fast written backup to what strategies you're asking her to do, because we aren't always paid enough to communicate with each other. I mean, every principal wants us to, but it's not always practical when the teacher has your undivided attention.    Jayson Davies     Absolutely, yeah, and I always tell people, you know, you can't just go into a classroom and interrupt them and start talking to them. I mean, as much as you want to and you feel like you should be able to, you just destroy the whole aspect of the classroom when you do that, and so you have to be careful, and you have to actually plan to have a conversation. You can't just have it at 11 o'clock in the morning when they're in the middle of math time. So yeah, there's    John Pagano     been some really cool ideas out there too. One is like block time that I found helpful. So if I have three very disabled kids in a particular preschool classroom, what I'll do special ed is I'll put them back to back so they're three half hours, 839, nine and 939, 3010 and then I'll with their parents permission, use their time three ways. I'll pull them out 20 minutes. I'll work with all three of them as a group for an hour a week. And in addition, I'll go into the whole classroom and give say a lesson to the whole class. And I find that that's one easy way to do it. Some therapists are playing with they're hired for so many hours, and they handle all the PPT. I haven't got the okay for that, but I think that's the coolest way. And so that way you can really make a difference. And it's a challenge, though, because there are times that the class is so chaotic you have to pull out. But I've also gone into classrooms and worked with my kids right in the classroom. I consider it direct, because I'm only with my one kid, but I'm sitting next to him, yeah.    Jayson Davies     Yeah. No, I really, I really. Really like that, mixed methods that you kind of talked about, where you're working with one a kid, individually, then in a group, and then in the classroom, because that just really, in my opinion, that helps with the generalization back into the classroom. And, you know, I always tell people, what's the point of doing therapy if it's only going to help them when they're with us? We're always trying to get them to be able to be in the natural environment, right? We want them to succeed in the natural environment, not just for 30 minutes in therapy.     John Pagano     So keeps us honest too. Oh, yeah. Does it really work in the natural environment? And sometimes it keeps me honest. I've conned myself in one to one. Yeah, that's not really how much learning takes place.     Jayson Davies     All right, so that was the that was some strategies for the teacher. Do you use the same strategies if you're giving any information to the parent, or do you provide different strategies? Or what do you think about communication, communicating with the parent and providing them some help?    John Pagano     Again, that's why, I mean, I really use this sheet constantly. On the bottom of the fab strategy sheet, it says Signature of parent guardian that they agree with and support this program, because that way you can send it home in their lunchbox if you have to, and get them to sign. So if you're doing any kind of touch, or you're giving a chewy or rifting chair, you get the parent to sign it. You shove it in a drawer, and if there's ever a problem, you have parental permission to do these things, because I've had friends who have gotten in trouble, even for giving a rifting chair to a girl with cerebral palsy was falling out of her chair and smashing her head because the parents didn't want her looking funny. So this way, you've quickly gotten the parent permission, and you're covered.     Jayson Davies     There you go, man. And it's interesting just to think about. I mean, I hadn't even thought about CHEWIES, but I don't know how what it's like in Connecticut, or what they're talking about schools coming back into session. But I know that CHEWIES are not the most sanitary things in the world, and with COVID 19 and everything going on, I can only imagine that schools might say, no CHEWIES.    John Pagano     I am. Appreciate that you're keeping me on track, and I love how you're doing it. I want to go out track one more time. I've been so impressed. I'm the vice president of our Connecticut ot Association, and they have this Community of Practice School system that goes on for an hour a week in meets, and the job they're doing, I'm just so impressed. I you know, they're using video, they're tracking down kids. They've lost. These OTs are just amazing to me, the people in the school. And I just wanted to thank your audience. I'm just really amazed that how they've coped with a situation that they didn't have much warning for.     Jayson Davies     Amazing to me. It's it's been crazy. I mean, in the in the snap of a finger. I mean, we went from seeing kids in the classroom to seeing kids on Zoom and, I mean no training, and teachers too. I mean, shout out to the teachers who are doing amazing work as well, and all the all the school employees, really, and the parents too, of course. But yeah, it it was a big shift in a very limited amount of time. And so.    John Pagano     Yeah, thought it was incredible. Yeah, OTs are adaptive.    Jayson Davies     I think everyone's had to adapt. Everyone's had to do it. I mean, it's crazy, but, yeah, no, I just want to follow up, though I really don't I can see schools. I mean, saying just, hey, sorry, we can't do chews anymore because of the saliva, like you kind of, I think you kind of mentioned was, you know, a kid takes out their chewy and saliva kind of flings across the room. I mean, that's not gonna be able to happen.    John Pagano     You could try to use it at home, you know, yeah, I think in school, I've become very much by necessity. So I didn't get frustrated seeing myself as a consultant. A consultant gives teachers and parents advice, and they're welcome to take it or leave it. What I do to up the ante is when I'm first giving a teacher or I'm first giving a parent a home strategy, I give them what I'm sure is gonna work. You know how, as we get old, as therapists, we kind of know what's working effectively. So I've tried this. This is gonna give them a lot of bang for their buck, and that's all I give first, and I make a copy, and if they lose it, I give them another copy. But then if they say, give me. More then those are the teachers I know I'm going to work a lot with, or those are the parents that I'm going to spend time with the HOME program, because they've got time to do it.    Jayson Davies     Yeah, no, and you know, I that's the other thing you got to tell people, is that some people will be receptive, others will not, and understand where to focus your time. Yes, you know you are going to have some kids in that classroom with the teacher that is not receptive, and you need to give those kids as much time as you can, as much energy as you can. But when it comes to finding a teacher that really wants to work with, you take it and run with it, because that's where you're going to see so much improvement in those kids, not just right now, but in the long term too. So absolutely. Well, John, I think it's about time to wrap up. I want to say a huge thank you, but I also want to give you the opportunity to share any last thoughts and also contact information for you, or where people can learn more about you and complex behaviors.    John Pagano     I'm going to put on your website, the fab strategies form. I also wrote a fab strategies book so that, if you don't know what I call something, you call it something else you can just look it up in the index. I call myself fab functionally alert behavior strategies. And I also have a Facebook, fab strategies site, so people are welcome to connect with me in any of those ways, or email me or whatever.     Jayson Davies     All right, sounds good. Thank you so much for coming on. Really appreciate it, and let's stay in touch and do this again.    John Pagano     Thanks. It's been a pleasure.     Jayson Davies     Take care. All right. Thank you so much again to Dr John pagano for coming on to the OT school house podcast and talking about complex behaviors. Hope you all gain some knowledge from that. Be sure to check out ot  schoolhouse.com forward slash episode 51 for all of the show notes and links to John's pages such as fab  strategies.com . All right, we will see you next time for episode 52 Take care, everyone. Bye, bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 169 of the OT Schoolhouse Podcast. Do you ever feel like daily notes are just another task on your never-ending to-do list? In this episode, we’re diving into the world of note writing in school-based OT with Jason Gonzalez, OTR/L, co-founder of Double Time Docs. We’ll unpack the purpose of documentation, discuss strategies to make it more efficient and explore how technology can simplify your workflow. Whether you're a seasoned OT or new to school-based practice, this conversation will help you streamline your notes and spend more time doing what you love—helping students thrive! Listen now to learn the following objectives: Learners will identify the essential components of effective school-based OT documentation and its role in student progress. Learners will understand common challenges in note writing and how to streamline documentation without sacrificing quality. Learners will apply strategies for efficient documentation, including using digital tools like Double Time Docs to track progress and inform interventions. Guests Bio Jason Gonzalez, OTR/L graduated from The Ohio State University in 2001 and has worked in pediatrics ever since. He specializes in evaluations and documentation with experience across multiple school districts nationwide. In 2017, he co-founded Double Time Docs, a platform designed to streamline occupational therapy evaluations. Most recently, he launched a new note-taking software to help school-based OTs simplify daily documentation and track student progress more efficiently. Quotes “It's considered best stand, best practice if you keep daily notes on your sessions, and to keep track of data, see how the kids are progressing or regressing, see what you need to change for the next, upcoming IEPs or how to take that data and do your progress reports, which is are required. Pretty much every school district I've worked in requires at least a progress note. Most of them require daily notes.”    -Jason Gonzalez, OTR/L  “Graphs really speak well to parents and others on the IEP team. So if you've got a graph that shows goal number 1, writing out the student's name, or whether it's, attending to a specific task for five minutes… all of that can be put onto a graph, and it speaks a lot.” -Jayson Davies, M.A, OTR/L When you have high caseloads, it's hard to memorize everybody's goals. It's hard to carry around, like, 15 binders, especially if you go to different schools…So, it's a good way to keep track instead of trying to memorize everything.  -Jason Gonzalez, OTR/L Resources 👉Double Time Docs Website:   DoubleTimeDocs.com This is where listeners can go to learn more about Double Time Docs and their services for evaluations and daily session notes. Jason's Email for Double Time Docs: jason@doubletimedocs.com Jason Gonzalez provided his email for any questions related to Double Time Docs. Discount Code for Double Time Docs: OTSH20 This code grants users 20% off their first charge at Double Time Docs. Episode Transcript Expand to view the full episode transcript.   Jayson Davies     Hey, OTPs, welcome to episode 169, of the OT school house podcast today. We're talking about daily notes. You know, those short notes that you are always on top of and never behind on right? Yeah, Me, neither. It's always hard to keep on track with daily notes when a, you aren't sure exactly what to write in them. B, no one gives you a deadline to actually complete them or C, you have no idea who, if anyone actually is going to read them. We all know that we have to get them done eventually, but they always feel like unnecessary busy work, so we put them off until the end of the day, maybe till the end of the week, and then, of course, to Saturday night while watching Netflix. Shout out to night agent my recent watch. But that should not be the norm. Daily notes should not be this difficult. That's why today we're diving deep into the heart of this pressing issue with someone who despises daily notes so much that he decided to find a more efficient way to get them done before the end of the day. Jason Gonzalez is an independent ot contractor with schools and the co founder of double time docs. Way back in episode 14, Jason joined us to talk evaluation writing and how to make that more efficient. So it's only fitting that he is returning today to share the secrets behind efficient and effective note writing, ensuring that your documentation process is set up to keep your weekends free from daily notes. So buckle up and get ready, because we're about to turn the dread of documentation into a structured, manageable and even empowering part of your ot practice. Let's dive in.    Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jason Davies class is officially in session.    Jayson Davies     Jason, welcome back to the OT school house podcast. It's been a minute since you were on, I believe it was episode 14 that you came on and talked about evaluations. But today we are here to talk about note writing. How you doing today?    Jason Gonzalez     Not bad. How about yourself? Thanks for having me again.     Jayson Davies     Of course. Always great to have you. For everyone listening, Jayson and I text, like, every three months, I'll just get a random text from him, like, Hey, what's up with the Lakers? Or hey, let's start a new podcast, or something like that. And yeah, so we talked, so this is gonna be a fun episode. Him and I are pretty familiar with one another, but I never give you a second, just in person. We have never met in person. Are you going to Philadelphia? Possibly, all right, we will all see Jason in Philadelphia.    Jason Gonzalez     Yeah I'll see you. So yes, I will be in Philadelphia.     Jayson Davies     All right, we we heard it from him on this podcast. We can hold him accountable now. Jason Gonzalez will be in Philadelphia for a OTA. I will be in Philadelphia for a OTA as well. But Jayson, share with everyone a little bit about yourself. How do you fit into the world of school based occupational therapy?    Jason Gonzalez     Well, I graduated in 2001 from The Ohio State University go Bucha, I guess, and then pretty much started from there, went straight into pediatrics at a after a short stint in Psych in Chicago, but I've been in schools in hundreds of school districts, from like New York to Hawaii to San Diego to San Francisco to Jersey to Massachusetts. So I've been all over the place and worked in lots of school districts. So.     Jayson Davies     I didn't realize it was that many. It is hundreds and exaggeration?    Jason Gonzalez     Exaggeration. It's only been three, no, I'm just joking. It's been like, probably 30 or 40. I also just evaluation. So I in in New Jersey. I do I I've been in like, almost, uh, no, 20 school districts just in New Jersey, just doing evaluations. So I'm independent contractor.     Jayson Davies     Okay, as an independent contractor, meaning that, do you contract yourself with a third party that contracts you into the schools, or are you contracting yourself directly with the schools?    Jason Gonzalez     third party. Sooner or later, I would like to do that. Skip the middle man. Hopefully my companies don't hear me say that, but it would, yeah, that would be my next step. Hopefully, then I can kind of wean myself out and hire somebody. But anyway, that's a whole different conversation, I guess.     Jayson Davies     Yeah,yeah. In fact, we have an entire podcast about that, actually, a few episodes ago, not too long ago, so I'll to follow that one to you. But anyways, today's episode is all about note writing, and you are one of the founders of double time docs, and you recently incorporated note writing into double time docs, I believe. So that's kind of why we got you on here to talk a little bit about the why, the how, the purpose of note writing, and we'll talk. A little bit about how you've ingrained that into double time docs, but let's talk about note writing. You ready? I'm ready. All right, let's do it. So I guess the first question is, what is the purpose of note writing in school based ot from your perspective, why do we write notes? And feel free to go any which way with that.     Jason Gonzalez     Well, I mean, I guess it's considered best practice is to keep daily notes on your sessions and to, you know, keep track of data, see how the kids are progressing or regressing, see what you need to change for the next upcoming IEPs, or how to take that data and do your progress reports, which is are required. Pretty much every school district I've worked in requires at least a progress note. Most of them require daily notes. Nobody really collected them, nor did I actually really read anybody else's daily notes. But it's good for your own self, especially if you're addressing daily notes, to address goals, because goals can be like, like, kind of like, kind of, some of the children can be like, left, fall through the cracks, and then when you go to a meeting, you're like, oh, shoot, I was supposed to be working on shoe tying for three months. So it's, you know, it's good to keep track. I mean, when you have high case loads, it's hard to memorize everybody's goals. It's hard to carry around like, 15 binders, especially if you go to different schools, and it's just like, flipping through pages and stuff like that, and being like, Oh, this kid has eight objectives and three goals or something. So it's just, you know, a good way to keep track, instead of trying to memorize everything.     Jayson Davies     Yeah, and as you mentioned, you've been to a lot of different states. You've practiced in a lot of different states, a lot of different districts. Have you seen any difference as you've gone from, I mean, all the way from New Jersey to Hawaii and anywhere in between. Has there been a difference? Has anyone given you instruction on to write a note, or has it always just kind of been the way you write a note, is the way you write a note?    Jason Gonzalez     I would say the latter. It's kind of like, you know, it I started back in 2001 so the mentorship actually really wasn't there. We didn't really have all the resources online. So it was like looking through paper files and seeing, like, what did other people do? We're getting, like, their files from from the previous therapist, and looking and seeing what they did. So it's almost kind of like the blinding the blind and and whatever I say, even with the evaluations, is like, I feel bad for the people who had me when I first started, because I was terrible at both daily notes writing evals, terrible therapists. But, you know, we all kind of start there at some point. You got to start somewhere, and then, as you you know, travel along, talk to other therapists, people. And you know, I'm glad that the mentorship I feel like has improved since 2001 you know, a lot more. Even the travel companies I've worked for, they do provide a lot more people available to answer questions, help you guide through. Because my first job, I had the physical therapist tell me what to do, yeah, and the principal, I actually had no idea what I who I was, or what an occupational therapist was, so, so hidden island at the same time, which is good.    Jayson Davies     Yeah. I mean, I still think that some OTs still feel that exact same way, right? 20 years later, 25 years later, we're still feeling pretty similar to that. Some of us, I think it has gotten a lot better in a lot of places, though, you mentioned, kind of like the blind, leading the blind, right, learning from the the past, person who probably learned from the person before then that learned kind of from the person before them. A lot has changed in the 13 years now that I've been in in OT and you've been in for almost double that, and wow, when you first started real bad, sorry, sorry, Jason had to do it. You still look young. You still look great, Jason, just so, you know. But lighting, yeah, you know, things have changed, right? A lot of stuff has gone digital now for me, when I first started, and tell me if this sounds similar, I think the first time that I was doing session notes. We had a calendar for each month that just had a 31 boxes on it, and we ticked off the day that we saw that student, or maybe we put the number of minutes in that little, tiny box, 30 minutes, or something like that. And then we had another paper that had like five boxes on it, one for each day of the week, or one for each session, for five sessions, and we would just write a little narrative in there. There might have been a few check boxes there as well, like worked on fine motor, or whatever it was. Is that kind of where you started? Or what would you say it looked like?    Jason Gonzalez     Pretty much, very similar. And it's kind of hard, because I think sometimes some school districts have that Medicaid billing and stuff like that. So a lot of people use that as their daily note, which is, I guess, fine, is they do have those comment boxes so you can kind of write, but a lot, from my experience of doing the Medicaid billing was that they didn't actually show what goals you were working on. It was just more like the. General descriptives of like, checking off a fine motor self care or whatever. And I think it got a little bit more, you know, more had more specifics on it, but and a comment box and stuff. So it was just more like, yeah, for the Medicaid billing, and a lot of people use it for attendance. So from my experience in talking to a bunch of therapists, and I did a survey a long time ago, where I surveyed like 60 therapists or something, and they talked about how a lot of people use the Medicaid billing then they also write in their binders of like, what the session did. And then, if you're working for a contract company, you kind of have to do your daily logs for that. So you're kind of doing like three different documentation that kind of a piecemeal everything together, like your company wants to know you're at work and which kids they can bill for. Then Medicaid billing is like doing the same thing, but it's a different type of billing. And then your daily none of the other two billings or documentation actually address goals, and so you have to keep track of your data on goals, so you have another form of documentation. So it's like three things that aren't necessarily super time consuming, but if you have 50 100 kids on your caseload, like some CODAs do, then that's a lot of time you're spending.    Jayson Davies     Yeah, yeah, absolutely. It all adds up and and I hadn't thought about that like I know for me, my process was I had basically put every student's goals for that day onto a paper that I could easily print out. And so like the paper just said, you know, 830 Jason Gonzalez, and then it had Jason Gonzalez's goals listed out, and then nine o'clock, had the nine o'clock goals ran out, and I would print that out each morning so that I could keep track of goals on that paper. But then sometimes that data would get turned into my my note. But oftentimes it was just kind of a separate thing, and I would save that paper in case I ever needed to reference back to it. So like every day, I was printing out two pages of paper with goals on it and and I literally just kind of, I don't even know where I saved it, but yeah, I would keep those on file. I couldn't really save it in any one student's file because it had multiple students goals on and so I would have to transition it over to an individual data sheet for that student, but I would kind of keep it as reference at least until I did complete my notes. So yeah, I know we all do it a little bit differently, which is nice, because it's like you said, no one really talked about this before, and I think people are talking about it now. And so maybe we can kind of come up with a standardized way to do these notes to help everyone involved. Let's talk about your goal writing, or not your goal writing. Let's talk about kind of what you have come to today. Obviously, we all learn about writing SOAP Notes back in school, right? Talking about subjective, objective assessment and plan. Do you write a full on soap note? Do you just write to the goals? Do you write more or less? What do your notes look like today if you're seeing a student for a session?    Jason Gonzalez     Well, the last time I wrote a soap note was probably in college, but, I mean, I did write them in clinic based like when I was in a private clinic, I did write so there, but for school based, I would just write for the most part, like, just like the things that stuck out, like, you know, and then what I tell some people, or when we talk about daily notes and stuff like that, is like, who's the daily note for? Is it for? I mean, most likely the parents aren't reading it. It's usually kind of like for you, if you're transitioning the student to another therapist or something, and they're reading it. So I don't like, right? You know, I write the what the kid actually did, and it doesn't matter if he wrote, drew a picture of Batman or did a holiday card or something like that. I mean, I guess you can say that, but it like, you know, it would be like he wrote two sentences and needed verbal prompts or highlighted lines to, you know, adjust spacing or line orientation, or write that he was able to write 46 of the 52 letters of the alphabet when copying from Farsight or something like that. So mostly just the facts, and if he has a behavior that sticks out, then I would write, you know, Jayson had a full on tantrum when I took the squish and mellow from him when he was transitioning. And so, or I can write that Jayson transitioned great when he held the squishy mellow for five minutes before transitioning back to the classroom. So it was just like the thing, the strategies that worked, the strategies that didn't, or, you know, he was able to attend if your goal, it depends on what the goal is, too. So if he was able to, if you have an attention, you know, five minutes on a tabletop activity or something, then you know, I can make note that, you know, Jayson was able to complete, you know, writing activity and attended for seven minutes, uh, independently, or something. So just like, pretty much the facts and like.    Jayson Davies     Yeah, it sounds, it sounds like, to me, that you're basically keeping in mind what the goal is in writing to the goal. If there's something else that stands out. Of importance, throw that in there, but primarily writing to the goal.     Jason Gonzalez     Yeah. Or if I, you know, if we give the teacher, like a move and stick cushion, or, you know, consulted with the teacher, if this consult, consultation is not part of his IEP, then I can just write, you know, when I dropped Jayson off, I told him that I discussed with the teacher that he transitions well, if he has a squish and mellow squeeze or something for three minutes prior to going into math or something. But just like those notes that I did talk to the teacher at some point or I gave him this materials also to help me remember that I gave out like 15 pencil grips and they were all to one teacher, and I don't know why she keeps losing him. So.    Jayson Davies     All right, all right, Jason, I feel like, I feel like I know you well enough that I can say I think you basically just pointed out three of the four. So No, asked you do some of some subjective, you like, you know, yeah, stand out. You'll do some subjective. You're doing objective as far as, like, how many letters, or, you know, time spent on an activity, the assessment piece, maybe you're getting in there. I think the only one that we didn't touch on right there was, was the planning aspect, like planning about how you move forward and, and that's something that I didn't start doing until a little bit later in my career. In my career, because I found that it actually helped me with next week's session planning. But yeah, so it sounds like you're doing a shortened, modified version of an SOA, we'll call it notes.     Jason Gonzalez     Okay, all right, I'm much better than I thought I was, apparently three quarters better than I thought I was.    Jayson Davies     Yes, yeah. So, yeah. So, so you're kind of speaking to the goals, but when things stand out, you're also kind of putting those in there. And that sounds similar to what I've done, like I was mentioning, I have started to, kind of, or I did start a while ago, starting to, like, put that plan in there, because I did find that it could help me with session planning for following sessions, right? Like, I could always look back at my note and say, oh yeah. Last week, when I was in the moment with a student, I thought about next week's session, what I could do based upon what I was seeing. It was so much easier for me to look at that note and say, oh yeah. Last week, I wanted to, like, I literally told myself, let's play operation next week so we can work on some dexterity skills. Otherwise, you know, it's so hard to treatment plan when you're sitting there trying to treatment plan for for 30 kids, but when you're trying to treatment plan for one kid and you're thinking about that kid in the moment, it's a lot easier. So that's kind of why, why I was doing that. The other topic that you hit on was about the audience. Who is the audience for your note? And so I kind of want to go a little bit deeper into that, like, Who do you consider to be the various audiences? And if you want to, kind of, you can even kind of rank them from most important to maybe not least important, but at least likely to read your note.    Jason Gonzalez     Oh, okay. I mean, I guess I would be the most important, or the therapist. And then I think, you know, if you're transitioning, if a kid's going from, like, elementary school to middle school, like the upcoming therapist, or if you're changing schools, or whatever, the next therapist that's providing services, and then maybe the parents, because sometimes, I mean, I've had lots of parents ask for daily notes, or, like, communication logs, because, and then, instead of doing a whole communication log, and that's just another type of documentation, so sometimes I would just send them to daily notes, and then um administration, if necessary, um, which, for me, really happens. And I think we mentioned about like being asked to provide notes. I have never, in my 20 some odd years of practice, had been asked to provide notes. But, I mean, I guess that, because it doesn't really go anywhere else. Yeah, nobody else has really asked for it.    Jayson Davies     The only other one that I could think of would be like Medicaid, but, oh yeah, so sometimes that's separate for Yeah, it depends, right? Like, it depends if you're if it's combined or not. But even that is so rare. I think in my career, I've had maybe three parents, and I live in Southern California, which is known for being litigious. And I haven't always worked in a litigious district, but two of the three that I have worked in were and it was pretty rare for the advocate or the parent or the lawyer to ask to see our notes. It just didn't happen. When they did happen, it scared the crap out of me, especially the first time, right? But nothing really came of it. Like they asked for my notes, I gave it to them, nothing came of it. I'm sure there's someone listening out there right now who has gone through this, and something may have come through it. Come of it, right? If that's you, please reach out to me. I would love to, you know, talk about it, but yeah, like a lot of times, we are writing for ourselves, like you said, or maybe the OT I would often tell people, um. People coming into school based OT, other ot practitioners, like, right, as though you're an OT who just got this student, like, what you're talking about, right? The kid who's transitioning into middle school, they don't know the student coming to them, but they're probably going to review a few notes to kind of better understand that kid. So right, as though you know you're going to have to read these notes later without any concept of this child. But yeah, I think that basically, kind of is the hierarchy first and foremost. I think there really are for us. And then you kind of go down from there as to who they might potentially be for and be read by.    Jason Gonzalez     Yeah, and nobody writes Medicaid billing, you know? I mean, like, if people are writing their notes and Medicaid billing. I don't even know how you can actually give that to somebody else, but when they transition to school, I mean, I'm sure there's a way, if you go into the program, but I mean, most of those things are, you know, they're pretty big also.     Jayson Davies     Yeah, I think it also depends, because I think some people are using their daily session, note, copy and pasting that into the Medicaid billing program. And I do know that one of the districts I worked at that was basically what we were asked to do, was to put them into Medicaid billing and then if a parent requested, the district could easily go onto the Medicaid billing platform and just hit print, and it would print out my notes that they could hand over to whoever they needed to hand over to. So.    Jason Gonzalez     but do all students get Medicaid billing? Do all students get Medicaid billing?    Jayson Davies     No, not all students do Medicaid billing, but things can be backdated, and so we would just bill for every single student the same way through Medicaid, whether or not they they receive Medicaid or not. And so we would basically just put 100% of our notes in there, even if only 50% of the kids had Medicaid, and we got reimbursed for Medicaid. So yeah, that's how it worked for us. All right, aside from notes, is there anything else that you're adding to this we talked about, like, obviously adding the date, but is there anything else that you're kind of adding, any other documentation, data that you're kind of adding to the note?     Jason Gonzalez     Well, I guess time, like 30 minutes, 20 minutes, 45 or whatever type of session, group, integrative individual, or if, like, student is absent, therapist is absent, it's just, yeah, keeping the track. Because I know, like, the current district I work in, you know, we've had a lot of overturned in therapists, so there's a lot of missed sessions. And so it's like, just keeping track of, you know, if there's any makeups to make up. And, yeah, you know, obviously, I mean, some school districts, you know, if students absent, you have to make it up. So it's just identifying all those things to get the right numbers, just in case it does become litigious or whatever. And then you need to keep track of all the minutes. And actually, I think on Facebook, I think you just tagged me on somebody about their administration is trying to keep track of minutes of and how they're doing that. So, yeah, so that would definitely be in my note is to you know, how much time he was there, or the student, what type of group it was, because, you know, if it's specified in the IEP that they're supposed to be seen in a group or an individual, sometimes they got a mixture of both, or a consultation. So just identifying what kind of service is done, name, obviously, but it's that's probably the most important things that I would include in The Daily Note.    Jayson Davies     Awesome, awesome. Now, since you have been, you know, a world traveler. OT, I guess, maybe not real, but us traveled. OT, every state's obviously different. Every district is different. So for an OT practitioner who's maybe starting at a brand new school, brand new district, or maybe they've been there for 10 years, and they just never searched this out, What should these ot practitioners kind of consider or where the where should they go to kind of learn what is required for their district, for note taking?    Jason Gonzalez     Oh, I would ask administration, but, I mean, half the time they don't even know, but so it's, you know, go with your state requirements for, I mean, if you Google, just like New Jersey, school based occupational therapy required to take daily notes. Pretty much every state says yes or whatever, but it's, you know, chat, G, P, T, I don't know if that's, uh, how accurate that is, but I mean, everything is like says best practice or standard practice is to take daily notes, whether or not you're in a clinic or school based. I mean, I guess I wouldn't see why you wouldn't. Other than that, it's time consuming, but you're making a record of what they're doing. You're making a record that you actually saw the person, because even you have teachers and other administrators, mean, like, Hey, you never came. So it's just like a paper trail of. You actually doing your job. And so you know you're kind of solidifying your position, and you know that you're actually doing your job and keeping track of, like, what people said, what you've given out, what strategies you tried. Because you know, if you get a new kid and you have no idea that they've been working on shoelace tying for 15 years, and you're like, oh, he doesn't tie shoes. I'm going to go work on this now. But nobody knows that he, he got exited from shoelace tying when he was in fifth grade, and now you can pick it up again in sixth grade. So it's, it's just, it kind of benefits everyone, including yourself, because, you know, it's more of a protection too.     Jayson Davies     Yeah, yeah. And right now we're actually working on something at the OT school house. We used to have a map that kind of guided people to the and we still technically have it, but it needs to be updated, and we're working on updating it is this map that guides people to their state school based ot guidelines. And as you mentioned, I kind of like, not every state has these guidelines, but that is definitely one place that I would look to for looking for any documentation guidelines. The other place, if you don't want to use chat GPT because you don't trust it, which I for this, I win it either. But just go to your state licensure website, and it should be in your licensure, like what is required, things like, can you evaluate a student without a doctor's order that would be in your license, your practice act for your state. Things like, what you need to document should be in your practice act for the state as well. So yeah, that's one place you can go. What's also nice about that, what I found is that you can use that to whether it's regarding documentation or otherwise, but as an OT, you have to uphold those practices. And so that is something that you can also show your administrators. Like, look, my you can go to your administrator and say, Look, my license, my body of governing, whatever requires me to do this documentation. Therefore, I need to do this documentation despite what you want, or say that could potentially help you in, like, showing them like part of your workload. They might not see documentation as part of your workload, but you can show them look. My licensure says I need to do this. And so you need to factor some time in for that, so.    Jason Gonzalez     and workload is such. I mean, you talk about workload a lot, or I do post about, I think a post about, right, I am, but it is. I mean, it's a big, it's a big difference, like, if you have 50 kids, I mean, sometimes daily notes only takes a minute and a half, two minutes. I mean, if you're doing on a program, it might take a little three minutes, because you have to click so many buttons to get to your student. But it's, it's, you know, three minutes. If you see a kid once a week, that's 50 kids, that's 150 minutes. It's, uh, it's almost three hours, two and a half hours that, you know, if you have 50 kids, how do you squeeze in 50, another 150 minutes of the daily documentation? So a lot of people do it at home, and, you know, not paid time off. A lot of people just don't do it, or wait until the end of the week when it's super busy, or wait until the end of the month, and then you have 450, minutes of of daily notes to do, and then you're like, I don't remember what Tommy did on Tuesday the third so I mean it, yeah, it's, it's, it's just, it's extra work, but it's a kind of a necessity to do it.     Jayson Davies     Sorry, Jason, Tuesday was actually the fifth of the month, so you are totally up on it. No, I'm just kidding.    Jason Gonzalez     I'm all out of whack. It's the daily documentation, so I can probably.    Jayson Davies     That's how it feels, right? Like that is literally how it feels when you're trying to document from two weeks ago, even if you have some shorthand notes that you took during the session and but you're trying to put together a cohesive, maybe not even cohesive, but at least, like, understandable note, doing it two weeks later. It's hard.    Jason Gonzalez     Yeah. Well, it's the same thing with evals. Like, if you know, I test two, sometimes three kids a day, and then if I don't write the report on Monday, and then I test two kids again, that's five reports. If I don't write the reports because I'm busy eating lunch or something, then I gotta go do it just adds up, and then it Wait, it's, it's in the even if you take notes like you said, it's still in the back of your mind of like, okay, I did this with that kid. I know I sometimes your notes are, you know, chicken scratch, and you'll be like, does that say left or right or something? It's just like it, regardless if you think you took good enough notes, it's, it's still somewhere in the back of your mind, until you actually put it somewhere where you don't actually have to think about it anymore.    Jayson Davies     Yeah, yeah, absolutely. All right, well, I think we're coming kind of the close of this podcast episode, but there's two more things we want to do this. First one here is a rapid response. We haven't I don't think we've ever done this on the podcast, but I want your quickest take, like, 15 seconds on these. And I haven't shared these with you yet for everyone listening. So these are going to be the first time. Am. Most of them are ot related. Some of them aren't. But let's go into it rapid response, completing notes during a session or completing them after a session.    Jason Gonzalez     I say at the end of the the five minutes of a session. So while they're usually I reward a kid for doing like they can draw or pick like a little activity. Actually, from, I supervise a bunch of CODAs, and it appears like everybody does that, like, you know, you do your work, you can play this game. So while they're playing that game, I will do a note at that time, just because, until it doesn't build out in the long run.    Jayson Davies     Yeah, that way you're not doing it while watching Netflix at 8pm um, how do you document, how do you document missed sessions?    Jason Gonzalez     Oh, I just, well, I have my own program, but it's, I just, you know, click soon and absent.    Jayson Davies     Okay, and then what do you do with that data? Do you do you show it to anyone? Does anyone ever ask for it?    Jason Gonzalez     Never. I mean, maybe I shouldn't say never, because then nobody will do it. But it's, I've never really been asked to show if it's students absent. I mean, that's easy to access from administer, like the attendance people, if they need proof that student was absent. I mean, sometimes I would write if students unavailable, like a student was at assembly or whatever. And then also, on those days, I don't know if this is what you're supposed to do, but I would go to the assembly with them. And then, you know, watch, you know, how they're tolerating the noise, if they're seeing still, like, just, you know, get different type of atmosphere, different type of note, because that might come up later in IEP meeting, be like, Hey, Johnny can't sit in assemblies. Like, oh, he never told me that, but if you go with him occasionally, you can see him in a different setting.    Jayson Davies     All right. Next one speech to text to write notes.    Jason Gonzalez     I never used it. It's my voice sounds funny. I don't pronounce things correctly, so it might just look funny to me. I type much faster. Yeah, it's, it's, I mean, I've used speech to text with other kids, and maybe it's better nowadays, but when using, like, Dragon or whatever, it's a lot of proofreading. And, you know, on a side note, my mom, who was fresh off the boat, well, actually, she's not. She moved in 72 but she's from the Philippines, and she had to trans. She's a doctor, so she had to transition in the last couple of years of her practicing to a speech to text and her accent threw everything off. And I know they learn and stuff like that, but she had such a hard time with it. But anyway, that's a side note.    Jayson Davies     All right, using, using AI for note writing.    Jason Gonzalez     I haven't used it because it's so brand new, but I don't know AI, I feel like you still have to take the note to give AI, to do something with it and like, it's and that's the same thing with evaluations. And I know I'm going to actually mentioned this before about AI. It's just like, you still have to know what the kid is doing to give AI that information for that to break the note. Like AI, I think would be great for progress reports. It can compile all the data you provided in your daily notes, and then they can, you know, take it up and mix it around, and then, you know, write a progress report on that. But for daily notes, like, if you're gonna write the information to give the AI, that's just one extra step for it to just write whatever you're gonna be writing for something that most people aren't gonna read. So even if it's shorthand, I would like to keep the notes simple, like, nine complete sentences wrote 46 letters of the alphabet or whatever, or couldn't write Q and W or whatever. But I don't need, like, it's not a writing contest, and the same thing I can write with the evals. Like, I just need the information out and have it be informative and pretty much concise, like nobody cares, like your grammar, especially for daily notes, your emails, reports, probably should have good grammar.     Jayson Davies     Yeah, yeah. And, I mean, I use shorthand all the time for my daily notes, right? Like Ho, H, if for whatever reason, you're doing hand over hand, or you could do h, u, H, if you're doing hand under hand, or something like that. So yeah, watercolor painting.    Jason Gonzalez     Nice transition. Watercolor Painting. Just picked it up. And then I was my wife wanted to do a watercolor painting, pay somebody $300 to do water cooler painting of my dog. And I was like, You know what? I can do that. And so I watched some videos of her, and I did it, and it did not look as good as hers. So pay that $300 No, I'm just joking. It's just different style. I couldn't get the realistic hair. But. I can. I'll send you that picture. Oh, actually, I think I already did. I'll send you the progression, but.    Jayson Davies     I will say this, it looked like a dog. It did look like a dog. That's good. You have a dog, right? I do. It didn't look like my dog, but it looked like a dog.     Jason Gonzalez     All right. Well, I send me a picture. I'll do a watercolor painting of your dog, and you can see if it looks if it looks like it's better than writing daily notes, better than writing daily notes.    Jayson Davies     You're better at painting than daily notes. All right, hopefully not good. We had you here to talk about daily notes anyway. Last one using double time docs?    Jason Gonzalez     Ah, yes. So double time Docs is the company I started in Episode 14, we discussed the evaluation part of it, and so we just added daily notes to it, surprise, surprise. And not because I wanted to, most, you know, it's because everybody asked for it. So not everybody, that's exaggeration. We had lots of emails being like, when are you gonna do daily notes? And the hard part was, is like, how do you speed up daily notes? It only takes two, three minutes or whatever to do. So it took us a while to actually figure out what the best way to do it is. And, you know, I guess we can include that a video later of how to go through it. But I tried to make just like double dime docs. Tried to make it as simple as possible, like, just the basics that you actually need, and then, and, you know, I've looked at other daily notes, softwares, and it was like, it's just a lot of clutter, a lot of things that a lot of boxes, a lot of check things. We just wanted to keep it simple so it's just, you know, you have a the date, all the demographic stuff you need, you know, a little note section you can write down, like what we talked about in this episode, like just the details, like what they did, how the behaviors. And then the great thing about what we have is that the goals are right there. So you can actually see the goals without having to click to another page or another pop up. You can see it's all on the same page, and so you can see their goals, and you can, you know, change the progress right there. And there's a graph that you can it changes as you change its progress. So it's all updated at that time it's saved. And the best part is you can do it on your phone, because we know a lot of people bring their phone, and so it's, I mean, yeah, you can, so you can just do it right on your phone, and it's very visible, it's user friendly, and it's very self explanatory.    Jayson Davies     Yeah, I really appreciate that you have the graph. That's really awesome, right? Because it's really nice come progress report time IEP time, you can literally just like, go to the student's goal, click whatever show graph, and you've got this nice little graph. The other feature that I that I remember about it, is that you have the ability to almost like, duplicate a previous note, right? Like you can kind of say this session, I know this session was similar to last week's session. Let me just like, pull over the note from last week, something like that, right?     Jason Gonzalez     Yeah, and we can, and I can show you that in the video. And as you mentioned before about how when you did your notes, you like to look at what they did previously, like, just even the week before, so you know how to pre plan for your next therapy session. So what you can actually do is, yeah, you click on when you're on the screen, you can just click on the date last week's date, January 8 or whatever, and then it automatically populates. Or if you push duplicate on that note, it will change the date, but it'll keep everything the same, so you can see what they did last week, and you can tweak it instead of just writing everything over again. Because, you know, from my experience of, you know, working with kids and doing daily notes, is that a lot of the activities are very similar. So if I'm addressing a writing goal, I would, you know, have them do an activity. And, you know, I'm just looking at the writing. If they're writing two to three sentences, it's pro I'm probably gonna do be writing two to three sentences next week, and then then week after that. So you can just change those little things that whether or not it changed or didn't, instead of writing a whole new he wrote two to three sentences or whatever. And you know, you know, most of our kids don't make big like, if it's shoe tying process or whatever, and I know that's not, you know, the slowest progress in the world for a lot of kids and some that can just stay the same. And that's you note that, you know, and that's the graphs are very beneficial in that aspect. When you're showing it to a parent or an administrator or teacher, you're just like, Look, he has plateaued on this goal for this many weeks. Or, you know, the graph can also show regression and stuff like that. It's like people calling for qualifying for ES, why? You can see that, you know, it took this long for him to get his skills back. And you know, an administration does need that data to qualify kids to whether or not they receive. OT. Eswa, yeah. I mean, whether or not they use it, who knows, but it's a that's usually how they determine whether or not they get eswa.     Jayson Davies     Yeah, yeah. And I think historically, OTs, we are not great with showing our data, and so I love that, that graph shows the data I know for a long time, until I started incorporating some graphs and data into my reports. Like the ABA therapist would show up with graphs, the speech therapist would show up with like, data on graphs. And here I am, like, just with a really long narrative, and no people like, really show on a graph, but graphs, graphs really speak well to parents and others on the IEP team. So if you've got a graph that shows goal number one, writing out the student's name, or whether it's attending to a specific task for five minutes, or if it's transitioning from one class to another class, like all of that can be put onto a graph, and it speaks a lot. So really cool that you've incorporated that as well. Where can everyone go to learn more about double time docs?    Jason Gonzalez     Oh, I guess you can just go to double time docs.com and then, or you can email me if anybody has questions at Jason at double time docs.com j, A, S O N, not J, A, Y, S, O, N.    Jayson Davies     Just had to throw that one in there, huh? I am Jayson with a Y, Yes, that is me. Jason has no Y in his name.    Jason Gonzalez     Don't want to get people.    Jayson Davies     But yes, double time docs.com we'll be sure to share a link over to that in the show notes. We also Jayson and his team member Scott, over there, they have been very gracious to give everyone at the OT school house who wants to trial out or wants to try out double time. Docs, a discount code. It is OTs H 20, and that'll help you save 20% off your first charge over there at double time. Docs, full disclosure the OT school house myself, we are a affiliate for for double time docs, so we earned a small commission off that. If you don't want us to earn a small commission off that, let me know. We'll figure out a way to get you the 20% off without me getting affiliate for it. But yeah, be sure to check it out. Double timedocs.com doing both evaluations and continuing on with your daily session notes from here on out, Jason, thanks so much for being here. Really appreciate it, and we'll definitely be staying in touch.    Jason Gonzalez     All right, thanks, Jayson. I'll see you in April.    Jayson Davies     Philadelphia. Let's go. Yep, and that is a wrap on today's episode of the OT school house podcast. A massive thank you to Jason Gonzalez for sharing his valuable insights on note writing. Also, after recording this episode, Jayson showed me exactly how he uses double time docs to complete his notes in just minutes. If you'd like to see that video, check out the show notes at otschoolhouse.com/episode , 169, and if you want to give double time docs a try, you can use promo code OT, S, H, 20 to save 20% on your first charge. That way, you can give DTD a try for yourself and see how much time it can save you, both on notes and with evaluations. Full disclosure, I am an affiliate for double time docs, and I might earn a commission if you use that code, and again, that code is OTs H 20, and you can use it at double time docs.com to start your plan today with that. Thank you for tuning in. I hope you found this episode not only informative, but also motivating to find a way to get your notes done quicker than ever and before you leave the office, thanks again, and I'll catch you next time on the OT school house podcast.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com . Until nex Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 172 of the OT Schoolhouse Podcast. In this episode, Doug Vestal, author, and financial guru, uncovers the path to financial freedom for occupational therapists. He will dive into the heart of money management and share how he and his wife tackled $150,000 of student loan debt in three years and offer invaluable strategies to help you do the same.  From budgeting tips to investing insights, Doug equips OTs with the tools to boost their financial health and leverage financial stability to become more effective practitioners. Whether you’re an OT seeking to start your own practice or simply aiming to get out of debt and plan for the future, this episode is your roadmap to financial empowerment. At the end of this episode, we had a giveaway for Doug's new book. Unfortunately, the giveaway is now over. However, you can get your copy of Doug's book here . (Amazon Affiliate Link) Listen now to learn the following objectives: Learners will identify the importance of financial literacy Learners will identify strategies to help pay down debt Learners will identify budgeting strategies and how to allocate funds effectively Guests Bio Doug Vestal, Ph.D.  helps OTs achieve occupational choice and freedom through private pay practice. He co-founded The Functional Pelvis with his OT wife, Lindsey, and has over a decade of experience managing an OT private practice. Before working with OTs, he spent 15 years in senior management on Wall Street, including as Global Head of Counterparty Credit Risk at a major investment bank. Drawing on his business acumen and passion for entrepreneurship, he has helped hundreds of OTs build successful private pay practices. Doug holds a Master’s in Financial Mathematics and a Ph.D. in Applied Probability. He is dedicated to helping OTs gain treatment, time, and financial freedom on their terms.  He is the author of the only personal finance book for occupational therapy practitioners called "Financial Freedom for OTs: A Guide to Building Wealth Without Burnout" Quotes “Number one limiting belief, I think, is people are thinking that money is the root of all evil. And in fact, money is just a tool. Right? In and of itself, it's just paper. Right?.” - Doug Vestal, Ph.D. “So I know money in and of itself is not an activity…managing your money, budgeting your money, saving your money, investing your money… Money is an essential ADL .” - Doug Vestal, Ph.D. “If I'm able to accumulate more money in my life, it allows me to give back to the causes and to the people that are important to my life, and I have a lot more agency and choice. And that's a really beautiful shift to see a lot of my students go through.” - Doug Vestal, Ph.D. “A lot of our thoughts around money are very subconsciously driven by our experiences as when we were children. And so I always ask people to sit in a quiet place and recall, like, keystone memories from your childhood.”  - Doug Vestal, Ph.D. “Focusing and knowing that it's up to you to decide how you direct and use the money that you have is really empowering.”  - Doug Vestal, Ph.D. “The only way to beat inflation is to start investing”  - Doug Vestal, Ph.D. Resources 👉   Financial Freedom for OT's Book (Amazon affiliate link) 👉 Doug’s Email 👉 Income-Driven Repayment Plans 👉 Vanguard 👉 Fidelity 👉 Target Date Fund 👉 Freedom of Practice Episode Transcript Expand to view the full episode transcript. Jayson Davies     $120,000 that's the debt I incurred to earn my masters in occupational therapy degree back in 2012 compare that now to an estimated $213,000 needed to complete a top ranked ot program today, and my debt just looks like chump change. And yet this is happening every single year. The unfortunate reality is that every year, ot practitioners are entering the workforce with over $100,000 in debt, if not more, and this leads to way too many practitioners having to work multiple jobs, leave their hometowns for higher paying travel opportunities, or potentially even leaving the field altogether in order to pay off their loans. And while this problem isn't exclusive to school based ot practitioners or OT practitioners in general, this is one that I have heard about from many school based ot practitioners in my community, on social media and in replies to my email newsletter. That's why today I've invited Doug Vestel, author of financial freedom for OTs, a guide to building wealth without burnout, onto the show to share how ot practitioners can move from overwhelming debt to financial freedom. While Doug isn't an OT himself, his partner is, and together, they've navigated the journey from major debt to financial stability and in New York City of all places. So if you're in the process of paying off your student loans while trying to build an emergency fund, or if you are in the post loan stage and are working toward building your wealth, this episode is for you. We'll explore why money is often neglected as an ADL Practical Strategies for Managing debt and growing wealth for retirement, all from an occupational therapy practitioner standpoint. Oh, last thing, be sure to stay tuned until the very end of the episode, because I have a very special surprise for a few of you that do now. Let's dive in with Doug Vestal.    Amazing Narrator     hello and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host, Jayson Davies class is officially in session.    Jayson Davies     Doug, welcome to the OT school house podcast, and congratulations on getting your first copy of your new book. That's awesome.    Doug Vestal     Yeah. Thank you so much. Jayson, I'm really excited to be here and talking with you absolutely    Jayson Davies     How does it feel to actually have this book in your hand?    Doug Vestal     I actually have it right here. I mean, it feels absolutely amazing. We were talking before you hit record. This is like the first time that I physically held a copy of it. And, you know, I've only seen the PDF before, and it just is an enormous sense of relief that I've actually gotten it to print and that it's going to be out in the world.    Jayson Davies     Yeah, financial freedom for OTs, it's a great I haven't gotten my hands on it yet, but I will, and I'm excited to share this with everyone, both here today in podcast form and then the book on its own. I know it's gonna be a great help to everybody. One of the most common topics within school based occupational therapy. In fact, all of occupational therapy, you know, we almost like, I don't want to say we judge one another on it, but we often will have the conversation like, hey, how much did your degree cost, right? Like, how much in debt are you right now? And so this is absolutely needed, and I can't wait to learn more about it with you today. So yeah, thanks for being here.    Doug Vestal     Absolutely I'm so excited to be talking with you.     Jayson Davies     Yeah, as we jump on, let's start with the monkey in the room, if you want to call it, you're not an occupational therapist, you are. You are not an OT No, I'm not, yeah. So let's dive into that. How are you connected to the world of occupational therapy?    Doug Vestal     Yeah. So my wife is an occupational therapist, and we've been together 23 years, married 20 years, and her and I together founded the first private pay ot practice in New York City focused on pelvic floor therapy for pre and post naval people. And the sort of deal that we struck was my wife, Lindsay, really loves the client aspect of private practice, and she was not that interested in all of the business stuff behind the scenes. And so we made this deal where I would work on all of the business activities, so things like the marketing and the sales and the strategy, so that she could really focus on all the client facing stuff, and through that, and through working with her. And then now I support a lot of OTs that are going into private pay practice. I get to have a lot of insight into the mindset of a lot of OTs, while still being able to look at it from a bit of distance, which I think has some some value to it. And so that's that's my story with, with working with my wife, and then the hundreds of OTs that I've supported. And through this, I found that. That financial challenges and financial mindset and limiting beliefs, without and within ot hold a lot of people back who really we should be supporting, because the work OTs do is absolutely incredible.    Jayson Davies     Yeah, absolutely. And I, like you said, I know you're working with people who are trying to start their own business, and from my experience, right? Like one of the things that accelerated my ability to focus on my business the OT school house was paying off my student loans. Like we made it a mission to pay off our student loans. We did it in about eight years. Got a little creative with it, but I didn't feel like I could really focus on my business or focus on buying a house, or focus on, you know, any life big things, until those student loans were paid off, because it was like $1,200 a month or something like that. So I'm assuming that's kind of something that led to the creation of this book, to student loans. Yeah,    Doug Vestal     so for us, we paid off. My wife graduated from NYU, so she had about 150,000 of student loan debt, and a big turning point for us was really getting serious about paying that off. And so, and I talk about in the book, we actually paid it off in three years through a lot of creative living situations that we did in New York City. And looking back, she graduated in 2011 so 14 years ago, a lot of her classmates still have over six figures of student loan debt, and they don't have a lot of occupational choice in their life, because the decisions they have to make are based upon what they can afford each individual month, not necessarily based upon their values, and so what I'm hoping with the book is that OTs learn strategies to pay off their student loans much faster than they thought was was possible, find ways to increase their income, start saving for retirement, because at the end of the day, we're all hopefully live long enough that we're going to retire and we have to replace that regular, steady paycheck if we want to have a fulfilling retirement.    Jayson Davies     Yeah, yeah. So obviously, student loans is one of the big ones, but, and you mentioned kind of the paycheck to paycheck, but as you were talking to OT practitioners looking to start their business, or even ot practitioners that weren't looking to start a business. What were some of those key things that just kind of stood out to you that were like, oh my goodness, like, if only you knew this, I could help you, or if only you knew this, you'd be be able to get along. So what were some of those things? Well,    Doug Vestal     I think one of is really just not even acknowledging the role that money plays in our life, you know. And I really think I talk about it that money is an essential ADL. So I know money in itself, is not an activity, but I use it as an umbrella term, because managing your money, budgeting your money, saving your money, investing your money. So I use the just catch all phrase, like money is an essential ADL, and it's important to recognize the role that it plays, because those things that you talked about, Jayson, of wanting to start your business, really focus on that. That requires, of course, being resourceful, but it also requires resources, you know, and money gets a really bad rap in the popular media, because everyone focuses on the greedy, you know, CEOs and everybody else, but the end of the day, money is a tool, and you can use it to advance your calls and do good things, or you could use it for, you know, nefarious purposes. And every ot that I've met wants to make an impact, where they want to contribute to the community. And at the end of the day that takes resources to be able to do it, because it either takes your time, so you're foregoing other opportunities, or you are, or it requires your financial resources. And so a lot of the OTs that I mentor, that go into private pay practice, really have this mindset shift, especially around charging, that we could do a whole podcast around, you know, charging cash pay fees. But they really have the shift of going, if I'm able to accumulate more money in my life, it allows me to give back to the causes and to the people that are important to my life, and I have a lot more agency and choice. And that's a really beautiful shift to see a lot of my students go throug.     Jayson Davies     Yeah, yeah. And I really like that. You mentioned ADL or money as an ADL. You kind of teased a few different areas of that. Let's dive into that a little bit. What are a few of those? If you want to call them sub ADLs or IADLs, maybe a money, yeah.    Doug Vestal     So I think it comes down to a few basic ones. So it's budgeting your money, right? So even, and we can talk about this, because a lot of people, I find they have a lot of stress when it comes to their financial situation, there's a lot of guilt and a lot of shame, and so what I see a lot is a lot of avoidance behavior. People have, you know, it's they won't even look at their bank accounts because they're scared of what they're going to find. And so the first step is really thinking about budgeting as an ADL. You know, where are your dollars going? And are you aligned from a values perspective, if you look at your spending on a monthly basis or over a six month basis, are are you really contributing to the things that light you up in life, that you find value in? And a lot of times, we find that we're spending money in places that aren't actually contributing to our overall satisfaction. And so it's a great exercise to start to shift and go, Well, maybe I can cancel this subscription, or maybe the type of house I live in is not as important to me as it is for other people. So I can downsize, so I can save some extra money to throw off, throw to my student loans. Maybe it's not important to me to drive the nicest car, and I'm fine with driving a 10 year old beater car, because that enables me to have a little bit of extra money to put towards my student loans and go on adventures with my kids, right? It's really getting on a conscious and intentional spending plan to direct that money, and then the next is really starting to invest. A lot of people are really scared to invest their money. They think it's really super complicated. They think that it's something that only rich people can do. But in fact, in this day and age, you know, it takes five minutes to set up a brokerage account with Vanguard or fidelity, and you can start investing $10 a month, let's say. And so those, those are the two big ones that I see the most, the budgeting aspect and then the investing aspect.    Jayson Davies     Okay? And you mentioned, you know, some people think of investing for those who already have a lot of money, and when it comes to budgeting, there's obviously some barriers there as well. What are some of those financial maybe tidbits that we picked up over the years that maybe aren't the best ones, and maybe they're even setting us back as opposed to pushing us forward.    Doug Vestal     Yeah. So I call those like limiting beliefs around money, and it really happens, I think, coming from childhood. So if we think about and I have this exercise in the book, but I think a lot of our thoughts around money are very subconsciously driven by our experiences, as when we were children. And so I always ask people to sit in a quiet place and recall like Keystone memories from your childhood, right? We all have these Keystone memories that we replay over and over again. We likely don't even share it with our spouse or our closest friends, right? But they made a big impact on us, and oftentimes there is a through line of money in those Keystone memories. And so I always ask people to sit down in a quiet, quiet room and really sort of meditate on those memories and see what role money played, because those scripts that we were fed from a very young age influence how we are as as adults. And that's where I think a lot of the money trauma comes from. That we experience is that we had parents who told us that money was the root of of all evil, or thinking about money makes you greedy, or, you know, rich people are bad, all of these sorts of things that get in our way of having a healthy relationship with with money. So number one limiting belief, I think, is people thinking that money is the root of all evil. And in fact, money is just a tool, right? It's in of itself. It's just paper, right? It's not or zeros and ones on a computer screen. It, in of itself, does not have a bias or an agenda. It's the people that have money who have a bias or agenda. So it's really like, what you do with it, right? It's up to you. It's, it's like having a knife. You know, like you could do that. You could perform surgery with that knife and cook a great meal for your family, or you could go out and choose something more nefarious. And I think just focusing and knowing that it's up to you to decide how you direct and use the money that you have is really empowering. It doesn't make you a bad person. In fact, it enables you to do a lot more good in the world. And that's the second limiting belief, I think, is that a lot of OTs will avoid thinking about money, because they feel like if they do good in the world, they don't need to focus on money. But the fact is, is that financial freedom allows you to do more good. It allows you to contribute to causes that you really want to support. It allows you to have occupational choice and get out of toxic work situations so that you can become the therapist that you always dreamed of. It allows you to drop down to four days a week so you can spend an extra day volunteering at your your kids. School, right? It allows you to put more emphasis on the values that you you actually have.    Jayson Davies     Yeah, absolutely, I, I agree, and it's hard from the OT perspective. I mean, even early on in my career, I had to make some choices right around money, around picking a job and fun story, actually, I haven't told this one in a long time. After about a year of being an OT in a school based realm as a contracted school based OT, I think my I was being paid hourly, but my salary would have been probably around 55 to 60,000 if I had added it all up, that was my first job out of out of school. A year later, I took an interview at a school district that was about an hour away from home when I was only working like maybe 15 minutes from home before, but the pay was starting around $105,000 a year. Yeah, an extra 50,000 Right? Like easily. Not to mention the benefits were improved, because it was a district job versus a contract job, and there are so many benefits. But the downside is it was an hour away from work. My wife actually thought that if I took that job, my now wife thought that if I took that job, we were basically over like, she's like, Oh, you're never gonna see me. You're never going to have time for me. You're always going to be driving. And that was a very tough decision, right? Like trying to figure that out, and me reassuring her, like, look, I can still have time to come to your house and you'll be over here, and all that fun stuff, right? That we that we have in relationships, but money was definitely a key aspect in that, because, like you said, I had a plan. A lot of that extra $50,000 that I was making every year went straight to my student loans to pay off those student loans so that I could get to a point where I didn't have to worry about paying an extra $1,500 or $1,200 or whatever it was, every single month for the degree that I held. And so this really does impact us really early on in our careers, obviously, money, and yeah, it's definitely something that I'm glad we're having a conversation with. And kind of also leads to the idea that OTs don't talk about money and not just because of the reasons that you talked about like there's that taboo of not talking about money at work with your colleagues. There's taboo about not we're talking about money with your significant others. Me and my wife, we're very open about money. Our accounts are connected, but I know friends of mine that like they've been married for longer than my wife and I, and they're still very separate. With their money, everything is completely separated. And I'm not saying that to say one way is right, one way is wrong. I'm just saying that it's different, and a lot of us aren't talking about it. And so I think that's why it's so important to have this conversation. So I don't know if anything I said prompted anything for you to think of.    Doug Vestal     Well, yeah, and just to add on to that. So, you know, money, arguments around money are the leading cause of divorce in the United States, so more so than arguments on any other other topic. And so it's really something that we can try to avoid it for a long time. But, you know, it's kind of like your mental health and physical health, like with your financial health, if you avoid it, it's eventually going to catch up with you. And so having the ability to talk to your spouse about it, your significant other, you know, even when you start a relationship, making sure that you're on the same page financially, because literally, like most of the big Keystone decisions you make in your life, are going to have some element of money. Always say, like, look at Maslow Hierarchy of Needs. You know, every single line of that pyramid has money as a requirement. As you go up that Maslow hierarchies of needs, like, it's there from from day one, and we've just been sort of conditioned over time to downplay its importance. But we're all walking around incredibly stressed about money, so why don't we just start talking about it and have strategies to deal with the stress and get out of that state?    Jayson Davies     Yeah, yeah, absolutely. All right, let's take a step back earlier. You mentioned the two main areas that that people should probably be focusing on is budgeting and investing. So let's kind of break down those two really quickly here. When it comes to budgeting, I have over the period of my money making life have gone back and forth with over budgeting versus under budgeting. And when I say over versus under budgeting, I'm not talking about like the amount in dollars. I'm talking about like how detailed I get, you know, like, I've got 23 categories one year, and then the next year I've got like, five, and I just go back and forth. I'm like, How much do I really need to kind of break this down? How much time do I really want to invest in this? Right? What are some tips that you kind of have for those who either a don't have a budget or, like. Me kind of struggle with figuring out which way to just kind of how to actually make it consistently in my life. What are some tips?     Doug Vestal     Yeah, yeah. So the what I recommend is 5030, 20 budget, just round numbers. So 50, no more than 50% of your income should be an in fixed expenses, so things like your car payment, your mortgage payment, or your rent payment, student loan, things like that. Then 30% for variable stuff like gyms, you know, the food that you're buying, any subscriptions that you have, and then 20% for investing. And if you just can invest 20% over a decade, you will become financially free. The math is on your side. It's just pretty much guaranteed that's going to happen. It's not going to happen within two years, but it will happen within like 20 to 25 years. And so for me, personally, I don't even really look at it at a super granular level, I look at, are we with the 5030, 20, and so we will just put all of our fixed expenses in that category. Are we at 50% we at 60% 70% and then the thing that's really important, because it's so hard to the reason why budgeting gets such a bad name. And I actually hate budgeting, like I wrote a book on personal finance, but I hate budgeting, which may come as a surprise to some people, but it's because I don't want to, like, sit there and count receipts and look at how much I spent on gum and mints and everything, like, there's just more pressing things to tackle. But my biggest tip is look at the big expense categories of your life. That's where you're really going to move the needle the most. And for most people, that is going to be their housing expenses, their their student loans and their their cars. If you can tackle those three categories, that is going to be the most impactful, versus switching out to the brand name cereal, and so that's where I always recommend everyone start and see if you can make big shifts in those big categories. Does that make sense?    Jayson Davies     Yeah, yeah, absolutely. I mean, I think about my life, and we have definitely kind of done that. And the other thing that I'll add is that it changes over time. Your values change over time. You know, for three, four or 510, years of your life, maybe you really value travel, and then for the next 10 years, you really value having a house or whatever it might be, right? Your values change. It could be cars. You talked about that earlier, all right, so that's the budgeting side, and I want to talk about the investing side in a moment. But first, something that always comes up, and I dealt with it for many years myself, especially when you have loans, is trying to figure out paying off loans versus investing, doing both at the same time. You talked about 5030, 20. Well, can I still put 20% away if I've got 30% of my entire budget as loans, right? What's your thought on that?    Doug Vestal     Yeah, it's a great question. So I think a lot of OTs feel financially trapped because of a really bad combination of two things. So you have really high student loan debt and relatively low salaries, and low salary increases relative to that student loan debt. And so we really have to approach it in two ways. And one is finding ways to pay off your student loan debt even faster, to free up extra money each month. And then the second is any ways that we can increase your money because you want to decrease your expenses at the same time you increase your income, so you have a lot of extra stuff to throw at your debt. What I would say is, especially with interest rates being where they are, you are much better off financially paying off your student loans as fast as possible. You know, like there's a lot of repayment periods that are 10 years, 15 years, 20 plus years, and it's kind of conditioned into us that, well, that's just the term. So it must be okay to take 20 years to pay off our debt, or 15 years to pay off our debt. But I would ask the more radical question, which is, how can you become debt free in the next five years? Like, how can you do it really, really fast? Because every dollar that you send to paying off your student loan debt is a guaranteed rate of return given the interest rate on your student loan. So if you have a 7% interest rate on your loan, every extra dollar you're sending to that you're basically saving 7% alternative if you you went and invested in the stock market, the long term average returns are around 10% so it's not that huge of a of a difference. And so sending as much extra money to your student loans and paying those off in a few years and living like a student. It right after you get out of OT school, you'll never I've never met anyone who regrets paying off their ot student loan that faster. I know you did it fast. We did it fast. I've interviewed OTs on my on my YouTube channel that paid it off in a couple of years. They've never regretted it. And so to circle back to your question, I would prioritize paying off your student loans before investing with one caveat, and that is, if you have some sort of employer match for your retirement account, I know for a lot of school based OTs there, they're not going to have that. So it might not be super, super relevant, but for others that are listening that either have a 401 K or 403 B in the 403 B comes with a match that is just free money that your employer has given you. It's baked into the cost of your employment contract and the cost of hiring you. And so if they match 5% of you know your salary, if you also contribute 5% I would set your investments up so that you are contributing that 5% and then all extra money gets sent to your student loans. And then once you are out of student loan debt, then take all that extra money that you've been saving and start investing that each and every month.    Jayson Davies     Yeah, and that's basically what I did, aside from, you know, a few months here and there, where I convinced myself that I really needed to invest and so I would, you know, dump a little bit of savings into an investment. But, yeah, I kind of am on the same board with you with that one. That's kind of the approach I took for the most part in I feel better about it because I knew that, yes, I could average in the stock market about 7% potentially, I kind of try to go the conservative route. I'm conservative when it comes to me making money. I'm very loose when it comes to saying how much I'm losing, right? So I would average up my loans and say they were 10% in reality, they were six or 7% but yeah, and I really wanted to knock out those loans. For me, I tackled the highest percentage loan first, even though it was the highest amount. I know there's different names like snowballing and whatnot. Do you recommend one versus the other? Or is it just kind of whatever works for you? What do you think?    Doug Vestal     Yeah, I talk about both strategies than the book. So the snowball method and at the Avalanche method. And so just to recap, so you can have you could go and attack the highest balance first, or you could attack the highest interest rate. So sorry, the lowest balance for us, what we did was we wrote down in Excel all of our loans. They were with no net at the time, and sort of just like, listed it down, and we didn't attack the highest interest rate, even though, long term, it would have saved money, we attacked the lowest balance. So for us, we wanted to be able to just eliminate that loan as a category. We had, like an $800 loan, and it felt so good to eventually just pay that off and not have to pay that anymore. Then we went to like the $1,200 loan, then we went to the $6,000 loan, then we went to like the $15,000 loan. And for us, that was really motivating, because we could see the progress happen very early in the beginning. And so we just felt like we were making so much momentum that that gave us the motivation to keep going forward, because it is tough to do right? You have to have a lot of discipline, and if you're not seeing that progress, it can kind of be demotivating. So I'm so glad to hear that that the alternative worked for for you.    Jayson Davies     Yeah, and I'll be again Frank, you know, it's when you're sitting down at the time I focused on mint. I'm so sad that mint doesn't exist anymore, but that's what I use to track everything. And while I focus on the highest percentage, there was definitely a few times where it's, like, this lower loan, it cost you $1,000 I've got $1,000 in the bank. I'm just getting rid of that one. Like, once it got to a certain point. I didn't want to have to deal with that one, because I knew that the following month, that's an extra 100, $200 for that payment that I can now snowball. That's where it comes from, right? Um, Snowball. That money now to one of the larger loans. So it was kind of a combination of the two, but I definitely prioritized those higher interest rate rate loans. So kind of going back to the numbers that you shared earlier, 5030, 20, 50% being your your fixed numbers, or your fixed expenses, 30% being some variable, and then 20% for for savings, if you have loans, it sounds like more that 20% is going toward the loans, right?    Doug Vestal     Yeah, exactly. I would be putting that 20% towards the loan and seeing if you can even increase it. So for us, the way that we were able to pay off 150,003 years was we downsized our living environment. We had we had just started our private pay practice and. Our kids are two years apart. I think they were four and two at the time, and we moved into a one bedroom apartment in New York City with two young kids, you know, and we put up a temporary wall in the living room so they could have space. And we just threw every extra dollar that we had so much more than the 20% like, probably 50% of our income we were just sending to the student loans to get rid of it as quick as possible. And what was amazing Jayson was it did a number of things for us, like immediately downsizing. We just felt so much more like expansiveness, you know, because we finally had a little bit of wiggle room, because we had been living paycheck to paycheck, essentially. And so we did start prioritizing, like going on date nights, which was fantastic, like with a four year old and a two year old. It was tough to find a babysitter that we trusted leaving them with. But once that happened like that, was amazing for our marriage and living in a smaller space. I mean, apartments in New York City are already small, but living in a smaller space with our young kids brought us really, really close as as a family, and we ended up staying there for close to four years, in fact, and even now, like, we live in a much smaller house than we could afford, because for us, it that's just our values, you know, like, we don't want to buy a lot of furniture And we don't want to spend time cleaning it and dealing with all the things that go wrong. We would rather spend that time and energy putting the kids in activities and doing hobbies with them and traveling with them. And so I would say, if you're looking at like that six figure loan or multiple six figure loan, you know, back into like, what do you need to be paying on a monthly basis to be able to pay it off in the three to five years. And where, in that 50% fixed expense category, can you make some of those big moves so that you now have more than 20% to throw at your student loans?    Jayson Davies     Yeah, one other thing that's really helped me, or at least with my mindset, is just hopping on Google and finding one of those calculators that will tell you how much you'll save just by paying an extra 10, 2050, bucks a month. Like, it's amazing how much you can actually save just by paying a little bit extra every month.     Doug Vestal     Oh yeah, yeah, the cost of the long term cost of debt is, is astronomical, you know. Like, you can especially true on credit cards, because the the interest rate is so incredibly high there. But with student loans like it's not uncommon to have 100,000 of student loan debt. And if you took the entire repayment period, that $100,000 would actually end up costing you about 280,000 just from interest payments, you know. And so it's like doing that calculation is very, very eye opening.    Jayson Davies     Yeah, yeah. It really helped me. Whenever I'm like, Oh, I don't need to make an extra payment this month, I use that calculator. I'm like, All right, just an extra 50 bucks a month can save me like four grand over the course of the loan. Absolutely. Let's do it exactly. Yeah, okay, for someone who hasn't looked at their student loan documents in a little while. Is there anything that they should really be able to know? Like, I don't know. I think of student loans, you mentioned, different ways to pay it off, different time lanes and percentages, obviously. Like, if there's something on that loan that someone needs to know, or do they just need to pay it off extra every month.     Doug Vestal     They I think they just need to pay it off extra each each month. Because, look, there is a difference between secured and unsecured loans and all of that stuff that people will talk about. But once you graduate, all of those loans terms are pretty much the same, right? The length of repayment might be different as well as the interest rate might be different, but the behavior of the loan itself is really the same. The purpose of the secured versus unsecured is really what's happening to the accumulated interest payments while you're still in school. So once you graduate, they're really kind of all the same. And I would just tack it in either that snowball or that that Avalanche Method, okay?    Jayson Davies     And one last question I'll ask you about about the loans. And then we'll move on to the investing side of things. Is as school based ot practitioners, there's an option for some of us, not even everyone, that we might be able to have our loans forgivens, whatever term we want to use, and you might have the right terms. But is that something we should rely on? Is this something that we should plan for? Is it something that we should not worry about and still try to pay off early? Do you have any guidance on that?    Doug Vestal     I think so there are like the repayee program. Is you so to think about the income driven repayments. Are you asking about income driven repayments? Or I    Jayson Davies     know there's income driven repayments, and then I also know that there's also, like, it's not specific to teachers, but people that work in public sector, after 10 years, sometimes they can be forgiven. I don't know how it works, totally, and I. Um, yeah, any thoughts you have on that? Yeah, so    Doug Vestal     that's the that's the repay program, and that's actually a decent program, because when the loan gets forgiven, you don't pay taxes on it. So other income driven repayment plans actually come with a big tax bill when the loan gets forgiven, so it's treated like that amount that you're forgiven at the end is treated like income to you, and so you can end up with a hefty IRS bill at the at the end of it, versus the public service loan repayment plans that sort of gets forgiven, and you don't have to pay taxes on that. So that's a good that's a good way. However, what I would say is it really depends on the individual in their work environment, because I don't think it's great for people's health and mental health to stay in a toxic work environment just to have some loans forgiven. So I would rather them switch to a higher paying place, somewhere where the benefits are greater, somewhere where they are enjoying the clients, their co workers, their their boss, because this is your this is your life at the end of the day, right? And so making sure that you are that the work environment is really great, I think, is the number one thing, and then making sure that you're not underpaid, because sometimes these positions come with underpayment from a salary perspective and long term, financially similar to what you said, you're better off finding the job that makes you $105,000 a year versus the $50,000 A year throwing that extra at the student loans, and now you have a salary of 105 and your salary increases based upon that, so now you have extra money to start giving to your retirement. Does that make sense? Yeah,    Jayson Davies     yeah, absolutely. And yeah, I again, I think every person's cases is different, right? For me, I definitely, I knew that that was an option the 10 year repayment plan. And so I think for me, I focused on the ones that weren't part of that first. But as soon as you know, it made sense to start focusing on that. I absolutely did. And yeah, it really worked out. So, yeah, I think that's it for the student debt. Anything else you want to add? I know we've focused on student debt, any other debt that you want to discuss really briefly?    Doug Vestal     No, I would just say for the others that are in the income driven repayment plans, that's not part of the public service work is, if you're eligible for that, I would enroll in it, but I would make extra payments. So it's great to decrease your monthly payments, because it gives you a little bit of financial flexibility. I just wouldn't treat that as like a 15 or 20 year endeavor. I would start looking at ways to throw extra money to the student loans, because even though you're in that program, you can send extra and you can repay it faster than the terms of the loan.    Jayson Davies     Awesome, perfect. All right, let's move on to the savings side of things. Instead of the spending all the money we have in our account types of things, let's talk about that investing side of things, and I don't know, let's just kind of assume that someone you know finally paid off their student loans, or maybe they've got their student loans low enough to the point where they're feeling confident and saying, Hey, I'm ready to start saving. You mentioned Vanguard and fidelity. Where should someone start?    Doug Vestal     Yeah, so I think someone should start with understanding, like, kind of how investing works and why you want to invest. And so for that, I always talk about compound interest. So I know Jayson, you're very familiar with compound interest, and you probably know this example, but I like to use it, which is, would you rather have $1 million today or a penny that doubles every day after 30 days. So you can have a million dollars a day, or a penny that doubles every day after 30 days. So that Penny tomorrow is going to be worth two cents, the next day is going to be worth four cents, then eight cents, and so on. What I    Jayson Davies     will say this the side of me that has a lot of things that need to be done around the house. Really want that million dollars right now, but I again, let's go with it. The penny. What does that lead to?    Doug Vestal     So after 30 days, that Penny, doubling every day, will be worth 5.4 million. And after 30 days, after 30 days is worth 5.4 million. And so the purpose of that is that, and I have the chart and the graph in the book is it really doesn't start to accumulate until, like day 26 and then you start doubling a big number, right? So it starts off really, really small. It doesn't look like anything's happening. But. But it's like building a snowball, right? Like the way to build a snowball is you start with a little rock, and you find a big hill, and you roll it down the hill, and slowly it's accumulating, accumulating, accumulating, and then now suddenly you have this humongous thing. And that's what compound interest is. Obviously, the time, like nobody's going to find this magical Penny. You know, it doesn't, it doesn't exist, but it illustrates like the power of compound interest, and that's really what you want from investing, is to take advantage of compound interest, and the main way to do that is investing in the stock market, right? So you basically go out and you buy shares of a company. So you are now part owner of Apple, or you are part owner of, you know, your favorite company that you go to, and when that company does well, if they make more and more products that other people want to buy, they earn more money, and their share price goes up. And over time your investments go up. Of course they can go down, right? But speaking broadly over the long run, and investing is something that investing is not gambling, right? Gambling is you're hoping to double your money you know immediately, or you might lose it. Investing is something that you takes decades, right? And so you're really putting a lot of your confidence in the strength of all of the companies in the US, all the companies in the world, to keep generating this economic activity. And so that's the that's the number one thing is, is knowing that it's not like gambling. Yes, it is risky. You could lose money, which is why I say don't invest any money that you need in the next five to 10 years. Is really a long term sort of thing. But that's the thing that's going to allow you to outpace inflation, right? We've seen in the last five years enormous inflation, right? Look at the cost of all your grocery bills, right? Costs are going up, and if you're not in a position where you have investments that track the cost of that and exceed it, then your purchasing power is diminishing substantially over time. And so the only way to beat inflation is to start investing. And the only way to really build financial freedom is to start investing. That's the only thing that's going to allow your money to compound and work harder than you working. And so the best place to start is really looking at any retirement plans that your employer offers. So you know, for schools, obviously there's, there's pension plans. Some will also offer 403 B's or 457 B's. If you're not in that, maybe you have a 401 K so looking at these retirement plans that your your company offers, making sure that you're maximizing your contributions to that because typically they're, they're pre tax, so it's better for it for you from a tax situation, and then making sure that you're actually going in and picking the investment choices. It's not enough just to have the account. You also have to direct where the money is going inside of the account. And the easiest thing by far to do, because I don't want people sitting there picking stocks or individual things. You want to purchase a broad, diversified, low cost index fund. It's something that is passively managed and just buys a basket of 5000 companies, and you sit back and you don't have to worry about it. But great way to do that is to do something called a target date fund. So this is a fund that will automatically purchase stocks and bonds in a certain combination, and they will readjust it according to how close you're getting to retirement. So if you're far away from retirement, it will be really super aggressive and more heavily invested in stocks. If you are really close to retirement, it's going to decrease your investment in stocks and increase your investment in bonds. And so if you had it's 2025 now if you desire to retire in 30 years, you would purchase a target date fund of 2055, let's say, and that will take care of it automatically. You don't have to do any rebalancing on your own. That is the easiest and fastest way to get started. Outside of that, you could just choose your own sort of broad, broadly diversified index funds,    Jayson Davies     yeah, it's, it's so interesting. The target date funds, those are relatively new, and I never heard about them until recently. And I was like, Oh, that's a very unique concept, and it makes sense. And the only other thing that I'll add to it is someone told me that if you want to, if you are more conservative, you could choose a target date fund that's a little bit earlier than your retirement date. And if you're you know, a little bit more of a go getter, and you're not worried as much about the stock market, you could pick a target date that's a little bit further out than your target retirement date, and it'll stay a little bit more stock heavy for a little bit longer time. So yeah, very I like how it auto adjusts everything for you, though you don't even have to worry about it. What you just. Put it in there, and it really is gonna make the changes you need to make for you.    Doug Vestal     Exactly. Yeah, it's great.    Jayson Davies     Very cool. All right, let's get to something that, yes, it's related to money, but it's actually more tied into our ability to feel good about work, hopefully and also be more successful at work. And I want to ask you, just in general, as you've worked with so many different clients, ot practitioners, how has financial stability impacted the OT practitioners that you've worked with, their ability to actually support their clients?    Doug Vestal     Yeah, it's a great question, so I would say it comes from having less stress, and when you are less stressed, you can be a better therapist, right? Like we know the impact that stress has on the body, right? We know the impact that it has on your sleep routines. We know the impact that it has on your relationships. We know the impact that it has on your digestion, right? Like stress is real and money, stress is real. It's the primary source of stress in most people's life. And so how can you be really fully present and giving in a session? If you are worried about your rent check clearing, right, or you are having to go to a second job to be able to make ends meet, it's going to be very tough. I'm not saying it's not possible, but what I've seen is that you can become a better occupational therapist by having less financial stress in in your life, because it's going to allow you to show up more fully as the OT that you want to be in your sessions, because you're not going to have this through line of financial stress, coloring everything and all of the interactions that you're having.    Jayson Davies     Yeah, and I think that that is true whether or not you want to start your own private practice or you're a school based occupational therapy practitioner and simply want to best support the students that you serve. I mean the financial stress, even if you're not under financial stress because of your living paycheck to paycheck, even just the financial stress of opening a credit card or having to move from one rental to a new rental because prices are increasing a little bit like, yeah, it kind of comes back to the money, right? Like, if, if we had the money in the right situation, maybe we wouldn't have to move homes, which then causes the stress of moving, which then causes the stress of getting new internet and utility bills set up and all that other stuff that goes along with it. So totally agree with that. I think that it is something that's essential, and I think you've framed it in the great way by saying it's an ADL, and it's an ADL that we often don't think about as an ADL. In fact, I don't think it's an official ADL. Is it? Is it an ADL?    Doug Vestal     I don't think it, I don't think it is, yeah, but it's, I know everyone knows that managing money and budgeting and everything is an ADL, but what I'm hoping to accomplish is, okay, well, we need to go deeper than that and go like, what do we actually do now? Right? It's not enough to say it. I think a lot of people will know it, but they don't have, necessarily, the tools and the techniques in their own life, and if they're not applying it in their own life, then how can you help your clients with it?    Jayson Davies     Yeah, yeah. And I did look it up. It is under according to OT it is an iadl, which I thought so, but I agree with you. I think it's more of an actual ADL, not just an instrumental activity of daily living, but a full on, like in your face, activity of daily living, it really does make a big difference in everything you do. We all have to deal with money every single day of our lives. It really is an essential. ADL, so kudos to you for bringing that up. I really appreciate it. All right, given the fact that I had to look up the money management was an iadl, obviously this is not something that is well taught in occupational therapy school. I think it's no surprise that money business, it's starting to be taught more in educational programs, but it definitely is not at the forefront of it. So from your perspective, if you were consulting with the NYU Boston universities and USC is, what would you want them to implement into ot education? About money for OTs.     Doug Vestal     Yeah, it's a great question. I would break it down to two different aspects. So one would be like basic financial literacy, and the other would be career path planning. So I think within the financial literacy, spending a lot of time talking about the budgeting, the investing, the student loan management that we've been been talking about so that new grads coming out can start attacking their student loan debt and their financial life with a plan, you know, like we're not really giving new OTs a plan to. Help them in this arena of their life. And I'm pleased so far, like a couple of OT programs have reached out, and they're actually going to require this book to be required reading in their leadership management class, which I think is, is great, you know. And I hope other universities will do the same as as well, because this is something that every single ot OTA needs to become very fluent in, and then the other is career path planning. So I would love to see there are more discussions around private pay entrepreneurship, salary negotiation, as well as how the insurance business model works, because I think a lot of OTs come out of school. They don't understand reimbursement and how it works, you know. And so then that ham that hinders their ability to negotiate salary raises, because there's been so focused on the delivery of the care, but not necessarily the financial implications of the delivery of the care. And then they get into a situations where they're working for a business, and the business is making financial decisions that maybe they don't exactly understand or appreciate or even agree with, right? And so just setting it up for like, actually, this is how the business of healthcare works in America, and you can have a very different life if you work in a school versus sniff versus home, health versus a private pay practice and understanding those different environments at a more granular level, I think would allow more OTs to go into that with a little bit more choice and agency.     Jayson Davies     Yeah, yeah. I couldn't agree more with that. I still, to this day, am baffled by Medicare, Medicaid, all the insurance pain. I think it would also be really important for us to understand, because not knowing all that, in a profession that is very heavy on advocacy limits our ability to advocate for ourselves, both in our job, but also outside within the profession. And you know, talking to senators like it's hard to talk to senators about asking them why they're cutting Medicaid, when we don't know where the money is going and all that fun stuff. So, yeah, I think that's really important, and something I wish I knew more about, because to this day, I still get confused all the time about it, and I definitely could not lead a webinar on Medicaid, medi, Cal, all the fun stuff. So great. Well, Doug, I want to say thank you, but before I let you go, your question about your book financial freedoms for OTs, what is the most surprising or impactful lesson that you hope readers will take away from reading your book?     Doug Vestal     Yeah, it's a good question. So I, in advance of publishing the book, I got about 25 different advanced readers who were all professors at different ot programs, or OT a programs, and most of their quotes are in the in the beginning of of the book, and the feedback that I got from them is exactly what I wanted to be, which is, wow. I didn't realize that I had been avoiding this topic for so long and just how important it was. So one of the persons who is the head of an OT program, she sent me a personal email, and she was like, you'll be glad to know that we just paid off our 11% credit card. And in the last two weeks of reading this book, I shared all of the strategies with my husband, and I came to realize that, like I was the person you were talking about in the book, who's been avoiding this, and avoiding coming up with a plan, because I thought it was too insurmountable. But now I'm using the tools and techniques, and I feel a lot more confident about the future, and so that really encapsulates what I want OTs and OTs to get out of this book, which is the feel empowered, to feel that this is an important topic, but equally, have the right tips and techniques that they can start to implement immediately in their life to find financial freedom over time.    Jayson Davies     That's perfect. That's perfect. Yeah, we got to stop avoiding stuff, and money is definitely something we cannot avoid, because we got to pay our bills. We got to get gas in the cars. We got to pay for those tolls and and before I let you go Doug, for everyone who has really appreciated everything that you shared today, and want to have everything kind of put for them in the book, and they really want to learn more about this. Where can they go to grab the book and learn more about you?    Doug Vestal     Yeah, so they can buy the book on Amazon. Just search for financial freedom, for OTs, a guide for a building and wealth without burnout. It's available there in paperwork version as well as Kindle version, depending on what your preference is. And then my website is freedom of practice.com where I have a lot of free resources on starting a private pay practice. And then I post regularly on Instagram at vestibular Doug, and then on YouTube, at. Doug vestiblo.    Jayson Davies     Awesome. Got the YouTube channel excited for that. Oh, right. One more time, Doug, thank you so much for being here. We really appreciate you sharing everything from budgeting to wiping down those student loans and then investing for the future. I think that everyone who reads your book is going to have kind of that, that moment where they realize, yeah, you know what, I can't I can't keep avoiding money, and that is a great way to see this out, like it's not about making you a millionaire. It's not about making you a billionaire, although a lot of teachers are millionaires, as you pointed out to me once upon a time. But yeah, it's about being in control of your own personal financial situation. And we really appreciate having you here.    Doug Vestal     Yeah. Thank you so much, Jayson, and thanks for helping me spread the word.     Jayson Davies     All right. And that is going to wrap up this episode of the OT school house podcast. But before you go, as I mentioned at the top of the episode, I have a special surprise for you, and that is that I have purchased 10 copies of Doug's financial freedom for OTs book, and I want to send it your way along with a little ot school house swag. Why? Well, because I want to help you reach financial freedom. More importantly, I don't want you to have to take your next job that you potentially loathe due to a financial hardship reason. I want you to be able to have the freedom to say no to a bad job and good to a great job, even if it pays a little less. So if you want to take me up on this offer, shoot me an email at podcast@otschoolhouse.com and let me know one takeaway from this episode that struck a chord with you. That's it pretty simple, right? I will then send a copy of financial freedom for OTs to the first 10 ot practitioners who do, and if you're not one of the first 10, don't worry, I will still reply to your email and give you some quick encouragement. So I hope you will take me up on this. I know many of you won't, but the ones who do will be in for a great read again. The email is podcast@otschoolhouse.com and before we sign off, I want to give one last big thank you to Doug for coming on the show. You can learn more about his book on Amazon and learn about him and how he supports ot practitioners over at Freedom of practice.com thanks again for tuning in, and I'll catch you next time.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 178 of the OT Schoolhouse Podcast. What does it really  mean to provide neurodiversity-affirming care in schools? In this episode, Dr. Bryden Carlson-Giving—a neurodivergent OT and creator of the Empower Model—shares powerful insights and practical strategies to move beyond deficit-focused practices and truly center student voice, identity, and autonomy. You’ll learn how to write strengths-based goals, conduct inclusive evaluations, and support authentic participation—while navigating the real-world challenges of school-based OT. Whether you're a seasoned OT or new to the field, this conversation will leave you inspired and equipped to better support neurodivergent learners. Listen now to learn the following objectives: Learners will understand the foundations of neurodiversity affirming practice Learners will identify practical strategies to make OT services more empowering for neurodivergent students Learners will explore the empower model in School-Based OT Guest(s) Bio Bryden Carlson-Giving, OTD, OTR/L is a neurodivergent and disabled occupational therapy practitioner (OTP) with experience in pediatric outpatient, inpatient, and school-based settings. Bryden earned his post-professional doctorate from Boston University, where his research focused on creating a toolkit to support OTPs in challenging ableism within the OT profession. This work led to the development of the first neurodiversity-affirming occupational therapy model, the EMPOWER model.  Bryden is also the creator of Neurodivergent Nexus, an online resource hub that supports practitioners in challenging ableism throughout the OT process. He received the 2024 Emerging Leader Award from Boston University, and will publish a book on this work in March 2026, titled "Neurodiversity-Affirming Occupational Therapy: Empowering Approaches to Foster Neurodivergent Participation.” Quotes "Neurodiversity is everybody. It’s neurotypicals, it’s neurodivergents… The whole purpose of neurodiversity is not meant to create a divide—it was created to help provide a language and a framework for elucidating the fact that we all experience the world differently, and even if you do, that’s not wrong. It’s actually quite beautiful." —Bryden Carlson-Giving, OTD, OTR/L  "OT has such strong potential to be a profession of empowerment and liberation, but in order for us to really do that, we need to really think about everything that we thought we knew OT should be about." — Bryden Carlson-Giving, OTD, OTR/L  “An evaluation isn’t just something we go through the motions for—we do the evaluation to get all this information so that it can inform our therapy moving forward.” — Jayson Davies, M.A., OTR/L Resources 👉 Instagram 👉 Neurodivergent Nexus Website 👉 Why Toolkit 👉 Autism Level Up 👉 MYSET (My Sensory Experiences Tool) 👉 TPT- OTs For Neurodiversity 👉 Interception- Kelly Mahler 👉 Learn Play Thrive   Episode Transcript Expand to view the full episode transcript.   Jayson Davies      Hey there, and welcome back to the OT school house podcast. I'm your host, Jayson Davies, and today is episode number 178, thanks for being here. Today. We are diving into a conversation I've been excited to share with you for a long time. In fact, it's something that I have been actively trying to find the best possible person to explore this topic with you, with, with you, with that's a weird way to say that. But okay, let's go with it anyways. I finally found that person. I connected with him in 2024 at a ot a and again now at the 2025 A ot a inspire conference, and I'm excited to welcome him to the podcast. That person is Bryden Carlson giving.Bryden is a neurodivergent and disabled school based ot practitioner who has also worked in a pediatric outpatient setting as well as inpatient settings. He earned his post professional doctorate from Boston University, where his research focused on challenging ableism in OT that led to the development of his Empower model, the first neurodiversity affirming ot framework of its kind. Brydon is also the creator of neurodivergent Nexus, an online resource hub for practitioners looking to challenge ableism and affirm neurodivergent identity throughout the OT process, he was recently honored with Boston University's 2024 Emerging Leader Award, and in 2026 he'll be publishing his first book titled neurodiversity affirming occupational therapy, empowering approaches to foster neurodivergent participation. And you can bet there will be some school based ot language in there. Now in this episode, Brighton and I are exploring what it really means to be neurodiversity affirming in school based practice, not just in theory, but in how we evaluate students, write goals, provide intervention and advocate for their inclusion and autonomy every step of the way. So without any further ado, let's welcome Brad into the show and dive into this thoughtful and empowering conversation.    Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.    Jayson Davies     Bryden welcome to the OT school house podcast. How you doing today?     Bryden Carlson-Giving     Oh my gosh. So excited and honored to hear Jayson. Holy buckets.    Jayson Davies     I love that. I love that. You know, I am excited to have you, Brian, like we've been coordinating this for what seems like a long time now. I think we first met at a OT, a down in Florida officially, and then more recently, in Philadelphia, had a chance to catch up, and I just love everything you're doing. I mean, I love everything that you're doing around neurodiversity affirming practice, but I also just love the idea that you are willing to not only answer the tough questions, but also ask the tough questions. And kind of come from this mindset that occupational therapy is not perfect. It hasn't been perfect. It can always get better. And just that, like you're trying to make ot better. And I love that.    Bryden Carlson-Giving     Thanks. That's nice for you. Thanks, Jayson.    Jayson Davies     no, it's it's true. I mean, a lot of people at the end of a session are ready to get up, walk out, go get their snack, go grab a coffee, and you are there for the entire bit of it, and want to get the most out of it and and I really appreciate that, that you really want to better OT and that's exactly what we're here to do today. So let's dive into it. You ready?     Bryden Carlson-Giving     Oh my gosh, yeah, absolutely.     Jayson Davies     All right. Well, let's go ahead, hit the ground running, because you have so much to say today, even if you don't know that you do, I'm gonna get it out of you. So we're gonna get it. But I want to start with the idea of neurodiversity affirming as like this buzzword. And I bring this up because I feel like some people within OT and outside of OT kind of have this idea that neurodiversity is a buzzword. Some people might even say we're all neurodiverse. Or some people might say, you know, this is just a divisive term that, you know, almost pitting neurodiverse people against, quote, unquote, typical people. And I just want to give you a moment to kind of address this, because you have actually done some research. And I want to, you know, pick your brain a little bit.    Bryden Carlson-Giving     Yes? Oh my gosh, no. That's a really great question. I think, well, first off too, and this is something that thing is very often confused within the neurodiversity movement and the neurodiversity just community, is that the premise of neurodivergent versus neurodiverse? I think oftentimes people use neurodiverse and neurodivergent as synonymous terms, but they're not. Neurodiverse is referring to everybody. So I illustrated, if everyone's average today, illustrated like the neurodiversity multiverse. It's like a huge concept. It's on my website. But in that neurodiversity multiverse, I actually also include neurotypicals, because neurodiversity is everybody. It's. It's neurotypicals. It's neuro divergence. I think when you're talking that's like, about the community, it's kind of like diversity everyone is, is like, even within the sexual sexuality, diversity universe, like heterosexuality, is within that umbrella, within the neurodiversity multiverse. Neurotypical individuals are within that multiverse. So in truth, technically, everyone, we are all neurodiverse. But we weren't talking about neurodivergence, where your brain, how you process and experience the world to diverges from the neuro normative norm. You're considered neurodivergent, and that includes anybody who not just individuals that were born with a neurodivergence, like developmental whether it's being autistic, being an ADHD, or learning differences, but it's also those that have acquired neurodivergence, so you acquired it during your lifetime, but also includes mental health, so like depression, post traumatic stress disorder, traumatic brain injury, Down syndrome, like the intellectual development disabilities community, is also within this umbrella. And the whole purpose of neurodiversity is not meant to create a divide. It was created to help provide a language and a framework for like, elucidating the fact that we all experience the world differently, and even if you do experience the world differently, that's not wrong. It's actually quite beautiful, and you deserve to to continue to experience and participate in the world differently, and you are not required to try to change how you experience the world, how you present yourself, to fit with what the neuro normative norm is. That was a lot of word vomit. Did that make any sense?     Jayson Davies     It did. And I mean, I love that you gave that response, because I fit right into that category like I was definitely I still am, and I will be, until I really wrap my head around it. Is someone who has confused those terms between neurodiversity, neurodivergent. I think even that in even in that question, I basically shared that Oh. And so I love that explanation. Thank you.    Bryden Carlson-Giving     Huge concept. Go ahead now you go just, it's a huge concept, and it's been around. Neurodiversity has been around for forever. It's not that it just happened these past, like 2020, years. It's always been around. It's just now we've had really brave people do the work and provide a framework. And I'm really excited for the neurodiversity movement to really infiltrate OT, and it really is beginning to really infiltrate OT. So it's really exciting.    Jayson Davies     I love that. I love that, yeah, like now I better understand how to talk about this a little bit and continuing down that road, as you just kind of alluded to. It's been around forever, but the last 20 years or so, it's started to creep more into occupational therapy, and now it is, it is here, and I want to get a little bit, and you can work your background into this a little bit. But how did you become involved into the neurodivergent neurodiversity conversation? And I guess, kind of what, what grasped you and made you go this route and look into this?    Bryden Carlson-Giving     Yeah, well, I so I'm somebody, so I'm a, I'm an ADHD er, I also have depression and PTSD, and I was actually diagnosed first with depression when I was getting my masters. I actually firmly believe, because I I've always had ADHD, but because I didn't fit, like the one of three or four boxes of what ADHD looks like, I never got the supports and services that I needed. And I think actually, because I never got those services, supports, the depression actually ended up manifesting. And that's actually, if anyone's interested, there's a lot of great literature coming out with those with those with CO occurring neurodivergencies that have ADHD or they're autistic, is that if they have another co occurring diagnosis, they're actually finding out that a lot of people, all these individuals, have developed, like, anxiety, depression, like first, like they were diagnosed with Those ones first, because they weren't diagnosed with being autistic or being an ADHD or with a different neurodivergence. It's like totally to adapt to the world and embrace parts of who you are. You called yourself dumb or stupid like it did my entire life, because I have terrible short term memory. My very first ot job, I mean, right out of school, was at an ABA clinic. And my first I mean, four or five months in, I remember observing some ABA and some even some stuff that, like ot like, with our community we were publishing and training some like, this, doesn't, I don't know. This doesn't feel right. And then I ended up just kind of diving down huge rabbit holes of social media accounts and blogs that were ran by neurodivergent people. But then I also discovered Meg, Proctor of learn, play, thrive. Like, back when Meg was just first creating, it was, like, her first year. I'm so proud of, like, where her platform is now. But I really opened up the world of neurodiverse, of strengths based approaches. And then, yeah, after strengths based approaches, that's when I really started discovering neurodiversity. And. I kind of really applying it to myself, and it has completely fundamentally changed everything that I thought I knew about ot.    Jayson Davies     You led me right into the next question that I was thinking about as you were, as you were, given that response, and that is the idea of OT, inherently, or not inherently, as a neurodiversity affirming practice. And again, I just kind of want to get your thoughts on this, because I I know you, and I have heard a little bit about your thoughts on this, but I've never heard you respond to like this. Question, is ot inherently a neurodiverse affirming practice, or is it something that is evolving and needs to continue to evolve?     Bryden Carlson-Giving     Oh, yeah. I mean, I think occupational therapy has such a beautiful opportunity, has such strong potential to be a profession of like empowerment and liberation. But in order for us to really do that, we need to really think about everything that we thought we knew what ot should be about, because I believe how many higher education programs that you know create occupational theory practitioners when you're a student and are continuing education at conferences led by our organizations, I mean, they're quite ableist. And I think, I believe ot has a lot of has so much work to do to be neurodiversity for me. And that being said, Though I even this year at a ot a it's been it's so helpful and so exciting to see so many more presentations even talk about neurodiversity and really take it seriously. And it's more about kind of getting people with a lot of the lot of the power to really authentically engage in those conversations. I mean, you saw me, you saw me ask those questions that when it was the session on OTs the sensory integration guidelines, and you know, whether or not sensory integration is neurodiverse, affirming is a whole nother conversation. But when you have a set of guidelines that uses ableist research, I mean, you can, you can switch language in an article and say, well, a lot of the articles that we still use still use sensory processing disorder, difficulties, challenges, dysfunction, but even if some articles like you can change it from sensory processing dysfunction to differences, but yet you're still measuring change and how autistic someone is, or how much they tolerate sensory input, or even if you use an occupation based assessment tool, like the Canadian occupational performance measure, the goal attainment scaling. You know they're supposed to be better than using standardized assessment tools. But if you're still your goals of how you're measuring success is really comparing to neuro normative norms, it still is ableist. And, you know, my question to them was, you know, you know, we're saying that sensory integration is evidence based, fine. You know that, whether or not that's taken that part of the equation of you know, how are you reconciling with the fact that all of these articles, like 99% of them, I've looked into each every single one of them myself. I've been talking about this stuff for a very for, you know, sensory processing and neurodiversity affirming care for three years now, and they all use ableist ways of measuring success. And I think if people in power really want to get the trust of neurodivergent OTs and really kind of walk the walk. I think we need to be better about that, like we need to reconcile with that, like you need to be open about that and say, yeah, for the longest time, we've been researching asi. We've been using that super great outcomes. We're apologizing. We're trying to make do with that, or even like strengths based approaches, the autistic guidelines that were the autistic individual practice guidelines that were just redone with my queen, Goddess Christy Patton and with Kavitha Murthy. I mean, they set a really good example. I mean, they literally invited autistic people to not just share what, what like a ot A should be prioritizing, or what the researchers, what Kavitha and Christy and Scott, what they should be prioritizing in the research. They literally were a part of the research the entire step of the way. They helped guide the questions. They helped guide what the outline like, what what the guidelines looked like. And that's, that's ally ship. And I think that people in power really need to kind of follow that kind of road, like inviting people that sensory processing differences to be a part of the work. Like, you know, are we even getting the guiding questions right? And I think I'm just, I'm so excited and so hopeful for, you know, little itty bitty people like me to, like, share these thoughts with people, and that people are listening, and other like, remarkable friends that are doing such great work in this and being brave and being courageous, and ever so slowly, like we're seeing these changes, yeah, but yeah, still a little bit of a journey, for sure. And that's and that's okay, yeah.    Jayson Davies     Yeah, yeah. And you know, just like each individual person, organizations have to grow, organizations have to change, and they have to make meaningful changes, just like individuals and and that's great that you're starting to see that, and we're starting to see that with a ot A, and it's going to take time to move the needle with that said, looking back a little bit when you are looking at research, what are you looking for in an article? What are you looking for that shows you, hey, this study actually applies to neurodivergent people, and it is actually informed by neurodivergent people.    Bryden Carlson-Giving     Oh, my gosh, yeah. So my first go to is language. I mean, language is not everything, but I also firmly believe that language is a powerful step. I mean, through language, we make powerful cases, and we'd like we declare love for our partners, like language is still powerful, even though action needs to follow language use. But, you know, is the article, a, are they even, you Well, A, are they even including neurodiverse? I mean, are they even mentioning that they've included the community of people that they're attempting to serve in the article, like, if it's an article about supporting an ADHD or student, do they even invite an ADHD or adult or individual to help with that article? What language are they using? How are they even describing in their introduction? How are they describing the neurodivergence. I've seen so many articles that are making the steps where, you know, for a lot of autistic individuals, they don't, I totally understand, like, don't like Autism Spectrum Disorder, so they say, you know, autistic or and so articles will like, they'll, they'll still use identity first language, but they'll still talk about what's a disorder. And so that language, if they, if they, if they've included a community member that they're attempting to serve and support within the article, how are they measuring success? So I always love looking into the into the methods and the results on how exactly are they measuring how effective the intervention or the strategy, or whatever they're trying to prove, or, I should say, prove, but like, show that it's efficacious. Are they measuring it by how long a student so I'm just thinking, I'm sticking with the school based example. Like, are they measuring, you know, how quietly the student sits at their desk? Are they measuring how little help the student asks the student request for help? Are they measuring how still the student is, are they measuring how much the student is looking at the teacher? Because those are all very neuro normative ways of viewing attention, because many neurodivergent people attend to things very differently, but those are the primary ways that I really love to look at articles first to see how seriously I take them. Because, you know, even within our evidence level period, you know, systematic reviews, meta analyzes are like the highest level form of evidence, I will, you bet that I will take a blog post that an autistic person wrote about a treatment intervention, I'll take that way more seriously than a meta analysis about the same intervention that did not include autistic people at all.    Jayson Davies     Interesting.    Bryden Carlson-Giving     Yeah, yeah. I mean, I have a whole nother thing that talks about the hidden, the inequity that the hidden biases and evidence is practiced, and how that actually promotes inequity for that very same reason. But that's a whole nother wonderful conversation we could have. But yes.    Jayson Davies     So I don't want to get too far into the weeds on this. But quick question, this is your podcast. You get to do whatever you want. Quick question, hopefully. Quick question outside of occupational therapy outside of the tradition, I don't know, or maybe within the traditional related services, as we often think of them. What professions do you see as kind of doing the right things, doing the best job? To make sure that research about neurodivergent people includes neurodivergent people, and that you know how they're measuring progress and whatnot. Is there? Do you feel like there is a model out there?    Bryden Carlson-Giving     No, that's a great question. I would say it's less about profession and more about maybe potentially location. I've been finding a lot of really great work has like, I feel like Canada, Australia, at least, from the articles that I've been finding have been in many ways, there are light years ahead of OT in the United States, especially when it comes to like, occupation based practice and all that. But especially when it comes to neurodiversity like I remember reading, it's like top five favorite articles of all time. I forget exactly how it's called, but it was like supporting, and this was like a 2009 2008 articles. They used ASD, but no, they were like, are we even, like, rightfully supporting children with ASD question mark? And it was like, are we losing our occupation? Centered focus. And they talk about, because this was a time too, I think, when sensory processing became much more of a conversation, and there was a lot of literature coming out about it, and a lot of time, and they're talking about how, you know, sensory processing differences are not a pathology that needs fixing. It's a unique form of the human experience. And this was a 2008 article. I think now maybe people are even maybe considering that idea in such a peer reviewed literature kind of way. Yeah, Canada and Australia, they've been, they've been publishing some really great work for a while, and that's why I think ot has such a such potential to be such fantastic allies to the neurodiversity movement. Because we're focused on participation, we're focusing on adapting the environment like we are so perfect to be like tremendous lava racist allies to the neurodiversity movement far better than any other profession such potential there.    Jayson Davies     Absolutely. Yeah. I mean, spot on the way that occupational therapy looks at the whole person. I think you're absolutely right about that. So yeah. All right, well, we're going to take a quick break, and when we come back, we are going to jump back in with Brighton and talk more specifically about school based occupational therapy. So stay tuned. All right, we are back with Brydon, and want to jump more into school based ot specific, within neurodiversity affirming. And I think as school based ot practitioners, we all want to be that ally. We all want to be neurodiver neurodivergent or neurodiversity affirming, to support all neurodivergent people. But we sometimes struggle with understanding what that even actually looks like. And so when you talk to people and say, Hey, I'm a school based occupational therapy, I really try to support neurodivergent people within my within my role. I try to support all people within my role. How do you kind of elevator pitch that a little bit? Or how do you go into detail? Like, what does that actually mean to you to be a neurodiversity affirming therapist within a school based ot world?    Bryden Carlson-Giving     Yeah, so a neurodiversity, a neurodiverse affirming approach in the schools. It's really this fundamental shift from how we view neurodivergent students, like they're not students that need to be fixed, but as a whole, like neurodivergent people are capable people that have fairly, very valid ways of thinking, feeling, communicating and participating in the world. And it's really about supporting their academic success and their overall like academic well being on their terms, and not necessarily like what the team thinks is best for them, or what teachers feel like is best for them. It's really honoring their strengths and their sensory and their cognitive needs in a way that really allows them to be their most authentic, authentic selves. And so for me, really what that looks like. It's like really rejecting, like the deficit based model, or the deficit based approach that really dominates school systems, and it really means like that we presume competence in every single student, especially when there's a lot of behavior, like a lot of challenges, or assumptions I should say about their communication or about their behavior, and I know we'll probably get more into this later on the podcast, but like, it's really about having the student be an authentic partner in their IEP. To me, that's like, the most neurodiverse, affirming thing you can do is really having a student not have the services being done to them, but the services services are really being done with them. And like, their lived experience and their voice is, like, central to the entire IEP. And what I like to tell people, people, whenever people, when we talk about neurodiverse, affirming practice in schools, is that it requires us to use our full scope of practice, that we go beyond handwriting and sensory and sensory diets. Like, like, I always tell my teams know that when I do evals and like, when I support with like intervention that they know, you know, I still support handwriting, I still support, you know, fine motor skills, but they know that's like 10% like my they know that when they when they want support and supporting positive disability identity, inclusion of that student within their general education classroom, supporting positive mental health and really helping coach them on to help better, help the student, like, really have more, more of a voice within the IEP. Like, that's that's when the teams reach out to me and to me, that's like, really what neurodiversity affirming OT is in the schools. It's so fun, it's so beautiful, and it's so fun.    Jayson Davies     Do you ever feel like the system makes that complicated? Do you ever feel like the system of school based occupational therapy makes being a neurodiverse, affirming therapist difficult?    Bryden Carlson-Giving     Yes, and I also feel like because of the system, because of how it's done, compared to outpatient and hospital like I'm. Speaking of like, you know, pediatric, outpatient, hospital based, we have far more wiggle room to be neurodiversity affirming. Like Minnesota, I don't, can't say 100% sure if it's if it's nationwide, but in the state of Minnesota, we're not required to use standardized assessments to help decide if, if a team would benefit from an OT supporter being a part of the team. And in many outpatient settings, you depending on the insurance, you need to have a standardized assessment score, you know, negative two standard deviations to qualify for insurance reimbursement or bottom fifth percentile. Like I probably I haven't used a center like a norm, referenced assessment tool in years and with the system, with how we are a related service, like we don't have specific goals on the IEP, like we really get to decide how our OT services are used to support the student. And I would say, with 85% of the students that I support in my district, 85% of them. It's focused on positive mental health. It's focused on interception. It's focused on really helping the student, in some capacity, lead a self determined life as a student and just better access and inclusion within their school environment. Whereas, like, yeah, the 15% is like, handwriting, fine motor skills, but because we are a related service provider, I mean, because we don't need to use norm reference tools, least, at least in the state of Minnesota, I feel like we have such wiggle room to be able to be neurodiversity affirming.    Jayson Davies     Yeah, and, and I think that is across the country from my understanding. And again, I'm in California, but I've talked to a lot of therapists all over the country. Yeah, idea does not require a standardized assessment tool. So when someone is requiring a standardized assessment tool, I have found it is typically related to the billing in some case or another, not necessarily related directly to providing services. So yeah, all right, I want to dive into evaluations, goals, some of the things that you just mentioned, as well as what you know ot service delivery even looks like from your perspective. But first, I know that you have this model called the Empower model, and I want to give you a moment to talk a little bit about that and where it fits into school based. OT. Side note for everyone listening right now, be sure to go check out neurodivergent nexus.com because Brighton also, like he really does put all these really into pictures, and he does it himself, no AI included, like he's an artist here. So you need to be able, or you need to be sure to check out his website and see all these, but it'll kind of help a visual to go along with the episode. So with that, Brandon, I do want to give you just a moment to talk about the Empower model, and kind of where that fits into school based. OT.     Bryden Carlson-Giving     Yeah. Oh my gosh, yeah. So the Empower framework is a model that I developed over the course of my it's actually created. It's actually like a side accident. I wasn't actually never planning on having that be a part of my doctoral work through Boston University a couple years ago, I basically was created this, this neurodiversity firming, anti ableist toolkit for OTs, and did a huge literature review on really exploring what have not just neurodivergent OTs, but justice focused, oriented OTs. Have set about just equity and inclusion within occupational therapy. And I was very surprised, even though neurodiversity is, you know, it's still kind of up and coming within OT, but it's been in, it's been in conversations for, you know, a few years now, we still, we never really had a framework or a model that not only focused on that really cut try, attempted to blend the neurodiverse affirming framework, or provide an avenue for the neurodiverse affirming framework to be combined With ot in a systematic way, but also we never, we don't have, to my knowledge, a framework or a model that really requires OTs to be critically reflexive or to support anti ableism. And so really, you know, with like even Moho, the model, model of human occupation, and even the remarkable P, O, P model, the participation environment, occupation performance model, they're occupation based. They're fantastic. But because of ableism, and how ableism is so intertwined, and how we even conceptualize occupation, there is still so much room for ableism to infiltrate those models. And still, you're still able, more able to perpetuate ableism through these models. And so I remember sitting with my husband, we were watching, like Real Housewives of like, Salt Lake City or something, and we were talking and just kind of sharing my frustration about how, you know, we don't have a framework, you know, we don't, you know, we don't have, like, a model, and it's. It's so tricky. And he was like, well, you basically did the lit review. Why don't you, like, give it a try? And I'm like, lol, that's funny. He's like, No, seriously, just get some liquid courage. Go explore and just give it a go for like, a week. And that's where the Empower model came from. So it's the empower the Empower model is the empowering, neurodivergent occupational participation and well being model, if you choose to go to the website, no worries. If not, will not be offended. But like on the outside, it's the I love the design because it was inspired by my love for fantasy video games and like science and so like on the outside, it's these four theoretical foundations that guide the model. So it's strengths based approaches display justice, anti racism and trauma, informed care, and they're all bonded by like lived experience, kind of like an atom, because really lived experience should be interwoven through everything, everything that we want, that we do to be neurodiversity for me, and then around the core, which is the goal of supporting neurodivergent occupational participation and wellbeing, around that core is the anti ableist occupational therapy process. I know we're not supposed to have favorite things when it comes to stuff that we make, but I will say the anti ableist ot process is probably my favorite, because that is, I think, where the bread, or the bread and butter comes in of providing a like, a really systematic approach how to apply anti ableism and the neurodiverse affirming framework in a very practical process. And so you have stage one, which is critical reflexivity. Stage two is inclusive evaluations. Stage three is affirming services and supports. Stage Four is neurodivergent outcomes, and stage five is advocacy, my big hope and dream. So I'm actually currently working on revisions to get this article published right now. And within that article, it provides a lot of practical ideas on each step. And I'm not talking like really abstract ideas. I'm talking about like these are ideas that you can apply tomorrow. Like these the assessment tools you can pick from if you hear, ways that you can reflect on your own ableism or your own biases. Here are the resources to choose from, or here are the intervention methods to choose from. This is how you can write strengths based on empowering goals. I provide all like really provide all that I do have ideas to link within my website, within my doctoral project, it's like, couple years old already, but yeah, that's, that's the model, yeah, yes.    Jayson Davies     And absolutely everybody, go check it out. Neurodivergent nexus.com just find the Empower model. It's easy to find, and we'll also link to it in the show notes. But I think I want to focus now on that cycle that incorporates all the steps you got, the five steps, reflection on ableism, inclusive evaluations, affirming service delivery, neurodivergent outcomes, and then, of course, advocacy. And I really want to focus, I think, in the time we have left on two, three and four evaluations, service delivery and outcomes. And so starting with evaluations from your perspective, within the Empower framework, what does that look like? What does it mean to have an inclusive evaluation?    Bryden Carlson-Giving     Yeah, so for me, I centered the students, lived experiences the center of my evaluation. I was so surprised by the number of school based OTs that I've talked to presentations, but with other school districts of how they just run IEPs, of how little student voice is actually incorporated, like I have experienced many IEP and eval like evaluate initials and re evaluations where the student is. There was never an assessment done with the student themselves. It was always caregiver sharing their information, the teacher, the psychologist, making their inferences about the data they collected by working directly with the student. And it's so surprising to me, of how this humongous service, how little the student was involved in it. And so I, for me, especially for initial evaluations, I always do a strengths based student interview with the student themselves. Right? Really, like, and I will probably get into all the different assessment tools too, but really highlighting like the student to try to be their most authentic selves. Like, I really, I love evaluations and reevaluations, because for me, it is an opportunity to try to try to show to teams that maybe we've been getting it wrong, like, maybe we need to be thinking about the student in a different way. And I can't even tell you the number of times where I've had family email me after reading the email report, and they'll be like, Wow. Like, you're like, Thank you for how you've written about my student. Like, I've never thought about my own child that way before. It was, it was like, it was like, an exhale. And so for me, really highlighting the lived experiences of the students in some capacity and whatever is sustainable for you, using affirming assessment tools. And then we'll get into that. And the schools typically go like OTs, technically, don't, shouldn't, quote, unquote, shouldn't, have their own. Goals within IEPs, but I do love to help collaborate on goals. I'm pretty vocal about that. I love to support writing strengths based on empowering goals with team members. So if we're talking about like during like during the meeting, like, we're talking about, you know, a student, and we're talking about like assistance and help of like, Oh, what if we could, what if we created a goal that focused on their ability to self advocate for their needs, or to be able to advocate for their accommodations? And we technically, students should always have their accommodations, but in the system that we're in that never, that often, does not really happen, but like really working on those self advocacy skills for the students their their ability to advocate for what they need, and so even offering to help write empowering goals, because even those like little conversations you have, advocacy work isn't just like protesting on the street or, you know, it's not that not just these big, momentous forms of Advocacy, advocacy is also the little more quieter moments. It's like, the those everyday conversations, like that five minute conversation you had with a special education teacher about autistic identity or or it's, you know, talking with another with, like, I don't know, your ot colleague about, you know, police brutality and racism with an OT like, it can just be those little moments too, and it's so beautiful. Of like, even just go talking about how to write goals, people will be like, Oh, I've never thought about writing a goal like that before. Oh, I didn't even realize that we can do that. Or because I, like, I said, language is so powerful, and with how we document, like, strengths based documentation is another part. So like, how you write up your reports, like research showed that how we write about students, how we write about people, it influences not only the fam, like the families when they're reading these reports, but also the students, if they ever do choose to read them, especially if they're middle school or high school. And like, I believe, how you write so, like the way you write about a student, like, when you write about a child differently, like, everybody sees a different child. You know what I mean? It's if you don't write about them from a Deaf right? Yeah, yeah. And so yeah, if I do like, a quick like checklist, like in the affirming assessment tools, centering the students voice as a part of the evaluation process, strengths based documentation, oh, assessing environmental supports and barriers. Like I always whether it's an assessment tool I use or it's questions I use with the students, I always assess, how is their general education classroom, or how is the school environment, how is it inhibiting, and how is it also supporting their ability to be the student that they want to be? Those would probably the primary ways, primary, like components of inclusive evaluations.    Jayson Davies     Yeah, I really appreciate that. And, and when it comes to, you know, injecting the student's voice into the report, into the evaluation, is that, as simple as you know, while you're working with the student to see how their fine motor skills are doing, just to kind of have a conversation with them, you know, while they're doing that, need to plug that in. Or do you have some sort of structured interview that you like to use? Do you have three questions that you like to ask? How do you like to get that information?    Bryden Carlson-Giving     You know, it all depends on what the team thinks my focus will be during the eval. So, like, what? It's a mixture of things. So if I'm a part of the eval primarily because of fine motor handwriting, surprise, surprise, right? Especially if they're like in second grade or above, when I'm like, assessing their ability to do different fine motor tasks that the student finds meaningful, not just fine motor tests that, like, we believe are meaningful, but like, really focusing on like, hey, like, do you want to get better at cutting? Do you want to get better at handwriting? But even the handwriting conversation, I always prioritize asking them, like, you know, how is you know? How is handwriting going for you? Do you even care about getting better at handwriting and really, kind of exploring the avenue of, like, assistive technology, if the student has expressed an interest in using at all, even during the eval, have that be a part of the assessment? Like, hey, how well can you use Google, read and write? How well can you speech a text and few good friends? And Alexis or so? Strengths based collective Kelsey Reed, she's an autistic psychologist. She's remarkable. They just released this, the self efficacy plan. It's also a strengths based interview protocol, and I've been using that as my primary method of maybe, while we're coloring together, while we're playing a game where, basically, I'll ask the student, like, hey, like, what parts of school are hard for you? Not just purchase school that we believe are hard for you, or that we've been told that are hard for you, but like, from your perspective, what parts of school hard for you, even just, and please don't let it just be math or reading. It could be like, yeah, friendships tricky is like, the lunchroom too loud, and really offering them a vulnerable like, a safe space for them to like, really share what that might be. And even like, by the time we finish our my portion of the eval with them, like the. Interview and stuff. I'll even ask them, like, hey, like, I've written down these few things that are really hard for you. Out of these things, what are some things that you really would love to try to work on or get support with while you're at school so the students can help kind of identify, kind of like a mini CEO PM, in a way, like the goals that they want to prioritize in the school environment. Those are some, like, really, really quick ways. Like, don't be afraid to have the interview with students. I think I've been learning it's actually quite uncommon for OTs to do that in the schools, is to actually, like, not just do fine motor testing, but like just talking with them, and like believing everything they're saying and asking some of these questions.    Jayson Davies     Yeah. Yeah. And you know, there are students who have difficulty with expressing themselves for many various reasons. There are kids who have difficulty expressing themselves, and there are alternatives to that, and I'll ask you that in a moment, but yeah, when we have the ability to speak with a student that is, gosh, that can lead to so many amazing things like you mentioned, right? Like just knowing what the students thoughts are on handwriting, on assistive technology. Do they already know how to use speech, to text, all those different things can can really support you moving forward. And we also kind of just, we also have to remember that an evaluation is not like just something we go through the motions for, like we do the evaluation to get all this information so that it can inform our therapy. Moving forward, going back to the question that I just kind of alluded to, for students who have difficulty with verbal expression, or maybe even those who AAC is not quite an option, at least not right now during your evaluation, have you gotten creative in other ways to kind of get some information from the student? Or, if not, what other means do you use?     Bryden Carlson-Giving     Yeah, if, ideally, you know, if, whenever possible, you know, AAC should be prioritized, like, even for me, like above ot because, like, communication is the foundation for everything. And for me, it's always thinking about, like, before even consider trying to do, you know, an interview with that student. You know how I always think in the back of my head, how can I help support the student to lead a self determined life? And for me, it's less about having that life look like many other people's lives, or what I think play should look like, what fine motor skill participation should look like, what participation or phi Ed should look like, really like, just by even observing the student. And you know, if you can a couple different parts of the day, depending on feedback from teachers and stuff or from the team, you know, what excites the student? What are they most interested? And then how can you, as the OT advocate in a sustainable way? Because you can't always advocate loud, because you'll burn yourself out, or maybe people will mistrust you, like you have to, you know, play it how you need to play within the system. Can you help have these conversations with team members about, if you see a goal that's written about, oh, yeah, the student is to write with, you know, paper, pencil, you know, four sentences, you know, and it's like, well, how functional is that for that student? Is that meaningful participation to that student? What if we showed them a computer and we had, like, Google, read and write up, or, you know, another form of at or even, like a game, like, are they just even visually more excited by that? You know what I mean? Like, even just by observing, by seeing what students choose, we can probably get a good idea of what we think the student might prioritize, even if they can't use, like verbal speech to communicate that, but they are communicating in a way. By, you know, been choosing between those two kind of activities. But what I will say, I really love to use. It just came out of the summertime. It's called the my sensory experiences tool by Autism Queensland. It just came out in Australia over the summertime. It is my new favorite sensory tool. It's across the lifespan. And what's really beautiful about it is that not only did autism, Queensland invite autistic individuals to help create the tool, it really endorses and promotes stemming. So this tool uses visuals. So you basically there's like three parts to this, this tool, the first part is, and it doesn't even get into the whole like, sensory discriminate, discrimination, sensory modulation. Like, because for many of us under diversion, like, I don't care what my sensory modulation or sensory discrimination is, it's more about what sensory experiences do I love, what sensory experiences do I hate what sensory experiences influence my ability to participate throughout my day? And then, how can I accommodate myself or advocate for what I need? Or how can I help cope with that as I as needed, depending on the activity? And so, like the mindset basically has pictures of all these different sensory experiences in the student that an individual. Can they sort these pictures into, like, a love, hate, neutral, and you can adapt it however you want. And so you can get an idea of from their person, like, literally from their perspective, what are sensory experiences that they love and they hate? And you can, like, adapt it to make it more complex, depending on the individuals, like, level, like, okay, out of these experiences, which ones most impact, impact your not your day. The second step is stemming. So it goes through different pictures of common forms of stemming, and the individual can, like, literally, pick these pictures and say and these larger cards, like, I do do this a lot, or I don't do this a lot. And there's opportunities for individuals to share other forms of stimming that they don't see, like by writing in a post a note, or, you know, other forms like that, but there's a category called stemming, which I think is so baller. And then the third category is interoception, but it all has pictures. There's no communication. There's no verbal communication necessary to complete the assessment tool.    Jayson Davies     That's great. I have not picked that one up yet. I will have to look into that one. Brand New Zealand. All right, very cool. Thanks for sharing that. Yeah, I'll get on top of that one.    Bryden Carlson-Giving     Oh, it's okay.    Jayson Davies     All right, I can't move on from this section. This section from asking you a few examples of other assessments, you mentioned this one, yes, but are there other tools that you just want to list off? A few don't even feel like you have to go into all the details, but.    Bryden Carlson-Giving     So for me, especially for middle school and above that, it's and I think out of the few that I thought about, only one of was created by an OT was by OTs. The my set was, I think, was the only one that was actually created by OTs. The my sensor experiences tool. The next one is the camouflaging autistic traits questionnaire, the cat Q, no pictures, but it's an assessment tool, very simple checklist to help the student identify to what intensity are they experiencing. Masking at school. If you want to try for younger kids, my go to, if I have the time and the energy is all kind of use portions of autism level ups, the masking regulator. It's not it wasn't created as like an assessment tool, but it was created in a way that you can use it to kind of help maybe gage what level of masking maybe like an elementary school student is experiencing, like third grade and younger, the Dynamic Assessment of social emotional learning. It's a fantastic student interview. There's also a parent, caregiver and teacher. Questionnaire forms are with it, but assesses self advocacy skills, social participation and also a little bit of goal setting to prioritize with the student, the self advocacy plan or the strengths based interview protocol from strange basic collect, strength space collective are phenomenal. I That's like my primary goal setting tool. I use, try to use all of it when I can. But if I feel like I only have, like, a few minutes, I'll just use portions. I also love to use the student subjective well being questionnaire, another one that I've adapted for even like younger kids, to kind of for them to kind of share their overall well being at school. So those are primarily, like mental health, SEL social, emotional learning assessment tools. But like for fine motor, I don't use the bot. I don't use the Peabody. Primarily, what I do is, depending on what grade level they're in, I observe them complete a handwriting assessment, like a handwriting task that's in line with what they typically do in the classroom, try to observe them doing it in the classroom, because that's like their real world is their classroom. And then I'll kind of explore at with them, if they're even interested, what that would be like if they're really young. I do like to use portions of the of the shootles School fine motor assessment, yeah. But again, I don't use it as a way of like comparing them to norms. It's more of like, hey, which tasks did they observe engagement and joy in? And then how can we prioritize like, those tasks within, like, early childhood and all that?    Jayson Davies     Yeah, yeah. Now you said you haven't used a standardized assessment tool in a long time, and just a quick follow to that then is, have you ever had anyone push back against that when you're reporting your evaluation, whether it be a parent, school psychologist, case carrier?    Bryden Carlson-Giving     I have been, honestly, very lucky so my husband. So my husband and I, we work for the same small town, rural district in town, and even though it is very rural, I have been so lucky with the amount of support I've been getting. I think, if anything, people have been excited about this. Literally, just had a meeting with our special education director, our one of our psychologists and one of our evaluators, who does a lot of the academic evaluation stuff, because they, you know, had had questions about not the sped direct. Sped director was very supportive of all this. Like this is, like, the real data. Like this is the data that we really need. Like, our evaluations shouldn't 1% of them should be about determining eligibility. The rest of them should be about determining how can we best support the student on their. Terms, like, I'm so freaking blessed to be in this district. And if anything, like, the psychologist love him to death. He was, he was very much he loved this stuff. Like, I've never thought about ot helping gathering data on SEL portions or the well being portions of the of the eval. Like, this is mind blowing to me. And And if anything, I've, I've, I've only have gotten like, you know, from colleagues, like, wow. Like, this is such juicy, beautiful data to that helps me see a student differently, or helps affirm, like, caregivers and family members like, Wow. Thank you for, like, really seeing my child. Because even though they don't have scores, it still is incredibly useful. If not, I think it's more useful than a score, like what the student is saying environmental supports and barriers, like with their hopes and dreams, and you can still use this data to help determine eligibility, like I've had people use my information from the mindset or information from the dasl to help get, help a student get actually eligibility, because the sunrise scores did not help them get that eligibility, if that makes sense, because you can waive and you can, I forget what it's called, oh, I forget the official legal phrasing. But if they don't reach the criteria for, like, the autism, educational disability criteria, or whatever, like, you can forget what the term is, but you can wave it and use other subjective data to help reason why they should get that criteria.    Jayson Davies     I totally understand what you think, what you're saying, and I don't know the name of it either, the official term.    Bryden Carlson-Giving     I just read it to the other day.    Jayson Davies     That is a great idea for anyone listening who comes across that situation, though, we'll have to, we'll have to get that up, but yeah. All right, let's go ahead and take one more quick break and we come back. We'll dive into the last segment of our wonderful interview with Braden. So be right back. All right, I was going to dive into IEP goals here, but you've talked a little bit about IEP goals and how you don't always write an IEP goal, more collaborative style of IEP goal writing with your colleagues, and so I think, for time's sake, we're going to move to applying anti ableist practices in therapy, because you've used that term a few times on this podcast, but we haven't really gotten into it. And what I'm talking about is, of course, ableism. And so I just want to hear from you a little bit some of the practices that you've implemented as a way to kind of combat this, this ableist practices within OT and other fields. I mean, we all talk about ABA oftentimes, but you've even mentioned within OT and with, even within the PEO peop model, it can apply there. So what have been some of your thoughts around this and some actions that you've taken?    Bryden Carlson-Giving     Yeah, so in case people don't know what ableism is, ableism is essentially this system, this mindset, this, I mean, really a system, essentially where we place value over really molds well with capitalism and racism and all that. But basically that it's this mindset that disabled people are less than than non disabled individuals. We place value on what people on how much someone can produce and and even if we don't think it, because ableism is so normalized in our society, we viewed certain ways of even participating in certain ways of being more than others. That's why in this article I'm trying to publish, I talk about neurodivergent occupations, because the way that we even just exist in the world sometimes is rebellious, and it's trying to be reduced or changed to be more neuro normative. And so anti ableism is this idea of trying to dismantle ableism. It requires action. And so in the schools that can look like so many different ways, I do talk about, if anybody's even open, who even thinks that maybe they are really affirming to always take it's called the assessment of individual ableism. Assessment of individual ableism by bridges learning system. It's a Google it. It's free. It's a really great assessment toolkit to kind of gage where you're at when it comes to ableism. And before I dive into the approaches, I do want to share, like ally ship, like being an ally. It's, it's, it's not like you read one article and you maybe change one thing for a week and now you're affirming. It's a lifelong journey. And it's, it's going to be hard, and that's totally okay. It's, it's more than a shift in mindset. It's a it's a lifelong commitment to learning, to unlearning, to growth and being anti ableist. It's it's challenging because it it asks us to question and to undo much of what we've been taught and what we've always known. It's not a linear path, and it really requires patience and reflection, but above all, like Grace for yourself, like I really love that we're doing this for. Podcast Jayson, like, it's just really about being okay with, like, knowing you're not gonna always get it right, but like, you're continuing to to, like, do the journey anyway. Like, that's the beautiful part about being an ally. It's, it's grappling with the fact, with the discomfort of potentially, and you likely will making a mistake or saying the wrong thing, but understanding that we make mistakes along the journey, but you're continuing to engage in the process of being an ally, regardless of that fear of making a mistake. And that's the beauty of ally shift. So if you do make mistakes, which you likely will, even as a neurodivergent person, to other communities, being an ally that I'm not a part of, like, I make mistakes all the time, and that's okay, but when we really think about like neurodiversity affirming practices or anti ableist practices in the school. And so they're supporting, about, like, supporting neurodivergent ways of learning and being rather than trying to fix and so actually, like, one of my favorite ways to be anti ableist is to help, like, I've actually have had conversations IEP conversations about how, like, traditional forms of written expression, such as handwriting, are neurotypical occupations. They are not neurodivergent occupations. And I even, I've even, I literally have said those words in IEP meeting, and we've had 10 minute conversations about it, because families keep on asking, like, tell me more about that. Like, what do you mean? And it's been like, eye opening for them. Like, yeah. Like, your child does not need to know how to how to share their thoughts using pencil and paper. Like, that's not a functional skill anymore. You don't, they don't need to do that. Like, it's like this. It's amazing. There's all sorts of ways. I mean, if I am working on emotional regulation, like I am working on creating an energy meter, it's my favorite alternative to zones with the client, we are going through fidget resources or regulatory tool resources, where the student gets to kind of explore different tools, and they get to decide what which tools work best for them, versus myself thinking what works best for them, or a teacher saying, Oh yeah, they won't do they don't do well with that. Don't like, don't provide that. Like, it's no, I, I center the students voice. It's avoiding, like, really avoiding any traditional, any behavioral approaches, and really fostering instead, like, an interoception based approach, like, you're being really curious about behave like any behaviors or emotional expressions with open curiosity. It's sifting it from trying to change the child but more about or changing the student, to changing the environment. So it's like switching the language of like, low and high functioning individual to whether or not our environments are low or high functioning, from the wonderful words of Christy Patton, like, like really directing the work to the environments and really promoting authentic selves. And so my favorite resources, if anybody's interested in any trainings, are any, just any free resources, autism level up. It's fantastic for anything energy regulation related, learn, play thrive. Podcasts are on their trainings are not free, but fantastic for anything strengths based related OTs, for neurodiversity, by Greg and Jacob Heller, both neurodivergent OTs, they have teachers pay teacher resources on communication and regulation and just autonomy. And then, of course, Kelly Mahler, interoception curriculum is really fantastic, but a lot of it is just framing it so like, you're really supporting the individual to be the most authentic selves, and you're trying to change the environment like while also trying to help provide confidence and empower the student to be able to advocate for what they need and to help them realize that they don't need to change who they are. Yeah.    Jayson Davies     Yeah. I love everything that you're talking about, man, the one or two of the things that I was thinking about oftentimes when it oftentimes when it comes to ableist practices within the school setting that I think we're just so accustomed to that we don't even question often is the idea of our special day or self contained classes, and how we have students sitting in these classes for all day long, away from their peers. Some of the other things that I've thought about, and probably others listening have had these same thoughts in an IEP meeting is when you hear about a student or a parent more so than a student potentially complaining about another child in the classroom, as though their child has more of a right to an education than a another student who might be in the general education classroom or even in another special education classroom, self contained classroom, whatever it might be. And I think it, just like you said, it's a lot of unlearning, a lot of unlearning and relearning. And even with IDA, Ida had this idea of, you know, getting kids back to the least restrictive environment. But things are not perfect yet. And those are, there's a lot of things that we. Still, still will need to change two last questions for you within your school based ot practice. You know it sounds like you are in a wonderful place to be in from your background within really trying to support neurodivergent people, all people, anti ableist, all that. What's still one thing within your school district that you really want to change? What's one thing that still, you know, pie in the sky I want to change? It's nothing perfect. So what's one thing you want to wear?     Bryden Carlson-Giving     Yeah? Oh yeah, no. I mean, there's always learning opportunities everywhere. I'm just grateful with all those things that I mentioned that I don't have to fight super hard for. I mean, just at my school, but at all schools, I would eradicate and get rid of all FBAs positive behavior support plans and instead, and I'm trying to, like, slowly, do that with the Y toolkit. And have you heard of the Y toolkit before you were just, oh my gosh, that's incredible. It's created by an autistic speech therapist, and it's literally created to be a neurodiversity affirming and trauma informed alternative to the FBA Pro to FBA because it focuses on its internal experiences and student voice because of how we do our FBAs and positive behavior support plans. It relies on subjective views of what of intentionality behind behaviors, and we make assumptions about students, and we oftentimes even within these regulation plans, students, student voices are never, ever considered or even asked. It's all based off of ableist data we get from evals, or if it's a standalone FBA, I mean just ableist data from assessment tools and observation or ableist observations. And what I've been doing because trying to get rid of the FBA, because I think we are learning and real like, like I'm learning, and realizing that the y toolkit is a legal alternative, especially in Minnesota, to the FBA, it's a it's a whole system override, and that takes time. It takes resources. It takes money. And so what I've been doing as like a baby step, is before really engaging in these huge system levels conversations with admin, like, Yeah, we should. We should not be doing this. We should be doing this instead. Here's why. What I've been doing is I have been advocating to any time the team meets about what a student that I support and they're meeting to talk about the behavior plan or talk about creating a behavior plan, I always ask to be a part of those conversations, because then that way, I get to help minimize the harm of the FBA and the positive behavior support plan, while also, in a way, trying to, maybe in like, quick little conversations, or even at this meeting, trying to change minds about how to view behavior. And I incorporate aspects of the of the Y toolkit that way, by offering alternatives and stuff like that. So actually, what's been really great is that now this year if we know that we're going to be creating an FBA for a student, I've been a part of, been a part of, like, the eval, and I've been a part of helping to create the FBA. Obviously, not to create the FBA for it to be an FBA, but helping to reduce and minimize harm. And so, like, I use different assessment tools, trauma informed assessment tools. I interview the student, and so we get to these. Use that data help minimize the harm of the FBAs. But that's like the big, big, big kahuna hope of dream.    Jayson Davies     Hey, you got to have a dream in order to make progress. So for everyone listening, that's at supportable solutions.com . We'll be sure to add Thank you, a link to that as well the Y toolkit. Very cool. And then last question, kind of a similar in similar vein, what is one research study out there that does not exist, that you wish did research study would be like the results, like, if there was, yeah.    Bryden Carlson-Giving     Well, if I had it my way. So actually, it's too are you, oh, are you asking, like, for me, like, what I would love the research to be on, or, ideally, what, like?    Jayson Davies     I'll rephrase it, yeah, no, no, no, not what it'll look like. No. So one last question, kind of like a pie in the sky, something that you could change at your school. What is one research that you wish existed that you could just pull up at any time to explain to a parent to something or explain to a teacher to something. What is one research that you just wish already existed? You didn't have to think about it. You could pull it up anytime.     Bryden Carlson-Giving     Honestly, it's also just actually a dream of mine that I would love to be able to do once life slows down a tiny bit, is doing a study where we invite, maybe not just neurodivergent adults, but neurodivergent students, like in public education, and we invite them to share what neurodivergent occupational participation means to them. So like, what does learning look like for you? What. Does participating in gym class look like for you? What does What does eating lunch look like for you? Getting homework done? What does that look like for you? And kind of getting a really good, beautiful idea of really, how diverse we really, truly engage in the world. Like, how we engage in the world is so beautifully diverse and, like, it's humongous, and yet we only focus on this tiny, tiny sliver way of being as the only, like, primary way of like, learning and being a student, so that actually research today, that I actually would love to try to do in the next like, begin to conceptualize the next couple in the next year or so. Like, really, like, what does learning look like for you and not like what we think learning should look like for you? If that makes sense.    Jayson Davies     Absolutely, absolutely. I think there's no matter how many studies are out there that try to explain the occupations of individuals, I always find myself wanting more and looking for more especially as the world changes. And I mean, all the research out there about child development seems so old now, like life has changed so much, and some of it just seems so old and outdated. And so any new information that we can get about about just kind of the perceptions of individuals. And I think for a long time, as you kind of already alluded to earlier, a lot of the old research was more about like looking at very, to a degree, very hard skills and skills that were perceived as important, not necessarily what even typical developing kids really felt as important, let alone neurodivergent students feeling what is important. So, yeah, I love that. I'm sure you'll make that happen in the I'll give it five years, it'll be done.    Bryden Carlson-Giving     Oh, goodness, well, maybe I'll enter academia by then. I have no idea. I don't even know if I want to be done anymore. We'll see. But.    Jayson Davies     Okay, I don't blame you, man. Hey, school based OT is a great place to be, and honestly, I'm sure your district loves having you be a part of the team, and hope you never, never leave unless I don't know something amazing happens for you. But anyways, Brian, as we wrap up here, I do want to give you one opportunity just to kind of share where people can go to learn more about you and more about everything you're doing.     Bryden Carlson-Giving     Yes, oh my gosh, yeah. So kind of what wonderful Jayson has shared. I do have a website called neurodivergent Nexus. You can reach it at WWW dot neurodivergent nexus.com , and it's everything I have on there is free, the model resources that I've created. It's all meant to be open access. I don't want there to be any financial barriers, so there's resources on there. I do also. I have an Instagram at Brighton Carlson under storm giving. But next March, holy buckets. I'm the editor of a neurodiverse, affirming ot book that'll be coming out in the spring with over like 50 collaborate, collaborators and co authors from around the world, even non speaking individuals, super pumped about it. But it's called neurodiversity, affirming, occupational therapy, empowering, empowering approaches to foster neurodivergent participation. And so they'll be through Jennifer Kingsley publishers, but that'll be in March of 2026 but that is me.    Jayson Davies     March of 2026 it'll be here before you know it, man, and we're all gonna be holding up her book, and that's gracious. I'm excited for it. I'm excited that's gonna be a lot of a lot of good stuff there. Like you said, a lot of people come in together to collaborate to make that possible. And so glad that you were the one that they reached out to to kind of put this together. It's gonna be awesome. And I can't wait. Can't Wait, man, all righty, well, we are done for today. Thank you, Brian. Thank you everyone for tuning in and yes, be sure to go check out neurodivergent nexus.com be sure to find Brian on Instagram. Follow him everywhere, because, trust me, you will, you will enjoy yourself. So Brian, thanks again, and we'll definitely keep in touch.    Bryden Carlson-Giving     Thank you, Jason. This was, this was a joy. Thank you. Thank you.    Jayson Davies     All right. And that wraps up episode 178 of the OT school house podcast. And of course, I want to give Brighton a huge thank you for joining us and sharing all things powerful insights with his Empower model, from unpacking ableism and traditional evaluation tools to reframing how we can write IEP goals and define student success. Brydon is challenging us in the best possible way to be more Critically Reflective and more deeply affirming in how we support neurodivergent students, be sure to check out his website over at neurodivergent nexus.com for free resources and a full breakdown of the Empower model. We'll be sure to link to that if you can't figure out how to spell it, but we'll have that in the show notes for you. And there are tons of visuals over there that, trust me, you will appreciate it. I think he said this in the podcast. He actually. Does the artwork for all of his like models, which is just amazing. So be sure to check that out. You can also find some of his artwork and more over on Instagram at Brian Carlson underscore giving, where he posts a bunch of tips and different advocacy updates and just everything amazing. Don't forget his book neurodiversity affirming ot will be out in March of 2026 excited for that. I will be picking it up, and I hope you will as well. If this episode inspired you or got you thinking differently about your own practice, please consider sharing it with your favorite bestie and leave a quick review on the platform of your choice, whether that's Spotify Apple podcast or anywhere else, it really helps us to grow the show. Spread the word about amazing occupational therapy practice within the school setting. Thanks for being here. Really appreciate it, and we'll see you next time on the OT school house podcast.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. Click here to view more episodes of the OT Schoolhouse Podcast

Welcome to the show notes for Episodes 96-99 of the OT Schoolhouse Podcast. Happy OT Month! To celebrate, the #ABCsofOT are taking over the OT Schoolhouse Podcast for the month of April. More specifically, we are taking on the ABCs of School-Based OT In this first episode of a four-part series, we will be expanding on the letters A-F and how they relate to school-based OT. Over the next four weeks, we will cover the entire alphabet and share some terms, concepts, and ideas related to school-based Occupational Therapy. Episode 96: A-F Episode 97: G - M Episode 98: N - T Episode 99: U-Z Click on your preferred podcast player link to listen where you enjoy podcasts Show References: The A-Z School-Based OT Course The course for all OT practitioners looking to better understand school-based OT. The OT Schoolhouse: Back To School Conference The online conference for school-based OTs. Earn 12 hours of professional development and get the education you have come to appreciate from Jayson and the OT Schoolhouse. Learn more at otschoolhouse.com/conference Get the OT Month Handouts With everything you've got going on, trying to promote OT Month can be tough. So, we are making it easy for you. Submit the form below to get your OT Month Tips Handouts that you can share with your school colleagues as a way to share how amazing you are and how you can directly support them and the students. Subscribe below to get your handouts! Episodes Transcript Expand to view the full episode 96 transcript. Amazing Narrator     Jayson, hello and welcome to the OT school house podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.    Jayson Davies     Hello, ot practitioners. Welcome to the OT school house podcast. And even more so, welcome to OT month. We are officially in April, and this is the time that we get to celebrate ourselves and also promote ourselves a little bit within April as occupational therapy month kicks off. We are doing a very special series here at the OT school house podcast, where we are going to be releasing one episode every single week in this month of April 2022, and we are talking about the ABCs of school based OT. You might already be seen on Instagram, on Twitter, the ABCs of OT trending hashtag. And yeah, that was actually started by an occupational therapist by the name of Shannon Marie, and she started the ABCs of OT. You can search for it using the hashtag ABCs of OT. But we're going a little step further. Here. We are doing the ABCs of school based OT. As you know, everything we do on this podcast directly relates to school based occupational therapy practitioners, and so we are going to do the ABCs of school based. OT, so what does that look like? That means that for the next four weeks, I'm going to be releasing a new episode for you each Monday, and we're gonna go over six or seven letters in a row, starting with A through F this week, and then we'll dive into the rest of the alphabet over the next few weeks. So I hope you're excited for this. I'm going to dive into A, B, C, D, E and F today, and then we'll kick it off with G next week. Also, another super exciting thing that is going on this month, this April of 2022 is that you can officially now register for the 2022 back to school conference that we hold in August. I know school isn't even over yet, but I'm already thinking about back to school in August. That is our annual kickoff event of the school year. It's called The Back to School conference. This year, the theme for the back to school conference is going to be all about collaboration. So all of our six speakers, including myself, we are going to be talking about topics that will help you collaborate with other professionals on campus to support those people that you work with, including the students, the teachers, administrators, potentially even some parents as well. So I really do hope to see you at the 2022 back to school conference in August. It is a live online event, but you can also watch the replays. If you're unable to join us live, you can learn more about the back to school conference at ot  schoolhouse.com . Forward slash conference. I hope to see you there. All right, so let's go ahead and kick things off. We're celebrating ot month. I hope you already printed out your handouts from a few episodes ago and have them sitting in the teachers lounge right now, or maybe you even posted on a door and grabbed some donuts for the teachers if you did that. Kudos to you. I'm sure you are the new teacher favorite at your school site. Go ahead and keep it up, and also give yourself a pat on the back. You're awesome. All right. Well, let's go ahead and dive in to our ABCs of school based OT, starting, of course, with letter A. And you know, sometimes you just can't pick one word that goes with the letter, and that's the case here. So we're gonna start off with two words for the letter A, and in this very first episode where we are talking about the ABCs of school based ot I'm using the letter A to describe two amazing people that I would love to celebrate, and that is administrators and occupational therapy assistants. Yes, occupational therapy assistants, not occupational therapist assistants. OTs are an assistant to the occupational therapy itself, not a assistant to the occupational therapist, we obviously do not run around asking OTs to grab us coffee or anything like that. If anything, it should be the other way around. We should be grabbing them coffee for all the help that they provide with doing a lot of the treatment that we may not be able to do because we are busy doing evaluations and IEPs, and honestly, as some of my favorite OTs have said, the things that they don't want to do anyways, you know, they want to be with the kids. And, I mean, so do we, but oftentimes we have to do those things that sometimes we don't always want to do. We'd rather be with the kids, but we have to deal with the IEPs and the evaluation write ups, the synthesizing of evaluation reports and whatnot. So with that, administrators, I want to go back to that really quickly and start there, and I'll come back to OTs. Administrators are really the people that we need to get to know really well within the schools. They are the people, even if they're not our direct supervisor. Here, they have kind of the gate and key and the lock to a lot of the funding and a lot of the options that we have as occupational therapy providers. They're the people that can give us the go ahead to implement some sort of RTI program, or to say, hey, yeah, you know, I do have a classroom you can use, or even just giving us a fund, a an account that we can use to purchase some occupational therapy supplies with so an administrator is one person that you should definitely get to know whether or not you're an OT or an OT a it is vital to know your administrators at your school site, and then even possibly at more the district level, going back to OTs this month, April, ot month is as much yours as it is mine as an occupational therapist, this is celebrating this month, I should say, is celebrating all of us, not just occupational therapists, practitioners, but all OTPs and all of occupational therapy, even if you're an occupational therapist working with an OTA or the other way around. You know how important it is to have a strong relationship, a strong rapport and a strong understanding of each other's strengths and even maybe the areas that we're not as strong in, so that we can support each other, help each other out, and making the best possible outcomes for our students occupational therapy and education in general is all about working together. And when an OT and an OT a can work together, it's amazing what can happen. I've had the pleasure of working with a few I just haven't worked with a lot, but a few great occupational therapy assistants from Evelyn to Jennifer and a few others, and we've just had such a good collaboration that we're able to work together. And you know what? Sometimes you'll challenge each other too. You don't always have to agree on everything, but there needs to be that respect for each other, and you need to be able to speak up and say when you don't agree with something in a way that is actually conducive to supporting the people that we're trying to support, being the students, the teachers and anyone else that we are on campus to support. So before we move on to letter b1, more time to all the OTs out there, the occupational therapy assistants listening right now, I just want to say a huge thank you from all the occupational therapists out there. You make this life a little bit easier for us. You make this life better for all the students that you work with and all the teachers that you bring so much value to. So thank you for being a part of this ot team, and that now brings us to letter B. And for letter B, we are using the back to school conference. No, I'm just kidding. We're not using the back to school conference. We're talking about behavior for letter B. And you know, this is something that over the years, occupational therapists, in my opinion, and occupational therapy practitioners, we've gone back and forth as to whether or not behavior is within our scope. And I just want to say that behavior is absolutely within our scope. We have the skills to work on behavior, and we can do it from several different ways. We can see how the behavior is impacting occupation and work on that from a top down approach. We can also look at it from the other perspective as to what is causing behaviors and almost a bottom up approach. And come from that way. I think that when we do our best work, we see all sides of it, and we see the occupation at the end that is maybe not being reached because of some of those lower level skills that that we can work on. And we mesh it all together. We are not BCBAs, or at least many of us are not BCBAs. I know some of you do have your BCBA out there. But that doesn't mean that we cannot work on behavior. So the next time that your administrator or your teacher comes to you and says, Hey, is this sensory or behavior? Well, you can respond maybe. I don't know. I'm not sure yet, but it doesn't matter, either way, I can support you with it. It's very likely that the sensory is actually impacting the behavior, and I would love to help you out with this. So, yes, absolutely. All occupational therapy practitioners can work on behavior as it relates to occupational output. And so if that is something that you can do, by all means, go for it. You can write goals for it. You can provide therapy for it, and you can track data to see if what you're doing is actually working. All right, so that's letter B. We'll keep that one short, and let's move on to letter C. I was conflicted on letter C, but ultimately I want to talk about common core. And if you're not in a state that has common core, then we'll use the terminology state standards. Every state does have state standards, whether it's common core or standards that are specific to your state. Now this is something we don't talk about very often. We don't kind of ask the teacher, hey, what Common Core State Standard are you working on today? No, we don't do that, but we need to be aware of the Common Core State Standards at the end of the day, most of our students are working. Lean toward graduating, and they are trying to meet the state standards, and we need to support them. We are there to support the education, the functional, the academic, the behavioral, the social output for the student when they are at school, and state standards are absolutely a part of that. When possible, you can use collaboration. Hey, there's another C letter for us today. Use collaboration to write a goal that is both academic in nature and relates to Common Core, but also functional, and we provide a little bit of that piece to that goal that is now a collaborative goal that is more likely to be met, because not only is the OT working on it, but also the teachers working on it outside of the 30 minutes a week that the OT sees the student right. We can't just send students back to the classroom another C and expect whatever we worked on in the OT room to be carried over into the classroom. It requires collaboration, and by creating goals that revolve around the state standards Common Core, then you're more likely to get that collaboration on the goal, and more likely for it to succeed, all right, so that's letter C. As you kind of see, these episodes are going to be pretty short. I'm just kind of briefly going over just a little bit of detail about one topic or two sometimes for each letter and that brings us to letter D. This is determining services. D for Determining Services, this is the question that I probably get the most frequently on Instagram and a few other places. In fact, we talked about this very topic in the Q, a, in Episode 95 just the last episode, and in Episode 95 we mostly talked about determining the number of minutes that you might want to provide to a student. However, there's more to minutes when it comes to the services that you are going to provide. Yes, we do need to determine the frequency and the minutes. So is it going to be once a week or every other week, or once a month or twice a week? Whatever it might be that's our frequency, and then we have our minutes. How long those services are going to be. But there's more than that. We need to determine in what setting are we going to see this student, in the classroom, in the OT room, out at recess, in the cafeteria, whatever that might look like. And then there's one more aspect to it, and that is, are we going to see the student individually or in a group? Or if you're in the classroom, are you going to do it more in a collaborative method, or are you going to sit next to that student and just work with that student? One other model is also a consultative model, and that's an option as well when it comes to determining services. So there's a lot of variance out there, and there is no one right answer. It all depends on what your goal for the student is, and what you feel like you can do, and what the evidence that you have learned about will help you and support you in meeting their goal. And just one last point about determining services before we move on to letter E, and that is that when we come to an IEP meeting, we are bringing a recommendation of services to the IEP we are not bringing the IEP team a ultimatum and say, You know what? It's either this service that I'm recommending or nothing when we go to these IEPs, everything has the opportunity, or the option to be discussed and even debated a little bit, and it's okay to potentially, kind of shift your mindset a little bit during the IEP if someone brings up a great point, or maybe you learn something new, or, I don't know, any number of reasons could cause you to kind of say, You know what, let me rethink this a little bit. Instead of using a group, maybe we should go with individual services. I think I said last week, or in Episode 95 of the podcast, that there have been times where I've recommended one thing and then I've changed my service a few weeks later because it just wasn't working. And that's why you need to be taking data to see what is working and then adjust from there. All right, so that is letter D, Determining Services. And we have two more letters for today, E and F, and evaluations, of course, is letter E. I don't know that we could have a better letter E, except for maybe executive functioning, but I may or may not be saving that for letter X, because X is a really hard letter. So evaluations, letter E, this is something that you can't be a school based occupational therapist for very long without having to conduct an evaluation. Evaluation should always be top down and in a OTA, in the occupational therapy practice framework, by a ot a, I should say they require three pieces to an evaluation, and those three pieces are, as you might guess, the first is an occupational profile. First, we need to start with developing an occupational profile, which you can get for free from the OT School House website. Just sign up for our newsletter if you haven't already, and I will give you. My occupational profile that is specifically designed for school based occupational therapists. We also need an analysis of occupational performance, and this comes in a variety of ways. Observations can help with that analysis, both in the classroom or outside of the classroom, as can assessment tools that are standardized or unstandardized, formal, informal, all of those types of tools can help you to to break down what is going on with the student and what you might be able to support the student in and that actually leads right into the synthesis of the findings. No evaluation is complete without this synthesis. You must take what you learned from the occupational profile observing the student, and any assessment tools that you use, and then synthesize that to bring all that information together and share how it's relevant, how things fit together, how the puzzle pieces fit together, or maybe what puzzle pieces are missing and and what can you do to support this student, To to create a full puzzle to use a really, really bad analogy, I think. But anyhow, we need to make sure that for a good occupational therapy evaluation, we need to be conducting an occupational profile, then getting an analysis of occupational performance through observations and assessments, and then synthesizing that all together within our summary to share how we can support the student going forward. All right, and that brings us to our final letter for the day. And for this letter, I don't actually have a word. I have an acronym, which I will spell out for you, and that is FAPE, F, A, P, E. If you have been working in the schools for, I don't know, at least a year or so, you should definitely know this, if not even sooner, the acronym of FAPE stands for free and appropriate public education, and this is what is required for all students, whether they are in general education or in special education, no matter their disability, no matter their race, no matter where they come from, their status as an immigrant or as a legal resident, doesn't matter. Every student is entitled to a free and appropriate public education. Now, going back to letter D Determining Services, when you look at that last page of an IEP, or whatever page it is that lists all the services, you will often see that is the offer of FAPE. And on that offer of FAPE, it will list out exactly what services the student is to receive. And it might say that the student is going to receive 30 minutes a day of occupational therapy, 30 minutes three times a week of Speech and Language Pathology, maybe two hours of specialized academic instruction, or special education instruction per day, and that is a subset of their regular education that they are also a part of, or if they're in a full day special education classroom, then it might say something like 345 minutes per day of specialized academic instruction that is the free and appropriate public education. Sometimes accommodations and modifications also might be embedded within that F, A, P, E, FAPE page. So all of that is part of the the free and appropriate education for a student with an IEP, if the student doesn't have an IEP, then their free and appropriate public education is considered the general education programming, all right. So that is going to wrap up our six letters to start our ABCs of school based ot just to recap, we started with letter A describing both the importance of administrators and occupational therapy assistants. Then we talked about letter B for behavior. We talked about C for common core. Oh, and we didn't talk about this one, but on deck for letter C, I had the OT compact, which is allowing us to practice across state borders, which is pretty cool, but we'll save it for another episode. For letter D, we talked about determining services for a student, letter E, evaluations, and of course, we wrap things up with FAPE for letter F, a free and appropriate public education. Thank you so much for tuning in with me today on the OT school health podcast to get started with our ABCs of school based OT. This is April, 2022 this is ot month 2022 and I cannot think of a better way to celebrate our wonderful profession than by spending some time with you here on the OT school house podcast. And don't forget to tune in next week. Yep, we are not skipping a week this time for letters G through letter M. We have seven next week. And I hope you will tune in for that. It's gonna be a good one. All right, I will see you in episode 97 we are getting close to 197 of the OT school house podcast. And yeah, I'm just excited to get through the rest of our letters. We've got three more episodes to go to get through every letter of the alphabet. And, yeah. It's going to be fun. So I will see you next week on the OT school house podcast. Until next time, take care and don't forget, if you're interested in the back to school conference, registration is now open at ot  schoolhouse.com . Forward slash conference. I hope to see you there. Take care. Bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.  Expand to view the full episode 97 transcript.   Amazing Narrator     Jason, hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.    Jayson Davies     Hello, ot practitioners, and welcome back to another special ot month edition of the OT school house podcast. If you listen to episode 96 then you know we are working our way through the ABCs of school based OT, and today we are diving into letters G, H, I, J, K, L and M, N, O, P. No, we're not gonna get there. That's next week. Last week, we touched on letters A through F. We talked about administrators and OT assistants. We also talked about letter B for behavior, letter C for Common Core State Standards, letter D for Determining Services, letter E for evaluations and F for FAPE, free and appropriate public education. Be sure to go check out episode 96 if you haven't already to get those first six letters, and then we'll continue on today. Or you can just listen today and then go back and listen to episode 96 if you'd like. We're doing four episodes this month. This is the second episode in our OT ABCs of school based ot month, special month. This is our month. It's ot month. We get to celebrate, we get to promote, we get to talk about how wonderful our profession is. So with that, let's go ahead and dive right into letter G. Letter G for us today is going to stand for guardians, as in the people responsible for the little ones we serve. Right? Sometimes it is the biological parent, but other times it is not always the biological parent, as we discussed in Episode 93 of the OT school house podcast, we talked about kinship families, and that is a real thing. As our foster families, right? We are not always talking about the parents, so we need to be mindful about that. When we are writing our report, if you know it's the parent that is perfectly fine to use that terminology, but you may want to potentially shift your templates over to use the term guardian to make everyone feel included, and that way, when you're sending out paperwork, a guardian who is not a parent might not double take when they see that word parent. You know, I'm sure they see it over and over again, and we can make them feel a little bit more comfortable by using that term guardian, potentially. All right, so remember, not all of our kids live directly with their parents. Some have other guardians, and we need to be mindful of that a little bit and make sure we're using inclusive language there. All right. That brings us to letter H, which you probably already know it's going to be handwriting. But I want to take a different spin on this, because, of course, we do more than handwriting, and when I think about the handwriting programs that are out there, size matters, the handwriting without tears, or learning without tears, program, some of the other ones, I don't think of those programs as being directed to us as occupational therapy practitioners. Granted, we are the ones that typically go to those trainings. When you really look deeper into those systems, they are really designed for the teachers, and we can be that middle person, as we know, handwriting referrals probably account for 90% if not more, of the referrals that you get handwriting, sensory and behavior, right? So what can we do with that if we know that all of our referrals are coming in for handwriting? Well, let's get ahead of the game a little bit. Let's introduce our teachers and our administrators and people at the higher levels of curriculum to handwriting programs, let's let them know that, hey, we can save the district a little bit of money and help our students more if we do something about it. And so what can we do? We can introduce these programs to those people, let them know about them, let them see the research and let them just know that they exist. Let them know how they can actually incorporate other parts of curriculum within handwriting, right? A lot of the handwriting programs, they're not just about how to form letters, but they do also bring in the outside components of typical language development and English language learning, right? They don't just talk about or just don't promote handwriting itself. They bring in other factors. So I'll give you a quick example how I actually used RTI in order to bring a handwriting program into a school that I was working at. As you have probably heard me say, I started with one teacher, and it grew from there. So I went to that one teacher who I had a student with handwriting concerns in her classroom, and I went to the teacher and I said, Hey, you know what? If this one student has some concerns with handwriting, then there are probably other students in your classroom that might have concerns with handwriting as well. How can. We support all of your students in your classroom. And you know, we talked a little bit, and I mentioned how I could come in maybe once a week for a few consecutive weeks. In this case, it ended up actually being eight weeks. Technically it was 10 weeks, but week one and week 10 were kind of more of a little screening tool to actually determine what we needed to work on. So I drafted up this program, and it was just something, I think I titled it, like the handwriting Essentials program or something like that. And I showed it to the teacher, and she's like, oh, right, let's do this. And so I came in once a week for about 10 weeks, as I mentioned, and then we had the evidence at the end of the 10 weeks that it worked, we had a writing sample from kids at the beginning and a writing sample from kids at the end that we're able to compare and see, hey, overall, there was improvement over these 10 weeks from there, it was super easy to get administrators and other teachers on board as soon as you can make something happen with one classroom, it's amazing how quickly others will come on board. And so from there, I ended up doing the handwriting program in another classroom, and eventually talking with the administrator, she ordered a curriculum for all the K through three teachers for handwriting, which was quite awesome, and that all happened within the span of about a year and a half. So it can happen quickly. I mean, relatively, right? So that's pretty awesome again. Just start with one teacher, one handwriting program, and well, who knows, maybe you'll end up reducing your amount of evaluation referrals for handwriting by supporting those teachers one time or a few times in a year and a half, it can happen. All right. So that brings me on to letter I. And letter I kind of goes along with what we were just talking about. I have I for in services. And why that's going along with what I was just talking about is because, if you know handwriting is a concern within your schools or in your district, then why not create an in service to support those teachers, create something that's going to help them help their students, and ultimately, potentially send you less referrals. Now, when it comes to referrals, I have three very simple, very actionable steps or recommendations, I should call them first is that be sure that you talk to your teachers and ask them what they want and need. We might see that they need handwriting, but if they don't want handwriting support, then they're less likely to implement it. So talk to them, talk to your kindergarten, your first grade, your second grade teachers, or whatever grade that you want to do this in service for, and say, Hey, what do you need help with? Second, keep it short. Teachers don't have a lot of time for in services. Oftentimes, their contracted day is only about 15 minutes before school starts and maybe an hour after the school day ends, so there's not a lot of time for them to learn from you. So set the time ahead and keep it short. We don't need to give them a lot of information. We need to give them useful information, which then leads to the third and final recommendation for an in service. Keep it actionable. They don't need to know all of the research behind handwriting. They don't need to know whether there is a lot or no evidence behind weighted vest. We just need to give them the actionable steps that they can use, that they actually want to learn about, and do it in a quick manner. All right, so that's three recommendations for conducting your next in service. I do teach a little bit more about in services, in my A to Z school based ot course through my RTI module there, if you'd like to learn more. And that brings us to letter J. This is a fun one, and it is j for jungle gym. That's because the jungle gym is the most under utilized area for occupational therapy treatment, right? We often say that we can't do sensory integration, we can't do sensory strategies because we don't have swings and whatnot, but you can absolutely work on praxis and a few other sensory integration type of skills by just heading outside onto the jungle gym. Now I know a lot of them look and are a little less fun than what they used to be back in the day when people you know, got hurt on jungle gym because they weren't as safe. And we could do a lot more, but they're still out there. There's still a lot of stuff to use. You know, the slides right at recess time, the aides are out there saying, Hey, don't climb up the slide. Don't do this, don't do that. But when we go out there one on one with the student, then we can actually promote some of that stuff. Of course, we need to let them know. Hey, you can only do this because I'm with you right now, and this is a treatment type of setting, or this is a therapy led session, but that's okay. You can still do some of those things that maybe you wouldn't be able to do with the student out at recess when there's so many other kids there. So feel free. Three to ditch the OT room and head out to the jungle gym to do some things. You can even take some materials out there and do some handwriting out there. Use crafts out on the jungle gym. That's perfectly fine, too. You don't just have to stick to the jungle gym. There's other things that you can do out there as well. So that's letter J for jungle gym. And next is letter K. I hope I actually have the alphabet in order. That'd be really funny if you're just like, oh, Why'd he do J before? I don't know I or something like that. Anyways, letter K, we have kindergarten. And you know, this is the only grade level that I bring up here within our our time together, going through the ABCs of school based OT, and that is because I feel like kindergarten is an area that every ot should be a part of. Every kindergarten teacher has always appreciated what I have brought to the table for them, and I love working with them. They are so open. They are so they have a I don't know. I feel like they just have a bigger picture. They typically understand that. You know, kindergarten is a hard time to work on academics, but we are setting the groundwork for these students for the rest of their educational career, if not even further right. And so our kindergarten teachers are always open to any ideas that we have, and I would recommend that if you're gonna do that in service that we talked about earlier, start with the kindergarten teachers. Ask them, Hey, what are you seeing in your classroom? And what can I help with? Now you can do that in service. And you know what, they're gonna love you for it, that they might even invite you into their classroom to do that handwriting, or whatever type of, I know a little early for handwriting. But whatever type of whatever type of help that you might be able to provide in the classroom using an RTI type of mentality, they might welcome you in with arms wide open to support them. And as an occupational therapist, you know, maybe this will help you in the future, by then having less evaluations, because you're supporting the students at such a young age, when their brains are malleable, when those synapses are pruning, and there's just so much learning going on, whether it be based on academics, play whatever it might be. So talk to your kindergarten teachers, ask them what you could help them with, find out what they need, what their students are struggling with, and provide that support that they need. All right. So we have two more letters today, letters L and M. Letter L is laws l, a, w, s, laws that we have to follow as practitioners within these schools now. A OTA has their own set of guidelines in the occupational therapy practice framework. But that's not what we're talking about today. I'm talking about two specific laws, national laws called idea, which you're probably very familiar with, and if you listen to the podcast a few times, then you are probably also familiar with ESSA or the Every Student Succeeds Act. So first idea, that's the one that we all know that basically, you can't get through a school based occupational therapy job interview without the question being like, Do you know what idea is? What is idea? How does ot fit into idea? Right? You need to know idea as a service provider, as anyone working in special education, idea is what governs IEPs and that we must support our students to access their their free and appropriate public education, right? FAPE, which was actually our F for episode 96 but essa goes a little bit further, and Essa is not just for students with special needs. Essa is for all students. And under ESSA, we are identified as sis. I know a lot of a lot of acronyms coming your way, si s p, stands for specialized instructional support personnel. It's kind of like the related service within idea. But as an SI S P, A Cisp, if I can say that right, as a sis, we are able to support all teachers, not just those with in the special education realm, and not just students in the special education realm, all students as well. So ESSA, ESSA, that is our way to get into RTI a little bit more. Unfortunately, essa hasn't been rolled out completely. It exists. The law exists. But Washington, DC hasn't really pushed out what that actually means that the law exists. And so if you listen to our episode with Abe Safar, I believe that was episode 91 we dove into that a little bit more, and hopefully what that will look like in the very near future. All right, so that's laws breaking down idea a little bit, and then comparing that to Essa both are national laws that kind of guide what we can do as school based occupational therapy practitioners here in the United States of America. And that brings us to our final letter for today. We're keeping this episode pretty sure. Short, right around the 15, maybe 20 minutes by time we finished, and letter M is for mindfulness. Yes, mindfulness. And again, we had a recent episode about this, right? Episode 92 with Dr Deirdre as a party. I was I'm always afraid I'm gonna say someone's name wrong, but I got that one right. I know I did so mindfulness, right? This is something, again, that you can do within the classroom or in a pull out setting. You can talk to your teachers and say, hey, you know what? I hear you telling me that you're having a lot of behavioral concerns within your classroom. You're having a lot of students just overreacting a lot. Well, you know what? Do you think it would help if I brought in a mindfulness program into your classroom. We can do this one time a week, maybe even start just every other week, just to see if it'll work. And I'd love to bring that in and support your students. You'd be surprised. What happens when you do that, and then 10 weeks down the road, how many other teachers you have saying, hey, you know you went into Mrs. Jones class, and did this mindfulness program? Do you think you could come over and do it in my program too, or in my classroom too? You will be surprised. It's amazing what happens when we start with that one classroom, whether it be handwriting mindfulness, whatever type of program you want to do, you can make game changers with starting with one teacher. Now, why mindfulness? Like I said, maybe you are talking to the teachers, and they're saying that my students are just out of control. To share. You know, they're so fatigued from all the zoom that when they came back to the classroom, they are just overwhelmed, and Things are hectic, they're crazy, and I need help. Well, that might be your key in and say, hey, you know what? I can provide some mindfulness activities within the classroom, and then look that up, go take a class on mindfulness, find out what you want to learn so that you can support your students within the classrooms on your school, remember your caseload is not your students. You are directly responsible for providing IEP services for those students, but every student on campus is your student, just like every student also is the first grade teacher. Student. The first grade teacher doesn't go out onto the playground and only watch her kids, right? The first grade teacher goes out onto the playground and watches all the kids. And the same thing applies to us as school based occupational therapists or practitioners. OTs, right. We are not there just for our caseload. We are there for the entire school. All right, so that is our seven letters for today. We had G, H, I, J, K, L, N, M, guardians, handwriting in services, jungle gym, kindergarten, laws, particularly idea and Essa and M for mindfulness. So thank you so much for sticking around with me on this ABCs of school based OT, ot month special episode of the OT school house podcast. This has been episode 97 and I really appreciate you being here today. If you want to see all the letters, or at least all the ones that we've done so far on the website. You can head on over to OT schoolhouse.com , forward slash episode 97 when you do that, you're going to see all four episodes. Well, at least once, all four are published right now, that you'll only see two if you go there right now, but if you're listening a little bit later, all four episodes will be published, and the entire ABCs of school based ot will be there, so you can see every letter and how it kind of relates to school based occupational therapy. So I hope to see you over at ot  schoolhouse.com , forward slash episode 97 and yeah until episode 98 I will have a great week, and I hope you will as well. So take care, and I'll see you next time. Bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to OTs schoolhouse.com . Until next time class is dismissed Expand to view the full episode 98 transcript. Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host Jayson Davies, class is officially in session.    Jayson Davies     Hello, everyone. And welcome to episode 98 of the OT school house podcast. Thank you so much for being here today. We actually have a very special guest. However, he may be a little quiet here with me today. This is the first episode that I am recording as a new dad and joining me right now within my Moby, which is a wrap. If you're a parent, you probably know what that is. Is my son, Kyler Kiyoshi Davies, this is the very first episode that I am recording as a father. Now, all the other episodes that you've heard leading up to today were actually recorded previously, before he was born. However, now he is about three weeks old as I am recording this, and yeah, I'm excited to do this. He is here. He may make a peep or a few cooing or crying noises, so you may hear that throughout this episode, but I'm excited to have him here with us. I'm excited to share Him with all of you, and I'm sure you will be a part of his journey growing up a little bit through social media and through this podcast. It's gonna give me a whole new topic to talk about a little bit over, over the air, over the podcast. So I'm excited for that. But today we are here to continue our ABCs of school based OT, or ABCs of OT for ot month in April. So this is the third installment of our ABCs of OT, and we are covering letters n through letter T today. So N, O, P, Q, R, S and T, we have seven letters to get through today. So before we get into letter N, I just want to give a quick reminder to everyone that the OT school house back to school. Conference is going to be happening in August, August, 26 and 27th that's a Friday and a Saturday. And right now you can get registered for this event at a special ot month discount. During the month of April, you can head on over to OT schoolhouse.com/conference to learn more about that. We are going to have six presenters, including myself, talking all about school based OT and how to improve and enhance collaborative practices within school based ot to support student success. We're going to be talking a little bit about sensory a little bit about visual impairments and visual processing and ocular motor skills. We're going to be talking about building and collaborative ot toolbox, and I will be helping to talk about how to make the shift to a more collaborative model within your practice. So if you want to join us for the OT school house, back to school conference in August, be sure to check it out at ot schoolhouse.com . Forward slash conference. Hope to see you in August. All right, so let's go ahead and kick off the second half of the alphabet with the ABCs of OT, and more specifically, what I like to say the ABCs of school based OT. Because, of course, that's what we're talking about here at the OT school house. So letter N for letter N, I have decided to use the word notes all of us as occupational therapists or occupational therapy practitioners, we have to write notes about our treatments. However, when it comes to writing notes in the school based setting, it's a little bit different I have found from other settings where you are billing directly to the insurance for a particular client, patient, whatever you want to call them. So in the schools, we don't, typically, you know, we don't get insurance information from every kid that we that we see. Sometimes we do collect Medi Cal or Medicare information if it's available, but no student is required to have insurance in order to to get the services that they require for school based occupational therapy. Therefore, our notes are really more for our self. Now that doesn't make them any less important or any less meaningful than if we were submitting them to the insurance to get reimbursed for that most districts do actually submit for reimbursement to, again, Medicare. In California, we call that medical so that's why you hear me say Medi Cal Of course, in California, we have to do things a little bit differently anyways. But back to the notes in school based occupational therapy, our notes are primarily for us. They're kind of a way to cya cover your own behind, you know, to make sure that if someone were to come back and say, Hey, you didn't see my kid this many times for the 2021, school year, whatever, you could go back to your notes and say, Look, yes, I did. This is what I did with your student. I have it documented, and it's all here. It's. Also your way to keep track of those progress on goals for you to write into your notes once a month, or however often you need to put in there the student met the goal in one out of two opportunities during this session, or whatever it might be, you have those specific notes for you, and oftentimes, I found no one ever sees my notes. The only time anyone ever sees my notes is when a particular student's case goes to trial or parents request all the documents for that student. Sometimes the notes will go with that. But other than that, our notes are really for us. Oftentimes, if a district does have us do billing, it's in a different platform. Some districts have gotten to the point where they kind of combine those platforms where you write your notes and bill on the same online platform. But that's not the case everywhere, and even then, most of the time, those notes aren't getting read by anyone. It's more than just the fact that we put those in there that they are getting billed. So when it comes to notes, a little bit about what we should be documenting, I do still use mostly a traditional soap note, right? You have the subjective, the objective, the action and the plan. I kind of go with that for the most part. I might adjust it a little bit, but I like doing that, because you get a little bit of each part right. You get to document how the patient, or in this case, our student, was feeling that day, maybe what you saw about that student, maybe what the student said. Then you talk about what you objectively observed with the student, and maybe you are putting into that objective, the data. What data did you collect? From there with your action, what did you do that was therapeutic? And then what is your plan for the next session? Or moving forward, I find that the plan that P is often left out, and unfortunately, when we leave that P out, it makes our job more difficult, because if we don't plan now for the next session, and it doesn't need to be a all full out plan like this is exactly what I'm going to do, but just a little bit of an idea of all right, I saw this this week. What's the next step that way? Next week on Wednesday, when your sessions on Thursday, Wednesday night, you're like, What am I doing tomorrow? You can really quickly look at that your soap note from the last week and kind of get an idea for what you need to work on the next day. So that's going to cover notes. I actually went on a little bit longer than I expected to on notes, but I'm glad I did, because that is something that we all have to do. And you know, it's, it's something that it's mostly for us. But also, like I mentioned earlier, cya, do your notes. Don't fall behind. And also make sure that you schedule your notes on your calendar time to do your notes. I mean, if you can't fit it in, in the last five minutes before the end of the session, or whatever might be, schedule time on your calendar, because it is part of your workload, and you need to have time to do those, otherwise you will fall behind. All right, so that covers notes and for letter o, we have observations. Now. If you have ever attended one of my evaluations, webinars that I do online occasionally, a few times a year, you know that I am big on observations, and for me, there's two different types of observations that are a part of every single evaluation. There are structured observations where we pull a student out and we are able to kind of control the environment. And then there are in classroom observations or in context observations where we are going to see the student in their natural setting. So observations are big for every single evaluation. We should not be doing an evaluation without at least one in context observation by getting into the classroom, getting into the cafeteria, recess, wherever it might be that we know that the student is having a little difficulty. We must see them wherever that that that struggle, that inability to access the environment, is happening. So that's observations. What I look for when I do my observations, like as I just mentioned, the context in context in the classroom, I'm really looking for the big picture. Is the student succeeding? What are they succeeding at? What are they not succeeding at, potentially in the classroom or wherever you might be doing your observation. And then in the more structured observations, where I'm able to pull that student out into my own ot room, or even out to an area that I can just control a little bit. Then I look more at the details. You know? I'm just going to use it the handwriting grip, right? I'm not going to go into a classroom to look at a child's handwriting grip. Or at least, that's not what I'm really looking for when I do my my classroom observation, I'm looking to see more of like, are they actually a. Able to get writing onto a paper, if that's the concern, right? But then once I get them out into my structured observation, that's my opportunity to break down that task a little bit more, to look at the the pencil grasp, or to look at, are they using both hands, one hand to support the paper, the other to write. That's where I get more into the details. All right. So one final point, when it comes to observations, I really like to do my in class observations before my pull out structured observations, especially when it is a initial ot evaluation for a student, and that's because I can do my in context, my in classroom observations while the student doesn't know who I am, doesn't recognize me, and hopefully won't try and, quote, unquote, show off for me. If I do those structured observations before I get into the classroom, then that student now knows me, and when I'm going into the classroom, you can kind of bet that they're gonna be looking be like, Oh, hey, you know, I worked with you yesterday in a pool out. Obviously you're in here to observe me. So let me show off a little bit, or even just, you know, it's almost like that flight or flight syndrome, right? You either get the kid that shows off or the kid that just, like does nothing. And so that's why I like to get my in classroom observation done first, before I move to my structured observation and talking about those push in observations, or classroom observations that leads perfectly to our letter P, which stands for push in model. Now the push in model may also be synonymous with collaboration, or collaborative model, which is kind of, you know, getting into the classroom, rather than focusing on always pulling a student out of the classroom into the OT room, or into the lunch room. Wherever you have your space, it may be a hallway at your school, but instead of doing that, instead of working with a student one on one, the push in model is about getting into the classroom to see what a student is doing in the classroom, and helping them be successful within that classroom. Now the push in model is different from observations. We were just talking about in letter O in class observations. For those, you might stand back right, you're gonna maybe stand by the door, walk around the classroom, but you're not interacting with the push in model of therapy services. You are interacting now you may be interacting with one student, you may be interacting with a group of students. You may be interacting kind of with one student as well as with the teacher, because they have such an important relationship, right that student to teacher relationship, maybe you're helping them both build a relationship and both understand each other to build upon successes that maybe you had in a pull out model. But either way, when you're going into the classroom, you're really there to actually do therapy, not observe. The push in model is actually a therapeutic model, as opposed to an observation, which takes place during an evaluation to see what is going on, where the student is right now. So one of the things that I really like to do with the push in model is first, I like to collaborate with the teacher on whatever the goal is that we're working on. I want to make sure that the time that I schedule on my calendar to get into that classroom every week, every other week, whenever it might be, is related to the goal that we have for the student. For instance, if that goal has to do with socialization, then I want to make sure I get in there during maybe a group time. If it has to do with handwriting, obviously I don't want to go in during math time. So you need to work with your teachers to find out when the best time is to go in. Now, when I go in, I'm not necessarily sitting right next to the student. Sometimes I'm actually doing more of a larger group collaboration with the teacher, where I'm helping co teach with the teacher, maybe a specific lesson. But other times I do go in there for one specific student, but even then, maybe I don't sit directly with that student, and I kind of maybe work within the group that that student is in. Of course, there are some times where I do go in and I do sit right next to that student, because that's what we need to do for that student. Now I'm not sitting there as an aide telling them exactly what to do and just hand over handing everything. No, that's not what I'm doing. I am finding the just right challenge for whatever they are working on as it pertains to the goal that we are working on. So it takes a little bit of use to to doing this type of model, because you have to find that sweet part, that sweet spot, I should say, between being a a nuisance to the teacher or a nuisance to the student. But you also don't want to be a aide. You are not a one on one aid for the student. You are there to help the student to meet their goals, right? You're not just there to give the student the answers. You are there to push the student forward, per se, all right, so that covers the. Push and model. And that is three of the four that we are covering today, N for notes, O for observations, P for push and model. Now this next one is a little outside the box. You know, Q is always a difficult letter to do when it comes to the ABCs of OT, or really the ABCs of anything. And I thought about this one a little bit, and I really like it, because sometimes, as occupational therapists, we get in a rut where we feel like every session has to be different. We have to do something different for the student this week that we did last week. It can't be the same activity, right? Well, wrong, and that's why letter Q I have quest, because I want to take our students on a quest a little bit I want to combine sessions together to to meet that overarching goal, and I have a great story to tell about this, because we had a student, and the primary goal for her was to get language written down on a paper, whether it be handwriting, typing, whatever it might Be, she had a lot of difficulty with organizing. Handwriting was very labored, very sloppy. We were moving toward a computer or even speech to text. But you know the last thing this student, who I don't think she was diagnosed, but probably really did, have ADHD, she could not sit in front of a computer and just like do typing practice right? That wasn't even an option, really, because it was just too boring for her, per se. So what did we do? We started a quest, and this quest for for a long period of time almost actually, is basically started right before the pandemic, and kind of took us through the entire time of the pandemic. Was to write a book, and we went through the entire process from planning the book to writing the book to illustrating the book. I mean, we spent a lot of time just developing an outline for the book and going through the organizational skills that it takes to develop an outline, and that is something that she's going to use for the rest of her life, right? I still use outlines when I'm creating these podcast episodes. YouTubers make outlines for their videos, right? Understanding how to make an outline and then going from there. What is the next step? What is the next step? How do we prevent ourselves from going from letter A to letter G, right? We need to go A, B, C, D, we got to go in order, and that is something that you can do within your therapy sessions. Maybe you do end up doing step one for an entire month, right? If you see a student once a week, you do step one on week one, you do step one on week two, and you're repeating, you're repeating, you're repeating the same things. That's okay. It's not practice. It is therapy. Well, I mean, it could be either, but for the most part, if you are leaving the student down a quest, there's a longer range goal, then that's okay. You are slowly moving through the process of meeting the student's goal. Don't feel like you have to have a whole new activity, a whole new craft, a whole new lesson plan for every single session that you meet with a single student, it's okay to spread things out a little bit and to make them longer. Lessons that that occur over time, that's perfectly fine. So quest queue for quest, take your students on a bit of a quest in order to meet their long term goals. And, of course, after letter Q comes letter R. And for letter R, if you have listened to this podcast more than a few times, you know, I am a big, a big advocate for RtI response to intervention, or as it's often called, RTI, two Response to Intervention and instruction. RtI is something that OTs have historically not been a big part of, but I think that we need to be more more part of RTI. Oftentimes, you'll hear of MTSS, which is multi tiered support services. Sorry, I was just trying to throw an L in there, but RTI, MTSS, they're often synonymous. But oftentimes you might hear an A or a B added after MTSS or RTI, they're they're basically the same thing, RTI and MTSS, but a and b referring to academic or behavior. But what about the other aspects of school, right? What about the actual functional activities that we so often work on as school based occupational therapists? Now we can support students, not just through the IEP process. In fact, IDEA says that we can actually work with students as a preventative model, and that's exactly what RTI is. We can go into a classroom, maybe support a teacher and CO lead a group on handwriting, or a Groupon typing or a Groupon organizational skills, something like that, and we could potentially help all 30 kids in that class. Room, rather than a single kid in that classroom. Now I'm a huge believer in RTI, and I really think that you should learn more about RTI. And if you would like to learn more about RTI, instead of going on a 3040, minute rant right here about RTI, I'm actually going to refer you back to episode number 42 I believe it was where I go in depth into the three tiers of RTI. So check out that episode, and, yeah, learn more about RTI. I really do see it as the future of occupational therapy in schools, and I really think that it'll help you out to know more about it. And now that brings us to our second to last letter for today, which is s, and for s, we are talking about screenings, not evaluations. Screenings, yeah, just screenings. That's it. Just just screenings. All right, sorry. Alan Iverson got to my head right now, practice, not a game. Practice. Now we're talking about screenings, and when it comes to screenings, screenings are very different from evaluations. And this is a hard one for many people, not just occupational therapists, but for people in education in general, to understand the difference between a screening and an evaluation. And it's very important to understand the difference between a screening and an evaluation, because A, they're different and B, if you do one in place of the other, it could get you in a little bit of a predict predicament. So yeah, you want to make sure that you, when you are doing an evaluation, you're actually doing an evaluation. And when you are doing a screening, you are doing a screening. Now the question that I often get is Jayson, do you do screenings? And my answer to this is twofold, because yes, I do screenings, but I do not do screenings of individual students. I do evaluations for individual students. I do screenings for entire classrooms or entire grade levels. Think about vision screenings. I'm using vision screenings because it's pretty consistent across the United States. I think that in certain grade levels, all students do a vision screening, right? Well, notice I just kind of said the definition in there, all students do the screening. They don't pick and choose a few students had a different classes, who the teacher thinks is having difficulty seeing the board, and only send those students to do the screening. No they screen all the kids in second grade or all the kids in kindergarten. That is the definition of screening, when every single student, or at least every single student within a classroom, is given the opportunity to do that quote, unquote test, if you want to call it that. Now, obviously that's different from an evaluation, because an evaluation is individualized. Now I'm not going to go into evaluations. We are in letter S, not letter E, so we are talking about screenings. So what might it look like then, if someone asked for a screening, so rather than screening an individual student to determine if that student needs an evaluation, I don't think that is what we should be doing, based upon how I have interpreted idea and Essa as well, but what I can do is help a teacher out by screening their entire classroom. If a teacher comes to me and says, Hey, I have this student named Johnny, I really want you to come take a look at him, I will gladly let them know the process for referring the student for an OT evaluation. But if they come to me and say, Hey, I have several students in my classroom, and they're struggling with this. Can you come and help me? I'd be happy to I'd be happy to come in observe or screen their classroom a little bit a screen could be an observation, or it could also potentially be getting a handwriting sample from all of their students, and kind of looking at all the handwriting samples, not too in depth, but just enough to get an idea for maybe what they need, a little support in and then I can meet up with that teacher at a later time and we can develop some ideas. Maybe I just give her or him some strategies, or maybe I end up co teaching with that teacher for a few lessons, whatever it might be. Now, the other thing that has come out of a screening. Say I do go into a classroom and I do see one student, or maybe even two students that I do feel like need a evaluation for occupational therapy or even something else, speech or just a psycho educational evaluation, then I do have the right, and actually I have the responsibility, to speak up and to help that teacher go through the process of potentially referring that student. Of course, I'm going to follow whatever the guidelines are for the district or the school that I'm working in, but that is the case again. That is different from the teacher saying, hey, I want you to come in and see Johnny. That was not the intent. I went in there. To see her entire classroom. I happened to find Johnny or said student while I was in the classroom, and then I helped the teacher go through the evaluation, or not the evaluation, but the referral process with or for Johnny, I should say so. Letter S screenings, to kind of keep it short for you to recap everything, the way that I like to say it is, screenings are for classrooms or even grade levels. Evaluations are for individual students. I think that's a pretty good way to kind of remember it. You know, one is for classrooms and grade levels or even an entire school, potentially, although it's hard to get to that level of a screening, and then evaluations are for individual students. And that brings us to our final letter for today, which is a fun one, or at least, I hope it is fun for you. It is team meetings, but we all need to have them. I shouldn't say, I was about to say we all have team meetings, but I know that's not the case. Some of us work in very small districts, and we don't have the opportunity to have team meetings. And when I say team meetings, I'm talking about those ot meetings, or maybe even a related service meeting where you meet with the other related service providers, like the speech therapist and the PTS, or maybe even the school psychologist. You know, we should all have some sort of of team meeting. And now, with the ability with everyone understanding how to use Zoom, team meetings should be a must, even if they're not in person, we should all be meeting with other OTs. Now, if you are in a small district where maybe you're the only OT, I would encourage you to reach out to the surrounding OTs in other districts, other counties, other co ops, other selpas, depending on what your county departments are called, and county of education departments in different states, they're all called something different. But reach out to other OTs and say, hey, you know what? What are you doing? Maybe one Friday afternoon, a month, or every other month even. Let's get together. Let's talk about some evaluations. Let's talk about research. Let's talk about the evidence. Let's talk about the struggles and the wins that we are having. We should all be capable of having team meetings. And yeah, you know, I know not everyone has them, because they are difficult to get together, and we are all so spread thin with our case loads and our workloads, but it is important to have those team meetings, because too often as occupational therapy practitioners, especially, we are left in our three, 510, Schools, and we may not see another occupational therapist for weeks or even month at a time, and by doing that, we don't have the ability to really grow to see what others are doing. So I would encourage you to talk to your administrators if you need to, and set that up. Ask them, Hey, can I meet with an OT from another district event? Or if even not with the OTs, can I meet with the PT or this speech therapist? Can we have a meeting together just to get on the same page of what's going on? And maybe that leads to more collaboration. Maybe that leads to more push in models. Maybe you decide to listen to an episode of the OT school house together and go over a specific piece of evidence, whatever it might be we all need to have team meetings. All right, so that's going to wrap things up today. Man, I'm still stuck in that team meeting. I have had big ideas about this, because I know many of you don't have the ability to have team meetings. I've thought about having an OT School House team meeting, where we kind of have open hours where people can come in, and maybe we have a set topic that we're going to talk about. I'm really excited for doing that, maybe in the future here, but yeah, sorry. It just got me it got me going. It got me thinking, something that I really want to do. Because, again, I really feel like we all need to be part of a professional learning community. You might hear the term PLC at your school. We all deserve to be a part of a learning community together. So that was letters, n through T. A quick recap. We had n for notes, O for observations, P for the push in model Q for taking your students on a quest to combine some sessions together to to cover a larger overarching goal we had R for RTI, S for screenings, as opposed to evaluations, and, of course, T for team meeting. Thank you so much for taking a listen to episode 89 of the OT school house podcast. Be sure to check out the show notes using the link in your player, your podcast player to check out the other two or three, other three episodes. Actually, if you're listening to this a little bit later, where we covered all 26 letters of the alphabet. Next week, when the next episode comes out, we will be talking about letters U through a letter Z. There's only. Six of them left, so we're going to knock those out of the park, and you can learn about every single letter by heading on over to OT schoolhouse.com . Forward slash ABC. We'll have all 26 letters there for you, and all four podcast episodes that you can listen to to hear all the ABCs of school based OT. Until then, I will see you later. Yeah, it's gonna be fun. We're gonna close out the ABCs of school based ot in Episode 99 and then a very special episode coming in, episode 100 take care. Have a great rest of your ot month, and I'll see you next time. Bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.  Expand to view the full episode 99 transcript. Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host. Jayson Davies class is officially in session.    Jayson Davies     Hello, everyone. And welcome back to Episode 99 of the OT school house podcast. I can't believe we have made it to Episode 99 and even better, Episode 99 correlates with ot month. And as you know, you've been listening to the last few episodes, we are diving into the ABCs of school based OT, and this is the final episode in our four episode series where we're going through all the letters of the alphabet and putting terms, putting words, putting phrases to each letter of the alphabet. In episode 96 we actually went through letters A through F. In episode 97 we went through letters G through M. In episode 98 the last episode. Last week, we went through letters n through t, and this week, we are finishing off the alphabet with letters U through Z, so u, v, w, x, y and z, we're gonna wrap up the ABCs of school based ot this week and then next month, which is moving out of OT month in to wow, it's already going to be May. I cannot believe that moving into May. It's even crazy to say that, because of the final month of the school year, it is that final home stretch, right? Well, in May, we are going to have a celebratory episode 100 of the OT school house podcast. I can't wait for that. It's a very special episode, and I'm bringing on someone to help me out with that. And yeah, you don't want to miss that that's going to be in two weeks from now. So I hope to see you there before we dive in two letters U through Z. Just one final reminder that the back to school conference that is coming up in August, is $50 off right now during ot month, and we are going to have six speakers talking all about how to collaborate more efficiently, more effectively in school based occupational therapy at this virtual, online conference, it's going to be live, but if you can't attend live, you will also have the ability to get access to the replays, and when you sign up quickly, you can also get a very special swag pack full of goodies for school based occupational therapists. We're going to be sending that out in August, just before the conference gets started. Now, during ot month, the month of April, you can save $50 on the back to school conference when you register early, and you can do that at ot schoolhouse.com/conference , you can learn all about the conference, everything you need to know, and also save $50 when you register this month. If you can't register this month, that's okay. The registration will continue to be open until August, but right now is your best opportunity to register at the lowest possible price. So I hope to see you in August. It's going to be a blast. We're going to kick off the school year the 2022 2023 school year with a blast at the back to school conference. And I hope to see you there. All right, so let's go ahead and dive into our first letter for today. We are kicking it off with letter U, and for letter U, I've got universal design here every ot that graduates from ot school. Now, you know, we can't get through an OT program without learning about universal design. And if you've been in the schools for, I don't know, maybe a year, maybe a few years, you might have heard the term UDL or universal design for learning that can add that for learning within the educational realm. They add that in there. So universal design is all about making the environment friendly for everyone, not just most people, right? And so one of the the best stories that I have to share about universal design has to do with something so simple, like it's something that most people don't even think about because it's so simple, and it has to do with seating right. When we walk into a classroom, whether it's a kindergarten classroom or a high school classroom, we have to remember that people come in different sizes, different shapes, different heights, different everything, right? Everyone's a little bit different. And one of the things that we forget, well, OTs, we kind of remember it a little bit more, I think, because we are so adaptive in nature. But a lot of educators need support and making sure that their classrooms are fit for all and not just the average student. And so I've walked into many classes, but I'm going to talk about one particular time that I walked into a kindergarten classroom and I'm looking around the classroom. This teacher has told me that she has some concerns with her students being very fidgety, and so I wanted to help her out, right? So I went into the classroom and I'm just. Watching, you know, just taking it all in. Why might these students be fidgeting? First of all, they're kindergarteners, right? All kindergarteners are fidgety. But I started to look under the desks a little bit. I started to notice that kids weren't sitting, but they weren't standing. They're doing that half sit where, like they have one knee on the chair, but the other foot is like standing straight up right one foot is they're standing up, but also sitting down at the same time. And I'm like, All right, what's going on here? Why? Why are we half standing, half sitting? And then I look over to another kid, and I see a kid who is tilting her chair onto the two front legs, and she's doing that so that her feet can sit on the ground. I look over at another table, and I see another student basically trying as hard as he can to move the chair a little bit over to the left without moving it too far so that his feet can rest on the leg of the table. Because what I notice is he can't reach the ground with his feet to support himself. So universal design. This is an example of an environmental change, right? So what did I say to the teacher? We need to look at the chairs that you have and the desks that you have. It seems that your chairs are too big. Well, if we get smaller chairs, then it's very likely that our tables are going to be too big. So you can't just change one factor. You have to change a multitude of factors. So I worked with the teacher, I worked with the custodian, and we figured out a way to lower some tables and lower, sorry, not lower, but change out some chairs for smaller chairs. But we didn't do that at all of the tables because there were also some students who everything was fit correctly for. So we had a multitude of different sizes of chairs that fit with the table that it should be because smaller chairs, smaller tables and bigger chairs, higher tables to fit for the students that were a little bit maybe they were older, maybe they weren't, but they were a little bit taller, and so that worked for them. So that's a little story, a little just something to think about when it comes to universal design. Now, just really briefly, as I mentioned earlier, in education, they add on for learning at the end of it. So it's Universal Design for Learning or UDL. Now it's very similar. It's just that when it comes to or learning, we're often talking about the actual curriculum. And as an occupational therapist, you can support with this too. You know, we think about, here's an example. We think about students who we give them a worksheet, and they struggle to fit their words into whatever boxes they're supposed to fit their words into, right? Well, as a universal design for learning tool, maybe you suggest to the teacher, hey, the next time, before you run off 30 copies of a worksheet, maybe just try adding some lines in those boxes. Or maybe letting your students know that if they can't fit their words into the boxes, then they can use a separate piece of paper, and they can just write like the number one inside the box on the worksheet, and then write number one on the line paper and put their responses there and that way when they turn in their sheet of paper, rather than it being four boxes squished with so much writing. Now it's a box that doesn't have really any writing in it, but it correlates to the writing that's on the line, paper that they know how to use better. So that's universal design, universal design for learning. You might hear it that way as well. And yeah, I hope you enjoy that little story, and I hope that helps you to think about what you can do to support a teacher, very simply, when you walk into their classroom and just notice a little bit about the environment, or just when they tell you, you know, I have a struggle. I have some concerns about my class. You know, there's more than having to evaluate a student. You can go in and provide general strategies for the teacher. All right, so wrapping up with letter U and moving to letter V, this brings us to a little bit of a controversial topic in occupational therapy and even in really special education in general, and that is the term vest, as in weighted vest, or maybe compression vest. Now when it comes to vest, I will admit it was one of my go to strategies when I was a newer occupational therapist, back in 2012 2014 and actually, if you look at the research from back in 2012 2014 there is some research that kind of said, You know what weighted vest might actually work to primarily help students with ADHD. That's what the research was really revolving around. ADHD. Now, those studies were very small, and since then, more research has kind of come out that flips the other way around and says, You know what, there isn't really a significant change in a student's outcomes when wearing a weighted vest or a compression vest. And so it just it. Just an interesting topic, because I have heard so many stories from individual parents, from individual therapists that just say how much great changes they've seen in their student when they wear a vest. But the research on the flip side has now kind of said, You know what, there's no really significant change, which then leads me to the terminology EBP, evidence based practice and a reminder to everyone out there that while evidence based practice, we do need to look at again the evidence right? It's in the name the research, the evidence behind different interventions. Evidence Based Practice also takes into account the evidence that we create as a therapist with the clients that we work with. And so while a research article out there may say, You know what, there was no significant change with a child with ADHD wearing a weighted vest, well, just because there wasn't a significant change for those 13 kids that they did the research study for doesn't necessarily mean that we shouldn't try it out with one of our students, because maybe it will work for one of our students. Every single student is different. What works for one student may or may not work for another student, right? So if there are limited or no contraindications for using something, such as a weighted vest, then it's okay to try it, but make sure you take data to determine if it's actually working. The worst thing you can do, I shouldn't say the worst thing, but what you shouldn't do is hand out a weighted vest to a teacher. Say, Hey, use this with whichever kids you want. And, yeah, just have it as at your disposal to use it with anyone or even here's a way to vest for Johnny. Take care. I'll see you in a year, and we'll see how it's going. It's going. No, we need to be very specific and saying, Here's a weighted vest for Johnny. Now, it may or may not work, and we need to track to see if it will work. And so for the first three weeks, we need to take data every time that he wears the vest. And you know what? We're going to start off with short increments of time, only 10 minutes of wearing and then maybe 30 minutes off. There hasn't been a very structured on off schedule for weighted vest. They don't kind of have a protocol for that. So you can kind of play around with that. But you want to make sure that you are taking data to determine whether or not it is actually working. If it's working, awesome, you can adjust to maybe see if you can get to work a little bit better in whatever you're trying to measure. But if the data is showing that it's not working, or maybe even things are getting worse, then switch it out. Try something else. You are creating evidence every time you take data, when you're using an intervention with fidelity, if you're not using an intervention with fidelity, if you're not actually measuring the intervention that you're putting into place, or noting down how you're implementing that intervention, then the data doesn't really show what you're doing, because maybe you're wearing the vest for 10 minutes today, 15 minutes tomorrow, and whatever. So you need to have a consistent intervention and a consistent way to measure that intervention, all right, so that's what I'm going to share for weighted vest or compression vest. Both of them work similarly. I will just kind of note in the past, I have leaned more toward the compression vest. I've seen a little bit more influence on the student, positive influence on the student when we use a compression vest versus a weighted vest, but that's just my personal experience. I am not referencing an article that says anything about that. Oh, right. That brings me to one of my favorite terms to talk about, and that is workload. And before we jump into workload, I need to take a nice big breath, because, you know, sometimes I just get going, and to be honest, I forget to breathe while talking. But that is part of my excitement. That's part of my joy of being a school based occupational therapist and also having the ability to share with you on the OT school house podcast. I really appreciate you being here listening to this episode right now. And yeah, I'm just excited to work with you. So real quick everyone deep breath in and deep breath out. All right, so work load. I love this topic because I believe that every school based ot needs to move from a caseload model to a workload model. And here's a little bit about my reasoning. A caseload model strictly looks at the number of students that we are responsible for on our spreadsheet, on our PDF, that tells us what kids we have to see, however many times we have to see them in a given week, month or year, the average caseload, I believe the last article that I looked at, was around 55 however, I have talked to therapist. And even in that article from ceru and Garfinkel, they found that therapists have caseloads anywhere from like 30 up to like 150 it ranges wildly. However, the average is about 55 now this is why caseload is not a good amount. Measure of the students that we are responsible for. Because bear with me here. It's going to take just a little bit of explaining, but if you have a caseload of we're going to use a round number, 50 kids, and each of those 50 kids has 30 minutes a week. That's 25 hours a week of services. Now say that same caseload of 50 only has 30 minutes every other week of therapy services, so the same amount of kids, so the caseload is the same. However, their workload is different. So if they only have 30 minutes every other week, then instead of 25 hours a week of service, you really only have 12 and a half hours a week of service. So there could be two OTs in the same district schools that are just a few blocks apart, and they could have the same caseload, but one caseload is 25 hours a week of therapy services, and the other is 12 and a half hours of therapy services in a given week. That's a drastic difference, right? And so we don't want that to be the case, and that's where workload comes into play, because a workload doesn't just take into account the number of students that you have on your spreadsheet. It takes into account all the time that those students require, as well as all the time that maybe your classrooms require for doing some RTI in the classroom, or maybe for doing evaluations right? A lot of us get a lot of evaluations. We need maybe three hours a week or so to do evaluations IEP time. Sometimes those happen after school, but sometimes those team meetings occur during the school day, and those eat up into our therapy time, so we need to be tracking our workload, not just our caseload. Now, just a shameless pitch here. I do have a course about moving from a caseload to a workload model. It's called making the shift caseload to workload, and you can learn more about that at ot schoolhouse.com/make , the shift. But yeah, I just love talking about caseload to workload because I think we all need to advocate a little bit more for ourselves. We all need to share with our administrators exactly how we are impacted by our high caseloads and what it would look like if we moved to a workload model. And that's exactly what I share in that course, and I share step by step how to make the shift from a caseload model to a workload model, including how to work with your administrators so that they understand why and how you're doing that and the long term benefits, not only for the OT but also for the school district as a whole. So again, you can learn more about that@otschoolhouse.com forward slash, make the shift if you're interested in shifting to a workload model. So that's letter W. I hope over the course of your career, you all are able to move to a workload model at some point or another. All right, letter x is always a hard letter to find something, and so I am cheating here just a little bit. I'm not going with like xylophone or something, because that doesn't really relate to OT. So I'm going with instead executive functioning. We are highlighting the second letter in executive the X. And executive functioning is such an important skill for any student to benefit from school. There is so much talk about kids not having EF right, executive functioning, short and EF skills these days, and I really like to associate this with free play. I wish I had more research behind me to back this up. I just haven't looked at the research. My guess is I could find it, but I just haven't taken the time to do that yet. And I really think that free play builds executive functioning skills. I think that our frontal lobe really does develop when we have the opportunity to play. Get bored, figure out more play. Get bored again and figure out how to play over and over and over again these days. So much of what kids are doing is very directed, whether it be a video game with a storyline or a YouTube video, or even tick tock that just automatically shows you the next video. You don't even have to look for. You don't even have to think about what you want to look for. It. The computers are just telling us what we want to look for, and unfortunately for us, in a way, they're correct. And then even with sports and whatnot, right? Not just because they're getting into games, but also when you get into sports, sorry, not just video games, but physical activity. Sports are very structured. There's a very set routine to sports. It's different from free play. I remember going over to my buddy's house, and right, we'd like, build like sand balls, and we'd fortify them with water and more sand. And then, you know, we do that for an hour, and we get bored, and then we'd have to think, all right, what do we want to do next? So then what would we do? We'd find, like, army men or something, and we'd bring those, and we'd incorporate them into the sand balls that we throw at them. And then we get bored with that, and then we'd find something else to build upon. And I really do think that that is part of the executive functioning skills that. We built as younger children, that kids aren't necessarily getting today, and it's not because they're not playing. They are playing. Kids are still playing right? They're playing video games, they're playing sports. They're playing even at recess, although recess has gotten shorter, but we're not seeing them use their skills when boredom comes into play, because they're never given that opportunity to be bored. We're constantly giving kids something to do, and they don't have that ability to build up the initiation and the planning phases of new unstructured play. So that's what I'm going to talk about, executive functioning. This is definitely an area that I want to learn more about. And at the back to school conference last year, we were very fortunate to learn a little bit about executive functioning from the pocket OT. That's Kara Kosinski. You can learn more about Kara, and she actually has a new course on executive functioning at the pocket ot.com I will be sure to link to that in the show notes at ot schoolhouse.com , forward slash, Episode 99 so that is letter X, executive functioning. And, yeah, you know now that I'm thinking about it in the last episode, Episode 98 for the letter Q, I talked about quest and helping our students go through a quest over multiple sessions of a ot therapy treatment, right? Not just this week, but the next week and the week after. And I think that going on that quest, leading our students on a quest where we're giving them options, that is one way that we can support students executive functioning. All right, we're down to our final two letters in the ABCs of school based OT, and that brings us to y, and for the letter Y, I'm going with things that happen yearly, so things in school based OT, or in education in general, that happen every single year that we can count on just as much As we can count on that annoying surge and evaluation referrals that come after every winter break. It happens to OTs all I know it happens to me. I get messages all the time in January, early February, saying, Where did all these referrals come from? And so I know about it, but there's a few other things that happen yearly, and one of those is our annual IEP for a student. This does happen every single year. Every student must have at least one IEP if there are a student in special education. And so at these annual IEPs, we have to remember that we look at the previous year's goals, we measure those goals, and then we develop new goals as well as present levels, so that we can eventually lead to services. Back in episode 96 for letter D, our letter for letter D or our word phrase for letter D, was determining services. But we can't determine services unless we have goals in place. The present levels of the student lead to goals, lead to new goals, I should say, and those new goals lead to the new services. So without developing where the student is presently, and developing our new goals, we don't know what the services should be. So based upon those new goals, if you have two goals, three goals, four goals. Maybe you have collaborative goals where you don't really have your own goal, but you're collaborating on a goal that still should help you guide your decision making for Determining Services. Some of the other things that happen on a yearly basis in the schools that I like to actually kind of take advantage of is the back to school night, which happens, you know, in August, September, sometime around the beginning of the school year, and also open house. As a school based occupational therapist, you're often not expected to attend these events, or you're just not invited, but I would definitely check in with your administrator and ask them, Hey, I would love to attend and maybe even support teachers or leave my own session for parents who are either receiving occupational therapy services or maybe they're receiving RTI support and see what your administrator says. I had the opportunity one time to speak at a it wasn't a back to school night, but it was like a parent learning night. The theme of the parent learning that was all about play and the importance of play for our students and how to incorporate play into learning. And as an occupational therapist, I was actually invited to talk about the importance of play. And so it was so awesome, because I get to stand up, not for too long, you know, 10 minutes or so, and just share with parents why play is so important. And it kind of was similar to the spiel that I just gave about executive functioning, we really need to make sure that our students are playing and you can do that by sharing with parents at an event such as back to school night or the end of the year open house, which might be coming up fairly soon for some of you all. All right, so that is yearly, and another thing that is yearly. Is the end of the school year, which is coming up. So congratulations, everyone. We are almost there. You're almost to that end of the school year, maybe four to six weeks or so from now, and you might get a summer break, or you might be heading into extended school year, but yeah, hopefully you're getting a little bit of a break. And that now brings us to letter Z and and, you know, I must admit, I had a little bit of a struggle coming up with the letter Z terminology. I didn't want to use the zones of regulation. I just feel like we all are very familiar with the zones now. So I went ahead and I'm using zigzag lines, such as when you are trying to teach a student how to either draw zigzag lines or maybe cut out zigzag lines right those jagged lines, it is something both drawing them and cutting them out that typical developing children will typically develop that skill right around the age of five years old, and so a lot of kindergarten teachers are kind of expecting students to have that skill in place when they arrive for kindergarten. Unfortunately, as you and I know as As occupational therapists in the schools, that isn't always the case. So there are a few things that we can do with students, and there's also some things that we can let our teachers know that they can do to support these students who just haven't quite mastered that skill yet. So I'm just going to share a few things that I like to do to support our students in mastering that ability to either draw and or cut out zig zag lines, which, of course, this applies to most other pre writing shapes, pre writing lines, maybe even some letters. You can use this strategy for all those but I just want to share a few ideas of what you can use. My go to favorite all time activity for working on cutting and drawing pre writing shapes, including zigzag lines, has to be using stickers. Some kids love to cut the stickers. Other kids love to avoid the stickers. And this goes for both writing and cutting. And so if you're going to do zigzag lines, you can either put stickers on the line and say, Hey, let's aim for the stickers right? And they cut right through the middle of the stickers. Other kids, they don't want to cut the stickers. And so I'll put the stickers around the line, but I'll kind of put them in places where if they make a mistake, they might get that scissor, so they have to be extra careful. And so yes, it is a little bit of a behavioral strategy, but it's a fun it's a fun game for them. And so I put the stickers around the lines, as opposed to on the line, because they don't want to cut the sticker. So that's one idea. Feel free to use that as much as you'd like. Another idea for cutting specifically is that you get a long sheet of paper, and you tape one side of that paper to the desk, and the other side of the paper is just hanging off, and it has a zigzag line drawn on that paper, so it's just hanging off the table. And so assuming they are right handed, which I know not all are, but I'm just going to use that for this example, they have to grab the paper and hold it up with the left hand so it's not hanging off the desk, and then they use the right hand to then cut. You can include the stickers or not include the stickers, but this really helps with the bilateral hand skills. A lot of times, kids, if the paper is just sitting on the desk, they won't use that second hand to support. But if we have that paper hanging or even just take away the table in general, it does prompt the student to use that second hand. Play Doh is also a fun idea when it comes to cutting. Play Doh tends to cut. If you have a real Play Doh, it tends to cut pretty easily, and it's kind of nice. So feel free to do that if you're really working on fine motor skills and the actual action of using scissors, then you can play around with the thickness of the paper. That can help as well. So those are some of my go tos for zigzag lines. Also a fun one is using DRAW by the letter or draw by the number, right? You know you connect letters, A, B, C, D, E, F, G, all with a line. That's another fun one. You can also do with numbers, right? 123456, and eventually it creates an elephant, or whatever. You can create your own zigzag line, type of draw by the numbers, and you can make sure it incorporates some zigzags, because a lot of those don't right. It's more like circles and squares. And then also, for a little bit more advanced, is imitation drawing. I love bringing up a YouTube video where they are teaching how to draw, and then we pause it. We watch the video. We watch what they do first, and then we pause the video, and both myself and the kid take a turn at drawing what we just saw. And if you have a drawing with zigzag lines in it, of course you're going to be working on zigzag lines. So those are a few ideas that I have, using stickers, using paper that just hangs off a table. Play Doh drawing by the numbers, or drawing by the letters, and also imitation drawing where you are watching a COVID. Someone, or even you, you can actually do the drawing. If you're good at drawing, by all means, go for it. I'm not good at drawing, so I bring up a YouTube video, but you draw one step, the child draws one step. That works for not only zigzag lines, but just about any other zigzags or any other pre writing lines and shapes. And also, it can be a little bit of an executive functioning activity as well. So there you go. That is letter Z, zig zag lines. So we have done letters A through Z. Next time. Won't you please sing with me? And yeah, we are wrapping up the ABCs of school based OT. Today we did cover letters u, v, w, x, y and z. We had Universal Design vest, as in weighted vest, workload, executive functioning, yearly things that happen yearly, and zig zag lines, cutting and writing them out. So thank you so much for sticking with me through all the letters of the alphabet. This has been the first time we produced four episodes in a single month, and it has been absolutely amazing. It's been rewarding, and I appreciate you for for listening along. I hope this brought value to you. I really do, because that's why we're here. The last thing I want to do is, Have you listened to an episode and you feel like you learned nothing that is obviously not the intentions here. I hope everything here helps you. I hope you go back to work tomorrow or after the weekend, whenever it might be, and you implement something that you learned right here on the OT school house podcast until next time, episode 100 is going to be fantastic. I hope you have a great week. I hope you have a great weekend. Hope you have a great morning, afternoon workout, whatever you're doing right now. And yeah, I will see you in episode 100 of the OT school house podcast. Don't forget to head on over to OT schoolhouse.com forward slash conference to learn more about the back to school conference. And yeah, hope to see you in episode 100 and at the back to school conference. Take care, talk to you later. Bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com . Until next time class is dismissed Click on the files below to download the transcripts to your device. Thanks for listening to the OT Schoolhouse Podcast! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 50 of the OT Schoolhouse Podcast. In this episode, Jayson hosts fellow occupational therapist, Amanda Clark, to talk about the differences between a contract school-based job and a district school-based job. After we identify the differences, we talk about how to land your first, or perhaps your fourth School-based Occupational Therapy job. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: ​​ TYPES OF OT JOBS Most common District, Contract, County/SELPA (California Special Education Local Plan Areas) as they are called in California Contract Jobs Working for a private company that contracts with a school district - working for someone who is getting paid to have you work at a district Pros Mentorship opportunities Salary and benefit negotiations are more common Travel options More job opportunities over a larger distance if you are willing to move More autonomy COTA jobs are few and far between district jobs, but contract companies often hire assistants. May be opportunities to move up in the company beyond being a school OT Cons May feel out of the loop with the district employees or changes in policy Benefits may not be as good as in a district. May work in varied districts/locations (could be a pro) Access to supplies, equipment, buildings, and even a space to work can be a challenge. Hourly or PRN positions are very common in contract positions. Unless your district is a staggered year-round model, you will make less or even no money during the summer months. Your caseload is more likely to fluctuate as a contractor. Maternity coverage is a common reason districts hire contractors. District/County jobs Working directly for the county education dept. Or a specific district. Pros Salary vs. hourly Benefits tend to be good May have more opportunities to collaborate and provide trainings Cons Limited opportunities to “move up” due to not having a credential Limited school budgets WHERE TO FIND A JOB Edjoin.org EdJoin is a national portal, but most postings are in California Go to the district websites you wish to work for Linkedin Talk to friends and colleagues. Referral bonus ​ NECESSARY DOCUMENTS Resume 2-3 current letters of recommendation Letter of intent OT License and Registration Drivers license and Proof of insurance Copy of your driving record CPR Certification Recent TB test Transcripts PREPARING FOR THE INTERVIEW Research the district a little bit Practice answering possible interview questions What is the OT's role in an IEP? What is an IEP? What is IDEA and ADA? Understand what FAPE means How might you collaborate with teachers to support students? Understand best practices in regards to the delivery of service: collaborative, consultation, and direct and when each is or is not appropriate. Be prepared to describe what a typical session would look like… How would you explain why you are decreasing services to a reluctant parent? - hint... the key phrase they want to hear is “least restrictive environment” Not just OT questions - Questions about overcoming obstacles, ethical dilemmas, working as part of a team, as well strengths and weaknesses are almost always a given. Know OT assessments used in the school setting. Know programs used in the school setting (e.g. Handwriting Without Tears) Likewise, prepare questions that you may have for the interview panel should you be given the opportunity. ​ AFTER THE INTERVIEW Negotiations Benefits CEU Stipends/allowances & material allowances Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson. Davies class is officially in session.    Jayson Davies     Hello everyone. And welcome to the OT school house podcast. And also, welcome to June. We have made it through another school year. This is probably one of the hardest school years we've ever had to make it through, but we have made it through another school year. Thank you for joining me today. I really appreciate you all being here again. My name is Jayson, and I am the host of this show. I also run the OT schoolhouse.com website where I blog a little bit, but mostly it's about this podcast and providing resources and so, yeah, that's a little bit about me. If this is your first time listening to this show, this is episode number 50, which is crazy to now see that we're on episode 50. It's taken about two years to get to 50 episodes, recording every other week or so, with a little hiatus back in December, with everything that was just going on. But I'm so excited that we are here and today, because we are at the end of a school year, looking forward to our next school year, we're going to talk about getting hired. We're going to talk about where to find a job. We're going to talk about what documents you're going to need in order to get hired or even to apply. We're going to talk about how to prepare for your interview. And then we're going to talk about the differences between contract as well as in House District jobs. We're actually going to start with that, and then we're also going to talk a little bit about pay benefits negotiations and all that good stuff. For once you actually get past the interview process. And the really cool thing about today is actually I'm bringing on a very special guest. Her name is Amanda Clark, and she's an occupational therapist that I work with. Both of us have recently gone through the whole hiring process and looking for a job and looking for a job, and so we're pretty we have that fresh in our minds, and so we're going to kind of throw at you what we have gone through. Quick disclaimer is everything that we talk about today is our experiences, and we are Southern California based occupational therapists, so that's what you're going to hear. But I can only imagine that it might be a little bit different, but probably pretty similar throughout the rest of the country of America. So we're going to give you our experiences, and just to throw it in there, no matter what other people might say about occupational therapists, we are not job getting experts right. We do not help people get hired, typically, especially in our realm. We're school based OTs. So despite what other people might think when they hear the term occupational therapist, myself and Amanda, we are school based OTs. We do not know every single thing about hiring, but we do have some experiences to share with you all. So without any further ado, please help me welcome my colleague and fellow occupational therapist, Amanda Clark, hey, Amanda, welcome to the OT school house podcast. How are you doing today?    Amanda Clark     Doing great. Thanks for having me. Jayson, yeah, of course.    Jayson Davies     I'm excited to have you on for everyone listening out there. You have no idea, but Amanda had no idea she was going to be on this podcast until about 48 hours ago, and it's pretty awesome. I'm excited that she's here. I hope she's excited.    Amanda Clark     Yeah, I'm really not sure how you talk me into this, but I'm thinking it's gonna be fun.     Jayson Davies     So I did a little bit of sweet talking. I even told her. I was like, See, she was talking, she was talking a little bit about this. I was like, I already sound like I'm listening to a podcast right now. It's awesome.     Amanda Clark     And I felt like I was getting caught a little bit excited.     Jayson Davies     No, it's awesome. We're gonna have a good time today. I'm super excited to have her. I work alongside with Amanda, and she's actually been at the district that I've been at for a year now. I was there for two years, and so both of both of us, have kind of gone through the hiring process, not frequently, but recently. And so we kind of know this, know this a little bit, so we're going to talk about that. But first we want to talk a little bit about the types of different school based ot jobs. So actually, I'm going to leave this up to you real quick. Then, Amanda, you want to share real quick, what are some of the common school based ot jobs.    Amanda Clark     So with school based. OT jobs, you can either be working for a contractor, and that can be somebody who runs their own private company, and they contract with the schools, and then what you do is you work for that person, and they set up the contract with the school, and you go to the school, but you're not a district employee. You can also work directly for the district. And then there are also county jobs. And Jayson, you want to go over the county jobs?    Jayson Davies     Yeah, I'll talk about that. We have county jobs, and we also have what's called the SELPA, which is the California Special Education local plan areas, and those are also county employees, but it's slightly different. But anyways, what the county and SELPA? The employees do or the occupational therapist that work for them, they kind of help the school districts who may not have their own occupational therapist. And so for those smaller districts that might be more in the rural areas, who don't have a full time caseload available, they might either a use a contract company like Amanda was just talking about, who might you know that contractor may be there for two days and then at a different district for three days, but the SELPA or the county can also provide that service. So it's similar to a contract gig in the sense that you're working in a district, but you don't work for that district, except you are a public employee versus a contractor like you're talking about. You are working for a private company that is basically, well, they're making money off of you working for the district. Let's just call it what it is. So, yeah, all right, so I think we should talk a little bit about the pros and cons of the two big ones, and that is the contractor job and the district job. And so you've worked for a contractor, right?    Amanda Clark     Yeah, I've worked for a couple of different um companies that were not just contracting with schools, but they also had other avenues as well, whether it be, you know, just ot in the clinic, also speech, um, PT, hippotherapy. So they were companies that did a lot of different things, okay?    Jayson Davies     And I worked for a contractor my first year as a school based OT, and it was different. And that's what's so interesting about contract jobs, is that they're all very, very different. Mine was specifically school based, and so I was at the school. In fact, I worked for one district through that contractor the entire time, full time, and so that just kind of makes our first point, honestly, is that all contractors are very, very different, and so you never know, and you really, I would highly suggest, and we'll get into this a little bit more, is that you research the contractor that you are actually looking into. And if you know anyone that works for them, you might want to just ask them what it's like. What are the pros and what other cons? And with that, let's talk about some pros. First of a contract gig. What did you enjoy about your contract gig?    Amanda Clark     So for me, I feel like the pros are the fact that there's a lot more flexibility for you. If you're someone who isn't necessarily a person who wants to work full time, it's a great place to be, because you can work as many or as few hours as you want. A lot of contractors give you a lot of autonomy. So they'll allow you to control your schedule. They'll allow you to control the hours of the day that you work. Taking vacations is kind of up to whenever you want to do those things. So there's a lot of freedom in that. And I find that to be a big pro working for the contractors that I worked for, and it's obviously not the same for everyone, but that was a big, a big plus for me was that flexibility.     Jayson Davies     Yeah, and I don't know about you, but I remember when I was first getting that job as a contractor, one thing they lured me in, although I never really took advantage of it is the travel opportunities. And you know, there are travel therapists out there, and a lot of times travel therapists are contract therapists, and what that means is that they might be in a contract for 12 weeks, or maybe up to six months, or something like that, in one location. It could be Washington, DC, and then with the same company, they're able to move across the state, to California and work in a different position for 12 to six or six months, or something like that. And so that's something that's kind of cool. If that's your personality and that's what you enjoy, traveling and whatnot, that would be a pretty cool perk.     Amanda Clark     Yeah, that's I have some friends that do that, and they really enjoy it, and they're traveling the world, living our life, you know? And if that's something that is attractive to you, then, yeah, contractors, it's a good place to start. I also feel like it's a good place to start. You know, the companies that I worked for as a new grad, because you did get the clinic experience, you got the school experience, we got to be able to the hippotherapy was another huge, you know, one for me that was a lot of fun, kind of a dream come true. But you know, that has built me up to be such a more well rounded therapist. I also had the opportunity to be mentored by a lot of amazing therapists who helped build me up. And then as the new people came in below me, I became their mentor. And by doing that, it helps to increase your knowledge as well, because you have to sort of solidify what you know into words, which is so important, especially when you're having to defend yourself in an IEP right, to be able to say, Hey, I know that. Why this is this way, not just because I know, but because I have a way to explain that in words people can understand. So I feel like that was a really great opportunity as well. And I recommend that highly coming out of school, if you're interested in schools that you know, these sort of clinics that do everything can can really help you to become very well rounded.    Jayson Davies     Yeah, that also sounds like a good way just to. Dip your toe into the water and see where you want to be. And you might find out that school based is a good place, or maybe you enjoyed the clinic. Or maybe you, I mean, sometimes I've also heard with contractors is that, like you said, you kind of dip your toe in different areas, but then maybe that one, that one employment opportunity, or that one site that you're working for as a contractor? Well, they decide to hire an OT full time, and they already know you, and maybe you just kind of work your way into that position. I know some contractors have, like, a non compete clause, so you got to be a little careful about that. But it could happen. Just saying, so you had, you had actually added something on here. What was that? Is that there's always a ways around it. Yeah, yeah. Always find a good lawyer. No. Anyway, you actually wrote something down here that I really wanted to address is Coda jobs, as far as district versus contractors.     Amanda Clark     Yeah, Coda jobs are hard to find in the schools. I am not 100% sure why. That is because Jayson, you and I both see the relevance and how much they can really help not only the students, but us and so, you know, a lot of the school districts want just ot ours. So if you're interested in schools, you're going to probably want to look more into contractors as a CODA, because you'll have a much better opportunity, and then when you get that experience, you can then apply for those few district jobs, because there is a lot of competition for those Coda district jobs. So reality is is, as a new grad, it's probably not going to be an easy job to get.     Jayson Davies     Yeah, and I think I said this in the intro. But everything that we're saying is based on our experience. And we are Southern California Occupational Therapist, and I have no idea what the coda job market looks like in Illinois or anywhere. And so we're kind of talking a little bit about our experiences in Southern California. One thing that I've seen, one thing that I've seen with OTs that take on a contract, contract gig, or contract job, is sometimes they're able to actually move up in the contractor realm. I think you might be able to hear my dog barking in the background. That's okay. This is a dog friendly podcast. But anyways, yeah, so you can actually, if you are the type of person that might have the desire to move up and maybe not always be an OT, maybe you have a business mind or something. If you start at the ground floor with a contractor, and you get to really know that contractor, whether it's small or a big one, there might be potential ability for you to move up and become maybe the mentor, or maybe you're the lead contractor for that school district, and you kind of work hand in hand with the contractor in the school district to make sure everything's going well. Or maybe you become a hiring expert, or you're going to conferences to try and find new OTs to come work for that contract company. So I kind of thought that was kind of cool. I knew someone that did that, and I don't know that'd be interesting to be able to do that.    Amanda Clark     And I think we both know some people that were able to take their knowledge of having being working for a contractor rather and then building their own contract business, so kind of learning from the ground up what it's like. There's more than a few people out there that I know have been mentored by their former employers to build their own contract company. So that's another opportunity you could have, and that, and that doesn't necessarily mean you have to be an OTR too. That's available for CODAs. You can run business.     Jayson Davies     Yeah, and we didn't. We didn't really bring that up as a common way to work for a district. We We focus on kind of the main three that most people are going to be dealing with, especially as a newer OT, and that is district working for a contractor, or like the county or something, or the state even. But that would probably be the next way to work for a district, is contracting yourself to a district. Yeah, and that's a whole nother topic that I am not even going to try to dive into today for another day, another day someone who knows a lot more than I do. All right, so as much as we talked about some of those pros, I do want to talk a little bit about our perceived maybe cons or less beneficial, as comparison to working for a district, when you work for a contractor, and the first thing I think both you and I agreed a little bit on was, sometimes you can feel out of the loop.    Amanda Clark     Yes, yes. Um, I coming into the schools, I'm going to be honest, into the district rather, um, I did not expect it to be very different than my typical, you know, work that I was doing when I was going into the schools as a contractor. But it's very different. There's a lot of there's a lot of things you don't know about, as far as like policy changes and paperwork, and things that are more just in relation to the job itself, and not actually, like the the treatment, but as you know more on the admin side of things. So, um. Yeah, there is, you know, we've run into this this year Jayson, where our contractor did not know that there was a certain change that had happened, because she's not always invited to the meetings, not purposely, but just sometimes, you know, we just don't remember to invite them because they're not on the email list, right? So, and, yeah, it can be very challenging when you don't know that there's changes being made.     Jayson Davies     Yeah, absolutely, that's yeah, I like to be in the loop. So we had put some things about benefits and job security on here, but I think I'm gonna wait for a little bit later when we're gonna talk about that. But one thing we kind of listed it here I did as being a con, but as we just talked about, it's also a pro potentially, depending on your outlook, and that is that you could be working in a variety of different locations. Like Amanda said, she had the opportunity to work in not only a school as a contractor, but also in a clinic.    Amanda Clark     Days that I started in the schools in the morning, went to the clinic in the afternoon, and then I was working with the horses by the late afternoon. So, um, that if you're somebody who gets bored easily, that is a really good way to manage your day.    Jayson Davies     There you go. That's a good way to look at it.    Amanda Clark     Likes consistency then, then you might consider that to be a con.     Jayson Davies     Yeah, for me, I kind of like that consistency of being in the schools. I almost would get anxious, like, kind of being away from the school for to, like, especially, you know, just because I get so invested in that one, that one classroom, or those classrooms, and I was like, I need to be there. But I guess maybe for caseloads a little bit less. What's that?     Amanda Clark     And that's all you're where all your things are at. So if you're moving around throughout the day, you're also having to lug your stuff around. So that's that can be a challenge.    Jayson Davies     Yeah. And then another thing Amanda alluded to, I think, a little while ago, is that maybe you haven't yet, I don't know, but anyways, about the way that the benefits work, as far as and I'm just talking about pay at school year salary you get paid. It doesn't matter if you work eight hours or 10 hours a day, whatever you got to put your time in. You're getting a salary. But there's a much larger variance. When you're working for a contractor, you can work a few hours, or you can work, I mean, really as many hours as you as they let you work, but what? What have, what experience have you had, as far as, were you all full time? Or were Did you work part time at some points?     Amanda Clark     So, um, both as a full time employee. One job was salary, um, with benefits. Another job was not, um, and I actually made more at the job. That was not if you're a hustler and you work for a contractor and you're good at managing your time, you could make a lot of money, and that might mean you're working 12 or 15 hour days, because you're going to treat as many hours as you possibly can throughout that day. But it also is feast or famine. I went and the reason I came to the schools was this reason. And I went from 2017 to 2018 and I lost $9,000 and that was not because I didn't run a full caseload. It was because those those kids weren't showing up, or those students weren't at school, you can't charge for, you know, not treating so you know, your your money is also reliant on building that rapport with the with the students, with the parents, you know. So working summertimes too is rough. So if you have a very large caseload of school clients. I'm working for an outpatient, slash, you know, school based situation. I have some friends that really struggle in the summer, because they're not going to give you brand new kids. There's just not always people waiting. And then what are they going to do with those kids when you go back in the fall? Yeah, so obviously you can still there's things you can do about that they go on unemployment. It's very common during the summertime for people who are straight school based contracts that don't work for you know, or have other options for income. Or some of my friends actually go to those clinics and then ask if they can cover summer vacations for the girls who are working. So that's another way you can pick up some extra cash. So even though they're, you know, there's sort of pros and cons to both.     Jayson Davies     Yeah, and I think you also mentioned in here was about maternity coverage, and that is one thing that a lot of times, contractors will help out with. Is for when someone in the district, a district employee, goes on maternity leave, they might bring in a contractor for a few months, or however long is needed, a few weeks to cover that period of time. So that's another way that that you could be contracted or pick up some extra hours.    Amanda Clark     Right? And I have seen that on edge join both ways. I've seen that through contractor companies, and I've actually seen actually. Will school districts post for a short period of three months? And that's another way you can get your foot in the door.    Jayson Davies     There you go. All right, so that's some of the pros and cons about a contract job. Our list is a little bit shorter for both pros and cons on the district side, but let's talk a little bit about that. I mean, the first one really, is that you're working directly with the district. As far as being a pro, you are there, you're in the meetings. You're not missing meetings, like we talked about earlier, one contractor in our district, just like she wasn't getting the emails, and so she didn't know that she was supposed to be at meetings or whatever. But so that's one big pro. What other pro Have you seen in the district?    Amanda Clark     Um, I feel like there's a few things that I'm really enjoying. One is the, you know, being able to budget. That's been amazing. Um, having those benefits, like you said, that stability, knowing I have a paycheck coming, knowing that I have raises coming, when you work for a private company, they don't always have the ability to give you a raise, even if you deserve it, you know. So, um, you know, when you're working for the district there, it's guaranteed. And so, you know, you're going to always, things are always going to get better, even if the work gets hard, you're always gonna get paid. And so I really enjoyed that, but I also enjoy, um, you know, as a contractor, you're not, you're not often part of the team, like you mentioned earlier, and because of that, you may not get the same sort of supports when it comes to IEPs, um, you know, if I go and have an issue in an IEP and I go to my boss, she's gonna back me up, the team's gonna back me up. There might be lawyers involved to back me up. Um, you know that they are very good at our district of making sure that we feel supported in that way and that they agree or support, you know, whatever decisions we make. As a contractor, I didn't have that same experience. Well, I didn't have any, you know, Nightmare experiences like some other people have, I feel very lucky, but there were times where I couldn't have anybody to back me up, and sort of had to bow down in the end. Or, you know, you could lose that position if you don't do what they want you to do. So it's there's an ethical issue there as well, where I've seen people have to leave positions for ethical reasons, being a contractor.    Jayson Davies     Yeah, one of the things that I really like, too, is that I'm going to use minimum days as an example, because we work eight hours, we're contracted as a school district employee for eight hours a day, and versus a contractor on a minimum day where, you know, we're only at school, the kids are only at school for Four hours or so, four and a half hours, well, the contractor would be sent home after that four and a half hours or more than likely, they're headed to another school outside of the district, where it's not a minimum, minimum day, or maybe they're headed to the clinic or whatever to get more hours in. But for us, we have that time to collaborate with the teachers. We have that time to potentially put on trainings for the teachers. We have that time to use, as far as to somehow make the school better. Versus if we're a contractor, we may, basically, as soon as the bell rings, we're out of there.     Amanda Clark     And you're not getting paid for paperwork either. As a contractor, most of the time, I even when I was getting paid, I was getting maybe an hour, you know, you know, sometimes for the whole peak, you know, my one hour a week for paperwork, that's insane. And we all know we take way more than that to do all of our paperwork. So, yeah, that's, I guess that would be, another pro of the district, is that you're getting paid for paperwork time.     Jayson Davies     Yeah. I mean, you're getting paid the entire time that you're at the school. The school, and kids are there for on average, on a regular day, what, five and a half, six hours. And so you have about two hours that either a you're in a meeting or you're doing paperwork, treatment, planning, potentially getting organized. Honestly, because it takes so much time just to get freaking organized. But yeah, so you do have that, that ability to work beyond the time that you're just working with the kids. So that's nice. What else do we have here? We had benefits tend to be good. And again, we're in California. As far as the school districts here, it's a public job, right? And so it's a county job. They tend to be known for having pretty good health insurance. That's relatively it. Basically, it's typically paid by the school district. You might have to pay a little bit out of pocket, but for the most part, the school districts are pretty good here at covering most of the benefits. So that's helpful, versus a contractor that could be non existent.    Amanda Clark     Yeah, I didn't. That was the major reason for me moving out of the contract world and into the district world was the benefits. Was the pay, of course, but it was also having retirement. You know, it's not easy to find that anymore, and we're not. On a 401, k so, you know, we got pension coming like, that's that's big. That's rare nowadays. And I think that that is the real gem of working at the school districts, is.    Jayson Davies     Hopefully in 30 years, we'll still be able.    Amanda Clark     To say this zipper right now myself.    Jayson Davies     Oh, man, all right. But of course, there are always some cons. Every job has pros. Every job, every job has some cons. So one of the things that I wrote down was potentially having limited opportunities to move up, and that is because we don't have an educational credential, and in order to have jobs such as a Program Specialist, where you're kind of helping out teachers. And I mean, honestly, sometimes it can look similar to an OT because you're helping them with modifying the environment a little bit. But we can't have that job simply because I don't have, or we don't have credentials. We are licensed occupational therapists, but we don't have an educational credential. And so you are limited in that you can't potentially really change positions in a school district. So that's one thing that I that I kind of put as a con. What about you?     Amanda Clark     I feel like, um, you know, I agree with you on that one, um, you know. And kind of feeding into that a little bit is that autonomy I mentioned earlier that gets thrown out the window when you're working for a district, your job is sort of set in stone. You cannot make changes policy wise about most things. So in a way, you do feel a little bit like a follower. For some things. I will say, though that I think I'm it's beneficial for me, because I also have a tendency to just do too much when they put you in a box. Sometimes you have to stay in that box and that and that can be helpful if you're somebody who overworks yourself.    Jayson Davies     No wonder who that could be. Anyways, budgets, of course, budgets are always a pain in the butt right now, who knows what's going on with with the COVID 19 pandemic? There's talk all over the place about budget cuts, and we don't know how that's going to affect us. It could end up meaning that we get furloughed a few days. It doesn't sound like we basically have been told that that's not happening this upcoming year in our district. But who knows, maybe in the 2122 they say, Hey, take an extra five days of vacation and not get paid for it. I don't think that's not going to be the end of the world. I don't think anyone's going to quit because of five days when you have 195 day contract. But it's a little it's a bummer, right?     Amanda Clark     Yeah, and it's coming from being in a contract position where every Christmas that happened to me, when we would close for Christmas, and it's a forced vacation, you know, and, you know, even though there were, you know, oftentimes, you know, a little bit of a bonus or something, it's definitely not going to cover a loss of pay for five days. Or if you get sick and you're out of your sick leave that's, you know, mandated by the state, you know, then you're kind of stuck. So I'm used to getting those long unpaid break breaks anyway. So it's not, I guess it's not as scary for me.    Jayson Davies     Yeah, and I mean, again, it's, it's an unusual thing, typically in the schools, like Amanda said earlier, for us, we have, I think it's five steps where you know that you're basically going to move up to the next step until you're at the fifth step every year, as far as your pay increase. And then, even then, districts tend to occasionally do a cost of living, which typically increases a cost of living increase, which typically everyone is given. So for the most part, your pay is going to increase, at least for several years. That's, again, that's limited to our experience. Every state, every city, is different, and so who knows. But in the jobs that I've had, there tends to be five to seven steps, and then after that, you just get the cost of living, or maybe, like, a 10 year extra little bit for longevity, or something like that. But versus contractors, you basically got to negotiate anytime you can, right?     Amanda Clark     And that inconsistency in caseload can, like I said, make massive differences from year to year, if you had, you know, 30 evaluations in the first like six months, you know, and you're budgeting that way, and then all of a sudden, like nothing for the rest of the year, you know? It's hard to make that that adjustment. So I think that I definitely am happier the schools.     Jayson Davies     All right, I'm gonna press pause here real quick before we move on to the next spot, because I just want anyone out there who's listening to press pause real quick and shoot me a direct message or something on Facebook, Instagram and let me know. One Pro, one I can't even talk right now, one Pro and one con. Of your job, whether you're in a district or contractor, if you're. On Instagram or something to shoot me a quick message, let me know if you're in a contract or district position, and then shoot me a quick message. And with that, we are going to start talking about where you can find a job. And so this is really, of course, for people who may just be getting out of OT school, or maybe they're just diving into a school base that just thinking about having a school based gig, Ed join. Ed join, at least in California. I know they have some national posts. You said, right?    Amanda Clark     Yeah, actually, I had a moment where I thought I was just gonna throw it all up and run away to Hawaii. I was looking or Washington randomly. So, yeah, I was looking in actually, I was able to find jobs in other places, not just in California. And you can actually decide what area. There's a way to search a specific area, okay?     Jayson Davies     And for everyone that is, it's hard to, I think, spell out if you hear it, so it's Ed, as in education, and then join J O, i  n.org , and that is where you can go. They have a lot of California spots. I don't think they have as many around the rest of the country now, but if you're in California, that is the go to place for education jobs. It doesn't matter if you're looking for ot PT, assistant principal or teacher, you're going to Ed join. But I did a little bit of research, and yes, there are some on like the the national, just the national job registration places like indeed, there's a few others out there. But the one thing that I would most likely suggest probably is going to the district website, the districts that are around you, because if they don't have the direct job openings on their website, they're going to tell you where they list their jobs. Typically, you go to their HR page or whatever on their website for the three districts that are near you, and you'll be able to find maybe they use edge join, or maybe they use LinkedIn, perhaps, or maybe they use indeed.com , but they should have a link on their website that tells you where they list their jobs if they don't list them right on their website. So good tip. Yeah. What else? Friends? Friends? Yeah, you gotta have friends.     Amanda Clark     And found out about this job opportunity was through a friend, through a colleague that I used to work with who became a friend, and you know, that's why it's so important, even when you're in school, to start networking and maintaining professional connections and relationships, because which he has a Small World Man, and you never know, like, who's going to be on that interview panel, you might walk in and be like, Oh, hey, we went. So, yeah, it's keeping in touch is really important, and asking friends    Jayson Davies     so true. And actually, the other thing you might know a little bit about this is the referral bonus for contractors.    Amanda Clark     I wish I would have got those. No, no, my experience, no, but I know that does exist.    Jayson Davies     Yeah. So the the contractor that I worked for, they had a referral bonus. Referral bonus. And actually the person that referred me got a bonus for me working for the company when I got when I got hired. And this particular company, they kind of had a, it was almost like a tiered level, and so the first few people that you refer you got like a $200 bonus or something like that. But by time you got to the fourth person, it was like 500 and then just kept going up. I mean, you could earn $1,000 bonus for referring your friend or for referring a new grad. And so that is something that that both of you can take advantage your friend and yourself. You get the job, and they get a little bit extra money. Maybe you can even ask them to split it with you, since they helped your you helped them get a bonus, I don't know, but yeah. So that's one way that you can do that, is talk to friends and just see what's out there. A lot of times, like Amanda said, it's a small world, we tend to know what jobs are going on around us or what jobs are opening around us. So yeah, alrighty. So those are where to find your jobs. Now we got to talk about what you need when you're going to apply for those jobs. We're going to talk about the documents, and I think I'm just going to really quickly list them out, and then we'll get in depth to a few of them. So of course, you need to have your resume, and that's the one that we're going to get in depth in just a second. But you also need a few other documents, and that might be or it'll definitely be, like your state license that shows you our licensed occupational therapist, your national registration as well. They typically want that a copy of that. If it is a school based job. They probably want your license, your actual driver's license, copy of that, and your driving record, because you're going to be driving from school to school, as well as proof of insurance. Some districts want a little bit more in terms of, like a letter of intent. We'll get into a little bit about that. Did I miss anything? Amanda, is there anything else?     Amanda Clark     I actually had to turn in undergraduate and graduate transcript. It's pretty shocking to me. I thought that I never needed that again. Thankfully, it wasn't a problem. But TB test, and then CPR. The CPR is going to be for most districts. You need the AED and basic first aid as well. It's not just you can't do an online class and qualify.    Jayson Davies     Oh, and then letters of recommendation, two to three letters of recommendation, that was another one that you're gonna have to get. And we'll get into that again. Like I said, those kind that's kind of what you need. But I want to break down the resume a little bit, and I want to ask, I want to get your take on this. For me, I believe that OTs don't need to put a lot of energy in making their resume super flashy. And my whole thinking on that is that there's not a lot of OTs out there that are typically applying for jobs, and therefore, it's not like they're flipping through them at 10 resumes a minute, trying to just look and see which one's flashy, right? What do you think?     Amanda Clark     Yeah, you know, I definitely making it look appeasing to the eye. So being too crowded, um, having, you know, if you're doing some sort of, you know, template, make sure that everything's lined up correctly. But yeah, sometimes less is more um. It definitely isn't a while we do have a, especially in school based, you know, that creative side as OTs and it's, it's also a professional job. So you don't want to be putting your resume out there like you're a makeup artist or somebody who's trying to get more like, you know, to stick with your resume. It might make it look like you're trying too hard.     Jayson Davies     Good point, yeah, I mean, I can just speak real quick. I was in a previous job where I had to hire an occupational therapist. I don't know if you've ever had to do the same thing, but our problem was not getting enough resumes or applicants versus getting too many that we were like, oh, sorry, no, your resume is not good enough. It was typically, we were like, please give us your resumes. Apply for our school. We need people. In fact, our HR department, they wouldn't even let us interview people. It was just a policy, I guess, until we had at least three applicants. And like, we struggled to get three applicants so that we could hold interviews. And so.     Amanda Clark     I waited from January to May and then had to reapply. I said that explains why I applied in January, and then in May it went back up. And I'm like, Oh, I guess.    Jayson Davies     It wasn't in the current district, but maybe I don't know. So yeah, no, it's just a Yeah. I just want to say, in my opinion, yes, you want to have good information on there. Yes, you want to have your grammar appropriate. But if you're trying to get your application in tonight, then get the information on there. And, like I said, work on your grammar. Don't try to make it you don't need to spend too much energy on making it look super flashy. You really just want to get your skills down on that paper. You can get, like a Teachers Pay Teachers template. I know that's what my wife did. She went on there and was able to find a decent template. Word has a few templates. I'm sure Google Docs probably has one. I don't know, but yeah, what type of things Amanda, did you list on your resume.    Amanda Clark     So on my resume, I listed, you know, obviously, work experience. I also put the relevant tools and assessments that I know, as far as like, what's relevant to school based you want to include your specialty certifications or any relevant training. That's very important. So even if you didn't get a certification in something, but you had, you know, a long weekend training course, that's important to add there, because it's definitely gonna make you stand out. And then also, I put my case management and so I put, like, what case management programs I had been familiar with, training programs, documentation, billing, management and supervisory roles, or even roles, yeah and yeah. And then, if you have a little space, you know, um, you can consider like that, that caseload you carry. So, um, because if you're a therapist who is like I said, you know, a real Hustler, and you're carrying a caseload of 50 to 60 clients that looks good to the school, because that shows that you know how to handle it, because it is hard. You have a lot of students to manage. And it's not just like, you know, 30 minutes or an hour a week. It's a lot more than that.     Jayson Davies     Yeah, exactly. And especially with schools and budgets, potentially budget cuts, caseloads are going to go up if budgets get cut, they're not going to potentially replace OTs that might retire or might leave the district. Maybe they're going to say, hey, we were doing okay with six OTs. Maybe we can do with five OTs. I don't know. Just. So yeah, you also, I think, added on here about supervision of OT a clients, oh, ot students or not, OTs students, sorry, OTs in general.    Amanda Clark     Yes, yes, because not everyone does that, you know, like where we're working at right now, we don't have OTs. So if you do have that, you know supervisory role, even if the district you're applying for doesn't have OTs, it shows that you can manage things, and it also shows that you know you can do more than just like your own caseload. And a lot of districts do have or not a lot, but some districts do have OTs, and so they might want to know that you know how to do that, but in our district, we're actually categorized as management, so they want to see that you can manage.     Jayson Davies     Yeah, but at the same time, and this kind of leads into a point I was going to make later, but I'll just make it now, is that you should research the district a little bit, because you might be able to find out if they even have OTs, because if they have OTs, then maybe it's super important that you put that on your resume. But if you know they don't have OTs, then maybe it's something that, if you don't have room for, you can add that and replace it with something else. So yeah, do some research on the district, if you can. All right, a few, just a few things about, oh, wait, if you were a new school based therapist or a new therapist right out of college, what would you put on your resume if you didn't have any work experience?    Amanda Clark     Well, I would definitely put where you did your volunteer service at and how many hours you did? I have been mentoring over the years. I mean, at least 40, maybe more, prospective ot students. And you know, I always allow them to put my information on there as they're applying for their first jobs. Because, you know, if they put in 40 hours or 80 hours just to get by. You know, that isn't as relevant as those students that worked with me for years, you know. So I let them put me down as reference also. But, you know, never underestimate that volunteer experience. Never underestimate customer service experience. And so that's one of the biggest things in working in working in schools is being able to keep your cool when things get an IEP. And by showing that you've been in an industry that requires you to do so, it makes you a very interesting applicant.    Jayson Davies     Yeah, for anyone who's been in a tough IEP, you know what customer service is and what it takes to get through a tough IEP I did a podcast a few episodes ago on getting through tough IEPs. So yeah, we're all in the business of customer service. No joke on that, letters of recommendations. Typically, districts want to see two, maybe three. My big thing on on letters of recommendation is make sure that the person you're asking to write you a letter really does like you. First of all, make sure that they're going to write you a good letter. The last thing you really need is like, just a rare letter from someone going to a district or a potential employer. You want that to be a good district. And of course, you may or may not know what they say in that letter based upon how the district wants the letter. Most of them now just want like a scanned copy, but I have seen employers want like a sealed envelope before.     Amanda Clark     So and contractors will do that as well. I've had some of my previous students apply for school based ot contract jobs, and they sent me something online that was sort of like a Google forms that you had to fill out. So this, that person never saw what my responses were. So it wasn't really, it's like they asked you for that letter of rec, but it really wasn't. It was just a link they sent you and then you filled out a form instead.    Jayson Davies     Yeah, all right. And then the other thing is that give the person time, whoever you're asking, for a letter of recommendation from give them a month to write it. And I'm going to say this is a little bit tricky, but I think it makes sense, is that if you need that letter A month and a half from now, tell the person that's at that you're having write you your letter of rec. Ask them if they can have it ready two weeks before you actually need it. That way they have a little bit of time for you to give them a reminder when they miss the due date. And I don't know what do you think about that?    Amanda Clark     Yeah. So for those people who are new to applying to districts, if you're applying to a contract job, you might need it sooner rather than later, because they have a tendency to need those people immediately. Everything has to go through several sets of meetings. So and they actually have to. Post for a certain amount of time before they can close that posting. So you should know a month ahead of time, as long as you're constantly looking you should know, okay, this closes on this date, and so therefore I have this much time. It's not always that easy when you're looking at a contract job. But yes, the time frame is huge. I have to tell you, like, as many letters as I've written, I know I've written at least 35 because I looked last night, um, and I have 35 saved on the computer I have now. So, um, yeah, so at least 35 and out of those 35 I will tell you that those, um, students that I did that for, and I don't do it for everyone. Mind you, so don't get upset when they tell me, No, um, but those who gave me the most amount of time, those are the ones that love their letters the most, and the letters that I felt most proud of, that I felt were the most beneficial to helping that person get get a job. Yeah, give them.     Jayson Davies     Yeah. And I would almost say, if you even have the slightest inkling that you might be applying for a job, you should probably start with getting the letters of recommendation. Because a lot of us, I know, we wait until like, the night before it's due to actually complete the application, because you're just like, you can't make up your mind if you want to apply for this new job, but you can at least get those letters of recommendation in your pockets beforehand. So that way, if you do decide to hit that send button to apply the night before, you already have them in hand, I understand that if you're in a position where you feel like you need your supervisor's letter of recommendation, but at the same time, you don't want to ask them, because you don't know if you're actually going to be leaving a job. It's a little tricky there, right? You probably should get your supervisors letter of rec, hopefully you they will say yes, and you'll get one, but that's the one where it gets a little bit tricky, because it's hard to tell your supervisor you're looking for another job, especially if you're not absolutely sure that you're leaving.    Amanda Clark     Right? And that's why I think it's also important to maintain those connections right, so you don't always have to go to that supervisor. That was not an option for me, and you know, not because I didn't think that she would write me one, but because I felt like I wasn't sure if I wanted to do it, like you said, I was just going to send it out, go to the interview, see what happened, and then if I got offered a job, I would think about it at that point. But it was just so much in the back of my mind, I felt like I needed to do something about it. So instead, what I did is I went out and I looked for colleagues, like you mentioned. And you want to go ahead and obviously have people that are in, you know roles above you, or maybe someone who's more experienced than you, to show you know that there are people out there you know that respect you. However, I will tell you, diversifying your letters of recommendation is important. I think that the including school based therapists, if you know them, obviously best, but my best letter of recommendation came from an OT A that I mentored and supervised. I literally straight up ugly, ugly cried when I read it like ugly cried so but when you're an employer and you're looking at that, especially if you're going into a district that does have OTs and they see like, Oh, wow. She's compassionate, and she's a good leader, and the people who work you know with her respect her, um, so, or him, sorry, I keep saying her, because I'm referring to myself, but um, so, I think that's important too. Is, you know, think about, think outside the box, about people who you know might be, um, able to write you a good letter that maybe aren't just people above you?     Jayson Davies     Yeah, I usually aim for an admin so it might be a principal or a special education coordinator, Director, or something like that. I usually aim for a colleague. That's an OT. And then I also try to get a teacher. I feel like having a teacher is a good one too, because those they work directly with you, and oftentimes the people that are going to be interviewing you were likely a teacher at one point. Yeah, there's probably an OT or two also on the interview panel, but it's very likely that the coordinator or director that's going to be interviewing you was a special education teacher first. And so that's why I try to get a teacher too, because it's kind of that connection.    Amanda Clark     And if you have options, I would also like to recommend, as far as like, if you're going into a location, whether that be a contractor or whether that be a school district and you know someone who works there, I would use that person as a person of reference, but not a letter of reference, because they will likely go to that person anyways. So you're it's better that you don't waste that letter, because that's actually like an extra recommendation.     Jayson Davies     There you go. I never thought about that good point. All right. So. So that leads us to the last thing that I kind of want to talk about just a little bit before we move on for the interview, but a letter of intent. And this isn't something that I think every district, or I don't know, do contractors ask for a letter of intent.    Amanda Clark     Not the ones that I've worked for? I'm not going to say they don't, though.    Jayson Davies     Yeah, but a letter of intent is, I mean, to be fair, honestly, I see it as almost a little bit of a formality. It's kind of you expressing your desire to work at this, this company, and also what you can kind of bring to this company or to this district, and why you'd be a good fit. That's all I really want to say. Too much about it. It's only a one pager. You want to add anything about that Amanda?     Amanda Clark     Yeah, so that one page, make good use of it. Try to find whatever your strengths are and tie them into what you know about that district. So for our district, Jayson, I looked online and I found information about a therapist that helped establish the sensory clinics within your district, and included that as inspiration in my letter by dropping his name. So flattery goes a long way, you know, to make sure it's genuine, because, again, you never know who's going to be on that interview panel, and maybe it's that guy or that girl.     Jayson Davies     Shoutout to Dennis. All right, you put on here. Actually, you added online personality test. I know that sometimes they'll do that.     Amanda Clark     I had to do that. I that I was expecting that more to come after the interview. Kind of thing. Actually had a district I applied for do that beforehand, and the questions were mostly in relation to conflict resolution.    Jayson Davies     Hmm, interesting. All right, I think we talked about CPR and a recent TB test. They usually want that. Some some want it up front. Others are like, we'll hire you, and then we'll have you go do the TB test or the CPR. But just check to see what whoever you're applying for, what they want. All right, man, we are giving out so much information. Let's go over. We're going to kind of shorten it down a little bit here, preparing for the interview. Let's go over the main things here. What did you do? We'll just talk about what we've done in the past to prepare for interviews.     Amanda Clark     Okay, so what I did when I was preparing for interviews is I went on Facebook groups, and I started asking questions from other therapists who work in schools, like what sort of questions were asked, or what sort of things you need to know. And so some of those things that came up were like understanding best practice in regards to delivery of service, whether it's collaborative consultation or direct and when it is or is not appropriate, and being prepared for what a typical session would look like. They want to know what you would do in a session. Now that's really hard because it's a general question, and we're not journalists, right? We are holistic with our approach. So with that answer, obviously you're gonna have to get a little creative and just make sure you're you upfront them with that you know that the thing for every student and and then another question that had come up was explain why you're decreasing services to a reluctant parent, like, how would you and so, hint, hint, the key phrase they wanted to hear was least restrictive environment. And yeah, there, I think that there's, you know, the standard things, like, you know, as far as you know, what is an IEP?    Jayson Davies     Yeah, know all the acronyms you put on here, there you go.    Amanda Clark     Yes, that's super important. And I did have that come up in an IEP, or no, I'm sorry, in the interview where I didn't know one of the acronyms for, I can't recall what it was, but it was a one specifically to that district or in that area, and I was completely lost so and, but don't, you know, rule out that they're going to give you those regular interview questions. So, you know, ethical dilemmas working as part of it, of a team, what are your strengths and weaknesses? Be prepared for that, because that caught me off guard. I was expecting all ot questions, and then I was like, oh, wasn't ready for that. So.     Jayson Davies     Yeah, I think the only real thing that I would add to that is to make sure you've done a little bit, little bit of research on the position and the school district, go online, look at the Special Education page. Do they have a lot of OTs that work at the district, or do they only have one OT, and you're replacing that one OT, because that might lead to for you to know what they're looking for. Are they looking for someone to build a program, or are they looking for someone just to come in and treat all day long? Are they looking for someone that's really going to be at one school, or are they looking for someone that's going to be at 10 schools? Just because you want to know a what you're getting yourself into, but also you want to know the key points that you want to know what strengths you have that you can share, and if you know what they're looking for, then you know what strengths that you have that you can point out a little bit more. So definitely look at what look for, what they're looking for.    Amanda Clark     And the population matters too, right? Right? So we're talking about the assessments. You know, they might ask you about what assessments you're going to use, and if you just throw, oh, I'm going to use the bot out there, and then they start talking about their severe program, you better have some ideas on how you would accomplish that as well, or what programs are used to using. So when they say programs, I got caught off guard. I didn't know what he was talking about. Um, you know, like Handwriting Without Tears, keyboarding without tears. Size matters, these things we know, but sometimes it's just the way that the question is worded that can throw you off. So.    Jayson Davies     Yeah, I have a question for you. Then, what's your take on when you are given the opportunity to ask questions at the end of the interview? Because sometimes that happens, they say, Hey, would you like to ask us any questions.    Amanda Clark     So yeah, when it comes to asking questions, I think what you had mentioned earlier about making sure you understand what's going on in the district in the way that they provide services. So you don't want to be wasting your critical one to two questions that you're going to ask. Do not ask a whole bunch of questions. It just annoys them. So make sure what you ask is good, and make sure what you asked it does not sound greedy. So I don't ask about salary in that first interview or benefit. It's, you know, we had, we had, going through this list, had a little bit of, like, differing opinions on far as you know, asking about caseload.    Jayson Davies     Yeah, I don't think I would specifically ask, like, can you share with me? Maybe I would ask it that way, can you share with me what your caseload or what the workload is? But I wouldn't just outright ask, yeah, I would love to know what the caseload is. I don't think I would ask something like that. Maybe, maybe ask, what does the caseload look like, or what does a typical caseload look like.    Amanda Clark     Right? So, you know, very risky question that I asked, but I needed to know this answer, and if you feel confident in how your interview went, or if you're not throwing all your eggs into that basket, it's always a good idea to ask, is it a caseload or workload model? Because that makes a huge difference in our day to day. Jayson, I know you know that, you know we may have the same number of students, but you might be working 10 times as hard depending on the severity of the program you're working in and I think that's important, because you need to know walking into that job whether or not you can handle it.     Jayson Davies     Yeah, that's it's tough and and you're under so much pressure. I mean, you're getting close to the end of your interview at that point. I mean, all the sweats just gone. I mean, but you're still a little bit you're kind of feeling great because you got through the interview, and then now they ask you that question. Do you have any question? And you should just be prepared for this some way, you have a few questions in mind, and hopefully they get answered during your interview, but if they don't, yeah, that's your time to ask that question. And a caseload workload question, it could be that. It could be about, will you be expected to supervise CODAs? Because if you don't feel really comfortable, then maybe the job isn't right and it's okay, especially, you know, if you're not putting all your eggs in one basket, like Amanda said, if you're interviewing at several different districts, I don't know. I don't know what the job market is in your area, but maybe you have a little bit of a leeway to choose which job you want. Same thing with the population. What type of population will I be serving if I get this job? Is it all is it like a full time Autism Spectrum Disorder caseload? Or do you have a mixed caseload? What does that look like? Those are questions that you're available to ask.    Amanda Clark     And also, as a new grad, you you can consider asking the mentorship question, very sticky situation. So as a new grad, they should short See, they should expect you to ask that, to be honest, but it implies that you need supervision, so which can make you look less attractive to a district if they want somebody who's just going to walk in and guns ablaze and take care of everything. So it kind of depends on your situation. How badly you need that mentorship. If you do need it, then you should ask about it. But if you think that you can get that mentorship elsewhere, you might want to keep that to yourself so that it makes you more attractive of an applicant.    Jayson Davies     Yeah, one thing you might be able to ask as a kind of way to around that one is maybe their thoughts on professional development, and if they help with professional development in some way, so at least you can get an idea that I think most districts would probably tell you is, if you ask them about professional development, they'd probably say, Yeah, we provide our therapist with a little bit of a stipend to go to professional development. Or maybe they won't say, they'll say, No, we don't do that. It's all you have to pay for all of your own professional development or something like that. I think they would be okay with saying something like that. Usually, yeah.     Amanda Clark     But, and Jayson, I feel like you have my favorite question, actually, the the first one that you put down on our list here, which one about the philosophy?     Jayson Davies     Oh, I totally scrolled down too far. Yeah, what is, what is the district's philosophy on occupational therapy and RTI? And I think that was my question that I asked for my current position. And just trying to understand, did they want me to just be there to service students one to one all the time, or did they want me to be able to help the teachers and help the entire school grow? And I mean, I wanted to know that. I don't necessarily remember what the answer was, but I think, I think that could be a good question, because it shows that you know more about ot just then working with the student one on one. It shows that you know a little bit about least restrictive environment just by asking that question. And it shows that you know that you can work outside of just a one to one model. So, yeah, all right, so let's move on. We are just about done here, and that is after the interview. The infamous after the interview, what happens? You're waiting for a call. You don't know if you're calling. You're asking your friends if they've heard from the district about your professional reference. There's not too much to talk about here, but I want to just do really quickly.     Amanda Clark     Jayson, you just said it though it's very important to be prepared for it to take a while. So don't hear back right away. Don't be disheartened. It takes true.    Jayson Davies     That is true. Don't take time. And it can be it can get tricky, too when you've interviewed for multiple districts, because maybe you really like one district, but they're the slowest district, and so now you are right, and so now you're holding out for that one district, and the other two districts are calling you like, hey, we want you what's what's your decision? And you're like, when do I need to know by? When do I need to tell you by? That's tricky, but it's okay to say you need a little bit of time. They might push you a little bit. And you know what? It may come to a point after you say that once or twice that they're like, hey, we need an answer. But you can let them know, be honest, especially after they've already told you that they want you. That's my opinion, at least.    Amanda Clark     Yeah, I agree. And they can't really move forward, as you know, if you're talking about, we're talking about specifically a district right now, not a contractor, but they can't really move forward until you accept or deny it, or until a certain time frame passes. So they I had actually spoken with some people at the district, and they were like, okay, basically, you have until this day to give us a yes or no answer. And thankfully, I heard back from our district before that. So, um, but yeah, you can, you can, you can drag it out a little bit, but I wouldn't drag it out too long, because you do have to eventually work with these people, and you want them to feel like you were their first choice, even if maybe they weren't. But you want them to feel that way.     Jayson Davies     So yeah, so I think the things that are in here, other than that question or you know that, that tricky, awkward moment of waiting for a call, we wanted to talk a little bit about negotiations, benefits and potential stipends for continuing education. We touched on negotiations a little bit. I think the gist of that was that you have some leeway to negotiate with contractors, with districts, you typically don't, because all the policies are set by the board, at least in most cases, that's how it is. There's five we talked about this earlier. There's five steps as far as pay scale, or seven steps. And you're going to be on one of those steps, you can't be on step four and a half, and you can't be on Step eight if there's only seven steps. So you're going to get paid on the steps, versus a contractor, they could offer you $45 an hour, and you could say, I was thinking closer to 50, and they could say 47 and you say 40 or 40. It goes back and forth potentially. This isn't a podcast about how to negotiate, but we're just talking about what to be prepared for, right?    Amanda Clark     And in the districts with the negotiation, it also depends, you know, if you feel like you have experience, that doesn't necessarily mean that you're going to be starting at step four. So if you have four or five years experience, you may not be coming in at step four or five. That usually is not the case. And there have been people I know that we're able to negotiate based on their previous income, yeah. But unless that's the case, most districts, I don't think would even give you a second you know question there. It's just no, the answer is no.     Jayson Davies     Yeah. And so what she's talking about is, I took a I was making more at a previous job, and I came to my current job, and I was able to negotiate for a higher rate than step one, not based upon my experience as a school based OT, but simply based upon my pay as a school based OT. In my previous District, which I'm not going to say I completely agree with, because I think it should be based on experience, not pay. But that may be how the district works. And so because I was making more, I started at a higher level than level one, because of making more at the other district, not necessarily because I had years of experience.    Amanda Clark     Right? And I was hoping walking in, that I was going to come in at my level of experience. So it was disappointing. So that's, I think, really important for everyone out there to know when they're going to apply that the likelihood is you will start at step one and be prepared to be offered only step one.     Jayson Davies     Yes, yeah. As far as benefits go, we talked to again. We talked about this earlier. In California, benefits tend to be better if you're with the district that's everything from insurance or insurance to your 403 B to your pension, retirement, all that good stuff. Versus with a contractor, there's so many factors that that that depends on, depends on how big the contractor is. I mean, you could be working for a contractor that only has three, three employees, and if that's the case, there's such a small business, they're not required to provide you with anything. I mean, obviously that depends on your location, but they're not required to provide you with health insurance, potentially, or a retirement plan, versus if you are with a like conglomerate, like a huge Pro, a huge contractor, then you're more likely to have some benefits. You might be able to negotiate a little bit. Benefits are hard to negotiate. No one really understands them.     Amanda Clark     But that comes down to whatever, just, you know that that contractor is able to access as well, even if they are able to access a program for you to be able to have some sort of insurance, it might not be good enough insurance. It's like you said, you have to have money to make money. So it does make it very challenging for them. And you know, you also the smaller the company you work for, you know there, you could use your negotiating powers to get extra per hour, which is what I did. So even though they did not offer benefits, I said, Okay, I'm going from not having benefit or from having benefits to not having benefits. And so this is the dollar amount I want you know, per per per client in order to make up that difference over the year.     Jayson Davies     Yeah, you know what I just realized we didn't talk about is being working for a contractor as your own contract, or working as a contractor as an employee, because those are also two different things, in the sense that if you're an employee of the contractor, typically, they'll at least have, like, sick time and stuff like that, and they have to pay your taxes, so typically they will pay less. But if you are acting as your own independent contractor, you're typically going to be able to ask for more. This is a complex question. I know some of you. This probably is going right over your head, and if it is, don't worry about it. Google it if you really want your episode, yeah, if you're an independent contractor, basically what that means is they're not taking out any taxes, they are not giving you any benefits. They are simply giving you $1 amount per hour, whatever you guys agree upon. But that means that you then have to go find your benefits, you have to pay your own taxes, and you have to figure out how to do that correctly or find someone that can. And so I would highly recommend, if you're a brand new OT, be an employee, whether you're a district employee or a contractor employee, be an employee if you don't know what it means to be an independent contractor, right?    Amanda Clark     And that's a question that you need to make sure you ask when you do go into those interviews with contractors and and, you know, another thing we forgot to mention Jayson is the panel, as a district, you're likely to be interviewed by a panel where, if you're on a contract, you know, job that you're applying for, It most likely will be one person.    Jayson Davies     So honestly, if, if there's one thing that you can take away from this podcast, it might be that districts have a very set they just have very set rules. They have very set policies that they have to follow by versus contractors, really, they don't have oversight as much as districts do, and so they can hire people on the whim. They can hire people with no interviews. They can hire people with three interviews. They can do things very differently than a district has to do. Of course, each district has some leeway to do things differently, but for the most part, policies are set by the district, and things aren't going to change much in the time that you're interviewed and the next person's interviewed, or the person before you was interviewed, usually, and so, yeah, it's just things take a little bit longer to change. Things might take a little bit longer to go through, like getting board approved so that you're actually an employee, like, say they like you at the district. Well, they have to get you. Board approved, which means that, basically they just have to say, we want to hire this person to the board. But that only happens. What meetings like that only happen once or twice a month, and so you have to wait for that. So it takes a little bit longer to get hired. All right, I think that's really all we have for today. That was actually a lot of information. I don't think we expected to be on here this long, but I hope it helps you all. Amanda, do you want to say anything else before we get out of here tonight?     Amanda Clark     Um, no, just that. You know, it's everyone's different. Everyone's needs are different. So it's not that one is better than the other. As far as contract versus district work, if you have a, you know, a partner that has benefits, it might benefit you more to work for a contractor where you have more flexibility, or, you know, more autonomy in your job. If you're somebody who needs stability, you know, the district is a good place for that. So there's no one size fits all. There's no one better than the other. Yeah, it's just what's best for you.     Jayson Davies     Yep, alrighty guys, well, thank you so much for listening, and Thank you Amanda for coming on as a special guest today. Really appreciate you coming on. Not bad at all, I told you. Like no editing even needed. All right, great. All right, I will see you later. Take care. All right. Bye. Bye. Guys. All right, everyone. Thank you so much for listening to Episode 50 of the OT school house podcast, a special. Thank you to Amanda Clark for last minute jumping on here and doing this episode with me. I think she had a lot of insightful points to make, so I really do appreciate her being a part of this. Yeah, that's it for today's episode, I hope to see you next time, and for some of the show notes, you can head on over to OT schoolhouse.com forward slash episode 50. All right, take care. Bye, bye.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to OT schoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 49 of the OT Schoolhouse Podcast. In this episode, Jayson interviews Sarah Collins, OTR/L. Sarah is an occupational therapist that specializes in supporting students who are homeschooled and the families that support them. Homeschooling her own kids has helped her to understand where the true needs are for this community and the research she has found supports the occupational coaching model that she uses with her clients. Listen in and earn 1 hour of professional development for doing so! ​ ​ Click here to earn professional development for listening to this episode! ​ Here are the objectives for this Professional Development Podcast. Listeners will: Demonstrate an understanding of common reasons why families may choose to homeschool their students and the stigmas that may prevent them from doing so. ​ Be introduced to some of the literature around homeschooling and special education related to homeschooling, as well as the need for educational occupational therapy support services ​ Gain knowledge in how an evidence-based coaching model can work to support homeschooling families. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: ​​ NHERI.org Get the facts related to homeschooling from the National Home Education Research Institute HSLDA.org ​ Home School Legal Defense Association Perspectives of Homeschool Educators on Occupational Therapy: A Pilot Study (AOTA) Effectiveness of Occupational Performance Coaching in Improving Children’s and Mothers’ Performance and Mothers’ Self-Competence (AOTA) CollinsAcademyTherapy.com Check out Sarah's business website​ Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host. Jayson Davies class is officially in session.     Jayson Davies     Hey, everyone. And welcome back to the OT school house podcast for episode 49 so excited for you all to be here with me today. We are actually getting back to having a professional development opportunity. So that's really cool. We are going to have a therapist who actually specializes in homeschooling. So I know right now we're all working from home, but it's not exactly the same as homeschooling. However, with that said, I think it might actually help some of us who are doing who are just struggling a little bit and trying to figure out how to communicate and how to work with the parents in a way that best supports our students. Okay, so let me go over the details real quick of how the professional development opportunity works. And then I will introduce our guest, Sarah Collins, so you can, if you'd like, listen to this podcast for completely free. And then if you would like, you can pay to have the opportunity to earn a certificate of completion for one hour toward your recertification as an occupational therapy provider. Right? So the way that you go ahead and do that is by listening to this episode all the way through, and then you head on over to OT schoolhouse.com , forward slash episode 49 and there, there will be an option to earn a professional development opportunity or a professional development development certificate. The way that that works is, once you do go ahead and purchase that. There is a short quiz, 10 questions that you go ahead and take, and that just shows that you listen to this episode and you demonstrate that you have learned the knowledge expressed in this episode. After you do that, I will go ahead and send you your certificate of completion, good for your recertification as an occupational therapist for NBC, ot per se. Okay, so it's pretty simple. That's all you have to do. And along with the opportunity to earn that certificate, you're also going to get a transcript of this podcast, or at least the meat of the podcast, the interview portion of the podcast. Okay, so that's kind of how that works, pretty simple. And because it's been a little while since we've done a podcast professional development, I'm actually going to have this podcast be 40% off between now and June 1. So for two weeks after this podcast released, it's going to be 40% off, and then after that, it will go back to its full price, which still isn't too expensive, right around $20 Okay, so, yeah, that's all I have to say about the professional development side of this. Now let me go ahead and introduce Sarah Collins. She is an occupational therapist that specializes in helping families that homeschool. She has a website called Collins therapy academy.com and she'll talk more about that in a bit. But the title of this episode is really meaningful, because it's homeschooling, coaching families for success, and it's that because Sarah doesn't necessarily provide direct therapy. And we'll go into the ins and out of the ins and OTs of that in the meat of the podcast, but it's really interesting, because we're going to go through and start broad and get specific. We're going to first start off and talk about what homeschooling is, what are some of the stigmas behind homeschooling? And then we're going to kind of jump into special education and homeschooling. Does special education even exist in homeschooling? Do kids that are homeschooled have the option to have IEPs? Can they get tested? So we'll talk a little bit about that, and then we'll dive into some of the research specifically behind occupational therapy and homeschooling. All right, there's not a lot, but there is some, and Sarah is going to share that with us, so hang tight, and yeah, it's gonna be a good one. So let me go ahead and bring on. Sarah Collins, I hope you enjoy the show. Hey Sarah, and welcome to the OT school health podcast. How are you doing today?    Sarah Collins     We're doing great. You know, in the middle of a pandemic, as great as you can do.    Jayson Davies     Absolutely, wow. I can't even talk today. Just stuck in the house. Man, everything's just gone. So actually, I just want to bring this up. You were just showing me your notes for today. You want to go ahead and describe your notes, what they look like right now.    Sarah Collins     Oh, well, there. So I a very nice little outline, just to make sure that I had some major takeaways and stuff. And my four year old was in here earlier. I have a nice light saber up in the corner. I think he was working on, I don't even know. I think there's an eyeball here somewhere in the middle. Looks like some cross, I don't know, but I'm going to be really lucky if we make it through with all of the major takeaways.     Jayson Davies     Yeah, and so I mean that just kind of. Show with everything going on right now with the pandemic, everyone is in the house all day long. Kids are anxious. Adults, we're all anxious. How are you and your family holding up?    Sarah Collins     You know, we are actually doing very well. I was just talking my we brought up my husband's grandparents last week or two weeks ago now, their COVID was in their assisted living, so we went ahead and brought them up here to make sure that they stayed safe. So now we have myself, my husband, my three kids and 290 year old grandparents. So the good thing is, is, you know, I also have a background in home health care, and good old nanny is, she's getting around the clock occupational therapy. She doesn't even know it okay, it's been an hour. Time to get up. Let's get walking.     Jayson Davies     I got that covered, right? The benefits of living with an OT, right? All right. So we are here to talk a little bit about homeschooling and how you provide homeschooling, occupational therapy type of services. We'll get into more of that in a second, but first, tell us a little bit about your background as an occupational therapist, right?    Sarah Collins     So I graduated, I don't even know a long time ago. I started out in pediatrics, working at Kennedy Krieger in Baltimore, and then once I had my children, my daughter's 11, so guess it was rough that time. But once I had my children, I kind of thought working with pediatrics, I was really giving my all the other people's kids, and I would get home at the end of the day and really just be zoned out. And so at that point, I started working home health care, and I did that. I was working full time up until my kids were my oldest was in third grade. My husband was working full time and had an hour and a half commute, and, you know, my so she was in, I had two in public school, and then my youngest was one in full time daycare, and so we were just, you know, doing that kind of corporate grind kind of deal. Then at that point, I actually was in a client's home, and her daughter was homeschooling their children. And it was, to me, just mind boggling the stuff that I would hear them talking about, and the discussions that they were having, and even even the geography that they knew that I was like, I don't know what, so that kind of just spurred my thoughts, um, at that point, and so, you know, but there was no chance for me to do it again. I was working full time. So then, actually, only about three or four weeks later, my husband was approached for a job up here in in Philadelphia, and we ended up moving within a matter of two months, I think we moved. He found out in January, we moved in March, we got up here. My kids were I moved them into public school up here, and then at that point, we were moving again in May to start into our like permanent home from a rental home. And I said, we're not switching schools again. This is silly. And so we started homeschooling at that point, and kind of have never really looked back. We came on a fantastic community of home families and just we've loved it. So that's where we are.     Jayson Davies     Okay, so what was your job transitioning when you moved Were you already not working at that point? Or did you find a new job when you moved up there or?    Sarah Collins     No, once I left Maryland and I came up here. Then now, I focused primarily on homeschooling the kids. And from that was 2016 that we got up here, so I did not start working again until starting Collins Academy therapy services. So I kept up, you know, kept up my license and kept up with research. But that was, that? Was it?    Jayson Davies     Gotcha okay. And so that's kind of obviously how you got into the homes homeschooling niche, obviously. So tell us a little bit about your current ot practice. What does that look like right now?     Sarah Collins     Right. So back in April of this year, you know, like I said, I was focusing primarily on my own children, so I but still trying to keep up my license. So I actually went to a Handwriting Without Tears workshop. You know, that obviously would make a difference in my own kids, since I'm working on that with them, and for me, for CEUs. But while I was there, the instructor who I wish I could remember her name, but I could not, because you've made a huge impact on my life. If I remember your name, I'm going to tell you, but she just kind of on a side track. Mentioned to me, you know, Sarah, there are so many families that are coming to these types of seminars that are working with their kids at home and whether they have special needs or whether they're just homeschoolers that are using this program that ask a lot of questions, and could really benefit from having an occupational therapist that is familiar with the homeschool world to bounce ideas off of and to talk with. And it kind of spurred my thinking a little bit. And then I had another family, you know, who was homeschooling their child who has cerebral palsy, and we talked through their day, a whole day. At one time, and just like you should really start a business. And so that was just April of last year or so, almost exactly a year ago. And took me quite a bit of time to get through, you know how to make this work and within licensure, and talk to a OTA, and to get through all the business part of it, and then in October, started Collins Academy therapy services. So basically, we'll talk a little bit more about, you know, later.    Jayson Davies     Yeah, just in a nutshell that you are basically helping parents who homeschool their children with ot like services in a way I'm using.    Sarah Collins     I'm acting, yeah, I'm more like an educational consultant with an OT background.     Jayson Davies     Is, yeah, basically what I'm doing, yeah. So obviously, right now, there are many kids that are quote, unquote homeschooling right now, not officially homeschool, but they're obviously at home and somehow getting school. Would you mind starting off with the what a more traditional homeschooling looks like. And obviously you learned firsthand this a few years ago. How was that and what? What have you come to know homeschooling as.    Sarah Collins     Right? So it's really interesting. You know, there's no two home schools that that look alike, and really it's the epitome of an Individualized Educational Plan. You know, even IEP really, because each family is choosing curriculums. And there's a bazillion, million of them, you know, that's that's a real number, by the way, a lot of of curriculums out. There a lot of different ways to do it, and even philosophies of education that are there. We in our home, we model called the classical model, which basically is going through three phases of learning. Starting. My primary example is really the alphabet. You know, you're starting to learn the alphabet and to recite it before you even know what those letters mean, you know. So my youngest is even reciting things like geography, places and history, sentences and stuff before he really comprehends what that means. Then later on in his life, and my older kid, OTs, obviously, you're able to ask more questions about that, and then later on, even further, then you're able to compare and contrast, and you're able to look at how that, how that fact, or whatever, can impact your world. So that's our main focus. There's tons of others. You know, we also do. There's something called Charlotte Mason philosophy, and that spends a lot of time outside and doing nature studies and child led learning. And so we do a lot of that as well. But again, there are no two families that do the same thing.    Jayson Davies     Yeah. And it's interesting that you bring up curriculum, because that's such a big word, obviously, for education, you can't really talk about education without curriculum. And that's one of the areas that I often find that occupational therapists don't know very much about, and I almost feel like that might impact the way that you do or do not provide services, especially if you're a school based occupational therapist. And so I guess my question then is, how has learning about curriculum impacted kind of what you do as a therapist?    Sarah Collins     You know, a lot actually, and because I got to go through this from both perspectives and both as a therapist and as a parent, my son has convergence disorder and visual scanning insufficiency, and so he has had a very difficult time with reading. And look, you know, so having to choose reading curriculums, you know, I was looking at working with my daughter who had no issues whatsoever, and really just took off reading, and then having to go through and sort through all of this information with my son, and coming up with different, again, educational theories and reading through, we ended up with something called the it's all about reading and all about spelling, which follows a Orton Gillingham approach. But it just opened my eyes that there are many different ways that children learn, which we know as OTs, you know, we look at kinesthetic learning versus visual learning versus auditory, you know, learning. And so for me, it has made a difference to know those options are out there. But then to put the onus kind of back on the parents in this area, I can do that. I can put the onus on the parents and say, hey, it seems like your child is a kinesthetic learner. Where can you go to find those resources? So I have been able to look at the way that a child learns and have that influence what they're doing within their home school.    Jayson Davies     Gotcha. And I just want to ask this up front is, are you providing at all ot services for your students? I mean, naturally, you are an OT as a parent, so you're going to use concepts, but you don't actually provide services to your students, right? You're just their teacher.    Sarah Collins     To my own children, or?     Jayson Davies     To your own children.     Sarah Collins     To my own Well, no. I mean. So that's really hard because, you know, occupational therapy, we're looking at, yes, throughout the day, so my mind is always working as an occupation.    Jayson Davies     And that's what I mean, yeah. So you're always an OT, but at the same time you're not trying specifically. And again, you are, in a way, because you're an occupational therapist, but you're just their teacher at this point.     Sarah Collins     Yes, I go, yes, there are things like I can say, because my son had convergence disorder and visual scan, like we play the game sequence, because I know that that makes a difference for him and helps him to practice. So I mean, I guess as an OT, if that matters.     Jayson Davies     All right. And of course, I really want to dive in. As we go further, we're going to dive more into this special education side of it. But first I have a question, and this is one that is a little weird, but I want to ask you, because I remember growing up when I when I heard that someone's being homeschooled, there's a little bit of a stigma around it. At least there was. I don't know if there is anymore, but I want to give you a moment to maybe address some of the misconceptions about homeschooling,    Sarah Collins     right? So, believe it or not, I actually wrote a paper in college. It was a persuasive essay on why not to homeschool your children? I came, right? I came from a public school background. That's what I knew. That's what you know, that was my biased opinion. And again, I had no intention of ever doing this was not in my plans, until I saw the beauty of it in somebody else's home. So I would say, yes, there is still somewhat of a stigma, you know, I get occasionally the well, how do you socialize your children? Question, but at the same time, it's growing by I think the numbers are two, two to 8% every single year, and so and and with kids with special needs, it's growing even faster. So I don't, you know, I don't really, I have not encountered any sort of stigma. What I would say, as far as therapists working with families who have special needs, or families with that are homeschooling, is a that socialization question. Don't ask it. It's you know, you can say things like, What extracurricular activities are your, you know, your kids involved in, or where are they, you know, with their peers, or how often are they with their peers, or something like that. But really, if you look at what, what is socialization, you know, families are going to be like, Oh, geez, not again, you know. And they're going to kind of shut down right away, so because they have at some point encountered that, that stigma. But let me tell you, My children are, you know, Mondays, we're with a group of kids all day long. Tuesdays and Thursdays, they go to a homeschool karate class, so they're with kids for two hours at that point in time. Wednesdays, we hike every afternoon with you. Well, not right now, obviously, but typically there's 40 kids that are hiking with us on Wednesdays and then Fridays, we are all over the place, so, and that is the typical experience of the homeschool families that I've come in contact with. So it is different, yes, but I think it's something like 2.5 million kids, yeah, 2.5 million kids right now that are homeschooled. So.    Jayson Davies     All right, and it's funny that you kind of brought up how it's growing two to 8% and I actually just got done recording the podcast that's going to come out just before yours, and just talking about this whole COVID 19 experiences. I mean, how is that going to change things? I wouldn't be surprised if there's an even larger jump to home over the 12 to 24 months.    Sarah Collins     Right there very well might be, I think, right now it's so hard, because the advantages of homeschooling, you know, are when you can pick your own the curriculum that does work for your own child, and you can be out and experience the world and go to all these museums and things like that on regular, and that can't happen right now. And the advantages of public schooling, you know, where your kids are in a group all day, and they're, you know, learning from their peers, and they're learning from people who are fully, you know, certified specifically in their subject, right? That type of thing. That advantage isn't happening right now. So really, we're getting, like, the worst of both sides right now. So I don't know. I think it could go either way. I think there are some people, and I have actually had several people that are like, Oh, well, I think I might stick with this. Or, you know, there's some people that are like, this is horrible, yeah, so I don't know. It's going to be interesting to see.     Jayson Davies     Absolutely. All right, so let's start to transition a little bit more into the special education and into ot you mentioned different curriculums, things like that. How might special education? Education look in a homeschooling model, not necessarily OT, just in general, right?    Sarah Collins     So really, like I mentioned before, it's the epitome of an IEP, because a person who is being homeschooled as maybe have their siblings around, but the family is choosing curriculums and choosing what happens during their day based on that child's specific needs. So when you're working with a family who is homeschooling like you can consider yourself working directly with that that team and saying, Oh, I mean, you you've got your whole day to work. You know, education throughout your entire day, not just like a nine to three, but you know, throughout your entire day, so you have so many options to work through.    Jayson Davies     Gotcha and then so again, continuing down that, that path. What about you mentioned IEPs? Do kids that are homeschooled have an IEP?    Sarah Collins     They can, it depends on the state, and I am not particular on what every single state does. We have a state of Pennsylvania, but there is also, there is an organization called HSLDA, which I think it's the Home School Legal Defense Association. And on that website, you can find out the home school laws for every state. And I actually would recommend you knowing them for your own state, because they're, like I said, if it continues to grow and there are, you know, it's 2.5 already million kiddos, then really we your chances are you're going to encounter someone who is homeschooled. So it's good to know those laws anyway. But here in Pennsylvania, you can, you can get an IEP, and we actually did for for my son when I was talking about his vision, because it was impacting his reading so much. And a lot of people will also do it specifically, just for the standardized assessments at the beginning, to be able to say how the how a child is growing, whether it's, you know, with my my kid personally had the VMI done over there at the school. He had the mvpt, and then he also had a lot of neuropsych testing done over at the school, and then we came up with his IEP from there.     Jayson Davies     Okay, so outline that a little bit more, because I think what you're alluding to is a little bit of the Child Find and that a district, if you live within a district, they're still responsible for special education services if a student needs it, whether or not they necessarily attend that public school. Is that right? Or how did that work for you guys to initiate that process? Right?    Sarah Collins     So it worked for us because, you know, being an OT, I recognized it, and I was like, I I would like to a have this testing done, and then B, they helped me to figure out the reading program. So in the public school that Orton Gillingham that I was talking about is the Wilson reading program. The Wharton Gillingham is was taken from that and designed for public or for homeschoolers. But basically, when I recognized it, then I contacted the public school system. And people who are homeschooling may go through that route if they can, or if they know to, or they may just do, you know, through the medical model. So it really, it really depends on the family. But yeah, so what we did is went in, we had all the testing done once I requested it, and then then they developed the IEP, and we had to have, you know, a regular, regular ed teacher sitting in there and a special ed teacher sitting in there, which was actually kind of funny. I think they just didn't really know what to do with us. My husband.     Jayson Davies     Couldn'tsign on the general education, special education, and the OT line all over.     Sarah Collins     I know, and my husband was sitting in there with us. I mean, this goes back to the stigma, but he was like, Sarah, I feel like they were waiting to see like you and show up in your denim dress and walk out from with your apron OT or something like, I know they didn't really know what to do with us, but yeah, because they ended up having people who had no idea who my son even was in the meeting just to fill those spots. So again, that's that's another spot where I would encourage you as as a school system, or as an OT who's sitting in on this IEP meeting with with a homeschool family, sure you're going to have to have those other people in the meeting, but really talk to them as if they know what they're doing, because chances are they do.     Jayson Davies     Yeah. All right. So then as far as services go, then did the public school have their employees provide services to your son?     Sarah Collins     So they offered and they could have, he qualified for ot once a month, which I kind of said, well, he lives with an OT, and so I and he was getting vision therapy at the at the same point, they offered him also the Wilson reading program there, but he was going to have to go in every day for half a day and and that would have been great, had we not had all the. So, you know, I mentioned all the other co ops that we do, and so it just it would have changed our entire life, really, our life for my other children as well, to be able to get him there back. And so we found the same program that we could do, that I could do at home. And so we did that. So now he just follows up every year to for the testing.     Jayson Davies     Gotcha. And then what about, in general, for ot speech, type of services? What are the options for you? Kind of mentioned that some do medical, some do public school. But if you can go a little bit more into detail about what that may look like, right?    Sarah Collins     So I mean, again, it really depends on the state, and what the state is willing to to provide, or what there are laws. And again, that's on the HSLDA site of, you know, because everybody is entitled to the free and public, you know, education. So really, yeah, so then they should be able to go into the public school for services as they're needed, or sometimes they're pull, you know, people are coming to their homes, if they're younger, the same, same type of thing, or you might just choose to do it within the medical model. That really is up to what the parents decide.    Jayson Davies     Gotcha. So with your in your case, you said that the school was offering one time a month, OT, which I'm assuming would be some sort of collaboration consult.    Sarah Collins     You would think, but no, that's they offered us 30 minutes of direct occupational therapy, and which I said, that seems really not like it's going to do much good.     Jayson Davies     Okay, so then they want you to bring your son in to the school to provide that service?     Sarah Collins     Yes.     Jayson Davies     Okay, and so, I mean, some of these questions might seem ridiculous, but it's just shows kind of where we're at, yeah, and where we're not at, right?     Sarah Collins     Well, right? And why I think I'm needed, and why I think this podcast is needed.    Jayson Davies     Absolutely. So let's get into some of the nitty gritty. Um, obviously we as OTs and the OT school house in general, we like research. We really enjoy knowing what is out there. Can you share with us some of the research that you have uncovered as it may relate to homeschooling and students with special needs?     Sarah Collins     Yes, all right, so actually, quite a bit when we were well, let's just start first with the research on homeschooling itself. So there is a website. It's called N, H, E, R, I, the national home Education Research Institute, right? And so they get basic statistics even on homeschooling itself. And that's where I came up with the numbers and the growth and all of that. And we looked into that, obviously, a lot. I mean, I'm an OT I have a research brain. I looked into that before we were deciding to homeschool our own kids. Just another interesting thing from that is that on standardized testing, right kids who are in the public school system. Obviously the norm is at 50% we all know how to look at scores. So the average for homeschool families is 15 to 30% higher than that. So they're scoring within the 65/65 to 80th percentile. So which, again, I mean if you're looking at if every kid could have an individual like education plan, of course, they're going to score higher. Yeah. So there's that. It also has a research journal that is peer reviewed. Actually, the most recent article that came out was on the evidence based practices for homeschooling children with autism. So, yeah, I know, I was like, Oh, look at that. It's just right. I mean, this one just came out, and I was looking through it, but, you know, kind of preparing for this podcast. But it even goes into the practical applications of learning and looking at evidence based practices for just, you know, moving from math, sure, we're doing our math worksheet, and then we're going to carry it over to cooking, which you can do when you're homeschooling, on it on an everyday basis, or carrying it over into, you know, counting, if you're a little kid, you know, little kid ot counting the acorns outside on the tree. You know that you always have that flexibility and freedom to be able to do. So they also have articles there on social development and what social looks. Social Development looks like for kids who are homeschooled, that type of thing. So that's the basic research, just on homeschooling, right, where you can get most of that. Then when, also, when I was starting looking into homeschool, or starting the business, starting Collins Academy therapy services. I looked at just what is the research on homeschool and occupational therapy itself, and there's only actually printed out my copy right here. I gave everybody credit, but there's only one or. Article that I could find. It was by Susanne Iliff, and it basically is saying that, well, the question, the research question was, do people, even who are homeschooling, do they know about occupational therapy? Do they know how to find it? Do they know how to access it? And so their results were that yes, 90% of the people did that they had general knowledge of occupational therapy, of their service or of the people that they interviewed, 29% had actually used but most of those were using public or private insurance. So they're, they're in lies the need for me, yeah, that they're, you know, their conclusion was that there's an opportunity for ot practitioners to provide services for students who are homeschooled in their educational environment, or to promote those educational goals, which, yeah.    Jayson Davies     And it sounds like they're kind of coming in from coming at it, from saying that there needs to be An educational like public school type of service, not going to a clinic a few times a week or something like that, right? All right. And was it, was that also the article that talked about the coaching model, or was that a different article?     Sarah Collins     No, those are different articles. Those are the ones when I was trying to come up with, how am I actually going to open this consulting service. Because, I mean, I mentioned before that it took me quite a while because I had to work through, what does that look like for licensure? Because, you know, we talked about how many people who are homeschooling across the nation, but if I have to be only seeing the people who are homeschooling exactly in the state of Pennsylvania because of my license, I'm gonna run dry here pretty quickly, so I had to switch over and switch my thinking to more of a consulting versus direct therapy, and that's when I was looking at a lot of articles based on coaching. Jeremy, go ahead and go into that now.     Jayson Davies     Well I was gonna ask you, do you want to give a little bit more in depth about what you're doing first, or do you want to talk about the articles? And I think we're going to go over both, but whichever one you kind of want to go with first?     Sarah Collins     Okay, so basically, what, what I'm doing is, I start with an initial consultation. Is, you know, I again, we've had to kind of work through what, what I can call it, because it's not an official an initial evaluation. I am not doing direct therapy, and I have to be very clear about that, because, again, I'm only licensed in the state of Pennsylvania. So with that being said, what I do is is really talk to the parents about what their home school day looks like. Now, again, it's kind of hard, because a homeschool day is not a nine to three or 730 to, you know, 230 whatever the hours of a school they are, because education, the good old quote that we all like to say is education is an atmosphere. So when you're homeschooling, you're looking at all day long, what what your child's day look like, looks like, and how you are learning throughout that entire day. So I get the advantage of being able to talk through, within the homeschool lens of even ADLs in the morning and cooking breakfast and, you know, go their time when they're going outside, and their extracurricular activities. And so the parents and I really talk through that entire day, you know, I I use the Canadian occupational performance measure to set up the goals with the parents, like, what? So, what is your child doing? Well, where are you seeing needs? Are these needs? Do they have sensory needs? Do they have, you know, is it a positional or the time of day? Is so an environment need? Or is it specifically like my kid is having a hard time with reading? Okay? So why? You know, we talk through the entire thing, thinking of them as the expert in their child, but also as the homeschool educator. So after that, then what I do is provide them with recommendations for things that they can change in their homeschool day. So again, I typically work through the PEO model. So I'm thinking like, is it something, again, with a person, is it with the environment or with the occupation itself? And so we kind of talk through all that, and I give them some written recommendations. I'm also, my main thing is that I am, and I have to, again, make it very clear I am not doing direct therapy. But a lot of times what I'm doing is trying to say, okay, so it looks like your kid needs direct therapy, and these are the ways you can go about it, either through the clinic or through the school system. And then I'm, you know, talking to OTs to make sure that they're homeschool friendly, that they're not going to come out with that, that bias right at the beginning and say, No, you know your educational choice isn't right, because each family's educational choice is their families. So I talk. Through a lot of that with OTs and try to network that way.    Jayson Davies     Wait, so how do you do that? Then are you like talking to an OT that might be evaluating the student that you consulted with?    Sarah Collins     If they need direct occupational therapy. Sometimes it's like at once I talk through with his family that no you know what, your kid is going to have a better day if we start off earlier in the day? Or I can say things like, you know, I can look at handwriting programs with that family because so if it's something that I feel like they need direct occupational therapy, then yes, I am. I'm calling around for OTs in their service area and finding someone that I think is going to fit well with them.    Jayson Davies     Oh, wow. Okay, and so then that parent then meets up with that occupational therapist, and it may or may not be through the public school, it may or may not be through a clinic or home health type of model, but you're kind of helping them with that. Okay, interesting, yeah, yeah, all right. So then you do that initial evaluation. You follow up? Do you, I guess. Do you do follow ups, other than trying to provide or trying to help them find services? Do you do, like a monthly consult to kind of just see how things are going, or something like that?     Sarah Collins     I do, I do twice monthly, and they're usually 15 or 20 minutes. I mean, they're really short, but it's looking at we continue on with our copm, you know, there, I'm looking at their scores. There, I do. I usually do that every again, I just started this in October, but, but my goal is to be doing that every three months, just to looking at my pre and post measures and and all of that, but, and their satisfaction scores as they're going through. But, yeah, so we then look at those recommendations, and is there anything new, or is there something that we need to tweak, or sometimes just reminding them of the recommendations that were already made. Or sometimes they're like, You know what this is? This has been going really well, but now I'm seeing this, you know. So We'll then talk through that, that next issue.    Jayson Davies     Gotcha. Okay, so we started down the road, and we went the other way. But about the research? Well, what research did you look up when you were kind of developing your program, right?    Sarah Collins     So I knew, because I couldn't do direct therapy that. And you know, there are so many people out there that are doing teletherapy right now, obviously, and more power too. Yeah, I think that's fantastic, fantastic. But I knew what I was going to be doing is working more with the families instead of with the child itself, again, because I cannot do direct therapy across the nation, so I had to look up, how am I going to effectively coach or effectively kind of explain the way that an OT thinks, or the way that I'm thinking, to help them within their home school. So I started, there's an article that came out in 2013 that is the effectiveness of occupational performance coaching and improving children's and mother's performance and Mother self confidence.    Jayson Davies     That's a mouthful.    Sarah Collins     But it was by Fiona Graham, and so that one really helped me to look through, what is performance coaching? How am I going to have pre and post test or post service measures? Really, what they did was they had a pre they did the copm, the goal attainment scale and, oh, it's leaving my head right now. But they did one other one, I think the POS, PSoC, but I don't remember what that stands for, because I don't use it. I'm glad that they did, but I did not anyway. And so what they found was when they were providing the emotional support, then they were giving an information exchange rate. So that's kind of where I am tutoring, or I am having a conversation with the family on what my thinking is, and then they had a structured process from there. So what they found was that even in just setting the goals, it allowed the family to be able to really hone in on what their needs were. And even just with those setting goals, they had a huge difference in the actual occupational performance, which I thought was really interesting, that even just having a parent set a goal themselves made an impact, had an impact on how the kid did or how they performed. And the other interesting thing was that it had generalized improvements across, you know, their lifespan or not, across their lifespan, across other occupational therapy occupations, other occupation. Yeah. So I thought that was really, really interesting. And at six weeks later, they had all maintained this, their levels on the cop, their satisfaction levels and their performance levels.     Jayson Davies     So just to clarify there, they set up a goal, potentially with an OT or with someone, the parent. Set up a goal. No services were rendered, but the students still made progress, potentially, because the parent had that on the front of their mind and was actually cognizant about what they were doing.     Sarah Collins     And because they had coaching on Okay, so this is how we could help to make a difference to achieve this goal. So the occupational therapist was coaching.    Jayson Davies     Did they say how, how often that was, or was it just like a, hey, here's the goal, here's some things you can try?    Sarah Collins     So they had, I'd have to actually look back at it to see when, when they were me. I think they met four times. Okay? So it was like, but some were even, it was like one week before they set the goals, and then they were setting the goals, and then they met a couple weeks after, again, I'd have to look back at.    Jayson Davies     Either way. It was a lot less than one time a week for 30 minutes for the entire school year.    Sarah Collins     Exactly, exactly, or one time a month. Yes, yes. Okay, yes. So I thought, I mean, that one was super fascinating to me. But then from there, I was like, Alright, so we can say that coaching would make a difference. But what exactly does coaching look like, right? So then I looked at an article. It was called occupation, occupation based coaching by means of telehealth for young children with autism spectrum disorder. So and they also mentioned in there some other coaching philosophies that I looked at, but from that article and putting those two together is where I came up with, what are the pre and post measures that I'm going to do? You know, the cop that I already talked about. I also a lot of times will give the PD, because that helps for us to really hone in on where, what occupations we are needing to address during the day. Which one was that the PD, the pediatric, I forget what the E is, disability inventory, yeah. So that one, and that's a parent survey too. Okay, so, yeah, so what is that? E that's really gonna bother me, because I always say PD, I never, I don't really remember even when it hit.     Jayson Davies     But for you, yeah.    Sarah Collins     Thank you. Thank you. But yeah. So those are two that I the copm is obviously during the interview, and the PD, I typically send out before I meet with the family. So the occupation based coaching. Once I read through, you know, this article too, it really comes up with making sure that you have authentic contexts with the family, that you're considering the family's interests and the goals, and again, that's that's where I'm using the copm and then having the caregiver interaction, right? So that's where I am explaining what my level of thinking is and why. And so I'm doing that with the parent, and then the having the parent reflect back to me. Okay, so this is what you're thinking, Sarah, and this is why. And so when they can reflect back to me, I know that they're they're getting it, and then they're able to generalize into their own home school, and then the parents sense of competence scale. So I have not used that one yet. I haven't researched quite a bit, but researched it yet, but that is one of the ones that they used in this evaluation or this article as well, and then, you know, we come up with our joint plan together. So that's what I'm saying. You know, I provide the written recommendations, but they're all based on that. They can take those recommendations and put them into a plan, and I typically have them say, All right, so what is one thing that you're going to take away from this, or one plan that you're going to implement? And that's gotcha, that's how we're applying the research research.    Jayson Davies     And putting it into place. Okay, so definitely using more of a coaching model. And then if people, if families, do, find it necessary, they're seeking out therapy through another mean, potentially someone that is more local. I mean, this is an experience that I recently, you know, one of my, my own personal ways of therapy for myself, is searching a database called Ed, join out here. Ed, J, O, I n.org and that's basically just a place where OTs, where public schools in California and all over the nation post their jobs, and so it's my own personal therapy sometimes, just to browse, just to see what's available out there.     Sarah Collins     Grass is always greener, right, right?    Jayson Davies     And one was actually charter schools. And I know a lot of and I don't know if you know anything about charter schools or how much you know about them, but I'm seeing more charter positions open up for occupational therapists, and a lot of them are this type of virtual, online coaching type of service, it seems like. And it just got me thinking. I was like, Man, I'm about to talk to Sarah, who knows so much about this. But are some homeschools through a charter system?     Sarah Collins     So, and that is so it's very different based on the state and your California, right? Yes, yeah, okay, so it's interesting because I was actually just working with a family who was out in California, and they were telling me that the way that it works out there is that, or homeschooling works is that you end up with, I think, an umbrella school, and you have to pick but then they get funds through that to help provide for curriculum that does not happen here in Pennsylvania. We don't have that, but our laws are different. We have to have we're evaluated at the end of the school year by just an evaluator that we pick. We have to do standardized testing when the kids are in third grade and fifth grade and eighth grade. So yeah. So it's all different based on the state. So when I was talking to this family in California, what they were saying was, yes, that they can get services through the school system, through their their umbrella charter school. So it sounds like that, that charters, you know that, yeah, the ones that you were looking for would.    Jayson Davies     And they would provide the service in some form another, I actually know a certified ot assistant. I'm trying to get her to come on, because she's doing because she's doing something similar. She's a certified ot assistant who works for a charter school, and so she actually drives from home to home, old, not right now, of course, but she's driving home to home, and she absolutely loves it, because the parent and the teacher, I mean, the same person, and they're so invested. And and so you get that carryover so much more than you might in an SDC classroom where it is, let's be honest, about a three to 12 ratio.    Sarah Collins     Right, right and right. And so what I would encourage you to do is to also look at what the homeschool philosophies are, or when you're going into this person's house, to know, oh, there are so many different homeschool philosophies. I'm going to ask them about it, because once you get that parent talking about what their education model is, or what parents who are so passionate about it because it's it is different. So obviously they're making a choice, and they're thinking they have probably searched and searched and searched and so they've they're pretty passionate about what they're doing. So for you to go in knowing that there's different options and to go in prepared with some questions for that family, you're going to have a whole different rapport than Yeah, how is your kid socialized?    Jayson Davies     Definitely, that's crazy. All right, so let's continue on. How do you think other OTs who find themselves working from home or even working closer with parents right now? Because obviously, when we're providing teletherapy, I know I kind of require that some sort of person over the age of 18, whether it be an older sibling or the parent, is there. How do you kind of recommend that they take advantage of what you've said today, with far as the research and the practical implications. I mean, obviously we're all practicing in this weird situation right now, but you kind of have had some experience with it, yeah.    Sarah Collins     You know. I think you know, even going back to that, that first article that I was talking about, where they said that that the occupation or the therapy was generalized over other occupations, it wasn't just the goals that they set. I think that is really something to keep in our brains, that if we are talking to these parents, more even about what we're doing and why it is way, it is more likely to be carried over than if we're just doing something and then, you know, at the end of the session, be like, Oh, that was great. Or taking your, you know, seven minutes that you have at the end and saying, This is what we did today. But instead really looking at them as your partner and talking to them about how and why, so that then it can generalize over. I also think right now, since we can't really put our hands on people during the, you know, even during direct sessions, and probably once we get back, it's going to be very different as well. You know, to be able to talk to the the family about where you're putting you know, when you're trying to create core stability, what, how you're providing that assistance and encouraging them to do that it, you know they can then do it a lot easier later on, because you're specifically coaching and working with that family. So, you know, I obviously we need to be working with children or working, you know, adults. We need to have that direct therapy, but to consider the family as more of a team member. I think moving forward is going to make a huge difference in our profession.     Jayson Davies     Yeah, and, I mean, I was gonna ask you a little bit later on, you know, how, how can we take what we have into practice, even when we go back into the schools? And, I mean, I'm just trying to, as you're talking, I was thinking to myself, I think I've only seen or worked with a student in the school system while their parent is there a handful of times, and I've been in the system for eight years, and most of those were during an evaluation, not even a treatment. This is during the evaluation, the parent brings them in for for evaluation, and then I don't see them again until they're in the school system, and then I'm seeing them me and the student. It usually.    Sarah Collins     Right? Well, then that's because you're working. I mean, your goals are all set based on how they can work in the educational model. I mean, their goals are throughout that that exact time period, whereas, again, the difference when you're homeschooling and is that your education is not just that specific when you're doing your math or your science, it is your entire day, absolutely. So I don't really remember where I was going with that.     Jayson Davies     Oh, I mean, I think, I think it just, even though maybe we're not speaking with the parent as much, once we get back into brick or mortar, we really have to basically almost replace the parent with the teacher, because the teacher is there for six hours a day with that student as our aides, right? Unfortunately, they can't. It's hard to find time that you can work with them. Be honest, they're with students six hours a day, so that doesn't leave them a lot of time for you to interject and work with them yourselves.     Sarah Collins     I would love to see you know the IEP meetings when you're coming up with those goals. If you can look at this article that is talking about when the family was involved in making the goals, the differences, and I mean, it said that some of the the success came before the interventions even happened, because their families were setting the goals. So if you're looking at setting them with a teacher or setting them with the parent, how different can that be for the child? Because everyone's involved and everyone is invested.     Jayson Davies     Yeah, and that's a big takeaway, because oftentimes at an IEP, the IEP team develops goals. Prior to the IEP. We walk in and we ask for approval, versus calling that, calling the parents ahead of time and saying, hey, where do you want to go with your students goals?     Sarah Collins     Right? Right? I mean, again, it is. That's the best piece area. You know, of course, everybody's time, everybody being so busy. But I also wonder, once we're getting back and the parents have really been involved in their children's education right now, whether, I mean, it was a forced pandemic schooling, or whether, you know it is, they're all more involved in their children's education right now, and so going back into the school system, I'm wondering if they're going to want even more involvement at that point. If they're going to say, Hey, I know how my kid does with fractions now, and I know how he learned when we were doing that, if it's going to be a different situation, I don't know.     Jayson Davies     Yeah, it's really interesting. I'm sure other therapists are seeing it that we have parents saying, hey, I need help with behaviors. Yeah, right. And they don't realize that it's they're not seeing different behaviors than we're seeing at the school. These are the same behaviors, but they think that maybe they're seeing those behaviors because they're at home all day, right? Not always the case. I mean, we were seeing those behaviors at the school, but they just didn't know about it.    Sarah Collins     Right, right? And, yeah, so now that you know, everyone's kind of on the same page, yeah. So I think it can be a fantastic thing for the future. I think also though, I mean, it's going to be hard and something to work through, but I think it really can make a big difference.    Jayson Davies     Yeah. And we just answered the next question I had was, how are things going to change forever based upon COVID 19, we talked a little bit. Oh, okay, let's talk about, how are things going to change forever in homeschooling, specifically not in therapy. How do you think this is going to change homeschooling?    Sarah Collins     Well, I mean, we talked a little bit before about whether it's going to the numbers are going to continue to increase and and I don't know. I do know that it is right now. This is not our typical homeschool either. You know, I mentioned before all of the US getting out how, however often we do, and the social interaction that my kids have with with other groups, and so all of that is different right now, and who knows when all of that will go back to normal? We also, it's funny, you know, I don't my kids. It's not that we're never on screens. But they are not used to zoom and they they are not used to having, you know, when they're learning to have like, 30 different faces staring right back at them from that's what we're doing with our nature study right now, and I found that they have about their attention span is of a net when that was happening. My son's like, changing his virtual background, yep.    Jayson Davies     Oh my god. I have so many kids. I'm like, show me your work sample. And he goes paper, and it blends into his background.    Sarah Collins     I do not he just think the Milky Way right now.    Jayson Davies     It's cars. This kid, he's just obsessed with cars. So he has a different Ferrari or Lamborghini, like every time I see him, Oh my gosh. All right. Last few questions, what tips do you have for any therapist who may be interested in dipping their toe into working with families who are homeschooling?     Sarah Collins     All right. So I kind of mentioned already that just knowing that there are different philosophies of homeschooling and different philosophy. Of education to be able to talk to the family, even just to ask the question, oh, so what kind of homeschooling do you do? Or what is your specific philosophy? Can really get them talking, and can you can find out so much about what the kid needs. Like, for example, with when I was talking before about we do classical learning, which takes, does take a lot of memorization when they're younger, and it also helps us. You know, we go through things with song, like adding things to song to help memorize, and we, or have, I have different movements or vision, or things like that that I'm adding in there. So it's good to know. Okay, so if you're doing the classical method, then these are some things that your kids are going to need and and to be able to say, okay, so, how do they memorize? You know, that's that's a good question to ask a person who is educating in our way. So just to know that there's different philosophies out there, and to ask those specific questions, or to say, You know what? What handwriting curriculum are you using? Or are you doing cursive things like that. I would also ask, you know what? What extracurricular activities are your kids involved with? The majority of homeschoolers are seeking out options for their kids to be involved socially so. Or another good question is, you know, does your child ever have to do public speaking? Right? I mean, the program that we do, my kids every single week have to do a presentation and so in front of their peers. So it is that is a huge part of our homeschool so for if, if I'm taking my kids somewhere, for somebody to ask them about that, or to ask me about it, you know, it's, it's, it is involving me, and is allowing me to set a goal and to look at a need differently than a person who would be in a public school system all the time. So I would just say really trying to think about your questions outside of the box, than just your social stigma that you know sometimes we talked about before.     Jayson Davies     Yeah, all right, cool. Well, before I let you go, then I just want to give you the opportunity to say any last words. Also give out your contact information, if you'd like to, and share any other resources you've you've listed a few already, the Pei, which I haven't I'll look that up. The performance.    Sarah Collins     The P, E, D, I Okay, yeah, pediatric.     Jayson Davies     You mentioned a few articles that I'll be sure to get from you so I can add to the show notes. And you also mentioned a few websites related to homeschooling that I will get up as well. But were there any other information you wanted to share.    Sarah Collins     Other than actually seeking out information? You know, I, in addition to when I'm working with families, sometimes giving making sure that I'm finding them, local occupational therapists, I'm also looking for the best resources to give to them. You know, for an example, I just was working with person on their new handwriting curriculum that was coming out, so that then when I can provide the best resources for these families, sometimes it is that I'm giving them places to go. You know, if you're looking online and you're just Googling something, there's so much out there. So for me to be that person, to sort through it all and to find what's really good for family is a lot better. So, and I love having ot resources. So if you are coming up with a new resource, and you think it would be good that homeschool families would love it, please send it to me and let me go through it and recommend it as I can or as it's needed, all right?    Jayson Davies     And then you mentioned your website. You want to say it one more time so that people could check it out if they wanted to.    Sarah Collins     Yeah, absolutely. So it's www, dot Collins, Academy therapy.com , and I'm also on Instagram at Collins Academy ot services, and there I've been posting every week about a different way that homeschool and occupational therapy kind of coincide. This week I was talking about motor planning and how we how I encourage that through my with my own kids throughout the day. So typically, you'll see my kids on there a lot, but it is how I'm thinking as an OT and help to give resources out to families. And that's the same way that, you know I was, I was talking about that. I was promoting, not promoting, but discussing another occupational therapy resource this week. So send in my way.     Jayson Davies     Sounds good, alright. Well, thank you, Sarah, so much for coming on and sharing all that wonderful information about homeschooling. It was it's actually really, really nice to hear about a different way for education, so I really appreciate it. And thank you.     Sarah Collins     Yeah, it was great. Thank you. Have a good time.     Jayson Davies     Thank you. All right. Well, take care. And I'll see you next time. All right. Sounds good. Sounds good. All right. Well, I want to give a huge shout out to Sarah Collins for coming on and sharing how she is providing occupational therapy consultation for students who are working in a home schooling model, not only the students, but also the families, because they are so important. As she shared, I really don't think there's many of us that are working in that homeschooling model. And with what she was talking about, potentially two to 8% of students moving toward that type of model every year, it's only going to get bigger and bigger, along with everything that's going on in the world right now, I'm sure there are many parents that might be looking into going to that model, so who knows. We shall see. But anyways, be sure to check out the show notes at ot  schoolhouse.com , forward slash episode 49 the links and the articles that Sarah talked about will be there and then. If you are interested in earning a certificate of completion for listening to this episode, be sure to also head over to the show notes, or you can also go to OT schoolhouse.com , forward slash, PD, as in professional development. There you can also purchase the episode professional development opportunities. So check those out, and we will see you back here for episode number 50. Take care. Bye, bye.    Amazing Narrator     Thank you for listening to the OT school house podcast. Now that you've listened to this episode, head on over to OT schoolhouse.com forward slash, PD, as in professional development to earn your continuing education certificate until next time class is dismissed.  Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 48 of the OT Schoolhouse Podcast. In this episode, Jayson shares how he has transitioned to providing teletherapy for the students on his caseload. He talks about the technology involved, the types of teletherapy, simple treatment ideas, and even some ethics of the situation. At the end of the episode, Jayson answers several questions that were asked on Instagram. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: ​ Link to Zoom's HIPAA ​Compliance Guide Link to Zoom's FERPA Compliance Guide Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies, class is officially in session.     Jayson Davies     Hey everyone, and welcome to the OT school house podcast. My name is Jason Davies. I am so glad that you are here with me today on May the Fourth, if you're listening to this episode on the day it launches, it is May the Fourth, also known as Star Wars Day. May the Fourth be with you. Really appreciate you all being here. Maybe you're stepping away from your Star Wars binge today to listen to this, or maybe listen to this a few days later, either way. I hope you had a great May the fourth. I also hope you all had a great ot month in April. Of course, it's a bummer that a ot a had to be canceled, and it was just a weird month, but Instagram, Facebook, all the social medias were just going crazy with awesome ot content, so much advocacy, so many pictures, so many videos, so many just like quotes and all that good stuff, the A to Z, school based OT or not even school based OT, just ot in general, the alphabet. It was just all so fun to watch. So yeah, great job to everyone who advocated for our profession using whatever method they had. Really appreciate that. Today we are going to be talking about teletherapy. I'm actually just going to kind of give an overview about what I'm doing. No guest today. It's just me and you talking a little bit about the timeline that I've been following with my district, talking about the tools that I use, both the hardware and the software, talking about some easy to use treatment ideas that you can implement with very little, very little supplies, because we don't know what our parents have at their homes. And then I also want to talk a little bit about the future, what's going to happen either A, when we go back eventually, and B, just how things have been changed forever because of all this. We're also going to talk a little bit about different types of therapy. As far as providing teletherapy, right? We have either live, you know, on Zoom, or there's also more of a consultative or coaching method, potentially that could be asynchronous, where you are actually providing the therapy and the child and or the parent are watching it. Later, also get into some billing and ethics, and then at the very end, I actually have some Instagram questions that I'm going to answer kind of in rapid fire, hopefully, but we'll see how that goes. Sometimes I ramble on, but that's okay. It could just means more content for everybody. So before I get started with that, though, I do just want to say thank you. Thank you. Thank you to everyone who participated in the A to Z school based ot course. I know many of you were excited for that. I was only able to accept 30 students for this course, and I just want to say a huge thank you to every single person that came on board with me. We finished that up last week. It was an awesome experience. I got so much good feedback. I both both feedback that was just like, amazing. People really love the course, but also a little bit of feedback where it's like, Hey, this is where it can be improved for the next round. So that's actually what I'm going to be working on now, is that I'm going to update that for you all before I submit it back out to you. So I know many of you are excited to to get on that, but I'm not going to release it just yet. Even though I'm done with the first cohort. I'm actually going to update it a little bit and then get it back out to you, hopefully by June. But I also want to be sensitive to the situation that we're currently in, and so it may be extended out again, just depending on whether or not we're even going to be back in school, because this course is really designed for when we're in the brick and mortar classrooms. It's not necessarily designed for teletherapy, right? We had no idea that this was going to be happening when we started that course, but yeah, so I am constantly looking at that situation and trying to figure out when the best time to release this course is for you all. If you have any input on that, please shoot me a direct message, a DM on Instagram and let me know what you are thinking about all that good stuff. All right, so we are diving into teletherapy today. I'm going to try and slow down a little bit. Sometimes I just start getting faster and faster real quick. This is a disclaimer, and that is just that everything that I'm talking about today is solely what I am doing. It is not what I expect you all to be doing. Everyone is probably doing something a little bit different, and that is okay. I am not endorsing any specific type of teletherapy platform. I am not saying that I am using whatever are the best method, methods that a ot a puts out or that another entity puts out. I am simply talking about what I'm doing and letting you know just kind of, potentially give you some ideas based upon what I'm doing. There is no one right or wrong way to provide teletherapy, so please know that just keep doing what you're doing. You're probably doing a fantastic job. I'm just here to try and maybe give. You a few tips or a few ideas that you can even expand upon, all right? So first thing I want to actually dive into is my personal feelings about this, this whole situation. I mean, it's crazy, right? And honestly, I feel like I am in over my head. I feel like districts are in over their head, and that we are all trying to fly the plane while we build it, and it is just. It's not fair. It's not fair to parents, it's not fair to teachers. It's not it's not fair to occupational therapists, physical therapists, speech therapists. It's not fair to anyone, and it is especially not fair for students with special needs. There are so many companies out there that provide online or teletherapy services, and they do a lot of work to do that before they get started. I mean, think about that. They actually set up a full on platform that is easy to use. Then they bring in therapists, train them how to provide teletherapy, and then they let them go out and try to provide teletherapy. And usually they try and bring in experienced therapists who already know how to provide therapy and can then adapt it for teletherapy. And these are actually like full on companies that are doing this. And yet, here we are within a week or two of being put on lockdown or being expected to provide therapy services for an entire caseload that we've never had training on. And I know many of you have listened to Episode 22 of the OT school health podcast to get a little bit of an introduction to teletherapy. But that is, let's be honest, that is not a full blown course where you are really learning how to use a platform in a way that it can best help your students, right? I also, as far as my personal feelings, man, this screen time is killing me. I just got off a three hour IEP. That's part three of an IEP. And my Adapted PE teacher, who is awesome, she's going to be listening to this and know exactly what time I'm recording this, but it was a part three, and we're still not done with it, but I was on basically Skype or zoom, sorry, from like 9am to 6pm and now I'm still in front of my computer recording this for you, and it's just so much screen time, my eyes are just like dying right now. It's kind of nice with the podcast, because I don't really have to look at the screen. I can just talk. But it is here I have my notes on the screen. It's just so much time on the screen, and it's tough. You know, it's a long day. Another thing personal feeling a little bit but also just it's happening, is my internet's gone down a few times. My wife's a fourth grade teacher. She's using a device or two in one room. I'm using a device or two in another room, and our internet is just right around 9am right when I start to provide services. It's just like, Nope, sorry. It only lasts for maybe 20 minutes, at least the last two or three days, but it's still a pain in the butt. It's like, what the heck. Come on, man. I really need the internet right now, and you're going out on me. So that's another thing that just kind of, it's a pain in the butt sometimes, honestly, another thing that I've been thinking about is just, and we'll get into this a little bit more later, it's just really, how is this going to change life forever? And you know, whether it's next week that we go back, I don't think it's going to be next week, obviously, whether it's August or whether it's January or beyond, how is life going to be changed forever because of this? And I hope that you're kind of pondering this too, because I don't know, I don't know where we're going to be, but I'll talk a little bit more about that in a little bit. Last thing on my mind is just, I want to say thank you so much to every parent out there, to every teacher out there, to every ot out there, speech therapist, anyone who is educating kids, working with kids, yes, for the most part, kids are at home in a loving household. But that's not the case for every student. And there are students potentially out there that rely on school so much for positive interactions for food and for so much and, you know, just really praying for those kids and they they are in a safe environment, and at the same time just saying thank you so much to all the parents that are having to do more than what they may have done two months ago, right? And they're with their student all day long, also the siblings that are stepping up and being on those zoom calls with us therapists and then working with the working with the student throughout the week, until the next session rolls around and we can see some of that progress. So thank you to everyone who is working with a student, no matter what your profession is right now, basically everyone on Earth is a teacher right now. So thank you saying thank you. Thank you. Thank you so much. All right, so now I want to talk a little bit about the timeline and how we actually got to this point where we are at right now. And I still remember sitting on my computer, surprisingly, right? It started on a computer and it's going to. Initial on a computer on March 13. It was a Friday, and I was sitting online in a conference that I was supposed to be at a hotel for, but literally the day before, or the two days before, they had emailed us asking, Hey, do you want to come in, or do you want to do it online? And most of us responded, hey, we still want to come in. And then the next morning we were we received an email that said, Sorry, we just can't do that option anymore. It's going to have to be online. So I want to give a huge shout out to Alicia and Lisa for still doing that conference, even though it just got crazy right there at the end. I don't know if they listen to this podcast, but if they do, thank you. Thank you. Thank you so much. If you know them, then you know what conference this is in Southern California that's been happening for several years now. They're pretty awesome, and so it was actually during that conference on Friday the 13th in March that myself and the other OTs in my district were all kind of texting each other. We're hearing that other school districts are shutting down, and we're just kind of waiting for the email. We know it's coming. I kind of assumed that it may not come until Sunday, because they don't want to, like cause panic while all the students were still at school on Friday. But nope, it came around noon, ish, maybe a little bit after and definitely, yeah, I don't know that I'll ever forget that day, right? The day that basically Southern California just shut down, and so we're all sitting in that online community, and boom schools are just shut down. So those are probably similar to many of you, although maybe most of you were probably at your school when you got the news, or maybe you were at home already and got the news, but whatever it might be, right, it was just a crazy day. I know for so many students, they had no idea what was going on. I mean, I know some students are just still so confused. I know one of my parents said she's basically telling her student with autism that school is sick and that's why they can't go to school right now. And you know, for kids who they don't quite understand this, that's kind of the best way that she found to talk to her student about it. So that leads me kind of to the next week, which, what do you do when schools closed and we don't know what's going to happen? We didn't know that we're going to be providing distance learning at that point. We didn't know what to expect, so we started putting together some resources, various resources that we could put onto the website, being very mindful of copyrights and all that good stuff. I know all of you have had to pay attention to all of that. But anyways, we eventually put some stuff together and sent it over to the district office, who basically made an OT resource page online. And then a week later, we had spring break, and after spring break, we came back and they're like, oh, we need you to redo it, really, because it wasn't quite enough. It wasn't everything that they needed to be up there. Remember, again, just flying the plane while we're building it right every week, something was new. And so at that point, we at least knew that we're gonna have to start providing distance learning or distance occupational therapy. And this is one thing. I don't want to say it's anything wrong with the administrators, but at the same time, remember, they're coming from a very educational point of view, and they don't know all the OT aspects. And they are used to working with employees that are credentialed, not employees that are licensed, and have a different body entity that looks over them like we As occupational therapists do, and so they don't know about occupational therapy and teletherapy, and they that has to be oversighted by your state licensure. And so I'm kind of bringing these up to and the rest of the OT team, kind of bringing these ideas up to our administrator and letting them know, hey, the state of California has these guidelines when it comes to and not just guidelines. They're actually legislation when it comes to providing teletherapy services. So letting the administrator know about what that legislation says, yeah, so that was kind of the week before, or the week leading into teletherapy services. Also that week, we were playing around with different just like you were, I'm sure, playing around with different platforms, playing around with Zoom, playing around with Google meets, anything else that might be out there. I looked at Microsoft Teams, which was confusing, but I've heard good things about it. Maybe you're using that and it's working out well. So anyways, we all got comfortable with with Zoom, and then all of a sudden, well, we're no longer allowed to use Zoom. I'm sure you've heard about all the Zoom bombing that happened. We basically got shut down, told that we couldn't use Zoom. So we all went over to Google meets, started to learn about that actually did about half a week with with Google meet. Rates of therapy, and then the district's like, Oh, hey, by the way, you can now use Zoom again, we did whatever we needed to do, which is actually they had to get an agreement with Zoom, basically saying that everything is secure. This is actually something that you should know if you have to do any type of HIPAA, if you're working with online teletherapy services. Yes, there is actually, it's called a BAA. Basically, it means Zoom is your business partner, and that everything is aligned technologically and and business wise, to make things work. I don't want to get into the specifics of that, but yeah, I know right now HIPAA is kind of relaxed, so you can kind of get away with using the free version of zoom, but in the real world, when we when this is all said and done, who knows what's going to happen with that? If they're going to go back to where yes to be HIPAA compliant, you should have the healthcare version of zoom, which is expensive and so real quick, I want to talk about those last few days before we started therapy, because I know that was hectic for everyone, and it was hectic for me. What helped was a lot of communication, so many emails, like my mind exploding because there's so many emails, individual emails with all the parents on the caseload. We actually wrote an email. I kind of drafted it like at 11 o'clock one night, and it's just okay, parents, this is the situation. Here's some options. A we can continue to provide live therapy to your student via zoom or something like that an online platform. Another option is that we can provide a recorded video for your student, and you can provide or you can do that activity with them, and we will provide ways to accommodate that activity to make it successful for your student. Option C was just, Hey, do you just want some worksheets? I mean, we can just send home some worksheets, and you can do it with your student. And option D was actually no services at all. I had no students or no parents asked for no services at all. They mostly wanted the video format where I send it out a video. And I'd say about maybe 55 60% wanted the video, and then another 40% or so wanted live. And so I have about 20 ish, maybe 22 live sessions that I'm doing every week. And so that final week was really tricky. I mean, we were planning sessions, so I was trying to figure out what sessions we were going to do. I was kind of grouping my students into levels, so I can kind of figure out what how many videos, and what type of videos that I can make for students. I know someone has had a question about that, so I'll get into that a little bit later. Also just trying to figure out how to record, how to schedule all these students at a time. And of course, teachers are trying to schedule students too, and the speech therapist is trying to schedule students too. So trying to get that all worked out, it was just crazy. And then also trying to figure out what tools parents may or may not have at home for treatment materials so that final week and even still now, I mean, it's just so much communication, so much asking parents, hey, what do you even have at your home that we can use for therapy? There was craziness when it came to zoom, because everyone was like, all on deck with Zoom, and then zoom basically got canceled for everyone, because not canceled, but just about every district said, No, you can't use Zoom all of a sudden, right right before we were about to provide services. But luckily, we are able to use Zoom. I really like zoom as far as for what we're doing, in comparison to Google meets, that is not a doubt with me that Zoom is better for this. It's amazing. So I talked about March 13 being that day that we got the email about school closing. On April 13, a month later, was the day that we actually went live. I sent out those recorded videos, and we started to provide services for students. And so one month and one month, we went from being all brick and mortar school to being fully online. And that is just crazy, and that is what leads me again to say, be kind to yourself. Understand that you are doing the best that you can do as well as everyone around you. As far as the educators, everyone is trying to do the best that they can do. It's crazy. You know, you hear some teachers are seeing kids or working with kids one, maybe even two times a day, in the morning, in the afternoon, and then other teachers are working with a kid once a week. And you know what? To each their own. There is no right or wrong way to do this same thing with you. There's no right or wrong way to provide ot right now and again. I don't I don't know how to say it any other way than that. It's just do your best. Do what you can do. If you know technology and you're good with technology, then maybe you can do more if you're not as great with technology. Then there's nothing wrong with sending home worksheets, as long as you are ethically billing them as as that that you are giving, you're providing the parent with resources and not actually providing hands on therapy. All right, so real quick, before we get before we move on, our district made the decision pretty early on that we were not going to do evaluations and that we are only going to provide therapy services, and I believe that is what most schools are doing. Now I haven't looked it up myself, but I have heard from multiple sources that idea has basically put a hold on the aspect for evaluations and is not necessarily requiring that evaluations be completed within the 60 day timeline. They understand that that is just not possible. So right now, we are only doing treatments, all right. So one of the questions that I've received on Instagram is, how am I doing videos? I also received an email about this. Thank you so much for asking. And I am actually using zoom to create my videos. I have a document camera that I borrowed from my principal, and I'm using that document camera as a second camera on Zoom, and then I am recording my session. It's just me in a Zoom Room, but I'm not inviting anyone into the Zoom Room, so it's just me and my document camera there, and we are I'm pressing record. I'm recording them. I am then putting that file onto our Microsoft OneDrive that we use at schools, at our schools, and then from there, I share a link to that Microsoft One Drive video or whatever other file that I want to share. Yeah, that's it's, I know it sounds probably simpler than it actually is, but that's how I'm doing it. If you actually need help with recording on Zoom, I highly recommend that you look that up on YouTube. There's a lot of explainer videos to show you how to record on there. So these videos are actually called asynchronous teletherapy, and what that is is that I am sending the parents a video. I am showing them how to do something, for instance, how to write in Play Doh, what they can do with Play Doh. So maybe they are warming up their fingers with rolling balls of play doh in their fingers. Maybe they're making larger balls, smaller balls, different types of squares, using toothpicks to build shapes with the Play Doh in the toothpicks. And then I start to have the student use a toothpick as a writing utensil and make lines or shapes or their name or or other letters, depending on their ability levels, right? And then so I make that video and I send it out to the parents. Mind you, I am not making an individual video for every single student. I am making four or five videos a week, and they are going out to a student that I have placed into a group for those for that individual video. So I have about four groups, sometimes, depending on the level or the skill that I'm working on, I'm breaking into five, and then that video is going out to, I mean, roughly a quarter of my caseload. And then they the other half of that is that I asked them to fill out a Google Form. Actually, it's a Microsoft form to give me feedback on how that went. Some parents are even sending me pictures of their student completing the activity, or a video of them, or just the work sample. And it's awesome, because I'm getting to see the kids, and it's nice to be able to see their smile. So that's really cool, but that is an asynchronous model for teletherapy. You are not physically working with the student. You are sending a video, and it's kind of like a YouTube video, except a little more tailored to them. You're giving them the idea, not saying, just go find a YouTube video, and within that video, I'm also giving ways to accommodate the activity so that they can help their student be successful. So yeah, that's actually working pretty well. Most of my parents have given me good feedback on that. I'm also asking them, in that form, when they complete it, for me to tell me about how much time it took them, so that could potentially help me know if it's too short or too long. I'm also asking them, you know, how much support did the student need to complete that activity. And if there's any other feedback, I have a few questions in there. It's very short. I'm trying to get parents to respond, and then other parents are going a little extra mile and emailing me those work samples or pictures, which is kind of cool. And then the other type of therapy is the synchronous therapy, which is the live zoom calls. And I want to jump into actually, some of my favorite activities so far. But first, I want to say that with the asynchronous the videos, we are not billing that as a direct treatment that is being billed as a consult. And so you are providing a resource in a way, so therefore it is a cons. Result, not a direct treatment. If it is, if you're working with a student live on a therapy session on Zoom, then yes, we are billing that as a live teletherapy session, and we use paradigm, so that's how we are billing it. All right. So I want to actually give you guys some easy activities that I'm doing. Some of these activities you can find on my Instagram page. I've been trying to make some short videos just to give you guys ideas, and I'll really quickly go over this finger Twister. I believe there is a video of that on my Instagram. Basically, the kids are creating a little Twister board with pencils and a marker or color pencils, and then we're playing finger Twister, which is a lot of isolation of finger movements, right? Another one that I'm doing is actually I'm using the zones of regulation program, and I'm making a Google Slides PowerPoint. And I've actually done this for three weeks now, and it's actually going pretty well. The kids enjoy it. I have some books and some little video clips that I can play for the students. It's also interactive, at least for the kids that I'm seeing live, because I can move the stuff around. I don't put it in presentation mode, I just leave it in editing mode, and then I share part of my screen on Zoom. And then I can move things around. So I can move pictures around so I can ask the student, all right, here's the happy face. Where does the happy face belong? In the green, red, yellow or blue? And then either myself or the student can click on the happy face and move it to the green zone. So that's cool. I've done shaving cream, just, you know, showing parents how they can use shaving cream, how they can slowly introduce shaving cream to their students, for the kids who might be a little adverse to that play doh already kind of mentioned a little bit of Play Doh, finger manipulation, building with toothpicks. I call this a grab bag activity. I don't think this one's on Instagram yet, but basically putting different items, toys into a bag and having the student just try to find those items in the bag without looking into the bag. So a lot of parents have like, reusable shopping bags that work plastic or, sorry, not plastic see through bags, but reusable plastic bags that work things like that. And you can really use you can really make that more difficult or simpler based upon the items that are in the bag, right? The more similar they are, the harder the activity is, the more dissimilar the items are. Then it's easier for the student to reach in and find those shapes without needing to look in there. Drawing with letters. That is one I have on Instagram. Basically, you draw you draw a letter. It's coming to my head, letter C, and then you turn letter C into a caterpillar with a few more drawings that's on Instagram. Check that out. And then so much you can do with Legos. I mean, so many things. Two things that I am actually going to be doing next week with my students is copying a Lego block design. So they're going to have Legos, and I'm going to show them a picture of a different Lego block design, and they are going to recreate that. If that's too easy, I'm going to take that away, the picture away, and I'm going to either do like a little visual, where I show it to them really quickly, and then they have to build it from memory. Or even for students who might have some planning difficulties and spatial awareness, is I describe how the image is built, and they have to try and build it based upon how I'm describing it, or vice versa. I can show them the picture, and they can describe to me how it's supposed to be built, and then I build it. And hopefully, as a team, we're able to build a structure that looks like what's in the picture. The other thing is a Lego code, and I'll have to post a picture of this on Instagram, but basically, for each letter, you have a different Lego block combination. So maybe green on top of red is letter A, and red on top of green is letter B. And then you can put that together in a picture, right, and have the student break the code to break the hidden message. All right, so those are some activities that I've been doing recently. Try it out, or share some of your other ones with me. I'd love to hear what your activities that you've been doing are on Instagram. I've seen so many good stuff on I mean, I told I'm telling you, man, April was an awesome month for occupational therapy on Instagram. Just amazing. So many ideas, so much advocacy. It was just amazing. All right, I've already mentioned a few of these, but I want to go over each one separately, and that is what tools and technology I am using for teletherapy, Google Slides. That's pretty easy, right? Everyone I think uses Google Slides or PowerPoint. I happen to have a web camera that I bought specifically for the A to Z school based, ot course, and that just happened to have, happened to come in like right before the whole quarantine started. So I have a web camera that is better placed than what would a like laptop. Web camera is right, and I can manipulate it if I want to. So if I want. Show my dog to a student, I can literally just pick it up really easily and turn it or if I want to point it downward, it's super easy to point it downward without moving my screen down to the point where I can't see my screen anymore. So you can get a halfway decent webcam on Amazon, maybe, but assume that they're probably selling out, but for not too expensive. So if that's something that you think might help you, a web camera, you can probably get one, a cheap one that'll do the trick for you for about 20, maybe $30 another thing that I use is a doc camera, a document camera that I mentioned earlier, and that is one that I honestly I went into school one day and I asked my principal, she had a doc camera that I could borrow, and she just happened to have one. If you don't have a document camera, you can look up how to use your phone as a second camera to your computer on YouTube. There are different ways, whether you have an iPhone, an iPad or an Android phone, that you can use your phone as a camera potentially. So that way you can have a second camera, instead of trying to shift your video camera on your your laptop webcam downward to look at your hands for a student. All right, so check that out. I mean, people are creative. They're even using like soup cans, just placing two soup cans up and then putting their phone on the soup can so it looks down at a piece of paper that they're working on, and that can work as a camera. I also have a second computer screen, which is like that I've had since high school, like 10 years ago, or whatever long no longer than that 12 years ago. I don't even know anymore that I've had, and it still works. And so I'm using that as a second computer screen, which helps when you're on Zoom, because you can see what you're sharing and you can see the student at the same time on large screen. So you can actually see both what the kid is seeing on your screen and also what they're doing based upon what it what they're seeing on your screen. So that's cool. I do use Zoom lots of emails. And if you need a phone and you want it to be a little more anonymous than your phone number, your actual phone number, you can use Google Voice. I'm sure many of you have already figured that one out all right before I get into my predictions for the future, and also some Instagram questions that I'm just going to kind of do rapid fire answer to. I also want to talk about your own health and that remember, you are at work every day from 730 to 430 or whatever your time frame is, and you need to remember to take care of yourself. So remember to get some exercise in, whether it's going on a bike ride with a mask on, or taking your dog for a walk or doing an exercise video. There's so many free exercise videos out there these days. Do that every day, if you can try and get a little bit of exercise in. I also want to remind you about the 2020 20 rule. I am not good at following this, and it's hard to do if you have a 30 minute session, because 20 minutes you can't just take a break after 20 minutes, right? You're you're trying to keep your student engaged. But the 2020 20 rule, and maybe you have a lesson actually teaching your kids about the 2020 20 rule is for every 20 minutes you spend looking at a screen, you should look at something 20 feet away for 20 seconds. So like right now, we're at 34 minutes. I've been staring at the screen for 34 minutes. I need to turn around, look out to my yard for 20 seconds and just kind of look around for 20 seconds to kind of give my eyes a break that they need. All right. So I'm gonna press pause and do that real quick, all right. And so along with that 2020, 20 rule is also make sure you have a nice setup workspace. I know that is not the easiest thing in the world. We don't all have a good workspace available, but try and make something your own. I mean, even if it's spending a little bit of money to get a nice, comfortable cushion for your uncomfortable chair, do that. That's what my wife did. Make sure that your feet are nice and planted on the ground, make sure that your computer screen is up a little bit higher. Again, that's the bad thing about laptops, is that the computer screen is so low, so you're constantly looking down. Not good for your neck, not good for your eyes. So if there's a way that you can lift up your computer screen somehow, and then maybe even use a Bluetooth keyboard and a bluetooth mouse to type on, versus having to keep your laptop at a bad angle, all right? And also, I mean, I've been thinking about this. I guess this is kind of getting into my predictions, which is a good segue. But, man, workers comp. I mean, how many people are starting are gonna have back issues from sitting in front of a computer for so long and looking at a computer screen. Man, I know my back hurts after a long day. It's hurting right now. And so what point is it? Something related to work? Because, you know, you used to stand up all day, and now you're sitting down. And of course, the district doesn't know what your desk looks like. The district doesn't. What your seating looks like. I mean, they don't, they don't even know what your they don't even care, really, what your house looks like. They just want you to do the work and see kids. And I mean, there's so much more I could go into about that, but, yeah, I don't know where that's going to go as far as ergonomics and people that are going to get injured because they're sitting on a computer for so long, and how that might impact districts and other employers, all right, which leads me a little bit to my predictions. And obviously, you know, these predictions are for California, maybe even only Southern California. At this point, I'm getting closer to feeling like we will return to schools in August in some form. I don't know what that's gonna look like. I have heard a few rumors that it might look like year round schooling. So maybe there's a B, C and potentially a D track. And there are three tracks in school at all times, and so one goes to school for three months and then goes off track, and another one, they just offset right? If you've ever worked or know about a year round school, they kind of work on tracks. I've also heard potentially, about kids, half the kids going to school in the morning, half the kids going to school in the afternoon. I don't really see that working out. Likewise, I don't see kids. I don't see the system working out if kids come to school on Monday, Wednesday, Friday, and then other kids come on Tuesday, Thursday, and then they switch the week after that, I just don't see that working for parents schedules. I don't see them wanting to clean the entire school every single night, because that kind of offsets the purpose, right? If things live longer than 24 hours, then, unless you clean the school, what's the purpose of distancing the kids? If things live and then they come through and touch something, and now every kid's sick again, right? So those are gonna be tricky. I don't know what's gonna happen, but, yeah, I also know that looking forward, because we have postponed evaluations, there's going to be a lot of evaluations to come back to whenever we come back, right? So that's another thing also, last on the last episode, Episode 47 you heard from Tony win, the special education lawyer, and he basically told us at the end of that podcast that he's already working with parents on a plan for what happens as far as makeup services go, as far as evaluations that were postponed goes. And so I am not looking forward to seeing what happens with that and how much makeup services we may or may not have to make up. And yeah, the last thing, really, I just don't know how things are changed forever. I mean, is HIPAA ever going to go back to being as stringent as it is now. Or are they gonna say, hey, it worked, so let's just keep it kind of relaxed as it is now. What about kids? Are more kids going to enroll in homeschooling or online schooling? I mean, they're already doing it now, right? So maybe some parents will find out it's it's nice and they can just do that. Will public schools start offering an online component, or will they offer online learning to maybe high schoolers or other populations of students that have kind of shown that, yeah, they can do it and it is effective. I mean, and again, what does that ultimately do to special education? Does Special Education kind of go away where maybe students are being educated on a computer and then come into a school for services. I don't know. I just know that things are probably going to be have changed forever, good, bad, whatever, things are going to be changed forever. All right. I want to wrap this up with rapid fire Instagram questions. All right, drum roll, please. I'm gonna try and do this quick. Weezy ISC wants to know, for those not doing teletherapy, when does it become unethical to do so, even if legislation says no, I don't know, our legislation says yes, we can provide teletherapy. I know there are some places that's probably still say, No, I know most services have relaxed that, but to answer the question, there's just so much hidden in that question. I don't want you to get sued. I really don't know the answer to it. I'm sorry. I wish I could give you a straightforward answer. That is a tough question. I think that is something that you really have to talk with your entire team at the school to figure that out. And I mean, if your students, if general education students, are getting an education, then IDEA says that your special education students also need to be getting the services in their IEP. That would be tough. I would be having a conversation with my admin if there was legislation like that. I would also be potentially calling my state to figure out, hey, you guys got to do something, because we need to be able to provide services, all right. KK, page 15 says or asks, How are occupational therapists supporting? Students and moderate, oh, sorry, students in moderate to severe, special day class placements, you can use the coaching model, where you're working more with the with the parent, and teaching them how they can help their student. I've also sat in on a few of the Zoom calls for my teachers, and so for one, for instance, one of our students was having difficulty attending to a zoom call. So I sat in and basically I just listened and watched that student, and kind of, now I'm gonna go back and work with the parent and say, hey, you know what? He was all over the place, but that's partially because we're sitting at a table that's so poorly, so poorly positioned for him. He can't touch the floor. He's leaning on you because he can't stabilize himself. Let's try something else. Another occupational therapist, Kelly, alt right, who actually was on episode 25 or 26 one, about the sensory integration, had a brilliant idea to put the kiddo into a laundry basket and kind of stuff it with some some blankets or pillows or something that way we can kind of support him, and he feels a little bit more interested in the activity, all right. Other ways that you can do that is by sending those videos out so that the parent can do it on their own time. That does help. I mean, parents are struggling, right? It's, I mean, I have a parent who has two students with autism and kind of an adolescent, so it's a handful, and she's struggling, but she, like, really appreciates all the support that we're giving her. All right? JDC, Mom x3 says, I need more ideas for activities with limited supplies. I am trying to be very mindful of limited supplies. With our parents, I am keeping things very basic. For some students, I'm even almost treatment planning the week before, when I'm on the session with them, we finish a session, and then I say, hey, what do you have? As far as toys? Let me see some of your toys that you have, and then I'm almost on the spot planning what I'm going to do the week later based upon what they have in their toy in their toy box. I'm making their toy box my toolbox, basically. Alyssa RAM, 87 Hello, Elissa. Always nice to hear from you. What's your take on parents wanting super late sessions, like after 6pm No, I'm just gonna say no, everything's gotta be during a school day. Some of my IEPs have been later at night. I am not liking it. Services should be during the school day. Callie B wants to know who determines using school based teletherapy. That should be a team decision. I know your school wants you to do it, but work with your team to figure out what is the best way, and that includes the parents, what is the best way to provide the services mini sasu Si su would like to know some advice for new grads starting in a school setting this summer and doing teletherapy. Oh man, take it easy and know that this is not the norm, especially if schools come back in August on digital platforms the way that we are right now. Take it easy and try your best. Definitely communicate with the other occupational therapists that you know. Reach out to me if you need a little assistance, reach out to another OT, get into the school based ot Facebook groups. There's so much support there as well, but take it easy and just try your best and know that parents will be appreciative basically with any therapy that you're providing, and they'll love you even more once you get back into the classroom and really see what you can do. All right. Katiari wants to know what are the requirements to comply with IEPs during these unprecedented times. Man, just try and follow the IEP as best you can. If it's individual, you can do individual services. If it's group, you may have to let the parent know that due to confidentiality, you may not be able to do groups. Every district is doing this a little bit different. You're really gonna have to look to your district for guidance on how they want to do this. District States know that IEPs are not necessarily being followed 100% but you're providing services to the extent possible. Oh, she also wants to know, will we be required to make up sessions? After all this work depends. Honestly, I'm just gonna say the squeaky wheel gets the worm right, or gets the grease right. So my guess is, for some students you will, for some students you won't, that is probably unethical. And by a district that's that's kind of a little unfair, right? But this the reality, and it was also the reality before services went all online. Some services, you know, you should be keeping track of missed services, and even you might have to be that squeaky wheel and say, Hey, I missed this many services, and I need help. Up when we come back, whenever we come back, because I need I need help, and you may or may not get it, and I'm sure your district is worried about that as well. So have the conversation with them. Leslie MCR, have you found a good way to get data on writing objectives? Not really. I'm trying to get objective. I'm trying to get data by having that Microsoft form, as well as getting work samples in the form of pictures from students. Sarah Schwartz wants to know, would you or sorry, she would like to know how to best support nonverbal kids who are extremely distracted on camera the same way that you would even when you are in the room with them. You've got to be very engaging. You got to have good facial expressions, be very active, and also work with the parents to do the same thing. Also, for some students, you may have to have or you may have to ask the parent to potentially be a little more hands off or more hands on, depending on the situation. Right? Every student's a little bit different, but keep them engaged with stuffed animals. Keep them engaged with your own personal animal. Try to find engaging activities. We have three more here. Garrido Ellen would like to know what platform I'm using to have sessions, and is it HIPAA compliant? I'm using the free or at least, I'm assuming it's the free version of zoom that is being provided to school districts. Is it HIPAA compliant? Technically, no, but HIPAA is relaxed right now. So yes, keep in mind that actually HIPAA has, or, sorry, Zoom has, a HIPAA compliant platform for healthcare practitioners, and you can't even look up the price until you ask them for a quote. So I'm assuming it's expensive. Actually, I will put documents or links to documents that Zoom actually has about HIPAA and fairpa, basically them saying that they're not officially compliant, because no one will give them a compliant title, or at least not the HIPAA or fairpa agency or whatever, but they believe that they are, for the most part, they do their best to remain compliant. Also, when you are using zoom and you're scheduling meetings, you know, don't put kids names in the meetings. Don't share information over a share screen that is HIPAA or fairpa, non compliant, right? Don't be sharing information on your screens. Sydney parrot would like to know what's the optimal length of time for a teletherapy session. I mean that that just varies Kid to Kid, right? I'm trying to basically do 30 minutes for the most part, because that's what's on the IEP. But the parents see it themselves when a kid is just zoomed out, as I call it, because I'm zoomed out right now. But yeah, I mean, parents are pretty they can also see when their kid is done with the session, right? And so be Be kind, be gentle, be real with the parent. And say, hey, you know what? I think it's time to kind of let your student have the play. Don't do whatever they want. And then lead into May, if you still have five or 10 minutes left of that session, talk to the parent and see what concerns they have. How do How can you help the parent to help the student? Okay? And last question, Madeline k5 would like to know about equipment and legislation. I talked a little bit about the equipment that I'm using, a webcam, an extra cam, or, sorry, an extra screen, a document camera is nice to have. Legislation. I can't keep up with it right now. There's just so much going on. Idea is changing little tiny bit. You still have to provide services, but it sounds like they're relaxed on evaluations, as I said earlier. But each state is also very different. I just don't know everything on that. So, all right, we're at 50 minutes. I am going to say goodbye. I hope that helped. I did not mean for this episode of the podcast in any way to be a professional development course. This is simply what I'm seeing, what I'm doing, and maybe you can get some tips out of it. So let me know if it helped. Shoot me a Instagram message, or even better, share this on your Instagram story feed. I would love that be sure to tag me so I can say thank you and and probably even share it myself on my own wall. Also, I would love for you guys to leave me a comment down in Apple podcast app, if that is where you listen, if where you listen to podcasts. Oh, man, I am done for the day. It is 644 I am out. Take care. Everyone. Stay safe. Stay healthy. Know that your parents and the kids that you work with are appreciating what you do. So yeah, until next time, take care. I will see you on episode 49 of the OT school house podcast. Bye, bye.     Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otsoolhouse.com Until next time class is dismissed.  Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast