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Want to earn 11 hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 69 of the OT School House Podcast. In this OT Month special episode, I am teaming up with Sarah Putt from the OT 4 Lyfe Podcast to talk about the importance of supporting our OT associations. We will discus the perks, the costs, and the reasons why we support our local, national, and world OT associations. The OT associations need our support so that they can turn around and effectively support us. At the end of the episode, we announce a giveaway put together to support you and OT associations all around the world. I hope you enjoy this special OT Month Episode! Links to Show References: Enter for the giveaway here! Become an AOTA Member (Affiliate link) OT 4 Lyfe Podcast 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. Jayson Davies     Hey, ot practitioners, the conference that your colleagues are calling the most valuable event of the year is returning just in time for the 2025 2026, school year. Join me and over 600 other school based ot practitioners this August for the fifth annual back to school Conference featuring 12 hours of practical a, ot a approved CEUs and resources from expert guests later in today's episode, I'll share with you about our incredible speaker lineup and a special discount just for our podcast listeners like you to learn more about the conference, visit ot  schoolhouse.com/conference and secure your spot today.    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 the OT school house podcast. My name is Jayson Davies, and I am super excited as always, to be here with you. It is ot month that is right. April 5 is here, and we are excited for ot month. I say we because today I am having a chat with Sarah from the OT for life podcast. I know several of you also listen to the OT for life podcast. So just so you know, our episodes are going to be pretty similar today, actually, because we did an episode jointly together and well, it was just amazing, so we decided to share it on both of our podcasts. So you're going to hear this amazing conversation between myself and Sarah put from ot for life. Today we are talking about ot associations, occupational therapy associations. We're going to be talking about local associate associations being, you know, your state level or regional level, if you're outside of America. We're going to be talking about national organizations here in America that is a OT, a, and then we're also going to be talking about the W, F, OT, World Federation of occupational therapy. So if that is anything that you might be interested in, be sure to listen. And if you don't think this might be interesting to you, I would encourage you to listen at least for the first five minutes or so, because we make it fun. This was a super fun conversation with the two of us. I really hope you enjoy this. And to top it all off, at the end of the episode, we are having a giveaway. So let's go ahead and get the OT month party started. Here is Sarah put from the OT for life podcast, and myself talking about ot associations. Hey, Jayson, how are you today? I am doing fantastic. How are you? Sarah,    Sarah Putt     yeah, that's a great word. I'm doing amazing as well. And honestly, like, I'm so excited to have this conversation with you today all about ot associations, because I know that both of us are very, very passionate about this topic, and I think, and I'm curious to kind of get your take on it. But I think ot associations is one of those things that isn't talked about enough in our profession, especially after ot school. I feel like it's like, drilled into our heads in OT school, and then afterwards it's like, oh yeah, no. It's just kind of one of those things you can do if you want to. And I also think there's a lot of misconceptions about ot associations, so I'm excited to just kind of like, jump in and dispel some of these misconceptions and really talk about why we think it's so important to be a part of OT associations across multiple levels. Here.    Jayson Davies     Yeah, absolutely. I mean, I actually want to piggyback on what you just said. I never thought about that, but you are right. Like, schools get rewarded, I think, for having, like, 100% a ot a association among their students. Like it's crazy. They advertise that their students are associated with a, OT, a or their state, just like they advertise their NBC, ot pass rates. So yeah, I never thought about that, that that's a good point that you make. But like you said, as soon as we get into the real world, and we now have to pay all that money that the school wants that we deferred for four years associations, you know, they they typically do cost a little bit of money, and we'll talk about more in a second, about the money side of it, but you're right. I think people do kind of start to decline in their membership rate.    Sarah Putt     So maybe we can just start and talk about what type of OT associations are out there.    Jayson Davies     All right, I'll just start by what I'm a part of, and that is actually my state association in California. It's ot Occupational Therapy Association of California. So that is the more local state association I'm also a part of a OT, a which everyone knows about, whether you're an OT in America or an OT outside of America. I think everyone knows a ot a because they do publish the American Journal of Occupational Therapy, and they're just a huge, or relatively huge Association. That's our national one. And then I recently became a part of w OT, which Sarah and I have different. Ways to pronounce this, or we say W OT, I call it woo fot,    Sarah Putt     and I love, absolutely love that. I've always called it woof it so, but I might be a convert, and I might have to start calling it woo fot.    Jayson Davies     I love it. But anyway, that is the world OT, Association. And, yeah, what about you? Where are you at right now? With associations? Yeah,    Sarah Putt     so I 100% agree with what you said, and I've always been a big proponent of being a member of the state association. So when I was in California, OT, that was the big one. And but now that I'm up in Washington, they have their own state association as well as a, OT, a, I've been a member for many, many, many, many, many years, and also woof it. I'm just a huge proponent of being a member at various levels. And because of all the international stuff that I do, woof it is a it's an important association that I am a part of. So, yeah, basically, state, national, international, that's it, right there.    Jayson Davies     So I have to acknowledge something. I did take a break from, I think OT, out of out of school. I don't think I took a break from a, OT, A, but I do think I took a break from the state association, and I think it was primarily because A, they don't have auto renewal, or they didn't at the time, and B, because I don't think I went to the conference, and so it just kind of fell off the radar, and I didn't re sign up for it. Have you ever let it lapse consistently when you are in one place? Does it ever? Have you ever had it lapse? Okay,    Sarah Putt     so I'm gonna be real and, like, super honest and transparent with you right now. Yes, I have. I haven't always been pro ot Association, and I definitely was members when I was in school, but as a new grad, and for the first few years of practice, I didn't see the value. I didn't so that I didn't see the value, but I guess I just didn't understand it. I didn't take the time to really, like, dive into it. And I felt like it was just, like, crammed down our throat in OT school, that I'm like, It's fine. I don't I don't need to do that right now. It really wasn't the money. It just kind of wasn't of wasn't understanding the value that they brought, and they actually did for our profession. So there were many years that I was not a member of any ot associations, and I am admitting that because I think there are a lot of people that might resonate with that and be like, yeah, what is the importance? Like, what do they actually do for us? And a lot of times, people just think it's like, you pay money, but you don't get anything in return. But what I will say is, once I went to my first A ot a conference, and I want to say this was like five years out of school, completely converted, and I was like, I get it. I totally understand why we need to be members of these associations now. So since that moment, I have not allowed any lapse in my memberships. But up until that point, I hate to admit it, but I did let it    Jayson Davies     lapse. You know, it happens, but you know the good thing is, is you can always renew, and it doesn't cost extra to renew. It's just the regular price. So not a bad deal. While you were speaking, and we're actually now moving into the point where we're going to talk more about the benefits of it. I realize one of the benefits that we hadn't talked about previously, and that is networking, and the fact that in 2017 at an OT event, you and I had lunch together, and that is how we met. So if we were not either of us were not ot members. At that time, this podcast wouldn't exist, like this episode right now may not exist because maybe we may not be friends. So I just want to throw it out there. That's a benefit of being part of an association, networking.    Sarah Putt     Yeah, you are 100% correct. Jayson, I remember that lunch and how fun it actually was, and I think it was supposed to be like, 15 minutes or whatever, like, just to like, Hey, this is so and so it's nice to meet you. And then I think we, like, sat down for like, an hour, hour and a half, and we were probably all late to the next session, because we just had this amazing chat. So I'm so glad you brought that up, because, yeah, like, You're so right. This probably wouldn't have happened if it wasn't for that conference, but then also for us being members, to even get to the conference and all that good stuff. So yeah, networking, that's absolutely huge.    Jayson Davies     So yeah, definitely advocacy. But let's go ahead and break it down. Let's start by association. At the local level, we talked about networking a little bit. What other positives and attributes do you find with the local state associations. What are the positives for those?    Sarah Putt     I think one of the big things is really figuring out what's happening at your local level, like within your state, and depending on how big your state is, like, at least for California, it's actually broken out into different regions, and really getting a pulse on what's happening within your region, within your state, and how that applies to your practice, your practice area, anything that is kind of happening that might be impacting how you practice as an occupational therapy practitioner. So for me, for being a member of the State Associations, it's really that like super niche, hyper, low. Goal, really getting a good idea of what's happening around you and within your very specific regional area. What do you think? Jayson,    Jayson Davies     no, you're right on, especially when it comes to advocacy. Because I don't know if you remember, in California, we had, I'm gonna shout her out, Sabrina McCarley, and she was, like, the biggest ot advocate ever. She's now with a ot a. Actually, she's kind of moved up the ranks to a ot A, but she had this whole program, and it was called the go to OT, like everything, you had to have a sticker that said go to OT. And what go to OT was all about was letting OTs know specifically that, hey, in California, there's only, like, I don't know. I'm just going to use the number 50 representatives. I should probably know that better, but I don't 50 representatives or so between the Senate and the House within California, well, there are a lot more OTs than 50 within our state. And so every single senator, state senator specifically for OT, should have a go to OT. They need to be able to know, hey, when something comes on the floor of the house and it has to do with something, with Medicare or with schools, I need to be able to call an OT and get their take on it, or an OT, or multiple OTs, need to be able to call them and be like, hey, this bill is amazing for OT. You know, this is going to be great. This is going to help the kids. This is going to help all of my clients, or vice versa. Hey, this is not a good idea. We need to, you know, put the brakes on this. And I just want to let you know that this won't be good care, because it all comes back down to the client, right? And so anyways, I'm getting off track. But the whole advocacy. Part of it is they really support advocacy. In fact, they even pay an outside agency to advocate for us. And so they have people at Capitol Hill in Sacramento, here in California, that are talking to the legislators on a regular basis, saying, What about this? What about that? You know, we want this bill to help our clients, and that's what part of our funds go to, right? Yep, oh,    Sarah Putt     completely Yeah. And I love that you brought up Sabrina, because any ot conference that I've gone to, I always go to any of the chats that she presents on, and I leave those like, hands up in the air, like, yeah, go OT. And I'm so excited. So thank you for bringing that    Jayson Davies     up, she's my favorite. I love her. My gosh, yes. All right. So the state associations, you know, once you move up to a OT, a, they have more members. They have the age OT and stuff like that. But the other big thing we already alluded to it a little bit, is your conference at the state level. And I know not every state has a super big conference, but I think states are starting to team up a little bit to have conferences, and now with virtual events, you can have people potentially outside of your state, or people who just can't travel to whatever big city is in your state. What's your experience been with state conferences?    Sarah Putt     I have gone to a handful so far, and I think every time that I go, I'm learning something new. I'm learning a lot of new things. I'm connecting with people that, again, are in my local region, and maybe I didn't know that they were doing this research, or that they were starting some sort of project or starting some sort of company, and it's like that networking piece, but also learning about other people, that you can start other practitioners, that you can refer to, that if you get a client that comes your way and you're like, yeah, they're not, they're not quite in my area, I can refer here. Or if somebody's looking for a certain type of therapist or therapy practitioner, you're like, Oh, I know somebody that specializes in dementia in this area. Let me refer them to you. So again, it's like, it really is just kind of keeping it at that local level and knowing what's happening, but then also being able to, like, make those referrals and make those connections to people that are within your area,    Jayson Davies     absolutely always back to the connections. All about that, those connections that you build, whether or not it directly affects your job, just having a network of other OTs to be a part of. I mean, let's be honest. You're listening to this podcast because you want to be a part of a community commune. OT Right, yeah. So that is definitely a great point for your local because, again, things change from state to state as well, and so being part of your local, your state association will help you understand what's going on in your state. Should we move to a ot a,    Sarah Putt     yeah, let's go to national national ot associations here. All right, I will    Jayson Davies     let you start. What's your most favorite benefit of a ot    Sarah Putt     a? That is such a good question. I feel like there's so much good that a ot a does for us. I think really one of my favorite parts is the promoting of the profession and also kind of securing who we are and what we do right. Like, again, a lot of people still don't understand what occupational therapy is when and when I say people were talking about society in general, and I. Really, truly feel like a ot a has done a really good job and are continuing to do a really good job to bring occupational therapy to the table and give us a seat at the table, especially with like leadership and helping promote what we do, which really we're going to need to be doing this for years and years and years and years and years to kind of go up the ranks and really get it where society as a whole understands who we are as a profession and what we can actually contribute. So that, I think is one of my favorite things, that I know that a ot A is working so diligently behind the scenes on, what would you say? What's your favorite, or what's your top thing of being a member of a ot a that you think is really important that they do    Jayson Davies     well, I think for the most part, I really appreciate the advocacy, but the part that I use most is the access to the journals. And it's not just the American Journal of ot the Asia, they also provide you access to other journals, I believe, the Canadian and Australian journals, I want to say, maybe also one of the European journals. So I find that to be a great benefit, because I love the Asia, but it doesn't always have everything. I mean, there's only so many articles that they can put out every year, and so it's nice to have access to other articles so that I can continue to build my own knowledge. And again, going back to we have a podcast, and our podcast is nothing without all of you listening. And so we want to have things to share with you, and we want to be able to help you as well. And so by accessing those journals that that is key    Sarah Putt     and OT practice magazine too, not not a journal, but still, you're going to be kind of privy to this information of things that are happening within the OT profession too. So I'll throw that one in there. Well, the    Jayson Davies     SIS too, that comes with that, right, your special interest section, maybe, but it comes in addition with you get your ot practice in the little baggie, and then on the back side of it, there's a little extra form that kind of has some specialty area to your practice area. So    Sarah Putt     I think also, one of the really important things that a ot a does is that it really focuses on assuring the quality of occupational therapy services and improving consumer access to healthcare services. So not just helping us as practitioners and helping us as students, but it really is about helping our clients advocating for what ot does, so our clients can have access to the services that they need as well. So really, I know we're focusing a lot on, like, what does it bring to us as practitioners and students, but also, kind of globally, for our clients, they do a lot of work behind the scenes in that aspect as    Jayson Davies     well. Yeah, and that's huge right now with the whole, again, I'm school based, so I don't know all the laws related to I'm gonna completely blush this. It's P, T, S, I don't even know the acronyms for the giant bill going through that is just changing up healthcare and a, OT, a sends out regular updates as to how they are trying to support both OTs and OT assistance in that bill, and how reimbursement is distributed, and all that good stuff that I don't know anything about because I'm a school based OT, but yeah, you know, just like I talked about earlier, how your state organization has advocates on Capitol Hill in your state, well, a OT, a does the same thing. They pay a contractor to have people talking to our US, legislators and so again, that's where part of our funding is going to So, Sarah, do you know the price for a, ot a, I do.    Sarah Putt     So there's, there's a couple different ones, and it depends on whether you're an occupational therapist, occupational therapy assistant. They also break it down for, like, first year ot practitioner, second year ot practitioner, I know. And also for OT and OT a, yeah, and they have a student price. So I'll just like run through this really quick. We'll have this linked in the show notes, and also link to the OT, a page where I got this information. Keep in mind, if you happen to be listening to this episode at a later date. This is as of April 2021. Things might change. So don't quote me and say Sarah said it's supposed to be this much. But for an OT, for the year, it's 225, ot a 131, first year, new ot practitioner is 119 first year, new ot a practitioner is 95 second year ot practitioner 175 second year ot a practitioner 120 and The Student price is 75 now, there's also other breakdowns that I'm not even gonna get, gonna get into there, so if you feel like you might qualify in a different area, definitely go to a ot a and look at their other breakdowns that they have. But now, Jayson, I know that you don't pay on an annual basis, so can you explain how you go about your payment    Jayson Davies     Correct? Yeah. So I have it set on auto pay on a monthly program, I believe, and I just did the math to make sure, but it's 225, is what you said for an OT, you know, with a few years of experience, and you break that down into 12, just a few you break that down. Over 12 months, it is $18.75 so yeah, you know, a few cups of coffee from Starbucks, and that's it. 1875 not that much for what you get. Definitely worth the 1875 and all the benefits that we just talked about. You know, they have conferences for us. They have all the research for us. They advocate for us so much. And I'm just gonna throw this. This out there. We are not being paid by a, ot A, we are not being paid by ot tag, and we're not being paid by who we're going to talk about next, which is W, F, OT or wufod.    Sarah Putt     No, definitely not. This is just you and me connecting on something that we're both passionate about and really wanting to spread the message so other people hear that like, hey, we know it's important, and hopefully other people can start to understand that there is a lot of value that our associations bring to the table.    Jayson Davies     Yeah, and you know, we haven't even actually mentioned this yet on the interview portion of this podcast. I'm sure you and I will both include it in the intro. But the reason that we wanted to do this is because it's ot month, and this is about supporting OT and, you know, not just supporting ourselves individually, but supporting our profession as a whole. And that is exactly what a ot A is doing for us. So I don't know if you want to add anything before we move on to wufod.    Sarah Putt     I think the only other really brief thing that I just kind of want to throw in as well is that there are other discounts as being a member of a OT, a so there are exclusive member discounts for books, continuing education, units, courses, anything like that, as well as some of their kind of affiliate partners that they have, like car insurance. I know that they have a discount through Geico. They have a discount for professional liability through Mercer or pro liability, which is what I have. And I learned that they had that discount, and I signed up through a ot A and then I recently just learned that they also have an affiliate with Sofi, which has to do with student loans and refinancing and all of that. So again, there's a lot more information that we're not even going to go into detail here, but go check it out if you're interested in any of that, and seeing what other discounts that they have. And I'll just kind of leave it at that, because there's a lot.    Jayson Davies     Well, it's nice to hear that GEICO thinks that OTs are good drivers. I appreciate that exactly. All right, Sarah, you're gonna have to help me out with this one, because I am a brand new W F ot member, and I can share a little bit after you kind of go into it, a little bit about how I did that. But what do you know about W F OT? We'll be back after a quick break while it may be summer break now, the school year will be here before you know it. Get ready for it at the fifth annual back to school Conference coming August, 23 and 24th of this year, join hundreds of school based ot practitioners online for this two day transformative learning event where you can attend live or catch the replays. Don't Miss Amy and Jack from autism level up, sharing neurodiverse strategies to support autistic students or expert handwriting instructor Peggy Morris, as she shares the most up to date research on handwriting and how to put it into practice. Don't miss this impactful event for school based ot practitioners by school based ot practitioners as a thank you for listening to this episode of the OT school house podcast. Use promo code podcast 25 for $50 off your registration at ot  schoolhouse.com/conference I'll see you there.    Sarah Putt     So really, in a nutshell, I feel like the World Federation of occupational therapists is the global voice for occupational therapy, and it really is setting the practice standards for what we do within our clinical practice. And I've been a member for many years now, and it's been really, really interesting to watch the member organization. Numbers grow throughout the years as new countries and new programs start to develop. And really, W, F, OT is all about promoting the profession of occupational therapy, but the other thing that they do is they are really diligent about setting up ot programs in countries that might not have universities or colleges that are teaching ot right now. So it is this, it's this global voice. And you know how much I love international ot work and all of that good stuff. So for me, like, what fit is just one of those things that's so important to be a part of. And ever since I found out that I could be a member, I've been a member ever since. So go with it or    Jayson Davies     and, yeah. So I mean, I've only been a member with W ot for like, two months. I didn't really know how to sign up. I didn't know what the cost was. I didn't know anything. And so I've got our little spreadsheet up here or Google Doc that you so kindly put together. And wow, 580,000 occupational therapy practitioners is what w f ot supports in 101 member organizations. That's amazing, isn't it? Yeah. And the best part of this for everyone listening. Mean, I want you to just close your eyes and guess how much it costs to be a part of WFO T real quickly, $30 if you're an OT, a 32 if you're an OT, and 27 if you're a student. That's insane. For the year, yeah, for the year, not a month a year, not a month a year. That's amazing. And Sarah, have you ever gone to the World Conference?    Sarah Putt     I have. Yes, I went to my first W conference back in 2018 and it was in Cape Town, South Africa. And I kid you not, it was one of the most amazing experiences I have ever had in my entire life. I went for like two weeks, and I went for a week before the conference, and I got to kind of just explore Cape Town and go see the sites and meet up with other practitioners from around the world. So I have some ot practitioner friends and students that are in Iceland that I met a couple years ago, and we all got to reconnect at the conference, and it was super fun. And then also just meet all the new people that I hadn't met yet. And then the conference, I just remember walking in every single day, just like my eyes super big, and just like soaking up all the information that I possibly could and leaving the conference just exhausted every day because of the breadth of knowledge and the amazingness of the OT practitioners and students that had showed up to share their research, to share their projects, to share their knowledge of what is going on with ot within their country. And it just was, it was a life changing experience. And we have the next WFO T Congress is going to be in Paris in 2022 and last I checked, I mean, with the current state of everything kind of happening with COVID and the pandemic, last I checked, they are running a hybrid option, so you can go if it's safe, and travel will permit you to go, but they're also running a virtual component as well. So hopefully that might actually open it up to even more people being able to be a part of it. And if I could say one thing. Do it go if it's virtual or in person, just do it. It will change your life. Yeah,    Jayson Davies     you don't have to convince me to go to Paris. That is amazing. I've never been to a Congress before, but I am looking forward to that. Especially. I gotta give a quick shout out to everyone that listens to the OT school house podcast and the OT for life podcast from outside of the United States. We were having a discussion about this before popping on. We have people from Australia, from Greece, from India, from what else, UK and Germany. Yeah. It's amazing. Shout out to all of you, and even for you, I hope all of you are able to be a W, F, ot member. This one, though, is a little tougher to become a member for at least if you're in America that I know of. For me, I actually had to, like, find it on the website. Mind you, I'm already an A ot a member. It's a little bit different. I think if you're signing up for your A ot a membership. I'll let Sarah talk about that in just a second, but I kind of had to find it, and then I had to email them say, hey, I want to be a member. And then we worked it out. But I believe Sarah, you said, now if you are signing up or renewing as an A ot a member, how does that work?    Sarah Putt     Yeah, so basically, you would go through your typical registration or renewing registration, whether it's new or if you have already been a member, and you get to a certain page on the renewal form, and it will actually say, Do you want to be a member of what fit, and it lays out the price and everything, and it's just a little check box. But I will say it can be easily missed. So if it's something that you're really interested in, make sure that you really pay attention when you're going through the renewal or going through the setup process, that you don't miss where it is, because it's just a little check box. And then once you get to the end, you should see it kind of on the summary adding to the total, right, you're going to have that, that price added to the total at the end. So it's there. It's a little tricky to find, but if you're intentional, I know that you can do it. And also, the one thing that I really wanted to bring up, that I think is super cool, that what fit does is they have an annual World ot day, and it is typically on October 27 and it's amazing to watch the scope of promotion of occupational therapy across the globe that happens on that day. It kind of actually happens over a couple days, because we have some people that are going to have that they're going to hit that day sooner than others. And it is amazing seeing schools come together that are putting videos of advocacy and what OT is in their country. And I love it again. It's like one of my favorite things about what fit too. So we got a couple months for that, but put that on your radar as well.    Jayson Davies     Yeah, I always kind of coordinate that, because it's the same month that OT, the conference in California, happened. So it all kind of comes together into one big celebration. It's quite, quite amazing. And I love putting together a social media post and campaign for that. It's just so much fun. And like you said, it almost happens over a few days because of the time zones. The day before you'll start to see posts, and you're like, Wait, am I missing it? Like, oh no, that's someone from Australia posting. They're just in the future. They're in the future. But, yeah, that is pretty. Be amazing. And actually,    Sarah Putt     you just reminded me of something to make note that I know, at least in Australia, and I'm not sure about it in other countries, but if you are listening to this, and you are not in the States, and you're listening from a different country, I know that some countries actually, when you sign up to be in your national membership association, you actually get automatically added to the World Federation. So I know Australia has won, because talking to Brock cook from the Occupy podcast, he mentioned that, but double check that too, because it might just be something that is automatically a part of your national membership, which I think is a great idea.    Jayson Davies     Yeah. I agree. A ot a should just do that. Just add it on there. Just add it on there. 30 bucks, just add it on. Yep. All right. Well, I think that, oh, wait, we had one more type of associations that we wanted to talk about really quickly. And this isn't specific to OT, but this is just like associations in general that might have to do with your practice area. Sarah, do you have a few examples of those?    Sarah Putt     I do, yeah. And again, we'll keep this brief, because it's not specific to OT but there are a lot of other associations out there that could be a part of your practice area. So a couple that I know of are being that I work in early intervention. There's the Zero to Three Association, and there I also have some training in hippotherapy. So there's the American hippotherapy association. So those are, those are the two that I have been a member of H A before, and I've also kind of had the zero to three kind of on my docket. Haven't joined that one yet, but I know that those two are out there. Are there any others that you know of? Jayson,    Jayson Davies     well, I'm pretty sure I'm gonna have to join the one that I just found out about, which is the Association for play therapy. I just kind of feel that as a pediatric therapist. I kind of like belong in this association, so I'm gonna have to check it out. One other thing about these associations is that you can't base it off any information you have about ot associations. You don't know what they do. You don't know what the price is. Some are free, some are paid. You don't know if you're gonna get access to a journal or whatnot. Each one's a little bit different, but I really didn't have much of an idea as to what this was part of until we decided to have this conversation. So super happy that we did, and now I have an association that I might sign up for. So yeah, that's about it. I think, I    Sarah Putt     think just bottom line is like, do your own research and look for whatever it is that you're interested in, and see if there are associations that are out there, reach out to other practitioners and see if they're affiliated with them, if they've gone to their conferences, if they think that it's worth it, because I think there's a lot of amazing work that's being done out there, and honestly, we can't even compile all of it into one podcast episode, so do your own research and see if there's something of interest, definitely for ot associations. But then even outside of OT associations.    Jayson Davies     Yeah, I think you're right. And you know what? Maybe individually, we can both do our own podcast episode on different associations that might kind of pertain to our areas. That'd be cool. So all right, well, we have one more thing that, yeah, Sarah's doing a drum rolling over there, one more thing that we want to do, because we just have such an appreciation for the associations that we are a part of, and we want you to have an appreciation for the associations, and we hope that you will sign up for them, not because we're telling you to, not because we are about to give you away something potentially if you are part of your association, but because we want you To see the value in it, and we want you to be a part of all three of your associations. If possible, we understand financials, you know, can come into play, but if possible, we would love for you to be a part of your state or region if you're outside of an area that calls them states, your national and the World Federation of occupational therapy. So I'm gonna go ahead and let Sarah make the big reveal drum roll.    Sarah Putt     So yeah, we think I'm gonna speak for both of us here. We think that it is so important that you are a part of your ot associations. If you can only do one, great, if you can do two, great, if you can do all three or more even better. So Jayson and I have teamed up, and we are going to be giving away a $50 gift card for people that sign up for their ot associations. So all you have to do is go to the link that we're going to provide in the show notes, and we're also going to be promoting it across social media, and you're gonna have to put in your email so we know how to get in contact with you. Give us your name, so we also know what to call you. And then you just have to mark what associations that you belong to, and each association that you belong to will give you an additional entry into the drawing. So if you're just state, that's one. If it's state and national, you got two. If it's state, national and international and the World Federation, you get three entries into the drawing. And I just wanted to say we're giving away a $50 gift card that basically covers your international association membership right there, and then some. So you know, just just a little. Little something, something, there just    Jayson Davies     a little something, some, yeah, or, I mean, even 1/4 almost of your A ot a membership, which, that's not bad at all. And you know, $200 to one person is 200 completely different to another person. And so again, we're not here to pressure you to make a financially irresponsible move and sign up for something. We just really want you to see the value in this, and when you can do it, we think that the benefit is just so great. It really helps. You know what? I think there was one stat that we meant to plug in, I don't think we did, and that was how many OTs a ot A represents versus how many OTs are part of a ot a. Do you remember what that stat was?    Sarah Putt     So according to what I pulled from their website just the other day, a ot A represents about 230,000 ot practitioners and students in the US, with only 65,000 being members of a ot A. And in my eyes, that's not good enough. That's not good enough for me. I mean, that's basically about a third of the practitioners and students in the states that are members. So I know I would love to see that number increase, specifically for a ot a, also for what fit for our states, for all of our OT associations. And I think you agree with me too, right? Jayson,    Jayson Davies     absolutely, absolutely. Can you just imagine? Okay, here, just hear me out real quickly. All right, I can just imagine. I know there's some people. I know there's some people that say, a OT, a doesn't do this. Doesn't do that for our profession. Well, what she just said is only 1/3 of us are actually giving them a little bit of money to do what we think that they should be doing. Imagine if we were all giving them $200 a year. Imagine how many more people they could have in Washington, DC, making the cause for occupational therapy. Imagine how much more grants maybe they could provide for the research that we all know ot needs more of. I mean, that is just amazing. Imagine if they had two thirds more within their budget. Basically it would, it would triple their budget if all of us were part of a OT. So just think about that. You know, we want, we are often quick to criticize, but they're also working with a third, I'm thinking of Hamilton, a third of what Congress has suffered. Anyways, they need our support so that they can do more of what we expect them to do. That's the that's kind of the short version,    Sarah Putt     yeah, hands down. And I think there's so much work that happens behind the scenes. And really this is another thing that we didn't really talk too much about, but you can be a member, where you pay your membership dues and you get access to everything that we've talked about earlier on in the episode, but you can also get involved and actually see what they're doing on the ground on a daily basis. And I think there's so much that's happening if you are a member that you don't even see happening behind the scenes. And I think that's where that disconnect or those misconceptions happen, where people just feel like they're paying money, but they're not seeing the benefit, because there's so much happening that you and I just don't see on a daily basis. So keep that in mind. I think it's extremely important to be a part of our OT associations for so many different reasons, and yeah, I'm just, I'm so happy we had this conversation today, Jayson, because I think it's really one of those conversations that needs to be had and shared so people see how passionate we are about it and how excited and just how important it is for us, and hopefully they might be able To start to see why it is really that important for our profession    Jayson Davies     as a whole, absolutely and so just to close out, I think, be sure to click on that link in the show notes, the description that's right below this audio, maybe right above the audio, wherever it is. Go there and let us know what associations you belong to. We're not selling this data. We're not benefiting from this data. We just want to know what you belong to, or go sign up now and then, click on the link and be entered to win a $50 gift card. We are going to ask the winner to show us their whatever association that they're a part of, just to, you know, kind of confirm that. But completely free to enter, we're going to give away a $50 gift card. All you have to do is click on a link one minute, most of your time to fill out a quick google form like this isn't anything fancy, it's a Google form, so feel free go ahead, check that out, enter and yeah, we will reach out to the winner. I'm excited for    Sarah Putt     it. Me too. This is awesome. And again, we're doing this to celebrate ot month in the States. So what better way to celebrate occupational therapy month than stand up for our professions and represent our associations and continue to promote the profession of occupational therapy at the state, national and international    Jayson Davies     levels. Well, sir, I have really enjoyed this conversation. I haven't smiled in a while this much, so I appreciate it. And yeah, it's been fun.    Sarah Putt     It has been fun. Who knew talking about ot associations could be this much fun, and it involves so much smiling. So thank you, Jayson for having this conversation with me too.    Jayson Davies     Did I not tell you that was gonna be a fun episode? Thank you so much to Sarah for putting this all together with me. It was so much fun. And yes, we do have that giveaway going on right now. You can register for it by clicking on the link in the show notes right below or above this podcast, or at ot  schoolhouse.com , forward slash podcast. Just find the episode and get it there. We did forget to mention when the giveaway goes to within the podcast. So I'm going to tell you right now. It goes until April 16. You have just about two weeks until the giveaway, and so be sure to click that Google Form link in the notes so you can get that right now. Okay, it only takes a minute to enter. You just have to let us know what associations you are part of, and you can win up to $50 for doing that little piece. All right, so until next time, enjoy your first week of occupational therapy month and 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 School House Podcast

Want to earn 10+ hours of professional development? Learn more about the OT School House: Back to School Conference Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 63 of the OT School House Podcast. In episode 63 of the OT School House Podcast, Jayson interviews a leader in the sensory integration community. Dr. Susanne Smith Roley, OTR/L, OTD, FOTA joins the podcast to talk about how she came to know and love both occupational therapy and sensory integration. We also talk a bit about the history and future of SI. We even address the difficult topic of how and why sensory integration has been criticized over the years within the profession and Dr. Roley provides great insight into the research and fidelity within sensory integration. We finish off this podcast with a discussion on Independent Educational Evaluations (IEEs). Listen in for a valuable experience! Links to Show References: CL-ASI.org OT Practice Framework Sensory Integration and the Child (Book - Affiliate Amazon Link) Episode 25 of the OT School House Podcast With Zoe Mailloux Episode 26 of the OT School House Podcast With Kelly Kelly Auld-Wright Frank, Porter, & Grahm Article Sensory Integration Fidelity Measure Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder ©2020 Building Competency in SI (OT Practice Article) Shared with permission from the Author Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hey, ot practitioners, the conference that your colleagues are calling the most valuable event of the year is returning just in time for the 2025 2026, school year. Join me and over 600 other school based ot practitioners this August for the fifth annual back to school Conference featuring 12 hours of practical a, ot a approved CEUs and resources from expert guests later in today's episode, I'll share with you about our incredible speaker lineup and a special discount just for our podcast listeners like you to learn more about the conference, visit ot  schoolhouse.com/conference and secure your spot today.    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, hello. Welcome everyone to Episode 63 of the OT school house podcast. Thank you all so much for being here with me today. I really appreciate that we have a really great episode. We actually have on an industry leader in the field of sensory integration today. It is Dr Susanne Smith Rowley, and I'm going to introduce her in just a moment, we're going to talk all about sensory integration, how it kind of came to be a thing, a little bit, how she got involved with it, where it's going in the future. And then we're also going to talk about independent educational evaluations, a little bit she provides iees here in Southern California, so I'm going to pick her brain on IEE. So stay tuned for that. But first, I wanted to make just a few quick announcements. I want to thank all of you that have already signed up for the back to school conference in August. Super exciting. I can't wait for it. I have received a frequently asked question about it, and that is, will I be providing continuing education units for it? So I want to make it clear right now, yes, I will be providing a certificate of completion for going. Currently, it is not a ot a approved. I am working on that, but just keep in mind that NBC, OT and most states don't require professional development to be a ot a approved. That being said, I am in the process of working on that, and trust me, I will make a big announcement when it is a ot a approved, crossing my fingers, hopefully within the next few weeks that I can do that all right. Second thing is, big announcement too is transcripts. I am now going to be producing transcripts for the OT school house podcast. So if you hear something and you just want to be able to read it as well, be sure to check out the show notes for this one. Ot schoolhouse.com forward slash episode 63 you will be able to either view the transcripts right there on the page or download a copy for yourself so you can read it. I don't know anywhere else you might want to read the transcripts. All right, so that is a little bit of housekeeping for today. Let's go ahead and move on now to my introduction for Dr Susanne Smith Rowley. All right. So, Susanne is an occupational therapist with over 40 years of experience in pediatric practice, specializing in child development, sensory integration, learning difficulties, visual impairment and autism. She obtained her bachelor in science in OT at Indiana University, her master's in allied health sciences at Boston University and her ot D at the University of Southern California, Susanne practices in a private practice in Orange County, California, serving children and families through evaluation and consultation services. She was certified in SI sensory integration in 1977 having studied under Dr a jean Ayres, who, of course, we've all heard of, she later co founded and directed the USC WPS sensory integration certificate program for 15 years. She is currently the co founder and president of the nonprofit organization Collaborative for leadership and sensory integration, also known as CLASI, which we will also talk about a little bit later today. She is a past chair of the commission on practice and the sensory integration special interest section for a ot a and a contributing author of the occupational therapy practice framework, domain and process from 2002 and 2008 so she really helped to lay the groundwork for the new otpf. She is an internationally recognized author and lecturer and CO editor of books understanding the nature of sensory integration with diverse populations and sensory integration, applying clinical reasoning to diverse populations. She's a fellow of the American ot Association and recipient of the American ot foundation Virginia scardena Award of Excellence and the American occupational therapy foundation a jean Ayers award. So please help me to welcome. Dr Susanne Smith Roley, hello. Dr Roley, welcome to the OT school house podcast. How are you doing today?    Susanne Smith Roley     I'm good. Jayson, thank you for inviting me.     Jayson Davies     Thank you. Yeah, I'm so happy to have you on I must say, I don't think any occupational therapist or occupational therapy assistant even can graduate out of school without. Seen your name somewhere, whether it's in a textbook or on a article. You have many, many I was actually just looking at your CV the other day, and it's just like pages and pages of so much amazing things that you have done. So thank you so much for being here. You're welcome. We're going to get into that research in a bit, but I want to start off with some questions about how you got to where you are in the OT world, and how you've made such this huge impact on the OT profession. And so my first question that I want to ask, and I do this with all of my guests, is, when and why and how did you decide to become an occupational therapist?    Susanne Smith Roley     Well, it was dumb luck, to be honest, really. Well, I didn't know what ot was, really, but I was, I was, you know, a college student, and my mom was a nurse, and I knew I wanted to work in health care, and I had volunteered in mental hospitals, and I wanted to do something in mental health, but I knew I did not want to be a nurse. That was, it was way too messy. That's funny. But then I looked in the catalog, and I was like, Oh, look at that. You can do crafts and you can do mental health, and, you know. So I, I signed up. I got into ot School, which was amazing. And then, you know, and then I was like, Whoa, you know, what? What is this? What we really doing here? And I but I think, honestly, my confusion with what ot was was a contribution. When later I worked on the OT practice framework, I thought, well, students should come in and have a, you know, summary document that they sort of grasp this profession that is so profoundly important and has such a big impact on on our clients. But it's a little hard to wrap your head around. So, you know, in that old English term occupation, what does it mean? You know, are you? Are you getting people back to work, you know? So, you know that age old thing, you know, what is OT? So, yeah, I was, I was just lucky, wow.    Jayson Davies     So, yeah, it's always interesting, because, you know, you have people that knew they wanted to be an OT, because maybe they themselves, or they had a sibling that that went to OT, but so often you find that no one knew what ot was until they're basically in it. So that's pretty interesting. I had no idea about the practice framework. I actually kind of want to lean into that just a little bit. You did work on the practice framework, but you kind of brought another side of it. And what you just said is that you really wanted to have this document for people coming in to really understand what the profession is. Can you discuss just a little bit about that and your work with that?    Susanne Smith Roley     Yeah, yeah. I was, I was so privileged. I was invited to be on the Commission on practice for the American ot Association. And it was in the tenure of their transition from uniform terminology to to something else, and that something else ended up to be the OT practice, framework, domain and process. So we actually stayed an extra year to get that first version done and and the idea was that the the UT three had become like a shorthand, even for for billing, but it was, it was a bit reductionistic. And so how do we take this volume of work in OT with so many different theories and methods and consolidated into something that can be used for all given the diversity of practice. And so I think that was an enormous achievement. And then I was invited to chair the Commission on practice for the next term. And in that term, we were asked to revise it, to do the second edition. So I was the first author on the second edition, of course, with a team amazing, an amazing team of OTs and scholars and and and in that position, we were also invited to, then, you know, go in different parts of the world to share this with other leaders in other organizations, for example, in Israel, or, you know, where I don't know we went. We went so many different places, Australia and Hong Kong and the leaders of those other countries. They didn't adopt our US model wholesale, but they use this framework to then construct their own, you know, with continuity of OT and of course, then what we saw is that the OT practice framework then changed the curricula in all of the OT programs in the United States so that there was con. Conformity, consistency of language and yeah. So that was, that was a huge and amazing undertaking, of course, now we have the third and fourth, yeah, additions with other teams that have gone on, I think, to make it better and better. Yeah.    Jayson Davies     I mean, there was a great foundation, but, man, I haven't even got through the fourth one, they really added a lot in this new version. I mean, it's a it's a handful, that's for sure. So I'm looking forward to getting into a little bit more. You just talked about having some very unique experiences traveling the world. I just want to ask you about that, because one of my favorite parts of doing this podcast is that I do have people from China that reach out to me, people from Australia, from the UK, what has been a memorable moment for you that has been a result of being an occupational therapist and sharing the profession?    Susanne Smith Roley     You know, I have so many memories. One of the things I was invited to do was to be on a panel in Brazil with scholars there who were talking about the essence of OT and the impact of OT. And it was, it was really interesting for me, because there, most of the people on the panel were really theorists, you know, they were creating ot style theory. And I, and I'm, I identify as a practitioner, okay? And I know I've done education and research, but, but I was like, well, let's get this grounded into practice. And it was really interesting to get feedback on that panel. I mean, I've, I've really traveled on every continent to teach sensory integration courses and and meet with leaders, you know, and you know, really ot so magnificent in terms of the evolution of our profession. You know, the US we have, you know, we have the best textbooks that probably the majority. Not that there's not wonderful textbooks emerging from other countries, but we have such a volume of scholarship emerging out of the United States that then influences people around the world. So in OT in general, but then also in sensory integration. So we've we've really gone everywhere and watched ot evolve in in various countries, and in my opinion, the work that we've done in sensory integration and the foundation of a scientifically theory frame of reference with very scholarly, data driven decision making that that informs clinical reasoning. It really advances the professionality of occupational therapy in in other countries, as well as the United States.    Jayson Davies     Yeah, definitely. I mean, like you said, we just have a lot of the research that's happening here. Ot I think, is just it's more well known here than it is in several other places in the world. And so we have people in school, we have people doing doctor, we have people doing research. That is that leads us to be able to have all that good stuff that we are able to do. Yeah, actually, again, going back to your CV, I saw that you had the W, F, ot on your CV, and so I didn't know it's only like, $36 a year or something like that. So I emailed a, OT, a, I was like, boom, I want to be a part of that, because I want to know what's going on. Want to know what's going on in the row so but yeah, all right, well, you kind of started to mention si a little bit. That's what we're really going to dive into today. And as we transition into that, I want to let you just kind of share where you are at in your ot career. What's important to you right now? What are you focusing on? Yeah, PM, we'll be back after a quick break while it may be summer break now, the school year will be here before you know it. Get ready for it. At the fifth annual back to school Conference coming August, 23 and 24th of this year, join hundreds of school based ot practitioners online for this two day transformative learning event where you can attend live or catch the replays. Don't Miss Amy and Jack from autism level up, sharing neurodiverse strategies to support autistic students or expert handwriting instructor Peggy Morris as she shares the most up to date research on handwriting and how to put it into practice. Don't miss this impactful event for school based ot practitioners. By school based ot practitioners as a thank you for listening to this episode of the OT school house podcast. Use promo code podcast 25 for $50 off your registration at ot  schoolhouse.com/conference I'll see you there.    Susanne Smith Roley     Well, you know, I'm, I'm, I'm on the downhill stretch here. Yeah, I've been doing this for, you know, over 40 years. And you know, what are we focused on? You know, the practical things I do on a day to day one is that I have my, my in. You know, my private practice, my business, and I conduct occupational therapy evaluations and consultation, and you know, it's housed in center point for children. And my daughter is now, she has her doctorate OT, and she's running that clinic. And then the other big piece is continuing with education and research, and we're running the nonprofit Collaborative for leadership in air sensory integration. We're offering synchronous and asynchronous online now because of COVID, we're not doing any on site, but synchronous and asynchronous online education programs in sensory integration.    Jayson Davies     That's awesome. Yeah, I did have the chance to go through the WPS SI program back when it was with WPS. I know now it now it's kind of gone a few different ways. And what you just mentioned is one of the ways. And yeah, you were, I think my course three instructor, one of the instructors, I want to say it might have been you and Zoe, but it was, it was just amazing being a part of that. And so I'm happy to have you here to share more about that. So let's talk about Si, and that first question is, is, how did you learn to come? Or how did you come to learn about sensory integration? And what were your kind of first initial thoughts of sensory integration, if you remember back when you're just kind of starting to learn about it.    Susanne Smith Roley     Well, it started in my undergrad. You know, I got a Bachelor of Science at Indiana University, and one of my professors was Shireen Farber, and she invited us, literally, the students, to come to her house and study neuro beyond the basic curriculum, because we were all kind of stunned with, you know, anatomy and neuro and and she brought it to life. And she was working with joy Huss and I don't know if you know these names, but they were really they were they were producing seminal work and sensory motor functions in theory, and also, you know, getting their toe wet in in research well. And of course, it was about that same time that Dr Ayers was publishing her original set of tests, the Southern California sensory integration tests, and and she came to lecture in in some, some, some place around there, and I went to hear her, and I was blown out of the water. OT in general, didn't captivate me. I was struggling with understanding what we were supposed to do. But as soon as I get it got into that I was I was captivated. And then I had the privilege to work with Jenny scardena in Cincinnati. I had a field work one of my field work assignments was in the Cincinnati Public Schools, and so we learned sensory integration and from the bottom up. And it was just, well, it profoundly affected everything I have done to this day.    Jayson Davies     Wow, yeah, you know, again I hear your name, I see your name, and I just like associate that with USC, but I know that you didn't start at USC. I know that came later, and that you did work your way to Los Angeles then be a huge part of the SI community. How did that kind of come to be? How did you get kind of folded into the actual si leadership and with the USC? And how'd that come to be?    Susanne Smith Roley     Well, I turned right before I turned left. So I was with an amazing group of students. And you will know these leaders names I was with, you know, Shelley lane and Jane Kumar and Joan Dostal and and Mary Schneider and Charlotte Ryan. I mean, these are many people who have become quite well known leaders in occupational therapy and and Jane Well, we started teaching sensory integration, but I didn't have a master's degree, and I knew that that was critical. So Jane, Jane Kumar, went to Boston, and I was thinking, Well, do I go to USC, or do go to Boston University? And I ended up going to Boston University, and Sharon stermack was, you know, my thesis advisor with Anne Henderson. So they were amazing. And then I knew I wanted to work with Dr Ayers, and I heard her, she was ill and and I thought, well, I need to do this as soon as possible. So, you know, given that you've already up ended your life, I moved to California to work with Dr Ayers, and then I was captivated by the weather. Here. It was like, I'm not going back to those winners below wind chill factor, right? I got seduced by the beach and the weather and and then also the work that was going on here, which was really quite phenomenal.    Jayson Davies     Yeah. Yeah, and so let's continue on with that. Then let's, let's talk about that work that you, you came to USC, you're here. You're working with Dr Dr Ayers, a little bit. Tell us about that experience.    Susanne Smith Roley     Well, that was also life changing. Dr Ayers was one of the most thoughtful, brilliant minds. She cared deeply about the children and and her insights and her inquiry was just unsurpassed. I mean, I have never encountered anything before or since, and I'm not the only one,    Jayson Davies     right? I heard it many times,    Susanne Smith Roley     yeah, so, I mean, she influenced a lot of people. She taught us how to think in in a scientific way, and then she taught us that to enact those principles, we had to do it in a very humane and compassionate, playful way. So, so this was really pretty phenomenal. And so, yeah, I was, you know, I was able to, you know, anytime she spoke, I went and, you know, if I was like, you know, can I help you in any kind of way? So I was able to help her with some of the RE standardization in a very small way, but, you know, but I kept hanging around, and I would stay in touch then, and so, so through that process, you know, I was around when the sipt was re standardized, and of course, I was one of the instructors for sensory integration International. Until that closed, things were going a little bit haywire there, and that's when we started the USC WPS program. Dr Clark. Florence Clark was the chair at USC OT department then, and we pitched the proposal, and I was the project director then for that program for 15 years.    Jayson Davies     Oh, wow, I had no idea that you're the program director. Yeah, I was the    Susanne Smith Roley     for, well, for the sensory integration certificate program with that partnership between USC and WPS, I left that position a little bit before they dissolved the partnership. They dissolved the partnership in 2016 and that's the point at which USC start teaching this set. We started our program in CLASI around 2017 we felt that, you know, we didn't know that they were going to create another program. USC has since started teaching sensor integration classes again. But so in 2017 we continue to, we continue to teach the sift. I know there's some misinformation that once they dissolve the partnership, the SIFT isn't valid anymore. That's that's not real. But yeah, we continue. Yeah. Continue doing it well. So    Jayson Davies     I don't want to jump too far ahead of myself. I want to ask you more about the CLASI, more about the easy, all that good stuff, but I want to kind of stay where we're at right now, the sipt You mentioned that, as far as I know right now, the SIFT is still the quote, unquote, gold standard sensory integration and Praxis test. Sensory Integration test, is that still the case right now?    Susanne Smith Roley     That is still the case right now. The SIP is quite an amazing set of 17 tests, and it's the only collection of tests that I know that allows you to understand the complexity of sensory motor and Praxis abilities in children. It shows you the different patterns of the way children are processing and integrating information and and it also gives you a road map of how to do intervention, and I don't know any other tests that allow you to do that. It's a it's a performance measure, and you have you get standardized results. So it's quite phenomenal, actually, as as a tool.    Jayson Davies     Yeah, and I remember I sat, like I said, about six years ago. I think it was the district that I was working for. They wanted someone that has some si training, and so they sent me to all four of the WPS USC courses in SI. I again, like I said earlier, I think it was the third course that you were there. And I just remember being able to, like, something would just pop up on the screen. And you know, you know it very well. It's the bar chart, the bar chart of 17 different tests and black lines going in every which direction. And the fact that you could just look at it and kind of almost give a story about this child based upon this chart. And I'm struggling, because I don't. Know how to how to ask you this question, but, but what does that look like? What goes through your mind as you're looking at the child's sensory integration Praxis test report? What are you seeing that some of us who aren't as well versed don't see?    Susanne Smith Roley     Oh, you know, actually, thank you for bringing that up, because I remember when I was working with Dr Ayers, she did that. She held up a graph, and she and then she just narrated what was going on with the child. And then she said, Well, in this and then Susanne, you should take this child, and you should get on the bolster swing, and they should swing and prone. How'd you get anything? You go, Okay, how did, how did you get there? From there, and then she could also see when there was an error. You know, while this, you know, this is probably measurement error by the on the part of the therapist. I mean, she could see when, when the things weren't scored correctly. Well, now I've tested, I mean, literally, over 1000 children. I mean, you know, I do a lot of tests, so now when we Okay, so a couple of things informs our information. One is, you know, having a lot of experience with this set of tests. But the other thing is that we have so many factor analyzes that have shown us the relationships between the tests. So so when you're looking at the configuration of scores, it almost gives you a profile of the child's nervous system. So you know, if they have a language based concern, if they have visual perceptual concerns. Does the visual perceptual system work well, but they still have visual motor concerns, or do they have poor body awareness through the tactile or proprioceptive systems? Then you start looking for Praxis or dyspraxia, because, you know, that's a pattern, and then you can see the vestibular piece. So, so you start to assess the strengths and weaknesses in the different sensory areas and how that links to those sensory motor skill areas that then are most related, yeah, and then that allows you to understand, you know, what's going on, you know, in a certain kind of way. And then also, you know, where, what are they going to like? And they're not going to like, they're not going to like what's hard for them. They're not going to, you know, if their language system isn't working for them, they're not going to like to follow a lot of verbal directions. You know, if they're dyspraxic, their transitions are going to be hard for them. They're not going to like other people, to figure out something and have them do it, because they're not going to figure that out. If they can't imitate, they're not going to like modeling, because that's going to be hard for them to decode. So it so it helps you understand behaviors that sometimes are interpreted in another way or not easily understood.    Jayson Davies     I like the way you phrase that that are interpreted in a different way or not easily understood with behaviors, because so often, especially in the schools, you know, I'm a school based occupational therapist, we often get dragged in to see a student, and the referral is behaviors. And sometimes the student will have ABA, sometimes the students will have it a functional behavior assessment with a behavior plan, but they still ask the OT to come in and look at these behaviors for sensory reasons, or whatever that might be. And so I actually want to kind of go a little bit further with that and tell me more about those behaviors and how sensory integration can or difficulties with sensory integration can affect behavior.    Susanne Smith Roley     Yeah, and I think that that's interesting. And you know, we're very committed to assessment, so I think it's, it's one thing to see on the the surface of what the children are doing. And you know, you and I know that you're going to see a whole range of behaviors. I mean, you know, depends on the system. So do you have a child with attention issues that can't sit still in the chair, and they're popping up and down, and they're not getting their work done, and they're very capable, but they're not sitting still. Why aren't they sitting still? So what is that? Is that just ADD or ADHD, or maybe, do they have a vestibular problem where they're not processing movement and sustaining a stable posture? Could? Could be a hypothesis. Of course, you have to do the assessment, and you have to figure it out, because it may be just ADHD, that's a you know, biochemical issue that you know is going to respond to Ritalin. And that's, you know, it's not, it's not the foundation isn't sensory, right? So that's fully possible. The what's happening a lot now. So many kids on the autism spectrum is that there's a whole range of behaviors where there may be, you know, self injurious behaviors or or running into other children or somehow pounding their body or throwing themselves on the ground. I mean, so more of a, you know, getting their body involved too much, too vigorously, where they might hurt themselves or others, and really rejecting what other people want them to do. And so for those children, you know what I would start to assess in the line of tactile awareness, kinesthetic awareness and praxis. Do they do they know, can they perceptually interpret what other somebody else is thinking that the other person's plan? And then, you know, even if they understand the goal, do they know how to get there? Do they know how to make that happen, that and so many of those kids with autism have that, and then such extreme responses to sensation, so either very under or over response. So sound hurts, some aspects of touch hurt, you know, food, you know, if they hear the, you know, the pipes. Or I heard one example that just blew me away. It was a it was an adult with autism, and he was explaining, when he was a student, that he took a spelling test, and when he finished this test, he had 40 words, but there were only 20 words on the test, and the teacher discovered that he had written the words that the adjacent teacher in another room was giving to her class well as his own. And so you think, Well, what is going on with that auditory system. And of course, this man would get completely dysregulated by the end of the day, or if there was too much sound, because he couldn't, he couldn't inhibit, yeah, all of that. And then, you know, keep decoding. The decoding was putting such a load on his nervous system that he was just completely fatigued in social environments.    Jayson Davies     Yeah. And, you know, that's really why I wanted to come on here. I wish we could go over, you know? I wish I could just show you a video of a kid and you do exactly what you just did. And obviously that's not the time or place for that we're gonna we're talking about sensory integration, but that's really what a course is for. And you know what? We're going to save it till the end. But I'm going to to announce, you know, Dr Rowley has been so kind to actually give us a discount for ot school house listeners. And so we will talk about that, that course in a minute. I want to ask you, for those of everyone out there, there's, there's a lot of people that aren't trained formally in the SIP aren't trained formally through CLASI or through any of the sensory integration programs. What do you? What do you, and I'm sure you get this question a lot, what do you say to school based OTs or even clinic based OTs that say, You know what, I just don't have that training. What can I do? What do you recommend?    Susanne Smith Roley     Yeah, you know our entry level ot preparation is phenomenal. There's so much that that is given to us in it at an entry level. But one of the things that I did when I was the chair of the sensory integration special interest section was to survey all of the programs in the United States. And I did it, of course, with my committee. None of this I did by myself, but we surveyed everyone, and we said, how much information do you get on sensory integration? And it was somewhere between none and maybe a week or two weeks, but that, you know, generally it was like a couple hours, and it was usually embedded in a peds. Course, we did it again, okay? And I think that this was when Theresa May Benson was the chair. So, so again, we surveyed say, Okay, well, what's going on? It was very similar results. So what we know is that these specialty areas not just sensory integration, but other kind of specialty styles of practice are not covered in the general curriculum and so. So this is, I think, something to be aware of, that that you need postgraduate training if you're going to specialize in sensory integration. There are, it's not just CLASI. There are other programs. As I mentioned, USC has a program. Theresa May Benson headed up a program through the spiral foundation. I think she's now doing education courses privately. There's, there's, you know, other programs around the world, doing it through the South African Institute of St. Integration, ASI wise, in the UK, Austria, there are other programs, not just ours, but I would very much encourage people to meet the international standard. The International Council for Education and sensory integration have has a set of guidelines. We published an article on this in OT practice. I'm happy to share that with you, if you want to share it with your your your listeners, yeah, definitely, yeah. To to move from entry, you know, our basic level understanding, to a certificate, and then, of course, on to more advanced and expert levels. So, so when, when I'm sitting across an IEP with a with a therapist who doesn't have this training, and then it's a little harder to to have that understanding of what the what the assessment data shows and and sometimes there's not always agreement on on what to do about it. So that's, you know, that's always,    Jayson Davies     where would you Where would you recommend that someone start? If they say, Hey, you know what? I want to learn more about sensor integration. Maybe they're maybe they're a year out of school, maybe they're five years out of school, and they just say, hey, you know what I want to learn more about? Si, should they start? Should they just say, Hey, I'm going to go through all four or all six, however many classes there are, and just pick a program and go. Or you kind of mentioned the article that you're just talking about, but what would you What's that first, first two or three steps that they should start doing.    Susanne Smith Roley     Well, you know, the the book that I love, that I think everybody should start with, is sensory integration in the child, by Dr Ayers. And, you know, we copy right now, we did a remake of that so that it's updated. It's published by Western psychological service. So sensory integration and child is, you know, that's, that's the beginning. And then, you know, the most recent book, textbook is Schaff and Mehler, 2015 a clinician's guide to using sensory integration with autism. It's based on shop at all randomized clinical trial. It's a manualized air sensory integration. It's beautifully organized. And then in terms of courses, I would say, you know, to start with a theory course, you know, sensory integration theory, I, you know, made the one for CLASI. But you know, there's others that you you know, I mentioned other programs so, but I think go look at sensory integration theory and and start to get a good understanding of that. Because I think the more depth you have in understanding going into it, the more motivated you will be to continue.    Jayson Davies     I agree. And I mean, I'm sipped technically. I'm SIP trained. I don't use the SIFT very often as a school. I just don't. But the theory, the theory is invaluable. I mean, it is just something that I think every clinician, if you're going to be working in a pediatric setting, you need to at least have the theory. So that way, as you're looking at a kid, as you're coming up with different ideas, at least you know the theory behind it, and so it's an option. So yeah, I agree with that. All right. So let's jump into the classy and the easy a little bit. Just share with us an overview of what is classy versus what is easy. And yeah, just an overview of what that is.    Susanne Smith Roley     All right. Well, CLASI, as I mentioned, is our nonprofit, and we're we formulated it so that we would have an organization that where we could offer educational opportunities, but also seed leadership. So we, we know we're aging out of, you know, of being the people who are teaching and, you know, and of course, many of our mentors are, are retired or retiring and so, so our idea was to get a foundation and to seed leadership around the world. And you know, that's really happening. We have, we have really amazing people all over and across the country and also in the United States. And, you know, Dr Kelly, all right, who's working with us that, you know? And I mean, just to name one, I mean, everybody, okay, so that so that was so CLASI. We've tried to get together materials. We have a training program that has now been offered all over there. I think we're in 20 countries, maybe, maybe more, and when we're collaborating with at least 10 other international organizations, and there's the pandemic sort of slowed things down, but there's a lot of international. Interest. Now, the fact that we've been able to sustain the work of CLASI through virtual media has been amazing, great, and we're trying to get a lot of work out that people don't have to spend a lot of money on that we can get resources. So one of the things that we had so much fun putting together was our wind down Wednesday webinars. Do a few of those. Yeah, yeah, yeah. So we, you know, during the pandemic, we said, Okay, how do we stay connected? Because it's this whole idea of social distancing. Was like, okay, physical distancing, distancing, but socially connected. So we were able to make those available, you know, at no no charge. So we're trying to get more resources that, you know, don't cost too much, that are, that are going to be available to, to therapists, and, you know, to to get as many resources in the hands of families. And, you know, one of the goals is children understood. Okay, so this, this is our tagline for assessment. Zoe Mahler, who's my partner with CLASI, and of course, we have Katie Estrada. I mean, there's other like, yeah, I don't want to leave anybody out, but if I start naming names, I'm going to, for sure, leave people out. But Zoe was, was Dr Ayers research assistant when she was being on the SIFT, and so she was and then she ran the airs clinic for many, many years. And so such a powerhouse, brilliant therapist. And so together with Dr Diane Parham, who, who you? She's so wonderful. And yeah, so she, she's been very instrumental in assessment development, including the sensory processing measure, which is very well widely used now. So the three of us, we felt that we understood the limitations of the SIFT, mostly accessibility. And I don't need to go over all of that. You don't use the SIFT much, and you know why? Okay? Because, you know it's big, heavy, but so we, we thought, but here's the problem is, if we don't identify the problem, the problem will not be adequately addressed. And one of the dilemmas is that most of our materials are in English, you know? So so that privilege we have in the United States of having so many resources. We kind of started out that idea of like, oh, we have so many textbooks. Well, they're in English. So how do we get this in the hands of people all over the world, and not just in our, you know, us language, and also not just US centric, normative data? So So we developed the easy set of tests. They're a set of 20 tests, and they're designed to assess all of the constructs of the of sensory integration and praxis, so including the perceptual areas, the postural and motor areas and the Praxis areas and reactivity. So these are 20 performance tests. We field tested them. We've pilot tested them. They have high Each item has high discriminative validity, reliability and and then we started collecting normative data all over the world, and we, you know, our goal was 100 countries, and I think we had over 100 countries signed, but then the pandemic really put a wrinkle in our plans and slowed everything down. We still would like to collect more normative data, but right now, what we have is we have about, I want to say, 2400 sets, data sets. That's a lot. It's a lot. It's it's worldwide. I think we have it translated in maybe 10 languages. And so the process that we're in right now is to see, could we generate some preliminary normative data through these, these data sets once, once that's done, which, which we're predicting is in 2021, we're working with an amazing team of experts, including Anita Bundy and her associates. So, yeah, so that's that's what's next. Once we have the normative data, we can start to use the test, and we've tried to make it easily accessible, so at at a very affordable price, just for the cost of the materials. And then. There will be some cost for maintaining the website, but other than that, this is, you know, really a, truly a nonprofit venture, and CLASI has agreed to to be to house this project, you know. So, so yeah, and if we can have an affordable, accessible set of tools. We hope that more therapists will be willing and able to use these tools to to identify and then get the right intervention going.    Jayson Davies     Yeah? And so for anyone I know, we're using acronyms, and just for everyone out there, easy stands for evaluation and air sensory integration, right? Yes, yes, yes. All right. Okay, so you mentioned 20 separate tests for the easy earlier for the SIFT, it was 17. And I know you guys really looked at the SIFT when developing the easy, you really wanted to, kind of, I know you didn't want to redo the SIFT, but you wanted to redo the sift in a way. So are there additional tests, or why is it 20 instead of 17? And why do you decide to do that?    Susanne Smith Roley     Well, we did use the sift. It's a brilliant set of tests. And so yeah, so we looked at that original work that Dr Ayers did in the early to mid, you know, 1980s and and that informs our constructs. And so all of the research that was done using that tool, all the many, many, many factor analyzes that were published. So so we used the SIFT as a model of beginning, and it defined the constructs. So, so where did we get 20 instead of 17? Well, you know, some, some of our tests that we had hoped to do, like a drawing test, like the beary motor coordination test or the motor accuracy test, we we weren't able to obtain, you know, discriminated data. So we don't have one like that, but, but we do have the very and we have the meta accuracy test note, but we have all of the constructs covered. So we have in the perceptual area, we have tests of a visual perception, tactile perception, proprioception, force and direction, and vestibular related measures in the area of reactivity, we have one reactivity test where we're actually doing, you know, sensory things and seeing, does the child like it or not? And then we also have observations of reactivity during the tactile and movement tests. We also have auditory localization that's new. Dr Ayers didn't have an auditory localization test. We have the postural control, the areas of testing that we used to do just clinical observations, but they were, they were not standardized. We took the ones that we had the most confidence in, that were the most reliable, that discriminated. And we have a postural control measure. We also have balance and bilateral coordination. And then praxis. We have    Jayson Davies     everyone knows the blocks, everybody. Everybody has seen that structure,    Susanne Smith Roley     yeah, yeah, yeah. Well, now we have make a silly room. So we have something, something a little different. I mean, such, so exciting. And then we've added an ideation measure. So, so that's an additional measure. You know, Ayers didn't finish an ideation measure. The only thing we have in the tactile area, which is so cool that we've added, is an oral Praxis test shape, you know? So this has huge ramifications, and we have an ocular motor Praxis test. So, so we've added components that are supported by research, that are with items that are reliable and valid. So, so yeah, we've been able to expand a little bit from what the model was with the SIFT awesome. And also it's more modernized, right? So we, we are using Rasch analysis, where we hope to have a start and an end point that will shorten the length of the test. It'll be online, you know, so the examiner could theoretically put the answers in as you go. Now, some of this, you're going to have to learn how to score. For example, ideation, you have to video now. I mean, I do. I mean, okay, count and and score. So, so it won't be automatic, but you will, you know, it'll be much more in real time with, with modern, you know, more modern statistical tools and, and what? We hope is that it will make it more efficient and easier shorter.    Jayson Davies     Yeah, that's great. I did get asked to do the sipt about a year and a half ago, and first of all, I had to find the little USB key to plug into a computer. Then I had to find a computer that was old enough to run the program. So that'll be great, that it'll be easier to get access to and whatnot. You know, one thing that I do want to we're going to go on, we have one more real topic that we want to talk about today, and that is kind of your practice, where you do evaluations. You mentioned it slightly earlier, but I want to dive a little bit deeper into that. But first I mentioned I meant to talk about this earlier was to congratulate you and everyone who has had their hand in si on it now being recognized as an evidence based intervention for children, youth and young adults by the National Clearinghouse on autism evidence and practice. I want to get your thoughts. How meaningful is that to you? I know there's long been a barrier. It's always si doesn't have enough research. Si doesn't have enough research. That's what a lot of people would say. People would say when, when si was brought up. So how important is this to you that it is now considered an ebp evidence based intervention, sorry, intervention.    Susanne Smith Roley     Yeah, yeah. You know it's it's so exciting to see what's going on right now. But I will tell you that when I started learning sensory integration in the 1970s it was the only evidence based practice I was learning. So sensory integration has always been evidence based. However, one of the things that happened is, as OT, the mandate became that you had to be evidence based. Si was there to critique, right? So many of the things, many of the methods that we were using, didn't have evidence to critique, and si did. And the state of SI research, in terms of, you know, the rigor, I think, also paralleled the maturation of the field, the profession of occupational therapy, we weren't, we weren't sitting at the table getting those big grants with NIH, yeah, and we had the biggest, best, brightest minds submitting grants, and we were not able to play. Nobody got nobody was getting funded because they were not sitting at the table distributing the grant. So, so, so, yes, I know the rhetoric of SI doesn't have enough research, but it ot doesn't have enough research, and so si kind of paralleled that, but, but I was very privileged to be part of the SI research collaborative that started in early 2000s and this was the collection of university based researchers and practitioners that came together with with a small planning grant. And this, this, this little team that we have, about 10 people have have continued for over the last about 20 years, and we've done a lot, so with a very intense intent to build and support the research in sensory integration, we've managed to publish a couple of special issues of age OT, I think maybe three special issues. Um, we've done a lot of, you know, publications, and one, and one of the most recent and influential is the shown at all systematic review in 2018 So, so this systematic review went into the Journal of autism. It's got a very high impact factor, so that means it has, you know, more influence. And so this was huge, because, you know, there's, there's also a press from the outside, not just from the inside, to diminish sensory integration, in lieu of methods that are, you know, maybe more near and dear to the heart of other professions, because Si, in my opinion, belongs in OT. Its best development developed in OT. So, so this was huge. And then that external review, I think you're referring to the Frank Porter Graham report on on evidence based methods in autism. And none of none of us that I know was was involved in that. So that was completely external, and they included sensory integration as an evidence based method. Now this is because, primarily because we have two very strong randomized clinical trials, one by Schaff and all, one by Pfeiffer at all. There's also another article by Dunbar. Now, these are not the only intervention studies in sensory integration. We have many more, but these were the strongest randomized clinical trials. So we have met the external criterias. What is enough? I mean, how much research you have to have to say? You're evidence based, and we've met, met the threshold.    Jayson Davies     Yeah, that's awesome. I just think it's amazing. Because throughout ot school and my younger years, it was constantly people like saying, you know, si doesn't have the research. Si, oh, it's just a, it's just a one kid, you know, study. And now, like you said, there is that that? Well, it's always been there, but now it's really ingrained. It's a really strong two research articles that you really talked about there. So perfect. I really appreciate you saying that, that I think that helps a lot of people out there who struggle with that. You know, I want to provide Si, but I get that constant push of people saying it doesn't, or it's not, it's not real, or doesn't exist, or there's not enough research. Well, no, there is. There is research. So    Susanne Smith Roley     great, well and but I will say, okay, so what also came out, very loud and clear, especially in the A ot 2018 review, was when you compare the intervention studies, not just two randomized clinical trials, but the the wealth of studies, the studies that used a technique on its own, for example, a weighted vest or a chew toy or a sit and move cushion, those studies show very little evidence that they work at all. Okay, now that could be because maybe the studies aren't very strong, but there's no evidence that says doing a sensory accommodation is evidence based. Okay, so this is really important for school based therapists, because then, when you compare to air sensory integration, which is used with fidelity, the manualized, you know, where you have a space to work, you have equipment to work with, where you're doing the individualized therapy based on the characterization of the problem, where you have done a complete assessment that is the kind of the intervention that is evidence based. So you can't say you're doing an evidence based intervention if you're just using a sensory tool. And so this is also really important, because, you know the rhetoric for sensory and go, you don't have enough evidence. Well, now we do have enough evidence, but then there's a pushback of using evangelized intervention thing. No, we have enough we have the evidence. It works, but you got to do it right?    Jayson Davies     Yeah, and I know you and the whole team spent a lot of time developing the fidelity measure and making sure that it was separated between what is sensory integration versus what is, might be sensory strategies or something else. And so, yeah, no, I think you're right about that too. Is that we can't confuse articles that aren't sensory integration with sensory integration. So yeah, all right. Well, let's jump to our final segment that I want to talk about, and that is, IEE is independent educational evaluations. I know you provide independent evaluations down here in Southern California, and you know as school based OTs not all, but, but many of us have felt that pressure of finding out that a parent has requested an IE, and you know, sometimes it can cause some anxiety, or it makes us feel like maybe we're not doing everything from the outside provider perspective, because I know you do those ies. What do you interpret when a parent comes to you, or whoever it is that comes to you, the district, the advocate, whoever it might be asking for an IE, how do you interpret that request.    Susanne Smith Roley     Well, okay, yeah, that's, that's the majority of my private practice right now, and I've been doing it for many, many years, since, since the IDEA reauthorization gave parents the the authority to request an outside assessment, you know, from an objective party that was not part of the district and and, you know, I am very happy that that parents have that opportunity, because it does give an environmental press right it, I think it ensures accountability. And the other thing that I've seen in the best possible scenarios is that the team is informed by experts coming in, almost like consultants, and informing the team in their area of expertise. So I think that's when it's working the best. Now, you know, I know that sometimes it feels adversarial, and in my I really wish that it wasn't like that. I wish that I really truly wish it was.    Jayson Davies     I completely agree. I like where you're going with the whole it should be more consultative in nature, in a way, and working together.    Susanne Smith Roley     Yeah, so, so again, you know, as a as an IE evaluator, I think my job, what I'm being asked to do, is to take a snapshot of the child in a certain amount of time to see what's gone on before. How is the child situated as his educational program, and at the end of the day is ot going to be a. Beneficial to as a related service to support that child in his educational program. And is it educationally necessary, right? That's that's the mandate, legal mandate. And so for me, what I need to do is I need to look at the assessment data. I do my own assessment data. I gather information from the teachers, the parents. We observe, we, you know, do performance assessment, and then we come up with our conclusion and our recommendation for service. And sometimes it's in in conflict with what perhaps the district therapist has has recommended. Sometimes it's very consistent with what the district therapist has recommended. And in that case, it's the best possible scenario that we're refining the goals. You know, we're in agreement, okay, maybe we're 15 minutes, you know, a week difference or something. But sometimes I have to say that I do an IEE, and I can't even imagine that the child that I have seen has not been recommended for ot service. And so in that case, then I'm, I'm very much an advocate for this, for this student to get what they need.    Jayson Davies     Yeah, and I think that's totally appropriate. And I want to ask you, going a little bit further, is within your evaluation, how? What tools do you use, whether it be citing evidence or really the experience that you have, I don't know, but what tools do you use to really bolster your evaluation, to give it the weight that, yes, this is a real good evaluation. Does that make sense?    Susanne Smith Roley     Yes, you know. And I'm glad you asked that as well, because sometimes I think I have sensory tattooed on my forehead, but the reality is that I'm very informed by the OT practice framework that I work, that I have done, and so I tried to get the full spectrum of the OT process engaged, you know, so starting with occupational occupation, and ending with occupation. And so I I use an occupational profile. I use sensory motor assessments. If I can. I can't always use the sip. Sometimes it's not possible. But I try to get sensory motor I try to look at those foundation abilities. I look at Adaptive skill areas. So I want to see, you know, what's actually going on in the daily life for teens, many times, from parent and teacher report. I want to look at skills, the fine motor skills. So I'll also do something like the theory or the test of handwriting. So, you know, I want to see real skill. And then I also look at higher order functions, such as using the brief so I try to hit the range of, you know, of developmental, sensory motor, adaptive occupation skill ability, and try to get into those performance patterns as well. So when I when I make my recommendation, I try to make it with that whole scope of function in mind.    Jayson Davies     Yeah, no, and that's great that it's not just sensory. You are taking it from an occupation base, from the top down approach to get everything you said that in the best case scenario, you and the districts are kind of on the same page. When that happens, do you call it a day after that? IEP? Or do some districts have you kind of maintain a consultative relationship at all. Or    Susanne Smith Roley     how does that work? Well, okay, so usually my job is done after I attend the IEP. I'm sometimes I will collaborate with the OT outside of the IEP to try to refine the goals, or get together with that secondary IEP to make sure that that's but in terms of actually providing a service to the family following the IEE, I don't do that, and that's to prevent conflict of interest. It's so you know, I I try really hard not to have a have a pony in that race, where I would benefit from ongoing consultation with a certain district or a family. I I just don't do that, but I really do try to get the family and the district connected with service providers in their area. So we're always looking for, you know, OTs, that that might be looking for a job in the district, or maybe they have a practice in the in the area, you know, something in proximity, because families come from all over. So try to try to get them connected with resources, awesome.    Jayson Davies     And you know one thing I want to get out of you, because you mentioned this when. We were talking in our phone call that we did the other day, and that was that you sometimes see both influxes and drops in iees from particular areas. What do you make of that?    Susanne Smith Roley     You know that just happened today, I got two referrals from a district that doesn't usually call me, so I think, all right, they've got an advocate in there who's decided that they that they should use me, or maybe they got on a list server, you know, parent group or something, but, but, OT, but over time, what seems to happen is that the districts who are, who are functioning very well, and the and the parents are happy, they don't, they don't contact me, you know, so, so I don't get to see all the good work that you guys are doing out there. I mean, that's not who comes to me, you know, if they're happy, I don't hear from you, but, but then what will happen is that, you know, maybe they're going along. This happened with one district. I won't name it, but things were going so well there. And then suddenly I got 123, I had like, a half a dozen referrals. And, well, what happened, you know? And then you go, Okay, well, you know what's going on in that district, you know? And so I don't, I don't always know as an outside evaluator. What happened? But many times, what happens is either the administration has changed, or they have changed the rules, or suddenly some administrators decided they're going to take a hard line and they're not, or they've started taking services away from children. And then I and then I get a whole raft of them, and then I know, like, Okay, what's going on? And hopefully that situation gets repaired. Or sometimes there's an underserved district, and suddenly somebody's in there who's kind of better informed, and they're going, but wait a minute, we don't get those services. And so this is, this is something, you know, being from, from more of the coastal communities, you know, they, they get lawyered up real quick. And those families, you know, get services pretty quickly. And then you go a little inland to underserved communities. And sometimes you just, you know, it's really hard to believe what they're not getting. You know that? Like, well, if you were in my area, this is what you would be getting more automatically. So sometimes they like, oh, well if and then then families get on board, and then they go, Okay, well, we we want that too, and we want that too. So sometimes it's, it's a bit of a snowball effect. But one thing I want to, I want to say, is that, you know, when I, when I started here in Orange County, I had already worked for a public school in Ohio, and it wasn't just for children with orthopedic handicapped or severe mental illness, or, you know, severely involved kids and and there was nobody in Orange County. There were no OTs being employed in the district. In fact, CCS all the special ed kids. If they didn't get CCS, they didn't get anything. Yeah. And one by one by one, ot we advocated. We advocated hard because the districts didn't want to contract out to, you know, a private agency or an MPA, one by one by one. And I will have to say, you know that OT, that most of the districts now in OT, in Orange County and surrounding counties have OT, but more. And so I continue to advocate. You know that, you know that, that you have this, and now you have and I know you guys have these big caseloads, but you know so you not, yes, so you all those kids need ot you need more OTs. And not only do you need more OTs, but you need a space to work. You need your equipment, you need a reasonable size caseload, and you need the time to assess and make the proper intervention, because otherwise, the OTs feel completely overwhelmed by just the magnitude of demand that that's coming at you and and so that, you know that's hard, but that can't dictate what you recommend for an individual child. I'm    Jayson Davies     so glad you said that, because that's the same thing. I say the same thing. You know, we oftentimes, as OTs, and whether you're in a school or outside of the school, you we complain about our caseload, and then what do we do about it? Oftentimes, we'll try and exit kids. Well, that's a different way to go. A different way to think about that is to say, well, I need help, not to exit kids, but to say, I need help. Look at this growing caseload. It's growing year after year after year, and that's not the time to say, hey, let's exit kids because I have too many kids. No, that's the time to ask for help. Go to your administrator and show them how you can't fit. I don't know. I'm just gonna make. Pick up a number 500 minutes in a week when there's only 400 minutes, like, that's just how it is. And you need to stay help. So I'm glad you said that. And we need to advocate for other things too, like a space.    Susanne Smith Roley     Yeah, yeah. Advocate, yeah. I mean, I was in an IEP team meeting where the OT said, Well, I can I, you know, I use the psychologist room when they're out, and I can use the hallway. And I went around the room. It's like speech, do you have a place to work? Yes, A, P, E, do you have a place to work? Yes. Psychologist, Yes. Teacher, yes. OT was the only one at the table who did not have a place to work. We, I mean this, this is a point of advocacy. We, we need the tools of our trade and access to the the tools of our trade, and then have reasonable caseloads. I mean, that's all advocacy, at it, at a at a local, state and national level, to ensure that the services that we're providing are effective. And I'm not just talking about Si, but you know that I was in an IEP recently where the child was given five minutes a month of OT. And I know people are asking me about the effectiveness of Si, but I want to know what is the effectiveness of five minutes a month consult for OT, what? And you Oh, well, my, my child got ot, but it didn't work. That it doesn't work. It doesn't work to have such a minimum amount of service that that it renders the perception of OT is ineffective when, in fact, you guys haven't been given an adequate amount of resources to to make a difference. The other thing is just to have handwriting goals and not expand. I was in an IEP meeting where they said, well, OTs, don't work on mental health. Oh, my goodness, yeah, yeah, yeah. Actually, we do. We have a huge history in our profession, absolutely, of mental health. We are such a valuable resource in that direction of mental health for so many of our students and so so also, I advocate not to be reductionistic in the role that ot can play in school based practice, not to overwhelm the practitioner, but but to have more of a breadth of understanding. Also, somebody told me, Oh, well, the child's 13 and and, you know, he's a little too old for OT and our adolescents. This is a huge area of advocacy, because our adolescents are are getting depressed, they're overwhelmed. They're transitioning to a whole other level of demand in their educational process. And 13, you know, when you're my age, 13 still looks like a baby.    Jayson Davies     Oh, man, yeah, no, you're right, though. And I am getting, I mean, I'm all I'm on social media. I had the podcast. And people have been reaching out. A lot of people have been reaching out about what to do with high school, what to do with adult transition, and it is absolutely the right place for occupational therapy. I'm not saying it's easy, but it is the place where there is a need for more of us to find out more information, to be more supportive in that role.    Susanne Smith Roley     Yeah, because we're all about promoting health and participation through occupation. I mean, using lifestyle design and redesign and, yeah, so those high school kids, you know, yeah, there's, there's the need is, is vast, but, you know, okay, so I don't, I don't want to leave on this grievances, but I just think it's so amazing to see that schools are, you know, one of the biggest employers of occupational therapists in the United States. It's phenomenal to see the impact we have had as a profession in schools when, you know, like we started, people didn't know what ot does, and so clearly, ot has something to offer that's that's unique and really valuable, and it's so amazing. I mean, it's so great for me to see that that possibility exists where it didn't exist for, you know, people in my family, my brothers, who had have disabilities, and they didn't get any help, no help. And you know, he's there for these kids. So, you know that's, that's so amazing,    Jayson Davies     yeah? And I think it's now, it's about one in four, one in five. Occupational therapists work in the schools, and like you said, yeah, they're just continuing to grow. I mean, there's more and more OTs in schools every day. It's fantastic, and we just gotta, we gotta keep advocating for ourselves and make it continue to happen. But Dr Rowley, it has been a pleasure to have you on. Thank you so much for coming on and being able or allowing me to pick your brain a little. Bit on sensory, on schools, on ies. Is there anything else you'd like to say before we wrap up?    Susanne Smith Roley     You know, I just think that we're pretty blessed to have such an amazing profession, and I have had just the best career ever. So just good luck to everybody who's listening. It's, you know, I think it's just great. And anyway, thank you for what you're doing and your contributions. You know, this is, this is pretty awesome, what you're what you're contributing out there. So thank you to everyone. Thank you.    Jayson Davies     And then lastly, can you just really quickly, off the top of your head, give the website for the CLASI, I can't remember what it quite    Susanne Smith Roley     is. Yeah, it's C L, hyphen, A, S, I dot O, R, G, so C L, dash, asi.org ,      clasi.org , great, and I will be sure to put up the link to that as well in the show notes, as well as the discount that Dr Rowley and the CLASI team are offering to listeners of this podcast. It's for about a month, so you have access to it until, I think it's about the middle of March of 2021 I know you can listen to this podcast well beyond that, but there is an end date for that promo, and so be sure to check that out soon. If nothing else, take the class, the first class, which is the theory class, right? Take all    Susanne Smith Roley     of them. They're all really good.    Jayson Davies     All righty, well, thank you so much, and we'll see you later.    Susanne Smith Roley     Take care. All right, thank you.    Jayson Davies     All right. So thank you everyone, and a huge special. Thank you to Dr Susanne Smith Rowley for coming on here. Please do check out the show notes at ot  schoolhouse.com , forward slash episode 63 where you can get all the resources that we talked about today, or at least a link to them, as well as the transcript of the show notes, in case you'd like to read along or review it at a later time. All right, so again, take care. Have a great day. Hope to see you at the back to school conference in August. Bye,    Amazing Narrator     bye. 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. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Click here to view more episodes of the OT School House Podcast

Want to know more about the OT School House: Back to School Conference? Click Here! Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 62 of the OT School House Podcast. In this episode, I interview Amy Laurent, Ph.D., OTR/L , from the SCERTS Model and Autism Level up . Amy uniquely holds degrees in OT, special education, and developmental psychology and she is a Co-author of the SCERTS model which is being used world wide as a way to support children with Autism. Listen in to learn about the evidence supporting the SCERTS Model and how Amy continues to support the Autism community.We will also briefly talk about the amazing TED Talk Amy had the opportunity to present titled: Compliance is Not the Goal: Letting Go of Control and Rethinking Support for Autistic Individuals Links to Show References: Amy-Laurent.com SCERTS.com SCERTS Facebook Page SCERTS Research AutismLevelUp.com Autism Level Up Facebook Page Amy's TEDTalk 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 Jayson Davies     Hey, ot practitioners, the conference that your colleagues are calling the most valuable event of the year is returning just in time for the 2025 2026, school year. Join me and over 600 other school based ot practitioners this August for the fifth annual back to school Conference featuring 12 hours of practical a, ot a approved CEUs and resources from expert guests later in today's episode, I'll share with you about our incredible speaker lineup and a special discount just for our podcast listeners like you to learn more about the conference, visit ot  schoolhouse.com/conference and secure your spot today.    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, episode 62 I am excited to be here today. I hope you are as well. My name is Jayson Davies, and I am a school based occupational therapist, and I'm here to talk to you today. So that is what we're gonna do. We also have a very amazing guest on today. It was the best of well, it was just a really good interview. I had a lot of fun. It is Dr Amy Laurent. You may have heard of her. She is actually a co author of the certs model, and I will come back to that in just a moment. But first, I have some super exciting news to share with you all today in Episode 61 I kind of teased about a conference that was coming, and now I would like to share a few details, as registration will be opening soon for the first ever ot school, house back to school, virtual conference. I am super excited about this. I'm actually almost shaking as I as I say this into the mic, but this conference will be held August, 27 28th and 29th that is a Friday through a Sunday, and it'll feature both school based ot clinicians as well as researchers that have collaborated with clinicians in the school. So it is really for the school based ot unlike this podcast, which is amazing, this conference will actually allow you to directly interact with both myself and other presenters, some of which have been on the podcast and some who haven't. So if you've enjoyed some of the presenters that have been on this might be your chance to hear them without me in the way. And I know, I know a lot of times I facilitate things, but I know sometimes you just want to learn straight from the presenter themselves. And this is going to be that opportunity. In addition to some amazing presenters and amazing sessions, we're also going to be having a networking lunch, in addition to an entire forum dedicated to learning together and meeting with like minded clinicians from all over the country and maybe even the world. Who knows, overall, you will have the opportunity to earn 10 contact hours by watching live or the replays of the conference. If you should happen to need to watch the replays, but that is up to you. It is going to be live with available replays. There's going to be a ton of information. It's going to be a ton of fun. And if you would like to learn more about this, you can do so at ot  schoolhouse.com , forward slash conference. I hope to see you there. And please, if you have any inkling about this that you might be interested, head on over to the website. I have a video there that kind of explains what's going on, as well as a ton of details, with even more details coming out in March. So stay tuned, and I hope to see you over there. Okay, so now I'd like to introduce you to the brilliant person that is Dr Amy Laurent. Amy is a developmental psychologist as well as a registered pediatric occupational therapist. She specializes in the education of children with autism spectrum disorder and other developmental disabilities. The majority of Amy's work involves collaborating with and supporting early intervention teams, school teams and families in particular, in particular, if I can speak, she focuses on the creation of educational programs and environments that facilitate children's engagement and learning in all settings. Amy is also the co author of the certs model, which we're going to be talking about today. And another passion project of hers that we'll briefly touch upon is autism level up, where her and Jaclyn feedey, a developmental psychologist, advocate for autism in a variety of ways. Amy has a laundry list of experience and credentials that you can learn about by heading over to the show notes at ot  schoolhouse.com forward slash episode 62 or at her website, Amy hyphen laurent.com be sure to use the hyphen. If you don't use the hyphen, you may be surprised, like I was, when you end up on Amy Laurent matchmaking website. Maybe I should be getting paid for that little sponsorship right there. But yes, don't make sure you use that hyphen. Otherwise, I don't know, maybe some of you won't use the hyphen. But anyways, like I was saying, I am excited to share with you this very fun, very upbeat interview with Dr Amy Laurent, I hope you enjoy the show. Hey, Amy. Welcome to the OT school health podcast. Yes. And thank you so much for being here today. I am super excited for this chance to have this conversation with you. I mean, we're going to talk about a lot of different things today, autism, the certs model, just excited to have you on here.    Amy Laurent     Well, thanks so much for inviting me. I'm really excited to have the opportunity to reach your audience and have a chance to talk to OTs.    Jayson Davies     Yes. And that's funny, you say that because you that was one of the first things you said to me when we had a conversation. You said you don't get to talk to OTs as often as you like sometimes. Is that? Right?     Amy Laurent     It is true. So we're talking about certs today, and I know we're going to dive more into it, but it's the work of four different people, and three of the four are speech language pathologists, and two of those are kind of monoliths in the field of speech language pathology. So we tend to draw lots of attention from speech language pathologists. And I'm the loan OT, and so sometimes I'm like, Hey, we're here too.    Jayson Davies     It's funny how that works. I mean, in speech and OT, especially also physical therapy, there are several programs that were kind of designed by an OT or speech therapist, and then it's like the other world kind of really takes it on. The zones of regulation comes to mind, like Leah Cooper's occupational therapist, but it's amazing. Now, it's like speech therapists are really the ones that implement that sometimes I feel like, so it's just amazing. I mean, it's great that we're able to collaborate, which, again, I think we're going to talk about in a little bit here. I think we'll get there. All right. Well, before we dive into search model, I want to give you actually a little chance to talk about yourself as an occupational therapist and how you what made you decide to become an OT and how did you get to where you are now?    Amy Laurent      So, a funny and true story. I was one of those hospital volunteers. Wound up working in a rehab department. Was totally fascinated by hand therapy. I thought I was going to be a hand therapist when I grew up. I was going to go into the operating rooms with the surgeons, splint the patients while they were on the tables, make all sorts of cool, dynamic splints. And then I got to school, and I started working with a really wonderful mentor named Maureen nightstad, who was a professor of occupational therapy at UNH at the time, and she kind of took me under her wing and introduced me to the world of neurology. And I loved it, and I never looked back when I first started working with her. We did all work, independent studies and honors thesis and things around traumatic brain injury. So that was really the first work that I did outside of school. And then I had to move when I when I moved, I moved to an area where the traumatic brain injury intervention was not nearly as cutting edge as where I had been. So I was concerned. Because I was concerned on two levels. One, I didn't want to get a head injury where I moved to because I didn't believe the therapy that was being delivered was going to be adequate. And two, I didn't have a place to work. It was a problem, but I decided to take a job to fill my time while I was looking for the correct place to work. I was going to work with kids because I could work use cognitive behavior therapy. I could use sensory integration. I could use NDT. I could use all of the different interventions that I had come to know and love, working with traumatic brain injury with the pediatric population while I figured out what I was going to do with the rest of my life. The first client I had at the sensory integration clinic where I was working was autistic, and I never looked back. I left that room knowing what I was doing for the rest of my life.     Jayson Davies     Wow, wow. That's amazing. It's interesting. You just find where you belong, right? You just like you had all this other things going on in the world, but that one kid, that one instance just kind of all right, this is where I belong. That's awesome. Yeah. So did you end up working there for a while then staying at that clinic for?    Amy Laurent     So that clinic is really the beginning of the cert story, to be honest with you. So I started working there. I was doing all outpatient therapy and some school based work actually, because we had contracts with schools in the area, and we were looking to provide alternatives to traditional behavioral interventions in Rhode Island, if you get in home services, a traditional ABA program is typically What is offered and funded through our Medicaid system. And some practitioners got together and said, Can't we be able to provide some sort of developmental alternative to this for families who are looking for something different for their children? And so the owner of the clinic where I worked, his name was Lisa Gerard, and she kind of brought me into the project, and she teamed up with Barry present, who is the first author of the certs model, who is a speech language pathologist, who brought Emily Rubin along, who is a speech language pathologist as well, and that's really kind of how we all came to start working together. Was looking to provide an alternative service for IN HOME programming for autistic children. So.    Jayson Davies     Awesome. And so where are you actually at right now in your career? Where are you practicing? Are you focusing on training? What are you doing?    Amy Laurent     So I do all sorts of different things. I am a co author of the certs model. And so as part of that, I do do training around the globe. I'm really fortunate in that way, in terms of helping people understand relational developmental intervention and really scaffolding people's competency with that. I mean, that's the goal of certs, is to empower practitioners to have the skills to use on their own. It's not an expert model. It's more about building confidence within staff. So I get to do that. I do teach adjunct at several universities, but the bulk of my time is really spent in a private practice with an autistic developmental psychologist. I'm a developmental psychologist too. I'm an OT but I'm a developmental psychologist and a special educator. I've got a couple degrees, so yeah, my Bachelor's actually my ot degree, and my master's is in special education, and my doctorate is developmental psychology, but the partnership is two developmental psychologists. One of us is autistic, that's Jacqueline Feeney, and one of us is not, that's me, Amy Laurent, and we devote our time to developing all sorts of tools informed by the Autistic community to provide authentic supports, largely focused on regulation, not entirely, but largely focused on regulation. And within that context, we do a lot of training. We do school consultation, that's probably our favorite thing to do, as well as family consultation, where we get to actually work with families and with educational teams and build programs within schools and things. So I do a little bit of everything which is really fun, because it keeps me really grounded. You know, I think a lot of times when people get into roles where they're doing a lot of training and traveling and things, they lose that clinical aspect, and I've been able to hold on to all of that. And I'm really, I feel really fortunate to be able to do that.     Jayson Davies     Yeah, yeah, no, really, I completely understand that. Like, I've always contemplated, like, going to doing adjunct professor or something like that, but I don't want to lose that side of it. So completely understand that. All right, so moving forward, that's awesome. We are here to talk about certs. We've already said the term a few times, haven't talked about what it means. So I'm going to give you the opportunity right now to tell us what does cert stand for, and why does it have the name. It does.    Amy Laurent     Okay, so CERT is a relational developmental model of educating autistic individuals, and that is an acronym because you cannot have a model of intervention for autistic individuals. It's not an acronym. There is not one that exists. Like, I literally, like, will sit around and try to think of like, is there something and there's nothing. They all have acronyms. So we're no different. We had to be just like everybody else, which is kind of funny, because we don't conform in a lot of other ways, but whatever. Okay, so cert stands for social communication, emotional regulation and transactional support. And it really is a model that is a partnership based model. So we're looking at scaffolding skills and development for students in terms of social communication and emotional regulation, these core foundational areas that are going to support active engagement and learning in relationship, right? Because that's where most learning happens. So I just said in relationship, that's the Ts, that's the transactional support part of the model. So we have a curriculum for learners, students, individuals, all ages, in communication regulation, but then we have a curriculum for the partners, which is the transactional support curriculum, looking at how we modify our interactive style, how we modify activities and environments and are supportive to the learner. So if we expect to see change in the student, in the child, in the individual, the adult that we're supporting, we have to be willing to change ourselves. So that's that's the acronym, and it did honestly start as C, E, R t, s, but we did get a letter from the breath mint company telling us there was trademark infringement. So it's true. So we added the s, and the model is much better for it, because it really does highlight the core area that we're trying to scaffold development.     Jayson Davies     Gotcha, that's awesome. And so like you said, You are the lone ot on this project, and I want to ask you, you kind of mentioned a little bit how you got pulled into it, but expand on that a little bit more. And then also, what value do you bring to the certs team as having as being the occupational therapist on board. We'll be back after a quick break, while it may be summer break now, the school year will be here before you know it. Get ready for it. At the fifth annual back to school Conference coming August, 23 and 24th of this year, join hundreds of school based ot practitioners online for this two day transformative learning event where you can attend live or catch the replays. Don't Miss Amy and Jack. From autism level up, sharing neurodiverse strategies to support autistic students or expert handwriting instructor Peggy Morris as she shares the most up to date research on handwriting and how to put it into practice, don't miss this impactful event for school based ot practitioners. By school based ot practitioners as a thank you for listening to this episode of the OT school house podcast. Use promo code podcast, 25 for $50 off your registration at ot  schoolhouse.com/conference , I'll see you there.    Amy Laurent     I'm I'm giggling because I have all sorts of ideas that I would so I, first and foremost, I should acknowledge my other co authors. So I have mentioned Barry present already. He is the first author. He is a speech language pathologist, and Dr Amy Weatherby is Barry is at Brown University. Dr Amy Weatherby is at Florida State University, and she's a distinguished research chair in the College of Medicine there. She's also a speech and language pathologist. I think I just said that. And Emily Rubin is my colleague as well. She's a speech and language pathologist. She is the Educational Outreach Coordinator for Marcus Autism Center at Emory University in Atlanta, Georgia. And then there's me, and so Barry and Amy had worked together for a really long time. They met in graduate school. They did tons of projects together looking at language development, social communicative competence in young children. Some of your listeners might be familiar with some of the tools they develop, like the communication symbolic behavior scales, comes to mind the CSBs it's a tool that's often used. There's a screening tool, the CSB SDP. So they had worked together for a long time. They had published together for a long time. They're very interested in the development of autism and supporting individuals working within the context of their neurology and really in an authentic ways. I always say that. So it's kind of started as Barry's doctoral dissertation, because Barry in the 1970s I still envision him walking around with a real to real camera on his shoulder, right, like because we didn't have, like, cell phones. But what he did was he video recorded five different individuals and analyze their language development patterns, because at the time, you have to think autism still a subtype of schizophrenia. So echolalia is viewed as psychotic speech and something that needed to be extinguished. And Barry was a psycholinguistics major, and he was like, you know, I am working with these kids in camps during the summer, and I'm forming relationships with them, and I'm understanding that this is truly a functional means of communication. It's just a different developmental path for communication for these individuals. And so that was what his dissertation set out to, kind of document. And he was the first person to publish the functions of echolalia and really be able to demonstrate that autistic individuals learn speech differently, oftentimes not all, but many autistic individuals do Adriana work followed quickly, kind of after that, they kind of republishing simultaneously, but that's like the crux of certs. And then as Barry and Amy started to look at, how do we scaffold development to help young children, really, in those areas where they may need some additional support, they started to talk about forming certs. So the two of them started to talk about it, and then they pulled in the other people that they felt they needed to round out the model. And so I got pulled in because, as they were developing it, Barry and Amy felt very strongly that regulation was a big piece of this model, that we knew that autistic individuals struggled oftentimes with being well regulated, being available for learning, engaging, participating in everyday activities, but they felt like they needed kind of a different take or a different angle on it. So when I was brought in, I was originally honestly brought in to help write one chapter of the manual, chapter three, Volume One.     Jayson Davies     Just self regulation.    Amy Laurent     Right? And it really is the foundation of the motion regulation curriculum that chapter. And as we started working together, they realized that regulation touched every aspect of everything that we're talking about, and that is true of certain certs. Is very much an interwoven model. And so very quickly, I was brought on as a full author to help kind of make sure that that was just infused throughout the whole model, which was really for me, I can tell you exactly where I was and what    Jayson Davies     happened, but really though about how long was that? When was the program developed?     Amy Laurent     So we first published on certs, the first art well, okay, very first presented on certs in we first started talking about regulation in construct with communication in 1998 was his first article. We published the first article on certs as a team in 2003 and the infants and young children. In Journal of infants and young children, and then the manuals themselves were first published in 2006    Jayson Davies     Wow. You know, that seems so long ago when you actually say the numbers in years, but really it was like yesterday, as far as like, the with as far as like, how long it takes to do research, or how long it takes to develop a program and get everything, it really isn't that long ago, even though, when you, you know, calculate the number of years, it seems like a while, but programs, I mean, they take so long to really develop and then to actually get them going, and get them known out, and get people actually using it. So I'm happy to hear or happy to happy to have you here so we can help share. Share this for people who may not have heard of it yet.     Amy Laurent     Well, and I think that's, I mean, it's a really good point when you talk about research. So we've always talked about when we've developed cert certs is an evidence based model, meaning everything in those books has an evidence base behind it. And I often jokingly say, like, it wouldn't be in there if it didn't, because Amy Weatherby would not have allowed it, like she's an empiricist to like the nth degree, right? But the reality is, we all are very passionate about evidence based practice and making sure that we are doing the best for our clients, and that means we're taking evidence from empirical research, but we're also taking it from qualitative and lived experience as well, and integrating those pieces too. But so certs is grounded in research. It has a really strong research base, but to get those empirical studies that look at the efficacy of the model, it does take time, just like you're talking about, right? So we've got several, and we one of the most notable ones was just highlighted in a government publication by the Institute of Education Sciences and the interagency inter agency Council, coordinating council in 2019 which was reflecting on 2018 research, which It was the implementation of certs in public school systems in K to two in any educational setting, so self contained setting, versus fully included without support, with support. But looking at these really large districts, and can we bring this model to scale in a public school system, in a real life situation, not in a clinic, but in like where we work every day. Can we make this happen? Can we bring teachers to fidelity? And can bringing teachers to Fidelity impact student performance and performance on things that are quality of life measures so active engagement in the classroom, time on task, responsive to teachers, rate of initiation, those things that really are the foundation of learning that that research was literally just published within the last two years, because those are longitudinal studies, and each one took, you know, four to six years to execute, and then to crush the data and then to get it out. So yes, you are quite right. These things take time to to disseminate, right or to be able to prove out that way.    Jayson Davies     I just want to highlight that you did not miss misspeak. You did say this took four to six years. Like that is how long things take to implement something, take all the data, put it all together, and then eventually get it published. I mean, that's that's a long time, so kudos to you and the team for for getting that all out there.    Amy Laurent     But I will, I was not a principal investigator on any of our major grants. I was a consultant on many of them. So Amy. Amy is actually the spearhead of many of the grants. She she's the one who can, like, write those applications and get that funding. You    Jayson Davies     need that person on the team for sure, all right, so you you actually just kind of led into the next question I wanted to ask, and that was about population. Obviously, this podcast, we mostly have school based occupational therapists listening in some clinic base, but it sounds like you're using this not just with a population with disabilities, but also kind of almost sounded like what you just said there was for even general education potentially. I don't know if I'm wrong about that, but I want to ask you, really, what population is the certs model? What was it designed for? Who is it used with?     Amy Laurent     So certs is designed to meet the needs of autistic individuals, because we're really focusing on those core areas of challenge that they experience that impact their ability to function in their daily lives in ways that are meaningful to them. So that's the communication and regulation with that being said, it's a developmental framework, and so we haven't talked too much about the difference between a model and a framework yet, but it's a framework meaning that I can take any kid, any typically developing kid, and look at our scope and sequence of goals and point out where their strengths are in their profile, and where their opportunities for growth are or their next steps are. What. Does that mean? That means, if you're supporting anyone who's struggling with communication or regulation, certs has application for them, because, and we're always thinking about, how do we support that in a relationship, right? Or how do we make those accommodations and those differences? So with that being said, you know, oftentimes, when we're presenting, people say, Oh, have you used it for this population? Oh, I've used it for this population. I'm thinking about this. And the answer is, we do see applicability beyond the autistic individuals, but all the research has been done on autistic individuals, and some of the transactional supports in our curriculum are specifically designed around their learning style. What does that mean? That means some of them you might look at for a different child, a different learner who has a different style, and say, Oh, visuals aren't as salient for this kid. Maybe I'm not going to use them for this individual, even though they've got this huge section on visuals, right? Well, we have that in there because we know about the learning style of the autistic individuals.    Jayson Davies     Gotcha. Definitely. I mean, it's just, you know, the autism population is very it's, well, it's, it's growing, and there is so much research, kind of, and I'm sure there's a lot of funding to going toward research related to autism, and it's just amazing what is coming out of the world today. And the search model. No different. I want to continue on with now that we kind of have dove into this or Devon and dove into this a little bit. I want slash, right? I'm not the work. I'm not the best with words, but I have a podcast. I try so social communication. I kind of want to break this down a little bit. We've been talking really fast certs is social communication, emotional regulation and transactional support. So if you can break down a little bit more that social communication for kids with autism, and what the goal is within certs, right?    Amy Laurent     And so I think one of the things that I should have highlighted when you just asked me about the population, just so everybody's super clear. I know most of your listeners are supporting school age students. And certs is very much applicable to the school age population. And when we talk about school age population, we're talking about full school age population, like three through 21 or 22 depending on the state you live in. But it is actually given that it is a developmental curriculum. It extends to the earliest diagnosed children up through adulthood we can support because it's this developmental framework. And so you know, our earliest research is done with children starting at 18 months of age who are just diagnosed. So just kind of keeping that in mind for your listeners who might be supporting different age ranges, there is applicability outside of the school years, even though the school years tends to be that sweet spot where we start thinking about intervention models and things. So when we talk about social communication, supporting social communication, we're really talking about helping individuals become effective and efficient communicators, people who are able to get their ideas across to others in ways that they want to so different messages to different people in tons of different environments. That's what we're looking for in terms of social communication competence, being able to connect to other people in meaningful ways. So we really look at supporting two different dimensions of communication. For communication. One is joint attention, which is why we're connecting to other people, right? So things like behavior regulation, getting getting your wants and needs met, which autistic learners tend to be better at. And then there's those social functions of communication, things like turn, taking, sharing, showing off, right? Greeting, things that can be a little bit more challenging for autistic individuals. And then we talk about joint attention in the sense of this kind of like shared experience, shared conversation, shared meaning, where we're co constructing play, or we're co constructing an experience with somebody. So when we think about joint attention, we're thinking really big and thinking about all the different reasons that somebody might be connecting to somebody else, and we want to make sure we're supporting a big breadth of reasons for connecting and communicating. And then the other aspect that we look at is supporting what we call symbol use. This is where it gets all jargony, right? Simply, symbol uses how, if joint attention is why. Symbol uses how. So we're going to start developmentally really young, and we're going to talk about things like facial expressions, vocalizations, gestures, proximity, right? Those really early communicative symbols, signals. And then we're going to build on that, and we're going to start talking about things like symbolic systems. So it could be spoken words, but it could also be some other sort of symbolic form, so sign language, a picture symbol augmentation. And then we're gonna start to talk about how sophisticated are they with those systems? Are they using single words? Are they putting words together? Are they using echolalia to go back to Barry's dissertation, like I said, it's rooted, right? And then we start. Layering in symbol use. We also think about play, because play is largely symbolic in nature, in terms of how we scaffold our development, like language. We know language and play go hand in hand in terms of development. And we also think about things like social conventions in symbol use, because social conventions, they're kind of like social currency, but they're largely dependent on the culture you're in and what the expectation in the environment. So learning kind of what underlies those for individuals, so that they can figure out what and when and why they might want to use them if it behooves them. So that's really where we think about social communication, is this very robust skill set that we're really looking to develop. It's not just how big is their vocabulary, how many words do they have? It's not how they respond to questions. It's how effective are they at initiating with other people.    Jayson Davies     All right, so that's the social communication side of it. And then you the team used a very specific term, emotional regulation, not self regulation, not emotional intelligence, emotional regulation. So explain that piece a little bit.    Amy Laurent      So emotional regulation, it's so convenient we have like, these big, like, you know, domains, and then underneath each domain we have two capacities. So underneath emotional regulation, again, certs is grounded in the developmental literature. So we're going to go straight back and look at how emotional regulation develops, and we're going to talk about self regulation, and we're going to talk about mutual regulation. And those are the two skill sets that we're looking to develop in the individual or support the development or the use of so of course, I mean, we as OTs, we know this, right? We got but self regulation is what we have at our own disposal to organize ourselves, to tolerate transitions, to delay gratifications, to maintain active engagement, right? So we have sensory motor strategies that we can use. We're all pretty good at those. I in full disclosure, Jayson knows that I am standing and pacing and rocking while I'm doing this, so I'm all about the sensory motor regulation.    Jayson Davies     Yes, I love your I love your standing desk setup.    Amazing Narrator     And then there is our language strategies, which are basically informational strategies, which help us navigate our day, things that provide knowledge. Knowledge is power when it comes to regulation, right? So even just being able to check my phone, to look at my schedule, to know what time I had to check hop on the Zoom call. That is a language based strategy for regulation. I'm using that to inform myself. And then we think about metacognition, right? So metacognition is being able to be reflective or forward thinking in a situation. So that's a developmentally really advanced skill or ability. One of the things that we should say is, while we're looking to develop a really robust profile of these things for our learners, for the individuals we're supporting, we have to meet them at their developmental level. So if I'm working with somebody who is pre symbolic in their communication, right, only using those facial expressions, gestures and proximity, that early stuff I talked about, I'm only using sensory motor strategies for regulation. That's how they process and understand the world, right? I'm not going to throw language and picture schedules at somebody who doesn't understand language and picture schedules like that's not smart, that's adding noise, that's adding clutter, and that's probably just regulating them further. So we're going to meet individuals where they are developmentally. What does that mean? That means when I get to students who are emerging language students, then I go, I can use information strategies here. I can use picture schedules. I can use timers. I can use first then boards. I can use emotional identification cards. I can use all of those things right when I get to that that level. And then for that last stage that I talked about, the metacognition, those are going to be for our students who are conversational, our students who are able to think about thinking right and we know in typical development solidly that comes in eight years of age, chronologically, like for a typically developing child, that's when we know that's a Solid skill. So if you're supporting learners who aren't developmentally at and chronic and chronologically, I should say, at an eight year developmental level, stick with the language and the sensory motor strategies don't pull in that metacognition yet. So that's the self regulation basket. But how do we how do we learn self regulation? We learn self regulation through successful mutual regulation with other people, right? Like it's people responding to our signals of distress and providing assistance us learning the strategies that they're offering to us work that we can use them ourselves as self regulation, or we can learn to ask them for help in the future. That's initiated mutual regulation. And so it's this dance of these two different levels. Oftentimes, you know, if we're thinking about working in schools, you know, people are always like, Oh, I gave them a fidget toy, like, you know, I did this great sensory motor thing, and they're like, it didn't work. And my initial response is, usually, did you teach them how to use it? And people go. What do you mean? Did I teach them how to use it? And this is what we need to know from development. Most self regulation is learned through successful mutual regulation. Right? Kids learn to use things because we teach them. Typically developing children who are plugged into the social world pick up on visual models of other people around them. They observe what's going on, and they internalize that, and they learn to use they seem to absorb self regulatory strategies based on what they see other people doing. If you're not so plugged into the social environment because you're autistic, like and that doesn't like you're you're more drawn to other things in your environment, you know, your passionate areas of interest, or something you know, like the number line at the front of the room, the alphabet. How many of us have kids that we know who love alphabets, and they put those alphabet in the front of the room, and then that's like, that's the focus of attention, right? But if that's their focus of attention, they're not picking up on the models, the natural models going on around them, we have to explicitly teach them how to use the fidget, and we also have to teach them why we want them to use it. And hey, we'll know this is working for you if you're able to pay attention, if you're able to answer questions, if you're not, otherwise, you've just handed them the best toy in the room. So when we talk about this dance in certs, about self regulation, mutual regulation, it is often about teaching. The objectives in the IEP often are first mutual regulation, and then we flip them into self regulation. I think so many times we as OTs, jump to self regulation and forget about the teaching process. So certs is big on making sure we don't forget about the teaching process.    Jayson Davies     I can think of one or two IEPs, but I've probably done that. Go back and revisit    Amy Laurent     that we all have. And what we always say is, when we know better, we do better    Jayson Davies     exactly, all right, so the last part of this is if I can scroll back up to make sure I have it right, transactional support. Because this is actually the area that I had never really heard of much before I came across you in the certs model. So I am interested to hear what you had to say about transactional support.    Amy Laurent     So again, transactional supports heavily rooted in developmental psychology and the developmental literature, and it is the notion that learning occurs within the context of relationship. It's a two way street. And as I said earlier, I know I said it, if we expect to see change in the student or the child or the individual we're supporting, we've got to be willing to change too, like it's not all about the individual, it's about meeting them where they are, and scaffolding development as we go. So that's really the the nature of transactional support. So just like we had two capacities in social communication, the how and the why of communication, and we had two capacities in emotional regulation, the self regulation and mutual regulation, we have two fascinating isn't it transactional support. It makes for a very neat and clean form. When we're we have two two things that we're really looking at, how partners are supporting students. And when we talk about partners, it's anybody. It could be parents, it could be teachers, it could be paraprofessionals, it could be special teachers, like anyone who's interacting with that child within the model is considered a partner. And so we're going to look at things like interpersonal supports. And this is where, like, the OT just kicks and meaning kicks in. Well, kicks in in lots of places, but this is, like, therapeutic use of self. Like, this is how do we modify our interactive style to truly meet our client, our student, our person that we care about, that we're supporting where they are, and kind of join with them, right? So modifying our language level so it's comprehensible to them, right? If I'm working with that pre symbolic kid, the child who's not using or responding to symbols, I'm talking to them like I'm talking to you. That's the Charlie Brown teacher that that's the wah wah wah. And what's going to happen the kid is either going to shut down right, push me out of the way, which looks aggressive, but it's not. It's just trying to get a buzzing bee away from them, or they're going to split they're going to run away, which is going to look like escape behavior, which is really just, I need to get away from that really annoying thing, which is me, which is not what we want. So modifying our language level is huge, and not just modifying for developmental level, but also modifying for regulatory state. Right when we get someone who's really amped up, moving towards maxed out and frenzied, even if they're conversational, they don't have the same language processing abilities when they're in that arousal state. So are we as partners monitoring their arousal state and modifying based on where they are and what they're able to process at that time? So the curriculum is really pretty robust, you know, getting down on the child's level, modeling, regulatory strategies that are more conventional, those types of things. It's, it's a full scope and sequence of goals that. We are actually assessing the partners on so at the same time, we would be looking for skills in the child, in terms of their communication regulation. We'd be looking at the partner at the exact same time and saying, how are they being supported? Because context matters. I mean, we, as OTs, of all people, know context matters, right? We don't operate in vacuums ever. And so that's one side is the interpersonal support, and the other side is learning support. And learning support is how this we are so good at this as OTs too. This is how we modify the activity or the environment, right? It's grading the activity. We're so good at this task analysis. How do we break it down? But it really is like thinking about things like infusing visual supports. Are we modifying the length of time? Are we thinking about the social complexity in the environment? Are we infusing visuals? If we're you working with somebody who is an AAC user, are we making sure that we're using that for receptive language, so we're teaching that way, not just expecting them to use it expressively. So again, it's a really comprehensive scope and sequence of objectives that we look for evidence that partners are actually implementing these things, and then we decide, what do we need more of? Or what aren't we doing that we should be doing, or what are we doing that's actually not helpful for this individual learner,    Jayson Davies     absolutely. So one of the key terms that I'm focusing in on as you talk is partners. It's an important term, not just because it's something that you guys use and that we all use, but right now, partners are the teachers are the parents at home are his big brother, big sister, who's on the computer with them. And I get a lot of questions from other therapists on social media and emails about, how do I help my teachers? How do I help my paraprofessionals, and now even the parents. And so when you're coming into a school with the certs model. What are, what is the team doing is, is, are the parents and the or not the parents, but are the teachers and the paraprofessional para professionals getting trained in the certs model? Or is the OT and the speech therapist going in and training them? Or what does that look like?     Amy Laurent     So the goal of certs is really a multidisciplinary model, and that means everybody is on board. I mean that when we're operating on all cylinders, everybody's on board and bringing their knowledge and experience to the table, right? Because we all have a piece that we can contribute that's really important. And so what does that that mean? That means, like, if we, if you're doing a full blown search assessment, like you're really doing the whole thing. It would mean that maybe the occupational therapist is going into the classroom during their morning meeting time and doing the observation to see what communication and regulation skills the students using and how the teacher supporting in that moment. And then the flip side is maybe that occupational therapist is supporting that child during recess or in a physical education class, and then the teacher comes and observes the occupational therapist during those times to see how the OT is supporting this child and what communication skills and what regulation skills the child's using in that environment. And so it's a cross contextual observational assessment that we're using, we try to get as much information from home as possible, because kids don't have home days and school days, they have full days, right? And so you know, if we're not in a remote learning situation, we'll ask families if they're comfortable sending in some video of their child at home, because oftentimes kids look really different at home than they look at school and but we can glean a ton of information about how they're being supported at home and what's working in that environment, and how can we leverage that to use that in the schools and vice versa. So the goal is to get everybody on board. We are also very realistic and knowing that that can't always happen. So we always say, shoot really high and land where you can right, because not, not every family is going to have the energy and the ability and the just even the time to be able to be fully a member of this team. But if we can help in some way, if we can provide some supports that are useful to them, or some intervention strategies, or they can they can share with us too. We're better off. But certs is really designed to be a cross contextual model that as many people can get on board as possible. So even if that's we come up with one transactional support that we think is really going to make a huge difference in the students life, in terms of their ability to be able to engage in their in their daily routines. Let's just say, What? What do I want to pick? I don't know. I have 100 ideas running through my head, but let's just say, maybe it, maybe it's something around communication, and it's around the ability to initiate asking. For help, right? And you know, the families agreed that that's a struggle at home, but it would make a big difference if they could do that at home, and we've seen it in the school in a variety of different environments. So the whole everybody goes, yep, this ask, this initiation for the purpose of asking for help is going to make a big difference. If we help him learn how to use the skill or ability, if we devise transactional supports for that goal or objective, everybody gets access to them, right? Not with, not with the parents expectation that you have to use this and you have to use it in this way, but more like, here's this thing that could be really helpful to you, right? Like, not in a guilt inducing way, we don't want to do guilt but as a resource, no, we don't know, no guilt resources. No guilt resources. We will. We want resources, but this idea of being able to provide the support. But then the flip side of that is in the school environment, is that goal or objective around initiating the request for help becomes the property of the entire team. So the OT is working on it, the speech pathologist is working on it, the teachers working on the paraprofessional is working on it. The special teachers are like, you know, the special teachers as an art, music, whatever anyone who's interacting with this child knows that's the goal or objective, and they know the types of supports that we're using to help facilitate or scaffold that. So what we're basically doing is infusing natural learning opportunities across the child's entire day, which is where we're going to get true learning. We're going to get learning where the child needs to lose use the skill, versus learning in isolated context or a drill based format, which doesn't work well and it doesn't generalize. Well,    Jayson Davies     yeah, and I had a question for you about being multidisciplinary, but you really just answered that. And so earlier, earlier, you kind of mentioned how search almost, I don't know, and correct me if I'm wrong, but you kind of it sounds like search was an alternative to something that was being used a lot, such as, like the ABA type of program. And so I do want to ask you, does ABA fit into certs at all? Do you use ABA type of, type of techniques, or where does that fit in? How does ABA fit or not fit? Or this    Amy Laurent     is a loaded question. No, no, no, it's totally fine. It's a question I get all the time. What we will say is, in the context of certs, when we talk about our overarching goals of the model, which are regulation, availability, for learning, engagement in ways that are natural to the individual. And we talk about social communicative competence, so social emotional competence and social communicative competence. And we talk about students who are able to initiate communication and are able to communicate for a variety of functions in a variety of ways, and truly kind of project themselves into the world traditional behavioral approaches don't support that type of outcome or goal, right? And I mean, that's just true, because when we think about behavioral intervention, and we could dice apart what people mean by ABA, and this is why I say it's a loaded question, because people have so many different perceptions of what they think ABA is and your perception is your perception. But when we're just thinking about behavioral intervention as a whole, and we think about traditional discrete trial training, that model always puts the child in a responsive role, right? So the teacher asks the question, the child's either expected to follow the direction or answer the question, right? It's the man intact, right? If we're going to go back and use kind of the lingo that we tend to hear behaviorist use, you can't become a spontaneous communicator if you're always in a respondent role. If that is our overarching goal for the model that teaching technique cannot support the attainment of that goal. It doesn't fly. It can't happen. And the same thing is true for regulation. You cannot drill somebody into being well regulated. We can pre teach, we can preview, but it's about teaching in the moment for an individual and also learning to be responsive to their cues, and being able to, again, through that successful mutual regulation, support, teach self regulation, and again, you can't do that in a discrete trial format. It is not possible. So when I say traditional discrete trial, or traditional behavioral analysis or ABA doesn't fit with inserts, it doesn't it. It just doesn't for communication and regulation, which are overarching goals. Sometimes, if we start to split hairs, people will say, Well, what about other aspects of the child's program? Right? So this is where I say I'm a developmental psychologist. If you tell me you're using. Behavioral learning theory for an objective, like an academic task, where it makes sense, and I think I might have thrown this example at you earlier, but this idea of we all learned our times table through mass trial, like repetition over and over again, some adaptive skills like tying your shoes, you learn through mass trial. Like it truly works. The teaching technique supports the end product and the goal, the key is certs would never subscribe ever to using a behavioral teaching technique for a child's entire program, right? We are going to say this technique to teach this specific skill, and this specific skill is related to something that everybody learns that way. And that's what's super critical. It's not like, oh, this child is an autistic student, so they need to be taught in this way. It's no this teaching technique makes sense for this skill, and I think that's where, and I'm on a bit of a tangent and maybe a little bit of a soapbox now, but I think that's where we go a little bit awry with ABA, where people go, Oh my gosh. We can use this to do everything, and we can't, and it, but it really doesn't fit within the model. We really want social emotional competence. We really want social communicative competence. We want these children to be who they are and not be trained to act in certain ways. So can you use some behavioral techniques for some certain things? Sure, is it a thing that fits easily within the model for lots of things? Absolutely not, gotcha? No, that's that is a very fair answer. And I well explained, well explained, I don't know, I kind of went into an attention and in circles, but it's a, it is a complicated answer, because I think people often say, and then, and then people will come back and say, well, you're talking about, you know, traditional or old ABA, and this is new ABA. And I often say, if behavior analysts would acknowledge where their new informed practice comes from, you would find it comes from the developmental literature. And then it's really not behavioral intervention, if it's relational. So again, it that's developmental psychologist in me that does like to start to argue, but like to start to argue those points, because sometimes, like, the field of ABA just goes, Hey, this is ours, and they grab it and they hold on to it, and you're like, No, where did you get it from? Like, just acknowledge it. That'd be great.    Jayson Davies     That's interesting, yeah, how you say that? Because you're, I mean, we all kind of grab them some things from somewhere, but yeah, yeah, acknowledge it and say where things are coming from. All right, you haven't mentioned this yet, but you mentioned it to me a little bit earlier, and I think it's something that people need to hear and that is about measuring goals within the search model. And how does that go about? Because I know a lot of times, you know, on an IEP, we have a goal, and it says the student will do this and this, and three out of four trials and 80% accuracy, which I can't stand having, doesn't make sense. But what does it mean in the certs model? I don't know if I should ask, what does the goal look like, or what is it considered when it's met? What are you looking at to make sure that it truly is met?    Amy Laurent     So it's an it's an interesting question. So as I said, the goals or objectives are the property of the whole team. So like, if we have a regulation goal, it's not the property of the OT, it's the property of the entire team. Like, who's measuring this? The entire team is measuring it. The OT may be taking the lead on the types of transactional supports that are used to help facilitate the objective, if that makes sense, because we might have special knowledge in that area, just like a speech pathologist might have special knowledge around augmentative alternative communication systems that they're bringing in for a communication objective, but everybody's addressing it. So what does it mean? It means when we write our goal or objective, we're really specific in terms of, let's go back and use that example of the child that I said, Oh, maybe initiating for the reason of asking help or other social interactions like that was going to make a big difference. Like that's going to come right off of our curriculum, because we've determined that, and we're going to go put that right in the IEP or the IFSP for the child, right? You know, John will initiate requesting for the purpose of help or other actions, which is different than requesting objects when, and this is where a transactional support piece comes in. We write it right in the goal or objective when partners provide choices of objects, maybe for this child or visual supports, or give time for processing recognize signals of distress and offer support like we we wind up kind of coming in with which one of those transactional support. So you're not going to, like have that laundry list of seven that I just listed. You're going to pick the one or two so John will initiating requests for help or other actions when partners give him processing time and a choice of object. X, right? So it's all right there. It's not just like these transactional supports get lost on this accommodations page, which often, like, is at the front of the IP that people forget to read, or, like, whatever    Jayson Davies     you said that. I say that all the time. Okay,    Amy Laurent     so, so, but it's right there. But what that means is, is the whole team's responsible. Everybody knows what they have to be doing, right? Like what they have to be providing, the wait time and the choice of objects, everybody's responsible for it, and then the measurability, which is, I think, the piece that you're really interested in comes into, how many partners, in, how many contexts do we see it right? So we're going to know that John's achieving this goal or objective, not if he just does it in speech therapy or he does it in his gym class being supported by his ot we're going to know he does it when he's doing it in three different settings across the school environment, with two or three partners, and at least one of the partners is a peer. When we see him doing it in that many places with that many people. We go, Ah, he's got this awesome do we change the transactional support, or has he truly internalized it and we're ready to move on to another goal or objective for him?    Jayson Davies     Gotcha? Yeah, no, I really like that. Just that last part that you really touched upon, you know, making sure that it's happening in the context that we want it to happen in not just a single context, that maybe, maybe social communication is easier to or occurs more frequently in the gym class. Well, then maybe that's not where we need to focus it on. We need to focus it on in language arts or at recess or something, whatever that might be, making sure it's happening everywhere across the board, not just in one place. And I think that's    Amy Laurent     an important thing to kind of highlight, and we haven't talked about it is when we say, these are the property of everybody, and we're doing it across the entire day. We are, but we're actually really strategic in certs. And what we do is we embed goals or objectives and activities where it makes sense to do so. So if we say requesting help or other actions is one of those places, one of those goals or objectives for John. Going back to her little guy, John here and we wanted to request help or other actions, it makes sense, probably, to go after that during meal times, right? It makes sense to go after that, maybe in gym class or an activity where there's a free choice. It makes sense to go after that, where it probably doesn't make sense to target make sense to target that is in library, during library, we're probably going to be targeting some self regulatory strategy to help maintain focus and attention. So we're strategic in which goals or objectives we embed. Everybody has knowledge of everything, but we're strategic in what we're really targeting, and in any given activity throughout a student's day, we're not really focused on more than two things at a time, because if we are, there's no way we can provide all the support. It's just not going to happen. And there's no way we can collect the data either, which is really important to be able to do. Yeah,    Jayson Davies     and you know, I in the back of my mind, I can hear occupational therapists listening to this and just thinking, when do I do this? When? When? How do I fit this into a day? And I think that's a whole nother discussion. If you want to speak to this, feel free to but that's a lot more about advocacy for our entire profession, which I don't think our profession has been the best advocates for ourselves, and we need to continue to get better, whether you believe that we've been great or not, we need to continue to get better and advocating for ourselves, advocating for our caseload, workload, whatever approach that your school is willing to call it, and making sure that we aren't biting off more than we can chew. And you know, I get it, there's budgets and everything involved. But it is something that if we feel something's right for a child, then we need to fight for that a little bit. And if that means trying to decrease your caseload by five kids, then maybe that that's worth doing it. I don't know if you want to speak to that at all    Amy Laurent     well. And I would say this, this educational model is really a lot about kind of universal design and really reaching a lot of students. You had said that kind of in the beginning, you were like, oh, you know, we're targeting autistic children, but it seems like it's going to have benefit beyond that it would, but I think it, you know, it is a bit of a paradigm shift to think about. And paradigm shifts are challenging. Change is always challenging, but in the end, certs is about working smarter, not harder, and if you've got everybody on board supporting that child's regulation, supporting that child's communication, you are going to actually wind up developing competency across your staff. Like I said, part of my job is develop competencies in staffs, right? So I kind of, like, want to put myself out of a job. Like, once I get people really invested in this framework, they've got the skills and abilities. I mean, I'm going in and teaching people who've got years of experience and tons of tools in their toolbox. I'm saying here's the framework to organize it, right? But one. You've got that framework, and the team you're working with has that framework. It really it flows in amazing ways. That does not mean the change to bring it about cannot be full of bumps, and administrative support is often really critical in making sure you've got the time to team with other people to make sure that everybody's on the same page. But once it starts slowing,    Jayson Davies     it is a thing of beauty. Yeah, yeah. It's just, it's just getting started getting the ball rolling. Go from there snowball at the top of the hill. All right, we're going to wrap this up here pretty shortly, but I couldn't get through this entire interview without mentioning your TED talk that you completed with seven of your best friends, basically, it sounds like and closest friends with autism based upon, well, you talked about autism, you talked about behavior, functional communication, a lot of things that we've already talked about today, but I actually want to give you the chance to kind of just talk about how that came to be and why you chose what you did. And then everyone can out, everyone out there listening can end this podcast and go watch it. So tell us, how did it come to be, and why is it so meaningful for you?    Amy Laurent     So the Podcast, the podcast, the TED talk, the TED Talks. Title is compliance is not the goal rethinking support for autistic individuals, and I think it really touches on pretty much everything that we've talked about here today, right? My focus, my passion, my interest, is really supporting regulation and supporting active engagement and high quality of life for autistic individuals and helping them kind of live their best lives in meaningful and authentic ways, the ways they want to. And we know from firsthand and lived experience that the ability to support someone's regulation is critical for those things. And for far too long, individuals have been subjected to behavior management approaches where we're trying to get them to comply, to look like we think they should look, versus what is comfortable for their neurology and what actually truly works and is supportive for them. So I do have many, many autistic friends, including my my best friend and partner at autism level, jayvi, who is in in the talk. And as we were just talking about kind of this, this idea of, how do we reach more people? How do you, how do you do this? Or like, okay, there's this TED talk thing, let's do it. But it was an opportunity to help really reframe the status quo and help people start to conceptualize and think from an autistic perspective versus from a neuro normative standpoint. And it was super fun because they did. I kind of, I broke the mold. I kind of like to do that, but I asked if I could use video and if I could bring in some autistic voices to help really illustrate so to be honest with you, I kind of feel like the MC in that TED Talk, like my job was just to set them up and let them deliver their message so it I feel kind of rotten, because you have to search my name to find the TED talk, but, but I feel like they're the stars of it, and they're the ones that we really want everybody to listen to, because they share some really powerful personal experiences and from a real range and background. So,    Jayson Davies     oh yeah, that's what I was really most, most appreciative of, I think, is like you had seven very different people on there, and one of your friends, I think she was filming it while she was in an airport, just showing that she was, like, in the community. While she was filming this, you had another, another gentleman who was filming, like, in a recording studio it looked like, and he said he is, Oh, Michael, yeah, yeah. I mean, just very interesting people from all different backgrounds. And then you also had people that were just sitting on their couch at home, and, you know, and that's fair, you know. And so very different people all living their lives with autism, but they're living their life, which is the important part of it. And I think    Amy Laurent     that, you know, the key part was to be able to show, and I'd be not telling the truth to tell you that that wasn't by design. We, I mean, we really thought about who we wanted to include. And I say we because it was a team. I wasn't, it wasn't just me, it was all of them like, what I I'm always like, it's a collective TED Talk. But, you know, we really wanted people to see that, even though we have individuals who have very different communication styles, very different educational levels, very different age ranges. We wanted to pull the threads of their common experiences. So to be honest with you, the way we did it is I did it like a qualitative study, and I sent them five questions. And I just said, please answer these and answer them on video so they weren't scripted. I didn't ask for specific talking points. I was just like, you know, what does stress feel like to you? What does Joy feel like to you? What is it has Has anyone ever tried to control your behavior? How does that feel to you? Those were the questions I asked. And then we just did a qualitative research study, and we literally reduced them for themes, and then that's how my talk framed around what they came up with. I didn't write my talk first. I wrote it around what they they said, shared,    Jayson Davies     developed like a true researcher data and then work from there. Awesome. All right. Well, before we wrap this up, I actually want to just ask you a simple question that I have no idea what it'll lead to, but is there anything else on your mind that you would like to share with ot school, house audience this evening, I would just    Amy Laurent     say, thanks for listening if you made it to the end. Pretty amazing. And I would say, thanks for being interested in thinking about supporting kids in scaffolding development, in their natural routines and in meaningful and meaningful ways, and that we do have resources available to help support with that. So if you're interested further in inserts or my work, you know we have a search Facebook page, and we have a website too. The website isn't as great, I'll be honest, like the Facebook page is a little bit more like active and current, but you can find some basic research resources on the website, which is just certs.com and the other thing that I would encourage you to do is check out my websites, because I've got a lot of practical tools that you can download and use for free. One is an older website which is my name, so it's Amy hyphen, laurent.com , and there are about 90 downloadable resources on there for supporting regulation and communication in all different ways. And then my current website is reflective of my partnership with Dr fiedy that I mentioned earlier, and that's autism level up.com and so those supports are super awesome and dynamic, because, again, they're around supporting communication and regulation, but everything we develop is infused by at least her perspective as an autistic psychologist, but oftentimes, as you said, as a true researcher, we reach out to the community and do all sorts of kind of surveys and things, and we use the information that we get from the Autistic community to help develop our tools. So you could, oftentimes, we're really transparent about how we've developed them, too, so you can actually see the process of how things have evolved and come along. So we have a Facebook page as well, and that's really fun and really active, and maybe a little where we have some fun and laughable time.    Jayson Davies     Page called Autism level up. It is okay. Well, I will be sure to add links to all of these resources in the show notes, which are, if you're in Apple podcast or right there, or you can go to the episode page on my website@ots.com and find all the links to all of those, plus all I'll get the research article. I think I already have it from you, and I will put a link to the research article that you talked about earlier. I think you actually mentioned too, so I'll do both of them. But yeah, Amy, thank you so much for coming on to the show. OT school house podcast. Really appreciate you having you on and Yeah, we'll definitely have to stay in touch. Excellent. Thanks so much for having me appreciate it. No problem. Take care and have a great evening. You too. Thank you everyone. So much for listening to that amazing interview with Amy Laurent. Be sure to check out the search models as well as autism level up and please, please, please, do go ahead and check out ot  schoolhouse.com forward slash conference to learn more about the back to school conference. Really hope to see you in August, August, 27 28th and 29th take care and have a great week. 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 School House Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 179 of the OT Schoolhouse Podcast. Are you ready to champion one of the most essential—and overlooked—parts of the school day? In this episode, Jayson Davies dives into the impactful world of recess with special guests Morgan and Catherine, founders "Say Yes to Recess." Listen in as they share how two passionate parents from Tennessee ignited a movement that’s reshaping school policies and even legislation around the country. This episode is packed with insights for school-based occupational therapy practitioners: you'll hear research-backed benefits of physical activity, learn strategies for advocating recess in your district, and discover why more unstructured play can positively transform classroom behavior and whole-child development. If you want practical advocacy tips and new inspiration to help your students thrive, you won’t want to miss this one! Listen now to learn the following objectives: Learners will understand the benefits of recess and the critical role it plays in supporting children's physical, emotional, and social development. Learners will understand about systemic barriers to recess, including legislative and administrative challenges, and strategies for advocating for increased unstructured playtime in schools. Learners will explore research-backed approaches, such as the LINC project, that highlight the positive impacts of physical activity on academic performance, classroom behavior, and overall well-being. Guest(s) Bio Say YES to RECESS is a passionate group of parents, grandparents, teachers, and community members united in the mission of restoring recess. Together, working to ensure that every child has access to the full benefits of recess, fostering their growth, creativity, and well-being, while also supporting and empowering teachers and school leaders. What began with three moms advocating to increase recess within their county, gradually grew into a statewide movement in Tennessee. Driven by their passion for making a positive impact, they launched the SAY YES TO RECESS nonprofit in early 2025, and now similar movements are appearing all over the country! Quotes “Children just learn everything through physical activity, through interactions, through play, through mimicking adult behaviors, basically." -Morgan Garner "Our whole mission as an organization and just even as moms on a personal level, is to kind of shift the mindset and the approach and the priorities of how we educate kids here in this country. And the shift would be towards more physical activity and less of a focus on big blocks of instructional time." -Kathryn Truman "We all want kids to sit still, but then if we don't give them the time to get their wiggles out, then they're gonna keep wiggling while we're trying to force feed them math, reading and language." -Jayson Davies Resources 👉 LINC Project:  Research project led by Dr. Debbie Ray at TCU focusing on the benefits of physical activity for children. 👉 The Anxious Generation by Jonathan Haidt : A book mentioned as influential during the legislative process. 👉 Say Yes to Recess:  The nonprofit organization advocating for increased recess time. Website: 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, as always, Jayson Davies, and today we're talking about something that impacts every child in every school every single day. And of course, that also means that it impacts every teacher and many of us as well. That topic recess one of our favorite. In fact, it was my favorite TV show growing up, recess on the Gosh, it wasn't the Disney Channel. Maybe it was, but it was also on ABC on Saturday mornings. Gotta love it. Now I'm coming at this from a different angle than usual. We don't have a school based ot practitioner on to talk about the importance of recess on child development and all that good stuff. Today, instead, we're joined by two passionate parents, Morgan and Catherine, based in Tennessee, and they are the founders of the nonprofit say yes to recess. They've made it their mission to change how schools and even lawmakers think about recess, and they're making real progress. Unfortunately, as you may or may not know, many states across the United States still have no laws or legislation requiring a minimum amount of recess time for our students. However, Morgan and Catherine helped to change that in their home state of Tennessee, and their movement is now growing beyond state lines. In this episode, you'll hear how Morgan and Katherine became powerful advocates, what legislation they helped to change, and how they're working with school leaders to make recess a priority, again, not just for fun, but for learning behavior and overall well being. This is the perfect summertime episode when kids are playing freely outside of school to reflect on how we can protect that playtime once they head back to the classroom. So whether you're a school based ot practitioner who is hoping that by adding more recess time will decrease behaviors in the classroom, or maybe you are also a parent who just wants to really see your kid have more play time at school, this is the episode for you. Let's go ahead and welcome Morgan and Catherine from say yes to recess to the OT school house podcast.    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     Kathryn and Morgan. Welcome to the OT school house podcast. Thank you so much for being here. How are you both doing today?    Kathryn O'Keefe     Oh, thank you for having us. We're doing good. Yes. Thank you so much for having us. Absolutely.    Jayson Davies     And that first voice that you heard for everyone listening, that was Morgan and Catherine followed her up, and we're gonna throw this kind of first fun question over to Katherine really quickly, and I think I already know the answer to this one. But if you had the power to snap your fingers and change one thing in public education Katherine, what would that be? And why?     Kathryn O'Keefe     Yes, this is kind of a loaded question for us, but our whole mission as an organization, and just even just as moms on a personal level, is to kind of shift the mindset and the approach and the priorities of how we educate kids here in this country, and the shift would be towards more physical activity and less of a focus on big blocks of instructional time. And sidebar, teachers do an amazing job every day. I mean, just incredible. What they do with those instructional blocks is incredible. But we we think that, you know, an increase in physical activity and kind of again, shifting our mindset to like, what are we prioritizing? Would be just revolutionary here. We're kind of done looking across into Europe and yearning for what they have. I think a lot of parents kind of talk on the playground and say, Oh, well, in Finland or in Norway, you know, they their kids get to do such and such, and we kind of looked at each other, we're like, why not here? You know?    Jayson Davies     Yeah, that's funny. I think recently, you know, just scrolling through one of the one of the social media platforms, something came up like saying that. I think it was Switzerland that, like, they came over and saw our methodology back in the 70s, saw that it was play based, and kind of took that, and they're still using it, despite us now kind of going really heavy on academics, and kind of a prime example of kind of what you're saying right there. It's amazing how things work out.    Kathryn O'Keefe     Yeah, exactly they looked at our model. We were very much physical, physically focused. And now we are looking back at their model and hoping to combine everything we've learned through the years and create a change here    Jayson Davies     awesome. And as school based ot practitioners, we love movement, we love all things, getting sensory and all that. And so this really resonates with, I think, a lot. The people that are listening right now, the school based ot practitioners, and so I really want to dive into a little bit as we get going here, you know, kind of more maybe about a little bit of the research behind it, and where what you actually had to do to make some of these changes. But before we do that, I do kind of want to just understand what originally sparked your curiosity and concern about recess time. We kind of just touched upon that a little bit. But what led you to start asking questions about how physical activity was not being prioritized during the school day.    Morgan Garner     I had my first daughter. Well, I only have one daughter, my first child in 2014 and I'm a 90s kid. I grew up, you know, when the street lights came on, we had to come home, and I'd rode to the park by myself, and, you know, we would, we just were kind of feral. And I think that there's a lot of that has gotten lost, and some of it for good reason, you know, I mean, in some ways the world is not safe to just throw children out and let them fend for themselves, but at the same time, children just learn everything through physical activity, through interactions, through play, through mimicking adult behaviors, basically and and so when My daughter went to kindergarten. After going to a wonderful preschool, she would come home and she was just like a different kid. She was like a jumping bean, and had so much and she was not a hyper kid, but she would come home and she just was like, almost, I can't even explain it. It was just like, crazy. What energy, so much energy, and, like, almost frustrated, and I would be like, did you guys have PE today? Did you have recess? And a vast majority of the time she would go, Oh, we didn't get to go outside because the grass was wet. I was like, it didn't rain, or we didn't get to go outside because the playground was too muddy, and it was just so many excuses. It had to be like, perfect, 75 and sunny degrees, and it hadn't rained for four days, and it was just ridiculous. And so I started going, this is not right. And I reached out to administrators, kind of, you know, was like, Oh, we know. We hear about this a lot, not really anything we can do. We wish we could. We hear you. And I'm just not one of those people who takes no very well. I'm also Southern, so I take it really, in a nice way, but I'm just not gonna go away with a smile on my face. And so really, that's what started it for me. And then I met Rachel through kind of just talking on Facebook with our on our school Facebook page about the same thing, and I'd been looking for people for years to join in with me, because you can't do this alone. And Catherine and I had known each other before, and when she heard what we were doing, she was just like, I want to help. How can I help? And that's really what got us started.    Jayson Davies     Awesome, yeah, no, I totally understand and feel what you're saying. I mean, I remember back in school, I specifically remember fourth and fifth grade having a specific designated PE teacher, and we would go out to PE however many times a week to that teacher. It wasn't our regular general education teacher. It was actually a physical education teacher that rotated from school site to school site. And you know, as school based ot practitioner, I have been at many school sites now, and I don't see a hint of physical education teachers other than adaptive physical education teachers, but I know even that is rare, but like, it's really hard on the teachers to have to be focused on academics. We're telling teachers, hey, we need to focus on reading. We need to focus on math, writing. Oh, but by the way, you also have to get 100 minutes every so many weeks to do physical education, but there isn't a whole lot of testing for physical education like that's just not fair to the teachers. It makes it really hard on them. So we don't want this, but it's hard.    Kathryn O'Keefe     Absolutely, I think you make a great point. And back to the shift in the mindset. Everyone has become very focused on the minutes that are mandated and required of these educators and we as an organization, we are just trying to start that discussion everywhere we can. Of Hey, what are we prioritizing? You know, are we prioritizing a high math score at eight years old? Or do we as parents, you know, want our children to learn some soft skills? You know, hey, I, you know, I had a fight with a friend on the playground, and I re I, you know, a teacher helped me work through that. I mean that especially I come at it from the boy mom lens with four boys, um. Yeah, but you know, girls and boys equally, across the board, need this. Of course, that's just my personal lens, but my husband and I, you know what we're prioritizing. It resonated with a lot of other parents. So this movement, I think it was truly grassroots, because we tried to just start that conversation, and now here we are.    Jayson Davies     Yeah, so, so Morgan, you said, you know, you don't take no easily. It sounds like you went to the office. Maybe you went to the district as well, but at some point you had to start digging deeper, if I'm right. And what were some of the things that the two of you started to find out as you dug a little bit deeper into recess, and maybe even PE a little bit,    Morgan Garner     yeah, we did. We learned the state law very quickly. We were very naive getting into this. So we thought, why is this so difficult? Why is everyone, you know, making it where we can't get more recess? I don't I just didn't understand it. I did not know what a Pandora's box we were opening. And as we dug in, we learned things like, what are actual mandates, and what are recommendations, and what people pretend are mandates that are actually recommendations. And interesting. It's very interesting. We also learned that the Tennessee has a labor law, and it's 30 minutes for every six hours of work. And our kids, well, that changed in May, but our kids were getting 15 minutes of recess daily per the law, so we were not even giving our elementary age children what we give adults based off of our labor law, which never thought about it from that way, it's yeah, it's wrong. I mean, they should be getting an hour. I mean, just yeah, definitely more than yeah for proper childhood development. And all the studies show it study after study. And so, yeah, we learned a lot about the law. And in Tennessee, the only thing that that we have been able to find, now, someone might come out here and go and please email us if we're wrong, but all we were able to find is that the two things that are law are RTI is required by law, which is an intervention, time and physical activity. The rest are recommendations.     Jayson Davies     That's funny that you bring that up because I've had, I've had Adapted PE teachers tell me the same thing here in California, that physical education is actually a required, the minutes are required by law, and, yeah, everything else kind of we we put tests in place that you know you need to focus on this, because there's tests about it, but technically, there isn't a lot of law around how many minutes for different other activities. So interesting. You bring that up, it's not just a California.    Morgan Garner     it's not and we did get some rumblings that there might be something somewhere of like a minimum for reading, but we never could nail it down. So there might be a minimum somewhat covered in there, but it's nothing close to what they're putting out there.    Jayson Davies     Interesting. Okay, now you started to touch upon some research that you found out there, and I don't expect you to be able to cite off three different articles, but just in general, while you're researching this a little bit, what were some of the you know, recommendations and guidelines that you were able to find? So we    Kathryn O'Keefe     scoured as much re research as we could. And there is a lot out there on this, and it is a resounding it is very supportive of our cause that we could find no research that said that more recess is a bad thing. So with that said, we kept coming back to a body of research out of TCU, which Dr Debbie Ray, she started the link project there, and whenever we would go into meetings with legislators or meetings with educational proponents or agencies, we would kind of look at each other and say, Okay, what can sum up what we're trying to accomplish here? Like, what's going to be our bedrock of research that we you know? What do we want in our bill language? We don't want to pull numbers out of the sky, right? So everything we found said that daily children should be getting 60 minutes of physical activity, and that is also what Dr Ray implements through her link project. And then her body of research is so great that it spans over 10 years at this point, and she also follows students in charter schools, private schools, public schools. So it's like pretty diverse, which we love, and her numbers speak for themselves. I mean, she when she implements her program, which is 15 minutes of physical activity for every hour of instruction. And it totals 60 minutes in a day within a year, usually, her students are finding much higher test scores. I I think for the most part, on average, they go up like 10 and 7% in math and reading. They're they're overall happier kids. There's qualitative data people in this realm like the quantitative, but there's a ton of qualitative. Nurse visits go down. You know, childhood obesity, you know they're they get more physically fit. The teachers are having much less disruptions in the classroom. They're just the teacher satisfaction, which I love reading her comments from teachers. Like, teachers are like we we're happier at our jobs. And I mean, what's more important, like Happy Kids, Happy Teachers. That makes for, you know, nothing's perfect, but it makes for just a better daily rhythm for everyone. Teachers are not on board with the link project, half of her, I was just gonna ask you about pushback, okay, yes, half of her reviews are teachers who were like, we wanted nothing to do with this. And now, yeah, they were like, we didn't we, but we trusted the process. And okay, you know. And they love it, and they, they, you know, they get to Catherine may have said that they get two hours back of instructional time in the classroom. That's a lot. That's a lot of time when you actually let kids do what their bodies are made to do. They're gonna focus. It's just, we all see it. So why are we not doing it? It's just it's so mind boggling.    Jayson Davies     Yeah, yeah. I mean, it's hard. We all want kids to sit still, but then if we don't give them the time to get their wiggles out, then they're going to keep wiggling while we're trying to force feed them math, reading and language. So yeah, totally get that. I wanted to have, I wanted to ask about one other potential pushback, and I want to get your insight on this, because I'm sure this came up at some point during the process. But the argument that, well, kids can get their play outside of school hours. Did that come up? What was I mean? What did you think about    Morgan Garner     that more times than I'd like to count. If I had a nickel for every time that question or that response came up, I would have a lot of nickels I and my response is, what about the latchkey kids? What about the kids who grandma picks them up from school and she maybe she's disabled and she can't go outside and watch them and supervise them? Also, let's not forget that it gets dark at 430 in Tennessee in the wintertime, I don't get home until 415 so my kids are just gonna go play out in the dark. We do not get hardly any outside time, except on the weekends in the winter, and it's terrible. I hate it. Yeah, you know, we might play out in the dark a little, but, I mean, it's just, you know, we don't really have a lot of street lights, and it's just kind of hard to be outside in the dark that I totally understand.     Kathryn O'Keefe     Oh, sorry. That actually reminds me of another couple comments we would get frequently, and it was, hey, you can homeschool your children, or they can go to a school that provides what, you know, a private school. Oh, wow. And, and we would have to, you know, our approach has always been very kind but direct. And we would say, Listen, we are doing this, you know, not not only for our children, but for the kids that do not necessarily, ha, have that option, and there are plenty of them, especially in the public school system. And what about them? You know, they deserve, they deserve this consideration, just like anyone else.    Jayson Davies     Yeah, definitely. All right, so we kind of put this basis for the reasons why and whatnot. And you know, I started to ask you, Morgan earlier about how, you know you said no and you had to move up. But what did that actually look like to go from talking to the administrators at your school to talking to district and then maybe even where you went from there?    Morgan Garner     Oh, it was very interesting. I got a crash course on politics. I apparently wasn't paying attention in my eighth grade social studies class. I'm so sorry, Mrs. Damon, but I don't, I didn't remember any of it. I didn't know who did what I mean, I had, like, a gist, but I just didn't remember. And so when we started with the principal, you know, that's easy. Everybody knows how to talk to their principal. And then it's like, Well, who do you talk to next? So we had to do research on, like, what is a director of schools? Who are the level directors? How does this umbrella work? And and so you really start to figure out who the players are. And that would be my advice to anyone going into this, figure out your local players first and take meetings with everyone. We took meetings with people who had zero power over this. But it's it's educating people. On why this is important, and then you never know, because they might go, you know what you need to talk to so and so, let me email them for you. And when you go in with kindness, we were we you. Our motto is like positive pressure. We're very kind, but we're very persistent. And we just we do not take no for an answer. It might be a no today, but that doesn't mean we're not gonna ask you for another meeting in six months after we've met with so and so and so, once you get to know those players, they're kind of the reason we went to the state, because in our county, we were getting 20 minutes, and our kids were not even outside for 20 minutes. They would go from the lunchroom, they would start the clock. They would walk back to their classroom. They would take a water break or a bathroom break, or both, put their lump lunch boxes away, and then walk to the playground. And then they'd line up three or five minutes early so they could walk back to class. And I asked my daughter's teacher one year, I said, Be honest with me, how many minutes are you guys actually getting outside, is it 10? She was like, Yeah, maybe. And that's wrong, and it's not the teacher's fault. They are. They have a gun against their head by the administrators. They put so much pressure on these teachers, and the teachers want to let the kids play. So we love our county, our our local school board has been fantastic in taking meetings with us. They really did, once we got rolling, they started working with us, and I think we just met the right people at the right time, and then things started happening. But they said like, hey, we can do 30 minutes, but that's it. If you want any more, have you thought about going to the state? And we were like, wow. And they were like, if you want more, go to the state. And we did. We asked for 60. We got 40. This is step one, year one. I mean, it's not over. We're gonna keep pushing, and hopefully at some point we will get 60 for elementary kids. But yeah, it's and then learning the players on the political state level. Oh my gosh, there's I could teach a class.    Jayson Davies     Yeah, I have gotten used to that a little bit as well. Over here in California, we're trying to do some stuff in OT and totally understand that trying to talk to anyone and everyone, and then you think you're going to be talking to someone, and you find out you're talking to their Assistant, Assistant, Assistant, or something like that. And so much fun, right? Yeah.    Morgan Garner     And one thing that was really interesting about the political sphere is they all kind of talk trash about each other, and not all of them, but like a lot. And if you go, okay, in your opinion, like, who's the best guy or gal? You know, who, who really needs to run this? If you ask, like, Tennessee is very heavily Republican. So we would ask the Democrats, they had nothing to lose. We're like, who should we be? Like, who do you think? And the same names kept coming up, and we're like, okay, so strategically, it makes the most sense to go to these people. So then you go to those people, and they'll either go, Ah, sorry, or we happened the one guy, actually, it was two guys who they kept mentioning. Both of them were like, Heck, yeah, this. We need more recess. And that's kind of how you do it. It's like, chess, wow, wow. You got    Jayson Davies     lucky. It sounds like because, like you said, you talked to, I don't know, dozens and dozens, if not 100 people. And of those 100 people is really the two people that you really needed to talk to, but you kind of had to go through all the other people to get to that    Morgan Garner     point. And I think it's just asking the right questions. Yeah, yeah, definitely. We    Jayson Davies     talked a little bit about teachers. Talked a little bit about, you know, the administrator or not the administrative process, but the legal process and figuring out who to talk to, and whatnot. Any other particular barriers, whether it be school administrators, district personnel, parents, any other people that kind of gave you a hard time going through this process.    Morgan Garner     Gosh, I feel like we've had an overwhelming amount of support. Wouldn't you say that? Catherine,    Kathryn O'Keefe     yeah, I think throughout the process, and people say to us all the time, like, I can't believe you did this so quickly. You know, people have been lobbying for things for years, but I think we remained research based, and like Morgan said, we we all agreed myself, Morgan and then Rachel Bush is the third mom. We all kind of looked at each other and just had an understanding of this isn't about our emotions. This isn't about our personal, you know, our egos, you know, we, we would go in with that same, just this united front, and then a lot of barriers crumbled. And, you know, and you, I think you're right, in a sense, we got lucky in a lot of ways. A lot of it felt very meant to be. Say, for instance, speaking of not knowing the system, our very first meeting a year ago, we just shot off these emails like, hey, this guy's a rep, this woman's a rep. Let's, let's see if they like recess. And we formed, we formed a meeting request, and it was perfectly, you know, you know, spelled out. And then we got we got a bite, and we thought, Oh, our first meeting. So we put our pink shirts on our say yes to recess. We go up there. Turns out his legislative assistant is a mom in Nashville, and she's like, I love what you guys are doing. Oh, perfect. He's not really aware that you're here, like, we show and we're like, what? And she's like, but I want you guys in to have a meeting. And we were like, thank you so much. So we go in and we sit down. He's like, who are you? Why are you wearing these shirts? And then we just, like, buckled down and just gave him our spiel. We had our link project infographic, and his wife happened to be there that day. She was like, I love this. By the end of the meeting, he's like, I'll run this bill. I mean, he wasn't really going to, but he was, like, motivated,    Morgan Garner     even on the Education Committee, that's how little we knew about what we were doing. He was like on some random committee that had nothing to do with education, but he knew the guy we needed to talk to, and immediately brought him in because he happened to be there that day. Oh, wow,    Kathryn O'Keefe     yeah, and it was really cool. A lot of full circle moments for us. But he brought in the head of the Education Committee and said, Hey, hear what they have to say. I think this is going to come down the pipe to you eventually. And in his hand he had the anxious generation the so the education committee chair had the anxious generation in his hand, and he sat down. He's like, what's this all about? And we're like, this is really the stars are aligning. And then we just kind of like that was like our catalyst. And we just said we had our first meeting under our under our belts. And we said, All right, let's go. And we we sent out 100 more meeting requests, and then we said we committed to meeting with as many people as    Morgan Garner     I actually feel like there were so many God winks throughout this process for us, and that was one of them. We found out later. So that rep had the anxious generation by Jonathan Haidt in his hands. We found out months later, somebody walked around that building and put that book on every single state representative and senator's desk. Wow, that day that that, I don't know if it was that day and that's his hand. I don't I have no idea, but wow. We the fact that everyone was so attuned to this, and half of them hadn't read it, but they had heard about it. Some of them just, you know, some of them listened to it, but everybody knew about it, and everybody was talking about the importance of this, and I think that's why we had so much success in such a short period of time. Again, like all the doors, you know, and something is just meant to be it's like all the doors start to open just where they need to be. And I hope to God that we can keep this going and they don't try to overturn this in the future. But we have 1000s of followers behind us now, and you'll bet we'll be marching the State Capitol in our little pink shirts, going, No, you can't take this away, but it very much felt meant to be.    Jayson Davies     Yeah, absolutely. Catherine, I think earlier, you mentioned that you asked for 60, and you got 40. The district itself said that they were willing to give you 30, maybe, but you needed to go to the state to get more than that. I think the 60 is pretty obvious. Where that comes from. You mentioned earlier in the link project and other research that 60 minutes is kind of what kids need. So what's your What are your thoughts on the 40 minutes now? Are you gonna aim for 60 in the future? Does it feel like a win? Does it feel like a half win?    Kathryn O'Keefe     Yeah, that's a good question. We were like I said. We were so research based that we had hung our hats on 60, and Tennessee is sixth nationwide for childhood obesity. So we again, we were just primed for this. But throughout the process, all our meetings, all our advocating, we were meeting legislators who really would go right back to their constituents, go right back to their superintendents and say, and they would use the term, this is too much of a heavy lift from because, remember, our law was 15 minutes a day every. Sense. So 15 to 60, I guess you could say it's a heavy lift. I say that in a positive way. They were saying it in a negative way. But we kind of, we had to really play a little bit of chess, and we would get to know their personalities, kind of see where they were coming from. You know, a lot of them homeschooled their kids, or had their kids in private schools, or just didn't know what the law said, which, again, a ton of bills come across their desk. There's a ton of issues out there, so we had to really educate and make aware even some of the legislators, some were really on it. They're like, Oh, yes, I know, and I agree this is wrong, yeah. But at the end of the day, in order to get the majority votes that we needed in each committee that the bill traveled through, we had to take meetings and really kind of have tough discussions, like a lot of them mentioned 30 and we, we kind of all agreed as a group that we wouldn't go below 40. We would let the bill die before we went below 40.    Jayson Davies     Time and energy,    Kathryn O'Keefe     yes, but I do feel extremely proud, because we more than doubled the recess period in this state. And again, we're not done. And through education and awareness and discussions and collaboration, everyone I do believe in my heart will realize that we need a massive shift in this country, but it's going to take some time, and that's fine, and we saw that firsthand in our meetings. And one more note is a lot of local control is what's important here. So a lot of legislators say, Well, I want my principals to be able to, you know, execute what the law says in their own, you know, with their own discretion. So we respect that too. And what I like about the 40 is they can do 220s if they so choose. We really would have loved 230s again. But 220s is way better than, say, 11 minutes that they were getting previously, or we had people reach out from rural areas, inner city areas saying that they were getting recess three days a week. So we're hoping that this is going to inform a lot of people of what the law was, and then help parents feel empowered to say, hey, are my kids getting that 40 minutes a day?    Jayson Davies     Yeah, one of my I guess I'll call it a question, was districts. I have found that I've worked with. Some districts the teachers supervise recess time. Some districts, they bring people in for literally an hour to supervise the various recesses or two hours. But every district does this a little bit different. So I can imagine, from the principal district perspective, the logistics of making this happen might be a little difficult. The actual amount that they have to then pay staff to supervise recess might get a little difficult. I guess. The question follow up here is, this has been enacted right now, like this is officially a law, it's in practice. So what are you seeing now that it's in practice? Is it being is it difficult for districts to enact does it seem to be pretty simple for them? Are some districts not following, and others are what are you seeing there?    Morgan Garner     Well, since we're not a year round school system, wait. School has not started yet. So school will start August early, like first, second week of August for uh, public schools. But the law went into effect. July will go into effect. July 1, okay, but it has been signed into law, if that makes sense.     Jayson Davies     Gotcha. So that's still to be determined. A little bit, how districts will wrap their heads around this.     Morgan Garner     Yeah, they saw it coming down the pipe. I think a lot of the school districts, from my understanding, is that they have people who watch the law and the bills that are coming through, and so if they see something that would apply to them in some way that might affect them. They, they kind of just have it in the back of their heads that that's, that's what's going to happen. So our big push has been, again, these are recommendations, reading, math, those numbers are recommendations in the way the Tennessee Board of Education has written these recommendations is really heavy handed. I mean, there's like 90 minutes of uninterrupted reading blocks that are recommended minimum for elementary so we're telling you're telling me you think that a kindergartener should sit down for 90 minutes minimum, and at most two and a half hours per reading. That's asinine. I have a kindergartener while he's now going rising first grader, there is no way that he would sit down for 45 minutes, much less 90. And so while I do think that this is going to be difficult logistically, when you have the mindset that. Those are mandates. Because if you look at what the Board of Education has strongly recommended, they feel like mandates. And I think a lot of schools are just not. They are so scared that their test scores are going to go down that they do not want to shave. But if they shaved a little bit of that reading. I know this sounds so counterintuitive. If they shave some of that reading, and shave some of that math, all those brain breaks that we've been taking all those disruptions and trying to bring the class back to that could easily equal 30 minutes of that 90 minute reading block, easily, if not more, yeah, let the kids come outside. So that's what we're trying to change the thought process behind it, rather than just go flippantly going, just cut it here and there. No like, these are recommendations. You do not have to, by law, do any of that, except for RtI and physical activity.    Jayson Davies     Yeah, Catherine, you look like you want to add on.    Kathryn O'Keefe     And we have found schools throughout Tennessee. For instance, there's a school in Crockett County, and there are administrators out there already doing this. So you know, they're saying they're looking at it, and they're understanding that they have that autonomy. You know, before we even had to pass this law, there were administrators out there saying, Okay, we're not going to do the 90 minutes. That's too much, and it's not going to be productive. You know, I want happy kids. I want happy teachers. So we have those schedules as an example, and we're really trying, like I said, to have those discussions and to spread awareness and educate. Yeah,    Jayson Davies     that's smart, because I just feel like you're going to have conversations at district levels, and they're going to talk about, well, if we're adding more recess, either a that means we need to cut somewhere else, or some districts might even go the slightly more difficult route and adding minutes to a school day or something like that. And it gets complicated, but it's not something that can't be overcome, like it's definitely possible.    Morgan Garner     I mean, that's that's kind of the beauty of the law is the autonomy for the districts. There are going to be districts that do it in a way that we probably wouldn't love. I'm sure that's going to happen. But the definite goal, and I would say the legislative intent behind this law, is to reduce minutes of core classes in order to increase learning retention and focus, because that's what the studies say. I mean, kids also need art. Kids also need music. They need PE. There is a definite benefit to PE classes, where you're in a structured environment, versus free play, like all of those things are so important for a well rounded child.    Jayson Davies     Yeah, yeah, absolutely. And, and for everyone listening really quickly, we will be sure to talk to just say, we'll be sure to link over to the link project so you can learn more about it if you want to. That research is definitely something that ot practitioners might want to have on hand. So we'll put that into the show notes. We got a few, a few minutes left, and I want to ask you, because, as you mentioned, you now have lots of parents following you, and people are reaching out to you and trying to bring this exact legislation, or at least the exact concept, to their state. So I'd love to let you both talk to us a little bit about what that means to you, and shout out some of those states that are doing their own thing now.    Kathryn O'Keefe     Yeah, thank you. When we were mentioned by Jonathan Haidt on his platform, it did spark a lot of interest across the country, as well as news of the law being passed, and we were really excited, because I think all of us secretly hoped that that would happen. You know, we always kind of thought big picture, but here we are, and we have amazing chapters set up in six states now we have say, Yes, Theresa Texas was our first one. Texas is a big state that's going to be, you know, a big job, but we have two moms heading that up, and they are awesome. Side note, the people who are reaching out, parents, moms, dads, you know. And we have community members, we have educators. We have grandparents. You know, it's it's not just a mom movement, it's very diverse, but the people who are reaching out to us are just incredible, and they come from such a different array of backgrounds. We have former educators. We have people in corporate America, and they're just bringing so much to the table. And. I'm excited to see the organization grow. We also have say us there. Recess, New Hampshire, say us to recess. Wisconsin, sayos. Recess, Michigan and say us there. Recess, Georgia, now, so those are oh and say yes. Recess, Ohio, thanks. So those are our official chapters in talks with Kentucky, Virginia, we have people reaching out, and it's very fluid. Um, it's whenever it's the right time and whenever that movement sparks. We really encourage, encourage you to start the discussion in your area and find like minded parents. Because, yeah, we're here. We're here to talk, if anyone wants to reach out.    Jayson Davies     Yeah, that's awesome. I mean, I know the legislative process is very, I mean, similar yet very different and unique, because you have completely different people in every state, but it's nice that you both have succeeded, along with Rachel, you've succeeded in this, and you kind of have a little bit of a framework that you can share with the other states, and you know, share the research, share the hot topics to press on. Know what research to have on hand about your state in order to make an impact with your legislator. So I'm sure the three of you are being a huge resource to those other states and and likely many more states to come. So thank you. Kudos to you all, that's awesome. Thank you. We'll start wrapping up here, but for everyone listening here, what advice would you give them for advocating for doing something like what you're doing, and advocating for more unstructured play in their own community and school districts? Gosh,    Morgan Garner     start small. And of course, you know, if you want to see this big picture, we're here for anyone who wants to start a say, a Cerises chapter in their state had it, if it's not already started, and if it is, we'll connect you. But start small and find like minded parents. Learn the players. Catherine, I'm sure you have some thoughts.    Kathryn O'Keefe     Yes, we, the three of us, sat at my kitchen table and took a highlighter and went down through the law line by line, and we read it, and we read, inked it, and then we discussed it like Morgan said. We were like minded, and we noticed that this is an issue. And then we were all at our soccer tournaments at our little league games at our schools, and just you strike up conversations with fellow parents already that we would bring this topic up and then kind of report back to each other. And it was just overwhelming, especially the parents with kids who you know have special education requirement, they would just grab me by the shoulders like we need to do something because, you know, I work till 7pm at night, and I can't afford another option. And that was really motivating for us three whether people like that. You know that we could be the voice for    Jayson Davies     Yeah, yeah, yeah, absolutely. All right. Well, I think that's gonna wrap us up for today, but remind everyone where they can learn more about say yes to recess really quickly. I know you're on Instagram, but where else    Morgan Garner     we're on Instagram, Facebook. It's all so our Big Mama ship is say yes to recess. But we locally are say us to recess. Tennessee, and our website is say us to recess.com . If you're curious, if your state has a chapter, pop on there. We get messages all the time, and it's not for everybody. You know, sometimes, sometimes it takes a while to find your people. I know it took me three years to find people who wanted to do this with me, and this is not something that is overnight. And yes, we've had a lot of quick success in the last year, but we've been at this three years, and three years prior to that, I was hoping and find, like hoping to find somebody to do this with. So it's not a fast process, and it is not for the Fauci of heart. So you know, if you're gonna do it, dig in and find your people.    Jayson Davies     Fantastic. Well. Morgan Catherine, thank you so much for joining us today. We really appreciate you sharing about say yes to recess and best of luck with all the other the five other states and maybe even more to come in Tennessee, so thank you. We really appreciate having you here.    Morgan Garner     Thank you. Thank you. Thank you so much.    Jayson Davies     All right, and that wraps up episode 179 of the OT school house podcast. And I really hope you found this conversation with Morgan and Catherine from say yes to recess as inspiring as I did. I actually just looked it up in California, where I live, does have a minimum of 30 minutes, and they passed legislation in 2023 that actually teachers are not allowed to take away recess. Now I did hear from my wife, who's an administrator in California, and she actually said that they can take away recess, but I don't think they can go below that 30. Minutes, which is interesting, you know, but I don't know if you're in California and you've heard something different, let me know. But yeah, interesting to see that different states are doing different things, but as Morgan and Catherine said, there's still a lot of states that just have nothing on the books, and we would really like to see that change. I'm not part of Say Yes to recess, but I'm saying we because, as a parent, as an OT practitioner, I think we all see the value that that recess has on our students. Oftentimes, more recess can have an impact on student behavior in the classroom. And I think Morgan and Catherine said in the podcast, you could take away, or maybe you don't need as many of the brain breaks if kids had the recess that they need. So how does that fit for us as school based ot practitioners? Well, we are school employees. We can have a say in the matter, and we are uniquely positioned to advocate for policies and practices within our schools to support whole child development. It's not going to happen overnight, but we all know that recess isn't just a break, it's a need, and we can help to make that a priority by talking to our leaders, talking to our principals, our assistant principals, or maybe even at the district level. Be sure to check out the show notes over at ot  schoolhouse.com/episode 179, or you can also go to say yes to recess.org to learn more about their mission, access advocacy resources and find out how you can get involved in your own school district or school as always. If this episode resonated with you, consider sharing it with a colleague or leaving a quick review. We really appreciate that every listen helps us to spread the word and support kids in the way that we know that we can. Thanks again for tuning in, and I'll see you next time on the OT school house podcast. Take care.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.    Jayson Davies     and I want to ask you one more question here. I don't know, probably both of you will have a response to this. It is in there, but I don't know if one of you had planned a response, but looking back at everything you've done in the last three years, what are you most proud of this question?   Morgan Garner     Every time we get asked this, it gives me chills. My daughter walked the halls of the State Capitol with me. She's 10, and especially as women, I have a son too, and I'm He's younger. He doesn't quite get it as much, but I'm just, I'm so proud for her to have watched me make change, like, not just like little change this affected 1000s and 1000s of children, and for her to be able to look at that and go, You know what? If I see something that's wrong, I can do something about it, and that, to me, more than anything, is the best.    Kathryn O'Keefe     I think what I I love that, and I agree having, you know, all of our kids, Rachel Morgan and my children, we have 10 in between, all three of us, having them witness this has been amazing. I'm also really proud of our approach and our reputation that we've worked hard to build and maintain. We did not want to, you know, again, we wanted to be research based, not emotionally driven, and just always be kind and collaborative. So anyone that we, you know, educational agencies, lobbyists, educators, legislators, fellow parents. You know, it could get emotional, and it did sometimes get a little contentious, but we really committed to our brand being super kind and then solution focused. So I'm really, really proud of that. 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! 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Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 60 of the OT Schoolhouse Podcast. In episode 60 I am looking back at what I learned from 2020 and sharing what you can expect from the OT Schoolhouse in 2021. We will also review 5 new years resolutions fit for any School-Based OT and one special announcement. Links to Show References: A-Z School-based OT Occupationaltherapy.com medbridgeeducation.com learnplaythrive.com MissJaimeOT.com * some of the links above are affiliate links meaning I own a small commission when you use the links at no additional cost to you. 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 59! 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, ot practitioners, the conference that your colleagues are calling the most valuable event of the year is returning just in time for the 2025 2026, school year. Join me and over 600 other school based ot practitioners this August for the fifth annual back to school Conference featuring 12 hours of practical a, ot a approved CEUs and resources from expert guests later in today's episode, I'll share with you about our incredible speaker lineup and a special discount just for our podcast listeners like you to learn more about the conference, visit ot  schoolhouse.com/conference and secure your spot today.    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. Hey    Jayson Davies     there, everyone, and welcome back to the OT school house podcast for episode 60. This is the very first episode in 2021 and I cannot be more excited for you to be here with me today, and for me to be here with you guys. I really enjoy this part of my day, this part of OT school house. And yeah, I'm just excited to be here. My name is Jayson Davies. I am the host of the OT school house podcast, as well as the kind of, the name, the face behind the OT School House website in all so thank you so much for being here. Really appreciate it. Today, we're actually going to go ahead and kind of recap a little bit about what was in 2020 and then talk about moving forward. I'm going to go over what I'm calling, calling the 3c as well as, um, talk about a few new year's new year's resolutions for any school based occupational therapist. So we're going to get into that. But yeah, I just want to again, say thank you so much for being here. Whether this is your first time ever listening to the OT school house podcast, maybe you made a resolution to find some some occupational therapy based podcast, and you stumbled across this one. Thank you so much for being here. Or if you've listened to all 59 now 60 episodes and you're just a ot school house super fan. I appreciate you being here. Thank you so much. So let's go ahead and jump into a quick 2020 recap. It was a year. It was a true, difficult year that felt like three years. I feel like sometimes, maybe four. But you know what? We made it through it. Congratulations and happy. New Year to you all. We are in 2021 we learned so much from 2020 that we are going to apply to 2021 and into making us better therapists. So the first thing I want to talk about, actually, is a, I don't want to call it a weakness, but a struggle, a struggle I had, and that was in the final quarter, I guess you could say, of the year, October, November, December, my motivation for getting up and doing these podcasts, or really doing a lot, anything, really, anything much for the OT school house podcast and OT School House website, I struggled with that. It was hard to get the energy to hop on here and talk to a microphone, talk to a camera, talk to you all, even through social media, I didn't post a whole lot. Basically, from the time of the presidential election, like from there on, I just didn't do a whole lot. And so first of all, I want to say I'm sorry for that, because I know a lot of you do look forward to a new episode every two weeks, and that's going to be part of the seas going forward. I'm going to get to that, but I just want to take that moment to, you know, say, just like you all probably struggled this year with schools going virtual and back into class and virtual again. I went through the same struggles with you all, and you know, it was about that time when we started to bring students back on the campus, and that took so much energy. It was only our special education students that came back onto campus, those in the moderate to severe cases or classes. Sorry, but that was, that was a struggle. I mean, trying to figure out all the PPE, not only that we had to wear, but also that they had to wear when we could or could not go into classes, how many students we could or could not pull in a day. It just took a lot out of me, and it was hard to get into the OT school house podcast when I got home from work. But it's 2021 I've got a lot of things going on, and now got a lot of plans. Things are changing so that I can have really more time to invest in the OT school house podcast. So big things are happening. And yeah, 2020 was tough, but we're moving forward. Also in 2020 I released the, well, actually, three iterations of the A to Z school based ot course, which you can learn more about at ot schoolhouse.com , forward slash A to Z, the number two. And, well, I started. Back in March, right around when the pandemic actually happened. Actually, I got used to zoom right before the pandemic happened, because of the A to Z school based ot course, our first cohort of about 30 people, we went through. And it was fantastic. The 30 people that got in sold out this course in just a few hours. And then the reviews from it were fantastic. It was an eight hour course spread out over eight weeks, and it was just amazing. We walked through everything from RTI to evaluations in the schools to even some of the laws and the logistics of being a school based OT. And then we go through how your evaluation guides your treatment planning, your treatment planning itself and the treatment, and then eventually to where you can exit students from occupational therapy or graduate them from ot in an ethical way. Like I said, we had about 30 students in the very first cohort back in March over an eight week period. I did it again in that time, the second time we actually had about 120 occupational therapists and occupational therapy assistants go through it from all over the world. Actually, that time, yeah, we had a few in Australia, and I think one in the UK, which was amazing. So thank you so much for being a part of that. But we did it a little bit quicker, since it was in the summer. We actually did it in a four week time span, two two sessions a week, and it was amazing, again, great reviews, to the point where I then made it a recorded course that anyone can take at any time on my website or through the website. It is called the A to Z, school based ot course. And like I kind of alluded to, we really go through everything from start to finish. What it the knowledge that you need to be a school based occupational therapist. I've had new, brand new school based OTs that have gone through it. They love it. And then I've had therapists that have been a therapist for 1015, years go through it, and they just, they tell me that they feel, not only does it validate kind of what they're doing, but it also kind of rekindles their spirit for school based occupational therapists. So thank you to everyone who has taken that course, and if you haven't, I still want to say thank you so much for listening today, and it is always available to you if you'd ever like to learn more about it. It is at ot schoolhouse.com forward slash A to Z in 2020 I also released a total of 17 episodes of the OT school house podcast, which is amazing we're now at. This is episode 60, so we're now at episode 60, and I cannot be more thankful for all of you for taking time out of your day to listen to the OT school house podcast. We've been doing this now for about three, a little over three years, and it is just amazing. I am again, so grateful. It has been a pleasure getting to know all of you. You get to know me through this podcast, but also I get to know you through social media and through the A to Z school based ot course our Live Office Hours that we do, it's just been a pleasure getting to know all of you. I really appreciate it. Some of my favorite episodes of the podcast from last year include episode 49 which where I interviewed Sarah Collins. She is an occupational therapist working specifically with students and parents of homeschooled students, and so she's really found this unique niche, and she is just killing it, helping so many people all over the United States. It's just amazing. Definitely check that out if you have any interest in homeschooling or helping students who are being homeschooled. Another fantastic episode was with Annabeth and Mara of the fanny pack therapist. That was episode 53 we talked a lot about AAC, augmentative communication and just how we can help our students to be successful with using AAC. Another one which is very unique, because it wasn't an occupational therapist. It's one of the few times that I don't have an occupational therapist on the show. It was with Tony Ty win of K 12, Ed law.com he is actually a special education lawyer down here in Southern California. He's a parent lawyer. And so it's very interesting having him on the show to kind of kind of see things from the opposite side of the table, if you will, during an IEP, right? Sometimes you have that table, that big table, conference table, in between you and the parents. Well, it was kind of nice to hear his side, what he's looking for when he comes into an IEP, what he wants to see the occupational therapist dotting and crossing, you know, those i's and T's, what does he want to see us doing in order to make a nice, strong IEP? I also did three episodes that I think helped a lot of you. Maybe there's more, I don't know. We did several episodes on teletherapy. We also had a few special guests on that talked about what their plans were coming up. And we did it back in August, kind of when school was getting started, what their plans were or what they intended to do as the school year got started. But of course, all of 2020, from. March on was really focused on teletherapy, and I hope I was able to help some of you through, through getting to know zoom or Google meets or just any teletherapy platform with the podcast. So that kind of wraps up 2020 and now I'd actually like to move forward into 2021 by talking about what I'm calling the three C's, I actually have these 3c listed up here. You can't see them, but they're on my wall, and it's just big bold, these three words that start with the letter C, that I want to focus on this year, and by myself focusing on the on the 3c this year, I hope to help you actually focus on these 3c whether or not you're cognizant of these. Of these 3c not you can forget about them. You don't need to remember these 3c for the rest of the year. Maybe you want to, but I want to help you with consistency, confidence and community, and I want to help you with those 3c by myself, using those 3c in my own practice, not only in my own practice as a therapist, but also in my own practice as being the host and owner of the OT school house. I want to be consistent for you all. I want to be confident and feed you confidence. I also want to help build this community. So I'm going to break this down just a little bit more, because in November, December, I wasn't consistent. This podcast, kind of like I said earlier, we took a short hiatus, about a two month hiatus where no ot school house podcast came out, and that not fair. I want to say sorry. I mean, I was burnt out. But at the same time, I want to continue and looking forward into 2021. I want to be consistent for you. More importantly, though, I want you to be consistent in your practice, and I want to help you be more consistent in your practice. I want to help you put habits and routines into play that will make your job easier but also more effective, right? It's not always about working hard, but working smart. How can we make our lives easier to help more kiddos or more teachers or more whoever we need to help? So that's where it comes down to consistency. I want to be consistent for you so that you can be a consistent practitioner. The next one that I want to break down a little bit more is confident. I want to help you feel more confident as a school based OT, and I also want to be more confident as my or for myself as a podcaster, as potentially maybe dabbling into the YouTube world, and also as a overall presenter. For you all, I want to be more confident so that you can feel confident as a school based occupational therapist. I don't want you to feel the imposter syndrome. I don't want you to be unsure about the future of school based occupational therapy in the schools. I don't want you to feel unsure about knowing what school based ot really is and whether or not you're doing the right thing. And so throughout this year, I want to focus on answering some of those questions for you and building up your your base knowledge of school based OT and really why? Let you know why you should be confident in this profession and as a therapist, there is no one way, one right way to provide therapy within the schools, but there are a ton of, a ton of correct ways. And so we really want you to find what works for you and feel confident in that to be, be the confident therapist that you need to be in order to support your your clients. And I think we've talked about this before in the podcast, your clients include your kids, your teachers, maybe other occupational therapists that you supervise, or codas that you supervise. But as well as did I say, teachers, parents, everyone that really works with that student that you also work with. We'll be back after a quick break while it may be summer break now, the school year will be here before you know it. Get ready for it. At the fifth annual back to school Conference coming August, 23 and 24th of this year, join hundreds of school based ot practitioners online for this two day transformative learning event where you can attend live or catch the replays. Don't Miss Amy and Jack from autism level up, sharing neurodiverse strategies to support autistic students or expert handwriting instructor Peggy Morris as she shares the most up to date research on handwriting and how to put it into practice. Don't miss this impactful event for school based ot practitioners. By school based ot practitioners as a thank you for listening to this episode of the OT school house podcast, use promo code. Podcast, 25 for $50 off your registration at ot schoolhouse.com/conference I'll see you there. Finally, the third C, we have consistency. Confidence, and then community. I hope to build consistency and confidence through community. I want to build up the OT school house community. I want us to be there for each other. I want us to be able to share ideas, get together and talk about it, maybe not live. That can't happen yet, but I want us to be able to be a community. My favorite part, I think I mentioned it a few minutes ago, of the OT school house podcast. OT school house in general, is the the opportunities that I get to meet all of you. I have met therapists from around the world in the last three years because of this podcast, opportunities that I would have never had before as a result of this podcast and getting to know all of you, through Instagram, through Facebook, um, through, through the office hours in the A to Z, school based. OT course, it's just been amazing. And I want you all to feel that too, if you don't already. And so I'm going to really focus on community within this 2021, calendar year. And I won't stop that. I'll continue it into 2022 2023 and so forth. But right now community, and I'm actually going to tease just a little bit about community coming up later this year. I won't release all the details, but it will be in August. I am planning a virtual ot School House conference for all of you. I'm laying the foundations for it, finding the presenters for it, but you can guarantee that. Well, if you know me, if you listen to the OT school hub podcast, you know that I put function first, and I really think it's about helping kids where they are. And so this conference is going to be exactly that. We are going to bring in special presenters from all around the nation. Some have been on the podcast, some have not been on the podcast, and you've never heard from them before, but we're going to talk about helping students be independent in the education environment that they are in. And I think that's what really OT is about in the schools. And so we are going to put together a full two and a half day conference about that. Can't wait to release more information to you on that in the in the coming weeks. It won't be it won't be long before I'm able to let you know more about this. I'm excited to share that with you, but I don't want to jump the gun yet. I've got a few more things that I got to put in place before we can really announce that. All right, so those are the three C's, consistency, confidence and community. I hope those resonate with you a little bit again. You don't have to remember these. You don't need to write them down in your journal, put them up on your wall, like I have over here. But I would, I think as you listen to the podcast in the future, later this year, you're going to see how I am trying to help build consistency, confidence and community within this community, within the OT school house community, but also for you individually, I want you to be confident. I want you to feel like things that you are doing are working, and that you're doing those things consistently to make yourself a better therapist. All right, so moving forward, I wanted to give you a little bit more in this podcast. And so I've got five new year's resolutions for the school based OT. Gonna go over these fairly quickly, and I'm gonna help you with fulfilling these resolutions as we go through the year. Okay, and so the first one that I have, I think every school based ot needs support with this I do as well, and that is to stay up to date on our treatment notes. This is like, you know, when they do in the, if you're actually in a real, like, live environment conference, they do the whole, you know, keep your hand up until, well, keep your hand up if you falling behind more than two weeks. Keep your hand up if you've fallen more than three weeks behind, yeah, and so forth, right? We've all been there. We've all done that. We've all been behind on our treatment notes in the past. So I'm going to try and try and help you with that. I think it's a great new year's resolution. In fact, I'm going to try and make sure 24 hours is going to be my period. I'm really going to try and do them in the last few minutes of each session, if not right after the session. But I think that's a great resolution for any school based OT, maybe any ot in general. Next one provide teacher trainings. And I did some, actually, I did two, one for parents and one for teachers in November and December, and it was fantastic. I've already gotten a lot of great feedback that teachers are implementing some of the things that I suggested. And so I highly recommend that you do the same, put together a teacher training and present that for your teachers, let them know how you can support them. That is one way. Remember, we talked about confidence up in the 3c by providing a teacher training. That is one thing, to help build your confidence, to let these teachers know that you are valuable, that you have great information to be shared, and so I do want to encourage you to at least do one type of training, whether it be for teachers or parents. Maybe it's for your own ot colleagues in your department, but do some sort of training, not only does it build your confidence, but it is really something that you. Helps you to be a better therapist in general, because you're going to have to do some work. You're going to have to look within and see, okay, what do I what do I know? What am I good at, and maybe what do I need to do some research on in order to to present this training? So I highly recommend that you make a resolution to provide at least one training of some kind this year. The third new year's resolution that I have here is become familiar with at least two new evaluation tools. If you've been a seasoned therapist maybe five years or so, you get set in your ways. You use the same three or four evaluation tools over and over and over again, and at some point I know you do this, because I do it. You're almost going through the MO, through the motions. You kind of, okay, kid, color in the circle. All right. Coloring the star. I don't even need to look at you, because I know I can score it later, and things like that. You know you don't want to get set in your ways. You want to keep life challenging, and one way to do that is to keep yourself on your toes by learning new things. Learn. I put two new evaluations here, but the next thing I'm actually gonna jump ahead, actually into my fourth resolution, is partake in 12 hours of meaningful professional development. And I say that because maybe you don't wanna learn new evaluations, but maybe you do have new treatment strategies that you can learn, and most of us need about 12 evaluation, sorry, not evaluation, professional development hours every year. So that's why I made this number 1212, hours of meaningful professional development that can be through the OT schoolhouse, A to Z course, that can be through occupational therapy.com that can be through med bridge.com . You can get a if you use med bridge, use promo code ot schoolhouse, and you get a discount. I get a small kickback from that. But honestly, I don't even know what it is, but use do something that's going to make yourself a better therapist. There's the training by Meg proctor on autism, learn, play, thrive.com . A fantastic training if you work with students with autism. Highly recommend doing something like that. There's vision trainings with Robert Constantine and Miss Jamie ot on her website. Miss Jamie ot.com , check those out. Make yourself a better therapist. It is an investment in yourself to be a better you highly recommend doing as much professional development as a your provider or sorry, your employer might allow you to and pay for and B go above that a little bit. Invest in yourself with some of your personal income to learn more about being a therapist, especially if you're a young therapist, a newer therapist, get out there and and learn. And then my final new year's resolution here, number five, is take care of yourself. And I have a few sub points here, because it is so important. The first one I have here is leave work on time. Yes, leave work on time. I know that sounds crazy, but yes, do that leave on time, whatever time you're supposed to work until leave on time. I know there might be some days where an IEP goes a little long and you have to stay that's okay. I get that, but try and set a plan for yourself to leave on time. Maybe, right now, you're leaving work every day an hour after 430 or whatever time you're supposed to leave and well, make a plan. You don't have to leave on time starting day one. Make a plan to gradually reduce that time. Maybe, if you get to a half hour by March, that's a win. And then maybe when you start up in August again or September, maybe you're down to where you are leaving work on time. Make that plan to focus on yourself by leaving work on time. I'm actually in the process of reading a book right now where they talk about your hourly wage and what your hourly wage really is, after you take into account all the extra time that you put into work, even that travel time that you spend that you don't get paid for that, but it's still required for you to work, right? So just keep in mind that after whatever time you're supposed to leave should be your time. Physically leave work, and also mentally leave work, try not to bring work home, try to figure out how you can fit it into the time that you have at work. And if you absolutely know that you don't have the time at work, then that's when you might need to ask for help, ask your supervisor, let them know, Hey, I did this time study. I can't physically fit all of this duties that I have into this seven and a half hour day, or whatever it might be. So ask for help if you have to. Also, what can help is celebrating the little victories, whether it is standing up for yourself and a student at an IEP, celebrate it if it's. Uh, your birthday. Celebrate it a holiday. Celebrate a day off from work. Celebrate it. Take the time to celebrate the little things. It makes life a lot more interesting. And I mean, come on, we all need more things to celebrate these days, especially after 2020 so you know, this is what I have for you today, five new year's resolutions. Stay up to date on your treatment notes. Provide teacher trainings. Become familiar with new evaluation tools. Spend some time energy and money on meaningful professional development opportunities that are going to make you a better therapist. And finally, take care of yourself. Get that Starbucks on Friday when you are just feeling like you had a good a good week, you know, take that time to celebrate it. And don't just get the Starbucks because you want Starbucks actually make it meaningful. Make it like a celebration. You know, you earned that Starbucks. You got through a tough week. You earned it all right. So that is going to wrap up this very first episode of 2021. Episode 60 of the OT school house podcast, I want to say thank you all so much for being here with me today. I am excited for 2021 I'm excited for the three C's, consistency, community and confidence. I cannot wait to help you, and also for you all to help me, as we have a great 2021 as always. Enjoy the rest of your day and thank you so much for listening. Have a great well. Have a great start to 2021 Take    Amazing Narrator     care everyone. Bye, bye. 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 the Episode 59 of the OT Schoolhouse Podcast. In episode 59 of the OT Schoolhouse Podcast, I'm sharing with you the who, what, when, where, why & how of screenings in the school-based OT setting. Whether you are a brand new OT or a seasoned School-Based OT, the likelihood that you are using screenings and the subsequent opportunities to their full potential are unlikely simply because it is not something we are trained in. I hope this podcast can inspire you to move forward with supporting more students than just those who are on an IEP. So please listen to learn how. Links to Show References: Sheryl Eckberg Zylstra, Beth Pfeiffer; Effectiveness of a Handwriting Intervention With At-Risk Kindergarteners. Am J Occup Ther 2016;70(3):7003220020. https://doi.org/10.5014/ajot.2016.018820 Check out the A_Z School-Based OT course - The Comprehensive course for OTs in the the school-based setting. Use Promo Code oct50 to get $50 off before Oct. 23, 2020 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 59! 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, Jason Davies, class is officially in session.    Jayson Davies     Hey there. And welcome to the OT school house podcast. My name is Jayson Davies, and I hope your 2020 school year is off to the best start that it possibly can be in light of everything going on right now, it's been eye opening to kind of see everything that's going on with all the emails and questions that I've received from everyone. It's crazy. Just, you know, a lot of you are virtually online, 100% like I am for the most part, some of you are having evaluations in person, while others are having evaluations over a teletherapy platform of some form. And then you have others who are in a hybrid model, where students are on campus two to three days a week, or they're split up in cohorts. And so you're on campus every day working with kids while they're revolving in and out of the school in some form. And then still others of you are full time and the kids are full time, and you are on campus seeing kids wearing that PPE, trying to figure out how to, I guess, limit the spread of the Coronavirus by either a, you know, minimizing tools that are used between students, or maybe, maybe you're going into classrooms as opposed to pulling out, or the other way around, you're only pulling out as opposed to going into classrooms as a way to try and prevent the spread of Coronavirus. It's all just been really, really amazing to just hear what everyone's doing. So with that said, trying to figure out what to do a podcast on has been a little tricky because everyone's in a different situation. You know, a year ago, we were all in house for the most part, and and I knew what to plan for, but with everything going on now, it's it's making a little tricky. So I'm trying to get the best of both worlds between those of you who are working with kids directly in the school and those who are working online. So this week, I'm going to talk about something that I hope can help you, whether or not you are providing services online or in person, and that is screenings, and how it relates to RTI, Response to Intervention. Before I jump into that, though, I want to real quickly say that the OT school house podcast is an extension of the OT School House website, and over at the OT School House website, I am kicking off a special sale on the OT school house A to Z school based ot course. The A to Z school based ot course is the first comprehensive professional development course for school based occupational therapists. In this course, we cover everything from screenings and RTI like what we're going to cover today, but then we go way beyond that to do also look at evaluations. We look at determining the level of service a student might require, and how to determine that level of service. We look at intervention planning to help our students meet their goals, and then we kind of finish everything up with graduating students from occupational therapy services in an ethical way when they're ready. And that's just the highlights. We also cover everything in between that it really is a comprehensive course, from what you need to know the day you step onto that campus, all the way through to when a student is ready to graduate, and everything in between, my personal favorite part of the course, and maybe the part that ends up being the most helpful for you, is actually our live Q and A sessions that I hold with Members of the course every Thursday evening. It has just been so much fun and so informative to get to know people that have taken the course and be able to answer your questions directly. So if there's something that maybe isn't actually in the course that you want help with, that's what our Thursday night Q and A sessions are for. It's just been so great getting to know everyone in the course and answering questions. I love that part of this course, and you get that with the course lifetime access to the Q and A sessions every Thursday. All right, so if you'd like to learn more about this, A to Z, school based ot course, head on over to OT schoolhouse.com . Forward slash A to Z, A, the number two and then the letter Z. And also stay tuned until the end of this episode, where I'm going to share a special promotional code to get $50 off when you purchase before October 23 All right, so let's jump into the topic of screenings. Today. I'm going to start off by just sharing what happens when you first start off as a school based OT. And you know, when you first get a job as a school based OT, there are a few things that you begin to learn quickly, and screenings is not one of them. Typically, you likely started with getting your caseload and trying to figure out what that will look like, right? You try and figure out how what kids have to be seen for how many days a week, or how many days a month. Trying to figure out what schools you have to be at on what days in order to make that even possible. And then, of course, how you're going to be in multiple schools at once, because there's just more kids that need to be seen than there seems to be time in a day. Or if you're in the teletherapy model right now, and you're just getting your first job, you're trying to figure out all the technology and how, again, you're going to fit all those kids into a one week period. And then just as you start to get a handle on your schedule, the invitation to IEP meetings start to come, and you realize you have no control over what time they start, what time they end, how long they occur, and how many sessions you will have to miss in order to attend those IEP meetings, you start to figure out what an IEP is. You start to understand that you need to input your progress on levels, your goals and your services. Maybe extended school year services as well. Maybe you even need to update the notes page a little bit, even eight years into occupational therapy, knowing that an IEP is scheduled at a time that I'm supposed to be providing services still causes me anxiety. And so that is one thing that you have probably come to realize, if you've been in the schools for even a few months, or especially if you've been there for several years, you don't have all the control that you wish you had when it comes to scheduling IEP meetings, and then your first referral pops up, and you know, you are now a full fledged school based occupational therapist. You are providing treatments, you are attending meetings, and now you have to figure out how to complete an evaluation. All of that can be really overwhelming, and that's also why most occupational therapists never make it past those three key aspects of being a school based OT, you know that saying that you'll often see on T shirts nowadays, it goes, eat, sleep, fill in the blank, repeat. I mean, I know from my experiences back in college, our favorite one was eat, sleep, rave, repeat. Well, in school based OT, it is easy to helplessly fall into the eval, meet, treat, repeat trap, and it can take you years to move beyond that. There can be, and there should be, so much more to occupational therapy in schools than evaluation, meet, treat and repeat, and that's what I'm here to talk about today. What is a screening in school based OT? What is the purpose of a screening, and why should we spend more time doing them? They can be very helpful when we do them the right way. Now, I know some of you might be a little bit confused about the difference between a screening and an evaluation, so let's start there. In some settings, screenings and evaluations might mean the same thing, and if you use the term screen or assessment or evaluation when talking to a parent, they might kind of think that they're all exactly the same. But I want you to understand that these are two very different tools that you have at your disposal as an occupational therapist in the schools. I'm actually going to do something here that most speaking coaches would probably say is pretty stupid. I'm going to start with the most important thing to remember here at the beginning of our discussion. And really, if you only remember one thing during this episode, remember this evaluations support individual students while screenings, support individual classrooms. One more time, evaluation, support individual students while screening, support individual classrooms. Now that may sound a little shocking to some of you that that are out there listening, especially if you are stuck in that eval, treat, meet repeat cycle, and never have a minute to stop thinking about those three areas, and aren't able to really move beyond and outside of that to think, what could I potentially do? You know, you kind of get stuck in that working with one or two students at a time for eight hours a day, and when you're not working with the students, you are doing an evaluation, or writing up the evaluation, or attending an IEP. And like I said, that's like the three key areas that we end up spending most of our time. Some of you may even be saying in your head, well, you know, I do use screenings, but I screen individuals to determine if they need an evaluation, not to look at the whole classroom. And for those of you that are saying that, bear with me. I'm going to address that and why you might want to reconsider that in a little bit. Now, in that phrase, I want you to remember evaluation, support individual students, while screening, support individual classrooms. Each word was very precisely chosen. I did not say that screening support groups of students or special education students. I said individual classrooms, and that's because each classroom is a small community complete with a leader. Hopefully that's the teacher, right, not a student that's leading the classroom. Or maybe an aide. But there may also potentially be a sidekick, and that might be the teacher's assistant in the form of an aide, or maybe even a parent that just happens to be able to help out quite frequently. You also have all the citizens in the classroom, which are the students, right? But beyond that, you have more. You have more than just the people in the classroom, you also have the environment and the expectations, both the social expectations and the academic expectations. Like I said, it's a whole mini community in the classroom, and they are then part of even a larger community that is the school. That's a whole nother topic, but today we're focusing on the individual classroom and the screening that supports those classrooms, all right, so let's take a step back real quick to the second part of that phrase, screening support individual classrooms, which I just established, are little mini communities. And in case you haven't had a chance to look at either the incoming or the outgoing. OT practice framework from a, ot a, ot a makes a point that ot practitioners can support communities, just as they can support individuals and families. Thus OTs can support classrooms as a whole. In the educational field, they do tend to call this RTI or MTS, S or simply collaborating with the teacher or collaborating with the classroom. Now the reason I'm laying all this out for you is because I know the last thing you want me to tell you is that you need to do more work. And I know no matter how great I make this sound, how great this episode is you won't carry this into practice unless I show you the benefits, right? So why might we want to support an individual classroom, as opposed to an individual student? Well, there are many answers to that, but I kind of want to narrow it down here. And first, I'll say, you know, supporting a classroom does not require a formal evaluation. Like supporting an individual student does require that initial evaluation for you in order to bring that student onto services. Sure you're going to want to collect data in some form to show that progress was made among the students eventually, but there's no 60 day timeline or standardized evaluations to worry about. So in that sense, there may be a little bit less stress for you. The second and probably more important benefit, at least, according to me, is that by supporting a classroom, you can support 30 kids, or however many kids are in that classroom, and a teacher in the same amount of time you might have supported only one student in that classroom. And then beyond that, the teacher will have the strategies he or she learned from what you have taught them, and that they incorporated with their students this year, and they'll carry that on to next year, and all the students that that student or that that teacher will have in the future. So by supporting that one classroom for maybe 10 weeks or three months or whatever it might be, you are supporting not only those kids, but you're also supporting the teacher who will go on to support countless kids in the future. Quick bonus reason for supporting the classrooms, especially your primary grades and special education classrooms, you're going to like this. You will eventually likely see a reduction in the number of OT referrals over time, because you are supporting your teachers with strategies they can use. Now. Don't get upset with me when you first see a bunch of referrals come in, because there probably will be an OH MY GOD phase where teachers finally understand how valuable you can be to them, and they might submit a few more referrals. But over time, those referrals are going to be reduced, because the teachers and everyone at that school site is going to know exactly what you would do in a certain situation, all right, so there will always be students that need an OT evaluation, but through this way, you might be able to cut down the number of referrals, especially referrals that may be unnecessary. Oh, and I almost forgot, because I don't want you to go to your administrator and say, Hey, Jason from the OT school house podcast that we can do screenings. Now I want you to have some evidence to back that up, and so I have here a direct quote from idea section 300.3 OT, three. OT, three ot two that provides a definition for screenings as it relates to special education. Here it is the screening of a student by a teacher or specialist to determine appropriate instructional strategies for curriculum implementation shall not be considered to be an evaluation for eligibility for special education and related services. Did you get that? I'm going to read it one more time, because I know when someone. Read something sometimes we tune out, so I'm going to read it one more time. The screening of a student by a teacher or specialist to determine appropriate instructional strategies for curriculum implementation shall not be considered to be an evaluation for eligibility for special education or related services. Again. If you need to listen to it again, go ahead and hit that little rewind 15 seconds button, and you can hear it again. What this is saying is that screenings should be used to determine appropriate instructional strategies for curriculum implementation. It does not say that we can use screenings as a way to determine if an evaluation is necessary. Remember, I said I was going to address that earlier. I know some of you out there are doing a screening of a specific student for a teacher to determine if they need an OT evaluation. That's not what IDEA says a screening is to be used for. It's to be used for curriculum implementation and instructional strategies. All right, some of you may have pointed out in that definition that it does say the screening of a student, not group of students, like I am proposing, can be used. I am hesitant to use a screening for an individual student, because I don't want it to at all appear like an evaluation is being somewhat used. I don't want it to look like that. I went into the classroom to look at Johnny, even though I don't have an assessment plan, because at that point I am well, I already know there's a concern with Johnny. Otherwise, why would I be going in to look at Johnny as an occupational therapist? And so it gets a little muddy, and if you're going in to look at one student, it should probably be for the purpose of an evaluation. I am hesitant to do that for any one student, because it might look like an evaluation. I just want to clarify that, because in 2008 there was actually a lawsuit against the School District of Philadelphia in which the occupational therapist did something similar, the therapist completed only, and I quote directly from the lawsuit, a cursory screening of the student and determined that the student did not need occupational therapy services based on only that little screening that they did, without getting into All the details I can tell you that that eventually came back to haunt the district. In fact, the student eventually did qualify, or I shouldn't use the word word qualify. We don't qualify students for occupational therapy. We make a recommendation, but the judge did order compensatory services to be provided for the student when later, that student was evaluated for occupational therapy services and found to need those services. So again, I just want to reiterate that if you're going to be doing screenings, especially if you're going to be doing screens of individual students, be very careful, because you do not want that screening to look like a poor evaluation, and you do not want to base a determination of whether or not a student needs occupational therapy services based upon a poor evaluation, because if an IEE or something like that is requested, it's very easy to say that, well, I mean that IEE is obviously better than your little observation for 15 minutes that you Did of a student to say that they did not qualify for ot services or that an evaluation wasn't even needed. Remember, IDEA says that a screening is for instructional strategies and curriculum development, all right, okay, so I think I've established the reasons why I think OTs need to be using screenings to look at whole classrooms. But what does a screening actually look like? Well, it's kind of like an evaluation, except with less formality, as I kind of went over earlier. First you're gonna start by having a conversation with a teacher. If you are trying this for the first time, I highly suggest that you find a teacher who has already seen the value of occupational therapy at work. Maybe they've had a student that you worked with and and saw the benefit that you were able to provide with that student. And hopefully they are open to new ideas, given that they've seen what you can do, hopefully they're open to ideas that you might have. I actually have a very basic form that I use to have the teacher identify areas of concerns for the class. But let's be honest, typically, it's handwriting. Sometimes it might be behavior or lack of student attention in class. Those are the three big reasons that teachers are typically reaching out to us. Maybe, if it's in kindergarten, then maybe using scissors might be part of that. So from there, I set up a time to chat, get a little more information from the teacher. You know, many times a handwriting concern, there's a lot more detail into that than just handwriting. You know, what is the real problem is it difficulties copying from. The board difficulties, copying from a book, learning, formation, sizing, spacing, so on. You know, as occupational therapists, we know how to break down tasks versus, you know, maybe a teacher, they're just going to tell us handwriting, but we really need to know what part of handwriting is, the difficult part. The same can be said for behavior, attention, using scissors and so on, right? What is the real problematic behavior, or behaviors? Why do we think attention might be limited and so forth, right? So once you do have a little more information from the teacher, then you can set up a time with the teacher to observe the class. Preferably, you want to do this when you will actually have a chance to see the concern, right? There's no reason to go in during PE if the concern is during handwriting time. So this would be similar to an observation you would complete for an evaluation in the classroom, except instead of looking at one student, we're looking at the entire community, right? We're looking at the whole classroom and how it works as a whole, or even potentially individual. Again, we're not going in there with the idea of looking at one student, but each student is a part of that community, so you might have to look at an individual student. Some important things to note may be about trends. You see that students are performing in the classroom. Do you notice anything about the environment. Are the kids seated in a way that's conducive to learning, or are they simply spending half of their time trying to figure out how to sit so that their feet can touch the floor? Just remember to keep the concern of the teacher on your mind as you do this, you may see things in the classroom that do cause you concern, but in this moment, your job is to focus on the support the teacher needs. We don't want to overwhelm the teacher potentially with ideas that may not actually be a part of the solution for the teacher's concerns. Okay, so now you've done your observation for the class. What comes next? There are a number of possibilities, but first, I would start by collecting your thoughts and debriefing with the teacher as soon as you can, while that that period of time that you were in the classroom is fresh for both of you. Share what you saw and what your clinical reasoning is leaning you towards. This is your time to share, and if you have some good advice, the teacher may even be open to some constructive criticism if warranted. What most frequently comes from these screenings, I find is that a I provide a few simple strategies, such as providing the students with different pencil options using adapted paper or adapted scissors, maybe with a handful of kids in the classroom, sometimes we have to get the custodian involved to help lower some desks or find new chairs. But there's other there's other things that might come out of this, other potential outcomes, and that could be that you and the teacher move forward with some form of collaborative handwriting program, or a movement program, a typing program, or maybe even some form of an emotional regulation program. Maybe you really know the zones of regulation well, and so you want to implement that into the classroom. One of the handouts that I actually provide as part of the A to Z school based ot course, is a sample 10 week handwriting program that could be replicated with the whole class. It's something that I did a few years back, and I keep on hand for when I do think there's a general education classroom that I could support through a collaborative handwriting program. If this is a younger grade classroom, maybe Kinder or first grade, maybe you could even just set up shop once a week in the morning and run a fine motor center. If they do centers, there are really a lot of options here, basically anything that you can come up with, and if your teacher is on board with you, you might need a little bit of support also from the administrator. But if you guys work together, you can come up with many different collaborative options to help. There's actually even some research out there that OT and teacher collaborations can lead to success when it comes to handwriting, that's really where the research is. I'm sure we could see success in those other areas that I mentioned, emotional regulation, using scissors, other fine motor aspects. But there is actually some research out there where they looked at an occupational therapist and a teacher collaborating. This was back in 2016 and they use the Size Matters handwriting program. And yeah, it's definitely worth looking into. In fact, the title of that article is effectiveness of a handwriting intervention with at risk kindergarteners. And it is in the Asia, the American Journal of Occupational Therapy that is published by a ot a and it was written by I'm not going to butcher their last names. It's Cheryl and Beth. And I will provide a link to that article in the show notes at ot schoolhouse.com , forward slash, Episode 59 you. Will find a link right there, in case you would like to print this out and have it for your own records. All right, so I went over to the possible outcomes, which is simply providing strategies to the teacher to try in the classroom. And the second outcome being potentially having some form of collaborative approach between you and the teacher that you work together maybe once a week, or however often you decide to do it, but there is one more potential outcome of a screening, and it doesn't happen often, but I want you to know about it, because it can happen, and that is, maybe you went into the classroom to observe, and remember, we're there to observe the community, but the community includes individual citizens or individual players, individual students, and maybe one of those students in particular was really struggling. It is possible that after your screening, you meet up with a teacher and you guys talking about this, you know, the entire community, you discuss this one particular student. And maybe this one particular student really does need more support than the rest of the classroom, and in that case, it may be beneficial for you to help that teacher go through the referral process for whatever service you and the teacher think that that student might need. Maybe they already have special education services, and you think that they could benefit from individual occupational therapy services, well, then you can help that teacher make an appropriate referral. I don't know about you, but I'd much rather have a teacher making a referral for a student who I have kind of seen through this, through the screening process, as as opposed to the teacher just making a referral for a student, they they don't really understand how occupational therapy will help them. Again, just to reiterate, that is not why the screening should happen. You should not be doing a screening simply because the teacher had a concern about this one student. So you're going to go in and observe the entire class as kind of a disguise for looking at that one student. No, that's not how this should work. You went into that classroom to observe the entire community, and in that you did end up finding a student that needs more support. If the teacher beforehand already had concerns for that student, then this should not be happening. You should not be doing a screening for that one student that should then be an official referral. Or maybe you start off with just some simple strategies for that student to the teacher without really knowing that student, but eventually that would turn into a referral anyways. So helping the teacher to submit a referral for either OT or maybe just special education in general should kind of be that last resort. Remember, we always want to t we always want to keep students in the least restrictive environment, and so we want to do everything in our power to help that community so that all students can benefit in the classroom. But I would be remiss if I didn't tell you that, yes, sometimes it is appropriate to go ahead and make that referral. Okay. So that wraps up the three primary outcomes of a potential classroom screening. One thing that I did forget to mention is that if you are going to do some form of a program, you're going to actually want to somehow track it to see if it's working. And so if you are going to do a handwriting program, do some form of simple data collection, it doesn't have to be using the ths for every student or the, I don't know, the edge for every student, but do something simple, even if it's as simple as a work sample of every student. Just so you have that before and a potential after comparison, so you can actually see if that handwriting program that you put into place, did it work? Did overall, did you see a reduction in words squeezed together, or did you see more kids writing on the line? Or whatever it might be whatever you and the teacher decide that you really want to focus in on, did that program make a difference? Because then you have the ability to say, hey, look, it worked for this first grade teacher. Now can we replicate that with this other first grade classroom and go from there? That's how your RTI program can continue to grow, but you need to have something that supports that what you did actually worked all right. So to recap, providing strategies to the teacher, collaborating with the teacher and or making a referral for a student to the right services are kind of the three primary outcomes of a screening or of a potential screening of the classroom. And most importantly, you need to remember that evaluations support individual students while screening support individual classrooms. If you can get to a point where these screenings become a part of your yearly participation with that school, you're going to enjoy your job more. I guarantee. It, you are going to enjoy your job because you're going to have more interaction with the teachers. You're going to see teachers using the things that you actually taught them. You're also just going to get to know them. You're also going to, like I mentioned earlier, I think you're going to see a decline in individual evaluation referrals. So I know this might sound counterintuitive, but by getting into the classrooms more helping more students, helping more teachers, you're going to have less teachers bugging you for referrals, because you're going to be in there and they're going to be seeing what you can do and how you support the kids. And that is especially true if you are able to support younger grade primary teachers, you know, K through 2k, through three, as well as your special education classrooms. By getting into those classrooms more the teachers are again, are going to see what you can do. They're going to see the strategies as well. Are the other adults in the classroom, be it aids or adults, they're going to see those strategies, and they're going to incorporate those strategies every day, as opposed to you working with a student once a week to incorporate those strategies. So again, this can really be beneficial for you, and I highly suggest that you look into incorporating screenings to get out of that, that evaluation, meet, treat repeat cycle and get into the classrooms a little bit more and screen those classrooms and work collaboratively with the teachers. Now, there's one more thing that I do want to address, because I know many of you are thinking, how would I do this virtually? And to be completely honest with you, I think it would look very similar. You would, of course, start off by having that conversation with the teacher to determine what concerns there are. Then after that, you follow up with an observation of the online classroom, where you can see all of the students and the teacher. And of course, the environment is going to be completely different, but one thing you might actually need to do to actually get this collaboration going is that you might actually have to have students submit their work somehow. Obviously, that's a big difficult area right now is actually turning in work, and so the students and the parents are going to have to somehow get the work samples to you, especially if you are working on handwriting or something. Another barrier might be that it is very tricky to see the students hands on camera right now, most of the cameras are pointed at the student's face, and so you won't be able to really see those fine motor skills unless you are working with a student one on one. So that is a barrier that if fine motor skills is a concern, you will have to address, and it might be a little tricky, just like if you're doing a screening in person. After you do that observation, you would go ahead and set up a time to talk with the teacher and go from there, debrief with that teacher and figure out a potential solution and work from there, determine if you're going to simply provide some strategies for the teacher. Are you going to collaborate with the teacher, or are you going to make a referral for any individual student. Obviously, the recommendations may look a little different because you're on a virtual platform, as opposed to in class, and you don't really have the ability to recommend, you know, environmental changes at home, really. I mean, you might be able to do a little workshop for the kids and the parents about what the what the environment could be optimized for, per se, how they could change the environment up at home, if they have the the option to do so, but things are going to look a little bit different. Maybe it's something about reducing screen time and sharing with the teacher different ways that maybe they can have activities where the student isn't relying on staring at the screen to do maybe it's as simple as saying, Hey, I know that we're trying to do a lot of typing because, well, everything's on the computer right now. But what if we actually have them do some writing on pencil and paper? Because a eventually they're going to come back onto campus and they're going to have to write and B, it's going to help reduce screen time. And then maybe you have to actually help teach the parent how to or, sorry, not the parent. Well, yeah, the parent too, but also the teacher and how to turn work in digitally, even if it is a written assignment. Another way that you might be able to collaborate with the teacher is on implementing some form of a movement program where there is movement incorporated into the academics or or spurs in between. Some of the academics that way, the students are actually getting up out of their chair. You know, it's surprising when you go into a general education classroom, they actually move around a lot, whether it's moving to form groups or whether it's moving to get up and get paper or to go get tools. Across the classroom, they actually move quite a bit. But, I mean, I don't know about you, but I don't move once I sit down at my work in my office, like I'm there and it's. Unfortunately, we're not moving around at all. You know, even those five minutes from walking from one classroom to another classroom or walking to the lunchroom, some of that just doesn't happen, and it's not happening for the students as well. So implementing some form of a movement program might be beneficial. I also think that some teachers are struggling to figure out how to how to provide academics the entire day through this medium, and so several of them may actually welcome you into their classroom to provide that program, because it's minutes that they don't have to focus on academics, which is a lot for them. They are not used to doing this online thing, just like we aren't, but they're being asked to do this with the same group of students every day for hours a day, and that is a struggle for some of them. So they may be more than welcome to have you come in and kind of take the lead for a few minutes a week. And you know what? Hey, there you go. You're now teaching a class of 30 students and a teacher how to make their life better over a long period of time. The hardest part to establishing a screening process is getting started. And so again, I just want to, I just want to help you get started. And so find that teacher who's going to be open to ideas that maybe you already have a rapport with, and start there. Where can you help that teacher? If you don't feel comfortable doing this virtually right now, that's okay. Don't feel like you have to do it right now. Wait until students come back. That's perfectly fine. I just want to give you options for both, whether or not it's virtually or in person. So I think that that is a great start for you to understanding screenings. And if you've listened this far. I really appreciate you being here and just listening to what I have to say. I want you to know that this is just the tip of the iceberg. When it does come to understanding screenings and RTI as a whole, there's so much to RTI and really, screenings are kind of a tier two system within the three tier system that is RTI within the schools, what we talked about today and with screenings and how to go ahead and move beyond screenings, is laid out in so much more detail and broken down, along with a lot more in the A to Z school based ot course that I have on the OT School House website, which right now I'm Running a special promo for $50 off until October 23 2020, using promo code ot 50, as in October 50. If you would like to dive in further with me to learn all the ins and outs of being a school based OT, I'd love to invite you to join me for this course. The course is a self paced course, complete with eight modules and an extra bonus module that lead you through the entire process of being a school based occupational therapist. Along with the videos, you'll also receive more than 25 PDFs and editable Word documents, including my evaluation template, as well as several templates related to RTI screenings and intervention planning, and as I mentioned at the start of the show, you will also have an open invitation to join me every Thursday night for our live Q and A support sessions, where we're going to get to know each other, know each other's concerns, difficulties and strengths. And it's not just me that provides feedback for everyone, the entire group comes on and helps each other. So it's a fantastic opportunity, and again, I hope to see you there sometime during those Thursday night calls. Again, you can learn more about this course at ot schoolhouse.com forward slash A to Z, or you can also head over to the show notes@otschoolhouse.com forward slash episode 59 and find the link to head over to the course page. All right, don't forget to use promo code ot 50, as in October 50 for $50 off before October 23 that's going to wrap up today's episode. I hope you all enjoyed this talk about screenings and about what we can do after we do our screenings. You know, collaborating with the teacher a bit. Remember, if you want to learn more about screenings and the entire process of being a school based. OT, check out the A to Z, school based. OT, course. All right, I will see you all next time on the podcast, take care. Have a great week. 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

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 58 of the OT Schoolhouse Podcast. In this episode of the OT Schoolhouse Podcast, I have a conversation with Amanda Speights, OTR/L about what occupational therapy looks like in a preschool. She works in a model preschool and I work in a preschool, not sure I would call it a model preschool =P Anyways, in this episode, we talk about what the goal is for working with preschoolers, the referral and assessment process, and why we think it is important to collaborate with the preschool teachers to serve our students. Links to Show References: Visit Amanda's website at AmandaTheOT.com 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 57! 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 58 of the OT school house podcast. Thank you so much for joining me. My name is Jayson Davies, and I am excited to be with you today. We are going to have a very short intro, and then we are going to start by jumping in with Amanda Speights, and we're going to talk about preschool and occupational therapy. She actually works in a quote, unquote model preschool down in Florida. And yeah, it's a great conversation. So I hope you will check out the entire thing. Also, real quick shout out to all my ot practitioners down in Florida. I don't know why, but there's so many OTPs down in Florida that really listen to the podcast. I really appreciate all the support from all of you down there, from everyone, but it just seems like lately I've been getting a lot of emails and whatnot from Florida. So thank you so much for for listening to the podcast, following the OT school house podcast, website, all that good stuff. Really appreciate that. All right, so real quick, before we do dive into preschools with Amanda spades, I want to invite you all to check out my Instagram, the OT school house Instagram page@instagram.com forward slash ot school house, all one word. I have actually figured out what reels are and how to use them, and I'm just really enjoying myself. Many of you, or at least few of you, might recall from the very early episodes when we kind of introduced who we were. I actually was considering being an animation major. I minored in film. And so the whole Tiktok reels craze has kind of gotten me back into that creative side of being, well, I mean, producing a little bit of film. I mean, the podcast does some I get to do some editing with the podcast, but I'm really enjoying the reels. I actually created one that's about a Pac Man tennis ball. I created another one about the zones of regulation. So I hope you'll head on over there. Check it out. Follow me, just for some general great school based OT. Content, all right, and with that, I'm just going to slide us on right into the interview. This is Amanda Speights, and she is a occupational therapist that works primarily in preschools down in Florida. I hope you enjoy the show. Hey, Amanda, welcome to the OT school house podcast. How are you doing this morning?     Amanda Speights     Great. Jayson, I'm so happy to be here.     Jayson Davies     Yeah, I'm excited to have you on why don't you go ahead and share us a little bit about your ot journey.    Amanda Speights     Okay, well, I went to Florida International University for my masters in OT, and I completed that in August of 2010 and immediately took a travel school job and moved to Virginia before I even took my boards.    Jayson Davies     Wow, that's a big before even officially being an OT, right?    Amanda Speights     So I worked on a temporary license, took my boards passed. Thank goodness that was a sigh of relief and and then worked in the schools in Portsmouth, Virginia for two years. Then I relocated to Atlanta, Georgia for about three years, before coming back down to South Florida, and I've been back home, but a little bit north of home, for about five years now.     Jayson Davies     You just couldn't stay away from Florida for too long, huh? No, I couldn't. So what settings were you in when you were moving around a little bit, primarily    Amanda Speights     school based, but then also some PRN jobs in the hospitals? Yeah,    Jayson Davies     I think we've all had a PRN job at some point. I worked in like a it wasn't exactly a sniff, but on the weekends, working in a little rehab area to work with some older, older clients. But yeah, I think we all kind of take that on, especially when we're younger and we're trying to pay off our student loans. It just helps a little bit. It helps a lot, right? So tell us, where are you now, and what does that job look like? Currently,    Amanda Speights     I work for Nova Southeastern University, and I'm in a preschool program that is accredited by the National Association for Education of Young Children, and our Prescott program is a model program for autistic children, and it's offered in partnership with Broward County    Jayson Davies     Gotcha. But that's not all. You're kind of sharing me that sharing with me that this is a very unique position, and how is that? So    Amanda Speights     it's unique because we're not just a school, we're a multidisciplinary demonstration and training center, so we train, and we serve as a model for a lot of schools to come and watch what we do, and we also conduct research and we train a lot of students. So currently, I actually have two level two fieldwork students with me who. Now, and that's    Jayson Davies     all on distance learning, right? Yes, it is. Oh my goodness, that's gotta be difficult. Yeah, I think I have a level two starting up in the near future. I think it's gonna be an occupational therapy assistant, but just like you, I think it's gonna be all distance learning, and I may never physically meet the student that I'm going to be working with. And that's kind of insane to think about.    Amanda Speights     It does it increases our time on Zoom, but I think that we've been able to have a pretty interesting experience and and they seem to be enjoying it. And one of my students said that she just thought that it was really relevant for the times, since it's obviously emerging practice, absolutely, it's a great thing to learn. Yeah,    Jayson Davies     and let's be honest here, even when the whole COVID 19 thing is over, things are never going to be back to completely the way they were before. I mean, Zoom is here to stay. Google meets is here to stay, teletherapy is here to stay. And so, yeah, you're right. It's, it's good that they're getting the practice now, and they're going to be better clinicians for it eventually. So definitely, yeah. So tell us a little bit more, because I know this, this unique area that you're in, you're actually at a university, right? Yes. Okay, and so how does the campus of the University, and how does a university work with a preschool? I mean, I've most occupational therapists, either A, we work directly for the district, or B, we're contracted for a third party, like a third party company or private entity that contracts therapist to a district and maybe, see you work for the county, or you work for a state, or like a we call them salpas Here in California, you kind of work for the county, and the county kind of contracts OTs out to the individual districts. But tell me how this dynamic works.    Amanda Speights     The University has a contract with the county to be an agency school, so that's how they provide the services. There's a couple of different other agency schools in the area that act as center based schools for kiddos that maybe need a little bit more of a restricted environment for their education. Okay?    Jayson Davies     And so this might be similar to a contract job, in the sense that you could be working for a private entity and working for the preschool, it just happens to be at a university. Yes, right? So    Amanda Speights     get all the benefits of being on the campus. You know, we have access to all of the great research and the professors are there. We have students that are are constantly being able to train and be on their level ones and level twos. And I've been fortunate enough to be able to guest lecture in the academic department as well.    Jayson Davies     Oh, nice. I was going to ask you, what, what academic sides do you get out of it? So you're guest lecturing every now and then,    Amanda Speights     every now and then, and I'm also working on my doctorate. Oh, wow,    Jayson Davies     congratulations on that. Maybe we ask what area you're kind of focusing in on right    Amanda Speights     now. I actually just got my practicum topic approved, and ta da telehealth.    Jayson Davies     Go figure. Yeah, nice. And so are your students coming from the same university that you work in? Then, yes, gotcha. That makes sense. All right. Well, let's kind of dive in a little bit further now into the actual practice. We know a little bit about Amanda. Now, how's distance learning going for you?    Amanda Speights     Honestly, it was a steep learning curve. It was, it's different. It was very different. I just, I really had to think about my coaching skills and and how I was going to explain what I do in layman's terms, to parents,    Jayson Davies     absolutely, I think communication has been something that we really had to focus on more so than we ever have had to, especially if you're working in a caseload with high needs where maybe your students aren't as verbal, and now you're Working with their adult parents, who are very verbal and are your your hands, your ears and your eyes. Working with that student, you really have to communicate with them. What do you think about that? Is that something that you're learning? Yes,    Amanda Speights     and I was really happy to receive an email from a family on my caseload in the spring who was working with a new therapist this fall, and we used blowing bubbles to teach breathing techniques for his self calming. And she was really excited to tell me that over the break, he actually began to use it independently. So I love that. I thought that that was a really difficult thing to translate, right? Because it's really abstract to teach him, but just through partnership, we were able to help him understand and he was able to grasp the technique. So, yeah, really happy.    Jayson Davies     That's awesome. Great job. So I gotta ask, because we're in the middle of a pandemic and everything, and I know people want, um. Resources, and just kind of to know what other occupational therapists are doing out there. So are you using zoom for your therapy sessions? Per se? Yes,    Amanda Speights     University has a professional contract with Zoom, gotcha,    Jayson Davies     and I know that's something that some school districts are weighing because of the price of the professional contract, and it's difficult. And even though I feel like zoom is the number one platform to be on, I understand that it's expensive, and so that may be a little bit of a perk of being at a university versus a public school that might not necessarily have the funding when they're already paying for Microsoft Teams and for Google meets, and it's just an extra expense for some of the public schools, but that that's great, right? So aside, you're on Zoom, what's going well and maybe what's not going so well with distance learning, what's been we talked a little bit about communication. But what else is going well or not going well?    Amanda Speights     I hope that my first evaluation is going well. I was assigned an evaluation to start. And since I did have access to the WPS online platform, I don't know if listeners are familiar with that platform, I was able to email mom, the SP MP, and correspond with her to clarify any trickier items. And the cool thing about that system is that it generates the reports for you, so it auto scores and generates reports. And since I have those students I mentioned, I was able to take it a step further and demonstrate the use of the quick tips to develop intervention reports. Nice and    Jayson Davies     is that the well, actually, you know what? I'm going to hold off on that question. We're going to get into some more evaluation questions a little bit later. But first, let's go ahead and dive into the role of an OT in the preschool system. I find that preschools are very unique for several reasons, the first being that there's no real mandated curriculum for preschools, at least not that I'm really aware of. The standards aren't really set. We're just trying to get them ready for kindergarten, and so I feel like a lot of options open up for teachers and providers with that. What type of occupations Do you feel like you focus on in the preschools?    Amanda Speights     Well, play, of course, naturally, right? Please. Preschool is really all about leveraging play for skill development, and it has to be fun. You can't be afraid to be animated, to be silly, if you want to be a preschool ot    Jayson Davies     i Yeah, second that, no doubt. But I think also at the same time right now, that's hard to do over, over this teletherapy platform, it's hard to get that engagement. What type of what type of population is your preschool? Do you have a wide variety of population, or is it all students with autism? Or what does    Amanda Speights     it look like? It is actually all students with autism? Okay? And so    Jayson Davies     my guess is a lot of times, and correct me, if I'm wrong, in California, a lot of times students don't get preschool paid for, or a free and appropriate education for preschool, unless they do have more involved difficulties with social skills, fine motor skills and whatnot, to be in that preschool for free. And is that kind of the case with you? Then, are these students a little bit more involved, have some more needs or higher needs?    Amanda Speights     Yes, my setting is considered intensive placement.    Jayson Davies     Gotcha. And so what can you get? Just paint us a picture of what the actual preschool looks like, not teletherapy wise, but just in general. What does it look like? How many kids, how many adults? What does it look look like? So    Amanda Speights     we have 145 preschoolers. Okay, so that's all children between the ages of three and five years old. And we have three OTs, three and a half because one of our speech therapist is part time. Speech language pathologists, two autism specialists, two behavior analysts and nurse. We have our director, our Associate Director, and 16 teachers. Oh, wow.    Jayson Davies     Okay, yes, okay. And so is you mentioned about 100 and what was it, 45 and are those students that all receive OT? Or is that all the preschoolers in general? Or are those numbers, those    Amanda Speights     are all the students that we have in the program in general? They don't all receive OT, but every classroom has an OT assigned that is acts as a consultant, so the teacher is receiving some ot education, some ot support. I    Jayson Davies     love that. Okay, and we're going to talk a little bit more about trainings and education a little bit later, but I want to continue on painting this picture. So the 140 550 kids or so, 16 teachers. We're talking about 10 kids per classroom or so. Uh, give or take, maybe a little request, give or take. Okay, and so you said that there's an OT kind of assigned to each classroom. That's awesome, yes. So how does that work? Then    Amanda Speights     that works because the OT we try to spread the kids out as far as when we're looking at placement in the classroom, so that not all of the kids that receive ot are just placed in in one class, and that way, when we're pushing in to service those kids, that's just kind of the push in model is that, you know, other kids benefit. And I think that's true, that even in in a less intensive setting, that that's that's what we would see in the gen ed population, that if there was a child that received ot in that classroom, just by way of the OT being there to service that child, we're going to notice something, and we're going to point it out, and we're going to educate the teacher so it really benefits all the kids in the classroom? Absolutely,    Jayson Davies     I agree. And so Are any of these classrooms, or any of them, like 5050, type of classrooms where there might be both students with autism as well as typical developing peers, or anything.    Amanda Speights     Or did, used to have a BPK program, but that we discontinued it. Okay?    Jayson Davies     You know what it's, it's, it's things that happen some places and don't happen in other places. And unfortunately, that's not something we have control of. But I just wanted to ask, because, like, what you just said, you know, ot can help all populations, and even if they're going in there, for the three students that are on the caseload, you're right, the other seven students, or however many students are in that classroom will absolutely benefit. So, yeah, all right, so we talked a little bit about the preschools that you work in and the populations that you work with. Another unique thing about preschools is that how students come to be referred for occupational therapy services. We have students that sometimes are almost in a way, sent into the preschool with ot because they had early intervention. We have some kids who are tested as soon as they're coming on because there might be concerns that the parent expresses. And then there's other students that we don't find until maybe they're four years old and they've already been in the program for a year or even older. You know, some kids we don't find out until they're in second grade, beyond preschool. But can you share with us a little bit about the referral process, how you find out about students? Maybe let's just start off with if a student's already in the program, and how might a referral look like    Amanda Speights     if they're already in the program, we proceed kind of with that RTI approach of implementing the whole group system, the small group, because, as I mentioned, the OT is already going into the classroom, probably for another student that has OT, yeah. And so we're educating the teacher, and we're giving suggestions and and we're making some modifications already and sometimes recommending specific individual strategies.     Jayson Davies     No, that's a great answer, and that's kind of what I'm doing right now, because I have a preschool similar setting. It's a public school, but it is. It's a classroom for students with moderate to severe autism, and so it's a one teacher, two other adults in the classroom, and right now, because it's the beginning of the year, there's only six or seven kids in there. I'm sure at some point during the year, might go up to nine or 10, but I kind of am in a similar situation, because just like you, I service three kids already in the classroom, and the teachers already asking for three more referrals to go through, and I'm doing an in class group. And so I'm trying to figure out at what point does it it's hard to ask this question, at what point do we do all these evaluations, or do we just kind of go the RTI route, where we just help everyone in the class and maybe not necessarily have an evaluation? And so have you ever had that kind of conversation with a teacher, maybe where they're trying to press a referral a little bit, and you're kind of like, well, we're already doing RTI. I'm already in the class a lot. Has that ever happened to you? And how do you kind of walk through it?     Amanda Speights     That has happened? Sometimes it seems as if the teacher just really wants ot to step in because they're nervous about addressing the skill, maybe they don't feel confident or competent to address the skill, and it can just be an educational opportunity for the teacher to show her you know how she really is doing this. Well, yeah, or and pointing out things. She is really doing well, or he is doing well. I think that sometimes the child just needs more exposure, yeah, explaining that, because especially in my setting, they're coming to me as their baby threes, they're just, yeah, they've just started school, so it's their first exposure to a formal educational setting. So that's something that I try to explain as well, is that they're they're really trying to adjust to, like, not missing mom and dad, right? So how can they focus on cutting or pre writing if they're just really wondering all day, where's Mommy?    Jayson Davies     Yeah, or even sitting in a chair for three minutes. I mean, right? A lot of times these kids haven't been asked to sit down for an extended period of time, and they've just been allowed to roam around the house or whatnot for the first three years of their life, and that's perfectly okay, but this is their first opportunity to be in school,    Amanda Speights     right? And that's the purpose of preschool, is to work on those skills of, can I sit down? Can I pay attention? Am I available for learning? Because as the child goes on, you the academics get more rigorous.    Jayson Davies     Absolutely, I like that. You brought that up because, again, like we've talked about, kind of a little bit earlier, things are so much different between preschool and once you get into kinder, first second grade, like you mentioned that it's really play based, and you're really focusing on that play to build the other skills. So I know we're getting a little bit off topic. We're on this referral topic, so I'm gonna drag myself back over here to this referral. We're gonna get a little bit more into occupations a little bit later, but so now you talked about how, and we've talked about how a student might be in the program, and you get that referral, you start with the RTI approach. At what point in that RTI approach do you say, okay, you know what? Let's go ahead with an evaluation.    Amanda Speights     I'm also looking to see in my setting. I'm looking to see like, the dynamics of the classroom and what's going on staff wise, and what's going on with the other kids, to see if you know this teacher really needs more support, that I really need to be physically present in the classroom more often.    Jayson Davies     Okay, okay, yeah, that makes sense. And whenever we do an evaluation, we should be taking into account those dynamics. How many adults are in there? What skills do those adults have, or what skills might they need? And again, I don't want to get ahead of myself. We're going to talk about evaluations. But what about child find? Do you participate in Child Find? Or is that something that you have to participate in, or is it really you're focusing on the kids once they're in that preschool?     Amanda Speights     I really focus on the kids once in a preschool, but some children do come to our program via Child Find, Okay,    Jayson Davies     fair enough. I know that's not an area that OTs really participate. There's there's another team that kind of, does that child find? And it's once they're in that preschool that we might really take on the roles. So right, understand that, I think that's kind of the extent of where referrals might come from. What about can you explain just a little bit about that process from an IFSP to an IEP? Just a little bit just an overview of what an IFSP might be, and bring that into an IEP. I know it's an individual family support plan, but how does that translate? Are you ever in those meetings that where a student is transitioning from an early intervention into a preschool setting, or does your or does the team have a specific team for that.     Amanda Speights     There's usually a specific team that sits in those transition meetings at times I might be called to what's called a staffing meeting when they've already been decided that they're going to be attending the program that I work at. Okay,    Jayson Davies     and even if a student has an IFSP, are they typically still evaluated even by the preschool OT, as they're transitioning from the IFSP to the preschool?    Amanda Speights     Yes, there's still a multidisciplinary team. Oddly enough, OT is not always included. I think sometimes, you know, someone has to raise a concern that they that's a red flag that ot needs to be included. But usually, when I see those multidisciplinary team evals that come through for the staffing, there is an OT included sometimes, well.    Jayson Davies     That's good. I know with our district, our preschools, the way that they decide whether or not ot should be included on that preschool evaluation, that initial evaluation is to look at the IFSP and see if ot was on there. If OT is on there, then yeah, they're going to go ahead with an evaluation for OT. But if it's not on there, then yeah, it really is up to either the team to look at documentation and if they see some, some. Delays within the activities of daily living, or fine motor skills to try and to basically ask for the OT evaluation. Or, really, I guess, the parent, and a lot of times, if this is a parent, say that their first, if this is their first student with a disability, they don't know what occupational therapy is, yeah, they're only three years into having this student that might have delays, and even then, maybe it's only been a year and a half that they've really understood that their student might have some delays or less time than that, and so I don't think they know to ask for OT, right, yeah, all right, so you talked a little bit just there about the multi team disciplinary evaluations, who all is on that team, and what are their roles and responsibilities on that team?    Amanda Speights     A lot of times, school psych and speech are kind of the default evaluators on that team, and then I'll see ot on there. If, like you said, ot was on the IFSP, or if the parents asked, yeah.     Jayson Davies     And you talked a little bit about having behavioral analysis or behavioral professionals on the team, I think earlier. Do they ever? Do you ever see them on that initial evaluation? Or is that more for a student that's been in the program and has shown some behavior difficulties.     Amanda Speights     It's usually for students that have been in the program and they might have a pbip when I would see your intervention program.     Jayson Davies     Yeah, gotcha. Okay, all right, so that's kind of a little bit about that referral process. Let's, let's dive into actually the evaluation. You know, what do you find to be the most common reason for an evaluation? Why are students being referred either right as they're coming in or by the teacher?    Amanda Speights     A lot of the times in preschool, I'm seeing pre writing, scissor skills and self regulation, for sure, because, like we were saying earlier, being able to sit down in a chair for three minutes can be hard our kiddos, and then specifically sensory related behaviors for my autistic kiddos.    Jayson Davies     Okay, and are you talking like related to stimming or hitting their head against something or I mean, I guess that kind of goes hand in hand with the self regulation.    Amanda Speights     Yeah, right, yeah. So some of it is some self stimulatory behavior, okay. And    Jayson Davies     you did talk about doing the SPM earlier, but what other tools are you using? And now I'm going to preface this with, obviously, things are completely different right now. Some tools are very difficult to use right now because we're on teletherapy. So let's go ahead and just imagine that things are back to normal. What evaluation tools do you typically use in your preschool assessments?    Amanda Speights     Well, for my county, we have a structured observation form. It's pretty lengthy and provides a pretty good deal of information. There's some yes, no questions, and there's some some rating of whether or not we think it's functional or emerging or or not present a specific skill. But what if I was looking to add a standardized assessment? I'm really loving the M fund right now,    Jayson Davies     the M fund as well, and I think it's great for the preschool populations, although I actually, when I was using the M fund, I was using it more with the K through two or K through three. It doesn't go up too high. So I didn't do the preschool part of the M Fund, which is a separate test in itself, right? There's the two books, yeah, exactly. So you have the book for preschool and then the book for K up explain what the M fund looks like for the preschoolers.    Amanda Speights     For the preschoolers, it has, you know, the same areas, and it comes with those observation checklists that I like for the classroom and the home. And then it goes through the neurological foundations reporting feature that shows all the different areas that really helps for intervention planning. And whenever I'm writing up my plans of care,    Jayson Davies     uh huh. And what are some of the actual tasks that that it asked the student to do? In them fun,    Amanda Speights     there's some folding tasks, there's some cutting there's like, balancing the ball on the spoon. I think that one's really fun and cool to try. And even some just like jumping and hopping in the gross motor section, yeah. And there's even some really cool, like the snack time game is really appropriate for preschool, because it's just going through having them, you know, try to open a water bottle and pour it out and pouring some crackers onto a napkin and seeing if they can manage it without spilling everywhere.    Jayson Davies     I'm not gonna lie, I always enjoyed the infant just because I got to eat some some goldfish. Yeah, but I. Um, no, I really liked, does the preschool version have, like, the little mazes that the older one does? It's like a little maze.    Amanda Speights     It does, but they're just very simplified, yeah, yeah.     Jayson Davies     And then I remember there was also some visual perceptual activities, like find the dog or find the airplane. I think that one's in there too, yeah, yeah, yes. So it's a very functional evaluation. That's what I really like it, is it? It's very much based on skills that the student is doing in the classroom. And so I really like that. A lot of like you've said, even that snack time, I feel like every time I go into my preschool classroom, they're always in snack time. I don't know why, but they're always eating. I feel like it's either eating or singing, yes, but you mentioned the neurological foundations part of the M fund. Can you explain that? Just a little bit more in detail, the neurological evaluation or foundations part of that,    Amanda Speights     right? So the M fund has three different things. It looks at it looks at. It looks at performance, it looks at participation. And like you said, the neurological foundations and the ones that I'm usually looking at are like the hand function, postural abilities, executive functions are really good ones, because we're looking at sustained attention. That's something that kiddos need to be able to be available for learning, like we talked about, and participation, and then even that non motor visual perception for, you know, scanning to find the dog or the bunny on that page.    Jayson Davies     Yeah. And can you briefly explain, like, how you go from looking at a child's work? How does the infant work? Where it goes from you have, you have the booklet that the child actually completed. They did the maze, they found the dog. How do you go from that over to the neurological foundations? If you can explain that briefly, well,    Amanda Speights     it just tells you that there's some different ways to score it by how many times they may have gone outside the boundaries of the maze, or if they touched a cat when they should have touched the dog, just to tell you that when they were supposed to be looking and scanning for the dog on the page, or even if they're supposed to be copying something, how many errors they made similar to any other test. It's just that the way it interprets it is by giving us an indication that a specific skill might be at risk. Yeah,    Jayson Davies     as I asked that question, I realized how difficult that is to answer, right?    Amanda Speights     It Yeah, it kind of it doesn't translate into a number. It translates it into an interpretation.    Jayson Davies     Yeah, because, as I'm thinking about it, it really you do get a score, or a standardized score, but that goes on the front page, and then you turn the booklet, and then you have this neurological foundations page, right? And it's really based upon kind of the individual score per task, right? Yeah. So if they got a zero, I think, or something or one. Then you go through this chart and you circle task number six, they scored a one on and task number six just happens to fall under the using appropriate pencil grasp or something like that, right,    Amanda Speights     right? Or bilateral integration, or sustained attention, or Yeah,    Jayson Davies     and that's what I really like about that evaluation, because it doesn't just give you a this student's performing at a 3.4 level, three years, four months level, but it actually tells you why they're performing at a 3.4 month level. It's because they scored low on that bilateral coordination specific activity, or they scored low on that fine motor pencil grasp activity or whatnot. And so that's why I find it really helpful. Do you have any other like things that you just really like about the M fund? I    Amanda Speights     think just those forms that I said about that, the observation forms for the classroom and home. Oh yeah. I like getting a good I like getting a good picture of what's going on across settings, because then I can know, is it really the skill, or is it the context? It could be the environment.    Jayson Davies     Yeah. And so you're kind of talking about all those different areas. So I'm going to ask you this question, then, is just paint us a picture of what your evaluation looks like. And I understand, again, things are completely different right now, but let's go based upon back to regular life. How are you What does your evaluation include, and what does it look like?     Amanda Speights     Our evaluations have different domains that we look at. So I know    Jayson Davies     you mentioned the you said that your county has some form of, like a checklist or structured observations that you go through, and then where do you move on? Is that the first thing you do? Or is there something you do before that? Or    Amanda Speights     that's where I start. I start with. I start. With what the county gives me to look at. So, looking at their learning environment, looking at self help skills, fine and visual motor, sensory processing, some, you know, gross motor and school related ADLs    Jayson Davies     and then. So from there, where do you go? After you've got that standardized or not standardized, sorry, that structured observations done. Where do you go from there?    Amanda Speights     Then I would look for an appropriate standardized evaluation. Since, as we talked about, my students can be a little bit more involved and and require a little bit more support, it's it might not always be appropriate to use that standardized test. Okay, so that's why the SPM, or sensory profile is is really good, since a lot of my kids do have sensory needs,    Jayson Davies     yes, and that is something obviously that the adults are able to do so just about any that's one that you can use on almost any student, because it's not actually the student completing it, it's the adult in the life of the of the child. Do you use both the classroom and the home form? Or do you tend to use just the classroom form?    Amanda Speights     I tend to use just the classroom form unless there is really a concern with it being very different. If the parents have reported something different, then I'd want to get more information and use the home form. And then, of course, right now, we can't use the school form exactly. You have to use the home form    Jayson Davies     exactly. Yeah, and I'm right there with you. I usually do the classroom form, but right now, obviously, we can't really do the classroom form, and so I'm only using the home form. So we talked about the SPM, the sensory profile, one of the other usually, and we talked about a little bit, the M fun. Are there other assessment tools that you might use?    Amanda Speights     I have used the VMI sometimes. That's a hard one with the preschoolers. That can be a hard one, but that's if I'm really looking like at a purely visual motor. And that's it like that. That's the only thing that the kiddo is really presenting difficulty with. Then I'll use the BMI.    Jayson Davies     Are you typically just doing the motor aspect of it, or do you also use the visual, visual perceptual part.    Amanda Speights     of it both? Yeah,    Jayson Davies     yeah. Do you do the motor coordination one as well. I think that's the is that the tan one where they have to stay within the lines.    Amanda Speights     Yeah, but those are usually really hard.    Jayson Davies     Agreed, agreed. The only other assessment that I know a lot of OTs that that work in that setting and the preschool setting, use might be as the Peabody. Do you ever use the Peabody?    Amanda Speights     I haven't, actually, I, I don't know. I think I just, I kind of got over the Peabody, and maybe that's why I liked I was really excited about the M fund when I found it, because it seems simple enough, like you said, there's the two books and and the younger book is much simpler than the older book. I actually do notice there's actually a pretty big jump in skills needed to complete, yeah, the older book than the younger book. So if I can definitely catch them when they're within the range for that younger book, it's a really great assessment for me.    Jayson Davies     Yeah, I think I'm gonna have to advocate for our district getting the M fund, because we use the Peabody for the most part for our preschool evaluations. And you know, don't get me wrong, the Peabody is a great tool, and I think they're working on the newest version of it. Don't quote me on that, but it's very much. I mean, yeah, it looks at skills that you need, such as crumbling paper, cutting across a page, staying on a line, but it's hard to administer just the way that it's broken up. I find it difficult to administer, and I don't find it very purposeful for the student. Versus the M fund looks like a coloring book. It looks like this nice, fun activity, and the student is just so much more engaged. I feel like there's more flow to it.     Amanda Speights     It's those isolated motor tasks. Yes, right? That's true too. Yeah, it doesn't make sense. It's like, here, do this, here, do this, here, do this. Like, why?    Jayson Davies     Yeah, why are we cutting a line? Like, versus in the M fun, it might be cut out this line to make a fish or something like that.     Amanda Speights     So folding the folding with the owl, you fold it to make the puppy for the Yeah, the puppy and the owl for the older one.     Jayson Davies     Okay, oh man, yeah, bringing back memories. Okay. So yeah, no, that's why I really, actually, I like the M fun. I mean, it's called functional. I mean, it has the word functional in the actual assessment title. And I really think that it absolutely is functional. So I really do like the M fund. All right, so we talked about the SPM, just review. Recap, real quick, SPM, sensory profile. We didn't really go over. Those too much. I don't think we need to go over those that much. They're both questionnaires that look at sensory perceptions from the adults perception, either or the adults observation, either the teacher or the parent. We talked about the M fund, talked about the Peabody, and touched upon the VMI as well, although at the same time as we were going over this, it sounded like you may not always use standardized assessments. Is that true? That's    Amanda Speights     true. All right, I don't have to use a standardized assessment, but it's, it's just my preference, at times, to get more information and just justify, you know, the need for services. I think it's really helpful.     Jayson Davies     Yeah, I agree. I mean, I don't know. I feel like there's almost like this split between occupational therapists. There's like, you have the 50% of occupational therapist, I don't know. I'm just making out numbers here. But you have OTs who feel like, yes, every assessment needs a standardized evaluation. And then you have the other subset of OTs who say, No, functional assessments are good. We don't need standardized evaluations. And I'm not here to argue one way or the other. But what would you say like during your evaluation process? What kind of goes through your head as to whether or not you feel like you need that standardized assessment? Right?    Amanda Speights     If there's a question on the team, if maybe, you know, the evaluation was was requested by a specific team member, and maybe other members on the team are not so sure. I think the evaluation helped. Those standardized evaluations help to give a better picture of, oh, actually, they are performing more on level than we thought, or because I think that there's, there's just an increase in expectations, even at the preschool level. It's just, I don't know if there, there's an expectation that they should be writing sentences or something by the time they're in preschool, but it's a little much at times, so I think that it backs me up as an OT to have my standardized assessment Absolutely.    Jayson Davies     And I think that is, I don't think it's a conscious decision that we make, but you're right. It helps. And I think when you've had that standardized evaluation, and you walk in and you have that data, then numbers sometimes speak louder than several paragraphs of narrative or a chart that says a student can do this or can't do that. I think that that number that says your student is in the average range, or your student is not in the average range, it just is easy to comprehend for people that may not be able to have the same lens that we have, right? And I think it's easier for others to understand the numbers or average, not average. So yeah, all right, I want to wrap up evaluations here. We talked about structured observations. We talked about standardized assessments. Is there anything else that you're doing? I'm sure you're doing interviews and whatnot. But after you wrap up your standardized assessments, is there anything else you really do, or you're writing up the report, obviously, right, right?    Amanda Speights     And then we're inserting that report into the IEP, usually under one of the four domains of our IEP,    Jayson Davies     under one of the four domains explain that, right?     Amanda Speights     So our IEP formats are curriculum and instruction, social, emotional and behavior, independent functioning and communication and oftentimes, ot will be found under that independent functioning section.    Jayson Davies     Gotcha, okay, independent functioning, that's a good place to for it to be, of course. All right, so that's interesting. I don't think every I don't think every IEP is laid out like that, and so that's interesting to see how exactly yours is set up. Okay, so then let's talk about, after you got this evaluation, you think that a student qualifies, what are some of the most common types of goals that you're writing you talked earlier about play. What type of goals are you writing for these students in preschool?    Amanda Speights     A lot of times we're we're trying to help them access their school environment. So it could be goals for self help skills and being able to be more independent with a functional routine, like arrival routines, or even the bathroom or the hand washing routines. I'll be writing goals, or being tagged on goals, because we try to really make it a collaborative thing that I've really been working on that like not going in and not writing the goal like really having my teacher tell me, okay, what is it that you need your student to do in order to participate in class? And I'm going to help you shape it into a goal that makes sense for you to take data on, because ultimately they're going to be taking the most data on that goal. And it needs to make sense for them.    Jayson Davies     Absolutely. I really like that you brought that up that was actually going to be my next question is whether or not you're writing ot specific goals or more collaborative type of goals. And I think that is so important to be writing collaborative goals, because almost like what we were talking about with the Peabody versus the M fund. Does it really matter if we can hand a student a piece of paper and, say, cut this paper across the line, or does it matter when we can give them a picture to cut out and they're actually able to cut out that picture and then paste it and color it? I mean, that's what we're really looking for, right? That functional skills. And we don't want to have just an isolated skill per se, we want them functioning in the classroom. So how does that work? Then, when you say, You know what, we need a collaborative goal, how do you go about that communication process to make it happen?    Amanda Speights     Luckily, I've had a lot of success. I'm not going to not going to lie. I've had a lot of success in this area, my teachers are really great, and they're really, really open to learning, and they really want to learn, to write better goals and to serve their students better. I think it's probably that being on that university campus, a lot of our staff might be students themselves. Maybe they're they're thinking about going into ot school or going to school to be a speech therapist or behavior analyst. Gotcha. So they are definitely very motivated to do that. And we'll just sit down and talk about, okay, well, what? What is the student doing for you in the classroom? What are they able to perform and demonstrate for me in an assessment or in an OT session? And how can we get those to match up? Yeah, absolutely.    Jayson Davies     All right. And so once we have our goals, then we OT, we obviously have to start with our services. And so we'll get into maybe a few of the specifics about types of services that you provide. But first, just give us an overview of what services you might put on an IEP and or provide for a preschool student.    Amanda Speights     It would just on the IEP, it would look probably similar to any other IEP where it just it says occupational therapy, you know, a certain number of minutes, one to two times per week.    Jayson Davies     Do you have to break it down to say whether or not those services will be individual or group?    Amanda Speights     Usually, I think we're able to indicate that on our plan of care if it will be individual group or a combination of both. Typically, I choose a combination of both because I provide push in and pull out services depending on the student's needs.    Jayson Davies     Yeah, and that's great. I only ask because, again, IEPs are different in every single state. Every single district does it slightly different, especially County and I know some districts, some states, they don't want you to put individual or group. They want you to put one of the other. And if you want to do individual and group, then you need to have two different services, one to say individual, one to say group. And so that's why I asked, just because it is different depending on where you are. So yeah, I know it's, it's something that I've learned specifically only because of this podcast and talking to OTs in areas across the world there. I mean, yeah, everyone does it a little bit different. So you do both individual and and groups. When you're doing groups, are these pull out groups or, well, again, trying to get away from this zoom idea right now, typically, if you're doing an individual, are you going into the classroom or pull out? And same thing with groups. Are you doing like centers in the classroom, whole groups in the classroom, or are you pulling a few students out?    Amanda Speights     I'm usually doing centers in the classroom, or I'm going on the playground. I'm pushing into gym class or music wherever I can figure out that I can get in there and work on one of those goals that I'm attached to?    Jayson Davies     Yeah, definitely. And so I want to challenge you just a little bit here is what planning goes into making that actually work. Because I know, and I think most OTs know, if you work in a school, you can't just pop into a classroom and things are just going to go great. It takes a little bit of planning. So    Amanda Speights     how does take it? Does take a lot of planning. Well, yeah, I have to coordinate with the teacher to see if, if, if we're going to co teach, or if I'm just going to be, I'm just going to be the support, you know, while she's teaching, and I'm just going to be, you know, trying to keep everybody in the area and trying to keep everybody on task. Or am I going to be teaching and the staff is going to be keeping everybody on task? Yeah, and so, and then helping to design the activity, especially for gym, oh, for Jim,    Jayson Davies     you go, you get some sensory. I love Jim. I love I don't know if you guys have a PE teachers. We have adaptive physical education teachers. They are my best friend. I've worked    Amanda Speights     with some great ones in the past, but we don't currently have them, so it's almost like we're it. Yeah,    Jayson Davies     no, I love it, because they do so much bilateral coordination, and they don't even know it. They do so much sensory stuff, as far as, like, motor planning and whatnot, and they don't even necessarily know it until we tell them, like, everything you're doing is sensory integration in a way, like they're doing so much crossing midline, using both sides of their body. It's just amazing how much work that they do that isn't just going to help the students physical activity, but also going to help them in the classroom. So I really, I really appreciate AP teachers, but that's cool. You get to do some of that a little bit. Then during gym, yeah, I get to do a little bit. And so when you're planning for centers, do you come in with your own activity? Do you just try and figure out what the theme of the week is? Are you taking a teacher's activity and modifying it? And how do you typically do your centers? Our    Amanda Speights     school is fairly structured, and I think that that's just the nature of our program. Because of the nature of, you know, the students that we serve. A lot of things are very structured. So we actually have a full calendar of what's the letter of the week? What's the core Word of the Week? Like it's planned out and our teachers, the OTs, direct the Handwriting Without Tears program. So that's one of the trainings that we provide to teachers, is on pre writing activities and incorporating Handwriting Without Tears, and they just follow a schedule that we give them for the whole year where they start with big line, then little line, and they might even repeat a couple throughout the but they follow a certain sequence that we've given them. Wait,    Jayson Davies     you said that We given them, yeah? Like they're following your guidelines for using the handwriting without tears, curriculum, yes, oh my gosh, that's amazing. I love that. I love that. And, you know, I think I want to pause, I want to talk about that, because that is not something that happens overnight, that is not something that's something that    Amanda Speights     has been built into the program, and it's, and that's why we're a model program, is that we try to show that okay, this is how it can be done, or how we how we would like it to be done, so in a way that we think is evidence based and effective.    Jayson Davies     Yeah, so you've been at the How long have you been with the current    Amanda Speights     program? Yeah, like four years, six months. Yeah, almost five years has,    Jayson Davies     has the Handwriting Without Tears program been there since you got there? Yes, okay, so you didn't go through the whole process of it being implemented. Have you by chance, like, just heard any stories about, like, how Handwriting Without Tears got implemented? Or was it in there from day one that you know of or you're unsure.    Amanda Speights     I'm unsure if it was in there from day one, but I know it has been in the program for quite some time. There's an OT that that's been with the program for 10 years, and she said that it's been there, always been there. It's always been there. Okay,    Jayson Davies     I just wonder, because, like I said, that's not something that happens overnight, and it's, I think it's difficult sometimes for OTs to implement some things like that. There's so many different barriers in place, whether it's because you're at a school for two years and then your district decides to move you to another school site, and you just don't have the time to build that rapport with teachers or whatnot, or the cost,    Amanda Speights     yeah, or the cost, because we end up being so. Part of us administering and directing this program is we have to manage the materials. We have to make sure. We have to go into the classroom and make sure that all the big lines and little lines and all the materials are there. We need to take inventory if, if something's missing, we need to report that to administration to be purchased. We need to wait to see what the budget looks like, to see if we can purchase it. So it does take quite a bit of coordination, and    Jayson Davies     not to mention just time in general, because a lot of districts are still working on this. I just the word coming to my head is arcade, archaic, like this old prehistoric version of a caseload where they just wanted to see students individually from 830 to 330 and that doesn't give you time to do something like this. You don't have the time to put a plan together. You don't have time to put an order together. You don't have time to get into a classroom without the purpose to work specifically with one student, and that is something that needs to be built into our time, right?    Amanda Speights     It's that workload approach that has been talked about so much. Yeah, yeah.    Jayson Davies     We're gonna have to talk more about workload in the future. There's a lot of there's actually a new article that just came out, and so I'll probably have to talk a little. Bit more about that in the future. All right, so I was actually going to ask you if you do trainings or in services, but you kind of already alluded to that, that you do, so share with us maybe just some of the in services you you provided and who you're providing those to.    Amanda Speights     Yes. So as I mentioned, we provided training on pre writing, including the use of Handwriting Without Tears. We talk about school related ADLs, and when we discuss sensory processing, we actually had teachers complete adult sensory profiles to kind of reinforce that the sensory differences are part of human experience. So that was really cool. I try to get I've been trying to get more creative in my trainings and use some different ways to help the information be relatable to the audience, because it can kind of come off as a bunch of OT jargon, right? And they think it's just ot magic like and that's why I think sometimes we might have some resistance on completing those evaluations or making sure that a child gets ot services. It's because it's still so mystical and magical to some people. What we do? Yes,    Jayson Davies     we're just gonna come in and that student is now just gonna sit for 10 minutes without Right? Any any supports. You know that students just gonna    Amanda Speights     be great, right? And that's probably what contributes to the insane caseloads. If we got it across to districts and teachers, that some of this stuff can be done by teachers, and it's just with our support, with our consultation with us as a coach, instead of us needing to be in the classroom every week for 30 minutes or 60 minutes, yeah, yeah.    Jayson Davies     And I think that is something that, you know, we provide a lot of in services to to teachers. But I think the other aspect is also in services, you know, we need to make sure that we invite our administrators and make sure that they're there as well. Have try and just invite them and hopefully they'll show up. Because I think they, while teachers may not completely understand OT, I don't think all the administrators do either. In fact, I've had an administrator tell me that OT is the hardest part of their job to, like, manage, because they don't truly understand OT. And I'm like, well, please just come talk to me about it. Like, come to my in services, like, I'm willing to let you know, and I'm willing to help you out understanding OT. So I think, I    Amanda Speights     think a ot a has some resources on that. On, yeah, on the website, there is, like, some    Jayson Davies     kind of manage OTs or something like that. Yeah,    Amanda Speights     there's an info sheet for school administrators. So maybe, like printing that out and flipping it in their mailbox or printing it out and when the next time you meet with them, when they do come to talk to you about it, you could just give that to them as a reminder to reference I just    Jayson Davies     got the idea of creating, like an anonymous email and just sending it to them from an anonymous email. Anyways, all right, so anything else about in services, or do you ever provide trainings for parents? Or is it primarily for employees? Yes,    Amanda Speights     actually, and we did through this whole kind of pandemic and the zoom, we were able to set up something for the parents in the spring as a service, we were providing support group for parents. Oh, wow, the OTs. We did a couple of in services on, I think we went over fine motor sensory sleep. Sleep was one that I was really interested in, and I thought that was really relevant for the time. So I got with one of the professors from the academic department and got some resources together, and we talked about sleep for one of our support groups.    Jayson Davies     That's really cool. I just want to highlight that aspect of your job, because you're working for a university, the aspect that you can kind of collaborate, not just with people who work in clinical practice, but also the academia side of it, and being able to work with them, that's really cool. I like that, all right. So let's finish up here. I want to talk about one last thing, and that is that transition from preschool to kindergarten. And I want to first ask you about where, what? What are the teachers expectations for preschoolers, or what is society's expectations you feel like for preschoolers? Where do preschoolers need to be when they're transitioning?    Amanda Speights     I think they're expecting them to be able to sit and attend for 20 minutes. That's a long time. It's long time. I don't I don't know if I always agree. I'm a fan of dynamic seating. I'm a fan of movement, infusing movement into the classroom and more interactive lessons. Instead of sitting down, as a society, we probably sit too much. Much. I think I've been sitting quite a bit now. I've been working from home, and I don't know why we're in a in a rush to make our kids sit down, like, let's keep them active for as long as we can. Yeah, no    Jayson Davies     joke. And then so let's just go over two areas. You mentioned earlier that the three main areas of referral were that self regulation, being able to kind of attend activities. And then you also mentioned writing and cutting. And so let's just cover writing and cutting real quick. Where do you think your preschool teachers or kindergarten teachers, as they're coming into kindergarten, are expecting these students to be at with writing.    Amanda Speights     They're expecting? I know, I know, by the end of kindergarten, they're wanting at least a sentence to be written. Wow. So going into coming out of preschool, they're wanting at least that name. They're wanting the kid to be but what if you have a really long last name? Really challenging. for kids, those poor kids, so and then with cutting, I think they're wanting them to cut out shapes, or they're wanting them to be able to cut, to do craft, so to be cutting out multiple, you know, irregular shapes. But that that might not be realistic, especially sometimes they're just handing them those thin floppy pieces of paper, right? And it's huge, the huge, thin floppy paper. And I'm like, oh my goodness, the largest    Jayson Davies     piece of construction paper they can find. Yeah, yeah, I get it. All right. So that's kind of the three areas. I think you're right about that. All right. So last thing, how does the transition work? For you guys, when a student is ready to go from preschool to kindergarten.     Amanda Speights     We're not required to evaluate, even though some students may be going through that process of, yeah, they might need an evaluation if they came in as developmental delay, right? And they're they're nearing that time where they're needing to kind of figure out a different eligibility, right, once that's more appropriate or more specific to what's actually going on. So school psych might be called in to do that, and sometimes, on a case by case basis, I've been asked just at the request of the parents for the purpose of educational planning. Maybe they really want, they really want those numbers, like we talked about earlier, that they just it's easier for them to understand the numbers sometimes. And if, and if it's such a hard time for parents, I feel like so it's a big transition, they're already just very nervous and and why not go ahead and and help them out, if we can. Yeah.    Jayson Davies     And so you mentioned earlier that this is like a model preschool program. When the kids are transitioning into kindergarten, are they going to a whole new school, or does the program that you're in also have that kindergarten program.    Amanda Speights     They are going to a whole new school? So yeah. So then there really can run high,    Jayson Davies     okay? And so that makes it difficult for you guys to even collaborate with maybe the kindergarten OT or the kindergarten teachers, because it's a whole new system,    Amanda Speights     right? We usually write some transition summaries, and we're responsible for letting the county know any equipment. So if we have any equipment on our plan of care, anything that we've recommended, anything that we've been using with the child, we're responsible for communicating that to the county so that they know to order that. And usually we've been told that it works out that they usually do have the items ready if we put it in because it's, it's at the end of the school year. Yeah, so they've had, they usually have the whole summer to get everything together. Hey, you    Jayson Davies     know, some districts are on it. Others not so much. So that's good to hear that the district is on it. Good to know. So, Alrighty, well, I think that's gonna wrap up today. Do you have any contact information or any if someone wants to reach out to you, or would you like to share your email or any information? Sure    Amanda Speights     you can actually find me at Amanda the OT com, and that's probably where you could find all the different links to like my LinkedIn and all of that good stuff. If you want to contact me and or email me something    Jayson Davies     great, Amanda the OT. And that is Amanda Speights, right? Did I say that last name correctly? You did awesome. Amanda spades, and she is at Amanda the ot.com check it out. And yeah, if you do have any questions for her, I'm sure there is a contact page over there or whatnot. So thank you so much, Amanda for coming on the show. Really appreciate you being here, and thank you for talking preschool with us. Great. Thank you for having me. Thank you so much. Bye bye, bye bye. All right. Well, that's gonna wrap up episode 58 again. A huge thank you to Amanda for coming on the show. From Amanda the ot.com I really appreciated what. Was talking about, as far as the evaluations go, and then how they just have this area where occupational therapy just fits right in one of those four areas that focuses on independence within the IEP. Super cool. I like how that just turns into having collaborative goals and then collaborative services. One last thing before I let you go, remember Check out my instagram at ot school house on Instagram for some fun content, some reels, some other posts and some treatment ideas. All right, until next time, my name is Jayson Davies. I will see you later. 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

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for the Episode 57 of the OT Schoolhouse Podcast. In this second episode of the 2-part teletherapy series, I discuss the pros and cons of the most popular telehealth platforms being used by public schools districts and some tips on how to use both Google Meet and Zoom. I then go into what a school-based occupational therapy evaluation may look like through a telehealth model. We will look at what assessments tools may or may not be possible. And finally, in the end, we will discuss ethics as they relate to telehealth and how to ensure that you are providing equitable services. View the first episode in this teletherapy series at otschoolhouse.com/episode56 Earn a certificate for 2 hours of professional development by listening to episodes 56 & 57 and purchasing the Professional Development Podcast Course! Links to Show References: Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: Designing a user-experience. Work. 2019;62(1):125-131. doi:10.3233/WOR-182847 Telehealth in Occupational Therapy . Am J Occup Ther 2018;72(Supplement_2):7212410059. https://doi.org/10.5014/ajot.2018.72S219 AOTA Back to School Resource page Criss M. J. (2013). School-based telerehabilitation in occupational therapy: using telerehabilitation technologies to promote improvements in student performance. International journal of telerehabilitation, 5(1), 39–46. https://doi.org/10.5195/ijt.2013.6115 Sarsak HI. Telerehabilitation services: a successful paradigm for occupational therapy clinical services? . Int Phys Med Rehab J. 2020;5(2):93?98. DOI: 10.15406/ipmrj.2020.05.00237 Osmo attachment for the iPad (turn your iPad into a document camera) (Link supports the OT School House Podcast) 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 57! 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 there, and welcome back to this two part series on telehealth. This is episode number 57 of the OT school house podcast. And my name is Jayson Davies. Thank you so much for being here as we get started. Well, not really started. We're continuing down the route of looking at teletherapy in schools. If you haven't already checked out episode 56 of the OT school house podcast, definitely check out that one, either right now or after you listen to this episode. In that episode, Episode 56 we talk about guidelines, practice and research, and in this episode, we're going to continue on to talk about platforms, evaluations and ethics related to occupational therapy in the schools and teletherapy. And just a quick reminder that you can earn two hours of professional development for listening to Episode 56 and this episode, Episode 57 on teletherapy in school based occupational therapy by heading on over to OT schoolhouse.com forward slash episode 56 or ot  schoolhouse.com/episode 57 there you will see a link in order to purchase and complete the professional development quiz that goes along with these two episodes. Pretty easy way to earn some professional development while you're driving from one school to the other, or just listening to the podcast while you write up your evaluation. So check it out if you would like to earn some professional development for listening to a podcast that you've already listened to. All right, let's go ahead cue the Introduction music, and when we come back, we'll dive into the content.    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     All right, and welcome back to the OT school house Podcast, episode number 57 you know, I realized as that Introduction music was going on that I forgot to let you all know that when you do purchase the episode 56 and 57 teletherapy, professional development podcast opportunity, you will also receive the slideshow that I have put together that goes along with these two episodes. So not only will you have had listened to the audio portion of the podcast and got in all that information, but you're also going to have the slideshow notes that go along with that, so keep that for your own records. It makes it really easy to just go back and reference what I said throughout this episode. So go ahead, check it out. It is@otschoolhouse.com forward slash episode 57 and you will see the link right there for you. Okay, so as I was reviewing episode 56 just to you know, make sure I had everything and that I wasn't going to repeat myself in this episode. And also, as I was writing up the outline for this episode, a few things occurred to me, and the first is that this professional development, or even just this podcast in general, is very different from most podcasts or most professional developments that we might listen to a lot of times. We pick out a professional development opportunity based upon what we hope to need in the future, or what we hope to be able to do when the school year starts, or maybe even further out, or maybe we're looking into a new job, and we want to know how to hop into that new field seamlessly. But in this case, this is different, because this isn't something that we're really desiring to do a lot of us? Yeah, maybe a few of us are actually going to seek out a an online position with a company that does teletherapy. But for the most part, if you're listening to this episode, you are listening to it because you need it right now. You are being thrown into a teletherapy model that you never thought you would have been in, I don't know, only eight months ago, right? And so it's a little bit different this type of professional development opportunity. And now the other thing that I realized is that I didn't really introduce myself in Episode 56 and what's nice about the podcast is that oftentimes I don't need to introduce myself because you've listened to episodes whatever before, some of you have listened to all 56 episodes, and so you have gotten to know me a little bit. But for those of you who haven't listened to all 56 episodes, or maybe this is only your second episode that you're listening to because you really wanted to dive into teletherapy, and your friend told you about this episode. Well, my name is Jayson Davies and I am the content creator, the CEO, whatever you want to call it, behind ot school house and Schoolhouse Education LLC. Yes, it is now an LLC. But anyways, I have been a school based occupational therapist for eight years now, all in Southern California. I have had the. Opportunity to be a contracted school based therapist for a district, and I've also been a quote, unquote lead occupational therapist in a small district where I actually developed their occupational therapy program from the ground up. Now I currently moved a little bit closer to home. I was driving about an hour and a half to work every day, so now I took an opportunity that's much closer to work, where I have worked now for the past two years, and I'm a school based occupational therapist every day. I do have this podcast. I do have a course all on school based OT, but I am truly a school based occupational therapist, just like most of you listening are, and so I've gone through these experiences right there with you since March 13, or whatever it might be for, for when your school stopped everything. I've been there, and we've been going through this together. We've had several episodes where we've talked about this. We've had other occupational therapists on the podcast, and we've talked about how schools are coming back together. Just a little more about myself. I am a thesis advisor for students at a local university, as well as being a school based occupational therapist and creating this podcast for school based occupational therapist. And I also have had the chance to both help the Occupational Therapy Association of California set up a conference about school based occupational therapy, and I've also had the chance to speak at a few of the conferences for the Occupational Therapy Association of California, also known as OT. Now that brings me to talk a little bit, just a tad, about the OT school house and the OT school house podcast. The OT school house was originally founded by myself and a colleague, Abby piranha, who we just thought that there needed to be a website for school based occupational therapist, and subsequently, we thought there needed to be a podcast for school based OTs. So as this episode is being released, we are actually celebrating the third year of the OT School House website, and we're about two and a half years into the OT school house podcast, so that's pretty awesome, and I'm so excited to just share all of this, because, I mean, we've come a long ways, and we now have a huge community of school based occupational therapists that listen to this podcast, that support each other on Facebook that take courses together and listen to podcasts together. So just want to say thank you to all of you for making this even possible. And I am so happy that that we're able to come together and just share our experiences together and and fight through especially this COVID 19 pandemic school year that is just about to get started. So what makes me qualified to then talk about teletherapy? I mean, I am a school based occupational therapist. Traditionally, I do work in the schools, just like most of you do, and I am not a specialist in providing teletherapy services. However, with that said, I have gone out of my way to look up research about school based occupational therapy and teletherapy in general. I've also gone and taken courses, both live and recorded courses, both before and during this COVID 19 pandemic, on what teletherapy could potentially look like and how evaluations could potentially occur throughout the teletherapy world, or teletherapy platform, whatever you are using. And so that's why I do feel like it's important to have this conversation. And I do feel like between the conferences that I attended prior the research that I have done since March 13 and the experiences that I've had since March 13, I feel like these experiences do provide me the experience to help you, and I hope that you really do find this podcast as helpful as well as episode 56 All right, so now we're going to go ahead and dive into our content that we're really trying to get through today, and so I'm going to just, and I'm going to start off by sharing with you really quickly, the three overarching goals for today. And those three goals are to review both platforms and the hardware that make providing services over a teletherapy model a little bit easier. We're going to talk about some of the pros and the cons. We're also going to go over evaluations and what that might look like through a teletherapy lens. And then finally, we are going to cover ethics. And these ethics principles that we're going to be talking about are directly related to teletherapy. Of course, there's so much to go over with ethics, and it's been on my to do list to create an entire episode just on ethics, but today we're going to focus on teletherapy ethics. All right, so let's go ahead and get started with talking about some of the platforms that are commonly used, as well as some helpful hardware that might help you get through this this time. So when it comes to different platforms that we may use for teletherapy, I know that. There are several out there. However, the two big ones appear to be zoom and Google meet. And yes, it's weird to say Google meet, and that's actually what it's called. There's no s at the end, but it does sound it sounds interesting to say it should be Google meets. In my opinion, names aside, both zoom and Google meets have their pros and their cons. I would argue that Zoom has more pros than cons when it comes in comparison to Google meet. However, as district employees, as most of us are, or as contracted employees working for a district, we often need to follow the policy that is set in place by that school district, and so we may be mandated or directed to use one or the other. So I'm going to go ahead a little bit over both of the pros and cons, and then give you a few extra tips beyond that. Okay, so let's go ahead and start with some of the pros for both zoom and Google meets. See I added the s on meet that time. Anyways, let's start with Zoom. One of the biggest pros of zoom is the ease of sharing your screen, your browser, a document, camera, or even an iPad, if you have one, it's very simple. There's a big green button right at the bottom. You hit that big green button and all the options appear to you. And when it comes to Google meet, they have a similar type of feature. You hit a button down at the bottom and it gives you some options, but there's just not quite as many options. You don't have the ability to just really quickly say, I want to share my iPad screen, or say you have a document camera. Same thing. You can't just share a second camera and so that your students can see both you and whatever your document camera is showing. It's just not that simple like it is with Zoom. Another potential Pro for using Zoom is the remote mouse control. And before I go on about what this is, note that if you or your students are using a Chromebook, they might not be able to use this feature, but what this is, is this is a feature where you can basically give the student you're working with on the other end of the internet at their own house, the ability to control your mouse. So say, you're using a PowerPoint slide deck or a Google slide deck, and you want them to be able to move things around on your screen? Well, if you're on a MacBook and they're on a MacBook, or if you're on an HP and they're on an actual HP, not a Chromebook, you could do that, but because they're on a Chromebook, they might not have that capability. So just be mindful, if you're trying to figure out why this feature isn't working and you're using zoom, it's likely because they're on a Chromebook and don't have that ability to do that. Another positive note for zoom is the ability to be easily set up with two monitors, meaning that you have your primary monitor, that is your laptop or or your desktop screen, but then you have a second screen attached to the computer. Zoom has a setting that is designed for having dual monitors. And when you do this, it makes it really easy to see your students all in grid mode on one screen. And then you can reserve your second screen as your your workspace, where you can bring up a website that you want to show, or you can have that showing your document camera, so that you can see what your hand is doing, or what they're seeing your hand do, at least on the screen, and then also see what they are doing. Now this next one I'm going to share with you is probably the biggest pro that I have found for zoom over Google meet, and that is the ability to have a waiting room. So in zoom if you've ever been on a zoom call or a Zoom meeting, Zoom webinar, you know that when you go in, oftentimes you'll see the screen saying, Please hold on. Shortly, the administrator will let you in, and that is when you are in the waiting room. Well, with Google meet right now, they don't have the waiting room aspect. And so what happens is, when I'm finishing up with Johnny at 129 about to finish at 130 and Samantha's about to come in at 130 well, sometimes Samantha and her parents show up at 129 and right as I'm finishing up with Johnny, I now have two kids in there, and you know Johnny and Samantha, they already know each other. They go to the same school. They might even be in the same exact class, but for that one to two minute time frame, there's that interruption, and you're trying to finish up with one student while the other student is still coming in. And that is that has been kind of a pain in my side the last few weeks, because back in the spring, when we were using zoom, I could just say, Okay, I see Samantha in the waiting room. I'm going to go ahead, finish up, say goodbye to Johnny, and then I'll let Samantha in. Well, now I have. Parents coming in, and sometimes they immediately leave real quick. Sometimes they just, you know, kind of hover in there for a minute or two waiting for me to finish. But you can see how that could be a potential privacy concern as well as just a general interruption. Now on Google, I could solve this by giving each student their own link, but that would mean that every time I transition from one student to another student, I would have to close out that Google meet and open up a new Google meet to be with that new student. And that's just a little bit more work that honestly, when you're trying to do something new and be efficient in this new world of teletherapy, it's just an extra piece that Zoom makes it easier to not have to deal with because you can stay in that one room. One kid can be in there, another kid can come into the waiting room. When Student A leaves, you can let Student B in. So I just see that as a huge benefit when it comes to using zoom over Google meet. Now, the last pro that I have listed here, I'm sure there are more, but the last one that I have listed right now is the ability to use Breakout Rooms in zoom. And this doesn't really matter if you are providing one to one individual teletherapy services to students, they can just leave the teacher's room and go to your your zoom or Google meet room. However, if you are going to try, and maybe on Tuesdays, you're going to push into Mrs. Smith's classroom and you're just going to see her students back to back on Tuesday. Well, it would be nice if Mrs. Smith is using zoom, because you can go in and she can just put Mrs. Smith, I mean, can basically say, All right, I want Mr. Davies and Johnny to go to a breakout room. And boom. We just go to a breakout room for 30 minutes. Then we come back and I say, Hey, Mrs. Smith, can you send me in a breakout room now with Samantha? And she clicks, Mr. Davies, clicks, Miss or sorry, clicks Samantha and boom. Now we're in a breakout room. The same thing could actually happen with a group. So it could be Mr. Davies, Samantha and Johnny boom breakout room. So you can see how that could be really nice, because then the student doesn't have to figure out how to leave Mrs. Smith's classroom and then join your classroom. They just stay within Mrs. Smith's classroom, but they're sent to a breakout room with you, and so there's no potential possibility for that student to, quote, unquote, get lost in the internet when they're trying to figure out how to leave Mrs. Smith's classroom and get to your classroom and vice versa. Okay, so I think before moving on to the pros for Google meet, I will first give you some of the cons, the few cons that are there for using Zoom. And the first is that it is expensive and there are limitations on the free version of zoom, the official HIPAA compliant version of zoom is $250 per month per user, and that's really expensive for a district, especially if the district is already paying For the Microsoft Office suite and the Microsoft Teams capability, as well as the Google Suite ability and the ability to use Google meet. And they're not going to stop using Google, because there's just so much more than Google meet to the Google Suite. You have documents or not excel, but you have sheets, you have slides, you have calendar, email, you have everything. And so now you're going to, potentially, the district be paying for both Google and Microsoft, if they use both, and then also be paying for zoom, which is expensive. So that is definitely the primary con for using zoom, is that cost. But also there's two other things that I want to address. The first is that Zoom is not fully integrated with Google Suite. It is pretty integrated. You can download an extension for zoom, which makes scheduling pretty easy through the Google calendar. You can also get an extension for Microsoft that, again, makes it just as simple, but it's just not fully integrated versus Google meet is completely integrated with Google Classroom. If you have a Google Classroom, your Google meet link is right at the top of your Google meet, or, sorry, your Google Classroom, so it makes it easy. The other thing that I want to address is the security issues that Zoom has faced. It is true that back in the spring, there was a thing called Zoom bombing, and people were somehow getting into people's meetings. But I really must actually applaud zoom for really taking this head on. And they've done a lot since March in order to combat this difficulty. They've made it so that every room has a password. They've made it so every room has a waiting room on, as I talked about earlier, right, where people, even if they get the password and get on, they're going to be put into your waiting room. And so if you don't recognize the name of that person or the name of that computer trying to get into your room, you can just simply ignore it or tell zoom to block them, and so they just can't get in and ruin your meeting. Likewise, there are just so many settings on zoom that you can alter and make it even more secure. You can make it so that no one has the ability to share their screen except for you. You can make it so that no one has the ability to chat, or that they only have the ability to chat with you if you're in a group. So maybe you do have a small group of three kids on it at the same time, and you don't want them chatting back and forth. Well, you can really easily just click a button and boom, and now they can only chat with you in the chat box. Okay, so that kind of goes over what zoom or the pros and cons of zoom. Now I want to go over Google meet, and I know, as we were talking about the pros and cons of zoom, I kind of put in some some different positives and negatives for Google, but let's talk about them specifically, as you likely could tell from what I was talking about zoom, I am not the biggest fan of Google meet, but I will say that it does Have some pros, and just like zoom, it does have some cons. And so my first pro for Google meet is that it is a Google product, and it is fully integrated with Google, and everything just works seamlessly with Google, which, let's be honest here, most districts use Google for so much more than just Google meet, like I alluded to earlier, Google meet works seamlessly with a Google Classroom. And so if you or the teachers have a Google Classroom, or both of you do, it's really nice because the link just fits right up there. And actually Google prevents you from changing that link to any other link, so you can't change the link at the top of your Google Classroom to say maybe a zoom link, they just don't allow that. That does add a little bit extra security, because unless you copy and paste that link, or your students copy and paste that link to somewhere else on the web, it's basically impossible for someone to get into your Google Classroom and find that link, especially if you're on Google Classroom, and you lock your classroom. So that is definitely a pro for Google. They do make it pretty secure. I mean, it's always possible that someone just types in meet.google.com , forward slash and some random bunch of numbers and letters, and maybe that would kind of let them into your meeting. But even then, you would get a notification if you're on Google, on Google meet, saying so and so is trying to access your room, it acts kind of like a wait list, except it's not because the only reason you're getting that notification is because the student doesn't have a.student.district.com email address. If they did have that student email address, they wouldn't be or you wouldn't get a notification saying that this person is from outside of your area. Right along the lines with it just being a Google product, is that Google and your district likely already have what is called a BAA or a business associate agreement, and basically what that means is that your district and Google have already basically done the paperwork, and they've set up their technology department to work with each other to be as secure as possible. So that is just, it's a natural positive, because that means that security is built in and that the district and Google are all on the same page, and everything is nice and secure. The last pro that I do have on my list of Google meet pros is that you do have what are called Google extensions, and there are many Google extensions out there that could potentially be added onto your Chrome browser to help make the Google meet experience better. The problem with these? Well, there's a few. Let me start with first, if you're using a district computer, the district program, you have to make sure that these are actually approved for you to use. You may not be able to download this cool extension that you just found out about unless your district has already approved it, and if they haven't approved it, you might have to go through some sort of approval process to see if they will allow it. The other thing about extensions is that there isn't a huge regulation on extensions, and so that's why the district needs to approve it, because you could maybe there is an extension that you can get because your district doesn't block anything. Well, now you're potentially putting your students data at risk because you don't know what data that extension is going to take from your Google meet. And you know, we all like to think that people are honest, but we don't know who these developers are, and we don't know what they're doing, or even what information they're really getting. The other thing about some of the Google meet extensions is that you have to have them installed, potentially on both your computer and your students computers for them to work. And so like, in zoom, there's a feature where you can, like, press the raise hand button and. And a little hand raises or whatnot, or thumbs up. Well, in Google, if you want to do that, everyone who's in the meeting has to have that extension built in. And just like an application on your phone, oftentimes you get a limited free trial and then to do what you actually want the extension to do. Because you know, when you downloaded it, it said it would do that, such as maybe give your student access to control your mouse, well, then you might have to upgrade it and pay a monthly fee of $10 a month or whatnot. And who knows if your district is going to be willing to do that. And I don't know if you really want to be putting your credit card on file for $10 a month for a program that you're using with the district. And before we move on, I will give you a short list of Google meet extensions that you might want to try out, because these are extensions that do, or at least they're supposed to help with making Google a little bit more like Google meets. The first is grid view, which would allow you to see more more of your students. If you have a lot of students on at one time, you can see more students on one screen, and that is called grid view. Another one is due Alice, D, U, a, L, L, E, S, and that is there to help you to see both whatever you're presenting from your screen as well as your students. It kind of splits your screen in half so that you can do that again if you're on Google this, or, sorry if you're on Zoom, this basically does it automatically, but this is something on Google that kind of makes it similar to zoom. Another extension that I'm actually downloading as I speak, is called the Google meet waiting room, and I already talked about how the waiting room is an essential feature. So you can bet I'm going to be trying this one out, although I'm downloading it on my personal computer. And again, I don't know if I'm going to be able to download it to my district computer. I guess I'll find out on Monday. And then the last one on my list here is Google meet breakout rooms, and it is called that. Unfortunately, this is not an extension that's actually developed by Google, even though it's called Google meet breakout room. You don't know who exactly is the person behind this developed app, and you don't know what data is going to be going to that person, so be sure that you check that before you move on and use it, because who knows what information is really going to be going to that person. All right, so one more thing before we're going to move into talking about some hardware that will be helpful for you, and that is the cons for Google meet, and I've already gone over quite a few, but I'm going to go through these really quickly, just so you have a summary of the cons that I believe to be for Google meet that is limited screen iPad and document camera sharing capabilities. Remember, with Zoom, it's very easy to share just about anything that's connected to your computer. It's a little bit more difficult with Google meet. Also, as I mentioned earlier, you don't have the ability to share your mouse control like you do with Zoom, and that may not be a big deal if all your students are using Chromebooks, because then you won't be able to do it with Zoom either. The other thing, again, also talked about was that there's no waiting room ability without an extension on Google meet, and I already talked about my experiences with not having that waiting room feature. So you might just want to keep that in mind. If that's the route that your school district is going, you might want to give each student their own link that way, there's no overlap between student when one is finishing a session and when one is starting a session. Another limitation that we already talked about was that Google meet does not have the ability to use breakout rooms, so that, again, only really affects you if you were planning on going into a teacher's room and breaking out with students from there and then the last, and we already talked about the ability to maybe solve this with the grid view and do Alice extensions, is that it's hard to see your students and whatever you're sharing. So if you're going to be sharing some sort of fine motor YouTube video to your student, it might be difficult for you to do that and see the student at the same exact time. So that's just some of the pros cons for both Google and zoom, and you can go from there to see which one will work for you. Personally, I like zoom, but I understand that districts control that. So even though I do prefer zoom, it is something that I have to live with is using Google and figuring out how to make it the best it can be. So yeah, I'm going to continue to do that. Okay, so let's go ahead and talk just a minute about hardware before we head into talking more about evaluations. When I'm talking about hardware, I'm talking about the physical pieces of equipment that you have in front of you in relationship to technology. Now the perfect setup would be you having a computer in front of you with. A second monitor, potentially a nice light in front of you, because, you know, you get dark on screen. Sometimes it would also be nice to have a an additional camera that's a little bit higher, so you don't have the camera looking up your nose, and then a document camera next to that, so that you can point the document camera at your paper and so that you can actually show the kid what you're doing with your hands. That's like the perfect setup, right? But to be honest, a lot of us are working with a lot less. We are lucky if we have a laptop with a document camera that is built into the laptop, sorry, not a document camera, a webcam built into the laptop, looking up our nose. We don't have a document camera, we don't have an additional camera to use for any purpose. We might be in a dark closet or a dark room. And if you're really lucky, you might have an iPad, and you're gonna have to use that iPad as your document camera, potentially, or maybe an old iPhone as a document camera, in a way. And even with that, you're going to have to get creative. I have been using what is called an Osmo O, S, M, O, as my document camera. And the way that I do that, because I'm using Google meet, is that I log into Google meet as myself on my computer. Therefore I can use my computer as my main hub, per se, where I actually see the student, but then I also will log into Google, meet through my iPad, and use my iPad as a document camera. The way that the Osmo works is that it comes with a stand as well as a little mirror that fits right over the camera on the top of your iPad, which then directs the picture down to the table. It then basically, kind of reorients your paper, using technology to kind of, you know, make the paper not look like a trapezoid, to make it look rectangular. And then basically it's a document camera from that point. And you can share your your iPad screen once you're on your Google meet. You can present your screen on the iPad, and your student will then see your paper your hand and what is writing. Now, keep in mind, it's great if you're just going to show writing, but it's not great as soon as you lift the paper up off the table, because of the way that it reorients the paper so that it'll fit on the screen and look like a normal piece of paper. So if you try and lift the paper to cut it, your hand in the paper, they're all going to look distorted, because it's assuming that the paper is laying flat on the table. So it's great if you're going to show writing, if you're going to show drawing, if you're going to show coloring, great. But if you're going to try and do any sort of coloring or in hand manipulation, where your hands are off the table, then it's going to be a little tricky. What I do then is that, if I'm going to do something like that, I take off the Osmo, which is that little mirror on the top. I take that off, and I make my iPad, my main camera that shows my face. And then I tilt my my laptop down to then be my quote, unquote document camera. So now the web camera that is built into my iPad is now looking down at my hands, and my iPad is looking at my face, so that the student can see both my hands and my face. And again, that only works because I have a second monitor connected to my computer, where I can still see the student's face on the second monitor. And so all of this as you can as you can hear you're listening. You can imagine how this gets a little tricky. Best Practice, best I mean, if you can ask your principal, ask another teacher, if they're not using their document cam, try and get a hold of a document camera, it will make your life 100 times easier, because that's what they're designed for, is to be able to show your hands, to be able to show what you're writing on the paper, to be able to show anything that's occurring underneath that space. So I highly recommend that you get a document camera, if you can, that's going to be the best thing that you can do. If you can get an Osmo great. But a document camera is really where it's at. I highly recommend it. If you absolutely feel like you need some of these things, I would recommend going on Amazon, finding a 20 to $30 webcam, that way, you're not having the up your nose shot. And you can also manipulate that web camera to look wherever you want it to. I would spend maybe 50 to $100 on a document camera, maybe. And that's a long shot. I mean, I haven't bought my own document camera, and I know how valuable it would be. And then the other thing is, if you're not going to get a document camera, I would try and pick up the Osmo, just because it will help a little bit. Again, it works with both an iPad and, I believe, a Fire tablet. The other thing that you might be able to do is ask your teachers or your principal or the custodian if he has seen an extra monitor lying around. Around that you can borrow. If the kids aren't on campus, they're not using the computer lab, maybe they'll allow you to use a monitor from the computer lab, so that you have two monitors, so that you can actually, you know, see the student while the while you're presenting something from your screen on your main computer. All right, I know that's a lot about technology. That's not what you're here to really get, but I wanted to share that with you. So let's go ahead and move on to evaluations, which I know is what you really want out of this. So let's go evaluation time, all right, to understand how evaluations might work through a teletherapy or telehealth model, first, I want to just do a quick review of what an evaluation looks like in a traditional school based occupational therapy model. And that is, first, we have to do a records review. Then we're going to do a classroom observation, or recess observation, or lunchroom observation, wherever we might need to go to see the skills that that there are concerns in. Then after we do some observations in the natural setting, then we would potentially do some observations, or structured observations in the OT room or OT closet, or wherever we can work with that student. After that, you dive into your standardized evaluations, which is the area that I think most of you are scared about, trying to figure out, what evaluations can we do via a teletherapy model? We'll get into that in a moment, and after you do your standardized evaluation, the last piece really is to kind of put it all together, put your your observations, with your structured observations, with your records review and the standardized assessments. Put that all together, analyze the data, and then hold an IEP to report all that data, right? Well, that's the traditional way. Let's go ahead now, and let's break that down piece by piece. When it comes to a teletherapy model, starting with the records review. That records review, it's not really going to change, right? You still have access to look at that student's IEP. You still have access to look at the psychologist report, or whatever report might be there. You also have the ability to either mail home a parent questionnaire or send an email to the parent about a parent questionnaire or call the parent to get an interview, or use a Google form or a Microsoft form to set up some way to get information from the parent, as well as the teacher, as well as any other person who you might want to get information from. So that is your records review. The next step is, then you're in classroom, or your your observation, wherever you need to see the skill. Now this is where it gets tricky, right. Now, if you're going to observe a student in a telehealth model, you are only going to see a small box with maybe their head and shoulders, and I say maybe because a lot of times these cameras are pointing over the kid's head, up their nose and over their head, or something like that, and you're not going to see anything. And so this is where it gets tricky. Your classroom observations are likely to yield much less information now than they would have when you could actually get into the classroom, on the playground or into the cafeteria, you're just not going to see as much. And to be fair, it's not really appropriate, in my opinion, to go into a classroom and say, Hey, Samantha, I already used that name once. They will use it again. Samantha, can you please tilt your computer screen down so that I can see your hands? Oh, by the way, you're not going to be able to see whatever the teacher is saying, because your computer screen is going to be tilted down. No, that's that's not fair. We don't want to do that, but at the same time, we do want to still do that observation so that we can see at least what we can see, you know, what? Maybe we will see that the student is attending, or maybe we'll see that the student's in an office chair spinning in circles. You know, what information does that give you? Maybe it gives you a little bit of vestibular seeking activity going on. Or maybe you just noticed that the student can't attend, and maybe you're seeing that in their glasses. They're watching a YouTube video. Or, I mean, yeah, you're not going to see what their hands are doing, but at least you can get some sense of what's going on. Are they at least able to attend? And then you're going to back that up with those questionnaires that we talked about a minute ago, finding out what the teacher knows this early in the school year, I might recommend that you reach out to the previous school teacher as well, because they might have been the ones who actually put the referral in, and the current teacher may know very, very little. I just got done with an evaluation. I talked to the new teacher, and she said that she hadn't even heard the voice of the student yet, and we're a month into school. That's how limited some of these interactions are when it comes to providing a teletherapy or telehealth model evaluation as well as distance learning. All right, so. With that huge limitation when it comes to that observation within the classroom, or whatever you want to call that you really are going to have to make it up with your structured observations, and you're really going to have to make the most of it. You're going to have to get in touch with that parent to try and put together almost a little toolkit to have available when you're going to do your structured observations. Likewise, you're going to have to communicate with a parent to make sure that in the next step, they have the materials that they might need if you're able to do a standardized assessment with the student. So let's start with those structured observations. How can you go about doing those? Well, I would put together a list of materials that you are very familiar with that are common in the house, that you could get the most information from. So actually, put together a short list of items that you might want to have available. And those might be crayons, pencils, paper lined and White Paper, Scissors, depending on, you know what, if the student's right handed or left handed, make sure that you have appropriate scissors, or that the parent has appropriate scissors, a small paper bag or a pillow case that the student can't see through. That way, you might be able to have the student reach in and grab tools to see if that tactile perception is there, that they can find the tool. Whatever you're requesting, small, very varied toys, maybe different colors that you can do some sorting with, maybe some cars or Legos, dolls, dice, whatever you might be able to hide in the bag and have the student find or use for sorting or use for any sort of manipulation skills. Of course, coins are always great as well. You can look at the ability to manipulate one or multiple items within the hands. If they have some form of maybe an Old Spice bottle that is all out of spice, you can you put all the coins in there and see if they can get the coins out. You could also have a spice bottle that has the small holes where toothpicks fit in and out of and you could use that, as far as your assessment goes, any sort of blocks, Legos. You can use those for building to see if they can reconstruct something that you show them. You can do something similar with plastic cups along with more they don't have to be plastic. They could be paper or foam, but you can cut them up, you can stack them. You can play the drums on them. You can see some hand supination as they flip that from one side to the other. So plastic cups is one of those things that you can see a lot with. And of course, if you're going to be evaluating a little kid play doh is a must. Tongs and tweezers to really see what kind of grasp we're using. Do we have the strength to keep those tongs closed or not? And a tennis ball, you can see some of the bilateral coordination skills just by using a tennis ball and doing some various activities with that. Of course, you're going to want to see some handwriting samples. You might want to also have an interview in that structured observation with either a the student, or both A and B, the student and the parents, that's your that's your additional opportunity to understand what concerns are, there are present and what the parents are thinking, as well as what their long term goals are for the student. And that then brings us to the final and probably most difficult part of a teletherapy evaluation, and that is the standardized evaluation processes. And as we get into this, I want to emphasize how important those structured observations that we just talked about are, because those structured observations are going to help you decide what evaluation tools you're going to use. Now, if there were no sensory processing concerns when you spoke to the parent and did your structured observations, then you might be able to rule out a certain set or or even a specific tool that you might use for most of your other students. Likewise, if there are no concerns with, I don't know, maybe bilateral coordination, crossing midline, and it's all sensory processing, self regulation. Well, then maybe you're going to use a different subset of tools, but that's why those structured observations and that records review are so important. So now, after you've done those those observations, and you've talked to the parents, you've got to decide which tools you're going to use, and this is, I think, where we're getting most hung up right now as a profession on trying to figure out how to complete these telehealth evaluations, we need to know what assessments can and cannot be used over telehealth in a way that will create a defendable report. So let's start off by talking about some of the easy ones, like the sensory profile and the sensory processing measure SPM. These are both questionnaires that can be completed by the adult at home or potentially maybe also by the teacher from last year, last school year, or if you feel comfortable and you think. That the teacher that currently has the student knows enough about the student they can fill one out as well. I would highly recommend that if you are one that does not typically send home, a home questionnaire for the SPM or the sensory profile, I would start doing that, especially if that is their main educational area where they're learning, we need to know what is going on in the home. And what's great about these specific questionnaires is that you can either a mail them home, or B, have your district hopefully step up and get the electronic versions of it, and they can be emailed to the parents and completed, so that can still be done relatively easily. One common questionnaire I know many of you out there use that you probably won't be able to use is probably the SFA, and that is because you're going to have very few people that can fill out the school function assessment accurately based upon current ability levels for the student, the student is simply not there to be able to observe and see how independent they are on campus, and so that one may just simply not be able to be used. And it's unfortunate, but luckily, we have other assessment tools that we still can use. So what is the next type of assessment that we might be able to use? The next step up from there, I think, is some of our visual testing that we might do, such as portions of the VMI or the ravma or the dtvp, that is all visual. And I know what you're saying. You know, if you're doing anything through the computer, it is no longer standardized, and I understand that, and we're going to talk about that in just a second, about what to add into our report in order to kind of accommodate for that a little bit, but at the same time, we need to get some sort of data. And yes, those assessments were not standardized in a teletherapy assessment or a teletherapy model. And trust me, I went back and I looked and I tried to find some tools that we can actually use that were standardized via teletherapy, and they're just not there. But that's not stopping practitioners from still providing evaluations through a teletherapy model. I'm thinking right now in my head of the VMI, the Rama, where the student just has to point to a stimulus that matches the stimulus above. I don't see why that is not something that we could do if we were to mail that protocol home a few days before jump on with them and have them do it in front of us, and we can still score it real time, just like we would. Similarly, I think we could do the same thing when it comes to some portions of the test of handwriting skills, or the bot too, where the student does have to use a red pencil to do certain activities or to copy shapes, or the etch, where the student is asked to copy the alphabet and or, sorry, not copy, but write the alphabet and copy sentences. I think that these are skills that we could see through the computer, and I understand that they will be slightly different, and they may not be quite standardized, but can you explain in your report the skills that you saw and determine whether or not you feel those would be accurate or inaccurate skills? Do you think that the environment of the classroom would have interfered with the student's ability to complete those skills? Do you feel that if the student was with you in front of you, that they would have performed any differently? Or do you feel that these are actually skills that you're seeing on the computer that you would see if the student was right there in front of you, as they might be during an in person evaluation. As I say this, I know you're thinking it. I'm thinking it. There's also some evaluations, or some evaluation tools, at least, that we likely will not be able to use, such as maybe the Peabody. That's a tricky one. There's a lot of tools that are needed, and they're very specific tools. The blocks have to be the right size, you have to have the string, you gotta have the scissors, you gotta have the templates that may be a little bit more tricky to actually pull off. Likewise, the M fun, which I really like, that might be a little bit more tricky too, because there are several pieces that you have to provide. There's the snack time part of it, which might be a little tricky, even if you do have the tools here and there. I'm not sure the whole social interaction part might work the same live as it would via a teletherapy model. So that is a little tricky aspect to it, but there are several assessment tools that I do believe that we could use the bot as far as the manual dexterity part. Yeah, you might not be able to do that part, but you can probably still do the fine motor precision and integration part. So there are areas that you can do and there are areas that you can't do. I would definitely take this on a case. Case basis, I would be a little picky in in choosing where and when and what assessment tools you're going to use. Be careful in that, but you can do this, and many districts are struggling, and they're just flat out scared of doing evaluations because they don't think that they'll be able to defend them in court. And if that's the case, if there's specific cases, or even if your district is just going that route where they want to bring everyone in for an evaluation, well then you can still bring them in person to complete one or two evaluations, or all of your evaluations, whatever you feel is necessary, of course, when I say bringing them in, I do mean with the proper protections in place, the barriers in place that are needed so that everyone, both you and the student and everyone else at the school, are in a safe and well, also efficient in a way place. You know, we don't want anyone getting sick, but we also want to get these students the services. And the only way to get them the services, if it's an initial is to do that evaluation. And I think districts are going to understand that if they are holding off on evaluations, be it because they don't think a teletherapy evaluation is defendable. Well, they're going to start to realize, I think, in the future, that they should have gotten that evaluation done, because you're going to have parents asking for comp services for all those missed sessions when their student would have qualified for services. And so we really need to somehow get these evaluations done. Whatever can happen online. Let's do it online, and if we need to bring a student in, let's try and do it in the safest way possible before we move on to potentially writing up the report. I want to say one thing about sending those assessments home, be sure that you are including in the packet or in the email to the parent that you don't want them to open that package until it is time to complete the evaluation with you. Basically let them know that do not open this until you are on the video call with me and I instruct you to open it that way, you can at least say in your report that the child did not have exposure to the therapy tool prior to you assessing the student with that tool, which is important because we I mean, with every assessment tool, the student is not supposed to be playing with it right before they are about to be assessed using the tool, right? So make sure you let the parents know not to open it and let their student play with it all right? So that brings us to the final part of the evaluation, and that is writing up your report so that you can give your report at an IEP. And I've already kind of alluded a little bit to this, but when it comes to writing up your report, you want to write it up just as you would if the student was in your room for that standardized evaluation and how it went, just like you would write up how the child participated and how the child interacted with you during that evaluation, and how they were engaged or not engaged, you want to do the same thing in relationship to the student's engagement participation when on the computer. And then go a little bit further, add in your thoughts on whether or not you felt that the student scores still reflect their ability level, and whether or not you feel that these scores are actually comparable to what the student might have achieved if they were sitting right there at your table. You want to make sure that this is all in your evaluation, because, again, if this does, for whatever reason, end up in court, you want to be able to say that you are comfortable with your evaluation and the results that came about from your evaluation. And if you feel that those scores are sufficient, you can score them and you can put them in your report, but I would just make sure that you clarify that this was done technically in an unstandardized way, because they were administered over a telehealth platform. And you know, there's nothing right now that you can potentially do to change that, because your district is asking you to do your evaluations over a telehealth platform. And you know what that is, something that when that day comes, it may need to be addressed. But again, like I said a little while ago, I think the parent and well, I mean, everyone involved is going to be just more satisfied that at least the evaluation is done and that now their student is getting services, albeit via a teletherapy model, probably, but that evaluation was taken care of. It was done in a way that allows you and the parent and everyone to feel comfortable that it was done in a way that was. Uh, really inclusive, and that everything was was thought of, versus not doing the evaluation because we're scared of having an evaluation, and then the student not getting services because of that. So just make sure that in your report you're adding those details in there. So I'm going to wrap up this evaluation section of the podcast really quickly with a quick disclaimer, as much as I hate them, that make sure everything that I'm saying you are running through your district just to make sure that everyone's on the same page. The last thing you want to do is have everyone else bringing students in for an evaluation, and you are providing an evaluation over a telehealth model, everyone should be on the same page, so be sure to do whatever your district is having or asking you to do. All right, so let's really quickly dive into some ethics as far as providing teletherapy services. And I want to share with you what is called the 10 E's. Now I came across these 10 E's in my research review, or literature review, if you want to call it that, as I was preparing for this podcast. And this comes from an article titled tele rehabilitation services, a successful paradigm for occupational therapy clinical services. This article was published actually just earlier this year, and it is in response to providing teletherapy services in this current climate with the pandemic going on. And so it wasn't so much a research article in the traditional sense, where they're actually going through and trying to see what works and what doesn't. It was more of a systematic review, and one of the things that they reviewed was the 10 ES. And so I'm gonna go ahead and read off these 10 es, and then we'll go back and dive into a few of them just a little bit further. Okay. So here they are, one through 10. The first is efficiency, specifically decreasing cost. Again, I'm not sure how much that relates to right now, and occupational therapy in schools, because right now, we're just trying to survive. Districts are spending more money in places that they're not used to spending it in. The next one is enhancing quality of care. Number three, is evidence based practice. Number four, empowering consumers. Number five, encouraging new relationships. Number six, education. Seven, enabling information exchange. That one I really like. Number eight, extension. Number nine, ethics and equity and number 10, easy to use, entertaining and exciting opportunities. And these 10 e's are designed to be things that a we need to think about, but also when you are putting into place teletherapy these, these 10 E's should be things almost outputs of teletherapy. It should be less less expensive. It should be more empowering to our consumers. It should enable information exchange, and it should also be easy to use, entertaining and exciting for not only the clients, but also for ourselves. So that's the 10 ease. And while I did get it from this one article, and I'll cite the article on the show notes page@otschoolhouse.com forward slash episode 57 these 10 E's have actually been noted as far back as 2001 from an article in the Journal of Medical rehab. That's the earliest I can find them, but it's all over the internet. So like I said, there's a few key points of those ease that I really wanted to focus in on. The first was number three, evidence based practice. And I'm focusing in on that one because there is very little evidence when it comes to providing teletherapy practice. I mean, there's a handful of articles, several of them I have mentioned either in this podcast or episode 56 so you have those, but there isn't a lot. However, that doesn't mean that the evidence based practices from all the stuff that we covered in episodes one through 55 and all the articles that you know about and the Size Matters handwriting program which is evidence based, and all those other programs that have evidence behind them, just because you are providing those now in a teletherapy model doesn't mean that they're no longer effective. It just means that we are providing that evidence based practice in a different way. The next few es that I want to talk about are encouraging new relationships education and enabling information exchange, because I think these all go very much hand in hand. If this were a traditional, you know, professional development opportunity and we were all in the same room, this is where I would ask, how many of you are providing therapy through teletherapy model means, and the parent is right there next to their student, and probably 98% of you would raise your hand, right, hand up. Got it well these three E's, encouraging new relationships, education and enabling information exchange is exactly related to that. This is a new opportunity for us to better understand our parents, to better understand their needs and to better provide them with information. Help their student. This is something that many therapists, I think, are scared of, but also excited about, because we have parents watching our every move when we are providing a service to their student, but at the same time, it's exciting because we're probably getting more carry over than we ever had before, because there is someone there watching everything that we do and carrying that over after our session is over or after school is over, and so that's fantastic. Be sure you're taking advantage of this. Let the parent know what they can do and how they can continue to develop their students skills or their child's skills. The last set of ease that I want to talk about is ethics and equity, and that is a huge topic right now. Right equity? What is equity when it comes to students learning and being able to access school right now? Does every student on your caseload have access to a Chromebook? Does every student have access to an iPad? What do they have access to and what don't they have access to do? They have the ability to sit at a computer in front of you in a calm house that doesn't have kids running around in the background or adults fighting, or are they just there looking at a screen with no adult trying to figure out what they're supposed to be doing, because they aren't even sure what the teacher is trying to get them to do. You know, this is a huge factor, and we need to try and work with the parents, with the teachers, with whatever adult is available at the house, or big brother, to see if we can get that get that student the help that they need in the home. And the last part of it comes to ethics. And within ethics, there are so many topics, right? But what we're going to talk about here is licensure, client selection, confidentiality, personal and cultural attributes and provider competencies. And so let's start with licensure. Many of you, I think, already know this, but you have to be careful. Be careful when you're providing services to make sure that you are licensed in the state that you are in physically as well as the state that the student is in physically. You know they're working to change this with the licensure compact that a OT is working on, but currently, for most states, that's the case. You're supposed to be licensed in both the state that you're in, so maybe that's California and Texas, if that's where the student is, or wherever it might be. So if you know that your students vacationing, and you know because they don't have to be at school, the parent has now moved them to another state for a while, until school gets started back up, you need to relay this information to your boss, and you might need to even reach out to your department of education or your department of occupational therapy at the state level and find guidance. The next area, real quick to talk about is client selection. I just want to remind you, I know I talked about this in Episode 56 but be mindful of who you are recommending to your team as being the kids that need to come back to school as quick as possible. And you know, if it comes down to trying to figure out what kids can and what kids can't come back, by working with these students online, hopefully you have a good idea of what students really need to be back on campus and what students are just simply not benefiting from occupational therapy or distance learning in general, and a teletherapy or distance learning educational model, also under this larger ethics umbrella I have is HIPAA and FERPA, you should be well versed, or at least have a basic understanding, of what HIPAA is and What FERPA is in OT school. We all learn about HIPAA. We don't all learn about FERPA. FERPA is really the educational version of HIPAA, and it does apply to us, as does HIPAA, if we are billing electronically. And so just be mindful as you're providing your teletherapy services that you don't have this crossing between students and parents. I already mentioned the difficulties that I have had with Google meet and how I've had students come in when I'm still trying to finish up with the previous client, and how that can be a little bit of a mix. You know, our special education department has kind of said You are good so long as you're not like talking about the student's IEP these kids, they see each other on campus. Many of these parents already know each other, and I know that is still a thin line, but for the most part, I think it's kind of that Wayne, well, we're trying to do this in the best way possible, and we know that not everything's gonna be perfect. Just remember that if a parent is on the line with you as you're wrapping up a session, and maybe they bring up another student that is the time to let them know that you cannot talk about that other student with them. That student is not their business, and it is not your business to be talking about one student with another parent. And our second to last topic that I want to discuss is personal. And family attributes you are in this family's home when you're providing a teletherapy session, and we don't know how a person handles stress, we don't know how a family handles stress, and we don't know what situations that family is in. And we need to be mindful of that. We need to understand that a parent might not be able to be next to their student, 24/7, when they are on distance learning and with you during your session. Likewise, families may not have all the tools that you might ask them to have for your evaluation or your therapy session, so be mindful of that and help them if they need to ask your therapy team at the schools, if you guys can put something together, or just have alternatives that people can use. For instance, maybe people don't have a stapler. Well, what tools might they be able to have that can replace the stapler? And finally, the last thing that we need to keep in mind is our own provider competency, as well as the competency of all the people that we are working with. Be kind, be gentle. You don't know what everyone is going through, the stresses they are going to through, not just the family, but also the teachers and the other therapists. You also don't know what training they've had in the past, and maybe what training that you can provide them. And so anything that you are getting trained in in an online conference, or whatever it might be, make sure you're taking some time to bring it back and let your teachers know, and let the rest of your therapy team know, so that they can also use that to their advantage. One way to do that is share this podcast with them, not trying to plug that in, but it is something that you can do. Share that information that you're getting with your team, all right, and that is going to wrap up this two part series on telehealth and teletherapy. We have talked about so much over the past two episodes. First, we started off by talking about what a ot a and other guidance and states say about telehealth. Then we dove into what some teletherapy models look like, and how you can use those and and how you can provide the best practices to your students. We talked a little bit about research, both in the previous episode and just a little bit in this episode, and then in this episode, 57 we dove into evaluations, ethics and platforms and hardware. So I hope you really did learn a lot from these past two episodes. Please do check out ot schoolhouse.com forward slash episode 56 and ot schoolhouse.com forward slash episode 57 for the show notes from these two episodes. At both of those links, you will also be able to purchase the OT school house professional development that goes along with this. And what that is is basically you already got the knowledge. You already listened, but now you can take it a step further by earning a certificate of completion for the two hours that you listened to this episode and the previous episode. When you do purchase that professional development opportunity, you're going to receive two documents. The first is going to be a PDF that tells you how to take the short quiz to prove that you actually listen to these two episodes. And the second document you're going to get is the slides that go along with this presentation. So you will have the ability to basically quickly reference back to your slides and know exactly what we talked about in these two episodes. All right. And with that, I'm going to say goodbye, and I hope you all have a great start to your school year.    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 Welcome to the show notes for the Episode 56 of the OT Schoolhouse Podcast. In this episode of the OT Schoolhouse Podcast, I share guidance, research and practical strategies related to providing telehealth occupational therapy services as a School-Based OT. We will look specifically at AOTAs guidance on telehealth, state laws to be mindful of, and the considerations to be mindful of when providing OT services via a teletherapy model. I also provide a few of my favorite teletherapy treatment ideas and how I have been adapting them. This is the first in a 2-part series on teletherapy. View the second episode in this teletherapy series at otschoolhouse.com/episode57 Earn a certificate for 2 hours of professional development by listening to episode 56 & 57 and purchasing the Professional Development Podcast Course! Episode 56 of the OT Schoolhouse Podcast is sponsored by Learn Play Thrive View the free Learn Play Thrive webinar by clicking the image below Links to Show References: Rortvedt D, Jacobs K. Perspectives on the use of a telehealth service-delivery model as a component of school-based occupational therapy practice: Designing a user-experience. Work. 2019;62(1):125-131. doi:10.3233/WOR-182847 Telehealth in Occupational Therapy . Am J Occup Ther 2018;72(Supplement_2):7212410059. https://doi.org/10.5014/ajot.2018.72S219 Wallisch A, Little L, Pope E, Dunn W. Parent Perspectives of an Occupational Therapy Telehealth Intervention. Int J Telerehabil. 2019;11(1):15-22. Published 2019 Jun 12. doi:10.5195/ijt.2019.6274 OT School House Instagram A-Z School-Based OT Course 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 about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the show notes for Episode 56! 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     Hello, my favorite, OTPs. Before we dive into today's content for the podcast, I want to share with you an up and coming podcast from a previous guest of the OT school house podcast, Meg proctor hosts the two sides of the spectrum podcast where she interviews researchers, OTs and people on the spectrum. The two sides of the spectrum podcast is changing ot practice to reflect new research and to help us shift our perspective so that we can better understand and serve our neurodiverse students. You can find the two sides of the spectrum, podcast wherever you get your podcast, or at learn, play, thrive, slash podcast. Now let's Cue the intro.    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 56 of the OT school house podcast. My name is Jayson Davies, and I am so excited to be here with you today, wherever you're listening. Just I really appreciate you being here, and I'm so happy to be with you in your ears today. All right, okay, that just sounded really weird that I said to be in your ear today. Anyways, we're gonna continue on. I'm just excited for today. Today is probably the podcast that has been most requested over the last weeks, if not months, and that is teletherapy. Today is the first of a two part series all about teletherapy. And today we're going to dive into the guidance of teletherapy, as far as like what a ot A says, as well as a few others, we're going to dive into the actual practice of the therapy sessions. And then I also have a few pieces of research to share with you today in Episode 57 which will be coming up here in two weeks, I will be moving into more of the actual evaluation side of teletherapy, and we'll also talk about some ethical considerations regarding teletherapy. This two part series on telehealth will be available for purchase at ot  schoolhouse.com , forward slash podcast, and just a reminder, because it's been a little while since I made one of these episodes a professional development opportunity. When you purchase a podcast professional development opportunity, you will receive a opportunity to take a quiz and earn a certificate of completion for listening to these two episodes, that certificate of completion can then be used for your mbco T certification and potentially your state licensure, depending on your state regulations for this particular podcast, teletherapy professional development opportunity, you will also receive the PowerPoint presentation that I have put together that goes along with the podcast episodes. To learn more about that, you can head on over to OT schoolhouse.com/episode 56 All right, so let's go ahead and dive into the content. Just a reminder, we are talking about teletherapy as it pertains to school based occupational therapy. I want to start off by saying, I'm probably going to be intermixing the terminology telehealth and teletherapy in this podcast. I'm going to use those terminologies interchangeably and to mean the same thing, which is basically the way that a ot a identifies the term telehealth. A ot a defines telehealth as the application of evaluative, consultative, preventative and therapeutic services delivered through information and communication technology, also known as ICT, that is information and communication technology. So like I said, I'm going to use telehealth and teletherapy interchangeably, even though teletherapy may more just be the actual therapy provision, where telehealth takes on the evaluation, consultative and preventative means in order to provide occupational therapy services. That definition that I just reviewed actually comes from the A ot a position paper, telehealth in occupational therapy from 2018 in that article, a ot also mentions that ot occupational therapy can be provided in both synchronous and an asynchronous model. We're going to talk a little bit about that later, but for now, just know that asynchronous is what we think of, such as like an email, where I send you an email now and you respond to it later. Versus synchronous is more what we think about when we're on a zoom call that what I'm doing you are seen in or very close to real time and responding to in real time within the position paper, a, OT, a also makes it very clear that they feel occupational therapy providers can make achievable outcomes with clients in every area that they can when providing traditional in person services, a, ot A does not explicitly mention pandemics as being a reason for teletherapy to be used widely, but they do note that teletherapy will allow clients. To access the necessary services in sub optimal conditions, such as in rural areas or when a client is unable to go to occupational therapy services during normal business hours. That might be a prime example for when an asynchronous model may be used, such as you might create a video or some form of text to send to the client, and then later at night, when they have an opportunity, they could then follow the routine that you gave them, or whatever else you might have provided, and then might send you back some feedback on how that went. Therefore you can then make changes and send something back to them. So that's a little bit about what a ot a things. Now, let's talk a little bit about at the state level. What do we need to know at the state level when it comes to providing occupational therapy services in a telehealth model, we need to start by understanding that regulations vary from state to state, so you need to be sure to check your state's board of occupational therapy for guidance on what is and is not allowed in your state regarding teletherapy. If you don't see anything on your state board of occupational therapy website about teletherapy, your best option is to probably call them or email them and ask for some guidance and ask, Am I allowed to provide teletherapy services within the state of whatever state you're in, that's probably going to be the easiest and most direct answer you will receive, unless they do, of course, have a website that talks about teletherapy and what you can and cannot do. Fortunately, by the time that this podcast is coming out in September, more than likely, your state has developed some form of guidelines for teletherapy, even if they may be temporary due to the current pandemic going on right now. One issue that has risen out of everything going on right now is the need for occupational therapy providers to provide services to students in another state or clients in another state. Currently, if you want to provide services to a client that is in a state that is not your own or not that you are actually practicing from, then you might need to be licensed in both that state as well as the state that the student is in or that the client is in. Currently, a ot A is working with state licensing boards to work on what is called a licensure compact, which may prevent this from being needed in the future. You might be okay if you have a California license to provide services to a student in another state, but at this time, that has not gone through yet, and so you need to be sure to check with the board of the occupational therapy board that you live within, as well as the board of the state that the client is in to see if it is okay for you to to be providing services for that student. This has become, actually a fairly common issue with schools being closed. Occupational Therapy providers may be providing services outside of the state that they usually live in. Maybe they're living at a long term Airbnb, or they're living with their parents that's in another state than the school district that they provide services to. Or maybe the student has moved because, for the same reason, because they don't have to go to school every day, so they're living with grandma and grandpa in the state next door as a way to continue to be on computer, because they have a guardian there with grandma and grandpa, but they're no longer in that state that they usually receive your services in, that is a circumstance where you probably need to address the boards and ask for guidance. Be careful with just asking your district, because your district may not understand occupational therapy, like they so often do not they. They are not the ones looking at the Board of occupational therapy to see if you can provide these services. They're looking at the board, or, sorry, not the board, the Department of Education, and seeing what they say, but sometimes the Boards of Education and the Department of occupational therapy, or board of occupational therapy, they don't always talk to each other, and so we have to work both under the guidance of the district and the Department of Education, but also the board of occupational therapy, who provides us with our license, another factor that You are going to need to check in on with your board of occupational therapy is the permission required from the client or the parent in order to provide therapy services. Now, again, in the case that we're currently in, this isn't a huge issue, because everyone wants some form of therapy, and they're likely to accept teletherapy if they can't receive typical therapy because the schools are just closed down, but you still need to check with your board to see what is needed. In regards to permission to provide teletherapy services. In California, we need permission to do that, but it's very general. It doesn't say there must be written permission. And it doesn't say you need to check in with the parent or the client at the beginning of every therapy service to get permission. It's very general. We just need permission. And so for me, I have gotten email permission from all of my students or all of the parents, and I'm working with that, along with them signing on to my zoom or Google room, that's also kind of giving permission, right? But in some states, that's not the case. It's very specific on exactly what type of permission is required before you can provide those teletherapy services you might need at the beginning of every single session to ask the parent, do you comply, or do you agree to this teletherapy session you might need in writing and with the signature in the child's documentation or the child's folder at the school site that the parent has given permission for that to occur. So be sure again, I would just put together an email template and just send this to the states that you work in and you have these specific questions, do you need permission in order to provide services. Can you provide services? And what if my student is living in another state? Potentially, the last state specific item that I have here regarding occupational therapy services in the school is reimbursement, and in the schools, typically reimbursement from Medicaid is a supplemental, not deposit, but it's a supplemental income for the district they are receiving state and federal funds, and the ability to build Medicaid is supplemental to that, and goes straight back into special education, which is awesome, But unfortunately, not all states will allow occupational therapy providers, in specific, the ability to bill for teletherapy services. Now this is changing, probably on a week to week basis, as this COVID 19 pandemic continues to go on. I know several states have already made the change and are now billing for teletherapy services, and some states might bill for individual teletherapy services, but not group teletherapy services. They might bill for evaluations over a teletherapy model, but not treatments over a teletherapy model. This is very unique state to state, and to be honest, what we're doing is we're just billing for everything, and we are letting the program that we use, the district contractors that we use, to weed out what is and what is not billable. It doesn't change the system that we're going to put into place. We're still going to provide services whether it's billable or not. And so we're just doing the best that we can and allowing the contractor on the other side to basically submit what's billable and not submit what is not billable. If your district happens to be a little bit smaller, and maybe they don't have a contractor that does the billing for them, and maybe they do rely on you to be taking on that initiative, I would definitely let your director know, or your coordinator know whoever you need to work with and let them know that you're not sure of these regulations and that you need to talk to someone so that you know what is worth your time to be billing. If no teletherapy is really billable, then is it really worth your time to be doing it? I know with insurance and with Medicaid, sometimes it's better to do the work now, because in the future, they may go back and say, Oh yeah, teletherapy services is back, or as far back as maybe 2019 are now billable, and we will give all the the schools money for the services that they build back then. So that might be a reason to continue billing. But again, you you should probably talk to your director and see what is billable, what is not billable, and if they don't know, then the district probably needs to get outside support from someone to look that up for them. All right. All right. So now I want to jump into the ethical decision making process when it comes to determining when to or when not to provide occupational therapy services over a telehealth model. Now, things are a little more black and white right now, because it's either a for many people, at least a receive occupational therapy services via a telehealth model, or don't receive occupational therapy services at all because the school is closed or B schools open, so we're going to provide ot services on campus and not provide virtual ot services or teletherapy services. That's pretty black and white. But what about when that's not the case? And maybe you are given the option to provide distance teletherapy services or on campus services. That might be the case when we go hybrid. If that, if your district is going hybrid, are you getting the option to either a see kids when they're on campus, or B do a distance learning program? We're not at the hybrid model, so I'm not quite sure about that yet. But what if that's the case? How do you decide what students can get a. Occupational Therapy Services through a teletherapy model, and which ones is that not appropriate for in general, we need to weigh the pros and the cons for teletherapy When making this decision. Like I said, things are a little bit more black and white right now, but when things open up, it might be a little bit different right now. As I'm saying this, I can think of those kids that are on my caseload that are just barely benefiting, if benefiting at all, from this teletherapy service model. And I just really want to bring those kids on campus, and hopefully those will be the first kids that we can bring back on to campus for services. Right now, California is in the works of putting together guidelines to bring some of our special education students who have high needs back on campus, and I'm sure other services, or, sorry, not other services. I'm sure other states are looking into similar opportunities. But I want to challenge you to kind of think about which students can and which students will probably not benefit from teletherapy services, and maybe need to be the first students to come back on campus. And maybe it's not just about the student's ability to attend to the to the computer screen for services, but also we need to consider the parent and family circumstances. Which of your families have the ability to be there when it's time for teletherapy services. Are your parents able to be there? Or is an older brother or sister able to be there during teletherapy? Maybe it's grandma or grandpa, but for many of our students, everyone's gone back to work, and now maybe it's the 12 year old sister at home alone with the five year old brother or whatnot, and you're trying to provide services for that five year old brother while that 12 year old sister is trying to attend to her what is that? Maybe seventh grade math lesson or whatnot. And that's not fair. That is not optimal, and it's very likely that the student is not going to benefit from occupational therapy services when there's no one there to help be your eyes and ears and hands. So if you're given the opportunity to potentially help the special education teachers decide which students to put into what cohort or for which students to come back first from distance learning back onto campus, definitely consider what's going on in the family. What did you and the special education teacher learn about the family, about the home circumstances for Student A versus Student B, back in the spring when we were all doing this, what students need to be on campus to truly benefit from their education? Those probably are the students that need to be back on campus the most. All right, so we're going to take a quick break right here, but when we come back, we're going to talk about a few different types of teletherapy models. But right now, I'd like to introduce you to my friend, Meg proctor from learn, play thrive. Hi. Meg.     Meg Proctor     Hey, Jayson.    Jayson Davies     Hey and welcome and thank you for joining us. I really appreciated all the content in your learn, play Thrive approach to autism. Course.     Meg Proctor     Yes, it was so much fun having you in the course. I actually have a new free 45 minute master class that I think your listeners will love. It's called autism specific strategies that transform ot practice.    Jayson Davies     That sounds great. Tell me more about it.    Meg Proctor     Well, even though the training is only 45 minutes, it goes really deep. I talk about why so many OTs are floundering in their work with students on the spectrum. Then I go over in detail the latest research on how kids on the spectrum think and learn. Finally, I teach really specific strategies that we can use right away to generate more meaningful and effective interventions.    Jayson Davies     From my experience. In your course, you always have fantastic research, so that sounds super exciting.    Meg Proctor     Yeah, you know, my goal is to really help therapists feel more confident and effective in their work, and also to empower more therapists to help our clients find joy, independence, connection and acceptance in their lives. This free training is a great place to start for both new and experienced therapists.    Jayson Davies     Awesome. Where can people learn more about this master class?     Meg Proctor     Well, they can check out, learn, play, thrive.com/masterclass . To start the free training right away.    Jayson Davies     Awesome. Thank you for that. And anyone interested in learning more about this can either use that link, or you can head on over to OT schoolhouse.com , forward slash episode 56 to learn more about the course. Thanks again, Meg, and we will catch up with you later. Thanks, Jayson, All right, welcome back. So before we jump into the three different types of teletherapy options that I really want to talk about today. I first want to briefly address a research article, and that is an article by Daniel wartveld and Karen Jacobs. I once had the chance to meet Karen Jacobs, actually, since the pandemic came about, it was actually a group of podcasters that had met together, and she happened to be on that Zoom. Call, and I briefly got to talk to her, but just from that short interaction, I can tell she is just very energetic and loves occupational therapy, and so I was happy to see this article from her. All right. Before I continue talking about it, let me make sure I get this title right. The article was titled perspectives of the use of telehealth service delivery model as a component of school based occupational therapy practice designing a user experience. Titles always tend to be long, but there's a reason for that. In this article, and they published it in 2018 I believe the research was actually in 2017 they interviewed more than two dozen occupational therapy practitioners on their perspectives related to telehealth or teletherapy. As a result of this article, some of the respondents actually reported some key benefits, being logistics, MTSS and classroom observations, support for homebound students, and collaboration, consultation and supervision. All of those were perceived as benefits. Let me explain just a little bit. First, you have logistics. They thought maybe with the idea of telehealth, it would mean less traveling for the for the therapist, maybe a better use of the therapist time because of that, less traveling, also because information could be delivered more quickly. Then maybe you could see more students in a day. They also perceived it as that they may be able to get more information out to more people more quickly, which that's a huge benefit, really. I mean, this is kind of nice about a podcast, right? I'm able to get a lot of information out to a lot of people relatively quickly, and that's all through the help of well, not teletherapy, but technology therapists also believe that telehealth, or teletherapy could be beneficial when it comes to the MTS, S and classroom observation side of occupational therapy within the schools, and they felt that because they thought it would be beneficial to to have parents and teachers understand more about occupational therapy, and they could do that through maybe recorded, recorded modules or something where parents and teachers could then better understand occupational therapy and could then help the kids that they work with. And that leads right into the whole collaboration, consultation and supervision benefit that could potentially be there with telehealth, you are only ever a zoom call away, or whatever program you're using. And so talking to a teacher, talking to a parent, is really simple. You don't have to physically walk across campus or drive across an entire district, right? And then also the supervision idea of it, it sounds like therapists really liked the idea of being able to supervise a therapist over a Google meet or Zoom call. The same thing was actually said for mentoring new occupational therapists. And I can't agree with that more zoom Google meets, Microsoft Teams, whatever it might be FaceTime, or whatever they call FaceTime for Google on Google phones, I don't know, but yeah, that is all a fantastic way to help more people in a quicker and easier format. I mean, people can mentor people across the state, let alone across a district or in the same same school. So that's really, really a great benefit of telehealth and teletherapy, all right. So whenever there are benefits, there are also typically some barriers. And so some of the barriers that were found as a result of still this same article, are logistics. And if you remember right, we had some logistics as a perceived benefit, but now we're going to talk about some of the logistics as a perceived concern. Also a lack of physical content was also considered a barrier. There were student factors, and I'll go over those in just a second. And then there are also just general concerns with evaluations as a whole. A few other perceived barriers that I will also go over, but those were the big ones. First, let's go ahead and talk about logistical barriers. Two of the highlighted logistical barriers included the lack of training related to telehealth for the occupational therapy providers. And yeah, I can imagine that was a huge logistical concern in 2017 and it still is today. You know, granted, we all have about three months of teletherapy now under our belt, even though we weren't planning for it. So things are a little bit better, maybe, but I still know that a lot of people are asking for teletherapy help, so there's still a need for training. As far as I'm seeing, we'll get more into that in a moment. But the other logistical concern was also about students being supervised wherever they are, and that is going to probably always be a concern. You know, we can't physically be there if we're doing or for providing teletherapy. Services, and we need to make sure that that student is safe, that that student is not in any sort of danger, that the student is not running away from the computer, right? Are they actually participating in therapy? So the ability to have someone supervising the student is definitely a key factor. And remember, this article was looking at the school based realm. So they're looking at, potentially, the supervision of a student within the school based realm. I can talk from my experiences, typically, when a student was was being provided a teletherapy service of some form, whether it was OT or speech, there had to be an aide in the room with the with the student. And that is not only a logistical concern about how that's going to happen, but that's also a financial concern for the district, because now they're not only paying for the therapist, but they are also paying for that aid that's going to be with the student. Just something to keep in mind. The next perceived barrier to discuss is that of student factors, and we're going to talk a little bit more about ethics next time in part two of this teletherapy series, we got going on here, but really quickly, there was a perceived barrier about student factors such as cognitive ability or behavioral concerns, and how that might play a role into teletherapy being effective. And you know, if it takes a lot of communication skills in order, at least that's what I'm learning, that it takes a lot of communication skills when you are working via teletherapy, you need to be able to communicate exactly what you're thinking, exactly what you want the student to do, as well as exactly what you want the parent to do, or whoever is working with the student on the other end of the screen. And so there's a lot of factors that go into teletherapy, including those student factors that we need to weigh when we're trying to decide if teletherapy will be an effective means for providing therapy services to this child, I think right along with that goes what is also an article lack of physical contact as a perceived barrier. As occupational therapists, we tend to provide not just visual and verbal prompts, but also maybe a slight physical prompt to a wrist or a slight physical prompt to some hands or two fingers or whatever that might be during a treatment activity. And so without that ability to have physical contact with the student and guide them in the in the way to whatever it might be, if you're working on Crossing midline or whatnot, you You lack that ability when you are in this teletherapy space, which just kind of goes back to what we were just discussing communication and how key that is. I mean, I was just working today with a student on some crossing midline, and one of the ways that I had to describe, describe to this student was, all right, I want you to touch the wall on this side of you, and then on this side of you, tap your mom's shoulder. And I mean, I've never had to use that ever in my therapy career, reach across, touch the wall, reach back and touch mom's shoulder. And that was just like a little warm up physical activity. And so imagine how much more complex that can be if you're getting into a real occupation of of writing, of using scissors, whatever it might be, in the classroom, getting organized. There's so much, I think there's a lot more physical contact than we actually realize in our jobs. And I think communication. There's more communication in our job as well, and when you add a third party involved that you have to communicate. I mean, whether it's the teacher or a parent or someone, it's just difficult, and you really have to be mindful of how you are speaking, and not only how, but who you're giving the direction to, to the parent or to the student. In that instance, of course, you can't really talk about teletherapy without there being some form of privacy concern. And that was also brought up in this article, of course, you know, back in March and May, the first thing that kind of popped up was zoom bombing and people getting into zoom calls. And you know what? There's always going to be people out there finding a way to get into a place that they shouldn't be that's going to be there. I think that as time goes on, you know, we're going to minimize that. And I think there's also a weighing of the cons and benefits, you know, is it worth the potential risk of someone bombing a zoom call to have therapy week after week after week. You know, if you just got to weigh those pros and cons, I think the idea of having weekly therapy outweighs the risk of potentially having someone sneak into a room. And you know, a lot of times that ends up actually being user air and zoom as well. The other platforms have gone a long way in fixing that by making sure that there's a password enabled, by making sure that wait lists are turned on or waiting rooms are turned on so that you know who's in your room before you actually let them into your room. So I think we're coming a long ways in that, but I understand that privacy is always going to be a concern, and then the last one on here that I really wanted to discuss was evaluations. Now I'm just putting it in in this segment, because it was a perceived concern. One of the things that is on the concerns list, but not on the potential benefits, is that evaluations. There was no potential benefit for evaluations. It is here under the barriers people. I mean when I say people, I mean occupational therapy providers are concerned about evaluations through teletherapy means. And I didn't really need this article to tell me this. You guys are telling me this in your emails that you sent to me, so I get it. Evaluations are definitely a concern to many of you, it is to me as well. So we'll talk more about that in the next episode. But today we're going to focus on the actual treatment within teletherapy. Okay? So we're going to talk about asynchronous, synchronous and the ability to provide consultations and collaborations. So I think the best way to start talking about the different models, different locations, if you want to call them or temporal spaces within teletherapy, and the different aspects that we have to consider when it comes to teletherapy. Therapy Services, first we got to talk about the traditional services when we are on campus. What are we looking at when we are deciding what type of services a student needs. If you've taken the A to Z school based ot course, or maybe if you've listened to some of the previous episodes of the OT school house podcast, then you know that there's three main areas that we look at, and that is the location of services, the model of services, and the frequency of services. But when it comes to providing teletherapy services, we have to add one more, and that is the temporal aspect of services when it comes to helping our students. What I mean by temporal aspect is that asynchronous versus synchronous aspect, whether or not we are providing the service, live with the child on the other end of a zoom call or a Google meet call, and they can see us and we can see them in live time, or via an asynchronous temporal model, in the sense that we are creating a video, or we are putting together an email that we're sending to the parent, and then the parent is doing that activity with the student at a later time. That's what I'm talking about when I talk about asynchronous model. All right, not to be confused with in synchronous model. That's a that's an NSYNC bye bye bye song. But now I want to dive into each of those aspects. Like I said, there's three original aspects, but we're adding that fourth temporal aspect when it comes to developing the type of services that our student needs. So let's first look at the location of occupational therapy services in a teletherapy model. If you're working in a full teletherapy model right now, because your district is completely on distance learning mode, then this is pretty straightforward. There's not much control you have over this. The location is the student's home, or wherever they might be receiving services. It might be the daycare. It might be, I don't know, at Grandma's house, and your location is either a somewhere in your school district, in a lonely office all by yourself, or maybe it's your desk at your home office, when we're at school and when everyone's at school, I should say, we often consider whether or not a a session would be best inside the classroom or inside our OT room or hallway or closet, wherever that might be. But when it comes to teletherapy, there is one location. Now I'll talk a little bit about whether or not a service can be in a quote, unquote classroom as far as like a Zoom Room or in their Google meet classroom. I'll talk more about that when we get to model. But as far as location, there's not a lot of options. So that does bring us to the model, the delivery service model, and how we are going to provide that service. So let's go ahead and talk about that. Now, I have four models listed here that we would use traditionally, and these same four models can be used in a teletherapy model that is individual services, group services, collaborative services and consultative services. So let's go ahead and start with, I think, one that most of you are most commonly using and most frequently, most frequently writing on IEPs, and that is individual services. Individual services are probably the most likely to occur during this teletherapy model, because it is just easier. Honestly, you are there on the computer screen. It's just you and it's just the student and hopefully the student's parent. It's simple. There's less distractions. There's not five different faces on the screen. It is you and the student. So. You can be over Google meets, it can be over zoom it can be over Microsoft Teams, whatever it might be. But that is probably the way that most people are doing teletherapy right now, just because of its ease. And you can just simply transition from seeing a student in a direct model in the schools to a direct individual model via teletherapy. The next model would be in a group. And now there's a few different ways to provide a group. You can provide a group within a classroom, or you can provide a group outside of a classroom. And that still holds true when it comes to teletherapy, you can either push into that preschool classroom and provide a group for all the students in there. It's tricky, but it can be done. If you're going to do that, you need to make sure that you are letting all the parents and everyone know what materials they're going to need way before you're actually going to do that. For me, I provide a group and a preschool classroom on Fridays, and so I make sure that either the Friday before or Monday at the latest, I am getting them a list of materials that they need, and not just the materials that they need, but how those materials should be set up. I've already learned that if you just send a picture of the activity that you're going to be doing, they are going to set it up like that picture. So even though I didn't want the rubber bands on the muffin tin already, they already had the rubber bands on the muffin tin. Well, that takes away part of my strengthening and finger manipulation exercise of actually putting the rubber bands onto the muffin tin. So make sure that you are being explicit in what they need and how you want them to be set up. And that goes for individual services as well, just like with providing group services in a well, brick and mortar type of classroom, you know, at school, not over teletherapy model. You need to also ensure that the that the students that you're working with have similar goals and similar ability levels, and that what you are are providing for that group is actually going to be helpful for every student, and not only two of the four students, or whatever it might be. So when you're going to think about groups, you need to consider what students can work well in a group together. And the last thing I really want to address as far as groups that you have to be mindful of is HIPAA and FERPA laws. Be sure that you are talking to your district about groups. Can groups even happen? Is your district willing to allow that to happen or not because of privacy laws at this point in time? I think people understand that it's more beneficial right now than it causes harm in order to be providing those group services, even though a parent from Student A might see Student B or vice versa and understand that they also have an IEP and they also have occupational therapy services. I think that is outweighing the consequence of not having services at all. Some students need that group service when it comes to the communication skills and those social skills involved. That's especially true when it comes to speech and language services. Oftentimes they are working in a group to develop those social and communication skills. For us, it's still true, especially with social skills. Maybe you're working on like the zones of regulation program or something where it works best in a group, or maybe you're just trying to get the students engaged through play, and more cooperative play, as opposed to isolated play. So definitely groups can be fantastic, but make sure that your district is all on the same page as to whether or not you are able to provide group therapy services. The last two models that I have here go hand in hand, and they are collaboration and consultation. I first want to start with collaboration and kind of share with you how I'm providing collaborative type of services right now. Maybe in the past, you've been able to go into a classroom and you can kind of sit near the student and kind of work with the student in the classroom as well as with the teacher a little bit well. Now that's very difficult, because if you speak in a Zoom Room, every single kid in that Zoom Room is going to hear you, right? So how am I doing that? This is what I'm doing a little bit differently. I'm going into the student's Zoom Room or Google meet classroom, and I'm simply observing, and I might observe for 15 minutes to 30 minutes, and now, before everyone gets started, I do not condone this type of collaboration when we are actually on campus, you should not be going in and just observing a student and calling that collaboration. But let me finish here. When it comes to teletherapy, I'm going to go in. I'm going to observe that student for 1520, 30 minutes, whatever I've kind of decided needs to be done. I'm also going to make sure that I'm going in during the right time of the day, determined by what their goals are. I'm not going to go in during math time if that's in the middle of the day, and we're trying to work on that getting started in the morning routine. That's not how it's going to work. So I'm going to go in at the right time, and then on top of that, I'm also going to schedule a debriefing time, if you want to call it. At and I'm going to, I'm going to debrief with the teacher, maybe later that afternoon, after School's out. I may also debrief with the with the parent or the student, depending on the level of the student, to use the example that I just kind of started down the road with, and a student's ability to get ready for their day and get started with that morning routine in a classroom? Well, I'm actually working with a student right now on exactly that, that morning routine right now, a lot of kids are having difficulty, especially, I mean, our kids, maybe they're they're getting up in the morning, they're still in their pajamas, they're showing up to zoom in bed. Maybe they're eating breakfast or whatever it might be. Well, that's not quite how it should be. You know, we want the students to be in classroom on time, and so I might go in observe a student from the time that school starts at 8am and then go through to 820 and then later in the day after school is over 130 or whatever that might be, I can then schedule that call with the teacher and with a parent and with the student again, if their ability level is there, and we can discuss some options, some potential strategies to try whether it be a checklist or a schedule. So that is one way that you could potentially collaborate. Other ways that you can collaborate is by going in and maybe you see some handwriting difficulties. Maybe then you meet up with the parent and the student later, and you let the parent in on some strategies that they can try. Or maybe you provide them with a handwriting checklist that they can take to their desk. Another example might be a student who has some sensory concerns, or maybe is easily distracted and needs a fidget that is something that maybe you see during that 30 minute period, and then later in the day, you collaborate with the teacher and the parent on some different strategies that we can use to keep them from getting distracted so much and keep them attending to the computer. Everything is different right now, so everything's on the table. Goals that might have been put in place last year may no longer be relevant, and you may need to potentially work on different goals. So keep in mind that services may look different now than they did when the student was on campus. When they were on campus, we barely talked to the parents as far as collaboration, yeah, we let them know how their student was doing on goals, and we talked to them at the IEPs. But now those parents are our eyes, our hands and our ears, and they're the ones that can actually implement change in the home where the student is for their education. So you're going to have to really help and really collaborate with the parents. Similar to collaboration, consultation is another way that you can provide services. And my only real difference between a collaboration in this sense versus a consultation, is that maybe you don't need to go into the classroom earlier that day in order to provide that consultation. Maybe it is happening in a one to one direct session, but you're really working with the parent on how to help their student in the quote, unquote, Zoom classroom, or whatever you want to call it. So consultation versus collaboration? I think collaboration is making sure you're getting into the classroom, versus consultation is more of talking to the parent, hearing their concerns, or talking to the teacher, hearing their concerns and giving them solutions to trial out. All right, so now we've gone over location and model. The next area that we must consider is frequency, and just like I was talking about a moment ago, how things can change because students are now in a complete different location for their learning, frequencies might have to change. Students who may have been able to attend to you for 30 minutes may only be able to attend to you for 15 minutes now, or maybe students that could only attend for 15 minutes now. Maybe computers work great for them, and you can get more done with them in a 30 minute period. You need to be consistently monitoring whether or not the frequency is the right amount of frequency for that student to make progress toward their goals. And as I also mentioned earlier, maybe their goals are different now, because they are on a distance learning program, every district is is taking this a little bit differently. Some districts are revamping the entire IEP versus others are kind of modifying the IEP slightly in an interesting way. And so depending on how your district is doing it, that can really change how your services look. And this now brings us to the fourth and additional aspect to consider when we're looking at teletherapy, and that is synchronous versus asynchronous. Type of therapy services, as I mentioned earlier, synchronous teletherapy services are those that we typically think of in a zoom call, where we are speaking and we are making actions with our hands, and the person on the other end of the computer can hear and see us in either live or very close to live time asynchronous or store and full. Word model is when you are creating something, you are sending that to the parent to the student, for them to do at a later time. So why might we choose either synchronous or asynchronous type of services? Well, because some students do better when they can be with you live, and other students do better when they can do that activity, potentially with their parent at a different time. There are so many aspects to consider when trying to decide whether or not a synchronous or asynchronous model will be best. Some of these factors include the student's ability to attend to a computer, whether live or in an asynchronous model. Another factor may include who's at home with the student, and at what time is older brother there and can actually help the student. Is a parent, grandparent or other Guardian available at the time that you need to see the student during the school day? For some of our students, that's not the case. Mom and Dad are at work. Sibling is on the computer in another room, attending to their high school curriculum, and there's simply no one there to be the therapist assistant, in a way, just as well. There could be the case where, yes, the parent is home, but there's also three kids that the parent is trying to help. They're trying to make sure that their teenager with ADHD is logged in. They're trying to make sure that their middle schooler is accurately getting from one class to another, because they're trying to figure out Google. And then there's the student that you work with who maybe the parent just can't get to at at the time that you need them to or maybe they just don't have time to do that. The parent is just frustrated and overwhelmed with everything they're trying to to make sure everyone's on the computer for class, they're trying to make sure that lunch is prepared. They're trying to make sure that the that the dishes are clean from breakfast, whatever it might be. But it's just hard for these parents, and so sometimes it might be easier to use an asynchronous model when working with our kiddos. So how do you prepare for when you have some kids on an asynchronous model and some kids on a synchronous model? Well, a synchronous model is pretty similar to seeing a kid directly in an OT room or in the classroom whatnot. You are there live with them. It's similar in the sense that you have to prepare your materials ahead of time. And like I mentioned earlier, you have to make sure that the materials are planned ahead of time at the at the house for the student. So make sure that you are sending in advance the materials that the parent will need. When you're looking at providing services in an asynchronous model. It's similar, but slightly different, because you're not going to be working directly with that student. You're not going to be able to, in live time, tell the parent how to adapt an activity that maybe that student's having difficulty with. And so what you can do is create a video or create a document that not only shares what the activity is and how to complete it, but also gives exactly the different types of accommodations that can be put in place if a student is struggling with a a specific part of the activity. So what does the parent do when their student is struggling to use tongs? Is there another way to go about doing this activity without tongs? Or what happens when the student will absolutely not touch the shaving cream that you were recommending in this activity. Is there a way to potentially put plastic over it so that they don't actually feel the shaving cream? There's just so many different activities and so many different ways to adapt the activities that we are going to be sending to our parents when using an asynchronous model. Recently, my go to method for creating asynchronous content for the parents is by developing a video. And I do this actually just simply using zoom or Google meets and I share a document camera so that the parent can see what my hands are doing while I'm speaking to them and telling them exactly how to model or to have their student create this activity that I've been doing. Some of my favorite activities so far have been helping the students to create mosaic art, where they're using a ruler and a pencil to draw lines, and then going back and coloring in those different shapes to kind of create a mosaic like art. And then they get to write their name on it, of course, or something on it in a nice, dark, bold marker. You can actually see an example of that on my Instagram account at ot school house. So then, after I've created a 10 minute or so video that has exactly what the activity is, how to complete it, and even several accommodations or adaptations to that activity. In case they need it, I go ahead and send that activity out via an email or the cloud or however, I can get it to them. Oftentimes, I upload it into the Microsoft cloud, and then I send them a link to it, and then they can view it and send me back some feedback after they've tried the activity with their kid. And so that's where. Out pretty well. I have also been using the zones of regulation program in a digital format in order to help my students. Using Google Slides, I've created a PowerPoint in a way that I work through with them. Now, before you email me right now and ask for that material, because I have had a few people asking for that as I did mention it in another episode. I can't share that with you for copyright and trademark reasons, but it is something that you can create. If you have the downloads or the materials from zones of regulation, you can actually kind of turn that into a PowerPoint and work that with your students. Many of the activities that I complete over teletherapy are very similar to the activities that I would complete in a traditional format, such as making a jellyfish to work on different ways of cutting and folding paper, or poking toothpicks into cardboard to match colors or letters or whatnot. A really fun one for the students was where they used their sandals to trace their feet or their shoe print onto a piece of paper, and then we put the shoe prints on the ground, and they got to jump from one shoe print to the next shoe print, making sure that their body was turned the correct way. I've also used American Sign Language as a way to work on visual processing and discrimination skills, as well as finger isolation and fine motor skills. Directed drawings have also been a huge success with my students, and I think the parents appreciate it, because it's so easy for them to replicate at a later time. Once I do that activity with them in person or even in an asynchronous model, they then understand how they can find a YouTube video that is a directed drawing video, and how they can press pause and help their student with imitating and visually replicating a picture from a YouTube video. Currently, I'm looking forward to actually putting together an activity where students are going to have to, well, the parents are going to have to help me with this, because we're going to take a toy, we're going to freeze it in an ice cube container, and then we're going to use some bilateral hand skills in order to get the toy out of the ice cube. So that's a fun one. I'm looking forward to it, but I'm definitely going to have to reach out to the parents in advance to make sure that they have the tools necessary to do that. So that wraps up the different considerations for teletherapy. Remember, we have location, we have the model of service delivery. We have the frequency and the temporal consideration of asynchronous or synchronous therapy, as I was talking about some of those different treatment activities. I'm sure there are several of you listening out there saying, Well, how am I going to do that when I don't have hands on capabilities with my students. You don't understand Jayson, I have students in a moderate to severe autism classroom, or students in a very low functioning, medically fragile classroom, and you know what? Well, here's what I have to say to that we have to learn how to transition from a hands on model to a communication based model. And what I mean by that is that our parents are going to be our eyes, our hands and our ears. They are going to be the people that we rely on, and we're going to have to learn how to communicate, not only to our students, but also to the families or the parent or the Guardian that is working with the student in that time, whether or not you're providing a synchronous teletherapy service or an asynchronous teletherapy service, you're going to need to learn how to communicate, and this is only going to help you even more when we actually come back to a physical school site, I already talked a little bit about how important It's going to be to make sure that you're communicating with the teacher and the parents in advance of your group or your individual session to ensure that they have the materials available. But also my advice to you and to myself, really is to slow down and remember that the parent and child cannot hear your thought process unless you speak it out. And so make sure that what you're saying to yourself in your head often, you need to say that out loud. You need to make sure that you're verbalizing those thoughts so that you can even let the parent know what you're thinking and maybe what you're thinking two steps ahead. Why are you telling them to get a different pair of tongs. Why are you giving them an instruction to hold their students wrist a little bit while they're coloring? As I say this, I think back to when I was a little kid, and my question was always, Dad, why do I need to do it this way? Mom, what do you mean? I need to do it that way. As adults, we question everything, and we want to know a little bit about what's going on and why we're doing what we're doing. Your parent is more likely to do something the way that you want them to do it and even do it later in the day, the way that you ask them to do it right now, if you explain to them why you're doing that, what is your process? What is your thinking? As far as why you're having them place their hand on their students wrist as they're writing, or why you're asking them to break apart their crayons, or why you're asking them to put a sticker on the kid's fingernails so that they can see their thumb when they're cutting all these are important not just to have the student do but also to explain to the parent why you're doing that. It may also be beneficial to send the parent a quick wrap up summary of what you did during teletherapy and how they can continue to build upon that over the next week, or until you see their student again. I know that takes a lot of work, but even if that is in some way, a copy of your documentation for the day. Maybe that is enough to help them continue the process. Okay, so that wraps up today's primary content. But before I let you go, I want to share with you a research article that's slightly more recent than the previous one that I shared. This article is from 2019 entitled parent perspectives of an occupational therapy telehealth intervention. It was published in the International Journal of tele rehabilitation. The article by Anna Wallace, Lauren Lytle, Ellen Pope and Winnie Dunn found that parents appreciated the collaborative telehealth model because they felt that the services were compatible with their daily life in the sense that they were more convenient and that they actually fit into their daily life. It was more about how the therapy services were in tune with what was going on in the house. Now, to be completely fair, these services were not provided from a school based model, nor were they provided during a pandemic. This was from 2019 and so I'm going to assume that maybe the actual research occurred during 2018 per se, and technology was a lot different. The current situation was definitely a lot different. And maybe they were working on school based occupations, but more than likely, they were working more on home based occupations because it wasn't school based. With that said, What is the educational environment these days? What is the home based environment these days? Where is the line drawn between home and school right now, everything's a little bit meshed together, and as long as students are receiving their education from home in a teletherapy model, it's going to be difficult to distinguish what is what and what school based occupations affect home based occupations, and what home based occupations affect school based occupations. Never before have the lines between school based and clinic based or home based occupational therapy been so blurred. What I can say from reading this article is that the parents really appreciated the collaborative relationship with the therapist. Some parents noted that it was helpful to have someone simply to talk about their child's occupations with and what their child was struggling as well as what they were struggling in in regards to how to help their student. They appreciated the ability to ask questions of the occupational therapist, and they felt more empowerment in their ability to problem solve activities within the house. They had a better understanding of maybe what an occupational therapist might be thinking, what an occupational therapist might do, and therefore they felt like they could better problem solve different occupations within their own home. So the next time that you are providing therapy through a teletherapy model, just remember that that parent is not only your hands, your eyes and your ears, but they are also the one that's going to be with that student the entire day for the foreseeable future. They are the ones that can carry out different things that you provide for them. They are the ones that can adapt their learning environment right now. They are the ones doing everything, and they need your support. Okay, so that is going to wrap up this episode of the OT school house podcast. Remember, this is part one of our two part teletherapy service. And yeah, I hope you enjoyed this first one. Next time, we are going to jump into a little bit about Medicare, Medicaid reimbursement. We're going to talk about evaluations, especially, that's going to be the key aspect for episode 57 and we're also going to talk a little bit about ethical considerations. We touched on it slightly today, but we're really gonna dig deep into it in Episode 57 and one last thing before I let you go, if you felt like I missed something in today's session, let me know, because I want to make sure that I've covered everything for you, and if I haven't well, then maybe this will turn into a three part series. But please let me know if I missed something, did I miss on what technology you need in order to provide teletherapy? Did I miss out on what software you need? Did I miss out on something? Let me know so I can get back to you and we can improve this. All right, take care. Have a great rest of your Monday or whatever date you're listening to this. I can't wait to see you in. Again or hear from you again in Episode 57 All right, if you'd like to see the resources for today's episode, check them out at ot schoolhouse.com forward slash, Episode 56 we will see you next time. 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 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