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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 47 of the OT Schoolhouse Podcast. In this episode, Jayson hosts Tony Tai Nguyen, a Special Education Attorney based in Southern California. Together we discuss why parents seek out attorneys and what attorneys are looking for in a good IEP meeting. We will also discuss why parents do not always agree with IEPs and what he is preparing for as a result of the COVID-19 Pandemic. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: ​ Visit Tony's website K12EdLaw.com Special Education Rights and Responsibilities (SERR) This is a resource that Tony commonly shares with parents and special education providers alike. 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 everyone. Jayson here. OT schoolhouse podcast. Thank you so much for joining me today. As you can tell, things are already starting off a little bit different with some music in the background. I really just wanted to start this episode off by acknowledging all the hard work that you are putting in right now. I just want to let everyone know we're all doing our best. We're all staying strong. We're all trying to help the kids that we work with, as well as the kids that are in our home, the dogs that are in our home, while we're trying to provide tele therapy, all that good stuff. And so I just want to say thank you, and stay strong. Keep doing what you're doing. The parents of the kids that you are helping are going through a lot as well, and just know that they appreciate every single video that you're creating for that student, every single worksheet that you're sending home, every single zoom Google meets call whatever way that you are getting to your parents. They are appreciating that. I also want to give a huge thank you to all the healthcare professionals. Of course, us as OTs are healthcare professionals, but for the most part, we're working in education. I want to give a huge shout out to all the OTs and other healthcare professionals working on the front line in the hospitals, in the nursing facilities that are seeing difficulties, just all those people that are taking care of our loved ones and putting themselves at risk. Right now, that can't be easy. But again, I just want to say thank you to all of those, and maybe you're in a school based OT and on the weekends you're working at the hospital. Thank you so much. Thank you for taking care of everyone's loved ones, and thank you for taking care of your own loved ones as well. I really appreciate it, all right, so we're gonna go ahead and make this a little bit lighter and jump into the episode. But first, here is 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     Hello, hello and welcome back. Thank you for bearing with me on that little bit of a somber intro. But I really just wanted to say thank you so much to everyone. All of you are doing a fantastic job. I've heard so many people reach out to me on Instagram, Facebook, everywhere, and everyone's just trying to do their best. I just wanted to acknowledge that today we have on a very special guest. His name is Tony Nguyen, and he is a special education attorney for parents. Very awesome. And he's going to be joining me in just a moment. You're going to want to stay tuned, if that's anything that you've ever been interested in, yeah, just being able to hear why parents go to him, and then also what his job entails and what he's expecting when he sits in on an IEP meeting, or when he is kind of summarizing what's going on in an IEP and has to decide with the parent how to move forward. So we're going to get into all of that in just a minute, but first, I just want to give you guys a quick update. I know people are interested in teletherapy and kind of what I'm doing. I know everyone's doing something different, but I just want to let you all in on what I'm doing, and what that is actually is a combination of asynchronous and synchronous. Teletherapy, asynchronous meaning that I'm actually creating videos of activities and sending them out to parents. These videos range anywhere from 10 to 20 minutes. Some have even gone slightly longer, like my zones of regulation PowerPoint that I put together. But yeah, it's just basically I looked at my kids goals and kind of and their skill ability, and basically put them into kind of like a category. And so I'm sending out videos that are specific to the skills that they need to work on to them. They might not be individualized, but they are very specific to the skills that that student needs to work on to meet their goals. So that is the asynchronous version. The synchronous version is that I'm using zoom to meet with students live, if you want to call that virtually live, right? And we're working on some sort of activity. Oftentimes it's the same activity that I'm sending out as a video, but I am doing it there with the parent, coaching the parent and this and the child through the activity. Sometimes the the students and the parents, they don't have all of they all the tools that I would hope that they would have in their in their home, like shaving cream or something. And so we we adapt, and we use what they do have for some students that looks like looking at what toys they have and saying, Okay, well, how can we make this toy that they have in their house acceptable to or not acceptable? But how can we make this toy that they have in their house developmentally appropriate so that they can improve their skills? So that's kind of what it looks like right now. I'm excited to keep on going. Actually, it does take a lot of time, a lot of effort, a lot of planning, but it has been rewarding so far. All the parents are super appreciative of both the asynchronous and the synchronous teletherapy. So without further ado, I do want to introduce Tony Nguyen again. He is the special education attorney at K 12 ed law dot. Com, that's where you can find him. If you want to learn more about him. I've had the pleasure of sitting in on a few IEPs with him, and he is just a class act guy, and he's doing a lot of cool things. So stay tuned. Here is Tony win from K 12 ed law.com Hey, Tony, welcome to the OT school house podcast. How are you doing this morning?     Tony Tai Nguyen     Hey,I'm doing well. Doing well, finally getting used to this work from home, or this COVID 19 thing so, so finally getting used to to the run of things around here.    Jayson Davies     Yeah, I think we all are now. I mean, the time that we're recording this, we're about two weeks into quarantine, just over two weeks into quarantine now, and people are starting to do some therapy. It sounds like schools are starting to figure out kind of what they're going to do, but yeah, we'll talk about that as we get further in. But to start off, I want to give you the opportunity to quickly introduce yourself and share how you got to where you are today as a special education lawyer.    Tony Tai Nguyen     Yeah, so my name is Tony Winn. I am a special education attorney, like you said. And how I got into this was actually an interesting story. It had to do with a girl, actually. And when I was in law school, I was dating a special day class teacher for a mild mod class. And you know, we had some distance between us because I was out, I was down in San Diego, and she was up here in Orange County. And you know, phone calls can be a little monotonous if you have, if you have a long distance relationship. So I decided to take up on an externship for a special education law firm, representing districts, I'm sorry, representing students at that time and and I didn't know anything about it, but I thought, You know what, let's, let's kind of dive into her world and see what she does on a on a regular basis. And from an externship, turn into a law clerk, turn into a paid position. And then, after my first year of law school, there was no turning back. I completely dedicated my my entire time in law school, to studying this and and you know, the other reason why I kind of delve into it and made my decision of going this route is I'm Vietnamese American, and I speak Vietnamese, and unfortunately, there aren't any Vietnamese attorneys doing this, so I'm the only Vietnamese speaking Special Ed attorney in the state. Wow. And actually, possibly the US. So I have yet to meet one. I'm for sure, in the state of California, but outside, I'm not sure, but I have not met one yet. So it's kind of interesting. It's kind of interesting.     Jayson Davies     Yeah, and we do have a pretty big Vietnamese population out here. One of my best friends is Vietnamese. And yeah, especially Orange County.    Tony Tai Nguyen     Yeah, yeah. Orange County is, if I read it correctly, we're the largest Vietnamese population outside Vietnam. So yeah, and California has has to the top that the top three locations. So it's here. It's in San Jose. Is the other location with with the abundance of Vietnamese residents. So Wow.    Jayson Davies     So then have you had quite a few clients then that it really helps having the language or being able to speak Vietnamese and knowing the culture.    Tony Tai Nguyen     Yeah, yeah. So, so when I first started the one of the barriers of all this is raising awareness, and this was about 2013 so there was still a lot of awareness that still needs to be raised culturally, and that had to pick up before I started gaining a lot of clients who were Vietnamese American. And now I would say about a fourth of my client base is Vietnamese, and the rest of them come from all all different ethnicities.    Jayson Davies     Gotcha. All right, I think I already know the answer to this. But are you licensed only in the state of California.    Tony Tai Nguyen     Yes, yes. For now, I'm only in state of California. I have plans of possibly going to other surrounding states, but right now it's a lot of work here in California.     Jayson Davies     Yeah. Okay, and so if you do get licensed in other states, then can you kind of do virtual type of stuff? Yeah?    Tony Tai Nguyen     So, so most of my clients, so I have clients all through the state, from from here in SoCal as well as up in the bay area. So the Bay Area in Santa Clara County, I have a lot of clients, and most of it is actually done virtually now. And I think, like every other profession, the legal profession, is kind of shifted to the virtual, you know, meeting, meetings over zoom meetings over, you know, video conferencing is very normal now. So working on a state, I imagine the same thing, the only thing that you would have to do in person would likely. We have to be one. I like to meet the kiddos a lot. All the kiddos I represent actually meet them in person. So that's one.    Jayson Davies     I appreciate it.    Tony Tai Nguyen     Thanks. And you know, the other thing is, is, you know the court systems, you got to be you got to be there in person. You know, whatever court proceedings or administrative law proceedings that they have, you have to be there in person.     Jayson Davies     Yeah, I really appreciate that. You do meet the kids. I feel like a lot of people, a lot of times, we're sitting in an IEP, and we have an advocate or a lawyer, and it sometimes becomes very clear that the person that we're talking to doesn't know the student. And I mean, yes, you can probably do your job without knowing the student, but, I mean, I wouldn't want to go to an IEP without seeing a kid recently, and I'm a professional that works with a kid, and so I think that's kind of just across the board, everyone should know the kid.    Tony Tai Nguyen     Yeah, I agree. You know everybody that comes to the IEP meeting you become a team member, right, part of the IEP team. And I feel that everyone needs to know the kid, and the more personal you have interactions with him or her, the better it is. And I think the more, the more your input carries carry some weight.    Jayson Davies     Yeah, definitely. All right, so before we get into the specifics about being a special education lawyer, can I ask, what's your day to day activities look like pre Coronavirus? Days? Of course, you mentioned a little bit of traveling, potentially zoom meetings. What are you doing day in, day out?    Tony Tai Nguyen     So I actually get this question quite a bit, and believe it or not, the majority of my day is fielding phone calls. If, in this area of law, I think that the really interesting part about it is that, you know, kids are by law, and by a lot of parents preference for them to go to school every day, right? Right? And if parents have concerns about a schooling issue or special ed issue or anything relating to to education, they see it every day, because every day their kid goes to school. And so potentially every day, I have to field a lot of phone calls because every day there's a new concern. And so that's majority of my day, believe it or not, is being on the phone with parents, being on the phone with with service providers that talk about the kiddo, the other parts of my day kind of I guess you can say it's a lot of the clerical side of things, and then I would say that the third of my day is actually doing record reviews, writing due process complaints, if that's a route that we're going for that particular family. But I would say a majority of the day is is hearing, hearing parents out, because there's so many updates that happen every day, every week and and to lend an ear for that, and to know more about the students most update info, as well as providing, I guess you can say a little bit of emotional support is really important. Is really important for those parents.    Jayson Davies     Yeah, I can imagine. So before we get into the specifics, you don't represent Me, you, or any person, or anyone that's probably listening to the show. But as we get kind of more into some detail, is there any sort of disclaimer that I know, oftentimes with lawyers, there's some sort of disclaimer.     Tony Tai Nguyen     You know what? It's such a lawyerly thing to do, but, but it's important. It's important for, I guess, everybody's protection. So anything that we discuss on here is, is, is my experience. A lot of it is storytelling and but any information that's provided here is, is intended as general information that that sometimes you can access through other meaning, through other means, but it's not, it's definitely not intended as as legal advice for any parents or any particular OTs or any other service professionals that that are listening to this for their particular situation. I mean, you're, we're going to be talking about a lot about IEPs and the I and IEPs individualized, so it's hard to talk generally about those kind of things. So, so, yeah, every kiddo is different. Every situation is different. So to the information that we discuss here is, is mostly general information.     Jayson Davies     Absolutely, so OTs, obviously, we work with a lot of kids, but some of us also have some of our own kids with special needs. I personally do not, but I know several who do first of two questions, I guess, what's the difference between an advocate and a special education lawyer? And then going a little bit further, why do people seek out advocates or special education attorneys?    Tony Tai Nguyen     Yeah, so you know the difference, the major difference, to be honest with you, that. And that's more noticeable, it's just the degree in the license, you know, for for a JD, and then your bar license outside of that, as far as experiences, I've seen a lot of excellent advocates out there who are very knowledgeable, and a lot of them, you know, carry experiences as either, like you said, parents, and they're also professionals. Some of them were previous special education administrators, special education service providers, things like that. So they do carry a lot of experience. The only I guess you can say some parents are are would select one over the other is advocates, because they're not licensed. As far as lawyers, they tend to be a lot more, more or less taxing on on the fees and the cost. But on the flip side, on the flip side of that, you know if, if you're successful in a claim, let's say you have a claim against the district and you're successful, that success also could come with attorneys fees. It doesn't come with advocate fees. So whatever advocates you may have brought to various proceedings, various meetings and things like that, with the district, those fees are not recoverable if you hire an advocate, you know, so the parent hires an advocate and and sometimes the advocate costs can be fairly high. I've heard advocates cost upwards to 150 plus per hour. And you know, some attorneys are just barely over that threshold. So is so it sometimes is definitely wise to bring an advocate, because it's more cost effective and things like that. On the flip side, a lot of parents later on discover that that those fees aren't recoverable, while attorneys fees could be recoverable. So that's that's one major difference. The other one, to be honest with you, is, is some parents tell me this, I haven't experienced this myself. Some parents say, you know, I've hired an advocate and I've hired a lawyer. It seems like when I bring the lawyer, I get more of a successful result than when I brought the advocate. And you know, when I hear those stories, I can only think of, you know, I guess from from a district, stand for point, or a public school standpoint, it's just seeing the the threat of litigation possibly bring an advocate. So, so that's those are some of the differences, but, but I'll tell you, in this state, particularly in California, advocates can represent you out of due processing. Um, so, so as far as going up to the to the due process, hearing or layman's term would be like a trial in this type of of a matter, bringing advocate or brain attorney can be equally as effective depending on their experience. Here is, I would say, is the biggest hurdle that a lot of parents have to get over when, when, when they do hire an advocate is because there's no licensing for them right now as an advocate, and because there's no licensing requirement, there's no regulations as well. So if, if a parent decides one day to say, look, you know, I've had a lot of parenting experience. I'm going to go out and open shop. There's no regulations right now in the state of California, there's nothing. There's no oversight by the state of verifying if these individuals have actually some type of an experience as a baseline to carry on these services, and so that parents are are fearful of that because they don't know the true experience of the minimal experience of some of these advocates.     Jayson Davies     Very true, good point. And so then going along that, when do you see parents seeking you or advocates out? Why are they coming to you usually?    Tony Tai Nguyen     So, so there's, I would put them into like, maybe three major categories. So for the very first one is that they're just starting off in special ed, so you're looking at early intervention, and you're, you're on the cusp of about three years old, and parents go through their very first initial IEP, or the initial assessment, actually. And they're like, what's going on? What am I getting myself into? Right? Yeah, what's going on here? I thought, you know some parents, they get an earlier diagnosis from from a medical provider, and they're like, Well, why isn't this enough? Why is there so much testing? The process is unfamiliar to them, so sometimes they'll seek me out as as a guidance or as a coach, if you will, to kind of just mandate them through the process without any type of legal representation. Most of them have zero violations and zero claims. It's just something that makes them a little a lot more confident to make parent decisions. In the same in the process. So that's, I would say, that's the that's the first set of set of parents. The second set of parents would be parents that that are asking for assessments or asking for to start something and there's a disagreement between them and the public school. So a parent might come there and say, Look, I have a medical diagnosis. I have suspicions that my kiddo might have some difficulties in school. Can you assess and the public school denies it for one of one reason or another, so the kiddo doesn't have an IEP yet at all. Okay, the third set of parents are the ones that that have IEPs ready. And in their opinion, the and their perspective, the IEP went went wrong at some point, whether it be that they don't agree with an assessment services are not are not adequate for this student, or if year to year goes by and there's they're seeing no progress and so so issues surrounding an existing IEP already. So I would say early intervention, and then just the start of IEPs, or the denial of even the IEP process, and then, and then students with an IEP. So those are the main, main categorical reasons why I think.    Jayson Davies     Yeah, and I often find that I don't know. I mean, I've been in, I've been in schools now for about eight years, and I find that oftentimes there's a miscommunication prior to an advocate or a lawyer showing up with an IEP team, and I really feel like that's where I try to always try to be transparent and stay in communication with the parent, whatever means it takes. Because I just feel like oftentimes, when you leave an IEP and things just aren't settled. Sometimes a few days later, a few weeks later, that's when we get a notice of an advocate or lawyer be on the team.    Tony Tai Nguyen     Yeah, you know, it's, it's, it's great that you bring that up, that that your willingness to follow up with possible miscommunications. And a lot of times it is just that, you know, not every phone call that I get, and not every initial consult I have with parents end up in me representing them. A lot of times I say, You know what it seems like, like there may be a miscommunication here, like you said. Or can you check to see if this is correct? Because I don't want to dive into something where, where, you know where there was a miscommunication that could be easily resolved. But a lot of times I would say, I would say, is that the feeling that they get is either one, a lack of effort from the IEP team or any of its members, a lack of effort, and two, the lack of response or something relating to truthfulness and something that that there's a disconnect, whether it's not somebody who's like, particularly lying or anything like that, but maybe parents asked for I had a recent situation where parents are like, Hey, can I get some of his schoolwork and and this particular educator could not provide any schoolwork, and so parents are like, well, what is he doing there all day? Can't you give me even one or two worksheets? And they could not. And that's where it gets really difficult for parents. So I guess you could say the mistrust is there, and that's when, that's when they would would kind of seek my help as well.    Jayson Davies     Gotcha All right. Cool. So I want to kind of move now into the quote, unquote IEP room, if we can and talk a little bit about evaluations. When you're stepping into an IEP, it's an initial or it's a try, what type of things are you looking for in the evaluations? What kind of things are just kind of in your head that you're looking for either this is great or this isn't great.    Tony Tai Nguyen     Yeah. So the very first thing about evaluations, regardless whether it's OT or any other areas, is whether that assessment covered all the areas of suspected need. So if a parent writes a letter or make some type of an email to say, my kiddo has a, b, c, 123, these are the difficulties that he or she is showing. The assessment should cover all those suspected needs. You know now, if the obviously, if the public schools not seeing any of that that can be, that can be repeated to parents, hey, we're not seeing this. But, I mean, I'm speaking from a parent's perspective. They're seeing it at home. They're not at school with the kiddo, you know, for the entire time period. So they're like, Well, if I see it at home all the time, he or she must do it. Sometimes at school. But you know, from my experiences, I'm sure from yours, kiddos act very differently between home and school. Yeah, sometimes better in one environment or the other, right? But most kids very similar in all those environments. So I would say one, make sure all the areas of of the educators, what the educators see as as potential issues, and what the parents see, that's one, the second one is, is the lack of data. So I'll give you an example. Let's say you have a certain testing protocol or testing procedure that you're going to use. The testing procedure has multiple sub tests. Okay, if I see a, if I see a testing procedure that I know have, let's say, four or five different sub tests, and I only see one or two as as the report that's gonna, that's gonna really, really make me alerted. Because, okay, why? Why wasn't it completed? Now, if there's a, if there's a legitimate explanation for it, absolutely, you know, a lot of times, is the child is, is too low functioning, or for whatever reason that that test may be excluded, then great. But if there's no explanation about that, that's problematic, that's really problematic. Or if I see blank grids, believe it or not, I see blank grids all the time for for sub tests, for multiple areas, I will see some, some using a percentage or a grade equivalency, and then others using a scaled score or standard score. But they don't report all areas. They don't report all of it. And I'm going beyond ot testing. Yeah, there's other areas of testing, of course. The third one I definitely look at is whether or not the assessments interact with the other assessments. Okay, so let's say you have an OT and the OT assessment says, you know, we couldn't perform all the testing because of behavioral issues, okay, and that's very common. That's very common, especially for sensory seekers, kiddos on the spectrum, things like that. But the testing, when they say that the kiddo has a lot of behaviors, it doesn't relate to the beat that maybe a functional behavior analysis. So so a recent case, I had a kiddo who had the tendency of throwing things and slapping, slapping educators or staff's hands okay when he or she didn't get what they wanted. And so from from that particular targeted behavior, that behavior of slapping and throwing things, never made its way on another assessment, like an FBA as a target. Okay, so while it's identified done greatly by the OT, you look over at the FBA and you're like, Huh, why? Why did it not make it its way over there? And so the interacting between testing and assessments is is really important for me going with behaviors. And that reminds me of a recent situation as well, where I had a kiddo with behavior. So there, the OT had literally two pages. The OT report had two pages. And while I can't speak to how lengthy a report should be, the first half a page just had the kiddos demographics, but what it said was the kiddo had such severe behaviors that we had to discontinue testing and then, but, but the assessment only made one trial of doing that. The the assessments.    Jayson Davies     Yeah, and so to be able to state, okay, well, the student wasn't able to do it. And then, like you said, try again, potentially. But then even if, even if you can't do that, you can still get into the classroom, do up some observations, go out to recess, go out to whatever, get observations on multiple occasions. So that's what I would expect to see.    Tony Tai Nguyen     Yeah. I mean, you hit it on the nail. I actually, if that's not possible, at least observe. At least observe. And when you observe, one of the things I look at is where you observed, how long you observed for, and what date you observed. Just like adults, we have good days and we have bad days, and so the kiddos are the same way. We have good days and we have bad days. And if you've only made one attempt, it's really hard to show that that's that's a true. Indication of the kiddos, ability of the students, ability. So doing your observations is extremely important, especially if their difficulties surround unstructured activities, structured activities, classroom settings, things like that. I think observations need to cover all those areas. Okay, I    Jayson Davies     want to move on. But one, I want a quick answer for this one, number one reason for IEE request,    Tony Tai Nguyen     parents disagreement that the IEE reports show difficulties and there was a denial of services somehow, okay?    Jayson Davies     And just for everyone out there, in case, IE is in the nationwide term, it's an independent educational evaluation. All right, so again, I want to, really want to get to goals and services, because I know that's what our OTs listening are going to want to hear about. But the present levels really quickly. What are you looking for? What are you not looking for?    Tony Tai Nguyen     Yeah, so a lot of present levels right after usually a triennial. I know a lot of districts practices is cutting and pasting from your assessment reports and dragging it right into the present levels. But assessment reports don't test every skill within the classroom setting or even an unstructured setting, right standard scores don't relate to an actual skill level sometimes. And so what I'm looking for in present levels are specific skills that's expected during that age group. And where's the kiddo at then? Okay, so if a kiddos in kindergarten and typical peers, you know, perform this way, you know, how is this kiddo doing in in, in that certain area? So present levels, what I look for is not just standard scores, because that doesn't cover anything, yeah, because, because standard scores don't always convert to goals, right? They should not so, so putting just standard scores on present levels alone in the IEP doesn't really cover the entire the entire skill set that the student has.    Jayson Davies     All right, So let's move on to goals. Then I talk a lot about smart or smart e goals on the podcast, the E being educationally relevant, but one thing I remember you noting is the baselines when it comes to goals. And I sometimes think baselines get overlooked. So what? What do you think should be in those baselines if you're writing a goal?    Tony Tai Nguyen     Yeah, so baselines are, that's the first thing I look at when I look at goals truly. Just think of baselines as starting points, right? And starting points is, you know, we all write goals, usually from from an annual basis, so for the following year and but we need to know where we're at today, okay, so going relating back to the present levels and using today or standard scores, what I see sometimes our problematic baselines are using standard scores as a as a baseline. You know, the student standard score for this skill is this, yeah, and, but in your goals, you always have either a four out of five times or you have a percentage accuracy, right? Yeah, those two have to relate to one another. If we're saying, I'll give you an example. We want a child to hit a student to hit a certain skill at 80% right? You can't give me a standard score on the baseline, because there's no way to indicate where they're at. Yeah, right. You have to give me likely a percentage. What I generally say is the baseline needs to be almost as specific as the goal.     Jayson Davies     Yeah. Recently, yeah, it's just making sure that. I mean, you basically have to rewrite the goal into the baseline and say where that student is. And if you're going to do four out of five, four out of five attempts for your goal, then in your baseline, if you can try and say how many times the student can hit the ball or whatever, in five attempts, maybe right now they're at one out of five attempts.     Tony Tai Nguyen     I think what you just said is an excellent tip. It's pretty much writing the goal, but where they're at right now, and that's it. So that's that's a really good tip. The other thing I really see problematic in baselines are really vague terminology. So going back to the student performing a certain skill at 80% and in the baseline, I'll say Johnny is having a hard time throwing a ball. Johnny is having a hard time gripping a pencil. Johnny doesn't like holding a pencil. Things like that that have no specificity to the to the goal is. Is, is could be really problematic, and I'll tell you why it's problematic. And this is, I'll be honest with you, this is how I present it to parents when they come to me and I'm looking at their goals. So let's say you have year number one, you don't have a baseline, you don't have a legit baseline, and your goal is at 80% okay, year number two comes around, and the student, let's say, doesn't meet the goal entirely. A service provider might say, Hey, can we continue this goal? And parents are like, Great, let's continue it. But what happens the goal, just by habit, gets copied and paste into the new IEP of year two along with the baseline, the baseline doesn't get renewed. Oh, man, so you now you have two consecutive years with bad baselines, but the same goal, right? Yeah? Well, parents really don't catch on sometimes until the third year, and that's when there's like, wait a second, same goal, yeah, with no renewed baseline. So from from a from a parent standpoint, they feel kind of like, Wait, so how is how's my kid, ot doing? How's Johnny doing? But on the flip side, from from a district standpoint, it may be really hard to even demonstrate progress if your baselines never get renewed.    Jayson Davies     I agree. Sometimes I sit in IEP meetings, and I personally like to say a goal is either not met or it's met. I don't really like using the partially met term. I will say a goal is not met, but progress was made, and this is what that progress was. But I feel like a lot of times you get that vague progress was made, but it wasn't met. Well, what does that?    Tony Tai Nguyen     Yeah, yeah, you know, I mean, we, we've all seen it. I'm sure you've done it. I've done it a certain skill. You've seen a certain skill that that that a student needs, and the student is just having a hard time meeting it right, and you want to continue it, because the skill is so important, it's so foundational, it may be, but if you don't renew the baseline, it's actually really hard for you to know whether or not the kid made progress as service providers, right? And then what if? What if you get transferred from one assignment to another? You know your, your, your, the following OT is going to come in there and go, What? And go, wait, what? Like, where was this kid, OT? And what might happen is you start duplicating the same services as far as, like, how you do things that maybe didn't work before. And so sometimes that that happens as well. So, so, so, yeah, I would say baselines are, are so critical. That's the first thing I looked at in a goal. Actually, I don't care what the goal looks like. I actually care what the baseline. I care what baseline looks like and and I think it's one of those things where I look at to really see progress or not. And remember, if you continue to goal update the baseline, yeah, because it's the present level, right? That you got to update it.    Jayson Davies     Absolutely alright. So one more thing with goals, I want to ask you, because in the OT world, there's kind of this. We are educationally based, right? We're not working at a private practice, and in a private practice, we often have very ot specific goals, but in the classroom, a lot of it is educationally relevant, and we're trying to help that student do educational skills. Do you have a take one way or the other on? I don't want to even just call it ot specific goals, but service provider related goals versus IEP team goals as a whole or collaborative goals? I don't know if you want to speak to that.    Tony Tai Nguyen     Are now by collaborative goals. I'm guessing, working with either the gen ed or the special ed teacher.     Jayson Davies     Yeah. So instead of a specific ot goal to write or to maybe, like, write individual letters, we might tag on to a teacher goal that is for the student to create a sentence, and it's a teacher, it's an educational goal, but we are doing our part to support that goal.    Tony Tai Nguyen     Yeah. So what I usually do, I know exactly where you're getting that. What I usually do is look at it from a skill standpoint. So if a student just going off of your example, the student has organizational difficulties on writing a sentence or writing a paragraph, right? That organizational difficulty is a different skill set than possibly legibility. Yeah, right, if you can, and I've seen it done where you can merge those two into one goal, okay? But the problem is, is that your goal is going to be very lengthy. It's going to be very lengthy because you're going to have to get specific on what legibility is, and then you're going to have to get specific on what the rubric for a structure. Paragraph, let's just say looks like. What I would say is just split those into two goals. Yeah, split those into two goals. And what you can write down under the notes section is it relates to each other. You know, goal number one from the academic writing. Goal relates to goal number one from the OT legibility and fine motor goal or something like that, so it interacts with each other. When I see those goals are so difficult, I would split up. And here's another reason why, because a student's organization, let's say, for example, the organization is absolutely met by the following year, but the legibility is still horrendous. Technically, if you combine those two goals together into one goal, it's not met, right? And when that happens, you know, I'll relate it back to your miscommunication, right? Where parents are like, Wait, my kid's not making progress. Well, the kiddo might have made progress in the organizational sense, but unmet on the legibility sets. So that's why I say, you know, splitting them is, is, is a benefit. The last benefit of actually splitting these goals when you're when you're thinking about it, is two years from now, if, let's say, there's some dispute between the district, and an OT gets called in for as a witness, you know, for for some type of a hearing, you'll know which goals you're absolutely responsible for, yeah, right. Instead of seeing a big, a big goal that has multiple skills, and then you're confused of what was your part,.     Jayson Davies     I never thought about it from that way. That's a good way to think about it. Always, what would happen when you get to due process?    Tony Tai Nguyen     Yeah? You know, it's one of those things where I think looking from the other lens, it's like taking ownership of of your specialty, of your expertise, right? And that's, that's, in this case, fine motor, or, you know, with that goal, gotcha so?    Jayson Davies     Yeah, no. Thank you. This question wasn't on our little list of things that I wanted to ask you, but according to the law, what is the IEP team's responsibility when it comes to meeting goals? And I don't know this because I've heard it over the years, it's like, well, the kid needs to meet their goals. Well, no, they need to make progress on the goals. No, it doesn't matter if they make progress on the goals. Progress on the goals, as long as we're doing our job to try and help them make progress on our goals. But you might have a better idea.     Tony Tai Nguyen     Yeah, so it's clear as mud as many times as as courts go through this. But technically, they they don't have to meet every single goal they have to make the meaningful progress in it and and, you know, the latest case was a couple of years ago on the standard of what's what's appropriate and what's meaningful and all these things. But what at the end of the day is that the Kittle has to make progress. You know, no doubt about it. Now that doesn't mean this either. You know, you go from one annual IEP to another and they don't make progress. It doesn't mean that, oh man, something that the world's gonna fall apart. No, you reassess it, right? You reassess the situation, maybe through formalized testing, or maybe through less formalized testing, and you may add more goals. You may adjust certain goals. You may adjust methods of implementation, accommodations, supplementary aids, services, so you have this big toolbox of how to adjust them. You know, the law doesn't require everybody to get this stuff perfect. That's why I think that a lot of people call the IEP like a living document, right? Like it can be changed at any point. And so with that said, you don't have to get it perfect on the first try. It's just on that day when you guys met at a particular IEP meeting, what was appropriate right then and there. It's a snapshot of that meeting, yeah, and then, and then, anything that happens after that, whether it be changes in whatever circumstance, from a district standpoint, from a kiddo standpoint, um, changes can be made. The the I guess, where things sometimes go wrong is when changes are not made right, and the kiddo still hasn't made progress. So so you have a lot of tools in in your toolbox for both from a parent side, from a district side, to to really make changes, to get to get it as right as possible, but at the end of the day, kiddo has to make progress.     Jayson Davies     Yeah, yeah. So has to make worse. And you don't know, again, going back to those baselines and the goals, you don't know if they're making progress, if you're not putting in baselines and then updating those, and it's all a big circle, right? And I.    Tony Tai Nguyen     Yeah, so that's, I think, I think you're right with that. But if you don't have those baselines, those are the things that you can show for yourself and for for the parents, of where, of where the student is, as far as progress goes. And let's get real. Every year is a kid who going to make some progress, possibly, but is it enough to say, Yep, the kids making progress? No, that doesn't happen all the time. And when that doesn't happen, it's okay to say he didn't make progress. But this year, these are the changes we were going to make. There you go. And if those changes are agreeable and parents feel that's appropriate, then then you're not gonna have any problems.     Jayson Davies     Yeah, yeah. All right, so let's jump into services a little bit. I'm gonna try and ask you some sort of question about this. I don't know how it's gonna come out. Gonna come out, but services are so dynamic, right? And we already talked about plops the present levels. We talked about goals. And as you know, plops lead to goals, and goals lead to services. So now we're getting to near the end of the IEP. What are you looking for in those services?    Tony Tai Nguyen     Okay? So the first thing is that, you know, when, when parents, when parents come to me, the first thing they they ask me is, like, hey, my services page, like, why are these lacking? Yeah, right. They don't think about what you just said, of of the goals, and then the present levels, or even, you know, assessment information. Sometimes they just look at straight at the Services page and go, This is what I got. Now, when that happens, you're right, you have to look at everything that comes before that. I usually tell parents. It's called, you know, when you when you want to get where you want to be, you need a GPS. And so needs right are shown in Present Levels and assessments. And then G stands for goals. P stands for placement, S stands for services. So you need a GPS, and when you get to the s part, when you get to the services part, the service provider has to be able to realistically say that given the amount of needs and goals here, this kiddo can make progress on this much of service or this style of service, okay? And a lot of times, um, it doesn't match at all. On its face, it doesn't um. One of my worst cases was, was actually for a speech service, a kid o was a student was non verbal, and get 50 minutes of speech, 5o minutes of speech per year, per year, okay? And it's not a typo, because it was written in for year after year, and obviously on its face, no educator, no specialist, can look at that and say, Yeah, that's legit. But I think the more important thing is, from year to year, if the kiddo has more goals or more difficult goals that he or she is not making. Something's got to change. Something's got to change, whether it be the method delivery, whether it be the amount, the frequency of it. A lot of a lot of public schools like to write things in a yearly sense, to have more flexibility for a certain service. So let's say, like, 1000 minutes for an entire year, versus you shrink it down per week. Sometimes writing it per week makes more sense to to the IEP team, because now you're, you know, you're committed to consistency. Yeah, you're committed to consistency. Because if you write it in a year, technically, you can load it all to one month or two months, and you're actually covered. But it doesn't really change, um, I'll tell you where, where services kind of, nowadays, kind of fall apart. There's a lot of classes and a lot of programs where services are embedded. Okay, so we're an autism month here, so a lot of it has to do with these autism specific classes. So autism specific classes, or special day classes, sometimes offer a social component, a behavioral component, and an OT component all all embedded in the class. So the speech pathologist, the OT and the behavioral specialist would come in for an X amount of time every week, because that's the that's the bare minimum for that program. Okay? But here's the thing, while it may be appropriate, let's say that the OT comes in through a collaboration model, working with that special ed teacher and working with the students in the classroom for, let's say, an hour a week. Some schools don't write it into the service grid. Okay? And a school might. Call one like, let's say this autism specific program is called program number one. If a child moves from that district to a new district, their programs are not going to be named the same. They're not going to be named. The Autism Program might not be named program number one. It might be named program number two, but nobody knows what's embedded. Yeah? What worked in district number one, let's just say, let's say there's no ot component in program number two. Then how is a parent supposed to know so the parent knows that it was working in the first district moves the second district still an autism program, but maybe that autism program doesn't have an OT component, does that make sense? Yeah. So, so even through a if it's embedded in a certain program, it needs to be specific enough, or else parents are gonna think, and this may be a miscommunication, that there's no service.     Jayson Davies     Yeah. So let's go back to that then. So then you would like to see, using the example, the OT goes into that classroom an hour a week to collaborate. You would like to see on that IEP, then that service basically one hour of OT per week going into in the classroom, collaboration.    Tony Tai Nguyen     Correct, correct. And then the reason why is, and you can write, there's always a note section in every service grid to say, you know, why are you choosing this model or this this frequency? You can write, oh, this is part of the district's autism program. Okay. You know, this is embedded in districts off, yeah. So, and going back to the dangers of that, is actually it from, from, I guess, from a district standpoint, they might look at it of a parent coming in and go, there's no OT. Why is there no ot in my service grid, I have ot goals, but when they've never heard it's been embedded in the program, and then they hear it after they raise the concerns it, it could lead to a mistrust or a miscommunication. Yeah, yeah. Versus if you write it in and you say, this is the embedded program. And you know, as more and more specific programs come up, these are the issues that seeing, especially if parents move away, they don't know what that program entailed that worked for their kiddo, and so their kiddo moves and and everything falls apart, because now.    Jayson Davies     Gotcha, yeah, we always have to keep in mind that a parent or a student could up and move the next day and be in a whole new environment. So all right, so we're through the IEP, we went over the Plop services, all that good stuff. What is your role after that parent? Now you're already with the you are already with that parent or the student. What's your role if the parent then decides they don't necessarily agree with the services and everything?    Tony Tai Nguyen     Yeah. So you know when, when a parent leaves an IEP, they have the right to either not sign for the IEP, not consent to it, they can partially consent to to it, or they consent to the entire thing, right? A lot of times, if they don't agree, what I think all of our experiences is, is they don't sign it all, right? They don't sign it all they don't want anything changed. My goal at that point is to talk to the parent, and I'll be candid with you. I ask them, you know, what are you looking for? You know, what is it that that you feel is lacking from these IEPs? Now, if they say, Well, you know, I know that I have a special day class, I have ot services and have speech and I only have problems with my ot service. Well, if that's the only thing you have problems with, then personally, you might want to think about considering signing for the other two right for your special day class and for your speech at least. I think what parents come to me and hear a lot is a lot of districts somehow getting the message across. And this could be a miscommunication or not, that if they don't sign it, they don't get the services. And that's what the parents hear. If you don't sign you don't get services. But a lot of times what what teachers and case managers mean to say is, if you don't sign it, you're not going to get the current services that we proposed in in in this particular IEP, it's not like your IEP gets cut. Yeah, right. So when they come to me, that's the feeling that they usually get. Okay, they have a feeling that services are not going to be provided because it's not adequate. What I usually do is engagement and discussion, a really in depth discussion of what is it that they think that could make this to be the appropriate IP it should be? And this conversation usually starts there and it ends somewhere. Of, you know, he hasn't been making progress, or she hasn't ever gotten any of these, any of these services, really, you know, be. Has failure to implement, or whatever that the cases may be. So my role immediately afterwards is, is try to come up with a with a method of conflict resolution. And sometimes it's it's just reaching out to the administration and saying, Hey, do you want to talk about this? And trying to resolve it without any type of formalities, and sometimes that doesn't work, and we have to seek a little bit more more formal means. But really, most parents come to me and they go, Look, I just want what's right for my kid, and I want to resolve this in the quickest and least painful way possible. Because when, when you start going through the formal litigation route, it takes a lot of time, it takes a lot of money, it takes a lot of stress, heartache, things like that, from both sides. You know, parents didn't become parents to to file lawsuits or anything like that, and educators didn't go into their field, especially in special education, knowing that there'll be a witness in something like that, and so. So my general personality and the way I usually handle things is, hey, what's the easiest way on, on, on the parent side, that's my that's my top interest for the student, where the student needs something right away. They don't have time to litigate, you know. And then also, you know, thinking about the IEP team afterwards, after the conflict is resolved. How does that work? And so all those dynamics play together, and it's usually a very successful outcome. My, my, my success rate for reaching some time in agreement with the district is very high because I think there's that working relationship.    Jayson Davies     Yeah, and that's one thing that I respected about our meetings together, is just how, how respectful you are, how you kind of have a way to see things from all points of views, all points of view, and and it seems like you have a good rapport with your parents and even with the IEP team, so it's nice to have you on board. All right, so we'll dive into this just a little bit that is the Coronavirus. I There's so much that we could go on and on about this. I'm sure you are talking to many people about this, and you probably have parents asking you a lot of questions. I just want to ask you, in your perfect world with everything going on, obviously, we can't take Coronavirus out or social distancing out, but what would you like to see as far as how the students are getting their education and services?    Tony Tai Nguyen     If To be frank, I think that you know, sometimes school providers, school employees, have different rights than private service providers, you know, because they work for essentially the government. And a lot of times, as far as my understanding goes, a lot of non public agencies and private providers are still working to this very day, I have ABA companies that are still working, and things like that. So interesting. I think, in a perfect world to finding those those resources for those kiddos is really important. The downside of that is that it's very costly to outsource things. It's very costly, and everybody's aware of that. Yeah. The thing is, is that for for your most, particularly for your most vulnerable, severe populations, that's still needed, you know? So I still think, for the extent that you can access private parties to still provide this in a direct sense, that still needs to happen. I've had a lot of phone calls from this from parents after the first week where, where the shock wore off. I've done a lot of phone calls. And the phone calls, from a parent standpoint, is that they're very understanding. I haven't had a parent that I think you described in one of your podcasts is like the helicopter paragraph, where, where, where. You know, if they're very upset, they're not, they totally get it. No, they totally get good to hear. They totally get it. But I think the more upset ones are going to be the ones where there are school districts out there locally in Southern California that I flat out said, you know, students doing this online thing, everybody's voluntary, because when they don't make it mandatory for for the gen ed population, then special ed rights are limited right, and so those parents are are more and more upset, because what happens is that in the special ed population, they're more vulnerable to regression. Yeah, no, and you. Even though I totally get, you know, the high responsibilities that that school districts have, and particularly in our state of California, where executive orders are coming out that that that you you've got to continue providing this, I think it makes it a very difficult responsibility. It's it's a true responsibility, but it makes it very difficult. So I think whatever, in a nutshell, whatever private providers can, whatever direct service you can still provide, you gotta find a way to provide, yeah, you've got to find a way to provide it, because that will, um, in my opinion, what that does that it mitigates regression. It mitigates against these kiddos losing skills. Because what happens is, let's say right now, I know the superintendent schools is anticipating the school year being over, but there's nothing that says es y or extended school year is over, and there's nothing that says, you know it from right now it looks like the start of the next school year is when things when things are going to go you're going to have a lot of kiddos coming back with IEPs that are the same, that won't get revisited when the students present levels have dropped severely true. And so to mitigate that right now and through potential summers, through private providers, is something I think needs to be heavily looked into. And I think incentives for private providers to to ask their employees to come in and work, from my experiences of friends and family who do work in the in the private sector of special needs. They're still working. A lot of them are still working. So are they with that said, Sorry.    Jayson Davies     Are you hearing them as doing you're saying they're still working? Are they doing it directly in the house, or are they doing it teletherapy or variation?     Tony Tai Nguyen     Some of them are still doing it in the house. Some of them are are still doing any house. It's very limited. But like I said, I think that the most vulnerable populations need to, yeah, those things need to be in place. If that, I would say at all costs, at all costs that needs to happen. And you know, from a protection standpoint, I think, you know, those private companies, and I don't know this in the legal sense, but obviously they can't price gouge either in these so, so I think, yeah, while it might be a little bit of a premium, I don't think it's going I think it's worth it, given the fact that if you wait essentially five to six months before school starts, you're looking at a half of half a year, annual year That's gone by and these kiddos are not receiving services. And to be frank with you, that's what I'm setting up for, from, from, from my, my service. I have to set my, my office, up for that, yeah, because I know that it's going to be a lot, and I know it's going to be very difficult for everyone, including the schools. It's going to be very difficult.     Jayson Davies     Oh yeah. And personally, I mean, this morning, I was kind of going through my caseload, trying to figure out, okay, which students do I know will be able to benefit if I send home worksheets, what students will be able to benefit if I create a video for a parent and kind of say, okay, parent, this is an activity you can do. Try doing it this way. And here's an accommodate, a way to accommodate it. And then other students, it's like, okay, well, what students will benefit from me doing it live? And let's be frank, there's some students that just, I mean, they barely attend, yeah. I mean, they, they can't attend to me when I'm in the room with them. And so virtual is going to be difficult. And that's where, I think what you just said, if school districts may or may not be looking into that, the private route, or however it's going to happen, because, I mean, they're going to have to provide the service at some point or another, or offer the service at some point or another. I mean.     Tony Tai Nguyen     Yeah, yeah. And I think what you're doing is, is awesome. I think all it took for you to do that was effort, right? Yeah, like, and, and parents, they would love to hear it in that sense of of that you're trying versus I. Most the parents have called me that said, you know, I got this worksheet. I don't even know how to do it. My kiddo is non verbal, why is he or she getting this worksheet with nothing else, like with even no instructions sometimes, and I think that to to a parent, that the parents that I've spoken to, they don't feel that that's that that pushes the I in IEP, yeah, it doesn't push them. It feels like, okay, so they're they're making mass copies of this worksheet or whatever, and there's hand it to everyone. For the kiddos that are higher functioning, some of them literally tell their parents, you know, Mom, Dad, this online program that they're telling us to go on. I skipped this during the regular school day because I can't do it. This is not a. Appropriate for me, yeah. And so hearing that, it makes it very difficult for parents. And so you know an OT like you that that effort is, is is beyond words. It's awesome that that that you can do that for for your set of students.    Jayson Davies     Thanks. I know a lot of us OTs out there. We've been very active on Facebook, Instagram, trying to help each other, trying to figure out what we can do, how to make zoom work, how to set up a meeting on Zoom, how to do all this stuff. I mean, we're trying to learn. I mean, we're learning more than our students right now.    Tony Tai Nguyen     I think, and I think with with this, with this, I guess, declaration from the superintendent school saying, Hey, be prepared. The school year is likely over. I think that's going to shift a lot of thoughts and and to be honest with you, I look, I try to look at things from very positive light. I think after this, these things are going to be seamless. I think after this, if a kiddo goes, I'll give you an example. The kiddo goes in home instruction because of some catastrophe or something that that made them be more appropriate at school, everyone will know exactly what to do, because now they shift everything to a virtual to a whatever type of technique and delivery method, and they do it. So I'm thinking about the HHS give the home hospital instruction kiddos who need all these services, who might not be able to go to school because of a medical condition or something like that. Now the HHI program are going to be, are going to be a lot more fruitful. So from a positive standpoint, I think the logistics for for that will be, would be super cool. I I'm really looking forward to that.     Jayson Davies     Yeah, no matter which way you look at it, the world has been forever changed. There's no doubt about that. I mean, things are virtual now, and we're learning that they can be virtual. So, yeah, yeah, all right, man. Well, thank you so much for coming on. I want to give you the opportunity real quick to share whatever resource you might have for people that might be interested in learning a little bit more about you.    Tony Tai Nguyen     Yeah, for me, my website is www, dot k 12. So k1 2e, D, L, A, w.com , so K 12, Ed, law.com , you know, I have, yeah, majority of my phone calls are with parents, but I have a lot of teachers and educators and service providers calling me. And most of the times I defer for them to listen to to the public schools Council, but a lot of times it's something of a quick concern or a quick question, I'm more than happy to answer anything I can with that, I think the other, the other resource that that I recommend a lot of educators and and service providers and even parents, is called the Special Education Rights and Responsibilities manual. If you it's a really easy read. It's a Q and A read, and it's put on by one second. Here it's put on by Disabilities Rights California. And if you Google Search special education, rights and responsibilities and disabilities rights, California, that's a publication that you can access, and it's called the Special Education Rights and Responsibilities manual, and it's a PDF file, Q and A form, super easy to navigate, and it'll answer a lot of your questions, and it'll actually lead you to sections and codes in the law that talks about that.     Jayson Davies     Gotcha? You need to access that, perfect. Yeah, we'll put a link to both of those resources in the show notes for ot school house, so you'll be able to access those if they go to our website. Great, man. Well, thank you so much for coming on. I really appreciate it.    Tony Tai Nguyen     Hey, Jayson, thanks. Anytime, anytime, anytime. Let's, let's do this again soon with other topics or or something, something more fun, even.    Jayson Davies     Drink in hand next time. All right, man, have a good one.     Tony Tai Nguyen     I'll see you later. Cool. Thanks, man, bye.    Jayson Davies     Alright, everyone? Well, I hope you enjoyed. Tony Ty win from K 12 ed law.com he's a really chill guys. You can hear he has a lot of knowledge. He's amazing. If you do have any questions, reach out to him. I want to thank him so much for just giving such thorough answers. I mean, he was open for any question I had. I really appreciate that. So yeah, I hope you all are doing well, enjoy the rest of your week, and we will see you next time on the OT school house podcast, take care and thank you. 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 Episode 46 of the OT Schoolhouse Podcast. In this episode, Jayson hosts "The OT Dad", Billy Hatridge, to talk about what it is like to an education-based occupational therapist in the rural area of southwest Arkansas. Listen in as we share stories to help you not make the same mistakes we have. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: ​​ Visit Billy's website TheOTDad.com to see what he is up to. Be sure to check out his videos where he provides some quick handwriting tips using the Handwriting Without Tears methods. Learning Without Tears ​ - Become a certified Handwriting Instructor through the Handwriting Without Tears​​ program Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript   Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy, tips, interviews and professional development now to get the conversation started, here is your host. Jayson Davies class is officially in session.     Jayson Davies     Hey everyone, and welcome to episode 46 of the OT school house podcast. My name is Jayson Davies, and I am here to support you through everything that is going on, as much as I can. We're all working through this Coronavirus together, and we're going to get through this with teletherapy, with whatever we got to do right before we get started. I do want to say that I hope you, your family, your friends, everyone is safe. I hope you guys are healthy, and I hope everyone is surviving. All the time spent inside. I already binged watched Tiger King, of course, and watching Netflix on a pretty much nightly basis. It's my way to get out in a way other than walking my dog to the park every afternoon. So today we have on Billy Hatridge. He is an occupational therapist in Arkansas, so kind of in a more rural area, he was actually on the podcast in Episode 40 when we reviewed an article about hand strength and pencil grasp, as well as handwriting a little bit. And so he's actually coming back on to share a little more about what he does in Arkansas, in a rural area, how he manages his time, how he works with his assistants, how he completes evaluations, and then at the end, we're actually going to talk about how he's planning for distance learning. So stay tuned for that. It's going to be really good, but real quick, I want to give a quick shout out to purpose therapy box.com for sponsoring today's episode, they have some really cool shirts over there, such as their popular motivator shirt with a emphasized ot within the word motivator. So check it out at purpose therapy box.com use promo code ot schoolhouse all one word to get 10% off your T shirt. Order or use ot school house five to get $5 off their subscription box, which is brand new coming soon, and it's only available until April 13. So again, check that out at purpose therapy box.com and a special thank you to ally and Holly, the founders of purpose therapy box.com for being a sponsor of today's show. All right, let's jump into it again. Billy hat Ridge, we had such a good conversation right here, so you're not going to want to miss this really good stuff. So yeah, here he is, Billy hatridge, and I will catch you on the flip side. Hey Billy, welcome back to the OT school health podcast. How are you doing this morning? I'm doing great. Jayson, thanks for having me this morning. Yeah, no problem, man, it's great to have you back in episode 40. We had you on, and you and I discussed an article review. It was about handwriting and strength, right? Or no, that right?     Billy Hatridge     It was handwriting autism and hand strength versus, I think it was finger strength and kind of comparing the two. There we go. And so at that point, you gave us a little bit of a background about who you are and what you're doing. But how about you go ahead and refresh your memories about where you are and and what your ot practice looks like right now? Well, my name is Billy hattridge. I'm supervising occupational therapist for progressive therapy kids. We are a therapy company that contracts with school districts across the state of Arkansas, myself, and located in southwest Arkansas, and so we service the schools down in this area. Our team currently provides services, or my team personally, to nine school districts, and then my myself covers five of those districts, as far as supervising those therapy services. Wow. Okay, so you got a big area to cover that. I'm assuming it's geographically large. But you know one thing, the disclaimer on some of the school districts is some of them have five or six kids for the whole district. And so some of these districts aren't large districts, some are. But it's easy to have that amount of districts when you know you only have a few kids at some of those. So.    Jayson Davies     How much do you tie Do you spend? How much time do you spend driving just in a single day sometimes?     Billy Hatridge     in a single day? My longest travel is about four hours of driving on some of my days. Typically, I'm looking at about 15 hours a week on the road. Man, that's quite a bit of time to be listening to podcasts or thinking about other things or listening that. Podcast is pretty much it, especially up there the mountains of Arkansas. You don't have any phone signal. You can't make any kind of conference calls or anything, so you're just kind of along with the podcast and your thoughts. Just gotta make sure you download them before you lose service. There's no There's no streaming, for sure. That's funny.    Jayson Davies     Well, anyways, I'm really happy to have you back on here, because one of the things that I have really it's hit me a little bit, and I've learned the last few weeks, is that in California, things are so different. And as I've started this podcast, and I've started to. Reach out and talk to people that are outside of California, or even some people that I know that have moved out of California. They just tell me how different occupational therapy and the educational system and special education as a whole is. And so I'm excited to dive into that a little bit with you, but first we're gonna get into all that I want to last time you introduced yourself, you talked about how you were Handwriting Without Tears. Certified and certified autism specialist. Is that correct?    Billy Hatridge     Correct? Yes. So story on that autism is something that I've been really passionate about since I was about 13, and so within a year or two of me starting my career as an OT, I became a certified autism specialist through the International Board of continuing education standards. I think I left a word out there, but And so, and that's kind of an international certification, and it really focused on, you know, a lot of the ABA kind of therapies and a lot of the behavioral approaches to that, and my plan at the time was to become a specialist and just work with kids with autism in the schools. Right after I got that certification, our caseload, it just expanded, and we picked up more and more school districts, and I was kind of brought out of a specialized role into a supervising role, and so I wasn't able to utilize that as much on a daily basis. I was as I would have liked, but in the process of doing that, we got more and more handwriting referrals, more and more kids with handwriting issues, and so we had kids who were 504, they weren't receiving any special education services, but their handwriting was just so terrible that they were not able to perform well in school, so I switched gears and went towards the time it was Handwriting Without Tears. They hadn't made the switch to learning without tears yet, but went to all the classes. Had to drive all the way out to Dallas for those but and became certified with that, which actually proved to be a bigger benefit to me as a school based occupational therapist, since a lot of our schools look at us as the fine motor people.    Jayson Davies     Gotcha. Yeah, one of the my caseload right now is probably about 85 90% kids with autism and monseveer classrooms, and so I've been looking into some various just considering autism type of training and certification type of things. And I know there's so many out there. There's like, their own, there's colleges universities that will have, like, a one year track that you can do, and just like two or one or two classes a quarter, and it's just all focuses on autism. And then I saw the one that you talked about, and then I know there's also some of the teachers in my district that are autism certified, and it's like a very, very short, brief, like, online program. And so there's a bunch of them out there, but I just wanted to hear a little bit about what you how, how yours had been so interesting.    Billy Hatridge     All right, yeah, and I, B, C, C, E, S, E, S, I jumble it. And I'm sure there's somebody out there that's got it, and they're rolling their eyes, but they have several levels of the certification that I've got. And so they have, like, a autism certificate that is for like, OTs or paraprofessionals, and it's a lot quicker to pick up and get. And then they even have an advanced autism certified autism specialist, which is a, I think, 3842 hours of ABA training involved in that. And so it's a huge scale as far as all the different ones. And they have some mental health certification, some anxiety based ones. So they have a lot of really good options for people who want to be able to pick up these certifications at home or on their own time. It didn't require any kind of in person training for any of those certifications     Jayson Davies     All right and right now, with everyone sitting at home, you might have the time to do that. One last question before we move on, Handwriting Without Tears, certification, what did that look like? How many classes did that was that and what does that allow you to say or to do now that you are certified in handwriting.     Billy Hatridge     So the handwritten cut tiers, the way the certification worked when I got it. And I don't know if they changed it, since they switched over to the learning without tears, but you had to go to all of the in person workshops. So the pre K readiness workshop, the handwriting workshop, and then the handwriting evaluation workshop that covers their print tool. And then after you complete those required in person trainings, you have this packet that you do at home. And so you go through two example evaluations of kids handwriting. You write reports on those. You do an in person workshop with like a dozen people or so to kind of go over the handwriting factors curriculum. And then there's like 100 question tests that you take as a part of that to take on paper and send in. And so you do all that, and then you send all that in, and you wait, and you know, they'll give you that certification, which is technically what they call a level one certification, which I don't personally like, because they only have one level. They don't have a level two yet. And so sometimes, you know, so what's. Level two. Why do you only have level one? Well, that's the only level that they've got, but it allows you to advertise yourself as a handwriting specialist. It allows you to kind of advocate in the schools that you're not just an OT who works on handwriting. You are a on paper certified specialist. And I have found even in the school districts I've always worked in, that changed the way they listened to intervention ideas or adaptations you want to make in the classroom quite a bit when they know that you have that certification, and then allows you to to try to do a lot of people who have the certification do handwriting tutoring, or penmanship tutoring on the side, you know, just a cash kind of deal with parents who want to do that. So I've seen a lot of people who go full time into just internship tutoring in bigger cities and communities, and being that you're certified in Handwriting Without Tears, you can advertise that you are certified in that. And so I'm assuming that helps a little bit further. It does, yes, and I've actually been able to go into a lot of districts and work as kind of a liaison for handwriting thought tears. So they're adopting their curriculum the school wide. They're wanting to implement Handwriting Without Tears. They don't really want to send every teacher. They have to handwriting for tears workshops. So I get to kind of come in and go over the curriculum with the teachers and talk about the ins and outs of it and how it works in practice.    Jayson Davies     Cool. So for anyone out there interested in handwriting without tears or learning without tears, I think it's LW, tears.com . If I remember, right? So yeah, you can check that out. All right. So we're going to jump into some demographics background. You already kind of mentioned a little bit about your area, rural Arkansas, and four hours of driving. But how many schools specifically do you have? And you kind of started to talk about how some of them might be small, but go a little bit more into detail to what these schools look like.    Billy Hatridge     So we, like I said, as our team, which is myself, we have two other OTs, and then five OTs, and we cover nine school districts. And I think that has 17 different school buildings, as far as you count, up elementary schools, preschools, high schools, etc, and those are scattered across five counties that we serve some most actually this most of our schools. Our caseload is anywhere from five to 10 kids, so we kind of come in, we see them for a few hours, and then we we get out and go on to our next school district. We have a couple school districts that are much bigger we have two that make up probably just those two districts alone, 75% of our entire caseload, okay? And those are in bigger towns, you know. And I say bigger towns, we're talking about the population. About 6000 people is the biggest community that we serve. And at those we have a lot of kids, and we have a lot of kids from the both ends of that, that therapy spectrum that we serve really severe children to children who are just needing some of that fine motor help. And so typically, our com Our team works is our OTs are stationed at schools that are close to them. And so we look at the geographical need there for the school districts, and then the supervising OTs kind of cover whatever is closest to them travel wise, because a lot of these schools, you know, they're having to pay some travel time to get therapists out there. So we try to make that into account and make that they're getting therapists who are closer to home to help offset that cost.     Jayson Davies     Absolutely. And so how does travel impact your need for organization and planning? Quite a bit.    Billy Hatridge     Now, for a lot of my OTs on the team, or for almost all of our team, it's pretty straightforward. You know, they have a set schedule there at, you know, this elementary school Monday mornings from eight to 12, and they go to this elementary school that afternoon, and they kind of roll with that. And the kids have expected times that they go to therapy. The biggest factor is carrying our stuff with us. A few of our therapists have the benefit of being only at one school all week long, and so they have these wonderful little therapy rooms with, you know, board games and everything else. But a lot of us are working out of our cars, you know, and so whatever we can carry into the school with us is what we have with us to do therapy with. And so that's kind of one of the big factors there. For me. It's trying to make sure I'm hitting as many of the schools as I can in a given week, making sure that I'm sitting down with all of my OTs for an hour a week to kind of go over the caseload, go over what's happening, what kids are getting evaluated, and then talking with the special ed teachers and making those visits to make sure that our plan of care is still on track. And typically, my weights have a pretty set format, but with annual Well, we're in the middle of this COVID 19 lockdown, so I don't know what annual reviews are going to look like this year, but typically that's when everything gets hectic. So because we'll have a meeting, you know, in the morning over here, and then two counties over, two more meetings in the afternoon, and I've got to figure out whether I need to be at both, whether I need to send an OT a in call in, whether all they want is a piece of paper, and they're fine. So that gets kind of hectic, but typically, I'm able to get to all of my. Districts at least once a week, and so we work kind of on a weekly basis. Of our start reviews and stuff go.    Jayson Davies     Okay. So you started to talk a little bit about your annual reviews and whatnot. How does your How do the districts down there handle that? I've heard or I should? I'll just start by saying what we do. We have annual reviews throughout the entire year. A kid could have an annual review on the second day of school, or the second to last day of school, or anywhere in between. Is that similar for you? Or do they tend to group them all into a similar time frame? I'm    Billy Hatridge     going to be saying this a lot. I apologize, but it varies by our schools. Okay, that is probably one of the most frustrating things when you cover as many school districts as we do, because we have a few schools that pick up a child, they do an extension IEP to where the end of that the interview falls at the year, or they would all kind of sketch out to work that way. And then we have other districts, especially our smaller ones, who like what you say. It just happens throughout the year. So if the kid came in in December, the next December is when you do your annual review. And that that makes it a little more difficult for me to kind of plan our big district that I was talking about, the one that makes up easily half of our caseload. They do almost all of theirs in May. And so I know when those are expected. They know when to have me there. Those are the day come in and I sit in the conference room from eight to three, and we just do meeting after meeting after meeting. But some of our school districts that have these interviews throughout the year, February, November, whenever it might be, we often get forgotten as far as those supplemental therapy services, and they'll call me up say, Hey, I forgot we had this meeting the other day. We need, you know, a report or something to put in the file, because when they're only having one here, one there, it gets a lot easier to get about some of those other service providers when you're only seeing them an hour a week.    Jayson Davies     Yeah, definitely. All right, so on top of that, you kind of alluded to, you know, last minute getting notifications for IEPs and whatnot like that. I've been there, done that. How are you able to take advantage of technology to lighten your travel needs. Or are you?    Billy Hatridge     We are a little bit especially right now, trying to figure out how to best utilize teletherapy. A lot of it is just calling in to those conferences. And usually the way it'll work is if it's at a school that I'm not driving to, or the school says, Hey, we really don't need you to drive two hours up here for this 30 minute meeting. If we can schedule it when my ot a is there, that's preferable, because then we have a person from the team who's there in person and can kind of relay that information, and then I'll make sure that I'm available to call in, you know, if we need to make any changes to the plan of care. And if that's not possible, then I call in, or I FaceTime in, depending on signal. And that's something else that's fun working in rural Arkansas is I have schools that I just have zero signal on my phone the entire time I'm there. And my wife loves it when I'm just unavailable for eight hours at a time because I'm down in a valley without single but I mean, that's something else that we have to factor into is saying I can't call in. Call in because I don't have signal when I'm at this particular school. So it depends on what's happening at the conference. Obviously, you know, for making a big change, and I try to really push and be there in person, but if it's, you know, run of the mill, we're meeting, we're kind of talking about general progress. We're not really changing a whole lot, then typically, the schools are fine with just having one member of our therapy team with us, ot PT, speech, and then, you know, the paper report to go over.    Jayson Davies     Okay, so you might submit a paper report, but the PT might be the one to kind of provide that paper report to the team, or something like that.    Billy Hatridge     Yeah, yeah. And that's happened quite a bit, especially for OTs covering for PTS, because our caseload tends to be a lot larger, and so the PT might only be at that school one hour a week, and isn't there on Tuesdays when having the meeting. So they'll send the report. And then the OT team, we're the ones who kind of understand how the bot two reads on that manual, or whatever, more so than maybe this bed teacher. So we kind of go over that, just to kind of break it down for those who can't speak the PT language a little bit. But.    Jayson Davies     So if the parent has any, I'm sorry, if the parent has any concerns, and you can just text up or call up the PT real quick, or if need be, or something like    Billy Hatridge     that. Yeah. And anytime we have any kind of meetings, and we know about ahead of time, we try to make sure supervising therapist that we're available to call at any at the drop of a hat, you know. So if you need somebody to come in and go over something or change something, part of the plan of care that we're available via phone.     Jayson Davies     All right, all right. So I want to jump into a little bit about caseload. Then, you mentioned earlier that you thought you're going to have more of a heavy caseload with students with autism, but it's kind of shifted into Handwriting Without Tears or kids with handwriting needs. Should say, What does your current caseload look like? Then you said you already talked about having several schools, but in terms of demographics and kids in different types of classrooms, what does that look like?    Billy Hatridge     Well, I'll tell you what I tell all my OT. Students that come through, I have what I call my rule of thirds, and that's something that's kind of been true since day one. About a third of the kids on our caseload, whether our caseload as a whole or individual schools, have some kind of prolonged, lifelong disability, you know, autism, Down syndrome, cerebral palsy. These are the kids that are in those special ed classrooms, those the ones getting all of the therapy services. Another third of our kids typically have some kind of developmental delay, and so these are kids who might be getting a, you know, special education just for math or reading, and then getting just a little bit of OT, maybe pt. And then about a third of our kids really probably wouldn't need any kind of services if their home lives were better. And this is one of the, actually one that might be growing and be breaking out of that third rule that I have, but Arkansas right now is the number one state for meth use in the country, and it is methamphetamines Okay, and especially in some of our rural towns and communities up in the mountains, that that number might be even higher. It is projected by our Department of Health for the state that upwards of 75% of all students will have some contact with methamphetamine before they turn 18, which is a staggering number. And so one of the things that we're seeing is kids who don't really have any kind of intellectual disability or or traditional disability that we might serve, but home life might be very difficult. We have a family that's moved in two weeks ago. They fostered a bunch of children who are found in a meth lab. And, you know, we're basically left their own devices. And so we have kids who are six, seven, you know, at six month old level, developmentally, and really trying to figure out how to combat that and how to serve those children who kind of have a very broad range of symptoms and needs that we need to address. And so that that's been the big change that we're trying to make is in reaching those people or those clients in school. You know, we're taught about how to address cerebral palsy, we're taught about how to address autism. For the most part, a lot of those traditional disabilities or diagnosis we might work with, but we're having bigger and bigger and bigger caseload of children who are just coming from rough family lives and are dealing with PTSD and anxiety issues and mental health issues and really trying to figure out how we as a team can better serve that population. I think I got off on a tangent there. I don't know if.    Jayson Davies     That, no, that's completely fine. I was gonna, I was gonna go with it and asking, I mean, you're not the first person I've heard that from surprising. I don't know if that's the prize at all, but has there been Have you had a chance to reach out and take any training specific to this area yet? And if so, I need to jump off.     Billy Hatridge     Well, we actually kind of as a team, started talking about this about three weeks ago. He said, Hey, we really need it. We really need to make sure that we're addressing this properly. We need to really send out, make some people. We're really trying to have our team, even though one ot a might be just at one district, but we're trying to make everybody a little specialized in different areas, whether it's low vision, autism, sensory, etc, so that we as a team can have kind of shared knowledge. But I think three days after we made the decision that we needed to focus on methamphetamine use and how we're going to deal with that, the COVID 19 issue came up, and so we're kind of stopped all of that for right now, and restricting gears towards teletherapy. And we're all scrambling to try to figure out how to how to do that. But at the same point, this is a good thing, because for the first time, we might have the option opportunity to get into our children's homes, even though it's digitally, you know, this is the first time we're seeing our kids in the home environment, and so that opens up a huge opportunity for us as occupational therapists to really observe the kid in the natural home environment, which something that you don't get to do in the school setting, and have that direct contact with families, you know, sit there with mom and dad, there at the computer, and talk to them in a way that you would be able to in the public school system.    Jayson Davies     Absolutely. And I definitely want to jump into that. I just want to kind of lump it all into one thing. We'll get there, because I know many people that are out there listening. That's what they want to hear as well. And so we'll definitely get to that point, thinking about, you know, before everything jumped off the walls and got crazy, did you have the opportunity you kind of talked talk about yourself in the supervisory role a little bit. Do you have the ability at this point to provide direct treatment, or is everything just about supervision for you?     Billy Hatridge     Now, there's quite a bit of direct treatment in my week. On my Tuesdays, I'm at, we actually have two satellite clinics that offer outpatient pediatric services in our area. And so on Tuesdays, I'm at one of those satellite clinics all day. And so I get to work on birth to 21 is kind of our our age range there, and it's about 50% of them are homeschool kids that. Would look like a typical, you know, school based provider, but over half is usually early intervention. And so that's a full day of treatment there. And then, when I make my school visits, if it's possible, I try to get in a treatment session with the kids, or look back through and if the kids missed a few times for, you know, sickness, illness, or if their ot had a conference and couldn't make it. I tried to make those sessions up, but most of it is sitting there redoing the charts while I observe the therapist doing or my OTs doing the treatment. But I would say, any given week I might get 12 to 15 hours of treatment.     Jayson Davies     Okay, that's still a good amount to just satisfy your needs. Probably you're not just running around doing evaluations the entire time.    Billy Hatridge     Yeah, it is nice. Every once in a while I'll have to cover for an OT a who's out for, you know, whatever reason, and it's nice to turn off the supervisor brain for a minute and just get back into the treatment and kind of be reminded about why I got into this in the first place.     Jayson Davies     Yeah, no, no joke. I mean, I think it was on the last podcast that I did with Kate and Mary, and they're talking about how the occupational therapy assistants they get to have, they get the fun job. They get to work with kids all week long. And we have to do the we're the ones that drive around and do evaluation and go to the IEPs and have to do those parts.    Billy Hatridge     But that's the conversation I have with my parents quite a bit. You know, in the meetings, and I'll ask why I'm not the one providing therapy services, why it's, you know, Miss Brittany or miss Allie or whoever. And I explained to them like you want your the OTs treating your kid because they're the best at treatment, because that's all they do. And I'm a little jealous of how creative they get with their interventions and how many wonderful crafts and activities, because I'm usually doing more research on the diagnosis and the plan of cares and figuring out, you know, effect, evidence based practice. And they get to really have fun with those treatment things and look up stuff on Pinterest, and they just blow my mind. So my OTs about how creative they get with that stuff.    Jayson Davies     Yeah, no joke, there's a lot of good ones out there. All right. Well, we'll go, we'll continue on the OT a route. Actually, what does a case load look like for them?     Billy Hatridge     Then my OTs typically have anywhere from 20 to 30 kids on their caseload, and other than one or two, most of them are within a single district. And we've worked really hard over the last eight years to get to that point, because, like I said, when we have nine districts, and every district does it differently as far as how they do inter reviews, how they do billing, how they want to do documentation, it gets really hard to keep up with all of that, and so we really kind of prioritize having our OTs at one single district. It just really helps make sure things are it's easier for them to kind of understand the rules or the guidelines. So typically, our services are almost always individual, individual, pull out sessions. We've been really having a push this year for push in services. Our schools have kind of mentioned that some of the kids are missing more class time than they wouldn't like. And so we responded with, well, we can do push in. We can absolutely come into the classroom and work with them, and then the teacher is like, well, hang on, you know, if they need to get pulled out, they can. And so we've kind of been playing with that a little bit back and forth with the schools and figuring out, you know, what's appropriate for each kid. Not every kid needs to get push in services. Some of them really need that pulled out one on one time. It can't be a one size fits all, you know. So we're looking for system for therapy services and so, and as far as So, usually, my OTs, their work week is treatment. You know, they come to work and they just pull kid after kid after kid after kid and that they kind of treat all day. My more seasoned OTs are really good about consultation, or consultation and working with classroom teachers. And there are some that have been doing this longer than I have, that, you know, absolutely are great about taking a lead and saying, Hey, this teacher has some concerns about some other kids in the classroom. They have the knowledge to kind of help provide training, or, you know, any kind of accommodations for those children, and then if we need more, you know, then we get the referral for an OT evaluation, and I come in and kind of work with that kid. But a lot of times it's more of a classroom as a whole. It's what we see from a lot of teachers, is saying we have all these kids who can't write, all these kids who can't cut and so our OTs are great about stepping in and helping there.    Jayson Davies     That's great. Yeah, we actually, recently, Episode 42 was all about RTI, and that's kind of that process of teaching the teachers, using that knowledge translation to let them help. Because, I mean, let's be honest, there's what a school district population of OTs, if you want to call it that, or how many OTs they employ, is very, very little in comparison to how many teachers and paraprofessionals and and just other professionals, and we just can't better ourselves. Help that then to work with every single student on campus, obviously. And so that knowledge translation and helping the teachers so that they can help not only the kids that they have in their classroom now, but the kids that they have in their classroom next year and the year after that, and be able to just support all those students. It really helped. Yeah. Oh, absolutely, yeah. What about you? Are you able to get in and do like in services for teachers, or is it more kind of on that individual teacher saying they're having concerns and so you help that one teacher.     Billy Hatridge     I'll tell you. And this is something I encourage all school based OTs really, who have the opportunity to sit in the teacher's lunch and eat lunch my first several months of this job, I would be sitting over there in the therapy building or closet or whatever they happen to have us, you know, chowing down real quick and trying to get to my next one. But I found that when you go and you join in with the teachers, and you sit there and you start talking, they bring up these questions that they wouldn't bring up in a more formal environment, and you can really jump in there. And I've had absolutely most of my quote, unquote teacher trainings happen over lunch in the teachers lounge, as they ask about, you know, handwriting interventions and things I've had the opportunity at school district across the state, actually, as far away on the other side of the state as possible, contacted me last summer, and I got to go up there and do a handwriting workshop for their entire Co Op. And that was a really great opportunity to kind of get outside of my own school. And I've tried to push it a little bit on my school district that I served, saying that, hey, I can do this. I can do an in service for you guys. But they kind of look at it and say, hey, well, what about you're already here. You're already working with our teachers. You know, they can contact you at any point during the school year. So that's kind of the way it's been working. It's just the teachers know who I am. They know where I'm at, so when they have questions, they reach out to me. Yeah, and how long have you been in the schools that you're currently with? This will be the end of my seventh year. So this is my seventh school year.     Jayson Davies     So you've had some time to build some rapport, meet the teachers and see some new teachers come in and really get them to know who you are.     Billy Hatridge     Yes, yeah. And that's, I don't know if you this is the same way in California, but it's a really high turnover in special ed here in Arkansas. Yeah, I found and so a lot of times the kids might be on their third or fourth Special Ed teacher, and I'm still their OT, and so that really or they're still the same ot A and that makes us really good advocates for our students as well, because we know these kids. We've been with these I feel old because I have a kid who's getting ready to go into high school that was like in kindergarten when I first started seeing and I'm just not ready for that, but, but, yeah, no, it's great because we're with Sam. We're one of the few providers, educators, adults that these kids have consistency with over the years, and so that makes us really strong advocates when they switch schools and they go to upper elementary or middle school or high school.    Jayson Davies     Alright, sorry, I just got an idea while you're talking, but I want to first of all commend you on your your little tip about having lunch with the teachers, because that's a great tip, and that's one that I'm actually going to challenge my to challenge myself to do, because I am, I tend to be that, that ot that kind of hides in my room during lunch time, because, to be honest, part of the time is because I'm writing a report. And so I can kind of justify it that way, but I do see the benefits and what you're talking about having lunch with the teachers. And so I just want to, want to just go back to that in a second and say, Yeah, I do highly suggest that too, and I'm going to try and get better at that myself.     Billy Hatridge     And I'll build off that just for a moment, because it is a soapbox of mine, because a lot of our schools that we've picked up over the years, their prior service providers have been they get in, they sign real quick in the office, they pull the kids out, and then they leave, and they go On to the next school, and the principal never sees them. The superintendent never sees them. A lot of the general ed teachers never see them, and they don't know who they are. They don't know their names. They know kind of their face. But that might be it, and that's a really bad way to advocate for the profession, whether you're an OT PT, speech, anything, because we really need to be taking the time, even if we're not getting paid for that time, which a lot of OTs are paid by the treatment hour. It's still really important that you have those conversations, that you talk with the principal. Hey, how are things going? You know, kindergarten? Is there any issues? And allow yourself to know that you're not just a treater, that you can educate the teachers, you can educate the administrators, and you can't do that when we're just getting there, treating and leaving, and so communicating clearly with the team is important.    Jayson Davies     Yeah, absolutely. And I do often stay at IEPs for longer than I think some service providers do, because, I mean, like you're talking about, we don't get to see what's going on in the home, and a lot of times that IEP is the only communication that we get with a parent and sometimes also with the teachers who are busy, and likewise, the administrators that you're just talking about. I mean, you have that team in there, and you're really able to build rapport with everyone in those meetings. So I try to stay in IEPs as much as I can, especially if it's after school or before school. So yeah, all right, so we'll jump into supervision of COVID Just a little bit. What does that look like for you? I think you mentioned earlier, trying to spend about an hour with your CODAs a week, or maybe as a month, I can't remember.    Billy Hatridge     So with my OTs, that hour a week is face to face, sitting down with them and talking. About the caseload, I tend to spend an entire day with each ot a okay? And so try to find where they are, what schools are at, and kind of follow them along throughout their day, if that's possible. You know, there's always meetings happening somewhere. There's always more kids to be evaluated. But that tends to be my model, one hour of sitting down and kind of going through the caseload, and then quite a bit of sitting back with the charts in hand, kind of reviewing those while they treat and just kind of observing and answering any questions they might have during that time. And so typically, we have a pretty consistent supervision. Sometimes it strays a little bit, but for the most part, I see all the OTs every week, and we kind of go over the caseload and go over any kids that need to be evaluated, re evaluated, etc.    Jayson Davies     Gotcha. And in Arkansas, is there a limit on how many OTs you're allowed to supervise, or?    Billy Hatridge     According to the Arkansas State Medical Board, and they might have changed the last couple years, but the answer that I got several years ago was no that as long as you're able to keep up the requirements of the supervision, but Arkansas Medicaid, I think, caps out at five, four or five and so. And I'm not really sure how that works. If some schools build Medicaid and some schools don't, you know what that count works, but that, yeah, I'm supervising four right now. Okay, when you're under and I have had five at one time, but two of those for part time that are only working 1015, hours a week for us, and so that still kind of made one collective full time ot a but yeah, that's four or five tends to be kind of the max as far as Arkansas goes, especially when you're looking for Medicaid.    Jayson Davies     Gotcha so. So it sounded like you're kind of in the room with them. They might be treating a little a little bit while you're reviewing some files, and then you're able to spend some time with them, like after the school day ends, or something, spend some time going over those files with them, or any type of treatment plans.    Billy Hatridge     Yes, and that typically happens, you know, lunch breaks, especially some of our smaller districts. You know, we've got some schools where all of our kids are at either lunch or racist at the same time, yeah, because there's only two or three classrooms per grade, and so that's a good time to sit down and kind of go through that, or just go through that while they're working with the kid, depending on, you know, the level that kids able to perform.     Jayson Davies     So all right, and so I want to ask you a quick question, what's your process look like? About informing an OT a after you just had a meeting, so you just had an IEP for a student. What's your process for letting the OTA know what was discussed in that meeting or what they need to work on now that that meeting occurred.    Billy Hatridge     If I'm going to see them face to face before their treatment sessions begin, that tends to be when I do it, when we have that sit down meeting and say, Okay, here's a new kid. This is kind of what the deal is. A lot of times, my ot knows who that kid is long before I do, because it seemed that kid in the classroom, the teachers have brought up concerns long before we get the referral. And so by the time we actually have that placement conference, it's more like, Okay, we're good to go. You know, the teachers already kind of expressed some concerns to you as the OTA who's coming into the classroom, but if not, if you know they have to see them before I see them in person. The next time it's a phone call, usually of, you know, walk in through it. This is where they are. This is whose class they're in. These are some of the concerns. And then, you know, we'll send them the the daily documentation, the evaluation and stuff via email or whatever that system is, so.    Jayson Davies     Great. And so what about when you're planning for meetings? Like you said, most of your kids are being seen by a coda or an OT a so when you're about to go to an IEP for a student, do you make it a point to see that student before going to that meeting? Or do you heavily rely on the information from the OTA?     Billy Hatridge     I try really hard to at least, you know, see that kid face to face, come into the classroom say, hey, you know, I'm just really, I'm the OT, talk with the teacher, their general ed teacher and the special ed teacher both, just to get an idea as to is this a sensory issue we're dealing with, fine motor issue we're dealing with, what's the biggest concerns that you have as educators for this child? And then kind of relay that information on to my ot a sometimes that doesn't happen. Sometimes we get a kid that moves in from another district, they have ot on their IEP. They're good to go. We're having this meeting in two days. I'm not going to be anywhere near that district, and so we go in a little blind. But my OTs are amazing, and they're really great about kind of bracing for that and being able to jump in and then give me updates when I get there.     Jayson Davies     Yeah, cool. All right. So that kind of covers the supervision aspect, I think. Unless there's any part of it that that you think I missed about supervision, does that sound like we hit it most of the points, yeah, I think so. All right. The next part I wanted to jump into assessments. What, when do you assess? What do these look like? I guess. Let's talk about like you started to say, teachers will ask you for an initial assessment, right? So what does an initial assessment look like for you?    Billy Hatridge     Well, typically, well, there's kind of two models, two ways to go about this. The first is. Are more severe kids who come in, they're in the self contained or the full time special ed classroom, you know, they have that pronounced autism, cerebral palsy, downs, and it's kind of a, you kind of, know, going into this kid is a kid that's going to need ot services, and that evaluation looks a lot different if I have a kid who's kind of on the fence and they're saying, I think he might need ot he might not. I'm not real sure. The first thing I try to do is get collection of their classwork, because that's the biggest indicator of that kind of motor delay, yeah. And then I go through that, I talk with the teacher and see kind of what the issue is. Is it their written performance? Is it an attention issue? And then, you know, we get that consent to a test, and then I'll pull the kid out for about an hour, and I'll go through that formal evaluation process.     Jayson Davies     Okay? And then for your kids in the more mild to moderate classes, are you doing a full blown assessment for them, or is it more very, I guess, functional based.     Billy Hatridge     It's typically a full blown assessment for everybody. Now, some of our more are more profound kid OTs who can't participate in a formal standardized assessment. You know, you kind of write that up depending on what level of therapy or what level of participation they can do, and that varies case by case, obviously, but yeah, no, all of our kids go through a formal evaluation process. I'll pull them out of the classroom, we'll sit down, and we will at least attempt some of those standardized of those standardized testing that we do, even if I know that they might not be able to, I still try to get something on paper that I can put in their in their report, even if it's a scribble across the green VMI and that's all they're really giving me. That's still something that I can have to refer back to in years later. So.     Jayson Davies     Absolutely, do you have a few set assessments that you tend to use?    Billy Hatridge     Our go to? And I know it sounds old and traditional, but we still use the bot two and the VMI kind of as our go to. They're tried and true, and our company and our schools both are happy with them. That being said, the sensory processing measure, the sensory profile or two that we have in our toolkit. We use the real which is the role evaluation of activities of life. And it is a life skills questionnaire that can get filled out by the teacher or by the parent, and that goes through all of those ADLs. It goes through toileting, hygiene, money management, all those things. And so when our kids get ready for high school, we switch gears and work on life skills, and that's a really good questionnaire to give us a lot of information about what the plan of care needs to look like. And then the goal.     Jayson Davies     I don't know what it stands for either. I know of it, but I don't. I can't stand for either.    Billy Hatridge     But it's a fun one too, to kind of go through. But typically the issue I'm having the goal right now is that by the time they hit high school, when they get referred to OT they're usually pretty profound or pretty delayed, and the goal tends to give us first percentiles on almost every kid we test, because by the time they get referred to us at that age, you know, that's what you're seeing. But those and then we have the Peabody. We have the day see so our little ones.    Jayson Davies     Okay, and so do you feel like being at so many schools plays a role in what your evaluations look like? Or do you feel like even if you're at one school, your evaluations will look just the same?    Billy Hatridge     If I was trying to think if I wasn't a supervisor and I had just my own case treatment caseload, my evaluations would probably look a little different. If I had the same 30 kids, and those are the only 30 kids I was seeing, I could probably have a better idea as to what specific assessments each child needed, but that being said, I'd be worth them every single week, every single session, and so the evaluation isn't telling me as much as they do the way I do it right now. Because aside from what my OT is telling me, what I'm reading in the charts, the evaluation is one of the biggest data collection moments for us as a team. So, you know, it's one of those things. It's hard to say what it would do if things were differently, especially when it comes to the cost and figuring out, you know what, what's efficient, and not really having opportunity to try a lot of evaluations before we buy them. It's a little difficult too, but, you know, we're getting there. So.     Jayson Davies     Yeah, I just think that it absolutely plays a role. I mean, you can't take out that time and the environment and what is available to you, it plays a role in what your evaluation will ultimately look like. And so thought it might be a interesting to hear your point on it. So yeah, thank you. All right, I had one other question. I don't know this is going to be a fun one. Have you ever shown up to a school to see a kid, maybe for it's an evaluation or direct treatment, and it was like, the only kid that you needed to see at that school, and they weren't there.    Billy Hatridge     Yeah, yeah. All the time, all the time we have, okay, so the farthest school from my house is two hours away, and that's two hours of driving 60 miles an hour down, you know, state highway. And. And there's two kids there, and there's just two kids there. And so when we leave our school, we call up and say, Hey, are they there, you know, before we drive all the way out there, but usually we're 30 minutes to an hour closer. I mean, I'm not driving straight from my house to this school. Yeah, you hit another school on the way there. But I tell you, it seems like all the time, by the time I get over that they checked out. So and so has gone home, so and so sick, you know, and so that that's a little difficult to deal with, especially when you're kind of coming up on a timeline, and you're only there once a week, and they're sick, and then the next time you come there, oh, speech has them. And then, you know, okay, I've only got so many windows here to get this evaluation in, and that's, that's one of the big issues in dealing with is when the kids are out quite a bit, especially when it's flu season. I don't know how it is in California, but Arkansas, we've had school closings for the flu. We've had several districts close for an entire week because the flu just got that bad. And we've had that because.    Jayson Davies     Not because of Coronavirus, just because of the flu, the flu.     Billy Hatridge     For the last three years, we've had at least two or three districts every flu season have to close because the flu count just got that high. Wow. And so this whole COVID 19 issue, you know, we've braced that a little bit. We've had some school closings in the past for it, but, but, yeah, it's just, you know, that's been the biggest issue. It's just meeting those timelines on a kid who's not there or is unavailable quite a bit.    Jayson Davies     All right, you guys have actually had a little bit of experience with the school closure thing, then, yeah, this is like a brand new thing for us. We're, like, losing our minds over here.     Billy Hatridge     Well, it's a little different though, because, you know, in the past, they say, Hey, we're closing for five days. We're going to meet back. You know how long it's going to you know how long it's going to be, and those have been solid school closures. They didn't do AMI days, they just closed the week. So this is, this is new for us as well.    Jayson Davies     Gotcha Okay, so we're going to come back to that. I'm going to remember that phrase you used, ami. I just want to ask you two questions about organization, and then we will get into some Coronavirus stuff. How do you remain organized when you have so many kids, schools and even therapy assistants to keep track of what what tips or what tools do you use?    Billy Hatridge     My biggest tool for organization is my OTs. And I know that might be like a cop out, but when my OTs are organized, and I show up for those face to face meetings, and they have their list of like, okay, here's the kid that need to get evaluated, here's the kids that are coming up for reevaluation, it makes my job so much easier. And when it's set up like that, I'm able to turn off my mind for all my other schools and say, Okay, I'm here at Mena. I'm only thinking about MENA today, and I'm gonna barrel through this list of stuff that you've got. And then when I'm at, you know, cost ot river, or whatever my other districts are, then I can kind of focus in on that. I have, you know, my trunk of I have a company car, which helps tremendously, because I'm not in and out of my personal car and unloading everything, so I run for groceries. But you know, I've got, I've got a lot of files in there. I've got a lot of handouts in there. I have a tackle box that I use for my therapy materials, and so it's just a tackle box about from Walmart. It's got little individual compartments and boxes that you can put in there. And I've got a box for the bot, so all the little manipulatives of the bot are in one of these little tackle boxes that I just slide into my big kit. And that works really well. We use Slack as our communication platform for our team. We don't share any patient information across it, you know, for the HIPAA reasons, but that's been the biggest thing. Hey, you've got a meeting at so and so. You know, here's a couple of initials. I know who those those kids are at that district. We have channels for every school district, and that keeps us really on top of things, being able to communicate via that system versus just texting each other. And then we have an ongoing record just in Slack. When we make those phone calls through slack, when we make our messages through slack, we can keep track of when we had those conversations for the supervising requirements with the OTA logs.    Jayson Davies     Gotcha All right. Well, that actually answers my next question was, how do you use technology to just basically for scheduling and to help your organization? But it sounds like Slack is a tool that you guys use as far as technology goes.    Billy Hatridge     It is. And, you know, speaking of technology, several years ago, I had this epiphany that I've got this almost $1,000 smartphone, I need to start using it. And so I made the decision, like, I'm going to start using Google Calendar, and I'm going to be a power user of this, of this phone, and I'm just going to go all in, and this doesn't make sense for me to carry this all day and not use it. And that lasted a few months, and I'm back to pen and paper. That's when I've got my paper notebook that I write my notes down in. It's accessible all the time. I don't have to wait till I have signal getting back up the mountain. But yeah, that's as far as technology and scheduling stuff. I'm still pencil paper on a lot of my stuff, a lot of my note keeping. We're still paper documentation for all of our daily notes. We still do that in paper, and our schools have mentioned trying to get us on some kind of digital platform, but I've seen our special ed teachers struggle with the computer systems for their IEPs paper notes there. I mean, even if there's no power in the school, you can still write your note. And so it's true.     Jayson Davies     All right, yeah, man, it's just crazy how things are. So. Friends. I mean, so different in our schools, our IEPs, many of our schools are projecting the IEP from the computer on the wall for the parent to see as we are writing it in. We don't pay paper IEPs don't exist there anymore, really. I mean, until they're printed out, the final copy is given to the parent. But, yeah, wow. All right.     Billy Hatridge     Well, we'll have, we'll have a paper copy at the meeting, and it says draft, you know, it's got the big watermark, draft, yeah, the parent through it, make those, those changes, and then everything gets compiled back up, and then back up to the parent within a day or two. Okay, yeah, that's not too far off then. All right, cool.     Jayson Davies     All right, let's dive into Coronavirus a little bit. I think this is something that you and I What's today's date? Today is March, 22 I believe 23rd 23rd it's I lose track because we're not in school anymore. It's a Monday. We in California have been quarantined for five days now, or one week, and this is We're in our second week of quarantine. Where are your schools at right now?     Billy Hatridge     So we're not we haven't had any official like lockdown measures across the state yet. It's still kind of social distancing. You know, you're still able to go out under, I don't know about California, but we haven't had any kind of curfew or mandated stay at home. Places stay at home, measures put in place. On the look at my calendar, we're on spring this is the first day of spring break. Technically, I'm losing track of my days. Also, last week, we were out all week, whatever date that was. You know, Arkansas schools closed on the can't do the math. I'm trying to pull up my calendar here. Look whatever date, the 14th. The 14th, it was a Saturday when ASA Hutchinson, our governor, came out and said, Hey, we need to close schools. Okay. And so the plan was at the time, we're going to be closed for two weeks, one week of school, spring break, come back on 31st Yeah. Asa Hutchinson made an announcement this past weekend. We're out to the 17th Okay, and so a lot of our schools are going to keep up with those AMI days and kind of move forward with that. And then some point, the next two weeks, we'll probably have an update, but until then, that's the plan.     Jayson Davies     All right. Yeah, we're that was a similar progression for us, except now we are out officially until May 1 gotcha, that's where we're at right now with talks that people seem to be under. The idea that it will go until the end of May even but we're not there yet, as far as officially on paper, AMI. What does AMI stand for? And what does that look like?    Billy Hatridge     So AMI is alternative method of instruction, and in the past, what a lot of our schools have done, and of course, nobody was ready for this, not to this scale, but what they've done is they've had, you know, big manila envelopes that's got printed classwork for the kids to do at home. And it wasn't an E school, it wasn't a digital learning it was just, here's this little handy packet of homework. Take it home and do it when we have a snow day or whatever, or flu days. I was talking about earlier with this, one of the issues that the schools are trying to figure out is a lot of our kids don't have access to the internet at home, or it's not good internet at home. Even me sitting here at my house, you know, we had trouble getting the Internet to work just for this call. And so the question is, if you've got kids who can't participate in learning, is it fair to your school population if only half of your kids can get online and do those, those e school things? And so our schools are really trying to figure out whether it's paper instruction, whether it's online, our company is trying to figure out the tele therapy part of it and how that will work and so, but that's what AMI is, typically, is when they call them AMI packet or an AMA diet, any of my day, it's those, those paper handouts and homework. Okay, it's in home.     Jayson Davies     So I think it was before we jumped on to this call you talked about your company with speech therapy has done a little bit of teletherapy, and you guys have a platform potentially. Can you tell us a little bit about where you're at in that whole process?     Billy Hatridge     Yes, so you know, we had an issue for several years now of providing speech therapy to some of our schools. That's one of the most underserved disciplines that we have at some of our area. And so I think about three years ago, progressive therapy kids had started providing speech therapy via telehealth or teletherapy. And so they usually have a pair of professional at the school with a laptop. They're bringing the kids, they sit them down, and then the kid interacts with that speech therapist over the computer. So we've been doing that for three years now, and so we've kind of been in the telehealth game a little bit, doing that, trying to figure out how to scale everything up, trying to figure out how OT and PT is going to work over the computer. You know, speech might be a little easier, but that's something that we're all kind of struggling with. I. Um, you know, the telemedicine as a whole has changed a lot over the last weekend or two, as people kind of try to loosen some of the restrictions and try to change the way it's getting paid for to help with that. And I think I'm speaking for everybody, but we're kind of just rolling with the punches right now and trying to figure out how that's going to look. You know, are we going to use Zoom. Are we going to use FaceTime? Are we going to use a more professional platform for this? Are we going to use telehealth? I think which is what we were using for Thera platform was what we were using for the speech therapy services. Say that again, I think it's Thera platform is the name of the what we're using for speech okay, I don't know if that would work for a company wide 17 plus therapist, but it also depends on the school district and what the school district wants to do, whether they want to go that route or not. You know, one of the things that we're hearing here in the state of Arkansas is the possibility of closing and then resuming school in the summer and going through the summer, and so if they close school, then the provision of therapy services via the IEP isn't take place, because the IPs are, you know, on hold until we come back to school. So.     Jayson Davies     Yes, yeah, so in California, I'll just give you an update what's going on right now. It's same type of conversation about teletherapy and equity as well, because, yeah, we do have kids that don't have devices, and currently, my wife's a fourth grade teacher in a school district I'm an OT so we're kind of going through the same thing, and both of our districts are trying to get computers to our kids, along with hot spot devices for those who may need that? It's my understanding that both of our districts truly underestimated how many kids were going to need these devices, because so many of them, or the families don't have a computer, they may have an iPad, but how much can you really do on an iPad? And most of them are relying on one smartphone for the entire family, and you obviously cannot. You just can't do work on a smartphone like that. Not acceptable. And so they grossly underestimated, from my understanding, how many Chromebook or whatever they're giving out they needed, as well as the device hot spots for the parent. So that's what they're working on now. We're on spring break too, just like you, and they're trying to get those devices out as fast as they can. And we're kind of in a similar spot, except we don't have, I think our district had a few speech therapists that were contracted for teletherapy, but that's a contract it's not like we have the platform in the district, right? And so we're, they're kind of playing around with zoom a little bit. It's my understanding that when we come back from spring break, or maybe the week, yeah, spring break, that we're going to have two weeks where it's called enrichment program versus distance learning enrichment is we're just going to be providing resources for parents, and so basically, we're just putting some resources up on the website for the first two weeks and saying, Hey, here's Handwriting Without Tears. They have free resources. Check it out and email us if you have questions. But after those two weeks, and now we're getting into, like, the middle of April, that's when we're gonna have to figure something out and start providing services through zoom or Google Hangouts, or whatever it might be called. So yeah, I think you're right. Everyone's just trying to figure it out. And so best of luck to you. Best of luck to me. Best of luck to everybody. I think, is where we're at right now. So yeah.    Billy Hatridge     And it's, and, you know, we're in a good place right now. My wife's an accountant. She usually works from home. She works for an IT network company who is booming right now. Oh, there you go, everything. And so I've had a good, good chance of being a stay at home dad for the last couple days. My two year old, and she's trying to get back to work a little bit. So that's been, it's been nice for her to kind of have that opportunity to go back to work, and they're able to give her more hours while I sit here, tell them my thumbs waiting on spring break, get back and see kind of what happens there, and how my supervision rule works. Yes, you know how our notes work, because all of our charts are still locked up at the schools. And, you know, can we go and get those? I need to send out all that stuff again and have our therapist work from home. It's, yeah, it's gonna be interesting, for sure, figuring out how this moves forward.     Jayson Davies     Yeah, and the speech therapist I work with at my school sites, or two of them, she's a contracted speech therapist. She's her own contractor, and she has employees, I think one other SLP, and a few slippers. And, well, basically, at this point, the district's kind of saying, well, we don't have a need for your slippers right now. And so I don't know. Are you in a similar situation where the districts may or may not be paying you at this point or your company because there's no school.    Billy Hatridge     I haven't heard that yet. So far, all of our districts have been pretty on the ball about saying, Yeah, whatever y'all can provide, we want to provide that to our kids. Now, what that's going to look like in a few weeks, what that's going to look like when we try teletherapy and it doesn't work as well, if you think it does, or if it does, if I work great. It might work great. And I'll open up a lot of opportunities. I feel like this COVID 19 situation is going to change healthcare forever. Absolutely, it's going to change the way we interact with the doctors or therapists. Is going to change the way we interact with so we have to teletherapy moving forward. We don't have to just serve schools that are geographically close. You know, if it's effective, and the question is going to be, how effective is it?    Jayson Davies     But yeah, and I think everyone, if you're not already aware of it, a ot A is working on trying to get licensure. I don't know what exactly they're calling it, but they're trying to basically make licensure easier, or like a universal license, so that way, and it's basically for telehealth. Because right now, if you want to practice telehealth in your state and Texas, you have to have a license in your state and Texas in order to see that get in Texas right. But they're trying to make it kind of a universal license to where you just need one. So a lot of things are happening to support telehealth, and we shall see what happens, I guess.     Billy Hatridge     So yeah, and that's going to change, you know, quite a bit on the supervision, because our supervision guidelines are Arkansas State Medical Board who has our state licensure, you know? And so if it's a national licensure, and every state, it kind of has to meet the same guidelines, you know, what will that supervision look like for our OTs? You know? What would that supervision look like, as far as how often you have to do it.    Jayson Davies     I forgot to ask you that question, what does that look like?    Billy Hatridge     Super so under the Arkansas State medical boards guidelines, you have to meet face to face for an hour for every 40 treatment hours that the OTA generates, which in the schools is typically like 25 hours a week, yeah, realistically speaking. And so by meeting with them face to face, every face to face, every week, I'm more than covering that, yeah, catch it up a week after you meet with each meet with each patient once every 30 days, and then you sign all the OT a documentation within 30 days of that service.    Jayson Davies     Wow. You know how nice it is to have that very specific guidance, because not every state has that. I mean, in California, I it kind of says the OT is responsible to provide guidance as necessary or as they feel necessary based on the experience of the OT or something like that. It's very broad. It's very general, and it kind of leads a lot for interpretations, especially when you're trying to tell your district that you're overworked because they don't understand that. Yeah, you do need to see your OTs once a week, and you do need to be seeing the clients of the OT, or the caseload of the OT, a you need to be seeing those kids, and they don't.    Billy Hatridge     That's one of the big things we've had across the state too, is the interpretation of that line. Meet with each client every 30 days, some ot school OTs or school OTs. Take that as I'm going to have a therapy session with each kid every single month. Others take that as I'm going to walk into the special ed classroom, look across the room, make facing, you know, eye contact with everybody. Check my box and move on. And that was my supervision for the month. You know, I'm trying my best to figure out, you know, the middle line there of observing them in the classroom, observing them at lunch, observing them with a therapist, treating them myself. But, yeah, that's the issue with guidelines. Is there's so much interpretation, whether you're talking about Medicaid or state guidelines, supervision guidelines, and I think there's a reason they make it vague so that you can kind of work work it to make what works best for your system.    Jayson Davies     Yeah, cool, man. Well, I want to wrap this up. We've been going on for about an hour already. Time flew by. Thank you, man, for coming on. I think we hit so many awesome topics. I mean, from Coronavirus that we had no expectations to address this a week ago to all the things that we did intend to address, and I think we nailed them. It's going to be super helpful for everyone. Do you want to give out any information? If anyone would like to contact you, or you have a website, I don't know what you want to share.    Billy Hatridge     Yeah, so I've got a website. It's the OT dad.com it's kind of more of a blog and kind of personal insight, but there's some resources there as well. I'm the OT dad on Facebook, Instagram, we got a Pinterest that's not as a bit as I'd like it to be, but yeah, the OT Dad, you can usually find me you know, I'm more than willing to help families during this time or other educators who are kind of struggling with this. I've really tried to reach out to my parents and say, anytime you have any questions while you're home with your kids and they're not getting these services. On time. This might be the first time a parent sees their kids handwriting, then suddenly it's a lot of questions. Oh, man. And so I think it's really important for all of us. I don't know when this is episodes going out, but just to make ourselves available to parents who are struggling or to other therapists, because this is new for everybody. And so if anybody has any questions or has any thoughts on school based OT or other OTs are working in rural areas who have issues. I am more than happy to help any way I can.    Jayson Davies     Great man. Well, thank you, Billy. I appreciate you coming on and we'll stay in touch and see you next time.     Billy Hatridge     Thank you, Jayson for having me.    Jayson Davies     All right. And that wraps up episode number 46 of the OT school house podcast. Thank you again. So much to Billy hattridge for coming on and sharing what things are like down in Arkansas. You know, sometimes I feel like in California, things are just so much different that it's nice to talk to people outside of outside of California and see what ot looks like out there. This was an especially nice phone call Billy. Billy and I kind of joked how nice it is just to have a conversation, or real, a real conversation with an adult, sometimes outside of the house. And you know, we're in quarantine. And so I hope this podcast can act as a way for you all to just step aside a little bit from reality and what's going on. So appreciate you listening, and I hope you found this as a very beneficial podcast for your practice. Let us know what you thought about this podcast. Leave me a comment down in the Apple podcast app if that's where you're listening, but yeah, otherwise, we will see you next time on the OT school house podcast. 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 ov er to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 45 of the OT Schoolhouse Podcast. In this episode, Jayson shares advice from eighteen fellow school-based occupational therapists and members of the OT Schoolhouse Community! We cover each of the following topics: Getting to know everyone on campus and allow them to get to know you Building Rapport Asking Questions Knowledge Translation - Get trained and train others Getting organized so that you can be flexible Advocating for yourself! ​ Listen in wherever you listen to podcasts! ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! ​ Links to Show References: ​ OTs on Instagram that contributed to this Podcast Alexandra from @TheAccommodationstation Amanda from @Yoursch00lot Tricia from @Tan23ot Sarah from @Theeverydayot Raejean from @Raejean84 ​ Dr. Meryl & Shae from @Kidscopinglab Elisha from @Haepi_ft Michelle from @Michellemarie5 Tarra from @Tarradp Theresa from @Kidsviewtherapy Christine from @Mamawells329 Ashley from @Ashmenzies Bridget from @Bridgetchristie Sarah from @Sarahbeeot Meghan from @Wootherapy Danielle from @mornings.with.an.ot.mom & @mindfulness.in.motion Hope from @Hopemccarroll Kenzie from @OTwithKenzie ​ ThePencilGrip.com (Sponsored) This link will automatically apply your 30% discount off your entire order!​ 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 everyone, and welcome to episode 45 of the OT school house podcast. I want to thank you all so much for joining me here today. My guess is you're probably listening to this and not the typical environment that you usually listen to the podcast because of all the Coronavirus, COVID, 19 stuff going on right now, you're probably at home and maybe you're not even listening to this as as quickly as you might, because you're not in the car driving, or you're not at the gym working out, but that's okay. We're gonna get through this today, and it's a great episode. It's actually a very user involved podcast. I should say we're gonna have a lot of input from people that follow the OT school house community members, so it's gonna be really good. But first, I do want to thank the pencil grip for sponsoring today's episode. The pencil grip is the original ergonomic writing aid. Writing becomes easy and natural with the pencil grip. It improves handwriting, helps to get more control and reduces hand fatigue. Its unique patent design gently encourages the fingers and hand to rest in the proper position for gripping the tripod grip, of course, unlike other grips, the pencil grip feels natural because of its ergonomic design and soft, flexible, latex free material. Be sure to use promo code ot schoolhouse, all one word at the pencil grip.com in order to get 30% off your entire order. Alright, so let's Cue the intro, and when we come back, we'll do a quick update on the Coronavirus and myself, and then we'll jump into the episode. 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, Jason Davies class is officially in session.    Jayson Davies     All right, so, like I was saying before our catchy intro tune, I still love that. I don't think I'll ever change it, but, yeah, we have a really good episode today where we're actually going to have a lot of user feedback, community members from the OT school house community, come on and actually share some of their tips for a new school based OT. But first, I want to address the elephant that is in the entire world right now, and that is the Coronavirus. And for the most part, I just really want to say that I hope all of you are doing great. I hope you are not well. First of all, I hope you're not sick. But also, I hope that you're doing okay in the house, and that you're not feeling too couped up, and that you're making sure to get out and go for some walks, at least, you know, staying away from people, but getting a little bit of exercise, taking the dog out or whatever you might need to do. We all need to get some exercise, and we probably also need to get away from the people that we're cooped up in the house with every now and then. So, yeah, go for a walk and take care of yourself, because it's hard to take care of other people when you're not healthy. So I hope you are healthy. I hope your family is healthy, whoever that might include, your friends are healthy. And also, one thing that I'm doing a little later today is actually having a zoom happy hour with some friends where we're all just going to jump on and since we can't go out, we're just going to have a drink on Zoom together and enjoy one another's company, maybe see if we can find a game to play or something. Everyone has a deck of cards in their their house, right? So maybe we'll figure out a card game to play or something. But I just really hope everyone out there is doing well. I'm going to try to to support you all as much as I can during this time, but for me, this is also a new experience. I am not a telehealth provider, and we're going to try and get through this together. Many of you have already listened to episode number 22 where I did have a chat with Tracy Davies on telehealth and how to kind of get started. I know many people have been listening to that over the past week or so, and many people seem to find it as a very beneficial listen. It's helped a lot of people so far. It is just an introduction, but I think it can help calm some nerves a little bit as for what I am doing and my district is doing. We're still in the planning phases. We don't know exactly what our sessions are going to look like. I can tell you at first, we are just getting some resources up on our website so that parents can have some ideas as to what to do after that, when we have to get a little bit more in depth with our sessions. We're not quite sure yet, but we are making that plan and trying to figure out what platform to use and what the services will look like. I hope to be able to give you more on that in the coming weeks, as we figure that out. Right now, I'm currently on spring break, and a lot of people are working at the district to get that figured out so that we can get back to work. All right, so let's jump into it. Today. We're talking about the top tips for new school based OT. And this is super cool. It's different. It's unlike anything I've ever done. And this podcast is a direct result, actually, from an Instagram post that I posted. Did ot a few weeks ago that simply asked all of you, all the people out there that follow me on Instagram, what tips do you have for a new school based OT? And from the 60 plus comments that I had from all of you that follow me over at ot school house on Instagram, I compiled them up and I put them together. I'm going to give several of you a shout out for the comments that you left. I did get permission from everyone to use their their words, their comments, so that was super cool, and actually created some new relationships and new friendships out of all that good stuff. So yeah, I've got six overarching themes that we're going to talk about today, and that first one is actually get to know everyone on campus and allow them to get to know you. And for any new school based OT, I can't stress this enough, and so to start off with the first quote from Alexandra at the accommodation station on Instagram. She says, make sure your admin know who you are, and that's important, because you know you're gonna get to know these people, especially if you're an OT you're going to get to know them in the IEP meetings, but you should really get to try to know them before then, because you're going to need them on your side when you're in those IEPs. You're going to need them to know your beliefs, your theories, things like that, that help them to support you, or even when they go into meetings where you're not in the meeting, and maybe ot comes up, you want them to almost know what you would say in that same situation. What advice would you have for that parent or that teacher or something that's having a struggle? So really, as an OT, get to know your admin. Also as an OT a Get to know your admin on campus as well as an assistant. It may be a little bit trickier, because you're not going to be in the meetings necessarily, with the with admin. I know in some districts, ot A is do go to IEPs and so you'll have a chance there, but that's not always the case. So as an OT and an OT a team, you should really strive to make sure that you both know the admin as an OT, you should really make that connection, or make that first introduction, let the admin know that this person is going to be on their campus, let them know who this person is and what their role is. I think there's some misconception that they are like an aid to us and an OT a as an aid to a OT, which isn't exactly the case, as you heard on the previous podcast with Kate and Mary. It's really a team, right? Team effort, and OT A is granted. They're not independent. They cannot work without an OT. They really do bring a lot of their own information to the table. That's fantastic. So yeah, just make sure that you really know your admin. And so the next quote is actually from Amanda at your school OT and she says, Let administrators know who you are and when you'll be in their building. Again, another key point, let them know when you're going to be there. You know, no one likes surprises. Let them know that you do jump around from school to school or how it works, you know, let them know if you're going to be there, Tuesday, Wednesday, Thursday, or whatever day. And as she says, let them know who you are. Just as it is important that you get to know them, you also need to let them know who you are, and let them in on your strengths and weaknesses and how they can support you, you know, let them know if you're feeling the pressure of being at too many school sites as OTs and CODAs, we're in this weird position where the school site admin are like a pseudo boss, you know, like, what I mean by that is that we are often, quote, unquote, supervised by the department of special education, as opposed to the school site admin, like a teacher might be right? So while the school principal is who we report to regarding like school site matters, it's often the the department of special education that dictates our case load and our school site. So it's a weird dynamic that by knowing and by letting your admin know who you are, it can help you. I've had admin fight for me to stay at a school site because they enjoyed me as a person. They knew that I was going to get things done, and so they were willing to speak up to the special education department on my behalf to keep me at the school site, as well as to also fight for my caseload too. So you want to have that good connection with your admin. I have two more quotes here for you regarding getting to know people on campus, and that is from Trisha at Tan 23 OT, and she says, to become friends with the custodian slash janitors. They know the rooms, the spaces, places that can be useful to you. And Sarah from the everyday ot says, Make friends with the custodian. You never know when you'll need to borrow tools hardware or have them rig something up for you again another must. Not only can they help you find a space to work in or a place to keep your stuff, but they also have access to the rooms when you forget your keys, and they might be able to help you find chairs or desks that are more suitable so. Size for the kids that you have. You know, sometimes you walk into a kindergarten classroom and all the deaths are just way too big. Sometimes the janitors custodians will know where to find different sized chairs and tables for you. You know, I want to give a big shout out real quick to one of the custodians at my school. His name's Pat, I swear he's like, the first person to show up, the last person to leave. Every day, he's amazing. He helps me out. I get him some coffee every now and then. And it's just really cool to have that other person on campus to be helpful. You know, every now and then, he, like, finds a stash of paper, and he's like, Hey, you want some paper? I'm like, Yes, please. You know, paper is a commodity around the school, so, yeah, get to know your custodians. Definitely. All right, the next quote that I have here, we're still working on that communication, slash, getting to know people on campus. This is from Ray gene at Ray gene 84 and she says, in addition to making friends with building secretaries on the janitor, befriend the gym teachers also don't forget to provide support to the specials like the teachers, art, gym, music, computer teachers, those types of non core curriculum, or whatever you want to call it. She says, These teachers a lot of time get little support and aren't quite sure how to meet students needs. Art and gym are often great classes to push in for OTs, and I definitely agree with that. For you, those of you out there looking to push into classrooms, I will often work very closely, not as much with PE because we don't have PE teachers, but with adaptive physical education teachers in my schools, they're one of my go to people often because I know that I don't necessarily have the time to get as much sensory integration, bilateral integration, coordination, whatever you want to call it in and so I often will coordinate with the apes and say, hey, when you're doing some stuff, can you just try to incorporate, you know that crossing of the midline, the two handed use motor planning stuff like that. They are fantastic. I love working with my AP teachers. Shout out to Joanne and Justin and all the PE teachers a PES that I have worked with in the past. They are amazing. And then she also mentioned secretaries, absolutely, absolutely, get to know your secretaries and the clerks, if that's what they call them up in the front office, just like the custodians, they have a relationship with the admin, and they know how to get things done for you, to support you again. Oftentimes, they control the keys, the paper, the master schedule on campus, so if you're unable to get a hold of your admin, oftentimes, the Secretary has has the key to it. And before I move on to our second official tip, I want to share a little story. It's kind of embarrassing, I guess, in a way, but I think it might be more helpful for many of you, and some of you might even use this tip. I don't think I'm the only one who does it, but when I was at a district where I had 13 schools to kind of attend to, I would actually keep a note in my phone that had the names of, like, the Secretary, the front office staff. That way I could reference to it before I walked into a school and just be like, All right, you know, just until I got to know their names, it was just a quick reminder that I could peek into my phone as I'm walking into the building. And that way I could, I mean, I don't know, everyone likes to hear their own name, right? So being able to just remember names, when you have a lot of people to remember, it's worth a little bit of a task to put in your phone and make it meaningful for you, and actually remember those people's names and and start to build a rapport with them. And that actually brings me to our second official tip, and that is building rapport. So Shay from kids coping labs, she actually had a quote, a great one, and she says, always start with building rapport with your clients. You'll be able to more efficiently meet your goals once your students have a solid trust in you and your relationship. And I think this not only goes for the kids we work with, but also the parents and the teachers. Of course, you know, you got to take the time to sit for the entire the entire IEP sometimes, if you need to talk to your admin about the possibility of sending home an OT newsletter to your parents for a few semesters, I sent home a summer and a winter newsletter. And it was very simple. It was just kind of, you know, different apps on the iPad that you could potentially use to help with handwriting, different websites that you could try the parents could go to to help the kid with typing, different fine motor activities that might go along with a theme, whether it be summer or winter, and just kind of that type of thing can build a rapport, Along with staying at IEP meetings and really fully understanding the concerns that the parents have, you may be able to even attend a back to school night or an open house and wonder about the classrooms which many of your kids attend, like the special day classrooms or or academic specialized academic instruction classrooms. That's something. Could do. Maybe, if there's parent teacher conferences going on, ask your teachers if there's any conferences that they would like you to sit in on, so that way they can get to know you and the parent. You can provide suggestions to the parent without having to wait maybe until the next IEP, if it's not for a while, all those types of things building a rapport. Just can't stress it, whether it's with the kid, the parent or the teacher. And we already talked a little bit about the admin getting to know your administration. All right, so Topic number three, another great tip for new school based OTs, and that is asking questions. And this comes from Alicia at I'm sorry, Alicia, I can't pronounce this, H, A, E, P, I underscore F, T is your Instagram handle, and she used the hashtag year two school, coda. So apparently she's been at this for about two years, and she says, Don't be afraid to ask questions. Along with that Michelle from Michelle Marie five, says, ask questions. Ask where the bathroom, gym, nurse's office is, rather than wandering about or wandering around until you find it. Ask for help. Ask what people mean by acronyms. You get smarter and better at your job when you ask clarifying questions than when you pretend to know what people are talking about. Yes, and I know all of you are in the business of trying to find out more information. Otherwise you wouldn't be listening to this podcast. But I can only give you so much. The guests on this show can only give you so much. Every school, every district, is very different. So ask questions in your setting. I really struggled with this one when I started out, to be honest, I still struggle with it sometimes today, but I know I often feel like I don't want to burden others, and that's kind of on me. I kind of want to be able to do things on my own, and so I do kind of still struggle with this. Sometimes even simpler questions like, How do I use the copier? Do I get so many copies a month? Do I get paper, or do I need to buy my own paper? Simple questions like that, they help. I know you don't want to ask them. You don't want to sound want to sound stupid. Maybe you want to wait until you get a rapport with another teacher and ask that teacher. But you know everyone understands that when you're new to school, you need to figure that out, and so don't be afraid to ask questions. All right, before we move on to number four here, I want to take a quick break for all of you out there listening. Maybe put down your phone. Just stretch your arms, stretch your legs out a little bit, unless you're driving, keep your hands and eyes you know where they should be. Or if you're in a place, a safe place, to do this, shoot me a quick Instagram message and tell me what your tip is for a new school based OT, or maybe something you learned from your first year that you would like me to share with the community. I will. I'll put those out on Instagram again, once I get a few of those in while you send me that direct message, I want to go ahead and say thank you again to the pencil group for sponsoring this episode of the OT school house podcast. The pencil group was designed by a doctor and is widely used in classrooms at home and in therapeutic settings, the unique shape is designed to be a one size fits all to help the hands of kids and adults and work for both righties and lefties, the pencil grip can be used as a training tool and then permanently for added comfort. The pencil grip fits on pencils, primary pencils, pens, crayons, markers, paint brushes, whatever you might use in your therapy setting. So it benefits can be widely enjoyed. A comfortable hand has more control and shows improved handwriting. The pencil grip guides the hand into an ergonomic position. It relieves hand pain, reduces fatigue and improves comfort. Consistent use teaches and reinforces the pencil grip and stops problems like fist grips, thumb wrapping and white knuckling. Parents, teachers and OTs widely recommend using the pencil grip. Get yours at the pencil grip.com . Using ot school house for 30% off your entire order. All right, so our break is over now. And number four tip for new school based OTs is knowledge translation. Get trained and train others. Tara, from at Tara DP on Instagram says, take advantage of all the mentorship you can get, watch and learn. She even used the wandering eyes emojis. So yes to this, you know, take the time to watch other OTs and OT as if you're allowed to take that time and again. This goes back to asking questions. Ask if you can take a few hours, or maybe there's a minimum day at your school, but not at another school. Take that time to go and observe what another OT is doing, whether it be in an IEP, if that's an area you need some help with or in treatment, you have to help them, to help you, right? You have to ask the questions, can you do this and then let them help you with their response of allowing you to come view them, or maybe you need help with some treatment, planning, developing goals, get all the mentorship you can. And then also ask if you can attend some trainings, whether it be a larger conference, a one day seminar, maybe some online courses. Ask your your administrator. Whether it be your principal or the special ed department staff, if you can go to some trainings, you know, especially if you're a new person, a new school based OT, you don't have that training. And I still feel that some of our school based ot skills are lacking in actually, ot school, or I should guess, I should say that the other way around. I think in OT school, they don't teach us enough about school based ot yet. I've been out for a few years now, so maybe it's kind of a little bit better, but I know when I was in the program, it just wasn't focused on school based ot at all. Right? And so try to find some courses that you can take and get out and go do that. Oftentimes they're on the weekend, so you don't you don't even have to miss a day of work, which I know can be burdensome, when you miss 10 treatments in a day, right for missing one day? So ask if you can do that. Go and get some knowledge. Theresa from kids view therapy says, do a lot of training. Train those teachers. Push in and present, present, present. You have too many kids to see all alone. So instill help in the staff collaborate constantly. Great advice from Theresa. You know Knowledge Translation goes both ways after you attend to trading or you get support from someone. You got to support your teachers by sharing what you learned. This is especially true if you go to any one of the handwriting seminars, Handwriting Without Tears, size matters. Any of those, there's so many little techniques that they share with you that can be so easily shared with your teachers. And you know, what your teachers will love? Would love that information. I mean, just the other day, I sat down with my kindergarten team, who I had never even met. I've only been at the school this year, but we didn't have any kindergarten kids with OT and so this was the first time I got to sit down with them and just give simple recommendations, like using loop scissors or using tongs and and things that are just, you know, everyday items for us, but they don't even know exist, or different types of visual activities, right? So make sure that whatever you get, you also transfer over to your teachers, they will be excited and happy to carry that stuff over with you. They will reinforce those skills with the kids that you will never have the chance to see. So yeah, I suggest you go back and listen to episode 42 if you're interested in some RTI, which includes that training and getting into the classroom. Episode 42 I talked about the three tiers of RTI, and that kind of goes along with knowledge translation, using your knowledge to help teachers. So have a look at that, or listen to that going along with the knowledge translation theme. Christine from Mama wells, 329, says, collaborate and create alliances with your case carriers and specialized academic instruction teachers. They will be your eyes and ears for your students every day, even if you physically can't be on the school campus. And this goes right along with what I was just saying, right? You know, I didn't have a specific tip for this, but this is, this fits under Knowledge Translation, you know, even if you physically can't be on the school campus, and this goes right along with what I just said. I didn't have a specific tip for this, but I think it fits under this knowledge translation, as you will quickly learn that it's imperative to rely on your classroom staff, right, to share the progress or potentially lack thereof they are seen in their students. Obviously, you're not there every day, right? And the teachers are, the parents are, and so after you share tips with them, check in to see what's being incorporated and also what's working and potentially what isn't. Christine says it really well. I mean, I can't really say it any better than what she said. They are your eyes. They are your ears, and so you need to listen to them, because they know what's going on in the classroom, whether it's good or bad, whether the teacher and the age are telling you, yes, this kid cut a complex shape for the first time in class, they're able to attend to it, and everything is fantastic. Or, you know, so and so still can't cut out a circle. We need to listen to that, because even if we see them cutting out a circle in that one on one setting, does it really matter if they can't do it in the classroom setting? So listen what is going Listen to what is going on in the classroom. Another comment by a school based ot follower from Ashley at ash Menzies. She says, push into the classroom. Let the teachers see you working with the students. It will help create rapport with the teachers and buy in for interventions you want to implement. Also make sure what you might be working on in a pull out session transfers into the everyday environment. Again, exactly what I just said right after I talked to those kindergarten teachers that was after school on a minimum day, we kind of sat down for about an hour and talked the very next day, I took my lunch time, and while the rest of the school was all at recess, kindergarten wasn't. And I took those, I don't know, about a combined 30 minutes between those two periods, and I just went in and gave them some cool materials and said, Let's go at it. And I just walked around the classroom and gave the teacher some strategies might have walked around. Just gave, you know, a kid some a little pom pom to put in their hands to, kind of, you know, try and help that pencil grasp a little bit again. These aren't kids that need occupational therapy. The teacher just doesn't have the strategies yet to help those kids, right? So that's what we're trying to do, get into those classrooms and let the teachers know how they can support their kids in ways that they were not taught in their teaching education. All right? So that brings us to our second to last tip for today's podcast, and it's kind of a two fold. It's get organized. But on top of that, it's get organized so that you can be flexible, or so that it doesn't hurt you when things kind of go askew, right? And Bridget, from Bridget, Christie on Instagram says, organize info about the students as much as you can beforehand. And this is something I always tell people, and that is on your first day, your first two days, your first three days, even, hopefully your district is giving you time to get organized before you have to jump in and start seeing kids, because that's that's really that's tricky, trying to go in figure out goals. It's like you're shooting from the hip, right? If you just see that kid on the very first day, at 830 in the morning, or whatever time school starts, and you're trying to look up their goal, look up their service, and see the kid all at the same time. It's that's ridiculous. So even if you have to do it the night before, try and organize things in whatever way helps you so that you can be prepared, because you don't have a lot of time in between kids, right? I mean, you go from 839 nine to 930 right? Every every minute is a new kid, or every 30 minutes is a new kid, or whatever it might be for your district. So Amanda from your school OT, you know, she says, use electronic documentation as much as possible and find some sort of way to keep track of IEP dates. And again, I couldn't agree more with this, with Bridget and Amanda, both from a second ago. You know, this is why I put up my organizational system as a freebie for those who subscribe to the otschoolhouse.com email list. It's out there. It's a Excel spreadsheet or Google Spreadsheet, however you want to use it. And it's a way just to keep track of those students IEP dates, keep track of when their annual versus their tries coming up, their services. Personally, yes, we have an IEP system in our school, and it's called sase seis, but I don't think it's very user friendly. As far as keeping data or not keeping data, but keeping records up to date, it's a little tricky in that you have to look in different areas to see when an IEP is coming up versus what services the student is receiving. And so I recommend creating your own document that you have right there, and that way you can, like split screen it. You can have their goals on one side of your screen. You can have the services on the other side, and boom, you're just ready to go. I personally use Google Sheets. And, well, I use Google Sheets for the OT school house, but at work, I use Microsoft Excel, right? And I do this to organize services, goals, IEP, dates progress on goals, upcoming evaluations, even as well as evaluations that have already completed again, you have to keep track of your data, so that way, at the end of the school year, you can show your administration. Hey, look, I was doing like an IEP every other day, or I was doing one evaluation every single week of the school year, and they need to be able to see that. And unless you're keeping data, unless you're organized, you're not going to get there. So this will take some time to get started, but I highly recommend, if you can take an extra day or two before you start seeing kids, to get this organized. Otherwise you're gonna just kind of be behind while you're seeing kids, and you're just continuously going to get a little bit more behind. So take the time and get that done if you can. Man Amanda from your school, OT, you had so many good tips. Another one that I pulled from your your little blurb, you said, try to avoid bouncing back and forth between schools, and this is why you need to be organized so that you can be flexible. I'm lucky now that I only have schools that are literally like a few blocks from each other, but in the past, I've had schools 30 minutes apart, and I know for many of you in a rural area, 30 minutes is like you're close schools. And so you need to have a plan, and you need to plan ahead and even possibly call ahead to see if the student you need to evaluate is even on campus today. It's kind of a bummer when you get all the way across the desert or all the way across the plains or wherever you're going to see one kid to evaluate, that one student, and they're not there that day, whether they're sick or maybe someone else is evaluating them, or whatever. You just can't see the kid that day. You kind of feel like you missed an opportunity, and at the same time, you kind of get mad at yourself for not calling ahead. So highly recommend calling ahead and seeing if kids are even there when you need to see them, because when you're driving 30 minutes between. Goals that can be harmful to your time and your productivity. All right, a few more under this organization umbrella, Sarah from Sarah B ot says, I recommend making yourself a checklist of all things that need to be completed before and after IEP, such as data collection, teacher consults, scoring goals, drafting goals, documentation, etc. And yeah, Sarah nailed this. I actually do this on a daily basis. On the home screen of my computer. On the desktop, I have an open notes page, and it just kind of that's exactly what it is. It's a checklist, and I just look at it. When I have an IEP coming up, I can look at that and just mentally say, okay, for John Doe, I have updated the progress on goals. I have updated the present levels, but I have not drafted a new goal. I have not put in my updated services. And then, as I'm at the IEP, I look at it again, because that's when I start the post IEP process, and that is, did I bill? Did I provide a treatment prescription? Did I fill that form out in and scan it with my phone and send it to whoever needs to be sent to, right? So that they can do the whole medical Medicare thing? Did I make my treatment plan for my own personal benefit and my own personal memory, right? Did I put their new goals, their new services, all that into those, those Excel spreadsheets that we talked about earlier. That's all on a little checklist right there on my home screen, on my computer, so I can reference to it right away. And along with that previous tip, Megan from woo therapy, who is amazing, has some really cool tape you should check out if you haven't yet. She says, Before an IEP meeting, observe the child in class, talk to the teacher and call the parents, yes, yes, yes and yes. Do not go into an IEP meeting without seeing the kid. Especially I do as Megan does, I highly recommend you also call the parent, talk to the teacher. Especially, one of the things that, again, I am not the greatest at, is calling the parent, and I can very much tell the difference and how confident I am at an IEP, as well as how well the IEP goes in general, with all providers, including the teacher, if we have or have not talked to the parent, you know, you don't want any surprises at the IEP. You want to be able to go in there, have everyone on the same page. Highly recommend calling the parent, but if you can't try to send them an email, or if you need feedback from them, I actually create a Google form or a Microsoft form that I'm able to send them a link in an email and say, Hey, we're doing an evaluation on your student. Can you please complete this form? Just click on this link and it'll ask you a few questions about your student, and that way you're getting input. If you have any questions about what comes back in that form or what comes back in that email, give them a call and follow up. You don't want to be asking a lot of questions at the IEP. You want to be able to do that beforehand, so that when you get into the IEP again, things that run smoothly. We talked a little bit about that in episode 43 right? 43 when we talked about some difficult IEP, so be sure to get that parent and teacher input. And here's one last tip as to why being organized help. And it's about flexibility. Hope. From hope McCarroll on Instagram, she says, Be flexible. Write everything in pencil because it will change. Also give yourself some grace to make mistakes and take longer on things The first year is difficult, she says all in caps, and so you need that year to learn the rhythm and routine of the school year. You know, when you are organized, it's easier to roll with the punches, right when a teacher stops you in the hallway, you don't feel as pressured if you're able to say, sorry, I'm on a tight schedule right now. But if you email me a reminder, I will get back to you Thursday when I reply to all my emails that is not rude, that's you know, that is advocating for your time, that's advocating for yourself, and that is telling the person, hey, look, what I'm doing is important, but I will get back to you right? And so likewise, when you know an IEP is due because you're keeping your own data, not relying on the teacher's email saying, Hey, An IEP is coming up in three days. You won't feel as caught off guard. And so there are times when a teacher will email you at 8am and say, Hey, I forgot to tell you there's an IEP at 3pm today, and it's not your day at that school site, right? So maybe you're across town and you're like, Oh, thanks. I have 10 kids to see today, and now I have to get to an IEP at 3pm right? No, keep track of your own data. You should be the one, at least, in my opinion, you should be the one two weeks before an IEP supposed to happen. Saying, Hey, teacher, I haven't heard from you about John Doe his IEP is coming up. Can you please let me know when it is? And hopefully you know that'll at least give them the cue to get back to you and again, that way you're not caught off guard when something happens. All right, tip number six for new school based OTs, or even just you all out there who are just like, Man, I need some tips from the community. And this is it. Tip number six is document, document, document. Alyssa Warne reminded me of a great quote that goes as follows, if it's not documented, it never happened, and make sure you cover yourself. Cya, right, by documenting your treatments thoroughly so that you can show the therapy you provided at a later date for any number of reasons. You know, I think by now, most districts are using some sort of electronic records program for billing, and so I highly suggest that you don't just view that as a meaningless record, but as something that you can be thankful for potentially one day right again. Cya, cover your own. You'll figure out what the A is. But likewise, I also suggest that you keep your calendar up to date in case your district or anyone else questions your whereabouts earlier this school year, I actually did a a workload study where I kept track in 15 minute intervals, what I was doing at all today. Granted, I still need to kind of analyze that data, synthesize it a little bit, but in doing that, I was able to really see that I was struggling and that I needed help, and so that's why I was able to send an email confidently and say, Hey, I can't do this alone. I need help. Please provide me with support. And you know what? I got the support. So document, document, document, whether it's your IEP, your calendar and obviously your treatment notes and evaluations, you don't want to be caught off guard a year or two years from now, not having some good notes that you can rely on. All right. And our last tip for new school based OTs, and this is just honestly for everyone, is advocate, advocate for yourself and advocate for the students. Kenzie from ot with Kenzie says, advocate for your children, but most importantly, yourself and yourself is all in caps. And then Danielle from mornings with an OT mom on Instagram, she says, change takes time. You will see many things you are not okay with. Focus on the things you can change, like every other tip, these are so important to remember. You know, you are only one person in a huge organization. Do not overburden yourself with things that other people should be doing as part of their job. Of course, help where you can, but everyone needs boundaries. So ask for help and let people know when you're struggling. I had to do this just a few months ago, like I was talking about, right? I had 100 missed sessions, and I used my my workload study to kind of show why I was missing those sessions. And it took some emails and support from the rest of my ot colleagues to help me out, but eventually the district did provide me with the support of a COTA one day a week, and so that's really helping me make up some of those missed sessions. So yes, advocate for yourself and worry about the things you can control. All right, I'm sure we could go on and on with many more tips. Maybe we'll have to do another follow up podcast for more simple tips like this, directly from you and for you. But that is going to wrap things up for today. I know I mentioned many people's names and many Instagram handles, if you would like to see those Instagram handles to be able to follow all those people, I will probably have something on my social media around the time that this comes out, like with a tag, so you can just click on their names right on my story. But also go to OT schoolhouse.com , forward slash episode 45 where I will have a link to each of these people's social media accounts so that you can easily just click on it and click follow. It'll be that simple. They are all amazing occupational therapists or occupational therapy assistants, and I highly recommend that you follow them. Yeah, you know as OTs, we need to, we need to support each other, and we need to follow each other so that we can get all the tips we can right. So just to recap, the larger six themes were get to know everyone on campus and allow them to get to know you. That was number one. Number two goes right along with that one, and that's building rapport. And how are you going to build rapport with number three, asking questions. Number four is knowledge translation. Get trained and then use that training to train others, whether it be other OTs, OTs, or teachers and classroom assistants. Right number five is get organized so that you can be flexible. And right along with that, number six is advocate for yourself, because we are all people, and we all need help. We all need time, and we all need to just do our job well, and we need to advocate in order to do that right. It's hard to do your job well when there's not enough time in a day. So advocate for yourself. Advocate for your students and yeah, keep doing you be awesome. You know, you're an amazing ot remember, like hope said, The first year is very difficult. So many people expressed how difficult the first year is, but you will get through it. You'll move on to year two, that'll be a little bit easier, and by year three or four, you'll be great at it, right? So keep it up. You're awesome, and we'll see you next time on the OT school house podcast. Take care everyone. Bye, bye.    Amazing Narrator     Thank you for listening to the OT school house podcast. For more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 177 of the OT Schoolhouse Podcast. In Part 2 of this important conversation, Dr. Savitha Sundar returns to explore what inclusive OT practice can look like beyond the buzzwords. In this episode, Savitha helps us shift from reflection to action, discussing how to align our evaluations, goals, and service models with the values of true inclusion. We also talk about building meaningful collaborations with general education staff, embedding participation-focused goals into IEPs, and celebrating small wins in systems that are slow to change. If you’ve ever asked how to make your OT services more inclusive and collaborative, this episode is a must-listen. Listen now to learn the following objectives: Distinguish between traditional “push-in” models and inclusive OT practices that center student participation in general education environments. Learn how to write IEP goals and conduct evaluations that promote inclusive outcomes for students with extensive support needs. Explore strategies for building trust and collaboration with general education teachers to support system-wide inclusion. Guest(s) Bio Savitha Sundar PhD, OTR/L. Savitha Sundar has served in public schools for over 17 years across three states, primarily supporting students with extensive support needs in self-contained classrooms. Her research focuses on the role of school-based occupational therapy in bridging the research-to-practice gap in inclusive education. For five years, Savitha served as an executive board member and later as a partnerships officer for a national nonprofit organization--Changing Perspectives, focused on promoting inclusive practices and social-emotional learning.  Savitha teaches entry-level OTD students during the summer at Texas Woman’s University and has mentored more than a dozen students in school-based practice. She also hosts the podcast Inclusive Occupations – Sharing Stories of Not Just Being Invited to the Party but Dancing. Through the podcast, she amplifies the voices of educators, researchers, and individuals with disabilities working to build authentically inclusive learning communities. Resources Inclusive Occupations Podcast  by Savitha Sundar Changing Perspectives  (Nonprofit promoting inclusive practices and SEL) Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hello and welcome back to Episode 177 of the OT school house podcast. If this is your first time listening, or if you happen to potentially skip episode 176 of the podcast, I highly encourage you to check out part one of this conversation with Dr Savitha Sundar to get the full context on supporting students with extensive support needs. Our special guest, Dr Sundar has over 17 years of experience supporting students with extensive support needs, and is committed to building more inclusive school communities through ot practice. She's also the host of inclusive occupations podcast, and has mentored numerous ot students and professionals on inclusive school based practice. In part one, Savitha helped us to unpack the history and challenges around how students with extensive support needs are often served, and what it means to rethink our role as school based ot practitioners to support them. Now in part two, we're shifting into the how we'll be talking about practical strategies for inclusive ot services, writing IEP goals that center participation and collaborating with school staff to move the needle one small step at a time to help bridge the two episodes we're going to begin with the final question from part one about how ot practitioners can start redefining their push in practices to become more inclusion focused. Now let's jump back into the conversation with Dr Savitha Sundar.    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.    Savitha Sundar     What if we provided these supports in the general education classroom? What if we put our effort in making that like OTs, the time we spend in what we currently do, don't take away any time. Don't expect adding more work to yourself. But just think about the same time if it was used in making the general education experience accessible, just recess, just cafeteria as an OT team. Can you all sit together and brainstorm? How can we make cafeteria accessible for all our kiddos in our district. How is it going in your school? How's it going in my schools? Can we all implement the every moment counts comfortable cafeteria program? So another finding of my research was when people knew the how. They always had a clear why. Why? When people knew their how, like people who were aware of these programs, you know, like a comfortable cafeteria program, or the you know, like the interoception program, or people who knew these had these tools, felt like they wanted to justify inclusion because they could do something about it using these programs. Gotcha. So I think having the tools to do it is so important for us to actually assume that role in schools. It's just that we don't know how to do it. That's the biggest problem.    Jayson Davies     Yeah, so I guess that kind of automatically leads us into our next area, which is the how part. And before I ask you how you've done this, you kind of alluded to it a little bit here. I mean, there are programs out there, I guess. But what are ot practitioners currently saying? Did you ask them in your survey? Like, how are you doing? How are you promoting inclusive practices?    Savitha Sundar     No, that was not a question in my survey, but the survey was to identify interested therapists who were willing to talk more about it. So I did identify some of my study participants from that survey, and also through a whole bunch of searching that went on for a while to select these inclusion focused ot practitioners, right? So I had a multiple case study of six inclusive ot practices, okay? And the findings were so interesting, great, great ideas. One of the themes that came out of the study was people had different conceptualization of what inclusive ot practice is.    Jayson Davies     Okay.     Savitha Sundar     Right, which sort of surprised me, given that I had very specific questions or like, access to general education, curricular, extracurricular activities, access to peer relationships. These were like the two criteria, despite that when they heard the term inclusive ot practices, or even when we had a discussion about inclusive ot practices, the most common understanding, which I think you can resonate with too, I think a lot of OTs, lot of us can resonate with, is they talk about seeing the student in the natural environment, like the portion services, yeah, okay. But. One of them said, Well, if I see my student in their natural environment, it's not inclusive ot practice at all, because they're all in self contained classrooms. How can that be their natural environment? So that was like, a big aha. Like, yeah, right. So we are working within a broken system, and we are perpetuating that system by providing ot services within like it's better than pull out services. Yeah, pulling a kid out of what is determined as LRE by the school, pulling them out of that and providing services is probably the least in the list. However, I don't even want to say that. If you want to delete whatever I said right now, take it off.     Jayson Davies     Well, it's the least restrictive. I mean, in terms restrictive to least restrictive services, pulling out a student is the least restrictive.    Savitha Sundar     Right? Right switch, okay, so if you switch to a different lens, okay? And look at it in terms of inclusion, okay, you're not going to talk about push and pull out services. You're going to talk about integrative collaborative services. Sometimes we have to give that one on one support to a student, because that's going to lead the student to make friendships with others. Sometimes we have to teach them how to use this assistive technology tool, one on one in a quiet setting, so this kid can actually learn to use it in the in the in so we can make the right recommendation to the teacher so it's used in their natural setting. Okay, so, okay, i That's why I feel like fees put this, oh, I only push in or I only pull out. We want to do focus on integrated services, where we take each person who com brings with their comes with their expertise in certain skills, or would take the responsibility to address certain skills. Can address those skills, and that can be fit into the student's natural routine.    Jayson Davies     Okay? So, yeah. So, yeah, the focus is on the outcome, not necessarily the type of service per se, and.    Savitha Sundar     Also understanding that me pulling this kid and working with this kid on using on a typing program, practicing typing program while learning a math concept in the class. Is not valuable. That's not integrative. Collaborative services. You would provide the service at a time when it's least disruptive to the students, you know, participation in their natural classroom, yeah? So weighing that, pros and cons and collaboratively as a team, coming up with this goal, like, what are the goals we want to focus on for the student with extensive support needs that will lead to the outcome we all desire for the student? Yeah? So I'm sure it's not so black and white and clear however, it's just something to it's something to think about, right?     Jayson Davies     Yeah, so play this game with me then. So for example, one of the service models that I've liked to use in the past was what I called the two to two model for I would see a student in a more traditional pull out setting, and then the next week, I would try to incorporate what I did in that pull out setting, but do that inside of the general education classroom or maybe out at recess the cafeteria. Would that be, quote, unquote, an inclusive ot model? Because the goal was in order to, yes, I did use that pull out service model for one of the sessions, but the goal was to promote the in class participation. So would you view that, then, as being an inclusive ot practice?    Savitha Sundar     In my view, yes, because you are working with this kid to be successful, to access the best quality education they can access, you're supporting with that?    Jayson Davies     Yeah, perfect, yeah. And I wanted to ask you.    Savitha Sundar     And you cannot do that. You cannot do that access by only working in pull out, because you have to know what's going on in the class. How does it translate into being functional in the class, and what are the other resources that are already available in the class that we can pull in that are even more effective than me teaching this kid. So.    Jayson Davies     Absolutely, because every time to look at Yeah, and every time you're observing a student in the classroom, you're also observing the classroom, and you're using what you know about the classroom to then adjust the services that you might be supporting during that pull out session, or whatever you you want to call it. So awesome. Okay, so where do you think the biggest struggles are then, right now, you mentioned, you know, a therapist even bringing up like, How can I provide these inclusive services when I'm when the student themselves is not included? Where are you seeing therapists have the most difficulty with providing, or maybe even understanding the practice of inclusive ot practice.    Savitha Sundar     So I don't know generally how it is with all other therapists, but the participants who I selected for the study were the ones who considered themselves as inclusion focused OTs, or. Or they supported inclusion, or they had enough stories to share about at least two students about inclusive practices, right? So these therapists shared examples of two types of inclusive ot practices, okay? One, when the student is already in a general education classroom and they're enabling access, they're making that the placement meaningful, making inclusion meaningful by supporting their access to participation in general education, content and contexts. The other the other type was, my kid does not have access to general education, peers or experiences, so I'm going to make it happen. I'm going to be the agent that supports this kid to access inclusion. I think they both are very powerful and important for our practice. So when you are in a situation where like, oh, this kid never goes to art, or because he just doesn't do anything, that he's just running around, right, and then you come in and say, Why is he running around? Let me go see well, because none of the activities given there are remotely meaningful to this kid. He likes being with other kids. He likes watching other people do art, but here you are sitting and forcing him to do art, right? So there's a range of experiences you can get. Like, participation has different dimensions to it, right? You don't have to participate. You may sometimes go to a party. You may not like any of the food, but you like you like the company of the people you know. So participation has different meaning to different people. So how can we enable that? How can we make that art lesson meaningful to this student, right? So then that becomes ot for inclusion, right? So you're providing ot with the expected outcome of inclusion. Here I have this other student. He is not able to sit and eat in the cafeteria. He's grabbing food from everybody. How can we make this it's a it's a complex problem. It takes, it takes the takes the skill sets of somebody highly trained like an OT is in participation, right? So we can, we can problem solve that with the team that I think would be include. And then there were OTs who talked about, like, here is inequity. My kids do not go to field day. They're just watching Field Day. Field Day is not accessible to my kids. Why are my kids sitting and watching Field Day? Shouldn't they be participating there? Well, they don't participate because none of the games they first of all, they were not invited. We've never invited kids from the self contained classrooms to our field day. Second of all, none of the sped team has been part of the planning. And thirdly, none of the games there are remotely designed with these students in mind. They don't know any of the staff or the kids in the playground, right?     Jayson Davies     The kids do get invited out because of those other two there ends up not being a successful experience, and therefore, next time, they're not invited out.    Savitha Sundar     Absolutely or they end up having behaviors because nothing was done to make it fun for them. They were not even considered in the planning process.    Jayson Davies     Exactly. It's such a hard because, as you're talking, the other thing that I'm thinking about is, well, going back to my example of using a two to two model, except maybe, let's just assume now that I'm using a a pull out model, strictly pull out one time a week, 30 minutes, pull out of the classroom to a degree. I just don't want us to us to let ourselves off the hook in a way. And so I don't want to say, well, all my kids are pull out, but I'm providing inclusive ot services, because my end goal is for them to be included into the classroom, into their general education setting. And so I you kind of alluded this too, I think. But go ahead, like, how do we prevent that?     Savitha Sundar     I think that's a great point you bring up, and we are at risk for this, because, in general, inclusive OT is considered as pushing services. That's the general understanding that we come from. What's inclusive ot practice is that I don't pull the kid out of the LRE, they're in the LRE, and the LRE is the self contained classroom has been predetermined as the self contained classroom, and there's a lot of flaws over there. How many of these students had a fair opportunity with supplementary aids and services, with related services in the general education environment, to try and fail before they were moved into a self contained classroom? They've only known a self contained classroom for many, many years of their lives. Okay? So it's just flawed in the beginning to start with. Okay, so when I say instead of saying inclusive ot practice, I want to say inclusion focused ot practice. So if it is inclusion focused, then the IEP goals are written with that outcome in mind, and you're not pulling a kid out of the classroom because it's convenient for you and because you have to meet your IEP minutes, and therefore this is the only time you can find to see this kiddo, and the only way I can do it is by pulling them out. Then those are not like justifiable reasons to pull a kid out, right? But if I'm say I'm pulling this kid out to go work. With one student in a particular experience, because this kid is the only kid who needs to go to science camp. And I want to have this kid part of the classroom, understanding the general classroom, understanding the science camp requirements. Then I'm pulling this kid out to get a richer experience, you know, for the purpose of them being able to succeed in beating grade level expectations. Yeah, right, so I hope that's clear.     Jayson Davies     Yeah. I mean, this is a complex topic.    Savitha Sundar     It is not easy at all to wrap your head around, but it's a process that we have to think and as a community, come up with ways to address.    Jayson Davies     Absolutely and I think it's also something, and you've mentioned this a few times now, that isn't often mentioned, or if it is mentioned in an IEP, it's more mentioned in the way that I talked about it, where it's just like, Oh, all right, that means the kid's going to be 15% in general education. But IEP teams, I think need to have more conversations about how much the student is included now, but also a year from now. What do we want their program to look like? Five years from now? What do we want their program to look like and start to I don't know is is it out of the question to make an IEP goal related to the percentage of a day that a student is included like that, obviously, is not a traditional goal by any means. I've never written anything like that, but I don't know. Is that out of question.     Savitha Sundar     I would personally put it more in terms of access and participation related, like say this student will be able to depending on where the student hears the student not even going to the cafeteria. Okay, this student is going to be able to have lunch with a peer in the cafeteria for five days of the week, or, like, three days in a week. Or you can say this kid is going to be part of science lessons for will actively participate in at least five of the 10 activities that are provided in science. I mean, I think creatively, we can come up with different goals to increase the access and participation in general education experiences. We can start with where they are already now so they are going to cafeteria. But how meaningful is the inclusion? Like, how do we want them to be right and and once kids know them and understand them, they have friends, then getting them into Gen Ed is not so scary. You know that is true. Their peers will be talking about this friend that they made and like the device that they use. It's so cool. Now I want to see how they use it in the class here. Let me show you how to use they may even explain it to the teacher. This is how you use her device. Let me show you how. So you know, it's just slowly starting from where you can to where you would like to be.     Jayson Davies     Yeah, I have so many follow up questions. I want to be mindful of our time, but I want to ask you, because a lot of therapists have come to me over the years on Instagram everywhere, and said, like, how do I provide services through a push and model without feeling like a paraprofessional? I want to get your take on that, because I have constantly told people on the podcast everywhere, like it's vastly different. The knowledge alone between what we have and a paraprofessional just immediately makes what we're doing different from a paraprofessional. But I want to get your take on how you see that.    Savitha Sundar     Yeah, it is. It is a hard question, because if the school district requires your one on one service, your individual direct services, like in some states, you're not required to say whether it's individual or group. In some states, some districts, you're required to say individual or group or consult. Some of them would just say on a on a range of indirect and indirect services. Some school district districts write it like that.     Jayson Davies     Depends who's been sued, how many times, and for what.     Savitha Sundar     Right, right, right, exactly. So based on that, I think a bigger conversation is for the team to come to terms with understanding how ot services will be provided, understanding that we are writing collaborative goals. Our expertise comes in planning the IEP and brainstorming it, and how are we going to implement that goal when we are not around sometimes you may you may look like a para educator, but you actually know the kid enough to make a meaningful recommendation in the class. Unless you work one on one with this kid, you don't know the dynamics of that process right. Sometimes that's very essential. And you don't want people to assume that you're gonna take this kid and we all walk away because you have this kid and I'm gonna go take a break or work with another student, right? That's another assumption that comes so making all these explicit in the beginning, and just like try our best to explain your role and say, you know, I want. Work with this kid, but, but my bigger goal is that they meet this goal, and I they can't meet this goal only by working with me. They cannot make this skill meaningfully applied in their day to day lives. If it's only me working with this kid, we need to collaborate on this so emphasizing that, you have to say it many, many, many, many, many, many, times to get the team on board with it, so it takes a long time, but don't give up.    Jayson Davies     Yeah, but I think the other part of that is the OT practitioner not feeling comfortable with providing that push in service sitting next to a student and that they internally feel like a paraprofessional at times. And I don't know what your thoughts on, like, how did you overcome that? How did you overcome this idea that you could be successful by pushing into the classroom and working with a student where you didn't have control of the environment, where you didn't have control of the activity, where you didn't have control of all the external things that go on in a classroom, like, how can we actually be successful in that where there's so much quote, unquote chaos because of the classroom.    Savitha Sundar     It is not easy and it's challenging, and the dynamics of the classroom, how welcome do you feel in certain classrooms, versus how annoyed they are that you are there in that Classroom, disrupting their schedule. So Many factors play in, right? So I think it's a case by case basis. I wouldn't say that. I always would push and like, sometimes I just go in and observe this kid in the class, okay? And sometimes I'm more effective by talking to the peer. So this kid doesn't feel like I'm isolating, yeah, her or him to, you know, to to listen to listen to what I'm doing, but I might just do something with the class, with the group, and it takes time to understand the dynamics of the class and to fit in, and sometimes just talk to the teacher. What is the best time for me to come in and be supportive here? And the teacher would say, you know, if you come during this time, that's when I need your help the most, depending on the goal I'm addressing, if I'm working on, say, writing, then I see like this kid is struggling so much to write. Why can't you just send this as a shared Google document, as a PDF, so this kid can work on the same assignment, but they just have to type the answers. They don't have to write it right? So I would not know that unless I'm seeing what activities they're actually doing in the class. So I go in and I observe a science lesson. They're, all they're doing is like separating these different solids, you know, magnetic versus non magnetic pieces. Absolutely. My kids in self contained classrooms can do that right now that I know what you're doing, I can tell you, I'll bring one kid in, make them sit in that classroom. You know, it doesn't even, it shouldn't even be that. But, you know, given our reality, say, I bring this kid in, and then I'm, like, trying to promote, you know, facilitate this activity. I know what is going to be done ahead of time, so I can plan it right once a week. I can do that for sure. And then you see the possibility, and then you're like, Hmm, it's not so bad, after all, we can take our kiddos, and many times the gen ed teacher is afraid, is afraid of our students. They're afraid they will do a disservice by not sending them to a self contained classroom. And that's such a wrong idea. You know, it's not as bad, as difficult as you think it is. These kids are not any more difficult or any less difficult than all kids in general. So that's true. It's just how we approach and when the teacher has a very positive attitude, the other kids follow suit.    Jayson Davies     That that's a great point, and I just want to cap that conversation off and just let everyone know, remind everyone like what I just took away from what you said was that ot in the classroom doesn't have to look like you sitting right next to the student, supporting them, like what you envision a paraprofessional doing, or like what you also envision an occupational therapist or occupational therapy assistant doing, in a pull out model, where typically we are right there with the student, but we can push into the classroom and work with the entire classroom, we can push into.    Savitha Sundar     Just the environment, the occupation, the activity, and the person, all three.    Jayson Davies     Yes, and the social aspect, of course, yeah. I mean, like, yeah. It doesn't have to look like you sitting right next to the kid for 30 minutes like that. I think that's the big takeaway. Absolutely, yeah. Now you started to bring up something that I wanted to address before we wrap up today, and that is the positive impact that inclusion has, not only for the students that we're working with, but the entire school in general. I assume that to be true, and I don't know that I have anything behind me to assume that to be true, but from your perspective, you've done some research. What is your take on that?    Savitha Sundar     So the research evidence we have is kids without disabilities either have a positive impact or no impact when a kid with a disability is in their classroom. That's what we have right now. The best research findings we have is that. That, however, if you were to expand it further from non research perspective, think about disabilities, how important it is that we all understand disabilities. It is the largest minority community in the world, and it's also the community that anyone can enter at any time. You may end up having a child with a disability as an adult, or you may end up being a teacher in a classroom, and you may find out that the student is not the typical kid that you know of. You may end up having an accident and enter into that community, God forbid. I mean the sense you know losing your skill sets is is sad. So given that reality, it's so important that the world that the society recognizes and understands the world of disabilities and how difficult it is for that community to fit into a world that wasn't created for them, and that it is a community effort to make it accessible for them. You if you know your friend, if you know your friend's strengths, if you know what this friend is good at, then you as an adult, can create job opportunities for this kid. It's so important that the gen ed community understands the world of disabilities. If we want our society to be inclusive in the future, then I think a lot of effort has to go into facilitating that in the schools, absolutely.    Jayson Davies     And there's one piece that we haven't addressed yet, and I don't think it's commonly thought of when it comes to inclusive practices, and that's the evaluation piece. And you know, we talked a little bit about earlier, I brought up that question about having a goal related to inclusive practices, but it's I mean, in order to have a goal for something, we really need to be evaluating it. So I want to ask you, how does inclusive practices, or the inclusion of students with extensive needs support work into the evaluation process?    Savitha Sundar     Yeah, so if we want to see changes in how ot services are structured to better support inclusion. We want to start with evaluating that. If our evaluation is addressing fine motor deficits, handwriting deficits, then we are going to address that area. But if you start off with a participation approach where you're looking into their natural routines, how is the kid coming into school? How are they doing what they're required to do. Why cannot they be doing it in a general education environment? How about are we looking into art and music and PE Are we looking into cafeteria experiences in our evaluation? Are we doing more of a natural routine based evaluation and looking into what are the personal challenges? How is how is the participation? Is it satisfactory or not? If it is not satisfactory, where is the biggest challenge? Is it the environment or the person or the occupation? Where can we address what can be addressed to make the best impact? So looking into every routine in their day, bathrooming or recess or dismissal, emergency drills, are we looking into all of those in our evaluation? So if we, if we start evaluating that and then identifying areas of participation needs in those areas inclusive participation needs, then we can also work on addressing those needs. And we don't have to be the only one addressing those needs, just like how handwriting does not have to be ot addressing it, right? And we always say that we are not handwriting teachers, right? And just a sensory is something that we evaluate and we make recommendations for the environment to change. Same thing with all these other areas of participation, yeah, instead of going, like, the top, the bottom up approach that we currently use, but like, what are the sensory behaviors? Oh, is he aversive to, you know, touch? Is the kid sensitive to smells? Are they auditory sensitive? Those are like they are, but then they're doing just fine in the class, you know? So, you know that that becomes, there may be one you just, you just put your focus light on the kid's problem. But if you start off with, like, here, there's no problem. Oh, there is a problem in participation. But the problem is not just in the child, but it's also in the way, yeah, the environment is.    Jayson Davies     So in your evaluations. Then do you try to point out, make it a point to point out the lack of inclusion in this student's education plan. Or do you try to find a way to observe the student in a more inclusive environment?    Savitha Sundar     I wish. I wish I still work within systems. Yes, I know. And I'm literally started this new job in a new district, so I can't come in with my revolutionary ideas and you know, like, hey, look, you're not including kids with extensive support needs. That's where I'm going to be working on. It's not going to happen over. Night.     Jayson Davies     Absolutely. And that's why I'm glad we're having this conversation, because I want to be real, like, exactly.    Savitha Sundar     Right? Yeah, so we start somewhere, right? So I started having this conversation about, how do we look at a participation based evaluation with my team? So we're going to talk about it. Okay, we need to educate our our administrator about the role of OT okay, we need to take that time. We need to put that as goals, and we need to be working on those things. And secondly, do what you can do. Yeah. So I have I work with in a school where the speech therapist and I have a great relationship, and we want to do something to to increase awareness about disability in our school. So we started, we brought it to our principal, and we were like, What do you think of us doing this program for the kids? What if we do these lunch punches? We got the approval next now, like, okay, provided your the curriculum you're proposing is approved by our district. So that's the next step, okay? And I'm just like, less than six months in this new district, so I try, in my little ways, what I can do. They had an opportunity to write a grant to do any programming. The gen ed teacher and I were the sped teacher, the self contained classroom teacher, and I were like, Yeah, let's do a program together. And we wrote up a grant, you know, just little things we can do. And also, just like, I'm going, I'm going, I'm working with this kid on communication. I'm working with her on her written expression, basically, right? So she has a device. My focus is that she's able to do a presentation in her class that is her written expression. So now I'm teaching her how to make slides to do a presentation. So every community, like every Friday, she does a presentation to her class, and she works with me on it the previous the earlier in the week, yeah. So I work with her in the classroom. Sometimes, sometimes I'm going to a quieter spot so we can put it together. And so it's just, it's just looking at that outcome in whatever little ways I can, because systems change will take a long time, but we have to start somewhere and go in the right direction.    Jayson Davies     Yeah, yeah, absolutely. And you know, system change too is something that ot practitioners, especially school based ot practitioners, we are not good at measuring that either, and we probably should be. And something that could be measured from an OT department perspective, is what percentage of our students that we support are being included in general education. And that is something that is something that we can start to measure. It doesn't take a lot of you know, it's an extra column on a spreadsheet in our caseload workload document, like it's nothing super out there, and it is something that we can actually use for data to show our administrators. Hey, look, as we're providing these ot services, we're actually helping students to be more included into the general education population, and little things like that can go a long way to getting your administrator support. So absolutely. All right. So Vita, I do want to wrap up our conversation, but before I do, I have to let everybody know about your podcast. OT for inclusive occupations. I had to throw it in there, because you are doing some amazing stuff over there, bringing on individuals, well, occupational therapy practitioners, but also the individuals that the OT practitioners have worked with to really promote inclusive occupations. And so I want to give you just a moment to to I know you probably don't like being on the spot like this. I'm sorry, but I want to give you a second to share with everyone what you're doing on your podcast.     Savitha Sundar     Yeah, I do like different seasons. Like right now I'm doing season four, and the focus of season four is to highlight the stories of young adults with disabilities and their lives and how inclusion played a role or didn't play a role, or what could have happened. How was their experience with it? And I had, I did a series with three students of an OT Dr, Deborah Schwind, and she shared about how her ot interventions were so inclusion focused, you know, the outcome of inclusion, and she helped these students, like the things that she had focused on with these students, along with what the families prioritized, and the team prioritized just their their lived experience of navigating special education and school life into being successful adults they are today, and how ot helped them in the process. And it's such interesting insights that I got from those interviews. And I just today released one episode again, you know, the perspectives of parents being a mother of a child with a disability, and how she became an advocate. She was, she's also a special ed teacher, and ended up becoming, you know, a global advocate, advocate for international like giving the resources and the training for people to support inclusion. So I think their stories are very, very inspiring to me, and I just share it with my community,     Jayson Davies     Absolutely, and and I agree they are totally inspiring just share. Sharing one, I know you had one young lady who you know she ended up being the or she now works in the cafeteria of the school that she went to. And while she was a student at the school, occupational therapy practitioner Deborah worked with her on helping to understand the cafeteria environment, and basically, kind of helped her to work her way into a community based role once she graduated, and now she's working at that school. So.    Savitha Sundar     Why don't we have a place? Yeah, why don't we have a place in high school? Why do our services continue to go down in high school? Because the area we focus is the developmental skills, right? And so we say they've like, maxed out, and others are going to take over our role. You know, sort of thing when, when they go to high school, but the needs are different. In high school, we're looking into job placements, looking into future. What can we identify as the best work opportunity for the student? How can we create the future that's a success for them? You know. So that's a real, great example of how the OT worked with her through high school to give her the real experience of working in as a school cafeteria lady staff.     Jayson Davies     Yeah. And didn't just think about the academic, you know, portion of today, but the life experience necessary for 234, 10 years from now. So 100% Yeah. Well, Savitha, thank you so much for coming on sharing all your insightful knowledge about supporting students with extensive needs, supports. It's it is something that we all struggle with from time to time, and I hope that this conversation will definitely support all those listening and know that there is a way to improve, like we're all struggling with this, and there is no one correct solution, but we can all make small steps toward more inclusive practices.    Savitha Sundar     Yes, it's just helping to row the boat in the right direction. You know, it's a collective effort the school systems are trying to with. The more research coming out, the more we know that we have been doing a disservice all these years, and now is like the how do we do it? So the educational field has a lot of work on that aspect. So what we can do is to support in the right direction and not Row the Boat backwards, right So, and we have so much potential to do that as OTs, I believe. So thank you. Jayson.    Jayson Davies     Well, thank you, and have a great rest of your day, everybody. All right, and that is a wrap on this two part conversation with Dr Savitha Sundar, I want to give a huge thank you to Savitha for coming on the podcast and sharing this knowledge. Savitha put a lot of time and energy into her PhD, and this was her topic, as you might imagine, as she shared, she's really wants to improve our ability as ot practitioners to promote inclusion for all students, especially those with extensive support needs. So at the end of the day, at the end of these two episodes, I hope you're walking away with not just insights into that, but also inspiration and maybe a few ideas to try at your own school, as Savitha really shared there at the end and got real with us. This is not easy. There are a lot of barriers in the way, but if we take one small step at a time, we can make improvements for our students. If this conversation with Dr Sundar really spoke to you and really kind of just re made you think everything you know, as it did for me, I would love for you to take a moment and share it with a colleague or maybe even your administrator team. Let this be with a colleague or maybe even your administrators. Let's keep this conversation going about what it really means to support students with extensive support needs and inclusive, affirming ways. And of course, don't forget to join us at ot  schoolhouse.com/join to get weekly updates with tips, research and strategies for school based ot practice. Thanks for tuning in, and I'll see you next time on the OT school house podcast.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.  Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 44 of the OT Schoolhouse Podcast. In this episode, Jayson hosts an OT/OTA team from the state of Michigan to discuss the dynamics of the working relationship and how to maximize communication. Mary Kleinheksel and Cait Bowen talk about the systems they have put in place to maximize communications and facilitate trust among the practitioners. We also talk about aspects of billing, evaluations, treatment planning, and how many COTA's an OT can supervise. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! ​ Links to Show References: Cait Bowen's Instagram Page (Cait_the_COTA) ​​ Cait's Teachers pay teachers shop ThePencilGrip.com (Sponsored) This link will automatically apply your 30% discount off your entire order!​ Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host, Jayson Davies class is officially in session.    Jayson Davies     Hi everyone. And welcome to the OT school health Podcast, episode number 44 My name is Jayson Davies, your host. As always, it's been great getting back into the podcast, back into the swing of things. I'm enjoying working with my A to Z school based ot course cohort. That has been a lot of fun this past week or two. And yeah, we're gonna keep this introduction short. Today we are talking about the OT OTA occupational therapy occupational therapy assistant relationship with two very special guests. The first is the occupational therapist in the group. I will mention her first. Her name is Mary kleinhexel, and she is also joined by her occupational therapy assistant, and her name is Kate Bowen. You may know her as Kate the COTA on Instagram, she and the OT that she works with are joining us today, so we're gonna get into that. But first, I do need to say a special thank you to the pencil grip for sponsoring today's episode of the OT school house podcast. The pencil grip is the original ergonomic writing aid. Writing becomes easy and natural. The pencil grip improves handwriting, helps to give more control and reduces hand fatigue. Its unique patent design gently encourages the fingers and hand to rest in the proper position for gripping the tripod grip. Unlike other grips, the pencil grip feels natural because of its ergonomic design and soft, flexible, latex free material, Get yours at the pencil grip.com and use promo code ot school house to get 30% off your entire order. All right, like I said, we're going to keep today's introduction very short and sweet. So let's jump into our interview with Mary and Kate and talk about the OT OTA relationship. Hi Kate. Hi Mary. How are you both doing this evening?    Cait Bowen     Hi, good. How are you?     Mary KleinHeksel     Hi!    Jayson Davies     All right, so I'm going to so other people know I can see you, but they can't, Mary, why don't you go ahead and share with us a little bit about your background as an occupational therapist.    Mary KleinHeksel     Okay, I have been an occupational therapist for 29 years. 20 of those have been at Jayson public schools, where Kate and I currently work together. I've done a lot of things prior to that, outpatient, inpatient, home health care, hand therapy, you name it, but I've landed in school ot as my passion. Awesome,    Jayson Davies     fantastic. And then also joining us today is Kate. Kate, how about you go ahead and introduce yourself.    Cait Bowen     Sure. This is my fifth school year as a CODA, and this is actually the only ot job I've ever had. So I started off as a social worker, and that wasn't really my thing, so I went back to school for ot to become an OT assistant, and this is my first job out of college.    Jayson Davies     Wow, so already a life or school based OT,    Mary KleinHeksel     yes,    Jayson Davies     all right, great. Well, welcome to the show. I'm so happy to have you. This is the first time that we've had an OT, ot a team, joined the podcast, and I think this is something that people, all the listeners, listeners are really going to appreciate. So I'm excited. I hope you guys are excited to share your knowledge. Yes, great. All right. And before we get started, Mary, you kind of mentioned the district that you guys work for, but geographically, where about is that?     Mary KleinHeksel     So, Denison, Michigan is a public school. It is Western Michigan, about 2030, miles east of Lake Michigan. It's in the lower part of Michigan. There.    Jayson Davies     Great and again, the main reason that we're talking today is to discuss the relationship, the working relationship, between an OT and an OT. So we're going to dive into not only the actual work skills, but the interpersonal skills a little bit, because I'm sure that's an interesting dynamic. I know I've worked with a few CODAs or OTs, and you really have to have some teamwork. And it sounds like you guys have some good teamwork. So I know there's probably OTs and as well as COVID, out there that have never had that chance to work with the other before. And I think that there may also be some people that just don't understand that dynamic. So this is going to be awesome, and I hope you guys are excited about this. So to start things off, I wanted to kick into just a little bit again the background, are you guys, district employees? Are you county employees? What? How's that work?    Cait Bowen     We are district employees as of what was it? Mary, a couple years ago,    Mary KleinHeksel     fourth year. Yeah, that they hired us on.    Cait Bowen     Yeah. Yeah. So before that, we were independent contractors, yeah.    Jayson Davies     Oh, okay. And were you guys working for another contractor, or you yourself were the contractor.     Mary KleinHeksel     We were the contractor.     Jayson Davies     Gotcha. So each of you were independent then, Yep, yeah, interesting dynamic. So then they decided that after a few years, it was worth just bringing you on board, huh?    Cait Bowen     Yeah, it's been really nice. There's some added benefits to being a district employee. It's kind of nice to not have to worry about the self employment tax situation, right?    Jayson Davies     That's complicated.    Mary KleinHeksel     yes, so I definitely prefer it being in Yeah. I appreciate our district doing that for us. Oh, yeah.    Jayson Davies     So you've been with that district either as an employee or independent contractor for a little while. Then Mary, right, right?    Mary KleinHeksel     So 16 years independent, and then the four years now I'm a district employee.    Jayson Davies     And so you're liking being an actual employee.    Mary KleinHeksel     Yes, pension and yeah, they Yeah, definitely.    Cait Bowen     Call that good stuff.    Jayson Davies     I know that good feeling. Yep, it's nice to have that behind you, I guess, or just kind of being taken care of without you having to really worry about it cool. So, and then, are you the only OT and OT a in the district, or are there others within the district as well?    Cait Bowen     So, other part time coda,    Jayson Davies     okay? And so, Mary, you also supervised that Coda as well.    Mary KleinHeksel     Yep. So it was, I came on the scene and took over some hours for another one. So I'm the only ot of the district. And then Kate took over a previous coda, who was there, like, 20 years before her Yeah, and she recommended Kate, and we interviewed Kate immediately. We're like, that's the one we did. Director. And I were like, Yeah, we were Kate, so yeah. And then Kate and I got so busy that we were both like, we needed help. So we wrote a proposal, and yeah, the district then approved our proposal for another part time. OT assistant, who we love as well. Yay, Jody.    Jayson Davies     Shout out to Jody. Great. So how many schools are in your district then?    Mary KleinHeksel     So, yeah, so we, Kate and I both work at 10 different schools, okay? And Jody works at two, okay. And so, yeah.    Jayson Davies     Great. So you guys are busy and married, that means, well, Kate, too, if you have 10 schools, you're traveling around. But Mary, yeah, cool. So we're going to get into the dynamic about all of that. The first area that I kind of wanted to talk about was kind of communication. So I have some various questions that kind of I consider fall under the communication aspect. And I think many OTs and OT A's out there have the same types of questions. So the first one is a mentorship slash supervision. Question. You know, what does that actually look like? How do you guys work together?    Mary KleinHeksel     Go ahead, Cait, you wanna? Yeah, what do you think?     Cait Bowen     Hey, so Mary and I meet once a week to just kind of go over how the week has been, anything that may have come up looking ahead to the next week, but that's really the only time during the week that we have together. The rest of the time, we're so busy with our own caseloads that we communicate through text or through email, but we save the big stuff for our once a week meeting.     Jayson Davies     Okay, and so again, going a little bit further in that once a week meeting, do you guys take, like kind of formal notes or anything, or is it just very open?    Cait Bowen     I would say it's pretty open. I usually have a list for Mary, and she's got a list going for me, and we just kind of go back and forth and work our way through our list. I give her any paperwork that I need to and vice versa, I would say it's pretty informal, though.    Mary KleinHeksel     Over coffee, we have to have coffee.    Jayson Davies     Right? I know I used to meet up with my COTA sometimes at Starbucks, like the local burger joint or something, wherever we could find a table so I get that.    Mary KleinHeksel     No, I'd say definitely informal, but yeah, we still have lists, checklists and stuff that we need to get through. And yeah, and we do, but    Jayson Davies     so do you guys, and I'm not expecting this to be a yes, but do you go over the entire caseload every time you meet?    Cait Bowen     No, no, I we would be there for hours and hours, right? So we just go over, I would say, maybe kids that have upcoming IEPs, new students on the case load, any students that maybe had a tricky week, we focus on those ones for our meetings.    Jayson Davies     Okay? So. A handful of kids that are coming up with meetings, or were tricky. Okay? And then, so actually, this is great. I didn't realize that Mary, you've been or, sorry, Kate, you've been with Mary for about five years. So I actually want to ask Mary, then, how has the guidance been similar and changed over the five years working with a new occupational therapy assistant?    Mary KleinHeksel     So, yeah, so good question. I think at first I, when Kate first came on, I went through and I made a list of scenarios of, if this comes up, we probably will do this. So then Kate didn't have to feel like she had to ask me every single time, every single question. She was questioned, she could reference that. I think that was helpful to Kate. So yeah, because there was a lot of things that Kate wasn't even sure that would come up, and she's like, Oh, it was right in there. So yeah, and if there were any questions, then she could, I mean, I'm available on phone all day long. So we make sure that we do that, but yeah, and then I just kind of, as we went, things that I felt were helpful, like Kate would be like, Oh, this came up, and I'm like, Oh, I didn't, you know, you won't think of it in every single meeting, but oh, I have these reflex integration exercises. Well, what the heck? Here you go. Or, you know, I think Handwriting Without Tears would be a great continuing ed program for you and Jody, the other assistants I go to, because that really is a treatment changer, and it was for me. So just as things come up and that I think about them, and the question is asked that, yeah, then I'll just give some guidance and think things that helped me along the way.    Jayson Davies     So every state has different legislation. And the reason I ask this is I know, as in California, we just changed from being able to supervise two ot as to three. But just like that, every state also has different guidance or different requirements for how much support you have to provide to an OTA? Is that something you went and studied before taking on an OT a or do you, I mean, maybe in Michigan, are there very strict guidelines on how often you have to meet or how often you have to talk about a certain or the cases or whatnot? Do you know any of that?    Mary KleinHeksel     I think we go by Medicaid as well. I don't know if you bill Medicaid medical, same thing. Yeah, Medi Cal. So, yep. So our Medicaid here, that really needs to be done quarterly, but I feel for best practice that if we we at least need to touch base weekly. I think that's that's very important. So I think it's just my personal preference of best practice, and I think to keep connected with Kate as well, so Kate doesn't feel like she's just out there all alone. Absolutely support, because, you know, she gets, you know, tough kid OTs too. But, yeah, she's amazing.    Jayson Davies     Great. And so Kate, then when over the past five years that you've been a CODA, how have you felt like guidance, supervision? How has it been for you? Did you feel like you needed more support at the beginning versus you do now? Do you still need the same amount of support? Or what's that feeling like?    Cait Bowen     I would say I definitely needed more in the beginning, especially as a new grad, I didn't have a whole lot of OT experience, so I relied a lot on Mary. Lots of questions. I wrote a lot of things down. I probably bothered her too much asking questions. But I feel like over the five years, I've become more confident in my job, more confident in the requirements, and so my questions are less frequent than they used to be, and I just feel more confident as a therapist.     Jayson Davies     Gotcha perfect. So then Mary, back to you. How do you keep up to date? I mean, it's kind of for both of you, I guess. But how do you guys keep up to date with who's seen what? Kids and just kind of those things that you kind of have to have a lot of trust in someone, right? But so how do you keep track of what each other are doing? Almost, does that make sense?     Mary KleinHeksel     Yeah. No, it does. So we each have our own case load. So the even the special ed Secretary will be like, this is Kate's caseload. This is Mary's caseload. This is Joy's case load. So those kids will be under Kate. Of course, they're all supervised by me, but I think it's important for everybody to have their own caseload, and I think that helps for, you know, just to feel ownership, and we believe in the relationship Kate has with her caseload, her students. It's better than I could just be coming swooping in and trying to do something. You know, I think that's important that Kate, that the OT assistant, has their own caseload as well, and of course, it's supervised by the OT. But yeah, so we when Kate first came on, she was, I. My love is all students, but I really love working with students with autism, so I kept, we have a categorical program, so I kept that. And a lot of times those are the trickier kids, and then Kate could decide when she was branching off, kind of where she wanted to go. So Kate, if you want to let him know, like.     Cait Bowen     My caseload is kind of a variety. I would say. I have students in the cognitively impaired program, emotionally impaired program. I've got some gen ed kids who just need a little extra help, some kids with developmental delays. It's kind of a variety, but it's fun.    Jayson Davies     Well, that's cool. So then you guys actually do, in a way, make up your own caseload. Obviously work together, but you guys kind of work to each other's strengths. Then.     Mary KleinHeksel     Yeah, I think so like, yeah. And if there's a tricky kid that I know is going to be tricky all around I will just keep that students, because that I just need to provide that level of Shall I save supervision or for that so Kate doesn't have to worry about getting involved in something tricky like that, so I'll make sure, I'll get a feeling at the initial IEP the evaluation, and then if that's the case, I will definitely keep that student So not to put Kate in any Jeopardy, especially. You are, though you You are amazing girl. So, yeah. So yeah, I just don't want Kate to be, have to be involved in the deposition or anything. So I will make sure that that stays in my court.    Jayson Davies     Absolutely I can hear the dog. That's fine. This is a dog. No, I always say it's a dog friendly podcast, so he's welcome to join us. I love it. No, totally fine. Oh man, it just makes me miss my dog a little bit. That's all right. So Kate, I want to ask you this. Then Mary was just talking about how she kind of, I mean, it's almost like screening, you know, and I've been in the same situation. There's certain kids that you have to be careful with, and there's certain kids you almost feel like you need to hold on to, right? Mary, you just kind of said that. But Kate, how do you go about if there's, like, one kid who you feel like you need more assistance, what is what do you do? Obviously, you would talk to Mary at that one to one meeting that you guys have. But have you ever had to go further and ask for more assistance?    Cait Bowen     I really haven't. Mary does such a good job at that initial screening and evaluation of taking any kids that might have something tricky coming up in their future. For any kids I've had that have been more challenging, Mary has always been so available to me that I've never felt like I've been alone or had to come up with a solution on my own. I know that I can just text or call Mary and she's right there to help me. And I've never had to go beyond that.    Jayson Davies     Perfect. That's great. I mean, that's nice when things work out that way. What about this? Have you ever had, because I've been in a similar situation to this? Have you ever had a parent request that their student be seen by the OT versus AOTA?    Mary KleinHeksel     You know what? In 20 years, I have not very fortunate. I am very fortunate. I know we, we have, not, we're I think we just are a team. And yeah, I just explained at the IEP that Mrs. Bellin is in this building weekly. She will be seeing your students. And yeah, and Kate does an amazing job. And I make sure the kudos goes to Kate, and the parents know that as well. So yeah, but no, I have, I have not, I think, I think it's screened out by me prior. I don't know. Yeah, I don't let it get there. No way.    Jayson Davies     That's good to hear. Similar to that. What about at IEPs? Does any? Of do, any of the parents request that the OTA be present because they're the because Kate's the one working with the child?    Mary KleinHeksel     Nope, again, that is, I know. But what will happen, though, is Kate's my, my backup. So a lot of times I'm double scheduled on, you know, on, fortunately, I can't beat the both. And I'll be, I'll ask Kate prior, and I'll be like, Kate, can you cover me on this one? And yeah, she's very willing to do that. But just for clarity, for staff, I think, for scheduling as well, that I'm the, I'm the paper pusher, and so that they need to, yeah, contact me and but Kate and I are a team, so yeah, a lot of the teachers make a comment like, Man, I want, I want Kate's job. I wanted to see the kids.     Jayson Davies     I've heard that a lot.     Mary KleinHeksel     Yeah, the deal, I don't know. I don't know, Kate, you're, yeah, you're amazing. So yeah, she just makes it look easy and sound easy.    Jayson Davies     Kate or codas, do have the fun part? You know, totally get that I've met many OTs. Or I'm like, Well, do you ever think about going back and getting the masters and doing the OT like, Nope, I'm happy here. Don't want to go to IEPs. I'm good here, right? But So Kate, it does sound like you do attend a few IEPs, if Mary's double booked, what is that experience like for you?    Cait Bowen     Yeah, I've been to a few because I don't do them often. They are a little bit intimidating to me, just because I'm not used to that side of the job. I don't work a lot directly with parents, you know. I'm just not used to those types of meetings, but Mary always does a good job of, you know, kind of outlining what I need to talk about, and it's a student that I've been working with. So in that respect, I'm comfortable talking about their progress and what we've been working on and the goals that we're moving towards. So they're they go fine. I would say.    Jayson Davies     Great. And so I kind of want to go another way. But you mentioned goals. And so how do you guys work as a team to develop goals? Does Mary, do you just look at the progress and develop goals, or does Kate have input? Or how does that work?    Mary KleinHeksel     So at our meeting, or whatever, so we'll, we'll look at the goals and the progress, and I'll I'll be like, I think this is the next, next progression, but yet, I'll run it by Kate, and be like, Kate, what do you think? Does this look doable? Does this look like because Kate will be like, yeah, no. I'll be honestly, you're crazy, and I love that. I'm like, oh, good to know. Good to know. I think we need to obtain our goals, and they need to be, you know, realistic, so, but that's the feedback, or, yeah, we it's really good. It's just a great feedback with like, Cait needs to let me know that's too much or so, but I, I'm the one that, yeah, that is in charge of developing the goals with Kate's guidance on who she's seeing. Because, yeah, it's not fair. I don't think to just slap some goals down and expect you know someone I wouldn't want that if they're so lofty that I know I'm not going to get them achieved. So I think it's important for Kate to give me feedback, and she does a really good job.    Jayson Davies     Awesome. And then, so what about the kids? So obviously, there's kids on Cait's caseload. They're also on your caseload, but you're not seeing them right, or at least not as frequently as Kate. Do you have a certain system in place for when you're about to go to that IEP? I know for me, I hated walking into an IEP for a kid that I hadn't seen in a long time. And so do you kind of have a system in place when you're in that similar situation, for a kid that's maybe is doing great with Cait, but you just haven't seen them in a while.    Mary KleinHeksel     Yeah. So Kate will give me whether she'll text me something like a sample, a work sample, she'll attach a work sample for me, or a sample of what the goal was. She just recently did. There was a typing goal. So she's like, look at the typing. Look at she'll do a lot of the handwriting samples for me, which is great, and I can see it right there. Hand it to the parents, and then, like I said at prior to that weekly meeting, make sure that I touch base with her before the IP any concerns. Like there was one girl that glasses. We didn't she didn't have her eye glasses. Oh yeah. So Kate advocated for that, saying you really need to help me with that. So we did. We went in the IEP and the physical therapist, and I, yeah, advocated to get the end it's done. So yeah.     Jayson Davies     That's funny, because I've had at least three kids where I've had to do the same exact thing, whether the kid lost their glasses, whether they broke their glasses, whatever it might be, there's always seems to be a kid that's not wearing the glasses that they need, or just haven't got the prescription updated or whatever, but yeah, it's almost like you haven't been a school based ot until you've had to talk to parents about finding the kids glasses. So all right, well, we're about halfway through our podcast for today's episode, and so again, I want to thank the pencil grip for sponsoring this episode of the OT schoolhouse podcast. The pencil grip was designed by doctor and is widely used in classrooms at home and in therapeutic settings. The unique shape of the grip is designed to be a one size fits all to help the hands of kids and adults and work with both righties and lefties. The pencil grip can be used as a training tool and then permanently for added comfort. The pencil grip fits on pencils, primary pencils, pens, crowns, markers, paint brushes, etc, so its benefits can be widely enjoyed. A comfortable hand has more control and shows improved handwriting. The pencil grip guides the hand into an ergonomic position. It relieves hand pain, reduces fatigue and improves comfort. Consistent use teaches and reinforces the proper grip and stops common problems like fist grips, thumb wrapping and white knuckling. Parents, teachers and occupational therapists widely recommend using the pencil grip. Check it out for yourself at the pencil grip.com and use promo code ot schoolhouse for 30% off your entire order. Alright, well, let's just. Jump back into it with Kate and Mary. And this next question actually comes from an Instagram follower of the OT school house, and her question is, how important is it to rely on the OT a for progress on goals?    Mary KleinHeksel     I'll let Cait answer that one.     Cait Bowen     Yeah, I write my own progress notes for my students, and then how we do it as I write them all out, and then at the end of that week, when I'm done writing them, I sit down with Mary and we go through one by one, just so that she can get a visual too, of where each student is at, how goals are going, and just so that we're on the same page.     Jayson Davies     Perfect. Sounds great. It's It's nice when you have a team that knows how to work together and things just work well, it's very, very fortunate. I like it all right. So what about services? You're in an IEP, you've gone over those present levels that it sounds like Kate really helps with. You guys have collaborated to develop some goals. And what about services? Who brings those up, or how did those get determined, or whatnot.    Mary KleinHeksel     So the frequency of service, frequency? Yeah. So we write a range. We're lucky here that we are able to write a range of time. So we can write it monthly, and then I make sure that Kate will be able to meet that whether it's no days that have one coming up in a couple days here, that kind of thing, monthly, we're not expected to backtrack and see those students. So by that we do write arrange. Kate sees students in groups, so there's Yeah. So we usually write a range monthly in there to cover that.    Jayson Davies     That's really nice to have that leniency. We don't have that here and in the district I work for. But anyways, I don't want to tear any ot OTA relationships up. But is there ever, or has there ever been a time when you guys have been in a little bit of a disagreement about goals or the frequency of services?     Cait Bowen     Have we ever had a disagreement Mary?    Mary KleinHeksel     I don't think so. Maybe over, who's gonna buy coffee? Right? My turn? No, I think no, because discharge for us is based on standardized testing. So a child.     Cait Bowen     a child, has reached a student, yeah.     Mary KleinHeksel     Yeah. So it's picking it up as soon as so it's not like, yeah, so it's based on data. I think that helps. So, yeah, I can't, I can't think of anything that we've, we've both are like.     Jayson Davies     So do you guys only, obviously, you need the data to discharge, exit, graduate, whatever your term you want to use. But what about at the annuals in between? Do you do do you keep most of the kids at a pretty consistent rate? Or do you ever decrease kids based upon you know, they're meeting all their goals? Or does that remain pretty steady?    Mary KleinHeksel     We actually do testing each year, yearly. We do. We test yearly for standardized testing. We do test yearly. So.    Jayson Davies     Is that a Michigan thing, or is that just something your district and you have decided to    Mary KleinHeksel     do? That's our district, yep. Why keep a student on for two more years if they're average, fine motor, visual motor, that type of thing. So yep, and as long as the IEP team is in agreement. So now, if it's if they're eligible under, let's say otherwise, health impairment under an OT eligibility, then we need to do a re eval if that's the case, like if that makes sense on an official form, to then make it official for a re eval. But yes.    Jayson Davies     Wait. Okay, so Reval, you like making it sound like they're different. So in my school or my district, we like one eval. Is an eval like we do it every three years for the triennial, but you're saying you'll actually do some standardized testing every year for some kids Correct. Okay? And so what does that look like?    Mary KleinHeksel     So that looks like maybe a Beery visual motor or beary motor, maybe a Peabody developmental motor. Scales for yes, so yep. So we will get standardized data and test on them yearly to show that's a good way to show growth as well. Yeah, and yeah, and you can give a test if you've given it a year the same time.    Jayson Davies     So, so do you do a full write up for that, or are you just kind of doing the standardized just to show that actual assessment in the meeting?    Mary KleinHeksel     So then I'll put that in, like, the present level, okay, of the IEP.     Jayson Davies     Okay, so not a complete write up. And that's what you're talking about for the other students, where you might do a complete report, write up.    Mary KleinHeksel     Correct which we call a re evaluation.    Jayson Davies     Okay, yeah, okay. And so how, what does that look like then the reevaluation?     Mary KleinHeksel     That has to be done at least every three years. It could be done prior, but usually it's a full team reevaluation. Do. Very few instances that OT is the only one on an IEP, yeah. So, yeah, and eligibility, we only have like 13 eligibilities in Michigan, yeah. So, yeah, I don't know if that's the case with you, but yeah, yeah.    Jayson Davies     I think that's pretty standard. I could be wrong, but I think that's pretty standard. Okay, so there are some kids that is new to me, though, is that you made it sound like there are some kids that receive only ot on an IEP that is not something in California that we do. And I an idea. I don't it must be a state thing. And so how many kids I mean, estimate, do you have that are ot only?     Mary KleinHeksel     At this point we don't have any very rare, very rare, okay, under an otherwise health impairment, such as, has to have an outside medical diagnosis, yeah, yeah. So perhaps then, yeah, they didn't test out, or they have more goals that they need for.    Cait Bowen     I think we had one Mary, and we graduated him in the fall.     Mary KleinHeksel     Yep, I think there. That was our last one prior to that, maybe one other one that I can think of, very rare, but occasionally does happen where, like, speech was on and PT, but then they both discharged, and our, our standardized testing showed that he still required or could benefit from ot service. Gotcha.    Jayson Davies     Okay, see, that's the thing in our district right now, is that there's the speech only kids, and the argument is that at least coming down from admin, is that they shouldn't have ot unless they have that specialized academic instruction, the sai, because we're supposed to be helping the student in their education, right? And if they don't have specialized academic instruction, then what is ot supporting? But I understand how every district is a little bit different, but yeah, so that's interesting to hear. What other states how things happen. So cool. All right. Well, we started down the evaluation route, so I want to go that way, and that is, how do you as a team handle evaluations, or Mary, do you do all the evaluations?    Mary KleinHeksel     So I, so I do all the initial evaluations, okay? And then Kate helps with then, if there's a student of hers, she will gather data for me for any re evaluations. I feel that's helpful, because she does have that relationship. I've had it before where I've come in, even if Kate's there, I'll sit down and the kids like, no working for you. And then Kate will be like, Come on, let's do it. And then, yeah, yeah.     Jayson Davies     That's when you got to bring the goldfish. Be like, goldfish Skittles. There you go. Does Kate ever do any actual formal assessments? I know some states allow it, as my under I know in California we can have ot as actually do some formal evaluations they are not capable of, or they're not allowed not to say that they're not capable of it. Many OTs are capable of it, but they're not allowed to interpret the results. So does Kate actually provide like, will she give the Peabody or the berry?     Cait Bowen     Yes, I give the berries, but I don't score them, so I will administer them to my students, and then I give them to Mary to score.    Jayson Davies     Okay, and so, how does that work for you guys? Do you feel like you're able to get all the data you need from the interpretations that are not the interpretations, but from the actual protocol, as well as all the information, you know, maybe the handwriting samples and stuff like that that she provides you.    Mary KleinHeksel     Yes, for sure. And then she takes notes for me. I, you know, show her what to look for. I need please comment on this, like any fidgeting or that kind of thing, you know, some clinical observations during it as well. So she definitely contributes to it as well. And that is allowed. I know. I believe our national association allows that as well.     Jayson Davies     Yeah. So then Cait, how do you feel about doing the standardized evaluations? Is it just the berry that you're doing, or are there others?    Cait Bowen     Yep, that's those are the only ones that I do. I usually do the Beery visual motor and I do the Beery motor coordination.    Jayson Davies     And those are pretty once you learn them, they're pretty simple to administer them in my sleep. I think most of us can. Personally, I don't do the berry because our psychologist likes to do the berry, and so oftentimes she'll do it, but I don't get the information until, like, we're at the IEP, and so I do, like the ravma, or, you know, the bot or something to help kind of get some of the things that I would get from the berry, but everyone does it a little bit different, right? That's right, yep. All right. So you go through the evaluation, whether or not it's a one year evaluation or three year evaluation, reevaluation, what are the steps Mary that you take after. That to make sure that Kate knows the new information based upon the evaluation.    Mary KleinHeksel     So, yeah, so I will, I'll score it, and then based on Yeah, when the IEP is or sometimes, I'll text her right away, woohoo. You know, he did it. There's been a few big celebrations. Yeah, you were on a roll. There it was live. So yeah, and it's really good that for Kate, whether her treatments working is, you know what? I mean, that's good data to drive the treatment as well. Or, oh shoot, you know, you're We're close, but we got to hang on there. So yeah, so I will definitely share that with with Kate before the IEP,    Jayson Davies     okay, and then what are so, I guess the question is like, once you have the completed IEP, how do you relay that information to Kate on the new goals, any new information based upon whether it be things that the parent told you or insight that the teacher had during the IEP or something like that. Yep,    Mary KleinHeksel     so I take notes on that IEP form. I'll copy it. We have a it's called Power School, our IEP system. Okay, so copy that document. I'll put Kate's copy at the top. I'll take notes on the back what parents said, because, yeah, we have so many we can't, can't remember those details. And then, and then we'll meet over coffee, and yeah, and right then. And then I give that document that it's Kate's document for her to keep, because I have a I have a copy in Power School electronically. And as well as I could put a copy in my my files. So.    Jayson Davies     Great. That works out. Well, then cool.     Mary KleinHeksel     It does work out. And there's that weekly meeting, I think is important a key, right? It is to keep up on everything.     Jayson Davies     And so I have a question, you have a part time Coda too? Do you meet with the part time Coda individually, or is this a group team meeting?     Mary KleinHeksel     Nope, I meet with her on a different day as well, individually. So because she's at a different school so, but fun. Side note, we're all gonna meet, three of us, actually, Thursday for Professional Development Day. Yay. We never get to meet.     Jayson Davies     Awesome. We're gonna get into that in a minute though professional development. So hold on tight for that. Earlier, Kate, you touched upon a little bit of the documentation. And correct me if I'm wrong. But Mary, you have to co sign all the notes, right, the daily progress notes. Or is that not necessarily a thing?     Mary KleinHeksel     That is not a thing in Michigan. We do not have to. We keep our own notes in our charts. But yep, there's nothing for me to sign daily here, which is, which is helpful, I think why it works so well. I do have to sign quarterly Medicaid that's Medicaid notes, yeah, but yeah, that's the only thing that I have to sign quarterly.     Jayson Davies     And so are your quarterly Medicaid notes are those also the same notes that would potentially go home on like a report card or progress report for the kids? Or do you guys not have to do that?    Mary KleinHeksel     Yeah, no, totally different. So Kate does the progress notes. I look at those progress notes, but I don't have to sign them,    Jayson Davies     okay, but those progress notes do go home to the parents versus your progress or your progress or your note that you're doing for Medicaid is separate, correct?     Mary KleinHeksel     It's just for, for Medicaid, yeah, and for, like, an audited one time. So definitely was good. We were,    Jayson Davies     yeah, they're doing a lot of stuff with Medicaid, medi, Cal, all that stuff right now. It feels like they're trying to reorganize it a little bit, and it's crazy. I mean, we use a system called paradigm, and yeah, I mean, we have to input our note every day after at the end of the day, and it takes time. And I'm not the fastest. Diaper takes a little bit extra time, but.     Mary KleinHeksel     We do as well weekly. We do our weekly Medicaid students after our session and weekly, and then I have to approve that monthly. So Kate inputs it daily, or whatever. After she sees it, she does a monthly summary, and then I approve Kate's monthly summary. If that makes sense, yeah, yeah,    Jayson Davies     that does make sense. It's amazing how things are so different from, I mean, obviously from one state to another, but I'm sure you guys have probably, well, Kate, you've been in this district forever, or since you've been in OT a but I mean, even when you go from just one district to another district, things can be so different. And of course, state to state, county to county, all that. It's crazy how different things can be. So it's kind of cool being able to talk to people from different regions. Yeah. All right. The last area I kind of wanted to touch upon is RTI and RTI again, response to intervention for anyone who doesn't know. It yet. Check out episode 42 broke it down. All there for you. It has three different tiers. We have that level one tier, level two, level three. I identify level one as being very general, very like trainings and stuff like that. Do you guys participate in trainings, both where you're the trained, being the person being trained, as well as the OT or the OT a providing trainings.    Mary KleinHeksel     So yeah, we do so our RTI, we give training to the teachers, just general classroom teachers. They say, We have students that need help with their handwriting. At that point, then we're like, try these techniques, and then we do, we are requested to do some trainings for teachers as well, just, let's say, on fine motor as a whole. So we've done that. And I don't know, Kate, have you? I don't know if you've done that with me. No, I haven't think that was at the early childhood center. So I think Jody did that. So we'll do like a parent child day, where the parents come in and we'll Devon in service on that as well, and the teachers are there. So various, yeah, so various in services for them and then for us. I think it's more of like Kate and Jody just went to that Handwriting Without Tears, conference, that type of thing.     Jayson Davies     Yeah, going to seminars and stuff like that. So what are you guys doing this Thursday for your PD day?    Mary KleinHeksel     So we are working on that special, telling Jayson earlier, our special, we have a special sensory equipment coming out. We can't quite say everything yet, but a big reveal soon. So we're going to work a little bit on that. And then that's actually in some of our schools right now, that as a program so and then, so we're going to work on tweaking that. And then preschool, actually RTI Kate came up with this fantastic idea for RtI home, home activity boxes. If you want to elaborate on that,    Cait Bowen     I can't claim the credit for the original idea, but I did adapt it to fit our needs. So we call them fancy fingers fine motor boxes. And basically they're just a box of fine motor tools that can be sent home with a student, but we rolled them out. Two years ago. I got some funding through Donors Choose, and we rolled out 35 boxes so we really focus on the younger grades. We gave one to every kindergarten teacher and every preschool teacher. Is that right? Yeah. And so the boxes were a little bit different for preschool and for kindergarten, but we included instructions inside, and it was activities like pop beads or a tennis ball mouth or putty with beads, just things that we picked out to really work on those fine motor skills, and that's been a huge help. We got a great response from teachers. For those we've actually had to make, I just made six more in the fall, and we need to make some more for the preschool. So they've been very popular.    Jayson Davies     Awesome. So do these stay in the classroom or do they go home?     Cait Bowen     We kind of leave it up to the teacher. They can use them at their discretion. So some teachers like to use them as like part of a center as kids are going around the classroom, and that's helpful if a kid is really struggling and the teacher feels like there will be follow through at home, we've left it up to them whether or not they want to send that home for a couple weeks and then send it back to school so that another kid can have it. We just kind of leave it up to them.    Jayson Davies     Okay? And then, since I just asked you about sending things home, do you guys as an OT, ot a team, send home anything like homework? Do you give the child ot homework? Do you give them things to do at home or home exercise program or anything like that.     Cait Bowen     Yeah, I actually created monthly home exercise programs or activity lists, and we send those home every month to all of our students. And I just started sending home just some extra worksheets for students, things that we've been working on in our sessions that have been kind of challenging, just some extra practice at home, cool. So we're really building up on that follow through outside of the therapy session.     Jayson Davies     That's awesome. And so you have an Instagram account? I do, yeah, are pictures of these items on your Instagram account?     Cait Bowen     You bet I have pictures of our fine motor boxes. I have pictures of some of the things that I send home, and they're also available in my Teachers Pay teacher store. So people are welcome to check those out. It's just some great i. Extra worksheets that they can send home or use in therapy or give to teachers.     Jayson Davies     Okay, so I know the easiest way to find your TPT, teachers, pay teachers account is probably through your Instagram. So what's your handle? Kate, the coda. Is it all? I can't remember. Is it just Cait the cota, or does it have underscores in it?    Cait Bowen     Kate, underscore, the underscore. COTA.     Jayson Davies     that's what I thought. Okay, yeah, be sure to follow her. I follow her on Instagram, so be sure to follow her. And if you didn't catch that, there will be a link to her Instagram on the show notes@ots.com forward slash episode 44 so yeah, be sure to follow her, and then I want to continue on the RTI route. So you talked about Mary, how you do some some trainings for teachers. We talked about how Kate will go, and the other COVID You probably do yourself, because you have to have continuing education, going to seminars, going to things like that. What about the next step, level two, kind of getting into potentially individual classrooms, doing groups of some sort. Are you guys able to do any of that?    Cait Bowen     So our level two, we do a lot of the classroom adaptive equipment at that point. So we'll push in. We'll say, try a slanted writing board. We've typed up handwriting legibility rules from Handwriting Without Tears. That work, amazing. We'll give pencil grips. We'll try different pencil weights, yeah. So at that point, we'll push in, give ideas, and then have them try that as well, before moving forward with with a pull out. Tier three for us is then the teacher is like, it's not working. Then I'll, I'll get parent written, parent permission for an OT evaluation, for a pull out    Jayson Davies     Gotcha. Yeah, cool. So I think I meant to ask you this earlier, but do you guys do a lot of treatments in the classroom, or is most of it a pull out session?    Mary KleinHeksel     So I do a handful of treatments in the classroom. We've done it both ways. We've done small group pull out, we've done push ins, we've Yeah. So I think it depends on the students. Definitely depends on the student needs. But for us, I think a quick, quickest remediation is that, is that pull out at this point, that we're able to still do that. We're pretty lucky about that. So.    Jayson Davies     Gotcha, okay, but it sounds like at the same time you're giving the teachers the material they need, at least, especially in the preschool, kindergarten level, with those boxes that you're talking about.     Mary KleinHeksel     Yes, they have, they that's, that's part of those systems that we talked about, they have to try these things first, and they find that, wow, it really did help. Wow, yeah, miraculously. So, yeah, the it's all things that we're telling them that we're doing in therapy sessions, and too, I like when they send it home, then the parents alerted that it's an issue, and they can, they can buy in before you send home a scary ot form. What I didn't know anything was a problem. Well, they'll know before then they're looped in to the process that we found that really helps too.    Jayson Davies     Cool, yeah, that's good. So I think we're getting down to the end. I want to ask each of you one more question. Don't kill me if it turns into three more questions. But for each of you, I'll start with Mary as an experienced OT. What would be your piece of advice to an OT who is starting to supervise a coda for the first time?    Mary KleinHeksel     I would say the most important thing is have open communication. That's that's huge, like just, just be open and allow communication to flow both ways. You got to be able to take things you know, have mutual respect as well. You know, Kate is not my assistant. Kate is an assistant of Jayson public schools. Just like, Yeah, I'm not necessarily my special ed directors. OT, it's, I'm Jayson. So yeah, just have mutual respect for each other. And yeah, I think that will go a long way, but that communication is key for sure.    Jayson Davies     That's fantastic. But you did mention that whole supervision weird thing. I know in the past, it's been a little complicated, because you're the supervisor, but you're not their work supervisor. You supervise the actual therapy, not the actual person. I mean, you are not Kate's boss, right? You she works for, like you said, she works for the district. It's probably like the director of special education is officially her boss, or something like that. True. That is 100% true. Yeah, yeah. And so I think that's just what I want to make. I want to just clarify, because I don't think a lot of people understand that necessarily. And it is a very unique dynamic.    Mary KleinHeksel     It is unique dynamic. I think just the name. Of our occupations. Yeah, it makes it confusing to others. And yes, I think that's perfect clarification.     Jayson Davies     Yeah. I mean, I think it even took me a while to realize that CODIS stood for certified occupational therapy assistant versus therapist assistant. I mean, right out of school, it's like, Wait, yeah, is it therapy? Therapist? What does that even mean? Like, what's the difference? And then you come to realize, then you come to realize, oh, that's why it's therapy assistant.    Cait Bowen     Yes, and I feel so lucky that Mary, from day one, has always made me feel like an equal. I have never felt like her assistant or just someone lower on the totem pole. It's always been an equal feeling, and I'm so thankful for that.     Jayson Davies     Great that's good. Kudos to you, Mary,    Mary KleinHeksel     Cait is amazing. You should see that you can own her Instagram. She is very, just talented.    Jayson Davies     All right, so Kate, a similar to question to you. You can't talk about communication because Mary just stole that one. But what piece of advice would you give to a new to an OT a new maybe they're new, maybe they're experienced, but they're kind of being supervised for the first time.    Cait Bowen     And I can't say communication. Come on.    Jayson Davies     I'll let it slide.    Cait Bowen     I just think it's so important to have that good relationship with the OT, just a place of trust, a place like Mary said, of mutual respect, someone that you feel comfortable talking to about the good, about the bad, about the struggles. I think that's why Mary and I have been such a good team. Is it's been so easy to talk to each other. And I honestly, I think that's the biggest part.    Mary KleinHeksel     Yeah, each other, anything and just be, for sure, totally brutally honest.    Jayson Davies     Scary. Sometimes. Well, that's great. It sounds like you guys have a wonderful relationship, both in work and the actual therapy itself, as well as outside of work. It sounds like you guys are doing things together, which is super cool, but yeah, thank you so much for coming on and sharing all that information. I'm sure many OTs and OTs out there listening, we'll find it comforting to kind of hear how things work, and maybe we didn't talk about too many struggles. It sounds like you guys are doing really well, but it's nice to know what a good working relationship can look like, and I think people will be able to take away a lot from hearing what you guys have had to say. So thank you so much. I appreciate it for all of you listening out there. Definitely do. Go check out Kate's Instagram. Kate underscore, the underscore coda. She has a lot of great information there, and on her home page, I believe right now, she has a link to her Teachers Pay Teachers account too. So go check that out. If you don't know what TPT is, then, I don't know what you've been doing in life. TPT is amazing. They have so many free and paid resources and yeah, so thank you so much for coming on the show. I appreciate it and    Cait Bowen     Thank you so much.    Jayson Davies     And we'll have to have you guys back on sometime when you guys have a little bit more info on the super secret sensory tool. All right. All right. Well, take care. Have a great evening, and I'll talk to you next time. Thank you. All right. And that wraps up episode number 44 of the OT school house podcast. A very special thank you to Mary and Kate for coming on the show and explaining their ot OTA relationship. They obviously have a great thing going on there. Thank you also to the pencil grip for sponsoring today's episode of the OT school house podcast. I really appreciate all of you listening through this podcast, and we'll see you next time for episode 45 of the OT school house podcast. Take care and have a fantastic 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 Episode 43 of the OT Schoolhouse Podcast. In this episode, I share 7 tips to help you get ready for a tough, maybe high-profile, IEP. With the help of a few personal experiences, I talk about how to ensure that you are prepared logistically and emotionally for what can be an intense 3-6 hours with the IEP team. Did you listen and feel like I forgot something on my list? let me know with an email! ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! Links to Show References: OT School House's A-Z School-Based OT Course ​ Check out the course that I have put together just for you, the OT School House community. This course is a direct response to the questions and feedback I have heard from those who listen to the show. Learn more about the course here! 10 Strategies to Help You Survive Your Next Difficult IEP Meeting Check out this blog post for more ways to prepare for that tough IEP you have coming up. ​ Dear IEP Team: Don't Call Me Mom​​​ A blog post from a parent about her feelings when attending an IEP and being referred to as "Mom"​ Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host, Jayson Davies, class is officially in session.     Jayson Davies     Hey everyone, and welcome to the OT school house podcast. My name is Jayson Davies, and I am happy to be back with episode 43 which is the first episode of the OT school house podcast. In 2020 went on a quick hiatus for a few months. Just had to get some things done. But I'm back. I'm excited to be here with you all. And yeah, whether you're driving, whether you're at the gym. Maybe you're working on any evaluation right now and just have the podcast playing in the background. I'm sorry if I'm distracting you, but I am excited to be back, and I'm excited for you to be here with me today. In this episode today, we're going to be talking about some tips that I have, both leading into one of those tough IEPs. Some might call them high profile IEPs, as well as how to handle yourself within the IEPs. These are things that I've learned over my seven years, almost eight years now, as a school based OT and I just have some tips that I have gathered from some of my mentors. Some are OTs, others are not OTs, but have taught me a lot of skills about how to prepare for an IEP, as well as handle myself in an IEP. So I want to share those with you, but, but first, I have to say a huge thank you to every single one of you who follow me on Instagram, Facebook, and you subscribe to my email list. All of you have seen the last few days that I released a course, and this podcast was supposed to be the big announcement kind of follow up with the email, big launch day type of thing, but you guys already bought it all up. And so I want to say thank you so much for selling out my first A to Z school based ot course. Honestly, I had no idea how much you all had, how much desire I could say you guys had for this type of course. I expected to sell maybe a few of these courses, and you guys ended up selling it out. For those of you who haven't heard, my A to Z school based ot course, is an eight week live and recorded program that we're going to do on a webinar format. We're going to use Zoom, and we're going to go over everything from RTI and how to refer students and how to set up a referral program. And then we're going to dive into evaluations and how to develop an IEP, working with the present levels, the goals, the services, and then we're going to get into treatment planning and how to figure out a way to help our kids meet those goals using the services that we had. And ultimately, we're going to get into talking a little bit about graduating OT or, sorry, not graduating OTs, graduating students from that ot caseload. Maybe some of those students have just been on our caseload for too long, and they're not necessarily making progress anymore, and we need to try and see if they're appropriate to graduate, and how to go about doing that. So again, this course is sold out. This was supposed to be the podcast where I got to come on here and say, Hey, this course is available. Come and grab it. It's gonna go until Friday the registration. But it's kind of bittersweet for me that I get to say it is sold out. However, I had a lot of people that were sad that they missed it, and so I have set up a wait list for those of you who may want to get in on the next round, which will likely be during summer, and then, of course, in the fall, as people are starting to come back into their school positions. So if you're interested in potentially being a part of one of those sessions, I'm going to give you a link right here. It is, ot schoolhouse.com , forward slash A to Z, the letter A, the number two, and then the letter Z, and that will send you to a website where you can sign up for the wait list and be the very first people to know about when the next sessions open up, in case you are interested. So again, that link is ot schoolhouse.com forward slash A to Z. If you can't remember that one, just remember that this is episode 43 and go to the show notes at ot schoolhouse.com forward slash episode 43 and there will be links to all that there for you. So again, thank you everyone so much for your support and for your just excitement over this course. I'm excited the people who are in are excited the people who didn't quite make it, I think they're a little sad, but they're also excited about being able to be in future iterations of this, A to Z course. So yeah, let's just keep the excitement going and head into our topic today. All right. Well, thank you so much for hearing out my excitement about my new course. But let's jump into today's topic. I'm going to try and keep the energy up, because this isn't necessarily the type of topic. Necessarily that just exuberant energy. You know, it's one of those things that we don't always like to let's just say it's not the best part of our job, right? Those tough IEPs, right? The seven things to do and remember when heading into a tough IEP is what I'm going to talk about here. And these are things that I've learned over the course of my years as a school based ot from mentors that I've had, from mentors that are both OTs and non OTs. You know, special education directors, psychologists, Adapted PE, teachers, speech pathologists, all these people that we work with, admin, all these people have taught me something. And you know, we don't always have to rely on going to the OT to find out about our job a little bit, right? There's other people in the schools that have an impact on us. I want to start off by sharing something specific to the district that I used to work for, and that was that we worked in a smaller district, a more rural district, and it was infrequent for us to have an advocate at an IEP. Part of that is because, you know, it was a more rural area, I think. But the other part of it was that we had the mentality that as long as you have us as a team, you shouldn't need an advocate. We should be your student's advocate. We should be your advocate as a parent. We should be able to support you and what you need and your students needs in order to get that education that you need. If the parent feels that a student needs an assessment, then we're going to listen to that parent and come up with the best plan in order to support that, you know. And same thing when it comes to whether the student needed or the parent wanted, a one on one aid or an OT evaluation or a speech evaluation, right? We're going to listen to that parent and try to figure out what the underlining factors are, what's the true concern, and we're going to be that student's advocate. This policy truly started at the top and went all the way down from our special education director. She had been in the situation where she was a parent, where she sat in IEPs, and she knew what it felt like to be that parent on the other side of the table, and from that all the way from the top coming down, she was able to share with us how it felt and how we can better support families within the IEP and so we went into IEPs with a nothing to hide mentality, and I learned a lot, you know, so much that I often still get praised today from parents and teachers and other professionals and even advocates about my professionalism in those tough IEPs. In fact, at one school I work at, you know, the principal fosters a similar type of community, and thus we recently have had an advocate commend us on how well our IEP team did and how well the meeting went, and it feels good you know, when you're able to get someone who is basically paid to be there to kind of be your adversary and bring up topics that maybe you don't want to discuss, and at the end of the meeting, they're like, Wow, if this would have been the IEP team last year, we wouldn't have this, all the drama and all The craziness that we have had to go through now, and we appreciate that, and we feel like this is going to be a good year. It feels good when an advocate and a parent are able to say that at the end of an IEP. So that's what we're going to talk about today, how to make parents, how to make advocates, how to make people that are in that IEP, in that IEP meeting, feel comfortable, supported, and like the IEP team, has a plan and knows where they're headed. So let's get into that first topic. All right, so Topic number one is to introduce yourself and attend to the meeting. Be confident in your introduction when you introduce yourself, don't be looking down at your notes. Don't be looking at your computer. Don't be looking around the room. Look up, look to the parent. Make eye contact with them. Introduce yourself as their students. OT or occupational therapist, right? It's pretty simple, but too often I see people in IEPs introducing themselves while they're still looking down at the paper that they're writing notes on, or something like that. And I see advocates do this. I see program specialists do this. I see administrators do this. I don't understand why you would do this. It's not a power play. It's not going to help you in the IEP. Look up, be courteous, be kind, be respectful, and give the parents the respect that they deserve by looking up at them and introducing yourself. Now, I know some of you might be asking, because you sit in a lot of meetings with advocates or whatnot, what if an advocate is there, right? Then, how do you introduce yourself? Is it any different? And my answer to and my answer to that is, no, the advocate is there as an invited guest of the parent. You are there for the parent, right? So again, introduce yourself to the parent. Of course, do not disrespect the advocate by looking away from him or her when they introduce themselves. And of course, glance at them as you introduce yourself, because you're probably glancing around the entire table a little bit, right? Do that? Don't be a jerk, right? But at the same time. So you are there to talk to the parent, so introduce yourself to the parent. Similarly, if no one else on the IEP takes the time to do this, also encourage the parents to introduce themselves. Sometimes parents are very shy. They don't exactly know what to expect in an IEP, and they might just kind of say, Hi, I'm so and so's mom, right? But you should encourage them to say, to introduce themselves as a person, and ask them how they would like to be referred to as, right? And a lot of times, whoever's taking the notes can easily do this by simply asking how they would like to be referenced to in the notes page, right? So oftentimes we put all the participants names in the notes or somewhere in the IEP. So that's a point where you could ask how the parent would like to be referred as unfortunately, the time to be confident and attentive does not end after the introductions. Of course, you need to remember to be professional throughout the entire meeting. You know, this is not the time to input treatment notes. This is not the time to bill for the services that you provided earlier today, or to send emails. You know you need to be taking notes, maintaining attention to the meeting. You don't want to be that person that gets caught off guard when someone asks a question about sensory or someone ask a question about fine motor task. You want to be able to attend to that and answer their questions strongly and without having to ask for a repeat of the question. Right? And this doesn't just go for you, I would suggest that you have a talk with your entire IEP team if this is the case, because you don't want to be that IEP team that looks like they are hiding behind their screens. Unfortunately, oftentimes in our IEPs, the entire team, or, you know, the people that work for the school, will sit on one side of a desk, and then the parents and maybe the advocate, if they're there, are kind of on the other side, and it creates this you versus them mentality. And then to top it off, you know, everyone, quote, unquote, on our side of the table, the people that are working for the school district are all on their iPad or their computer or their Surface Pro or whatever, right? And we're all hiding behind our computer and only looking up when it's our turn to talk. That shouldn't be the case. You know, you want to be attentive. You want to be looking up. Yes, it's okay to take some notes. It's okay to have your computer out to be taking notes on that. IEP, I often am working on my treatment plan during the IEP, right? But that's one thing, versus sending emails and completely tuning out what is going on. You don't want to be that person on the IEP and you don't want to be that IEP team either. So be sure to introduce yourself confidently and continue to be a part of the meeting and be in the meeting you know, actually present in the moment. All right. So that brings us to tip number two, which I have down as seeing things from the parents perspective. And you know, this is a big one, and this is what made our IEP team so successful at my previous district, and I think now at my current schools, it's also why we're able to get through meetings pretty well, and that's because we try to see things from the way that the parent views education and the way that the parent views their child's success, but it's hard to do that if we don't know what our parents long and short term goals are for their student and also what they view as their child's strengths and also their child's weaknesses. You know, we need to ask these questions, and a lot of times we do ask these questions as part of our evaluation process, but then we should also be asking them again during the IEP, because sometimes other things come up. Maybe we just talked about speech a little bit, or we just talked about other areas, and that might jog the parents memories. So I highly recommend that you start by asking questions at an IEP. Sometimes we just want to give information, and we forget to ask for information so that we can see from the parents perspectives, their view on their child and what they would like to see their child achieve. A simple tool that I often use during an IEP is to actually ask questions of the other professionals that the parent may not know to ask, right? So it's a little bit hard to do when you're actually speaking, and I hope that other people in the room would do this if they had a question, but when maybe the psychologist or the speech therapist is is talking about their report or breaking down their report, right? It's easy for you, as the person not speaking, to take note of the parents facial cues, you know, when others are presenting and see, did the parent look like they fully understood that? Or maybe they didn't, and if they didn't understand it, what question can you ask? Can you ask a clarifying question of the speech therapist or the school psychologist about what that score on the a bass really means, or what it means that a student doesn't have the TH sound or something like that that lets the parent know that you're on their side, right, that you want to know just as much as they want to know, and that you're confident in asking the questions that they may not be so confident in asking, because they don't want to be seen as potentially a difficult parent, right? Or they don't want to be seen as that helicopter parent. But. But if we can ask the questions that the parent might be thinking, not only does it help build rapport, but ultimately it helps the student, because that means that everyone's now on the same page. Just a quick reminder before we move on to topic or suggestion number three, and that is that, you know, the parents are not occupational therapists, they're not speech therapists, they're not teachers, they're not admin, or at least not most of them, right, and they don't have the same education as us. They don't necessarily meet they don't necessarily know what standardized scores mean. They don't know that an 85 is considered average. They don't know that an 84 is below average. And so without letting them know this information or showing them graphs, it's really hard for them to truly understand the information we're giving them. They simply don't know, and they don't know what they don't know, and so they don't know to ask the questions, right? And so by, again, seeing things from the parents perspective, and asking those questions, that may be a little on the iffy side, and again, if I don't know something, then I can almost guarantee they probably don't know it, because I sit in those IEPs all the time, right? I hear it every other day, but they don't. And so we need to be on their side and ask the clarifying questions of the other professionals. And again, I would expect others to do the same to me. That would ultimately help the student and help the team make an informed decision on the best goals, the best services for this student, all right? And that brings me to tip number three, which is kind of goes back to number one, and that is, speak to the parents, not just the advocate. Again, just like when we make our introductions, we want to make sure that we are talking to the parents, and that goes throughout the entire meeting when you're going over your progress on goals, when you're going over your present levels of performance, your report, your services, your new goals, all that good stuff you should be speaking to the parents. Advocates are hired to be consultants for the student and the parents. They are not there to replace the parents. Right? An advocate does not come in place of the parent. They are there to support the parent in making decisions. So when you provide your test results and all that good stuff that I was talking about, make sure you're addressing the parent. Of course, if the advocate again, just like earlier, if the Advocate has a question, if the Advocate has asked for some clarification, don't be a jerk. Respond very politely and respectfully, but know that at the same time you are there to speak to the parent, by speaking to the parent again, you are giving them the control, the respect, to make an informed decision on their students best options, right? And if you were going about your report and you're only talking to the advocate, you're now taking away that respect, you're now taking away that power from the parent and putting it to the advocate, giving the power all to the advocate. And that's not right. I mean, I'm sure there probably are some parents and advocates that would probably actually prefer it that way, that you speak to the advocate, but in my experience, talking to the parent is the best way to continue to build that rapport, give them the trust that they need, and, I mean, ultimately, make them feel like they are included in the IEP. I think it's now a nationwide thing that at the end of IEP, you know, when they're signing, whether or not they agree or not, there's a little box that says, Do you feel like you were facilitated in your student's progress and in your student's IEP. And I don't know if I was a parent and someone was just talking to the advocate the entire time I was there, I may not feel like I was actually included in an IEP. I'd feel like my advocate was, but I wouldn't necessarily feel like I was. And let's be honest here, the parent is a specialist on their student. First and foremost, right? I know the teachers spend a lot of time with the parents, or, sorry, hope not, but I know the teachers spend a lot of time with the students, but first and foremost, that parent is the specialist on their students. So again, don't completely ignore the advocate. I am saying, do not ignore the advocate at all, but address the parent as much as possible. All right, we're at the 18 minute mark or so, and number four, we're halfway through just about this is to keep the child in mind. I don't think I really need to even tell you all this, but sometimes you need to remind others to do the same, to keep the child in mind the best interest for that student is what this IEP is all about, right? Sometimes these difficult IEPs can get a little dicey, a little emotional, a little personal, and we just have to remember to keep that child first. Don't take statements about services personally, right? If you are recommending your service, whether it be once a week or once a month, know that any statements or any questions about your service are not about you. They are about your service. The question is, why does the child require specialized ot services? Not why are you. Two as the OT recommending once a month consult for my student. Why are you recommending only 15 minutes? No, that's not the case. The question is, why is 15 minutes of service recommended for my student? And again, if you're not taking that personally and you've done all your research and all your homework, you should be able to explain exactly why we only need 15 minutes a month to support that student, or why we need two times a week to support that student. On the other side, you know, sometimes it's the administrator that might be saying, Are you sure you need that much time? And yeah, so you need to be able to explain yourself. And also understand that things typically are not personal, even though they might seem personal, right? With that said, when you're an occupational therapist, you're working in education long enough, even if you're a teacher, admin, whatever, sometimes things do get personal, and it's happened for me. I know it's happened for others, and so my quick story, I don't want to dive too deep into this. It happened a long time ago at a previous district, but I basically had a parent during an IEP accuse me of not caring about their child. This is a child that I had worked with for probably about three years or so. At the time myself an occupational therapy assistant. The occupational therapy assistant had worked with a child even longer than that, probably close to five, maybe six or seven years since they were in kindergarten. But this I was kind of new to the team, and this parent decided that she didn't feel that I cared about that child even though we had up services and we had changed goals around, and we had done so much to support this student. I mean, I think at the time we were working on assistive technology, we were doing a lot to try to make this student be able to stay in that general education curriculum or general education class as long as possible, but in the heat of the moment, this parent accused me of not caring for for her child in the middle of the IEP and as you can imagine, that was tough on me. This is with that IEP team that I talked about earlier, that I didn't feel like we needed an advocate, because we always cared about the child and we always cared about the parent and were willing to do what needed to be done for every for every kid. And then that happened, and to be quite honest, I didn't really know how to respond. I can tell you, I probably respond a little bit differently now, if I had the chance. But when she said that, I basically stood up and walked out of the door. I can't remember if I even said anything, but I know I walked out of the room, and I was probably out of the room for a good five minutes or so. I talked to, I can't remember who it was, sorry, but someone in the office outside the conference room. I talked to. Calm down a little bit, and then I calmly re, re inserted myself into the situation, back into the IEP room, quietly, sat down, participated in the meeting, as though nothing had happened. And then at the end, I made sure to stay so that I could apologize both to my school psychologist who was kind of a mentor at the time, as well as the parent, of course, and so that happened, uh, things, you know, went pretty well after that. Of course, there's always a little animosity, I guess you could call it between us for the rest of the time that I worked there because of that situation. But we were, we were able to continue working. And, you know, it worked out. I don't know if we always loved each other, of course, the parent and I, but we were able to have a working relationship, and in future IEPs, we worked together. It really helped that the school psychologist that was kind of a mentor to me, and that parent had a great relationship, and so she was able to kind of help us both stay on track, and it was really good to have that person in the picture, but nonetheless, you know, it wasn't a great situation, and I hope that none of you ever have to deal with that. Sometimes I just have to remember a quote from one of my favorite movies, and that is Oceans 11 to check my emotions at the door, because in these heated IEPs, sometimes things get a little personal, and you just gotta be prepared for it in case it happens. And think about, what would you do in a situation where someone attacked you personally? I mean, I don't know what else could happen, but being accused of not caring about the specific child, that's pretty significant in my book. So again, I hope none of you have to deal with something like this, but just know that it could happen and to be careful. So to wrap that section up, just remember to keep the child in mind, to keep the IEP team focused on the child and you. Be good to go. Alright? And so that brings us to tip number five, which I'm just going to kind of touch upon, because I know I've touched upon it in past episodes, as well as I will be touching a lot more in depth in my course, the school based OT, A to Z, school based ot course, again, check that out. But number five is to make sure that your plops, your present levels, your goals and your services all match, right? Remember, your present levels lead to your goals, and your goals lead to your services, so they all need to match. And you know, another thing is, don't blame OTs for old goals, right? So you inherit a student, but don't say it was a bad goal that the student didn't meet and blame that the previous ot didn't know what they were doing. They made a goal that's not measurable, right? That just sounds like you're trying to give all the blame to that person, and that the reason they didn't meet the goal is because of the bad goal, right? No, don't do that. Take responsibility and tell it like it is. Say, Hey, the way that the goal is measured, the student did not meet the goal. They were able to do this, this and this, but they were not able to do this, and therefore they didn't meet the goal. And here's my proposed next goal. There's no reason to make it sound like someone didn't do their job. Remember, at the end of the day, you are a district as a team, right? And so if you're throwing an OT under the bus from the previous school or even the previous school district, it just doesn't sound good, and it doesn't help in the report building, also know that it's okay for goals not to be met. I know a lot of times there's pressure to say that a goal was met, but that's not always the case. You know, we're trying to push these students, and we should be writing goals that are difficult for the student to meet, whether it is a quote, unquote, pure ot goal, or if it's an academic goal, that's a whole nother discussion, but give your honest opinion, your honest measurement of that student's progress on their goals. It's okay if a goal was not met, but just continue forward, report it and then create new goals that go forward, right? So just a quick example before we move on to number six, about keeping everything kind of in order. So if you put on your present levels that a student struggles with cutting due to poor bilateral coordination skills, right then, going forward, you would work on your goal, which I don't know, maybe your goal would then be for the student to cut out a complex design, if they've already cut out simple designs. And then your service should reflect that goal as well as any other goals that you have. And so if you think you only need to see the student twice a month to work on that cutting goal. That's all right, but maybe you add another goal, a handwriting goal or something, then do you need to see that student another two times a month to make it once a week to meet both of those goals? That's how you should be establishing that. And then as we move on to number six, it's very closely related to number five, and that is about providing draft reports and IEP documents. This is becoming more and more popular, at least in California, around my area. You know, parents, whether or not they have an advocate, are asking for the IEP documents ahead of time. They're asking for the reports ahead of time, sometimes as early as a week. Sometimes they're okay if they have it a day before, and so I've been giving this some thought, and when it comes to my reports, by all means, yes, it's it's a good idea to send home the reports in advance. I do this. I try to get it out as early as possible, but typically I do follow that sometime within a week, oftentimes, our teacher will try to set a date for us, and we'll all send it to the teacher, and then the teacher will send it home. Not gonna lie, sometimes I miss that date and I end up sending it home in an email a few days later, or in the kids backpack A few days later. But still, before the report, the only thing I would suggest to you, if you are going to do this is make sure that you put, like a watermark, a draft, on the paper, on your report, or at the top of your report, say, draft copy and make sure it's on every single page. I rarely change my report from the time that I send it home to the time of the IEP date, but occasionally I do, and when it or whether or not it does, I come to the IEP with fresh copies of that report to give to the parent and the rest of the IEP team. So again, when it comes to reports, I'm all good with sending this home to the parents ahead of time, but I do recommend putting draft on your report. Also, I am not your boss. I'm not your special education department, obviously. So definitely check in with them before you start doing these types of policies. Similarly with the plops, the present levels and the goals, same thing goes, we often will put our present levels and our goals down on a draft IEP and send it home to the parent beforehand. That way the parent comes in already, kind of knowing what they look like. We also do this with our progress on. Previous goals, so that the parent can see what progress has been made and have appropriate questions at the IEP meeting. When it comes to services, though, that's where my belief changes, and I don't think that we should send home a copy of our recommended services, and that's only because things change a lot. And so at an IEP, a lot of new information comes out related to present levels and goals, and maybe how progress on goals occurred, different areas that parents might have concerns about, different areas that teachers general education teachers may have concerns about, right? And so we may add goals or we may remove goals, and services should be reflected in those addition to goals or removal of goals, right? And so you got to be careful, because if you say a student on your draft IEP requires once a week services, and he requires those once a week services because you're working on goals A, B and C, and you need once a week services to meet goals a, b and c1, year from now. Well, what happens then, when the parent or advocate or teacher says, Well, I think we need to add a goal for number four or number five even, right? Well, then what happens to your services? Do they change as well? Because now you have more goals to work on. So as you can see, what I'm trying to allude to is that services can change a lot based upon what happens earlier in the IEP. And so it's when it comes to services that I don't necessarily recommend always sending the services home in a draft that being said in my current district, that is our policy. And I absolutely go ahead and I follow that policy, but I would just say that in my opinion, I would prefer not to do that with all that said. Ultimately, no matter what you your IEP team, your school, your district, decide to do regarding sending drafts home, you have to be flexible in IEP and you have to have the child's best interest in mind. These are things that we've already talked about. And if you have a fixed mindset, when you go into an IEP, a that's when you're going to probably start to butt heads. And two, it's kind of illegal, and that's why it's a draft. Remember, drafts can change. You are not allowed to create an IEP without the parent, right? So it is a draft. You need to be flexible and keep the child's best interest in mind. All right, those were the six, quote, unquote, I guess, kind of heavy suggestions and tips. I wanted to go over number seven is a little more light hearted, and that is to remember, no matter what the meeting will end, you will make it home in time to watch The Bachelor, to see Victoria get kicked off the bachelor, hopefully tonight and or whatever your guilty pleasure show is, I guess you could say, but tomorrow will come. The IEP will eventually be signed, right? There's only so much you and your IEP team can do eventually. There are things that are above your head, above the OT position, right, that you just don't have control over. And so you have to be willing to let those go at the end of the day and say, and feel comfortable in saying that you did the best part that you could do to make that a good IEP and to make this child success possible, right? So that's everything for today. That is episode number 43 again. Show Notes can be found at ot schoolhouse.com , forward slash episode 43 uh, almost got stuck there real quick, but we got it. Thank you. Thank you. Thank you everyone for joining me today. Welcome to 2020 even though it is already, uh, almost March, I appreciate you all always for being a part of this podcast, for listening and letting me join in on your drive to work, drive home from work, or wherever you may be listening. Truly do appreciate it. For those of you still listening, I wanted to add a little something. I really hope you enjoyed this podcast episode. This is the first episode in a while that I actually completely re recorded, because I recorded it at first, and it just, it's a hard topic to keep upbeat. I guess. You know these, these are difficult subject matters and difficult IEPs that we unfortunately have to be in. And no one prefers to be in this right? We all want to be in the classroom or in our OT room, working with our kids. None of us got into this job to go to these strange IEPs, right? But we did it. I think it's a lot better now, and I hope you enjoyed it as well. Let me know if you're still listening to this in a direct message on Facebook or Instagram or something, and give me a fist bump or something. So with that, I will see you next time on the podcast. To take care and yeah, have a great rest of your week. Bye. Bye, everybody.     Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed.   Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 42 of the OT Schoolhouse Podcast. One aspect of school-based OT that both therapists and administrators alike seem to be reaching for is the development of an effective and organized RTI program. One that allows therapists to have a meaningful difference in the classroom for the students and teachers. ​ In episode 42, Jayson explains how RTI has moved from being just for teachers to being for service providers as well. He talks about what an ideal RTI system looks like, how he implements RTI, and how to start moving toward an RTI model. Listen in for some excellent tips to get you started! ​ Plus, don't forget to subscribe to the OTSH Email list below to get your very own copy of the Occupational Profile For School-Based OTs discussed in Episode 41 of the OTSH Podcast! Links to Show References: ​ National Survey of Occupational Therapy Practitioners’ Involvement in Response to Intervention ​​​​Susan M. Cahill, Beatriz McGuire, Nathaniel D. Krumdick, Michelle M. Lee; National Survey of Occupational Therapy Practitioners’ Involvement in Response to Intervention. Am J Occup Ther 2014;68(6):e234–e240. https://doi.org/10.5014/ajot.2014.010116 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 everyone, before we get started today, I just want to give a big thank you to medbridge  education.com for giving otschoolhouse listeners $75 off their first year a subscription medbridge  education.com offers continuing education for OTs, PTs, speech therapists and many others. And by using the promo code "otschoolhouse" on one word, not only you are getting a 50% discount, but you're also hoping to support the otschoolhouse com podcast and the otschoolhouse.com website. It's a great deal. What I love about it is that you can watch any of the first chapters completely for free before you even decide to go ahead and make a purchase. So check it out at medbridge  education.com and let's Cue the intro.    Amazing Narrator     Hello and welcome to the otschoolhouse com 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 42 of the otschoolhouse com podcast. For you who don't know who I am yet, thank you for listening. My name is Jayson Davies, and I am a school based occupational therapist here in Southern California, where I work for a school district and I service three schools. So that's who I am. Quick introduction. I hope you'll go back and listen to some of the older episodes and learn a little bit more about me. But to get things started off today, I wanted to say just a huge thank you to all of you for listening, whether this is your first episode or your 42nd episode. I appreciate it. Everything that you all have done for me has been amazing, the emails, the support when I go to conferences and I see you all. I just love doing this. I love being there for you, and I love actually having you guys be there for me as well. Some of the emails have just been amazing, and I love it. But really, I want to say thank you, because this is episode 42 and for 42 episodes now we've been diving deep into occupational therapy, how we can support our students, how we can support the teachers and the parents that we serve. And I don't know. I just love it. I love all the feedback that I get from you all. And I hope you all are enjoying the podcast as well. One of the ways that I do know that, among many ways, one of the ways that I do know that you enjoy the podcast is through downloads, and I can see how many downloads we get over a period of time. And well, I'm excited to say that we're not quite there yet, but as this episode comes out, we will reach 100,000 downloads of the otschoolhouse podcast, which just blows my mind. I mean, we're we're 42 episodes in, and we're already reaching 100,000 downloads, and it comes out to about 8000 downloads a month now that we get and I just want to say thank you so much from the bottom of my heart. Thank you for for for basically making that happen. I mean, I put the info out there and and I bring on guests, but it's you guys who are continuing to listen. And I super like, I just gonna be more appreciative of that. So thank you. I also really, like, I was talking about a second ago. I also just love all the support that I get from you all through the emails going out and seeing you all at conferences. It's amazing. Thank you for just for supporting me honestly and the otschoolhouse podcast. I really appreciate it before we dive into today's episode in the journal that we're going to talk about I also want to give a quick shout out to Vanessa rapier and all the other OTs and OT assistants that will be attending the Utah otschoolhouse com later this week. Vanessa actually reached out to me about sharing the otschoolhouse podcast with her Utah colleagues at the conference, and so we were able to make something happen. And I just want to, again, give her a shout out, as well as all the Utah OT and OTs that will be attending the conference later this week. I hope you have a wonderful conference and that everything goes smoothly, and you just learn a lot of information that you're able to take back to your jobs and implement quickly and effectively. So yeah, I hope you just have a great two days of learning and getting to know each other at this conference. You know, getting to know who your colleagues are and where each other worked, and how you guys can support each other. So take care and have a great two day conference there and be safe. All right, so now we get to jump into today's topic, which is going to be all about RTI. And the reason we're diving into RTI today is because earlier this school year, at the beginning of the school year, I sent out an email asking everyone out there who subscribed to my email is saying, Hey, what are your concerns regarding this upcoming school year? And I was a little surprised when I saw RTI was mentioned by quite a few people trying to figure out how to get RTI into their school, how they can use the RTI model to their advantage, to not only help more kids, but also to potentially help themselves. I think a lot of people are. High on the idea of RTI because of the idea that that they're overworked, and they think maybe RTI can help them with their large caseload. I'm not sure if I already said it, but RTI is Response to Intervention. There's also RTI too, which is Response to Intervention and instruction, or instruction and intervention, however you want to say it. There's also MTSS, which is multi tiered levels of supports and systems, which RTI is basically baked into. But we're going to use the term RTI for today. And like I said, a lot of people are interested in this one, because I think there is that mindset that by by using an RTI method, I can potentially make my life a little bit easier, and ideally that is the case. It should do that. But I'm going to start up and be frank up here, up at the beginning of this is that it's hard to transition when you have a large caseload over to an RTI model. And a lot of times, you know, we think it's going to be the best model possibly, best model possible, and it's just a struggle to get there, and you have to get a lot of people on board to get there. But I'm here to tell you a little bit about what it ideally could potentially look like, and I'm also going to give you what it looks like for me at this point, as well as what it's looked like for me in the past, and kind of where I'm trying to get to with RTI in my transition right now. So I'm going to talk a little bit about that. I hope it'll help all of you out there, at least some of you that are trying to to do that transition as well, from a very heavy, if you want to call it a caseload model, you know, pulling a lot of kids out, seeing them individually, more to an inclusive RTI model. So let's dive into that. So RTI has been around for a little while now, but it wasn't until recent that it started being applied to special education and, more specifically, occupational therapy, speech and language pathology and physical therapy. And so the way that RTI works in an academic or educational model for children in the classroom, again, not talking about OT or PT, is that you have your foundation, your level one, and ideally somewhere between, let's say, 75 to even 85% of the kids in school, both general education and special education, should respond to level one supports. And level one supports really, that is your first best training. And So level one is really sending teachers and other staff to to end services to training, so that they can be the best professional that they can be when they're working with as many students as possible, really. So when you think of like a fourth grade classroom, you know that teacher is going to go and learn English, language arts strategies, they're going to go and learn math strategies. They're going to go and learn science history, all that, even physical education strategies so that they can bring back to their classroom and work with 30 kids to try and make the best possible scenario, or the best possible outcome for those 30 kids. And so that's what level one really is. Also included in level one could be like screenings. So again, those district level academic tests that that districts do you know, each class sets aside a day or a few days once a trimester to kind of go over these tests to see where the kids are, and that's data that's taken for level one RTI, so that way they know when they're planning for next year, hey, where do we need to train our teachers in so maybe math scores are on the rise, but Ela is still not not coming up. Well that way through that screening, that district screening, they know, well, we need to train our teachers more in ELA, so that way we can bring our scores up in that area. And So level one is mostly all about training. It can also be, you know, potentially co-teaching. You know, some teachers get together, and they might co-teach lessons as a way to help a a younger teacher or a less experienced teacher learn how to teach in ELA likewise, transitioning now for for level one, RTI into OT. Occupational therapists can do the same thing at a level one, level one area you know, working with the teachers to train them, providing in services on sensory providing in services on fine motor development, teaching kids, or teaching, sorry, not teaching kids, teaching the teachers the steps to handwriting, or even just giving them the resources, the available resources, so that they may make the best decision on different programs that they can use. We can do trainings at several different levels. We could do trainings at the site level, you know, on their Tuesday afternoon meetings that they meet once a month. We can get in for that. Or you can even do it on a bigger level, at a district level. You know, those Welcome back days or the teacher professional development days. Those are, those are times when occupational therapy can provide a training. Likewise, an occupational therapist could also help to set up a either school or potentially a grade level screening for, let's say, kindergartners, you know, using some sort of screening tool that every kid in kindergarten takes at the beginning of the year, and then maybe six weeks into the year to see if there's been progress with some of those pre writing lines, pre writing shapes, and then steps toward being able to write their name. Those are a way to just kind of keep an eye on all the kids, and again, that helps you then determine where you need to help the teachers help the kids. So maybe all the kids are getting stuck with squares and they're not stopping their lines on time. Well, that's an area that you can then teach the teacher on some strategies so that they can incorporate back into the classroom, all right. And that brings us to level two, and I like to think of Level Two being at a classroom level. And so now in level one, we were looking at an entire grade level, or an entire school, or maybe even an entire district, you know, finding a program that the entire district could use to teach handwriting. But at level two, we're looking more at a classroom, and I'm going to use the I might use the term small group, because in comparison to a school, you know, one classroom is a small group, per se. And so for level two, maybe we are talking directly to that teacher to find out what her specific concerns are, or his specific concerns are for the classroom. And we're going to give the teachers again, give the teacher strategies based upon those specific concerns. So now again, using the square analogy that I was using earlier, or example, you know, maybe the entire school has difficulties with the kids stopping their lines on time when they're making squares, so their squares are looking more like, I mean, squares with lines coming out of all four corners. Anyways, maybe this teacher is having some difficulty with her kids rounding the corners of their squares. And so that's a different problem than the others. Well, now that's a different strategy from what the rest of those teachers need. And so at the level two area, we could potentially go in and co teach with that specific teacher and teaching them how to teaching kids how to stop and start, versus making one long line that ends up making a square look more like a circle, per se. Again, excuse my examples, but I'm just trying to give you guys an idea the difference between level one and level two. The other thing we can also do at level two is go in and do a screening of that classroom. And when I say screening of a classroom, I'm not saying we're going in to screen a classroom, but really we're focusing on one kid that we all know who that kid is. That's not the case here. We really are going in to look at a specific concern that the teacher has in the entire classroom. My favorite way to describe this one is when teachers come to you and say, Hey, dude, I just have, I have this really wiggly classroom this year. You know, I just don't know what to do. They're all really moving and groove in and and they just can't stay in their chairs. What do I do? And you know, this isn't a child specific problem. This is obviously a classroom problem. And so I'm willing to go in, observe the entire classroom, and then meet later and talk with the teacher. And so maybe it comes down to, I try and keep it a little simple. So, you know, I try and find the three most likely things that that we could implement to affect the classroom, and oftentimes it is, you know, finding the right size chair, the right size tables, and then providing some sort of movement breaks. You know, they're trying to have them sit down for 30 minutes at a time in a kindergarten class, and that just isn't going to happen, right? And so trying to suggest different types of movement problems, you know, animal walks in between centers, or using goat noodle or something like that. But that's kind of an that is a level two strategy, and many of you are probably already doing this. You just don't realize it's a level two strategy. It's talking with a teacher about their specific concerns in the classroom and trying to find a solution for that, because if we don't do that, then, well, what's going to happen to several of those kids? They're going to end up being referred, potentially for special education, even though all they needed, potentially was a correct size chair desk and maybe some movement in the classroom that you're now providing. All right? So level two, just to kind of sum it up, it's really working directly with the teacher, a specific teacher, really, because level one is working with several teachers at a larger level. Level two is getting it down to like one specific teacher or one specific group of children, all right? And that brings us to. Level three of the RTI system, and level three, again, I'm going to kind of start off with the academic side of this. What it looks like with teachers and the way that they do things. RtI level three is for those students that have received good instruction, maybe an educational specialist has come into the classroom to co teach with that teacher on ELA strategies, and there's still a small group of kids, two to three kids, in that classroom, that still aren't getting it. Well, now those two to three kids, maybe they go with two to three kids from other classrooms that are still struggling in ELA after the same after getting the same supports. So now those kids are going to go into a learning center or some type of small group that has a focus on English language arts or the area that they are struggling on. I hope that kind of makes sense. So basically, you're taking the kids that still aren't getting the work or still aren't understanding the topic that they're being taught, even though they've had, they've been taught at several different ways, are now going to a smaller group with a focus on that area. So now, as I transition now to OT, but what this looks like for OT? Again, I'm going to stay with the square, because we've already done it for level one and level two. At level one, you know, we had several kindergartner teachers saying, my kids aren't getting the square right. And then at level two, we had one teacher who say, All right, it's getting better, but they're still rounding all their corners. And so maybe we gave her some strategies, such as using stickers or something as a way to outline stop and start points. But as she did that, she realized, you know, there's still a few kids in my classroom that just don't get it. I mean, even when we give them stickers, they they don't get it. We've tried highlighting, nothing's working. All right? Well, I happen to have a pre writing skills group, potentially, that I'm working with, and she's going to send those two or three kids that are going to come to me, along with two or three kids from Mrs. Hernandez's class or whatever, and we're all working on this one or this area, that even after all the instruction that the kids have had in the regular classroom, still aren't necessarily getting as far as fine motor development, visual motor development. And in that case, this isn't an individualized education plan. We are not working on those student specific goals. We are working on the skills that these kids need in the classroom that they just haven't gotten, and it's just a little area that they're missing a little bit. And so that group that they're coming to, it's not designed based upon, I guess you could say that child's individual needs, but because we have this group, they're able to come to that group and hopefully get the needs that they need met. I hope that makes sense. Another example of this could potentially be like a social skills group for a handful of kids who are just having difficulty at recess, communicating, understanding, feelings, stuff like that, and are getting into maybe some trouble, or, you know, they're just showing high risk behaviors at recess. Well, maybe as an occupational therapist, you could provide a a social skills group that has lunch together and then after lunch, and talking during lunch and and going over different possible scenarios, role playing, stuff like that at lunch. Well, then they go out to recess and try to implement the strategies that are worked on. And again, this isn't an IEP based decision. This is a decision that the teachers and or parents have kind of understood. Hey, this program exists for all kids who may may need it, and so they are sent to that program as a way to just to get some of those skills. And I want to remind you, this is for kids, both on or off in IEP. You know they don't necessarily need to be diagnosed, not diagnosed. Sorry, they don't necessarily need to qualify for one of the 13 conditions to get an IEP in order to be a part of this. We're not saying the kid has a specific learning disability, and that's why they're not understanding how to get the square. We're just saying that this happens to be a difficult topic for this kid to pick up. Maybe they're doing a circle or, I mean, all the other things, great, but you're seeing that they're not getting that square, and that square is impacting their ability to move move ahead onto more difficult letters and whatnot. And so they need to get that and so that's why they're coming to you for a short time again, not saying that they necessarily have a a condition or a disorder, or anything like that, that they would need an IEP for. We're just saying that they have a few skills that need to be cleaned up so that they can get back into the general education on that same area and continue to progress. So to really sum up, level three of the RTI, I just want to say, you know, this is a targeted group intervention, and it's specific skill. Or skill area. And these kids, they are identified by the staff or the parent, and again, they may not be on an IEP, the groups that we're putting together, they're not individualized. They're more skill based versus individualized based. We are giving them the strategies to help mate meet that skill and I guess I'll get into it right now by the end of RTI level three, if they're still struggling, that's when the team, or the teacher, the parent, even yourself, if you're part of that team, working with that student, may want to think about referring for special education if they're still not getting it after they've had this much support. And again, maybe this is a once a week group or or twice a month group, I don't know, but it's not part of the IEP. And so that kind of sums up level three. And now I want to get into some specific examples of what level one, two and three interventions or supports could look like all right, so let's jump back into level one of RTI. If you remember, I did say that providing trainings was a good way for level one, either doing screenings at a school or maybe a specific grade level at the school is another good level one activity, as well as conducting centers or co teaching on more of a larger scale. When I say larger scale, I'm saying getting into all of the programs, maybe all three of the first grade classrooms, or all three of the kindergarten classrooms, rather than one specific kindergarten classroom. So I want to start off by saying I just kind of brainstormed a little bit, and I think these would be wonderful types of trainings that occupational therapists could do for teachers at either a school level or district level, and that could be maybe working with teachers, paraprofessionals or even bus drivers on understanding what autism is and how it may impact that specific area, whether it be, you know, out on the playground or in the classroom or on the bus, I highly recommend that if you're going to do something like that, get in touch with an active person in that area. Get in touch with another teacher and a paraprofessional or even a bus driver and work together, because you're going to need some of their input. You can't just go and present to a bunch of people without having their input. And so pair up with one of those, those people and put together a training, and then provide that training to that that group of people. Another area you know, that teachers would love to have information on is sensory processing. 101, you know, just a very broad overview of what vestibular, tactile and the proprioceptive senses are, and how they impact so many of the skills in the classroom. Again, you don't need to teach them about what sensory integration, everything that it is and how to treat you know, that's not their role. They're not there to treat the kids in sensory integration. They're just there to know a little bit about it and kind of say, okay, you know what? Understand that when you're saying, Oh, he's over regulated, what does that mean when that gets under regulated? What does that mean and why you're not giving a kid who's over regulated a trampoline that's gonna even raise that kid's arousal level even more. You know why you're trying to give them deep pressure, things like that that can be tangible and helpful. They really go a long way when you're working with those those teachers. Another one, you know, fine motor development and its relationship to handwriting, that could be a really simple training, you know, 30 minutes to an hour that you could provide after school. And then another one that I thought of was simple tricks to keep your kids on task. You know, maybe you're going over a little bit about ergonomics, a little bit about movement, you know, simple things like that, and how to incorporate movement throughout the day to help the teachers keep their kids on task. Also in that level, one area is screening. This isn't something that I have done. I've never been able to conduct a screening at the kindergarten or first grade level. That's probably where I would do it, maybe preschool. I've never had the ability to do that because it does take a lot of work. It really does, and it's hard when you have a full caseload. But what I have done is been able to work with teachers and administrators to identify a tool, and in this case, it happened to be Handwriting Without Tears or or learning without tears, as it's now called, but I helped them to identify that tool and how it could be used. And eventually, all the kindergarten and first grade teachers were using that tool, and they were doing the screenings at the beginning of the year. So it was fantastic. And again, all I had to do was kind of put together a little bit of a training and let them know the options that were available, and the teachers, you know, they had the data showing that their kids weren't progressing in handwriting. So it was really easy for the teachers and myself, working together to share with the administrator and say, Hey, we need this program. And then the last area that for level one, again, was conducting centers on a larger scale. Scale. And again, when I say larger scale, I mean kind of doing it across an entire program. If you're doing it for one specific classroom, then it's more level two. But if you're going into each kindergarten class, you know, once a week or twice a month to work on just some developmental skills in there, that's still considered a level one activity, because you're reaching all the kids at that level. You're not only reaching a handful of them. You're not just reaching the ones on IEPs. You're reaching all the kids. All right, so level two, again, remember, as I said earlier, going a little more specific, a little more small group. And so when I say small group, again, I'm meaning like individual classrooms. I guess the best way to really describe this is when those teachers come up to you in the break room and say, Man my classroom, like, I just, they have something about their classroom, right? Like, man my classroom, they just, they just can't space. They they can't put spacing in between their words. Or, man, my class this year, they just, they're moving all the time. I can't keep them in their seats or, man, this year my class, I mean, you know, it's just, that's the perfect opportunity for this, you know, they say, Man, my class is having so much difficulty spacing. Well, that's the perfect time for you to offer, hey. Well, you know what? I understand that, you know, maybe there's some areas that I could potentially help As occupational therapists, you know, I can, I can break up the analysis a little bit and see where I might be able to help you out. And so you go into the classroom and you observe them, obviously, during a time where they're working on this specific skill or a task that includes that skill. And then you debrief with the teacher a little bit later, you know, you say, Well, you know, I was watching during writing time, and no one's using their finger to space. Or, you notice that a few kids, maybe they're left handed, and when they're copying, they can't see what they're copying because their left hand covers it up. And so simple strategy, you know, put that give them two worksheets so that they can have one on the right so that they're copying from the right hand side. Simple Strategies like that, you know that that they don't affect just one kid, they affect an entire classroom, and it's based upon your observation of that classroom. The other thing that usually that follows that as well, as, you know, debriefing with the teacher a little bit later or a consultation, is you could then also potentially co teach with that teacher, or do a small group in that classroom a center, and again, that typically needs to follow some sort of observation, so you know what help they need. And maybe so for a few weeks, you go in there and you work on that spacing. You know, every kid comes through your center in the morning, and you work on spacing for four weeks straight, and then you go back and observe again on the fifth week and say, Hey, we now have some data, or maybe they use that screening tool, and we have some data now that says, yes, that four weeks of centers did make a difference, and those kids are now progressing and spacing out Their words a little bit better. So yeah, level two, those are some decent strategies I think you could implement pretty easily, but I understand again, there are some concerns as far as time, and we're going to get into that in just a minute, but first we need to review level three. And I'm going to admit level three is the trickiest, and it's one that I have yet to master, or really even take on completely, because it's tricky, in the sense that it almost looks like what we're already doing when we pull out small groups, because it is working with a small group. However, the difference between an IEP small group and an RTI level three small group, is that in an IEP, we have evaluated the students. We have seen the specific areas in fine motor development, visual motor development, visual processing, sensory we know the specific areas that these kids need assistance with, and so we put them in a group with other students that have the same type of difficulties, and we're working on those, those skills, sometimes from a top down, sometimes from a bottom up model, but in an RTI level three group, we're targeting a specific skill in the sense, going to go back to using the spacing right Now, the spacing in between words. Now these kids, we know they're coming to us because their teacher, their parent, the administrator, whatever, said, Hey, this kid has some difficulty spacing, spacing their words still, even after we'd done so much with them. And so they're coming to this group specifically for spacing. And now we haven't assessed them. We don't know what their visual motor abilities or visual spatial skills look like, but we know they're having difficulty with the spacing of the words, and so now we have, you know, five kids maybe that we're working directly on that, and we're using a very task oriented, top down approach, you know, we're just trying to hit that one skill, because that's the area. Area that they really been identified in as needing help with. And so that's kind of how it's a little bit different. But again, you can kind of see how it looks similar and how it can be a little difficult to interpret. I guess. You know, my kid is not on an IEP, but they're going to a small group out of the classroom. You know, that doesn't necessarily always appear Correct. I guess you could say so. It is a tricky one. It is one that I have not mastered. I do think it is something that could potentially help with eliminating unnecessary referrals, per se for occupational therapy. But I do think, because your your groups need to be tailored to, you know, the screening tools that were done in level one, how else are you going to know what, what type of program to run? You need to have a screening tool. So if you don't have a solid foundation and RTI for levels one and two, then level three isn't really going to ever happen, because you have to go through level one and level two to get to level three, and so it's hard to develop a level three or even get to where you're doing level three, RTI, if you don't have a solid foundation of level one and level two. And I think that's part of the reason that I've never gotten there before, is because, yeah, I've dabbed into level one. I've helped kids and teachers in the classroom, co taught like a handwriting type of program for a few weeks, but it was never consistent and solid enough that we were able to kind of move up the ladder and eventually get to level three. So again, I started this podcast not to say that I am the greatest ot in the world, but to share with you my struggles and what I've learned throughout my school based ot career, and it's difficult, and it takes a tremendous teamwork, and you really have to work with your administrator as well as the team, including your teachers and even your parents, to get there. So that's my talk about level three real quick. But I do want to now dive into what I'm doing right now, as far as trying to help myself eventually transition into more of an RTI based model, because right now I do have a very caseload heavy model. I have kids that are once a week, some kids that are twice a week, and they're individual. And when your schedule is completely full with individual sessions all week long, you know, from bell ring to Bell, bell ring to go home, then you can't sit in RTI. And so I'm going to share with you just a few tips or a few things that I'm doing right now to try to kind of flip that upside down a little bit and get myself some more time. So stay tuned. All right, so it sounds like I'm in the same boat as many of you. You know, we have a caseload that, like, as mentioned a second ago. I'm seeing kids from the time the bell rings to the time the bell rings, basically for the kids to go home, start Bell, to finish bell. And that makes it obviously, very difficult to do. RtI level one, you can still do because you can do trainings, right? And a lot of that can occur after the kids have gone home. You can put together a training after the kids have gone home. You obviously will be presenting your training after the kids have gone home, or during a non pupil day, or whatever. But other than that, level two, level three, I mean, you have to have the kids in school to be doing level two and level three, even parts of level one. And so you kind of have to to work towards your caseload. I don't want to say reduction, because that's not the that is not the case. But in the long term, you have to be thinking that RTI is going to help reduce your caseload, in the sense that if you're doing RTI, hopefully you're going to be able to prevent occupational therapy referrals, right? And so that's kind of the goal, is to get to kids before they before they might need a referral for occupational therapy. And so have a few strategies here that we can use in order to try to work our way toward using more RTI and spending more time on RTI to be effective, so that we can do that prevent, prevent referrals. And you know, the ones that may take up more time than they actually take up to help the student. But before we get into that, I want to take a quick moment to take a break. I'm getting a little restless. Over here, my dog, TJ, over here, is also getting a little restless. He's shaking his toys and wants me to play with him. So let's take a quick break right here. Move about a little bit. Get your wiggles out if you need to press pause, take a break. Check the social media I really appreciate it. If you left me a positive review wherever you are listening to this podcast. If you're able to do that on Apple podcast or some of the other networks, really appreciate that. Or just shoot me a social media message real quick and give me a fist bump or thumbs up or something and say hi. But. Yeah, just take a quick brain break, and then we'll get back into it right now with a few strategies that you can use to facilitate progressing in your own RTI program. So all right, let's get back into it. My first strategy here is start with educating. Figure out, you know, one or two teachers that understand what OT is, and they find you as being a valuable member to, if not the IEP team. But they they just personally believe in what you have to say. They think that everything you have to say is a good idea. They've taken your strategies and use them and implemented them, and, you know, try and take it to the next step, see if they'll let you come in and observe their classroom and consult a little bit and talk together, talk together afterwards, and see if there's not some strategies that make may even better help them. I mean, right there, that in itself, right there is a tier two, tier one strategy, you know, getting into the classroom, observing and then collaborating and consulting to find out where we can improve even a step further from that. I mean, it's a level one strategy, but see if they're willing to work with you on creating an in service, you know, maybe a teacher and yourself, especially if it's like a special education teacher who has to do a lot of behaviors, maybe they're willing to do a sensory and behavior in service for other special education teachers with you, that'd be great, right? And there you go. You're starting that level one process, and by observing in their classroom, you're starting that level two process, right? Another thing you can do as an IEP team member is identify the students that are making progress and can be seen in the classroom. And I understand that we're going, you know, we're trying to talk about RTI here, but again, we're trying to flip our caseload in a way, right? And so find the kids that you can see in the classroom, that you can work with in the classroom and make progress toward their goals. That way you are getting into the classroom, you'll be able to befriend those teachers and show them the value that you do have, or that you can provide in helping those students, and not to mention, but you'll also be in the classroom, and so you can see the other struggles that kids are having, you can see the struggles that the teacher is having, and you can continue to build those relationships with those teachers By pulling the kids out of the classroom. And I'm not saying that's a bad thing. There are definitely kids that need to be pulled out for therapy services, but we miss a lot of the context that they get when they're in the classroom. And so if we can push in, not only can we potentially help that kid, but also we get to see the dynamics of the individual classrooms on campus and get to know the teachers a little bit better. Another opportunity to take advantage of is during IEPs. That can be an opportunity to show not only what we have done for a student, but what we can do for a student, and potentially even a group of students or an entire classroom. And you know, it can be difficult to show our administrators what we can do. Oftentimes, they kind of know what we're supposed to be doing, but they don't know how we do it, or what we do in the in the classroom or in the therapy room. To make that happen. So take advantage of your IEP meetings and let them know what you've been doing and what you can do and what you could even do in the future, given more responsibility in the classroom, working with the teachers. And the final strategy that I have for right now is to go to staff meetings. And I want to share a little story about that, because I've been in OT now for seven years, and I think last week was the very first school staff meeting I have ever gone to. I have obviously gone to special education meetings. I've gone to hundreds of IEPs. I've gone to occupational therapy meetings. I've gone to district level meetings, and when I was at a different district, but I think in seven years, this was the first time I went to a a school site staff meeting for teachers, and I took a lot away from it. You know, you can't know what the school is focusing on unless you're going to meetings like these, and you need to know what the school is focusing on, to know what, how you can help in that focus. And you know, if, if the entire school is focusing on math, and here we are trying to focus on, you know, language arts. Well, we're already a kind of a step behind because, you know, they're trying to focus on math. And so this week, I found out my school's really focusing on positive behavioral intervention strategies this year, PBIS, in fact, they're kind of moving from tier one, potentially up into tier two. And so I was like, hey, well, first of all, they're already talking about RTI, right? And secondly, it's, it's about behavior, and OT is inherently intertwined with behavior. And so now I know going forward, I know the topics that I need to talk about, and the areas where I. Can help out with behavior and sensory and potentially using different type of mindfulness activities and stuff like that to influence behavior, and I can have an impact on that. And so I think you guys have probably heard me say, you know, I don't I try not to bring work home, but this time, it was totally worth it, because I went to a staff meeting and I learned a lot about my specific school, or one of my three schools, and it was worth bringing work home this today because or this weekend, because now I know going forward what more I can do at the school site to help them and to, you know, kind of catch their ear on different things, how I can help them with So, yeah, that's what I have today about RTI. I hope that gives you a better understanding of the three tiers of RTI. There are some people adding more tiers, tier four. Some people do say that RTI tier three is an IEP. I think I said earlier, I don't necessarily agree with that. I think it's it's before an IEP, or I shouldn't say, before an IEP, but it is not part of an IEP. It is a general education function still. And I think OT is just getting into RTI, but I think it is where our role is going to be going even more so more on the consult slash collaborative side, versus the individual treatments, there's such a push to keep kids in the general education classroom as much as possible, and through the RTI we could potentially, through the RTI method, we could potentially do that and help out the teachers to have more strategies for the kids, and even if we're going into the classroom. I mean, you think about it, this is what RSP teachers and aides do often. They go into the classroom and they work with the kids in the classroom in their natural environment, right? Isn't that what we're all about, natural environment? And so I think that's something as OTS that we should be looking forward to and figuring out how we can provide a more supportive role in that aspect. So yeah, this is my episode on RTI, and sure, we'll talk more about it in the future, but I know we've talked a lot about it in the past, but we hadn't really, like dove into it deep to figure out exactly what RTI is. And so I hope you enjoyed that. I am really looking forward to hearing the email responses from this. I know you guys are going to have questions. I know you guys are going to have more wanting more specifics. And so I'm working on something for that, and I'll let you know more about it, but feel free to email me, let me know if you have any specific questions about this. And, yeah, just keep on going. I mean, right now I'm working on a presentation that I'll be presenting in December for my teachers. Again, it's going to be kind of that sensory processing 101, type of training for all the special education teachers, I think, at two or three schools. So that's one way that I'm doing level one, and I'm hoping to continue to build off of that. It was more at my previous district that I got to do some more level two type of the stuff, but I'm trying to get that going here. And one way, like I kind of talked about earlier in the way that I'm flipping it, is I'm looking for those students that I know that I can be assistance to them inside the classroom versus pulling them out. And by doing that, I'm going to be in the class more making progress with those students, but also seeing the concerns of the teacher and the other students and the paraprofessionals, and working with them to help the kids in the classroom on a daily basis. So yeah, that is my 40 minutes or so on RTI, I hope you all enjoyed it. This has been a great episode. 42 I appreciate you all listening. Thank you so much for helping me reach 100,000 downloads in just over 600 days. It's been fantastic, and I look forward to many more. Take care and have a great rest of your week. Bye bye.     Amazing Narrator     Thank you for listening to the otschoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com , until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 41 of the OT Schoolhouse Podcast. Have you ever gotten halfway through an assessment and realized you could have saved yourself so much time if you had just done a little homework? If so, you may want to check out this episode. ​ In episode 41, Jayson talks about the AOTA Occupational Profile and how it can be better suited to meet the needs of school-based and pediatric occupational therapists. We will look at why it is important to build an occupational profile and how to best do that in the schools to save you time and energy! Plus, subscribe to the OTSH Email list below to get your very own copy of the Occupational Profile For School-Based OTs discussed in Episode 41 of the OTSH Podcast! Links to Show References: OT School House - School-Based Occupational Profile Use this link if you would like to read more about the OT School House Occupational Profile for School-based OTs​ American Occupational Therapy Association - Occupational Profile Use the link above to head over to AOTA.org and download AOTA's version of the occupational profile document American Journal of Occupational Therapy - Occupational Therapy Practice Framework ​ Occupational Therapy Practice Framework: Domain and Process (3rd Edition). Am J Occup Ther 2017;68(Supplement_1): S1-S48. DOI: 10.5014/ajot.2014.682006. Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript   Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host. Jayson Davies class is officially in session.     Jayson Davies     Hey everyone. And welcome to episode 41, of the OT school house. My name is Jayson Davies, and I am your host now and forever. Thank you so much for joining me wherever you are today. I really appreciate it, whether you're at the gym in the car on your way home from work or maybe you're on your way to a conference in a plane. Just thank you so much for joining me today. Today, I have something really special that I want to share with you all after we take a look actually, at the occupational therapy practice framework published by a OTA. Of course, you can get that for free on the Asia ot website. You don't even actually have to be a member of a OTA in order to access that one. It's one of those, like powerhouse articles that they want everyone to have access to. So it is free. So we're going to look at a small section of the otpf today, but first, I want to start off by sharing a little bit about what's going on with me, as well as ot school house as a whole. So first of all, you might be able to hear it a little bit in my voice, but I am trying to get over this nagging cold that's just been kind of having me struggling to stay awake and struggling to get stuff done for the past week or so, and so I'm trying to get over that, but I'm here being optimistic and just trying to get some stuff just put down on the mic so that we can have another great episode. So we're gonna get through it today. Please excuse my voice, but we'll get through it today, next time, we'll come back stronger than ever. But even more so, I want to say that you know this, this start to the 2019, 2020, school year has just been a little bit of a struggle for me. There's just so much going on. You know, I've got a large workload, caseload, whatever you want to call it, and that's another episode that I want to have with us at another time. But, you know, it's just been a lot on my plate at school, and then between that and some other roles that I've taken on, be it at OT or just with the OT school house, man, it's just it's been a little strong. It's been a little bit a little tough for me this, this past past few months. So I just want to put it out there, but I want to say thank you so much for all of your support. I appreciate all the emails, all the Instagram shares, all the Facebook posts that you guys I mean, I I need to take a picture of this, but I've got a little wall going on here that I've started just with some of those emails that you guys send, or whatever that say. Thank you, just because it keeps me going, between you guys and my wife and the support that I have around me that just keep pushing me to do this, sometimes it's a struggle. After coming home from a long day of work and hopping on the mic, I love doing it, but sometimes it's a struggle to get started. Once I get started, there's no stopping. But yeah, it's just been a little a little tough this past few months at work and with everything going on. But with that said, I am working on something very special for you all, actually, and I can't wait to have this done. It's going to be an actual webinar. Course I'm putting it together. I'm hoping to have it done by January, it's gonna be somewhere around eight videos or something like that, and it's gonna be all about school based ot it's gonna be great for you guys, and I can't wait to get that out and share more information about it. I'm just not ready to do it yet, but hopefully come January, I'll have something super special for you, and you guys will be super excited. I can't wait to share it with you all. Yeah, I've been working on it for a while now, and it's going to be awesome. So with that, we are going to jump into the occupational therapy practice framework, also known as the otpf, from the A OTA, and as ot we're going to look at a very small section of it. Some of you who have subscribed to the OT School House website on not just the podcast, but also the website, you've already, at least, probably seen it. You may have you may have downloaded it. You may have skipped over that. A lot of people I know join the website to get the gray space paper. Another thing I haven't mentioned in a while, but it is a paper that you get for free when you subscribe. But the other thing, or one of the other things that I also give away for people who subscribe to the website, is called the school based occupational therapy profile. And so that's what I want to jump into today, the occupational profile, and what that is, what it looks like, why we do this and how it can help you and your practice in your evaluations and moving forward into your treatment. So we're going to get into that right now. But first, I want to review just what the otpf, the occupational therapy practice framework, says about the occupational profile. All right, so many of you are probably familiar with the concept of an occupational profile. You've heard. Of it. You kind of know that it's a snapshot, if you want to call it that, of our client or of the student that we work with. But I want to go a little bit deeper first by starting off with what the otpf actually says about an occupational profile. And so I'm going to read this verbatim real quick from the otpf, and it says that the initial step in the evaluation process which provides an understanding of the client's occupational history and experiences, patterns of daily living, interests, values and needs, the client's reason for seeking services, strengths and concerns in relationship to performing occupations and daily life activities, areas of potential occupational disruption, supports and barriers and priorities are also identified, and that is within the occupational profile. So it really is this all encompassing picture of what's going on with our student, what are the strengths, the weaknesses, what is also going on in the world of that child? You know, what's going on in the classroom, at recess, at lunch, things like that. What does this child need help with accessing? You know, there's a difference between this is where we get into that medical versus educational model. As school based OTs, we are paid by taxpayers. I mean, if you go all the way up the steps, right? And so there are some specific areas that we are to look at. We're not a medical based ot we are looking at the student's ability to get to the educational curriculum. So that's something that we need to take into consideration. The Occupational Therapy profile. You know, one thing that they do say in the otpf again, is that just because the student may be your client doesn't necessarily mean that all the information has to come from that client or that student. It says that you're allowed to get other information from the family, friends or other permanent people in that that person's life. And so again, not just getting information from the student. Of course, if this is a I don't know, a kid, maybe older than third grade or around that age, you can get information from them, but you should also, again, get information from the parent, the teacher. Maybe there's noon duty aids, or a recess or lunch aids, a principal, anyone who has some input on the student that can help you develop your occupational profile. So I'm going to go into some of the categories right now that they actually have on the A O T, A occupational profile. They have four sections titled client report, environment, context and client goals, and in these areas, you know, we're asking, Why is the person seeking services and and what things are they successful in, versus what are they not feeling successful in? What are some of their values and their their occupational history, their life experiences, and then also performance patterns, such as the routines, the roles, their habits. You know, all those things that we look at, are they able to succeed in these, these important aspects of their life? And then you start to look at the environmental factors, and that's, you know, the physical factors, such as, you know, where they go. Can they access the buildings? Can they access the school environment? Can they access the playground, and then also in their social environment, you know, what are their social skills potentially look like? What does their their network look like? Do they have friends? Do they not have friends? Are they scared to come to school? Potentially? What does that social environment look like? And then you also have their context, cultural, personal, temporal, and one that I really appreciated when I saw this is virtual. Obviously, virtual is a huge context. We're using a virtual platform right now as you listen to me. So the virtual thing is coming. Telehealth is coming. It's already here, actually. So virtual is something that we definitely need to look at. And then, of course, client goals. And you know, we wouldn't have a job if it didn't come down to client goals. And we're going to get a little bit deeper into the client goals in a minute, but I just want to say that is somewhere that we definitely need to be looking at. And I think that's one area that sometimes we forget to really look at. We kind of think, What is our goal for this? For the person, but we need to be considering what their goals are. So yeah, we'll get back to that in just a minute. So those are the areas that a OTA really thinks that we should look at when we're when we're conducting an occupational profile. But as I read it and I look at it and again, all of you can access the A Ota otpf online. It is a free download for anyone. You don't have to be a member to get this one, because they really, I mean, it's basically mandatory if you're in some sort of medical field, because I believe it's a requirement to get reimbursement. Is using the occupational profile. Of course, being in schools, we have a kind of different mindset, like I was talking about earlier. We're. Funded by the taxpayers, not necessarily funded through insurance, but we still need to take into consideration this occupational profile. But again, if you've ever seen it, if you haven't, I encourage you to go look at it, because when I read it, when I look at it, it doesn't feel like it is as applicable to what we are doing in school based occupational therapy, as well as in pediatric occupational therapy, because things change when you're working with a child or a student. You know, this is a very young mind that we're working with, and oftentimes, I mean, all the time, there is someone else, there are other people that are often giving us information that are that is not the child. And so when I look at the occupational therapy profile from a OTA, I kind of see this, this picture. I kind of get the mindset of a therapist talking to the client and getting a one to one relationship with them, and getting a lot of information from that client, maybe some record review, but it doesn't really have the tone of getting everything from all the people around the child and student and so actually, I've had this for a while. Like I said earlier, I developed it about two years ago, but I want to make sure that you all know about it and have access to it, because I'm not, because I'm now going to go over kind of my adaptation for this that I created. And it is, I call it the school based occupational profile, because I just adapted it slightly to make it more school based relatable. And, you know, I do want to share this with you all, and so I didn't make huge changes. I just made it seem more appropriate for school based and pediatric therapists and models. So I'm going to share that with you right now, actually, and you'll see there's not a lot of changes, but there are some significant, small changes, all right, before I get into that, I do realize that many of you are very visual and that you like to have something in front of you when someone's talking about something. So before I get into the details of this, I do want to let you know that you can get this occupational profile for school based. OT is completely free. All you have to do is go to OT schoolhouse.com , forward slash episode 41 if you're on Apple podcast or some of the other platforms, there's a show notes link right there. Just click on that. It'll take you there. You'll fill out the form which subscribes you to my website, which is just for emails and such, completely free. And you will actually get a link in your email about how to access the this form that I'm talking about. So if you want to press pause here real quick, get that and then come back so you have it in front of you. Now is the time to do that otherwise. Go ahead, listen on, and I will share again at the end of the episode how you can get access to it. So let's jump into it. So just like the occupational profile from a OTA, I have four separate overarching categories, I guess you could call them, and that is student history, environment, context. And instead of client goals, I said priorities, just because I like that word a little bit better. And there are so many different priorities coming from different people. And you'll see when I get down to that, why I broke it down into priorities. So first, within the student history, there's five different kind of questions, slash areas to look at, and the first one is, who's referring the child for ot services, and what are their concerns related to school engagement? So that's the first thing we need to know. Who is saying, hey, this student needs to be referred. Is it the parent? Is it the teacher? Is it someone else, the principal, the assistant principal, maybe it's coming from a counselor or school psychologist, and what did they what did they see? Obviously, a teacher or a parent is going to see something that's so much different than a school psychologist who has done like standardized testing with the student, and maybe they saw some visual motor skills that were lower while the vision processing abilities were high, and so they say, okay, maybe there's some fine motor delays there, versus the teacher might say, you know, their handwriting is just horrendous. Or maybe it's the parent that's saying he just can't get to school in the morning. We can't get him up. We can't get him moving. He's like, terrified of coming to school. Whatever it is. We need to know who's referring that student, or maybe it's the entire team, and they all have a general consensus of a concern, and we need to know what that concern is, because that's what we're, in theory, really going to hone in on, on our evaluation. The next area of that is, what are the students strengths in school? So what can the student do in school? What is he capable of doing independently or with very little assistance. Keep in mind that, you know, a lot of kids need help with something, and just because a kid needs a little bit of help with cutting doesn't mean that that can't be a strength relative strengths versus relative weaknesses. But again, strength based approach so that what are the students strengths? The next item I put here, again, under Student history, is, how does the student feel towards school? What does the student enjoy about school? You know, that's something important, whether it comes from the student or from his teacher or the parent, again, anyone around the student. What does that student enjoy? Does he enjoy? I'm going to use he just because it's easier for me to stay on one track, but does he enjoy going to recess, or does he like Is he scared of math? Does he enjoy reading, but not like writing? What are the areas that the student enjoys and again, is he able to enjoy school as a whole? I often say, as educators, you know, our first job is to get that student to want to come to school, just because, you know how much, how much work are we really going to get, or how much learning are we really going to get out of that student if they just hate and dread being there. So what does the student feel about school? The next area is occupational and medical history, both inside and outside of school. Often, you know, we look at the vision and hearing screening that is conducted, but we need more than that. You know, we need to call the parent and say, Hey, what's going on? How was that child's birth? Was everything normal at that point? Has the student gone through any therapy? Has the student had any traumatic events in their life, surgeries, extended periods in the hospital, long sicknesses, or maybe there's a death in the family, or something that can have that that just mind changing experience. Maybe it's a specific diagnosis that we would never have found out just by looking at just other reports within the student's educational records. So we need to call the parent. We need to find out some occupational and medical history. Occupational history, you know, has a student, did they meet their developmental milestones on time? Are they mostly independent at home, getting dressed? Are they able to do that thing, those types of things, or do they need a lot of help? Obviously, of course, we're looking at school based occupations, but some of those occupations that we find out about at home kind of gives us a more rounded picture of the student, and it might lead us to kind of have some ideas about what might be going on if they're having difficulty sequencing at school and they're having difficulty figuring out how to put their shoes on the right way and how to tie their shoes. Yeah, you know, there might be a correlation. It might be something going on that's affecting both areas, all right. And so the last area that I have here under Student history, that we really need to look at is school related history. And you know, that includes everything from RTI services response to intervention or MTSS, if you want to call it that, what have they interacted in in school? What have their IEP services and goals look like? You know, what types of services do they actually receive? Are they in ABA or do they receive ABA services? Do they have a one on one aid or not? Do they have goals related to fine motor skills, or are their goals more academic and sense? How old is the student? When did they first start school? Have they been in school since the preschool age? Or did they not start until they turned five in kindergarten? All these things are important also. Did they have an IFSP or, I mean, maybe that can be a little hard to find out, but the parent will be able to tell you, did they have an IFSP, and why, and what was the basis around the IFSP? Did they have a diagnosis already? All these things are school related history that are so important also, you know, has the student been held back a year for some reason? And if so, why was it because of grades immaturity? Why did the parent or the school decide to do that? Those are all very important school related information, also grades. You know, those can be a little hard to track down sometimes, but if you can get either most recent grades or current grades, all that that helps in developing your report and mindset for what this student potentially needs help with All right, so that wraps up the student history portion of the occupational profile for school based OT, but it leads us into the environment factors. And again, this is going to look at physical environment as well as social roles and expectations. And there's a reason we look at physical environment and their social roles after we do the student history or look at the student history, and that's because and that's because, again, up in the student history, we looked at, why is this student being referred for services? And so that's the real important part, right? So maybe it all has to do with desk work. Then when it comes to the environment, we really need to see that student at their desk doing desk work. And what is the concern, and what does the environment look at look like at their desk, you know, is the chair the right size? Is the desk the right size for both the student and the chair? Is he able to see the board, or is he is his back to the board and he has to turn around to look at it? What are those factors in the classroom that could be preventing this? Student, of course, when we also go back and look at the medical history, there might be something there as well. You know, depending on the diagnosis the student may have, maybe they have auditory sensitivity, and so we need to make note of how loud it is in the classroom, or what's the visual field of sight for that student, what is he seeing every time he looks up? Is he seeing a rainbow on the wall that's just distracting the heck out of him, or is he looking up and seeing the whiteboard and being able to focus on that? Maybe there's a concern out at the re out at recess, and so we need to look at the recess equipment. Is the student able to access the recess equipment? Maybe there's adapted tools that the student is already using. We should be able to note this. We shouldn't be going into an IEP and having to ask, Oh, does the student already do this? Have you tried this? No, we should already know that. We should have asked the teacher already, or the principal or the parent, has the student ever tried adapted pencils, adapted scissors, pencil grips, whatever. You know, there's so many things out there that we can get by having conversations with people in the other area of the environment is the social roles and expectations, and again, both in class as well as outside the classroom, what is the peer and adult interactions like in that classroom? Does the student isolate himself or herself from others, from the teacher? You know? What are they able to Who are they able to get help from? You know, teachers will often teach a student to ask a peer before they come up and ask the teacher, so, is that happening? Or does the student refuse to talk to anyone around in the group? Are they able to follow directions? If so, how many directions are they able to follow? Can they simply get up, push their chair in and go line up. Like do they need multiple cues to do that? Or is that something that they can do with one cue? Also the difference between a novel and a familiar direction. You know that one that I just mentioned, getting up, pushing your chair, going lining up. They've been doing that since kindergarten. But what about something new? I don't have something off the top of my head, but there's always so many things going on that are new to a classroom, you know? And so we need to, hopefully we can see that during an observation. The next area is context, and this is an area that gets a little more personal, you know, we're looking at the cultural context, personal context, temporal context, and again, virtual context. And so cultural is one that's a little tricky to get into, but there are things that we can ask our parents and our teachers about. And when I say cultural, I don't just mean like the student's background, but also the culture of the classroom. What does that look like? Do they have a good culture? And this kind of goes in with the social roles and expectations. But again, are there classroom jobs and things like that going on, or does the teacher expect the student to be at their desk all the time, personal context as well? You know, just kind of this kind of goes back a little bit to the history. But you know, what does the student like dislike at school? Things that just kind of odds and ends that you kind of want to get from a typically, that'll come from a student interview, if you can get it. And then there's the temporal factors, you know, what is the student's age at this time, as well as their developmental age in relationship to their peers. You know, do they seem immature or very mature? Do they enjoy talking to their peers, or do they need the structure of talking to an adult? And then the last one is virtual context. And again, this is just becoming so important to look at. How are students able to use and interact with virtual components. You know, a lot of times I see kids getting put onto a computer, and they don't have the attention span to either a not press a button until after the question has been read to them, or B, they just like spam everything. Or they don't even know how to get like to the actual program that they're supposed to be on. And so that takes a lot of a lot of assistance. And do they have a one on one aid to help them with that? Or do they have a teacher that has a small enough class to be able to help them to do that? Is there something that you as the OT can help them with virtual Of course, we're seeing it so much more in schools, and it's a trend that we're going to have to start getting used to, all right. And so the last area of this one pager, the occupational profile, is priorities. And in the OTs version of the occupational profile, they just have it as client priorities. But here, I thought this was extremely important, and so I really broke it down. I broke it down into three specific sections, and that is student priorities, parent priorities and teachers priorities, because everyone has a different priority, it seems like. And you know, like I was saying anywhere around third grade, even even slightly younger, if they're. 30 into what's going on, a student can give you their priorities for school. They can tell you what they like, they can tell you what they don't like. They can tell you what's important to them and probably what's not so important to them. Even kindergarteners can do that for the most part. But as school based OTs, and generally, as any ot working with students or kids, we also, of course, have to take into account the parent priorities. And what does the parent want for their student? What is important to that parent? Does the parent care that their handwriting is messy but legible? Does the parent not think that their handwriting is legible at all? Does the parent see them not able to access the curriculum at all. Or do they see them? You know, they're doing okay and PE they're doing okay in math, but language arts are just they're just not gonna they're just not getting it, and they don't understand anything. Same thing with the teacher. What do they see? What do they see as a strength? Do they see this student as being able to learn in the classroom? Or do they feel already at this point, when the student's being referred, that they're at their max and they need help, maybe? Do they think that the student needs to be potentially worked individually with? Or does the teacher have priorities such as maybe us coming into the classroom to teach them strategies? The reason it's so important to start here at the beginning of our evaluation, getting those priorities is because then we're more likely to have success at the end, when we know what they're looking for, and we know what type of treatment or what type of help those people need, maybe again, the parent their priority is To keep that kid in classroom, in the classroom, and the teacher's priority is to say, or they're saying, I need help. I need the resources in order to help this kid. Well, then why are we going to then go into the into the IEP and recommend that the student be pulled out? I mean, the parents priorities are to keep the kid in in the classroom, and the teacher says, I need help, so why not go with some sort of collaborative model in the classroom, and then maybe the students priorities are recess. But you know, of course, that's why the occupational profile is so important, to get everyone's priorities. Because, of course, the kid may be a kindergarten, third grader student, so we need to get the priorities of everyone, and we need to take those in mind when we're writing up our evaluation and making our recommendation for goals and services. All right, I hope that makes sense to everyone. I know you may not have it right in front of you right now, but this is free on my website, and it's going to continue to be free, and I want you all to have access to it. So in order to get that go, ahead and head over to OT schoolhouse.com forward slash episode 41 that is the show notes for this episode. I will have there a little form for you to sign up and access the occupational profile for school based OTs. And if you are already a subscriber to the OT school house and you're just like, Man, I need to get my hands on this. But I don't remember going to your email first and just type in OT school house, it'll be actually a link in the first email you ever received from me. So if you can find that, then go ahead and click on the link to get your freebies, and you'll be able to access it. If you can't find that email for whatever reason, go ahead shoot me an email. I will respond to you with a link in order to get that download. Again. It's called the occupational profile for school based OTs, and you will be able to access that at ot schoolhouse.com , forward slash episode 41 Yeah. So that is the gist of what I wanted to talk about today. I do want to really reinforce that this occupational profile should be the first thing that you do when you start an evaluation. You know, you get that referral, that assessment plan, and you're like, all right, I got 60 days to get this referral done. Ideally, of course, ideally, trust me, this doesn't happen to me very often, but ideally, you start working on that occupational profile in the first week, you call up the parent, you send the teacher a questionnaire if you need to, or you somehow get them on the phone. I know they're busy, but you somehow get on the phone with them, or stop by their classroom and find out what those concerns are. Is because too often I've been in the situation where I've done it backwards and I've done maybe the bot, you know, I do the bot too. And I'm like, Wow, this kid did really well in the bot too, because I didn't get my occupation or profile first, and I didn't realize that fine motor skills weren't the concern. Oh, well, duh. Why am I doing the bot too? If it's not fine motor skills and visual motor skills is a concern. No, I went ahead. I go through I talk to the parent, I talk to the teacher, and I find out, Oh, it all has to do with sensory regulation in the classroom. Student can't focus to save their life. And now, well, I'm going back and I'm doing something different. Now, I'm pulling out the SPM, or the sensory profile, and I'm going into the classroom and I'm. Looking at the observations that I should have done two weeks ago, and if I would have done that two weeks ago, then I would have saved myself a little bit of time with the bot. And so that's where this occupation profile can really help, not only to, you know, get it right, to help the student the most, but also to save you time, to save your energy, and to help you figure out what the next step should be, because once you know what that student's history is, once you know the environment that they're in, once you know all this context about the student, as well as the priorities from the parents, the teachers, the student, and of course, don't stop there, if you if you need to, you know, go to the assistant principal, Principal, counselor, psychologist, whoever's making that referral, you need to get them some input from them and get those priorities and then figure out, okay, what tools do I need to use in order to figure out where the concern is or the depth of the concern? It'll save you a lot of time. It'll help you get the best evaluation possible. And, yeah, I mean, it's just the way that I believe an evaluation should actually happen. And unfortunately, we get pressed for time, and sometimes we end up doing it backwards. And yeah, it's, you know, I'm not gonna sit here and say, Don't do it. Don't do it the other way. I mean, I'm gonna say, hopefully you can do it occupational profile first, but overall crunch for time. I've done it backwards, but just trying to tell you in advance, it it hurts. Sometimes when you do it that way, you end up doing more work than you need to, and then you're doing the evaluation, or you're rewriting the evaluation because of new information that you got that you didn't have before you started. So, yeah, I hope you enjoyed this. This is this episode was all about the occupational profile, specifically for school based OTs. It does overlap a little bit with pediatrics, but yeah, I hope you will go grab it at ot schoolhouse.com . Forward slash, Episode 41 it is just a one page form that you can print out and use it over and over again. Just put it on your clipboard when you go in for that observation and start to get some some notes from the teacher and and have it there when you call the parent. Yes, I do absolutely believe that you need to call the parent, or at least at the very minimal, send home some sort of questionnaire that helps you out with getting some of that information, even if it's an electronical questionnaire that you can email out, but you need to somehow be getting information from the people that are involved in this student's life and school education. So yeah, that's all I have for you today. I hope you appreciated this podcast episode, it's been a pleasure being here for you all. I can't wait to see you all again in two weeks for another episode. So take care. Have a great week. Two weeks, and we'll see you next time. Bye, bye. Thank    Amazing Narrator     you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 40 of the OT Schoolhouse Podcast. In this episode, Jayson hosts the OT Dad, Billy Hatridge, to review an article titled "Hand Strength, Handwriting, and Functional Skills in Children With Autism" by Michele Alaniz, Eleanor Galit, Corina Isabel Necesito & Emily Rosario. This is a 2015 article from the American Journal of Occupational Therapy. ​ This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here! ​ Links to Show References: Visit Billy's website TheOTDad.com to see what he is up to. Be sure to check out his videos where he provides some quick handwriting tips using the Handwriting Without Tears methods. ​ Michele L. Alaniz, Eleanor Galit, Corina Isabel Necesito, Emily R. Rosario; Hand Strength, Handwriting, and Functional Skills in Children With Autism. Am J Occup Ther 2015;69(4):6904220030p1-6904220030p9. DOI: 10.5014/ajot.2015.016022. (Link to AJOT) Freebies! Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript   Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies, class is officially in session.     Jayson Davies     Hey everyone, and welcome to the OT school house podcast. My name is Jayson Davies, and I am your host now and forever. Of course, today we have reached episode 40. It's fantastic. I'm excited because, I mean, we're on episode 40 every time we kind of hit that milestone with a zero at the end, you know, 10s. It just feels really good. And so I'm happy to have all of you joining with me. I'm also excited today, because my wife and I, we went out and actually adopted a puppy. His name is TJ, because he's from Tijuana, I'll have to put a picture of him up on social media so you can all meet TJ. But he's been a handful getting to start training him and all that good stuff. So I've been a little lax on the OT school house, responding to emails a little bit. It's been a little crazy around here, but thank you for your patience, and I will have to introduce you all to him. You might be able to hear him walking around in the background. He's still a little anxious, so he's hovering around us. But anyways, today I am welcoming on a new friend of mine from Arkansas. His name is Billy hatridge, and he actually reached out to me with an article about handwriting and autism and how they go together. And you know, I thought you guys would probably like to hear it, so we're actually going to review that together today. The article is titled hand strength, handwriting and functional skills in children with autism. And so we're going to go over that here in a minute. But I do want to let you all know that Billy is a man of many hats, and today he is putting on his autism specialty hat, as well as his handwriting without tears certified hat, if you want to call it that. Billy is also the blogger behind The OT dad.com as he'll share a little bit more at the end of the episode. Just want to let you all know that you can go there. He has some actually pretty cool blogs. He kind of, well, you know what? I'm not going to share it. He does share with us a little bit about his story right up here front at the beginning of the episode. So have a listen. I hope you enjoy a little bit about the article. There's a link to the article. It is an Asia article. So if you're an A OTA member, you obviously have access to that. And there will be a link in the show notes. You can go to OT schoolhouse.com , forward slash, Episode 40. And yeah, it'll be really simple to pull up the actual article so you can read it for yourself, or just take a look at the charts and highlights. So without further ado, let me introduce to you Billy hatridge, occupational therapist from Arkansas. Hey there, Billy, how are you doing this afternoon?    Billy Hatridge     I'm doing good. Jayson, uh, thanks for having me.     Jayson Davies     Yeah, of course. You know, this is the first time that we're going to have a guest on today to share with us a little bit about a about a journal article. And so I'm happy to have you on so we can kind of do a little give and take about what we learned and what we liked or didn't like about this article, which is kind of cool thing that we get to do here on the podcast today. Yeah, I'm excited. Yeah. So before we jump into the article, why don't you go ahead and introduce a little bit about yourself in the OT world.    Billy Hatridge     Alright, my name is Billy hattridge. I'm an occupational therapist in the public schools of Arkansas. Been doing this for about six years now, 2015 I became a certified autism specialist to the International Board of continuing certification, continuing education standards. It's a mouthful, but then this year, I became a certified through handwritten about tears, and so I supervise a team of four OTs. We cover seven school districts which some of the secrets are real small. Might have like two or three kids in the whole district. We're talking about mountains in Arkansas, so it's a lot more driving than treatment some days. But yeah, it's good. I enjoy it. Wow. Okay,    Jayson Davies     so out here in California, we can actually only supervise it. Just got raised from two to three occupational therapy assistants. But I know from my experience, the more assistance you have, the more meetings you end up sitting in.     Billy Hatridge     Right it is, you know, this, this career change happened for me about a year ago when I went into just a supervision role. So seeing how different therapists do different things, as far as their treatment, as far as their approaches, and then being able to be involved in plan care, that means students, but the end of the work week, it's a lot more just reading through documentation, meeting with OTs and being in those IEP meetings. So that takes a majority of my work week.     Jayson Davies     Yeah. Alright, so today, we're here to review an article. It's called hand strength, handwriting and functional skills and children with autism. And if I remember right, this was from 2015 And real quick, just to give them their credit, the authors are Michelle Allen, is Eleanor, galit Marina, Isabel necesito and Emily Rosario. So I'm sorry for any of you, if you're listening and I slightly mispronounce your name, but they are the primary authors on. This research that we're about to look at. So, Billy, what, what did you or what drew you to this article?    Billy Hatridge     Well, you know, I mentioned earlier, you know, the certified autism and handwriting specialist. So this was like, right in that niche for me, in terms of both of those areas, because a lot of times, in my clinical view, I kind of separate those two. You know, I have my Spectrum caseload here, then I have my handwriting here. And so to see these two combined and see kind of the correlations that they found within the study was that was pretty insightful.    Jayson Davies     Absolutely. And so I'm going to let you review a little bit. I mean, oftentimes when we talk about articles, we kind of look at that Pico. And so what kind of population do they have in this article? Well,    Billy Hatridge     the population is looking at, you know, kids between the age of four and 1024, of those being typically developing, and then 27 of those children being on the autism spectrum, and several of their their typically developed children, I do believe, came from children of the staff there at the facility, is that right?    Jayson Davies     Yeah, I believe so. And then the kids with autism were actually kids that they were treating at the clinic, very much a a population that they had access to.    Billy Hatridge     Right? And and I know that they're talking about how they they kind of excluded several kids on the spectrum due to limitations in comprehending the instructions and the communication and the ability to to participate in the testing protocols that they provided.     Jayson Davies     Absolutely. All right, so that's kind of the population that we're looking at. And so this study, we didn't actually look at an intervention, but we did look at comparisons, and if you'd like to talk a little bit about what what they're what they were comparing.    Billy Hatridge     So what they're looking at was the pinch and grip strength and its relationship to handwriting and functional skills between both typically developing children and children with autism, and trying to figure out if there is a correlation between things like grip and pinch strength, and then the ability to write legibly and to be independent in those activities of daily living.    Jayson Davies     Yeah. And, you know, looking at 2015 when this research was done, you would have thought that maybe they had some norms as far as pinch strength and grip strength by time you got to 2015 you know. But when it came to children that with autism, they really didn't find anything as far as consistent scores or norms for kids with autism. In fact, I think some of the articles that they mentioned, like everyone was using a whole different way to measure this, and so there was no consensus on even how to measure grip strength. So they did reference that, I'm not going to go into detail, but they use, they used, a consistent way of measuring the kids strength, both with the the dynamometer and the pinch mechanism that they use. So,    Billy Hatridge     right? And I think we see this trend a lot in especially our OT literature, right is there's not enough evidence to back up kind of what we're suspecting. And so more and more research like this needs to be done, because one of the things they said here was that there's not consistent, reliable information on pitch, pinch strength norms for children. That's crazy to think about it, right. Like for us as OTs, we do so much pinch activities in the schools. And for this one, say, look, there's not enough reliable information on even knowing what those norms are. You know, if I were to sit down and test a kid on their pitch drink, I wouldn't have a clue. Wouldn't have enough evidence to base that off of and that's not just autism.     Jayson Davies     That's just kids in general. Yeah, that's just kids in general. That was just a typical population.     Billy Hatridge     So that's kind of amazing to me that, you know, it's 20, this 2015 Now I'm curious what that you know how much has changed, but in 2015 you know, there just weren't pinch norms for children, typically developing children. So.    Jayson Davies     Yeah, surprise, surprise. So going a little bit deeper, what other outcomes did they use to kind of look at the correlation between pinching and grasp, as well as the handwriting legibility.    Billy Hatridge     So, like I mentioned earlier, with the strength, they use the Preston Jamar hand and not dynamometer, and then the pinch meter, you know, those are the Patterson medical brand stuff there that was just to get their measurements. And then they use the VMI motor coordination sub test to look at the pencil control. And I think that was kind of the big, you know, standardized norm referenced paper protocol that they used. And then they used the etch the evaluation of children's handwriting for the handwriting legibility. And then they had created a questionnaire to get the ratings on the ADLs.     Jayson Davies     Which that was a parent completed in house, created parent questionnaire, basically.    Billy Hatridge     And said 27 items on that. And I kind of wish they had described that a little more in detail, since it wasn't that they made in house, just. Kind of know what that looked like specifically.    Jayson Davies     But yes, I agree. And maybe, maybe after this podcast, someone will reach out to us and say, hey, I can share that with you. We'll see. But if that happens, we'll be sure to get it out as easy as as easily as we can, if possible. So let's talk about a little bit of the outcomes then. So when it comes to strength, we already dipped into that just a little bit. But what else did they find?     Billy Hatridge     So one of the big things for me that was shocking in terms of their their out outcomes, was that the pinch strength did not have a correlation with pencil control, that it was the grip strength that had a bigger impact on writing legibility and pencil control than the pinch did, and that was for both the typically developing and then the children with autism. And I think that for us at school, OTs fall into that trap of when we're working on that pressure, we use so many pinch based activities. And you know, their study here is kind of showing that it's a lot more based on just that whole hand grip strength in terms of that pencil control, and that was my big takeaway from that, just in terms of what I do on a daily basis.    Jayson Davies     Yeah. And I believe that was on the VMI, right?    Billy Hatridge     Yes. That was on the motor coordination on the VMI. That's where they found that, yeah.    Jayson Davies     And if I remember right on the edge, they found that grip strength overall correlated with the edge scores. And they looked at the upper case, lower case, and numbers on that those sub tests, but they found they in just the group with autism, that grip strength did not correlate with the legibility of writing. And so again, same thing, like you're kind of talking about a little bit of inconsistencies between whether or not it correlated with typical kids versus kids with autism.     Billy Hatridge     They made quite a bit of mention when they talked about the limitations of the study, about how complex both handwriting and autism are, because, you know, as we know, OTs handwriting is not just motor there's so many more elements to that there's a sensory elements, just visual elements, and so they're only able to Look at those that one specific category with the handwriting. And so the fact that grip strength correlated with the typical peers, but not with those with autism, definitely shows that, you know, there's a lot more things influencing that handwriting when it comes to to autism, as far as the the eligibility of the writing.    Jayson Davies     And you know, that kind of goes with the whole As occupational therapists, we have, you know, this PEO model, we have other ecological models that take so many factors into place. And we can't just look at grip strength, or just look at their pincer grasp or something, you know, there's so many other factors that come into play. Cognition, you know, is a huge factor. And they tried, if I remember, right, they tried to account for that as much as possible by making a cut off, or, if you want to say exclusion criteria. But even then, I think I remember the limitations, that there was still a correlation between understanding of the task and and overall grip strength. And so you just see the kids, of course, you know, if they don't understand how to do this, how to use the dynamometer, then you know, is their strength really going to be right? It should be.     Billy Hatridge     And that was one of the big things they had mentioned right was, was the children's inability to follow the directions to the T and that impact on especially the getting those grip and pinch strength.     Jayson Davies     Yeah, one thing that really stood out to me, and as far as the strength, was that the hand and pinch strength patterns were similar in the sense that, you know, kids with autism, as well as typical, typically developing kids both increase their strength as they got older. However, the kids with autism were always lower at the same age. And they were also very inconsistent. You know, they were doing the average of three scores when it came to grip strength. And the kids with autism were just like all over the place as far as their inconsistent ability to provide a similar score each time that they were tested. And so that's, that's pretty, you know, influential.     Billy Hatridge     And I think that's one of the tricky parts about, you know, doing any kind of study with children on the spectrum. And anyone who's worked in that population knows that minute by minute, it can be a very different kid that you're working with. You know, consistency in these kinds of tasks can be very tricky when working with those, those types of kiddos. So, yeah, yeah.     Jayson Davies     So that kind of sums up the article. I think. Going forward, what are you taking from this article and implementing as your role, either as an occupational therapist, providing the therapy, or even when you're working with your assistants?     Billy Hatridge     Can I stop you there real quick? There was something I want to jump on in the limitations, that they had mentioned, and they had said here that they did not complete any visual perceptual testing. And so they know that they're limited in their interpretation of the the handwriting part because they didn't do any visual testing. And I was wondering why they didn't go ahead at least do the visual perception subtest. You know, it's two minutes. It's not going to take that much extra time. They're already doing the motor coordination test. And so, you know, one of the the writers is listening in, I would definitely like to know, you know, Shirley had talked about it and why they had left that out, just to kind of be able to get, get those numbers on the on the visual perception part.    Jayson Davies     Yeah, and you know, that also talks to what we do going forward. And you know, we need to make sure that we're doing a visual perceptual test with with the kids. And of course, they also didn't do the visual integration part of the actual test. They did the motor coordination, but not the actual part to see if kids can copy, you know, overlapping circles and all the good stuff that isn't that one, for those of you who aren't as familiar with the VMI coordination. What that is, it's almost kind of like tracing or staying within the lines or something. So it's very all the material is right there for you. All they were really testing was, is that that really pencil control and they stay within the lines? So, yeah, definitely, I see what you're saying there. It would be nice to know a little more visual perceptual skills and visual motor tasks for these kiddos.    Billy Hatridge     So moving ahead for our OT practice, I think the takeaway for this study has more to do with the handwriting interventions than it does with the autism. The study found that there wasn't as big of a correlation with students with autism when it comes to grip and pinch strength, there's a lot more factors to focus on there. And, you know, with autism, there's so much in the grand scheme of things that you addressing. But when it comes to the handwriting, you know, we have more and more and more kids are coming to our caseload who that's the that's the point of what we're doing with OT, it's going to be kind of backing away a lot from those pinch activities, the fingertip activities, and working more on just building up that general hand strength, I think, because I'm looking at their implications here, and it's, you know, grip strength correlates with pencil control, grip strength correlates with hand ability. Grip strength correlates with functional abilities. And so it all comes back to this, the strength of the hands. And so definitely gonna get my kids out there monkey bars a lot more, I think, in terms of the handwriting instruction, those kinds of activities.     Jayson Davies     So definitely I love it some of those more, more child friendly occupations, you know, not just sitting at the table, working on pinch and working on just handwriting, handwriting, more handwriting. So, right, yeah, I definitely think you're right about that. Alrighty, man. Well, I think that kind of sums up what we're talking about today. Before I let you go, I want to give you a chance to let people know if they have any questions for you, specifically where they can get in touch with you.     Billy Hatridge     Yeah, so the OT dad is my social media handle, and that's for, you know, Instagram, Pinterest, Facebook, the whole shebang. I have a website or blog, more specifically, the OT dad.com and, you know, I found working in the schools, our communication with parents is very limited, and so I kind of created up the Facebook page to help share resources and links and articles with my parents, and then it kind of grew from there. And so, yeah, if anybody wants to reach out to me and see what I'm doing over there, they're more than welcome to I said handwriting and autism is kind of my, my passion project, so I love talking about it.     Jayson Davies     Awesome, man. Well, thank you again, so much for coming on and sharing this article with us. We really appreciate it, and I hope to see you again soon. All right. Well, thank you, Jayson. Talk to you later. All right. Well, thank you everyone for listening to Episode 40 of the OT school house podcast and a special thank you to Billy hatridge for coming on this show. Again, he is from the OT dad.com and he's actually the one who reached out with this article to me, and it was great to have it. I hope you all enjoyed and learned a little bit about handwriting and autism and hand strength. So it was great. I hope you're enjoying this little Journal series that we're doing here on the OT school house podcast. And yeah, take care. Have a great week, and we'll see you next time on the podcast. Bye.    Amazing Narrator     Bye. Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

As school-based OT practitioners, we’re trained to focus on student goals, classroom participation, and meaningful occupations. Unfortunately, federal privacy laws are often an afterthought. While most of us learned about HIPAA in OT school and its rules about protected health information (PHI), working in schools introduces us to the lesser-known Family Educational Rights and Privacy Act (FERPA). Though they sound and seem similar, these laws serve different purposes and apply in different ways. Understanding which privacy law we need to follow affects how we document services, share information, and even where we provide therapy. I learned this firsthand when questioning whether or not a shared OT/SLP therapy space was legal. What I discovered changed how I viewed privacy in schools. While HIPAA may prevent shared therapy spaces, FERPA does not. And as it turns out, most school-based OT practitioners are governed by FERPA, not HIPAA. So, let's explore the key differences between HIPAA and FERPA and get an idea of which one applies to school-based OT practice. What’s the Difference Between HIPAA and FERPA in school-based OT? HIPAA in a Nutshell HIPAA (Health Insurance Portability and Accountability Act) protects  protected health information (PHI)  held by "covered entities," like healthcare providers and insurance companies. HIPAA: Applies to clinics, hospitals, and medical providers who bill electronically for health services Requires safeguards for PHI and limits on information sharing Does not apply to education records protected by FERPA (This is possibly the most important line in this article. Keep reading for more details) FERPA in a Nutshell FERPA (Family Educational Rights and Privacy Act) protects the privacy of student  education records  in schools that receive federal funding. That includes your session notes, evaluations, and progress logs if they are maintained by or for the school. At a high level, FERPA: Applies to public schools AND private institutions receiving federal funds Grants parents (and eligible students) rights over access, amendment, and disclosure of educational records Protects students’ PII (Personally Identifiable Information), which refers to information in educational records that can identify a student, such as name, student ID, disability status, or educational performance. Covers OT documentation if it's part of the student's educational file In schools,  FERPA protects PII in education records, even if that information overlaps with what would be considered PHI in a clinical setting . That means your therapy notes, student emails, and progress logs aren’t PHI. Instead, they’re PII, and FERPA is what governs them. According to  Joint Guidance from the U.S. Departments of Education and Health and Human Services (2019) , when a school receives federal funds and maintains student records, those records are considered FERPA-protected  education records , even if they contain medical information. So, even if you bill Medicaid , as long as the documentation is kept by the school and not a private clinic,  FERPA applies, not HIPAA . See page 8 in the joint guidance above if you want to see how it is noted in the official document. Additional helpful references can be found at the end of the article. What Is Protected under FERPA (and What’s Not)? It’s vital to note that FERPA protects  records and disclosures , not  student visibility . Thus, students receiving services in school settings do not have the same level of anonymity as in a medical clinic bound by HIPAA laws. So, what's protected then? Protected Under FERPA: OT evaluation reports and therapy notes stored in the IEP system Progress monitoring logs and data sheets Emails with school staff about a specific student Student information discussed in an IEP meeting Records used for Medicaid billing (if maintained by the school) Not Protected (or Not a Violation): A peer noticing a student walking with the OT to the therapy room A bulletin board sign that says “Therapy in Progress” (without student names) A student saying, “I have OT next” in front of others Shared therapy rooms when conversations related to PII are kept confidential What FERPA Violations  Might  Look Like Here are some practical, real-world examples that could lead to a FERPA violation: Leaving a printed report on a shared copier or a teacher’s lounge table. Although FERPA allows you to share PII with teachers, it should only be shared with teachers who have a current interest in the student’s education. Sending student info through a personal email or an unsecured platform Recording a therapy session and sharing it without written parental consent Discussing a student's diagnosis or progress loudly in a hallway or staff meeting Using a student’s full name and details in publicly visible documents or shared drives Posting a picture of a student completing a therapy intervention on your Instagram, even if their face is not shown. These examples all involve either improper  disclosure  or  storage  of identifiable student information. Using your personal computer for work may be the easiest way to lead to a FERPA violation. Practical Tips to Stay FERPA-Compliant Use school-approved platforms  for email, documentation, and file sharing. Avoid discussing students  in public areas or with staff who aren’t part of the IEP team. Lock up physical records  and password-protect digital ones. (with 2-factor authorization when possible) Don’t store student files  in personal cloud apps (like your personal Google Drive). Use initials or pseudonyms when collecting data that might be viewed by others. (The same applies if you are putting any data into AI) Get parent consent in writing  before taking photos or videos for any reason. Common Questions from School-Based OT Practitioners: "Who oversees FERPA, and can schools get in trouble for violating it?" FERPA is overseen by the  U.S. Department of Education , specifically the  Student Privacy Policy Office (SPPO) . While families can't sue for FERPA violations, they  can  file a complaint. If a school is found out of compliance, the Department may require corrective action or, in rare cases, withhold funding. Even without formal penalties, these issues can erode trust. That’s why understanding FERPA matters for school-based OT practitioners. "What if I’m contracted through an agency, not employed by the school?" You still must follow FERPA if you are acting  on behalf of  a public school. Your documentation and actions are covered by the same laws as school employees. "Does HIPAA apply because we bill Medicaid?" Not necessarily. According to federal guidance,  FERPA supersedes HIPAA  if the records are maintained by the school and used for educational purposes, even when Medicaid billing occurs. "Can I post a faceless picture of a student on Instagram to show a cool treatment I did?" Maybe, but proceed with caution. Even if a student’s face isn’t shown, other elements (like unique clothing, assistive devices, or the setting) may still make the student identifiable . FERPA protects  personally identifiable information  in education records, including photos linked to educational services. Unless you have written parent consent and district approval, it’s best to avoid posting any images that include students, even if their faces aren't visible. Instead, consider using a reenactment, a staged photo without students, or a graphic/illustration. I always look at it from this perspective. If I were browsing Instagram or TikTok and found my child's OT account, I would be furious if there was a picture of my child. And as every parent knows, you can recognize your child without seeing their face. Wrap up: It's a FERPA World Navigating student privacy laws as a school-based OT practitioner can feel overwhelming, especially when you’re balancing your clinical background with the rules of the education system. It’s no wonder there’s so much confusion between HIPAA and FERPA, since we were trained under one, but in schools, we’re governed by the other. The good news is this:  you don’t need to memorize every federal statute . You just need to understand the basics: FERPA protects student education records and personally identifiable information (PII). HIPAA usually doesn’t apply in public schools. If in doubt, always err on the side of confidentiality and check with your district. From shared therapy spaces to documenting services, knowing when and how FERPA applies helps you to protect yourself, the child, and the district. Plus, when someone asks whether HIPAA applies in schools, you’ll be able to answer with confidence (and maybe even share this article). Thanks for reading through this article. I hope it helped. 📬 If you'd like to know when I publish future articles about school-based OT, be sure to subscribe to the OT Schoolhouse Newsletter .  I share tips, research updates, and evidence-based practices for school-based OT practitioners every week. References: U.S. Department of Education & U.S. Department of Health and Human Services. (2019).  Joint Guidance on the Application of FERPA and HIPAA to Student Health Records . U.S. Department of Education.  Student Privacy Website  – Central resource for FERPA regulations, FAQs, and guidance. Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. § 1232g; 34 CFR Part 99 . Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191; 45 CFR Parts 160, 162, and 164 . U.S. Department of Education. FAQs on Photos and Videos under FERPA  – Official guidance on handling photos and videos in educational settings.

About once a month, I receive the following question: "Do you have any data sheets I can use to track IEP goals?" For years, my answer to every email about this was a quick link to Teachers Pay Teachers.  In fact, I even shared this tip in my A-Z School-Based OT Course. For a long time, TPT proved to be a fast, convenient, and free way to find plug and play IEP data sheets. However, with Chat GPT and Gemini providing quality AI content for free, I had to give AI a try and see how it would do to help create data sheets. In this article, I’ll walk you through why I used to recommend TPT, why that changed, and how you can now use ChatGPT to quickly generate tailored, HIPPA/FERPA-friendly data sheets for your students. Why I Rarely Created My Own Goal Data Sheets (Until Now) To be honest, I used TPT for data sheets because it felt like too much work to create a new data sheet for every student. Between writing evaluations, attending IEPs, and delivering services, there simply wasn’t time to reinvent a new custom data sheet for each kid. The effort didn’t seem worth the outcome . As such, I’d usually end up reusing a generic sheet, scribbling changes in the margins, and hoping it would suffice. In the years I did take time to create my own data sheets for kids, I found that I would use them until their IEP came up, but would then forget to update them afterwards. As such, I would often download and print many copies of a few TPT data sheets to stash in my desk. That way, after each IEP I could grab one, write the student’s name on it, and place it in their file. At the end of the day, the time saved using TPT data sheets simply outweighed my need for data tracking sheets to be specific to each student’s IEP goal. Then Came ChatGPT When ChatGPT first came on the scene a few years ago, drafting IEP goals and creating data sheets was one of the first tasks I gave to the AI. At that time, the new and exciting Open AI tool was nearly useless for data sheets. The chatbot could draft an IEP goal, but it would become very confused if you asked it to create a chart or table. Today, though, that is a different story. Even with the 100% free, no-email-required version of ChatGPT. Now, with a single, well-crafted prompt, you can generate a student-specific goal tracking sheet in five minutes or less. I pulled a goal from the OT Schoolhouse Goal Bank  and paired it with this prompt to generate a data sheet that I could copy and paste into a Google Doc. Please create a print-ready data sheet that I can copy into a Google Doc and give to a teacher to track an IEP goal. Include the student's Present Level of Performance, the annual goal, and all benchmarks or objectives. Also include a separate summary table for tracking progress over time. I then gave ChatGPT that prompt and the goal information. Within a few minutes (Starbuck’s WiFi was very slow), Chat GPT created the data sheet you see below. From there, all I had to do was copy and paste the AI output over to a Google Doc. Tips for Pasting the AI Output into a Google Doc Copying the AI-generated content into a Google Doc took just seconds. There is even a little “note” looking button that you click to quickly copy the entire output (See the video below). From there, I made a few tweaks to make it visually clean and easy for educators to use. Here’s a step-by-step walkthrough: Switch to landscape mode : Tables tend to display better in this format. Clean up unnecessary formatting : ChatGPT often includes horizontal divider lines you can delete. Make your tables visible : In Google Docs, click on the table, choose the three-dot menu, and bump the border thickness up to 0.5 pt to make lines visible. Resize and customize : You can easily adjust column width or add/remove rows based on the goal complexity. Organize it your way : You might want the goal objectives grouped separately from progress notes, or you might combine both into one table depending on your preference. Click here to view the formatted Google Doc This quick customization process helps ensure the document looks professional and fits your data collection style. Why This Is Now My Go-To Recommendation Let’s be honest, documentation can feel overwhelming. That’s why I wanted to share this with everyone. There are many things we cannot or should not use AI for, but for the creation of data sheets, using AI is quick, customizable, compliant, and easily accessible. Plus, the flexibility means you can create as many variations as needed: goal-specific sheets, daily or weekly tracking versions, or simplified classroom check-ins. Watch It In Action Want to see the process for turning a goal into a data sheet from start to finish? Watch the video below to see how I use ChatGPT to create a goal-tracking sheet in under 7 minutes. Final Thoughts If you’re spending more than 7 minutes creating data sheets for each student and are open to using AI, give this method a try. ChatGPT has made it easier than ever to build personalized, printable tools that save time and improve documentation. After you give it a try, shoot me an email at Jayson@otschoolhouse.com  and let me know how it works for you. Until next time, 👋 Jayson

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 176 of the OT Schoolhouse Podcast. Ever wondered how school-based OTs can meaningfully support students with extensive support needs?  Supporting students with extensive support needs has long been one of the most challenging and under-resourced areas of school-based OT. In this first of a two-part episode, Dr. Savitha Sundar joins Jayson to unpack the history, systemic influences, and practitioner struggles that shape how services are delivered in special education classrooms today. From redefining outdated language to exploring how friendships and peer modeling can shift trajectories, this episode is a powerful reflection on the ethical and practical realities of inclusive education. This episode sets the foundation for building more inclusive school communities—and why occupational therapists play a key role in leading that change. 🎧 Stay tuned for Part 2, where we’ll move into actionable strategies and systemic shifts. Listen now to learn the following objectives: Learners will reflect on the historical and systemic factors that have contributed to the segregation of students with extensive support needs in school settings. Learners will identify challenges OTPs face when serving students in self-contained classrooms and how these challenges impact practice. Learners will understand the evolving terminology and research around inclusive education and how it relates to the role of school-based OTPs. Guest(s) Bio Savitha Sundar PhD, OTR/L. Savitha Sundar has served in public schools for over 17 years across three states, primarily supporting students with extensive support needs in self-contained classrooms. Her research focuses on the role of school-based occupational therapy in bridging the research-to-practice gap in inclusive education. For five years, Savitha served as an executive board member and later as a partnerships officer for a national nonprofit organization--Changing Perspectives, focused on promoting inclusive practices and social-emotional learning.  Savitha teaches entry-level OTD students during the summer at Texas Woman’s University and has mentored more than a dozen students in school-based practice. She also hosts the podcast Inclusive Occupations – Sharing Stories of Not Just Being Invited to the Party but Dancing. Through the podcast, she amplifies the voices of educators, researchers, and individuals with disabilities working to build authentically inclusive learning communities. Quotes “It's so meaningful, the power that a little bit of social presence can bring to education, leisure, and play skills. And that's just really powerful.” -Jayson Davies, M.A., OTR/L “I got 186 responses. And nearly the majority of the OTs said that at least 40% of their caseload are students with extensive support needs.”  - Savitha Sundar PhD, OTR/L “The need for us to recognize that it's the support needs of the student that is where the focus should be and not on the student's disability…then our intervention will also focus on the environmental factors, not just the person's inability to do things."  - Savitha Sundar PhD, OTR/L Resources 👉 Inclusive Occupations Podcast  by Savitha Sundar 👉 Changing Perspectives  – A nonprofit supporting inclusive practices and social-emotional learning in schools. 👉 Every Moment Counts  – Structured approaches to promoting social participation and comfort for all students. 👉 NTACT:C Predictors of Post-School Success  – Evidence-based practices that improve post-secondary outcomes, including the role of inclusion and goal setting. 👉 Effecting Change in School-Based Practice: Fostering Social Inclusion in a Co-occupation Program  (OT Practice Article by Dr. Sundar - AOTA membership required) 👉 Interventions and measures of social inclusion for students with extensive support needs in K-12 schools: A scoping review ( Article by Dr. Sundar - Journal of Intellectual Disabilities) 👉 Interoception Program -guide for mindful self regulation 👉 Sensory Integration Program  - Ayres SI  Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hey there, and welcome to episode 176 of the OT school house podcast. I am your host, as always, Jayson Davies, and today, we are diving into a topic that many of you have reached out to me about over several years, and that is how we as school based ot practitioners, of course, can better support students with extensive support needs now, whether it's figuring out how to provide meaningful services in various types of classrooms, or feeling unsure about how to write truly inclusive goals, or maybe even just wondering how to make a bigger impact within our schools, this is a challenge that has weighed on school based ot practitioners ever since I got into the field, and probably for much longer than that. That's why I'm thrilled to be joined today by Dr Savita Sundar. Dr Sundar is someone who I have known for several years now through the OT school house, but she recently completed her PhD, and she has a lot of information to share with us. Savita has served in the public schools for over 17 years across three different states, so she has seen what school based occupational therapy can look like in various areas. She has primarily supported students with extensive support needs, as she'll share in a little bit during her time as a school based ot both in practice and through her research, Savita has put a spotlight on bridging the research to practice gap and inclusive education through occupational therapy. In addition to her role as a school based occupational therapist, Savitha teaches at Texas Woman's University, mentors emerging ot practitioners and hosts the inclusive occupations podcast, where she helps to share the positive impact inclusion can have on individuals. Now our conversation ended up being a little bit longer than we thought it would be, but that's because we had so much to talk about in this episode. So in this first episode of a two part conversation, Savitha is going to lay out the foundation for what it really means to support students with extensive support needs, not just clinically, but also ethically and systemically. We talk about the history of segregated services, how peer interactions and friendships can reshape outcomes, and what we need to reconsider in our own training and mindsets. It's the kind of episode that invites reflection and re imagining. And then in Episode 177 part two of our conversation, we'll discuss more the practical application of supporting students with extensive support needs to promote inclusion. Now this is a topic that I've wanted to address here on the podcast for a long time. It is one of our most requested episode topics, and I am thrilled that Dr Sundar was willing to have this real conversation with us. So let's welcome Dr Sundar to the podcast and go ahead and get started.    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     Dr Sundar, how are you doing this afternoon?    Savitha Sundar     Doing great. Hi, Jayson, so good to be here.     Jayson Davies     Hi. Are you getting used to that doctor in front of your name yet?     Savitha Sundar     Not completely. Since I'm still a school practitioner, I go by Ms s with most of my kids, it's a little like, I have to get used to this.    Jayson Davies     Yeah, it's not very often.    Savitha Sundar     Yeah, has its value. You know, sometimes use that, but I have to get used to it and comfortably.    Jayson Davies     Yeah, it's definitely more for the conferences and the podcast and the webinars of the world than it is for working with our kids in the school. So I imagine it will take some time. But yeah, thank you so much for being here. Really happy to have you and really excited to have this conversation with you about supporting our students with extensive needs like this is something that a lot of people have questions about. A lot of people feel very uncomfortable, and I think we're going to talk about that. So I first want to ask you is how you or why you decided to go down this route of researching the support that occupational therapy practitioners provide to students with extensive support needs.    Savitha Sundar     Yeah, that's a great intro question, because, you know, it happened very organically for me. I started in school practice. I always wanted to be in pediatric practice, and I entered school practice probably of my 20 years, as in 24 years as an OT I've spent the majority of them in school setting, and I happened to be placed as a as a contract therapist who was dependent on a visa sponsorship in a program in the Bay Area. When we moved to Bay Area in 2012 No 2008 in this program that exclusively is. Supported students with extensive support needs. So in the Bay Area California, we have the county programs, and I'm not sure if it's the same in Southern California as well, but a lot of big school district big urban communities have this system where students who have high support needs are usually supported by an external program, because the school districts may be relatively small, or they don't have the resources. So they combine several districts, and they create these programs where they get more funding from the federal government, and they end up giving them more services and, you know, supports and all kinds of things, and that was the justification for them to be moved into a separate program outside their home school. So when I worked there, I, you know, did my traditional ot stuff, whatever, you know, we've been trained to do. And just over the course of time, I happened to be working with some of these amazing teachers who went out of their way to enable friendships for kids in their self contained classrooms. They connected with a gen ed teacher, they arranged for peer buddies. They did all these things. And every time I saw my kids in that space, I felt like I saw a different side of them come out, you know, like they showed us things that you know, that we never got to see in our regular school day. And I'd like to share this one story that I think is very powerful, because it was my turning point. So in one of these self contained classrooms, the K 2k, to 3k, to two self contained classroom, we had a student. We had tried a lot to get him to feed himself, and over the years, he had started with us in preschool, and he wasn't walking, he wasn't using any communication, wasn't touching anything. He'd come a long way, but all the way up to second grade, he wasn't feeding himself. Wasn't a motor problem. We couldn't tell if it was a sensory issue that we hadn't detected yet, but when some of his peers came into the classroom. He adored those girls, the older girls, who came into the classroom to partner and play with our students. And when one of the girls came in and saw him with his food and said, Oh, Jimmy, you have yogurt. His name is not Jimmy. So Jimmy, you have yogurt. I have yogurt too. Let's eat. And so she just sat next to him and started eating. And then he started feeding himself like he's been doing that forever. And we were like, and we were like, Oh my gosh. So this kid knew all along. He wasn't eating at home, he wasn't eating at school. It was one of his IEP goals that he would feed himself. And here he was just out of that peer pressure, or, you know, just to feel like he belonged to this, this group, he started feeding himself, and it was an aha moment for me. And then I couldn't unsee it, like I saw so many situations where kids, we were trying to walk them in their Walker to go one place to another, but when they were in the playground, they were automatically geared towards people they were attracted to. And, you know, there were some kids who were just more friendly with our students in the in the SDCs, and they would try to respond to them so much better than they did. So that became my focus in my practice. I tried to bring in peers to be part of my therapy sessions. I started doing groups with Gen Ed peers whenever I could. Wasn't always possible, and then moved on to and there was a lot of support and encouragement to do this as well in the in the school. So that was my understanding of inclusion. I'm going to make these pure relationships possible for these students with extensive support needs. And I felt that was the most meaningful thing I can do to them, for their future and even for their present, to build a community that understands them and that can, you know, create a better world for them, basically. So that's how I started. My interest in this population, inclusion and extensive support needs came, and I'm sorry I probably gave you a long winded answer to this.    Jayson Davies     No, it's a great start. It's a great start, and it makes me think of the OT practice framework, right? Like we have these various occupations that we always talk about, play, leisure, education, ADLs, all that fun stuff, but, but we don't always consider the social aspect involved with each and every single one of those occupations. And it's so meaningful the power that a little bit of social presence can bring to education, to leisure and play skills, and that's just really powerful.    Savitha Sundar     Yeah, definitely.    Jayson Davies     Okay, as I mentioned, as we kind of, we're just getting started. A lot of therapists have, it's almost to a degree, it's an ethical conundrum, because, you know, we are ingrained, especially over the last 1015, years in OT school, about the power of inclusivity and inclusion. But then we get into the real world, and we do see these programs like you were talking about earlier in the Bay Area, down here as well in Southern California. I know it exists across the country. Century, where these students are in a separate classroom, sometimes they're in a complete separate school, because, as you mentioned, Wright county programs are often in like one school, and sometimes kids have to ride a bus an hour to get to those programs. And so I guess the question here is, how did it make you feel when you transitioned from student into these programs and started to understand this difference from what we have been taught in OT school? And then, you know, obviously you just talked a little bit about your experience. But then let's start to move on to Okay, well, what you were going to do about it, but first, I just want to get your idea of like, idea of like that first time you realized that these inclusive practices weren't exactly happening. How did that make you feel?    Savitha Sundar     I think as new practitioners coming into the into practice, we're really very focused on getting a job and keeping that job. Okay, yeah, we yeah, we don't want to go in and rock the boat and do anything like, Oh, my ot program taught me this. And I'm not, I'm not going to do this handwriting practice. That's not what OTs are for. I don't think in OT school, they really gave us any training on how to teach handwriting to kids. We learned it over the course of our practice. We found that this is a big need. And then we attend all these continuing ed courses, and then so we come with that mindset into practice. And I was the same too. I wanted to come in. I wanted to feel like I fit in and I belong, and people liked me, and they listened to me and everything. And once you get comfortable in that position, and then you see this very important need, and you start addressing it in a very natural way. And then everything falls in place. This is what I went to OT school for, right that I address the social environment, that address the physical environment, that I address the activity, the occupation. I don't do a task analysis. I do an occupational analysis, which includes us looking into the personal factors, the environmental factors, the performance, skills, the performance, you know, the roles, rituals, habits, all of those areas we look into the whole picture to see how a person is successfully participating in an occupation. And when we try to include a student in an environment that has the best opportunities for them, then I think that ot lens just comes in, and it's like, this is my role in schools. You know, that was my aha moment, and that's what led me to sort of obsessively pursue this area, like I spent five and a half years in my PhD looking into this area. How can I make it most meaningful to myself and to my ot practice? Because it just feels so right. And a lot of therapists resonate with me, and a lot of therapists are like, Oh my gosh, this is just doesn't make any sense. So I feel like this both these perspectives, but to me, it feels like we try to articulate our who we are in schools, right? Or we're not motor specialists. We're not handwriting specialists. We're not, you know, there's no, no role that really pulls in all our skills and our resources, you know, and to enable inclusion, to be an access professional, that pulls in all our true ot background in place, and it's just like a big wow. This is what we need. We should be doing. And I guess so it's a journey.    Jayson Davies     No totally understand. And one of the things that I've been kind of talking a lot about recently is the idea that it's like a blessing and a curse, that people don't know what we do in the schools, because it's a curse. No one knows what we do. But it can also be a blessing, because we can be the one to show them, and a lot of people don't know what OTs do, and therefore whatever we do is what they're going to know as OT. And so I think you know that's that's the blessing of it. If we want it to be handwriting, then we can focus on handwriting, but if we want ot to be about more than handwriting, then we can show them that OT is more than handwriting. So.    Savitha Sundar     And every school district is so different. I worked in so many different districts now in so many different states, and every school is so different, and some administrators have already set the stage with OTs role as fine motor and handwriting, like every other area is taken by somebody else. So it's so hard when you are put in that position to convince the administration no we can do more. So it has to happen both ways. You know, the admins have to be open to learn what else OTs can do, and OTs have to kind of do the uphill battle for a while to show them what else we can do. So yeah, and people have huge caseloads and they don't have the time to do anything except check off IEP mandates, then it's very, very hard.    Jayson Davies     Yeah, yeah, all right, continuing down supporting students with extensive support needs. At what point did you start to think to yourself, Okay, I am starting to support these students. I am seeing how I can support. Whether they're in a county program or if the district hasn't been housed. But at what point did you think to yourself, like, hey, there's got to be research about this, or, oh my goodness, there isn't research about this. And what did you start to figure out as you were looking into that research?     Savitha Sundar     Yeah, so my friends and I have always struggled with this. Any conference we go to, they tend to talk about the kids who are not the kind of kids we see in our county programs, right? Okay? And they tend to talk about the sort of the higher functioning as it was called before, or the low support needs students, as we call rightly better now, the focus has always been on we never found anything that really catered to the students. Like I went, I wanted to go get my si certification, and I went there, and the whole we were, like, getting so many referrals. This is back in 2012 so many referrals for addressing sensory needs. And then I'm like, Okay, I need to understand more about Si, and I go take the training and and the whole of Si, the IRS si training focused on students, I mean, kids who had milder who didn't have cognitive disabilities or didn't have intellectual disabilities. That was the focus of the training that I went to. And so it just puzzled me. Like, why is there so little focus on and when I looked into the literature, there was one article from 2004 that talked about OT and students with severe disabilities. So OT and students with severe disabilities in the education context, I could not identify an article at all in my entire like, I've done a lot of literature search, and over the years, we just could not find anything with all these three combined. They talk about it in terms of, like a diagnosis. You can see OT and autism, OT and intellectual but then you know, intellectual disability is also a range. Autism is a range, right? The kids who are the districts are not able to provide FAPE and send to accounting program, those kids, the ones on the ends of the spectrum, are we focusing on them? No, and that just really made me feel sad, because those 100% of my caseload were these students. So did I your question?     Jayson Davies     Yeah, and you brought up a great point too, because, like, I think probably just about everyone listening to this podcast episode right now has been in a professional development training where, in the back of their mind they're listening to a speaker and wondering, does this program support the kids that I work with and we, I think we've all been there, right? We've been listening to a training, whether it's handwriting training and executive functioning training, no sensory processing training, whatever it might be, but we just kind of have that, that little inkling in the back of our mind, like, is this training for my the population that I work with? And that's really hard when you come to grasp that you're in a training and it's not actually for the population that you work with, it kind of lets you down a little bit totally. So I totally understand that.     Savitha Sundar     And the other thing is, the medical model with which we have been trained over the years makes us want to only address the student. And the whole IEP, the whole of special ed, is set up to retrofit these kids into general education, right into the normal world. So the world was not designed with people with disabilities in the first place. Only very recent. Only 50 years ago, we started including them in our educational system, so you can and when, and all our services, all our training, has been in that deficit focused model. And I think OT is very progressive in that way that we are probably one of the few that really look into the person, the environment and the occupation when it comes to participation, right? So yeah, the thing is, we can't if we identify these problems there in the environment, and we have very little control over what we can do in these environment and these systems, right? So maybe that's why, yeah, don't talk about it much?    Jayson Davies     Yeah, before, I want to get more in depth into our conversation today, I do want to ask you about a topic, or just it's not really too much of a topic, but I want to know how you came up with a specific language that you did. You used the language students with extensive support needs. And I want to ask this because I think you know it's, it's kind of commonplace right now to be very careful about how we use language, especially in IEPs, and when we're talking about students with disabilities. And so I wanted to ask you, did that come from articles that you reviewed within OT, outside of OT? Did you make it up on your own? Where did that come from?    Savitha Sundar     All outside of OT, for sure, education, all the research that I the information I could get for my research, was all from education, educational psychology, educational literature, was where I went to. And we used to use the term mod severe in California. So when I started my PhD in 2019 The term was still. Severe disabilities, right? And then as I went along, I think the awareness also increased, and the and the need for us to recognize that it's the support needs of the student that is where the focus should be, and not on the student's disability the students functioning from saying high functioning or low functioning to high support needs or low support needs and high support needs that places the need for change outside the individual, then our intervention will also focus on the environmental factors, not just the person's inability to do things. Yeah, so I think that's why the term is used now a lot in the literature. I think that's the most so the way it's defined in the literature was, I think in 2017 tob came up with that definition, and she says there are students who it's not a very crystal clear definition, either, but this is what we're trying to use in the literature, in research with this population, mostly students who may have a diagnosis of autism, intellectual disability, or multiple disabilities, who tend to have needs across multiple domains of school participation, and who most often will qualify for their state's alternate assessments based on alternate achievement standards. So and they represent one to 3% one to 2% of the 53 million students who are educated in the American public school system, a very small percentage.     Jayson Davies     Wow. So, yeah, okay, very small percentage.     Savitha Sundar     This is, this is what I wanted to say. So when I started, 100% of the students I supported were that one to 3% of the population. So I wanted to find out, how is it with other OTs? Do they only work with kids who are in general education settings, or they work little bit with kids who are in self contained classrooms? What does your caseload look like? And I put out a survey on Facebook, and it was just a one question survey, mark one of the five options, what percentage of your caseload involves students with extensive support needs, and this is what I mean by extensive support needs, and the kids who also spend I also added the fact that they spend the majority of their day outside general education settings, and in a day or two, I got 186 responses, and nearly the majority of the OT said that at least 40% of their caseload are students with extensive support needs. Wow. So. And then I did an IRB approved survey, and I had 156 OTs who took that survey, and the result was exactly the same. And if, when I go to a presentation and I put that question among the at the audience, and it's very similar. And I look at my own caseload now, more than 50% of the students I support are students with extensive support needs. So I mean, the rationale is so different from in different places, but they tend to have IEPs, and they have a more explicit, obvious need for ot sometimes. But then again, ot comes like, okay, they are too severe to benefit from ot because we're working on handwriting, and therefore this is not something that we can address, or they are too high functioning. And then we don't work with the kids who are in gen ed classrooms, and we only work with kids who are in self contained classrooms. So what lenses do you look at? How you provide services is where the determination comes?    Jayson Davies     Yeah, wow. So a good majority of us are working with these students, yet many of us are probably also questioning how we're actually supposed to be supporting these students. You mentioned your survey, not the one question survey, but the follow up survey that you did, what was some of your goals with that and what were some of the outcomes that you found from that survey?    Savitha Sundar     So the survey study was looking into both special education teachers who work with students with extensive support needs and OTs who work with students with extensive support needs, looking at, what do you like? The main question of the survey was to find if there is a relationship between attitudes and efforts. Like, if your attitude towards inclusion of these students is high, then is it likely that you would have more put more efforts to support inclusion in your school? That was my big question. But part of the study was all these other questions. And one of the question was like, What do OTs work with this population? What do you address with this population? And the results were not surprising at all. The majority of them mentioned fine motor handwriting, and then it went on to sensory self regulation, sensory regulation, and then moved to ADLs, and then social participation. And then they were like, vocational, pre vocational. All of those were some of the little bars in the findings. So we the what, what I was hoping I would know, or what I didn't know is if these are the areas, and it was an open ended question, like, what do you work with your students? And then, you know, based on their. Responses. I categorize the responses, and what I don't know is, how do these engender access to lesser restrictive environments, right? How does it give you how does, how do you addressing fine motor lead to the desired outcome that you expect from the student? How does it lead to inclusion? That's something we don't know, right? And if we don't even know if that's a focus of our interventions, maybe therapists work on it with a purpose, like, okay, so this kid is in the general education classroom, and they're supposed to put their things in the locker, and therefore we need to work on opening and closing the locker. And so I'm working on this fine motor skill. Then I understand this is for the purpose of inclusion. Yeah, right. But if you're just working on stringing beads, or you're working on your pencil grip, or you're working on handwriting, for that matter, right, making all the letters legible, how does that lead this kid to access grade appropriate knowledge and express grade appropriate understanding of grade appropriate content.    Jayson Davies     Yeah, you know, and I've struggled with this too, it's like, Well, are we working on a skill? And is that skill or, I mean, I'm working on a skill. Is that skill going to support inclusion? Sometimes I think about that, and sometimes I'm not purposefully thinking about the inclusion aspect. And I talk about that because should we be, should we be either a, creating specific goals related to inclusion, or B, at least, at the very least, be writing our goals, to a degree, with the idea of inclusion in place. I don't know if you have thoughts on that.    Savitha Sundar     Absolutely, and I think the whole special ed team should be working on that. So special education and related services are there to support this kid Access General Education, environments and experiences. That's the purpose of, I don't think you would disagree with me, or anybody would disagree with me. And I like to use, okay, and you may have, I don't know if you've already, I think somebody in your podcast also shared this, the National Association for transition, the ntac, or National Collaborative for transition, something. So the N taxi, the collaborative, whatever, I'll share the information with you. So they have come up with this in school predictors of post school success, right? You know what I'm talking about, right? So if you look at those predictors, there are two of them that are research based across education and employment and independent living. One of them is goal setting, and the second is inclusion in general education. Those are the only two research based across all three areas, and so far, there is no research that says there is a clear advantage of a separate class over a general education classroom for a student, for any child, including students with extensive support needs. And I mean, I always know as a researcher that no research is 100% everything is very contextual, very situational, but it's something for us to consider that this is a good and, you know, I I've been looking for an analogy to explain this, and this is the closest I can come with. You can take a plant, right, and you can put that plant inside the house. You can take a plant that's supposed to be outside and put the plant inside the house. You can give it artificial light, you can give it all the fertilizer. You can do everything, but unless you put the plant where it has to be, you can never meet the needs of the plant in a different setting. And the other analogy I came up with is it's from a Buddhist it's from a Buddhist saying where, like wisdom and compassion are two wings of a bird, without which the bird will fly in circles. And the one I use is access and placement are like two wings of a bird without one, the bird will tend to fly in circles. So if you are providing placement but you're not providing access, meaningful access and belonging, then that's not inclusion. And if you're providing access in a self contained classroom to grade appropriate instruction or whatever. That also is not inclusion, because by the nature of the program, a student is not exposed to what a child without disability will will be exposed to, will get just by the nature of exposure, it's coming from presuming that these kids just because they cannot tell you what they know, we assume that they don't understand, but our job is to give them the knowledge and give them the tools to express themselves most effectively, most functionally, right? So I think, yeah, I almost forgot your question, but that.    Jayson Davies     That is totally fine. Who? No, no, no, you're fine. My favorite IEP, my favorite part of the IEP, and I say this somewhat sarcastically, is that little piece that says the percentage that a student is in general education and in those programs that I've worked with, you know, the county programs, or even the in house district programs that operate similar to county extensive support needs program that you were mentioning earlier, there always has to be that percentage that the student is in general education. And for these programs, it would often range from like zero to 10% and if it was 10% the 10% usually referred to the time that the classroom was in the cafeteria and the time that the classroom was at recess. But if you look a little bit more in depth, you would find that yes, the classroom was going to the cafeteria with their general education peers. However, the caveat is that they were sitting at their own table. They were in the cafeteria, but they were definitely not part of the cafeteria. And same thing when you go out to recess, yes, they're out there with their peers, but they're still kind of have their own little area out at recess.    Savitha Sundar     They play with higher educators and teachers     Jayson Davies     Exactly, exactly. So I guess my question here is, what does authentic inclusion look like in a school setting, beyond just having the student in the same area as the general education population.    Savitha Sundar     Authentic inclusion must address all three dimensions of inclusion, which is the physical dimension, physically being there, second, socially, having A sense of belonging, where others know about you. And when it comes to kids with communication challenges and social challenges, I think the bigger step has to be taken. You can't really meet in the middle. And we've tried a lot pushing our kids to come to the middle. A lot of times the gen ed kids have to come a little bit further beyond the middle to reach to our kids, and that's the nature of society. That's that's the society we live in, and that's the society we want to be in in the future too, right? So authentic inclusion will take efforts addressing that social dimension of belonging. Okay? Everybody understands the student. The student has friends, people know them by name. Being in the cafeteria like, that's the thing, right? We can always come up with excuses. We don't have enough staff. We don't have enough, you know, money, to make this happen. And, you know, oh, the Gen, ed community is not going the parents are not going to accept it. All of these excuses can come in. It's very easy to say no, because you can always cite a lot of reasons, but if you say yes, you may not get 100% but at least you'll do a little bit better. At least two students will have the opportunity, and then you'll see how that works out, and then you'll be inspired to bring in more peers are such powerful resources in the class, you know, they can do a lot for us, and I've also seen a lot of students don't even appear to be students with extensive support needs, because they've always been in a general education setting, and therefore they don't exhibit that kind of a need, because it's just it's I've heard this from experts, and I have seen this myself. I can look like that is why this whole continuum of placement, least restrictive environment statement, all of this is so subjective to interpretation, right? So what the same student can be in in Texas and can be fully included, and the same student can be in Oregon and be in a special education classroom. I'm just giving an example of two different states, but, you know, or in the same same state, you can be in a different district and be fully included, because the team feels that's the LRE, whereas in another place they feel like, oh, we have, we have a really nice program, a really nice, self contained a special education program with all the resources, and you market that program for The kids. So it's really not the students need. It's what we are capable of doing or our mindset that is 100%    Jayson Davies     true, and the fact that the LRE is not really well defined and can change from any given IEP to the next IEP sometimes too, like I could, I could manipulate and like what the LRE means for any specific situation that I really need it to mean.    Savitha Sundar     Yeah, yeah. We need to acknowledge that. You know? We need to acknowledge that, yeah.     Jayson Davies     So, yeah, okay, so sorry, really quickly. First was physical location. Second was social inclusion, and what was the third one?     Savitha Sundar     Then third is academic inclusion. So when you they must be able to access the same content that their peers access, right? So we don't even present like a kid who has extensive support needs often is learning the alphabet all the way up to high school, right? Because we don't. Know what they know, what they are capable of knowing, true, right? What if we provided these supports in the general education classroom? What if we put our effort in making that like OTs, the time we spend in what we currently do? Don't take away any time. Don't expect adding more work to yourself. But just think about the same time if it was used in making the general education experience accessible, just recess, just cafeteria as an OT team. Can you all sit together and brainstorm? How can we make cafeteria accessible for all our kiddos in our district? How is it going in your school? How is it going in my schools? Can we all implement the every moment counts comfortable cafeteria program. So another finding of my research was when people knew the how. They always had a clearer why. Why occasion when people knew their how, like people who were aware of these programs, you know, like a comfortable cafeteria program, or the you know, like the interoception program, or people who knew these had these tools, felt like they wanted to justify inclusion because they could do something about it using these programs. So I think having the tools to do it is so important for us to actually assume that role in schools. It's just that we don't know how to do it. That's the biggest problem.    Jayson Davies     All right. And that wraps up part one of our conversation with Dr Savitha Sundar. I hope this episode sparked some new insights for you and maybe some new thoughts about your students, your role, and maybe even the system around you, as I mentioned before. And part two, we'll move more into the practical strategies and what it can actually look like to support students with extensive support needs through inclusion focused ot services. We'll also talk about goals and how to promote participation and even collaborate with General Education staff in meaningful ways. So if you enjoyed this episode, or even if it was almost a little hard for you to listen to, because, you know, these conversations are so difficult and they must be had, even if they're not easy, then I want you to be sure to subscribe to this episode or subscribe to OT school health podcast, so you get notified as soon as episode 177 comes out, because in that episode, we're going to talk about more of the how to move forward stuff. So with that, be sure to subscribe to the podcast, and if you're listening on Apple podcast or on Spotify, please leave your thoughts in a comment. We would love to connect with you and learn more about how this podcast is supporting you now, and also how we can support you in the future. Be sure to also head on over to OT schoolhouse.com for more information about how you can support your students with our weekly newsletter at ot school house.com/join I hope to see you over there on the website, as well as in Episode 177 of the OT school house podcast. Take care.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now. Head on over to otschoolhouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. 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