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

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

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

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

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

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

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

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