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Social and emotional development supports a child's occupational engagement in all settings. Occupational therapy practitioners' holistic approach to prevention and positive mental health promotion is ideal for bolstering each core competency of social-emotional learning as defined by CASEL. This presentation will highlight how pediatric occupational therapy practitioners can use evidence-based interventions in each stage of childhood to promote social and emotional development while utilizing a public health, trauma-responsive, and relational (rather than behavioral) approach. < Back School-Based OTP's Role in Social-Emotional Learning Presented by: Colleen Cameron Whiting, OTD, OTR/L Attend live on May 15th, 2025 @ 4:00 PST/6:00 CST PM or watch on demand the next day Join OTS Collab & Earn CEUs Learn more about OTS Collab Course Description Social and emotional development supports a child's occupational engagement in all settings. Occupational therapy practitioners' holistic approach to prevention and positive mental health promotion is ideal for bolstering each core competency of social-emotional learning as defined by CASEL. This presentation will highlight how pediatric occupational therapy practitioners can use evidence-based interventions in each stage of childhood to promote social and emotional development while utilizing a public health, trauma-responsive, and relational (rather than behavioral) approach. Learning Objectives 1. Learners will define each core competency of social and emotional learning (SEL) as defined by CASEL. 2. Learners will identify evidence-based occupational therapy interventions for each SEL competency across stages of childhood. 3. Learners will explain how pediatric occupational therapy practitioners are equipped to support social and emotional learning. Contact Hours This course is 1 hour in length. (0.1 AOTA CEUs) OTSchoolhouse.com is an AOTA Approved Provider of professional development, #0252. National Board for Certification in Occupational Therapy As an AOTA-Approved provider of professional development, OTSchoolhouse.com courses are accepted by NBCOT® at a rate of 1.25 NBCOT PDUs per each hour of course content. NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc. Register for this course and future courses inside the OT Schoolhouse Collaborative for as little as $120 Register Now Learn More about OTS Collab Agenda 0-5 minutes Introduction 5-15 minutes Importance of Social and Emotional Development 15-25 minutes Overview of Social-Emotional Learning (SEL) Framework 25-40 minutes Occupational Therapy’s Role in SEL 40-50 minutes Evidence-Based Interventions 50-55 minutes Applying SEL in Practice 55-60 minutes Questions and Answers Your Instructor Colleen Cameron Whiting, OTD, OTR/L Colleen Cameron Whiting, OTD, OTR/L has worked as an occupational therapist for over twenty-five years. Her expertise lies in holistically supporting children, particularly those with sensory integration and processing challenges, autism, and who have experienced trauma, using theoretically based, evidence-informed interventions, and advanced professional reasoning. She is currently an assistant professor at Johnson & Wales University in Providence, Rhode Island. Registration To access this course and others, become a member of the OT Schoolhouse Collaborative . OTS Collab is an online community dedicated to providing school-based OT practitioners with highly valuable professional development and interactive support to implement learned strategies. In OTS Collab, we learn together, support and encourage one another, and celebrate our achievements as a collective whole. Click here to learn more about the OT Schoolhouse Collaborative and register in our dedicated community of school-based OT practitioners. Instructional Methods A combination of speaker presentation with a slide deck and both synchronous & asynchronous Q+A with the presenter. Target Audience & Educational Level This is an introductory level course intended for occupational therapy practitioners working in school systems or with a goal to better understand occupational therapy in school systems. Course Completion Requirements To receive a certificate for this course, you must watch the recorded course in its entirety. Then, you will need to take a learning assessment test and earn a score 75% or higher. If you pass, a certificate will be automatically generated and sent to your email. Special Needs Requests This course will include closed captioning and a transcript may be available upon request. You may also rewatch the course or sections of the course as needed. Additional accommodations may be requested by reaching out to us via email. Financial & Non-financial Disclosures Speaker Disclosure Colleen is receiving an honorarium for this course. Part of the content is coming out in the new CaseSmith textbook this spring. Sponsor Disclosure The OTS Collaborative Community is a product of the OT Schoolhouse. Content Disclosure This learning event does not focus exclusively on any specific product or service. Schoolhouse Education, LLC is proud to be an AOTA Approved Provider of Professional Development AOTA-Approval for this Professional Development Opportunity is in progress. Stay Tuned! Join OTS Collaborative Terms and Conditions Schoolhouse Education, LLC will keep a record of your completed CE courses. When applicable, transcript services may include reporting to professional associations and/or state licensure boards. While Schoolhouse Education, LLC will make all reasonable efforts to offer CE credit for its courses, it is not responsible for state or national, or regulatory current policies or changes in CE requirements that may make courses ineligible for CE credits. Participant Agreement By registering for or attending any event or activity associated with the Schoolhouse Education, LLC and OT Schoolhouse, I agree to the following: Professional Development/Information Disclaimer The material presented in this course is not intended to represent the only or the best methods appropriate for the occupational therapy and/or medical condition or professional development issues being discussed but rather is intended to present the opinions of the presenters, which may be helpful to other health care professionals at arriving at their own conclusions and consequent application. Attendees participating in this professional development education program do so with full knowledge that they waive any claim they may have against the A-Z School-Based OT Course, Schoolhouse Education, LLC, and OT School House and its staff or representatives for reliance on any information presented during these educational activities. Waiver of Liability Agreement I release Schoolhouse Education, LLC, OT Schoolhouse, and its staff, presenters, and any other individuals or entities associated with this course from any and all liability connected with my participation, as well as from any liability related to changes to the schedule, events or activities. I acknowledge and agree that I am participating on my own choice and assume all risk in connection thereof and that in the event that a need for emergency medical service arises, I authorize and consent to such services being provided at my own expense. Cancelation & Refund Policy In the event that Schoolhouse Education, LLC must cancel the event for any reason, participants will be offered a credit toward the rescheduled event. OT Schoolhouse Collaborative subscribers may cancel their subscription at any time.

Sensory modulation, defined as the ability to respond appropriately to sensory information and remain at an appropriate level of alertness, is critical for academic and social success. Research shows that modulation is a skill that can be taught. When viewed within a larger educational framework, sensory modulation is seen as a component of emotional regulation and social-emotional learning. This webinar covers the evidence supporting instruction in sensory modulation, basic concepts and terminology to be used in this instruction, and a specific curriculum available to ensure success in this endeavor. < Back Just Right! Teaching Sensory Modulation in Grades K-5 Presented by: Kim Wiggins, OTR/L Watch on-demand and earn AOTA-Approved CEUs Join OTS Collab & Earn CEUs Learn more about OTS Collab Course Description Sensory modulation, defined as the ability to respond appropriately to sensory information and remain at an appropriate level of alertness, is critical for academic and social success. Research shows that modulation is a skill that can be taught. When viewed within a larger educational framework, sensory modulation is seen as a component of emotional regulation and social-emotional learning. This webinar covers the evidence supporting instruction in sensory modulation, basic concepts and terminology to be used in this instruction, and a specific curriculum available to ensure success in this endeavor. Learning Objectives 1. Define sensory modulation and the three major subtypes of Sensory Modulation Disorder (SMD). 2. Identify where sensory modulation fits within a Social-Emotional Learning (SEL) frame of reference and within the tiers of intervention when using a Positive Behavioral Interventions and Supports (PBIS) framework. 3. Delineate components of the Just Right! curriculum, including materials and preparation, instructional modifications, and access to demonstration videos and student handouts. Contact Hours This course is 1.5 hour in length. (0.15 AOTA CEUs) OTSchoolhouse.com is an AOTA Approved Provider of professional development, #0252. National Board for Certification in Occupational Therapy As an AOTA-Approved provider of professional development, OTSchoolhouse.com courses are accepted by NBCOT® at a rate of 1.25 NBCOT PDUs per each hour of course content. NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc. Register for this course and future courses inside the OT Schoolhouse Collaborative for as little as $120 Register Now Learn More about OTS Collab Agenda 0-5 minutes Introduction 5-30 minutes Sensory Modulation Overview 30-45 minutes Correlation of sensory modulation and Social-Emotional Learning (SEL) 45-60 minutes Using the Curriculum within Response to Intervention 60-75 minutes How to Use the Curriculum Lecture 75-85 minutes Demonstration of Curriculum Lecture 85-90 minutes Questions and Answers Your Instructor Kim Wiggins, OTR/L Kim Wiggins, OTR/L, is a seasoned and sought after occupational therapist with a specialization in pediatrics, boasting extensive experience in diverse settings such as public schools, outpatient facilities, and home-based services. Currently serving as a full-time therapist in a school district in upstate New York, Kim is also the owner of OTKimWiggins LLC, a venture dedicated to delivering educational opportunities for both parents and professionals. With a notable background as a National program developer, Kim has successfully created and presented training workshops and seminars on various subjects. Since 2010, she has engaged audiences nationwide and internationally, sharing her expertise with therapists, teachers, administrators, and parents. Additionally, Kim is the co-author of "Just Right! A Sensory Modulation Curriculum for K-5. Registration To access this course and others, become a member of the OT Schoolhouse Collaborative . OTS Collab is an online community dedicated to providing school-based OT practitioners with highly valuable professional development and interactive support to implement learned strategies. In OTS Collab, we learn together, support and encourage one another, and celebrate our achievements as a collective whole. Click here to learn more about the OT Schoolhouse Collaborative and register in our dedicated community of school-based OT practitioners. Instructional Methods A combination of speaker presentation with a slide deck and both synchronous & asynchronous Q+A with the presenter. Target Audience & Educational Level This is an introductory level course intended for occupational therapy practitioners working in school systems or with a goal to better understand occupational therapy in school systems Course Completion Requirements To receive a certificate for this course, you must watch the recorded course in its entirety. Then, you will need to take a learning assessment test and earn a score 75% or higher. If you pass, a certificate will be automatically generated and sent to your email. Special Needs Requests This course will include closed captioning and a transcript may be available upon request. You may also rewatch the course or sections of the course as needed. Additional accommodations may be requested by reaching out to us via email. Financial & Non-financial Disclosures Speaker Disclosure Kim Wiggins receives a speaking fee from Sensational Brain LLC and is the owner of OTKimWiggins LLC. She is the co-author of Just Right! A Sensory Modulation Curriculum for K-5 and receives royalty payments from the sale of this product. Sponsor Disclosure The OTS Collaborative Community is a product of the OT Schoolhouse. Content Disclosure This learning event does not focus exclusively on any specific product or service. Schoolhouse Education, LLC is proud to be an AOTA Approved Provider of Professional Development AOTA-Approval for this Professional Development Opportunity is in progress. Stay Tuned! Join OTS Collaborative Terms and Conditions Schoolhouse Education, LLC will keep a record of your completed CE courses. When applicable, transcript services may include reporting to professional associations and/or state licensure boards. While Schoolhouse Education, LLC will make all reasonable efforts to offer CE credit for its courses, it is not responsible for state or national, or regulatory current policies or changes in CE requirements that may make courses ineligible for CE credits. Participant Agreement By registering for or attending any event or activity associated with the Schoolhouse Education, LLC and OT Schoolhouse, I agree to the following: Professional Development/Information Disclaimer The material presented in this course is not intended to represent the only or the best methods appropriate for the occupational therapy and/or medical condition or professional development issues being discussed but rather is intended to present the opinions of the presenters, which may be helpful to other health care professionals at arriving at their own conclusions and consequent application. Attendees participating in this professional development education program do so with full knowledge that they waive any claim they may have against the A-Z School-Based OT Course, Schoolhouse Education, LLC, and OT School House and its staff or representatives for reliance on any information presented during these educational activities. Waiver of Liability Agreement I release Schoolhouse Education, LLC, OT Schoolhouse, and its staff, presenters, and any other individuals or entities associated with this course from any and all liability connected with my participation, as well as from any liability related to changes to the schedule, events or activities. I acknowledge and agree that I am participating on my own choice and assume all risk in connection thereof and that in the event that a need for emergency medical service arises, I authorize and consent to such services being provided at my own expense. Cancelation & Refund Policy In the event that Schoolhouse Education, LLC must cancel the event for any reason, participants will be offered a credit toward the rescheduled event. OT Schoolhouse Collaborative subscribers may cancel their subscription at any time.

What is dysgraphia? Many professionals think it is simply a handwriting challenge. However, orthography is so much more than handwritten material. Debunking these three myths will change your perspective and clarify your understanding of dysgraphia. You will become the expert in your community about this disability and become competent in explaining the definition to other community members. Together, we can change the lives of 110 million children. < Back Three Myths of Dysgraphia Presented by: Cheri Dotterer, MS, OTR/L Watch on-demand and earn AOTA-Approved CEUs Join OTS Collab & Earn CEUs Learn more about OTS Collab Course Description What is dysgraphia? Many professionals think it is simply a handwriting challenge. However, orthography is so much more than handwritten material. Debunking these three myths will change your perspective and clarify your understanding of dysgraphia. You will become the expert in your community about this disability and become competent in explaining the definition to other community members. Together, we can change the lives of 110 million children. Learning Objectives 1. Learners will identify the components of Dysgraphia as outlined by the DSM-5 2. Learners will identify three commonly held beliefs about Dysgraphia that are not supported by research. 3. Learners will identify the various types of Dysgraphia and how to identify them. Contact Hours This course is 1 hour in length. (0.1 AOTA CEUs) OTSchoolhouse.com is an AOTA Approved Provider of professional development, #0252. Course approval ID# 06189. This distance learning - interactive and independent online course is offered at 0.1 CEUs (Introductory level, Foundational Knowledge). The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. National Board for Certification in Occupational Therapy As an AOTA-Approved provider of professional development, OTSchoolhouse.com courses are accepted by NBCOT® at a rate of 1.25 NBCOT PDUs per each hour of course content. NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc. Register for this course and future courses inside the OT Schoolhouse Collaborative for as little as $120 Register Now Learn More about OTS Collab Agenda 0-5 minutes Introduction 5-10 minutes What Dysgraphia is not 10-15 minutes What Dysgraphia is 15-30 minutes Intervention Types for Dysgraphia 30-40 minutes Common misunderstandings 40-50 minutes Dysgraphia Interventions 50-55 minutes Conclusion 55-60 minutes Questions and Answers Your Instructor Cheri Dotterer, MS, OTR/L Cheri is an international speaker, author, and consultant who helps teachers, therapists, and parents build clarity, community, and competency around the barriers to writing success. Her book, Handwriting Brain-Body DisConnect, has remained in the Top 100 on Amazon since publication in Handwriting Reference and Learning Disabilities. It was also a Top 10 Finalist in the Author Academy Awards in 2019. In addition, she was nominated the USA 2022 Dysgraphia Expert of the Year by Global Health and Pharma Magazine. She has worked in many concentration areas as an occupational therapist for 25 years. However, it wasn't until starting her private practice that she found her passion for helping others understand this disability. In addition, she has been an adjunct instructor at several universities. She lives with her husband of 32 years. They have two adult children. Together we can impact the lives of 110 million children by 2025 with writing challenges. Registration To access this course and others, become a member of the OT Schoolhouse Collaborative . OTS Collab is an online community dedicated to providing school-based OT practitioners with highly valuable professional development and interactive support to implement learned strategies. In OTS Collab, we learn together, support and encourage one another, and celebrate our achievements as a collective whole. Click here to learn more about the OT Schoolhouse Collaborative and register in our dedicated community of school-based OT practitioners. Instructional Methods A combination of speaker presentation with a slide deck, polls, and Q+A with the presenter Target Audience & Educational Level This is an introductory level course intended for occupational therapy practitioners working in school systems or with a goal to better understand occupational therapy in school systems Course Completion Requirements To receive a certificate for this course, you must watch the recorded course in its entirety. Then, you will need to take a learning assessment test and earn a score 75% or higher. If you pass, a certificate will be automatically generated and sent to your email. Special Needs Requests This course will include closed captioning and a transcript may be available upon request. You may also rewatch the course or sections of the course as needed. Additional accommodations may be requested by reaching out to us via email. Financial & Non-financial Disclosures Speaker Disclosure Cheri is the owner and co-host of The Writing Glitch Podcast and Community. She creates PD for dysgraphia for Dotterer Educational Consulting. Sponsor Disclosure The OTS Collaborative Community is a product of the OT Schoolhouse. Content Disclosure This learning event does not focus exclusively on any specific product or service. Schoolhouse Education, LLC is proud to be an AOTA Approved Provider of Professional Development AOTA-Approval for this Professional Development Opportunity is in progress. Stay Tuned! Join OTS Collaborative Terms and Conditions Schoolhouse Education, LLC will keep a record of your completed CE courses. When applicable, transcript services may include reporting to professional associations and/or state licensure boards. While Schoolhouse Education, LLC will make all reasonable efforts to offer CE credit for its courses, it is not responsible for state or national, or regulatory current policies or changes in CE requirements that may make courses ineligible for CE credits. Participant Agreement By registering for or attending any event or activity associated with the Schoolhouse Education, LLC and OT Schoolhouse, I agree to the following: Professional Development/Information Disclaimer The material presented in this course is not intended to represent the only or the best methods appropriate for the occupational therapy and/or medical condition or professional development issues being discussed but rather is intended to present the opinions of the presenters, which may be helpful to other health care professionals at arriving at their own conclusions and consequent application. Attendees participating in this professional development education program do so with full knowledge that they waive any claim they may have against the A-Z School-Based OT Course, Schoolhouse Education, LLC, and OT School House and its staff or representatives for reliance on any information presented during these educational activities. Waiver of Liability Agreement I release Schoolhouse Education, LLC, OT Schoolhouse, and its staff, presenters, and any other individuals or entities associated with this course from any and all liability connected with my participation, as well as from any liability related to changes to the schedule, events or activities. I acknowledge and agree that I am participating on my own choice and assume all risk in connection thereof and that in the event that a need for emergency medical service arises, I authorize and consent to such services being provided at my own expense. Cancelation & Refund Policy In the event that Schoolhouse Education, LLC must cancel the event for any reason, participants will be offered a credit toward the rescheduled event. OT Schoolhouse Collaborative subscribers may cancel their subscription at any time.

Terms of Use The information contained in this blog is meant to be used as a helpful resource for Occupational Therapy practitioners looking for resources to support their therapy. This is a personal weblog. The opinions (and they are only opinions) expressed here represent my own and not those of my employer (including but not limited to current, former or future employers). Nor of any universities or colleges I attend or have attended. The information written here is meant to support occupational therapy practitioners. It is not meant to replace consultation or treatment provided by licensed occupational therapy practitioners. If you are a parent, caregiver, or teacher who is concerned about the functional development of a particular child, you are encouraged to seek out a complete evaluation from a licensed occupational therapy practitioner. All therapy materials, websites, or applications mentioned in this blog are discussed as potential tools to aid in the development of functional skills. These tools are to be used as a part of, or in adjunct to, occupational therapy services and not in place of those services. It is up to the individual professional to determine if any of the mentioned therapy tools are applicable to the therapy process for each individual child. In other words, all content of this blog should be read and used at the discretion of the reader. Copyright Information: I blog and podcast because I love to help other therapists! I make therapy materials because I want to make your efforts easier. Feel free to use any of my ideas as long as you give credit to the OT School House and link back to OTSchoolhouse.com, a specific page on the OT Schoolhouse website, or an OT Schoolhouse social media page! Thanks! Please do not sell my ideas as your own. You may always link to my materials in your own blog or website with credit given. You may not use photos from my blog without expressed written permission. You may not host any content from otschoolhouse.com on your own website. You may link to this website but you may not allow direct downloads of the item from your site. You may not re-post any part of my blogs without expressed written permission. Please email me at info@otschoolhouse.com for permission. Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 United States License. This blog is a personal blog written and edited by me. This blog does accept forms of sponsorship and accepts and keeps free products, services, travel, event tickets, and other forms of compensation from companies and organizations. The compensation received will never influence the content, topics or posts made in this blog. 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Thank you for your interest in the Gray-Space Notebook! Since you have already subscribed to our email list, you know what our Gray-Space paper is and how it can help your students succeed in meeting their handwriting goals. Now, we are taking it to the next level to help those students who struggle by introducing the Fading Gray-Space Notebook . Just like the original documents you received when you subscribed to the email list, this notebook is designed to help your students improve the sizing, spacing, and placement of letters on the line as they use it in their classroom. Check out this video as a refresher and an extra tip for assisting your students. ON THE FIRST PAGE SMALL TALL AND TAIL AS A REFERENCE - I COULD HAVE ADDED THIS TO THE BOOK, BUT I BELIEVE IN LEARNING BY DOING AND THE APPRECIAtION OF SELF-CREATION FOR KIDS So here's a quick recap of the components embedded in this notebook that will help your students: ?? gray-scale pages designed to help your students size, space, and place their letters and words in a legible manner. 1/2" lined paper with a dashed midline throughout the entire notebook. 1/2" lined paper is used by most 1st to 3rd-grade classroom teachers. This is also perfect for students who require extra support for handwriting in all grades. The portion of each line from the dashed midline down to the baseline is 1/4" and fades from a pronounced gray shade on page one, to absolutely no gray in the final section of the notebook. Just like the gray fades, so do the tick marks that help your students space their letters and words. With 20 individual spaces for letters on each line, your students will be able to write an average of 4-5 words per line. Pages can be torn from the spiral binding, but we recommend leaving them in so that your student can see the progress they have made. Order Now! Here's the deal, Just like we said in the email, we are ready to produce and ship out these notebooks as soon as we get a total of 50 units ordered. So now is that part where I ask you to click the "order now" button if, and only if, you are thinking of or can think of a student who would greatly benefit from this notebook. At the end of the day, we (Jayson and Abby) are here to help students succeed. All students have different needs and we hope to have a way that can help them, but if not, we understand. If you would like to order 1 or more these notebooks for $14.99 each plus shipping, just Click here!

As we continue to decrease children’s time and space to move and play outdoors, we are seeing a simultaneous rise in the number of children that are presenting with sensory and motor deficits. At the same time, classroom teachers are observing more and more children having trouble with attention, falling out of their seats in school, increased clumsiness, and even aggressiveness with games like tag on the playground. So, how can we reverse this alarming trend of sensory and motor issues in children? How can we ensure that children are fully engaging their body, mind, and all of their senses? Using the same philosophy that lies at the heart of her popular TimberNook program—that nature is the ultimate sensory experience, and that psychological and physical health improves for children when they spend time outside on a regular basis—Angela Hanscom offers several strategies to help children thrive in outdoor environments using a therapeutic approach to nature play. < Back The Decline of Outdoor Play - And the Rise in Sensory Issues Presented by: Angela Hanscom, MOTR/L Attend live on January 22, 2025 or watch on demand the next day Join OTS Collab & Earn CEUs Learn more about OTS Collab Course Description As we continue to decrease children’s time and space to move and play outdoors, we are seeing a simultaneous rise in the number of children that are presenting with sensory and motor deficits. At the same time, classroom teachers are observing more and more children having trouble with attention, falling out of their seats in school, increased clumsiness, and even aggressiveness with games like tag on the playground. So, how can we reverse this alarming trend of sensory and motor issues in children? How can we ensure that children are fully engaging their body, mind, and all of their senses? Using the same philosophy that lies at the heart of her popular TimberNook program—that nature is the ultimate sensory experience, and that psychological and physical health improves for children when they spend time outside on a regular basis—Angela Hanscom offers several strategies to help children thrive in outdoor environments using a therapeutic approach to nature play. Learning Objectives 1. Learners will identify at least three changes in child development due to decreased outdoor play. 2. Learners will identify the underlying reasons why children increasingly present with sensory, motor, and social issues, as well as a decline in creativity and imaginative play abilities. 3. Learners will identify at least three strategies to promote healthy sensory and motor development, creativity, and independence through outdoor play in various environmental settings. Contact Hours This course is 1.5 hour in length. (0.15 AOTA CEUs) OTSchoolhouse.com is an AOTA Approved Provider of professional development, #0252. National Board for Certification in Occupational Therapy As an AOTA-Approved provider of professional development, OTSchoolhouse.com courses are accepted by NBCOT® at a rate of 1.25 NBCOT PDUs per each hour of course content. NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc. Register for this course and future courses inside the OT Schoolhouse Collaborative for as little as $120 Register Now Learn More about OTS Collab Agenda 0-5 minutes Introduction 5-15 minutes Understanding the history of TimberNook 15-30 minutes Impact of Reduced Outdoor Play 30-45 minutes Therapeutic Benefits of Outdoor Play 45-60 minutes Importance of Outdoor Play 60-75 minutes Strategies for High-Quality Play Opportunities 75-85 minutes Additional Strategies 85-90 minutes Questions and Answers Your Instructor Angela Hanscom, MOTR/L Angela J. Hanscom, MOTR/L is a pediatric occupational therapist and founder of TimberNook—an award-winning developmental and nature-based program that has gained international popularity. She is the author of Balanced and Barefoot: How Unrestricted Outdoor Play Makes for Strong, Confident, and Capable Children. Hanscom is also a frequent contributor to The Washington Post and in 2019 won the Small Business of the Year Award for the State of New Hampshire. Registration To access this course and others, become a member of the OT Schoolhouse Collaborative . OTS Collab is an online community dedicated to providing school-based OT practitioners with highly valuable professional development and interactive support to implement learned strategies. In OTS Collab, we learn together, support and encourage one another, and celebrate our achievements as a collective whole. Click here to learn more about the OT Schoolhouse Collaborative and register in our dedicated community of school-based OT practitioners. Instructional Methods A combination of speaker presentation with a slide deck and both synchronous & asynchronous Q+A with the presenter. Target Audience & Educational Level This is an introductory level course intended for occupational therapy practitioners working in school systems or with a goal to better understand occupational therapy in school systems. Course Completion Requirements To receive a certificate for this course, you must watch the recorded course in its entirety. Then, you will need to take a learning assessment test and earn a score 75% or higher. If you pass, a certificate will be automatically generated and sent to your email. Special Needs Requests This course will include closed captioning and a transcript may be available upon request. You may also rewatch the course or sections of the course as needed. Additional accommodations may be requested by reaching out to us via email. Financial & Non-financial Disclosures Speaker Disclosure Angela earn an income via being an author, presenter, and through TimberNook programming Sponsor Disclosure The OTS Collaborative Community is a product of the OT Schoolhouse. Content Disclosure This learning event does not focus exclusively on any specific product or service. Schoolhouse Education, LLC is proud to be an AOTA Approved Provider of Professional Development AOTA-Approval for this Professional Development Opportunity is in progress. Stay Tuned! Join OTS Collaborative Terms and Conditions Schoolhouse Education, LLC will keep a record of your completed CE courses. When applicable, transcript services may include reporting to professional associations and/or state licensure boards. While Schoolhouse Education, LLC will make all reasonable efforts to offer CE credit for its courses, it is not responsible for state or national, or regulatory current policies or changes in CE requirements that may make courses ineligible for CE credits. Participant Agreement By registering for or attending any event or activity associated with the Schoolhouse Education, LLC and OT Schoolhouse, I agree to the following: Professional Development/Information Disclaimer The material presented in this course is not intended to represent the only or the best methods appropriate for the occupational therapy and/or medical condition or professional development issues being discussed but rather is intended to present the opinions of the presenters, which may be helpful to other health care professionals at arriving at their own conclusions and consequent application. Attendees participating in this professional development education program do so with full knowledge that they waive any claim they may have against the A-Z School-Based OT Course, Schoolhouse Education, LLC, and OT School House and its staff or representatives for reliance on any information presented during these educational activities. Waiver of Liability Agreement I release Schoolhouse Education, LLC, OT Schoolhouse, and its staff, presenters, and any other individuals or entities associated with this course from any and all liability connected with my participation, as well as from any liability related to changes to the schedule, events or activities. I acknowledge and agree that I am participating on my own choice and assume all risk in connection thereof and that in the event that a need for emergency medical service arises, I authorize and consent to such services being provided at my own expense. Cancelation & Refund Policy In the event that Schoolhouse Education, LLC must cancel the event for any reason, participants will be offered a credit toward the rescheduled event. OT Schoolhouse Collaborative subscribers may cancel their subscription at any time.

Dr. Gibbs provides an overview of Trauma Informed Care and introduces the ACTION from Trauma Approach. The approach maps out neurological connections to further enhance understanding of the underlying mechanisms influencing behavior following exposure to trauma. < Back Self-Regulation and Trauma Responsiveness Presented by: Varleisha D. Gibbs PhD, OTD, OTR/L, ASDCS, FAOTA Watch on-demand and earn AOTA-Approved CEUs Join OTS Collab & Earn CEUs Learn more about OTS Collab Course Description Intergenerational, Organizational, Social, and Cultural trauma This course delves deep into the signs, symptoms, and evidence-based intervention approaches to address the various forms of trauma and challenges with self-regulation. Specific treatment techniques and strategies, including sensorimotor activities, self-regulation, and activities to address cultural safety based on the ACTION from Trauma Approach. Case examples will further illustrate symptomology such as emotional dysregulation, musculoskeletal problems, challenges with sensory perception, poor self-regulation, the impact on self-help skills, and cognitive deficits. Dr. Gibbs provides an overview of Trauma Informed Care and introduces the ACTION from Trauma Approach. The approach maps out neurological connections to further enhance understanding of the underlying mechanisms influencing behavior following exposure to trauma. Learning Objectives 1. Learners will examine the neurological connections and implications to lived experiences resulting in trauma and related conditions (i.e. Autism, SPD, and ADHD) 2. Leaners will apply methods and strategies to provide trauma responsive care 3. Learners will analyze Intergenerational, Organizational, Social, and Cultural trauma Contact Hours This course is 1 hour in length. (0.1 AOTA CEUs) OTSchoolhouse.com is an AOTA Approved Provider of professional development, #0252. National Board for Certification in Occupational Therapy As an AOTA-Approved provider of professional development, OTSchoolhouse.com courses are accepted by NBCOT® at a rate of 1.25 NBCOT PDUs per each hour of course content. NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc. Register for this course and future courses inside the OT Schoolhouse Collaborative for as little as $120 Register Now Learn More about OTS Collab Agenda 0-5 minutes Introduction 5-15 minutes Review of neurological connections and the Parasympathetic Nervous System 15-25 minutes Applying neurological connections to lived experiences for people with trauma-related conditions. 25-40 minutes Understanding Intergenerational, Organizational, Social, and Cultural trauma 40-50 minutes Introduction to trauma responsive care 50-55 minutes Moving forward with the ACTION Framework 55-60 minutes Questions and Answers Your Instructor Varleisha D. Gibbs PhD, OTD, OTR/L, ASDCS, FAOTA As an occupational therapist, Varleisha has a passion for designing strategies to support individuals in their journey to live their most independent and fulfilled lives. In addition to being a licensed occupational therapist, she is an author, speaker, and expert in the areas of the neurological connections for self-regulation, sensory processing, trauma responsive care, and health and wellness. She holds four degrees in psychology (University of Delaware), Master’s in Occupational Therapy (Columbia University), a clinical doctorate in Occupational Therapy (Thomas Jefferson University), and a PhD in health sciences and leadership (Seton Hall University), with a focus on health disparities in the autism community. Varleisha’s experience extends beyond her professional training, as her personal journey consists of various traumatic events that have shaped who she is today. Registration To access this course and others, become a member of the OT Schoolhouse Collaborative . OTS Collab is an online community dedicated to providing school-based OT practitioners with highly valuable professional development and interactive support to implement learned strategies. In OTS Collab, we learn together, support and encourage one another, and celebrate our achievements as a collective whole. Click here to learn more about the OT Schoolhouse Collaborative and register in our dedicated community of school-based OT practitioners. Instructional Methods A combination of speaker presentation with a slide deck, polls, and Q+A with the presenter Target Audience & Educational Level This is an intermediate level course intended for occupational therapy practitioners working in school systems or with a goal to better understand occupational therapy in school systems Course Completion Requirements To receive a certificate for this course, you must watch the recorded course in its entirety. Then, you will need to take a learning assessment test and earn a score 75% or higher. If you pass, a certificate will be automatically generated and sent to your email. Special Needs Requests This course will include closed captioning and a transcript may be available upon request. You may also rewatch the course or sections of the course as needed. Additional accommodations may be requested by reaching out to us via email. Financial & Non-financial Disclosures Speaker Disclosure Dr. Gibbs is an employee of AOTA. She is also the author of books shared in this session. Sponsor Disclosure The OTS Collaborative Community is a product of the OT Schoolhouse. Content Disclosure This learning event does not focus exclusively on any specific product or service. Schoolhouse Education, LLC is proud to be an AOTA Approved Provider of Professional Development AOTA-Approval for this Professional Development Opportunity is in progress. Stay Tuned! Join OTS Collaborative Terms and Conditions Schoolhouse Education, LLC will keep a record of your completed CE courses. When applicable, transcript services may include reporting to professional associations and/or state licensure boards. While Schoolhouse Education, LLC will make all reasonable efforts to offer CE credit for its courses, it is not responsible for state or national, or regulatory current policies or changes in CE requirements that may make courses ineligible for CE credits. Participant Agreement By registering for or attending any event or activity associated with the Schoolhouse Education, LLC and OT Schoolhouse, I agree to the following: Professional Development/Information Disclaimer The material presented in this course is not intended to represent the only or the best methods appropriate for the occupational therapy and/or medical condition or professional development issues being discussed but rather is intended to present the opinions of the presenters, which may be helpful to other health care professionals at arriving at their own conclusions and consequent application. Attendees participating in this professional development education program do so with full knowledge that they waive any claim they may have against the A-Z School-Based OT Course, Schoolhouse Education, LLC, and OT School House and its staff or representatives for reliance on any information presented during these educational activities. Waiver of Liability Agreement I release Schoolhouse Education, LLC, OT Schoolhouse, and its staff, presenters, and any other individuals or entities associated with this course from any and all liability connected with my participation, as well as from any liability related to changes to the schedule, events or activities. I acknowledge and agree that I am participating on my own choice and assume all risk in connection thereof and that in the event that a need for emergency medical service arises, I authorize and consent to such services being provided at my own expense. Cancelation & Refund Policy In the event that Schoolhouse Education, LLC must cancel the event for any reason, participants will be offered a credit toward the rescheduled event. OT Schoolhouse Collaborative subscribers may cancel their subscription at any time.

My Items I'm a title. Click here to edit me. OTS 196: AI and Clinical Reasoning in School-Based Occupational Therapy Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 196 of the OT Schoolhouse Podcast. Artificial intelligence is quickly entering healthcare and education, and occupational therapists are asking an important question: How can we use AI responsibly without losing the clinical reasoning that defines our profession? In this episode, Jayson Davies sits down with OT educator and researcher Tara Mansour to explore practical, ethical ways school-based OT practitioners can begin using AI tools. Tara shares how she teaches future occupational therapists to use AI as a “first draft partner” while still prioritizing evidence-based practice, professional judgment, and student-centered care. They also discuss privacy considerations, prompt strategies, treatment planning ideas, and how AI can support data collection, documentation, and intervention development. If you're curious about how AI might fit into your school-based OT workflow—or concerned about how it could impact clinical reasoning—this episode provides a thoughtful and practical perspective. Tune in to learn how AI can support occupational therapy while keeping the human clinician firmly in the loop. Learning Objectives — Learners will describe appropriate ways AI tools can support school-based OT practice, including treatment planning, documentation drafting, and intervention idea generation. — Learners will explain ethical and privacy considerations when using AI, including FERPA and HIPAA concerns and strategies for de-identifying student information. — Learners will identify the "human-in-the-loop" approach to AI-assisted practice, distinguishing between AI-generated versus AI-assisted work and the role of critical clinical reasoning in evaluating AI outputs. Guest Bio Dr. Tara Mansour, OTD, MS-HPEd, OTR/L, is an Assistant Professor and Academic Fieldwork Coordinator at the MGH Institute of Health Professions with over 23 years of clinical experience. As a PhD candidate in Health Professions Education, she investigates innovative approaches to prepare students for professional practice, with a focus on integrating artificial intelligence into fieldwork education to strengthen learning and critical thinking. Dr. Mansour co-chairs the Generative AI Task Force at MGH IHP, leading initiatives to explore AI-driven innovations in health professions education. She has authored scholarly articles on AI integration in clinical education, including publications in Frontiers of Medicine , Medical Education , and the Journal of Allied Health . Nationally recognized for her contributions, she has presented at AOTA's Education Summit and Academic Leadership Conference and serves on ASAHP's Clinical Education Committee, shaping best practices in clinical training across disciplines. Quotes "AI is really… a first draft partner or an option generator. It is not a decision maker.” — Dr. Tara Mansour "The risk isn't the tool—it's turning off your critical thinking. When used well, AI can actually strengthen reasoning." — Dr. Tara Mansour “Unreflective use weakens reasoning. Over-reliance without thinking weakens reasoning.” — Dr. Tara Mansour “AI probably won't replace us soon, but we need to use AI. to basically enhance OT and to keep it at the forefront of health sciences.” —Jayson Davies Resources 👉 ChatGPT for Educators 👉 Claude 👉 Co Pilot 👉 Google Gemini 👉 Linkedin 👉 Tara’s Research 👉 Pearson Clinical Assessments 👉 American Occupational Therapy Association 👉 AOTA INSPIRE Conference 👉 MGH Institute of Health Professions Episode Transcript Expand to view episode transcript Jayson Davies Welcome back to the OTs schoolhouse podcast, your source for all things school based occupational therapy. I'm Jayson Davies, and today we're diving into a topic that is reshaping our profession, artificial intelligence and occupational therapy. Joining me today is Dr Tara Mansour, assistant professor and academic fieldwork coordinator at the MGH Institute of Health Professions with over 23 years of clinical experience, including extensive work in school based occupational therapy, Tara has become a national leader in integrating AI into health professions education. In this episode, we are tackling some of the questions that you have been asking me, like, Can AI help with IEP goals. How do we ethically use AI in our practice? Will it weaken clinical reasoning for current and or maybe even future occupational therapy practitioners? And most importantly, how can AI give us back the time that matters most so we can work directly with our students, whether you're AI curious or AI cautious, this conversation will give you practical, ethical strategies to make AI work for you, not replace you. Let's get started. Amazing Narrator Hello and welcome to the OT school house podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies, CLASI is officially in session. Jayson Davies Tara, welcome to the OT school house podcast. It is a pleasure having you on as you know, I love AI, and it sounds weird to say I love AI, but it is true, and I love it, how it can support us. And I know you have a lot of experience with AI, so I'm excited to dive into this topic with you. How are you doing today? Tara Mansour I'm well, thank you for having me here. I'm excited Absolutely. Jayson Davies And, you know, as we get started, I just kind of want to give you an opportunity just to share a little bit about where you are in the world of occupational therapy, and you can even start to dive into, kind of how you came around into the world of AI, Tara Mansour sure I'd love to. So I've been an occupational therapist for almost 25 years, and I spent a large portion of my clinical career in school based practice. I started my career in inpatient rehab with a specialty in neuro rehabilitation, and then transitioned to school based practice working in an elementary school that housed a medically complex sub separate classroom. Over time in that same public school district, I worked across different elementary schools, the middle school and the high school, really working with a variety of students with different needs. In that setting. Also, I served as a level two fieldwork educator for many students, which led to my transition to academia, where I now serve as the academic fieldwork coordinator and assistant professor at the MGH or Massachusetts General Hospital's Institute of Health Professions. There, my role focuses on preparing future occupational therapists for clinical practice, especially through field work education. Jayson Davies And that is not an easy job. There's a lot of people that you have to coordinate with, the students, the field work educators, the people in your program Tara Mansour there sure are. It is satisfying. I love when our students come back from their level two field work placements and are ready to jump in and ready to make the transition for my students to my future colleagues awesome. Jayson Davies And before we really dive into everything, I kind of want to ask a fun question here, and that is, how is AI been the most helpful for you in this role as a field work coordinator, Tara Mansour from an education perspective, it helps me in developing resources for our students and our field work educators, from learning activities to evaluation tools. It is a great draft partner. You know, we'll talk a little bit more as we move forward about a human in the loop approach, but from composing emails to creating learning activities, I find many, many ways to utilize it within my current practice in education, perfect. Jayson Davies All right, so yeah, now let's kind of get to that point where you started to maybe the first, the first points at which you started to realize that AI could be helpful, and what brought AI onto the radar for you? Tara Mansour So honestly, AI first got on my radar because I have teenagers. They were the ones who introduced me to chat, the chat GPT app on their phones, and at first it was more of a curiosity thing. Coincidentally, around the same time, I was also hearing from field work educators that they wanted to see our students coming up with more creative intervention ideas. Well, I absolutely can appreciate and understand that I was a level two fieldwork educator myself, and very much appreciated a fresh set of eyes and creativity from my perspective now as an academic field work course. Of neater. My concern was different. I was less worried about whether students had creative activity ideas, and more concerned about their clinical reasoning. Were they grading activities appropriately? Could they create a just right challenge? Were their intervention choices evidence based? Could they successfully document the treatment session? I didn't want our students spending an hour and a half scrolling Pinterest or maybe these days Tiktok for treatment ideas. I'd rather they spend that time thinking through the clinical decision making behind the plan, especially because they're new and they don't yet have a deep toolbox to draw from. So that's when the question shifted for me, how can we leverage AI to generate idea options quickly while still teaching clinical judgment, ethics, safety and responsibility? And for me, that really became the entry point for my work with AI and OT education. Jayson Davies All right, perfect. I like that because I think there is a fear. I've done some work, some research, in AI, and some of the things that we hear is that students aren't going to have that clinical ability, that ability to process clinically because of AI. And I'm sure you probably have had this idea and wrestled with this idea as well. So I really want to kind of dive into this. It's not a resource, this program that you've started to put together a little bit and how you are trying to help the students without, you know, giving them this tool that makes it too simple for them, absolutely. Tara Mansour So, you know, AI is really, I frame it as a first draft partner or an option generator. It is not a decision maker. So while AI can indeed suggest things like goal language, intervention ideas, ultimately, as the OT practitioner or student occupational therapist, you are the one evaluating and editing everything clinical reasoning you know, lives in the filtering and the adapting. You know you're asking, does this actually match my client? Is it the right challenge level? Is it appropriate in this environment? Is it evidence based? So while AI might be able to handle some of the repetitive scaffolding pieces, the structure, the wording. Some idea lists the therapist always have has to apply professional judgment. It widens the option set, but the OT still chooses the path. Jayson Davies So I will mostly, you know, frame this all around school based OT, because that's exactly what 99% of the people that are listening to this are so I guess my question is, then, when you're supporting your students or either even other clinicians, how are you suggesting that they prompt? Is it more of because you talked about right finding ideas versus the actual clinical reasoning? Are you suggesting that they prompt in a way that's like, I have this student experiencing this strengths? Are this? What are some ideas? Or do you kind of flip that approach and say, Hey, I have this idea for painting something. How would this apply to my student? Or is it a mix of both, or more than those two? Tara Mansour Yeah, I would say it's really the first but that's just the first part. So I teach them how to enter in case study information while not providing any client identifying data. That's the first part. We do talk about prompt engineering, what makes a good part a prompt and what doesn't make a good prompt. And they get the opportunity to kind of play in that playground a little bit. Ultimately, though, what is generated by AI that is just really the first part of the assessment, because then they need to take what they have found, those intervention ideas. And maybe they scaffold that, or they they reprompt Based on what the output is right to narrow things down. But once they choose three intervention ideas, which is what we do as part of the assignment, then they have to go to the literature, they have to go to their textbooks, they have to go to peer reviewed journal articles, and they need to justify, for me why that intervention is indeed an evidence based choice. They have to go back to what I provide them as the patient's chart, looking at their precautions, and they have to determine why, ot what their final choice of interventions is based on that review. So we're not just teaching them to utilize generative AI for intervention planning ideas, but we're incorporating evidence based practice so they can effectively evaluate what AI is putting out there. Jayson Davies Yeah, that's smart. I think we all. So the term hallucination should have been like the word of the year a year and a half ago or so. It's still it's still happening. I like to think that it's happening less when I'm using it, I'm seeing less completely made up research articles being linked, but it still happens, and obviously the output definitely have to judge it and find out if it's right, just like you have to do honestly with any article, though, like any article we read, we have to go through that process to make sure it's worth reading and worth really taking information from So, yeah, absolutely okay. One thing that you brought up was making sure that your students aren't using identifiable language, right? We have to be HIPAA, compliant, fair, but compliant within the school based realm. What is important to not put into something like chat, GPT? Can we use a first name? Or can we not use a first name? Do we need to use pseudonyms? Should we just erase all information period? What's safe, what isn't? Tara Mansour So I think, you know, some non negotiables, no matter what setting you're in is no identifiable student information ever goes into a public AI tool. So I would not even consider using a first name and not a last name. I would say, you know, make up a name, no dates of birth, no school names, no facility names. You know, I think sometimes even within our communication as practitioners, we think that using initials is non identifying. When, in reality, if somebody was, you know, being, you know, if public records were being utilized, they're going to search for those initials as well. So no initials, no unique facts, and no uploaded reports or IEP documents. Jayson Davies Yeah, yeah. It's funny when I was doing sorry really quickly, when I was doing my initial, like HIPAA review, you know, for myself again, just to kind of go back and look, I forgot that you know if that first name can be attributed to you and where you work, and you only have you know one or two of people with that name on it, well, that is officially identifiable information, and anyone can go on to your LinkedIn page and figure out where you work. And so that's pretty easy. Tara Mansour Yeah, absolutely. And I think that you know, what I teach students and clinicians is to really make sure they're using generalized de identified descriptions. They can they can mention functional skill areas, maybe interest themes, goal categories that should be really more than enough to generate useful ideas without risking privacy. The other thing from my experience is that in the school system, they often have contracts with sites that do indeed allow you to provide identifiable client information. And I've heard some things around Google and public school access that has said it was FERPA compliant. But unless you have that from your district's IT department, I would always default to the side of caution and depersonalizing any added information. Jayson Davies Yeah, absolutely. While you're speaking, I was trying to look up the chat GPT free educator version, because I know they provide chat GPT to free for educators and students, I believe, but I don't know if that free version is HIPAA compliant. I want to say maybe, but definitely do your own research. And it could change, right? They can change anytime. Tara Mansour And I wouldn't go by the the external program telling you that super compliant. I would go to your IT department and make sure that you're following your own institution roles. Jayson Davies Great point, yeah, third party, or even the people that on your side, make sure you're covered from that and not don't always. I mean, we don't trust the AI for the content that they generate all the time, so we should definitely be mindful of what they are saying as well. Good point. Okay, we're gonna go ahead and take our first break, but when I come back, I want to talk to Tara about where she feels that AI can best support school based ot practitioners like us. So stay tuned. Okay, so, so there's a lot of OT practitioners in the research that we've done, they were worried about new students almost being having an over reliance on AI and not having the clinical reasoning skills because they've had chat GPT since, like your teenagers have. So the question is, is, how do we prevent that? How do we ensure that these students that are coming out of OT school aren't just relying on chat GPT, and that if chat GPT were to, you know, die overnight, they would still have that clinical reasoning. Tara Mansour So I would say this is a large concern, and I take that concern very seriously, especially as, you know, faculty in an OT education program, I actually don't think that the tool, it's. Self weakens reasoning. Unreflective use weakens reasoning. Over reliance without thinking weakens reasoning, and that risk exists with many tools that we already use. True from a school based perspective, let's think about the example of weighted vests. Okay, if a clinician reads an article in a peer reviewed journal about weighted vests, and then starts using weighted vests with their students, without collecting data, because the article deemed it effective, yet they proceed without any monitoring, without monitoring any outcomes. The issue is not the vest. The issue is the reasoning process around its use. So did they look at the evidence base broadly? Did they individualize? Are they measuring the students responses? I really think that AI is similar. The risk isn't the tool. It is turning off your critical thinking. I do believe that when used well, AI can actually strengthen reasoning, because it gives you multiple options to compare and critique, and that comparison process in itself is a clinical reasoning exercise. The key is how we teach and we model use AI should really expand their option set, not make their decisions. And clinical reasoning lives in the selection, the adaption, the justification and the outcome tracking, and that part remains fully human. Jayson Davies I want to, I want to press on that. How does, how does Chachi BT expand options? I mean, you mentioned the vestibular or the weighted vest or pressure vest, and I totally understand that, right? We need to make sure that on the back end, we are tracking data and whatnot. But you mentioned that idea of chat GPT opening up the options. What do you mean by that? Tara Mansour So it may give you a variety of interventions, ideas that you may or may not have considered, but again, that human in the loop approach. We're not using chat, GBT as our Google and then just taking what it says. We are saying, okay, these are some good options. Now I need to critically reflect on what it is suggesting and think about is it evidence based? Is this beneficial for my client, is it going to be of interest to my client? So so it expands that as long as you are not you know, what I say to my students is, if you're running late for a field work and you haven't done your treatment planning for your 8am session, you cannot use chat GBT in the five minutes that you're getting off the bus to say, I am working with a patient who had a stroke. What should I do? And then jump in there five minutes later and just translate the output of chat GBT into your treatment session? There is no reflective use in that Jayson Davies good point. Yeah, it's true, and it's interesting, because I think there is kind of this, these tools, I don't think are readily available yet, but eventually, I think that, good or bad, you will be able to do something to that degree. I think because eventually, and it's already happening, AI is being built into our EMRs, and therefore it knows what I did with Johnny yesterday. Knows what I did with Johnny last week, the week before, the week before that. It it has the evaluation in a form that is secure and HIPAA compliant, and it does know a lot about Johnny. And so to what degree should I still or do I still need to reflect upon something if it has all that background data on Johnny tough Tara Mansour question, well, we're not there. We're not there yet. I think you're right. I think that what initially was spoken about when we thought about generative AI were these standalone, large language models, chat, GBT, copilot, Gemini, you name it, but what we're really seeing now in clinical practice, just like you said, is that there are systems, there are AI systems being built in to the EMR. My concern is, less How much does it know about Johnny, and more about how much does it know about Johnny's diagnosis or appropriate interventions? What it's not going to know is Johnny's interests, that Johnny likes cars, but he hates baseball, right? And so you're not always going to be to be able to rely on the suggestions outputted, right? It also depends on what is your system. Where is your system pulling the data from? Is it pulling I would always continue to be extra cautious if data is being pulled from the web, or are you behind a firewall and it's only using the information you've provided it with? So I do think we are a long way away from simply throwing a prompt out there and being able to act on it again. From a school based perspective, it might have wonderful ideas. When students are presenting with certain disabilities or diagnoses, but it still doesn't know their interests and that personalization piece that makes us OTs, yeah. I mean, never say never. But I that wouldn't be a way in the near future I would envision teaching anybody to use the tool, Jayson Davies yeah, yeah. I also know, I mean, how many times have all of us gone into a session with an idea that we thought was great, whether it came from Instagram, Tiktok, our own brain, or chat, GPT, and then we had to go through three different interventions during that session, because students, you know, have days. We have days and and sometimes plan A and B don't work, and so you got to move to Plan C and D. So you've got to have that clinical reasoning skills to do it in the moment, not five minutes or five days before the session actually starts, Tara Mansour absolutely and I think that goes into just old fashioned treatment planning, right? Like, you know, even with with generative AI aside, students have to be able to, you know, be iterative or change their treatment plans. And to be fair, that is a more challenging experience for them, because they don't have the toolbox. They don't have the automaticity yet that those of us with more years of experience have. And so you know that goes back to a whole nother activity that has nothing to do with chat GBT per se, which is making sure our students are completing treatment plans when possible that has a variety of interventions so they're not panicking and freezing in that moment when things ultimately have to Change. Yeah, that's a best practice in field work, education, I would say, versus, you know, generative AI, Jayson Davies yeah, yeah. And that's fair, kind of touching, you know, going specific into school based OT. I often like to break school based ot into a few categories of things that we do. One is that evaluation piece. Then we kind of have the after the advice, after the evaluation. We have to do treatment planning. We actually have to do the treatment itself. And then there's some, you know, administrative side to it. There's some MTSS, do you think that AI can really support all of those areas equally? Do you find it more beneficial for particular areas? Obviously, we've talked about treatment planning a little bit, so little bit so far today, but what areas encompassing school based OT, do you feel like AI can really be supportive? Tara Mansour So, you know, I think, I don't think it's equally across all of the things that you just mentioned. I think that first draft note, writing, goal wording, again, with full human review, can be accelerated with the use of generative AI. I think that accelerated time gives students and clinicians, you know, more time to think deeply about what actually happened in the session or what to do next. I think it's important to realize, especially within the context of school based practice, this kind of technology isn't completely new. In ot we've seen earlier ways of digital assessment technology, right? Many of our evaluations moved from manual scoring to digital platforms years ago. You know, tools like Pearson's digital scoring lets you enter subset scores and generates for you structured summaries and interpretive language. If your district subscribes to that platform, the sensory profile went digital. No more hand scoring grids, right? That was an early automation supporting clinician efficiency, and I think I see AI, you know, as a part of that same evolution with a little bit more flexibility and more interactive. I think it can help with things like drafts of reports, you know, drafts of progress notes, drafts of IEP goals, drafts of present levels of performance. But ultimately, the interpretation and clinical judgment still belongs to the OT. I think the goal is, you know, time saved on mechanics, and it's kind of reinvested, reinvested in, in reasoning, if you will, gotcha. Jayson Davies And, yeah, I completely agree with the time saving thing. I've experienced this before, and I want to hear if you've experienced this, or, or, if you've, you know, worked with some of your students or other clinicians that have experienced this, where you think that AI is actually going to save you time, but then you get playing with it, and you go down a rabbit hole. I mean, we always talk about how many tabs we have open in our, you know, our Google Chrome, but oh my goodness, the chats that I have on the left hand side of my chat, GPT, like it's infinite. I don't know how many are there. So have you experienced that yourself and or from others, Tara Mansour I think, as a new clinician, or being exposed to a new tool that you are not that you are not used to using. So it's always going to be time heavy. In the beginning, the your clinical reasoning is going to be more time heavy. Learning best prompts is going to be time heavy. I don't think that it's one of these things that you introduce and all of a sudden it is, you know, a magic fix. When I was working in school based practice, I did have a student who was struggling with report writing, and a friend of mine, a peer of hers, had this company where you just entered in some of the student information from the evaluation, and it actually generated a whole report for you. Now I didn't love the format of that report, and initially, when practicing to utilize that system myself. It took me longer to write a report than if I just sat there to write the report myself, but over time, it did decrease the amount of time I needed to write the report, and I came to really appreciate that as a resource. Jayson Davies Yeah, yeah, and I agree. I mean, it takes a it takes some time getting used to chat GPT and or if you're going to use Claude, or whichever going to use, it takes some time to get used to it, and again, some time to understand prompting. You talked earlier about how you help with prompt generation for the students that you're working with and helping them understand AI, do you find that there are specific ways, or specific, I guess, templates for prompts that work out well for school based occupational therapy, or just ot in general? Or can you just write in anything? Tara Mansour So I don't, I very intentionally don't create templates as it's different for every student, every client. What you're asking, you know, generative AI to do. What I will say is, I do educate them on a process in generating good, you know, strong prompts. And I I just pulled up my slideshow that I use with them. And what I'm looking at is in generating an effective prompt. This is the outline that I suggest they go through, which is, step one, identify the client population and condition. Step two, specify the occupational performance challenge. Step three, define the intervention focus. So for example, as I bring them through this learning activity, as we are reviewing the case study, I am asking them to determine the frame of reference to their approach. Am I looking for a compensatory, rehabilitative frame approach? Am I looking for a more remediation or biomechanical frame of approach? Then I'm asking them to consider the treatment setting and available resources. Is this inpatient outpatient school based? Where is this session happening? And then they can request a specific response format, give me some intervention ideas. Or they might say, give me some ideas for a 30 minute session. Or they might say, just give me ideas that fit within the biomechanical, you know, frame of reference. And then step six, which is most important, is refine the prompt. So when you get that first round of generated text, what do you like, what don't you like? Do you need to refine your initial prompt? Or can you just dive in deeper with some additional clarifying questions? I like to think of it. This whole approach was built for those people that have experience in doing literature reviews or searching databases for literature, you might put in a few words and get 12,000 responses, and then you're going back and you're saying and this, and that narrows it down, and this, and that narrows it down. So my whole instruction of utilizing generative AI in prompting and follow up prompts really is based on that whole idea of a literature review. Jayson Davies And you bring up that idea of a literature review, and I love that, because one of the biggest problems that I've run into with AI, and we talked a little bit about hallucination making up links and whatnot, is that I don't know what Article, database, chat, GPT or cloud have access to, and what they don't have access to. And so if I'm asking it for evidence or best practices, I am sometimes shocked, because it sometimes has access, complete access to an article, and other times it's only using just the abstract, and I never know what it's actually using, unless I kind of go into or click on the link and try and figure that out. So I guess my question is is, how do we and maybe the answer is, we just have to do it, you know, on our own. How do we know if something is actually evidence based? Raised if it's citing these articles, but we don't know if it has access to it. Does that make sense? Tara Mansour Yeah, absolutely. So I think that you know, remember, some journals are open access and some journals are not open access, right? So, so it can indeed only have access to an abstract, which sometimes will give you enough information that you need, and then other times it doesn't have access to full journal articles. Regardless, you should never trust gender, you know, generative AI's output into quoting the evidence, even if you put into your prompt, find only for me. You know, peer reviewed published articles. I still would not trust the system. I think a great first step is to say, give me the DOI number and follow the link and see if it's actually a DOI, right. And again, you're still never just trusting the information that it told you about the article. But now you have the DOI. Now you have access to the article. Read the article right, or download the article, put it back into the generative AI system and ask for a summary. Even that isn't always right, but now at least you're looking at very specific information that you fit it. Jayson Davies Yeah, interesting that you say, say that I have definitely gotten a quote from chat GPT, clicked on the DOI command, F or whatever search feature, type that quote in, and then you're always like, wait, you told me this was a quote. Why can I not find this three set of words in a row in this article that you said was directly from this article? So yeah, you got to be careful. You mentioned pulling the article and putting it actually into the source or the AI, I am, I have gone back and forth on this all the time, and I don't know where we fall as a profession on this one, and where is the line drawn, because i don't know i i Just troubled with it a little bit. I have done it. I definitely have downloaded an article, put it into chat. GPT, hey, help me summarize this, or what are the key points, or whatnot. But I'm torn on this, and I don't know where the profession stands on this. Have you heard anything? Tara Mansour I haven't. I feel like I have come to my own personal judgments for how I am choosing to utilize it. What I'll say is, if an article is open access, anybody has, yeah, access to it, right? So it's not that you are uploading copyrighted protected information. I will tell you that I have, I have been able to access an article. When I say access, I mean, understand an article more that if I was just reading maybe some of the statistics, language was going over my head, and I was having trouble really engaging in that article. But rather than just pushing it aside, being able to, then again, interact with generative AI to ask it specific questions, right? Not just give me a summary, but the article talks about Cohen box, you know, statistic. What does that mean? What is that measuring that, in my opinion, is a best practice of how we're utilizing it's almost your own personal tutor. You know to go back and just say you're going to rely on something for a generated summary. I agree with you. I have fed it content different across different platforms, actually, and and the different platforms vary about how accurate the quotes are that it gives it back. But even at that, find me a quote. Find the quote right? Like you should never be in a position to just use ever what generative AI outputs and then assuming it, you know, is correct. That goes back to what I said in the beginning about that reflective reasoning. There is always a human in the loop approach. It is never copy and paste. Jayson Davies Yeah, absolutely. All right, we're going to take a quick break, but when we come back, I'm going to ask Tara how she thinks that ot practitioners like us can use AI in our evaluation process. All right, I want to go through a few common tasks that school based ot practitioners would use or would complete throughout the day, and kind of just get some ideas from you about how AI might be used, and you've already mentioned a few, but kind of just task specific here. So for any evaluation, you know, most people already have their kind of set evaluation. They do certain things in order, but how might you begin to incorporate AI into the evaluation process? Tara Mansour So, you know, I'm not sure that I would, from the get go, be incorporating AI into the evaluation process. If I was given a referral and the students challenges, I would still initially, independently identify. By which tests I was going to complete, right? I would not utilize AI per like within the testing, because it is so much more. Testing is so much more than just following the protocol. It is observing their posture. It is absorbing it is observing their pencil grasp. It's observing their behaviors in the environment. I see the possibility of entering some of the data into the system after to help it draft with that being said, Because AI was introduced as I was outside of the clinical career, outside of my clinical practice, I'm not really sure how successful that would be or necessary. I always say that we're paid the big bucks that we are because of our clinical reasoning. So I still do think it is our responsibility to, you know, evaluate that ourselves. With that being said we said earlier. There's systems like Pearson that you're entering that information, and it's generating for you some summaries. Again, you're deciding what you're including and what you're not including. But I'm not sure that I would say in the evaluation part is where I would be utilizing AI. Now, if that was moving forward to the creation of an IEP, maybe entering my de identified evaluation and asking for some goal recommendations in the goal areas that I identify, that might be a nice step. We're always looking to kind of expand our goal bank, if you will, and then utilizing that system before you've even started the treatment to help you develop, you know, data tracking sheets so that once you start your interventions, you're able to track that data to determine if they're, you know, making effective progress. Yeah. Jayson Davies And I think a piece that school based ot practitioners can really use is during their like synthesis process, because I think we often question ourselves if we're thinking the right, you know, recommendations. And I think if we use it like a thinking partner and and talk to it, hey, you know, based upon what this assessment said and my clinical observations, I'm thinking this, you know, tell me where I'm right. Tell me where I'm wrong, tell me where what I'm not even thinking about, and get some ideas that way. Tara Mansour So maybe another way I might think about utilizing it is I've seen OTs in the past write handwriting goals that a student would likely never be able to do because they don't have the reading skills to match the expectations for the written output, right? So we don't necessarily, we're not necessarily masters of our Inter you know, professional colleagues tests that they're doing, but we might say, you know, again, de identified, how do their results on these tests impact their success with handwriting, right? What does develop, you know, what is a reading level of? I'm going to make something up, you know, for mean, oh, that means that they are, you know, at the syllable level, okay, well, then I don't want to write a handwriting goal around writing full words or sentences, because, you know, they're not necessarily able to, you know, if they have such significant challenges with encoding and decoding, yeah, we have to work within those boundaries. Jayson Davies Interesting, I hadn't really thought about that that much, because we often don't understand all the assessment tools that the speech therapist use, or we don't understand the psych assessment tools, or the teacher assessment tools. And that actually came up with me a few about a week ago, my son came home with assessment. He's in preschool right now, and I never heard of it. I don't even remember the name of it, but I was really quickly able just to take a few snapshots of the assessment results. And it's like, oh, this is what this actually means. I was like, Thank you, because there were no keys to what these graphs meant and whatnot on this test. So that can definitely be helpful for us to better understand the student in a way that we couldn't before, because we didn't know what the assessment results that the teacher or psych or SLP were giving us good point exactly. Tara Mansour And it's important that we have that whole picture right when we are creating our goals. Jayson Davies I guess, moving on from the evaluation piece, you've talked about an IEP and how it could be helpful with generating, you know, drafts or ideas for goals, ideas for maybe what the present levels of performance might look like, maybe even accommodations, rather than asking you the specifics of how you might do this, I want to go a different way with this question and ask, have you created, or have you advised others at all to create custom GPT prompts or custom gpts or that kind of help make this a little bit quicker, because. You're doing it so often. Tara Mansour So I will say right now I have two Capstone students working on developing custom gbts, one to support our field work educators, and one, believe it or not, to support their fellow peers through studying for, you know, their own courses I have, you know, I will say that within the conferences I have presented with we started at the level of playing in the sandbox, of utilizing it for things such as, I have a 30 minute session. You know, it is a six year old with this diagnosis, this diagnosis, with these goal areas. I mean, in diagnosis, in school based practice matters less, right, but they it is a six year old with these goal areas. They love trains. This is the format of my typical treatment session. Give me treatment ideas and a timeline, and that is both thrilling and exciting for my audience of practitioners, I think that what you're describing would be like next level, intermediate, advanced, right? I think people have to be comfortable before they can even wrap their head around a custom GBT. I've been playing around with it myself lately. I think there's amazing potential for it, absolutely, but I don't think that is your entry point for practitioners to utilize. Jayson Davies Ai, yeah, we've been playing around with one. I created one specifically to help students or not students. Sorry, I created one specifically to help ot practitioners take their de identified, present levels of performance, their goals for a student, or sorry, their present levels of performance, maybe some accommodations that they have in place, and any other information about the student, of course, de identified, and the tool will then, basically automatically, without Any additional prompting, create smart IEP goals. It will create some treatment ideas based upon those IEP goals. It will create both pull pull out and push in ideas. It also kind of will generate, if you tell it what grade the student is, it'll say, hey, this goal is related to these standards for that grade level, which I think is a piece we sometimes miss a school based ot practitioner. So I think it can be very helpful, but it's, it takes, like you said, a little bit more advanced, and it takes some time to set up in order to actually use it. So, yeah, yeah, all right, we talked a little bit about evaluation piece. IEP, we really started this, this process with talking about treatment planning per se. Where do you feel like the best opportunity for AI use exists for school based ot practitioners? Do you feel like it is that treatment planning piece, something we've already talked about or something that we haven't discussed yet? Tara Mansour I do think it's the treatment planning piece, and I think it's the data collection piece. I will say that you know, learning to take data that is not just a conversation you have with a teacher in the hallway is something that is our speech and language counterparts are so good at, and I don't think that OTs are always great at collecting data. So I think saying these are my goals. This is my timeline. How can I track this is an amazing use to show that you know our role is justified. I just had a student finish level two field work, and she speaks to how amazing it was to personalize sessions for her children, for her students, and how much more motivated they were to participate in the session when she came to the table with pictures, she quickly printed of resources, you know, of their favorite Disney characters or their favorite something. And so I think that the hard, the clinical reasoning part of you know, what level do we want to perform this at? Do we want to be asking them to copy letters? Do we want to be asking them to, you know, write it from memory? Do we want to be asking them to write words or full sentences? But then we can kind of say this person is a reading level of four. Again, they love trains. Give me some words I can ask them to write that have to do with trains that are able to be, you know, encoded by somebody with a reading level of four. And now, in an instant, you potentially can get so much more buy in and ultimately it, you know, the impact of that is not just efficiency, but it really is about, you know, increasing students participation in performance, and that motivation might help your your students, like, become even more engaged. Watched in their sessions. Jayson Davies Yeah, yeah. I've heard the same thing from from therapists as well, really being able to kind of bring the interest of the child into therapy much more easily. I mean, if you wanted to bring bluey into your session five years ago, you had to go back and research Bluey, watch some bluey episodes. Now you can just go on and say, hey, look, this is my treatment plan. Let's, let's implement the bluey version of this treatment plan. And, you know, put a few details, like their reading level or their writing ability and and you could get a lot of pretty ready to go stuff. So yeah, Tara Mansour and look, I'm a theater kid at heart. You want to have a conversation with me about Broadway shows, I know a lot, but if you want to have a conversation with me about how the Patriots did in yesterday's game over my head, but I can do a quick search in a system that looks at the web that if I get it wrong because it's not validated, that's fine, but like, I could easily bond with somebody in the first 30 seconds of building rapport, you know. Think about how many times, you know, our middle school students come into an evaluation session with the hood over their face, and they don't want to shut they don't want to say anything, you know. But if you can do a little bit of work in advance and find out what they're interested in, all of a sudden, you can come to the table with some facts that maybe wow them, or, like, at least engage them, and then all of a sudden, you know, what used to take, you know, a lot of time. You can shorten that rapport, building time. Good point. Jayson Davies Very good point. You mentioned a little bit about the research that you got going on, but I do want to give you an opportunity to share a little bit more about that, because I personally think that, and I think you kind of share this as well, that OTs need to be addressing AI in multiple fronts, otherwise there might be some negative consequences. And so I want to understand what you're working on in terms of AI. You mentioned a few of your your students doing some custom gpts? But what else you got going on? Tara Mansour Sure, so you know again, what was already published was from something that we did in 2024 about this education process. I told you about this learning activity, and we measured for the students, what did they learn? What did they like about use learning to use generative AI? What were the ethical challenges, safety challenges? And so that's something that we did and was already published. I just recently published something else that we need to study a little bit further. It was kind of an opinion piece on how can we use things like voice GBT to train our students with professional behaviors or difficult conversations, or how to explain the role of OT to a patient, to a family member, how to have a difficult conversation with a field work educator and be able to practice in a psychologically safe environment, right? And so again, depends on the prompting, because you're asking it for feedback, but that is one pretty cool way I'm currently having my students utilize it, and something that we need to get a formal study around. One of the bigger projects I'm working on most recently is this idea of using AI for qualitative data analysis of field work educators narrative comments in the field work performance evaluations, where there is so much valuable written feedback that clinical educators or field work educators provide about students strengths, their challenges, their professional behaviors during level two field work, but traditionally, the qualitative analysis of narrative data is incredibly time intensive. You're hand coding comments, you're building theme structures, you're checking reliability, and you know, it limits how large a data set most ot education faculty can realistically analyze. And so what we're studying right now is how AI can assist with this early stage qualitative coding and theme clustering, again, with a human researcher absolutely still in the loop validating and refining the findings. The goal is not to replace your typical qualitative methods, but to scale them in a responsible way so that we can use that information to, you know, adjust our curricula, better support our students and better prepare them for clinical practice. Jayson Davies Yeah, it's it's going to be amazing. The next five to 10 years of research with AI being embedded into every facet of the world, it's going to be interesting. I mean, in OT alone, I can only imagine all the studies that are going to be if not already happening right now. I mean, we've used AI to support some of the research I've done, and I know others are doing the same. I cannot wait to get to an. Inspire in Anaheim and and wherever it's going to be next year, and just see how many, how much research is going to be coming out that is AI supported OT, basically, to a degree. I think it's going to be interesting. I think it's something that we got to do. I've said it several times that like AI will not replace us, and we're very fortunate in OT, by the way, that we have registration, like we're certified, we're licensed, we have some protections, and I think we need to lean on that, but so AI probably won't replace us soon, but we need to use AI to basically enhance OT and to keep it at the forefront of Health Sciences. Tara Mansour So yeah, we do. You know, I've heard some valid concerns, right? Like, if you speak to folks, especially those in outpatient and acute care settings that are dealing with significant challenges in productivity demands, I think there, I've heard the concern, and it's a valid concern. Well, if you make my documentation time even more efficient? Are they going to expect me to see even more patients, right? So that also limits people's interest in adoption. Per se, they're not going to be eliminated. AI is not going to take them to the bathroom or teach them how to shower, right? But how many people you might have to work with could change if things get, you know, potentially more efficient. Jayson Davies Yeah, I mean, I think it's hard, it's gonna be hard to get more efficient, because we already have these high I mean, I'm in the school based role. We don't have this nearly as much, but I hear people in, like, acute rehab. It's like 90% plus efficiency. Like 90% of the time is supposed to be with a client, and I don't know how much more you can really get out of someone, even if documentation gets easier, but I'm sure, yeah, private companies will squeeze when when given the opportunity, so hopefully it occurs in a way that is sustainable, because otherwise, yeah, won't, won't be good. Tara Mansour Well, I think that's where our own research and being on the forefront and being proactive about how we best utilize it in our practice is really important, rather than waiting for someone to tell us how we should be utilizing it in our practice, Jayson Davies I think that is possibly the most important point of this episode, because we really do have to understand it so that we can make recommendations based upon it. Otherwise, someone else is going to make those recommendations, and it's going to be someone who is at the hospital above our head, is not an OT and is worried about profits over patients, and so absolutely got to do that. I was going to ask you, I think I still will ask you this one, it was kind of on the same, same line that we're talking here. And that is, if it's not that, what are you most concerned or fearful about? Ai, is it that, or is Tara Mansour it something else? So what worries me most? I guess, I mean, yeah, while I do recommend the importance about teaching reflection. I think what worries me most is over trust and over automation. People treating AI output as an authority instead of just an input. If we do stop questioning, verifying and reasoning, that is indeed a problem. I'm also concerned about privacy, equity of access, and, you know, tools being used without the proper literacy or guardrails. My hope is that, you know, in OT, we begin to model this balanced path forward of innovation with ethics, efficiency, judgment, and always, always, you know, a human in the loop approach. Jayson Davies Yeah, that's going to be key, especially for us who are so, you know, whole human centric as occupational therapy professionals. And, yeah, we got to, we got to keep that in the loop. Tara, it's been wonderful talking to you. Where Can anyone interested in you and your work learn more about you. Tara Mansour So you know listeners can find my work through my presentations and publications, both in occupational therapy and Health Professions, education, I mean, especially around AI, literacy, clinical education, field work support. I regularly present at OT and health professions education conferences on practical and ethical AI use in both teaching and clinical practice. I'll be at a ot a inspire in California in April, and I'm running a pre conference Institute focused on using generative AI for content analysis, for both educational and clinical applications, it's going to be a very hands on and grounded in real ot workflows, ethics and that human in the loop practice. You can find me on LinkedIn. I've made some wonderful connections for research and collaborations. I with people across the country, so you can find me there. Jayson Davies Absolutely Tara thank you so much. We really appreciate it. We will link to all those different sources, your research articles, as well as your LinkedIn so anyone interested can learn more. And you're going to be in Anaheim for like five, six days. Enjoy that. Have fun. Thank you. Thank you. I'm looking forward to it as well, so we'll see you there. And yeah, Tara Mansour thanks again. Wonderful. Thank you so much, Jayson. Jayson Davies All right, that wraps up episode 196 Thank you, Dr Mansour, for sharing your insights on how AI can support and, of course, not replace our clinical reasoning as school based ot practitioners from treatment planning to data tracking, it is clear that when we use AI thoughtfully, it can help us to free up time for what matters most, meaningful student centered practice, if you're looking for more practical resources, professional development and real time support from a community of school based ot practitioners who get it and are in the thick of things just like you check out the OT schoolhouse collaborative. It's where you'll find mentorship from myself and other school based ot practitioners, access to tools like our ever growing goal bank and documentation templates and a space to connect with other practitioners navigating the same challenge as you are. Head on over to OTSchoolHouse.com slash collab to learn more. Thanks for listening, and I'll catch you in the next episode. 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 OTs schoolhouse.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 More Your First 90 Days as a School-Based OT (Checklist Included) No matter the university you attended or the experience you have in other OT settings, starting as a school-based OT is equal parts exciting and overwhelming. The caseloads are high, the calendar is packed with IEP meetings before you've even met your students, and no one has handed you a manual on where to start. The good news? You don't need to have it all figured out on day one. Here's a week-by-week roadmap for your first 90 days to help you get from overwhelmed to a point where you actually have an idea what is coming next. Get your FREE 90-Day Checklist! Before we dive in, I put together a free companion checklist that walks you through every step in this guide, organized by week. It's printable, it fits in your binder, and it's yours to keep. Enter your name and email below and I'll send it straight to your inbox. *School districts sometimes block our emails, so we suggest using your personal email to ensure you get your checklist. Week 1: Orient Yourself Get to Know the People Who Will Support You Before you worry about therapy schedules or IEP goals, invest time in building relationships. Your effectiveness as a school-based OT will depend far more on your connections with people than on your clinical skills alone. Make it a priority to introduce yourself to: Other OTPs: If your district has other OTPs, be sure to connect with them. Try shadowing or meeting up with another OTP for lunch once a month to get the support you need. The speech-language pathologist (SLP): When there isn't an OT to ask for help, SLPs can be your next best option for IEP and goal writing support. Later on, they also make great collaboration partners. The school psychologist: A key partner in evaluations and eligibility decisions. They tend to have a good sense of the referral processes and district policies. They test a lot of kids and may be able to help you understand standardized assessment data. School secretaries: T hey run the building (no joke). Be kind, be grateful, and never underestimate them. When you need a quiet room, copies of your report, or help finding a kid, the secretary will be your go-to contact. The custodians: They will help you solve problems you didn't know you had. The custodial staff has helped me with everything from finding a chair for a kinder kid to building a Southpaw Swing rig in the OT room. Organize Your Caseload You can't serve students if you don't know they exist. Set up a spreadsheet before your first week is over and populate it with the following for every student on your caseload: Student name and grade Classroom teacher Case carrier (If different from the teacher) Service frequency, minutes, and type (direct, consultative, or both) Date of last evaluation Annual IEP date Triennial re-evaluation date This spreadsheet becomes the dashboard that guides your week-to-week operations. It may not be glamorous (unless spreadsheets are your jam), but it might be the single most important organizational tool you build. Get the Google Sheet I developed to track my caseload by joining the School-based OT Collaborative. Quick note : To complete this step, you will need access to your district's IEP and student management systems. Don't be afraid to reach out to the IT department if you don't have access to these systems in the first few days. Get Ahead of Upcoming IEPs Scan your spreadsheet immediately for students with IEPs that are past due or due in the next 4 to 6 weeks. Get in touch with the case carrier to see if an IEP has been scheduled, and block time on your calendar now to meet with those students to review their goals before the meeting. The thing you want to avoid at all costs: walking into an IEP and telling a parent, "I haven't had a chance to see your child yet." Unless it is genuinely your very first week on the job, this erodes trust quickly. IEPs don't wait for your timeline, so flag them on day one. IEPs are such a big deal that I have heard of new school-based OTPs being asked to attend an IEP even before their official start date . So, yeah, you want to be prepared for them. Weeks 2–3: Get Moving Set Up a Schedule. It Doesn't Need to be Perfect. New practitioners often delay starting services until they can build the " perfect schedule ". But let me share a secret with you. There is no such thing as a perfect schedule! Build a schedule, start seeing students, and adjust accordingly as conflicts arise. You can (and will) regularly revise your schedule as you add students, dismiss students, and make changes to students' service minutes. A schedule that starts imperfect and gets refined beats a perfect schedule that never gets off the ground. Movement is progress. Pro tip: Using a Google Doc or Sheet to keep your schedule makes it easy to share with teachers who want to know exactly when you see their students. Some teachers care, others don't. Build Your Goal-Tracking System Keeping track of student goals and progress doesn't need to be complicated, but it does need to be consistent. One approach that has helped me is using a physical binder for each school site (or every one to three schools, depending on caseload size). Organize each binder by the days and times you see students. When you finish with one student, flip the page, and the next student's goals and data sheets are right there. No hunting, no guessing. And if a student is absent, you just flip to the next student. Your daily progress notes and data tracking can live in the same binder. Prefer digital? A Google Doc or folder system organized by school and session time works just as well. What matters is that your system reduces friction so you can focus on the student in front of you, not on finding paperwork. Want to fast-track your way to being a confident school-based OT? Skip the uneasy feeling of being brand new to the schools & learn how to better support the students you serve with the A-Z School-Based OT Course. Learn and implement the processes and systems I put in place as school-based OT beyond the first 90 days to make my life easier and support my students more effectively. Click here to explore the A-Z school-based OT Course Weeks 4–6: Build your School-based OT Momentum Prioritize Rapport Over Progress This might feel counterintuitive, but for your first six weeks, worry more about building genuine relationships with your students and their teachers than about driving measurable goal progress. It is very difficult to make meaningful therapeutic progress with a student you don't know yet. Once rapport is established, students trust you, and teachers see you as a collaborative partner, progress tends to follow naturally. Show up consistently, be curious about each student, and earn your place in the classroom. That investment pays compounding returns. Conduct Your First Assessment At some point in these early weeks, you'll face your first school-based evaluation. If you're not sure where to start, Episode 1 of the OT Schoolhouse Podcast walks you through the process step by step. Don't let the unfamiliarity paralyze you. A solid evaluation follows a clear process, and you've been trained for this — even if it doesn't feel that way yet. We also have posts about completing evaluations and various assessment tools in our article archive. Get Comfortable Not Knowing the Answer You will be asked questions you don't know the answer to — in IEP meetings, in hallway conversations, even from students. This is not a failure. It is an unavoidable feature of being new to a complex setting. The professional and perfectly acceptable response to this is: "That's a great question. Let me look into that and get back to you." Then follow through. Teams respect this far more than a confident-sounding answer that turns out to be wrong. Lean on your SLP, school psych, and fellow OTPs. Find a mentor if you can. "Fake it till you make it" is not the correct approach as a new school-based OT. Weeks 7–12: Find Your Footing Start Driving Intentional Goal Progress With relationships established and your systems running, you'll (hopefully) begin to feel confident enough to shift from orientation mode to practice mode. You know your students now. You know the teachers (enough). Start pushing intentionally toward goal progress and use your data tracking system to document it. Lean Into the PLOP → Goals → Services Framework If there is one idea that will get you through 90% of your IEP meetings, it's this: the Present Levels of Performance (PLOP) drive the goals, and the goals drive the services. Services are not justified by a diagnosis, parent/doctor referral, or even a well-intentioned teacher. They are justified by a documented gap between where the student currently performs and what is required for educational participation, and by goals that aim to close that gap. Understand this deeply, and you'll be able to confidently explain and defend your recommendations to any team. When in doubt: start with the PLOP. Everything else follows. Inside the OT Schoolhouse Collaborative, I teach a course on how to determine services. Learn more about it here if you need additional support. Refine Your Schedule and Systems By now, you're starting to figure out what's working and what isn't. Adjust your schedule, move some pages around in your binder or digital system, and start building the rhythms that will carry you through the rest of the year. What NOT to Worry About in your first 90 days... Just as important as knowing what to do is knowing what to set aside... at least for now. Advanced CEU courses. Your energy is better spent consolidating what you know and applying it. Focused, short-form courses ( like these ) will give you far more practical value in year one than a deep dive into a specialty framework you haven't had a chance to use yet. Hours of therapy planning. Over-detailed session plans don't survive reality. Absences, scheduling conflicts, and the unpredictable energy of real students will constantly reshape your plans. You will be amazed at what you can create in the moment with just the student, some paper, a few different manipulatives, and some open space. Trust your ability to adapt in the moment. MTSS. The multi-tiered system of supports is an important framework, but it's a layer of complexity to add after you have a solid foundation in the IEP process. Get that foundation first. MTSS will still be there when you're ready. You've Got This The first 90 days of any new position are hard. In a school, they're particularly difficult because real students, real families, and real teams are counting on you. But every experienced school-based OT you admire walked through the same uncertainty you're in right now. Follow this roadmap, give yourself grace during the learning curve, and focus on the relationships that will make everything else possible. The clinical expertise you're still building will catch up to your commitment — it always does. And when you need support, this is what the OT Schoolhouse is here for. We'll be here to support you with articles, the OT Schoolhouse Podcast , and the OT Schoolhouse Collaborative. Now, go enjoy being a school-based OT practitioner! Don't Forget your FREE 90-Day Checklist! I put together a free companion checklist that walks you through every step in this guide, organized by week. It's printable, it fits in your binder, and it's yours to keep. Enter your name and email below and I'll send it straight to your inbox. *School districts sometimes block our emails, so we suggest using your personal email to ensure you get your checklist. More OTS 195: Understanding the Why in School-Based OT From a Parent's Perspective Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 195 of the OT Schoolhouse Podcast. Join us in this episode where Nicole Dahl shares her powerful journey as a parent navigating occupational therapy services for her son on the autism spectrum. She opens up about the challenges of understanding the "why" behind therapy activities and the frustration of disconnected communication between providers, teachers, and home. Through Nicole's story, school-based OT practitioners gain invaluable insight into what parents truly need: clear explanations in plain language, collaborative communication between all team members, and practical strategies they can implement at home. She emphasizes that while the journey wasn't always smooth, consistent OT support—combined with strong parent education—transformed her son's trajectory from struggling in isolation to thriving as a high school senior and water polo team captain. Ready to hear how better communication and parent partnership can make all the difference in a child's IEP journey? Listen now to gain perspective that will transform how you work with families and create lasting impact beyond the therapy session. Learning Objectives Understand the critical importance of communicating the "why" behind OT interventions to parents in accessible, non-clinical language to increase understanding and home carryover Recognize the value of collaborative communication between school-based OT, outpatient providers, teachers, and parents to create cohesive support systems for students Identify practical strategies for empowering parents as active IEP team members through education, consistent feedback loops, and actionable recommendations they can implement at home Guest Bio Nicole Dahl is a notable marketing leader whose efforts have helped launch companies onto the Inc. 5000 list, guided by a career rooted in both purpose and performance. Her personal journey as the mother of a son on the autism spectrum—now 18—has deeply shaped her perspective, informed by years spent navigating diverse therapeutic environments. That lived experience fuels her commitment to human-centered innovation and meaningful change. At Korro AI, where she currently serves as Vice President of Marketing, Nicole is driving change by empowering pediatric providers, caregivers, and the children they serve, ensuring every child is truly seen. Quotes “I know 100% we would not be where we are today without OT. A decade ago, I never would have imagined college tours and captain of the water polo team were possible for him.” – Nicole Dahl “We undervalue how important simple communication is.” – Jayson Davies “I didn’t understand the why behind everything they were doing. I’d say he can’t tie his shoes, and then I’d see him on a swing playing with Play-Doh and think… did she not listen to me?” – Nicole Dahl “It’s coming from a point of love. When a parent keeps calling meetings or asking questions, it’s because you both have the same goal — to support the child.” – Nicole Dahl “It wasn’t that he was ‘fixed.’ He was equipped. He had tools, and he understood himself.” – Nicole Dahl Resources 👉 Korro AI - AI-powered platform for pediatric therapy (OT, speech, PT) that captures data during gameplay, provides progress tracking, and includes parent portal features 👉 University of Central Florida's Card Center - Resource for autism information and checklists 👉 Nicole Dahl's LinkedIn Episode Transcript Expand to view episode transcript Jayson Davies Hello and welcome back to the OT school house podcast. This is episode 195 and I'm your host. Jayson Davies, today's conversation is truly special, and I think it's going to resonate with you in more ways than you might actually expect. We're speaking with Nicole Dahl, who is the Vice President of Marketing at Koro AI. You might have heard of it, but more importantly, for today's conversation, Nicole is a mother who spent years navigating the occupational therapy world alongside her son on the autism spectrum. Nicole's journey began over 15 years ago when her son was kicked out of multiple preschools, thus she and her family were thrusted into the world of IEPs, evaluations, therapy sessions and everything in between. She lived through the frustrations that many of the parents that we support right now are facing every single day, that disconnect between clinic and the classroom, the lack of communication between providers and the family, and that persistent question of, how is catching a ball in therapy going to help my son zip up his jacket. Fast forward 15 years, and her son is now a high school senior captain of the water polo team and preparing to jump out of an airplane with a Navy SEAL. That's a long way from learning to zip up his jacket, right? Well, in this episode, Nicole is going to help us by pulling back the curtain on what parents really need from us and what they want from us as school based ot practitioners, you'll share why communication matters more than we might actually realize how collaboration between both home and school made all the difference, and why educating the parents on the why behind our interventions can transform outcomes. This conversation is a very powerful reminder that our role extends beyond the student. We must support the parents, we must support the teachers, just as intentionally as we support the student, and we got to do this if we want to make that lasting change. So please help me in welcoming Nicole Dahl to the OT school house podcast. 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. Jayson Davies, CLASI is officially in session. Jayson Davies Nicole, welcome to the OT school house podcast. It is such a pleasure having you here today to talk about your experiences as a parent of a student with occupational therapy as well as with an IEP. And I'm so happy to have you here. Nicole Dahl Thanks for being here. Absolutely. I'm happy to share and hopefully inspire some people and learn some fun stuff along the way. Jayson Davies Yeah, and you know, it's really interesting how you and I got connected. Never would have thought that you work with coro.ai and I'm sure you'll explain a little bit about that as we get going. This podcast is not about Koro AI, but we actually connected about you being a parent through our connection at Koro AI. So to get started, I would love to just let you kind of introduce how you fit into the world of occupational therapy, which is very different from all the other times I've ever asked that question. Nicole Dahl Yes, absolutely. So it kind of came full circle and backwards all at the same time. So I was introduced to core ot so I'm currently their VP of marketing, but really I fell in love with it from my personal experience. So I am a parent of a child on the spectrum, so I have the lived experience of being in and out of different therapeutic environments for over five years, solid in a private practice, and also school based as well. So we've gone through OT, pt, pt, feeding, speech, you name it. We've been there and done that, Jayson Davies yeah, and that is part of why I really wanted to have this conversation and and before we go way back in time to you know, when everything got started, I would love just to kind of hear an update from you about how your son's doing now, where he's at and how that's going. Nicole Dahl Oh, that'll get me crying right off the bat. I am so grateful for ot I know 100% we would not be where we are today without it. So he is currently a senior in high school. He for their last game he was captain of the water polo team. Tomorrow, he is jumping out of an airplane. What? Jayson Davies Oh my gosh, yes. So we, are we? Are we associating that with some, you know, vestibular seeking tendencies? Nicole Dahl It's more of like his open I never in a million years. Would I have guessed that he would even consider that? That's a whole different funny story. But we're an active Navy family, and so he's getting strapped to the back of a Navy SEAL like a spider monkey and and jumping out of a plane tomorrow, but, but, yes, he was the child who was sitting on top of the refrigerator as like a self soothing, I'm just cool up here type thing. But he's doing so well and looking at colleges and things like. That, and I never, you know a decade ago, would have imagined that's possible for Him. Jayson Davies That is awesome. That's fantastic. You love to hear like because I can only you know as an OT, as a parent, both, both of us, and we're going to go back right now, but like when you see your child when they're three, when they're five, when they're seven, it's sometimes hard to think what they're going to be like, you know, when they're 1516, 18. And I can only imagine how many times he has forced you to reconceptualize your perception of what he can do, what he wants to do, what he enjoys, what he doesn't enjoy. And as a newer parent, I'm looking forward to all that as well. Nicole Dahl Yeah. I mean, I would get asked, like, What's your goal for your son? And, you know, at that point, I was like, let's get out of the house without a meltdown, or let's get dressed and not fight what clothes we're wearing because they're uncomfortable. I mean, the goals back then were so different than they are now, Jayson Davies yeah, wow. All right, well, let's dive into that actually. And let's, you know, jump in that DeLorean, and head back 15 years or so. And when, like, did you first start to realize, you know what, hey, my son might need additional support. Or, hey, you know what they're he might not be neurotypical, and what was that point in your life like? Nicole Dahl So it was very different, I think, from the traditional journey we were at. So we had a hard go of it at first, because he kind of falls in between that line of, you know, standard symptoms and things like that that you would normally associate so he would be considered more on the like Asperger's spectrum of things, but he was diagnosed with ADHD and after he was kicked out of four different preschools because they said he was too much or wouldn't follow instructions, or would kind of be doing things for self soothing, of just not wanting to get off a swing and come inside when recess ends. So that was hard as a parent who was working full time saying, Okay, now we have to figure this out all over again and establish a new routine in a new place. But I was very lucky enough to find a school who in the mean in the kind of in that timeframe, I worked as a publisher, and so one of the schools advertising with me was actually a school for mostly disabilities, but they admitted children, what they can called role model children. And then so my son was admitted as a role model child. And then later the teacher was like, hmm, there's there's something else, something else here. Have you considered having him tested? And also, at the same point, I was developing a website for the University of Central Florida's card center, and going through the checklist of symptoms, I was like, This is my child. Jayson Davies Sounds familiar. Sounds familiar. Check, Nicole Dahl yep. So it was through the encouragement of the staff at his preschool that we then got on a wait list to get him tested. It took probably nine months to a year before we actually were able to get tested and get that diagnosis. And then I really think I was handed a Xerox sheet of paper that had been copied multiple times over. Of, here is autism, here's types of things you can expect. And then that was it. I was handed a referral to OT and there was no in between of, hey, what's next, or what is OT, Jayson Davies yeah, yeah. Can I ask really quickly that that evaluation process, that preschool, was this a public preschool, or was it a private preschool? And was the assessment done through like a medical model, or through more through the school. Nicole Dahl It was a private preschool, and then the referral was done at a medical clinic with a medical doctor, yeah. Jayson Davies Okay, so you you got this referral then, and you have a referral, sounds like for occupational therapy. I don't know if speech or anything else was involved, but were they then recommending you to actually, I guess, get services through the school, or were they recommending you reach out and go through insurance? Or how was that? Nicole Dahl So at first we it was a recommendation for outside private OT, and so I had submitted the paperwork to his school ahead of time, saying, you know, here's his diagnosis, here's what we do. And they were like, Okay, we'll get you on the calendar for an IEP meeting that probably took nine you know, if we're talking about the beginning of the school year system, where he's now in kindergarten, I don't think we had that initial meeting until the spring after you. The new year. So it took so three quarters of the year in, yeah. And during that time, you know, I kind of brushed it off that he was not liking school because it was a new transition, because his preschool was so amazing, but he did not want to go to school at all every day, it was a fight to get in the car and go. And I kind of trusted the process and said, you know, we're figuring this out. It's a new school, it's going to be okay. And then, come to find out, at the first parent check in, which had, you know, maybe several weeks had passed during school, the teacher was like, you know, I figured out a way for him to focus. And ever since then, it's been going better. And I'm like, Well, what, what do you mean? Like he's saying he does, like he's having a hard time, and so she had put him at a desk facing the wall by himself, isolated away from the classroom. Yeah, and that's how she got him to focus so, very inclusive, not very inclusive. He wasn't making friends. He had been kind of, you know, labeled, almost like a leper, like, oh, that child is, there's something going on with that child, because he's isolated away from everyone else. Wow. Jayson Davies Okay, and then it like you said you didn't end up getting that IEP until, you know, several months later, wow. Okay, before we dive into that AP process, I first want to ask you about your initial thoughts on occupational therapy. It sounds like to me that the first time you really heard of occupational therapy was when you got that referral. I mean, maybe you had heard of it, but this is the first time you really had to think about it. What were your initial thoughts when you heard about occupational therapy and maybe you did some initial research, like, do you recall? Nicole Dahl Yeah, I do, actually. So I had never heard of occupational therapy beforehand. I was never exposed to it. I didn't have any friends kids who had gone to it. So obviously, you know, looking online, I was like, Well, this is supposed to help with our daily life. This is supposed to help him, you know, work at handwriting to even kind of daily living goals of getting dressed, transitions in the day, things like that, to help things go smoother. So it kind of looked like this golden treasure trove of here's possibilities that can help and then, unfortunately, my experience in the beginning did not necessarily offer that interesting. Jayson Davies Okay, so let's dive into that then, and let's talk about some of those experiences. It's hard because, as you know from the experiences you have outside occupational therapy and school based occupational therapy, and throughout this podcast, I might ask you to clarify a little bit, just because it is a little overlapping, and I don't want to make you have to figure it all out all the time. But so I guess you know, as you dive into that confusion, where did that start? And was that it sounds like you probably started with outpatient before the IEP, because it took so long to get to the IEP. But correct me if I'm wrong and and go ahead, we Nicole Dahl started definitely with outpatient before we got the IEP implemented for in school and outpatient, I felt like they kind of just went off of a pre prescribed checklist, like, here's what we do for every child who has these goals. But it never felt like it was directly connected to my child. So nothing felt personalized. I often talk that we were, you know, given carry over homework that truthfully, felt like and sometimes I would even see like we're taking a piece of paper off of a stack that I'm sure every family got on their way out of the clinic that day. So it wasn't relevant to my child at all, nor was, you know, chances are it would probably get destroyed in the car before we even got home. And then I was left feeling like, Okay, I have this one five minute activity that I can do to help support my child through the week, but what else can I be doing in between? So a lot of the time I felt kind of frustrated and looking for answers that I didn't know exactly where to find or how to find to better support my child. Jayson Davies Yeah, and I can only imagine that being tough. Were you going basically once a week? Nicole Dahl We were going once a week to OT and then once a week for feeding or sorry to speech as well in the beginning. Jayson Davies Okay, so I can only imagine that is, you know, you're there for the let's just call it an hour, assuming, and you get that hour of time where your son is with the therapist, and then at the end of the hour, you're walking out with maybe a little general piece of paper, maybe some quote, unquote homework, per se, and then you're expected to come back next week with maybe that completed homework, and, you know, for the next session and and so you're for seven days, you're questioning what I'm. What the heck was it going on? What did they do? Is this working? I mean, how are you feeling? Nicole Dahl Yeah, that's exactly how it felt. And then I felt like, you know, even during the session, because they would go back, you know, into a room somewhere where all me and all the other parents were left sitting in the waiting room. Typically, that handoff was maybe no more of a two minute check in. Of, Hey, how are things going? Anything new this week? And you kind of had to have this pre script plan of, here's what we really struggled with at home. Or finally, you know, I was like, Hey, can I go back in the session with you guys? And they were like, Oh, well, that's like, really, we have the parent waiting room here, but I guess we could try, but you'll have to sit kind of on the floor in the corner, which I was fine with. But I would say things like, you know, he can't tie his shoes, and then I would see them him on a swing and catching a ball, or playing with Play Doh. And I was like, did she not listen to me? Because I said he can't tie his shoes, and now they're they're just playing. How is any of this supposed to help? I really didn't understand the why behind everything that they were doing, and I wish that had been explained to me as a Jayson Davies parent, trying to figure out which follow up I want to ask her. So obviously, you know, you came to love ot so things got better, and we'll get to that point. It sounds like you wish things were a little bit more collaborative. Communication was a little bit better. Did that eventually start to get better? Did it take, you know, multiple different therapists, multiple different, you know, clinics, or at what point did you start to transition from, you know, what? I don't understand how playing with Plato is supporting these goals to Okay. I start to understand Nicole Dahl it took being involved as a parent, and then we did have a great school therapist. Once we finally got involved with in school OT. We had also switched districts. We had moved in between, and our new ot in school had brought up things that I had never even considered, or had ever even kind of been discussed with me. So things like, you know, the teacher would say he's he's rocking and doesn't stay still all day. So then the OT would go in the classroom and say, Well, what's going on here? And come to find out the legs of his chair were uneven. So he would sit there and and teeter back and forth all day. And so the OT was like, okay, Mom, here's this little seat thing that he can sit on and kind of just wobble without making noise and a distraction. Would you be okay with getting that support in classroom 100% yes. Or, you know, in this particular classroom, the lights overhead buzz a little bit loud and can be a little distracting, you know, mom, would you be okay with, you know, getting a floor lamp for the classroom. If the teachers okay with that, yes, 100% are you kidding? I had never even considered that lighting was coming into play as a distraction. When the teacher would say things like, Oh, he's not focusing, or he's drifting off and staring into the the abyss, it was because he couldn't filter out that sound of the fluorescent lights to really be able to hear her over the lights. Jayson Davies Yeah, you know, I, as I listen to you really quickly. Like, the way that you're explaining things are the way that I feel. Like, oftentimes we should explain things, especially when we're talking to parents, but I think sometimes we try to get too smart sometimes, and like, use complex words and, you know, sensory processing and vestibular and proprioception and and all that. And it's nice to hear from a parent, like, just, you know, in layman's terms, like this is what they kind of want to hear from a therapist. Nicole Dahl Yeah, I wanted to hear real world, relevant insights for my child. So the provider would come and say, you know, what are your biggest struggles at home? Or what? You know, what goals do you have? And you know, after we got integrated with school, ot I was like, You know what I would love for Him, to be able to have a friend and to have someone that he can talk with at school, because otherwise it seems like he's really alone. And so the school of Tay was like, That's a great idea. I've got some other kids that I'm working with that I think a social group would be really valuable. So during lunch, I'm going to pull these kids and we're going to start a group of saying, hey, what's another child who maybe likes some similar things that you like, and practice those like reciprocal conversation skills back and forth, and that was a thing I had never even considered as a parent. I'm like, I know he's obsessed with sharks and dinosaurs. What? Where can we find those other children who are also obsessed with sharks and dinosaurs? Maybe ask like, which ones do you like? Or why? Yeah, but I very vividly remember the first time he asked me how my day was after practicing those reciprocal conversation skills. And it was jarring. And I had never realized that he had never asked me that before. Wow. Jayson Davies That really tugs at the heart strings a little bit when that happens on Yeah, that's awesome. So it sounds like we've got this occupational therapist in the schools. You've already mentioned them, kind of consulting with the teacher regarding the lighting, regarding the seating, as well. Now you've also mentioned a small group. It sounds like with, you know, working with you know, working with other students on social communication and social skills. Did you also, did your son ever have on his IEP individual pull out services with an occupational therapist? Yeah, he did. Okay. Very much. So okay, and then if I can, because I have a follow up, but I just want to get the the basis here, did he also have the occupational therapist ever actually go into the classroom to work with him individually? Nicole Dahl Yes, and that's where we kind of would see some of those things that hadn't necessarily been brought up as maybe a difficulty before. Is, you know, we would get feedback from the teacher, and then the provider would see it and from a different lens and say, Okay, let's try this, or even giving feedback to the teacher. Of, instead of saying, you know, time's up on this activity, come to the carpet. How to word things even a little differently. Of, hey, we're going to work on this for five minutes. That's okay. If you don't finish, you will have time later in the day to work on it, and then we're going to go to to the rug for story time, or just framing things a little differently so he didn't get caught up in the I'm supposed to finish this. I need to finish this, or I'm going, you know, it's going to be counted negatively against me, so I'm not going to go to the carpet and I'm going to sit here and finish working on my paper. Jayson Davies Yeah, yeah. And it sounds like you're the occupational therapist or occupational therapist that you know you you and your son have worked with over the years, but years have been very flexible, because one of the things that I've found is that, and the research backs this up, is that sometimes occupational therapists can be a little rigid, and the type of services that they provide, some therapists provide, or they prefer more that pull out model. Some prefer more pushing into the classroom. And it sounds like you've experienced, you know, kind of the gamut of that. And I guess my question here for you is, looking back at that, did you feel like one service was better than the other, or do you feel like it was something that needed at the right time, and that all the services you know, fit into a particular part? Does that? Does that make sense in the question? Nicole Dahl Yeah, it does. So I would say, from my lens, when things really started to click is once I got everyone talking together. So when I got the outside private, ot talking to the in school, ot talking to the teacher, I had requested, you know, for the next IEP meeting, can can you come to this? Or can we loop you in on the Zoom call? Because it's once we started talking together. That's when the biggest differences would get made, because the in school at ot would say, Okay, here's what we're working on here. So then the private ot would say, Okay, I hear that. Now we can work on this, and then I can give carryover skills for you to practice at home in between. So it wasn't just these, like, you know, little hour snippets two times a week when there's, you know, over 160 other hours in the week that nothing else is happening. Here's actually tangible things that I could be doing at home. And that's when the difference really got made is when I started understanding the why behind everything, and had skills that I could be working on at home to further their work. Jayson Davies How long did it take to get to that point? Because I know you experienced a lot of frustration, so how long did it take to get Nicole Dahl to that? It took a solid three years before we got to that point. Jayson Davies That's a lot of missed opportunities. It was, and Nicole Dahl it's huge. I mean, that's such a critical period in their life, too. And you know, there were times when a provider would leave on maternity leave, and they would say, you know, oh, we're just gonna hold his spot with this provider. Are you okay with waiting till she comes back on maternity leave. Yes, a horse of 100% we love her. Then she would decide not to come back. And then, so then we were put back on the wait list waiting for another provider. Or they'd say, you know, you can look for somewhere else to go. And then we'd try getting on a wait list somewhere else. So accessibility. Was also a huge part of that. In the meantime, too, trying to find a spot of somebody who had opening. You know, I learned both personally and professionally my work with coro, like there just aren't enough providers to handle the demand that's out there. Jayson Davies That is true, very true. All right, we're going to take a quick break, and when we come back, we're going to talk about more of that advocacy piece a little bit as well as you know how we can improve communication between parents and the parents. So we'll be right back. All right, we're back, and Nicole, I wanted to ask because in a previous conversation we had, you've mentioned that you've lived a few different places, and I can only imagine that moving while having a student on an IEP can be a little difficult, and so I wanted to ask you about that experience. Was it difficult, or was it seamless, and what made it better? Nicole Dahl Truthfully, I had a couple of years under my belt at that point, so I had learned my lessons that I need to speak up and almost, you know, get labeled as that annoying parent who's not going to go away right out of the gate. So that was the biggest lesson I had learned. Is, you know, you're your child's personal cheerleader. You're the one who's with them the most. So if anyone's going to speak up, it's, it's going to be you parents? Jayson Davies Yeah, I know. I completely agree with that. Like being on the inside right in the school, you almost get a little frustrated sometimes with parents who are like that. But when you take that step back and you realize, like this parent is simply trying to make sure that their student doesn't get forgotten, like you kind of understand it. And as a parent, I would absolutely do the same thing for my kids, like we have to stand up a little bit, just like as an occupational therapist, you've got to stand up for yourself in the school to make sure that you don't get forgotten as an employee in the school, and we're all trying to, at the end of the day, get the services and the support for the people that are important in our lives. And so yeah, I get it. Sometimes you feel a little defensive as a therapist when you have that parent who is calling an IEP every three six months, but from your perspective, right, you're just trying to get the best services for your student. So yeah, yeah, and it's coming from a point of Nicole Dahl love, by the way, whenever, when you have a parent that does that, it's and you guys both have the same goal to help and support the child. So it's a shared goal, but it's just figuring out, like, how are we communicating or not communicating what's happening behind the scenes? So there were times when they would say, you know, oh, this has actually started, and I just didn't know that it had started. Or my son didn't know that that's what that was, yeah, where it was not even, you know, he just thought he was meeting with another teacher at the school. But it wasn't said, Oh, this is your new in school occupational therapist. So when I would say, Have you started ot in school yet? He would be like, No. And then there was a time when I was like, Oh, well, you know, they said, Mrs. So and So was your new OT? Oh, yeah, her, yeah, I do meet her, yeah. So making sure things are explained as, like, super baseline, basic conversations, Jayson Davies and it's it's amazing, because in today's world, it is so simple to communicate, like you don't have to pick up a phone, you can do a quick email. We all have systems in place at the schools where we have, you know every single person and their mom's email on file that we can send a quick email and and whatnot. But it does take time. It does take energy, and it does actually take that initiative to say, You know what, something changed. It's not that big of a deal, but communicating this to the parent or to the teacher or to the outside provider, whoever it might be, really goes a long way. Like we undervalue how important a simple communication is. Nicole Dahl Just remember, like we're humans on the other end of it too. And, you know, and sometimes I don't even think parents know that that one provider could have 80 students that they're helping. So just keep that in context as well for parents of saying, you know, I hear you. I got your message. And it may even seem a little like combative to say I have 80 patients, but most parents don't know that. They may think you work with like, four or five patients, but if you don't have that inside lens, you might not understand why it's taking so long to get back to you. Jayson Davies Yeah. So that actually leads me on to a question about an IEP like being in an IEP meeting as the parent, and when it comes to the occupational therapist, you know, sitting across the table from you, let's assume this is like, maybe not an initial, but a triennial, and they have an evaluation to present. Yeah. From a parent perspective, how much detail are you expecting? Do you just want a quick overview? Do you want the full, you know, page by page rundown? Obviously, every parent's ever but your perspective, what do you like? Nicole Dahl I had both ends of the spectrum on that? You know, in those initial days, it was just a quick run through of, you know, here's the goals, here's where we're at. Any questions, okay, now we're done. And then, truthfully, it felt like just a check box that was getting hit. And at that point I didn't know what to ask for, or what to kind of dive in, or even what was possible. But then I had providers who, you know, after we kind of made that switch a few years into it, who went through everything, but I understood, they also kind of translated it, what was on the page, into parent friendly language that I could understand. And again, that's when things really started to click. And things that I could also practice at home, that I just became more aware of how to support my child. You know, there were things like incorporating motor brakes or, you know, they would set up like stickies on in the hallway floor outside. It's like a little obstacle course for him to go through. And sometimes they would even bring me and show me how it is and what it helped, or, you know, different things like that and that. I truthfully felt like that was the most valuable. Yes, it was in depth, but I had a better understanding of why they were working on the things that they were and how it supported my child? Jayson Davies Yeah, absolutely. And, and it can be hard because, like, I don't know, in the area across the nation, evaluations vary widely. In my area, in California, we would often write 1012, sometimes longer reports. And in other areas, I know it's very common to write a one and a half two page, you know, report as an occupational therapist to provide to the teacher. So I guess my question is, when you receive a report, and it doesn't necessarily just have to be ot but what do you taking out the verbal communication aspect, right? We're not in the IEP, just looking at a report. What do you hone in on? Is it the recommendations? Is it the analysis? Is it everything? What do you really hone in on? Nicole Dahl The recommendations? That was definitely the biggest part for me, other than, you know, there were things, little highlights, I felt like, because they were reports sometimes where the teacher would also have to do a report compared to the OTs report compared to the outside OTs report, and they would mesh them all together and then figuring out where the misalignments were, or where were the things that, you know, hey, maybe he's regressed a little in this skill that we had been working on over here, but it's showing up in the classroom. So that saved space where, really, everybody could talk together and figure out what was best moving forward, if anything needed to be adjusted. So everybody was on the same page. That was really helpful for me. Jayson Davies I think again, it's hard when you get a 15 or even 10 or even a five page document about your student, and then you also got a document from the school psychologist, a document from the speech pathologist. Like going through all of them is not simple. And so I think that's kind of why I wanted to ask you that question was to see, is it just, you know, mostly the recommendations. And I say that because, I think a lot of occupational therapy practitioners, we really put a lot of focus on the scores inside the assessment, as opposed to the actual synthesis and analysis that then leads to our recommendations. And I think it's important to know that your recommendations are just as valuable as conducting if not more. So the SPM or the bot three, or whatever it might be like, those recommendations aren't just they don't go or they do go somewhere. They go to the parents, and that's something that the parents can can look at. And the Nicole Dahl recommendations were obviously the most helpful from my perspective, because, you know, the reports are great. It shows, like, the measured progress, but in my brain, like, that's that's done. What are we doing next? What are we doing looking forward? Or what can I be doing to support the work you guys are doing in the in the school? Jayson Davies Yeah, all right, so you mentioned a communication has just come up, like time and time again in our conversation so far, like and I understand that, and I want to ask you beyond just you know, communication, both with yourself and with the team, is there another aspect of occupational therapy? Especially within the schools, that tended to make you feel more comfortable with occupational therapists or understand that things were going well versus going bad. Nicole Dahl It was just those feedback moments of saying, you know, hey, we talked about implementing the motor breaks between classrooms. I touched base with the teacher, and you know, she said that that's made a huge difference. Here's when they were doing it, and, you know, it's made an impact. So I just wanted to touch base and let you know that. Jayson Davies So someone's saying they're going to do something, doing it, and then touching base with you to let you know it was done and and that was the outcome, or whatever the outcome was, yeah, yeah. You know, at the end of the day, that's pretty simple, simple, right, right? And so now I ask you, because it sounds like you've also had some, you know, troubles, maybe even beyond those first few years. What was the breakdown when there was a breakdown ever? What do you mean? I guess, yeah, if the communication, and you know, the simple, you know, the simple communication, making sure everyone's doing their job is what works really well, I guess my question is, is in times with an IEP, where maybe things with the district haven't gone so well, and, you know, things maybe last year they were good, and this year they're not. What do you feel led to that? Was it just simply the communication, or was there anything else that led to, you know, something's not right here. I need to call another IEP, because things aren't going well. Nicole Dahl It was, truthfully, that disconnect when people weren't talking together, collaboratively. So when you know the teacher would say, you know, oh, I have that paper, but I have 30 other kids in the classroom, and I can't devote this special attention just to this one child, or just that, that disconnect, when it didn't feel like everybody was, was really working together. And there's so many invisible moments that that happen when each of us are are with, you know, my son, and how can we it? And, yes, it's a lot on each person to say, here's how it relates to this, or here's what we're seeing, and that's, you know, truthfully, one of the reason I love Koro is because it takes those invisible feedback and translates it into real data that everybody can see on the back end. So it brings people together and not just keeps them all isolated on their own. Jayson Davies Yeah, it's amazing. I really feel like we undervalue communication, and it's something that, and it's not just us, it's an entire school district, like, you know, it's, you know, I'm sure, from your experience, it's not just the OT, who you needed to communicate, right with? It was the SLP, the teacher, the psychologist, whoever else at the district level. So, communication, yeah, just, just so important. One thing I wanted to ask you and talk a little bit more about your son is how things changed as he got older, both in relationship to occupational therapy, but also with IEP. I mean, a did he continue to receive ot for for a decent amount of time? Or how long was that Nicole Dahl he continued. So he in school. We first got it at the end of his kindergarten year, and then we stopped receiving it as he transitioned. So the middle school he went to was six seven, so we stopped receiving it after seventh as he transitioned into high school or eighth after the end of eighth transition, or we stopped receiving ot as he transitioned from middle school to high school. Jayson Davies Gotcha, that makes sense. And can I ask then, because you already had experienced a transition from elementary to middle school. Was it even a thought to discontinue ot transitioning into the middle school, or any other services from elementary to middle school? Was it one of those things like, and you no one made the recommendation, or B someone maybe thought about it, but we decided, You know what? This is a transition. Let's hold on to it. Nicole Dahl We definitely scaled back going from elementary to middle school. A lot of those things he'd been working on in elementary school were kind of like baseline toolbox of items I felt like he needed to develop. So he was able to kind of get these strategies that that helped him, where he could then implement them on his own going into middle school. So it was more as that IEP was there as a buffer in place for middle school, saying, Okay, we're going to give him some a little bit more freedom to see, see how he does, and test it for those two years before transitioning to high school. I think. Jayson Davies That's a perfect opportunity to do something like that. And I've definitely have sat in IEPs and kind of maybe said in a slightly different way, but yeah, you know, we're going to keep it on, but maybe we're going to scale back to a consult, you know. We'll be there if necessary, you know. And we can always increase services back up again, but let's see how this goes and be able to support the teachers, yeah. So then going into high school, what made you feel, you know, OT, it's a safe point at this time to discontinue OT, Nicole Dahl well, he's always been a smart kid, so grades were never really his problem, and that also worked against us, because in the early years, they would say, you know, academically, he's fine. There's no need for intervention. But at the same point behaviorally there, there was a lot, you know, he would get in trouble for not following instructions, or even sometimes arguing with the teacher, because he would look at it from another lens and say, You know what? I know, I'm right and you're wrong, yeah, because his brain just saw things a little bit differently. Yeah, so, but it really made sense for us going into high school to give him that freedom and say, okay, you've learned years like you know this. You've got this. We believe in you to now take that step forward. In hindsight, are there some teachers he's had in his high school career where I wish we would have still had that in place? Yes, 100% but it's very isolated, and we're able to talk through it at home, because I can say, You know what? Remember, you know, let's and like, let's break that down, and we talk about it at home, but that's because I've learned so much from the providers over the years that I can help see maybe what he's struggling with, or what tools I can also say, hey, remember this, or remember when. And that's helped a lot too. Jayson Davies Again, coming back to the communication like just the more that we can empower our parents, our teachers, to be able to use the strategies that we support them with. It's just so impactful. And it leads to not just impact today, but as you just kind of confirmed, right? It leads to impact years later, and you're able to point back to those so awesome. I love it, yeah, Nicole Dahl and I would say, you know, just remember that a, you know, yes, you have your your client or your patient being the child, but really, I encourage people to think of it more as the family or the caregivers also as your clients and patients, because the more you can educate us. And I know some parents will just say, you know, yeah, okay, got it or good. But really, some parents are, you know, or depending on the day, can be struggling to get through that single day. And so don't be afraid to say the same thing multiple times, because, you know, our brains might have been so filled with what just happened in the parking lot before we even got into the school or into the appointment, that it may have went in one ear and out the other, right? Jayson Davies And you're a VP of marketing. What is it? How many times does someone have to hear something before they get it into their brain, like seven or something like that? It depends. Nicole Dahl It depends. Recent studies have actually shown that it can be up to 21 times that they need something to turn it into a habit. Jayson Davies Yeah, see, those are the things that you're not going to learn in OT school. But we need to, like, we need to remember that just because we say something one time doesn't mean that the teacher heard it, or the parent heard it, or that they it was processed. So don't be afraid to kind of, you know, in a very polite way, nudge a little bit and and send reminders. So, yeah, yeah. All right, Nicole, looking back at just, you know, the last, gosh, 18 years now, then about what are you most proud of in your son's journey? Nicole Dahl Again, I never would have imagined that where we are today is where we would have been back then. You know, truthfully, when he was in preschool and kindergarten, I never would have anticipated him going, you know, we were even wondering if he would be okay in a mainstream school at that point. I never thought he would go to college. I never thought he would drive a car or maybe even be able to live on his own, and all of those things are very tangible, and we're talking about them and having those discussions now, never in a million years, what I'd say, you know he's going to play a team sport, know all of his teammates names, be able to engage in conversation, Much less a sport like water polo, where it's so stimulating all of the time, we were just blown away watching him being able to do that. And I think back to to little him who would struggle with wearing a itchy sweater that he got from his grandma. And think it was you. Know the worst thing ever in his life, and then have to in high school, say you're going to stand up in front of a speedo in front of the entire school like I no way would I have imagined that without OT and all the supporting services in between. Jayson Davies That's fantastic. I'm so proud. I'm so proud of him. I don't even know him, and I'm proud of him. I love it. I love that you and your family have gotten to a point where it's just a point where you never knew, never potentially thought that you might get to that's just, that's really awesome. Kudos to your entire family. All right, I do have two final questions here for you, and the first one, I think I might already know a little bit of the answer, but if you were well, I mean, you are speaking to school based occupational therapy practitioners right now. What is one piece of advice or wisdom, or what do you just want them to know? As a parent, Nicole Dahl we want to be educated. We may seem busy, or we may seem, you know, passive in the process, but every parent I've ever met wants the best for their child and make us understand, if you have to, you know, stand in front of us and say over and over again, this is why I'm doing this, and this is how it can impact your child. You have to tell us the why behind things, or we're not going to understand and we're not going to get the buy in that you deserve for all the hard work that you do. Jayson Davies Yeah, yeah. I think that's what sometimes we need to hear as therapists do, to know that you know what, we do need to support a little bit, not just the student, but also the parents, and let them know everything that we're working on Absolutely. And the final question here is actually for the parents listening, because I imagine that there might be some parents who find this podcast and just really want to hear from a parent perspective. And so words of wisdom for for parents who are kind of, maybe they're in their kids in kindergarten right now, and they're just getting into school based. OT, what words of wisdom do you have for them? Check with it. Nicole Dahl That is the best advice that I got from that preschool in the beginning. As this will help, because in the beginning, you know, if I'm honest, those first two years, I didn't see a difference that it was making. I didn't understand how it was going to help. I didn't understand the why behind anything, but really just trusting the process, but getting involved to educate yourself. It takes a village that is said over and over again, but really, you have to communicate what you're seeing at home, find supports that can, you know, communicate things holistically, because your child deserves that chance. And days are hard with a special needs child, they are long, they are frustrating, but your children deserve your attention, and you're the one who can provide the biggest impact in their life and what it's going to look like. Jayson Davies Yeah, yeah. Nicole, thank you so much. It has been a pleasure. Thank you for being so open and sharing your story and letting us know about both the good and the difficult times. I know that's not always easy, and I'm just so glad we're able to do this. I think it is going to help, you know, school based ot practitioners, this episode is going to help them just as much, if not more than 100 other episodes that we have that are about the details of an assessment, or about, you know, the details of sensory processing or something like this, like it is so important. So important for us to remember that a parent is just as important to the IEP team as anyone else that's there, and that we need to work with them. They are not our foe. They are part of our team, and we need to be in communication with them. It sounds like that is just a huge piece that can sometimes either be missing or really make the entire team come together to support a student. So thank you, Nicole. Really appreciate it. Nicole Dahl Thank you for having me and sharing stories. Jayson Davies Yeah, and that's going to wrap up episode 195 thank you so much for joining us today, and also a huge thank you to Nicole for sharing her family's journey with us and reminding us why parent communication and collaboration matters so much. Nicole's story is a powerful example of how occupational therapy, of course, when paired with clear communication and teamwork, can really change the lives of the students we serve. If you found this episode valuable, I would love for you to share with another school based ot practitioner who might benefit from hearing a parent's perspective, or perhaps share it with a parent who you think could benefit from hearing Nicole's story. And if you're looking for more resources, professional development and mentorship to support your school based ot practice, come check out the school based ot collaborative at. OTSchoolHouse.com , slash collab, we've got a whole community of practitioners ready to support you, plus monthly PD courses, a global bank, AI tools and so much more. Thank you again for tuning in to this episode of the OT schoolhouse podcast, and I will 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. Click here to view more episodes of the OT Schoolhouse Podcast More OTS 194: Supporting Teachers First and How Coaching Creates Lasting Impact for Students Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 194 of the OT Schoolhouse Podcast. Supporting teachers can be one of the most powerful ways to create lasting change for students—but it requires a shift in how we view our role as school-based OTs. In this episode, Dr. Ellen Cullen shares her groundbreaking doctoral capstone work on occupation-based coaching, where she treated teachers as clients and used MOHO to support their self-efficacy and align their practices with their professional values. Ellen reveals how experienced teachers often don't lack competence—they lack alignment between what they value and what the system demands of them. By becoming co-designers rather than experts, OTs can empower teachers to reclaim their autonomy, reduce burnout, and implement sustainable strategies that truly benefit students. Whether you're struggling to make time for consultation or wondering how to make your impact last beyond the therapy session, this episode offers practical, immediately actionable strategies. Listen now to discover how supporting teachers isn't just good practice—it's essential to creating meaningful change for the students we serve. Learning Objectives Learners will understand the power dynamics in classroom consultation and how to approach teachers as occupational beings Learners will identify how to apply occupation-based coaching models (using frameworks like MOHO and IRM) to support teacher self-efficacy Learners will understand practical strategies for integrating teacher support into existing service delivery models Guest Bio Ellen M. Cullen, OTD, MS, OTR/L, BCP Ellen Cullen is a school-based occupational therapist who is passionate about creating systems-level change that supports teachers, students, and classrooms as interconnected ecosystems. She holds an MS in Human Development from the University of Rochester and a post-professional doctorate in occupational therapy from Bay Path University. Ellen blends occupational formulation, the Model of Human Occupation, and the Intentional Relationship Model with design thinking to co-create practical, context-driven solutions alongside educators. She owns a private practice, providing pediatric occupational therapy and CBIT for individuals with tic disorders across the lifespan. Ellen is also the founder of JustGrowPlay, LLC, where she focuses on innovation and design, developing products and consulting on environments that enhance play, learning, and occupational engagement. Quotes " Teacher self-efficacy is a type of self-efficacy wherein teachers are strongly affected by their beliefs about the potential, their potential to impact student learning... It can also affect teacher stress levels and their desire to stay in the field. And as we know, teacher burnout is a huge issue." -Ellen M. Cullen, OTD, MS, OTR/L, BCP “OTs being trained in more of a medical model enter schools as outsiders… we don’t always know where we stand with a particular teacher.” -Ellen M. Cullen, OTD, MS, OTR/L, BCP “We are systems thinkers… we don’t just look at tasks, we look at motivation and the reason behind why someone does the task.” -Ellen Marie Cullen, OTD, OTR/L “If you love your teachers — in a real, human way — and co-design with them, that’s a powerful model for change.” -Ellen Marie Cullen, OTD, OTR/L “Rather than trying to go in with power, you’re going in with open-mindedness and letting the teacher have the power.” -Jayson Davies, MA, OTR/L Resources 👉 IRM Model 👉 Self Determination Theory 👉 Moho Model Episode Transcript Expand to view episode transcript Ellen Cullen I think this is why it's really important to distinguish between consultation and coaching in terms of how we implement that and what that looks like. We can look at consultation as being more expert driven, so the OTs are the ones providing the solutions to problems, whereas in coaching, we're asking the adults that we're coaching to find their own solutions to the problem. Jayson Davies Hey there, and welcome to episode 194 of the OT school house podcast. It's great to have you. What you just heard was Dr Ellen Cullen breaking down the difference between consultation and coaching. And now, if you're thinking, Okay, I kind of get it, but how does coaching fit into school based occupational therapy, you are not alone. The distinction between being the expert who provides solutions and being a facilitator who asks powerful questions isn't always clear cut, and implementing this shift in the day to day reality of a school setting can feel overwhelming. But here's the thing, in OT school, we were trained in a medical model where we're expected to be the expert, we assess, we diagnose, we intervene, but when we step into the schools, we're entering someone else's domain, and the power dynamics are not the same. Teachers hold the key to implementation, and if we don't bring them along as partners, our best strategies often fall flat. Today, I'm joined by Dr Ellen Cullen, a fellow school based occupational therapist and board certified pediatric specialist who has spent years exploring a powerful yet underutilized approach in school based practice treating teachers as clients through a coaching model. Ellen's doctoral Capstone challenged the traditional consultation model by using occupation based coaching to support teacher self efficacy, particularly with English language learners. But here's the twist, her research revealed that experienced teachers didn't lack confidence in their teaching. What they lacked was alignment between their values and the demands of the system. During this conversation, Ellen breaks down how school based OTs can shift from being the expert in the room to becoming a co designer and partner and guide empowering teachers to reclaim their autonomy, reduce burnout and create lasting change for students. We'll talk about power dynamics, the difference between consultation and coaching, and how you can start implementing this approach right away, even within the constraints of a caseload model. If you've ever felt like your impact fades the moment you leave the classroom. This conversation is for you. Let's dive in. 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 Ellen, welcome to the OT school house podcast. How are you doing today? Ellen Cullen I'm doing great, Jayson, thank you so much for having me. I'm excited to be here. Jayson Davies Absolutely this is going to be fun one, as I alluded to in my intro earlier, a lot of school based ot practitioners have difficulty with really supporting teachers. You know, we are pretty darn good at working one on one with a student, or maybe even in a small group with a student, but we have a lot of difficulty when it either comes to a consulting with a teacher directly away from the students, or working kind of even collaboratively with a teacher or two. And so I'm really excited to jump into that and to kind of get started, I want to ask you, why do you think that is the case? Why is it that so many ot practitioners, you know, we have advanced degrees, we really learn about people, the psychology of people, and all the different aspects of people, but we have so much trouble when it comes to working with teachers. Why do you think that is right? Ellen Cullen Well, that's a great question, and I have explored that in my own mind as well. I feel that OTs being trained in more of a medical model, maybe more of that clinical mindset. Enter schools as outsiders, so to speak. So when we meet a teacher or try to affect change within a classroom on behalf of a student, we almost feel like we're the outsider, or we can approach it as we're the expert. So we want to make sure that a teacher is receptive to what we have to say. So we want that relationship to be strong. However, we don't always know where we stand with a particular teacher, so developing that relationship can be really important to helping us feel welcome and entering that classroom space, I think when we enter that classroom space, it's almost akin to a family entering someone's home where the teacher is a caregiver taking care of the kids in that classroom. And I remember working in home care, and having that same feeling stepping into someone's home and really making sure before I entered that home that I was aware of the power differentials that could be part of that setting and part of that system. So we are trained in more of a medical model. We in our training. We don't get as much training as how to work in that educational. So working and collaborating with teachers is something that still is somewhat unfamiliar, I would think, to most OTs, unless we have a lot of experience working with teachers and feeling comfortable in that setting. And then I think teachers might have different experiences working with different OTs, and then they can come to that relationship with different experiences as well. Jayson Davies Yeah, one thing that you really mentioned right there was, like that power dynamic, and it sounds like you learned about that from maybe your was it early intervention experience or home health model? Ellen Cullen Yeah, so I worked in both early intervention as well as working with adults in home care, and I learned how when you approach someone's home, I found myself having to take a deep breath and really check my ego at the door, check all the medical model at the door, and just open myself to a human with another human being, and really entering that space as a listener. Jayson Davies Yeah, yeah. And so now kind of, how did you start to, I don't want to go into the how you applied it yet, but I guess, kind of, what are some of those, those dynamics, power dynamics that apply to school based occupational therapy. As you got into school based occupational therapy, have you been able to actually identify, I guess, what those power dynamics are, or at least kind of to, I don't even know how to say this, but like the things that we need to think about as school based ot practitioners. What are those power dynamics in the classroom going on? Ellen Cullen Sure, I my experience working with teachers has been so enriching for me, so I've really gotten an inside look at what a teacher's day is like, and what thoughts go through their head. And I can almost tell now when they look at me what kind of day they're having. So they're either looking at me like, Oh no, you're here, or oh no, I wasn't ready for you. Or Oh no, you're going to judge me. Or Oh no, what do I need to do next? What? Or what aren't I doing right? Am I another person you know? Is she gonna judge me, or do I? Do I trust her? Do I feel safe with her? I think trust and safety are huge dynamics in a relationship. So, you know, I can look at a teacher and they're either gonna, you know, sometimes they look at me like, help me. Ellen, I just need to go the bathroom. I just need to leave for a second, or it's a great day. We everything's clicking. Everything's great. Come on in. So there's, am I being welcomed, or am I like? It's not a good day. Can you just take Johnny today? So I am ready for anything. Jayson Davies So in that sense, you're what you're kind of explaining is, what I'm hearing is that rather than you trying to go in there with power, you're going in there with absolutely open mindedness in terms of letting the teacher have the power Ellen Cullen absolutely and it's easy to walk in with my agenda and my therapy plan and not check that at the door. Have it? I you know, I think as OTs, school based OTs, we have our plans, we have our goals. We're busy, just like everybody else, but we also have to be very mindful of the teacher's well being, what's going on in her classroom, her dynamics. Maybe she just met with an administrator. Maybe the tone that she's using isn't necessarily targeted towards us, but just something within the system itself she's experiencing, or a pressure coming from what happened before work, or something that's happening within the classroom. So I'm always aware to, like, check any preconceived notions prior to entering a classroom and prior to entering that relationship, Jayson Davies yeah, and I, I get that it is also much harder said than done, because, as you mentioned, right? We go in with our plan, right? Like we know we need to see Johnny. We need we know that we need to see him for 30 minutes, and then we get in there and the teacher is just flustered. Maybe Johnny, or maybe somebody else is doing something in the classroom they're not supposed to be and the teacher has to take care of that. And there just really are a lot of things going on in the classroom at all times. I guess, kind of going back to that power dynamic. We address that power between us and the OT per se, or sorry us and the teacher per se, about kind of having to have this openness, maybe taking a step back when it comes to to the power that we have. But what are some other power dynamics in the classroom that we really needed to be mindful of as we go into a classroom Absolutely. Ellen Cullen And the classrooms I work in this year, I'm in both gen ed classes, and then I'm also in special classes where there are many paras, and in gen ed classes there may or may not be paraprofessionals, so I think then you have a whole nother. Other level of dynamics going on with the teacher within her room, how she's coping with managing, push down from above, but then the push down from within, and then push down from push up from students. Like there's a whole lot of things she or he is managing, in terms of managing, and I'm I sometimes am viewed as one more piece that she or he would have to juggle. So I think as far as I can understand, when a teacher wants to claim their power, because there is so much pulling at them or expectations on them and demands on them that I don't want to add to that demand, and I can understand when they want some control. And I think changing, you know, reframing, it is I want, so bad, to give you the control instead of No, it's my piece of the pie. I think if I can put reframe it as I want that for you, and I get it and how can I help you, like when I enter in that mode of let's just take care of you. First. Johnny will benefit from a teacher who is a that a teacher's well being is being attended to? Jayson Davies Yeah, you bring up a really interesting dynamic, especially for within school based ot practice, just school based ot in general. That is the dynamic between teacher, OT, para, para, educator, and then you have the student also in there as well. That is a very dynamic situation. It's one that I have found myself in the middle of multiple times, like, do I talk to the Para? Do I talk to the teacher? You know, do I include the Para or exclude the Para from pull out services, or even when I'm in the classroom, and all that and and it's not just about, you know, working directly with the Para, but it's also about making sure, or figuring out how the teacher or if the teacher needs to be looped in. So I definitely want to address that here in a little bit, as we get more to our to our action oriented part of this podcast episode. But I do want to talk a little bit about you've done some research with this and whatnot, and I want to know a little bit about your research, but also kind of what made you dive into this, because you were very well of these power dynamics, and very well aware of supporting teachers, almost to the same extent that we support the students themselves. But was it always the case, or did it take some time getting into that? And is that what led to your research, or kind of explain what led to the research, Ellen Cullen what led to the research was really back in I would say, well, it had been building up a sense that I wasn't feeling effective as a school based OT, in terms of seeing the change a sustainable change in students, they might come and through the years, I've primarily back. I'd say 20, I'll say 2010 it was still a pull out model. And so, oh, I'm here for Johnny. So really, the interaction with the teacher and I was scheduling, and then I really would say he did great, or, Oh, he didn't do great. So it became a he did great or he didn't do great. But it was really like, where is the sustainable change in occupational engagement in the classroom, I wanted to see change, occupation based change, and I wasn't in that context. I was really that that context wasn't authentic in the therapy room, and I wasn't feeling like I mattered. What am I doing? I see great things in an OT room, but I wasn't, what did that matter if in an authentic setting, it wasn't happening? So that was driving me to go back to school to answer that question, how can I affect change? And I did go to a teacher school within a university. So I really immerse myself in a teacher's world. And I learned different theory, a motivational theory called self determination theory, which aligned nicely to the Moho I felt there were so many similarities there. I was like, how come I never learned about self determination theory? It's so Moho ish. And then I really being in class with teachers, I really started to hear their stories, and I felt such empathy for them. I really started to connect with the piece that I was missing the teacher, which I really I don't know how I missed it. They were there the whole time. I was so focused on the client being the student, that I had missed the teacher, the teacher, in the relational context of the classroom, was the one trying. Facilitating or restricting occupational performance for that student within that context. And I think I've grown to appreciate Moho embracing context more as I went back to Moho and looked at it and learned more about the intentional relationship model. So then, after my master's, which I infused Moho with self determination theory, and my thesis focused on transitions, not just the major transition for students out of school, but transitions along the way, and how important caregivers and caregiving staff are, I really didn't start diving into addressing the teacher as really an occupational being, until I then went on for my post professional doctorate. Then I really I pivoted a bit from looking at student autonomy to teacher autonomy. And I think that links real well, Jayson, with your notion of power. Where is Teacher autonomy? What are we? How are we as OTs supporting teacher autonomy and teacher occupational adaptation? So again, that's where it really you know, I hadn't seen any coaching model that looked at the teacher as the caregiver of their classroom family. We have coaching models, addressing caregivers in the home, parents, yeah, families, but who? Who's addressing in the classroom, family, the teacher, yeah. Jayson Davies And so now kind of to put a little definition, I guess, behind this right, the the teacher as the caregiver. When you're speaking to that. Are you thinking of it in a way, in a way of like, as a consultation for a student, or is it very different from that, or a collaboration for a student? Or is it very Ellen Cullen different it's and the way the system is set up now I fly under the radar with my consultation, by definition, consultation still views the OT as holding the power and being the expert in terms of us giving strategies, but not necessarily being an equal partner with the Teacher and letting the teacher make the decision. I think teachers do. They'll take what we say. Do they always implement it when we consult with them? I don't know. So the teacher always does hold the power. We just gotta, like, remind ourselves, you know, they always do hold the power. We just have to be okay with that. So coaching acknowledges it puts out some things. I love to picture us in coaching as CO designers. But what's really happening? We're letting a teacher's natural tendency to want these things happen for their student happen. We're just providing the aha moments through coaching where they're like, Yeah, and we let them own that, and then we can throw out ideas, and then they're like, Ah, no. And we're like, okay, and maybe in consultation that can happen too, because maybe some OTs are already coaching, but that's where I'm I'm really coaching it within the consult, so within the school based setting. That's how I'm I'm kind of flying under the radar. Jayson Davies Yeah, so would you consider that your coaching model is still pertaining to a specific student, and therefore you're coaching the teacher basically pertaining one particular student? Or is it more of a I'm coaching this teacher in general, or is it a little bit of both? Ellen Cullen It actually, that's a great question, Jayson, because it actually is both, but we just don't really call it that, because we in the schools have to focus on Johnny. But as I'm focusing on Johnny, I'm like, oh, to the teacher, I noticed you did that. Do you know you do that? That was awesome. So I really try to notice what the teacher is doing well, or Wow, what you think about that, or just kind of ask some guiding questions. Or teachers don't always have. I would think OTs are pretty non judgmental people. We're not like another teacher that's judging them. We're not an administrator judging them. We're giving them feedback as just a co I like to think we're just like peers together, and if we can kind of, oh, did you notice how, when you did that, he did that? Oh, so we're and I'm like, Oh, I noticed, like, how, you really seem to value checking in with the students about how they're feeling. I noticed when you did that, he just lit right up. And it just kind of helps connect teachers with their students. If you can find something like a teacher might come to you and say, Oh. Johnny today, and I can say, Yeah, but isn't that spirit? And I know you're someone with spirit like you and Johnny like you, you have the same thing going on with spirit, or I try to make a connection there. So I am helping to find values that align between the student and the teacher, to help this, you know, help that relationship. But then we're also co designing intervention in context for students and I it does start with that relationship. They have to trust you and be authentic. They know. They know, yeah, they know, if you're you know. So I think it's, I love coaching. I really think that it allows the teacher to connect with why they went into teaching and get that enthusiasm back, and we can be the ones to help them light that fire again. Jayson Davies Yeah, yeah, absolutely great. Love the ideas. So many things I want to discuss, but I do want to continue moving forward. And I want to understand what your research actually looked like, what the goal of it is, and then some of those outcomes. So if you could really quickly kind of talk us through the what the actual research entails. Ellen Cullen So my research involved an occupation based coaching model implementing an occupation occupation based coaching model with two kindergarten teachers, and the focus was on teacher self efficacy. I wanted to explore whether or not my occupation based coaching approach facilitated teacher self efficacy. So this was a pilot program, and to start teacher self efficacy is a type of self ethics efficacy, wherein teachers are strongly affected by their beliefs about the potential, their potential to impact student learning. So there's a lot of research about teacher self efficacy positively impacting student achievement and the teacher's willingness to implement innovation. It can also affect teacher stress levels and their desire to stay in the field. And as we know, teacher burnout is a huge issue. So we're really looking at will this model in terms of what I can provide to the teacher facilitate their self efficacy. So I started with opening myself up to the teachers, to whatever way that coaching would go. So I really had to make sure I focused on building that trusting relationship with these, these two kindergarten teachers, and I did that through using intentional relationship model tools, and I explored what was going on for them and both it just happened to be the two teacher volunteers within the school district were both teachers that had a high percentage of English language learners in their class. These were two experienced teachers. However, they we were coming off of covid. This was 2021 and they expressed their frustration with having to meet standardized testing criteria with these English language learners who were just coming to school, and then they had a whole class of students that were coming off of covid. So their frustration was, we have to meet standardized testing scores, but these kids are nowhere near ready to learn. So their values were, we are good teachers. We know what it takes to have them be ready to learn, but there's no way we can implement that with the demands the system is placing on us. And I said, I want to help. And that's how it began. We started. I learned about them. They're about their occupational identity. We explored occupational competence. We use the OTs short form. It was a very, it's a medical, medically based tool. However we I did say, let's frame it in terms of your teacher occupation. So that helped us get some data that we needed. And yeah, we went from there, wow. Jayson Davies So by saying, you know, how can I help? And that led you down this entire path. Now I believe that this is in in addition to the services that you were completing under an IEP correct. It's not an instead of IEP services Ellen Cullen this, yes, this capstone project was in addition to my ot caseload, so I had to work on doing my weekly coaching sessions with the teachers in addition to my ot caseload. Jayson Davies Yes, yeah. So, yeah, yeah. And that's kind of why I bring this up a little bit, because one of the things that I constantly hear and I've also experienced. Many times it's like, how do I even have time? Or how do I find time to support teachers? And given that you kind of forced yourself to do this, I'm interested to hear what were some techniques that you used, or what were the most successful techniques that you think you used that actually led you and the teachers to be able to make this time, or to set aside this time, or to, you know, a lot of people, we say we don't have time for something, but it's more that we're not making time for it. And that comes from both sides, right? It's not just the time that we have, it's the time that we have and the teachers have. And so I'm interested to hear kind of how both you and the teachers made this work, time wise. Ellen Cullen Well, fortunately, my district supported me, which was great. It really, I had a relationship with these two teachers, so I they knew me, and there was that element, and they wanted to help me as well. But I think, truly, we were all invested in this. And they really, really, they were motivated. They wanted to work on these things, and they were excited to have someone who would partner with them to try some innovative strategies that I think there was a part of them. Even though they were experienced teachers that they thought, No, nothing's going to change. They were always like, Nope, this is how it's going to be. This is how it goes. But I was like, wow, we could try. And I'll back you up. I think, wow, okay. And I'm like, yeah, it's our capstones, you know? And I was lucky. I did have a field work student with me, who happened to be an English language learner, student back in the day, himself. So it was really amazing how all these pieces fell into place. I had no idea that these two teachers would volunteer. I had no idea they were both the L slotted l kindergarten teachers, and I had no idea my fieldwork student was an L. So it was really a fascinating time. Gotcha. Jayson Davies Fantastic. Cool. Well, we're going to take a quick break and we come back, we'll dive into kind of those results of your research, and then move forward with actionable tips for school based ot practitioners who want to collaborate and consult more and support their teachers more. So we'll be right back. All right, to wrap up the last question, Ellen, when did you actually meet with those teachers? Was it during lunch? Was it after school? Before school? How did you or what time frames worked for the two of you, after school? Ellen Cullen It was after school. But what we did was, do we enacted the actual work during the day? Jayson Davies Okay? And so because of Go ahead, Ellen Cullen oh yeah. So my, well, in the in the district took away this program. We had a kindergarten support service program where I had to push into kindergarten classes anyway. So my actual coaching sessions with the teachers, like we would kind of say, How am I doing? How are you doing? Where we actually met was after school. However, the work that we did was during my ot kindergarten support program, and I think that's where a workload model is so necessary to have something like this work really well. Jayson Davies Yeah, I think that's accurate. And I also like the idea of, I don't know if you've done this, but if I knew that I needed to work with a student both in the classroom and also consult, I was very specific about putting both in the classroom and consultation on the IEP, not just one or the other, and kind of hoping that I would make time for it. I was very intentional about putting more than one service on an IEP if necessary, so that I could have both that in classroom time or the pull out time and the consultation time. So yeah, the other question that I really wanted to ask you was, how did you, or did this even come up with where, because you were working with the teachers, consulting with them or coaching them in the afternoons. Did that lead to you having missed IEPs that you weren't able to attend because of these consultations? Did that lead to other things not getting done that you know, an OT traditionally has to do, progress, notes, all that fun stuff. Did that occur as part of you needing or as part of you consulting and coaching these teachers? Ellen Cullen Fortunately for that capstone project, I was fortunate to have an OT fieldwork student that lifted some of the load off of me. However, in my typical school based life right now that wouldn't happen. I would have a real hard time implementing a coaching program like this. My district operates by a caseload model, not a workload model. However, we have built in an extra week of coaching time, so we do a. Monthly model. So we have three weeks of direct and one week that we can use for coaching. However, sometimes we do have to make up students during that week, but that, as I look at it, that is when I do most of my consultation. Jayson Davies I love that. Yeah, they're using the three to one model. Awesome. Did you were you there when that happened? Or Yes, and did that happen as kind of a result to your research and seeing the Ellen Cullen benefits of that. It was actually something that in our area where I live, a lot of school districts were moving over to that model. So when we as an OT department brought that up, it was something like, yeah, let's get on board. Other districts are doing it, so I'm really happy for that. We're real thankful to have that extra time. Now I don't know how we did it without it. How did we do our I don't know, but I think it has really moved us closer to a true workload model, although, you know the medical model pushes in, we, we, you know, still have kids in blocks of time, time slots. Jayson Davies Yeah, all right, I'm gonna prevent myself from asking you all the questions I have about a three to one model, because we will go way off topic if we do that. Well, I'll just save it for another episode. But going back to your research, I noticed that when you're talking about kind of the constructs of your research. You're talking about a working with teachers or coaching teachers their self efficacy, and English language learners. Yes, most of those. If you talk to most school based ot practitioners, I'm going to say, like 98% of them, they will say a I do not focus on English, second English as a second language students in the sense of, I may support them, but not you know any term not related to language. B, I don't touch teacher. Self efficacy and C, consultations are really difficult for me. So I guess the question here is, even though what you decided to work on like almost sounds nothing like traditional or school based occupational therapy. Why was that important like? Why is it actually important that school based ot practitioners focus, I guess, primarily on that teacher self efficacy, and is that something that should be more of our role? Absolutely. Ellen Cullen I like to think of OTs, not fixers. We are there to support all students. All students are our students. And if any student is struggling with their occupational performance in the classroom, if there's any part of that, or I'd like to think if there's any part of its teachers occupational performance that we can help support or problem solve, we are the people to do it. We are systems thinkers. Our ot education has helped us think convergently and divergently. So we can go in and out and look at big systems and then we can hone in on a problem. We we are systems thinkers, so I really feel that. Again, back to Moho, self efficacy. We're looking at volition, we're looking at values. We're looking at what matters to me. You know, the either what what values did this? Does the teacher have? What values does the student have? No one is going to engage in occupation if they're not motivated to do so. So we really need to look at those motivational constructs. That goes back to our Occupational Therapy education. That's just who we are. We don't just look at purely tasks. We look at the motivation and the reason behind, behind why someone does the task. So I think you have to look at those things. We're dealing with, humans and ELLs. I think maybe there's a stigma that, oh, OTs are medical people. There must be a problem medically or a special need. No, we can, we can support ELLs. And many times, some of the strategies we use with other students work for ELLs. They visual support ELLs routines, visual video modeling, using auditory cues like a bell for transitions, we can, we can help support L's. Jayson Davies Wow, yeah, I've never, even, never even had the thought process of supporting English student language learners like that's just not something I've ever focused on. I know we absolutely, I will shout from the rooftop that MTSS, you know, is essential for occupational therapy to be a part of. But Never have I thought like it's also essential for us to maybe to focus on students who are learning the English language and need support. And they absolutely do need support, and as ot practitioners, we probably have more to offer than we have ever even thought of. So thanks for sharing that absolutely all right. So now let's talk a little bit about your outcomes. I know when it comes to capstone projects, sometimes we get fantastic. Results, sometimes we get more anecdotal results. What have you seen, both the short term results that you know maybe went into your capstone, and then also maybe some of the longer term results? I'm sure you're still in touch with some of those teachers. Kind of what were those results for you? Ellen Cullen The results were not what I expected, I think, in different situations with different teachers that might have been different. I had two experienced teachers who knew me and wanted to support me, but they truly were honest and saying, No, this program really helped me. I did not have it in my mind at all that I would see the difference, the significant difference in value that my program provided for them, and and I was blown away by that. So the outcome, yeah, the outcome of my research showed that when the program wasn't there, the teacher slipped back into what I do doesn't matter. I'm really not supported. Standardized tests are coming. Parent teacher conferences are coming. I have the slip in student learning from covid. And what the outcomes found was that when I was there to kind of to support them and say, No, we got this, you got this. We can handle this. Let's reframe it as you know, something different in the capstone project itself, we co designed together in the classroom, put some real innovative ideas in place. The teacher they added to the program because they had a parent connection piece, which I hadn't even thought of. So they said, Oh, I think we need to get parents involved in this. I'm like, That's awesome. So but then I pulled away, and we let we didn't have our weekly coaching sessions, we didn't have our weekly co design in context sessions. And I think that lack of having a guide on the side. They felt that. And I I think they got back to like, my values do not align with the district's values. They just want to see me pumping out test scores that align with how they look to other districts. And I think they felt back into like, okay, it's mid year. We started the year Ellen. Everything was going great, but now it's mid year and and I'm back to waiting for summer vacation. I'm like, Oh, we got to keep that momentum going. And I think I would like to know what would have happened if I did a year long program. I'd like to think that the coaching that OTs do does help keep teachers rolling along with some positive momentum, that we can address volition and that like why you went into the profession, and that you do matter, and that you are a good teacher, and there is room for innovation. Jayson Davies Yeah, yeah. I'm curious, are you in a What state are you in? Ellen Cullen Again, New York State, that's right, Jayson Davies yeah, in a state that ot practitioners cannot become anything other than an OT in the school based setting, just unless they go back for school for a long, long time, right? Ellen Cullen However, my district was very, is very innovative, that they allowed me to actually run a summer program for ELLs where I was the program administrator. So I was able to be an OT leader in that capacity by using grant money to run a kindergarten driving to learn program, and that was the program we put in place during my coaching capstone project, we did a kindergarten coaching to learn program where the kids got their kindergarten driver's license. We set up rest areas, pit stops. We had all sorts of like stop signs, and the kids loved it. And we related to, oh, what are you going to do to get ready to go to the math trip? We got to get our pencil eraser. And then we, you know, instructed on strategies like verbal rehearsal and using a kinesthetic one finger pencil eraser notebook. And you know, it was all in the context of play, and all kids want to drive, so they made cars, and we had to adjust our engine speed. So in the summer, we ran that program to as a boost to get the L students ready for school, yeah, wow. Jayson Davies And you said that that was not part of your capstone, but it was kind of based upon the capstone. Because, yes, so were you during your capstone? Was that something that you might teach, or you might support your teachers with implementing something like that? Or, I guess my question here is, what did the actual time spent with the teachers look like when you were meeting with them after school. Was it focused on, you know, that volition piece? Remember why you came into school based OT? Or was it super structured? Or was it more, less structured, interview and support? Ellen Cullen It was structured. I really had to do the program with. Fidelity. So we did look at our IRM tools. I reflected on how I was being true to my own modes and my my own ot goal of using my modes very intuitively to what the teacher was looking for. So I did reflections, but the teacher and I would say, How are you doing? How are things going? What could we do differently? Let's plan for our for our in context session this week, and that's how it would go. And we always revisit our occupation, the occupational formulation, I always referred back to that story, their occupational narrative, that they told me, and that together we developed and we developed our goals, occupational formulation, style goals, based on the theory of Moho, so that it was a structured process. But we always had a plan, yeah, Jayson Davies yeah, yeah. So, okay, so now I'm going to put like, the last three questions that I've asked you kind of together, because I think some people, if let's just imagine an occupational therapist isn't listening today, or an occupational therapy as an assistant isn't listening. And they might be thinking, okay, working with teachers, working with students, with, you know, English as a second, second language learner. How is this OT? Why? Why is this being done by an OT like, shouldn't this just be teacher supporting teachers, or shouldn't this be an administrator supporting a teacher? And so I want to let you kind of answer that. Like, why is it that this is an occupational therapy program, not just a teacher getting support from another teacher, or a teacher getting support from an administrator? Does that make sense? Does that question Ellen Cullen make sense? Yes, and that's a great question. And during the Capstone, I was there to support the teachers occupational adaptation. So I was looking to have more alignment with the teacher, to teachers values and how they felt competent, and that was my role as an OT to support the teacher. So in that moment and the district doesn't pay me to have the teacher as my client. They pay me for the student to be my client. However, there are some nuances there that in order for me to have the most impact or bang for my buck with Johnny, I have to support the teacher. I have to support the teacher's occupation. So I'm always focused on occupation, and I do care about the teacher's occupational identity and their feeling of self efficacy and the mastery experiences that ot provides, or we can provide the environment and context for those to occur. Promotes teacher occupational adaptation. And if we look at our role as focused on occupation that applies to we can do that to the teacher, to a parent, to the student, to the system as a whole. Like we really need to have that systems lens of how we can impact through our skills, and we could do that in the community. So I think the more the otpf four look looks to us to look beyond the individual, we do need to extend out to different systems and show that we have value. Are we bringing value to the people that we work with. And I don't think we always frame who our client is, but I think it's real important to then apply our occupational reasoning skills to those clients. Jayson Davies Yeah, yeah. And to think about the teacher as part of the client is an important side of that. So all right, we're gonna take our final break, and when we come back, we're gonna really talk it, talk about how to implement this right now, like, how can a school based ot practitioner kind of use this? And maybe it won't look exactly the same, but how they can use this. So let's take our break. All right, we are back with Ellen, and Ellen, you've done this now as a capstone, it sounds like you're still doing some teacher collaboration and coaching within your three to one system. You've got that that week that you can kind of support teachers a little bit more and not worry as much about the direct intervention with students. I want to know what you learned during your capstone and even before your capstone, because you talked about your your past experience. Really supporting you and what you're doing now. But what did you learn that you're still really implementing today when it comes to supporting those teachers, even though you don't necessarily have this official program in place to support teachers, Ellen Cullen my capstone changed me as a school based ot everything I do now views the teacher. I have a loving response towards all teachers, and there certainly might be some teachers that I would prefer more than others, but I always approach them empathetically, and that my capstone showed me. Me a little glimpse of what their life is like in the in the constraints they're under. So I think, if anything, it allows me to be to provide a loving response towards them. And I think I just it's okay for a day for me to say, How can I help, like I or without even asking, just provide materials or say, Hey, how about can I lighten your load? And how can I do that for you? Like I want to show them that I am supporting their well being. And that is doing my job for Johnny. Jayson Davies That's interesting. The way that you wrap that up, that is doing my job for Johnny, because I did kind of want to ask that a little bit, did you ever get any pushback? Or do you get pushback in terms of, well, supporting the teacher isn't supporting Johnny Ellen Cullen i and I've been in it a long time in this field, so now I'm like, I just like, I just know I am. But I mean, I certainly think I could however. You know, I'm always careful to make sure that in my documentation, like I, I do consider that time of modeling in the classroom really good for kids, because they see a teacher and I loving each other. They see a teacher and I co designing together. They see us fail. They see us laugh. They so I think kids, kids need to see that we can be in our authentic selves, certainly professionally, but like kids learn to problem solve and be creators and fail and and I think there's sometimes with cookie cutter curriculums, teachers feel like they don't have that their autonomy has, in a way, been taken away. They're afraid during a walk through they're going to be judged for not saying the curriculum the way it has to be said. But I kind of there we just, I think, if anything, kids see human beings being real with each other. And I think that's really healthy. Jayson Davies Yeah, no, I think, I think that is absolutely true as well. I just know it's sometimes very difficult within our school based constraints. And, you know, being careful here, and I know we have to be a little careful, because of the documentation, because of the billing practices, because of how everything like it's hard. You can't obviously, you can't documentate. You can't document what did not happen, obviously. And so I just feel like you have to, if a teacher comes in and asks you for help with something, there might be some times that we have to say, Hey, that's a little bit beyond my scope. But if we can work it to Hey, yes, I can support you, and I see how this supports Johnny somehow to in relationship to his goal and or something else important for Johnny, I could see how that would work. And I think it can help two birds, one stone to a degree, absolutely. Ellen Cullen And I would want listeners to know, most of my therapy is done within context. There are some situations that I pull students, some of the older students, to do some targeted intervention. However, most of my work is done in context. So there is more of especially kindergarten, there's very much of a different kind of it's a little bit easier to do that kind of work. It's easier for me to be set up at a center, and I work on cutting. It's easy for me to just go in and do a lesson, and we're working on some executive functional, function skills, but it's based on job stations where one is shredding what it so it's easy to kind of have that environment and context, be able to bill for that, because that is occupation, and I am strategically placing myself with a certain student, but it allows for some flow and CO designing with the teacher. So I I try to, I take a cart into the classroom, and I have a lot of materials in it, so I really have forced myself to build good relationships. Make sure I'm welcome in the classroom. If I'm not, it's okay. I respect the teacher saying hey today, and I'm like, yep, oh, I got you. So I think, but I can't, I always make sure that what I am doing is delivering a skilled service. And I think we we walk that line by being real creative with how we deliver our services? Jayson Davies Yeah, yeah. And so your your capstone we've talked a lot about revolved around the self efficacy of the teachers related to a particular student subsection, yes, now, though, it's much more broad, I'm assuming, because you're not focusing on students as English language learners, but it's a little bit more broad. You have that time set aside for some consultation and coaching. What are you finding that maybe either a teachers are needing most or B that you are most effective at when it comes to supporting teachers? Ellen Cullen I feel that what teachers are looking for is help, especially with some of the more challenging behaviors they're experiencing in their classroom. And I think that's what I'm noticing more recently, is that they're feeling overwhelmed with the level of need of student that they're getting, and they're not feeling competent in terms of managing all, being able to differentiate for all of the students. So I find myself focusing a lot with the teachers on that, and they're very welcome to those kinds of suggestions. I think, I think, personally, I'm very good at like, kind of breaking down a problem, because the original problem the teacher may think is the problem, may or may not be the problem. So when I can reframe it as, what do you think? What happens before? What happened? Like really trying to break down what is happening, because I think they see it in a little different way. But we can come at it through more divergent to convergent, we can look out, and then we can look in. And sometimes that helps a teacher say, Wow, I didn't even see that. I was so focused on this. And those are things that I think we can help the teacher look at a situation maybe a little differently. Okay? Jayson Davies And I want to also ask, is there something more in relationship to newer teachers? I know you've been in this field for a little for a little while. Are you finding that newer teachers have similar concerns to more experienced teachers, or does it take a different approach? What do you see with newer teachers? Ellen Cullen Yeah, what I'm noticing some of the newer teachers, they're scared not to get tenure New York state. So I do notice that some of those newer teachers want to do things by the book. They're very scared to deviate from anything that they could potentially not have a job. And I'm very sensitive to that. So I I really gage their comfort level with like some of the more innovative ways to implement curriculum. For instance, if they're working on numbers, we set up hopscotch, and I say, Would you be willing? What do you think? What it's up to you? And they might like, Oh, that's a little, you know, whatever their comfort level is, yeah. Or I do tend to really be real gentle, because I understand the constraints that they're under, and they don't know a lot about OT. So I love to be an OT that can say, hey, we do a lot of things as OTs, but we can address this. We can address that. Are there things you're noticing with your students? Could that I could help with? And how can I be of assistance to you? So they think of us a lot, of the fine motor, the handwriting. But then then I kind of say, Okay. And then I say, Oh, do you Did you notice that, you know, I can help you with that, or, or I could, we could work to develop some solutions. So I really tried to take a take their lead on what, what is a problem for them? Yeah, that Jayson Davies that's interesting. I was just going to ask you if you felt like this model of coaching teachers, directly interacting with teachers, as opposed to focusing on just the students, has opened up your scope of practice to a degree. And it sounds like that's kind of what you're alluding to Ellen Cullen right there. Yes, yes. And it and I personally struggle with sometimes ot tries to be everything. However, when I just focus on occupation of student, or when I just focus on, say, a student's having difficulty with toileting, how can I help? So if you really look at it and through an occupation lens, it really can help keep us focused as we're occupational therapists. But yeah, our scope of practice can expand, but I have found working in education, what helped me tremendously was getting some teacher education myself, learning more about curriculum, learning about how I can take curriculum and then mesh it in a developmentally friendly way in the classroom. And that human development training and our OT training and teacher training part that I had to seek out I didn't get it in my ot program back in the day. That really helped me, because then I'm like, Oh, I know curriculum. Why? Why is you're working on digraphs. Tell me more about digraphs. Like, I don't really like, tell me, okay, I can help. Like, we could, we could, you know, slide with our finger across a digraph. We could do some fun, take a dip on the digraph, you know. So I can implement some of my motor skills along with digraphs. So I try to support teacher goals with my goals, ot goals, but they should all be goal, team goals, but, yeah, I Jayson Davies was just gonna ask you about goals, if that helps you. No, I totally get that right. Like, is it a goal? Is it ot goal? Is a teacher goal? It's actually the kids goal. I don't know, so I was gonna ask you about that. Like, does the way that you as a team write goals make it easier to facilitate teacher training, teacher consultation and collaboration? Ellen Cullen It should. Good. I mean, ultimately we should all be doing team goals. But I do know it gets tricky, mechanics wise, when you're doing progress monitoring to tease out the data collection. However, that is the dream. The dream is to see how it can all blend together, how we can integrate some fine motor visual perception into reading. I think that's a really great area to expand it. I mean, there's so many areas that they could be holistic. I know as an OT, I don't have that extensive knowledge to really be able to know the curriculum well enough to be immersing myself as an occupation based person, so that, I mean, as much as I do know, I do think that actually having a school teacher credential and part of an OT program would would be great, because then we could really be occupation based. I mean, we are. We do address occupations of like the fine motor and the cutting, but the actual occupation of learning, yeah, and, you know, I can do as much to address executive function, but there are actual components of, like, you know, just different things that I'm like, Yeah, we could do long division on the floor with a big mat and, like, I could jump to carry the number, you know, There's been, I'm like, Oh, I wish I had, I wish I had a little bit more knowledge of how you teach those things. Jayson Davies I mean, it's hard to, it's difficult to address an occupation if you don't fully understand the occupation and right, like we type in, or we write in, right? Education is an occupation. I believe it's ideal, or no, it's an ADL. But like, education is very different, K through three, four through six, six through eight, and then adult learning and high school and all that. Like, it's very different. And understand education from a large concept, yes, to the education in this classroom for this student and this teacher, and how that works together. So I totally get that and how being and having some educator training could help. Ellen Cullen Yes, and I do think that's why that collaboration between the OT and teacher is even more important in the school setting, because we do rely on them to teach us as much as they're looking to have us teach them. We really need to know in order to do our job effectively. We really need the nitty gritty of, like, how, that's how that's being conveyed in the classroom. Are you, you know? How are you? What's your mode of instruction? Like, like, what tools do you use? What, what are you going to have them do? And, and we don't always have the time to collaborate. Oh, this is our science lesson. We're going to have them do that. Great, awesome, you know? And we get that. But, yeah, Jayson Davies I want to go back to something we discussed earlier in this podcast, and I said I would come back to it. And so I want to do that. And that was the dynamic of supporting paraprofessionals as well as teachers and supporting students. And I guess, to kind of kick this off a little bit, and we'll probably wrap up with this is a, do you feel like you also need to provide that support to paraprofessionals and B, I guess it would be an or, or, do you support the paraprofessionals through the teachers? How do you see that? Ellen Cullen Wow, those are such interesting dynamics to think about, because there are so many different relationships there. I target the teacher and what their goals for their classroom are, and then I ask them how, how are you feeling about your staff, your team here is everyone on the same page with the things you value or what you'd like to see happen. And through that conversation, I get a little bit bit more insight, because I'm not there all the time. However, yeah, I, I said, I, you know, I can help. Is there anything I could do? And sometimes I know, as OTs, we, we do observe things. So sometimes I'll say, Hey, what is your feeling about, you know, a certain thing it might be, you know, you know, and rightfully so, some of our paraprofessionals are hired without knowing their job isn't to do for students. Their job is to, you know, enable maximal engagement and participation. So, you know, they may say, Well, no, I don't think they can do it. So sometimes, as an OT or a teacher, if we frame it as sometimes your job is, is not to do anything, but just be there, make sure they're safe. And I think that's like, wait, but I'm supposed to do a job. So it's interesting, because teachers have to walk. Teachers are navigating that all the time, but I think those are important relationships, but I always make sure the teacher remains the the head of their, their classroom. That is their, their domain, and I am entering it. So I think I always keep that idea present, and I'm more than willing to have the teacher hold that degree of control, because they don't have control. Over a lot, I'm finding they have a lot of things pulling at them, and I really want to make sure they know that, that I'm not there to take any of that away. But if I can help them, I'm here for them. Jayson Davies Yeah, yeah, yeah. I totally get that. It is a very unique dynamic, and it's almost akin a little bit to the OT. OT a relationship only in the sense that they are their supervisor. From the sense of they instruct the paraprofessional on tasks and how to support students and whatnot, but at the end of the day, they are not the supervisor when it comes to any type of workplace concerns, right? Like it's not the teacher's responsibility to discipline the paraprofessional, and so it's this very unique dynamic where you you're giving them a ton of support, but at the same time you're not their supervisor, so you're supervising them without their being, without being their supervisor on paper, and it is just a, yeah, interesting concept. Ellen Cullen Think about that. They're not only managing their students, they're managing staff that are also working with their students, so they feel responsible for what happens with those students through the staff, however, they're not ultimately in charge of dictating to those pair of professionals different things because they can't make the rules. So think about, think about how that would feel. I often think like, wow, that's really putting them in a precarious situation, liability, or like, just your sense of, again, self efficacy and autonomy, yes, and how, how instruction is being dosed to our students. It's real interesting because, you know, everyone has their own style. So yeah, I mean it really exactly yes, yes, yeah, that's a great point. Jayson, great. Jayson Davies Well, the classroom is a very dynamic place, as I think we all realize, but maybe don't fully understand, and I love your idea of, you know, really viewing the teachers as a client, because it's really hard to support an individual student without fully understanding the classroom. And of course, the teacher, the paraprofessionals, everyone else in that classroom, is absolutely a part of that student's learning environment. If we look at the PEO model, right, it's not just about the person, it's also about the environment, and everyone in that environment, which is everyone in that classroom. So, yeah, Ellen, are there any, I guess, tips? Last tips, don't feel like you got to go over everything, but just something that you share with other school based ot practitioners, if they want to maybe coach their teachers up a little bit more. What are maybe 123, tips that you just kind of have for them to help get started? Ellen Cullen Yes, I think if you know certainly, you can look into theories. I use the Moho. I used intentional relationship model. The Moho Clearing House has free resources that that you can use, the self assessment of modes. There's also a real quick check on modes that the teacher and the OT could use. So those are great resources. I think you know, again, I love occupation occupational formulation. It really is similar to an occupational profile. So I love getting teacher stories, but again, I know time constraints, but looking at different teacher coaching models, evocative coaching is a real good one that helped me quite a bit. But I think if, if you again, I know this sounds real simplistic, but if you love your teachers, and not in a romantic love, but a real, like loving, loving stance, and really have empathy for them, and think about CO designing and innovating with them, and then offering, offering to care for them. And you know, we care for our caregivers as OTs, that's a great model for coaching. So I would say if I gave other school based OTs some tools or things to think about, I, you know, I hope that, I hope that helps, and some references that you can Jayson, I'll share some references that they could check out. And hopefully coaching will be, at some point, a school based model that will be acceptable and I think it's authentic. It's occupation based. It's it. It helps generalize what we do so, and that's what we want to see. We want to see that generalization occur in authentic settings where occupation is occurring. So I would say, yeah, if we can reframe the school as family and the caregiver as the teacher as a caregiver that has a lot of demands on them. We want to keep our teachers. I love them. Keep our teachers because we can affect change in occupation through the teacher, the teacher as the change agent. And we as the OTs, can facilitate all that change in Johnny and hopefully in the teacher too, and in us. So it's it's good all the way around. Jayson Davies So yeah, and if nothing else, I think even with the way that we potentially frame talking about this in IEPs, could, could be helpful. I mean, when we sit in an IEP, we are sitting in an IEP with caregivers, right the parents, and they understand that term as a caregiver. And I think if we could explain in an IEP look, you know, you're Johnny's caregiver, but the teacher is also Johnny's caregiver, and they need support. And you know, maybe I don't need to see the student one on one for 30 minutes. Maybe, rather, I need to support the student. And maybe that's not called coaching. Maybe it's called consult on the IEP, but maybe you put on to that IEP 30 minutes a month of consult. I'm doing air quotes for those of you who can't see me, which you can't, because it's in an audio only podcast. But you know, calling it consult because that falls into the confines of occupational therapy, as opposed to calling it coaching. But at the end of the day, you're coaching the teacher, maybe that's the way that you could do it Ellen Cullen so well, absolutely. So the program can be delivered through consultation, and the way we deliver that consultation is through a coaching model. So it could, we could definitely, we could make a case for that, and I think it could be ready to implement tomorrow. And I think truly letting the teacher lead, and that's hard for OTs, but if we can let that happen, that only empowers the teacher as well, because they're the ones that are with the kids every day, so they're going to implement the strategies they want to implement on their own anyway. So who's kidding? We're not kidding ourselves. But you'd hope they'd see value in some some of our recommendations. It is, yeah, I mean, I think, I think we offer a good reframe, though, because we can see it from a different lens. And I think, you know, when, when it happens, it just it clicks. And I think they're thankful for that. And when we can see we've helped them, then we're, you know, then we feel a sense of self efficacy ourselves. So, yeah, yeah. I think teachers want to be heard for sure. So I think OTs are great people to do that. Jayson Davies Yeah, yeah. Well, Ellen, it has been a pleasure. Thank you so much for joining us here on the show. I think this is going to help a lot of OT practitioner not to only better understand that coaching model and how they can do that, but to also understand that, you know, things a don't happen overnight, and B, I don't want to say that you finagle the system a little bit to work for what you want it to do, but I guess it's more things are fluid a little bit. And it's not always a straight, you know, a straight line from point A to point B, and you got to kind of be a little fluid. So thank you so much. Really appreciate you coming on, and I look forward to keeping in touch. Ellen Cullen Thank you, Jayson, thank you so much for having me. Jayson Davies All right, that is a wrap on episode 194 of the OT school house podcast. Ellen. Thank you so much for joining us today and sharing your work on occupation based coaching for teachers, the way you've reframed teachers as occupational beings, and using the Moho framework to understand their volition, habituation and performance capacity, is exactly the kind of shift that we sometimes need in school based OT, to revitalize the work that we're doing and also to have more impact with teachers. Your research challenges us to move beyond the outsider expert, if you will, with all the answers, and instead become a co designer with teachers to empower them to reclaim their autonomy and align their practice with their values, and that way we can support so many more students on campus and to you the listener today. Thank you so much for being here and for your commitment to excellence in your school based ot practice. If today's episode resonated with you and you're looking for more resources and professional development and direct mentorship to take your school based ot practice to the next level, I would love to invite you to join us inside the OT school houses, school based ot collaborative. Inside the collaborative, you'll get access to exclusive trainings, a supportive community of school based practitioners, and, of course, direct mentorship with myself. Head on over to OTSchoolHouse.com slash collab to learn more and join us until next time, keep supporting your teachers, empowering your students, and remember you're making a difference every single day. I'll see 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 OTs schoolhouse.co m 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 More How School-based OT Services Differ From Special Education Services Last week, I received a question I knew I would have to address in an article one day... Well, that day has come. In response to my occupational therapy services in high school article, Meghan asked: “What about this is specific to OT versus special education or other IEP team members?” While her question was tied to supporting older students, it could just as easily apply to all school-based occupational therapy. And honestly, I would be lying if I said I’ve never asked myself this same question while sitting in IEP meetings, observing classrooms, or even while working one-on-one with students. The truth is, while what we do can sometimes look similar to what a teacher does, the actions we take and the reasons behind them are very different. So let’s talk about it. Not from a place of defensiveness or turf protection, but from a place of clarity. Why This Question Comes Up So Often This question comes up because schools are changing, and with it, so are how OT servies are provided. We’re seeing more inclusive practices, more push-in services, more collaboration, and more emphasis on real-world skills. Teachers are thinking beyond academics. Special education services are increasingly focused on functional outcomes. Speech therapists are working on participation and self-advocacy. Mental health supports are embedded across settings. All of that is good. But when everyone is supporting similar outcomes, it becomes harder to articulate why occupational therapy is at the table, especially if our answer starts sounding like, “Well… we all kind of do this.” Overlap among providers is not the problem. Lack of role clarity is. So, how is OT different from Special Education services? IDEA is a good place to start to answer that question. SDI vs Related Service One of the most important distinctions to understand is how IDEA views the two different services. Special education services exist to provide specially designed instruction (SDI) . The purpose of instruction is to teach a student new skills, content, or strategies aligned with educational standards and goals. IDEA, as well as AOTA’s Guidelines for Occupational Therapy Services in Early Intervention and Schools , make it clear that school-based occupational therapy is not an instructional service . As part of an IEP, we are not in schools to teach reading, writing, math, or curriculum content, and we are not responsible for designing or delivering academic instruction. Instead, occupational therapy is considered a related service under IDEA. That means our role is to support access, participation, and performance within the educational environment. Access: Can the student physically, cognitively, and emotionally engage with classroom activities and routines? Participation: Can the student take part in school tasks alongside peers in meaningful ways? Performance: Can the student carry out those tasks effectively and with increasing independence in real classroom contexts? So while a teacher may be responsible for teaching a skill, an OT practitioner looks at what might be preventing the student from using that skill in the classroom, whether that barrier is related to the environment, task demands, tools, routines, or supports. OT services are provided when they are necessary for a student to benefit from special education. Not to replace instruction, and definitely not to duplicate it. Teaching Skills vs. Enabling Use of Skills Here’s a simple way I often think about it. Special education teachers often ask themselves: “How do we teach this skill?” Instead, we as OTPs are tasked with answering, “What is getting in the way of this student using the skill here?” We are trained to analyze the interaction between the student, the task, and the environment. Not in isolation, but together. This perspective is foundational to occupational therapy and is explicitly described in the Occupational Therapy Practice Framework (OTPF-4) . Example of the Teacher & OT Roles: A teacher may notice that a student understands writing concepts but struggles to stay focused long enough to complete written work. While the teacher can re-explain directions or provide instructional support, the barrier isn’t the writing skill itself. Rather, it’s sustained attention during the task. In this situation, OT wouldn't focus on the writing. Instead, OT focuses on analyzing what is interfering with attention and engagement, such as task length, visual demands, seating, or the structure of the writing routine. By adjusting these factors, the OT helps create the conditions that allow the student to remain engaged and use the writing skills they’ve already been taught. The OT Lens & Looking Beyond the Student This is where occupational therapy most clearly differs from special education services. While educators understandably focus on instruction, progress, and outcomes, OT practitioners are trained to look beyond the student alone and examine: The demands of the task The physical, social, and sensory environment The routines, expectations, and supports surrounding performance Our evaluations and interventions are not only about determining whether a student can do something in a controlled setting, but also whether they can do it within the actual occupations of school, such as writing during timed assignments, managing materials between classes, participating in group work, navigating transitions, or using assistive technology independently. This is also why classroom observations and occupational profiles are so central to school-based OT practice. They help us understand performance from the student’s perspective, across contexts, rather than through isolated skill testing. Even Then, Overlap Happens. That’s Not a Problem Executive functioning. Self-regulation. Written expression. Transition skills. These are areas where occupational therapy, special education, speech therapy, counseling, and even general education often overlap. That overlap doesn’t mean services are redundant. It means teams are addressing complex skills from different angles. The special education staff may try teaching strategies explicitly. The OT may help the teacher modify task demands, environmental supports, or routines so those strategies can actually be used. Meanwhile, the SLP may support communication demands tied to the same activity. Let’s look at an example. A teacher instructs the entire class on how to copy assignments from the board into their agenda. Within a few days, most students have the routine down, but not Timmy. As you might expect, this is frustrating for Ms. Jones, who doesn’t have the time to "re-teach" this task to Timmy week after week. Enter you, the OT practitioner. You’re likely not going to pull Timmy out, practice copying from the board in isolation, and send him back to class. That would simply replicate what the teacher already did, and would likely lead to the same result. Instead, you observe Timmy attempting the task in the classroom. You talk with Ms. Jones about what she’s noticing. You check in with Timmy about what feels hard. You may assess visual processing, attention, or organizational demands before making any recommendations. Only then do you intervene based on what you learn about Timmy, the environment, and the teacher's expectations for the student. Maybe the solution is a seating change. Maybe it’s a simplified agenda format. Or maybe you discover that Timmy is intentionally avoiding writing assignments so he can later tell his parents he has no homework. Whatever the outcome, the key point is this: Your recommendations are not guesses. They're not even "educated guesses." They are the result of the occupational therapy process, grounded in observation, analysis, and professional reasoning. Could Ms. Jones have tried a different seat or a simpler agenda? Possibly. But those decisions would likely be based on intuition alone, not on a structured occupational therapy framework designed to analyze participation within real classroom demands. That distinction matters. How I Try to Reduce Confusion of What OT Is One way to reduce confusion is to be very clear about accountability. And the best time and place to do this is often the IEP. During the IEP, you likely have a moment to explain what OT is, and how you plan to support a child. This is your chance to explain your role while the parent(s), Teacher(s), and even the Admin are tuned in only to you. So use that time wisely. Here's a script you can even use in your next IEP to help others better understand your role. It may even help you to be more confident in your role. “My role as the OT is to support [student]’s access, participation, and independence within the school environment. I’m here to look at how educational task demands, routines, and environmental factors may be impacting [student]’s ability to use the skills they’re being taught. When challenges come up, I can work with the student and/or the team to identify what might be getting in the way and to recommend supports or adjustments that help [student] participate more fully and successfully throughout the school day, and I’m happy to build on that as we talk more about [student]’s needs. Note, there's nothing about handwriting, sensory, executive functioning, or behavior here. Instead we focus on task demands, routines, and environmental factors. That leaves the door open for us to support in many different ways. Still sorting out the role of school-based OT? You don’t have to do it alone. Understanding the difference between school-based OT services and special education instruction isn’t always straightforward. Inside The Collab , school-based OTPs come together to talk through these exact questions. You’ll find: school-based CEUs designed around real educational roles peer discussion and mentorship when role confusion comes up practical tools and language to clarify OT’s contribution on IEP teams support applying evidence in ways that align with school systems If you’re looking for ongoing support to confidently navigate your role — not just read about it — The Collab is where learning turns into practice. 👉 Explore The Collab → Common Misunderstandings That Get in the Way I often hear things like: “A teacher can suport (insert skill here), so why do they need OT?” “If I push in to a classroom, how is what I do different from a paraprofessional?” "If a teacher is addressing ADLs, then why should I? So let's address the reality of each of these, one at a time. “A teacher can support [insert skill here], so why do they need OT?” Teachers often support the same skills OT practitioners address, but OT focuses on identifying and reducing the barriers that make it hard for a student to use those skills in daily school routines. OT supports access and participation so instruction is more effective, rather than replacing the teacher’s role. Often, a teacher does effectively support a student. And when they do, they tytpically don't ask for more help. If they are coming to you, it is because they need assitance. “If I push into a classroom, how is what I do different from a paraprofessional?” Paraprofessionals provide ongoing assistance, often with little training or guidance. OT practitioners focuses on determining what supports are needed and how to fade them over time - something that paraprofessionals are not paid or expected to do. When you push in, you're observing, analyzing, and collaborating to adjust supports with the goal of increasing independence - not just helping the student in the moment. “If a teacher is already addressing ADLs, why should OT?” Teachers may support ADLs as part of the school day, especially in transition programs. However, OT looks at ADLs through a participation and independence lens, analyzing why tasks are difficult and how routines or environments can be adapted to promote long-term autonomy. I have found that most teachers appreciate the guidance I can provide on supporting ADL skills - even if I only via a once a year consult. Remember, we are not there to compete with instruction. We are there to support instruction. Practical Takeaways for OT Practitioners To wrap up, if you’ve ever struggled to explain your role (or even to believe in your own role as an OTP), here are a few anchors that can help: Focus on participation, not just skills Describe your role in terms of access and independence Emphasize collaboration, not ownership (especially when it comes to IEP goals) Frame OT as enabling instruction, not duplicating it IEPs work best when we work as a team with out special education colleagues. We serve the same students. We share the same goals. But we bring different training, perspectives, and responsibilities to the team. And when we lean into that, students are better supported. 📬 Want more support like this? Subscribe to the OT Schoolhouse Newsletter for weekly tips, research updates, and evidence-based strategies for school-based OT practitioners. Join now to get our next helpful tip this coming Monday! Resources & References American Occupational Therapy Association. (2017). Guidelines for occupational therapy services in early intervention and schools . American Journal of Occupational Therapy, 71 (Supplement 2), 7112410010. https://doi.org/10.5014/ajot.2017.716S01 American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001 American Occupational Therapy Association. (2021). Improve your documentation and quality of care with AOTA’s updated occupational profile template . American Journal of Occupational Therapy, 75 (Supplement 2), 7502420010. https://doi.org/10.5014/ajot.2021.752001 Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. § 1400 et seq. More OTS 193: How the C-SEA Can Help You Transform Classroom Environments Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 193 of the OT Schoolhouse Podcast. Walking into a classroom filled with visual clutter, constant noise, and lingering smells from an air fryer might leave you wondering how any student can focus—let alone those with sensory processing challenges. In this episode, Dr. Heather Kuhaneck joins school-based OT practitioners Linda Kinkade and Dana Hawkins to introduce the Classroom Sensory Environment Assessment (C-SEA), a tool designed to help teachers assess and modify their classroom environments to better support students with sensory needs. Unlike traditional assessments that focus on individual students, the C-SEA evaluates the entire classroom across five sensory domains: visual, sound, movement, touch, and smell. Dr. Kuhaneck explains how the tool provides teachers with a visual map of their classroom's sensory profile—without labeling it as "good" or "bad"—making it easier to gain buy-in for meaningful changes. Linda and Dana share real-world examples of how they've used the C-SEA to uncover hidden sensory triggers, like the surprising impact of an air fryer on student behavior. Whether you're struggling to help teachers understand sensory processing or looking for a collaborative approach to classroom modifications, this episode offers practical strategies you can implement immediately. Tune in to discover how the C-SEA can transform your practice and create more sensory-friendly learning environments for all students. Learning Objectives Identify the purpose of the Classroom Sensory Environment Assessment (C-SEA) and describe how it differs from student-centered sensory assessments such as the SPM-2 or Sensory Profile. Identify the five sensory domains addressed within the C-SEA and describe common classroom-based sensory considerations. Describe how the C-SEA can be used to support conversations with teachers about sensory-friendly classroom environments. Guest Bio Heather Kuhaneck, Ph.D., OTR/L, FAOTA , is a Professor and Founding Program Director of the MS in Occupational Therapy program at Southern CT State University. Prior to this, she taught occupational therapy students for 19 years at Sacred Heart University. Her clinical practice as an occupational therapist included a specialization in autism and sensory integration, working in urban, suburban, and rural public schools as well as private clinics in three states in New England and the midwestern US. She is certified in Ayres’ sensory integration and is fidelity trained. Dr. Kuhaneck is a Fellow of the American Occupational Therapy Association and the co- editor of Case-Smith’s Occupational Therapy for Children and Adolescents. She is also the editor / co-editor of 3 editions of Autism: A Comprehensive Occupational Therapy Approach and 2 editions of Making Play Just Right. She is a co-author of the Sensory Processing Measure first and second editions. Linda Kinkade, OTR has just started her 35th year as a School Based Occupational Therapist and was named Indiana OTR of the year in 2009. Over three decades, she has gone from being the only OT covering 5 school corporations to currently 1 corporation with an additional full time OTR and 2 COTAs. Services have gone to pull-out to in class and are moving towards school wide support for ALL students. When AOTA formed a Cadre of 33 school based therapists throughout the country Linda was selected to participate and presented on IDEA and No Child Left Behind throughout the area. Presentations have been shared at the local level and at the Indiana Occupational Therapy Association State Conferences. Suicide prevention and mental health support to students and staff is also an area she presents on often. Dana Hawkins, MOT, OTR began working in the school system in November of 2021. She brings over 17 years of hospital experience with a focus on acute care, trauma, and concussion management. Visual training is also an area she has extensive training in. Her experience as a college athlete with previous injuries and having a child on the autism spectrum and severe ADHD brings a personal touch with students accessing their education. She has worked with Linda on presentations at the state level for the Occupational Therapy Association on keeping all Occupational Therapists on the Same Page when treating in the school setting. Additional presentations within the school district include presentations on Sensory and Fine Motor Bootcamp. Quotes “ The C-SEA kind of flips it around. Instead of assessing an individual student, you're assessing the entire classroom." —Jayson Davies, MA, OTR/L "It's not about the room being good or bad, it's just really about the match between what this room is set up like right now, which is changeable, and this child that you have in your room right now." —Dr. Heather Kuhaneck "The SPM and the C-SEA work so beautifully together." —Dana Hawkins "Once the classroom kind of becomes calming, then that also helps the students regulate to be able to learn more." —Linda Kinkade Resources Assessment Tools: 👉Classroom Sensory Environment Assessment (C-SEA) - classroomsensoryenvironment.com | Available through ATP (Academic Therapy Publications) at $3.50 per administration 👉 Sensory Processing Measure - Second Edition (SPM-2) - Used to assess individual student sensory processing 👉 Sensory Profile - Individual student sensory assessment tool Programs & Initiatives: 👉 Every Moment Counts - SUBASIC program that includes "Comfortable Cafeteria" component Equipment/Tools: 👉 Decibel meter - For measuring classroom and cafeteria noise levels 👉 Light meter - For measuring classroom lighting levels Related Research: 👉 Multiple articles published in American Journal of Occupational Therapy (AJOT) and SIS Quarterly about the C-SEA development and implementation 👉 International research using the C-SEA to measure teacher training effectiveness (particularly in UK and European countries) Episode Transcript Expand to view episode transcript Jayson Davies Hey there, and welcome to episode 193 of the OT school house podcast. I'm your host, as always, Jayson Davies, and today we have the perfect follow up to our last episode on sensory processing within an MTSS system. In episode 192 We primarily focus on supporting students using a sensory lens. This time though, we're focusing on supporting teachers and their classrooms through the use of the classroom sensory environment assessment, aka the CSEA, or the C SEA, as you will hear it reference. Now, I don't mean to cause you too much anxiety here before we get started, but how many times have you walked into a classroom full of sights and sounds and smells and wondered to yourself, Man, how does any kid in here learn with all the stimuli going on? If your answer is more than zero, which I imagine it probably is, then this episode is a must listen. We're going to discuss how you can help a teacher not only assess their own classroom, but also how they can use the C SEA, and you can use the C SEA results to start helping them make lasting changes. Joining me today to do just that is Dr Heather kohenek, one of the co authors of the classroom sensory environment assessment, as well as Linda Kincaid and Dana Hawkins, who are two occupational therapy practitioners in the schools using the C SEA to get buy in from their admin and better support the schools that they serve. Together, we're going to uncover the who, the what, when, where, why, all of that related to the C SEA. And more importantly, Dana, Linda and Heather will help you to identify how you can use it to help teachers and students alike, 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, Jayson Davies, class is officially in session. Jayson Davies Heather, Linda and Dana, welcome to the OT school house podcast. It is such a pleasure to have you here. I'm excited to dive into the C SEA and just really learn about what it is and how Linda and Dana, you are using it in your everyday school based ot practice. So Heather, really quickly. It is a pleasure to have you here. How are you doing this morning? Heather Kuhaneck I'm great. Thank you very much. I'm excited to be here and talk about this easy Absolutely. Jayson Davies And we have Linda and Dana joining us as well. Linda and Dana, why don't you share just briefly a little bit about the school based setting that you're in? Linda Kinkade Well, this is Linda and I. We are in very southern tip of Indiana, close to Kentucky and Illinois, and we work for what's called the Warwick County School Corporation. It's kind of a suburban area outside of the big city. Next to us is Evansville, Indiana, and we have about 10,000 students in our corporation that attend school here, and basically there are over 18 schools that Dana and myself, our two assistants, are able to cover, or have the possibility of covering, serving All the students, along with private schools. So yeah, it's great. We are never bored. There's never a dull moment, and we try to be innovative in doing the best that we can to serve all the students needs that we get to serve and support the teaching staff as well. Jayson Davies Absolutely, we kind of have to do it all. The school based ot practitioners got to, got to help everybody. And Dana really quickly. How did I guess we're going to dive into the C SEA. But to what extent do you feel like you had to learn about sensory processing, sensory integration, as a school based occupational therapist, and at what point in your career did you kind of start to hone in on that a little bit? Dana Hawkins Well, we're very unique here at Warwick County, because we do have some classrooms that we have labeled Autism Behavior Support classrooms, so those children have a high sensory need, and we complete the assessment called the SPM two on every single one of the students in that classroom, as we have this kind of melting pot of all these sensory needs, it became very obvious to us that the SPM alone was not the tell tale tool that we could use to get everything done, and we really, as occupational therapists, look at the environment. We had built this environment for those students with high sensory needs, but then we needed to have something else to help us to problem solve some of these kids that we couldn't really figure out just using the SPM two alone. Linda Kinkade Yeah, we really liked when the C SEA came out, because we had been going in and doing environmental. Scans on our own and making suggestions with to the team of changes that could be made, but then actually having an assessment to really kind of back up and formalize what we had said, really kind of helped our suggestions come to fruition? Yeah, absolutely. Jayson Davies And, and let's go over to Heather and talk more about this, because we are here to talk about the CC. I've actually got the C SEA the classroom sensory environment com website pulled up. I love that you have this like ASI links for the C SEA website, and if I scroll down to the articles, of course, your name Heather, as well as Jacqueline Kelly, hers name pop up on a lot of these articles. And I wanted to point that out, because this isn't a assessment tool that someone decided to put together and put it up on Teachers Pay Teachers, or on their own website, perhaps, and just kind of put it out there. This is something that you obviously spent a lot of time going through the proper channels, the proper route, to get to the point where this is a really legit assessment tool. And so before we really dive into the assessment tool itself, I want to hear a little bit about that background and how you went from I understand sensory integration to I need to create this tool for sensory Yeah. Heather Kuhaneck So sorry. I was working at Sacred Heart University at the time, and our Dean had given some grant money to fund interprofessional collaboration. And so Jackie is a special educator who also has children with ASD and and so she This was her area as a special educator, and it was my area of practice to work in the schools. And also I had worked in sensory integration clinics. And si was kind of my love. And so those two things really got married together, school based, practice and SI. And early, early on, as I started kind of dipping my toe into doing research, I was seeing kids in the schools that had these intense sensory needs that weren't being met and taken care of in that environment in a way that was helpful for them to be in school. So, so my first, you know, all my first stuff was ot related and sensory related. And then, because of this grant that we were given, Jackie and I started working together and thinking about, well, what, what can we do together? And the idea of looking at the classroom environment as a special educator and an OT together so that we could help teachers, that that really just kind of came up as a way that we could use this grant money. And so we started this project, and that that was really how it got started. We went all over the state of Connecticut, going into classrooms and talking to teachers and and it just, you know, it just kind of blossomed out of that. So I want to thank our dean, Pat Walker, for really getting this started. Jayson Davies So awesome. Shout out to Pat All right, so now you talked about that. You decided, you know you have this grant money. You wanted to figure out how your Collaborate. I want to hear how this conversation way, because I'm sure you had this conversation with with Jackie, the SPM to exist. The Wow, the sensory profile also exists. And here you are thinking, You know what? That's not enough. We need this other tool. Did you have that conversation? And kind of, how did that go? Like, how did you decide, You know what? That's not enough. Heather Kuhaneck Yeah, I'm trying to remember exactly how it started, but I don't know if this was the initial thing, but somewhere in the early conversations her one of her sons, was talking about how much the environment of the classroom impacted his ability to learn. And, you know, he's someone that is on the spectrum, and I remember him talking about that he was in a classroom and he was learning about history, but everything on the walls like maybe it was, I'm going to make this up. It was a math room, right? So everything on the walls was all math, but he was in that classroom learning about history, and he found all the math things really distracting when he was trying to learn about history. So it was something about the visual environment and how distracting that was to him, and that just got us down this path of the visual environment of classrooms, and that's where we started. And I started talking about how as an OT, I would go into classrooms, and I know that teachers love their rooms, and they think they're beautiful, but I would walk in sometimes and be just completely overwhelmed by all the visual in that classroom space. And so we really started initially on this whole visual idea, and then it just, you know, of course, being an OT, you know, it's. Not just about the visual system, right? So it, but then we got into the school bells and the fire drills and the, you know, the chairs squeaking on the floor and the electric pencil sharpeners and and as we started talking about all this stuff, it just, you know, it really became apparent that, wow, we should do something about this. Let's, let's, let's make our project bigger, and let's, you know, start doing some research. And so our initial work was just kind of descriptive, like, what's going on out there? Let's go look at classrooms and see what is the sensory environment in the classroom. And then that blossomed into, Okay, now let's try to measure it and see if we can help fix it, change it, etc. Jayson Davies Yeah, wow. So really started with that visual component, and then kind of expanded from there, awesome. Yeah, I've always found it really interesting, because Linda and Dana feel free to speak up for to this point, and Heather as well, if you have this experience. But I would give the SPM, I would give the center profile, and the teacher is filling it out on behalf of the student. And we're learning a lot about that individual student. But then often we go and talk to the teacher and say, hey, look, this student has visual overstimulation. What do you think about changing your classroom? But the way that we're going about that is kind of this roundabout. It's for this one student works, versus the CDC kind of flips it around. Instead of assessing an individual student, you're assessing the entire classroom. So I can imagine that maybe that gets some more buy in. Is that what the three of you have seen? Linda Kinkade I mean, go ahead. Oh yeah, we have in we're in the unique situation that these Autism Behavior Support classrooms were new, and we have a very powerful, proactive principal leading our charge, and she was very receptive to our input, and in the team collaboration that we have with these new classrooms. And so we also kind of start with the visual aspect, because teachers do, it's their it's their home away from home. And let me back up, because in the classrooms, we have a tiered system to our classrooms of three different tiers, where it's not tiered correctly, because ask us, but our tier one classrooms are the students that are their first time coming to school out of an ABA facility, so they really need A lot of support, more support than our tier two students that are able to do some individual tasks and are ready to learn, versus our tier three classrooms that those students are going out for Gen Ed. So we took a look at each different level of the classroom needs, again, starting with the visual aspect, because, again, teachers have a lot of stuff that they want in their classrooms, and the board, and the white board, the Promethean boards that they want students to do a lot of from there's a lot of stuff on the sides that we came in and suggested, Why don't we put curtains up and cover some of the extra stuff before, you know, so the student actually knows what to focus on visually. So even before the C SEA, we were trying to make different suggestions of how to eliminate the distractions based on what the classroom needs are. And once the classroom kind of becomes calming, then that also helps the students regulate to be able to learn more. Yeah. So it goes hand in hand the seat, the SPM and the C SEA work so beautifully together. Jayson Davies Yeah, yeah, and we'll dive into more of that in just a moment, because I think it's important to see how using the SPM with Johnny and using the C SEA with Mrs. Johnson, and how they work together can be really powerful. But before we do that, Heather, you took a moment when we met earlier to kind of walk me through what it actually looks like a little bit with the C SEA. And for those who are listening, many have never heard of the C SEA, and many have never, you know, had the chance to view it, and this is mostly an audio podcast, and maybe we'll do something on the side later, but for those who have never seen it before, can you walk us through a little bit about what it actually looks like from both the OT perspective as well as the teacher perspective in using the C SEA, Heather Kuhaneck yeah, so, you know, we we wanted to make it as easy as possible. And you know, in this day and age, we wanted it to be an online tool, partly because we wanted the information that they get back to be. Very visually based, and able to change based on what they input. And so it didn't make sense for us to have kind of a paper report come back. So everything was developed online. And so when the OT or the teacher, either one can go on and start the tool, you have questions to answer. So it looks almost, you know, like a regular, any kind of regular assessment tool that would be online. You answer questions, and it takes you through, First all, the visual environment, the auditory environment, things that children can touch, think how children can move in the classroom. And each section is separate, and it also will, you know, depending on how you answer, it will bring you to the appropriate next question. So if you say no to something, then you don't have to answer all the follow on questions from that original question, so it makes it efficient and a little quicker. But if you say yes to something, then it might ask you about, you know, how much, how often, how strong, etc. So there's kind of step down questions from each question. When you're all done, what you get is a visual picture that is color coded to kind of show you which sensory areas are the most strong in your classroom. So it kind of gives you, like a visual map of your classroom. And what was really important to us when we were developing this, and the reason why we wanted to do it this way is we didn't want teachers to get a score on their classroom and feel like their classroom was good or bad compared to some imaginary average classroom that doesn't exist. You know, back to that idea of teachers love their classrooms, right? They put a lot of time and energy into putting their classrooms together. There's all these videos on YouTube about com. See my third grade, right? Like, they love their rooms, and it is, it's like, it's like, their bedroom at home. And, you know, I think as OTs, we need to be really careful to not go in there and, you know, and like, trash their bedroom, right? Like, oh, this color is all wrong. Oh, this is all wrong. Oh, you have to change this, right? You wouldn't want anyone to do that to your to your house. So, so that was very much on our mind when we were developing this, to not have a score that would say something was good or bad, but just here's a description, a visual map of what is, and then maybe what is works for Joey, but doesn't work for Johnny or, you know, works for whoever you know, Linda, but not, but not for Dana, right? So that it's, it's not about the room being good or bad, it's just really about the match between what this room is set up like right now, which is changeable. And this child that you have in your room right now who won't be there forever, so can we make some modifications that work for this kid in this moment? And I think the other piece of it was just to give teachers ideas of things they could modify that they maybe don't even think about usually, because they definitely think a lot about visual but not so much about the other senses. Yeah, we did find that in our research, so perfect. Jayson Davies And I kind of want to piggyback off that, because on the ATP website that, you know, list out where you actually purchase the C SEA, it has this little map that's really cool, because it talks about like the classroom, and then it breaks the classroom into visual, sound, movement, touch and smell. Proprioception is not on there. We have movement, which could be that vestibular. We don't have probe. And then from there, it breaks it up into even further details. And that's kind of what you talked about a moment ago, where depending on what questions you respond to, it'll ask you different questions to get more details. How did you come up with those five visual, sound, movement, touch and smell, but decide to leave rope off. Was there any conscious decision about that? Was it based upon the observations that you conducted? How'd that work out? Heather Kuhaneck So yeah, we just, we put probe in with movement, because, you know, we wanted this to be relatable for teachers. We didn't want to use words like vestibular and proprioception, and you know, we were really aware of that also with the SPM that we wanted it to be teacher friendly and parent friendly too, and not use all of our big words that, you know, we understand but nobody else does, and the way that we really see when kids have probe issues is through their movement, or, you know, through their kind of lack of coordination of movement, or their forcefulness and their movement, or it's all really part of movement, or we wouldn't really know, so we just lumped it all in together with movement, and it that makes sense for teachers. And I think you know, OTs that are versed in sensory processing and sensory integration understand that and can and tease that out, you know, and so also in in the classroom, I don't know that you would, you wouldn't really have any kind of activity that was purely probe or purely vestibular, right? It's all put together. Other. You know, if you're jumping on a trampoline or you're out on the playground and you're swinging, or you're going down the slide, or you're climbing or whatever you're doing, it's both together. So it's just movement. And so Jayson Davies that was Gotcha. Yeah, gotcha. Similarly, I'm assuming taste isn't in there, because most kids are doing something out for when it comes to taste, it's more in a different environment, not the classroom setting. Heather Kuhaneck Yeah, it's, it was, you know, we, we did see some when we went looking around the rooms, you know, people having snacks. It was so, so, so variable. It just, you know, you could get a little bit crazy about, like, listing all the different kinds of tastes that could be in a classroom. And so, you know, in in this, in the way that we were worrying, the items we were trying to think about, you know, things that children would do in this classroom, right? So, and then, what can the teacher really see, etc, right? So, it's not so much about the child tasting something. It's about, does the teacher provide things to taste in the classroom? And that's so variable between the different teachers and the different grades, and, you know? So it wasn't a huge focus, Jayson Davies yeah, yeah. And I think that is something to, I mean, very and maybe Linda and Dana, you might be able to speak to this. I think the the amount of referrals and actual assessment intervention that we do around, you know, feeding and tasting and all that is so minimal in school based ot compared to, you know, the students are overwhelmed with all the visuals in the room or the sounds going on. So I think you hit the hit the right spots to focus on. Dana Hawkins Yeah, I think the biggest that we can see also is when it comes to taste, she's absolutely right. You know, the kids have snacks. And as far as the school environment goes, those children that are so highly picky, they're typically bringing their own lunches and their own snacks to school that are their preferred items. So we don't really get too involved in that area. But what is interesting is when it comes to smell, one thing that we found that was just something we hadn't even thought about, and that what's beautiful about the C SEA is when it asks those questions and you start really diving into it with the teacher, there are things on there that you're like, Oh, I did not even think about that. And we had a very unique situation where within our Autism Behavior Support classrooms, because these children are picky, a teacher was bringing an air fryer into the classroom to heat up chicken nuggets because of the texture of it, because of the way that the kids wanted it. And whenever. But we were trying to figure out why children, why we were struggling with these kids kind of getting very dysregulated of an afternoon. And as we dove into the C SEA, we realized that it was actually the smell from the air fryer that was setting off so many kids within that classroom, and it was a simple movement of moving the air fryer to a different classroom outside of their natural environment, so the kids were not smelling that subtle smell from the air fryer that was just completely just regulating them. Wow, yeah, Jayson Davies and we all know that air fryer smells do not go away easily. So that smell lingers, all right. And yeah, so Heather, if you're looking for another project, maybe we need a C SEA, except for the cafeteria. Heather Kuhaneck Oh, my goodness, the cafeteria is set we did when Jackie and I first started this, our initial foray out into the schools. We did measurements in the cafeteria. We brought a decibel meter, we brought a light meter. The cafeteria is just so so so loud we didn't get into, you know, at that point, if there are tools now that can measure smells, and there probably are, we didn't have any of those when we went at that point, so we weren't measuring smells, but, but just the noise. Oh my goodness. It was really, really eye opening. And most OTs know the cafeteria is really loud, but to actually go with the decibel meter and measure it. Linda Kinkade We did. We did that our in our school, trying to do some of the every moment counts, the Sue basic, I was gonna say the the cafeteria program, yeah, yeah, comfortable cafeteria. And when we took decibel measurements, it was just below a rock concert. And, yeah, so and, of course, there's so many correlations between cafeteria and behavior referrals of the gen ed students, because they're all trying to scream a bunch above each other. And yeah, the cafeterias, we try to avoid them as much as possible for personal reasons. Jayson Davies So yeah, yeah. It is a hard, very difficult place. I mean, I know from my experience, typically it is not a teacher in the cafeteria. You had a few paraprofessionals in the cafeteria. The same thing, my wife's an assistant principal. Same thing, usually paraprofessionals assuming that they can actually find people that want that pair of professional role, and oftentimes I feel like it's their staff, because it's a $20 an hour job that's often doesn't include benefits, and it's not a, not a great job. And so it's hard to get people to want that job. And then it's just chaotic. It is just simply chaotic in there. And so the cafeteria is definitely a tricky place. Let's go ahead and take a break. We lost Heather. I'm sure she'll be right back. All right, so we'll move on from the cafeteria here. Heather, earlier, you mentioned going out and kind of observing schools, and I also talked about how this obviously wasn't a tool that just, you know, came together overnight or over a few weeks, you guys did your due diligence, you put out articles describing everything that you did and how this came together. So I want to give you a few moments to kind of share a little bit what that process looked like, because I know a lot of data went into this. So how did that evolve through the data? Heather Kuhaneck Yeah, so we definitely had multiple stages. I had mentioned earlier that one of the first things we did was just going out to schools and sitting back and just watching, and we just wrote down everything we saw in terms of, what were teachers doing, what were the movement opportunities? What were the sounds? What were the you know, the smells, the sights, etc. We videotaped all the rooms so that we could look at the visuals. We made sure the kids were out of the rooms. When we did that, we had a decibel meter. We measured noise in the classroom. We measured hallway cafeteria. So we were just getting a lot of descriptive data of just what's going on. And we made sure, you know, Connecticut is a small state, but we do have very urban areas, very rural areas. And we went to schools in the inner city, in the, you know, farm land, and we and everything in between. We made sure we went all over the place. And then after that, we did a focus group with teachers. We did some one on one interviews with teachers. Then I think we've made our I'm trying to remember all in order. The order might be a little bit out, but then we made our first draft, and we had teachers look at the draft, and we got their feedback on the draft. Then we went out and we tried to use the draft and actually rate classrooms. Then we had a bunch of student projects. I had ot students doing their capstones. So we had a variety of student projects. And so did Jackie. So our students went and they rated the classroom, and the teacher also rated the classroom. We were trying to get reliability ratings. Jackie had her student teachers go out and rate classrooms and then explore what did they learn by doing that process, we also had our OT students work with teachers to try to rank order what the teachers thought would be the most and least bothersome kinds of things we were trying to get an idea of, you know, If we wanted to rate and give numbers scored to this visual environment. Could we reliably rate which visual environment was more or less stimulating, and we found between the most and the least, yes, but in the middle, not so much. So at that point, we were just like, Okay, we're not going to be able to score things like this. Like, it's just too subjective to be able to score what a classroom looks like. And that was when we decided the whole, you know, we're just not going to score things, and we have good reason to not score things. So, so lots of different steps along the way to get it to where it landed. The one article where we had, we rated a bunch of classrooms, over 150 classrooms, that gave us some descriptive data, which was kind of our first look at just what is out there, what are teachers doing. So that was helpful. The other thing that was really helpful was hearing from the student teachers of what did they learn from doing it? That was helpful for us, in terms of how can we use this, and also just knowing that the teachers did find it helpful, I think, kind of along the lines of what Dana was saying earlier, about just helping you think about things that you might not think about typically, and that that was one thing that the teacher said quite a bit, that they they do mostly focus on the visual, and this helped them see All the other things that they weren't really focusing on, yeah, so that was kind of like all the different steps in a nutshell that got us to where we are. Jayson Davies I'm curious, what did you find out? Because I'm sure some of this came up is, what did you find out in terms of what teachers already knew about versus what they did? Know about that. The C SEA was really helping them with, yeah. The OT was helping them with Yeah. Heather Kuhaneck The teachers talked a lot about things being distressing or things being overwhelming or over stimulating. So they kind of got that idea in particular around noise and visual. Those were the two, you know, they really seemed to get that, especially for the kid OTs on the spectrum, you know, that loud noises were bothersome and and that certain visuals were bothersome, they really understood that, I think they were less likely to understand that some of the sensory aspects of the classroom could be helpful, that it doesn't always have to be a bad thing. Sensory is not always bad, like some some of the things we do can be helpful for them, and also just that things that are, you know, maybe bothersome or distressing for one child might not be bothersome and distressing for another. And that makes it really complicated, that it's not a one size fits all, and that, you know, even with loud noises. There might be loud noises that some kids like. So, yeah, it would, you know, I think it just the scope of what OTs look at. I think was a little eye opening for teachers, at least, for this, for the student teachers, at least, Jayson Davies yeah, and I'm curious now, because I think a lot of people, they, and when I say people, I'm referring kind of to the people that this is designed for teachers. They might take something like this, you see, and look at the results and saying, Hey, these are great. I yeah, I agree with these. Or, Oh, I didn't think about this. But the carryover might not be there, maybe because it's a little bit overwhelming. Now, before we think about people like Linda and Dana and all the other school based ot practitioners listening that can help implement those What did the teachers say once they got the results? Were they saying, Hey, this is great, but I have no way to actually do this. Or were they saying, Great, now I know how to do this. Or, I guess, like, What do teachers actually get when they see the results assuming that an OT or other person is not yet involved? Heather Kuhaneck Yeah, I mean, I guess first thing I would say is I would hope that there would always be involved, but I'm sure there's going to be times or that's not the case. And so you know what the teachers are going to see, you know, depending on how they fill it out, is my classroom has very strong visual components, or my classroom has very strong auditory components, and maybe I don't have a lot of movement in my classroom, or I do have some strong smells, or I don't have some strong smells, so they just kind of get a visual picture of, sort of where the sensory experiences are more or less in their classroom. And so also with the C SEA, when they click on individual items, it gives them some suggestions. So if they don't have an OT involved, Jackie and I did go, we made suggestions for teachers, you could try this, or you could try this, so at least it gives them some place to start, you know. But I would hope that there would be an OT involved to help really make it right for that particular situation, as opposed to what we did was kind of general, oh, your classroom has a lot of loud sounds you might want to try, you know, XYZ, which was a very general suggestion, as opposed to, you know, for this kiddo that you have, that's where you really need the OT and the teacher to collaborate. And, you know, for Jackie and I, that was really our goal, was to create a tool that people would collaborate around and work together. Jayson Davies So, yeah, I guess my question would be, like, without an OT involved, would changes actually be made? Are teachers actually taking this and implementing changes, or really, does it kind of you need that ot on the side to kind of almost to a degree, interpret it a little bit further and help the teacher, because teachers are busy, and like you said, they're very connected to their classrooms. And you know, it's, I think it's nice that telling them your classroom is too visually overstimulating, coming from an assessment is a little bit more softer, I guess, than an OT saying your classroom is very visually overstimulating, like you having this quote, unquote data, like telling you something, is a little bit easier than this person who comes into your classroom two times a month telling you something. And so I just wondering, I guess, if teachers are taking that and actually running with it, or if, typically, an OT is getting involved. And I know we're going to start to transition to how Linda and Dana are using it. But any thoughts on that? Heather Kuhaneck Yeah, I was actually going to say that maybe they should take this question. You know, I'm not out in the school based practice anymore, so, you know, I'm teaching in academia. So, you know, I. Don't have firsthand experience right now with how our teachers using it, so I'm going to toss that to Linda and Dana perfect. Dana Hawkins The biggest thing is a lot of times when the teachers get the C SEA, you know, even with some of our seasoned teachers, you know, first of all, a teacher is usually pretty defensive about how their, you know, bedroom or their classroom looks. And I think our role as OTs, and we spend a lot of time, you know, kind of like you said with the whole terminology, is we try to speak in layman's terms. So especially whenever they get this report, sometimes what we have to do is just focus in on one section as to not to overwhelm them, because I feel like whenever we come in and we say, you need to change this and this and this and this, they become defensive, yeah, and a little bit overwhelmed. So sometimes what we do is we just kind of focus in on one area, bring it down to layman's terms, kind of discuss it with them, simplify it of what they can do and how it's truly impacting the student. Focus in on that one area, and then the next time we go in, okay, let's focus in on a different area. So I feel like whenever we have that interaction with the teacher, we still kind of tiptoe in a way, because we don't want to overwhelm them, because as soon as you overwhelm them, then you've kind of lost a little bit of the body, so we kind of use that as a very gentle conversation with them. The thing is, too It depends on how much a student or a group of students is blowing up that room. So if that teacher is literally pulling their hair out, and they are so incredibly frustrated, we know that's our opportunity, that we can probably hit a good portion of the C SEA, because they're just so desperate for help. Linda Kinkade And the other thing that we really know too is we use our psych background in dealing okay with staff sometimes, because if you want to make a change, you find the teacher that wants to make a change the most, and that's where you start. The other thing is relationship. You have to have that relationship with your teaching staff because, yeah, we're not there day in and day out, dealing with the stuff all day long. So who are we to pop in and go, Okay, you need to change this. That does that's you're not going to get the buy in. So you have to have the relationships with the staff, not just on a professional level, but to ask about their family and what they're going to do over break and all the other stuff that goes on day in and day out, to have that trust, so that they will trust us to make the changes that we're suggesting. So it's, it's, it's a whole lot, but it works. Dana Hawkins And then the other factor of it is too, with the administration, you know, the C SEA provides the credibility for why we're making those suggestions, and especially whenever consistently going to the administrator and complaining about children being dysregulated, and, you know, they're constantly needing help. When we bring this to the administrator, we, you know, say we have been making suggestions and we have been using the CC, they see that as a credible source, and then that kind of puts some ownership back on the teachers of you know, if you're continuing to have issues with these students because of dysregulation, and we have licensed professionals coming in using assessment tools and kind of giving you suggestions of what to do to help until you do that, I don't Know what you're asking. So it really provides that ability piece to us. Jayson Davies That that's a great point. That's something that most evaluation tools don't do because they're so specific to an individual students. So Wow. All right, well, Dane and Linda, you just answered like, the last of my remaining five questions, and I'm just kidding So, but we'll take a quick break, and I actually do want to after the break, I wanted to back up just a little bit and talk about, kind of where you both started with the C SEA, and kind of how you use it in your day to day. So we'll be right back. All right, Linda and Dana, I do want to talk a little bit about how you are using the C SEA day to day, and then kind of go back into that advocacy piece that Daniel was just talking about. But first, how did you two first get involved with using the C SEA? How did you learn about it? Why are Linda Kinkade you using it today? Well, I can speak to that because we have been going into the classrooms, in our abs classrooms, and we, again, like I've said, we do have a very powerful, progressive principal that loves us, which is always good, and we she knew we were going into these classrooms, the teachers were having some struggles with and we were doing our environmental scans, and we were coming up with different suggestions. We also. Have monthly team meetings with the with the teaching staff of these classrooms, and it involves the OTs, speech therapists, admin, the teachers, behavior, everyone involved with the in the classroom, we get together and talk about these big things. And so that was an opportunity for us to talk about the environmental concerns that we were seeing in the classrooms, and then, you know, we are always looking and trying to be the best that we can be. And so we came across the CC, and it's like, oh, wow, this might help us. And we were in one of our meetings one of our monthly meetings, and I brought it up, and we were discussing it with the principal, and the principal said, yes, let's get this. I'll buy it. And how many times does a principal say they're going to buy something for OT? Yeah, not after being convinced 18 times, yeah. And so, yeah, we talked about it. And, I mean, it ended up coming out of the OT budget because, of course, we have other buildings that we wanted to use it on, but we tried to get some money out of her, yeah, so I'm not gonna lie, if they're gonna offer, we'll take so she bought other things anyway. So we had that backing. We had that support, and so we jumped on it. And actually, when we started using it, Dana and I started going back into those same classrooms, and it was kind of fun then to see, were we off our mark, and what things that we had seen, it kind of goes, yeah, it was kind of, we didn't get a score on how well we did, which we were very glad, but yeah, but there's always room to learn and grow. And so that's what this tool also helped us as well. And so we've also started, we've got some teachers that we've given had the teachers to do it too, and that just gives them so much more ownership and credibility and another learning opportunity for them, because teachers tend to use the word sensory and kind of blame that for a lot of stuff. And you know, sensory is supposed to either make or break someone's life, and it doesn't really work that way. So it's another learning tool for everyone involved that gets to use it. So thank you, Heather, so much for creating this. Dana Hawkins I'm glad it's being used and it's helpful, Jayson Davies right, right. Always nice to have something you create be helpful. Okay, so you've got this tool now, between, yeah, hopefully it would come out the school budget came out of the OT budget, but you've got this tool. What was your initial thinking about? It sounds like you were initially planning to use it with the classrooms you wanted to go into a select number classroom that you had identified with, the classroom that had autistic students inside the classroom, is that kind of generally how it started. You started using this in select classrooms. Dana Hawkins So we did use it in select classrooms, and we chose the classrooms that we obviously had a very high sensory need within that classroom, because those are the classrooms that needed the most help at the moment, and we have found the tools so incredibly useful that it's almost been the missing piece to our team meetings where we have multiple licensed professionals all sitting around a table problem solving these issues that are occurring within the Classroom. It's kind of in the missing piece, the aha moment, that's kind of brought everything together. So now that we have been using it with those highly specialized classrooms, we're now branching out to use it within our other classrooms, where maybe you have a few kids that have a very high sensory needs, but others are not struggling, but we're using this to kind of bring it in to help decipher and, you know, figure out these kids that we're still continuing to struggle with. Linda Kinkade Right now, we're able to think bigger and when we're doing classroom observations and more of our gen ed classrooms. I mean, I was in a classroom a few weeks ago, and I was so overwhelmed. I don't know how the students were able to learn in this classroom. It was at the point I thought, Oh, gosh. Even the teacher was so distracting in her outfit that I thought, Well, maybe it's a dress up day, and it wasn't. So it was very scary. So I would love to give this teacher the CC to have her just kind of look at her own classroom. I mean, there's so many teachable moments and other uses. Heather Kuhaneck I. Yeah, Linda, you just made me think about Jackie and I had talked about years ago. We never got around to doing it, but it would have been a really great project. And if anyone's listening, needs a doctoral project to have the teachers do an adult SPM on themselves, yeah, and then do the CC with the classroom to just look at like to the teachers that are, you know, maybe they're sensory seekers. To their rooms look like that, etc, etc. Anyway, all I'm Linda Kinkade gonna say is the student I was observing was not the issue in that class. You can edit that. Jayson Davies Oh, no. I think we've all been there. We've all we've all seen that. Yeah. Okay, so it sounds like, in general, you are using, both of you are using the CC outside of the IEP system, per se. Is that fair to say, in the sense that you are not using it as part of an IEP evaluation tool? Linda Kinkade Like, no, no. This is bonus. Jayson Davies Yeah, I like that. Because the reason that I'm thinking is because I'm often getting asked, you know, anywhere, email, Instagram, direct messages, all that fun stuff, like, how do I conduct whole classroom screenings? And this is kind of like what I'm seeing as the perfect tool, right? You could pair this potentially with a classroom observation, and you would have a lot of information. Linda Kinkade Well, this would lend itself to a whole nother discussion on caseload versus workload. And we love the workload model, and have basically been doing it and not telling anyone, yes, that's the right way to do it. Jayson Davies Yeah, that's how I started it. Linda Kinkade I mean, there's people that still ask caseload, and we get the job done and we and we do a good job. So I mean, caseload versus workload in our system, that's kind of there's some people that will always focus on caseload, and we let them. So this is part of workload, and this is part of making a change in the educational environment that needs to happen across the board. In every classroom, in every building, there's myself. I love it. Jayson Davies Now going piggybacking on that a little bit because you're doing the CC with a teacher. Now, let's say you did the CC with a teacher at the beginning of the school year, but you do have an evaluation for a student now in January, is there a chance that you're going to do use the SPM or the sensory profile, and then kind of almost refer back to the CC that you did at the beginning of the school year with that Dana Hawkins classroom, absolutely, because I feel like you can retrospectively, go back to the CC to get those pertinent, pertinent pieces that may be contributing to the dysfunction of the child that you see within that SPM, and that's what's so beautiful, is you can do the CC at the very beginning and have that information and that data that could then be referred back to for an entire school year. Now, where you're going to run into difficulties would be if a teacher did the CC, they looked at the report, then they made multiple changes to their classroom. But then by the time you get to January or February, you have a student who is showing you know, significant sensory dysfunction. You may need to repeat the CC, because that environment has been changed. So you then need to look at that environment now versus back in, like August or September, when the classroom, you know, whenever the teacher first filled it out, if there were significant changes that occurred. Linda Kinkade And we were just having the discussion yesterday, Dana and I, because we talk about the CC all the time now on, we really do. But when would be a good time to have to have the teaching staff complete this. And we were talking, well, maybe the beginning of the year, but then, you know, the beginning of the year is so crazy, you get your classroom ready and yada yada, and then the end of the year you're tired, you're burned out, you want to throw half your stuff away. So we actually have a professional development day about mid September that we thought, well, maybe that would be a good time to have some teachers. You know, they've kind of been in a little bit. They're kind of a little bit in the zone. So how about mid September? You do the CC, and let's just see where you are and see where we can make changes if needed, and get things under control before we get into the chaos of the holiday season. It's everyone off. Jayson Davies Yeah, yeah, I love that. I mean, like, I'm coming up and I don't know, Heather, if you've done, like, professional development, like at conferences on the CC, but, like. Like, I can almost imagine doing a professional development in the school, you know, with so many teachers there, and kind of going through the CC together in a one hour session, and kind of just showing them, like, how it works out, and kind of the changes that, you know, use one teacher as an example and go through it. Alternatively, I could see ot practitioners, you know, before your PD day in September, giving it out to teachers a month before that, or maybe two weeks before that, letting them complete it, and then using that data to then drive a PD, if your school will allow you to be one of the PD providers and kind of, hey, you know what? We had 10 teachers complete the CC. These are some of the results, and we want to provide you with ideas based upon those results. Linda and Dana, I don't know, maybe you're already doing that, but. Dana Hawkins Not as we've been discussing. You know, we get to this mid year, and we start thinking, Okay, next year, what are our goals? What are we thinking? What are we going to provide to our staff for their PD day, and that was definitely within the discussion of this would be an excellent tool to use with those teachers, because you're so fresh into the year, even in September, you know you've been in there, you got your feet wet, you're starting to know the kids. You're starting to understand the kids. And this may help to help with some of the sensory dysfunction that may come around with those kids. Because, as we know, you know that new environment coming back from summer break, you know they need that first, like 30 days to just kind of acclimate to the new environment of being in the classroom. So it's allowing that newness to wear off, to see what you're left with with these kids, and to see which ones are going to have those sensory dysfunction, you know, aspects. But the thing that we're hoping is once the teachers start to truly undergo the CC and start to look at things almost with a different lens, you know, they may understand things a little bit differently from their environmental aspect, and how it can be contributing to some of that sensory dysfunction that they're seeing within those kids. And so therefore, subsequent school years, things may be a little bit more proactively based, rather than reactively based. Linda Kinkade Yeah, always the goal as far as professional development, as long as I've been in the school system, there's never been a PD set up to gain more knowledge for OT, so shocker, so we always have something in our back pocket to do. PD wise, to help staff, whether they want to want us or not, we're ready and willing to do it. Jayson Davies Love that. Love that I am always so happy anytime. Like, it doesn't happen a lot, but we actually get districts that will reach out to me and say, Hey, can we use your conference or courses that you offer and provide them for our OT professionals? And I'm always like, yes, like, usually a high discount. I just want people to use them like, yes. Ot practitioners are sick of just being said, Hey, you have to go to this. PD, course that's designed for teachers and sit there. Or, hey, we don't have anything for you. Just have a day to yourself and meet as a team and yeah, do something. Heather Kuhaneck Yeah. Jayson Davies So I love that. I want to kind of do a good bad, and instead of ugly, good, bad in OMG with like, because OMG can go either way, good or really, really bad, right? And the scenarios that Linda and Dana that you've experienced after having teachers take the CC, what have been some of the really good experiences, and what have been some of the more tough experiences that you've experienced with teachers trying to follow up on the results. Dana Hawkins Well, I think the biggest thing is just trying to understand each other through our own lenses. And I think what was very interesting when we did the CC is we did it with our classroom where those students are getting pushed out into gen ed. So of course, we come in and we do our environmental scan, you know, we have the teacher go ahead and undergo the CC and kind of do that, and the results came back. And here we have a classroom of autistic individuals with lots of sensory needs, but they're regulated enough that they're pushed out into Gen Ed, okay? And so it comes back and it shows all the visual changes that we need to make in order to calm down the environment. In with our OT brain, we're sitting here going, yeah, we've got to really calm down the visuals. But the teacher then said, but do we? Because if I am pushing my kids out to Gen Ed, I need them also to be able to learn and function within that environment that has a lot of visuals, because in order for them to succeed in their push out into Gen Ed, this is the environment that they're going to be faced with. And that caused me to take a step back and say, you know, you're absolutely right. This may indicate that we need. To do a lot of, you know, visual changes to this room, but maybe we don't, because if they're being pushed out, you know, in her classroom, the way that we have it set up, there are kids in that classroom that are all the way from kindergarten all the way up to fifth grade. So it's not as though they're only getting pushed out into one grade to where we can make changes. This is school wide. And I'm like, you know, until we are able to really get the understanding and knowledge out to our general education teachers and get the buy in from them to understand within their gen ed classroom how the visuals are very distracting to learning. I was like, You're right. In order to allow these kids to truly succeed within the next school year, we kind of have to let this one go. And that was just kind of a very much of an eye opening experience to me, to just be, you know, we have these results, and you have to be kind of sensitive to what environment, what teacher, back to the psychology of the teacher, how you're approaching with them, and kind of picking and choosing your battles as to what do we really want to do in this situation? Jayson Davies Yeah, that's why I love occupational therapy. I love our PEO model, because you kind of just hit it right there with the PEO, right? We can adjust the environment, but we can also adjust the occupation and the person. And sometimes you got to tweak all three. Sometimes you think, you know, it's not worth tweaking the environment in this in this instance. And of course, as soon as you go to a different environment, it all starts all over again. But no, I love that, because you're right. We can't tweak everything. We can't We can't change the environment for one kid in every environment that they will ever be in. And so sometimes we have to focus on the other two areas and see if we can do other things to support the students. So love that. All right, Linda, what about you? Linda Kinkade We call that the Walmart guest, because it's amazing how, like, if you can handle Walmart, you should be able to handle anything. And I mean, for real, and yeah. And, I mean, just think of it. Yeah, there's a lot going on there. So yeah. And it's interesting whenever you see kids out at Walmart and they're able to handle things, but then you see some little thing at school that they can't handle. So yeah. So you have to again, look at the whole picture. We're not going to do. Maybe we should develop a C SEA for Walmart, for industry. Jayson Davies Yeah, that would be great. Oh yeah, absolutely, for retail and whatnot like that would be a legit thing. We're going to see Linda start taking kids on a bus to Walmart to evaluate them for their. Dana Hawkins That would be our weekly field trip of we go to Walmart. And by the way, we may be working through the grocery list that we've printed. It may be ours, it may not, but we'll make sure it's functional. Jayson Davies There you go. Linda Kinkade All activities you can do. Jayson Davies Yeah, yeah. I that's do you guys do your classrooms? Do some of them do a weekly field trip and like the adult transition, or is that just your weekly field trip? They don't do Heather Kuhaneck weekly but they do field trips. But I would say maybe once every couple months, maybe once a month of a teacher is very proactive, but definitely not weekly. Linda Kinkade Yeah, and that happens more at the middle and high school level, within more of our functional academic classrooms. Jayson Davies Yeah, perfect. Yeah. No. I think there's a lot of applications here for the C SEA, and I definitely think right, like, we need to understand the classroom, but there's so many other environments that we need to better understand. And there's a, you know, a large there's a decent amount of not information, I would say there is information, but there's a decent amount of societal push for having, especially autistic individuals, working in various sectors, especially within the tech sector. And so I could see a version where it is related to the workplace model. So another project for you. Heather Kuhaneck Heather, yeah, we talked about that. Yeah, I'm getting close to retiring. That's a project for a doctoral student. I have a whole long list anyone who wants to go back to school, just email me. I have a whole list of project ideas for you. But yeah, we did. We talked about it. That would be such a huge project, because there's so many different workplaces, but, um, but I am fascinated by, you know, how do people choose where to work, and how does that relate to their own sensory needs? And, you know, why is this environment good for you in terms of a workplace? It's definitely interesting. Jayson Davies So, you know, be really interesting. We just had Matthew Hill and brand on the podcast a few weeks ago, and he works in an adult transition population, and once a month they basically they have a month long cycle where they prep for a work experience outing. And and then they actually conduct that work experience outing. And so I can absolutely see him using the C SEA, giving it to the actual owner of the business a month before letting them do that, bringing the results into the training of the work experience for the adult, you know, transition population, and using that to train for the actual work experience. Like, oh my goodness, it'd be insane, but yeah, so many ideas, Heather Kuhaneck yeah, you know, the the items on the C SEA were so specific to elementary schools. Like, not all of it would be applicable, but some of it could be, or at least the idea of it could be, and somebody could take the idea and go to a workplace and basically do the same thing. We just started with just describing what exists, and that's how we got our items. Jayson Davies So Heather, to your point, though, you mentioned in there, it's primarily designed for elementary school. But I do want to come back to Linda and Dana and ask, have you used this at all within the middle school or high school setting. Have you had a middle school teacher use the C SEA Linda Kinkade at all? Well, we haven't yet. I mean, we're back to us doing it so, but I do see, I think that we have some of our middle school classrooms that would still be able to do the elementary level of this. I mean, basically, environment is environment, so I think it would very easily lend itself to both middle and high school, and there's a huge need for it, because people still have the same issues, no matter where they are. If it's truly sensory, it's going to come out. Yeah, I think, I think the challenge Heather Kuhaneck that would is going to come from like the middle school and the high school level is, you know, within the elementary level, those kids are pretty much in one classroom through the day, and as you get to the middle and the high school level, you transition to different classrooms. And every classroom has a completely different feel. And so I think in order to appropriately do the C SEA, you would essentially need to do it on every single class that a student visits through the day, if they're having to be able to relate it back to where they're having sensory Linda Kinkade dysfunction at and I think there would also need to be a component to look at hallways and transitions, because that's a lot of time that is spent in the middle and high school buildings of that transition and, Oh, that's a whole nother sensory experience for everyone. Yeah, yeah, absolutely. Jayson Davies All right. Well, Linda, Dana Heather, we didn't get quite into our our ability to talk more about like getting administrators on board and advocating for this, but you sprinkled some stuff in there. Obviously. You both had a great principal who really facilitated you, talked a little bit about focusing on the teachers who want support, and that's something I always talk about as well, but unfortunately, I think we're out of time for the advocacy part. Are there any last words that the three of you would like to share when it comes to using the C SEA in a school based occupational therapy setting, any one final tip that you have? Heather Kuhaneck Yeah, I actually back a bunch of questions ago, when we were talking about kind of getting teacher buy in, one of the things that popped into my head was using single subject research methods to collect data for an individual student. So, you know, if teachers really are sort of like, I don't really want to change this, sometimes we can get them, you know, will you just change it for a month? Right? Let's collect some baseline data before you make this change. And I'm just going to use an example. Let's say, you know, again, using the name Johnny, right? Johnny's been hitting another kid every time something happens. How many times a day does he hit for these five days? Now, let's make this change, and let's keep data again. And does making this change in the classroom change the behavior? And then the teacher can see that, yeah, if I make this change in the classroom, this behavior gets better for this particular student, then hopefully they're more likely to want to keep that change in the classroom. So if you're really doing single subject method, you would, you know, you do baseline, you do a change, then you go back to baseline, then you do a change again. That's sort of gold standard. But sometimes you don't even need to, if the teacher sees that, like, oh, wow, this really seemed to help. Then, good, we're done. We just leave it there and but, you know, getting them to just be willing to do it for a short time, and collecting that data helps the OT too, because maybe you make a suggestion that actually doesn't work, and then, okay, so now let's not do that if it's not working. So the data collection piece is really important. That's my last tip. I think my biggest tip is allowing the teacher to complete. The C SEA, rather than the occupational therapist going in and sitting in the classroom to complete it for them. Because I feel like perspective is everything, and we are trained in our task analysis and to look at things very analytically. And I think whenever the teacher actually sits down to start filling out the tool, they start to get some understanding of the lens that we look through each and every day, and how we really break things down and start to analytically look at things sometimes just them, completing the tool alone without even seeing the results, allows itself for an aha moment where the teacher is like, oh my gosh, I did not even realize how many visual distractions I had within my classroom until I started actually objectively looking at it, counting and filling out this form. So definitely having the teachers fill it out themselves. Linda Kinkade And then I think another important thing after the teacher completes it, then that would be prime time for the OT to come back and say, Hey, how'd that go? Do you have any questions? What can I help you with? And that's a beautiful time for collaboration and support with the teachers. And you know, it'd be nice if teachers, whenever they have if they have paraprofessionals in their classroom, to also help with the assessment, give them some ownership, because the more ownership and buy in you get, the more support and follow through you're going to have. So that is a wonderful time. Then to follow up and say, Hey, and it may be okay, well, we want to change this. And then the OT can say, Okay, well, I can help you with that. Or here's some ideas that we can make this work. So just that follow up piece, yeah, yeah. Jayson Davies And earlier, I think it was Linda, you mentioned maybe Dana, the team professional meetings. And I think that even if this can just help you get into the door, right, because you talked about your principal liking the data and showing the principle of the data, and then the principal may be saying, Hey, could you come to our third grade team collaboration next weekend, share a little bit about this with the team. Like that is an opening that you can use to start making changes. So I love it. Linda. Dana Heather, thank you all so much for being here. Really appreciate your time, your energy, your enthusiasm here this morning, and we'll definitely have to stay in touch to see what more goes on with the C SEA and in your ot practice. Thank you so much. Thank you. All right, that wraps up episode 193 of the OT school house podcast. As always, I want to extend a huge thank you to Heather, Linda and Dana for sharing their expertise on using the C SEA assessment with us today, the insights that you all have shared really give us an idea of a why the C SEA even exists and kind of how it came to be, as well as how we can use it in our day to day practice to support teachers better understand their classroom environments and better help shape those classroom environments to support the students that we serve. Now, if you found this episode helpful and want to learn more about implementing tools like the C SEA in your practice, I invite you to check out the OT schoolhouse collaborative. This is where you can access exclusive resources, monthly professional development courses and direct mentorship from me in the group setting to help take your school based ot practice to the next level, head on over to OTSchoolHouse.com , slash collab to join our community of dedicated school based ot practitioners. Don't forget to subscribe to the podcast as well, so you don't miss our upcoming episodes. And if you found value in today's conversation, please share with a colleague who could benefit from learning about the C SEA as well. Until next time, keep doing amazing things. Amazing Narrator Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to OTSchoolHouse.com Until next time class is dismissed. Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. Click here to view more episodes of the OT Schoolhouse Podcast More The Role of School-Based OT in High School (And What the Research Says) By the time students reach high school, occupational therapy services frequently come under scrutiny from our peers, and honestly, even ourselves. Caseloads look different, pull-out services are questioned, and supporting legible handwriting can no longer be easily justified. All of that can lead OTPs to question our own role in the high school arena. So, do we still support students when they get to high school? Of course, we do! In this article, I want to help you Define a clear and confident role in high school settings Use transition planning to guide goals, services, and interventions Support access to curriculum through collaboration and consultation Answer your questions about Handwriting and 1-on-1 sessions in high school And prepare students for life beyond high school I'll also share four real-world OT programs that are being implemented across the country. You'll find those in the pick boxes. Why OT Still Matters in High School By high school, students are expected to manage complex schedules, multiple teachers, increased academic demands, and fewer built-in supports . When a student isn’t ready for that level of independence, participation is usually the first thing to break down. Research consistently shows that students with disabilities experience poorer post-school outcomes related to employment, postsecondary education, and independent living. At the same time, research has shown us exactly what will improve these outcomes: Self-determination, Work experiences, Inclusive environments, Technology use, And daily living skills ( Mazzotti et al., 2021 ) Those predictors align directly with what we do as OT practitioners. This isn’t a coincidence. It’s confirmation that OT in high school matters, especially when it’s aligned with life beyond graduation. Cue section on Transition planning... Transition Planning: The Backbone of High School OT Transition planning awareness among OT practitioners has come a long way in recent years, but it is still not discussed enough when planning OT services in middle and high school. Transition planning shouldn’t be a procedural requirement section of the IEP you review as parents are walking out the door. Rather, it should be the focal point of the IEP, driving goals, services, and interventions that extend beyond the here and now. As a profession, we bring a person-centered perspective to transition planning by focusing on how students might function in real roles beyond the classroom. Research shows that when transition-focused OT is included in high school, students demonstrate improvements in independence, social participation, community living skills, and self-determination ( Pierce et al., 2020 ; Harvey et al., 2022 ). So rather than ignoring transition goals or transition planning altogether, let's use it as an opportunity to step forward with clarity and confidence. So, say it with me like you actually believe it: Transition-focused OT helps students to demonstrate improvements in independence, social participation, community living skills, and self-determination. A REAL OT STORY - 1 Using Direct OT Services to Build Life Skills and Self-Determination What the OT did: An OT practitioner provided direct services to a ninth-grade student with Down syndrome as part of her transition plan. Rather than focusing on academics, OT targeted functional life skills, including dressing, meal preparation, decision-making, and basic work-related routines. How services were delivered: Over six weeks, the OT provided one-to-one intervention twice a week using task analysis, coaching, and collaboration with the student’s teacher and family. Skills were intentionally practiced across both school and home environments to support carryover. Why it worked: The student showed measurable improvements in daily living skills and self-determination, along with increased independence and confidence reported by both school staff and family. This example highlights how short-term, occupation-based OT services can meaningfully support transition readiness when tied directly to life beyond high school. For more insight into this example, view this research article: Harvey et al., 2022 Join us for this 1-hour CEU course on improving transition outcomes for middle and high school students through occupational therapy. Learn evidence-based strategies to enhance self-determination, pre-vocational skills, and employment exposure, while engaging parents and teachers effectively. Join the School-Based OT Collab today & learn how you can have more impact on the high school campuses you serve! Explore The Course Here > Collaboration That Improves Access, Not Just Compliance High school classrooms move fast. Content is dense, expectations are high, and flexibility can feel limited. This is where OT collaboration becomes especially powerful. While some students may still need to be pulled out of class for OT to work on isolated skills, we can also support access by collaborating with teachers to adjust task demands, support executive functioning, and offer multiple ways for students to demonstrate learning. This work that directly supports inclusion and participation often happens quietly through planning emails, classroom observations, and "between the bells" coaching, as I like to call it. (you know, the five minutes in between class periods). I've often found that a 25-minute observation paired with a 5-minute consultation can support a high school student more effectively than a 30-minute one-on-one session. We also play a critical role in guiding paraprofessionals. Helping adults know when to step in and when to step back can make the difference between dependence and independence. Inclusive educational environments are a predictor of post-school success, and OT consultation is one way we actively support them. Working with an adult rather than the student may not always "feel" like OT, but it is. A REAL OT STORY - 2 Collaborating With Staff to Build a Community-Based Instruction Program What the OT did: An OT practitioner partnered with special education teachers and paraprofessionals to launch a small on-campus coffee cart aligned with student transition goals. Rather than operating the program independently, the OT collaborated with the team to identify student roles, task demands, and support needs. How collaboration showed up: The OT coached staff on task analysis, prompt fading, and how to support students without over-supporting them. Together, the team aligned daily routines and expectations with IEP transition goals and shared responsibility for monitoring progress and adjusting supports. Why it worked: Because the program was built collaboratively, it was sustainable and transferable beyond OT sessions. Students practiced real work skills across the school day, staff felt confident supporting independence, and the coffee cart eventually expanded into a broader community-based instruction program. Learn more about this program in Episode 109 of the OT Schoolhouse Podcast! One-to-One OT and Handwriting in High School: Reframing the Debate If there are two topics that consistently create debate in high school OT, it’s direct one-to-one services and handwriting. These questions come up often: Should we still be pulling students? Does handwriting even belong in high school OT? Here’s the reframe: neither one-to-one OT nor handwriting disappears in high school, but both change purpose . In high school, individual OT sessions must shift away from the repetitive skill practice often seen in lower grades and toward functional problem-solving. One-to-one time becomes a safe, judgment-free space to teach assistive technology, support self-awareness, and help students figure out which strategies actually work for them in real academic and life contexts. Likewise, written communication still matters, but the goal may not be legibility or "80% linear placement accuracy". Instead, the focus moves to efficiency, endurance, functionality, and access. That may look like helping a student learn to use keyboarding, speech-to-text, or even AI to express themselves effectively. It may also mean helping a student to learn how to advocate for those tools. We must reframe the question from "Can I help an older student with handwriting?" to "How can I help this student express themselves?" When we do that, many more opportunities for intervention arise. Here's an example: A REAL OT STORY - 3 Reframing Handwriting Through Access, Participation, and Self-Advocacy What the OT did: An OT practitioner recognized that handwriting was limiting a student’s ability to demonstrate what he knew. Instead of continuing handwriting remediation, the OT shifted the focus to access by teaching the student multiple ways to express knowledge, including Google Slides, audio recordings, visuals, and other digital formats. How services were delivered: These alternative methods were intentionally practiced during OT sessions and classroom activities, not treated as last-minute accommodations. The OT collaborated with teachers to normalize these formats and ensured they were written into the student’s IEP so expectations remained consistent as he transitioned into high school. Why it worked: By removing handwriting as a barrier, the student became more independent and confident in academic and extracurricular settings. He learned how to advocate for the tools that helped him succeed and went on to meaningfully participate in electives and activities such as marching band and unified sports. This example highlights how high school OT reframes handwriting—not as a skill to perfect, but as one of many ways to support participation and self-determination. This story is featured on the Inclusive Occupations Podcast , Season 4, Episode 2: “Living the Amazing High School Life.” Looking Beyond High School One of the most compelling reasons high school OT matters is that the skills we support don’t become irrelevant at graduation. High school is where students begin practicing skills they will need in real life. Thus, high schools are where these soon-to-be-adults must learn to ask for accommodations, explain what helps them learn, and problem-solve when things don’t go as planned. When OT services intentionally build toward these outcomes, we aren’t just supporting success in school. We’re helping student design and bridge to their adulthood I think this also makes our role easier to explain. When colleagues ask, “Why OT in high school?” the answer isn’t about age or diagnosis. It’s about readiness for what comes next. Here's how one OT supports what is to come for his students: REAL OT STORY - 4 Supporting Real Work Experience Through a School–Community Partnership What the OT did: An OT practitioner designed a transition-focused program to help high school students gain realistic work experience before graduation. Rather than limiting instruction to classroom-based work skills, the OT partnered with community businesses to expose students to real job expectations, routines, and environments. How work experience was supported: Students first practiced job-related tasks on campus, such as folding boxes, sorting materials, cleaning, and following multi-step routines. The OT focused on task analysis, executive functioning, endurance, and problem-solving. The following week, students completed the same tasks at an actual community job site—such as a pizza restaurant, grocery store, or supply warehouse—while supported by an interdisciplinary team. After each experience, students reflected on preferences, challenges, and next steps. Why it worked: By pairing on-campus preparation with real-world experience, students developed confidence, self-awareness, and realistic expectations about work. They learned what different jobs felt like, how management styles varied, and which environments matched their strengths. This early exposure helped students see employment as achievable and informed more meaningful transition goals and planning. Learn more about this program in Episode 187 of the OT Schoolhouse Podcast! Key Recommendations for School-Based OT in High School If you’re looking for a clear way to anchor your high school OT services, these recommendations pull together the main themes of this article. Anchor services in life beyond graduation. Let transition planning guide your goals, services, and intervention choices. Ask how each service supports participation, independence, or self-determination in and beyond high school. Prioritize participation over remediation. High school OT is most effective when it removes barriers to meaningful participation. Focus on access, routines, tools, and strategies that allow students to engage in real roles rather than chasing isolated skill deficits. Use collaboration as a viable service delivery model. Work alongside teachers, paraprofessionals, and staff to design supports that live in the classroom and on the school day. Coaching adults on how to fade support can be just as impactful as working directly with students. Use one-to-one intervention strategically. Direct OT services still matter in high school, especially for assistive technology, self-advocacy, and problem-solving real-life challenges. Keep individual sessions purposeful and connected to functional outcomes. Treat assistive technology and alternative output as access tools, not shortcuts. Teaching students how to use and advocate for tools like speech-to-text, digital organizers, or alternative formats builds independence and confidence. Include real-world experiences whenever possible. Whether through community-based instruction, on-campus work routines, or extracurricular participation, authentic environments are where skills generalize, and confidence grows. Final Thoughts High school OT isn’t about holding on to outdated models or justifying our presence. It’s about showing up with clarity and purpose at a time when students are preparing to step into adult roles. When we focus on participation, independence, and life beyond school, our role becomes easier to explain and harder to replace. If you are helping students access learning, take on real responsibilities, and understand themselves as capable young adults, you are doing exactly what high school OT is meant to do. 📬 Want more support like this? Subscribe to the OT Schoolhouse Newsletter for weekly tips, research updates, and evidence-based strategies for school-based OT practitioners. Resources & References Carroll, T. C., & Schwind, D. (2023). Evidence-based predictors of post-school success . American Occupational Therapy Association. Cahill, S. (2023). Interventions to support transition-age students . American Occupational Therapy Association. Kari Renahan, Erin Knobl, Annie Jiang, Chitrini Tandon, Wenonah Campbell; School-Based Occupational Therapists’ Roles Supporting Transitions Into and Throughout Kindergarten to Grade 12: A Scoping Review. Am J Occup Ther September/October 2024, Vol. 78(5), 7805205170. doi: https://doi.org/10.5014/ajot.2024.050634 Harvey, L., Zapf, S., & Groger, S. E. (2022). Occupational therapy in secondary transition: A case report . The Open Journal of Occupational Therapy , 10(3). Inclusive Occupations Podcast, Season 4, Episode 2. Living the Amazing High School Life . Mazzotti, V. L., Rowe, D. A., Kwiatek, S., Voggt, A., Chang, W.-H., Fowler, C. H., Poppen, M., Sinclair, J., & Test, D. W. (2020). Secondary Transition Predictors of Postschool Success: An Update to the Research Base. Career Development and Transition for Exceptional Individuals , 44 (1), 47-64. https://doi.org/10.1177/2165143420959793 (Original work published 2021) OT Schoolhouse Podcast, Episode 109. From one coffee cart to an entire community-based instruction program . OT Schoolhouse Podcast, Episode 187. Realistic strategies to build work skills for high school and transition-aged students . Pierce, D., Spence, A., Sakemiller, L., & Roberts, C. (2021). School-based Transition Readiness Services for Adolescents with Disabilities. Journal of Occupational Therapy, Schools, & Early Intervention , 14 (2), 207–224. https://doi.org/10.1080/19411243.2020.1835601 Rehab Ink Magazine. (2023). The emerging role of occupational therapy in post-secondary institutions More OTS 192: Applying your Sensory Knowledge to MTSS Tiers 1 & 2 Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 192 of the OT Schoolhouse Podcast. Dr. Aimee Piller joins the OT Schoolhouse Podcast to explore how school-based occupational therapists can apply their sensory expertise within a Multi-Tiered System of Support (MTSS). She shares practical strategies for moving beyond traditional IEP-based services to support entire classrooms at Tier 1 and small groups at Tier 2, helping OT practitioners maximize their impact while managing their caseloads more effectively. Learning Objectives Identify the three tiers of MTSS (Multi-Tiered System of Support) and how occupational therapy services can be effectively integrated at each tier to support students with sensory processing needs Describe assessment strategies for evaluating sensory processing patterns at population, group, and individual levels within the MTSS framework Implement evidence-based sensory interventions at Tier 1 and Tier 2 levels, including strategies for training paraprofessionals and monitoring progress through data collection Whether you're new to school-based practice or looking to expand your service delivery model, this episode offers actionable insights on implementing tiered sensory interventions. Listen now to discover how you can support more students while staying within your professional scope and managing your time effectively. Guest Bio Aimee Piller PhD, OTR/L, BCP, FAOTA Aimee Piller PhD, OTR/L, BCP, FAOTA is the owner and director of Piller Child Development She volunteers with the American Occupational Therapy Association in various capacities and with the American Occupational Therapy Foundation. She is the author of Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs and has several national and international publications, presentations, and podcasts. Impacrful Quotes "Anyone can Google classroom sensory strategies, but they don't have the expertise that we have as occupational therapists to understand the theory behind it and really that interaction between the client and the environment." - Dr. Piller "We have to be the ones that are saying, 'Hey, we can be here too.' Your MTSS processes are already in place and we know how to do this." - Dr. Piller "Find the one person who's open to your ideas. There's going to be one, maybe two teachers that really see the impact that the OT makes, especially when we're talking about sensory processing." - Dr. Piller "Sometimes these kids don't need our services individually. A paraprofessional compared to hiring another OT — that's a huge difference from a budget standpoint." - Dr. Piller "We can move from three to two to one and not leave our parents or students with no support. We can ease out of that direct intervention." - Dr. Piller Resources 👉 Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs by Aimee Piller 👉 Piller Child Development Website: pillerchilddevelopment.com Contact: aimee.piller@pillerchilddevelopment.com Episode Transcript Expand to view episode transcript Jayson Davies 0:01 Hello and happy 2026 and welcome to episode 192 of the OT school house podcast. I'm your host, Jayson Davies, and today we are addressing sensory processing within a multi tiered system of support, aka MTSS with occupational therapist and newly minted author, Dr Aimee Piller, I'm thrilled to welcome Aimee to the podcast fresh off this publication of her new book for ot practitioners, titled implementing school based occupational therapy services a multi tiered approach to sensory processing needs. Now I've had the pleasure of sitting in on a few of Aimee sessions at a ot a also here in California at OTC, and I'm always impressed by her ability to take ideas within the OT world that are sometimes more focused on the quote, unquote, clinical side, and apply them to school based ot practice, such as the case with sensory integration and sensory processing inside of MTSS. So if you've ever wondered how to support more students with your sensory expertise beyond just the IEP. This is the episode for you. Aimee shares practical strategies for implementing sensory supports At Tiers one and two, helping us shift from only working with individual students to supporting entire classrooms and small groups within those classrooms. We'll discuss assessment approaches for each tier, intervention ideas that don't require more of your time, and how to advocate for your role within your school's MTSS framework. So whether you're brand new to school based ot practice or a seasoned ot looking to expand your impact in the classroom, don't miss this episode. Let's get started. Amazing Narrator 1:36 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, CLASI is officially in session. Jayson Davies 1:53 Dr Pilar, welcome to the OT school house podcast. It is great to have you, and we're actually have a few episodes with you coming out, this being the first one, and I'm excited to have you on so welcome for the first time of hopefully several, to the OT schoolhouse podcast. Dr. Aimee Piller 2:09 Well, thanks, Jayson. I'm really excited to be here today and share a little bit about some the book that I wrote. Jayson Davies 2:15 Yes and congratulations on that a book is never easy. I have had the idea of books for a long time, and just getting started is probably the hardest part. So congratulations, a on getting started and B, completing it. That is a monumentous, or I don't even know how to say that, but a wonderful thing that you have done, and I know it's gonna help so many, not just ot practitioners, but also educators and whatnot. So yeah, actually wanna start with the book, because in the book, you actually shared an experience that is kind of similar to mine, in the sense that you kind of dove head first into the real school based occupational therapy right out of school, out of OT school, you jumped right into, I don't know if it was in the Arizona area where you are now, but you were the only ot practitioner with a team of occupational Are you the only ot with a team of occupational therapy assistants? I just want to let you kind of share how that has shaped your experience, kind of just diving into it head first. Dr. Aimee Piller 3:12 Well, yeah, so I actually started my ot career in the school system. I worked not in Arizona. I was in the Midwest, and I was a great job. I mean, I was one of those where if I hadn't moved, I probably would still be there all these years later. It was a very supportive environment. I had a great mentor that I can meet with, and now she wasn't on site, but I still was able to meet with her work at the assistants. But what was really nice, I think, is being a young, new practitioner, you kind of are like, you don't really know how it's supposed to look, so you just figure it out, right? And that's how that kind of happened. I was able to just build learn from my assistants. I was able to learn from the teachers. They had not had an OT fully in their building before, or had been many years since the OT had been in their building, and I was able to stay in the building the whole time. So that was a really nice opportunity for me to just kind of get into the classrooms. And then I just started working with teachers in different ways, even though, when I stepped into the role, it was everything was pull out based I kind of was like, I was talking to the teachers, and they're like, one teacher in particular is very open to, what do you do, and how can I support the kids in my classroom? And I was just like, Well, why don't I just come in for a little bit? And then, of course, as we know, caseloads grew, and I was like, why don't I come in for more kids? And so just became a really nice model, as probably many of your listeners have worked for a long time in the profession and done these things that now are part of who we are in this, in our models of school based therapy, Jayson Davies 4:37 yeah, yeah, absolutely. You know, you mentioned a few things. One, you know, it being a pull out model, and you just kind of maybe didn't know better, and so decided to work with that one teacher. And how awesome is it to have that one teacher? Because I think we all have that one teacher, but we don't always recognize that we have that one teacher, and how important they can be. Unknown Speaker 4:54 Yeah, I mean, and I talk about that, and when I in the book, when I discuss, you know, kind of, how do you. Get started with changing the model of practice, or what your current practice setting looks like. It's find the one person who's open to your ideas. There's going to be one, maybe two teachers that are really, really see the impact that the OT makes, especially when we're talking about sensory processing and our sensory strategies that we can implement. You know, if you have some great ideas, and the teachers start to see their students doing better, and it's kind of reducing some of that teacher burden, for lack of better word to manage behaviors. So you know, they want you to be in their classroom. They want to know your strategies. And then they talk in the work room, and then in the work room, another teacher says, Well, I'd like that too, or I'd like to know more about that. And that's kind of how it got started, when I was again, not knowing what I was doing, just in there doing it. And the teachers would then she would talk in the work room, and another teacher would come to me, say, can you come into my class? And then it spiraled, yeah, yeah. Jayson Davies 5:52 And before we dive, you know, full head in on MTSS and sensory The other thing that you mentioned in your first answer was talking about a mentor. And you mentioned that your mentor wasn't necessarily on site, so I'm assuming, probably not even working within that district or with the contractor, whatever system you were set up with. But can you just share a little bit about a how you went about finding a mentor? Was this someone you know in your past already, or or someone new, and the impact that that had, like, and how did that work? Yeah. Unknown Speaker 6:23 So she was just a member of that the, you know, the OT community is very small. Even as a new practitioner, I was kind of working in a more, not a rural area, but a small city. So there was a pretty known on who the pediatric OTs were in the area. I had come back from ot school to where my hometown was, and so I'd heard of this person, you know, before, like, Oh, she's that. They would call her the sensory guru. And I was like, I'd like to be a sensory guru too, right? So that's how I was like, just, you know, I was that, you know, perhaps you'd like to mentor me. We would meet once a week, and we ended up doing things like, we would go on bike rides, and then we had more formal meetings as well. And she was like, I'm happy to mentor you. I had a good mentor, and I wanted to pass that on. And then we became friends, of course, which then just gave us the opportunity to talk about ot all the time, which was invaluable as a new as a new graduate, right? So it was a great opportunity for me, and I have tried to do that now, and my career is to pass that on to other therapists as well, because I was given such a great gift. I want to share that with the next generation of therapists. Jayson Davies 7:23 Wow, wow. That's, that's very awesome. You mentioned her kind of being a sensory guru. Obviously, your book is now on sensory and MTSS a little bit. What kind of drove you down that route of sensory Why did you want to follow the sensory guru? Why did you want to learn so much about sensory? Unknown Speaker 7:39 Yeah, and being, I've been in OT for about 20 years now, so things have changed a bit. And sensory was important in OT back then, but not so mainstream as I think it is now. But, you know, I think when I was I knew I always wanted to do pediatrics. It's always been, my passion has always been kids. And I remember studying about sensory integration, I was like, it's so when you're in school, it seems so hard to understand. And I remember, and that's one of those things, but when you see it in practice, it's like, Wow, that really works. But it seems it's hard to learn, right? There's lots of different aspects to it. You need to learn and figure out how to do. But I could see such a difference in kids. And I was like, I really enjoyed studying it too. Is very interesting to me. And then I have found, and I tell my younger therapist now too, like, when you find something that you're interested in and then that you're actually pretty good at, like, that's your specialty area. And so I found myself to be pretty good at sensory and I loved it. And so that's where I specialized Awesome. Jayson Davies 8:35 Now, something that was also relatively new 20 years ago was MTSS, I mean, it's still relatively new. You mentioned, right that when you got there, I'm assuming most of the OTs and previous OTs were using that pull out model, as you kind of mentioned, and and you kind of started to ask why, and started to think about what the alternatives could look like. When did you start to hear about MTSS and start to think like, hey, this could be a model that ot practitioners or that could apply to OT Unknown Speaker 9:06 well, I'll admit, it was many years later, not something I knew I was doing at the time, you know. And I think a lot, a lot changed in education since when I was a first practitioner, and continues to change. It's an area that we always have to that molds and modifies as we move along. So I never really put it into that model, until later, when I was like, Oh, wait, this is exactly what I was doing as a new practitioner, and didn't really know about it, you know, I had worked at the, you know, if we identify that level, tier one, as a classroom level, I was able to work at that level. And then I had small groups, and then I had individualized kids too. And it was really something that when I plugged it back in to the MDSs model, it fit so nicely, but it was not a prospective way of treating at the time. Jayson Davies 9:50 Yeah, yeah, definitely. And I think especially when you come from the background of occupational therapy in general, but then even more specific sensory processing. And you know, whether you've taken a sipped course, whether you've taken CLASI, there, you've gone to the USC program, Star Program, whatever it might be, or if you've never done any of those, and you just know occupational therapy, we know that it is very Client Center. And I use client in the sense of one individual, yes, ot practitioners can support communities, groups and whatnot, but for the most part, we look at individuals, especially in school. So T that's kind of like what we focus on. And the same goes first century, when we're talking like one of the most famous lines, I think, if you go through any of those courses, is it depends, it depends on the client. It depends on the client. It depends on the client. So the question that I'm coming up here, and it's admittedly probably a little bit of a toughy, but when we are taught so much to look at a singular individual, especially when it comes to sensory, how do we start to move this framework to thinking about sensory for a group of Students, or a entire classroom of students? Unknown Speaker 11:02 Well, it's certainly a big question. That's kind of what most it took a lot to get that model and that mindset to change a little bit, and I'm sure, and I've only touched the surface, right? I mean, so other people will probably do it more justice than I did in the book, but it sensory processing is very individualized to the person, right? Each of us have different sensory processing patterns and preferences, and how we interact with our sensory environment is very individualized based on who we are, but we also function in groups and we function in communities. And so we can look at patterns of the client and the population sense, or the client and the group sense, as well as, as we see the individual within that context, and see that there are patterns. Are there certain areas of and I talked about that in the book, as well as, like, how do we see that? You know, at this time of day, students need to be at this level of arousal, and all students need to be there now. They may need to have different needs to get there, but that's where we need them to be. If it's time to sit down and do quiet reading, that's generally speaking about the same level of arousal for most kids. But how can we incorporate those sensory strategies within that routine, which is really important. I talk a lot about routines in the book, and how to structure routines to help that aspect to switch from Yes, it's an individualized sensory need, but it does fit within the participation of the group. Jayson Davies 12:26 Awesome. Appreciate that. So I have a little bit of a fault in the sense that I believe that every single person listening to the podcast has listened to all 180 plus episodes of the podcast, which obviously isn't true. And so I know not everybody understands MTSS and all that. And so I want to give you a moment to kind of share how you identify MTSS, how you define it, and the tiers that you kind of when you talk about MTSS, the tiers that you define. Unknown Speaker 12:55 Yeah, and thanks for that question, Jayson, because I know when you and I first spoke, we found that there are some state differences as everything in education, right? So it's important that I define, and giving thanks for giving me the opportunity to define what I mean in this particular book is that MTSS tier one in this book, I defined it as a population, which could be the entire district, school building or classroom, and then this tier two is defined as smaller groups individuals that have been identified as requiring additional support, but not all the way to the point where maybe they need very individualized support, which would be under the tier three. So those tier two kids are okay. These general population or general strategies the entire school or classroom is using isn't enough support for these clients. They need a little bit more, but maybe not quite individualized. And then the tier three is really what I think our classic thought of OT in the school system is, which is that under the IEP, more individualized services. So that's how I define them in the book Gotcha. Jayson Davies 13:55 And for tier two, could that potentially include students that maybe are on a 504, plan, or maybe, like a student study team of some sort that the schools might have? Unknown Speaker 14:05 Yeah, absolutely. That's a great example of what a tier two might look like. Jayson Davies 14:09 Okay, perfect. All right, so we're going to dive more into how we can begin to assess these different tiers, or students within the tiers and the maybe even classrooms within the tiers. But before we do that, let's take a quick break. All right, we are back with Aimee, and we are going to begin to talk about assessments within the tiered model. So Aimee really quickly, or maybe not so quickly. It's up to you. It's your response. How does an individualized assessment look very different from maybe a tiered assessment, and we can go deeper into this, but kind of an overarching, Unknown Speaker 14:47 yeah, and one thing I really want to point out that's important if you're going to be functioning or providing services, especially sensory supports, at a population or group level, is that you do still follow the OT process and do. That assessment piece. I know that can be sometimes we get something in our mind, especially in a school based setting, where it's like, oh, assessment, well, I've got to follow the IEP process. I have to follow that met plan. I have to get the permission. It's like, No, we assess in lots of different ways. Right? As OTs, we're constantly assessing our clients and in various points within the OT process, but assessment is really important for us to make sure that we're tailoring those sensory interventions to what the client needs, whether that is the population or group, and not just providing a blanketed here's a sensory plan like I feel like that's very important for us if you're functioning and working under MTSS model as an OT with sensory integration or sensory processing. What you need to make sure you're doing is providing that high quality assessment, and I'll talk a little bit about some ways to do that well, to provide more tailored interventions that then you can see if they're effective or not. I mean, anyone can Google, send classroom sensory strategies, put them in place, right? But they don't have the expertise that we have as occupational therapists to understand the theory behind it, and really that interaction between the client and the environment and the client sensory processing needs. So it can be it's a little bit different model. I talk a lot about different ways to do it in the book that are effective. I had give some ways to gather the occupational profile. Some of that from the district standpoint, is, you know, what do students have access to outside of school that's sensory related, right? Are there parks nearby? Are there do they have extracurricular activities they're able to engage in? What kind of things are valuable to the school district? What is matters to the district from that kind of occupational profile, and then also looking at the clients themselves, right? I want to know what's important to the student, but I also want to know what's going on and what's important to the students. So I provide some examples of different games that you can play that are like classroom based games. There's a bingo game in the in the book that I talk about, there's kind of a two truths and a lie, just just fun games that you can gather some information and how to do that on their occupational profile, and then ways to look at sensory processing patterns, especially in a population and group. You know, some of that is still looking at the individual processing needs of a student, whether that's just a simple questionnaire or that you can give to the students and the teachers, maybe it's just an observation interviews. I talk a lot about how to do interviews that you can do very either quickly in person or maybe turn them into something electronic, so they can be done at any point in time, rather than having to try to find that face to face time with teachers and students. So there's lots of examples of those and questions that you might ask, so you can really start to see what the sensory processing patterns of each student is the teacher's sensory processing patterns and preferences and the classrooms routines and sensory environment piece. Jayson Davies 17:49 Okay, so obviously, if we, if we're going into any kindergarten, first, second, grade, third, any grade level classroom, we're going to go in, and we might begin to say, you know, 90% of the students, or 75% of the students, of the students, probably closer to 50% of the students are showing maybe some heightened needs for movement. But then we're also going to see 25% of the classroom that maybe it's the complete opposite, or some variance of a sensory processing need. So when it comes to that assessment piece and we're providing our our findings, I guess my question is like, how do we represent that? And how do we provide recommendations for a classroom that has varied needs? And I'm trying to stick to the assessment piece here, not go too far down the weeds. We'll get to that. But, but how do you explain that in assessment? Unknown Speaker 18:40 And I think that's an excellent question, because you think, does it all have to look the same? But that actually is your assessment, right? That some of the people in this environment and in this classroom, in this population need this input, and the other part need this input, and that is your assessment, and we have the clinical expertise to make those determinations, as well as designing a population based intervention that provides two types of input, right? And you think, Oh, that could be kind of tricky. I mean, so because we have this mindset of, I'm so used to like the child needs calming input, so I give calming input, right? But sometimes you need calming and someone else needs alerting. So I talk a little bit in the book about how to design different interventions that you can modify it based on the client's needs. It's the same kind of activity, but this group does it calming. This was a more alerting and movement basis. Of course, really common. And then also the environments I talk about how some students, I think when we talk with teachers, they really do a good job of trying to, you know, help students with sensory needs. But there's oftentimes that that mindset of, I can help the students that are hyper reactive to sensory input, and they don't think about those kids who need more stimulation to function at the optimal level. And so helping them design areas in their classroom that are low stimulation, on on sensory input and higher stimulation. And big parts of that too. Especially at the population level, is just observing and assessing that routine of the day, when is the best time for this input to happen for each for the individuals. And then I think one last thing to think about is sometimes you are going to see those clients as you're assessing that population level that really are just not fitting in those patterns, and that's a good indication that now, of course, after progress monitoring and data collection, those are probably clients that might be more appropriate for a tier two okay. Jayson Davies 20:32 And that's a perfect kind of segue, because I think what we've talked a little bit so far with it, within the assessment world, is like kind of larger picture tier one assessment, and I think for the most part, ot practitioners are relatively familiar with what a tier three in the realm of what you discussed kind of being that traditional IEP assessment might look like, but then we have this messy middle of tier two, and so does a tier two assessment look more like a tier one assessment, where you're being kind of more broad, getting a lot of information from the teacher, or does it look a little bit more specific, like an IEP assessment or the messy middle? Unknown Speaker 21:09 Yeah, so it's, to me, you're going to start off with that kind of broad based population assessment, but as naturally, we're going to see those clients who don't, kind of who clearly need more intervention, right? We're really good at that. As OTs of picking out. We just know, we know the kids that need the support that we can provide them, right? I don't I think anyone could walk into a classroom, you might be there for one kid, and see two other kids that need you, right? Really need you. And so as you're doing those assessment pieces, especially as you're working with those individual as you're getting individual information on each participant of that population, sensory processing needs. You're going to start to see those clients that have higher needs. Now, in the book, I talk about how to match those clients at that point, since it's a more, a little bit more intensified intervention, you can kind of match those clients so they're those kids that need more input. We can put those in a group and those who need kind of less stimulation, we can put those into a group, and so you can do a little more targeted intervention at a group level, but your assessments are fairly similar at that point. Okay, you Jayson Davies 22:13 mentioned matching a little bit, and I get that process of matching some of the kids who I pause here because too often, every single person has been guilty of this is putting kids together in a group that have no reason to be in a group together. And so I like that you talk about that matching, because sometimes we just match kids because we need to cut down on our minutes in a day. And so we group a third grader with a sixth grader. That makes no sense at all. So I like how you talked about that matching. To what degree does the other staff have an input when it comes to matching a little bit? And I ask this because sometimes we have kids who maybe are not in the same classroom that might be able to be matched a little bit together. Within that tier two, are we able to potentially see a kid that is in Mrs. Jones class and Mr. Jones's class, or should they be in the same class? Or I think this varies from district to district, but what have you experienced? Unknown Speaker 23:10 I mean, ideally, if your district is supportive of that, it is about not just in the classroom. It can be across classrooms like these students have the same needs at about the same time of day. I mean, that's obviously the idealistic world. It doesn't always work out that way, right? But we can advocate for those aspects, especially if we're collecting really good data that's showing this is effective for the students being more successful. And so sometimes it's just maybe I can only do three at a time, and then if, when this occurs, maybe we can form another group that's similar, with different students. So when I talk about it in the book, the tier two does take students from across classrooms, not just from one, if that's available to you at your district, Jayson Davies 23:49 yeah, yeah. I think that is something that we default to thinking that it's not possible. I know I did when I was first in school based OT, and then I started to realize that if I advocate for it, people are usually actually open to it, so long as we can explain how it connects to MTSS because people typically think that if an OT is doing something, it's an IEP, and therefore everything needs to be on the IEP before you do anything. But if we come at this from an MTSS perspective, people seem to be a little bit more open to it. Does that sound familiar? Unknown Speaker 24:25 Yeah, I agree 100% and that's sometimes when I'm talking with other OTs about kind of this concept and model. They're like, Well, how do you fit it in? I'm like, well, MTSS is really already laid out for us to put it in. We don't have to come up with new policies or procedures. We just have to embed ourselves within that MTSS process. I will mention, I just think it's just an interesting story is that I was, I was at a school climate conference, and it was all about, you know, promoting social emotional and I happened to go to a class on someone who was, she was in charge of the MTSS program for a very large. District in Southern California, and I just happened to it was great breakout session. And I mentioned to her afterwards, like, so great. I'm always trying to talk to OTs about how we can embed ourselves in tier one and tier two, and we shouldn't shy away from it, and we need to be at the table. And she looked at me very large district, and said, I have never considered asking the OT to com to MTSS meetings, or tier one or tier two. So we have to be the ones that are that are saying, Hey, we can be here too. And here your processes are already in place, and we know how to do this. We can really help students so that then at the end of the day, we have more time for those individual students that need, those that have those higher needs, and we have the time to service them individually. So sometimes these kids don't need our services individually. And I do have a whole section on how that looks. How do you train your staff to get there? Jayson Davies 25:52 Yeah, I love that, because obviously we're going to maybe talk a little bit about advocacy and implementation at the very, very end, but we might as well like just work it in here, because you're right. We have to kind of speak up and let people know that we can do this. And I think a lot of districts often have two MTSS routes, if you want to call them, there's MTSS a, academics and MTSS B, behavior. And sometimes the academic might be broken down into English, language arts and math, but nowhere in there is there like speech. MTSS, OT, MTSS, ape, MTSS, like it's just not necessarily designed with related service providers in there, because Esso didn't really come around and kind of define a little bit until 2015 everything you know takes some time to implement. So, so we do have to speak up, and that's absolutely important. Thank you for bringing that up. One other question that I get often is, at what point do we need to let parents know that they are receiving some form of occupational therapy support? Obviously, with tier three IEP, they're very informed at tier one or tier two. Do you feel like there or what does MTSS kind of say? What are districts doing in terms of letting parents know that OT is involved? Unknown Speaker 27:10 Well, and Jayson, I think that's the best part of it. Is that whatever that that procedure is already in place for those MTS kids who are receiving MTSS one or two, there's some procedure already in place in the district on how those parents are notified of that. And so just embedding yourself within whatever that district policy is on, hey, now the OTs involved in this process is the best thing. And so it's not, to me, something that we need to reinvent the wheel of or say, hey, we really need to make sure this happens. Like, what's your current policy? I think that will be fine. Can we just add to it that the OTs is going to be involved in this situation? Obviously, tier two has a little more, you know, kind of communication with parents in that way, and that's all right, but again, it's like, that's our guiding practice for that is going to come from the district, all right? Jayson Davies 27:56 And one last question, in terms of assessments, you know, we talked about that tier one assessment being a little bit more, I think, teacher centric and larger picture centric. And then as we move to tier two, it is a little bit more about the students. I think people have a difficulty, especially with tier two, in terms of, is it occupational therapy, or is it educational services provided from an occupational therapy perspective. And then either way, what does that mean in terms of, like, what is occupational therapy actually working on? Are we working on a specific quote, unquote goal, as it might say on an IEP? So I guess the first question at tier two, do you think it is intervention, as we move to interventions a little bit, is it occupational therapy for those students, or is it more of educational services provided by an OT if that makes sense, or how do you explain that? Unknown Speaker 28:52 Yeah, that's kind of a complex question and such a simple question, right? Because, of course, anything that OTs doing is occupational therapy, right? But I can, I think of it more as educate. It's the education from an occupational therapy perspective, and even in the book I present that the OTs probably not doing the actual intervention piece. They've designed it. They're monitoring it. But it's not necessarily done by the OT it might be done by a pair of professional maybe someone else that's doing some of the RTI situations or things like that. And that's why, when it comes down to it, because, of course, we're very busy as practitioners. We have so much to do, not enough time in the day. And so it's, well, how can I add in? That's the question I get. How do I add this? And I'm like, well, you're training someone to do it, and then you're monitoring that progress to see what needs to be changed and what's working what's not working. When do you need to come back in and kind of reassess or remodify the programming? But you the OT doesn't necessarily have to be the one that's implementing it at those levels. Okay? Jayson Davies 29:54 I'm going to give a second to have a follow up to that, because I know we just lost some people. Because they heard we need more support in some way, and it can't be us and and they love that you said it's not going to be them necessarily, because, yeah, like you said, OTs don't need more work, but at the same time, teachers don't need more work. So I diving into that intervention piece. How does that begin to work? Like we're developing a program and then maybe training a paraprofessional. Is that kind of what tier two in what you've done kind of works, Unknown Speaker 30:27 yeah, and models that I've worked in, and when I especially, like, when I was that first initial job where I had no idea what I was doing, it just came about. What happened was the teachers were like, This is so great, but Aimee doesn't have enough time, and we don't have enough time. And they were like, they came together as a group and said, We need another paraprofessional to help us with this sensory piece. They came to the because of the effectiveness. And I said, that would be fantastic. Like, I could train her. I can make sure she can kind of not report to me, but in a way, we can always touch base about data. And the school said, Yeah, okay, we're seeing that students are being more successful. We're not having as many, you know, referrals. This is a good thing, and a pair of professional is something that's in the budget. So that was great, because the teachers came to my advocacy, not me, right? Yeah. And so that was excellent. And sometimes it can just be embedded within another program, like, if you've got some of those working on some of those social emotional pieces, can you put some of that sensory piece into whoever's doing that social emotional piece? There's things like that that you can utilize as strategies to try to help get those extra services. And then I also, you know, I know we're getting into this later, but there's an element of, you know, a paraprofessional compared to hiring another OT, that's a huge difference how much budget that is. So if you can really, really show that you're through progress monitoring and data good quality data collection and training, that you a pair of professional can help you. So maybe we don't have to, you know, hire another ot from a budget standpoint, that's what districts want to see, right? Jayson Davies 32:01 Yeah, see, this is, this is, like, the exact reason why I wish we were posting this on YouTube, because, like, I don't know if you can see, but I'm like, thinking like crazy right now, like, because you got me thinking, like, we think about all the things that we do, and we often try to say, Man, if only I had another occupational therapist, if only I had another ot a to help with this. But we rarely think about, man, what if I just had a three hour paraprofessional, like, even, not necessarily even, like five days a week, even if it was just a few days a week and and I think that kind of goes back to that very first question that we talked about assessments where you talked about doing a tier one overall assessment of maybe it's the entire first grade level team, or, like, the entire school, but you could show in that quote, unquote assessment, where 15 hours a week of paraprofessional support could make a life a lot easier for every single person at that school, Dr. Aimee Piller 33:02 Yeah, correct. And it really comes down to that aspect. And when you're going to advocate for things, is to really make sure you have your data right. I mean, if I because data and data is not just hard data, I mean, that's part of it, but those teachers were huge for me to get that paraprofessional right. She was a part time person. Just came in. I think she was there four hours a day, four days a week. It was great, though, right? So that the teachers are a huge source of that data as well, but as you're gathering those data too and making sure that, and I talk about strategies, and I give really good methods and ways to make sure your staff is well trained so that you can keep that fidelity of intervention. But I've utilized that model, and I'm I utilize it in schools even now. I work in clinic based but I still consult and contract with some schools, and I utilize that model a lot, because I can't be there every day, right? And I need to make sure that they're that some of these students are working, have really high sensory needs, that the staff is trained well, they're able to gather the data. I need to make determinations on if that's effective or ineffective, or if we need to make changes, and then also seeing the improvement within that setting. And so we can sometimes think other people can do certain things we do if we train them correctly and and teach them how to gather the data we need to to know to make decisions. Jayson Davies 34:20 Yeah, and I think I'll just kind of put the quote, unquote disclaimer out there, like some states kind of lay out, what an occupational therapy, not an assistant, obviously, not an OT a but there is another term I don't even know, because I've never really been there, but I I don't know if that has to be really looked At here, if we need to think of them. Obviously, they're not an OT, a they're not an occupational therapy practitioner in any way, but to some degree, they're supporting you, and I think that's something that the district needs to look into. And as well as the OT, if they're the ones implementing this program, like, what can and cannot that person do? Just to make sure everyone is staying in compliance with licensure laws and all that so but yeah, no, I love the idea. It's got me thinking a lot like you could do Dr. Aimee Piller 35:07 that's really very important to consider too when you're putting the programming in place, Jayson, is that if this person is a teacher or a paraprofessional, you're not going to provide anything more than what maybe would be as part of a home programming, like what you would give to parents. And so I think that's a real important distinction, because if I'm going to be doing like, real ot based interventions under that model, where it's an I'm working towards, you know, a specific goal, and it's skilled intervention that's you need to abide by your licensure laws. These are more and supports of participation, which is something in any setting, we give teachers all the time, we give to parents all the time, right? So that's the kind of modeling that that you would want to use. Jayson Davies 35:50 Yeah, yeah. Awesome. All right. Well, let's talk a little bit about the interventions. And I kind of want to, I think we're just go through all three, well, at least the main two, obviously, when we get to tier three, as we've talked about, that's more IEP specific. We can talk a little bit about it. But when it comes to tier one, you do that assessment a little bit that you talked about earlier. After every assessment, we tend to have, like these goals. So when it comes to tier one, what are some things that you might be looking to as a goal? Are you looking and I say that with goal being loosely, it may not be a SMART goal, right, but at the end of the day, you're doing an assessment with an outcome. And so what is that outcome that maybe you might try to look at and kind of say, well, this is here we are, and this is what we could work toward. Obviously, it would be different from a district to a school to an individual classroom. But what are some things that you've used as as outcomes? Dr. Aimee Piller 36:44 Yeah, well, again, you know, I try not to reinvent the wheel. What? What goals to the district have, per se, you know, are we looking at, are we looking at number of referrals for behavioral difficulties? Are we looking at test scores? Are we looking at teacher retention? Like all those things can be indirectly related to how the students perform in the classroom, right? So I sometimes will look and see like, that's where it goes back to that assessment process, your occupational profile, what's important to the district? What's important to the classroom? If the teacher is really like, I need my students to be, you know, participating in a certain time of day, or I need them to make sure I'm having trouble getting the students to pay attention at this time. That's the goal of that classroom. And so those still can be semi individualized. And I give some examples of goals in the book, and some of them, I do try to provide SMART goals if possible, but I think you make a good point that sometimes it's just an outcome, what's our what's our desired outcome, and it can just be that, you know, sometimes it is like the teacher can report that she doesn't, you know, she feels less stressed at the end of the day. That's not a bad outcome either. Jayson Davies 37:49 Yeah, yeah. And, and, I just want to say, like, that's one of those. It depends responses. Like, everybody hates that response to hear, Oh, well, you know, what is the district worried about? And like, but that's absolutely like what you should be doing here. Like you've said several times, don't reinvent the wheel. Like, I think, especially when it comes to tier one, some of your most valuable tools are looking at your school's website, looking at your district website, seeing what their What's that called like, the plan that they have to create, like a school site plan or district level plan. And like, what is their mission? What are their values? What are they trying to actually accomplish? What are they telling every parent in their district that their kids will achieve? And how can you support that? Like, that is a great way to develop an outcome. So I love that answer. It's not the one that people often want to hear, but I think it is a great response. So, yeah, okay, so based upon that, what are some wonderful intervention kind of ideas at tier one? What are some easy go to things that you often share with ot practitioners that are relatively simple to kind of get started with? Dr. Aimee Piller 39:01 Yeah, I talk a lot in the book about designing simple sensory environments within the classroom. I also talk about how that's so important to know the students needs, but also the teacher's needs as well, and teachers preferences and meeting the teacher where they are as well. I don't want to come into their classroom. It's like, what do you have that's working for you? How can we provide some supports for different students. I provide a lot of examples, of course, of that movement base. There's just lists of different movement based and heavy work activities that we all are using all the time, right? But how do I put them within learning environment and structure within that routine? Is really what that chapter is focused on in the book. I also talk about some things when it comes to like, do we need extra tools for, maybe tactile input or proprioceptive input? How do we create, creating a lending library of sensory equipment so that then you can also, you know, get some of that data. Let's try some of this equipment. Is it working? Well, maybe we can advocate, then for a budget to get a little bit more and how to, how to establish a. Sensory lending library. What does it look like? How do you put in a referral for a piece of equipment? So all that's in the book too, because I know we're all working on budgets, and we don't all have endless Some districts have lots of money and some don't have hardly any money. And so how can we, you know, provide the support? And of course, like I said, as we know, sensory processing changes all the time, right? Like sometimes our kids have different needs in the second quarter than they did the first quarter. So if I advocate to purchase something, it may not be good for that classroom for the whole year. We might need to change that. So utilizing things like a lending library to do some of these activities can be really effective. And I also have a little section on the importance of and how free play and allowing opportunities for free play is so key to the sensory piece for our kids, and how to advocate for that recess time. And what does it look like to allow students to have the free play opportunities at recess, not just structured play time. And so there's a little bit on in the book, if you are advocating for recess time in your district, that might be helpful. Awesome. Jayson Davies 41:06 Yeah, no, absolutely. And I thought you were going to go even a little bit further to where I was going to go right now. And I want to ask you about this, because it is something that ot practitioners frequently come across, and that is the use of sensory rooms within a school. And I guess the first question is, A, have you and or your schools utilize sensory rooms on campus? Dr. Aimee Piller 41:27 Yeah, I've worked with schools. And then, of course, you know, my first, my that first job, again, had a sensory room, which was also my room, right? Or I didn't get to design it, but I had to treat in there, yeah, yeah. So sensory rooms are sometimes available, and I think they're really good for a tier two because you have access to more equipment. Most of the interventions provided in the book for tier one are things that are just really can be done in the classroom. This is the idea of it, right? Is that we're working at that population base level. If we do have access to a century room, and you can bring the whole class and great, but that's, I don't know that that's feasible for everyone, and since tier two tends to have a little more intensified needs, sometimes that that sensory room can be a better option, or space for those interventions and groups to take place. Jayson Davies 42:15 Yeah, and that's kind of where I wanted to go with because the question with people who, a already have access to a sensory room, or B are thinking about, you know, asking their district, their school, to have a center room, or maybe they've even been funded for one, but don't know where to start. What have you seen that works best? Or does it not work for tier one and sensory rooms? Do you think that? I mean, I don't see many cases where an entire classroom can go into a sensory room, but to what extent could a small group from a tier one like and, and I guess, what would you want to do to set up to make sure that it's actually helpful and not harmful? Dr. Aimee Piller 42:56 Yeah, and, you know, ways that I've utilized kind of a sensory room, or the idea of a sensor room in the past, is that more like kind of when they have their independent work time or center work time, that's a great time for them to this group goes to the sensory room for 15 minutes, or this, you know, these are we're doing independent work time. So this section of the class gets to go do those sensory based activities in the sensory room. And so I know that sensory rooms look very different depending on where you're at. So I will be honest that I didn't write the book necessarily from the perspective of sensory room, since they I wrote it more on based on, like, what equipment, wherever that may be located in your in your district or school, so that you can put that together either in a more structured, formal way, like a sensory room, in which case I would probably make sure that I had access to, alerting equipment, calming equipment, and then kind of making sure that I'm guiding those students to the place they need to be when they return to the classroom. So that goes back to that routine pace of like, when they go back, what are they doing? Is it time for them to then sit down and do their independent work? Or are they finished and they're going to lunch? So where are they in that routine base, too, changes your activities. Jayson Davies 44:02 Yeah, yeah. I've just heard so many different stories with sensory rooms. Like we had a child using a sensory room at our school, the teacher, I believe, had taken the student in there, and there were multiple students. Student was on a swing, fell, broke their arm. Obviously not a good situation. And it ended up being that, basically the school decided only the OT can use the sensory room with one on one or small group services. And I've been at another school site where we basically, these were, every student had an IEP in the classroom, but we would write up on the wall, like Johnny a. These are some activities that Johnny a can do, Johnny or, you know, Sophia, these are some activities that Sophia can do when they're in here. So in that sense, they came in in small groups, and they had more of a defined routine for that for each child. So there's several ways to do it, but yeah, it's always a tricky situation that I also try to. OTs that it's not only on you, like that sensory room is for the entire school, and it should, in my opinion, be the entire, you know, the players that need to come up with the rules. So it's everyone's responsibility, not just the OTs responsibility. Dr. Aimee Piller 45:12 No, I think that's a great point, and that's really the importance too, of like, when you're working at the MTSS level, the making sure and advocating so that you have the opportunity to train staff so that they know is that the right piece of equipment, is that that right activity for the this group, or these these students, and then how to do it, but it is absolutely everyone's responsibility to make sure kids are safe and their needs are met, and you have the expertise from a sensory standpoint as an OT on how to help them make sure those needs are met. Jayson Davies 45:41 Yeah, yeah. All right, I'm gonna ask you an either or question, and feel free to completely shut it down. But would you rather have a sensory library or a sensory room? Dr. Aimee Piller 45:52 I'd rather have a sensory library really? Yes, I just am such a and I think that's one thing that's important to me, and one a big reason I wrote the book, besides the fact that I thought, you know, so many kids need sensory supports these days, right? We know that many times we can provide these good, quality sensory supports without having to be direct intervention, but we really still need to be the one that's assessing and guiding that intervention. And I'm such a proponent too, of like, when you're at like, if you can be in the classroom more, of course, that's what we want to do, is be in the classroom more. And so I love that aspect of if I can provide sports supports and what this class is already doing, that's the ideal aspect, not always possible. And sometimes it's great to have that separate environment where I can go out and get the sensory needs met. And that's a great thing too, but if I could only have one or the other, I'd take this at the library. Jayson Davies 46:48 I appreciate you going with it and picking one like I know not many people do that. They're always like depends. That's the OT answer. So no, appreciate you doing that. All right, we're gonna take one final break, and when we come back, we're gonna talk a little bit about tier two interventions and some data collection as we move over to tier two. All right, we'll be right back. All right. We are back with Aimee to wrap up this episode, and we just talked a lot about tier one, what the outcomes might look like, what the intervention itself might look like as we transition into tier two, I first want to ask you during that tier one, what might data look like? What are you how are you collecting data? Are you having the teachers fill out a Google Form? Are you using pencil and paper, maybe just a few things that you might be wanting to track? What does that look like? Yeah. I mean, any Unknown Speaker 47:39 of those methods are great. I prevent I prevent I present a couple of different ones in the book. So some are paper pencils. Some are, you know, something virtual, like, easily, Google form, like Likert scales. Sometimes it's you making sure you're coming into the classroom every so often, and checking those progress and goals, you know, once a month, or something along those lines. So there's lots of ways that you can monitor that progress, and you're still track. I mean, you really do want to try to write goals that you can measure in some way. So sometimes it's just like, if you're looking at, well, how many students have you had for a behavioral referral this month? It's like, well, that's a pretty hard piece of data, yeah. So that's just a quick ask to a teacher, so easy to do on those Yeah. Jayson Davies 48:19 And you can do that classroom by classroom, by classroom, or you can do it by grade level, or you could do it entire school by how many visits to the vice principal or assistant principal's office. So, yeah, cool. Okay, so then moving forward into tier two, how are you deciding which students need that tier two to tier three? We did talk about assessments a little bit earlier. Would you say you're doing more of an assessment piece here, or is it more based upon that data collection that you got from tier one? How does that work? Unknown Speaker 48:51 I really kind of, again, function, put it, embed it right under the MTSS model. Let's start with the least amount of intervention. Gather the data on that, do that progress monitoring, and then if we are showing that that's not effective, and we've even changed interventions, or whatever we need to do, is it time to add in more support? And I that's where that data comes in. Because one, you need it. It's a it's part of the MTSS model. You have to have the data for that. But two, it's going to also give you the information on what kind of groups do you need, like, how often do these groups need to meet? Do I have enough for you know, one group, two groups, three groups. What does that look like? What types of sensory interventions do they need to implement? And a lot of times, these groups don't have to be very extensive or long periods of time, 510 minutes can sometimes be just enough. Maybe after recess, we got five students that need to go do some extra calming input before they come back to the classroom. That's that's real easy to embed in a in a day, but still kind of functions under that tier two model. Yeah. Jayson Davies 49:50 So I'm just going to play what the listeners thinking right now, because we just talked about data collection, and we talked about maybe one of the examples we gave was referral. Right? Referrals to the teacher giving us data, the assistant principal may be giving us data, or the entire first grade team giving us data. So how do we go from that data? That's more about like this month I had 30 referrals versus last month, I had 25 referrals. And pare that down into Okay, well, these are the kids that need that additional support? Unknown Speaker 50:22 Yeah, and that's a great question, because then it becomes like, are you seeing patterns of the same students as those students have been repeated? Do you have students that you might be concerned with that these interventions don't seem to be helping out? Right? That's a question that I'm going to ask teachers, like, Who's Who do you feel like these are not being effective for and those are then you can come in and take another look at that, rather via observation, talking to the students themselves, things like that, to see if that's something that's matching the data that you're collecting a lot of times too. Once the intervention might start going at that kind of tier one level, I might ask teachers to just kind of make note of specific students that seemed to what I would I just put I make it so easy for them, as easy as I possibly can. It's a plus or minus. It was plus it was they seem to have a pretty good inner response to it. Minus. It didn't seem to work, you know. So if I have a lot of those kind of like, Who are these? Minus kids, can I come in and take an extra look at them? Or what kind of things are you noticing? Do you think they might need a little more support things like that. Yeah. Jayson Davies 51:23 So you've got your larger data set, but then sometimes might have to look a little bit deeper. And then, even then, I can imagine that's where you might need to do a little bit of an assessment to kind of determine why the other approaches, the tier one approaches, weren't necessarily working to to update what tier two might look like, all right? And then, so let's dive into tier two. We talked a little bit about it briefly, being like more small group, but what does that actually look like day to day? Unknown Speaker 51:51 Yeah. So again, these are a little more our targeted, designed interventions. But you know, depending upon your setting and where it may be, these are things that you've trialed with the students that you know are going to be the right intervention. You've done a good quality assessment. You know what their sensory needs are. Hopefully you've paired them, kind of based on their sensory processing needs, the best you can with what you have. And so that you've designed these interventions. And I often would suggest that ot does those group interventions a few times as she's training whomever will take that to do those again, they don't have to be long, be 510, minutes at a time, sometimes longer, but they don't have to be so can to make sure that that's the right intervention for that group, or that that's the right mix of students together as well. You know that's important piece to consider. I even had the colleague of mine was explaining how she implements tier two with her tier she has her one of her tier three students lead the yoga group for the tier two, which is, like, just a fun way to kind of incorporate some social, pro social participation with the tier three student. And then the tier two is getting extra input. She's there guiding and getting minutes for taking care of everyone. So just a fun idea. Jayson Davies 52:59 Yeah, and earlier, we talked a little bit about that, like, paraprofessional support. How has that looked like? And one of the questions I kind of have with that is, are you creating the programs, or are you even finding programs that already exist, or a mix of both, yeah. Unknown Speaker 53:16 I mean, a little bit mix of both, right? We know that there is just a laundry list of sensory, you know, activities, right? You can put those together in your own programming based upon what a student needs. You can pull a little bit from things you've done in the past. We know that that vestibular piece is really important, proprioceptive, tactile, especially deep pressure, tactile. All of those are going to be in a mix of whatever you want the student to do, whether that's that kind of, I need to increase my alertness level. I need to decrease my alertness level. What's my match for that? And again, this tier one and tier two, from that standpoint, really does focus mostly on that reactivity side of sensory processing. And I didn't mention that before. It's not a lot on that kind of, that more motor aspects or motor planning pieces. It's more about like, is this child getting the sensory needs met so that they can participate in the classroom? So I wanted to make that distinction too. So once you're kind of getting the that programming in place, it's going to look very routine based after that. And that's a great time to pass that on to the pair, or whomever can can help implement that. Jayson Davies 54:18 Yeah, yeah. I really like that. And, and, I mean, when you were working with a with a pair of professional sounds like you had about four hours a day or so with that paraprofessional, what did their day kind of look like? Was it kind of going from class to class to class and implementing these for a few minutes in each class? Yeah. Unknown Speaker 54:33 So what would happen every morning she would come in and we just touch base, kind of like, make sure we had a plan for the day. What's she gonna do? Anything didn't go great yesterday, if I didn't get to touch base with her, you know, whatever it may be. And then she had a schedule. She had a schedule of students that some needed more intensive. And she did a lot of the tier two, mostly, and tier three. But then she also during her extra time, which was what was great, is she was there in the classrooms with the teacher, so not all of her four hours were filled with one. What I needed her to do, she got to float around the classrooms and help them out. And since she had, like, a little bit more training and sensory she could always implement that within the within the classrooms. So it was really great model, and she was a fantastic, you know, pair, but the teachers just found it so valuable. So when she would come in, we'd touch base, she'd go implement she'd give data trackings. I would check those every day or often, you know, if I could, and then anything that seemed awry, that would be a flag for me that I need to go in and see what's going on with that kid, or I need to maybe take a peek at that group that you're working with. So it's real easy to identify when I needed to go in there and take a peek at it. Jayson Davies 55:36 Yeah, and we haven't talked much about tier three, because we already identified that's like the IEP, but I'm assuming then you're talking about looking at the data from that paraprofessional. That's the data that you would look at to then maybe make a determination if a student needs to go to tier three. Oftentimes, within the MTSS, there are periods of time, typically eight to 12 weeks or so. People often talk about every eight weeks, every 12 weeks, needing to look at the data to determine to move up or down. Is that kind of what you use, or is it just kind of, when you see the data, that makes sense? Yeah. Unknown Speaker 56:11 I mean, a little bit of both, right? You want to make sure you're at least checking that, you know, usually every other month. But, you know, I try to check a little more often than that, if I can. And I do also want to mention and just because it's something that I don't think we always think of with the MTSS, but I don't know about everyone, all of your audience, but I know sometimes parents get a little bit nervous when services are discontinued from the tier three level. And so that's something that I think is a very valuable if you're working in a district that has good supports at a tier two and a tier one. Yeah, we can move, you know, from one to two to three, but we can move from three to two to one and not leave our parents with, like, our students, with no support. There's still support tier for you. You know, we can ease out of that direct intervention, because I know sometimes parents get kind of nervous student, my child's finally doing well in school, and now, you know, you're saying he doesn't need it anymore. Jayson Davies 57:05 Yeah, yeah, definitely. And that's kind of what I tell tell practitioners as well. Like, it's always nice when you have the MTSS program embedded, because then you can say, Look, you know, we're still gonna be even though the students not receiving an IE or OT on the IEP anymore, they will still definitely have access to supports from the occupational therapy team that that does help a lot. All right, really quickly, talking a little bit about barriers and ways to get around them, a little bit you talked earlier about working with that one teacher that is that's willing to support you. But what are some of the other barriers, and how to overcome those barriers that you've experienced or have heard about others experiencing. Unknown Speaker 57:45 Yeah, and you know, time is always a big barrier for us as OTs, right? We're just busy people, and we really, really care about our clients, and we want to give them the best services that we can. But oftentimes there's just not enough hours in the day. So I do talk a lot in the book about how to, like, read, redistribute your time, how sometimes you can put a little extra time in at some point to get Freer time, and it pays off in the end. So not being afraid like I used to go and attend the meetings with the staff, not every time, but sometimes like that, I was a familiar face then right and then I knew what was going on. I knew what was important to them as teachers and staff, I knew that. I knew what was important to the department. So all those things paid off in the end, even though it took a little extra of my personal time and the beginning, it paid off in the end. So thinking about that aspect too is something that when you're considering time, and at the end of the day, if I can provide supports for more students and have more time to give that individual, that student who needs that individualized I'm less stressed as a person. More kids get help. It's just a better match if you can get put the groundwork in. The other aspect I already did talk about is that sometimes they just don't think of us as part of that plan, like that the MTSS is not thinking of the OT as part of that plan. So we might have to insert ourselves as part of that. And I provide some ways in the book, a very formalized proposal that you can present to your administration, how to actually write that to have the data and information that's meaningful to administrative staff, that's might look different than what's meaningful to us and so that, but that but that can get their attention. Sometimes they're just like, I need to have a meeting with you, or I want to meet with you, but for not speaking their language, or may not give us the opportunity to tell them how great we are, how much we can help them. Jayson Davies 59:32 Yeah, absolutely. And there are team meetings happening without us even knowing about them. And and we won't know about them unless we ask, unless we, you know, do some digging on the website to determine that some sort of group called Ice BD do whatever, like MTSS like, even exist in our district, and we have to figure it out. So, yeah, no, definitely, we have to be a part of those teams. I have one final question for you, and hopefully it's a little bit of a fun one and idealistic question. In if you were, you know, just kind of, let's just assume you have one school in that school. How would you first start, like, tier one? What would you want to do for tier one? If you're just starting a brand new job today, and you're like, you can do anything, everyone's on board. What would you do at tier one? First, like, the first thing Unknown Speaker 1:00:19 you would do that's when I would set up sensory programming for the whole school, but I would probably do it at a classroom level. So I would train my staff really well to understand what sensory processing is. How does it impact it? And then I would embed, since it's idealistic, I would help them to learn how to teach in a was sensory, right? That would be like my ideal classroom. I have a I have a degree in elementary education as well, and so just to combine that sensory piece with the academics and create this beautiful curriculum that would be my ideal world. Obviously not really feasible, but that's because I think if you can teach, if you can embed sensory in the learning process every it's just more effective for everyone. Jayson Davies 1:01:06 Yeah, yeah. And then obviously, moving kind of on to tier two. Then how much time do you think you might have to dedicate to tier two? Unknown Speaker 1:01:16 You know, hopefully, if you're if your tier one is looking really good and it's doing a lot for those students, your tier two shouldn't be a lot of time, right? And you know, because it's just they need a little more, a little different, but they're already getting all this great sensory in tier one anyway, so it's just a little bit more or a little bit different, maybe a few more frequency and during the day, yeah. Jayson Davies 1:01:37 Okay. And then obviously, tier three, we have IEPs, which we can't always control, versus where they come from, but hopefully we are with tier one, tier two, we're able to limit the need for that tier three, although I will ask you, what are some of the things that you mentioned a little a moment ago, about how everything that we talked today is More about sensory regulation, not that motor piece and whatnot. So what are some things that if you see you almost kind of instantly think you know what? Maybe we need to move toward that tier three. Yeah, I mean, Dr. Aimee Piller 1:02:11 and from a sensory standpoint, that's a great question, because if I see a kid that has significant kind of motor planning or Praxis that's related to that sensory processing, I know that that's going to impact everything they're doing in the day at school, right? So that's a and that's a whole different intervention, right? It's a completely different type of sensory intervention, and it's very individualized and should be serviced under a tier three versus like a child who's just kind of, maybe just needs a little, you know, having trouble paying attention or sitting down or following directions, but with some added support, does Okay, and can participate in those classroom routines. So the motor plate, the motor planning, or then that sensory integration and processing piece is really key, or just those kids who have really, just really high sensory needs, right? So I'm not going to be able to embed a two minute movement activity, and that's going to be enough for that kid. That if a child has really high movement needs, then that's obviously something that's going to be needed, needing to be serviced under a more individualized approach, absolutely. Jayson Davies 1:03:12 Well. Aimee, thank you so much. It has been a pleasure, and please remind us where we can find both yourself and your book. Dr. Aimee Piller 1:03:18 Yeah, so you can. I have a website that's my company, pillar, p, i, L, L, E, R, child development.com There's resources on there that'll take you to the book. The book is published by Routledge press, and so if you go on to their website, they will have a link to that book, and you can purchase that for your own use. Jayson Davies 1:03:36 Yeah. And that is implementing school based occupational therapy services, a multi tiered approach to sensory processing needs. Aimee, thank you so much. It has been a pleasure, and I look forward to having you on the show very, very soon. Thanks again. Great. Thanks, Jayson. All right. That wraps up our conversation with Dr Aimee Piller on implementing sensory strategies within an MTSS framework. I want to extend my sincere thanks to Aimee for sharing her expertise, of course and practical insights on how we can support more students through a tiered approach to sensory processing. I think it's also super important that we are helping the teachers, because those teachers will go on to support many students that we will never even come across. Now, if you found this episode valuable and you want to dive deeper into implementing these strategies that Aimee shared in your practice, I encourage you to check out her book implementing school based occupational therapy services a multi tiered approach to sensory processing needs, which is available through Rutledge press as well as on Amazon. We will be sure to add a link to to the book in the show notes, and for those of you looking to connect with other school based ot practitioners and access additional resources, not just related to sensory processing, but all of school based occupational therapy. I invite you to join us at the OT schoolhouse collaborative. The OT school house collaborative is where our community comes together to share ideas, solve problems and grow professionally. You can learn more and become a. Member at ot schoolhouse.com/collab thanks again for tuning in, and I hope you have a great start to 2026 I'll see you next time. Amazing Narrator 1:05:09 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 OTs schoolhouse.com Until next time, class is dismissed you. Transcribed by https://otter.ai 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 More OTS 191: Turning Grant Funding Into Mental Health Advocacy in Schools Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 191 of the OT Schoolhouse Podcast. In this Episode of the OT Schoolhouse Podcast, Jayson Davies welcomes Dr. Jamie Hunter and Dr. Kaisa Syväoja from The College of St. Scholastica to discuss how OT practitioners can utilize grants to advocate for mental health services in schools. Learn how grants can expand your OT practice beyond traditional tier three services, whether you're looking to fund a sensory room, provide professional development, or implement a school-wide mental health initiative. This conversation demystifies the grant-writing process, offers practical tips for finding and applying for grants at the federal, state, and local levels, and highlights the power of collaboration to sustain impact beyond the grant period—making this a must-listen for OTs ready to expand their role and amplify OT’s value in schools. Listen now to learn the following objectives: Learners will identify how to apply for grants (both small and large) to expand mental health services and other OT initiatives within school settings. Learners will understand how to effectively advocate for occupational therapy's role in supporting mental health at all tiers (especially tiers 1 and 2) within school-based practice. Learners will develop strategies for creating sustainable partnerships and programs that can continue beyond initial grant funding by demonstrating OT's value to school administrators and staff. Guest(s) Bio Jamie Hunter, OTD, OTR/L, AFWC Jamie Hunter is an Assistant Professor, Academic Fieldwork Coordinator, and Co-Director of the Department of Education Mental Health Service Provider Grant at The College of St. Scholastica in Duluth, MN. She has over 27 years of professional experience in school-based practice, pediatrics, leadership, and fieldwork education. Kaisa , OTD, OTR/L Kaisa Syväoja OTD, OTR/L is the current Program Director for the Master's of Occupational Therapy program at The College of St. Scholastica and the co-project director for the Mental Health Service Provider grant funded through the U.S. Department of Education. She has a background working with a variety of practice settings including early intervention and school-based practice. Her recent work has been focused on providing mental health related occupational therapy services within school-based settings . Quotes “It’s opened my eyes to how school-based practitioners can practice. It expanded my practice and just different ways that I see school-based practice and where the future of school-based practice can be.” — Dr. Jamie Hunter “It’s a lot of collaboration and co-teaching with counselors, teachers, and really focusing on the prevention and promotion aspect of just positive mental health and well-being.” Dr. Jamie Hunter “If you are an idealist and a visionary, find someone who’s a type A analytic.” — Dr. Kaisa Syväoja ”You have to be able to sort of build your project around their timetables. So that's something also to think about, is it's nice to have like a longer range plan, where do you want to go as a district or as an OT? So then when those grants open up, you're able to apply for them.” — Dr. Kaisa Syväoja ”Those businesses in your community, if you see them out there supporting your local school district…that probably means that business is interested in supporting endeavors that might be related to occupational therapy.” — Jayson Davies, M.A.,OTR/L Resources 👉 Every Moment Counts - Susan Bazyk's program for supporting mental health in schools 👉 Autism Level Up - Program developed by Jack and Amy 👉 Energy Meter - Tool developed by Jack and Amy at Autism Level Up 👉 Grants.gov - Federal government grant resource portal 👉 Mental Health Service Provider Grant - U.S. Department of Education grant program 👉 The College of St. Scholastica OT Program Episode Transcript Expand to view episode transcript Jayson Davies Hey there, and welcome to episode 191 of the OT school house podcast. Thank you so much for being here. I am your host, Jayson Davies, and I'm excited to have you here. So I think I speak for a lot of school based ot practitioners when I say even just the idea of submitting a grant seems too daunting to even consider. Am I right? If I'm not, please reach out, because I want to know what grant you have submitted. But if you do feel that way too, the next 54 minutes or so will definitely help to calm your nerves and also help to see how maybe a small grant can help you to implement a new change in your schools, whether you want to build a sensory room or organize a library of tools that you can share with teachers throughout the year, or maybe you even want to bring on a full time or part time employee to support a program that you designed. This episode will help guide you to do just that. Today, I'm thrilled to welcome Dr Jamie Hunter and Dr Kaiser savoya from the College of St Scholastica. Dr Hunter brings over 27 years of professional experience in school based practice, pediatrics, leadership and fieldwork education, while Dr savoyes serves as the program director for the Masters of OT program and has extensive experience in both early intervention as well as school based practice. Together, the two of them are leading a groundbreaking mental health service provider grant that's transforming how ot practitioners approach mental health in the school setting. And so if you have ever wondered how maybe a grant could support you and the practices that you want to implement at your school site, you are in the right place, we'll explore how to effectively utilize these grants to support your practice, implement mental health initiatives across all of the MTSS tiers, and also create meaningful partnerships within your district. So let's go ahead and dive in. 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 Jamie Kaiser, welcome to the OT school house podcast. It is such a pleasure to have you here, and you know we're going to be talking about grant writing within school based OT or not, particularly the writing process, but the actual using of grants to help school based occupational therapy practitioners. And I'm excited to have you here to talk about that, to get started. I would love to let you both share a little bit about where you are in your ot career, kind of how you got here, and why supporting grants or helping school based ot practitioners get grants is so impactful for you, Jamie, would you like to kick us off? Jamie Hunter Sure, absolutely. Thank you, Jayson for inviting us to speak today. I am Jamie hunter. I am school based practitioner by heart. I think I practiced for 23 years in a school district in Wisconsin, prior to shifting to academia, I am now currently the academic field work coordinator for the occupational therapy program at the College of St Scholastica in Duluth, Minnesota. I work alongside kaisa as co director of our mental health service provider grant, and it has been an absolute whirlwind, you know, over the last few years for us to be able to grow and develop programming we are supporting area school districts. And so it has just been It's opened my eyes to how school based practitioners can practice it is has expanded my practice and and just different ways that I see school based practice and where the future of school based practice can be. Jayson Davies Love that I appreciate you sharing how school based OT is kind of been supported by your expansion beyond just school based OT, and you know how grant writing can really support you. So kaiza, what about you? I'd love for you to share a little bit about your background and your your passion for grants and school based occupational therapy. Kaisa Syvaoja Yeah, thank you, and thank you for having us today. This is a topic that we love to talk about. We spend a lot of time talking about it, so we're happy to be here. My name is kaisi suvoya. I am the Master's Occupational Therapy Program Director at The College of St Scholastica, and like Jamie said, I'm also the CO Project Director for a mental health service provider grant when we embarked on this journey. And Jamie puts it very eloquently, like it has been a whirlwind of a journey, but it's been really exciting. We launched this particular grant initiative being one of the first ot programs to be able to be awarded this particular grant. And that has really. Shown us what OTs can do and how we can practice at the top of our licensure in so many different ways. I too came from school based practice. I worked in rural practice settings, so I've worked in a lot of different settings. But prior to coming to academia full time, I had been in rural school districts. I had a really big caseload birth to 21 and I think that this particular grant showcases all that OTs are actually able to do within those spaces, and a lot of it is advocacy. It's advocacy that we see on the ground with these particular grants, and it's also advocacy for all OTs to say, like, yes, you you have the capacity to be able to do this. And I think that's been the beauty of this particular grant, perfect. Jayson Davies You know, why don't we just actually go right into the grant that you both have? Kind of are working with that mental health service provider grant and share a little bit about what it entails. I know nothing about grant writing or about grants or very little, and I'm sure most of the people listening similar. So just share with us, kind of what the goal and what it looked like to potentially even get it, and what it's allowing you to do. Yeah. Kaisa Syvaoja So this was a depart federal us, Department of Education grant. So at the federal level, which has its own nuances. So if you're looking at for somebody, that's brand new, if you're looking at grants, there's federal grants, state grants, and then grants that are from outside of governmental organizations. So when you're dealing with a federal grant, there's a level of structure that goes into both the application and applying for it, as well as the day to day operations and the management of grants. So this particular grant was a mental health service provider grant that was really focused on training, so working with professions that are considered mental health within scope, which occupational therapists are within mental health. We know this as OTs. We've done a lot of advocacy in those areas, and so this particular grant was really intended to train individuals to be able to go into school settings and be able to provide some of those supports, to kid OTs, to school personnel to really address some of the mental health needs that our young people are experiencing today. This particular grant came from the bipartisan safer homes act. So it was something that came through Congress as a grant for expense. So that was sort of a little bit of the general context to that particular grant. Jayson Davies Gotcha, and you mentioned that it allows for training. Is this training occupational therapy students? Is it training ot practitioners that are already practicing, what does that what does that Kaisa Syvaoja look like? So our particular grant right now has been working with Level Two fieldwork students. So ot students obviously pre licensure and going out into area schools and completing one of their level two rotations through the school districts, with the primary emphasis on mental health and how ot can work within those school settings to support the mental health of kid OTs from an occupational therapy lens, wow. Jamie Hunter And I think if I can jump in and just add a few additional details when I think about the vision of what it was expanding and helping to fill the gap of mental health services. We're partnering with four area school districts to be able to provide additional supports. Many of them were in rural areas or areas where they just didn't have the services to be able to support needs of students. We're not only doing the training with this next generation of OT practitioners that could potentially be school based practitioners in the future or pediatric mental health practitioners in the future, but also being able to provide training to the staff, the teachers, the administrators, paraprofessionals, anyone that is working alongside our students. It's a lot of collaboration and co teaching with counselors teachers, and really focusing on the prevention and promotion aspect of just positive mental health and well being so that's kind of a nutshell of the beginning of our project. Jayson Davies Yeah, I love it. And, you know, we as as ot practitioners, we often reference like the 17 year research gap, how it takes 17 years from research to get into practice. And, and, yeah, you're potentially working primarily with the level two students. But how? Much of that knowledge is then going back to like what you mentioned, Jamie, the rest of the staff there, and it sounds like you might even be working directly with the staff a little bit education. But even more importantly, the OT practitioners that are supervising those fieldwork students. I'm sure they're learning a lot more because, I mean, I speak with ot practitioners, you know, every week, if not every day, and I often get I don't know how to support mental health on campus. I don't understand what that actually means. I don't understand what it looks like. You know, is that SEL or what is it? And so it's great that we are now supporting those students, and this grant is allowing you to do this, but in turn, those students are going to kind of spread the word and support others, which is fantastic, congratulations. Jamie Hunter Yeah, and our students enter additional training before they start their rotation, we built out training modules that really focus on understanding school based practice. What is multi tiered system of support. What is individual education plans? What is special education? What is all of those components? How do we begin teaching them additional avenues to explore pediatric mental health? What are the supports that they need to be able to be functional in those settings? And we relied on every moments counts. Susan basics, her, her work, that, that she has done, to develop that every moments count, programming autism level up. We referenced that and gave additional training for our students to be able to use the edge the energy meter that Jack and Amy, Amy, Amy, yes, that Jack and Amy have developed so definitely giving the students a forefront of learning before they even hit the ground, running at at the sites that they're Going to and the school districts that they're helping. Jayson Davies I love that, because those are not cheap programs for new practitioners to get access to, to learn from Amy and Jack and Sue basic and the entire team over at every moment counts. So that's awesome. Kaiser, did you want to add? Kaisa Syvaoja Yeah, I was going to say that that's a really critical element to what we've been doing is because what, what our students are doing, is a little bit unique in the sense that we don't have a lot of OT practitioners in the school settings that are doing this, in practice, in in a large scale. I think all of us as OTs do this, right? It's, it's foundational to who we are as providers, but we don't necessarily have that Avenue at the district level to be able to do this in a larger scale. And so a lot of the practitioners and providers right now are looking at it from approaching it from that tier three aspect, which I think is really important, right? We have a lot of kiddos at that tier three level that need additional mental health supports. What we are doing is focusing a lot more on that tier one and tier two, so preventative, and also those students that are more at risk. And I think that that's been really, a really great thing from a ot advocacy lens, because we are able to showcase at the district level. This is what you can use your OTs, and this is sort of your your return on that investment. But also that's been something that we've had to be really mindful of when we work with our level two students to say, you know, you're going to be walking into spaces that are going to look different. You're going to have to apply your ot critical thinking skills in a little bit different way, and so we've had to do a lot of that early training for them in order to be successful. And I think our students have really walked away with a lot of benefit from that. Jayson Davies Yeah, you know, I have so many follow up questions I just want to and we can touch on this maybe in a moment, but both of you have really mentioned that rural component, and how there aren't a lot of practitioners in the area using mental health, and this is just going to overflow. But before I do that, I want to kind of direct follow to that question, because I know with if you get a grant, you've got to kind of measure this, just like an IEP goal, you've got to measure in order to get potential future funding and whatnot. And so are you? I'm sure there's multiple ways you're taking data, but are the field work level two students then in some way implementing our project in their level two that kind of corresponds with this program? Kaisa Syvaoja Yes. Jamie, do you want to take that one? Jamie Hunter Yes. So our students absolutely are, they're doing projects. They're, you know, I think this last cohort of students that that we have out currently started doing some research. You know, even in their their coursework before, like, two semesters. Before they actually went out to rotations. And you know, they've done research to be able to develop programming and planning. Some of them were focused around teacher burnout and well being. How do we use cognitive behavioral therapy supports to be able to support the teachers we can't support our kids without identifying that we need to address teachers well being as well. You know our students when we think about application of tier two interventions, being able to develop some cafeteria interventions, some things that are happening at the resource recess level, all of our students, depending on the district needs, are meeting the needs of our clients, which are our districts in a variety of different ways. Some wanted those embedded strategies right in the tier one classrooms and our students have created an intervention menu to be able to push to teachers and say, What things are you needing in your classrooms? Is it movement and mindfulness? Lessons, is it growth mindset? Lessons? Are there ways that we can look at just regulation and CO regulation needs within your classroom? Our students are doing assessment to be able to determine what might be needed in a classroom. When we look at the population level of a classroom, or a whole cohort of sixth grade students, or do they look at more tier two, where it maybe is some smaller groups of students who might be at risk, and the teachers are bringing forward, hey, could we do an anxiety group? Or maybe we've got a tech dependency theme that's happening, and we can help address and provide some lessons. So those are just snippets of some of the projects our students have been working with, and it just depends each district has come forward with different areas of need to be able to support the students they have. Jayson Davies Yeah, I am totally resisting the urge to go on a deep dive with you all into MTSS, because I know that's not the topic of this podcast. We have other podcasts that we can save that for. But you mentioned all these wonderful things that are happening. Remind me again, how long have you all been working kind of under this grant? Kaisa Syvaoja So we are in our third year, okay? So we've been working with our districts, really, for about two, two and a half years, okay? And we've done a lot of build with that space. This particular grant was a non continued grant, so we'll be ending in December, so we'll we're sort of wrapping up our project as we have initially envisioned it. We've got a lot of things that we've got in the works, as far as how we're continuing this in other capacities, and those partnerships with our districts, because we've done a lot of really good work. The other piece with this too, is with a federal grant, there are specific things that we have to measure. This was a mental health service provider training grant, so we were really looking at like number of students that were trained and practitioners, number of placements, number of like recent hires, those types of things. So they're looking much more at that higher level space, which gave us a lot of opportunity to be able to really directly interact and meet those district needs. And then what we have done from an OT advocacy piece is we have really encouraged and focused on being able to disseminate this information to other ot practitioners, to other people that are going to interface with our districts in various ways, whether that's at the local level or nationally. So we've been a lot of different places, and that's that's been a really, I think a big benefit of this particular grant is we've been able to do that, and obviously having conversations with you that type of thing. Jayson Davies Yes, yes. We love conversations about it. Jamie Hunter Yeah. Even though it's been a non continuation, it definitely has planted seeds of how, how could this look? How can we continue this with sustainability? Specifically within our four area school districts, there are things that are going to continue that we've been creative to identify. How can we continue this, this work, but then also, at, you know, there is going to be that continued advocacy to to examine, how does this impact where school based practice is going in the future, you know, whether it's impacted individual OTs. And just saying, Hey, I never even thought I would be able to work in this area. Oh, I didn't know that the ESSA laws allowed for ot to work in this space. Yes, there is idea you could allocate funding to be able to support those preventative and promotion levels. So it definitely for me. I came from school based practice where I was mainly tier three. I. With IEPs, and I thought I was siloed in only being able to work with those on my caseload. And it really has opened up the opportunities to to see the possibilities of where I knew that we could work, even though I felt like I had the restrictions of where I could work, if that makes sense, yeah. Jayson Davies Oh yeah, absolutely. And, and I the reason I asked how long is because I actually want to look a little retrospective these four districts. Were you working with them actually, before? Did you have students going to those four districts? Kaisa Syvaoja No, we weren't currently working with students in this capacity, like we might have had field work placement students, in a general sense, going in, yeah, and doing what we consider that typical OT, but no, we were not doing this particular program or partnership with any of these districts prior. Jamie Hunter Yeah, they had gone there for a traditional school based practice, and it opened the door because we had the existing partnerships with these districts, but it allowed for expansion of, how can we really enhance this partnership to be able to support the district beyond just the student learning aspect of a level two student being taken by a ot at the district, perfect. Jayson Davies And that's exactly what I wanted to bring up. Is, what did it actually look like for our Level, Level Two students going before this program, right? These students were, you had students five years ago. They were going to school based ot placements, but they weren't going with this knowledge that they're now going in with. It sounds like they get one or two terms of education before they go into their field work on every moment counts, and autism level up and other programs that are fantastic. But have you seen, I guess, a big shift in what you know, your level two fieldwork students from five years ago compared to those that are going in today? Jamie Hunter Yeah, I would say yes, we've seen a huge growth with the students capacity for learning while they're on the site, but then also what they can bring as as resources to the districts that they're working in. And so previously, students that would go into school based practice in these four school districts, it was that traditional tier three, you know, caseload that that you see OTs typically working in, you know, and I think even from the our first year of the grant, there we were, what is our phrase, Kaiser, we were saying we were building the plane as we were flying it, right? So here we're building programming. We're building the different interventions. How do we assess at the group level? How do we assess at the population level? We're building things that our students could be using, reflecting now to the students who are out on rotations right now this group of students, we embedded them in research prior to going so here they immerse themselves in in the language of everything school based, all the language you know, it's a foreign language when you're a medical professional and you're going into the educational setting, right? And so it immerse them in that. It immerse them in the evidence based components that are going behind. What is school based practice, and what are the mental health components that are needed? And definitely in addition to those learning modules that we have the students do before they go on site, but then also the programming that our students and our field work educators have built over the last two and a half years. Now we have programming. We have things built so that we can really expand and begin to build those things at the district level. And so it definitely has made a huge difference, and students are feeling more confident in in that advocacy and being able to build programming for our districts. Jayson Davies Yeah, yeah. And on the flip side of it, because you mentioned right having that opportunity to collaborate, I'm sure you're also getting feedback from people at the district, whether it be teachers, other service providers, hopefully even administration. What has that looked like? Like? Are people like, Oh, I understand ot now? Or are they like, Oh, I'm surprised. I didn't know that ot could support mental health. Or, I guess, what are you hearing when? When other both OTs, but also non ot practitioners? Kaisa Syvaoja So all of the above you can probably imagine. You know, a lot of that goes back to the advocacy piece. So, you know, like when we first started those conversations, we got a lot of, oh, I didn't realize that ot could do that. Or some hesitancy is that, you know, is that a direction we want to go? You know, we sort of got the system and process, so there was a little bit of that as we have built the relationships. And I think as you are able to see. What your OTs in those schools are able to do to support the whole school, that conversation has really shifted to, you know, what else are you able to do? How can you expand these types of things? They start to come and see you as more of a partner in whatever those initiatives are at that district level. So I think a lot of that just comes back to continually being present and advocating for for us as as a profession, and then advocating for those kiddos too. Jayson Davies Yeah, yeah. Love it awesome. I just love how you know, it starts with just the fieldwork students, but then it expands so much beyond the fieldwork students and like, what I mean to extent you call that, like, grassroots advocacy, right? Like you just start with the smallest number of people that you can and just grow from there. And that's awesome. Kudos to y'all. All right, we have spent a lot of time really talking about the program, what it has looked for the two of you, and for the students and and for the schools that you work with, but now that we got everyone excited about what they can do if they get a grant, let's talk about grants. And first of all, is this something that is too overwhelming for a school based occupational therapy practitioner? Obviously, the grant that you got, the two of you got, is a little different, right? You were getting a grant to educate others so that they could make progress. But is getting a grant, whether it be federal or others, I don't even know what exists out there, feasible for school based ot practitioners that are, you know, working a 3540 hour week, absolutely. Kaisa Syvaoja I mean, will it be work? Yes, but I think that there's a lot of payoffs for that, you know, whether that's getting a smaller grant, and there are a lot of smaller grants out there, especially if you're looking at maybe just a school level or at the district level, and you're not trying to do, like, what we're doing, where we've got really big partnerships and placements and stipends related to placements, and, you know, that type of aspect, and you're really just looking at the implementation of an initiative like this, you can certainly find smaller grants that are going to support that, that are going to support some of those startup development costs, getting diversifying your assessments, and, you know, resources that You have at at the school level, and then also being able to provide some potential offset to your increased workload, or shift in that workload. I think that that's a big area that people need to be thinking about, if you're looking at it more from that practitioner level, is the school districts, especially if you're coming from a district that is short OTs, they're not going to want to pull you, even if you are really skilled and wonderful and can do all these wonderful things. And so being able to have some dollar amount, to be able to offset that, is going to be incentive to your districts, and it's going to help you get your program launched. There's a number of non government grants, but then at state levels, there's a number of states we're in Minnesota, so I pay attention to Minnesota, Wisconsin pretty frequently. But you know, there are state level grants that do come through. The big thing with applying for a grant, whether this is at the small level or the larger level, is really think what your project. Think through what your project is. Think through what are all the different elements of it. Have a really clear vision of what that is. And for OTs, that can be really hard, because we're good at everything. We can do lots of things. So narrowing that down being really concrete with what it is that you are able to offer how many people or kid OTs, or what's that impact look like? You know, how are you serving them? And what are your specific project areas are going to be helpful to somebody that is going to be reviewing that grant that is 99.9% of the time not going to be an OT. So you have to explain what OT is in a way that's tangible, and also not get tangentile in that explanation with really clear. This is my like to say, like the artifact. These are the things in the point that you can that you can see and walk away with, Jayson Davies yeah, yeah, absolutely. I want to touch on something you just said. But before I do, we're going to take a quick break and we'll be right back. We'll be right back. All right, we're back. And you mentioned this thing that, how do I phrase this? I thought about grant writing. I've thought about trying to figure out something, maybe even Donors Choose, or whatever that website is called, where other people finance things. But I always, to a degree, almost felt a a little bit selfish or b I didn't know what to actually ask for. And so I love that you brought up some assessments. I also really love that you brought up the idea of potentially compensation to bring on, like another ot practitioner to help out, even if it's a few hours a week. Yeah. Is that something you've seen practitioners do? Like, in I guess do you have to kind of, like, lay it all out on a spreadsheet? Like, I need these assessments. Is going to cost this much. I need a part time. OT, we have a contract company that we work with. It's going to be this much. And is that kind of what it looks like? Kaisa Syvaoja Yeah. So you would essentially be creating a budget spreadsheet. And within that budget spreadsheet you're going to have those operational things that you know are tangible things, you know, the assessments, the equipment that you need, the potential, you know, if you had to do any renovations, those kinds of things, right, that have a really easy attached dollar amount. The other part to that budget is your time like you have to see yourself as an entity, or somebody else as like you need to. You need to monetize that time in some way, whether that is yourself to say, Okay, this percentage of my workload is going to be covered through this and put $1 amount to that, and also then for the district, because now they're going to lose that person percentage of your workload for your traditional services that you had been providing that then you're going to need to say, okay, and I'm either going to work overtime, and this is going to be the percentage that The grant is going to pay me for overtime, so you essentially compensate that for yourself, or you're going to bring in somebody else that's going to be able to offset that cost, and you're able to pay for that through a grant source. Obviously, some grants don't allow for personnel, so that would be something you need to look at specific to your grant, but assuming that you have a grant that allows for you to build that budget, and they have, they have guidelines, and you're not just, you know, you don't guess here, um, they'll tell you, I can Jayson Davies totally see, sorry, really quickly, I could totally see, like, an OTs will therapist, like, going out, getting this awesome grant for like, $50,000 to help them, like, offset their work, and then being like, how do I give this money to the district? Like, just not understanding all that, but obviously, all the guidelines, or each grant has guidelines. Most of the times it goes through the district in some capacity, correct? Kaisa Syvaoja Yes, yeah. And this is where, like, obviously, like, you might have one person writing it, you might have one person envisioning this, but you're not going to probably go rogue and just, you know, create a grant, or apply for a grant and get a grant, and your district's not aware of it. So like, you need to have these conversations at the district level, or if you're in a cooperative, you know, with your cooperative, however you're however you're structured. So yeah, don't go rogue. But within that budget spreadsheet, like you really want to be thinking about, what are those tangible things, and also, what are those personnel aspects? Because that is what's going to make your grant successful. Because you can have all the most brilliant ideas in the world, and you might not have either time to do it, or there's nobody to be able to pay to be able to do this. And when you are looking at shortages of personnel, districts, cooperatives, whoever is paying you and building out that case so that they're going to be really protective of your time in those other spaces too, because they need you to be working with the kid OTs that they currently have. And we know that there's a lot of kiddos that need to be worked with for ot across the board. So these are really, really great opportunities to build my recommendation. If you're a practitioner looking at this, start small. You don't need to do a multi million dollar, massive project with all of these different aspects to it. Think about, what can you do if we're looking at like a tier one approach, and that's your focus. Like, what can you do in that classroom level? What can you do in those between classes times that's going to help with supporting the culture in a positive way at that particular school that you're working with, or that particular classroom that you're working with like these don't need to be huge, massive projects that are really challenging to organize. You can start small and then build that also is helpful. If you're working with a district that maybe is a little bit on the fence, or you've got teachers who don't really understand this, it's a good way for them to be able to see in small snippets what you are able to do and how you can support them, and then you can build from there, and whether that's through additional funding or they reallocate things at the district level, and you've got some release now for that, because now they're allocating dollars coming in from other sources to your salary. You know those are those are ways for them to be able to see it, but those grants are really helpful to be able to launch that, especially with a district that maybe doesn't have the means or resources to be able to do that on their own, or maybe doesn't understand what you are able to do as an OT in those spaces. Jamie Hunter And I think, yeah, I think, you know, like Kaiser said, Don't go rogue. It is you have a team. You know, many times you're working alongside counselors or teachers who have passion and have, you know, similar ideas. Start having conversations about, hey, I have this idea of how we could grow programming. I saw this grant right? How do you work collaboratively as a team? It may be something that you need to bring to administration and get that buy in too, right? And maybe, then, whether you're at a bigger district where maybe you might have some people who have been had experience writing grants, you know, that was my first taste. Is I partnered with a teacher and we wrote a grant for a sensory room, you know. So I think it's very feasible to be able to write those grants. But you know, having other eyes on it is another supportive measure. And and showing your district administration, hey, this is what ot can do. And how can we showcase this through grant writing? And here is the idea that we have to bring to the district to enhance what's already happening and and build from there. So yeah, definitely start small, but don't do it by yourself. Kaisa Syvaoja My big advice to this is, if you are an idealist and a visionary, find someone who's a type A analytic to read through and clean your proposal. Jayson Davies Yes, yes, I am the first and definitely need a lot of help with the person, people who implement so I totally understand that statement. I had a question, and you made me laugh, and I forgot about it. But no, the question is, is ot practitioners, we often go to our administrators in times of need, and the sense of I'm burnt out, I need more support to help me get through my already high case load. And we sometimes forget that when we go to our administrators, I find when we go to our administrators, we go with problems, and we don't often go with solutions. And I feel like this can kind of help us to go with a solution. Yes, it takes a little bit more work. Don't get me wrong, it does take hours beyond seeing kids, assessing kids going to IEPs, to sort this all out. But long term, it can support us. Is that kind of how the two of you see it? Kaisa Syvaoja Yeah, absolutely. You know it's, it's definitely some work on the front end and and I don't think it's a quick fix. So if you are a practitioner who is burnt out, this is not going to be just like the next day. Things are all wonderful. But the work that we have particularly been doing through the grant, and if you can get a grant to support this is sort of twofold, like you're able to do more at that tier one and tier two level, which, in theory, and we've seen, I think, good, good anecdotes to that this actually works. But you know, when you're working with tier one and tier two, you're preventing potentially more involved tier three needs, which, if you're a burnt out practitioner, can also be helpful, because maybe you're not working with them at a high intensity in a tier three IEP capacity, and you're maybe working preventatively with some of these kiddos so that you don't have as large of a tier three caseload. So that's where a benefit is. Obviously, that's not immediate. I think the other thing to just in context and have people think about is like, this will take time for you to learn and to get a system and process like we've been doing this now for a couple of years with our students. We've learned a lot along the way. Definitely, the way we're doing it now is not how we started, and if we could go back, it would probably be a lot easier. But, you know, those that first time that you're trying something new, it's going to take more cognitive load and also planning and work on your part, so you're putting more time in early, yeah, with the return hopefully later on, yeah, in different ones. Jayson Davies Yeah, absolutely. And Jamie, if I can come back to you, because you mentioned how you actually worked with the teacher to develop a sensory room on campus, I would love to just kind of get a quick overview of kind of how that got initiated and the steps that you kind of took to make that happen. Yeah. Jamie Hunter So in practice, when I was working for our school district, I was working with an autism teacher, a teacher that's specialized in in that area. At the high school, we did not have a resource room. We did not have a place that that students could go to decompress, to take a break, to get some of those sensory needs met. And so we had a local grant that the teacher was like, Hey, do you want to see if we can apply for this grant together and see if we can get funding to be able. To get the equipment that we need. The district was on board to say, hey, we'd provide a classroom space for you. We'd allocate that, but we just don't have the money to be able to buy the equipment that we would need to be able to support that. And so the grant was written to be able to get equipment. So we were able to get swings, we were able to get scooters. We were able to put mats in the room. We had lower lights, you know, all of those sensory based tools that that students may need, depending on on what where they were at with their regulation for that moment of time. And so it definitely was a great opportunity for us to apply for the grant. We received it again, those same factors that Kaiser shared before, we had to itemize everything that we wanted on our wish list. What would this money go towards? How would we spend it? We had to give like we were going through catalogs and absolutely writing down every single thing that we could potentially put in for the funding, and then we had to document that on the tail end side when we did receive the grant, to be able to spend the funding down. Jayson Davies So so just to demystify a little bit more, here you thank you for kind of sharing that last step that you really had to do, or several the steps that you had to do at the end of your answer. If, how long did it take from the moment that you guys, like, had this idea to actually being done with the process? Not like, how many hours it took you? But was this a week long project? Was it a years long project, months? Jamie Hunter So kaisa asked, Hey, do you want to do this grant? Jayson Davies I'm just talking about the small one. Not the not the big one, but like the small one, the small one that we're talking about right here, the sensory room, right? Jamie Hunter So the small grant that we did, gosh, you know, I think it was a meeting. We we met. We talked about, what does this look like? You know, I think we met a couple times. We had a shared document that we were growing and developing. The application process, I took over kind of looking, because OTs, we look at those sensory catalogs and equipment and things like that. A lot I took on that aspect of diving into what things would we want to go in there, how much money would each of those things cost? The teacher kind of took on more of the responses to, what are the questions? Why do we need this? What is the need? So we kind of tasked it out that way when we were applying for for the grant, you know. So, I mean, definitely it took some time and investment, you know, definitely a few meetings looking at that deadline, you know, are we meeting that deadline of when it needs to be applied and submitted? You know? So, and then on the tail end, once we did receive the grant, then it took a little bit more time again, going through the orders working with the district, because it had to come through the district where all the funding went, and, you know, the processes to get it all ordered and set up, and then the training, yeah. So then, after that fact, we had to do training to whoever was using that room so that we knew that the equipment and everything was going to be used appropriately. So definitely, when you're thinking about, what is your product, what are those outcomes? What are the components that you might need to invest in to make sure it's a successful run? Kaisa Syvaoja Can I jump in real quick just on some logistics for grants? Having some ideas in your head is a really great thing. You can write them down on paper. Obviously you're going to tailor your project specific to the funding requirements in the source. So you might have a big project that you have to make a little bit more tangible to that particular grant. So, you know, have that in the back of your mind. The other thing with grants, typically, they operate on cycles. So usually, you know, there might be a heads up for a grant, like, Hey, this is going to post, or we anticipate it's going to post at a certain time. But grants typically aren't just continually available. I mean, smaller maybe non governmental grants, you might have just a pool of money that's available and they do it on a rolling basis, but usually you're going to get a grant window time. So between, you know this date and this date, you can put in an application. And so you have to be able to sort of build your project around their timetables. So that's something also to think about, is it's nice to have, like, a longer range plan. Where do you want to go as a district or as an OT? So then when those grants open up, you're able to apply for them. Yeah? Jayson Davies Is the easiest way to find grants. Just kind of go on google search California education grants and kind of obviously type a little bit more details than that. I'm assuming every state's different and all that. But is that kind of the starting point? Kaisa Syvaoja Um, yeah. So. There's a couple of good places at the state level, like looking at your state websites are going to be probably your best options. And there's there's grants specific to individual elements or aspects of that state government structure. So you can apply to be on listserv and get email notifications when grants get posted at the state level. I do that for Minnesota, and that's across, I Jayson Davies think, like the Department of Education, Kaisa Syvaoja Department of Education, but it's really through, like, there's your state government, and it posed pretty much all grants, at least ours does within that that spectrum, as far as what you're wanting to sign up for. So that's one grants.gov is going to be your go to for federal grants. And that system, you know, once you're in it, it's a little bit clunky. You can sift and filter through and just look at forecasted ones or ones that are open. You can look at certain funding sources, so if it's us, you know, Department of Education, or an NIH grant, or something along those lines. It lets you sift through that way that's going to cover your governmental grants, non governmental your we have foundation level for, like, local areas, whether that's a city level or, like a couple of counties, that's usually a good place to start, because they might be pooling a number of people, or just reaching out to those foundations and organizations is also helpful to just say, Hey, we've got this project. We're looking at some funding sources, you know, what might be some local, you know, area dollars that might might be interesting to look at, and they're usually pretty useful. Jamie Hunter I think the local one, like, like I spoke to about funding equipment for the sensory room at the high school, right? That was a foundation locally. It was through a hospital, you know. So looking at your local organizations, sometimes those retail organizations that are local to you might put out small grant funds that that you can apply for funding. We've had some of our students apply for those at a retailer, and they've gotten $500 for equipment to help at middle school recess. Kind of you know, where they have some more equipment available for for students. So definitely different ways that you can look at exploring those funding options. Jayson Davies Yeah, that's a that's a good idea, like, because I know recently in our community, I think it's smart, and final, has been just kind of out there in the community. Really like doing things for our schools, and I almost see that as like a way to also potentially find they might not have a specific, quote, unquote grant writing or grant a program. But those businesses in your community, if you see them out there, supporting your local school district, if you see them out there, you know, maybe your city just opened up a new playground and it was provided by or sponsored by this business. Well, that probably means that business is interested in supporting, you know, endeavors that might be related to occupational therapy, and so reach out to that company, and maybe it's not a formalized grant or something, but they might be able to support you in some way. So great idea. Kaisa Syvaoja One of my best advices is go with a project. Don't necessarily go and ask for the money. Just go and say, Hey, I've got this idea. I'd love to be able to talk to you about it. You're not asking for anything. You're just having a conversation. So you know, starting there for those smaller partnerships and conversations, that works really well, then you can go back and ask later, or they might offer something. Jayson Davies Yeah, yeah. You never know. You never know. I would be remiss if I didn't ask this question, is chat GPT helpful in any of this? Kaisa Syvaoja Well, we didn't use chat GPT when we developed our grant. That was still a little bit before chat GPT was very well versed. Yeah, I think that there are some benefits, you know, being able to put in, like, if you're brand new to building spreadsheet related stuff, don't really know what you should be including help with definition of terms, that type of thing. I think AI can be a really useful tool to sort of help structure that narrative or pull out aspects of that document. Maybe as far as developing and building I don't think that any of our AI sources are that adept at the nuance of OT especially if you're wanting to build a innovative and new project. I think that AI generative AI is really good with things that it already knows a lot of what you are wanting to do, hopefully and be innovative and creative. Hopefully, AI doesn't have a really great idea looks like. So you're going to have to build that aspect of the narrative for sure. But I think it can help with some of the nuts and bolts, maybe of some of those grant writing resources. Jamie Hunter And I think if you. Have that idea and you're like, okay, am I addressing this question to the detail that they're wanting? You could run it through an AR generator, you know, is it more clear? Is this? Can this be more clear and concise? Is this, you know, am I addressing all the components that is in this application and have it be like a second set of eyes to just say, is there anything else that I could expand on? Is that a way that you could use that tool? But again, I think you still need to have those ideas. You have to have the build of it and use it as a supplementary support. It's not going to generate everything that you're going to need? Kaisa Syvaoja Yeah, and I review grants. We still have humans reviewing grants, at least at this point. I think it'll be interesting. The next couple of years, are we going to see generative AI doing screenings for those initial grants? So that might be something interesting to pay attention to. Like, are they screening out certain things. If you don't have certain words in that initial application, to my knowledge, that's not something that's happening at this point, but that might be a way of also pulling in generative AI for the future to say, Hey, do I have all the key words and target things that this particular grant might be looking at, so that you are at the top? But when somebody is reviewing a grant, they want to hear your story. They want to hear what's what's really exciting about what you're doing, how it's going to impact your local community, or whoever it is that you're working with, like that's what they want to see. So you have to be able to showcase that. Jayson Davies I love that. That's a great I think that's kind of a great wrap up here. I was going to ask you both for one more tip, but I feel like you all have given so many great tips throughout this entire episode. So unless there is one more thing that you kind of have on the tip of your tongue and you really want to share, I wanted to ask if is LinkedIn the best place for someone to find you, potentially, if they have a question, either specifically about the program you're working on, maybe a quick grant question, or maybe they're local to you, just want to you. Just want to support you. Is that the best place for people to find you? Kaisa Syvaoja Yeah, this is crazy. You can certainly reach out to me on LinkedIn. I'm pretty active there. Love to connect with anybody and everybody. Jamie Hunter Yes, I would say the same. You know, I guess the only other thing that I think about is that, can this be done without grant funding? I think another advocacy piece is thinking about your ot practice and what things you may want to expand in your practice. There is always partnerships. You have local ot programs in your state. Are there ways that you can collaborate to help build some ideas and programming and just being able to expand where we are with school based practice. Jayson Davies Absolutely, that is a great wrap up. Kaiza Jamie, thank you so much for coming on this show, sharing so much about your grant that you received, and congratulations on getting this all like you're at the finish line now. Congratulations on that. That is amazing, but also here to support others who might want to do something similar with grant. We really appreciate your time, your energy and, of course, your knowledge. Kaisa Syvaoja Thanks for having us. Jamie Hunter Thank you, Jayson. Jayson Davies Thank you. All right, and that wraps up episode 191 of the OT school house podcast. Thank you so much for tuning in all the way to the end. I want to, of course, extend a heartfelt thank you to Dr Jamie Hunter and Dr Kaiser Savoia for sharing their incredible insights on how ot practitioners like us can use these grants to advocate for mental health within our school sites, as we've learned today, grant writing doesn't have to be super intimidating, and whether you're looking to fund a sensory room or provide professional development or implement A school wide Mental Health Initiative, there are resources available to you to help expand your practice and better serve your students. If today's conversation inspired you to think differently about your ot practice, or want to do more within your ot practice, I encourage you to join us over inside the OT school house collaborative. This is where you'll find additional resources, professional development opportunities and direct mentorship from myself and other school based ot practitioners to implement what you've learned today. Together, we can elevate school based ot practice and make a lasting impact on our students and, of course, our school communities to learn more about that head on over to OTSchoolHouse.com , slash collab and join our growing community of innovative school based ot practitioners, until next time. This is Jayson. Thanks so much for joining us, and remember the small steps that you take today will lead to big changes in your practice tomorrow. I'll see 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. Click here to view more episodes of the OT Schoolhouse Podcast More OTS 190: From Behavior to Regulation: How the Good Sense Rocketship Framework Transforms OT Practice Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 190 of the OT Schoolhouse Podcast. Get ready to blast off into a powerful new way of understanding sensory processing in schools. In this episode, Danielle Pluth and Ruth Isaac—Canadian occupational therapists and creators of the Good Sense OT Rocket Ship —share the innovative visual framework that’s transforming how OTs assess, communicate, and support student participation. The Rocket Ship helps therapists differentiate sensory-based behaviors from other performance factors , guiding you from foundational sensory regulation all the way up through sensory-motor, reflexes, perceptual motor skills, interoception, and cognitive functions at the top of the “rocket.” This structure gives OTPs a clear map for identifying root causes of behavior and choosing targeted, meaningful school-based strategies that go far beyond “wiggle cushions and chewelry.” Whether you’re brand-new to sensory integration or have years of experience, this conversation will deepen your clinical reasoning, strengthen your confidence, and help you clearly communicate sensory needs to teachers, parents, and IEP teams. If you’ve been searching for a practical, visually powerful way to explain sensory processing to your teams and build stronger intervention plans, the Good Sense Rocket Ship may be exactly what you’ve been missing. Listen now to learn the following objectives: Understand the Good Sense Rocketship Framework and its application in addressing sensory-related behaviors in school-based OT practice. Learn strategies to identify and assess sensory processing challenges and their impact on students' functional performance. Explore effective interventions to support regulation, sensory-motor development, and collaboration with educators and parents. Guest(s) Bio Danielle Pluth is an OT in Medicine Hat, Alberta Canada. She graduated from the University of Alberta in 2002. She worked in various areas before starting her business Advance OT where her team provides OT services in local schools, community and their sensory clinic. Danielle has done extensive post graduate education in the area of sensory and OT. In addition, she completed her SIPT certification in 2016. Danielle has created a universal sensory program for teachers and parents that has been used throughout schools in her division since 2008 called Good Sense for Teachers and Parents. Ruth Isaac is an OT who has worked in pediatrics for 20 years. She studied at the University of Manitoba and has been working exclusively in pediatrics since 2005. She has worked with Danielle at Advance OT since 2008. Ruth has also done extensive post graduate education in the area of sensory and OT. In addition she complete her SIPT training in 2012 and completed the University of Southern California's Sensory Integration Certification program (OT610)in 2017. Ruth has created a universal fine motor program for teachers and parents that has also been used throughout schools in her division since 2007 called Fine Fun for Teachers and Parents. In 2021, Danielle and Ruth created Good Sense for OTs to fill the gap to help all OTs feel confident in using a sensory processing lens for OT services in the school and clinic setting. She is passionate about educating as many OTs as possible in this area to help change kid's lives. Quotes ”The first layer was looking at regulation, being out of that just right state. Thinking about how sensory is coming out as an output in motor sort of a way. And it's a foundation as well. And it can also impact regulation. -Ruth Isaac “Often we see behavior being that tip of the iceberg. And we want to have a lens or a way to look at what's going on below the surface.” -Ruth Isaac "The semicircular canals are going to tell me is my head up, is it down, is it spinning around, and that information is going to feed the muscles around my eyes for eye coordination." -Danielle Pluth “Connect the dots and make it super easy for someone to understand, why I'm working on sensory regulation and how that is impacting daily living activities or academic learning and hitting all the other sections in between.” -Jayson Davies Resources 👉 Good Sense Rocketship Framework 👉 Instagram Episode Transcript Expand to view episode transcript Jayson Davies Hey there school based ot practitioners. This is Jayson, and you're listening to Episode 190 of the OT school house podcast. Thanks so much for clicking play on this episode, and I hope it provides you with precisely the sensory information that you need in this moment today, I'm thrilled to welcome Danielle pluth And Ruth Isaac, the creators of the good sense ot framework, this pair of OT practitioners based in Canada have developed an incredible visual tool called the good sense rocket ship that will make it super easy for you to understand and address all the sensory processing concerns that you may see in your school practice. If you've ever struggled to explain the connection between sensory challenges and classroom behaviors, or if you found yourself handing out fidgets without a clear framework for why you're doing that, this is the episode for you. Danielle and Ruth will break down their comprehensive approach that goes far beyond wiggle cushions and jewelry without explanation to help you confidently assess and address your students sensory needs, you'll learn how to trace behaviors back to their sensory foundations and communicate effectively with teachers and parents using this powerful visual model. Whether you're new to sensory integration or an experienced practitioner, you'll gain practical strategies to elevate your practice immediately. Stay tuned as we blast off with the good sense rocket ship framework. 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 Danielle and Ruth, welcome to the OT school house podcast. There's two of you here today, so I'm going to do my best to prompt you. So Danielle, how are you doing this afternoon? Danielle Pluth Oh, I'm doing well. Thank you. Yeah, it's beautiful here. Jayson Davies So yeah. And Ruth, how about you? How are you doing? Ruth Isaac Doing good. I'm excited to be here and chat with you. Jayson Davies Yes, and this is a special occasion, because it's happened a few times, but this is one of the times that we are speaking to an occupational therapist combo here that are not in the United States. So why don't you go ahead one of you share a little bit about where you are and kind of the setting that you're in. Danielle Pluth Sure, we are in medicine, Hat, Alberta, Canada. We work within we have contracts with the school divisions here, and we also have a clinic, so we see children privately within the clinic and also in the community and in their homes. So our city is about 60,000 people or so, and we're in all the school divisions here. Ruth Isaac One of one of our school districts is a lot of driving. I drive two hours to get to one of my schools and two hours to get back. That's the farthest one. Danielle Pluth Yeah. So it's fairly large region of southeastern Alberta, wow. Jayson Davies So that is a very large area to have to cover really quickly, because I think you are a little familiar with school based ot in the States, at least from you know, just, I know you haven't practiced here, but you've heard about it. If you kind of had to quickly explain to someone just the differences, like, how do you describe it as being similar or different to school based ot where we follow, or in the states where we follow, idea, we have a lot like, we have our own caseload and whatnot. Is it similar to that in Alberta, or is it a little different? Danielle Pluth I think so. I mean, we have, they're called ISPs, that we follow like so documents that the teachers will write that have the functional goals and whatnot in there. A lot of our recommendations are in there, along with speech and physio. We have kind of a set amount of time per school division, and then we have a lot of freedom to determine how we do our service delivery with regards to OT and OT assistant. What I've heard from the States, it sounds like you guys are a bit, maybe a bit more restricted with you have to really say how much time you're spending per child per week. Those kinds of things. We don't have those kinds of restrictions, so we can kind of flow a bit more within our service delivery, from Universal to groups to direct one to one. We probably can't do as much direct one to one as we sometimes hear that you can do down in the States. But even that, I don't know for sure, we tend to be more of a consultative model. Our ot assistance would do more of maybe, like direct like treatment groups and stuff like that that we've oversee. I think. Jayson Davies Yeah, yeah. I think that kind of is a good, good idea. It gives people a good sense of what's going on. So today we're here to talk about the good sense program that you two have developed and put together and are now even providing training for and I had the pleasure of sitting in on one of your webinars a few months ago, and just so excited to have you all here, because I was like, Oh, this is awesome. I want to bring it to everyone here on the OT school house podcast. Yeah. But before we dive into kind of the the nitty gritty of it and talk about. This really cool, good sense rocket ship you have here, I want to ask you, like, what inspired you to develop this program? What was the problem that you saw, and what was the problem that you aim to solve? Ruth Isaac Well, we've been working for a little while. It's probably over 20 years ago, and we never really okay, it's hard to admit, but we never really knew exactly like, the theory that we were using. We were just, like, eclectic. We're just doing a little bit of everything. And I think we've all been at that place at 1.0 yeah, where you're trying a little of this, and you're trying a little of that, and you're trying a little of this. And we just realized that we needed more of some structure to help guide and support us as we were doing our treatment and as we worked at mentoring more people in our community here, or our group of therapists. Danielle Pluth Yeah, I think we've come a long ways. Like in the early 2000s sensory theory was pretty new in Canada, and it was pretty kind of ooga booga To be honest, like people didn't really so, yeah, it was kind of new, and initially, like, a lot of our referrals were for like, wiggle cushions and fidgets and like things that eventually you're like, wait a minute, I think I can do more as an OT and we really didn't get much training on sensory theory in school. So both Ruth and I went down to the states, and we did all of our SIP training, and Ruth did the OT 610 so all that extra stuff that we brought back here, we started developing universal programming for the schools, because we're like, you know what? You guys can trial legal cushions and fidgets. So we developed a good sense, actually, for teachers, program that is a step by step program to help them implement strategies in the classroom. And then what was happening is our education kind of just really took off, and as we would get new therapists in, they just wouldn't be at the same level that we needed them to be. And what the schools were now expecting us to know, because we are supposed to be the sensory experts, right? So I kind of progressed where, you know, we needed, like, an in between. We can't send everybody away all the time. Ruth Isaac To all the different therapy, like, yeah, like, trainings, right? Not everybody Danielle Pluth can do all, yeah, we've done so many. I mean, when, when you have like, 15 years, we're worth a post grad education, right? So just needing to pull that together, and we decided to come up with our own sort of training model. And then it just kind of grew and grew where we ended up developing a framework, and that framework now, you know, it's what we use every day when we're working, and it's what we train our staff in. And then we decided, you know, let's try to make an online course, because it looked like it'd be so easy, but, and we just, we're very passionate about sensory, so we wanted to bring that to everyone out there who's interested, right? To have a way to use leaders really feel sensory is really occupational, like, based in an occupational therapist invented it. So we want, we want to own sensory and we want to make sure OTs are trained to be able to run with it right out of university. Because a lot of schools don't teach, even teach the theory, let alone how to then functionally use it out when you're working. Ruth Isaac So yeah, and I think that our different areas where we work are looking to us to be the experts, and so we want to be at the table. We want to be having these conversations, and we want to be showing what we can do as occupational therapists. And we don't want to be this, that the other thing and just trying different things. We want to have a structure and a way of approaching how we're providing service. Jayson Davies Awesome and that kind of I have two follow ups here, but I'll start with this one. As you mentioned, you in the system that you're in, you work both in a clinic and also from a school perspective, as you were developing good sense, did you find that it catered more to one versus the other? Does it fit for both? Kind of how did that develop? Danielle Pluth It fits for both? Yeah, yeah. It's the foundation of how we do OT services here. So we developed the good sense rocket ship framework, and that's specifically looking at the child from a sensory theory, sensory lens. But we are also using it within like a PEO model, where we're still looking at the environment around the child and the tasks themselves. So we can use it in the school, and we can use it in the clinic, in the schools. The other thing about it is, as you use it for your clinical reasoning, for how you're assessing and then coming up with your intervention strategies, you can decide where on the rocket you kind of want to start, and are you going to take more of a bottom up approach or a top down depending on. Environment around the child. So if you're in a more consultative model, you might do more of a top down approach to help children in those areas to optimally function within their let's say, their classroom, whereas if I'm seeing them in the clinic, I might be able to do more of a bottom up approach, because I can go a bit more with actual treatment and intervention to make you know, impact some of their functioning within that that theory as well, if that makes sense. And we also look, even within the school, how much can we do some bottom up as well? I think what it helps the most is to help you to know where are my biggest priorities, and how am I going to intervene? So I know for sure. Am I doing a top down? Am I doing a bottom up? And who around the child is going to do what? So we might have an OT assistant or an educational assistant doing some of the bottom up stuff, and we might be doing more of the top down or vice versa, just depending on who's available. So it helps that whole thought process, no matter where you are, even if you're in the clinic, it might be, what can parents be doing to help support the child as well? Jayson Davies Awesome, perfect. And then the other follow up that I had here was because it's really hard these days to talk about sensory without talking behavior, and so I wanted to get kind of your take on as you were developing this, like, how was that conversation in your own mind? Because I'm sure you anticipated people asking you about sensory and behavior. I'm sure you've been asked about sensory behavior and behavior plenty of times. So how did that kind of work its way into the good sense program? And how do you share that with people? Ruth Isaac I think that often we see behavior being that tip of the iceberg, right? And we want to have a lens or a way to look at what's going on below the surface. Sometimes, maybe we've seen where people will say, OTs behavior, and then we don't get involved. And when we're like, oh, somebody else has to deal with that. That's not something that we can deal with. And we feel pretty strongly that actually using a sensory frame of reference can be a great way to help navigate and support a child who's having difficulties and having different behaviors. And there might be different reasons as to why you might be seeing those behaviors. If we're thinking about the good sense rocket ship, those behaviors are things that are at the very top right and and we're looking at what else could be going on there that could be impacting. Danielle Pluth Yeah, like, if they are over responsive to noise or touch or movement at the bottom of the rocket ship, that could be impacting their behavior, they're going into fight or flight, or they're going into shutdown. You can have kids who have poor postural control in the middle part of the rocket that can impact their breathing and their regulation that way they might have a startle reflex that's impacting like so they're, yeah, I think we, we really feel like it's our job as occupational therapists to own sensory and to use our lens to bring to the table what might be going on for the child as for that piece of the pie, right? There could be other reasons why they're having behaviors other pieces of the pie, but I think it's super important that we bring that full assessment piece there to show you know because, and if they are struggling with those areas, we definitely want to figure out how to help them with those areas. And maybe it's not going to solve everything, but it's going to solve or help that piece of the pie. Ruth Isaac Because there's no, there's so many, there's so many reasons that could be going on. That's why that tip of the iceberg. Danielle Pluth Yeah, we are also really lucky with the division that we're working in that, you know, like 20 years ago, them seeing, wanting to have a more proactive approach, and being really supportive with us, getting sensory strategies universally in place. And we've seen a huge shift within our division with having universal strategies in the classroom for all kids, having hallway sensory stuff in place for some kids, and then we have sensory rooms for a few kids who need that even extra input. So we've been able to see over the years how much this approach can impact those behaviors overall. So to us, it's just, it's for sure, it's so obvious you absolutely have to Yeah, yeah, awesome. Take a look at that part for every child that we work with. Jayson Davies Yeah, yeah. And I love, I mean, I remember sitting here and watching the presentation you all, you both gave. And I remember sitting here you talked about evaluation, Danielle, I believe. And I was sitting here like, just thinking about how this is so helpful. Like every ot can just print this out and kind of fill this out as part of their, you know, part of their evaluation, part of their occupational therapy profile, like this can really help you to better understand a student. We're going to dive into the rocket ship here in just a moment, but first we're going to take a quick break, and we'll be right back all right, and we are back here with Danielle and Ruth and. We're going to dive into the good sense ot rocket ship. But before we do, I want to let you all know that Danielle and Ruth have been very kind and are providing a way for you to get the good sense ot rocket ship PDF. So be sure to check out the show notes. You'll find a link there. You'll head over to their actual their website, where you'll be able to get that resource for yourself. So let's go ahead and dive in to the rocket ship here, and I'll let one of you take the lead here and share with us, kind of where we start. Ruth Isaac So if you imagine in your brain, because it's a podcast, if you imagine how a rocket ship looks, it's just a fun visual way to show how things build on top of each other, a little reminder that there are things around a rocket ship, if you imagine being in space, there's other things that could be impacting, like fuel or asteroids or things like that, and that might be like sleep or nutrition or home life and all of those pieces that, of course, are going to impact. Jayson Davies I just have to say, really quickly, I'm sorry to cut you off, Ruth, but I love that you just like, work the combo model in here, like that is awesome. I love it. Ruth Isaac There we go. But, but, like, the rocket ship itself is looking at the sensory but, of course, there's other things going on around there, right? And so when you're looking at that, Danielle kind of talked about starting at the top or starting at the bottom for the point of now we'll start at the bottom and we'll work our way up. Danielle Pluth Okay? And I think we mentioned earlier too. So the good sense rocket ship is a framework to look at the child that you're working at with within their environment, and then the tasks as well. Ruth Isaac So excellent. So at the bottom of the rocket ship, that's where we're thinking about sensory regulation. So this is where we're looking at visual, auditory, tactile, vestibular, taste and smell, proprioception, overuse, and how that might impact your ability to be in a just right state. Danielle Pluth Yeah, and when we're looking at this. We're looking at how, yeah, how does this area impact this child? And in our course, we go in a lot more detail with regards to looking at, like, what would a profile of this child be, what's the neurology, what's the assessments that you would do, and then what's the interventions and recommendations? But what we like about this is, as you're doing your assessment, you can start kind of plotting on there how this child is impacted from a sensory lens, and we have down the side of it, fight or flight, too fast, just right, calm, freeze, kind of all down there as well. Jayson Davies Yeah. Quick question on that actually, really, if I may, obviously, I have it right in front of me, and hopefully everyone's going to your website so they can get it too. You talked about how you have the visual, auditory, vestibular probe, tag, taste and smell here. Do you tend to get this data by talking to the student, talking to the parents, the teacher? Do you tend to use something like the SPM sensory profile? Obviously, you both have extensive experience, and I'm sure you can get a lot just from observation. But what are some of the different ways that you use to get this data? Danielle Pluth So yeah, we like to use the sensory processing measure. Sometimes we'll use the sensory profile, and so we'll get a background, basically sensory history from the parents and also the teacher. And what's kind of unique about our good sense rocket ship is we've put on there the areas that we feel can put you into fight or flight or so we have like, over responsive to touch. You can see on our rocket ship we have that higher up as a thing that could send a child into that fight or flight. We don't. What's different about our approach is we don't say you can be over responsive and under responsive to touch. So you're not going to see touch below the just right state on our rocket this might be confusing until people actually look at the rocket ship, but you'll see on there that we have under responsive to vestibular as something that can cause you to be under the just right state. So our approach is a little bit unique that way. And what it does is, when you're then mapping it out, it really helps clarify from a sensory lens what's actually impacting regulation. So you'll never hear us say they scored out, over and under in every single area, and it's all definite difference. We can't figure out how sensory is impacting them at all. You'll never hear us say that, because we can clearly map it out as to what's what they're actually over responsive to, versus under responsive. And we have it that if you're under responsive to touch, we have that higher up in the rocket ship into sensory motor. Ruth Isaac So we're jumping up, yeah. Danielle Pluth But I think it's a thing to really clarify, like that's something that a lot of OTs we see struggling with, and that our framework will help you to not struggle with, yeah. Jayson Davies And so as you move up into that next level, you do have sensory motor and under under sensory motor. You've got vestibular probe, tactile bilateral coordination, ocular motor and postural control listed. So I'll let you all share a little bit. Ruth Isaac So there, as you've moved up in the rocket ship that are the good sense rocket ship, excuse me, there is your sensory motor output. We're taking in that sensory information, we're processing it, and then that can impact our output. And there's a difference here, right the first layer was looking at regulation being out of that just right state. Now we're thinking about how sensory is coming out as an output in motor, sort of a way, and it's a foundation as well, and it can also impact regulation. And there's an example that we talked about earlier, is if you have poor postural control, that actually might be impacting your regulation overall. You might look super wiggly and having a hard time focusing, but it might actually be more related to the sensory motor versus the sensory regulation. Danielle Pluth Yeah. So helping you to come up with those kinds of hypothesis. And for a long time, I really, I mean, maybe it's obvious to everyone else, I really struggled with how sensory, sensory regulation, sensory motor were related. And now I feel like I've such a clear picture of how they fit. Jayson Davies Danielle, you are definitely not alone in that. Trust me, there are many OTs listening right now that totally feel what you just said right now. Like, that is hard. And then you start talking about praxis, and it's like, the same thing, right? Like, Praxis versus executive functioning and stuff like that. Like, yeah, the sensory world is confusing until you get the education. Danielle Pluth Yeah, yeah. And I think, and then having that, that framework right to see that, you know, Praxis is higher, even higher up. And you know, and you need to have your intact proprioceptive and vestibular and tactile motor systems to then have good praxis, good motor planning. And so, you know, if you're jumping, you know, if you find out that your child struggling with motor planning, you have to look lower down to see what's going on in that framework before you can address it. Yeah, so then it just becomes way less overwhelming, because you can figure out where to start and what you're looking at. Jayson Davies All right, so I just got an idea, because so many people reach out to me and they're like, the teacher thinks they know everything about sensory. The ABA therapist thinks they know everything about sensory. The admin thinks they know everything about sensory. If that's the case, send them the last two minutes of this podcast and let them see if they still know everything about sensory. I'm just gonna Danielle Pluth say that right now. Oh yeah, very complex, but yeah, sorry, keep going. Jayson Davies Yeah. No, it is complex. You're right, and we're gonna start moving into what I think makes the good sense rocket ship very unique here, because in a lot of sensory courses that I've taken, they talk about regulation, they talk about sensory motor talk about modulation a little bit, but the next four phases of the good sense rocket ship are often not really addressed in sensory courses here. So the next level up on my screen, it's yellow. So if you have the color version, it's yellow. It's sensory reflexes. And I really like that you have built this in there. So I'll let you talk about that. Ruth Isaac Yeah. So on this level, now we are looking at the sensory reflexes, and we're looking at some of the commonly seen reflexes in the classroom, right? So the moral, the tonic lab, atnr, stnr, the spinal glont. There's more, but these are the main ones that we see functionally in the classroom. And we just see how there's an impact there on the higher levels of the rocket ship, and these are impacted by the lower parts of the rocket ship. So again, I know that with reflexes, we need to be careful, right? Because we don't want to just address reflexes. We need to have a functional output for it. But if we seeing a reflex, what else is going on below it that could be causing that? Right? All of those reflexes are based on some of the way that we process the sensory motor and potentially some of the sensory regulation as well. So it's building up as we go up the rocket ship. Danielle Pluth So yeah, when you're looking at reflexes, we want to make sure our staff are also looking at that underlying sensory motor systems that play into that. And reflexes is kind of one of those controversial areas in the OT world, but we've seen differences when we address them so clinically, we see that it helps children. So that's why we've added it into our into our rocket ship. Jayson Davies And I want to go back Ruth that you were talking about, why you put the sensory reflexes there, kind of in the middle of the rocket ship, because I have very little training in reflexes, and it was kind of my perception and the limited experiences that I have that it could potentially be at the bottom of the rocket ship. And I don't know if this is you kind of alluded to, and I would just want to let you kind of reiterate that a little bit, why it's kind of at the middle as opposed to somewhere else. Danielle Pluth Yeah. Yeah, that's a good question, because I think, yeah, some people will think that's the first thing to get integrated. But as a baby, as you're developing the vestibular system and the proprioceptive and touch system that that sensory motor level, that's how you are then integrating those reflexes. So they're foundational to the integration of the reflexes, and that's why we have it higher up, because most often, if you do have a reflex that's not integrated, it's because you have a delay underneath in that sensory motor system, in the vestibular or the probe or the tactile. So we want to make sure therapists aren't just jumping right to that reflexes. We want to make sure they're digging deeper to see what's going on underlying. Ruth Isaac Exactly, digging deeper. Jayson Davies Yeah, I think that's important. Because, like, you kind of said, I think a lot of the trainings, especially if it's not from an OT perspective, a lot of the popular professional development courses out there about reflexes, often call that the base level, and they don't necessarily look deeper. Danielle Pluth No, no, and they kind of, like, sell it as like, oh, you test the reflex this way, and then this is the exact exercise you do without you really clinically reasoning through why you're doing what you're doing. So I think it's important to understand that's how we've decided that it fits best, and, and that's Yeah, and we want to make sure that we're addressing those underlying things, yeah. Ruth Isaac Yeah. And I think that's then some of those reflexes also can go all the way down and impact regulation. That's where, like, the moral, that startle reflex, right? Like, oh, what was that? And then OT, we're out of that just right state, and we're into a different dysregulated place. So as we're working up the rocket ship, you can see how, as we're going up, things higher can impact all the way down to the bottom, as well as from the bottom, impacting things moving up. Danielle Pluth That's one thing we don't have on there. Is kind of arrows coming down. But that is what happens, like when we were talking about if postural control impacts your regulation, you need a little arrow OOP down to regulation, or if that startle reflex down to regulation. So, great point. Jayson Davies Great point. Because when we often think about a lot of the theories that we learn, you know, even in elementary school, a lot of things are used in a pyramid, type of MTSS, right? Is an example, level one, level two, level three. But oftentimes it's the top of the pyramid is impacted by the bottom, not vice versa. But the rocket ship goes both ways. Danielle Pluth Exactly, even the way we have the too fast, too slow, just right, shut down, you know, down the side of the rocket ship there. We know that that can be circular. It's just, how do you make a model that you can use? That's, you know, we it's, we couldn't make it in a circle, so we didn't know how. Jayson Davies Yeah, totally get it all right. So we covered sensory regulation at the base of the rocket, sensory motor at the next level, and then sensory reflexes. What's next? Ruth Isaac Now we're up to the perceptual motor, and this is the area that, like most occupational therapists are super familiar with. This is where fine motor fits in. This is where Praxis is in there. There's other pieces in there as well, but those are the pieces that often we know that really well. Again, what could be going on at that level that could be impacting all the way down to the bottom? So if we've got a kid who's really struggling with fine motor skills, for example, that might be causing all sorts of dysregulation, or the opposite way, it could be going all the way up to the way up to the top and impacting the behaviors, right? We're looking at how it's a moving framework, right, right? Danielle Pluth And it helps you to be an advocate for your child, to be able to say, like, yes, you're seeing these behaviors up at the top, because they actually, you know, I've had kids in grade seven and eight or whatever who are scoring first percentile on the berry VMI, and nobody realized they had these extreme fine motor delays that were then actually playing into the behaviors they were seeing in the classroom. So I think that's really important when we're able to show that. Ruth Isaac As they're moving up and then higher up, that's where we've thrown in, introception, right? The like being aware of hunger and thirst and pain, temperature, your bowel, your bladder and and a lot of our kids, they don't maybe are not as aware of these, like, not like ear quiet, but like quieter sensations within your body, right? And so because everything else below can be so overwhelming, from regulation, from motor reflexes, from perceptual motor, all of those things could be impacting so they're not really as aware of that interception piece. And then, and then you're up at the top, and there we are at the beginning again, with that cognition, right, academics, behaviors, activities of daily living. This is where our referrals come from, right teachers, parents, they're they see and they know that there's issues up there, and they're saying to us, hey, help what's what's going on, and we're able to look at what more could be going on underneath there. Jayson Davies Yeah, I love how you frame that, like that's where the referrals are coming from, because that's truly as like, we get a referral for handwriting. We don't get a referral for proprioception and bilateral. Motor coordination. Like, yeah. All right. All right. So now that we have this rocket ship framework here, for the good sense rocket ship framework, I want to get a sense for how you actually use it during your evaluation, and maybe we'll go into intervention a little bit, but I'm like envisioning printing this out for every single student that I evaluate, and just marking the heck out of it. And I want to know if that's what you all do, or how do you kind of use it in the evaluation process? Danielle Pluth Yes, we have kind of an expanded we basically we have a background observation form that's color we really are into this color coding thing. Our background observation form is color coded to match the rocket, and that's where we put so when I go out to see a child, depending on how much time I have for the child, I mean, in an ideal world, I get a sensory processing measure history done on everybody. I then am going to do my clinical observations based on like earn a Blanchet kind of stuff to help look like the sensory motor pieces. I'm going to do some kind of fine motor screen or assessment. I'm going to talk to the teacher. I might do a classroom observation. And again, all of that is going to depend on the severity, the case load and whatnot, for how in depth I go at each level of the rocket. So basically we have, you know, different assessments that we would do, or different observations at each at each level, and then pulling that together, basically that is where you could mark up the rocket to start seeing, where are you seeing all of the different areas of concern that might be impacting the child's function. And then we do have a color coded initial visit summary to then relay that information to the teachers. And if I will pull out the actual rocket to explain my report to them and show them where my thinking is coming from, and my recommendations, then, as well, are also based on all the areas of the rocket. So whether I'm going to start at the top or the bottom, all of that I outline in my visit summary. So that's how I I use it every single day. So yeah, that's always in the back of the now it's pretty much in the back of my mind. I don't necessarily need the print ot right in front of me, but. Ruth Isaac The thing that I like about it as well is that you, once you've marked it up, then you can start to see like, Oh man, I'm doing a lot of circling around one specific area that is going to guide me in my report and in my interventions. And then, if you're at a meeting with a parent, you also have that visual right in front of you. You have a teacher, you have that visual right in front of you. I think we talk about having visuals for kids, but I think we as adults need visuals to help guide us as well, right? Yeah, and then that way it can help to focus you. Where am I going to start my intervention? Sometimes that rocket ship for a kid can be completely like circled every area, almost right. Some kids, you start to see a pattern where you're like, oh, okay, well, I'm just gonna really target a certain area. But yeah, I would use this, this handout a lot, obviously, a little shameless plug for our course, would be to come and learn more about all of those pieces. Danielle Pluth But yeah, it's definitely used for my assessment, my clinical reasoning, and for my intervention, the whole process, and then communicating it to everybody, yeah, and it helps us to just feel super confident in knowing why I'm recommending what I'm recommending. I can easily trace it all the way back and show you exactly why do I have that kid on a bungee? I can trace it right back to where I am on the rocket. What the neurology is, what assessments I used, and I can lay it all out for you, which is super helpful. Jayson Davies Yeah, that's perfect. I love the idea of visualization. I mean, I don't know, in our conference room at many of our schools, we always had the bell chart, like, just so we could kind of show a parent, like, this is the bell chart for the assessment, and where, where the student is on the assessment, mostly used by the psychologist. But, yeah. All right, well, we're going to take one final break, and when we come back, we'll dive into some intervention strategies with Danielle and Ruth. All right, we are back with Danielle and Ruth, and we're going to dive just a little bit into the idea of using the good sense framework and the rocket ship to help you collaborate and educate others when working with a student. And then we're going to talk about some intervention and advocacy pieces as we wrap up. So the question here is, how do you really use the good sense framework, and I can imagine the visuals being helpful to really help parents to understand or to help teachers understand maybe why behavior is impacting sensory or being impacted by sensory, or maybe even how sensory motor is being impacted by another area. Danielle Pluth We like to talk. Um, a lot about and train our staff a lot in we call them little elevator pitches. Basically is, how can you quickly summarize what's going on? So a very quick example might be the vestibular system. So being able to say in a meeting like, you know, little Johnny is over responsive to movement, so it's harder for his movement system to get the input that it needs. And the movement systems in our inner ear, and we have like the semicircular canals are going to tell me, is my head up? Is it down? Is it spinning around? And that information is going to feed the muscles around my eyes for eye coordination. It's going to feed my cerebellum for bilateral coordination, for using both my hands to cut and those kinds of things. And it's going to impact the extensor muscles of my neck for that postural control to keep me upright. And so we'll use little spiels like that to then link it to the top of the rocket ship to show functionally, what they're seeing. So just having little spiels for like, all parts of the rocket ship, and then being able to quickly link it so I feel like I can quickly explain, in a pretty succinct way, of how the different areas are impacting the child so. Ruth Isaac And it also helps us to think about, are we doing treatment, or are we doing an accommodation? Right? For example, like, if you've got poor postural control, right, first off, accommodation, make sure those feet are flat on the floor, right? Do they have foot support? Something as simple as that, some different seating options, right? All of these things that we know, but it just helps us to say, okay, that's what we're targeting. Is the postural control of the sensory motor, let's say, and we're doing an accommodation teacher. Here's a quick something I want you to use this. This is why, or maybe we are looking at more of an intervention strategy, right? Could we work at something like just keeping it really simple, getting on the floor, doing some tummy time, where that body is in an extended position? Can they hold that position for a little while. Danielle Pluth Or we might give specific exercises that will ask them, you know, for six weeks, can you do these once a day? Because we're targeting this area to help that posture control, so that they can now sit at circle time, you know. So just keep bringing it back to here's where we're targeting. Here's what we're using to target that area, and why the functional impact, and so you just get way more buy in then, because people really appreciate knowing the why and the background, and they're just way more willing and excited to do the recommendations, because it just makes more sense to them. Jayson Davies I could totally see myself like, I don't know, I don't know if you have this yet, but I would just like, somehow get this on a whiteboard and carry it around, like I'm a coach on a football team, and just like, Hi teacher, look at this. Is the line. This goes here, and then, just like, connect it for them, and connect the dots, and make it super easy for someone to understand. You know, why I'm working on sensory regulation and how that is impacting daily living activities or academic learning, and hitting all the other sections in between, and kind of showing exactly how it how it works. So question here you've talked a little bit about, and this is more from the theory perspective that we talked so far about how you can go up or down the rocket, vice versa, how one part impacts another part, whether it's top to bottom, bottom to top. When it comes to the intervention side, though, how do you start to decide where to start? Do you start down at the bottom with sensory regulation? Do you start with reflexes? Do you start with interoception? I mean, as I kind of just alluded to, you could draw a line all the way down right and hit each part. But then, how do you move from understanding the difficulties to actually deciding where to start? Danielle Pluth I think, like you'll notice on our rocket ship, that regulation piece is the biggest chunk, like even size wise, visually, and so typically, that's where we will usually start. Is that regulation piece, we need to make sure kids are regulated before you can even start accessing the higher level of the rocket. So whether you know and you can look at that different ways, you might be looking at that from a universal level, what needs to happen for that child universally? Are there things in the classroom that we can start implementing that can help them do we need to start implementing, you know, heavy work breaks or things like that, and then looking at, maybe for the child specifically, is there different exercises we need to start working on to help them with those overall systems, depending on, again, how much time you have to work with that child, like, if they are tactically defensive, is, do we have time to actually work on that system, or do we need to put accommodations and strategies in place to help them cope and manage with that system, and just knowing that and being able to communicate that to everyone else around them, like, you know, I'm not going to be able to maybe change this child's tactile system at this like the way that they're processing it. That's why we want to make sure we're accommodating. Working for it. Ruth Isaac So yeah, and I think it also depends on where you are working right, what your setting is, what you've got. I think having this background helps you to then be creative in where you're using it. And you know your own setting. You know who you have access to, who your extra tools are, if there are extra people, if there are extra resources, what you have available, but at least you have that structured approach, and you're not just grasping at things. It's taking away that guesswork of like, let's try this thing and let's try that thing, and let's try this thing. It's giving you that organization and confidence to then take it to wherever you are using it. Danielle Pluth I'm going to know why I want to try different sensory tools and and in saying that too, you know, we might also need to address the fuel to the rocket initially as well. Like, is this child getting any sleep? Are they getting enough nutrition? Some of those things that might be your biggest red flags at the moment that you've got to address first. So it gives you kind of that systematic you could even number on your rocket which ones are your top priorities that you want to intervene with? First, you know, what, what? And also, kind of looking for your biggest bang for your buck. You know, if I have a kid with a startle reflex and dysregulation and postural control issues, what exercises can I give that's going to target kind of more than one area. Is another thing that you can be looking at too. Jayson Davies I am totally looking forward to version two of the rocket ship that has like asteroids on the side of the paper. No, but real question though, there's a lot on the good sense rocket ship, right? There's a lot of different areas that we're going to look at. And I know the two of you at this point, you're no longer, I don't know, maybe you do sometimes, but you're not marking it up, like I've talked about, like we've talked about a little bit today, but in your experience with it, do you ever find that one section doesn't have any difficulty, or is it pretty regular that If you're finding some difficulty with cognitive you're also going to find some difficulty in the other aspects as well. Danielle Pluth I think, I think what's fun about it, what I enjoy the most is you're building a profile for each child, and so you might be doing a lot of repetitive assessment type work, but in the end, the mapping out looks different for every child. And I think that's what's kind of neat. It keeps you away from getting like I think in the past, I would just get stuck every kid looked the same, you know, you'd kind of just have whereas, I don't know, for this now, I feel like I'm building a profile that's different for every child. And so I would say I've probably hit every area in some kind of combination for kids that I have worked with. Ruth Isaac And it's not cookie cutter, and it's not boring. It's, it's, it's individual, and it's and what's, what's that child's needs, and where do they need support? And where is that just who they are, you know? And what are the things that we need to work on and support? Danielle Pluth Yeah, and I think too, like, yes, it, the foundation of it is all sensory. But as you get to the top, we have definitely incorporated other areas of OT and even though the like the self care kind of classroom participation area, we look a lot at like kids play skills and developmentally where they're at with their play skills. So using we bring into it different assessment tools that help us figure out those different areas. And so it just keeps it, yeah, very comprehensive and, like, thorough without it being cumbersome. It's not like we're always assessing every single area, but yeah. Ruth Isaac and definitely, today we are doing a very fast recap and stronger chip, we could dive in and spend a lot more time talking about each area. Danielle Pluth But I think it, yeah, it starts it gives us that framework, and we run with that, with the majority of our kids, and we talk about like we still, we want to get training from all the OT gurus out there, and that's where we end up adding on the asteroids and all that kind of stuff, right? Because there's other thoughts and stuff out there, and we're always bringing it back to see, how does it fit with our model? Jayson Davies Yeah, absolutely. And I think we're down to the last two questions here, and I want to go back to, I can't remember. I think it was Danielle who mentioned earlier about, you know, initially having difficulty understanding sensory regulation, sensory motor and and I know you know, both are providing a lot of professional development, both online through this program, but also just, you know, mentorship within the therapist and OTs that you work with. And so I want to ask you, what are maybe one or two of the hang ups that you find that practitioners often get hung up on when it comes to sensory maybe those who haven't gone through the SIP training, maybe those who haven't attended some of the other, you know, big programs, the CLASI or whatnot. What are some of those, those hang ups that you often see? Danielle Pluth Well, okay, I have, I guess, two things when it comes to sensory, motor. What has happened is, I'll give exercise. And people think my exercises are to impact regulation, and they'll say, you know, there was no change in him afterwards. And I have to get them to understand that we're working on the underlying motor system, and it will take longer, maybe, to see changes. So helping them to see that my exercises aren't always just for regulation, that sometimes it's for other areas of the rocket. So that's one area, I think, for OTs, what happens is, if they haven't been trained yet in sensory, What scares me is that they then sometimes want to dismiss it as an area, they'll say, oh, you know, everyone thinks everything is sensory, and it's a super key area. And so I do, I don't want people to just dismiss that, because they can then struggle, like we had said earlier, with interpreting the sensory profile, thinking, Oh, it's all definite differences, and not being able to pull it apart and clinically reason it, and then also getting hung up on evidence. So saying, like, oh, you know, somebody wants me to trial a weighted vest or a neoprene vest, or we just don't get hung up. We feel like, yes, definitely we want more research articles for all the sensory tools and all the things that we do. But I don't think we should constantly just be throwing stuff out because we are not a profession that has a super well established research base yet, and so I worry that we, if we just start throwing that stuff out when it can be effective, that we're doing a disservice to the children that we work with. So we very much believe that through having our framework, it gives us a way to properly assess and come up with interventions and then to trial them. And so, you know, so we use weighted vests, we use neoprene vests, we use brushing, we use the astronaut training. We use therapeutic listening. We do all of those things in the schools in a systematic way that has proven to be extremely effective. And I think that it's sad to me when I hear OTs just say, Oh, I'm not using I'm not touching that because, and maybe it's different down in the States, maybe we have more leeway or whatnot, but we have we track it, we document it, and we see impressive outcomes. So. Ruth Isaac And we just don't we stop. Danielle Pluth Let me say, yeah. And we just really want OTs to experience, I guess what we're experiencing in the schools, we're having a lot of success with a sensory approach. It's, you know, yeah, so I think I might have just gone, I'm not sure if I went way off your question or. Jayson Davies No, that was spot on. You gave, you gave several great answers. I really appreciate that. Ruth, did you want to add anything? Ruth Isaac Yeah, I think when you were asking about, like, when the confusion, I remember when I first started, there's there's so much terminology in our profession, and there's so many acronyms, and it can be really complex. And I remember something just as simple as somatosensory and thinking that was a whole nother thing, that's just tactile probe, that's all that is, and sometimes just sharing that basic information with people so that they understand, Oh, we're talking about proprioception. We're talking about tactile that's what that is. And then how does that functionally impact? That's the piece that I feel like was just really eye opening, especially when I'm working with new therapists. And I remember myself wondering, what is going on here, how, what is the difference between these things, and how does that impact? And having a bit of that neurology in the background is also super important, so that you understand what's working there and how it's not ooga booga. Danielle Pluth It's actually grounded in science Exactly. Yeah, exactly. And I was gonna add one more thing on to what you were saying there. Go ahead. I was also just gonna add in there that we've spent a lot of time going through that vocabulary. So anytime we go to a new course, or we hear new terminology, we're constantly trying to figure out, okay, what do you exactly mean by sensory seeking, for example, or sensory craving, or, you know, and distilling that down to what it is, and then figuring out how it fits in with what we're already thinking. Do we need to change what we're thinking? Or is that different than what we're thinking? Or does it already fit into what we are thinking? It's just semantics, right? So we've have spent a lot of time figuring those kinds of things out. Ruth Isaac And still working on it. Like, I feel like it's a never ending thing, right? He is, yeah, like, and thank goodness, because otherwise I think we would be bored. Yes, I don't want to be bored with what I do. I want to keep pushing myself. I want to keep thinking about how this impacts a child's function overall. And I want to share that passion which we have with other people, so that they can see that as well. Danielle Pluth And that's the thing. Like within our community, we have built a whole program around OTs using sex. Sensory intervention, like with regards to our universal strategies, our direct one to one, our sensory rooms in the schools. And it's been a lot of fun to see impact across our whole division of, you know, 15 schools or whatnot. And so it's, it's neat, and it's nice to have something that you keep coming back to, that you keep, you know, we can keep training our teachers and parents and whatnot in it, and we're continuing to have success. Jayson Davies Yeah, perfect. Yeah, no, I think that's another five minute segment that people can send to their admin teachers and people who think that they're sensory experts or even another therapist, like, there's a lot to do with sensory and it requires training. And, yeah, it requires training. Ruth Isaac Ongoing, right? You never, I don't think you're ever done, like we're still learning as we continue on. Danielle Pluth And I think that that's the thing. Like, if we can have the OTs well trained in sensory, then you can really see that sensory is not just wiggle cushions and jewelry. That kind of brings us full circle, back to the beginning, right? So some people can think, Oh, if I give you a box of sand, I'm doing sensory intervention. Well, that's a sensory strategy, but that's not the basis of sensory theory, right? So, yeah, I think there. There's so much more to it and that that I know psychology has really gone into sensory but we've like, it's that vestibular probe piece too, that we really bring, as occupational therapists to that whole lens as well, that we can really understand. Jayson Davies So, yeah, absolutely. Well. Danielle Ruth, thank you so much for being here and sharing your good sense ot rocket ship and all the theory behind it and how you use it in application that's really amazing. Before you leave, I want to give you both the opportunity to kind of share where people can go to learn more about the good sense rocket ship, the theory that you're putting out there, and learn more about you all. Danielle Pluth So if they want to go and get a download of our good sense rocket ship, they can go to advance. Ot.ca , back, slash, sensory. Hyphen. Approach. Ruth Isaac And we're also on Instagram. Danielle Pluth Yes, you can follow us on Instagram at good, underscore sense, underscore OTs as well for our little video educational clips and bloopers. Jayson Davies Bloopers are always fun, awesome. We will be sure to link to both of those resources and all the other resources that we mentioned today. I don't think there are too many, but we'll have those two for sure, and any others that that we, you know, can find to send your way, and we'll put those in the show notes, so it makes it super easy for you to find everybody. I have the rocket ship up right in front of me. I am not lying when I say like I would mark the heck up of out of this thing during all my evaluations. And I think that you will find it very helpful too. So be sure to go get it, and you're going to learn a lot from Danielle and Ruth over however long you follow them on Instagram and are part of their atmosphere. So Danielle Ruth, thanks so much for being here. Really appreciate having you, and can't wait to see asteroids on the rocket ship. Danielle Pluth And thank you so much. Ruth Isaac Thanks, Jayson. Jayson Davies Of course, I want to give Danielle and Ruth A big thank you for joining me today to share the good sense rocket ship framework with you. And of course, I also want to say thank you for listening to this episode. I hope you found value in understanding how this framework can help identify, assess and address sensory challenges that you come across with your students. Be sure to find the good sense rocket ship PDF in our show notes, and be sure to follow Danielle and Ruth on Instagram at good sense OTs to continue learning from their expertise. And as always, if today's episode left you wanting more practical strategies and support for your school based ot practice. I would love to invite you to join us inside the OT school OTs collaborative. It's where hundreds of school based ot practitioners come together for resources, professional development and direct mentorship from me. Within a group setting, you'll find frameworks like the one that we discussed today, plus tools to help you advocate for sensory, informed practices within your schools, head to OTSchoolHouse.com slash collab to learn more and join our community. Also, as a bonus, as a member of the OT schoolhouse collaborative, you can even earn a CU certificate for listening to this episode and many others within the OT school house Podcast Network until next time. Keep making a difference in your students lives through the power of occupational therapy and just have a good time. Don't forget to play. Don't forget to kind of sit down and just be in the moment with your students. Sometimes the best sensory interventions just come out of being present with the students. Take care and we'll see you next time 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 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 More OTS 189: How switching to a workload model can transform your school-based OT practice Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 189 of the OT Schoolhouse Podcast. Dive into groundbreaking research on the transition from caseload to workload models in school-based OT with Stanbridge University MOT students Jalen, Michelle, Jared, and Ari. Their nationwide survey revealed striking results: practitioners using a workload model reported significantly lower burnout scores compared to those using a caseload model and majority strongly agreeing that the workload approach reduces stress levels. The students' research identified key barriers to making this transition—primarily lack of administrative support and scheduling conflicts—while highlighting successful facilitators including peer support and improved collaboration with teachers. Their findings emphasize the importance of data collection for advocacy, suggesting that tracking time spent on indirect services provides compelling evidence when approaching administrators about workload changes. This episode offers practical insights for school-based OTs feeling overwhelmed, with recommendations to start small by tracking weekly time usage and increasing teacher collaboration. Listen now to discover how transitioning to a workload model can transform your practice, reducing burnout while improving service quality and student outcomes. Listen now to learn the following objectives: Listeners will compare the impact of caseload versus workload models on therapist burnout, stress levels, and job satisfaction. Listeners will identify key barriers and facilitators to transitioning from a caseload to workload approach. Listeners will identify practical strategies for initiating a workload approach. Guest(s) Bio Michelle Aquino is a Master of Occupational Therapy student at Stanbridge University in Irvine, with experience as a Behavior Interventionist in a school-based setting. Working with children with diverse needs has sparked her interest in pediatrics. She is passionate about occupational therapy because it allows her to help children build independence and develop essential skills they need to reach their fullest potential in everyday life. After completing the OT program, she plans to specialize in pediatrics in an outpatient or school-based setting. Quotes “I’m hopeful for a future where school-based OTs are recognized for the true impact of their work.” — Michelle Aquino “Peer support and collaboration make a huge difference for school-based OTs’ satisfaction.” — Jalen Arcadio “Administrative support is the key to successfully transitioning from caseload to workload.” — Ari Aguilos “Tracking time tells a story administration might not see, and it improves student outcomes.” — Jared Sarmiento Resources 👉 Michelle’s Linkedin 👉 Jalen's Linkedin 👉 Ari’s Linkedin 👉 Jared’s Linkedin 👉 OT Schoolhouse Collaborative 👉 Garfinkel & Seruya Research Episode Transcript Expand to view episode transcript Jayson Davies Hey there, and welcome to episode 189 of the OT school house podcast. I'm your host, Jayson Davies, and today we have a truly unique episode. Over the last year, I've had the incredible pleasure of advising four master students through their thesis research at stanbridge University. Jalen, Michelle, Jared and Ari together, these four developed their research question, conducted their lit review, formed their hypothesis, developed a survey, and completed their data collection and analysis, all about using a caseload and workload approach. In fact, you may have even helped them with a survey response when I sent that out in an email a few months ago. Now, what makes this especially exciting is watching these students transform from virtually knowing nothing about school based occupational therapy to now deeply understanding the challenges of traditional case load approaches in the schools and maybe why we need to move to a workload approach. Now that they're done with this project, they are currently headed off to their level two fieldworks and are on track to join the OT workforce early next year. Congratulations, guys. I know you're listening to this, and couldn't be more proud of you. Now their research that we are discussing today examines, as I mentioned, caseloads and workloads, and this is a topic that every school based ot practitioner is impacted by every single day. So what we're going to talk about is the transition from one to the other, from a caseload to a workload approach, and how that impacts burnout, effectiveness and even student outcomes. So if you've ever felt overwhelmed by your caseload or struggled with documentation time, or even wondered if there is a better way to structure your services. This episode is essential listening. We'll explore what the research shows about therapist burnout rates, quality of intervention, and even the key barriers and facilitators to making this important transition from a caseload to a workload model. I'm so happy that these four have decided to distribute what they've learned through the OT schoolhouse podcast, and it is truly a pleasure to have them join me for this chat. Let's go ahead and get started. 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 Jalen, Jared, Ari, Michelle, welcome to the OT school house podcast. It is a pleasure to have you here. We've all been working together for about nine months, maybe, gosh, close to a year now, but it's all come to this. We are recording a podcast together. We're going to share what your findings are and kind of the research that you went about to determine a little bit about caseloads and workloads, I don't want to get ahead of myself. I'm going to let you all talk about that, but let's get started. Jalen, how you doing today? Jalen Arcadio I'm doing great. Thank you for asking. I hope you guys are all doing well. We're in break, but Michelle Aquino living life, you know? Jayson Davies Yeah, absolutely. And if I may, what made you decide that you wanted to get into occupational therapy? Jalen Arcadio I honestly joined for the sole purpose of knowing that you're helping people always, and it's a great way to expand your compassion and like being just passionate for helping others Jayson Davies very cool. And Jared, how you doing? Jared Sarmiento Doing good, doing good. Very excited to be here. Awesome. Jayson Davies And why don't you share a little bit about the program that you're in and the entire group is in and how you're doing? Jared Sarmiento Yes, so we're all masters of occupational therapy students at stanbridge University out in Irvine, what's called, we only got about a little, oh, actually, a little over, oh, under a year now, so, but I stepped into our level two field work very excited about us, kind of get, like, our real first hand experience, and, you know, just the maze, you know, it's come down to this point. A lot of schooling this last full year. Very intense, a lot of work. But, you know, kind of excited to see it come into mutation, whatnot. Kind of get that feel what it feels like to be an OT, you know, Jayson Davies it'll be here soon. It'll be here very soon. And Ari, welcome to the podcast. What made you decide to pursue occupational therapy? Ari Aguilos Hi, yes, thanks for having me. I'm Ari. I think just like Occupational Therapy and Occupational Science is so valuable. And after shadowing a bunch of different health related fields, I just knew that ot was, for me, fantastic. Jayson Davies And Michelle, same question to you. Michelle Aquino Hi, I'm Michelle. I think the one thing that really helped me learn that occupational is for me was from watching the school based OTs that I was working under while I was a bi at school district. And I really just sparked a career. Capacity in me. Jayson Davies Awesome. And now here you are completing what ultimately is a school based occupational therapy type of project. So awesome. Kind of full circle here. So well, let's go ahead and dive into it. We're talking about cases and workloads within this episode. And I'm going to come over to you, Ari, and I want to ask you that, why do you think that this was important? Why was it important for us to look at cases and workloads, and why was this worth looking into in terms of research? Ari Aguilos Yes, ultimately, we had a great opportunity to study the practitioners themselves, and I feel like they're especially during our initial review, we couldn't find any or little to none of research on OTs themselves when it comes to work life balance, when it comes to burnout of the actual practitioners. So what we got to do was answer some of those gaps of knowledge, figure out even more things that could be researched and very generalizable to not just school based OTs, which is a very important role nationwide, but for all, for the all, the whole field of OT awesome. Jayson Davies And I kind of want to let anyone respond to this one, because Ari did bring something up, is that sometimes you find research related to other areas, but not what you're looking for. And so for any of you, because all of you had to partake in the lit review, was there something that was there a moment where you remember kind of being frustrated because of the lack of research that you were, you know, looking for, and what you were able to find? And kind of like, that's just what did it feel like? But what were just share that experience, I guess, anyone want to dive into Jared Sarmiento that definitely, kind of researching the difference between workload versus caseload was very hard. You know, we had a we'd maybe find like, one or two articles, and then we kind of have to, like, see, like, what they were referencing, just to kind of get like, a better gage when determining the difference. The big difference between workload versus caseload definitely saw a lot for like the realm of for like speech therapy, but it was very limited when it came to the field of occupational therapy and kind of like what the main differences are, especially for school based OTs. It was a lot. It was hard, but kind of have to work with what you get, you know, saying absolutely. Jayson Davies And just kind of a quick follow up to that, was it difficult to find research specific to school based as opposed to, more generally, about pediatric therapy as a whole? Ari Aguilos Yes, we had some leading sources for our, like, initial research, which we had to follow their sources and dig deeper into that, but it was very limited. And like, we basically had to start from like, we had to understand school based practitioners from from, like, as students, we don't know what their life is like, so we had to, essentially, like, understand that first before even developing our research. So I think we had an extra challenge when it came to even beginning to research and finding that there wasn't a lot out Jayson Davies there. Yeah, yeah, absolutely. And as you pointed out, right? You're you're all current occupational therapy students. It's not like you've been in the field. It's not like you've even determined exactly what field within occupational therapy you want to go into. And so I know Michelle mentioned, right? She's worked in a school based setting, not as an OT, but for the rest of you, I don't think you really even had an understanding of school basis, so you kind of had to learn that part before you could even do the literature review process itself. And I know that was a learning process as well. All right. Jared, for listeners who may not be as familiar, briefly explain the difference between a case load model and a workload model and why that matters so much. Jared Sarmiento Yeah, so for a caseload model, basically the practitioner, their work measure is measured based on the amount of students that they see overall. So for example, they may have 50 students on a caseload, and that kind of determines, like the schedule. They're basically responsible for seeing that at those 50 students within a certain timeframe, whether the week or the month, and then, whereas, for the workload model, it kind of measures the overall work that the practitioner is doing. In total, this can be both direct and indirect services. So both seeing the students you know, doing interventions with them, maybe even doing assessments. And it's kind of like the things outside of just meeting with the students. So for example, documentation, collab, collaborative meetings with the teachers, maybe even the students, families, IEP meetings. And for the workload model, it kind of distributes their time accordingly, rather than just by the measure of how many kids they see. And it kind of matters. It's very. Strong because, you know, a lot of schools traditionally are utilizing just seeing a practitioners work overall, by the amount of students that they oversee, but what they're not accounting for is the hours and time that practitioners have to put on or just outside of everything, kind of like those indirect services, and it kind of leads to a lot of burnout inconsistent, inconsistent types or service deliveries, and ultimately unrealistic expectations. Jayson Davies Yeah, and I think that kind of like summarizes the lit review. You guys broke down the lit review into a few different themes. And I think that kind of is the overarching themes from the lit review. So once you kind of had a little bit of background within the realm of school based ot looking at the research, kind of what's already out there. Jaylen, I want to come to you, because once you have that information, what was the way to move forward, what was the main purpose of the study, and what were you trying to or hoping to discover about school based ot practitioners within a workload approach. Jalen Arcadio So yeah, like what Jared was saying, we wanted to expand on the school based OTs and how they were experiencing a workload model. But with that, we had to do a survey with Google, Google Sheets. We conducted a state like a nationwide survey to see the transition from caseload to a workload model, and we just wanted to discover and understand their experience and real world impact, like a burnout and work life balance interprofessional collaboration And just the quality that the students were receiving from the OTs, awesome. Jayson Davies And then there was also a second kind of theme that we wanted to discover too. And we split that survey up a little bit, but I want to give you that opportunity to kind of like to address the second part of the research. What was that second part that we really wanted to understand when it came to therapists who maybe had made the transition from a case of Joe workload approach, Jalen Arcadio we wanted to see, like, how effective it really was. So we wanted to see what types of experiences they were dealing with in terms of, like advocating for this specific case our workload model and how they wanted to be a front line for the students, because at the end of the day, they weren't getting the support from their peers, and it from the survey that we got. It was mostly just their ot peers who were also just supporting them. Jayson Davies Yeah, and we'll get more into all the details, because ot peers were important, a few other players I know we'll be addressing in just a little bit. Ari, I'd love to give you a chance to kind of dive a little bit more into how we designed the research, how we how we built that Google form up to get the data that we wanted. Go ahead. Yeah. Ari Aguilos So for the Google Sheets survey, we knew that Google Sheets is really accessible, so we knew we automatically just wanted to do Google Sheets now we would do email snowballing, but for the actual content of the survey, we had developed aims such as, like, if they have experienced the caseload, what's their experience with a work, or if they experience a workload, and what's their experience with it? And then the second part was, were they there at their site when they transitioned from a caseload to a workload approach, and what was that experience like? So with that like, we got to do, like a qualitative like we did, Likert scale questions mostly, and then open ended questions, basically aiming to explore those themes. Yeah. Jayson Davies And really briefly, can you just share what the criteria was to be a participant, or the criteria to not be a participant. Was, you don't need to read a verbatim but just in general, Ari Aguilos yes, essentially, our inclusion criteria was you had to be a school based occupational therapist currently working, and you had to have some experience with the workload model. And opposite to that, the exclusion criteria is if you were retired, s, B, OT, Jayson Davies All right, awesome. So we understand we use a Google survey. We had some electric questions, we had some open responses, and then we had school based ot practitioners, non retired who had some workload experience. Now, Google Surveys are great in the sense that they give you these nice clean graphs for the questions that create nice, clean graphs, you know, the yes or no questions, the Likert scale, but when you have open ended questions, that gets a little complicated. So as you all were planning to have these open ended questions, and knowing that we were going to aim for, you know, 100 a few 100 different responses. Is, what was the plan for actually analyzing that data? Ari Aguilos I can take that question, so when it came to the open ended questions, and knowing that we would have to sift through a lot of responses, we basically, as a group, wanted to use artificial intelligence AI to do the to use it as an organizational tool to do the initial coding phase and to basically speed up the process of doing the thematic analysis and coding. And it really allowed us to organize the themes faster, kind of, yeah, can I leave it there? Jayson Davies You can continue on. So what were the benefits of AI, and how did you use it as a tool to support you? Ari Aguilos Well, the benefits of AI is that it was it's really simple to use. I feel like past research tools that we've used in practice, like deduce it was very convoluted. Takes a lot of time versus the versus the model that we used. It was able to be replicated. It's able to be like the output was way faster for us as a group to what's the word I'm looking for, essentially, like Jayson Davies to sift through and then determine if it's accurate. Yes. Okay, and you mentioned using AI. What specifically did you use AI? Because some people might listen to this and say, Oh, you just went on to Gemini, or you just went on to chat GBT and and dropped your spreadsheet into there and got some responses. Was it that simple? Or did you do some research into how to use AI to do this? Ari Aguilos Yes, we definitely did some research on how to use AI as a tool so that it didn't replace us as researchers. We wanted to essentially figure out, how would it replace the coding phase, just the coding phase. So that way, once we get all our responses, we basically looked for we did like our own research, and looked for like what researchers are currently using AI to do in their research, and we basically replicated what they did. So then that means that they use a specific, a specific tool that can be accessed afterwards. It means that you can double, you can double check, like if the responses are true to what the AI is outputting. It's essentially like, again, not replacing the researchers, but using it as a tool for us, just speeding up the process. And, yeah, we found a few articles that, like Cambridge was playing around with, like, certain AI models, and that's we use that as a guideline, essentially in our research, Jayson Davies awesome, and obviously it helps save time with that theme development. This will be an open question for anyone, did the AI at all make things more difficult? Did you get ever get frustrated with the AI at all? Or was it pretty straightforward? Michelle Aquino I feel that overall, it was a pretty straightforward process. I feel like it it got us to really think about what to really focus on and what to eliminate. Jayson Davies Okay, and was it able to provide you? Obviously, it provided themes, but was it able to help you better understand the, I guess, to a degree, the voice of the therapist? Did it just provide you? Hey, these are the overarching themes, or did it help to provide you additional information to support your research project? Ari Aguilos I would say the original quotes from the responses are always like the best and painted the best picture of what they are experiencing. And AI, honestly, just put it into it helped us put it into other words, but it necessarily didn't capture like what they originally said. So that was a limitation. I would say that AI, we would, we would always look out for Jayson Davies awesome Ari. I do want to give you one more thing to kind of discuss, and that is the second half of the survey. A little bit. What was that? How did we filter people and how to what was the purpose of the second half of the survey? Ari Aguilos The second half of the survey was to get the experience of transitioning to a workload model, because it's an emerging model, not of not a lot of school based occupation yoga therapists have experienced it. So we wanted to see the ones that have experienced it. What facilitators led to that change. So was it administration support? Was it team collaboration? And through a series of Likert scale questions and open ended questions, we were able to get more insight into that experience, just that, like transitioning part or if they were there. Four after the transition of going from a caseload to a workload approach. Jayson Davies Yeah, and Jared, I want to come to you really quickly, because we had this actually became something of a we got a little confused at times during writing this thesis about the number of people that we actually had partake in our project, and we were hoping to get somewhere around 300 because of this, like 1% number of school based ot practitioners that we think are represented, but we ended up having two people, 200 I believe it was kind of click over to the survey, and then significantly less actually take the survey. So I want to give you a moment to kind of address that, yeah. Jared Sarmiento So kind of like you said, So we initially, you know, we're aiming for 300 hoping, like that was going to be our set number. When we got 200 responses, we're like, okay, like this is pointing in a good direction. And then once we excluded those who said that they had no experience with the workload approach, it only brought it down to like, 114 and then by that time, we're just like, Oh, man. Like, so it kind of showed us like, wow. Like, there's really not a lot of school based therapists out there who really have true experience with the workload approach. And then even just when it went down to have you made that transition, it cut the number in half again. So I think it was only like, what it was only was, only between 75 to 80. So it kind of left like little room. I mean, it helped understand a good perspective. But, you know, we want, we were hoping that we would have a big, big number, so we understood, like, you know, what is working for people to make that effective transition from a case load to a workload approach. So at that point we're kind of like, man, like, it was very eye opening, I would say, very humbling, you know, that way. And it kind of gave us more of that purpose to, like, really produce a really good paper so we could help future school based OTs for the future and whatnot. Jayson Davies And based upon that big gap, you know, the 200 104 200 114 that can continue on, and then even the 75 or so that went on to the second half of the survey, based upon that, have, have any of you given any thought to like, if we redid it, would we do it a little bit differently? Or do you feel like we got what we're aiming for? Jared Sarmiento Um, personally, I feel like at the end of the day, we kind of got what we were aiming for. I mean, yeah, we would like to obviously see more get, kind of get more perspectives, but that kind of just attributes and shows like how emerging this model is and how there has to be further on research to really, kind of like, understand and helping making the making, help people make that successful transition. You know, it kind of just adds to, like, what we talk about, the literature and the background. It's just, it's very new, but, you know, hoping that it could be the start for kind of, like a big movement, for people to really make that effective change and whatnot. Jayson Davies Perfectly Wrapped up. All right, we're going to take a quick break, and we when we come back, we're going to discuss the key findings of the research, as well as how we can translate this research into practice. So stay tuned. All right, we are back, and we are going to start things off with Michelle right now and Michelle, what were some of the biggest takeaways or themes that started to emerge from both the qualitative and quantitative data? Michelle Aquino Hi, yes. So for the biggest takeaways and themes that we've noticed throughout our data was there were a lot of barriers when it came to transitioning from a caseload to a workload. A lot of the staff and administration had a lot of trouble trying to change into the workload model. They're pretty resistant with how they wanted to change. They were so used to the caseload model that they didn't really see how a workload model could improve their their overall satisfaction. Jayson Davies Okay, so difficulty transitioning from caseload to workload. What were some of the others? Michelle Aquino Another other findings was a lot of the therapists noticed that they had a better satisfaction when it came to transitioning to a workload. It they felt a lot more balanced. They felt like they could increase more quality of care. And it was also like very satisfactory towards the clients as well. Jayson Davies Yeah, I remember seeing the chart that you all put together when you came back for one of our one of our sessions, and it was like we had asked, I think it was a four point Likert scale, maybe five point Likert scale. And those who felt effective, basically on a caseload model, were like, at a two, two and a half. And those who felt effective on a workload model was closer to four. I mean, that's a pretty significant jump of just feeling effective like, you know, it sucks to work in a job and not feel like you're effective like, just no one likes that feeling. So that's a really cool insight, that just simply switching from a caseload to a workload model can make someone feel more effective. What about collaboration? Do we have any results related to like being able to work alongside teacher, peers and others? Michelle Aquino We did have some, some results on that as well for collaboration, from transitioning from a caseload to workload, the collaboration was a lot more improved. It felt like it was better for the OTs to feel like they had time to actually work with the students rather than just doing it and like it was. It didn't really matter what they did, they just like it felt a lot more like they had time to actually focus on the child itself. Jayson Davies Gotcha, Jared, we also wanted to look a little bit about burnout and stress. How did the workload approach impact burnout and stress compared to a traditional caseload model? Yeah. Jared Sarmiento So we kind of first started off by asking the and the question to the practitioner, like, what type of service delivery model are you using currently in this point in time? And then we followed up with the Likert scale question of how much burnout they feel overall. A score of one meant that they felt little to no burnout, while a max score of five reported reports feelings of high burnout. And you know, based on the 114 participants, those who are currently using a case load model reported an average score of four out of five on the burnout scale, while those who are using a workload service delivery model, or from the past reported an average score of 2.1 so you kind of see like that really big difference in how, how a workload model can lead to less burnout, less job satisfaction overall. And then we also kind of did a follow up question of comparing stress levels between using a workload versus a case load model. Score of one would mean that the practitioner is disagreeing the workload model doesn't play a factor into stress, while score of five reports that they agree highly that the workload model reduces stress, and at least 60% of the practitioners who answer that question reported a score of four or five indicating that they strongly agree that A workload model definitely plays a major factor in reducing stress levels for them. Jayson Davies Absolutely, all right. And Jalen, coming to you with this question, Michelle spoke a little bit to the idea that it was hard to transition from a caseload to a workload model. But what were some of the specific barriers that we found when asking therapists about the difficulties shifting? Jalen Arcadio The common barriers we really face were like that we were seeing were lack of administrative support, the scheduling conflicts, team collaboration, and I feel like that that's what separated a lot of the workload model to the caseload, was the amount of support from their peers, like I said earlier today. And it's just one of those where if that district or school doesn't see the vision, then it's it's hard to kind of manage and like, go through. Jayson Davies Yeah, one question I was really happy that you all added to the survey was that we didn't just look at the barriers, but we also asked them about the facilitators. Like, what was it that actually made it easier to transition from a caseload to a workload approach? And Jaylen, if you want to start in, if anyone wants to add, what were some of the what were some of the comments that ot practitioners who had succeeded moving to a workload approach, what were, what were their thoughts of what helped them? Jalen Arcadio What helped them that I was like seeing and from reading, from the surveys, was the amount of peer support that that's what I was reading. They were saying a bunch of things like, Oh yeah, I tried pushing for it, but some of my peers was seeing like that type of idea, so that they were trying to help push that back too. It was just like the upper administrative that just doesn't see it. And that's what kind of like led them to either staying to the caseload and not transitioning. Jayson Davies So it really took the OT practitioners to work as a team all get on board before the administrators would get on board to a degree. Does that sound about right? Jalen Arcadio Yeah, and it's also like quality, like if the students aren't getting the. Same treatment anymore are the same quality because their OTs are dealing with scheduling conflicts, or they're just too busy prioritizing one student and they have to go to the next one and have that cut short. It's just poor quality at that point, and it's leading to the rest of the barriers, like burnout and all that. Jayson Davies Was, and I don't know the answer to this one, but was there any responses that anyone recalls where it was actually everyone thought something was broken in relationship to the impact that therapists were having on students that ultimately led to administration and the OT team deciding, hey, we need to change something because OTs not working. Maybe if we use a workload approach, services will be more impactful and more effective. Does anyone recall saying that? Ari Aguilos Yeah, I can answer that. So when we asked them what was successful in transitioning, about 20% 23% said that it was administrative support that essentially supported their transition. So like with that, that means that OTs were like initiated, but the administration helped support that change, and from there, they also rated that their perceived client satisfaction improved, or like their perceived like outcomes improved. Jayson Davies So yeah, no, I completely hear that. And that's like, what's awesome that we're able to say that there is improvement beyond or once you move to the workload approach, I guess kind of the question is, and I don't know if there was actually data, and this isn't something that we've talked about in one of our meetings before, but I don't know that we had any particular maybe we can go back and look at the data another time, but I don't know if we had, like, Just even one occupational therapist or one participant say, we took data and we found out that our OT services weren't effective, and so we knew that there needed to be a change and like because ultimately, that's what I would love to see. I would love to see an OT department at a school look internally and say, hey, you know what, only 20% or 25% of our kids are meeting their goals, something's got to change. We need to improve ourselves and make a decision based upon that, how they want to improve, because ultimately, things don't typically change unless there is a reason to change. And we've seen with the Surya and Garfinkel research in the past that ot practitioners tend to prefer the case or the workload model versus the caseload model. Our data is basically showing that the same type of things right and that a workload model can be more efficient and less burnout, less stressful than a caseload model. But I feel like administrators really to get on board. And I don't know if any of you heard how OTs got their administrators on board, but I feel like to get administrators on board, they really need something to be they need to see something broken, data to say something broken in order to make that transition. I don't know if anyone has comments based upon what I was just saying. Ari Aguilos Other than that, we agree that there's a lot of systemic change that needs to be made. Jayson Davies Was that was that addressed? Was systemic change a term used in our survey responses, or something similar? Ari Aguilos It was something similar. It was what we found like in our lit review, but that wasn't the focus of the survey. Jayson Davies Yeah. Okay, we'll move on here. All right, so we've got our key results right. We know that we need support. We know that we need to work as a team. We know that ot practitioners feel the benefits of using a workload model as opposed to a caseload model. But we also know from that gap, you know, 200 people who wanted to take the survey, versus only 114 who had the workload experience to actually take the survey. That that this large gap of people that aren't using a workload model. So Michelle for school based ot practitioners listening right now and they feel overwhelmed by their caseload, what's one small step that they can take toward transitioning to that workload approach? Michelle Aquino Yes, so I feel like my for my recommendation by starting small, such as, like, tracking how you're spending your week, trying to make time to collaborate with the teachers making that time into your schedule, I feel like that's a step that could could help you transition to a workload model. Just by that small step of like, trying to track your time and how you're using your time can really help a lot. Jayson Davies Yeah, absolutely, as we were just kind of talking about, you've got to have some sort of data to show your administrator that things aren't worth. In, and one thing to track is your time. Some ot practitioners, very few. We track individual student goals, but we don't track our ability support our to support our entire, our entire client caseload. You know, we're not looking at, you know, I have 50 kids, and 85% of them met their goals. That sounds pretty good. But maybe that's another thing that we can look at, is overall goal attainment scaling for our entire program, not just, not just an individual student by student basis. And Ari, what role we talked a little bit about administrators, but what role did administrators play in successful transitions? And how can ot practitioners advocate more effectively to their leadership, to adopt this approach. Ari Aguilos So it seemed that administrative support was like one of the leading reasons why there was a successful transition. I would say what that means for those that haven't experienced the workload approach. I feel like, unfortunately, it's up to the school based ot to like, have that open communication, have that if you're able to express your needs, express like, like you said, the data that the system that they're currently using isn't effective towards the students. Ultimately, you want to advocate for the student and their outcomes. So when it comes to speaking to administration, you want to have that information, have that information forward approach when it comes to advocating for yourself and the student. Jayson Davies Yeah, absolutely. And Jared, how can workload data, like time studies, documentation of indirect services, things like that, how can they help us to make the case for better staffing and for student outcomes? Jared Sarmiento Yes, I can say it's definitely, you know, tracking, workload data tracking, it could definitely be like a power tool, like we said, to like, advocate for themselves and kind of like what they need in order to be successful as a practitioner. You know, by tracking their time and trying to gage of like, how long their indirect services take, it definitely tells a story that the administrative side might not be able to see. You know, if the practitioner goes to the administration and goes, I'm overwhelmed, that's going to be different than them telling them, than the practitioner telling them, oh, I spend 12 hours a week in meetings. I spend 10 hours a week in documentation. Maybe I spend three hours a week also in maybe driving back and forth between, you know, different students or whatnot. You know, overall, that tells a very different narrative, and it kind of kind of leaves room for the administration to kind of get that different perspective, like, Okay, this is what the practitioner needs in order to be successful. Maybe that could be more staff and overall, like that can lead to just better student outcomes, you know? Jayson Davies Yeah, yeah, absolutely. As we start to wrap up here, I'm going to ask each of you two questions. I want to I want to hear from, from each of you. The first is looking back as researchers. What's one thing that this study taught each of you about the future of school based OT and what gives you hope for the profession moving forward? I'll go ahead and throw this over to Jared. Jared Sarmiento I would say this project Well, overall, it took it taught me a lot, or kind of just taught me, like, the basis of, like, what school based ot really is, because I've heard about occupational therapists being in schools, but I never understood, like, you know, is it them doing their own one on one sessions? Are they in the classroom? So it kind of gave me a better sense of, like, what their goal is, especially in terms of making them successful for their academic career. And I think that biggest thing, like say, like, I'm hopeful for the future school based OTs, kind of like them being recognized, of the impact that they're making for these students to know, I think that's like the biggest thing that's kind of undervalued, and more, the more people I told about my topic or our topic of our thesis, and they went, wow. They're like, Yeah, you know. And there's some people I even met. They're like, you know, I worked with the their a school based ot when I was in school, and if it wasn't for them, I wouldn't have been successful. And I was like, wow. Like, kind of just to understand how big, kind of, like we said that, how big of an impact that they can truly make in terms of student success, you know, their ability, also maybe even their confidence. Jayson Davies Yeah, yeah. It's, it's kind of funny you say that because, you know, not everyone goes bragging that they got school based occupational therapy services or school based speech services or anything like that, but we do have an impact on on a substantial amount of the population. Absolutely. Michelle, what about you? What's one thing that this study kind of taught you, especially since you have a little bit of experience within the school realm, what did it teach you about school based? OT, in the future of school based. Michelle Aquino for this research, I feel like it taught me a lot. Lot about the differences between how to approach your workload in a more balanced way. Before this, I had no idea that a caseload versus a workload was a thing. I was I was really confused. I remember when I was working with the school based OTs. I did remember them talking about how they would feel so burnt out about having to drive from one school to another. And I feel like for the future of OTs and school based, I feel like there's a more balanced approach uphold and it will be a lot easier to to work under. Jayson Davies Yeah, absolutely. And Jaylen, what about you? What's, what's one thing that you know you learned throughout this research about school based occupational therapy? Jalen Arcadio To be honest, though, I I didn't have any clue on school based ot to get this whole thing started, like I, I was a coach for a basketball team in high school, and I thought that's those are the extracurriculars, besides teachers and like coaches for sports. But I didn't really understand that there was a whole section for OTs in schools, so that was eye opening for me, and that I learned a lot because I didn't really understand the whole concept until this research. Jayson Davies Gotcha. Yeah, yeah, you don't know what you don't know. You don't even know who all is on campus. And a lot of us, we all go through public school about eight, no, not quite 18 years of it, 16, no, not even that. 13 years at least. And we don't even know. Wow, I cannot do math in my head right now. So, yeah, you know you don't know what you don't know. All right, what about you? What's one thing that this study really taught you about school based OT, and maybe the future of school based OT? Ari Aguilos I feel like what it taught me is OT. School Based OT is very much in demand in schools, but it's also undervalued a lot of kids, special needs, kids that I've worked with, I see that they would get a lot of value from OT, but even the teachers like they don't necessarily know what OT is. So it makes me hopeful to know that there is a great number of great number of people nationwide that care about school based OTs and that there's a lot of research that can be developed and further looked into, just for everyone in the school system. Jayson Davies I felt like that would have been a perfect way to end this podcast, but I have one more question for you all, and that is here. I love that answer, by the way, all right, but if you had unlimited resources available to you now, you just completed this research, you've got information from this research, and you had unlimited resources, time, energy, money, maybe, you know, let's just call it like you're going to go get your PhD in OT, and you're just like, driven by this study and you want to continue this on, what would you want to follow this study up with for another study? What would you want to look into that maybe we weren't able to look into? Or what? What would you want to look into now, knowing what you know about caseloads and workloads, it doesn't have to be a survey. It can be a survey. But maybe you're going into the classrooms. Maybe you're having direct interviews with people. What would you want to do? Ari Aguilos I feel like if we had unlimited resources, the ultimate question that we would want to give OTs was, how much is this really costing them, and how much it's really costing administration, as we talk a lot about being information driven, being data driven when it comes to transitioning to from a caseload to a workload, and that, like, ultimately, if we give them the right numbers of saying, like, this is how much it's costing this how much it could save you, I feel like that's a big question that would take a lot of time and money and effort to answer. Jayson Davies Yeah, definitely something that the OT practitioners, we often either ignore or don't want to ask, but it's definitely something that administrators, principals, and even at the district level, they're always thinking about money, and so giving them a sense of if it's beneficial financially, could could do wonders. Yeah, Jared, go ahead. Jared Sarmiento Oh, yeah. I mean, my answer was pretty much the same. I felt like that was a very common theme that we recognized within our research was, you know, like we said, the hardest, the biggest barrier, was administrative support. But on the other side, for people who had that successful transition, was the facilitator, was the administrative support. So kind of want to understand, like, from the administration side, like, what may prevent you from making that effective transition for the practitioner, you know, like, what's the constraints? Because at the end of the day, there's stuff from a ot side that we don't understand, you know, for them. So it's also, and that's why I talk about kind of like, it has to be a collab. Generation between OT and the administration to kind of find a way that they can like gage and like me in the middle, you know, all right, Jayson Davies Michelle, I'm going to come to you in just a second. Michelle Aquino I'm going to think back on Jared as well. I feel like there needs to be a lot more research on administrative support. I feel like we didn't really get to see that much while we were collecting data. No, not data itself, but more art research articles on on that topic. So I feel like that would be really important. Jayson Davies Yeah, and that was something that I know you all had to do. We talked a little bit about the difficulty finding literature at the beginning, but I know that something I had to tell you all very much upfront was you might have to get outside of the OT literature, and I know you all had to kind of go out into education literature, and you had to go out into like, speech therapy literature to see kind of what they're doing. So yeah, it would be fun to kind of get more insights from the administrators, as I think it was Jared alluded to, like the biggest category for success and the biggest category for failure was administrative support, one way or the other. But what, what constitutes as administrator support for one person might be different for another person. So what? What does administrative support actually look like? All right? And Jaylen, why don't you wrap us up with what, what study you would like to look into with all the information that you now have about our study? Jalen Arcadio I'm gonna kind of swerve off to the same section that they've been going off, but I kind of want to see the use of AI in all of this. I kind of want to see the growth of AI being actually used the right way. And this is a great start. If we had unlimited resources, it'd be a great start to try and implement AI into the transition and see how we can show them that it's useful. Because in our research tool, we used it and it was, we used it like properly, and it was a great it shortened a lot of stress and, like, time. So that that was one thing I kind of want to dig deeper on. If there is a tool for all this. Jayson Davies Yeah, yeah, and and OT practitioners want a tool that is specific to school based ot from Ai, we've seen that. We've heard that from school based ot practitioners as well, and it's interesting because there's a fear and there's a love for AI, there's a fear for AI, there's ethical concerns related to AI, and we all want to use AI to make our lives easier, but you know, as you mentioned, we need to figure out the right way to do it, and we also need to do it in a way that actually saves us time, not creates more kind of wasteful time spent on trying to use AI when actually it would have been just quicker to write the note on our own, like the way that we usually do it. So, yeah, studying AI and school based ot would be a really, really good one as well. Personally, I would love to kind of dive further into that, that impact on students. You know, I would love to be able to look at maybe a historical review and find 10 therapists to use the caseload model last year and see if their students met their goals, and then two years ahead, if they use a workload approach, or different 10 therapists who are using a workload workload approach and see if their students are meeting their goals. And I don't have the know how to make that possible, but it would be a lot of fun to somehow figure that out, to be able to hopefully maybe show that using a case or using a workload model is not just easier potentially for the therapist, but also more effective for the students that they serve. So yeah, all right. Well, I want to thank you all so much for being here. Jared, Ari, Jaylen, Michelle, thank you all for spending the last nine months or so with me and then this hour or so on the OT school house podcast. Really appreciate it. Congratulations again on wrapping up, and hopefully right around the time this episode is coming out, we get to find out if you'll get to present your information in Anaheim at a ot a best of luck. Jared Sarmiento Stay tuned. Thank you. Thank you. Jalen Arcadio Thank you. Michelle Aquino Thank you so much. Jayson Davies And that wraps up episode 189 of the OT school house podcast. I want to extend my sincere thanks to Jalen, Michelle, Jared and Ari for sharing their incredible research on caseload versus workload models, as I mentioned earlier, watching these students grow from having little knowledge of school based ot to conducting meaningful research has been truly rewarding. Their insights into how this transition can help us to reduce burnout, improve service quality and enhance collaboration are truly valuable for our field, and I want to thank them for taking this kind of passion project of mine on Be sure to check out the show notes at OTSchoolHouse.com . Slash episode. 189 where you can view their research poster and dive deeper into their findings. Also, if you're feeling inspired to explore a workload approach in your practice, remember that small steps like tracking your time can make a big difference, and you don't have to make this journey alone. For continued support resources and professional development on topics just like this one, I invite you to join us in the OT squash collaborative. There you'll find a community of school based ot practitioners, as well as our comprehensive caseload to workload workshop designed specifically to support ot practitioners like you make this transition. Additional resources on workload models are also inside of the collaborative, and we would love to have you join, and we would love to support you in your transition from a caseload to a workload model. Head over to OTs schoolhouse.com/collab to learn more about that community and more about the caseload. Course, one more time. Thank you so much for listening, and I'll catch you in the next episode of the OT schoolhouse podcast. Amazing Narrator Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to OTs schoolhouse.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 More 3 Must-Have School-Based OT Systems That Will Change Your Practice (Plus, a Free Evaluation Checklist) Be sure to scroll down for your free Evaluation Checklist Handout! Ready for a quick game of school-based OT Bingo? Let's see if you get three in a row! Are you frequently: Getting referrals for students who really just needed adapted paper or a pencil grip. Being invited to IEPs to review OT evaluations for students you've never even heard of . Realizing the day before a triennial IEP that you forgot to observe a student in their classroom. BINGO? Trust me, you're not alone. With countless treatment hours, a half dozen open evaluations, and 3-6 IEPs a week, it can feel like we're running on autopilot, juggling too many tasks and reacting to problems instead of preventing them. These moments don't mean you're disorganized. Rather, they show that the system you're working within needs refining. The good news is that by implementing just a few intentional systems can completely change how you manage your workload and collaborate with your school team. By setting up three simple processes ( teacher consultations, referral management, and evaluation procedures ), you can create more time, consistency, and confidence in your daily practice. Let's look at each of these systems and how we can design them to work for us , not against us. System 1: A Teacher Consultation Process (Pre-Referral) Why It Matters Teachers are often the first to notice when students struggle with handwriting, attention, or self-regulation. But without a clear way to reach out and get simple support from you, they may jump straight to an OT referral, even when classroom-based strategies could make a difference. A structured consultation process (MTSS Tier 1) gives teachers an avenue to access your expertise early on, before a specific student is even named. These conversations should be about general classroom challenges , not individual students - even when the teacher has 1 or 2 specific children in mind. By keeping the focus on participation, routines, and environmental supports, you're helping teachers apply occupational therapy principles directly into their classrooms. This approach protects student privacy, aligns with FERPA and IDEA, and supports a workload model where OT services reach all students through collaboration, not just those on your caseload. How to Build It Here's what a practical, ethical consultation system can look like: Create a general consultation request form: A simple Google Form can allow teachers to describe their concern (e.g., "Many students rush through written work") and what they've already tried. Embed consultation into existing meetings: Join grade-level, PBIS, or Student Support meetings to share quick strategies related to broad classroom challenges. Provide universal resources: Share quick-reference strategy sheets for common topics such as pencil grasp, posture, attention, or transitions. (Collaborative members can access printable handouts in the OT Schoolhouse Collaborative Resource Library ). Offer brief classroom visits: Observe general routines (like how the class manages materials or transitions) and recommend task or environmental tweaks that can benefit everyone. Document and follow up: Keep short notes about what topics were discussed and the supports shared. This documentation helps highlight your workload contributions beyond direct service. Bonus : Record short and simple videos about your most frequently asked question from teachers. Upload them to youtube as “unlisted” so they are not searchable, and then send teachers the direct links. That way you don’t have to repeat yourself every week. The Payoff When consultations focus on classroom concerns instead of individual students, teachers feel supported without needing to file a referral. They are also able to incorporate their newfound knowledge for years to come. Plus, you become a proactive partner rather than a reactive evaluator, and your impact expands across the entire school. For examples of how this proactive approach works, check out our articles on “ Reducing OT Referrals: Using MTSS and RTI-2 to Better Assist You! ” and “ Getting Ahead of Your OT Evals Using Tier 1 Interventions ” Both explore real-world strategies for collaborative support. System 2: A Referral Management Process Why It Matters Even with a strong consultation process, some students will still need a formal evaluation. Unfortunately, referrals often arrive missing crucial information, such as classroom data, previous interventions, or a clear description of how the concern affects participation. A consistent referral management process ensures that every referral you receive is complete, appropriate, and aligned with educational needs. How to Build It Design a comprehensive referral form: Include sections for student strengths, targeted concerns, classroom strategies tried, and data on functional impact. Use a combination of checklists and open ended questions for the teacher/IEP team to complete. Require pre-referral documentation: Encourage teachers to document which strategies they implemented (ideally based on your consultation suggestions). Define clear referral criteria: Educate staff on what constitutes an appropriate OT referral versus what may be addressed through consultation or Tier 1/2 supports. If possible, attend the IEP meeting when a referral is discussed: Even if you can’t attend the whole meeting, a short discussion helps clarify concerns before moving to the evaluation stage. Communicate timelines: Let staff know what happens next and when they can expect feedback. The Payoff This system means you'll spend less time tracking down missing information and more time completing meaningful evaluations. It also helps teachers make informed decisions, reducing unnecessary testing and keeping your workload manageable. 💡 Collaborative members can access our school-based OT handbook template, which outlines a referral system that schools can use to ensure referrals are relevant, tracked, and acted on. Learn all about the Collaborative here! System 3: An Evaluation Process and Checklist Why It Matters Without a clear structure, evaluations can feel scattered. It's easy to miss a classroom observation or forget to include an activity-level assessment. A well-defined evaluation process keeps your work consistent, efficient, and student-centered. How to Build It Use a top-down approach: Start with participation and performance in context before testing isolated skills. Follow a consistent sequence: Review records → interview teachers and parents → observe in natural settings → assess → analyze → report. Create an evaluation checklist: Include each step (from prep and interviews to writing and follow-up) to ensure nothing gets missed. Know your tools: Know the assessment tools you have access to and understand what tools to use for which concerns. Build evaluation time into your schedule: Build time into your schedule to focus on evaluations. Completing evaluations on the fly has never led to great findings, at least for me. Track your progress: Use your checklist to monitor completion and stay organized. The Payoff With a structured system, you'll produce thorough, defensible evaluations while saving time. Reports become stronger, recommendations clearer, and you'll feel more confident presenting results at IEPs. Need a checklist to help ensure you complete every evaluation in an organized and top-down manner? Enter your email below and we’ll send it over in just a second. Bringing It All Together - School-based OT Systems Building these three school-based OT systems ( consultation, referral management, and evaluation ) isn't about adding more work. It's about creating clarity and efficiency so your day feels smoother and your impact greater. Sure, they take a little bit of time to set up, but once they are running, you will save countless hours every month! Start with just one system, refine it, then layer in the others. Before long, you'll have a sustainable, organized practice that supports you and your school community. Systems don't restrict you. They free you to focus on what matters most: helping students participate and thrive. 📬 Want more support like this? Subscribe to the OT Schoolhouse Newsletter for weekly tips, research updates, and evidence-based strategies for school-based OT practitioners. More

OTS Collaborative Community Guidelines Hey there! We are excited to support you and learn how you will support others in the OT Schoolhouse Collaborative Community. OTS Collab is a place to connect with others, ask questions about school-based OT, and have conversations about everything school-based OT. The community is only great because our members make it great. Please help us to keep OTS Collab a place where all OT practitioners feel safe, welcomed, and heard by reading and complying with our Code of Conduct. Code of Conduct OTS Collab is an inclusive conference community intended to help members connect with one another and grow their capacity as school-based OT practitioners. The dos: ❤️ BE KIND Be kind to each other. Use welcoming and inclusive language, be respectful to others’ viewpoints and culture, even when they differ from your own Behave professionally. This is a safe space for OTPs to network, brainstorm, learn, and collaborate. Be inclusive. This is a community of humans from all over the globe 🧠 Be Mindful Be aware. Respect each other’s digital boundaries. We all experience the internet differently, so it’s important to remember that personal space exists online as well. Be thoughtful. Become a pro at active listening and know when it’s time to let others speak. Be purposeful. Maintain interactions with other members that are driven by good intent. 👍 BE COMMITTED Be involved. The value of this community lies in your commitment to participating; get involved, ask for and offer feedback, and utilize the resources available. Be open to feedback. Accept feedback gracefully, and offer helpful and kind constructive criticism. Share your perspective! The do nots: No solicitation This is not a place to solicit other programs. Mentioning programs relevant to the discussions is allowed. Non-disclosure and intellectual property agreement Do not quote anyone outside of the OTS Community without permission and do not share anything told to you in confidence or private messages. No Spamming or infringing on other people’s ideas or content, including that of the OT Schoolhouse, without expressed permission. How we moderate: Members asked to stop any inappropriate or unacceptable behavior are expected to comply with OTS team requests immediately. Behavior that violates our Community Guidelines will be met with appropriate action, which may include: Gentle reminders of the Community Guidelines Firm warnings and removal of inappropriate content Removal from the community without refund or eligibility to reapply in the future We have a zero-tolerance policy for harassment and sexual advances. We maintain the right to determine the consequences of any issue at our discretion and are under no obligation to share our findings or determinations beyond the individual involved. How to report issues: Reach out to your Community Manager directly with serious concerns You can directly message us in the community or email J ayson@otschoolhouse.com We look forward to supporting you! No person is perfect, no community is perfect, and no guidelines are perfect. As we grow, learn, and change together, these community guidelines must also evolve so that we can continue to make OTS Collab a safe and inclusive space that is mindful and considerate of all experiences. Being a member of OTS Collab means you are committed to embracing learning, even when it’s hard. Be available to educate and learn from each other with kindness. Be open to feedback and avoid becoming defensive when things may seem challenging. Mistakes can be a powerful teaching moment when used with compassion and empathy. As a community, we’re thankful for our members embracing this process with us. Join OTS Collab OTS Collaborative Community + Professional Development + Mentorship

OTPs are often asked to assess sensory functions of children on their caseload, even though sensory integration is an advance practice area. Practitioners that take this course will receive an introduction to sensory functions and their impact on children's ability to participate in their school settings, with a focus on sensory perception and praxis. Assessment strategies will be reviewed, as well as basic interpretation of data and goal development. OTPs will have a deeper understanding of the complexity of sensory integrative issues, and strategies of how they can further develop and refine their own practice. < Back Sensory Perception and Its Role in School Participation Presented by: Kelly Auld-Wright, OTD, OTR/L Watch on-demand and earn AOTA-Approved CEUs Join OTS Collab & Earn CEUs Learn more about OTS Collab Course Description OTPs are often asked to assess sensory functions of children on their caseload, even though sensory integration is an advance practice area. Practitioners that take this course will receive an introduction to sensory functions and their impact on children's ability to participate in their school settings, with a focus on sensory perception and praxis. Assessment strategies will be reviewed, as well as basic interpretation of data and goal development. OTPs will have a deeper understanding of the complexity of sensory integrative issues, and strategies of how they can further develop and refine their own practice. Learning Objectives 1. Learners will be able to identify the difference between sensory reactivity and sensory perception. 2. Learners will be able to link school-based participation challenges with specific areas of sensory integrative deficits. 3. Learners will be able to identify assessment tools to assess sensory functions and have a basic understanding of how to interpret assessment data in order to develop school-based goals. 4. Learners will demonstrate a basic understanding of interpreting assessment data to develop school-based goals. Contact Hours This course is 1.5 hour in length. (0.15 AOTA CEUs) OTSchoolhouse.com is an AOTA Approved Provider of professional development, #0252. National Board for Certification in Occupational Therapy As an AOTA-Approved provider of professional development, OTSchoolhouse.com courses are accepted by NBCOT® at a rate of 1.25 NBCOT PDUs per each hour of course content. NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc. Register for this course and future courses inside the OT Schoolhouse Collaborative for as little as $120 Register Now Learn More about OTS Collab Agenda 0-5 minutes Introduction 5-30 minutes An overview of the sensory registraion 30-45 minutes The difference between sensory reactivity and sensory perception. 45-60 minutes How sensory reactivity and perception difficulties impact school participation 60-75 minutes Assessment tools available for addressing sensory reactivity 75-85 minutes Interpreting the assessment data 85-90 minutes Questions and Answers Your Instructor Kelly Auld-Wright, OTD, OTR/L Kelly has been working as an OT, with a primary focus on pediatrics since 2007. She advanced training and mentorship in Ayres Sensory Integration and has worked in homes, clinics and school settings. She is passionate about providing high quality services, including comprehensive evaluation, to help us fully understand the children we serve. Currently, Kelly works in private practice, providing Independent Educational Evaluations and work for the Collaborative for Leadership in Ayres Sensory Integration (CLASI), where she teaches and plans onsite courses in the United States. Kelly is also a wife, a mother of two young children and a dog that keep her busy. Kelly's favorite occupations include swimming, pilates, groups classes at the gym, walking, spending time with her family and eating good food. Registration To access this course and others, become a member of the OT Schoolhouse Collaborative . OTS Collab is an online community dedicated to providing school-based OT practitioners with highly valuable professional development and interactive support to implement learned strategies. In OTS Collab, we learn together, support and encourage one another, and celebrate our achievements as a collective whole. Click here to learn more about the OT Schoolhouse Collaborative and register in our dedicated community of school-based OT practitioners. Instructional Methods A combination of speaker presentation with a slide deck, polls, and Q+A with the presenter Target Audience & Educational Level This is an Intermediate level course intended for occupational therapy practitioners working in school systems or with a goal to better understand occupational therapy in school systems Course Completion Requirements To receive a certificate for this course, you must watch the recorded course in its entirety. Then, you will need to take a learning assessment test and earn a score 75% or higher. If you pass, a certificate will be automatically generated and sent to your email. Special Needs Requests This course will include closed captioning and a transcript may be available upon request. You may also rewatch the course or sections of the course as needed. Additional accommodations may be requested by reaching out to us via email. Financial & Non-financial Disclosures Speaker Disclosure Kelly works part time for CLASI and is a course instructor for CLASI. She is also receiving an honorarium for this presentation. Sponsor Disclosure The OTS Collaborative Community is a product of the OT Schoolhouse. Content Disclosure This learning event does not focus exclusively on any specific product or service. Schoolhouse Education, LLC is proud to be an AOTA Approved Provider of Professional Development AOTA-Approval for this Professional Development Opportunity is in progress. Stay Tuned! Join OTS Collaborative Terms and Conditions Schoolhouse Education, LLC will keep a record of your completed CE courses. When applicable, transcript services may include reporting to professional associations and/or state licensure boards. While Schoolhouse Education, LLC will make all reasonable efforts to offer CE credit for its courses, it is not responsible for state or national, or regulatory current policies or changes in CE requirements that may make courses ineligible for CE credits. Participant Agreement By registering for or attending any event or activity associated with the Schoolhouse Education, LLC and OT Schoolhouse, I agree to the following: Professional Development/Information Disclaimer The material presented in this course is not intended to represent the only or the best methods appropriate for the occupational therapy and/or medical condition or professional development issues being discussed but rather is intended to present the opinions of the presenters, which may be helpful to other health care professionals at arriving at their own conclusions and consequent application. Attendees participating in this professional development education program do so with full knowledge that they waive any claim they may have against the A-Z School-Based OT Course, Schoolhouse Education, LLC, and OT School House and its staff or representatives for reliance on any information presented during these educational activities. Waiver of Liability Agreement I release Schoolhouse Education, LLC, OT Schoolhouse, and its staff, presenters, and any other individuals or entities associated with this course from any and all liability connected with my participation, as well as from any liability related to changes to the schedule, events or activities. I acknowledge and agree that I am participating on my own choice and assume all risk in connection thereof and that in the event that a need for emergency medical service arises, I authorize and consent to such services being provided at my own expense. Cancelation & Refund Policy In the event that Schoolhouse Education, LLC must cancel the event for any reason, participants will be offered a credit toward the rescheduled event. OT Schoolhouse Collaborative subscribers may cancel their subscription at any time.

Join 11,000+ school-based OT practitioners learning to better support their students. Confidently support your students in just 10 minutes per week. Join 13,000+ weekly readers 👇 The OT Schoolhouse Newsletter is designed to help you become a smarter and more effective school-based OT practitioner. Every Monday, we'll cover aspects of school-based OT that they don't teach you in OT or OTA school. Each week, I'll share: Lessons from real case studies Article reviews and takeaways Free resources to save you time Updates on laws & regulations related to school-based OT ...and more. Subscribe now to join 13,000+ school-based OT practitioners learning tips to support the students and teachers they serve every week! What real school-based OTPs have to say... "Jayson, your newsletter is hands-down THE MOST VALUABLE resource in my inbox these days! Thanks for all your hard work!!!" - Liz Lombard, MS, OTR/L -

Thanks for visiting! Grab our most popular download as a thank you! Hey there! As a thank you for visiting the OT Schoolhouse, I would like to share with you our Gray-space Paper , a resource that has helped many of my students greatly improve their handwriting legibility. This collection of Gray-space paper grows with your students from kindergarten on up and is designed to be intuitive for kids in both general and special education. To receive your digital download of our 9-page Gray-space paper package, simply subscribe with your name and email. All messages I send are 100% related to School-Based OT. Thanks again, Jayson Looking for a podcast dedicated to school-based OT? Click here to listen to the OT Schoolhouse Podcast Looking for more support as a school-based OT professional? We've got you covered with courses & a private community for to school-based OTPs! A-Z School-Based OT Course OT Schoolhouse Community