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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 166 of the OT Schoolhouse Podcast. In this episode, Discover the transformative power of the TimberNook program, where nature becomes the ultimate classroom for sensory integration, emotional growth, and creativity.  TimberNook empowers children to explore, problem-solve, and thrive through outdoor play.  Jayson and Angela discuss how this innovative approach can be woven into school curriculums and the profound benefits it offers.  Get inspired by the magic of unstructured play and its critical role in child development. Tune in and reimagine what learning through play can achieve! Listen now to learn the following objectives: Learners will identify common sensory and motor issues affecting students. Learners will identify the impact of outdoor play on sensory integration and child development. Learners will apply strategies to incorporate nature-based activities into therapeutic interventions. Learners will recognize the benefits of outdoor play for children's physical, emotional, and cognitive development. Guests Bio Angela J. Hanscom 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. Quotes “Restore the occupation of outdoor play and make it as authentic as possible, and that's why it's so therapeutic.” Angela Hanscom , MOTR/L “Part of having many children of mixed ages and mixed abilities, is that it helps create that community, which helps form the individual child." Angela Hanscom , MOTR/L “The whole objective is to inspire, a higher level of play." Angela Hanscom , MOTR/L "30 minute, 20-minute recess sessions are not enough. Kids are just figuring out who am I gonna play with, what am I gonna play, and then the bell rings often. So they don't ever get into those advanced play schemes, which really work on development. I would advocate for, at least an hour recess session." Angela Hanscom , MOTR/L “A lot of times in the school based setting, we try to group, you know, similar age and, similar ability level potentially, but maybe that's completely wrong. Maybe we should try and mix that up a little bit.” Jayson Davies, M.A.,OTR/L Resources 👉 Balanced and Barefoot book  👉 Timbernook Video 👉 Timbernook Episode Transcript Expand to view the full episode transcript.   Jayson Davies     Hey friend, welcome to episode 166 of the OT school house podcast. My name is Jayson Davies, and I am so happy to have you here with me today. Today's episode is one that I've wanted to share with you for a long time now, and I'm very excited to say that I have found the perfect guest to properly introduce you to nature based occupational therapy services. As you may know, nature based ot services have been steadily creeping up into the world of pediatric occupational therapy. However, do nature based ot services actually lend themselves to school based occupational therapy? That is the discussion for today, is that even possible? I mean, within a public school, charter school or private school system, can nature based occupational therapy be embedded into the school day, or maybe even nature based learning? Well, you might be surprised by what today's guest has to say about that very topic. Angela Hanscom, author of balanced and barefoot and the OT, creator of the timber neck program, a nature based program for kids, is here to share how her program now supports kids in schools for up to four hours a day. Nope, I didn't say that incorrectly. I said four hours per day in a nature setting. Now that is not four hours of occupational therapy per day. Instead, it is four hours of nature based learning, based on a program designed by an OT and backed by research intrigued, yet I hope so. Angela is here to share some groundbreaking insights about how mixed age group dynamics and self directed play in natural setting to contribute to critical skills like executive functioning and conflict resolution. She's also going to share with us all about the timber neck approach and why reducing adult interference might just be the key to fostering independence and problem solving abilities within children. And if you enjoy what you hear from Angela today, I highly encourage you to join the OT school house collaborative where Angela will be presenting a course this month titled The decline of outdoor play and the rise of sensory issues. The course is a 90 minute long a OTA approved course, and you can catch the live event on january 22 that's in 2025 or catch the replay of it inside the OT school house collaborative members will have ongoing access to the replay so you can learn more about Angela's course and the OT school house collaborative at ot  schoolhouse.com/courses with that get ready to challenge your views on traditional therapy settings and discover how taking your Students outdoor might just create a profound impact on their sensory and developmental health. Let's dive into it.    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     Angela, welcome to the OT school health podcast. It is so great to have you here. Thanks for joining us.     Angela Hanscom     Yeah. Thank you for having me.    Jayson Davies     Asolutely. You know, we actually met a long time ago at, I believe it was the Occupational Therapy Association of California conference or symposium, something like that. Had no idea. You know, several years later, we'd be on a call together talking about timber Nook and nature based services. It's it's going to be fun. I am happy to have you here and share everything that you're doing with the school based ot community.    Angela Hanscom     Yeah, I'm very excited. And I think this will be really relevant information.     Jayson Davies     Absolutely. You know, the last few days at the gym, in the morning, I've been listening to the book I love, Spotify, and now they've added audio books. I It's in my morning. So I actually want to start off with something that came to mind as I was listening, and actually something that you provided some imagery to right on the or right at the get go of your book. And I think it's something that many of us have experienced right you talk about a child, I believe it was around a six year old who may or may not have ADHD, but this child is being sent home every day with a yellow happy face sticker, and his friends are getting green happy face stickers, and that's causing some potential self esteem difficulties with the student, and to be honest, probably the parent as well, Because as as parents, we know how like much we internalize everything that our child does, gets, and all that fun stuff, and so I guess I just kind of want to start off with is, when did you begin to see this, and how has this shaped what timber nook has become?    Angela Hanscom     Yeah, oh my gosh. It started about 14 years ago, when I my children were really young, so one of my daughters is now in college, but when she just turned five is kind of when I was paying attention to children around me. I was working in a clinic setting at the time, and I just remember seeing really interesting sensory issues, like at a little boy that came into the clinic setting that didn't. Like wind in his face. And I remember thinking, How do I treat that indoors? Like do I get a fan and blow the fan on the child? You know, a lot of kids not wanting to get dirty, but the number one issue is kids are I was hearing from teachers that kids are starting to fall out chairs and onto the ground, starting to run into each other more frequently. And so, you know, just paying attention to those issues. And so it kind of led me down a rabbit hole of, you know, paying attention to the kids around me and some of the issues that were being reported.    Jayson Davies     Wow, yeah. And so you began, so what led you down the road, I guess, to start seeing students outside as opposed to inside? Were you originally working in, like, a clinic setting, or what made you decide I'm going to go outside?    Angela Hanscom     Yeah. So basically, actually, when I had my second daughter, so I have three children, I have two teenage girls, and then I have a son who's eight. And when I had my second daughter, I actually decided I was going to stay home from work. And I ironically, never wanted to be a manager of anything, and I had no business experience. I just wanted to be a traditional occupational therapist, go home and, you know, be a stay at home mom for many years, and then maybe go back and work in a clinic setting. So this was never my plan. But what happened is, when my I stayed home with my kids, I ended up joining a mom's group, because that was kind of the thing to do at the time, and to meet other like, you know, like minded moms and I had people ask me interesting questions. Like, some, you know, people knew I was an occupational therapist. And one, one mom asked me, Why does my daughter spin in circles all the time? Like, what is happening? And then another one asked me, you know, my child's in preschool and he's having trouble paying attention. You know, what do I do? And so again, just really reflecting on, like, why are we asking kids, you know, age four, to sit down and pay attention? Like, isn't, isn't learning through play. So just really paying attention to that. And then, um, when I was staying home, I just around that time noticed there was not a lot of kids playing outside. We have 12 acres of woodland here and about 50 acres of conservation surrounding our property. So we're we live in the boonies on our site, but sometimes I take a shortcut through a neighborhood, and I just remember thinking like there's children that grew up the same age as my kids there, but I never saw them outdoors. And I kept thinking, why are they not outside? I grew up in Vermont where, you know, we were outside till the lights went off, type thing. So, you know, just starting to pay attention to what was happening around me. And then I had a friend I knew I wanted to do something outdoors, and so I was going to run nature classes until I did my first one. And I had a parent come up to me with our son in hand, and she said, can you tell me why the leaves change color? And I was like, ah, it has something to do with a pigment and the leaf like, you know, trying to remember from my science classes, from high school here I am an Occupational Therapist. And I was like, it really helped me reflect on what is my background here. I'm not a teacher and I'm not an environmentalist or a naturalist. And I kept thinking, you know, back then, the professionals running nature programming was most likely, you know, naturalists and teachers. And so I kept thinking, what does an occupational therapist have anything to do with nature programming? And when I learned over the years is that, you know, the main, as we all know, the main occupation of a child is play, and outdoor play is a particularly meaningful occupation that is really at risk in ways that we never anticipated, and that's really affecting child development. And so really what I learned over the years, and you know, there's another whole story to this. But you know, as I was running this nature programming, that really became started as a form of summer camps, actually, because I had a friend that said, I think adults are more likely to drop their children off, so why don't you start with summer camps? Oh, there you go. So that's how timber Nick started, but really over the years, observing children in play out in the woods. You know, that's what I realized, that the whole mission behind Tim Roy is to restore the occupation of outdoor play and make it as authentic as possible, and that, and that's why it's so therapeutic.    Jayson Davies     I love that. Yeah. I mean, again, I haven't made it through all of your book, but I know you really start by looking at some of the research that you talked about chiropractors, and you talked about other types of MDS and other people within related services, and you're seeing a lot of different outcomes because of lack of outdoor play, potentially. And I'd love to kind of give you a moment, I guess, just just to share some of those things that you're talking about, you know what? How is the lack of outdoor play impacting our children?    Angela Hanscom     Yeah, absolutely. Well, so just to dive a little deeper about this, you know, some of the major issues that we're seeing is chiropractors and physical therapists were saying that they're seeing this pre adolescent posture. An earlier age. So they're at this upper body curvature and this forward head position and an earlier age, and they're having to treat back pain earlier. And you know, this makes a lot of sense to me, because when we did a pilot study and looked at core strength of children from, you know, nowadays, compared to 1984 which was my generation growing up, we found and looked at just having a normal balance reaction. We found only one out of every 12 children could meet standards from like 3040, years ago. And so that was really alarming. So it led to a lot of research, and going down the road of asking veteran teachers had been around for at least 3040, years. Were they seeing a rise in sensory and motor issues in children? And so what teachers are reporting? Because they've, they've a lot of these veteran teachers have seen a change over the years. As one is, like I said, the posture is changing. Another thing is decreased attention. So, and this is everywhere, no matter where I'm speaking, they're reporting a decreased in focus in the classroom. So, for example, we had a teacher say she was able to teach a whole classroom as a whole, and she said, maybe, you know, one or two kids had trouble paying attention back then. She said, now, on a good day, at least eight of those 26 kids are really struggling to pay attention. And she actually did change the way she taught so like breaking them up into small groups to engage them in a task. And you know, these are just a couple of quick things, but emotional regulation is another huge one that teachers reporting there. You know, kids are crying at the drop of a hat, much more easily frustrated than years past. A lot of kids are fidgeting. And then the other thing is, kids are falling out of the chair onto the ground. So there's a slew of issues that we're seeing.    Jayson Davies     Yeah, yeah. And you even start to address this in the book, you know, it's not something that can be addressed in one book, but there, of course, is some societal changes, right? That that might be at play here, different expectations for children. But one of the things you really brought up, that you know is a never ending conversation, is the idea of updating versus changing norms. And you know, a lot of people are asking for our everyday tools, whether it be the SFA that hasn't been updated since, like, 2000 or before, and the bot three that just got updated Right? Like, are we changing the goal post? Are we even changing the starting line by updating these norms? Should we be comparing students to 1984 norms, or should we be comparing them to 2023 norms? And, yeah, I don't know if you want to provide any thoughts on that, or which way you lean, I'm sure it's probably somewhere in the middle, is my guess. But go for it.    Angela Hanscom     Yeah, no, I actually, I think at the conference I was at with you back in when, and I was the book wasn't published yet, I don't think, or.     Jayson Davies     I think you were like on almost, like a launching tour, like it was just, I think you had a few copies available, maybe.     Angela Hanscom     Yeah, it was almost longer. But I remember someone coming up to me and saying, Do you know that they're thinking of changing the standardized norms for one of our OT assessments, and that was the first I heard about it, when I was at that conference. Is, you know, like they are actually wrestling with the dilemma of changing it and and they actually have gone and changed it. I always feel like we should keep them to the same standards. But, yeah, the problem was that everyone was presenting with issues, you know, like, let's say grip strength. All the kids are a good majority of kids are presenting with trouble with the grip strength when compared to, you know, 3040, years ago. So what do you do with that? Yeah, yeah. My personal opinion is we shouldn't make it easier for them. We really should take a hard look at our environment. What is going on if a good majority of children are struggling with basic sensory skills?     Jayson Davies     Yeah, and, I mean, again, you know, even your book, right, 2016 to some degree, is already, quote, unquote, outdated, right? Like, we've had a pandemic since then, we've had, like, iPhones and iPads and computers are even more popular. Just got everything that kids are using these days. So, yeah, so interesting how that works while you're while you're talking. I just had an idea, and if anyone from WPS or Pearson is listening, I think it would be really cool, even actually, if, like, when you complete the bot three, not only did it give you the current norms, but maybe it gave you the norms from 1984 too, and you could almost see, like, the where this child placed on today's norms versus older norms. That'd be really interesting. Definitely possible in today's technology age.    Angela Hanscom     Yeah. It'd be fascinating.     Jayson Davies     Yeah. All right, let's start talking a little bit about what the actual treatment itself looks like. When I think of timber Nook and nature based services, to some degree, I see parallels with sensory integration per se, a lot of like clinic based si so I want to just let you kind of have the floor to discuss, maybe the similarities differences and how it goes. Beyond si or or not beyond Si, I don't know, but I want to give you that, that opportunity to share, you know, what it looks like compared to SI, I guess, or other services.     Angela Hanscom     Yeah, absolutely. Well, you know, the more again, I observe children in, you know, clinic settings and in the school environment and then out in the woods and out nature, the more I realize that nature really is the ultimate sensory experience. And the first thing to keep in mind is, when you step outdoors, you know multiple senses are being ignited. So like you have the wind, you have temperature changes, you have depth perception, you have bird sounds, you have uneven ground. Like inside, you don't really have to think about it. It's not challenging you as much. True, you know, there's you can't see as far. The noise levels are different. But yeah, when you step outdoors, multiple synapses are firing in in the brain, and so your chance for sensory integration or organization of the brain is going to be stronger when you step outdoors. And then, if you look in our OT books, right, the ideal state for sensory integration is to be in a calm but alert state of mind. And you know, you look at the colors outside, and you'll see blues and greens and browns, and we'll paint our preschools those colors you go for a massage and you hear crashing waves and nature sounds. There's a reason why doctors say bring your babies outside. It's calming, but you're alert, right? Because you have to pay attention the grounds uneven an animal might run by. You're navigating your environment, and so that happens to be ideal for that sensory integration for children. So we want to think about what percentage of time are children in an environment conducive to that integration. And then what percentage of time are they environment that could be disruptive or dysregulating? You know, in some of our classrooms, even looking at how we have posters on, you know, a lot of posters on the walls could be dysregulating. Even just being closer to other children can be disorganizing as well. Noise levels change when you step indoors. And you know, the other thing is transition. So, you know, in a lot of times in the school environment, we're constantly shifting children. We're like, switch, okay, we're going to switch every 45 minutes to an hour. We're shifting the child. And a lot of kids with sensory issues have a hard time with transitions, and so it can be very dysregulating. Whereas, where you go out in the woods, you go out in nature, often you have a lot of time. You know, one thing that Tim Burke is known for is time and the space out there, so like, hours of outdoor play time, so they can dive really deep into play and to regulate and to just be, you know, that's another thing that we're we don't often give children enough time to create change to the development and then, yeah, so time and space are very big, but those, those are the things to keep in mind for the sensory integration piece.    Jayson Davies     Yeah. I mean, you, you kind of set it straight from the SI. I'm blanking on the terminology, but the document that says whether or not you're using SI, and that is that you need a calm yet alert safe space inside, and oh, it doesn't say inside. But would you say that you are providing sensory integration? Is that how you would kind of say just an alternative, non typical environment, or would you say it is very or somewhat different from SI?    Angela Hanscom     Well, I think, I think SI is very much a part of it. It's just to me, like another example, because I'm such an example person. Yeah, you know, sometimes we'll bring a little box of sand inside and call that sensory and then, like I often compare that when I do presentations to giant like the kids searching for frogs and giant mud puddles out at Tim Burnham, let's give that as an example. And I say, okay, both are considered a sensory experience. However, for our true objective is to create change to the senses. Which one do you think will be more conducive to that. And then I have people step back and say, what is happening in the image where children are in these giant mud puddles searching for frogs, and what you know that you're not getting with a little box of sand searching for, let's say, plastic frogs. And you know, they start breaking it down like, first of all, it's a whole body sensory experience, right? Is head to toe engagement. You're probably, is probably uneven under there. So you're, you're having to balance. There's different smells, right? You're, you have nature sounds. There's other children involved. So now you have more space for other children. You're having that communication piece and that engagement and connection with other children. You know, there's endless opportunities for play. So a stick could be 50 different play affordances, and someone else might use that stick in a different way, and it helps you get new play ideas. So there's endless opportunity for sensory integration and for, you know, other skills that we often kind of break down as a. Occupational Therapist, right? Like executive functioning skills, social emotional skills, all that good stuff.     Jayson Davies     Yeah, is there any aspect within occupational therapy that maybe you used to be able to provide in a clinic, but you found it difficult to provide outdoors? Or has it been pretty simple to adapt everything?    Angela Hanscom     So, well, the way that timber Nick works is it's a pro it's a program based intervention. So it's not a one on one or small group intervention. It's an entire group of children. So it's very much like program based and so it would be if I only had one or two kids out there, then it does change the game, because part of having many children of mixed ages and mixed abilities is that it helps create that community, which helps form the individual child. So some of those children might have more advanced language skills that will model that for that child, or more advanced play skills, and it will take that child to a different level, and it will be more effective because it's actually within the context of play, the mean of meaningful occupation of play. And so that's going to be really effective. The other big change is that the adults actually take a step back. So it's very much where the adults have to get out of the way to foster the environment. So we use the environment and we stage it and put items out there to inspire higher level play, but the adults. So that's very different than like an individual or small group model, where the adult is kind of front and center. And I can explain why we do that, if you want, but that's that's a big difference.    Jayson Davies     I think we're here. We might as well just, just roll with it. Go for it. I've got many questions for you, but I want to let you talk about the program.    Angela Hanscom     Yeah. So a great example of this, or why we step back in the first place, is, let's say kids are building a four out in the woods, right? There's so many developmental benefits to building for in general, but we noticed that if an adult is standing too close to the kids, the kids started seeking constant adult reassurance, like, Is this okay? Or can you do this for me? Or there would be more tattling going on. But there was a constant seeking for help from the adult but when we backed up 1020, feet and we got down low and reduce adult presence out there. What we found is that the kids would turn to each other to come up with their own play ideas and then execute those play schemes, solve their own problems through play conflict resolution, regulate their emotions, you know, and just but and execute those play schemes. So like one thing that we tend to do in society in general is we're giving the kids all the ideas, and kids are alert like they don't get a lot of opportunities to initiate their own ideas anymore and to execute those ideas. So at Timber neck, that is one huge benefit, is that they get to plac practice those play schemes, those executive functioning skills and a very real context that can help generalize over to other play scenarios, if that makes sense.     Jayson Davies     Yeah. Yeah, absolutely. So since you do it as a group, I don't know if you do it every time, but do you take, you know, pre test, post test, or have you done research where you've done pre test, post test and and I don't necessarily need to you to go into like, all the outcomes or whatever, but I'm just interested in, like, what interested in, like, what are you measuring when you do that, whether it's subjective data, whether it is a standardized assessment, what? What is kind of your outcomes that you're looking for?     Angela Hanscom     Yeah. So we we have an observational tool that we can use if providers, those that are running timber, not prefer if they want to or if a school has implemented timber nook, they can look at different measurements as well. So there's a couple different ones. One is an observational tool that we created with the University of New Hampshire, and it looks at the effectiveness of a play experience and how rich it is. And so it's has the person running timber to kind of assess the effectiveness of it. How what is engagement like for the children? How many kids engage in that play experience? You know? How many times did they need adult intervention, like or seek out an adult and so you can kind of measure the change over time. Looks at social, emotional skills and in play skills. So that's one measurement. And then a lot of times, if it's in this school setting, like so Tim Burnett can go into a school and be part of their curriculum. They will often do some sort of reflection after so they might do like a literature prompt when they get back in the school to evaluate, you know, like what children are getting out of it? We do a very quick evaluation. At the end, we'll say what's one thing that challenged you today to the children? And you know what's also like evaluating how much they enjoyed pleasure and engagement as well? But it's, yeah, it's a little different than traditional. Oh, OT, more program based, yeah.    Jayson Davies     Yeah, absolutely. I, I think it's really cool. And I know you're, you're diving even more into the school realm. Here in the future, I live in a place where, you know, we actually have a state park right behind us, but a lot of times going outdoors. You know, you mentioned a mom's group. And my friend runs a mom's group, and like, to be honest, sometimes they just, they go to like a local mall, and they're doing, like a work at a local mall, like, that's part of the work. That's part of the Southern California moms group working out together. But obviously you have a much larger space in your backyard. But this is spread. And so what are some of the ways that people who are maybe more in a suburban, maybe even, dare I say, urban area, like, are they able to kind of adapt this? And do you have any examples of what that kind of looks like?    Angela Hanscom     Yeah, that's a really good, a good question. So we, I live in a suburban area as well, and we do have timber nooks that are, you know, we still find a patch of woods to do timber neck in. We do have timber neck in some cities. So like Calgary, Canada is a city that they're bringing timber nook in. So there's parks Los Angeles timber and Los Angeles, same thing. They're bringing it into the park. It is more work on the people that are running the program, because they have to bring all their supplies in and out. Timber neck is it's ideal if you have an outdoor classroom where you can leave things out there. It does make it more simple. However, there are people that are like, this is so important, you know, I think there's room to grow for this. I think there's, there's gotta be a way to be able to, like, find transportation for kids that are disadvantaged to be able to access the woods to, you know, get timber neck. Because what we're finding is a lot of kids are play deprived, and we, we've been doing a lot of field trips here, and people, we have kids bussing from an hour that are in the inner city coming out for timber knock. And you can tell they're like, so like, the sense of urgency that they have to get to play really quick is very fascinating to me, because the typical programming that we run almost like a forest program, the kids are very relaxed. They know they have hours out there where a field trip is different. They get a taste of timber Nick and they're like.    Jayson Davies     Just the first day, yeah, okay. Now, when I think of a kindergarten or any schoolyard for that, you know, being obviously, you think of a large grass area for some soccer or whatnot. You think of a blacktop for basketball and tetherball and those fun things. And you think of a playground, right, albeit minus swings, largely due to our favorite people in the world, lawyers. So it sounds like when you're integrating or when you're providing timber nook as a program for schools, it doesn't sound like it's being done on the schoolyard. It sounds like it's being outside of the school, correct?     Angela Hanscom     Yeah. So timber means trees, so typically it's within a forest or woods. In a lot of our schools that run timber neck have woods to be able to run it. We have had some locations do it in the past. Actually, we do have one in New Jersey that's a school that has a very pretty small area, a couple trees, and they still run timber Nick and they make it work, and they see benefits. So there is a possibility of doing it now on a playground. It's very hard, because what happens is, with Tim Burke, you want to get away from playgrounds, because you don't want to get playground play where they all stand in line and they're they're using equipment. You really want them to create societies, create their own worlds out there, dive into a magic Terry type play, and that you kind of have to get away from the man made stuff, and so it is harder to do that nearer play structure.     Jayson Davies     Yeah. Okay, so then you talked about, like, how it can be a field trip. You talked a little bit more how maybe one of the private side of things outside of the schools, right? Kids are maybe coming once a week or several times a week for schools. Is it primarily, then that field trip type of thing. And is it a one off, or is it a multiple thing? Or what does that look like?    Angela Hanscom     Yeah. So multiple things, actually. So some schools will just do field trips at a local timber neck site. Some will do a series of field trips. We do have a provider that is running timber nook at a school right now and so And what's cool about this is, she's a dental hygienist. She's not an occupational therapist, but she's trained in this authentic occupation, and she's mastering it, so she's bringing it in. And what's happening is she's she's doing it at the woods. There's woods at that school right now. They have two other schools bussing the kids to that one. So there she's running tomorrow, four days a week for that district, and then she just recently got another school interested. So there's a huge need for this kind of program right now because of, I'm sure, you know, like, some of the behavioral issues we're seeing, and a lot of you know, just connection and social skills. Kids and all the things that you can't really, you can't really replicate this in a clinic setting, or one on one, or, you know, they treat that true neighborhood play, which they're not getting. If you send your kids outdoors, they're not getting that rich type of play anymore.    Jayson Davies     Yeah, yeah, wow. And, you know, you mentioned the frogs, and I know in the book, you talk about, you talk about, you know, actually going out and looking for real frogs. And you also mentioned a kid who's on like a rope swing and falls and, you know, gets the wind knocked out of him for probably the first time in his life, and having to learn about that experience and whatnot. What are some other really quickly, because I do want to dive into what it looks like in the school, but just really quickly, like, what are some of your favorite activities and moments that you get to share with the children out in the program. What are some of those? You know, rope swinging and fun things that you like to do with the kids?     Angela Hanscom     Yeah, so Tim Reddick, we call it. They're called play experiences and and the reason why is because I'll give you a couple examples of them, is because environment is staged to inspire that kind of play. So an example might be three little pigs. So that's a favorite of mine, where we might do a puppet show of the three little pigs, or we'll read the story and then after out there, before the kids even come out, like it's the we have bales of hay out there. We'll have real sticks, well, big bricks of different sizes, Wolf masks might have some milk crates and pulleys and rope. And then we'll say, now you have the opportunity to create your own three little pig homes. And so they have the opportunity for hours, to build life size three little pig homes. And they may or may not do that, or they may do it for a period of time, and it might go to a different kind of play experience, but the whole objective is to inspire a higher level of play. And because you have children of mixed ages, it's true neighborhood play, right? So you'll have some older kids that will take play to another level for the little kids and help them tie knots and stuff, where, whereas you might need an adult if they're all five, right? So, so that's a beautiful thing. Another, like popular one or one that I enjoyed doing, actually, Merrill shoe company, their design team came out and did this as adults. Did this verdict, experience is a giant ball run, and so using, like, real gutters and big tubing and ropes and pulleys, duct tape, and then they create their own ball run out there. And so what's cool about that is, you see different leaders come forward, and children like often when schools come out, you'll, you'll hear teachers say, I never knew that kid was a leader until I saw them in this kind of environment. And then you, you know, they do so much like fine motor coordination, you know, design work, but there's a lot. It's like OT and steroids. It's very and it's all in the context of play, which is, you know, why I think it's so effective. The kids are really deep into it.    Jayson Davies     Yeah, yeah. Two things keep coming to mind as we talk, you know, one is, like the dystopian world of Lord of the Flies. Obviously, we're not going dystopian here, but like all the kids just kind of having to learn. And, you know, leadership. Some some kids step up to leadership roles. Others turn into followers. And then that changes over time. And I love that idea of, you know, older kids with younger kids. A lot of times in the school based setting, we try to group, you know, similar age and similar ability level, potentially, but maybe that's completely wrong. Maybe we should try and mix that up a little bit. The other thing that came to my mind, as you were talking about, you know, that like the marble run or ball run, and having just random objects like gutters and pipes and tubing and stuff is a research idea from, I want to say, was the early 2000s I think, where, don't quote me, it might be Anita Bundy, but they just put out random things on the playground and actually trained the aides to step back, and they found that that had a positive effect and timber not, kind of reminds me a little bit about that.     Angela Hanscom     Yeah. So Anita Bundy was one of our keynote speakers for our turmeric conference a few years back, and she did the Sydney playground project. And a lot of times she talked about how loose parts so these materials, like milk crates, that could be used for many play ideas that it was actually like gives a lot of times children with special needs and invitation to play with other children too. They have something to offer. So anyway, yeah.    Jayson Davies     Yeah, it's not just the physical advantages to using these random objects, right? It's the social emotional it's the societal and general advantages to using these things. So love that you're actually conducting some research in collaboration with the University of New Hampshire right now, and I believe this aims to understand the cultural impacts of timber nooks. So I would love to just learn a little bit about that. What are the key areas you're hoping to explore, and, yeah, what you're hoping for?    Angela Hanscom     Yeah, absolutely. So we actually met with them this morning again, but we are basically looking. At our current timber neck schools, so schools that are doing timber as part of their school day. And let me explain that real brief, just so people understand. But they might have a two hour time block of timber nook within the day. So it could be that they go to school and then they from like 930 to 1130 they have timber knock before lunch, and they might have it every day. They might have it once a week. They might have it twice a week.     Jayson Davies     Hold up, sorry, I have to interrupt you, because I know everyone is asking me, how is this like? How is this even possible? How do like schools allow this?     Angela Hanscom     Yeah, oh, so Well, they do research. You know, let me give you an example. So, Laconia Christian Academy is an example school that we have not far from us. We have a number of schools in our area, but that's one example. And they they started researching for schools in the area, knowing that outdoor education was really important. And they ended up at Timber nook, because we get, we offer, like ongoing professional development on training. It's, you know, it's a lot of times you get trained in this for school approach, and you're on your own. This is very different. But they, what they did was they started with timber neck once a week. They got rid of their phys ed for pre K, okay, that scary because, because it's very physical, yeah, this is their phys ed, basically. But they so they got rid of phys ed. And then what happened is, after doing it once a week for two hours, they looked at their recess, which is half an hour a week, and increase the Rhesus to an hour every day because of what they were seeing at Timber nook. And then they went to twice a week timber nook, so now they have like, five hours of timber knock and an hour of recess every day, and they have been looking at the data. This is a very academic school, and so no change of anything, an increase, and this was during the pandemic when they were looking at it. But not only that, they're seeing that the kids are happier, they're healthier, they're more resilient, they're able to solve their own conflicts. They're more creative, and the teachers are happier, so they're finding more joy in their work again, when you're getting a lot of teacher turnover. So this is what we're researching. So this, I figured, okay, really inspired us to like we need to look at, you know, how Tim vernick is affecting culture. Because they said, you know, Tim Bernick is our part of our culture. Now it is our culture, and it's, yeah, so.    Jayson Davies     Wow. So they started small, and they found that internally, you know, maybe they looked at various scores and they said, Hey, this is supporting our children. So they went with two hours a day that that is amazing. I like how they did the physical education. They kind of, well, we don't need phys ed because kids are outside for two hours, so they've replaced that. But now I'm sure they're embedding other academics into that time to some degree. Maybe it's Wow, yeah, it's just that's pretty crazy. So when you're talking about understanding the culture, elaborate that on that a little bit more like changing the culture within the school, changing the cultural in general, and increasing play. What is that?     Angela Hanscom     Yeah, so we're going to look at, you know, what effects Tim Murdoch has had on the school. So we're going to look at, like, the teacher satisfaction, you know, teacher retention. We're hoping this is not like, I don't, don't quote me on all of this. I'm not sure we have to keep on the actual research aims, but these are some of the things we're playing around with, you know, the health, the the well being, and the health of the children, and then, yeah, like, how is it affected? You know, recess. Like, have they increased recess? You know, has it? Is there a carry over to their teaching techniques, which is what we're hearing. We're hearing they now teach differently. You know, they're able to allow for more child independence in the classroom because they can let go of controlling everything in the aspect, so.    Jayson Davies     That's awesome. All right. Well, I guess we'll kind of start to wrap up here with with just a few things that maybe ot practitioners who are listening to this podcast, who, you know, are school based ot practitioners, primarily, maybe some clinic based, but you know, they're interested in this and the idea of a playing more and B playing outside. Let's assume that they're more in a quote, unquote, typical suburb in school, right? And they don't have woodsy area outside that they can use. What would you and kind of just start to encourage them to potentially do, to maybe start to either A, get more play time because they need more play time, or B, kind of incorporate the ideas of timber nook without having a wooded area.     Angela Hanscom     Yeah. So I, you know, the book balance and barefoot, I think does a nice job for like, if you're, you are limited, or you have you're going to start with your back at yard, or are you going to start, you know, at recess. So, you know, that is if people want more information, that I would definitely turn to that book to read more. But, you know, obviously, timber knock is a specific program, and they can. Research more on that, and it is credentialed with iota. So any OTs that train, they get ongoing certification. If they have woods, I would definitely recommend looking into it, because there's a lot of training and support and education that needs to be done and advocacy. And it's big thing. It's not easy work. But if they just have, like, a playground, or if they, you know, like just, maybe even just looking at the environment, like, can you have an area that is away from equipment that is accessing some sort of nature? Can you put out loose parts, like materials that be, can be used for many purposes. So, like, some examples of loose parts are, you know, planks, tires, baskets, you know, building, building materials, stuff. They can build forts with little, little pieces of rope, bricks. And that, that alone is going to take some education, just introducing those parts to the school, but that, you know, that is a way to kind of change the game and then allowing for more time. So, you know, 30 minute, 20 minute recess sessions are not enough. And you know, kids are just figuring out, who am I going to play with, what am I going to play and then the bell rings often so they don't ever get into those advanced play schemes, which really works on development. And so I would advocate for, you know, at least an hour recess session. So those are things I would consider. And then, you know, advocating to parents to allow the kids to get outdoor playtime at home, advocacy is huge, because it will create change the child and going on a screen when they get home or being overly scheduled is, is is really sad and they're not getting that social piece they need. Yeah, so.    Jayson Davies     That's awesome, yeah. And the other piece that I would love to hear from you really quickly, because it kind of incorporates you brought it up earlier, right? Is, is in your place, right? It's the clinicians or the owners or the people that are working right, taking a step back in the schools. That's often a para professional, sometimes teachers, how can ot practitioners support them to maybe step back? Or have you seen school based ot practitioners or other people you know help to train those people as a way to how to how to best support the students during recess? I guess.    Angela Hanscom     Yeah, that's it. That is a challenging one. It's funny, because I was just talking to someone recently, and they said I was I'm training them to be a provider. And she said that she at recess because they also work in the school, and they're also going to be doing timber duck. Then she got yelled at because she stood back. So there, I think that this is a bigger thing, that there needs to be a lot of education done. And so the helpful thing is, when Tim roux gets into a school, it's education for everyone. So everyone's on the same page, versus you're fighting one person with, I'm going to bring in these loose part and people don't understand. They're like, What are you talking about? Loose parts and rhesus alone, like, the way they have it set up, there's the number of children they have out in the small space. Like it can affect dynamics. So I think looking at the environment, you know, and advocating for less, is more less children out there at a time. But yeah, it is. It is a little harder with public schools as well. Like even this, the school that Tim Rick's going into, the public schools, they have a wood separate from recess, and the teachers, what's happening is the teachers are sitting, watching recess and then watching timber knock and saying, How can we see behavioral issues at recess? But not timber, not but it's but the nice thing is, is planting seeds going okay, well, what about this environment is different, and what can we do different about recess? So I to be completely honest, I think the best way to create change is to be an example, and for them to see it, these teachers have to witness it sometimes, because you can talk to them, you know, until you show.    Jayson Davies     Them, you can't just tell them. You got to show them, right? Yeah, so quick, quick question. We don't need to go too in depth into this one. But would you rather see two half hour recesses over the course of the day, or one longer recess? If they had to?    Angela Hanscom     One longer recess?     Jayson Davies     Okay.    Angela Hanscom     definitely.     Jayson Davies     I mean, ideally, right? We're getting two one hour recesses, but just one longer recess. You think it was more beneficial?    Angela Hanscom     Yes, because the reason why is it takes, like it, like I said, it takes a lot of time. It takes sometimes 45 minutes to dive into a play scheme for kids. And so when you cut it short, they don't get to those social emotional opportunities where they do have to regulate emotions and solve their own problems. It you just never get to that point. The other thing is, it takes a good 45 minutes to an hour to regulate the body to be able to pay attention and learn. And so sometimes you let them in in 20 minutes, 30 minutes, and they've gone from here to here. And so then you're having like, dim lights and like refocus them to pay attention after, so.    Jayson Davies     Wow, you just blew my mind, because, like, that reminds me of something completely unrelated. It. But I use, I don't even know what the name of the app is, but I use an app to wake me up. And it doesn't just wake me up at the time I want to wake up. It measures my sleep using my Apple watch, and it says, oh, during this half hour time, when are you, quote, unquote, least asleep? That's when we want to wake you up, because that's when you'll be best to wake up, right? You don't want to wake up from deep sleep. You want to wake up from light sleep, and kind of correlating what you just said, right? We we don't want to get the kids all riled up and then take them into the classroom. We want to get them riled up, calm back down, and then bring them into the classroom in 20 minutes. It's hard to do that.    Angela Hanscom     Absolutely. Yeah.     Jayson Davies     Wow. Dropping knowledge here. Oh, right. Angela, we'll wrap up with two last questions. This is a fun one, and then we'll let people know where they can learn more about you. But what would your ideal playground look like at a school? At a public school?    Angela Hanscom     It would be in the woods.    Jayson Davies     Okay, we gotta go a little more in depth, in that woods.    Angela Hanscom     and what so like my second best, if it couldn't be in the woods, would be like a natural playground. That was like replicating. We worked with be in stock natural playgrounds for a long time, and they came out to Tim road to see, like, we can't ever replicate what you're doing here, but we can do some things that, like on a scale of therapeutic, you know, that's a step forward. And it's like, you know, natural logs. It's, you know, there are some posts that are like trees. There's where they can dig really deep and start engaging the muscles and, you know, create change to the senses. On a bigger scale, that that would be ideal, less equipment that only has so many uses, and then having loose parts, like materials they can pick up and move around, would be really important.    Jayson Davies     Yeah. How much do you feel like having some sort of body of water, whether it be a stream, small pond, like I know in the school setting, right? We can't get kids like super wet and then send them back to classroom. But would that be ideal for you, or is it too difficult to use?     Angela Hanscom     Yeah, it's funny. We just had this conversation at the Research meeting. Is some of our our schools have outdoor showers. I which I just about, I didn't realize it outdoor shower. But, you know, having the ability to get dirty is actually, I feel like, really important, because it's just part of engaging the senses. One thing people can look up as a Swanson elementary school. It's a school in New Zealand that implemented change their recess. It is mentioned in the book, and one of the things that he implemented was loose parts. The adults step back and he and the freedom to get dirty. And he said, the first week, they did a mudslide every day of the week, and they said, but once they got out of their system, the kids, you know, it was not an issue, and they had a full hour recess session, and they were ready to learn. So they saw a decrease in bullying and an increase in attention just from those changes at recess.     Jayson Davies     Wow, wow. I think that is a great place to start to wrap up. And Angela, we've already mentioned the book, but where's the best place for people to learn more about timber neck?    Angela Hanscom     Yeah. So timberduc.com and then we're also on Facebook and Instagram. Fantastic.    Jayson Davies     Well, Angela, I really appreciate you coming on and sharing so much about timber duck and also about how timber Nook is being used currently in the schools, that's that's fantastic. I can't wait for more people to learn more about timber nook. I wouldn't be surprised if someone gets an idea and decides to go do something special with this information that you have shared today. So thank you. We really appreciate it, and we'll definitely have to keep in touch to learn more about your research as it becomes available.    Angela Hanscom     Absolutely. Thanks so much for having me.    Jayson Davies     Well, that wraps us up today. Please help me in thanking Angela Hanscom one more time. Angela, thank you so much for sharing invaluable insights about the timber nook program and the wonderful benefits of outdoor play. Your passion and dedication to children's sensory and developmental needs are truly inspirational that we can all learn from and also, thank you for tuning in today, I hope you feel inspired to champion the power of outdoor and nature based activities after this episode within your communities and beyond, don't forget you can learn more about nature based OT and the impact that decreased outdoor play has had on sensory issues within our Students at the OT schoolhouse collaborative. Become a member today at ot  schoolhouse.com/collab , to join Angela's course live on january 22 and catch the replay after that. As a member, you'll also get access to all of our other courses, resources and so much more. Once again, thank you everyone for joining us today. Let's continue to foster these environments, these positive and nature based environments within our schools, to support our students, take care, and I'll catch you next time on the OT school house podcast. Adios.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on. Over to otschoolhouse.com Until next time class is dismis Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 8 of the OT Schoolhouse Podcast. In this episode, Jayson and Abby look at the many ways to earn professional development per NBCOT guidelines and share 9 specific places where you can earn your needed Professional Development Units (PDUs) or Competency Assessment Units (CAUs) as NBCOT calls them. We also announce that we will soon be offering professional development units for those who listen to the podcast and take a short quiz to prove you have listened and learned the objectives we intended to be learned through the episode. Have a listen if you would like to have these three questions answered: 1. Who needs continuing education and how many units do you need? 2. What counts as professional development? 3. Where can I earn professional development units? Links to Show References: NBCOT - Keep track of your CAUs and earn more for free with your paid certification Navigator Ways to earn CAUs AOTA - Acess free and paid continuing education courses Continuing Competence Requirements for each state licensure Log into your MyAOTA account to earn continuing education Also, don't forget to pick up your Best Practices for OTs in Schools book from AOTA or Amazon . MedbridgeEducation.com Medbridge has over 150 courses related to school-based OT practice on an easy-to-use website. Use Promo code: OTschoolhouse to get your first year of unlimited courses for $200 versus the $250 advertised rate. The OT Schoolhouse does receive a small commission for any OTs who sign up to use Medbridge with our promo code. OccupationalTherapy.com Occupationaltheapy.com has over 70 School-based related courses that you can watch, read, or listen to earn continuing education all for $99 a year. Use the link above to help the OT Schoolhouse earn a small commission when signing up. This helps us to keep bringing you excellent content. Summit-Education.com Summit provides high-quality online and live courses. Get access to all online courses for $249 per year. For $299 you get access to both online and live in-person seminars. PresenceLearning.com Presence Learning is a company that provides telehealth OT and SLP services to school districts across the nation. As a part of that, they provide several free seminars including a 90-minute presentation with Q&A from Temple Grandin Check out one of our blogs about lessons learned from Joann Sorg , one of Presence Learning's own. PocketOT PocketOT.com is a fantastic blog and resource from long-time Occupational Therapist Cara Koscinski. Not only is she an OT, but she also has children of her own with special needs. she is a great resource and you may even see her name in the conference brochure at your next AOTA conference. OTSchoolhouse is an affiliate for PocketOT as well. Rhythm Works Integrative Dance Program (RWID) Rhythm Works Integrative Dance is a comprehensive dance program for children with special needs. Be sure to visit RhythmWorksID.com and hear the founder, Tricia Gomez, on Episode 2 of the OTSH Podcast. Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.    Abby Parana     Hey everyone, welcome to the OT school house podcast. This is episode number eight, and we are talking about professional development today. Woohoo. How are you today Jayson?    Jayson Davies     I'm doing very swell. It's a nice being on summer vacation.  It is and it's hot today.  Yep, Southern California for you. I mean, Pennsylvania, don't even know.     Abby Parana     No, they don't take me years to adjust and not to mention our professional development that we're discussing today. But we're also talking we have some important news and business to take care of here. At the beginning of the podcast, we have our winner for our schools out contest, giveaway. Woo hoo. That's pretty exciting.     Jayson Davies     Yeah, well, we're gonna make it even more exciting right now, because we're going to announce her name. But first, we want to say thank you to everybody that participated in our schools out giveaway. We had a lot of good turnout. There are several ways to earn points. Many of you completed the survey, many of you followed the podcast and liked us on Facebook and entered for more entries every single day. So we want to say thank you to all of you for participating in that.     Abby Parana     Yes, thank you guys so much for participating. We love to see a lot of group participation and things like this. It's really fun. This is our first contest, but it won't probably be our last.    Jayson Davies     Yeah, this was too fun, to fun for it to be our last.    Abby Parana     Right? Who doesn't love a good giveaway?    Jayson Davies     So should we announce the winner?    Abby Parana     Yeah, let's do this. Why are we putting this off any longer?     Jayson Davies     I don't know. I don't know. Everyone out there is probably sitting on the edge of their seat right now, all right. Well, the winner is we do a drum roll. The winner is hope Marie from Florida, not Nassau County, but Nassau County is where she's from.    Abby Parana     Good, you had to practice that. We both had to look up how to pronounce that appropriately. Yeah, turns out there's a YouTube tutorial.    Jayson Davies     A 15 second YouTube tutorial about how to pronounce the name of this county.    Abby Parana     Yes, which is awesome. But hope we are really excited that you won.     Jayson Davies     Super excited.     Abby Parana     So what does hope win Jayson?     Jayson Davies     Hope will be joining us on an episode of a podcast coming up here soon, and we're gonna talk to someone that is on the complete opposite side of the country from us about how she provides occupational therapy services in a school based setting in Florida. So I'm pretty stoked for that, because I've never talked to a Floridian school based occupational therapist.    Abby Parana     Me either. And I think the other thing that's kind of cool is, when you talk to occupational therapists, we all have a reason for doing the practice that we chose to be in, and we also have a reason for being an occupational therapist. Most of us like why we got into the profession. So I'm really curious about Hope's backstory, too. So I'm excited to have her on to share some of her techniques and strategies that she uses, and learn a little bit more. So thanks hope for signing up and participating and willing to make a guest appearance.    Jayson Davies     Yeah, that's gonna be really cool. Can't wait. So with that, definitely stay tuned. Make sure you subscribe right now to the podcast so you don't miss any future contests that we might do. I mean, who knows next time it might be another guest podcast? But we like to, you know, we like to mix it up a little bit. Maybe we'll give away the best practice in OT school book, or we'll give away some other stuff that we have for for a year. I don't know. We'll find something, but we'll see how this goes. I'm really looking forward to it.    Abby Parana     Me too. Me too. And also stay tuned to the end of this podcast, because we happen to have some pretty cool news for ot from ot school house and some interesting ideas that we're going to be bringing you. I can't wait to go over that and announcing I know I'm really excited about it. You guys are going to love it. Yes, I love it.    Jayson Davies     Me too.     Abby Parana     Super easy and convenient and wonderful, so I'm very happy about it.     Jayson Davies     Yeah, all right, Abby, well, let's jump into the actual content for today, which is all about professional development, what it is where you can get it, all the nuances about it, such as why everything has like, eight different names, CEU, PDU, Cau, contact hour. It can be confusing. Yeah, let's start there. Let's start with the whole what all the acronyms are, and how they work, and that stuff. So the first one, I think, is the easiest one to understand, because it's in its name, is contact hour. Yeah, because, oh yeah, isn't I think that's the easiest one. A contact hour is one hour of professional development.    Abby Parana     Yeah, that's pretty self explanatory.     Jayson Davies     Right? And so in my understanding, the closest thing to a contact hour is a PDU, which is a professional development unit. In most cases, one PDU equals one contact hour, correct? All right, so now this is where was that?     Abby Parana     Well, and now it gets hairy, yes, now you have continuing education units.    Jayson Davies     CEUs.    Abby Parana     or CEUs, which one continuing education unit equals 10 contact hours, or PD use.    Jayson Davies     Yes, and you don't see this too much, but I feel like every now and then you see it, and you're like, What the heck? Like.    Abby Parana     Yeah, can we just be direct about it?    Jayson Davies     Because this is the one that you see oftentimes that is in a decimal form. It's like you need or this is point one CEU, which makes it seem like you're getting like nothing. It's like 1/10 of something is what you're getting, right? But point one, or 110 1/10 of a CEU is the same as one contact hour, typically, right? Hence, 10 contact hours equals one CEU continuing education unit.    Abby Parana     And then, to top it off, it seems like every board or state, they all follow something a little bit different. And then you have the NBC ot that follows the PD use. And so you just have to know oh and see au Yes, which, let's see if you can get it this time. Jayson.    Jayson Davies     All I can competency assessment units, CA, use Yes. In essence, this is basically the same thing as a PDU, it's typically one hour equals one Cau. However, there are some instances where it equals 1.25 contact hours one cau does in other instances. And we'll get into this a little bit, because you don't always measure something in hours. When it comes to NBC. OT, you can, you can earn ca use by publishing, and how do you measure how many hours it took you to publish something? And so that's where they have to break it down into competency assessment units. So we'll get into that in a minute. And we're actually going to share on the show notes. OT schoolhouse, com, forward slash episode eight, a resource that points you to the NBC, ot website that kind of explains a little bit about what you can do. And we're going to talk about it in a minute, about what you can do in order to earn these. Ca, use. There's like 32 different ways, and we're getting we're going to get into some of them and here.    Abby Parana     And you know, I think it's interesting, because until we started doing the research for this podcast, I sort of always just assumed I needed to have CEUs and the ones from a ot a but it turns out there's actually a wide variety of ways you can demonstrate that you've done professional development, not just for NBC OT, but also for different state boards and all of that. So we're we're going to go ahead and get into it.     Jayson Davies     Yeah. So another thing we wanted to touch on, I think everyone listening, or most people that listen to this podcast, are either an occupational therapist or a certified occupational therapy assistant. Therefore you mostly all know that OTs and CODAs, we need 36 units caus every three years if we want to keep our MBC ot certification.    Abby Parana     36 PDU.    Jayson Davies     or CAUs, a CAU and no, it's actually CAUs, oh, it's ca use, yeah, I thought we needed 36 well, they're the same thing. Remember?    Abby Parana     Oh, god, okay.    Jayson Davies     So yes.    Abby Parana     so you need 36 hours. Yes,    Jayson Davies     you need 36 hours, basically. But again, not everything's measured in hours. So you need 36 units.    Abby Parana     Right or 3.6 CAUs,    Jayson Davies     exactly. So now that the math portion of this podcast is over, we all need CEUs, if you're an occupational therapist or as a CODA, even if you don't need MBC ot as a certification, such as if you are in a state where they only require licensure and not certification, you very likely need some sort of continuation to suffice for your state's licensure. So every state's a little bit different, and so we are going to actually put up an. Another resource for each state. It's all it's directly from NBC OT, and it shows you what states require what type of continuing education.    Abby Parana     Right? And, you know, I think it's important to note like, what is the purpose of continuing education and what is the purpose of professional development? And it's because, you know, as professionals, our profession is constantly changing. Occupational therapy has evolved tremendously from its inception. So if you think of, you know, our need to stay on top of evidence and research, this is a way for state licensures and the national board to regulate and make sure that OTs are achieving that, yeah, and staying, you know, staying up to date with the evidence based research and that we're doing evidence based practice, because that is what allows us to get paid essentially and justify ourselves so right and justify ourselves as a needed service.     Jayson Davies     Not to mention, I don't know about you, but coming straight out of college, I felt like I knew nothing, and I've learned so much through going to conferences, taking courses, getting the SIP certification, like so much of that has helped shaped the occupational therapist that I am so right. College is just the beginning.    Abby Parana     Oh, it really is. And if you think of like, I've been out of school 10 years now, and I think of just everything that's changed, even with theories and research, sensory integration has a lot more research behind it now than when I was in school. There's just a lot of research that comes out, and if you're not doing professional development and getting these hours, then you're not going to be able to practice using evidence based which is a requirement of the education codes, at least in California. But it's the requirement for special education is that we provide our students with evidence based practice.    Jayson Davies     Exactly. So one thing about NBC, OT or or licensure for a state is that typically, they don't ask you to send in all of your certificates every two years, every three years when you do it, they only just ask you to write down the name of the course and when you took it or how many units it was However, that said, I don't know about you, I think you might have been too. I was recently audited, but.    Abby Parana     No, I've not been audited.     Jayson Davies     Oh, no, I got audited by NBC ot this past year.     Abby Parana     Knock on wood. My renewal is coming up in September, so I'm looking for it because I'm I'm just sort of assuming it's going to happen soon to me, because it just does.     Jayson Davies     It seems like, I feel like it seems like a few people that I know have been audited, audited this year. So it's like they're going, you know, maybe every few years, they just decide we're gonna audit everyone. I don't know.     Abby Parana     How, how quickly were you informed you were being audited after you submitted your application? And how did that happen?     Jayson Davies     It was fairly quick. I got a notice in the mail. I know that's how it came, right? But I don't know how long it took to process that got it so. But, you know, it's relatively simple. I keep all my certifications in a file, you know, with the rest of my important documents that I have. And I also keep an Excel spreadsheet that kind of keeps up to date what I've taken and stuff like that, so that way it's easy to get to, easy to find.    Abby Parana     Well, you're way better than me, because I just kind of put them into a folder.    Jayson Davies     Yeah. And I also used OTEC Occupational Therapy Association of California. They have their own system. If you're an OT member. They actually keep track of if you go to an OT conference, they actually log all those in for you into their Occupational Therapy Association California. They have a some sort of contracting company that you have access to as a member.     Abby Parana     Yeah. And then on top of that, I recently started using the NBC ot navigator, which also provides a similar service where you can log, or they have a renewal log, where you can add activities. And it's super user friendly. It seems really intuitive. I found it really easy to use, and it helps you keep track of all your professional development units that go towards your NBC ot registration. But I think you could probably use it to also keep tabs for your state licensures. It's just it doesn't automatically go back and forth between them.     Jayson Davies     Yeah, yeah, that'd be cool. Yeah, created that, but, oh, that's pretty good.    Abby Parana     So if you're listening NBC OT.    Jayson Davies     AOTA YouTube, but no, but speaking of NBC OT, we should. We can jump into the different ways that NBC OT or not, the different ways that they do. But you. Yeah, well, they have 32 different ways that you can earn. Ca use, PD, us. And so we're gonna, we're not gonna mention all 32 because that's quite extensive, and the likelihood of you using all 32 is probably not likely, because you're not all researchers, but we're gonna go over a few of them. And one of the ones is what Abby just mentioned, is actually the NBC ot navigator. And so what did you find on the Navigator?    Abby Parana     So even on the navigator, when you you sign up and it'll give you your certification number, whether or not you're active, and then right at the top, it says, well, on mine, because I haven't put them in yet, it says zero, 36 units completed. This is not an accurate account, because I have done some continuing ed. However, then you scroll down and it'll have you can click on certification or or navigator or services, and it will help you go through that. But the biggest thing would be like the renewal log as well, and then it pops up with a list of relevant ca use that you can take, and then it will log those in. So on mine, because I'm like a pediatric, I use like I had them look at me as though for pediatrics, because that's my main area of practice. And if you list that, it'll say, you know, you can do case simulations. And for instance, if I click on one child with a vision impairment, and then I can go through that case simulation, and it will give me a continuing or, I'm sorry, Oh, I did it a competence assessment unit.    Jayson Davies     For them, yeah? And I know I went through one of those to the virtual experience, and, man, I learned a lot. They were tricky, yeah, but they're actually not bad. They're, I'm not gonna lie, they're not the most entertaining thing in the world, but they're actually the content involved is pretty darn good. So yeah, that's one way you can earn.    Abby Parana     And it says, too, as part of this navigator, that units earned in NBC OTs navigator are accepted by 38 states and the District of Columbia, and they if you click on the you can find your state. If you click on the link and see if it is accepted by Navigator, and it turns out there are a ton of them, the only ones that do not accept it are in gray. And then there's some contingent upon any additional state specific requirements. So it happens to be the state that we're in, of course. And Pennsylvania, the other state I'm from, it turns out that that would be the only thing, but at least they have a pretty easy, easily accessible map, and it really looks like there's only 10 states that do not use this as part of their continuing ed toward your state licensure. So I think Navigator is a really good thing to check out.    Jayson Davies     Yeah, definitely. It sounds like you can do some cool stuff and and you can, because most of us have already paid for it too. So it's basically, Yeah.    Abby Parana     And you can create a reading list for yourself by and use ProQuest of research articles you need to read, and then looking through your navigator history as well. So I personally think it's a really cool tool.    Jayson Davies     Yeah. So a few other ways that you can earn ca use is through volunteering five hours earns you one cau you can actually, you know how we all read these articles that are peer reviewed. Well, there's actually a way to be a peer reviewer, and you earn five units of caus for every article that you are part of reviewing. I don't even know how to do that, but that sounds cool. You can mentor a ot colleague that gives you one unit for every two hours that you mentor a colleague. You of course, have to, you know, keep track of what you did, what the what the men tease, goals were, and kind of what you how you help them. But that's a kind of free way to do that, to earn some CAUs.    Abby Parana     Right, And I'd say, you know, that's really great if you're certified in something really specific and you want to mentor an OT colleague in that like, if you're really good at feeding, and maybe I'm an OT that works in schools with a certain population, I need mentoring on feeding, because I'm not as skilled in that area. We would just need to set goals for that mentorship and find a way of documenting it so that you could earn those credits for mentoring me. If there's anybody out there who wants to do that.    Jayson Davies     Right, Actually, you know what? Later, it actually says that also the mentee can receive caus as well. Oh, so both people earn some of the caus some other ways. Of course, if you present at a conference that earns you two units for every hour of the conference that you present same thing with a. Poster, you earn two units for every poster presentation you present. Being an adjunct faculty member earns you some some credits. And of course, the most popular is actually courses, right? You know, online courses that that you watch, or attending seminars, or doing a certification of some sort, or going to a conference. Those are all ways that you can earn caus through MBC, OT. One good thing, you know, we didn't mention this earlier, it popped up on my screen right now, is that if you are, if the course is an A OTA approved provider, it seems like that they can actually provide 1.25 so one and a quarter caus for every hour of content, versus if they're not a OTA approved, it's only one hour for or one unit for one hour. So I guess that's kind of a perk of it being an AOTA approved.    Abby Parana     Right, so you could earn a little bit more for less time if you're going for your MBC, OT.    Jayson Davies     And then the last one I really want to mention is that being a field work supervisor, you know, that gives you one unit of CA use for every week that you're working with a student. And so whether it's level one or level two, you get one unit per week per student. So that's kind of cool,    Abby Parana     yeah, and it's something like, it's funny, I, until we started researching for this Jayson, I didn't consider all of these as continuing education. I probably could have been claiming a lot more honestly, continuing ed than I realized I was.     Jayson Davies     Yeah, one was even giving a seminar like to a related service. It doesn't even need to be a seminar for OTs. It can be a seminar for related services. So if you give a in service at your school or at, you know, your place of employment, your district, for related services, which, in my opinion, includes special education teachers aides, because those are ones that need this information. You can actually earn continuing education for that. You can only do it one time per that course that you give, but that's still cool.    Abby Parana     Yeah, definitely.    Jayson Davies     So let's get into the next phase, which is, where can we get? Where can we earn, I should say, professional development. And we have a list of about nine places we're going to go through this, first one, second one, and third one, probably pretty quickly, because I think we've already killed it a little bit. We have NBC OT, obviously we've said, you know, you can go on there. There's so many ways that you can earn continuing education on NBC OT, through the Navigator tool, and they have articles that you can review and ways that you can earn. So check out NBC OT, and I hope everyone is MB, cot certified. Still, it's just a good resource to have.    Abby Parana     It really is, and it makes it easier, with state licensure in a lot of states, to have that certificate.    Jayson Davies     So the next one will kind of, I think most people are pretty familiar with the A OTA website, and they do provide some online free as well as paid professional development on there. You can even earn professional development by reading the best practices in school based ot book, which I know so many people have in reference to a lot. So for every two chapters that you read, you can you can do a small write up, and you earn one hour of CAU.     Abby Parana     I better get on that. I've read a couple chapters, right? It is a very big book. It is. I was surprised. Take your time.    Jayson Davies     Yeah, but it's actually not too hard to read some of it. So.     Abby Parana     No, the chapters are short and very fast and very on point to what the purpose of the chapter is. I found it to be a really good resource.    Jayson Davies     Yep. So another thing is the A OTA conferences. Of course, you know, everyone wants to go to the A ot a annual conference. Shout out to New Orleans next year. Yeah.    Abby Parana     I didn't realize it was in New Orleans. We should go Jayson, we should.    Jayson Davies     But then a OTA, they also just recently started holding their annual school based conference. So I can't remember where that one is coming up later this fall, but I didn't make it to last year's one, but I kind of want to go to this one, so we'll see. Yeah. And then, of course, your state organizations, most states, have some sort of state conference every year, and you can attend that. And some states even have their own webinars and seminars online. And so those are always They're pretty cheap, typically, because it is a state organization, you know, they're trying to give back to their state's OTs, and as long as you're a member, they're relatively affordable to take that's true. Yeah. So all right, now we have a few of the more mainstream websites that are out there that many people use for earning professional development. Some of these have actually, the three that we're going to talk about real quick, actually have a year long subscription. The first one. Is med bridge or med bridge education.com and they have a lot of classes, actually, both this one and the next one, occupational therapy.com I'm really impressed by what they have online. They they got a lot they do absolutely. And I was watching one recently on occupational therapy.com it's actually by Winnie Dunn. And you know, everyone wants to hear from Winnie Dunn, and so she was talking about, you know, how to be really inclusive in the schools. And it was really cool. And for $99 a year, that's not too bad. So med Bridge is a little bit more pricey. It cost, I think they what they say the cost is, is $375 typically, they have some sort of promotion for $250 but actually, ot school house us, we actually talk to them and well, we're able to offer a $200 per year subscription, and that's A 20% discount from the $250 promos. So all you have to do if you want to go over to medbridge.com or medbridge  education.com and start up that subscription, it's, well, yes, $200 you just use the code ot schoolhouse for the discount, and you'll get that for a little discount.     Abby Parana     Right? And we are an affiliate for them, so it helps us keep the podcast going and helps us bring you more content.    Jayson Davies     Exactly same thing with occupational therapy.com . We don't have a a promo that says cheaper, but for them to if you use a link through our through our show notes, or somewhere on our website, we do actually earn a small commission off of that one as well. This next one Summit, we don't earn a commission, but we like it, so we want to let you know about it.     Abby Parana     We do. I was just clicking through their autism continuing education courses, and it is a really, pretty good they have a lot of them.     Jayson Davies     Oh, really?    Abby Parana     Yeah, 19 of them.     Jayson Davies     Oh, wow.     Abby Parana     And they're they really range and provide good content.    Jayson Davies     That's cool. So what I like about Summit is that they have a almost, if you want to call it a dual immersion type of way that they do this, you can pay 249 to a year for just their online content, or you can pay an extra $50 299 and you get their online content as well as any live course that you want to go to. So if you're in an area, a metropolitan area, where summit courses, you know you're getting those things in the mail, the mailers all the time that say, Hey, this is Summit. We're going to be at the hotel near you. I mean, you can go to as many of those as you want for $300 and take their online courses.     Abby Parana     Yeah, I think that's really nice to me in particular, because you and I live in Southern California. Yeah, access to and we have access to everything's kind of within driving distance.    Jayson Davies     Plus there they tend to be, like, surrounding us. They'll do one in Anaheim, Ontario and Pasadena, which is like, doesn't matter which way we drive, we get to one right, right? So this next one's really cool. This is actually a website, or it's a business that is actually trying to bring on people to work for them. So it's like a contractor, but they do telehealth, and so they have, they contract with school districts to provide occupational therapy through the computer with students. And so you can imagine, this is really popular, I'm sure, among districts that are in the more rural area. In fact, the district that I work at, we forgot to tell them that you have a new job.     Abby Parana     Oh, that's right, I'm changing school districts, and I'm super excited about it. I'm going back to a district I previously worked for that I really enjoyed, and I'm back there now.    Jayson Davies     More on that.  I didn't even cheat. We didn't even tell anybody. I know, yes, the district that she used to work for, and I still currently work for, is using presence learning for speech therapy. And so we have students that with an aid, they get on a computer and they receive speech therapy, therapy through or from an SLP that is on the computer. And so it's kind of cool. It actually worked out. We're a little skeptical when we started it, but it seems to be working out for students that are at least at a certain level or higher. So.     Abby Parana     Right? And I don't know, Jayson, did you go to the presence learning part of the California Occupational Therapy conference.     Jayson Davies     I did, really cool. Joanne sword, yeah, we both were there. Yeah. Joanne sword gave that presentation, and she kind of showed us how it worked.    Abby Parana     Right? Because I was super skeptical of telehealth. But we may need to bring them on the podcast to see how that talk to them more about that.    Jayson Davies     Yeah, that'd be really cool. As far as today's conversation, they super cool, but I know we both but anyways, they actually provide free professional development on their website. Just two nights ago, I was watching a webinar that was from Temple Grandin and. Many of you, I'm sure, know temple, she's kind of all over what is autism, and everything about that, everything that is autism. And so for it was a free one hour course that was directed by Temple Grandin, and at the end, I got a certificate of attendance. Yes, presidents learning is very clear that this is that they do not offer continuing education for these webinars. However, they send you the certificate of attendance. Does it have the amount of time? It does? It shows the amount of time that in minutes, how long it was. And so I really, I want to call NBC OT and ask them about it, because it's, it's strange that they say we do not provide professional or continuing education, is the term that they use. But then they send you this certificate of completion. So I'd be, I'm still interested, you know, MB, C, OT, a, OT, a, they don't always make it easy to know what it is, and that's what we're trying to talk about here today. So.    Abby Parana     Right? It is kind of confusing. It still continues to be sort of confusing, but you always have to check with your state licensure guidelines, of course, and then just checking in with NBC OTs list, really?    Jayson Davies     Yeah. So one more that we put on here was, it's pocket ot.com and this is actually a smaller she's an OT. Her name's Kara Kasi. She runs pocket ot.com you know, she has a few courses on there, like five or so, and they're two hour courses that she charges about $50 for. And two of them are called, one's called, it's sense, is it sensory, or is it behavior? And the other is learning disabilities, and ADHD a toolbox for OTs. And so this is just a person, you know she's, she seems like she's knows what's going on. She's got a fantastic website, just doing a lot of things. And I know she is a presenter at other conferences. In fact, she even has a course on occupational therapy.com so.    Abby Parana     I mean, $50 a course is super reasonable, yeah, for two hours, my opinion, for two hours.    Jayson Davies     Yeah, I haven't. I've been meaning to check out, is it sensory, or is it behavior her course, and I just haven't done it yet, so I can't yet speak to the quality of it, but based upon what I've heard about her and what I know about Kara, I'm sure it's amazing. We will have a link to her website as well, where you can check out her courses. She also has a ton of other free resources and paid resources on her website, so I'll highly recommend it and and we, again, we are an affiliate for her as well, because we do believe in what she's doing, and so we do receive a small kickback if you use our link and purchase either one of these courses or something else on her website. So I website. So right, real quick, I want to say we are definitely not, you know, just recommending these sites, because we do earn something from them. In fact, we haven't earned anything from any of these sites, except for med Bridge, which is like one, one person signed up for med bridge from us. But these are just honestly good websites that people enjoy and use. So that's why we're recommending them correct. And so we just want to make that clear. We have one more on here, and I put this one on here, not only because she was on episode two of the podcast. Tricia Gomez with rhythm works integrative dance, but also because it shows that you don't necessarily have to be an occupational therapist in order to provide professional development. And likewise, as an occupational therapist, we don't need to be need to earn professional development from an occupational therapist. Specific, I think it's important that we actually go outside of our range a little bit, because it allows us to expand. Ot like I would never have even thought about dance, but because she collaborated with other OTs, other PTS, and even behavioral therapists, she put together a certification course that OTs can take to learn how they can use their occupational therapy skills to work with students who are interested in dancing. How cool is that? So.    Abby Parana     I think that's fantastic. And I think that you're right, um, there's a there's some vision therapists too, that I think OTs because we often are addressing vision processing, and visual processing needs, if you're looking for you know that or taking courses from SLPs are very helpful, because we need to be able to communicate with our students too. You I would say definitely going outside of occupational therapy and occupational therapists is a really good way to earn your professional development and get some insight and into things that you might not be thinking about as an OT. I was just thinking I took a when I took Handwriting Without Tears. The person that gave that course was a teacher, a special education teacher, and I remember I learned so much about how educators educate students. Students, which made me better at assessing kids within the school setting, because I understood how they were being educated. I learned something like direct instruction. I finally figured out what that really meant. And teachers we use just right challenge, but some teachers would use zones of proximal development. So you I only got that information from taking continuing education courses that were not provided by an occupational therapist.     Jayson Davies     Yeah, so that's super cool. It's good that we don't always stay in our realm. You know, sometimes we go to conferences and all we do is like, I don't know, we kind of get into that ot bubble, yes, but sometimes it's nice to get out of, get out of the OT realm and take a course from here, take a course from there, and see how we can apply that to occupational therapy. So that's cool, right? All right, so we actually have one more way that, it's a new way that you'll be able to earn professional development. And how is that Abby?     Abby Parana     Well, we're super excited to be starting to deliver you opportunities to earn professional development for listening to our podcast. Not every podcast is going to be applicable for professional development, but we're going to design podcasts that are and that's going to incorporate having specific learning objectives, using evidence based practice tools, and giving you the opportunity to earn professional development while you're doing things like, in my case, walking my dog, yeah, or driving to work, driving or driving between schools, or working out at the gym.    Jayson Davies     Cooking dinner, I don't know.    Abby Parana     Oh yeah, cooking dinner, I love listening to podcasts while I cook dinner, actually. So that being said, you can hop on over to OT school house, and you can look for professional development quizzes that you can take in relation to the podcast that you've listened to. And we will identify what podcasts will be available for professional development so that you can earn those credits on the go.     Jayson Davies     Yeah, and so this isn't quite up just yet, but they are coming. And yeah, we're excited to get this rolled out for you guys.    Abby Parana     Right. And right now, we are working towards becoming an A OTA approved provider right Presently, we will be providing you with a professional development certificate of completion our podcast that we're provide, I guess, providing you the opportunity to earn the professional development for we are making sure meet the criteria of NBC OTs professional development lines.    Jayson Davies     That we discussed guidelines for the podcast, yeah, and so it's really going to be simple. You just go on after listening to the podcast, you go to that podcast episode, and then you click on the the link that says, you know, earn professional development, and you'll pay a small fee. We're thinking somewhere between 10 and $20 right now, per episode, depending on the length of the episode. You will take a short quiz, and the next thing you know, we will be emailing you a certificate of completion that, as Abby likes to do, hang them up on her refrigerator.     Abby Parana     That's correct. So should you want to hang that up on your refrigerator, as I like to do, or frame it and put it over your bed? That's weird. Don't do that unless you really want to if you're really proud of it. I know some professional development courses are like the difficult, but these are just opportunities for you to earn these credits, or, well, earn professional development time toward your licensure or toward your NBC, ot registration. Now, as far as state licensure goes, that's your responsibility to check and make sure that what we're doing provides what you need for your state licensure.    Jayson Davies     Correct. We're going to be doing our best to make sure that we can reach as many OTs in as many states as possible. But every state, like we said earlier in the podcast, is a little bit different. So make sure you check out the episode eight notes page and click on the link that shows you each individual state's requirements.    Abby Parana     Right, because we don't want to provide say that it's good in your state, but that we don't know specifically those state guidelines.    Jayson Davies     Yeah, eventually, we hope to have some sort of list of our own to show you right California, except ot school house podcast. Yes, it does. Maybe, you know, or does New Hampshire? Well, New Hampshire doesn't. Hopefully, we'll eventually have a chart for you that shows you exactly which states our professional development our podcast will work for. But we're not quite there yet.    Abby Parana     Right, so just make note of what your state's requirements are, and then go ahead and we will start bringing you podcasts that you can check out quizzes for and earn those certificates of completion. And yeah, I'm super excited about it. Actually. I think it's a new platform, and it's exciting.    Jayson Davies     Yeah, me too. And so make sure if you haven't already hit that subscribe button. Up on the top, so that you know, as soon as the next episode comes out, there is a very good chance that the next episode will be a professional development opportunity. So stay tuned, right? Yeah, stay tuned. And with that, we are going to say goodbye today. We hope you are enjoying your summer vacation, and we look forward again, one more time, to speaking with hope Marie in the near future, and thank you again to all of the participants, and make sure you're looking out for a special thank you email from us. We'll see you next time. Take care.     Abby Parana     Thanks everybody.    Amazing Narrator     Thank you for listening to the OT school house podcast, for more ways to help you and your students succeed right now, head on over to OT schoolhouse.com . Until next time class is dismis Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 7 of the OT Schoolhouse Podcast. In this episode, Jayson interviews occupational therapist and Doctor of Health Sciences, Dr. Rachelle Murphy. Dr. Murphy is currently an instructor at the American Career College in Anaheim, California and she is currently in the process of researching the effects of using a mindfulness program in small charter school. During this episode, Dr. Murphy reviews recent research related to the mental health status of school-aged children and shares how she is using mindfulness and meditation to help both students and their teachers. Have a listen if you would like to have these three questions answered: 1. Listeners will demonstrate knowledge of mental health among school-aged children and teens. 2. Listeners will understand a brief history of mindfulness and meditation 3. Listeners will demonstrate knowledge of various mindfulness practices that can be used in a classroom. Links to Show References: Dr. Rachelle Murphy - Linkedin Dr. Rachelle Murphy - Email Dr. Rachelle Murphy - Website (coming soon) Website Recommendations: www.mindfulschools.org www.mindfulnessinschools.org Reading Recommendations (Amazon Affiliate Links): The Mindful Child by Susan Kaiser Greenland Mindful Games Activity Cards: 55 Ways to Share Mindfulness with Kids and Teens – Susan Kaiser Greenland and Annaka Harris Sitting Still Like a Frog: Mindfulness Exercises for Kids (And Their Parents) by Eline Snel Puppy Mind by Andrew Jordan Nance Article References: Dr. Murphy provided us with so many mindfulness articles that I decided it would be better just to provide you with a pdf download rather than list them all here. Just click here to start your download! Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript.   Jayson Davies     Hey there everyone, and welcome to the OT school house podcast. As you can likely tell, this episode is already off to a different start. We will, no doubt get into mental health and mindfulness in a moment with Dr Rachelle Murphy. But first, I wanted to take a moment and say thank you for listening to the podcast and as a thank you for listening Abby and I thought it'd be a really fun idea to hold a quote, unquote, schools out contest where one lucky winner, maybe you will win the opportunity to join Abby and myself on an episode of the OT school house podcast. We're really excited for this, a bit scared, honestly, but, but we're excited because this is our first contest, and we can't wait to see who wins and who we get to have a conversation with on this episode to talk about maybe what they're doing in schools, or what they're doing in their practice, whether you're an OT a teacher, a parent, or any other person with an interest in students with special needs, we want to invite you to enter the contest at ot  schoolhouse.com . Forward slash summer. Again, it's not just for OTs. This is for anyone out there who listens to the podcast and would be interested in potentially joining us on an episode to talk about special education, occupational therapy and just students with special needs, we'd really like to hear from from anyone out there. So once entered at the OT schoolhouse.com , forward slash summer, you will be shown how you can gain even more entries into the contest. For instance, one such way is to complete a short feedback survey about this very podcast. Another way is simply following us on Instagram. It's really that simple. So we hope you'll take us up on this contest, because we really look forward to talking to one of you in a future episode. Some details real quick. This contest will be running for the next week, and it will close Monday, the 18th of June, at midnight, Pacific Standard Time. And we will then announce the winner of the contest on the next episode, which will be June 26 so be sure to head over to again. OT schoolhouse.com , forward slash summer on your phone or computer now and get signed up. It only takes a minute to get signed up. You just type in your email real quick, and then from there you there's several other ways that you can gain even more entries to potentially win. So with that said, we are now going to cue the music and get into today's session with Dr Murphy. Hope you'll stick around.    Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.    Jayson Davies     Hey there, and welcome back. You know, we're already two minutes into this episode, so I'm just going to review today's objectives, and then I will introduce Dr Rachelle Murphy, and we will get started. So today's objectives are, number one, you'll be able to demonstrate knowledge of mental health concerns among school aged children and teens. Number two, you'll be able to understand a brief history of mindfulness and meditation. And number three, you'll demonstrate knowledge of various mindfulness practices that you can use in the classroom. So that's what we're gonna go over for today. And today we are very lucky to have on Dr Rochelle Murphy. Dr Rachelle Murphy and I worked together as colleagues in a district before she was a doctor. She was just Rachelle Murphy back then, not too long ago. But she does have her master's in occupational therapy from Loma Linda University down here in Southern California, and she does have over five years experience working in schools with children. She went back to school and got her Doctor of Health Sciences from Nova University, and now she is an instructor at the American Career College in Anaheim, California. So without further ado, I introduce to you, Dr Rachelle Murphy on mindfulness and mental health. Hi Rochelle, thank you for joining us on the OT school house podcast today. I'm super excited to have you, and I can't wait to get into some mindfulness techniques with you.     Rachelle Murphy     Thank you for having me.     Jayson Davies     Great. So I was just sharing with everyone how we used to work together at a school district previously, and since then, you've kind of gone on, and I've gone on to do our own things, and now you've ended up at a college instructing certified ot assistants, which is super cool. And we recently got to catch up over at the OTT Occupational Therapy Association of California spring symposium where you were actually talking about mindfulness. And with that, you know, I had to ask you to come on to the podcast and talk about that a little bit, so we're excited to have you.    Rachelle Murphy     Thank you. Thank you. I'm very excited to be here.    Jayson Davies     Great. Well, first of all, I just want to give you a minute to give a little background about yourself, a little bit about your education, work experience, and how you ended up where you are today.    Rachelle Murphy     Sure, so I've been an occupational therapist for eight years now. I graduated in 2010 from Loma Linda with my master's, and I've pretty much been working in school based that entire time. I've worked for big districts. I've worked for little districts. I currently work for a charter school. So I've had all kinds of different experience with that. I've kind of dabbled in some. Other areas as well. So I've done a little bit in early intervention. I did a year where I worked in hippo therapy, working with horses, and I've kind of ended instructing, and so working as a full time faculty member. Now, I went back a few years ago and decided that I wanted to get a doctorate, and I decided to go the path of getting a doctorate in health science, because I was kind of interested in seeing program development and learning a little bit more about global health and seeing what else was going on around the world. And so I pursued that degree, which I took at NOVA, Nova Southeastern University in Florida, which was really a blessing, because it was kind of a culmination of people from all kinds of different backgrounds and all kinds of different areas of the world. And it was really, really interesting to see how ot kind of fit into all these different areas, and how we could make a role for ourselves in some of these different programs and areas that we didn't traditionally see OTs in. And that's kind of what got me interested in the mindfulness was just some exploration of Alternative and Complementary health practices and looking at global health and looking at program development. And I took that and kind of found mindfulness and found yoga, and saw how it was helping me, both personally and that there's a potential benefit for using it with some of the kiddos that I was treating at the time. So and now I'm here.    Jayson Davies     Very cool. That's a great story. You mentioned the hippotherapy. That's I haven't met someone who's done the hippotherapy. That's super podcast, right? Well, to find someone who specializes in that definitely, oh, man, so. So one key thing that I didn't hear in the response was mental health. Mental Health, right now, with everything going on, is a hot topic, buzzword, you could say right now, from everywhere, from politics down to everything that's going on in schools right now, even with 13 Reasons Why You know the Netflix phenomenon. So what can you tell us about the status of mental health? Have you done some background research in mental health, a little bit to get into the mindfulness?    Rachelle Murphy     Yes, yes, definitely. So I'm sure, as you've seen, and most of us that have worked in schools have seen there's definitely an influx of kids coming in with mental health issues. We seem to be seeing it younger and younger, which is kind of what prompted me to become interested in this topic as well, is that, you know, I was working as a traditional school based OT, but it seemed like more and more times I was getting these kids in my classes that there was something else going on, and nobody could quite figure out what to do with these guys, and we were seeing that emotional intelligence levels were really low for our kiddos coming into kindergarten, and they didn't quite have a lot of those skills that we would traditionally expect them to have. They weren't able to problem solve, they weren't able to pay attention, they didn't have good peer relationships, and so I started seeing this more and more. And so that's kind of what got me interested in it. After that, I started doing research on it. And so some of the statistics that I found that I thought would be interesting for you guys, so in the United States, right? Well, the current, most current research that we have right now is saying that 13 to 20% of children experience a mental health disorder each year, and that prevalence is just increasing. That was, according to a CDC report back in 2013 which is the last one that they've published. So that was five years ago, and I can imagine that when the next report comes out, that number is probably going to be even higher, just with what we've seen and so mental health disorders that we typically see in the schools. A lot of times we're going to see kiddos that have ADHD. We see a lot of the behavioral or conduct disorders, things like Oppositional Defiant Disorder, developmental Mood Dysregulation Disorder. We're seeing huge influxes of kids with anxiety and depression. We'll talk about that in a little bit too, and then autism Tourette Syndrome. So all this stuff that we're seeing an increase in, I think anxiety and depression is the one that is kind of scary that we seem to be seeing more and more of. And like you talked about with suicide, the numbers seem to just be climbing, and it seems to be coming something that's more and more commonplace in our culture. So some of the statistics on that for severe depression. In 2012 It was estimated that 5.9% of children had severe depression, and then in 2015 that actually increased to 8.2% and that's according to the America or the Mental Health America organization. Back in 2010 suicide was the second leading cause of death among adolescents age 12 to 17. Right now, suicide is actually. The leading cause of death in girls ages 15 to 19 worldwide. Yeah, so scary numbers. We're seeing that 5000 adolescents each year commit suicide, and there's another 600,000 that self injure themselves. So definitely some scary statistics with suicide. Additionally, we're seeing an increase in mood disorders about right now, they're estimating about 15.4% of children have a mood disorder, and then they're saying that one in three adolescents will meet the criteria for an anxiety disorder by the age of 18. So definitely, a lot going on, and the services right now for mental health, especially in the schools, are very, very underutilized. I'm sure anybody that's out there that's working in schools know that there's not a lot of people addressing this in schools. And sometimes the people that are supposed to be addressing it, they just, they don't have the time, they don't have the resources. So unfortunately, a lot of times this just, it's not getting addressed. Even in the healthcare insurance realm, there's just not a lot of school or not school, but child psychiatrists, child therapists. It's just a really, really underutilized service that children are kind of, you know, not really getting the benefits that they need in order to be successful, and for us, oh, go ahead.    Jayson Davies     Oops, I just hit the microphone. In our district, we have a lot of internships as our clinicians for mental health and because they can't, but they can't find just like occupational therapy and speech therapists. Throughout the United States, there seems to be a shortage of counselors as well, and so they're having difficulty getting well equipped counselors.     Rachelle Murphy     Yes, yes, I think it's just a shortage of, you know, the supply can't keep up with the demand right now of people that need to be addressing this. And we say a lot, and it's becoming these, you know, big, hot topics, but unfortunately, it's just we can't keep up with the need that's out there for our children. And as OTs, you know, we we address mental health, we address quality of life, we work on school participation and abilities to participate in the home, in the community, and find stuff that's meaningful. So I really think that this is an area that we can kind of step up in a little bit more and teach some of those productive skills to help our guys be more successful in school and at home and in the community.    Jayson Davies     Definitely. So the topic of today's podcast is mindfulness, and so obviously we're going to jump into that now. How are you how are you using mindfulness? How did you come across the merger of mental health and mindfulness to get to what you're doing now?     Rachelle Murphy     Sure, so I am currently using mindfulness in a charter school that I work at. Primarily. I'm kind of dabbling in some other areas as well, because I'm seeing a need for it in other areas. But I actually trained with Mindful Schools, which is an organization that's here in California. They're actually located up in Oakland, and so I started initially training with them when I got interested and saw some of the benefits that mindfulness was offering. So I've trained through them, and then I've gone through some additional training with Dr Chris Willard, who's actually at Harvard and is a psychiatrist, and gone through some of his trainings, and then just done a lot of self study to kind of see what parts of mindfulness would work in schools? What parts would work with being an occupational therapist and kind of just going from there to building it? So right now, I've been really blessed with the ability to work at a charter school who's been very open to kind of exploring different opportunities, and so for them, I've developed a couple of different programs. Actually, I started going in and developing an after school program for them, for their TK, first and second graders, we did an after school mindfulness program, and we started it at one day a week, and we did all kinds of different not only just meditation activities, but we incorporated some yoga, we incorporated some mindfulness activities that were a little bit more hands on for them because they were younger and a little bit more wigglier, and we've grown that. And so I was very lucky to be able to have a couple of field work students from my school to go there and develop that program a little bit more, and they were able to implement it four days a week with our students there for a period of three months. So that was really, really exciting to see, because we saw a lot of benefits from the kid OTs getting it each day there. In addition, I've also gone in. Implemented the mindfulness curriculum through Mindful Schools in the older classrooms, which is fifth and sixth grade, and that is more of a structured program, that it's 15 minute sessions that you go in and do them once a week, and it's more about having the teacher there with you, and then having them carry it over in the classroom when you're not there. And then additionally, I'm working on developing a program for them. Next year we're going to start trying to do five minute mindful mornings, where each morning the students will have different mindfulness activities to do before they start their school day. And that'll be a school wide implementation that we're going to do.    Jayson Davies     That's really cool. So I jotted down two quick notes that I wanted to ask you. Sounds like you're doing a mixture of yourself or another occupational therapist leading as well as teachers leading? Is that correct? Yes, yes. Okay, so it sounds like you're or the OT might be doing a little bit more with the younger kids, and then the teachers are doing more with  the older kids.    Rachelle Murphy     Yes. And so the idea is, with the older kids, it's more teaching the kids, but also the teachers skills, so that they can kind of carry over the things that they hear me say and some of the terminology that they might hear. And so usually I'll leave cheat sheets or something with them, or some homework, so that I'll come in teach a 15 minute session, and then they can kind of have some clues as to how to follow up that week with what they're getting with the after school program. It's primarily been me coming in and working with them and kind of doing the hands on they do have staff that's there after school staff, and so a lot of times they're present in the room. And so we expect that they'd be carrying over a lot of the language and stuff, too. And then the other thing I didn't mention is, I actually do still use this with some of the kiddos that I have on my caseload as well. And so it's not, you know, a whole treatment session of mindfulness, but I do use a lot of the strategies and techniques with some of the children that I treat, especially the children that have high frustration levels or are having difficulty paying attention to class. So I'll teach them some of the mindful breathing activities or mindful listening, because all this stuff is going to help to improve that attention, which is only going to benefit them in the long run, when we're working on something like being able to pay attention to their handwriting assignment or something like that.    Jayson Davies     That's super cool. I'm glad to hear that you're seeing that. Have you had a chance to do any pre post, pre post testing with them yet?     Rachelle Murphy     Not yet. That's on the docket for next year. Yeah, this year was more developing the program and making sure we were going to find a fit for it. Now that we've gotten it, kind of got it going, next year, we'll definitely looking at doing some research with it.    Jayson Davies     So nothing official. However, you are hearing from teachers, hearing from kids.    Rachelle Murphy     Oh yes, very cool. Yeah. So the teachers, we've heard that they are noticing increase in attention definitely is a big one. And then we've also just seen a lot of our kids that were kind of more reserved and quiet. We've seen that they've opened up a lot and they're more willing to talk about their feelings and share their feelings. A lot of what we've done too has been based on a curriculum that teaches kindness and compassion, and so we've seen better results with that, with kids just being more understanding of other kids, or being more compassionate towards other kids, and kind of getting along a little bit better as well.    Jayson Davies     Very cool. What about Mindful Schools? Have they done any research that you know of?    Rachelle Murphy     They have, they have. They had a huge study that came out that they did with the University of Berkeley. Hold on me. Make sure I have the right one. Oh, I'm sorry. University of California, Davies, so it was the 2011 to 2012 school year. They had 937 children and 47 teachers in three Oakland public elementary schools. And so with their program that they implemented, it was a six week program, they saw a 7% improvement in paying attention in class, improvements in calming and self control, improvements in self care and participation, and then improvements in showing care for others, wow. And so that was one of the their more major ones that they've done. That second one that I was thinking was done in 2010 and that was a pilot study that was looking at depression, and they did it with 18 minority children at a summer camp, and they saw that the mindfulness group showed significantly more reduction in depressive symptoms than the control group, and then anxiety results also decreased as well. So those are the two main studies that they've done through Mindful Schools, but they do have quite a bit of stuff that they're working on right now.    Jayson Davies     Yeah, I'm sure I'm gonna have to get some links from you for that, for our show notes, and then I will also link to the Mindful Schools in Oakland so that people can check that out. Very cool. So would you say that? And maybe this is more of a question, I guess, for that people can look up on Mindful Schools. But can anyone take these types of trainings as a geared toward occupational therapist, or is it geared toward counselors, or who can do this?    Rachelle Murphy     It's really geared toward anybody. So they have a couple of different options. They have a foundations course, which is geared towards really anybody that wants to start to develop a mindfulness practice and kind of understand it more for themselves. And then they have an educator course, so that's really anybody that's working with students or working with children or for parents as well. So those are their two main courses. They also offer a certification in mindfulness, and so that's really for somebody who wants to be a mindfulness educator and be in charge of a program. And so that's actually a year long certification, but the foundations course is really great. That's what I started with. And it's really about teaching, teaching the basics of mindfulness, and teaching somebody how to get started with that and how to start being more mindful. Because when working with children, you really have to be genuine, and you have to follow through with what you're saying, because those children are going to pick out right away if you're telling them to do something, but you're not actually practicing.    Jayson Davies     I see that all the time when I'm observing kids in school. See the teachers just not. You can just see the teachers. Sometimes they don't quite they say something, but they don't take into account all the body language that's coming out of them.     Rachelle Murphy     Yes, yes. That was one of the biggest teaching things that I had to do with it was especially in like the after school programs. Is, you know, here we're trying to tell the kids to be calm and pay attention and, you know, use quiet voices. But then when one of them would, you know, do something, then they would get yelled at. No, no, we can't do that.     Jayson Davies     No, it's not just the activity. It's a full time type of thing.    Rachelle Murphy     But anybody can really do it. I mean, you know, a lot of people, I think, when they think mindfulness, they think of like, Oh, I've got to sit cross legged on the floor and meditate for 30 minutes with my incense. And it's not like that at all. I mean, a lot of it is just taking five minutes out of your morning to just sit quietly or just be more mindful of what's going on in the present moment. I mean, maybe going for a walk and actually noticing the trees or noticing the birds singing, or sitting in your classroom and noticing something that maybe you haven't even paid attention to, that being there before, noticing the color something is so it's really just being able to pay attention to what's going on in the present moment.     Jayson Davies     Very cool. So earlier, you kind of mentioned a little bit of the age groups that you go to, and you go all the way as low as kindergarten. When I think of kindergartens, you know, I'm in a kindergarten class earlier today. I cannot imagine this group of 20 kids sitting quietly, all all just focusing on their own within their own minds. How does that look?    Rachelle Murphy     Um, it can look a bit chaotic sometimes. I'm not gonna lie. So if you go into your first class and you got 20 kindergarteners, don't expect that. They're all just gonna sit down and say, Yes, let's do our mindfulness. It's it's more activity based with the younger group. And so what we've done is we've incorporated more games, more movement exercises, and we tend to do shorter bouts of meditation or mindful breathing or mindful listening. But we've done things like blowing bubbles and blow a bubble and then pop your bubble, and then when you pop your bubble, that's your, you know, bad thought that you had, or your anxious thought. We've done things like having all the students sit in a group and then everybody has a cup, or there's a big cup of water that's completely full, they have to pass it around the circle, and so they have to be more mindful of being able to hold the cup and being careful and paying attention and working together. So it's more activity based stuff like that, with the younger ones to kind of keep their attention a little bit more with the older ones, you can do a little bit more of that meditation. You can do a little bit more of the contemplative stuff with them, because, like you said, they have more of those critical thinking skills, and their attention can be a little bit better. So it's a little bit different in the way that you approach them, although the older ones, they still have fun with a lot of the activity based stuff as well. You really have to just kind of think about it as you're teaching a habit. So if you're working with young kids, it's really just teaching them habit. We talk about it like everybody tells kids to pay. Attention. But does anybody ever teach kids how to pay attention? And so that's what we're doing, is trying to teach them how to pay attention. And so teaching that habit as young as possible is only going to set them up for more success as they grow, because they'll learn that there's actually preschools out there nowadays that are developing mindfulness based preschools. So there's a few different ones. One of the ones that I can think of is up in Seattle, I believe it's called the cove school. And they're a mindfulness based preschool program where they really work on, you know, attention and loving kindness and compassion and all that stuff is just built into what their values are for their schools. So I think it can be a little crazy sometimes, but it can definitely work with the younger ones.    Jayson Davies     All right. So two things also, again, popped up into my head. I didn't send these questions over to you, but I would never question you on this, because I completely see the relevance. But has anyone kind of ever, you bring up mindfulness and they just ask mindfulness and occupational therapy? Do those kind of go together? Has that ever happened? Has anyone ever kind of, maybe a teacher or?    Rachelle Murphy     Not necessarily, but I can see where it can come up. Like I've said, I've been very lucky with where I'm at, because they kind of are all on board with everything. But I can see where it can come up with that, because a lot of times they'll be like, Oh, well, you know, you're supposed to be working on the kids fine motor skills and their handwriting and their attention. But we get a lot of these kiddos in our in our caseload that, you know, we want them to pay attention. We want them to be able to participate in their school performance. You know, attention is so ingrained in the so many of the things that we do. I think as OTs that teaching that habit and teaching that skill is really something that's going to benefit the students participation in school, overall, and what do we want to do as OTs want them to be able to participate in their occupation of being a student. So if we can do something that's going to support that, then I think it definitely falls into our role. And again, you know, we teach those habits. We teach routines. You know, why not teach them a habit that they're gonna be able to take with them to be more, you know, more successful throughout their life, not even just in school, but be more present and more able to do things all the way through their lifetime.    Jayson Davies     Definitely. And the one other thing that I jotted down here real quick was self regulation, mindfulness. Self regulation, similar, different. Have you had, do you think about that when you're thinking about mindfulness?     Rachelle Murphy     Yes, yes, definitely. I see that the mindfulness, it does help a lot with that self control and with that self regulation. And you know, especially with our kids, that they get really frustrated, really easy, especially with our kids that have some type of mental health issue where maybe they're oppositional, or maybe they get frustrated and they don't want to do something that's non preferred. It really teaches them to kind of take a breath and think about their response and so I mean, and it teaches that for everybody, I mean, because even as adults, how many times do we get frustrated and we kind of fire off something that maybe we didn't mean to do or we didn't mean to say? And so with mindfulness, it really teaches you to Okay, think about what's going on in the present moment, take a breath and then respond to it, instead of having that immediate fight or flight response of somebody said something I don't like it, and then I'm just going to go quick into this stress response. So it's really teaching you to be more aware of what your response is, and making sure that you're having a more appropriate response. So I think with self regulation. It really ties in very well because it again, it's teaching that skill of, how do I manage my frustration? Is my problem really that big that I think it is in this moment? Or is it something that I can kind of take a step back, think about, take a breath and then respond to it, and real quick.    Jayson Davies     I want to just confirm you're doing this with both general education. General Education students and students with special needs, right? Yes, yes. Very cool. I really like that because, you know, there's so many kids out there that don't qualify for one of the 13 Special Education criteria, but they benefit from so much that we do. So that's super cool.    Rachelle Murphy     Yeah. And I think, you know, as OTs, we're definitely, you know, suited to go in and do this as a whole population, and so we work off this public health model with the different tiers. And I think that, you know, we can go in and offer this as a program to a school or. Maybe at least give them the resources that they can be familiar with it and then work more on, you know, maybe there's a group of students that are, you know, particularly a little bit more needy that might need it and then do that. Or maybe you have one to one student that's already on caseload. So I think that we are suited to work across the realm in schools, of not only just working with our caseload, but really offering these services to administration, to the schools, saying, Hey, look at we can do this for everybody. Everybody's going to benefit from this, not just ours, you know, students that are on IEP.    Jayson Davies     definitely, and that's that's one thing that I think a lot of us, OTs bring into a school site, and not just working with good kids with special needs, I know and my district, I've been advocating a lot to try to get into classrooms, into general education classrooms, and implementing RTI programs, because there's so there's just too many kids out there to be seeing every kid, one to one, or even in a small group. If we can help multiple kids at once, you know, why not?    Rachelle Murphy     Yes, exactly, and it's, it's only going to benefit everybody. Exactly. It's not, you know, it's not just going to be, oh, I helped this one kid. But you know, if you get it school wide, it's, it's going to show an improvement throughout the whole school. So just, you know, I don't know.    Jayson Davies     Exactly. I know what you mean. So have any of the teachers asked you to do a mindfulness group for the teachers yet?    Rachelle Murphy     No, not yet, but I have been asked by administration that would be something that I would be interested in doing. There is actually a study on that too, that I want to say I don't know if Mindful Schools did it or somebody else did it, but they're saying that so teachers it showed that it reduced stress and burnout, that teachers that learned mindfulness reported grade their efficacy and doing their jobs and had more emotionally supportive classrooms and better classroom organization. So again, it kind of goes back to that, you know, we need to practice what we preach per se, that if you have a teacher that's trained in mindfulness, that they're going to respond better. They're going to have lower stress levels. They're going to have lower anxiety. And thus, by doing that in the classroom, their classroom is going to be a calmer place too, because their kids are just going to feed off of that from their teacher. So I think that there's a definite benefit to teachers almost better, that teachers get trained in it, because they're going to be that example, and they're going to be the ones that are going to have that appropriate response to demonstrate to the children, so that the children will pick up on it.     Jayson Davies     Yeah, you really have to practice when you preach, what you preach when it comes to stuff like this. I feel like, Oh, yes, yes. Very cool. Well, is there an activity that we could do that would would our podcast listeners would kind of get that feel of the mindfulness is there something that you can think of that    Rachelle Murphy     you could do? Yeah, we can just do. We can do mindful breathing.    Jayson Davies     Okay, I think everyone that's even driving might be able to do that. Yes or No, yeah, right. Don't close your eyes. Be careful. Don't close your eyes if you're driving right now or if you're out. Or if you're out walking the dog in the door, keep your eyes. Keep alert.    Rachelle Murphy     Yes, yes. Okay, so we'll do two minutes. And so with this one, this is a little bit more of a meditation. And just to kind of be straight like mindfulness is not just meditation. And so I think it kind of gets confused with mindfulness is meditation all the time, but there's so much more out there to mindfulness. But a lot of what we do will be more meditation based activities to kind of just quiet the mind down a little bit. So we'll do a two minute mindful breathing. And so what you're gonna do is, I'm gonna try to ring a bell. I actually forgot my bowl at the school.    Jayson Davies     I was hoping you had it.    Rachelle Murphy     I know I'm sorry, so I'll ring a bell, and what you're gonna do is you're gonna just count your breaths. And so you'll just think to yourself as you breathe in and breathe out one, breathe in, breathe out two. You can say it out loud if you want, but ideally we want you to count in your head. As you're doing this, you're going to notice that your mind is going to start to wander, because that's naturally what our minds just start to do. We start to think about, what are we going to make for dinner tonight, or what am I going to do at this meeting tomorrow? Or what did I say to this person yesterday? So your mind's gonna wander. It's natural. It's gonna happen. So what you're supposed to do is just acknowledge that your mind has wandered, and then just bring it back. Don't give it any judgment. Don't think, Oh, I'm terrible at this, because I can't focus. Just acknowledge that your mind wandered, and then you're gonna come back and start over. Again with counting your breaths. And every time you start to notice that your mind wanders off, just bring it back and start over again at one with your breaths. And we'll do this for two minutes. Okay, so everybody ready?     Jayson Davies     Let's Do it.    Rachelle Murphy     All Right?     Jayson Davies     Oh, my God, that was so long. That was so long.    Rachelle Murphy     So it feels long as at first, but once you get into the habit of doing it, actually goes by quite quickly. You'll be surprised, because if you practice daily, and you start kind of building up your practice. So I used to think like, oh my gosh, two minutes. That's so long. But I actually got to the point where I could sit for 30 minutes, and that was a long time. And there's yeah, there's people that'll sit for a long time. So for me personally, I usually try to do about five to 10 minutes a day. And you know, I've been doing this for a few years now, and there's some days where I feel like I can't even get five seconds without my mind wandering. There's other days where I feel like I'm I'm doing great and I'm doing good. So, you know, with mindfulness, it's all about just, you know, not judging and being non judgmental, and just, you know, acknowledging that you're going to have thoughts your mind is going to wander, and just being kind to yourself and bringing your mind back and just saying, Okay, I'm going to focus on my rest again. Or maybe you want to pick a key word that you want to focus on for that day. So maybe I want to think, you know, calm or kindness or something like that, and then just kind of repeat that. So you can do that as well with the same type of exercise. And when you feel like two minutes is nothing, then add another minute. And then when you feel like three minutes is nothing, then add another minute to that. So just something really, really simple that anybody can start with and do their practice, and all you have to do is carve out a couple minutes every day.    Jayson Davies     Yeah, my mind kept trying to think what I was going to say after the two minutes were over. And I was like, no, come back. So what age group would you would that work with?    Rachelle Murphy     I've used it with all of my age groups, yeah, and so usually with my youngest ones, we would do a minute, kind of, starting with them, we would do a minute. And sometimes it's, it's a really long minute. Sometimes, you know, they're on it, and they do really good. You know, sometimes with my fifth and sixth graders, we'll do a minute, and it's a really long minute, and sometimes the kids are like, staring at you, or you have, you know, the class clown that's trying to be funny and make noises. So, you know, it's not always going. Be this perfectly silent Zen moment, but a lot of kids, they really do appreciate it. I remember I had one little girl that came up to me once, and she would tell me that it was the most quiet part of her day, and that she looked forward to it because it was the only quiet part of her day. And I think that's true for so many of our kids, because there's so much noise, and there's so much distraction, and especially with things like social media nowadays, that our brains are constantly just firing, and there's never any quiet.    Jayson Davies     Yeah, there's been a lot of I've seen some research coming across, or at least the, you know, the flash messages, of course, they're coming up on my phone about how getting away from Facebook can make you more happy. Yeah, look at that. Adam getting the message from Facebook. All right. Well, that's really cool. Are there any guidelines that you would say for people who want to try this in the classroom, any must do's, might do's or absolutely stay away from if you're doing this in a classroom.    Rachelle Murphy     I would say, stay away from anything that says that they're going to cure something. So kind of the same thing with any ethical guidelines is, you know, it's not going to cure anything. You're just providing skills with our schools, especially if you're working in a public school is to make sure that people understand that mindfulness is not religious. Because I think with the historical context of where mindfulness has come from, some people seem to connect mindfulness to religion, and that's not how we're utilizing it. Now in our culture, it's really just, I mean, some people definitely still utilize it as religious, but for what we're doing in the schools, we're really just teaching children to pay attention to what's going on in their present moment. And so stay away from any type of religious connotation. Don't do any bows. And sometimes in yoga, you know, you might hear like namaste or something like that. So leave anything like that out. Leave any artific artifacts out. So really just making sure that the way you're presenting it is very secular, so that everybody can be included. We really want to offer that model that any child can participate in this, because it's just teaching them a skill to help them pay attention, to be kinder, to improve their focus, improve their concentration. So that's what I would say. And again, just, you know, practice what you preach. Because in order for you to be successful at teaching this, you need to be able to do it yourself. So don't expect that you're going to walk into a classroom tomorrow, if you've never practiced anything, and teach them how to do it. So it's really important to, you know, take some classes, get some skills, practice it yourself for a little while, so that you know what they're experiencing. And that way, if the children come to you with questions or concerns, that you can truly answer them and provide your experiences. And it's not just here do this, but I don't really know what it does. So really take it upon yourself to kind of become knowledgeable about what it is that you're teaching good.     Jayson Davies     All right, well, I want to say thank you again for coming on. That was super informative, and I can't wait to hear about how your research comes out in maybe a year. So if you get the end of that, that'd be super cool. So yes, yes, thank you definitely. Before I let you go, Is there anywhere where listeners can either get a hold of you or, I don't know, I know we've mentioned the what was it Mindful schools.com but if someone has a specific question for you, maybe about research or something, is there somewhere that could get a view.     Rachelle Murphy     Yeah, yeah, definitely. So you can always find me on LinkedIn. I have a profile on there. Rachelle Murphy, R, A, C, H, E, L, L, E, M, U, R, P, H, Y, I am working on a website right now. Okay, hoping it'll be done soon. All right, so that's just Rochelle murphy.com So yeah, if you go there and it's not up yet, I'm promised I'm working on it, so it should be done sometime soon. And then my email is just Rochelle Murphy otr@gmail.com and so I'd be happy to answer any buddy that emails me there. As far as learning more about this. It's actually mindfulschools.org and so they're the one that I trained with. There's another one called mindfulness in schools.org I think they're a little bit more popular on the east coast, but both of them I've heard have, well, Mindful Schools, I know has a really good program. The other one I've heard very good things about, and there's stuff, you know, kind of up and coming every day. It seems like there's new people developing new programs, so it's really just doing the research and seeing what's going to work best with you. The OTEC presentation, sorry, Occupational Therapy Association of California. I. Um, they recorded the mindfulness presentation that I gave, the one that you attended, and so that's supposed to be going up on their website. It's not up yet, and I don't have an exact date, but it should be up there sometime in the future. So that's OTEC online.org .    Jayson Davies     Yeah, and this, this podcast that we just did was very similar to that one, but I think we did a few more actual at your seminar. We did a few more hands on type of stuff. And I remember you saying, excuse me, the bill might be really loud for some of the people that are listening on the podcast, but yeah, if you want to see her cool bowl, definitely watch the watch the replay, so.     Rachelle Murphy     If you want to see everybody walking really funny.    Jayson Davies     Good times, good times. Well, we will definitely link to all of that stuff in the show notes so that people can find it. And with that, I will say goodbye. Thank you again for coming on, and I look forward to hearing more from you in the future.     Rachelle Murphy     Thank you very much.     Jayson Davies     Definitely take care. All right. Well, that was Dr Rochelle Murphy of the American Career College joining us today to talk about mental health and mindfulness. It was a great episode. I learned a lot. I'm pretty sure, if you listened through all the way, you probably did as well. She has a lot of good research that she's done, and then with the mindfulness, there's a lot of great things she's doing with her students, as well as some of our teachers now, so that's really cool. Everything that we talked about today we will be linking to at ot  schoolhouse.com , forward slash Episode Seven. We'll also put on that notes page the link to the contest that I told you about earlier, the schools out contest where one lucky winner will have the chance to join us on an episode of the OT School House to talk about what they're doing in schools. So we look forward to all the contestants entering into that and can't wait to have a winner to talk to on a future episode. Alrighty. Well, that concludes today's episode. Thank you again for listening, and we hope you enjoy the start to your summer, take care.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com . Until next time class is dismissed Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 6 of the OT Schoolhouse Podcast. In this episode, we look at two commonly used school-based Occupational therapy assessment tools. Both the Bruininks-Oseretsky Test of Motor Proficiency, or BOT-2, and the Miller Function & Participation Scales (M-FUN) are standardized testing tools that occupational therapists use to assess fine motor and visual-motor skills in children. While they are similar in what they assess, they are very different in how they get their results. Today's Objectives: 1. What skills do both the BOT-2 and MFUN assess in a child’s educational capabilities? 2. What are the pros and cons of each assessment tool? 3. How do you decide which assessment tool is best suited for any given school-based OT assessment? Links to Show References: Learn how to earn professional development units for listening to this podcast here ! ​ Bruininks-Oseretsky Test of Motor Proficiency, Second Ed. This is a link to Pearson Clinical where you can purchase the BOT-2 to use at your school or clinic. The OT Schoolhouse has no affiliation with Pearson Clinical or the BOT-2 tool. Miller Function & Participation Scales - This is a link to Pearson Clinical where you can purchase the M-FUN to use at your school or clinic. The OT Schoolhouse has no affiliation with Pearson Clinical or the M-FUN evaluation tool. In this episode, we mentioned three other evaluations. You can click the links to find out more about them. 1. WRAVMA 2. Beery VMI 3. Peabody Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.    Jayson Davies     Hey there. Welcome back to the OT school house podcast. Today's episode is now number six. We've been doing this for like two, over two months now. Abby, this is awesome. We're already on episode number six.    Abby Parana     I know it's suddenly like hot outside.    Jayson Davies     It's actually a little overcast over here, but it is warming up, that is for sure. So how are you doing today?      Abby Parana     I'm good. I'm good. I'm ready to talk about some ot assessments on the menu today.    Jayson Davies     Exactly. So with that today, yeah, we're talking about the bot, the one that I'm going to just butcher right now and say the next ot test, of motor proficiency, Second Edition.    Abby Parana     How many times I mean, I've I every time I go to sit in an IEP meeting to say to a parent, and the test that I conducted was the Bruni, like, I have to practice it in my head before it actually.    Jayson Davies     In IEPs?    Abby Parana     yeah, yeah. But nobody knows what that is.    Jayson Davies     Well, I tell them, I say, the reason I'm calling it the bot too is because I don't know how to pronounce it.    Abby Parana     Well, I always try to pronounce it and I always fail at it.     Jayson Davies     All right. All right. Well, good. A for effort. A for effort. All right. So today we are going to talk a little bit about the bot two, and then we're also going to compare and contrast the bot, to which I believe most of you would all agree that is, it is a very commonly used assessment in school based, school based therapy. We, a lot of us, use it. The other one, I don't think it's quite as commonly used, but we, at least I, use it pretty regularly. It's called the Miller function and participation school scales, also known as, for short, the M fun, M, F, U, n. So it's called the M fun for a reason, because it's fun.     Abby Parana     Well, it is fun, and we put the fun in function as OTs, yes, yes. Also, I'm a recent convert to them fun. I hadn't used it in the past until I met you, Jayson, and then I recently started to use it, particularly with the younger kids. It's a really good tool.    Jayson Davies     Yeah, and we'll get into, we'll get into in this podcast, what we like about each one, but we're also going to be objective and tell you about what tasks each test looks at what different skills they look at how they relate to education and, well, yeah, eventually we'll kind of give you, you know, you'll kind of hear the a little bit of bias come out as to which one we like, but there are also reasons that we do like and use the bot. So we'll get into that before we jump into that. We're going to go over today. We're going to do something a little bit different from the other five episodes. We're going to give you the objectives for today's episode, and the objectives, I'm just going to read them here for you. They are for all of you listeners to have an understanding of what skills both the bot to and the M fun assess in a child's educational capabilities. Number two, what the pros and cons are of each assessment tool. And three, how to decide which assessment tool is best suited for any given school based ot assessment so by the end of the episode, we hope you will feel that you have met those three expectations that we're trying to trying to meet for you. If you don't, if you don't feel that we did that, please shoot us an angry email. We will do our best to.    Abby Parana     Maybe not an maybe not an angry email like a constructive criticism email, constructive criticism. That would be perfect. I'm all about constructive criticism. But also, you know, I think too it's important. These aren't the only two two assessments. These are the two we're going over today. We're not really promoting them or not promoting them. We're just kind of reviewing them.    Jayson Davies     Correct and to follow up what I just said. If you do like what we go over today, please, and you feel that we do meet our objectives, please give us a shout out to one of your friends, colleagues, let them know about this podcast. So with that, you know what, I think we are going to jump right in. We are going to start off with the bot. First, it's a little more well known, and we're going to give you our take on it and let you know a little bit more about it. So first, we want to kind of go over what the bot is, what what skills each task looks at, and the different sub tests that are within the bot too. So, Abby, how about you? Go ahead and go over those for a little bit.    Abby Parana     Oh sure. So the brunette saskaretsky testimony was really good, I might add. Thank you. I nailed it. Got it is a. Ministered amongst multiple subtests, and there are goal directed activities that look at a wide range of motor skills. And it looks at it for individuals ages four through 21 there are different subtests, and you can use each individual subtest to get a scaled score. And then it also looks at composite scores that give you a standard score. And so I really like the bot, too. I use it frequently because I'm familiar with it and I can administer it pretty easily. Like I said, I'm a recent convert to the M fun, so I tend to go with tests, standardized tests that allow me easy use. So if I'm familiar with it, I know I'm more likely to get an accurate score because I've administered it so many times. So when you're looking at which test to pick, that might be something you want to look at, all    Jayson Davies     right, so the final order precision tool or task is the first sub test. It belongs within the broader fine manual control sub test. What are some of the tasks in the fine fine motor precision test?     Abby Parana     Right. So the fine motor precision test looks at your precise movement of those small muscles in your hands and control of those finger and hand movement. So it requires you to do things such as color in small shapes, fold paper on the line with accuracy, cut out a circle within a specific boundary. Looks at tracing through a path or a maze and connecting four dots. It's measuring the accuracy of your movements.     Jayson Davies     Mostly it also, I take it also as one. It's measuring a two step activity, or at least I get a general sense of that, because that's true asking them to connect the dots and not lift out their pencil. And it also does look at how they're able to plan their forearm movement in order to see where the dots are without taking their pencil off the paper.    Abby Parana     Right? And I think too, with the small shapes, you can get a good observation of that distal control of their fingers, you know, if they're using whole hand movement, or if they're using big wrist movement, that's going to really come out when they're coloring in those shapes, that also comes out with the maze, if they're a kid, oh, we've talked about this before. These are just observations. They they're not directly measured in the score that you get for the kid, but these are areas that you can observe through each task and just kind of make a little note for your narrative parts of your report. So for instance, like, I think we talked about this before, when we're observing a kid do the mazes, how that kid, I've had students where they're moving their whole body while they're doing the maze. So instead of just moving their hand, they're moving their whole body around the maze. And you can see them where they don't want to cross their midline, they're almost using their whole body as a unit. And you can see that, or if they're trying to turn the booklet and move it and manipulate it, because you can only turn it, what 45 degrees? Degrees, yep. So you can gain a good understanding of those areas, and those are just little observations you can make while they're doing it, and that can impact their function in the classroom. So those are they're not directly measured by the test, but that is measured or an area that you can observe while they're doing each of the tasks.    Jayson Davies     So that's the fine motor precision, fine motor integration. This one is a lot like some other tests, such as the VMI, the visual motor integration buries VMI, as well as the wide range of visual motor abilities the radma, which looks at the ability to copy shapes. The one thing that I do like about the bot versus some of those other tests is that the scoring criteria is more specific on the bot, for instance, copying a circle. You look at it, does it have a basic shape of a circle? Does it have closures, or are the lines touching, or do they cross at the end or at the beginning and the end of the circle? Is it more like an oval? Or are the edges, quote, unquote edges for a circle? Is it pretty regular, cross and height wise? And then you also look at the overall size, which is very important. Recently, actually, there was a question on Facebook recently as to whether or not you would score the circle or any shape on the fine motor integration test. If the shape went outside of the little box that they gave you to write in, I've always scored it that yes, if they even if they go outside the box, you still score it as though it's in the box. I've had that some kids, when they're drawing the star, they'll get to the edge of the box, and then instead of continuing on, they'll kind of draw a line up, or they'll move it because of the box. And so, right? You get a lot of information from looking at that. But as far as scoring goes, I've always scored it even if they go outside of the box.    Abby Parana     Right? And then just making a note of it. I think it's just important you just make a note, you know, that child went outside the box or, or maybe the position of. The shape was off, because that could denote, like, a bit of a planning issue, or just not attending to things so but no specific difficulty on those sub tests, I think directly indicates an issue. You have to look at it, because that's a snapshot of what they're doing. So you have to pair that observation, yeah, and it just might be something that you know. And then on classroom observations and in work samples and talking to the teacher, you might want to look for other signs that that can be functionally impacting them.     Jayson Davies     Correct. And for those of you who aren't as familiar with the bot, the sub test number two, the fine motor integration that we're talking about. It looks at a child's ability to copy a circle, a square, overlapping circles that kids often confuse for the number eight, a wavy line that looks like a sideways s, a triangle, a diamond, a star, and overlapping pencils, which is kind of a common shape for some reason among tests. I don't know why.    Abby Parana     It really is. It's on what the VMI? Yep, I don't think there's one on the ravma.    Jayson Davies     No, not on the ravma. No. So that is the fine motor integration portion of the test. The next most commonly used sub test, a lot of OTs, I know don't use all the sub tests on the bot. It does get into more of those gross motor skills that PT might look at later in the test. But the next one that most of us do use is the manual dexterity score, right, right? The manual dexterity, I think most people use that one. I commonly see that on incoming students with ot assessments, and I use it probably about 85 to 90% of the time as well, unless, for some reason, I absolutely don't think there is a fine motor specific fine motor concern. But within the the manual dexterity scores, you have five tasks. One is basically as quick as the child can. They put a dot into these small circles, and there's like 100 circles on the page. Most kids get to like 15 or so.     Abby Parana     Because you don't count them all.    Jayson Davies     I did not but, but I think there's about 100 I'm just gonna go with 100 I think it's a safe assumption, maybe 98 but the next test after that is transferring pennies. The kid has to pick up a penny with one hand and flip it over, transfer it to the other hand and then put it in a box. The next one is placing pegs into a pegboard with one hand. Number four is sorting cards. There's some cards that have blue circles and other cards that have red squares, and you have to put them in the respective pile with one hand. And the last one is stringing blocks. And of course, that is a two handed task.     Abby Parana     Oh, that's not one that would be so hard. Okay.    Jayson Davies     So for each of these tasks, you get 15 seconds to have the child perform these tasks, and you are supposed to give them a little direction and practice before you actually test them. And then on all of them, except for the making dots and circles, you actually assess the test twice to try and get their best score. Yep. So what do you like and not like about these few tests Abby?    Abby Parana     I think some things to look out for. One the on the manual dexterity I have a lot of little experimenters when we're doing the manual dexterity test, so they like to try and test the best way to do things, and they'll experiment with how they're gonna do it, even though I've directed them and they've done the practice round, okay, it seems like when I time them, they think they're gonna outsmart me with some sort of random thing, which inevitably makes them slower, so especially on the stringing blocks, yes, so I often preface my directions, Yeah, the blocks. They all want to line them up and then see if they can get that string through, like six at once, which is never something that is kind of, it never works. And so I will preface with, I'm going to show you the fastest way to get this done.    Jayson Davies      That's a good.    Abby Parana     Yeah. So I'll just kind of to save myself time and headache of having to, you know, constantly redirect or restart the assessment or do something like that, because the more they practice, the faster they're going to be. So then that impacts the reliability of the score or the validity of the score. I will preface it with, I'm going to show you the fastest, easiest, best way to get this done. And if you don't do it this way, I can't count it, and we will have to start over. I'm just pretty direct with that to try and get them to understand that concept. I think the other area that you always have to look for is, I have kids that just, even though I've shown them and on the practice section with those circles, those darn circles, they just don't want to put, like, a little poke in the circle. They want to color a little dot, and that just makes it slows them down. Slows them down, yeah? Or the opposite, where they just want to go through and be like, super fast.     Jayson Davies     Correct, and, you know, I wouldn't mind these that, yeah, because you also can't put two dots in one circle. They put two dots around. Circle. It doesn't count, but that's one of the areas with this testing that I kind of have a little discrepancy with. Is one because of the timing. The timing makes kids typically either, either they get super anxious, they don't understand the timing, or they just kind of shut down. And then what I do like about it is that you do get to see a lot in your clinical observations while watching this test that isn't actually scored, such as that crossing midline. It's not it's not actually scored on the test whether or not they can cross midline, but you can watch a kid. And on the most a lot of these tests, transferring pennies, you don't actually cross midline, but they do have to cross from one hand to the other hand. But on the sorting cards one and the and the pegboard, they do have to cross midline. And you can see stuff like that.    Abby Parana     Oh yeah. And then, and then you can warrant further observation of functional skills. So whatever it is that they're having trouble with, like you see those kids that they don't want to transfer the penny between their hands. Instead, they hold the penny with both hands and then drop it into the container. And they do that, they bring it to their other hand, and then they put both and drop it in. And it's those little things that you observe for that are could be impacting them functionally. So you you know, and like I said, every assessment is a snapshot, so you don't those are just little observations that might warrant further investigation.    Jayson Davies     Correct, so moving on past the manual dexterity, we get to sub test number four, which is bilateral coordination. Now this is one that I know not every ot assesses every student with I do typically see sub test number one, two and three on just about every single occupational therapy evaluation that comes across my deck desk as a transfer in the rest of them I don't always see, but I do use some of them, and I know other OTs do occasionally use some of them, depending on what their observations are of the child. So sub test number four is bilateral coordination, and this includes some tasks such as seeing if a student can do jumping jacks, seeing if they can touch their nose with their index fingers, eyes closed, this is basically, you know, the typical drunk driving test. Can you reach out with your fingers and bring your finger to your nose. You know you only have to do it four times, but you know the officer may want a few more than four times, but and then right the other ones are some sort of jumping in place, or the next two are jumping in place. While you jump in place, you're moving your hands and your feet. Sometimes you're moving your right hand with your right foot, and other times you're moving your right hand in the opposite direction of your right foot and left and vice versa. So it's got some bilateral coordination, definitely, as the test name suggests, it also has a lot of planning.    Abby Parana     Yeah. And I think you have to really look at, when you're looking at the bilateral coordination sub test, you really have to have an understanding. So if that child receives speech you really need to know what that speech therapy assessment says, because if they're receptively not understanding directions, it may not be a coordination issue or a planning issue. It may be that they just really don't understand what you're doing exactly all the time. And so given, and I think, I mean, that's just something to consider. They may need more practice or whatnot, and, and at times, you know, I'll do these, like this sub test only if I'm hearing that they're having problems with certain tasks. Yeah, functional tasks, so, or I've observed them have problems with certain functional tasks, like being out at recess or in gym class or something like that. But if they're not having those problems, then I might not do this. It depends on what the areas of need are.     Jayson Davies     Definitely, the last one that I do typically see on on an occupational therapy evaluation is the upper limb coordination, which most people will know, this is the ball test. You have a tennis ball, and you're doing many different items with the tennis ball. You're having the child drop the tennis ball and catch it with one hand, with both hands, with their non dominant hand. You're having them throw and catch the ball. And you're even having them I think the hardest one is the dribbling the ball that one's always tricky for kids. Oh, gosh, yeah, either with one, either with their dominant hand, or when you have to switch hands, it even gets more tricky. So that's kind of what the upper limb coordination looks at.    Abby Parana     Right, and I think if they're having trouble with tracking, or they have behaviors related to difficulties with tracking in the classroom, whether they're having the teacher reports that they're skipping words when they're reading or they're having trouble with that skill, I will look at this subtest, or I'll do activities related to tracking and then determine whether or not to do this subtest, because I think sometimes if you're looking too heavily at standardized scores, you lose the function. Definitely, you know you're right. So and a kid can look really bad on a standardized test score, but functionally they're very high. So yeah, just keeping that in mind.    Jayson Davies     I also use this sub test, especially the throwing of the ball, which is the final, final task of this test at a red target, at a small target, is how a student is able to learn, because especially when you're working with the younger kids, they haven't learned how to throw a ball, and you really get to see, are they able to learn from you teaching them such a gross motor activity? And I can only imagine how difficult it would be for a kid to learn something more complex in the classroom if they're having a difficulty just learning how to position their body and throw a baseball or and so again, it's not something that's actually scored within this test, but it is definitely some clinical observations that you're able to notate and and give your results on in your report.     Abby Parana     And I think just keep in mind, when you're doing the bot, what is the purpose of your assessment. It's a school based assessment, so you're not going you may need to detect all of these difficulties if it's impacting them in the classroom, but you may also not need to detect them correct in a way you know you want to assess in we're only obligated to assess in all areas of suspected need. So if a kid's accessing their environment and they're able to do functional tasks kind of related to these things, even if their standardized test score is in the well below average range, you I mean, if it's in the well below average it probably is impacting them functionally, but if it's in the below average range, it may or may not impact them functionally.    Jayson Davies     Correct. So the other tests that are not commonly used by OTs is the sub test that is identified as balance. Number six is running speed and agility, and number eight is strength. I rarely ever you see those on an occupational therapy evaluation. I have seen an OT and a PT collaborate to do all the tests together and do a multi disciplinary type of evaluation, but not too commonly do. I see OTs doing those on the back of the bot. It's kind of cool. They have a short form. I think I've only used it once, but it does kind of break it down. And you only have there's about 15 components that you do, and it does include a few of those gross motor ones. I don't necessarily recommend it. You get a much better snapshot of a student when you do the full form. But just do not the entire bot. You do the fine motor and visual motor ones.    Abby Parana     And I think it's really important to note here too. When you talked about multi disciplinary assessments, I love multi disciplinary assessments. I think, yeah, a podcast. Um, no, anyway, so I just like them, because I think it gives you a much better functional picture of a student versus just an OT assessment for that reason. So I like the bot.    Jayson Davies     All right. So that took slightly longer than we expected. So we are going to jump in now to the fine the, sorry, not the fine motor, the M fun, the Miller function and participation scales, also known as the M fun. So one thing that Abby touched upon with the bot is that it does have a wide range. You can test a student from four years old all the way up to 21 which is quite nice, because you know, if we're testing a student officially for the triennial every three years. You can rest assure that if you tested on three years ago with the bot, you're going to be able to test them again three years later with the bot, and compare and contrast scores with the M fun, the scores, or, sorry, the ages that you can use the M fun for is from 2.6 so two and a half years old, which, you know, not many school based therapists are working with kids that young. Usually, you know, we have some preschoolers that might be, what, four, three and a half, four, but it only goes up to seven years, 11 months, which is pretty young. You know, if you would test, if you test a kindergartner by the time they're in third grade, there's no, there's no given that you'll be able to use this assessment again. You might have to use the bot once they turn eight, or some other assessment tool. So that's kind of one thing that's not as great about the M fun. However, there are a lot of great things about it, so let's go over it.    Abby Parana     Yay. I'm a recent I'm a recent convert to the M fund. So I'm gonna let Jayson kind of school me up on it all right, because I am not as used to using the M fun. But when I have used it with certain age populations, particularly kindergarten, or those transitioning into kindergarten and preschool, I think it's a really good tool.    Jayson Davies     Yeah so I really enjoyed it's my first go to test for any younger child that I think can actually get through it, it is a little bit longer of a test. It does take a little bit more attention, but it's fun, and so it tends to even kids that are a little bit would have a little bit more trouble getting through the bot. I think they enjoy the end fund, so it helps them get through it a little bit better. So the. M fun has four components, really. The first component is the visual motor. The second component is the fine motor sub test. Then you have the gross motor sub test, which I don't use. However, every time I look at it, I think with like the next kid, I should do the gross motor part of it, because a lot of it is kind of things that you would see on the bot upper limb coordination, like the using of a ball, or the bilateral coordination, the jumping and balance part of it. So I will use it one time, because it actually it does seem pretty good. So I also, again, have seen OTs and PTs collaborate to do the gross motor test.     Abby Parana     How would you say? Oh, sorry, go. Sorry. I didn't mean to interject, but I think with the how do you think it compares? Have you used the Peabody developmental scales? Like, what do you think? Because the Peabody, well, I mean, I guess the Peabody goes up to.     Jayson Davies     What it goes up to six, yeah. And so I like this one more, because it's just more organized the Peabody, you know, you can have to jump around a little bit. It's, it gives you a different type of score to get a ceiling and a basal exactly, gives you the basal level and the ceiling. This one is more straightforward. It goes through. So I prefer this one for the kids that are a little bit older. Again, we don't have preschools, so I might write, I might try that one more with a preschooler, but by time they get to kindergarten, I'm pretty much said on the M fun versus, unless they can't do the M fun.    Abby Parana     On the M fun looks a lot at like, school based tasks, specifically where the people it's more developmentally based.    Jayson Davies     Yes, definitely. And the last part of the the M fun is the checklist. It has a home checklist, a classroom checklist, and a test observations checklist. Again, don't use these as often. I find that my own narrative is is better than going through the checklist and providing providing answers to those and then saying whether or not the child is average or below average according to the checklist. I would rather just give more feedback via a narrative in my report, and we were just looking up some the validity and reliability of those checklists a minute ago, before we started the podcast, and they actually the subjective portions of the assessments, both the bot and the M fun, such as checklist and observations, are actually less valid, valid and less reliable than the rest of the the test overall. So in my opinion, I think Abby will agree with me, is just the narrative. Being able to add a little bit extra to your report about what you observed during the test or in the classroom gives more than the observation the formal observations from the test.     Abby Parana     Yeah. And I think so long as you can defend your observations and keep them extremely objective, like just deliver the information. Don't elaborate too much subjectively on what you think it means in your report, just deliver the information. This is what you observed. Sort of remove your opinion out of it, and save that for your recommendations and your summary, but also just noting that your opinion is highly subjective. So if you are doing your narrative and you choose not to use, you know, checklists and that sort of thing, because they're maybe you don't find them as reliable, or because you feel like your narrative is more relatable, just remember to keep it objective in your report, and keep it very specific to what you looked at functionally with the child. And then just be prepared to defend your observations. Definitely. You don't necessarily need a score for everything.    Jayson Davies     Exactly. So I'm going to run through a few of these tasks that are on the M fun. It starts off in the visual motor task with a it's called the amazing mazes game. And it's literally, it's a maze with one of them is a dog is trying to find her puppy. Can you help the dog find her puppy? And the kid has to go through a short maze. There's a total of three mazes. Each one gets a little more tricky. And so you kind of get that, where does the child fall? Do they fall on a maze? Do they fail on a maze that is kind of designed for four year olds? Do they fail on a maze that's kind of designed for five year olds? Or are they able to get through all of them? So that's a cool thing. The next one's a race car game in which you get to look at a little bit of those that motor control and the ability to cross midline, because you're kind of going in a spiral. The kid has to, has to trace a quote, unquote Road, as they call it, which is a thick gray line, to get all the way to the end. So it looks at some bilateral coordination skills and motor accuracy. There's some visual processing skills where you have to find the hidden objects. There's the find the forks game, as well as the find the puppies game. There's also one where you get to draw you draw a kid. Actually, the assessor draws a kid, and then the student tries to copy your your drawing and or draw their own person as well as they can. Yeah. Another great thing that I find about the M fun, other than the bot, is that it actually specifically looks at handwriting. You start with tracing handwriting, then you move to copying some letters, then you moved on to writing some letters from dictation. It's only three so it's not too difficult for the kids. You can pretty quickly determine if a kid can write letters from dictation or if they can't.    Abby Parana     Yes. I love that part of it, actually.     Jayson Davies     Yeah. And the last two writing activities are writing copying simple words, three letter words, and then the most tricky one is copying about a six sentence word or six word sentence or so. Yeah, it might be a few more words, but it's not too diff. It's not too long of a sentence, but you can definitely determine between you can see a big difference between the ones that can do it, and the ones that cannot do it.    Abby Parana     And I'd say even on the sentence copying portion it, it's very age appropriate in how they have it set up. You can tell whether or not they understand that double lined paper because of how that task is set up. Yes, you know, you can see like, oh, have they learned to use that dotted line, and it's very age appropriate in the sense that you would expect, you know, a six or seven year old to have been taught that. And if they're not able to do that test, you can tell pretty quickly. I like that part.    Jayson Davies     I agree with you. The second portion, or at least the fine motor portion, of the test, is similar to the manual dexterity of the bot a little bit, except more functional in my opinion. You know, there's there's cutting out a fish instead of cutting out a circle. There is playing with clay and rolling clay into a snake and flattening it into a cookie. There is an origami game in which you see if a child can imitate your folds. You fold a dog, and then the child folds a dog. So you can see whether or not they can they can imitate. They can use those fine motor skills in order to fold. One particular question is, does the student use two hands to fold? Or do they only use one hand? Or do they kind of use that second hand to fold? So that's kind of one of those questions that you get a lot from. There's a penny bank game, which gives you the opportunity to see a lot. You get to see crossing midline. Do they cross midline to pick up pennies? It also looks at in hand manipulation skills. You put five pennies into the child's hand and see if they can get them out to put them into the Peggy bank one at a time. Can they do it with one hand, or do they need to use their second hand to to facilitate that, that movement of those small items. The last test is the snack time test, which, I mean, I were just talking about this, when we kind of see it a little bit out of place, because it's not necessarily looking at just fine motor skills, but it's also kind of cool, because it gives you the opportunity to actually objectively score functional social communication, which, yeah, that's not something that you get on many tests. So for right since you one of the descriptions is, does the student consistently demonstrate appropriate core cooperation and attention? Which is kind of cool, because you actually get that social skill aspect of the test. I know Abby had something to say about this.     Abby Parana     Yeah, and I think just for me, I think it takes a little bit of practice and comfort level with the therapist using it. You might have to practice it a couple of times and definitely be prepared. The other thing I just wanted to touch on, even with the fine motor test, in a little bit with the M fun, unlike the bot is it's almost the activities are super engaging for kids. I noticed there's always the goal direction is fun. Like, instead of just folding paper to fold paper, where a child might not put forth the effort because they don't really know what care about it or know what they're folding, there's no goal at the end of folding papers, just to fold the paper, just to fold it.    Jayson Davies     It sometimes looks like an alligator if it's full.    Abby Parana     Yeah, exactly. And so I think with the M fun folding a doggy and putting the ears and doing that is more engaging and it and the child's more likely to put forth an adequate effort that will give you a truer picture. And so anyway, back to snack time. What do you have to say about snack time? Sorry, I just was thinking about that. I was like, oh.    Jayson Davies     No, that's a good I like it. Snack time. It's it's a good one. You do see, can a poor, can a poor, can a child pour water from one cup to another cup? Can they dump their crackers onto a napkin without, you know, making the the crackers go everywhere. So there are, again, some of those functional skills that a class that a child would do in a classroom. So it's kind of nice. The thing that I really like, absolutely love about the M fun versus the bot and just about any other assessment tool I can think of is that they have this component called the neurological foundations profile. And, yeah, bear with me. That's kind of hard to explain, but based upon the scores on your test, if a child scores. On a Likert scale. Say, you know, it's a zero if the child didn't do it, do it well at all, and it's a three if they did do well, if they get a zero or one, you circle something on this foundations profile, and based upon where you're circling, it tells you the exact foundational skills that you may want to work on with the child. So for instance, some of the foundational skills that you could potentially find that the student has difficulties with is hand strength, pincer grasp, in hand manipulation, mature grasp, motor accuracy, motor planning, crossing midline and bilateral coordination. So those are all specific tasks that the M fund can weed out as far as what you may want to work on going forward. So that's really cool, in my opinion.    Abby Parana     And then that way you're not developing treatment activities that are working on, you know, we were talking about this pincer grasp or something like that, when really what you should be working on, as, you know, other areas like visual processing, areas such as visual discrimination or scan like you're not. It's very specific.    Jayson Davies     Yeah. So two examples would be the cutting in the bot versus the cutting of a fish and the M fund, the bot scores the cutting as either a 0123456, or seven points, right? Versus the Miller actually looks at is the child holding the scissors correctly? Are they using the second hand when they to turn the object while cutting? Do they cut within a given space, just like the bot does? But you notice that there's more criteria to fill in and to observe and to take data on. So that does make the M fun. Take a little bit longer to actually administer and to score. But in my opinion, and it's totally worth it, because you do get so much more information that you can relay to other occupational therapists, to the parent, to the teacher, to the the certified ot occupational therapy assistant that you can get that information to. So in my opinion, it's Yeah,    Abby Parana     Well, and it helps with developing baselines and goals. So if you're, you know, if the kid is not holding their scissors correctly, that could potentially be a goal. If the child is, you know, not cutting doesn't understand cutting on the line around a boundary, that could be a goal, but they're holding their scissors correctly, you wouldn't work on scissor grasp. You would work on that and, and it gives you a direct baseline so that, oh, I have a shape, I have something that they weren't able to do. And, and the fish is much more compared to the bot, particularly for those younger kids. I think that fish is more engaging, but also just the whole cutting on the boundary around the shape where the circle some kids just it's too difficult for the young ones.    Jayson Davies     Yeah. Well, plus the the hardest part of the fish is actually, when you get to the tail, you have to cut in and then cut out, which everyone knows that's, that's like cutting a complex shape, and that's more tricky, yep. So you do get to see a little bit more than just cutting out a simple circle. It's a little bit harder of an item to cut out, but Right? It's more engaging, and kids are more likely to actually try and cut it out, right? So I think our biggest concern with the infine is just that it only goes up to seven years, 11 months, that you can test a student with. Unfortunately, it's not normed for older than that like any other test. Yes, you could technically use it with an older student or an older child that is above that age, but make sure you're going to put into your notes. This test was used with a student outside of the designated age range, and that standardized scores do not cannot be really drawn from this testing, from your test, because it's not standardized for that age. However, you can get a lot of useful information from using the test with older kids, as far as observation wise.    Abby Parana     Yeah, and do you think, I mean, I'm almost wondering if maybe part of the reason it goes not quite as high up in age as kids are kind of expected to have those skills by that certain age, I think so, by eight years. So it probably I mean all the if I'm thinking of the sub tests and all the things that they're asked to do developmentally, children should be able to do those skills by that age.    Jayson Davies     If they can do it at eight, then they can do it at 11, type of, right? Yeah, right. I think you're right on that. It should have been mastered it, but it would be nice if it went up higher. Who knows, maybe they'll change it up a little bit and create a more middle school type one later down the road. That'd be cool. But anyways, the last objective that we wanted to get to is, you know, we wanted to share with you, kind of, and we've talked about a little bit already, but we wanted to share with you how we decide which one we want to use. And so we have a list of a few things here we'll go over. And the first one is age. Of course, we just got done telling you about how the M fund can only go up to 711 so if it's over, then seven if the child is older than seven years, 11 months, we're more likely. To use the bot?     Abby Parana     Yeah, absolutely. Because if it's normed for a specific age group, you want to try and stay within what it's designed for.    Jayson Davies     Yeah, if you can, it's best. The second criteria that we kind of had here for picking a test would be, what are the concerns or the reason for the referral for the student? And again, this kind of hints back toward the end Fund is a lot of our referrals are for handwriting. And there is a small handwriting section in the M fun. So if they're within that age range, I'm more likely to go toward that one.     Abby Parana     Yeah. So yeah. And I think with handwriting too, if it's, you know, they're copying letters or something like that, or we'll get referrals for I'm thinking of why I would use the bot if I get a referral from a school psychologist that is saying, oh, their mortar motor coordination was low on the BMI or their but their perception was high, and then their Visual motor integration was low on those scores, I would likely use the bot to get more information and try and tease out okay if they're accurately matching shapes, and able to perceive the shape and process it and verbally tell you what it is, then it may be a coordination issue. So I would use the bot.     Jayson Davies     Another one that we criteria that we had was what test was used with the student previously. So if you use the bot previously, you may want to use the bot again, because you can compare and contrast scores. Same thing if a kid used the Miller fund, the M fund back when they're in preschool, maybe before you had the student. And now there's seven years, eight months. You can still use the Miller functional assessment for one more time before you got to change it up because of their age. Another one that we had on here was time allotment. How much time do you have to complete this test the bot, I can tell you, it is definitely a lot less time, not a lot less, but it is significantly less time to both administer and to score, especially if you only do the first two or three sub tests.    Abby Parana     Right? And I think too, when you're looking at time allotment, the tests that you're comfortable with will go faster than the test you're not comfortable with. So if you've for me, I tend to use the bot a lot more than the M fun, just because I'm really used to it, and I know the test very well, or at least the first four sub tests I know pretty well. I'm sorry, four, first four, yeah, yeah. So I know them pretty well, and I'm used to giving them so I can, essentially, you know, administer them and be fairly confident that my scores are going to be very reliable, so I tend to opt with that, and you can deliver it faster when you're familiar with it.    Jayson Davies     Definitely, all right. Well, that's what we wanted to wrap up for you today, was those three objectives. So now you know a little bit about the M fun and the bot. You know what they assess? You know what kind of some of the pros and the cons are of using the bottom and fun. And you kind of have heard a little bit about how we decide which test to use with the time thing. I don't want to say, you know, that it's something that we pick because we're in a rush to get assessments done. No, no, no. Not that. It's just, you know, you some kids can't go for too long as well, and so you kind of have to break it up. And you can break both tests up very easily, but the bot can be broken up a little more quickly.     Abby Parana     Right, And I think too, when you're looking at time allotment, that's that whole you need to know the kid. So if you're noticing attention and executive functioning difficulties, you do need to pay attention to the amount of time you're pulling them for testing, because it will impact the standardized scores on both of these assessments. They have to have good self regulation in order to do things such as cut on the line and color in shapes and take their time with those things, or else their precision is going to look very poor when it's really probably not.     Jayson Davies     Yeah, definitely. All right. Well, that's going to wrap up episode number six. As always, you can refer to our show notes for anything that we talked about. We'll have links to both a few things about the bond as well as the M fun at OT or OT schoolhouse.com forward slash episode six, all one word, Episode The number six. If you enjoyed this episode, we hope you will subscribe to both the podcast and our website@otschoolhouse.com we keep on growing. You guys keep helping us out by sharing us on Facebook, on Twitter everywhere. So we appreciate that, and we're just gonna continue to bring you more content. So any last words Abby?    Abby Parana     Nothing. I'm just having a really good time making these podcasts. I think it's really fun, and I enjoy sharing information with other OTs. So like Jayson said, If you like what you're hearing, please share us so that we can get you know the word out and continue to bring you more information. Or if you have any constructive criticisms, not angry criticism, please go ahead and shoot us an email, a direct message us. Follow us on Instagram and kind of share your input. If there's podcasts or things that you want to hear more information on, share that with us as well, where we look to bring you guys information that you would enjoy hearing or that would better your practice, just like this is bettering ours.     Jayson Davies     Yep, definitely. So we look forward to many more podcasts in the future. We have some good ones already lined up, coming up here soon, and we're trying to figure out how we're going to do podcasts over the summer, so stay tuned a little bit for that, and we'll let you know. All right. So have a good rest of your day, everyone, and enjoy the end of the school year coming up.    Abby Parana     That's great. Thanks for stopping by.     Jayson Davies     Bye, bye.     Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 165 of the OT Schoolhouse Podcast. Are your caseloads pushing you to the brink? In this episode, Jayson digs into the pressing and widespread issue of high caseloads faced by school-based occupational therapists. With eye-opening statistics Jayson uncovers how these overwhelming demands contribute to burnout and impact the quality of student services. But this isn't just about identifying the problem—it's a call to action.  Tune in for innovative strategies and practical steps to create change and sustainability in school-based OT. Listen now to learn the following objectives: Learners will identify the critical factors contributing to high caseloads in school-based occupational therapy and their impact on service quality and practitioner retention. Learners will understand the broader implications of high caseloads on related service providers and school systems, including the need for collaborative advocacy. Learners will understand two different approaches to start addressing high caseloads. Guests Bio In 2017, Jayson founded the OT Schoolhouse website and now supports school-based OT practitioners via courses, conferences, and the OTS Collaborative community. With experience as both a contracted therapist and an "in-house" employee for two distinctly different districts, Jayson has had the opportunity to appreciate the differences between both small-rural and large-suburban districts. For over five years, he has been helping therapists implement proactive tiered interventions, support IEP teams with goals and services, and feel more satisfied with the job they are doing as school-based OT practitioners. Quotes “83% of those practitioners indicated that their workload impacts their ability to provide adequate services to students. That's 8 in 10 practitioners saying that their high caseload, whether it be speech, OT, or PT, that their high caseload is basically making it impossible for them to give their students the services that they need.”  -Jayson Davies, M.A, OTR/L “We need to flip the script from let's figure out what the problem is with high caseloads to how the heck are we gonna fix this problem with high caseloads. Because it is not a question as to whether or not we have high caseloads. It is a fact, and we need to figure out how we are going to change it.”  -Jayson Davies, M.A, OTR/L “ We know the impacts of high caseloads. It means that people leave the field. It means that those who stay struggle within their field and don't actually feel competent or don't feel like what they're doing makes a difference within the world.” -Jayson Davies, M.A, OTR/L Resources 👉 Jayson’s Email 👉 Oregon Department of Education Report 👉 AOTA Report (2023) Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT school house podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started, here is your host. Jayson Davies class is officially in session.    Jayson Davies     Hey friend. Welcome to Episode 165 take two of the OT school house podcast. And now you might be wondering why I said take two, and that's because I just recorded about one half of take one of episode 165 and basically just threw that file in the trash on my computer because I got halfway through, and I realized I was trying to share too much within that episode. I was trying to share with you three trends from 2024 and the three trends that I see coming in 2025 AI, the need for play based OT, basically, or the research on Play. And then I got to the third trend of 2024 and that was caseloads. And I got to that point, and I decided, You know what, this episode right here, as we're transitioning from 2024, to 2025, needs to be all about this one topic, and that topic is the astronomically high case loads that we currently have in school based occupational therapy. And what can be done about it, because I really feel like this is an inflection point, not just in occupational therapy, but for all related service providers. We are not the only ones experiencing high case loads. Speech therapists, physical therapists are also having trouble with it. Teachers are having trouble with it as well. And something's going to give, something will give, and we are starting to see some of that, because practitioners are leaving the field. Teachers are leaving the field. Those who are staying in the field are struggling. And this isn't new news, right? Over the past five, even 10 years, research has been coming out stating that practitioners and teachers have such high case loads that they are leaving the field. And that brings us to today, or at least to, you know, this time period here, as we transition from 2024 to 2025 and I do think that this is an inflection point, right? We know the impacts of high case loads. It means that people leave the field. It means that those who stay struggle within their field and don't actually feel competent or don't feel like what they're doing makes a difference within the world, and we're seeing that. Just back in January, the Department of Education in Oregon released a report, and this report was kind of in tandem with, I guess, House Bill 2618, it was titled school based occupational therapy, physical therapy and speech language pathology, workload methodology, a report to the Oregon Legislature. We'll link to that in the show notes over at otschoolhouse.com/episode 165, anyways, the two primary outcomes that I wanted to share from this report was that of the 600 about 550 or so participants that they surveyed, 83% of those practitioners indicated that their workload impacts their ability to provide adequate services to students. That's eight in 10 practitioners saying that their high case load, whether it be speech, OT or PT, that their high case load is basically making it impossible for them to give their students the services that they need. That's ridiculous. In addition to that, 62% of licensed practitioners indicated that they are considering or planning to leave the field, while only 38 say that they plan to stay. Definitively. When I read that, all I can think is that this problem is going to get a lot worse before it gets better. 83% of practitioners say they already have high case loads, and 60% of practitioners now say, You know what, I might leave what's going to happen to the 40% of practitioners this day? Are people going to want to come and be a school based OT, PT or speech therapist when the caseloads are crazy, absolutely not like this is going to get maddening, in addition to the logistical concerns, right that there's not enough time and people to actually service the students that need services, I feel that this burnout is also leading to a role confusion among therapy, specifically ot practitioners, because we know that we need to move beyond handwriting and find motor skills. We cannot be the quote, unquote, handwriting teacher and our skills, I mean, support that, right? We can do so much more than handwriting and find. Otter skills. And so many of us want to branch out, and we want to support student executive functioning. We want to participate social participation, and we want to get outside of the only elementary school to support high schoolers and middle schoolers. But there's a small part of our brain that's saying, If I do that, I will not survive because of my high case loads that I have at the elementary school supporting students with fine motor and handwriting difficulties. So now you have some role confusion. There you have other therapists who are saying, look, the research is telling me that the best way to support students is through a collaborative model within the classroom. But again, if I do that, how am I going to do it? When am I going to have time to learn how to do that? Will it be successful knowing that I have 60 kids that I need to see individually as well, and so these are all coming together to kind of create this perfect storm, and that's why I'm putting this episode out right now, because I do think that here in 2025 this is the moment that we need to address this. We need to flip the script from let's figure out what the problem is with high case loads to how the heck are we going to fix this problem with high case loads? Because it is not a question as to whether or not we have high case loads. It is a fact, and we need to figure out how we are going to change it. So that is where I am going to stop my discussion about the problem and move to the potential solutions. Because it's simply just not enough to talk about the problem anymore. We have to start talking about solutions. I want to start this conversation off by saying that this is not going to be easy. This is not going to be easy for anyone. It's not going to be easy for us as the OT practitioners. It's not going to be easy for our administrators. It's not going to be easy for the teachers, for the parents, for the students. It's not going to be easy for anyone to fix this problem. This problem has been growing since, from what I understand, I mean, obviously since before I was an OT in 2012 this problem has been growing from what seems like around the turn of the century in 2020 and it's going to be difficult, like it's not going to happen overnight, the way that I see ot practitioners addressing this right now tends to be, or tends to fall under one of two categories, either a to a degree limiting our scope in order to prevent referrals, which then leads to a decrease in services. That looks like saying, Sorry, that's a behavioral concern, not an OT concern, so not really going to address that in OT. Or that's a social concern. I don't really address social skills here in OT. Maybe speech therapy can help out with that. Those are the two primary categories. But I'm sure you have seen more. Maybe you have experienced more. That's one option that I see happening right now. The second option is that we show our value of what we do and the data to support potentially higher staff counts, or the data to support investing in the occupational therapy program and whatever that looks like. Maybe that is more therapist. Maybe that's software to help therapists be more efficient. Maybe that's more tools to help therapists. Maybe that is contracting with an agency to provide therapy. But these are the two primary ways that I see ot practitioners addressing this. Currently, I have gone the route of showing value in what we do, and also providing data as to where my time is going and what supports a student is not getting because my time is somewhere else, or even showing that services are failing because of my time and energy spent somewhere else, we're going to have to choose one of these, or each of us is going to have to choose one of these, or each district is going to have to choose one of these, because at this point, there's no state law, state mandate, federal mandate, or law that is deciding that for the districts. And so each school and district is going to kind of have to do that on its own. Now I am doing my best to help the way that I can, and by putting out episodes like this, and I have a caseload to workload course that I put out, and I'm trying my best to work with both California and a OTA a little bit on this. I'm doing research, actually right now on this topic, but we're all going to have to do our part. We're all going to have to help in showing the district the value that occupational therapy has and how our data can support student outcomes over the last few months and maybe even a little bit longer. I've heard of different ways that both districts and states are kind of handling this. You know, you have some states that have. Put mandated caseload caps in place. Ohio is one of those states that has a caseload cap. Now speaking to therapists in Ohio, the cap is not always followed, but it is there. It is something that they can point to. In other states, you have ot practitioners trying to work their way into an administrator role so that they can have an impact from within the district. In other areas, you have ot practitioners forming or joining a union so that there is a bargaining unit for them, and that bargaining unit can actually work with the district to implement some sort of caseload cap or workload cap. In other areas, still, therapists are doing their best to implement an MTSS program as a preventative model, as a way to decrease long term case loads and stabilize their workload. There's a lot of creative ways to do this, other than just hiring more people. Sometimes the end result is hiring more people. Yes, that's true, but if we are showing the data that shows that we have an impact on student outcomes, then districts will be less hesitant when it comes time to actually pony up and put the money forward to get another occupational therapy practitioner. As we move forward through 2025 I'm really excited to see the results of the survey that a OTA put out. I believe it was in August and September about school based occupational therapy. Abe Safar at a OTA, he has been on the podcast a few times. He really championed the idea of better understanding the school based ot practitioner, and our situations like this is almost going to be kind of a state of school based ot survey results when we get those results, and I can't wait to see them, because I'm interested to see not only things about caseload and workload, but like salary. And you know the difference between working in California versus working in Arizona versus Colorado, Texas and New York and all the other states like this is going to be really interesting. Every so often, a OTA publishes their national workforce survey where they kind of break down all of occupational therapy. But it will be really interesting here to see just school based occupational therapy broken down and see how that goes. Because, yeah, it's going to be really interesting to see where, or if it's just across the board, Everyone is struggling with providing the services to the students that they're supposed to be providing services to. I think that's going to be really interesting. So I'm gonna wrap this podcast up. I am sorry for ending 2024 on a little bit of a somber mood, I guess we could say. But I just felt like this podcast had to be put out really quickly. The other trends that I was going to discuss in today's episode, the first one was AI and documentation idea generation, or documentation and idea generation, the second was going to be talking about the emphasis of play, but I'm super excited because we're going to be talking about play two weeks from now in the next podcast episode. And then I was going to talk about high case loads. I was also going to talk about the future trends of more using AI, but instead of, from a documentation perspective, using AI in a way to actually support our students. So imagine helping our students use AI to overcome some of the difficulties that they experience every single day. The other one that I was going to talk about was more services in the classroom. I think that's going to happen more in 2025 I think that people are really going to be reaching out for support to do that, and I hope, I really hope, that we can achieve it even with our high case loads, or that we can do something about our high case loads so that we can get into the classroom more frequently. Because I think that is going to have the largest impact on our students if we can get into the classroom. They don't call it the PEO model for nothing, person, environment, occupation, you've got to look at all three to best support a client. We can't just look at the person in the occupation. We have to look at the environment, and the teacher and the peers are all part of that environment, so we need to be in the classroom to best support the students. So with that, I'm going to say Happy trails for 2024 and I look forward to seeing you in 2025 if you have any comments about this specific episode, please email me. Jason@otschoolhouse.com let me know. Let me know if you are combating high case loads in some form or another, or if you are simply drowning in high case loads and you need support in one way or another. This is definitely going to be a topic that I will be addressing more here in 2025 and yeah, I just look forward to supporting you related to this and every. Else related to school based occupational therapy. So thank you one more time for sticking around and listening to this to some degree somber episode in 2024 but I promise to be back in two weeks with Episode 166 that will be much more light hearted. And we are going to talk all about play and nature based settings. So it's gonna be a fun one. Stay tuned. Hit subscribe. If you haven't already, leave a comment or a review. If this podcast helped you out a little bit, really appreciate those and share it with a friend. You know, if you and your colleagues are all experiencing high case loads and not sure what to do, give this episode a share. Let them know that they're not alone and that we're going to get through this together. All right, enjoy the remainder of your 2024 I appreciate you. I appreciate you listening, and I will see you in 2025 until next time, take care.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otsoolhouse.com Until next time class is dismissed.  Click on the file below to download the transcript to your device. Thanks for listening to the OT Schoolhouse Podcast. A podcast for school-based OT practitioners, by school-based OT practitioners! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Subscribe now! Thanks for visiting the podcast show notes! If you enjoyed this episode, be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 4 of the OT Schoolhouse Podcast. In this episode, we talk to Kerry Mellin who is a motion picture and television costume designer by day, and a creator of the EazyHold by night. The EazyHold is a universal cuff she and her sisters designed that is allowing children to access occupations they never thought were possible. Hear how this idea of a modern universal cuff came to be and why we prefer it over any other cuff we have seen available. Links to Show References: EazyHold.com - Use this affiliate link to get your set of Eazyhold grips and support the OT Schoolhouse while doing so. Here is a Giff to tease one of the many fun topics we discuss in this podcast: "Hammer Time" Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.     Jayson Davies     Hey there, and welcome back to the OT school house podcast. My name is Jayson, and this is episode number four already. Anywho, I hope your day is off to a great start, or maybe you are winding down the day with us today. Either way, just want to say thank you for taking the time to listen in and for supporting. Abby and I, we couldn't be more appreciative. So today, we have another special guest on the show, so Abby will not be joining with us today, but she is working on an interview with a board certified behavioral analyst of BCBA for an upcoming podcast, so stay tuned. That should be a very interesting one to say the least for this episode. However, we have Kerry Mellin, who is a Motion Picture and Television costume designer by day, and she was just telling me that she has dressed anyone from Ariana Grande to Michelle Obama and several others on Nickelodeon. And we actually get into that a little bit in the interview. It's kind of a funny story you'll hear, but today she's here to talk about the universal cuff she and her sisters recently designed actually to help ourselves, but she came to find out that there's so many other purposes for it, and now it's helping many other people. So she's going to tell us about how her easy hold cuff is helping adults and kids, especially in schools, access the occupations they never thought were possible if you work with a population who requires assistance Grabbing and holding on to objects, whether they be big or small, such as forks or bottles or even maybe a tennis racket. This is the perfect podcast for you. Before we jump right into this podcast, I do want to remind you that you can find all the links that we talk about in today's episode at ot  schoolhouse.com , forward slash episode four. And these links that do send you to Amazon or to even the easy hold website, they are what's called affiliate links, which means that we do get a small commission at no additional cost to you, and this helps to support the OT school house podcast and website. And we definitely appreciate it when you do use these links. All right. Well, Carrie is absolutely fantastic and super passionate about helping others, and I know you will hear that inner voice, so let's jump right into it again. This is Kerry Mellin, one of the creators of the eazy Hold E, A, Z, Y, hold cuff that is replacing the velcro universal cuff. Oh, and my apologies for the quality of the sound during parts of this interview with Kerry, for some reason, the Internet was not fully cooperative, but it doesn't draw from the content. So please just enjoy the interview. Hey there, Carrie, thank you so much for joining us today, and welcome to the podcast.     Kerry Mellin     Thank you. It's so nice to be here. Jayson.     Jayson Davies     Yeah, I don't know if you can tell, but I'm really excited for this chat with you. I've been preparing for it all week. I hope you saw one of the emails that we sent out about your product. We're happy to have you here and share your product with our listeners. I think it's something that many people will value from hearing so yeah.    Kerry Mellin     Great to hear that I've found really a warm reception from occupational therapists and physical therapists regarding easy hold. So I'm excited to talk to you about it and answer any more questions you might have. I know you know a little bit about it, but feel free to ask away. I love talking about easy hold.    Jayson Davies     That's perfect. That's great. That you're doing something that you love. That's one thing that many of us occupational therapists can say, is that we love what we do. It's awesome. So I want to give you a little chance to say a little bit about your background. You're not an occupational therapist, so tell us about what you do.    Kerry Mellin     Well, I'm a costume designer for television shows, TV commercials. I have done few movies, and I've been doing this for about 30 years. So I build costumes, I dress actors, anything that's involved with making an interesting costume. So I'm very handy and very crafty. I have always had a little bit of interest in occupational therapy, because before I started my career, I was told by a counselor that I would make a good occupational therapist. She looked at my background, and we took, we took a couple of tests, occupational tests, and she had said, you know, I think you'd make a great therapist. So I did volunteer in an occupational therapy hospital for about a year in the spinal cord injury wing, and at that same time, I was also starting to work in television, a little bit, making costumes. So I was during the day. Some days I would go and work at the occupational therapy week, and I would see what kind of tools they were using, what kind of assistive cuffs and universal cuffs, and I would try and help the patients and the clients to hold implements. And I never really forgot that. 30 years later, I did decide to go into Hollywood and costume design, but I never forgot what I. In that occupational therapy wing. And you know, when I found myself just recently, about two years ago, having trouble with my own wrists and hands, I looked back at that time and wondered if they'd come up with anything new, any kind of universal cuffs or gripping devices.    Jayson Davies     But sure enough, there hasn't. It's still that mostly, most therapists are very familiar with the Velcro or nylon universal cuff. I want to ask you one question, sir, what one costume that you, you have designed that probably everyone knows, is there one out there?    Kerry Mellin     There is actually, do you know who MC Hammer was? Yes, of course. Hammer time. Yeah. Okay. MC Hammer. He had to float off of the Taco Bell with his pants needed to blow up from fill with air and float down the bell down to the ground. And I did those, I designed those MC Hammer pits. Wow. And for whatever reason, that seems to be a costume that a lot of people remember.    Jayson Davies     That's funny. I can't say that I've seen that, but I can imagine in my head. I'm sure many people out there have actually Hammer was a character.     Kerry Mellin     Yes,and you know, I've loved designing costumes and making costumes, but I'm finding out that my talents now, as I'm reaching a certain point in my life, my talents can be used elsewhere. And so I've really switched over to designing adaptive equipment. And it's really quite fulfilling.     Jayson Davies     Yeah, I mean, it's only natural that if you design in one area of life, then, I mean, you came up with this new product. So how about you tell us about the product. What is it? What is it made out of? What is how does it work?    Kerry Mellin     Well, it's a one piece silicone band, and it's soft, 100% food grade silicone. And on this band is two holes at either end. It's really super simple, and it's made of silicone, and it's slightly sticky and tacky, so it kind of sticks to your hand, and it doesn't need to be tight. So you take this one piece band and you, if we're for instance, let's use a fork. We would slip it over one end of the fork and the other end, and you would tuck your hand inside. Now with the traditional universal cuff, you might put the fork into the actual cuff, and then put the cuff on the hand so the fork doesn't actually rest in your hand. But with this simple band, the band goes over the back of your hand, and the fork would be in your hand, so you would actually feel the fork on the palm of your hand. You would feel how cold it is, how hard it is, you would feel the vibration. So it's a much greater tactile experience having this soft silicone band instead of a large, bulky apparatus that you're holding onto, and the fork would be put into that.     Jayson Davies     So you're saying it's we have people. Obviously, this is an all audio experience, the people that are listening to this. So are there different sizes? Is it one size fit all? How does that work?     Kerry Mellin     We have eight different sizes. So it can be something as tiny as an infant's hand holding a little rattle or a teether, tiny little band that's not more than an inch and a half, all the way up to a large band that's eight inches, that will hold a sippy cup or a baby bottle or even a water bottle. For a sports enthusiast, it can hold things like a row boat paddle or, I mean, it goes up to large equipment.    Jayson Davies     Yeah, I think I saw a picture of you someone using a baseball bat or a broom, and I think didn't you originally do it with a broom?     Kerry Mellin     Yes, that was my first easy hold that I crafted when I was out in my barn, and I was getting ready for a family holiday, and I went to grab my broom sweep it out, and I couldn't, because of the repetitive motion and my sore thumbs from an inheritance I got from my parents, which was arthritis, not money, arthritis in my thumbs. So I was gripping the broom, and I'm trying to sweep and sweep after sweep. It's getting more and more painful, and I have family coming over soon. So I grab a roll of duct tape, and I make a loop onto the broom handle, and I slide my hand in, and I go finish finish brooming. And it was really effortless, very comfortable. I didn't have to grip tight, but that little bit of leverage over the back of my hand just gave me enough grip to finish the job. And so I finished sweeping, and I'm thinking, gee, this is, this is really a really helpful, useful tool. I wonder if there's anything like this out there. And later that evening, after I'd been getting ready for the party, my sisters came over and we were talking about aging, but wanting to continue doing the things we loved. We're a really active family, and I've always been very active and equestrian and outdoorsman. Love sports and hiking, everything outdoors. Yeah, and I was talking to my sister, saying, gee, are we going to have to change our life? Because gals, today, I actually had to tape my hand to the. Room to clean my own barn. And so while they laughed about it, it really got us thinking. And my sisters are avid sports people. They are. They love cooking and dancing and tennis. And so we all agreed right then and there to see if we could come up with some kind of an assistive grip device that would help us maintain our activities. And at that time, we were really thinking about the aging population, and we were thinking about the population with arthritis, perhaps stroke, that kind of a thing that might happen as you're aging. But we did find out that it was going to be much more helpful for many more than than just adults, for children as well. So that, that was the day that we decided to come up, my sisters and I to innovate a new product. We did go back to our computers then and try and just to discover whether there had been any advances in assistive devices or universal cuffs since the time I knew about them 30 years ago. But we really didn't find anything. No. Nothing had really changed this. The griffin cuffs, or universal cuffs were still made of velcro and plastic or leather or elastic they had. We did find some neoprene universal cups, which were a little bit of an improvement, but we discovered the problem with them is they weren't adaptable. They couldn't fit large objects. Everything was made for a pencil or a maybe a crayon or a fork, nothing large for outdoor equipment or sporting equipment. And so they just weren't very adaptable. And then we also came to learn that not only were they not adaptable, but they were not sanitary. You cannot they harbor bacteria. You cannot clean them. You can't disinfect them. So we wanted to make something that you could keep clean, and.    Jayson Davies     So one thing that I've noticed that you're right, I can attest to that, is that it's very easy to clean, very easy to dry. If a kid drops it in their soup, you can just rinse it off real quick, and they can have it back on their hand in a few seconds, which is awesome.    Kerry Mellin     Yeah. Or you can leave it right on that fork, and you can put it right into the dishwasher. It takes high temperatures very well, up to 500 degrees. Not that you need to, because actually soap and water cleans it very well. And then hospital grade disinfectant wipes are really wonderful for it. You can use those, and you can pass them from student to student or client to client or patient to patient.     Jayson Davies     Awesome. So thinking about something that's rubber, how sturdy is this thing? Does it last for the long haul? What would it take to destroy one of these?     Kerry Mellin     They are very sturdy. Now they're soft enough where they're comfortable on your hand, so they're not indestructible. But as you can see right here, you can see how large I can stretch this hole. Yeah, so this hole might be about a half inch, but it can stretch to about two inches, two and a half inches, so the soft, elastomeric silicone stretches and grips tight but does not break. So the tensile strength is very is very strong, and it should last a whole lifetime. No, it won't degrade in the sun. It doesn't degrade over high heat, and it should last a lifetime. But, and they are guaranteed if you buy them and we'll replace them if anything happens to them, awesome.    Jayson Davies     So one of the things that I'm so happy that we've taken on this in Denver the podcast is hearing back from people about them, enjoying our podcast, learning from our podcast. What about you? I'm sure with these tools, you've heard a lot of not only customer reviews, but just testimonies about about your product, how it's changed lives. What would be your What's that story that always comes to your head when you think about your product and how it's changing lives?    Kerry Mellin     Oh, you know, early on, when we first started selling them and trialing them, I think one of the first things that sticks in my mind is a mother who wrote and sent a picture of her child, and he was holding this little giraffe, just a just an action like a toy giraffe. Yeah, and she hadn't, she said, this is the first time my son, who looked to be about four years old, has been able to hang on to that squeaky giraffe that's been in his bedroom for years. So I realized that this simple little strap was allowing children to hold toys, action figures and dolls, which they had previously not been able to do, not been able to hold a toy. You know, a mother is going to want their child to hold a toy, but she's not going to go taping a toil toy to the child's hand, and you're not even going to want to use an ace bandage to wrap a toy. No, it's not, but the easy holds are really it is too much effort, and you want it to be able to come off easily. If the child becomes frustrated or doesn't like it on it. And the easy holds, they actually feel like a toy themselves, because they're soft and stretchy and they're colorful and pretty, so they look like part of the toy.    Jayson Davies     Oh, definitely, I think I've caught myself fidgeting with them every once. In a while, just kind of messing around, kind of like what you are. Can see you on the screen right now, just fidgeting with it. I do the same thing every now, yeah.    Kerry Mellin     So I would, I would say that the first when we first started selling our easy holds, we were so heartened and kept inspired every day, because parents would post pictures saying, this is the first time my child wrote a Mother's Day card for me, or this is the first time my child has drank his own bottle or held his own sippy cup. But I would say that one of the most inspiring experiences we've had recently was a fellow by the name of Michael, and Michael, he went out for the State Board of Cosmetology exam to become a hairdresser. And Michael has only one arm, and he considers himself a lucky fin, because he has one arm, and on the other side of his shoulder is just a very small flipper, a very small flipper. He was able to pass the State Board of Cosmetology and become a hairdresser because he uses easy hold and he puts them on his flipper, with his blow dryer, with his comb, and he's able to do people's hair all day long. This is his occupation. He does hair and cuts hair and styles hair and colors hair. Wow. So he sent us videos, and I think it's just so inspiring. It's, it isn't just for eating and drinking and playing with a toy. It's actually for a career. It's, it's putting people back into the workforce who who have limb loss or grip issues. So that was a very inspiring story, and I owe him also on Facebook and watch his progress with his work. And.    Jayson Davies     Yeah, I wanted to point out, just for the OTs out there, that today I was talking to a teacher, and this is a teacher of moderate to severe and more severe disabilities. She wanted, she wanted to let me know, you know, this is definitely a product for a student that has the cognitive capability to want to do something, she has some kids who they put it on and they just kind of looked at it, they didn't know what to do with it, but that's also because they don't necessarily know what to do with a spoon. So you can attach it to a spoon and put this on their hand, but that doesn't mean they're going to be able to eat if they don't have that cognitive capabilities. So this is definitely a tool that you need to keep in mind that it's for people who have the desire, who have the ability to learn how to do a task, but just can't, because they can't hold on to the object, and this helps them with that part of it.     Kerry Mellin     Absolutely, one of the first little children that we trialed easy hold with was a little girl named Emmy. Emmy was about a year old, and she has severe cerebral palsy and other conditions, and she was able to move her arms, but she has no grasp. She's very tiny and very weak. So what her mother did, her mother did want her to be able to to hold a teether or a pom pom or a shaky noise toy. So at that age year, we do have tiny little cuffs. She put a teether in Emmy's hand, and Emmy was able to get that to her face and to her mouth. And even though she wasn't cognitively aware of what she was doing, that instant reward of her actually getting something into her mouth taught her this eye hand coordination and to try harder. So her her mother, from that from one year old, has used easy hold on musical instruments, on teethers, on on on spoons, on plush toys. And throughout her infancy, she's now three years old, she has used and uses the easy hold with spoons and forks and toys and musical instruments and drumsticks. So even before she was really aware of what to do with the easy hold, she was able to play with it, shake a pom pom, and hear the music. So I've heard, I've talked to other OTs who have said that if a parent can put use easy hold with a small child first, they are less adverse reactive to it later. Because some OTs have said, well, what if my my older child does not want to put it on that's something you can't you can't help if a child is by the time a child is seven or eight years old, if he has some type of an adverse reaction, to have some something on his hand, you may need to work with him a little bit harder, like putting the spoon in front of him with a favorite food, or having a musical instrument that he loves the sound of or or with older children, we find that the drumsticks work really well because that's something they really, really would like to do is play a drum, so that gets a lot of the students interested.    Jayson Davies     Awesome. All right, so first of all, I did want to give a shout out to Wendy and Marilee, who are your sisters? Right? Yes, exactly. And correct me if I'm wrong, but Wendy is an artist and a chef?    Kerry Mellin     Yes, she is awesome. Wendy is an artist and a chef. So when we were starting our easy holds, she was able to steer us in the right direction when it came to colors, the color palette, what's attractive, what children would like. She was also able to draw our prototype drawings and then get our patent drawings. She was able to assist us with that. And then also, she gained gave us a lot of insight into the sizes for cooking, because a lot of the easy holds are wonderful in the kitchen for pots and pans and cooking and household equipment. So you Wendy was very instrumental with the artwork and the sizing and coloring and then the kitchen utensils.    Jayson Davies     Okay, cool and and Marilee, your other sister, I'm sure she came in to be a big part of this is she's an She's the director of early education facilities, right?    Kerry Mellin     Exactly. She worked as an early educator director for 30 years or so, and so she knew firsthand what it takes, what it took for a teacher to actually assist students in the classroom, and how a teacher may have 20 to 30 students, and what kind of implements might be helpful to her, and especially in a special, special needs classroom, where there is one teacher and an assistant teacher, and there may be several students who want to do something at once, easy hold can be very helpful, because one student can have it on their paint brush, and another could have it on their pencil, and another could have it on their musical instrument and then that same implement, because it's washable and you can sanitize it. You can switch them up and give them to another student, or use them over and over. Actually, that's that's one of the best things about easy hold, is that it is the only universal cuff that is currently being stocked and and bought by educational facilities because it is the only cuff that can be disinfect. Disinfectant.     Jayson Davies     We definitely have a few of the old traditional ones lying around. And to be honest, I've never even thought about the ability to disinfect it, but you're absolutely right, and and I know that while I don't think about that, I've given it to a teacher, and then I noticed that it quickly is no longer being used. And I asked them, and they're like, OTs just too dirty. So completely understand that. Well, very cool. Yes. All right, I have one last question before I let you go browsing your website. It did come across something called the small things program, and it looked like a really cool idea, and I wanted to get more information on that. What is the small things program?     Kerry Mellin     Well, we noticed a lot of people following our Facebook page and Instagram, we have about 12,000 followers, and we noticed a lot of people follow, but they didn't themselves. Have children with special needs, or they were not special needs, but they were always giving a lot of support. And then we had some inquiries about how they can help. So we started a program that would benefit California Children's Services, United Cerebral Palsy. We have Maya's hope, which is in the Ukraine, which aids children who have been abandoned and have no means of any income or support support them. So we have sent Maya's hope easy holds, and we continue to support them. So our program is, if you donate an easy hold strap, we'll double that and then send that to California Children's Services, United Cerebral Palsy and Maya's hope and other local charities here that ask us for easy holds. We try and send them them whenever we can.     Jayson Davies     That's super cool. And where are you guys located? Again, we're in Simi Valley, California. Oh, you're right down the street from me.     Kerry Mellin     Yeah, we're not too far.    Jayson Davies     Depends on the traffic, I guess.     Kerry Mellin     Yes, yeah, we have noticed we do get a lot of requests from for Special Needs foundations, which we we really do want people to know the different opportunities people can have with that. It isn't just because the old universal cuffs were basically for feeding and grooming. We do want people to know that that individuals now are they're skiing with them. They're sit skiing. They're doing adaptive skiing, adaptive rowing, adaptive horseback riding. We even have a Paralympic equestrian who is using ours on the on the rains and the crops, so they go on to just about any implement. So there are really no limits to what a person who has lost their grip through limb loss or stroke, arthritis, Parkinson's. There's no limits anymore to what you can hold. Yeah, from, you know, from the time you're a baby to adulthood.     Jayson Davies     Yeah. And I definitely want to stress just that. The coolest thing I find about the easy hold is how just about any size thing can go into it, versus the traditional cuff, universal cuff. It's designed like you said, just for sometimes even a full size spoon won't fit into it. It's like a plastic spoon has to go into it with the easy hold just about anything I could put my entire pint sized cup into one, and it'll keep my hand nice and secure to that cup.    Kerry Mellin     Absolutely and then it puts the two. Tool in your hand. So if you are, if you're trying to have a child that is needing to learn to explore and discover and play, part of that is also feeling the vibration of the drum beat, or feeling the softness of the fabric or the coldness, or actually feeling the paint brush running across paper on off the table. And you can't really feel that with the old cuffs, but with this, you can, because the actual tool is in your hand.    Jayson Davies     That's super cool, alrighty. Well, thank you, Carrie, so much for joining us. Very much appreciated. Would you like to share where they can find more about you?    Kerry Mellin     Yes, absolutely. You can find it at our website, at easy hold.com and that's e, a, z, y, H, O, L, d.com , and if there are any questions from OTs that would like to have some personal answered, I can also be reached at Kerry@easyhold.com , that's k, e, r, r y @ easyhold.com .    Jayson Davies     Awesome, and definitely do check that out. They have a variety of options for you, starting with like a two pack all the way up to a full seven pack, that's designed for teachers that have multiple sizes of hands and tools to be using the Easy hold with. So be sure to check that out. We will put a link to that up on the show notes. So Alrighty, well, have a good night. Carrie, thank you so much, and take care.     Kerry Mellin     Wonderful to talk to you. Jayson, we'll talk to you again. Bye, bye.    Jayson Davies     Hello. I'm back, but no wrapping this time for those of you who listen to episode three already. So shortly after recording the episode, Carrie emailed me, and one of the things she wrote really stood out. I wanted to share that with you. It was that the easy hold cuff is allowing parents to see what their child with severe disabilities or or a missing limb, perhaps, is actually capable of when given an accommodation. And as teachers and school based OTs, you know, adapting the environment is a large part of our job, but it isn't always easy to convince someone that an adaptation is going to work. The Easy hold, though it's different, it's so quick, it's obvious, and it's a lasting change for that individual. This is something that they can use day one or 510, 1520, years down the line. It's something that's so easy to see how well it works, and it can help an individual in almost every occupation. And that's why, exactly why I wanted to bring Carrie on today. I hope you enjoyed hearing from her as much as I did today. I look forward to having many more conversations with her as we continue on this, this new friendship, alright. Well, that is all for today's episode. As always, you can find all the notes for this episode@otschoolhouse.com forward slash Episode Four for this one. And if you know someone that may benefit from hearing about the easy hold or our podcast in general, you know we'd ask that you guys, please share this with them, send them a link on Facebook, or even just mention it to them, to them at work. So thanks again, everyone for listening, and we'll see you on the next episode. Take care.     Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otsoolhouse.com . Until next time class is dismissed Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 3 of the OT Schoolhouse Podcast. In this episode, Abby returns to discuss SMART-E goals and how these goals should drive a service provider's decision on how frequently to see a student. Links to Show References: SMART Goals Blog post - Referenced in the podcast is a post written by Abby all about smart goals. Click here to check it out. Collaboration Geared Toward Classroom Participation (Article Review) - This is a post that looks a little bit at OTs who work in a collaborative model and how it can be effective. Best Practices for OT in Schools - This is a book that every OT should have. We regularly refer to it when we are stumped and even if it doesn't directly tell us the answer, it points us in the right direction. ​ Subscribe - Subscribe to our website now to get access to our free downloads of Gray-Space paper and Occupational Profile for school-based assessments. Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript.   Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session.    Jayson Davies     Hey there, everyone, and welcome back to the OT school house podcast episode number three. Thank you all for being here today. Guess who's back with a brand new rap. And I don't mean rap as a new case, some old school Eminem there, but Abby is back and she's laughing her butt off right now.     Abby Parana     Surprise.     Jayson Davies     Yep, I rap not.    Abby Parana     I loved it. Do that every episode, every episode, we're gonna have a vote. If you like it on Facebook, just comment in your comment section, and Jayson will rap every episode.    Jayson Davies     I'm gonna have to get up to date on my rapping skills. All right. Well, anyways, today is episode number three, and we are talking about smart goals. I'm sure many of you have already talked about or know about smart goals, but we're gonna change it up just slightly for you, and we'll tell you about that in a second. First, want to say thank you to everybody. We are recording this the day that the episode number two actually went live, and you all have been listening to it so much and well, Abby and I cannot be more happy and excited, and that's why we're recording today. You're pumped.    Abby Parana     I'm super pumped, because I thought the majority of the listens would be family members of mine, which any family members that did listen. I'm eternally grateful.    Jayson Davies     But for all of those that didn't we.     Abby Parana     But all of those who are unrelated to me and listened on top of it, I'm also super excited about it, because I do think it's pretty cool. Yeah, so thank you to family and non family members that have listened to our podcast so far. We hope to keep bringing you good stuff.     Jayson Davies     Yeah, and you guys have already been giving us some great feedback, so we appreciate it. So yeah, the first episode, we talked about assessments and trying to put together an assessment that could be well defended by yourself in an IEP. And in our second episode, we talked to Tricia Gomez, the Global Director of rhythm works integrative dance, both very good episodes, and recommend that you have a listen if you haven't already, also, if you're enjoying this podcast already. I know we've already been a little silly today, go ahead and hit that subscribe button so that you can hear when all of the podcasts come out. So that's gonna be it for our intro. I think let's you ready to head into the SMART goals. Abby, oh yeah, let's do this. All right. Go ahead and tell them our little extra thing for smart goals.     Abby Parana     Okay, so we've decided to add an E and create smart e goals for all you smarty pants OTs out there, but ultimately that E is to make it educationally relevant. Smart S stands for Specific. M is measurable. A is actionable, and using action words in your goals, R means that it's going to be realistic and relevant, and t is time limited. So when we're talking about E, we also want to add that there's an educational component. And whenever we do education, we do it in the least restrictive environment. So I guess that E could be both education and environment.     Jayson Davies     What do you know? Alrighty, well, let's dive into smart goals a little bit. You gave the brief synopsis of it, but what does it mean for smart goals to be specific?     Abby Parana     So when we're looking at a specific goal, we need to make sure that it is functional, and that when we are being specific, we are looking at something that is measurable. So if we're looking at a child's grasp of their pencil, or something like that, we need to be extremely specific, that it is the grasp that we're looking at or that when we're looking at their self regulation skills, what is it that is specifically we causing them to become dysregulated? That specific part helps us be able to lead to the M in smart goals?    Jayson Davies     Yeah, I agree. Because I think sometimes we try to measure too much in a goal we try to measure, like some of us will just say handwriting in general. Devon, they can write their name, but you know, as OTs, we all know that there are so many things that go into handwriting, and sometimes we need to break it down a little bit to make it more specific. So maybe we're just looking at if they're able to size their letters correctly. So that's kind of what I think of when I think specific, or if it is like you're talking about sensory integration or sensory processing, looking at the one behavior that will be the result of in increased or improved sensory skills.     Abby Parana     If that's where establishing those baselines. So when you're looking at establishing a goal for a kid, you want to actually measure that goal before the IEP meeting, even if they're doing it zero out of three opportunities with 0% accuracy. You want to be very specific and what that baseline is in order to establish that goal. So, and just like you were saying, getting into the nitty gritty of those baselines will help you be more specific when you write the goal.    Jayson Davies     Definitely. So then that's s, I know we kind of said measurable in there a few times, but this one is measurable, and it is similar measurable means that it's a behavior that you can see, right? You can't measure something that you can't see. If you can't take data on it, then it's probably not the best goal to be measuring, and you want to write that at all.    Abby Parana     So when we're looking at measurable, you want to consider the service level in that part of your goal. So if you're recommending whatever your measurement is, you should be recommending that level of services. So if you are providing a two time a month 30 minute collaboration for the student, you should be measuring that goal two times a month. And when you do that, you should be specifically documenting the specifics of that goal twice a month. And so when you write a goal, for instance, I was making the mistake of saying, like, oh, four out of five opportunities observed. But that's for like, a goal that I'm going to work on with a kid every day, in which case the teacher would be measuring it. If I am measuring a goal specifically as an OT. I would be writing it as Oh, the child will do it in four out of four opportunities over a two month period with 80% accuracy. If it were like a handwriting legibility goal, because that would allow me to observe it the two times a month and I'm in there and adequately monitor that progress. Does that make sense? Definitely. So we're going to move on to the letter A in smart goals, and that stands for actionable words or action, I guess, oriented. That's a good word goals. So some folks will write goals that are, oh, they'll do it with minimal assistance, or they'll do it with, I don't know, a level well. In our district, they'll say level one prompt, which is a whole system that I have trouble with. But I choose to only write goals that are independently achieved, because I feel that as an OT when I'm trying to establish the just right challenge, I think that a goal, an annual goal, should be able to be independently achieved by the child. If it isn't able to be independently achieved by the child, it's probably too difficult for them, and you would want to dial it back a little bit, because we want the child to develop the new skill in order to access their educational environment. What do you think?    Jayson Davies     Yeah, we want them to be able to do it in the classroom by themselves, without needing the OT by their side or an aid by their side, or even the teacher by their by their side, so they should be able to do whatever we're trying to get them to do independently. And yeah, that may be that may mean sometimes we have to lower our expectations slightly, but that's still progress that they made, and they made it to a point where now you can build upon whatever progress they made.    Abby Parana     Exactly, and I think that this is particularly relevant when you're working with kids in special day classes for children who have moderate to severe disabilities. And the reason I say that is because oftentimes we're ourselves as therapists, but also I think the aides and teachers were likely to prompt them through things. And I don't think that's I don't think prompting is a I think prompting is a great way to teach a skill, but it shouldn't be a goal of the skill or like, if I look at cutting skills, I'm not going to have a child cut out a circle with moderate prompts from an adult in the classroom, or, well, you know, tactile prompts with an adult in the classroom, if they're not holding the scissors with a thumb up position, I would dial that goal all the bit way back that the child would independently position the scissors with a thumb up position in their dominant hand in order to cut, you know, or participate in a cutting activity in the class, whether that's they snip the edge of a paper on their own or whatever, I don't care that the end result is that. Are accurate, my end result is only that they held the scissors correctly, because that's the independent skill they need to be able to achieve. Sorry, just hit my mic.    Jayson Davies     And you know what? Maybe they do need help once they actually have the scissors in their hand. But that one step of them being able to get their scissors into their hand appropriately is a big skill, especially for some of those, those kids with more needs so and then you know what that gives you. Now you know exactly what your your goal is going to be for the next year. Now, they're going to be able to snip paper in a year, or they're going to be cut a five inch line in a year. So yeah, building upon previous years goals. All right, let's move on.    Abby Parana     Leads to relevant and realistic, the R and smart goals, man, we're just moving right through these. We are moving right through the actually, if you follow this, like logistical pattern, it really makes a lot of sense. When you're writing a goal for an IEP, you start to be like, Oh, each one kind of flows into the next. It's not like, Oh, I got the s done. I got the M done. It's not really a checklist. It's more of like a grade flowing. So.    Jayson Davies     And you did a good job at showing that in the blog post, so we'll definitely link to the blog post that you did to kind of and that has some examples of goals as well. So definitely that in the show notes. Again, the OT schoolhouse.com , forward slash, episode three. Now three. Episode Three. So three, yeah, okay, so relevant and realistic. It's like what Abby just said. You know, it's just making sure we're not giving a goal to a student that's just outlandish, and sometimes that's the best attribute an OT can provide to a teacher, because a lot of teachers try to make goals that are for the child to write their entire name, and yet they can't. They can't form a circle, a line, or in a vertical or horizontal line yet, and they're trying to work on S, A, M, A, N, T, H, A, to write Samantha. And so sometimes we just need to help bring that realistic value, that realistic projection for the student.    Abby Parana     Oh, yeah, absolutely. And that's where that collaboration on goals is really important, because as OTs, we help bring the child, the occupation and the environment together to create a just right challenge. And writing a relevant, realistic goal is super important to that, because if a goal is too difficult for a kid to achieve, they're going to get frustrated. You might actually see an increase in their behaviors, particularly when it comes to tabletop writing activities or anything relevant to that center or those types of activities, you're going to see the kid try and escape, and then before you know it, they're like, Do you have a strategy for this? Well, the goal is too difficult, maybe. So those are those relevant and realistic goals that it's got to be meaningful to the child, the child's got to understand what it is they need to do, and then you help them develop the skills to bridge that gap. That's that part of being relevant and realistic.    Jayson Davies     all right. And then the last one of the original, SMART goals is T for time limited. And well, Abby, you put this in a good way. So go ahead.    Abby Parana     Yeah, so when you're looking at it, you really want to look at in one year's time, what is it that that child would should be able to achieve? And that's where, when you're looking at those developmental stages or developmental milestones, or you're trying to understand the development of cutting skills, or the development of handwriting skills, you're trying to look for a one year advancement in that so, like we were just talking about with the cutting, if they're not able to hold with a thumb up pattern, you want them to be able to do that. But then the next year, oh, they can hold with a thumb up pattern and snip. What's the next step that they be able to stabilize the paper and cut with a forward fluid motion? So maybe you want to take them that one more year down the road. And so really looking at those time limited objectives as to what they can actually do in an annual, you know, within an annual IEP, because it's the worst when you write a goal that's too hard and you have to go in and be like, yeah, partially met, they can kind of do it or not met at all. But, I mean, be honest with yourself, you might have to just dial it back and just say, Hey. I was, you know, I was thinking that this is what they could do, but that's establishing the baseline, and following S, M, A, R, T, and we'll add the E component here at the end, but following that flow and that pattern will help you lead to writing a good, time sensitive or time limited goal that can be achieved within the year. So follow each one of those steps and you'll and you should be able to achieve it pretty easily. Okay.    Jayson Davies     Yeah, I want to interject real quick, a year is such a long time, and it's even harder because it's not really a year. It's only like nine and a half months, because you got Christmas break, summer break, spring break, you have all these breaks. So a year really isn't a year. So don't stress out about this one too much. Try to do the best you can, because this is very tricky. I mean, I can't project what I'm gonna have, I mean, for breakfast tomorrow morning. So looking to hear out true, that's tough, but do your best.    Abby Parana     Oh my gosh. And particularly with the kids that have. I was just thinking of a student I had that had a lot of behavioral concerns when I first assessed her and I wrote a goal for her to write her first name, she could write the whole alphabet and copy sentences by the time her annual rolled around, because once the behaviors were kind of handled and she got better at understanding her school routines and environment, her Visual motor integration, her ability to write that was like nothing for her, she could pick up on that real fast. So then my goal was not just met, it was exceeded. And in those cases, that's where that progress monitoring and make sure you know you keep tabs on it and hold an IEP before it gets to that point is probably a good idea. But lesson learned, and thanks bring me back.    Jayson Davies     All right. Letter E for Smart E goals. This is one that we kind of came up with earlier today, and we really liked it because SMART goals, they're great for all OTs, but smart E goals are great for school based OTs and anyone in the school based setting, you know, we are not we do not see children in schools for them to be receiving OT. They are there to get an education. We see them because they need ot in order to access their education. So everything we do should be related back to the education environment, the educational curriculum, the educational skills that they need. So that's why we added the E here. What do you think?    Abby Parana     Oh, absolutely, I think so many times it's easy to confuse the education model with a medical model, but I think adding the e to the goal and understanding that this goal is to be educationally relevant, and it should be within their educational environment, and that environment should always be least restrictive. So LRE so when we're designing things with our goals in mind. We need to keep in mind that the goal for the child is not to receive occupational therapy services at school. The goal is for them to participate in their education as least restrictively as they can. And so ot should always support that.    Jayson Davies     Yeah, and I, real quick, I want to combine the E for education and the S for specific, because you should put in your goal in what setting the child is going to meet their goal? Are they going to meet their goal in a one on one session with you? Hopefully, you know, there are some kids that do need that one on one, and they will meet that that goal one on one with you, but hopefully then the next year, you're working on implementing that goal to be met within the classroom setting. So that's where you got to be specific about in what setting the child is going to meet their goal.    Abby Parana     Oh, yeah, definitely.    Jayson Davies     All right, great. So I'm going to read those off real quick for you. Just as a refresher, we have s for specific, M for measurable, a for action, R for realistic and relevant, T for time limited, and our special E for educationally purposed or educationally relevant.    Abby Parana     And you could say educational environment, we got two E's.     Jayson Davies     Boom, smart E. All right, so.    Abby Parana     So once you've developed your smart e goal, you want to determine your service level. And I had a really I guess maybe it was like a poignant moment where our special maybe not poignant isn't the right word, but our special ed director was discussing an IEP where she kept trying to prompt one of the service providers to develop the level of service. And these were one of those moments where the parent wanted an increased level of service.     Jayson Davies     No, oh, IEP, they didn't want to. IEP, yeah. They just wanted the services to stay the same. Yeah, this service provider was trying to decrease services after the student had not met their previous goals and and then they were trying to propose less goals and less services. And so the parent was upset because. They said, Well, okay, I understand that you're saying he needs less time because you only have one goal. But why do you only have one goal? You had three goals last year. He didn't meet any of them. So why are you cutting back goals? The student needed more. And so that's where that came from. And the service provider, yeah, she had a difficult time coming up with why she was giving the service at the recommending the service at that level. So.     Abby Parana     Oh, that's right, okay.     Jayson Davies     and that's why we're putting these two things together on this one podcast, because your goals should be driving your recommendation of services. And so I wish you could see me right now. I'm doing all these hand gestures, but the goals drive the services. So those Smarty goals that you develop, like Abby was saying, should drive your service. In the sense of, how many times do you need to see this the student, and in what setting in order to help that student meet their goals? Yes, perfect. So we're gonna go a little deeper than that for you to develop that, but that's kind of the gist. So there's a few things that you have to look at. To look at when you're looking at service, you have to look at how many times you're going to see the student in a week or in a month period, and you have to know where you're going to see them. Are you going to pull them out, or are you going to see them in the classroom? You can also see them in a group or individually, or just working with a teacher to work with a student, also known as consult collaborative. So those are the kind of the the three main areas that you're looking at when you create a service. Does that make sense? Heavy about right?    Abby Parana     OT, sounds amazing. Jayson, so yes, absolutely, because and, and that's the most important thing, because when we're looking at least restrictive environment, you don't want to be providing too many services or too little services for the child to be able to meet their goal, and so establishing that service level and really being able to defend because I notice in most points of contention, is that offer of free and appropriate public education that we make at The end of the IEP meeting, where you say, you know, you've developed this amazing goal, you've gone through the your assessment or the present levels of function, and you know and have established strengths and concerns, and you develop this goal, and you recommend two times a month for 30 minutes collaborative push in services for the child to meet that goal. Being able to establish why that is is super important, because the parent will only hear or the IEP team is not really just the parent, it's the whole team. I've had lots of people asked about that is going to hear, you're only going to see my kid twice a month for 30 minutes, and they're supposed to be able to, you know, improve in this area. Well, yes, but that's where that whole evidence based practice comes in, which is going to lead us to another topic.    Jayson Davies     Whole another topic, evidence based practice in episode number one. Gonna get the two into that today, but I can promise you there will be more episodes about that. So yeah, when it comes to developing your level of service, you just really got to take into account mostly how much occupational therapy, or, if you're a speech pathologist, how much speech or how much of your service does the student need in order to meet their goals? And so with that, it's again, like I was saying earlier, this is one of the toughest things to do. To look out a year in the future is a tough thing, and no one expects you to get it right on the nail. Sometimes students won't quite meet their goals. Sometimes they're they'll surpass their goal tremendously. And you know, we always want to see that, but do your best to to make sure that the goals and the recommended service levels kind of make sense. If you have three goals, you might need a little more than one time a month. And if you have one goal, you may not need once a week. Remember, this is individualized education, so trying to make it individualized to the goals. So all right, well, that just about wraps up what we got for you today. I hope that makes sense. We'll definitely tag some links into the show notes to help it make a little more sense and give you some examples of goals and services. So check that out for sure. Do you have any last things to say Abby?    Abby Parana     just go ahead and check out the blog post on this too. If you're having questions about it, you know you can always submit a question to us on our website or our email. Um. Check us out on Instagram and Facebook, where we have a lot of resources and information on these things, and just keep the conversation going. I love learning about how occupational therapists write goals. I develop these strategies by talking to Jayson a lot in the office, and Jayson talking to me a lot in the office and kind of commensuring, like, oh, that goal last year was not a good goal. I want to write a better one for this kid this year going forward. And so, you know, let's collaborate, let's share. Let's keep this going.     Jayson Davies     Yeah, yeah, and yeah, we'd love to keep it going. And we are very much enjoying doing this podcast thing. We're having a time of our lives, and we hope it's it's helpful. We're getting great feedback from you all, so we appreciate that.    Abby Parana     If you like what you've heard, or maybe you don't like what you've heard, and you want to give us your opinion on it, please leave us a review on iTunes, I mean, but if you liked it really, please leave us a review.    Jayson Davies     Yeah, it really helps. That would be fantastic. We're hoping to reach, we're hoping to get a community. It's not necessarily about us reaching as many OTs as possible. It's about all of us OTs getting together, whether it's on Facebook, this podcast, any website. So.     Abby Parana     Yeah, cool. Thanks for listening.     Jayson Davies     Bye, everyone.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to otsoolhouse.com Until next time class is dismissed Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 2 of the OT Schoolhouse Podcast. In this session, Jayson interviews Tricia Gomez who shares her program that is gaining a lot of attention from OTs and special education teachers across the nation. Learn how dancing can be used to teach ADLs and improve other skills. Links to Show References: Subscribe - Subscribe to our website now to get access to our free downloads of Gray-Space paper and Occupational Profile for school-based assessments. Rhythm Works Integrative Dance (RWID) website Hip Hop in a Box Program Interactive Metronome The SIPT (Sensory Integration and Praxis Tests) Course SIPT Textbooks Sensory Integration: Theory and Practice Sensory Integration and the Child - Jean Ayres The RWID Team: Tricia Gomez, Global Director Zoe Mallioux OTD, OTR/L, FAOTA Akemi McNeil, OTR/L Deborah Rothman, PT, MSPT, C/NDT Dr. Shaana Berman, Ed. D Sensory Processing Measure (SPM) Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research. Now to get the conversation started, here are your hosts, Jayson and Abby, class is officially in session.    Jayson Davies     Hey there, everyone. And welcome to session number two of the OT schoolhouse podcast. My name is Jayson Davies and I am going to be your host today. Abby piranha is not going to be with us today. You can hear her lovely voice on episode number one, but today, because we are interviewing a special guest, we thought it'd just be easier to have two people on today. So in the future, you might hear me with interviews, you might hear her with interviews, or you might just hear the two of us doing an episode like we did for episode number one. So we hope you enjoyed episode number one and will enjoy this episode as well. So to get right into it, today's special guest is Tricia Gomez. She is the founder and director of the rhythm works, integrative dance program for students of all abilities. She also has a hip hop program for typical developing kids as well, and we'll get into that a little bit. But she is just a great all around person. She really cares about kids, and she loves dancing, and she has found a way to make her passion available to all to help many people of all abilities. So I'm happy to have her, and without further ado, we'll just jump right into it so she can give you a little bit of background about herself. So stay tuned. Hey Tricia, thank you for joining us today on the OT school house podcast, and welcome to the program. We're happy to have you. I'm happy to be here. Thanks for having me. Great. So today we just wanted to talk to you about rhythm works. Obviously, that's your program, integrative dance, and how it can be used in schools. So I'd like to get into that, but first, I do want to give you a little bit of a chance to kind of tell us a little bit about your background and how you got to where you're at now, doing this rhythm Works program.     Tricia Gomez     Cool. Well, I am a dancer by nature. Have spent the last 40 years dancing, but the last 25 of those teaching dance class, and, you know, I've kind of geared myself, I guess, moved myself towards hip hop. I enjoy the energy of it. I enjoy just the athletic abilities of it. It's just, it's a fun, it's a fun style of dance. So that's what I like to focus on. But yeah, 25 years of dancing teaching, and then, of course, a professional dancer for the past. Oh gosh, 20 something years, I moved out to California, and I was a Laker girl. I danced for the Lakers. I danced for Universal Studios and Disneyland. I actually still work with Disneyland. I'm a teaching artist with their Disney performing arts program there, so I still currently do that, and I get to work with dance studios and dance schools from all around the world. They come in and they take dance class with me backstage at Disneyland, and so that's a lot of fun. And started my dance studio out here in Southern California in the early 2000s and and just took it from there. So yeah, like lifelong dancer, but, um, but I've always been a scientist at heart, so there is a part of me actually. My original major in school was chemical engineering.    Jayson Davies     A long ways from dance.    Tricia Gomez     It's a little different, but, um, but I think that that sciency part of we, part of me, is kind of what brought me back to, you know, working with with the world of OT and PT and all those good things. So I think in the long and, you know, it was, it was a long road to get there, but I think I ended up with my arts and science combination that I was looking for in the beginning.    Jayson Davies     Great. That's cool with that. How, why did you come up with rhythm works? How did that come to be?    Tricia Gomez     Wow, well, I'll try to make a very long story kind of short. Okay, so about, well, probably 15 years ago, now, I owned a dance studio I owned a dance studio. I was teaching about 21 classes a week, and I was not feeling well, so ended up getting myself checked out, and I ended up getting diagnosed with lupus, and at that time I was teaching, I was teaching hip hop to kids, you know, as young as age three, but the majority of the world was teaching Hip Hop only to about maybe starting at age eight, 910, somewhere around there. And so I was really having a difficult time finding a replacement for me, because I had to cut back on a lot of my classes in order to tend to my health and. To him, and I kept saying, I just wish I had something that I can like, hand to these new teachers and say, Here, teach this in class. And a friend of mine said, oh, you should. You should make flashcards with your dance steps on it, because I already had kind of the system that I was using when I would teach, I would call, like, each little combination of movements. I would call them little funny names that made it easy for our kids to remember. And so I was like, flashcards with my dance steps on it. I'm like, That's a great idea. So we actually ended up pulling together like a bunch of people that were part of my dance studio, like parents and students and the recording studio next door, and together, we actually made flashcards with my dance steps on them, which came to be known as hip hop in a box, which was my first kind of for what foray into, like teaching tools, right? So it ended up being exactly what I needed. I was able to, like, have these dance step cards and hand them over to teachers who already knew how to teach little kids and just say, Here, teach these dance steps. And it ended up working really well. I made it for myself, but in the production of making them, it actually ended up being not that much more to make 2000 units than it was within what it costs to make one unit.    Jayson Davies     So you got a lot. All right.     Tricia Gomez     Yes, I figured, well, if I can use I'm sure other people might find it, find it useful too. So I kind of hit hit the dance world with that first and and that kind of grew into what's now called the hip hop made easy program. And we are in our we're about almost halfway done, about with our second printing of it. So happy to say we're probably in close to 3000 studios and schools worldwide with the hip hop made easy program. And that that program is, it basically focuses on, you know, typical hip hop for ages three to seven years year olds. And it's a developmentally appropriate program, an age appropriate program. So it became really popular and but the way getting back to The Rhythm works thing, and I had an experience about five years ago where I went through an extremely tragic, horrific event in my life, where I was pregnant and I lost my son, and halfway through my pregnancy, I lost him, but During that time, I almost died as well, and through this one particular experience, during that I came out of that knowing that, that I was left behind for a purpose, and that there was still something that I had to do and and then, you know, you don't know what that is, and you're in a depression for a while, but once I was able to kind of come out of that, I just made myself open to, okay, what? What is it supposed to be? Just, you know, send me the signs, basically, and, and everywhere I went, I would, you know, either see the word autism, I would hear it, someone would ask me about it. And there was always a correlation back to the hip hop made easy program and autism, and that kind of kept going on for a while. So finally I started thinking, well, maybe this is what I need to do. Maybe I need to kind of develop a program that is helpful for kids who have autism. So I decided that I was going to do a year of Yes. If my Yes, that's a good one. I like that year of Yes. So because, you know how, like, someone will say, Oh, have you read this book, or have you taken this class, or, you know, you want to come out to a party with me, or you should meet my friend, I think you guys are really good along, but we don't like, we don't want to go to the party, so we stay home, we stay home, we don't meet the friend, we don't take the class, we don't read the book. But I knew that things were going to be put into my path so that I can figure out what it is that my purpose was for. So I decided, you know, what if, if someone's asking me and bringing this into my point of view, then I need to say, Yes, I will do it, no matter if I don't want to, or however much it costs, I'm going to do it. So I decided that I would start kind of looking around for maybe therapeutic modalities that might help me in my understanding of how I can better serve this population. And I came across a class online that was happening. It was called Interactive metronome, which I think, you know, it's, yep, a lot of therapists use it. And I thought, well, that's interesting. It's rhythm based, and what I do is rhythm based, and maybe I can learn something. So went to the class, and it was a wonderful class feel. Filled with, you know, neurologists and OTs and PTs and all these, like, really smart, brainy people, and then, like, me, I'm a dance educator, and everybody looked at me like I was crazy, but when I told them what I was doing, I became, like, the popular kid in class. And everyone, like, any break that we had, they were like, oh, not just autism, it's for every kid. And there's so many things that you can do, and there's research, and, like, everyone was just like bombarding me with ideas, and it was wonderful. But the girl that was sitting next to me in the Course says, You know what, I would love to connect you with, with a friend of mine. She's an OT and she's a dancer too, and she might be interested in what you're doing. And I said, Sure. And she, like, a couple minutes later, said, My friend said she's available to meet you for dinner, and her friend ended up being a Kimmy David, I think you know very well, yes, yes, and, and so I went and met Kimmy for dinner.    Jayson Davies     I didn't realize they Kimmy was the first person, kind of on the scene with you.     Tricia Gomez     So, yeah. So I told a Kimmy what I was doing, and she's like, this is awesome. I want to be part of it. Just let me know what you need. And they said, right now, I'm really just educating myself, you know, I I need to learn as much as I can first. And she said, Well, have you considered taking the sipped course? And I was like, I have no idea what that is. You know, it's a semester long course at USC. And I checked into and it just happened to have like a five day Crash Course happening and and so I signed up for it.    Jayson Davies     Yeah, that's where we really, actually first met, right?     Tricia Gomez     Yeah, so did I met there. But of course, you know, you sign up and then it's like, here's your pre reading material, yep, which is like $350 worth of text.    Jayson Davies     I still use those textbooks every, every now and then, you know, they're good ones.    Tricia Gomez     Yes, I put it on Facebook. I said, Does anyone have these books and and this random friend of Facebook, friend that I didn't really know. You know how you have those friends that friends with them, but you don't know, you don't know how you became friends with them. So this girl says, um, I think I might have them. Let me check when I get home. So, you know, she checks, we end up actually getting on the phone with each other because we were messaging, and it was just becoming too much to message, so we needed to talk. So that person ended up being Dr Shawna Berman, who is Doctor of special education, and, and, and she's also a behaviorist. And so she, you know, I told her what I was doing. She says, I want in this. We have to do this. This is amazing. The kids need this. Just let me know what you need. And she says, Oh, wait, I need to introduce you to a friend of mine. Her name is Zoe Mahler, and she's like a world class researcher with sensory integration, but she travels the world all the time. She's never home, but at least I can make an introduction to you. And I said, Well, absolutely, thank you. And she did. And literally, like, right away we get a response from Zoe, saying, Hey, I'm in town. Let's have lunch. And so I go to lunch and I meet Zoe, and Zoe loves it. And Zoe's in and she says, let me know what you need to help. You know, I'm here to help. Let me know what you need.     Jayson Davies     Yeah, and I love Zoe. She's amazing, great person to have on your side.     Tricia Gomez     Oh my gosh. Just talk about a wealth of knowledge right there. And all this time, I was considering, well, maybe I should actually go to school to become an OT and we actually started looking into it. And I thought, You know what, I'm just gonna surround myself with really smart people and kind of get, you know, not necessarily go through the expense and the years, but just get the knowledge from everyone and anyway, so Zoe had worked at pediatric therapy network, and a former student of mine, an adult student of mine, had worked At pediatric therapy network as well. She was a physical therapist there, and she was actually when hip hop in a box came out, she was one of the first people who got it and and gave it to, I mean, she got a grant to run a program like a summer camp at PTN using hip hop in a box. So I was like, I need to get back in touch with that girl. And but she had moved away to college, and so, you know, but I had her phone number, and I was like, maybe I'll just give her a call and see if I can still connect with her. And lo but behold, she like, she answered the phone and told her what she was what I was doing. And she was like, Oh my gosh, she goes, you'll never believe it. I'm actually considering moving back to California, and I think this might be the thing to get me there. Wow. So this is Deborah Rothman, who also became one of my advisors. And so, like this year of yes turned into this amazing compilation of geniuses that what we ended up doing. Doing was taking the hip hop meet easy program that had been in existence for a decade, and we completely stripped it apart and rebuilt it, but rebuilt it in a way with purpose. So we would say, you know, I would say, you know, here's, we do the we do these things, and then, you know, I had all of them in a room, and everybody would pipe in to say, well, that's helpful for this, and this is helpful that we would use that for this. This, you know, they kind of started correlating everything that I was doing to what they were doing in therapy, and how it can support what they were doing in therapy. So, you know, it this whole entire program got rebuilt around these evidence based practices in occupational therapy and physical therapy, ABA therapy, speech, like so many different elements, bringing them all together, but then we applied the music and the and movement to it. So I don't think I ever could have imagined what it turned out to be, and the good that it's doing for the people that are in the class, and not just the people that are in the class, but the teachers that are doing it too. It's kind of pulling all these different elements together, and in a way that I haven't seen done before.     Jayson Davies     Definitely. Yeah, my teachers are absolutely loving it. And the AIDS too. I mean, they love just dancing a little bit every now and then we do it every, every Monday morning or Tuesday, if we skip on Monday because of a holiday. But both the teachers, the aides and then, of course, the kids absolutely love it. One thing that I really like, you know, I took the SIP course with you, and I know, because of the rules and stuff, you couldn't completely finish it, but I did go ahead and finish it. And one thing that I've been struggling with over the last four years or so is implementing sensory integration in a school based model, where we can have kids integrated in academics, and not pulling them out from their classroom. And I feel like your program really helps with that, because we can just kind of do a whole dance program. And for instance, we our kids, they have their breakfast in the morning in the cafeteria, and then we transition right from that into the dance to rhythm works dance program in there for about a half hour. And so we have this wide open space in the cafeteria. And we start off with the rhythms and stretches a little bit, and then we jump right into today we did the zipper dance move, which was that jumping up and down a little bit, and getting your hands down on your knees, which was awesome. And also, what I like about the program is that you have it set up for that beginner, intermediate and advanced level. So typically I'm in that beginner level with my kids. But even then, it can be broken down even more to be one step at a time on each given beat or whatever. And so it really we're finding a lot of benefit with it, even for kids who may not be able to jump and spread their feet at the same time. We can break it down, so maybe they're just spreading their feet versus jumping and spreading their feet. So it's really cool. I really like it.    Tricia Gomez     Thanks. We like it too. Yeah. I think, you know, even like the rhythm works, or the rhythm lessons part of it, oh, definitely provides an opportunity to kind of bring in concepts that the kids may not be fully understanding yet in the dance portion of it, you know, so if someone's having a difficult time crossing, you know, crossing their feet and then opening their feet, we can actually take that into the rhythm lesson section, where we're doing kind of drumming with our hands and doing unilateral movement, where we're crossing and then opening and crossing and opening, and then we transfer that to lower extremities while they sit. And then, you know, once they've mastered that, then we stand them up and we we do unilateral and then bilateral movement, so that they start to build the concept of, what does it mean to cross the midline? How am I supposed to do that? Teach it with arms first and then feet, and then full body. And, you know, these, these kids are, you know, within, you know, 1011, 12 weeks, making so much progress on on a wide variety of things. It's really cool to see.     Jayson Davies     Yeah, we had one kiddo who was, he was supposed to spread his legs, but all he was doing is like opening up his knees. So you just imagine his little knees kind of going out, but his feet are still together and so, but, you know, three weeks later, now he's got it, and he's opening up his legs all the way and closing them, and yeah, so you're right, it really helps and and it's just got that intrinsic motivation factor. I mean, kids love to dance. They love music and the sensory aspect you can't deny is a good part, is a big part of learning in general. So it kind of they need that, that structured sensory play. Absolutely, yeah, so, man, I did not realize how your whole team came to be developed through the course. I loved it because you had. Had all these people that kind of taught their specialty, whether it be the OT, the ABA, even the speech, as well as yourself, and that was just a big part of the course that I know. I really, really got a lot from, you know, not so much. I had a lot of the OT side of it, but not the behavioral side of it. So my question to you is, what if someone were to take this course that didn't have that background, what kind of information are they going to get by taking that course?     Tricia Gomez     All kinds of information, I mean, that that's one of the things that I struggled with in the a little bit in the beginning, because I knew, Okay, well, OTs will have, you know, usually they have the sensory part of it, and then, you know, if a PT comes in, then I don't want to get them bored with learning, you know, basic or not, anatomy, but, you know, just like kinesiology, basic Kinesiology. But what we found was, you know, and I'm sure you can relate this to do as well. Gosh, I can't even talk right now to this as well. You know, when you're in your your discipline, you see it from such a academic level, right? But the way we teach it, we teach it from a very like layman's point of view. Like, what is it for the majority? What does it look like, and what can I do about it.     Jayson Davies     And correct me if I'm wrong, if I'm wrong, but a majority of your students are dance instructors, or not anymore?     Tricia Gomez     Yes, yeah, no. Well, we're definitely growing in the therapeutic and the academic world now. But you know, in the beginning, it was all dance teachers. So you know that those you know, the OT, the sensory, the behavior, the kinesiology, movement, safety, all of that was new to them. But what we found from the therapists that were coming was that it was such a refresher for them to hear it spoken about in such a basic way that made sense, and they were actually having better success explaining it to their parents, of the kids, and in a more layman's term, that was easier for them to understand. And so, you know, yes, you know, if you're an OT, you will get a little bit of review on sensory if you're a PT, you're going to get a review on.    Jayson Davies     On kinesiology and.    Tricia Gomez     Thank you. Yeah, they, you know, behavior. So whatever your discipline is, whether it's dance or, you know, whatever it is, you're going to get a little bit of a review, but we do it in a way that really integrates everything all together. So, you know, you get a little bit of an inside of OT, little bit of inside of PT, little ABA, a little speech, a lot of dance. So, you know, music theory and understanding how to find down beats and how to find count number one, so that you can start the eight count in the right place. And, you know, relating movement to music and how, you know, dance steps kind of mimic music notes in a way, and so it, it's a far reaching course that covers many, many, many topics. But you know, by the end, you really start to see how it all comes together. And actually, one of the last things we do in the course, and then, you know this, is we, we give you a sample student and all of his therapy goals, which are quite a few. And what we have the teachers do is, or the therapist is, actually come up with a dance routine of a short, four step dance routine that uses movement that assists in either achieving certain skills necessary to, you know, is, I think one of Johnny's goals is walking down stairs independently. So we look at, you know, well, what kind of skills are involved with that? But Johnny is also a vestibular seeker. So what kind of movement can we put into the dance routine that you know, Johnny can get some more intense vestibular input in a constructive way, as opposed to doing something that's more destructive or distracting. So, um, yeah, it just brings all kinds of disciplines together into something like you said, that's just intrinsically fun and motivating, motivating. And it's hip hop. So it's cool. You know, even our older kids who are doing it, we've seen, you know, socially, their their social skills are increasing, because now they have something cool to talk to about. You talk to the other kids about. And you know, when you're in high school, you're going to dances and things like that. And you know, as much as I love ballet, you don't go to a high school dance and do ballet, you know.    Jayson Davies     Moving and grooving, yeah.    Tricia Gomez     So it's actually practical in life as well. So, yeah.    Jayson Davies     very cool. Ma'am, I thought just left my head, but it. Real quick reminder, everyone can take this course, right? This isn't specific to therapists and dance instructors.    Tricia Gomez     I have had a chef come in to take the class with me, because they do, they do classes for kids who have Down syndrome, so they wanted to just learn a little bit more about it. And I've had grandparents come in and take the class because they're, they're, you know, grant their God, child or grandchild has, you know, whatever. And they like, but they'd like to dance, and so they wanted to do something that was a little more productive than just kind of bop around. So, yeah, you name it. They've, they've been in class and and, you know, it's really interesting, as some people go, Oh, no, no, I'm not a dancer. I could never do right? And, and I'm like, wait, you know, can you put your pants on? Because, like, one of our moves is called put your pants on. And if you can put your pants on, then you can do this. If you can crack a stick over your knee, and at least go through those movements, then you can do hip hop, like, it's not hard. If you can do a high five. That's one of our dance steps. It's, you know, people, I think overthink about, overthink it, but it's really the movement is simple, functional movement that you would see, or, you know, in your daily life, or do in your daily life. And you know, we turn, you know, the like movement of brushing your teeth that turns into a little dance step. And so anybody can do it, whether you're a dancer or not. And what I found is that some, some of my best teachers, are not dancers. They, you know, they are wonderful therapists, and they're really great at, you know, showing the movement, but they're also really great at recognizing if there's any kind of, you know, maladaptive movement patterns, or, you know, if they're using, you know, if they're favoring one side to the other, if they're favoring internal rotation as opposed to external rotation, they kind of have the understanding of, okay, I need to do this set of things in order to either create opposing, you know, strengthening opposing muscles, or, you know, they have a task analysis kind of, yeah, so, so they, you know, we've seen some wonderful, wonderful things. In fact, we have, one of our teachers is an OT she works in the school system in New York, and not a dancer at all, and but she's just a joyful person. And so she started, she went back, she started teaching the program in one of her classrooms, and they were having such a great time and seeing great improvement that they rolled it out to six other classrooms in the school. And then her district supervisor got wind of it, and the district supervisor, like once, it rolled out in more schools in their district. And, you know, there's they, the one thing that they noted that they saw was improved handwriting from all of the everybody, because you're strengthening all the, you know, the posturals, and you're working on fine motor, and you're moking, working on crossing the mid range, and you're working on mid range control, and, you know, eye tracking and I stabilization and all those things that go into handwriting. There's a lot, you know, they need, you need to work on that way. So.    Jayson Davies     Yeah, I've been repeating myself in IEPs lately, you know, just saying you don't, a lot of people don't realize how much goes into handwriting and all those skills that you just mentioned, everything and without those gross motor skills and everything before fine motor, yeah, it's not gonna happen. So that's what's great about your program, is, is that it incorporates everything. I really like it. You hit on my next topic a little bit, which was the New York thing. I know that's kind of blown up a little bit. You're seeing the handwriting improvements. Is there any research in the works or anything like that? Or you're kind of.     Tricia Gomez     Oh, funny, you said.     Jayson Davies     I honestly did, no, I didn't ask him, maybe.    Tricia Gomez     We, we just had a group of students from stanbridge College do kind of an informal study on on the program and the benefits of it. They they did blind surveys with some of our certified teachers. But they even went so far as to surveying the parents to see what the parents started realizing, you know, to see any differences that the parents recognized outside of the dance class.     Jayson Davies     Do you know if they use the sensory processing measure or something like that, or was it just an informal?    Tricia Gomez     I don't know what they did. I know that it took them a very long time because there were lots of board approvals and rules that they had to follow, but I'm really hoping that that's just the start of it. I would love, love, love to see someday, a, you know, an official, like, major, major research project done on it, because I really do see the benefits, and the people who are doing it see the benefits. So it's, you know, it's. I'm not making it up. No, you're not. I things that are working, you know? So.     Jayson Davies     Yeah, I'm pretty sure your dance moved helped me teach a, I think it's a fifth grader with autism, how to give a high five. And that's the thing is, just it really does help. I can't sometimes you can't lose the words a little bit, but just between all the sensory stuff going on, the the internal motivation, the gross motor skills, all coming together with the music and rhythm, it just works. And so I'm glad that that I've had the opportunity to discuss this with you.     Tricia Gomez     That's why we called it. Rhythm works, because it does.    Jayson Davies     It does. You are correct. All right. Well, we're just about to wrap up, but I definitely want to give you the opportunity to let people know where they can find you, how they can find the program and all that stuff.    Tricia Gomez     Sure, so rhythm works. ID is our website, and I'll give you a little cheer, because no one knows how to spell rhythm. So if you go R h y t h m, I love it, r h y t h m, and then works W, O, R, k, s, I D, as in dog.com We'll take you to our website. We do offer three ways to get certified. You can get certified in our premium course. We have a three day in person premium course here in Los Angeles this summer. We usually do one or two a year. We also have hybrid courses, which consist of a about eight and a half to nine hours of online course learning before coming to a one day in person course to kind of pull everything together. And we have those throughout the US and Canada for 2018 set right now. And if you can't make it to any of those locations, then we do have the full online course, which is it ends up being about 18 and a half hours or so, of course work. We are an approved provider with a OT, so you would get, if you do the do the online course, I think it's 17.5 hours, clock hours, so 1.7 hours, something like that. And then the in person courses are 1.85 units as well. And we if you're just an not just an educator, you're never just an educator. But I just spent a couple weeks ago at the CEC special education conference down in Tampa and spoke to administrators from all over the country who just flipped out over the program, and they they are expressing interest in actually bringing us in to do in services for the school. So it would be the hybrid version. But you know, if it's something that interests anyone, that they want to talk to their administrators about bringing in to get the whole staff certified, then we can definitely work that out as well. Very cool. Yeah, and I can, if you don't mind, can I give everyone my email address just in case they want to.    Jayson Davies     Yeah, go for it, and I'll definitely put it up on the show notes.     Tricia Gomez     Okay, cool. So my email address is Tricia, T, R, I, C, I, A, @ rhythmworksid.com .    Jayson Davies     Awesome. Great. So that's where you can find Tricia. Very cool. So we will definitely put all that information on the show notes up@otschoolhouse.com for you all to find, in case you forget. But I was just thinking that I might also put my video that I had to submit to you to get certified up on that page, just so people can kind of see a little bit. Oh my gosh, that was the that's what held me up for so long, doing that I just like, filming myself on camera was just like, but it was totally worth it, and that it's not hard, Nope, it's not hard. And the case study was really, I thought it was a great case study, and it really made me think. And in fact, I think I used that, that case study that I did, I basically used that 30 minute session as my first session for the rhythm Works program that I did at school. So yeah, so it's really cool. So all right, well, we'll wrap it up. Thank you, Tricia, so much for coming on and talking about rhythm works. We appreciate it.     Tricia Gomez     Thanks for having me.     Jayson Davies     Definitely take care and hope you feel better.     Tricia Gomez     Thank you. Bye.     Jayson Davies     All right. Well, thank you everyone for listening in to that conversation between Trish and I. I want to give her a special shout out as I hope she's feeling better. She had a little bit of a cold while we were recording that, but she was a trooper, and I'm glad she was able to get through because I wanted you guys to hear that so badly. It's such a great thing that she's doing with that being said, I do want to say if you would like more information on rhythm works, integrative dance, you can either reach out to her at rhythm works id.com , or you can see the show notes. And we have, we will have a link there for you to that website. Feel free to also give me an email. I'm using that program currently in my program. At school, so I have a little bit of insight, but definitely reach out to Tricia. She's fantastic. Lastly, I just want to say thank you for listening to this, and if you haven't already, please do subscribe to the podcast so you know when the next one is available. Also, if you enjoy our podcast, even if you don't, we'd love to hear a con. Hear your comment in the comment section below just helps us to guide the way that we're going with this podcast and to know how you're feeling about it. So please give us some feedback, and with that being said, you can get all the information from this podcast over at ot  schoolhouse.com forward slash session two. Hope to see you there and take care.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otsoolhouse.com . Until next time class is dismissed Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Press play below to listen to the podcast Or click on your preferred podcast player link! Welcome to the show notes for Episode 1 of the OT Schoolhouse Podcast. In this very first episode of the OTSH Podcast, Jayson and Abby introduce themselves and jump right into the steps required to develop an assessment that you can defend in an IEP and beyond. Links to Show References: Subscribe - Subscribe to our website now to get access to our free downloads of Gray-space paper and Occupational Profile for school-based assessments. About us - In the first part of the podcast, we were able to briefly introduce ourselves. For more info about the OT Schoolhouse, as well as Abby and I, visit our About Us page! OT Practice Map - Find your state's school-based OT and/or PT guidelines. Not all states have their own guidelines. If your state is one of those without a set of guidelines, check out California, New York, or Wisconsin for a good start. OTAC - Occupational Therapy Association of California AOTA Conference - The Annual American Occupational Therapy Association Conference Blog Post - "Essential Components to any School-Based Occupational Therapy Assessment" Gray Space Paper - Get your free download of our 9 pages of adapted paper that helps your students with their sizing and spacing of letters and words. Handwriting Research - A blog post written by Jayson after reading up on some handwriting research. Freebies! Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs. Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com Well, Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts , Google Podcast , Spotify , or wherever you listen to podcasts Episode Transcript Expand to view the full episode transcript. Amazing Narrator     Hello and welcome to the OT schoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby, class is officially in session.    Jayson Davies     Indeed it is. Welcome everyone to the OT school health podcast. My name is Jayson.    Abby Parana     and I'm Abby.    Jayson Davies     And we are your host for the OT school house podcast. This is episode number one, the very, very first episode.     Abby Parana     First one.     Jayson Davies     First one. So thank you guys, and thank you everyone for tuning in and listening to us. We really appreciate it. Today we're actually going to be talking about everything you need in order to get through a great assessment, starting with being handed the referral, actually, even maybe before the referral, all the way to the point where you are ready to present it at the IEP meeting for the for the rest of the team. So that's kind of what's coming up. Before we get into that, though we thought that we should probably introduce ourselves. So I'm gonna just go ahead and let Abby introduce herself. Go ahead.    Abby Parana     Well, thanks, Jayson, I've been an occupational therapist. Well, I will have been coming up on 10 years. I've been working the schools consistently for about four years now. I prior to that, I had some medical based ot experience. When I first started looking into occupational therapy, it was graduating high school. I wanted to be an elementary school art teacher, and I shadowed. I had the opportunity to shadow an occupational therapist who was working with a child who has cerebral palsy on an art project, and she was having her do this art project. And I thought, wow, that is really a very cool profession. She was using the art project to get all kinds of movement with the child that the child wouldn't normally be able to achieve. And I just thought that was amazing. So that led me to going to study occupational therapy. Working in school seemed like a natural progression to me, as most of the people in my family, my mother, my grandmother and my sister, are all teachers, so I it just seemed logical that I would end up in schools at some point, and I really enjoy it. That's the other part. I guess that also makes sense to me. So Jayson, how did you end up in school based OT?    Jayson Davies     I got into ot by observing my sister. Actually, she's six years older than me, and she's also an occupational therapist, and she was a pediatric ot as well. However, not school based. She worked in a sensory clinic in Pasadena, California. And so I went in, observed and helped out over at that clinic, many, many hours worth. And it was really cool, because I always kind of had a helping heart, I guess, and being being there, seeing her, being able to help so many different kids with disabilities, it was really cool. And they were really lenient there, and kind of, you know, let me be hands on and kind of get some good experiences there. So I really enjoyed it. It's funny, because actually, you know, just like Abby, I was more interested in an art, actually, like film production, but somehow I found my way into occupational therapy as well. So that's what's kind of cool about OT is a lot of people come from many different backgrounds. Yeah. So, so I ended up at University of Southern California and got my bachelor and my master's in OT there, and I too have been in school base for about five years now. My first year was a as a contract therapist, and then now I've been in the same school district that Abby and I are in together for about four years, and it's kind of cool. I got to actually start the start the OT program there, and eventually we brought on Abby, and so we are a growing Occupational Therapy department within our district, and it just keeps getting better. But the one thing that we don't have is a lot of other OTs to collaborate with. So true. Yeah, so that's kind of why we're doing this. But I'm gonna let Abby explain that a little bit more explain what the OT school house is. So go ahead, Abby.    Abby Parana     Oh, no, you definitely touched on it. I think our conversations in the office definitely led us to decide to bring those conversations to a platform such as ot school house, where we have a website and a podcast that can bring all of the information and resources that you and I share together to a community of school based OTs, because our job is difficult, there's a lot of things that are constantly changing, and we need to stay up to date on those things. So some of the things that ot school house that we hope to achieve are to bring you good articles and blog posts about strategies and things to make our jobs easier, more efficient and just better all around we also have a good clickable map where you can check out your state guidelines. Guidelines, and we're hoping to bring you continuing education units as well on different school based ot topics. So you can go ahead and sign up for our email list, and we'll keep you up to date on those things. And then, of course, the podcast, our podcast, is a cool place for us to bounce ideas off of each other, as well as bring together input from different members that could be on an IEP team, as well as occupational therapists are doing cool things in the field of OT that are related to school based practice. So we're really trying to, you know, narrow down what school based OTs are working on, and bring you that information so that we can make our jobs easier and your job is easier, essentially.     Jayson Davies     Yeah, very true. And with that, you know, our goals for you guys and for us as well is just to continue to learn. Abby and I are both, you know, we both are huge advocates for OTs. We are huge advocates for our students, and we are huge advocates for continuing education. We both, you know, we attend the Occupational Therapy Association California conference every year, and we're hoping to go to a OTA this year in Utah. That's a big so if any of you are there, we will come find us. Yeah, but we want to be here for you guys as much as we honestly need you guys to be here for us, because we want to learn from you guys as well. And like Abby touched upon, you know, we're going to have a bunch of different bunch of different people on this show. You know, sometimes it may just be Abby and I talking and giving you, you know, something that we're doing today that works. But other times, we're gonna bring on teacher, an administrator, another OT, someone who's creating a curriculum, a handwriting curriculum. You know, maybe someone from the school, or the size matters, or Handwriting Without Tears program, something like that.    Abby Parana     I even have, oh, well, I mean, I even discussed one of our newer special education teachers who works in a moderate to severe special day class. She would love to come on of just what her needs are, working with those students in that population, and that really helps when you're trying to collaborate with students. So just having a perspective of what teachers and staff are needing. OTs can really impact so many areas. So I'm really excited to I don't know, just get into it.    Jayson Davies     Yeah, and I don't know about you guys, but I love helping teachers, because I feel like I can help one kid at a time, maybe a small group of kids at a time. But when I help a teacher, I can help 30 kids at a time. And every every year, they have 30 new kids. And so if I help one teacher today, I could touch however many lives. So that's really cool. So I think we just about touched on everything that we wanted to touch in our intro. And so we're gonna hop right into this assessment piece of our of our very, very first episode. Sorry, I can't get over this, though. It's our very first episode. This is so cool.     Abby Parana     Aren't you really exciting? I'm really pumped.    Jayson Davies     So we hope you guys are pumped too. I mean, we're digging it, and we hope you guys, you guys are loving it as well. So today, we're actually kind of gonna go over assessments. Like I said earlier, we're going to talk. We have about 10 things here that we just want to go over. And these are very actionable things that you can honestly if you wanted to start tomorrow. They're going to be about what to do when you get that referral, what to do once you've done an observation, what to do and so forth. You know, we're just going to kind of make it very actionable, very straightforward for you. And we know a lot of OTs are kind of wondering about assessments, because everyone does them differently, and so we kind of want to help you. Maybe, odds are, you're probably doing 80, 90% of what we're going to talk about today, but maybe today you'll hear one piece that kind of resonates with you that we do, and maybe it'll help out. So without further ado, let's get into it. Abby, what is the first thing that you should do when you receive a referral for an assessment?    Abby Parana     So in our district, I mean, you can receive a referral for nearly anything, and I oftentimes am stopped by teachers or staff in the hallways, or I'll get a random email or a phone call from someone just saying, like, hey, this kid needs an OT assessment because of X, Y or Z, and it may or may not be related to OT. So once you've gotten that referral, Jayson and I have a referral form that we're asking staff to fill out and then we actually send out the assessment plan ourselves, along with the parent questionnaire once we receive that referral, because you have to assess in every suspected area of need, obtaining that referral form and really getting to the concern of the teacher or the parent is Probably the most important thing that you have to do first. So in the beginning, that's usually where I start. So once I've received a referral, it's important to get signed permission from the parent to, you know, via an assessment plan, to assess the child. And once you've obtained that, it's good to delve into their. History and background. That's the first thing you want to get a really good, strong developmental history and background on the student, and that comes from parent interviews, that comes from chart reviews and any other assessments that have been completed prior. So this allows you to really establish what the concerns are for the child that could be impacting their academic performance. Jayson, do you have anything you want to add to that part?    Jayson Davies     I mean, yeah, the first thing I try to do is, honestly, I try to write, I try to write the first part of my assessment before I even see the kid in that just starts off by going through the documentation, looking at the psycho educational evaluation, looking at the speech evaluation, if there is one, any medical charts that we have based upon the kid, but yeah, that really helps to give that profile of who this kid is and what may or may not be the problem. As you get down further, you'll see, you know, it's an evaluation is almost like narrowing down to the least common denominator. And if you don't have that background, I mean, you don't know what to look at. So you're looking at fine motor, gross motor, visual motor, visual spatial, visual perception, anything else sensory, right? You're looking at everything. You're looking at everything. So if you can kind of narrow that down, it will save you time when you move on to steps 234, and down the line. So and you know what? The second step in our process is actually finding out the reason for a referral, which is kind of what we just talked about. They're kind of interchangeable a background, and finding the reason for a referral, boom. You've got to get those step step one, step two, kind of happen at the same time. So the next step in the process is to collaborate with case carriers and other IEP team members. So Abby, go ahead.    Abby Parana     Oh, gosh, yeah. And if you're lucky, like Jayson and I, we work out of our district office, so most of our school psychologists are located right within our district office. And if not, you know, they're short, email slash, phone call away. I constantly talk to our school psychologist about their report findings before an IEP meeting and before I even go in to assess the student whenever I can. Now, I know we're all pressed for time. I mean, this is not the perfect system, but I think collaborating with the teacher, the speech therapist and the school psychologist are is super important before you even go assess the child. And the reason being is, you know, if you are looking at a child, I don't know Jayson, like, for instance, I had a student that they were claiming a lot of sensory difficulties with, but he also had an auditory processing deficit as well as a visual processing deficit. And if you think of a school environment, those two deficits, I mean, that's how we That's how most information is presented in education setting. And so a child that has difficulty with those processing skills can also then have difficulties with attention, and so, you know, and create a lot of anxiety for them if they're trying to learn. And so what might be looked at as a sensory difficulty is more related to the auditory and visual processing. So I like knowing that information before I go in and work with a student?    Jayson Davies     Oh, definitely, and especially in the population. We're in a rural area, and so a lot of our kids are, well, they haven't had the best nutrition, they haven't had the best medical care. We have a very high percentage of kids that are foster are in foster homes, and all of this can can make a big difference in how a kid performs in school. And so that's very important to know this. And by talking to people and by looking at the reports, you can just gain so much that you win it if you just went straight to a standardized test. So true going forward. The next step that we do, again before we even do standardized assessments is we go in and we observe the kid. The reason I do this before the assessments is because I don't want the kid to know who I am, why I'm there, and so I kind of sneak in and get some observations before the kid knows who I am. Typically, you know, by the end of the observation, they figured out that I'm watching them. But unless you're very sneaky, very sneaky, very, very sneaky. No, but, but, yeah, those observations are so important. And I know Abby and I, we both, we both tried to observe in as many areas as possible. I mean, we start off with the morning routine. We try to get on there, during recess, during lunch, anything, any area where that kid might be having difficulty, and hopefully we already kind of know where that is, because we've looked at the research, or not the research, but the data from previous professionals, the teacher and the psych to know what what we're looking for. You know, some kids don't have problems in the classroom, but they have problems at recess, and without knowing. That we might go in and we might go in and observe them during the classroom, and then we get to the IEP, and they're like, oh, did you see the kid at recess? Or like, no, so, so we want to make sure that we observe them in all the areas necessary so you have anything to add. Abby.     Abby Parana     Oh, yeah, of course. I think it's really important to observe the student both in structured and unstructured time, as well as during classes when the student is super confident, like in areas of strength. So if a child says, you know, I do really well in, you know, reading and writing class, like in classes that involve reading and writing, or science or history, you want to observe them in there. But then if they tell you, you know, math is my least favorite class, and you find out that they're having all these behaviors with their math teacher, you also want to observe there. So that way that can really tell you a lot about the strengths and weaknesses of the student and their own perceived strength and weakness, and that can make you have a better informed decision on how you're going to guide the IEP team and function, you know, maximizing that child's potential as far as their functional abilities related to their school.    Jayson Davies     Yeah, and, and that's something, you know, we don't they don't know about us yet, but you work in a lot of the middle schools, and so especially with that, yeah, you have a chance to talk With a lot of especially the kids who may have, like, a specific learning disability or something, you know, they're mostly in general education, but you you want their input as well, not just the teacher and not just the parent and not just, you know, the principal, but also the students input. So, yeah, that's great. So what's the next step? After observations? What's the next step, Abby.    Abby Parana     After observations, I usually start pulling the student to assess them. And at this point it's good to build a good rapport, and you need to remember that you are assessing in all suspected areas of disability. And that is a direct term from a training we went to with our school lawyer. So when you're looking at all suspected areas of disability, the bar is very low. So if you're suspecting that the kid is having trouble with anything really functionally related to school, you are required to kind of assess in that area. Sorry if that was loud, so you don't want to leave anything unturned. I use both functional skills observations as well as standardized assessments. So sometimes standardized assessments don't they might be scoring well below average, but they're also getting A's and B's, and the classes that were would require that skill, so they may be able to compensate for those things. So don't rely solely on standardized testing. And mostly, I mean, well, our California state guidelines, they don't really say we have to rely solely on standardized testing correct.     Jayson Davies     They actually say that you don't have to rely on standardized testing if, if I recall correctly. They basically just say that you can't make a decision based upon one source of source of information. So by getting those observations, by getting those functional assessments, by by talking with the other professionals, that's your multiple sources of input. So even if you don't have a standardized assessment, you can still, you can still say whether or not a child or I guess you shouldn't say whether or not they need it, but you can make a recommendation to the team whether or not they need occupational therapy. So that's a great, great input.    Abby Parana     Oh, I might add one more thing to that, sorry, one more caveat that I learned recently after kind of like a difficult case, would be meaningful participation of the parent. So in your ot assessment, just making sure that you meet the guidelines kind of for that meaningful participation. So don't go through your whole assessment without ever getting parent input. Always at least send home a parent questionnaire and call them for an interview and add that to your report findings, just because you need to be allowing the parent meaningful participation in all aspects of that child's education. So just to cover your bases, that's a really good point to start. And that allows you, I mean, and that allows you to have rapport with the parents. So when you're going into the meeting, it's not like, Oh, who's this? OT that's going to tell me about my kid. It's you've already established some sort of communication.     Jayson Davies     No, exactly you hit on all points right there. I mean, just, just talking to the parent can help you in an IEP team, in an IEP meeting, so much. I mean, just by knowing the parent before and knowing what their main concerns are. A lot of times we wait till the IEP teams, like, basically the the meetings over, and then we say, oh, parents, by the way, what's your concern? We shouldn't be doing that. We should? We should? We need to know what the parents concerns are before so, yeah. So then after that, Abby kind of already touched upon it, but relating your assessments to the school based functional skills, like she said, you know if you're if your kid has below average scores on the bot, but they can copy. Anything you give them, well, then they've learned to accommodate for their for their poor visual motor skills, or whatever it might be. I mean, okay, maybe they can't copy a star, but they can copy the alphabet like nobody's business, and can copy from the board. And so again, academically, how is it going to functionally impact their skills in the classroom? I really like this next one. Abby kind of surprised me with it in her in her list. But adding she has it in here is add the guidelines stuff. I like that because what she means is she's literally pulling information straight from the California guidelines or idea or the practice framework. So go ahead.    Abby Parana     So you don't want to just and I mean, I think I learned this because of being involved in some due process cases I've never actually, you know, had to justify things on a witness stand. But I think it's important that if you are talking about your school based assessment, you need to make it as objective as possible and refer to your ethical and guidelines. State guidelines and standards so you take it away from your subjective professional opinion, and your your professional opinion is always based on guidelines provided to you by the association giving your professional title. So when you're giving your assessment report findings, you need to refer to that, because you are not just pulling these recommendations out of nowhere. You're pulling them based on guidelines that you've been provided. It doesn't really matter if you're recommending services or not recommending services. You need to always do it in accordance with your guidelines, and so that'll save you a lot of hassle, and it takes out the subjective component, which is not easily defensible. If you're too subjective, you can't defend yourself, because it's your opinion. And well, opinions are opinions, you know, there's no it's hard to defend an opinion.    Jayson Davies     Yeah, no joke, that's my opinion, right? I'll argue your opinion. Abby, no, no. With that also research, any type of research that you might have come across in the age OT or any other publication you know, any research you can add will always help back you up    Abby Parana     those handwriting referrals for sure.     Jayson Davies     Right? Lastly, we got to sum it up. We got to sum up the report. How do you sum up your report?     Abby Parana     Well, you need to tie all those dots together. So if you have your sensory and your fine motor and your visual perception and your, you know, functional skills. You've got to kind of in your observations. You've got to bring all that together and pinpoint, you know, and address the concern. You want to tie it back to the original concern and the referral for occupational therapy, and then you want to tie back to you know what your findings were. So if your kid is having you know, low visual motor integration skills, you've got to tie all those strings together and come up with a remediation plan. So I oftentimes think to myself, if I can't come up with a specific plan for this kid, then you probably don't they probably don't need the OT services. So you should, as part of your report, be coming up with a plan and coming up with ideas of how you're going to fix the problems that you're finding. And that plan is all put into your recommendations. And then, of course, you go into your remediation plan, which leads to your goals. I like, IEP.    Jayson Davies     Yeah, um, in fact, just recently, at the end of my reports, I added a prognosis section. And I mean, prognosis may or may not be the right yeah, that may or may not be the right term. But the plan I like, too is like, if you don't, I like what you just said, If you don't have a specific plan of how you're going to help this kid, then maybe you're not going to be able to help the kid. And you know what? As OTs, we have to be able to say that to an IEP team, you know, say, hey, you know what I'm saying, this, this and this with your student. But I'm sorry, OT, at this time, may not be the best solution, and right maybe counseling is the right solution, or maybe speech therapy is the right solution, or maybe behavioral interventions is the right solution. So.    Abby Parana     Or, you know, oh, sorry, Jayson, I didn't mean to cut you off, but I just thought of something. Or, you know, maybe if you don't have a plan, but you can provide, you know, ideas on accommodations under like your supplemental supports. That is a that is a way to do that too. You know if it's if it can be fixed with a simple strategy, like chunking information or changing the child's seating or anything like. That there's no problem putting that under supplemental aids and supports. But ot doesn't necessarily need to be a service to make sure that happens.    Jayson Davies     I agree with that. So the last thing we have on our list is also thinking about the future, kind of coming up with a plan for when the student may not need ot anymore. You know, what do we see? How long is this? How long is ot suspected to need to be on this kid's case before maybe he doesn't need ot again, or maybe he'll be, he'll finish a few different goals, and he'll be able to be independent in the class. So.    Abby Parana     Well, I think discharge planning should always be a part of your assessment. I think once you've identified the concern, and you start talking about how OT is going to help the child, and you have a plan, and you have a goal, and you go through that process, I do not like the idea of OT services being on an IEP for three to six years or indefinitely, which happens rather regularly. Actually, I see that all the time, and exiting kids from services is super difficult. So I yeah, it can be really hard, and you need to assess a kid when you do exit them to make sure there's not another area that you're missing. And I agree with that, but when you are looking at an OT assessment, I think it's important to just have that discussion, starting from the beginning, saying, you know, OT is not a service that is meant to be there permanently. We want the we want to foster independence with the child, and I think having those discussions up front with the IEP team, whether that takes, I mean, that could take many years. That's fine, but you need to start talking about it in your remediation plan, and talking about that ot services you you don't want the kid to constantly receive ot services. If they are then they're not making progress. So, you know, I think that that's important to just have that conversation up front, not that you're pre determining an exit from OT, just that you're the goal of OT is to not always receive OT. And the goal for school is that the child be in school learning.     Jayson Davies     Yeah, definitely. And unfortunately, there is a I don't want to call a misconception, because for some kids, it's perfect, and for other kids is not so perfect. But the idea of, once you're in special education, you're in special education forever, or once you receive speech or in speech forever, same thing with OT and that's not how it should be. I mean, we're here to get these kids back into general education any way that we can do that. I mean least restrictive environment. Yeah, yeah. And every, every 30 minutes that I see them in a pull out session, they're missing education, which puts them further behind, right? And, of course, that's a whole nother another discussion between pull out and inclusion services, which we do hope to have here in the future. For you. All right, guys, so sorry if we started rambling on here for a minute, but just to sum it up, these are, yeah, sorry guys, if this is the very first episode we're recording, and we hope it's Well, we hope it's the best episode and the worst episode, because we want them to get better every day every week. So with that being said, I'm going to run through this list real quick. First, you got to start with your developmental profile of the child and the reason for the referral. Then from there, you got to collaborate with the case carrier and other members, as well as review reports so that you can get the best idea of what is going on with the child. From there, Abby and I, we like to observe the student in all areas, recess, everywhere, everywhere. From there, we go into our standardized assessments, and then after that, once we have our scores for the standardized assessments, we are relating our assessments back to the school based functional need of the child. So how do those the scores that they scored on the bot? How is that affecting their functional skills in the classroom. After that, we then definitely look for some some stuff that we can incorporate from our practice framework. What's an ADL versus what's not an ADL, what's a occupation versus a habit, versus all that good stuff. Yeah, and find out what our guidelines say, and we understand that not every state has guidelines, so you may have to focus on that practice, framework, framework, but the California, New York, I think Chicago, all of them have pretty good guidelines. So I recommend checking out those guidelines. All right, then you get Ohio has good guidelines. Yeah, there's a few really good ones after that. Once you've got all that stuff in there, now you gotta sum it up. You gotta kind of relate the strengths to the concerns as well as what your recommendations are going to be. And like Abby said, your recommendations could be services, they could be collaborations with the teacher, or they could be just like simple things, like a different type of desk that the child may have an accommodation right? Yeah, all right. And then I really like this one, the last the last two that Abby was talking about here was finding evidence to make a plan. Because, like she said, If you don't have a plan, how are you going to help the kid?    Abby Parana     Well, and I would just add to that real quick, if you are looking for evidence, just start putting it in a binder. Make a handwriting evidence studies binder and a sensory processing studies binder. And then you, once you've looked it up for one kid, just start sticking it in a binder. And that way you have it on hand, like, oh, I have another eighth grade referral for handwriting messiness. And look at all these studies saying, you know, it's habituated, or whatever it is that you're looking at. And then you can pull those studies out and be like, this is the prognosis, and this is the evidence. So just start stocking that stuff away with each case that you have. That's what I wanted to throw in there.     Jayson Davies     Yeah, no. And then the very last one, which is planning for the future, looking, you know, just letting the parents know, you know, ot won't be on forever, hopefully. And you know, if they need it, it will be on forever, but hopefully it won't be. And you know what, once the student meets this, this, this and this, and any other future concerns that we might have, well, then it's going to be time to get that student back into the least restrictive environment real quick. Abby, how long does it take you, would you say, to do an assessment, from referral to writing up the report.     Abby Parana     I mean, honestly, it probably takes me six, I would say at least six hours compared like from if you count all the observation time, the writing time, the refer, it can take six hours to even 10. I would say total time to do a good occupational therapy assessment. And I know that's hard.    Jayson Davies     Yeah, to do, and it's hard because of time constraints. I mean, when you got a caseload of 7074 kids, something like that, it gets hard. But, yeah, that's a whole nother conversation that, again, hope to have with trying to figure out caseload and workloads. But I agree, it takes me a good six plus hours to do a really good assessment. And I'm not gonna lie, sometimes I catch myself kind of doing, you know, a not so great quality assessment sometimes, and to all been there, right? It makes me feel bad. And you know what? I end up a lot of times I go back, and I do end up putting that time in, because I don't want to be putting a bad assessment. I mean, the last thing I want is for the kid to move and then another ot reading my assessment, being like, what's this? I mean, come on.    Abby Parana     We've all sent those assessments and read those. You're just like, oh my gosh, what were they doing? And then you're also like, you send in a set like, I think, as assessments I wrote three years ago. I was like, Oh, my goodness, definitely a world. And then I look at the kid now, and I'm like, What was I thinking? I was not even sure what I was thinking about that kid. And then you're Oh, yep, I figured it out. Yep, yeah, I've done the same thing. It happens. We all are there at some point.    Jayson Davies     All right. And with that, it is time to wrap up this episode, episode one, the very first episode of the OT school house. So with that, you know, we just want to let you guys all know that you can find all the resources we mentioned, including a blog that is kind of about the assessment that we just went through the 10 steps to an assessment and all that will be at ot  schoolhouse.com backslash. Episode One. So OT, schoolhouse.com backslash episode one, and you'll be able to see it there. And with that, well, we hope you enjoyed this podcast, and we hope you'll go to the website and subscribe, and when you do subscribe, you will be you'll receive a download for some adapted paper that we made that helps kids with spacing and sizing of their letters. And you'll also be, yeah, you'll also be the first one to know about any future podcasts we have coming out, or resources that are coming up, and a newsletter and a newsletter, yep, newsletter.    Abby Parana     Fun. I don't know why we didn't start this sooner Jayson.     Jayson Davies     Right? So thank you guys. Thank you everyone out there for joining us today at the OT school house. We cannot be more appreciative of you listening to this podcast right now. We hope this helps and visit us at the site and feel free to contact us. We'd love to hear from you guys. So everyone take care. Have a good one.     Abby Parana     Thanks guys.    Amazing Narrator     Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to OT schoolhouse.com Until next time class is dismissed.    Abby Parana     Can I be like, can you hear that?     Jayson Davies     Yes, I can hear that.     Abby Parana     Okay, just, I feel like you should just put that on. Can you hear that? I'll be like me, me, me.     Jayson Davies     Stop tapping your mic.   Click on the file below to download the transcript to your device. Click here to view more episodes of the OT Schoolhouse Podcast

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 149 of the OT Schoolhouse Podcast. Thinking about working directly with schools or going through a staffing agency? Jayson and Elise explore the pros and cons of direct contracting vs. staffing agencies and share insights to help you make informed decisions about your career path. They discuss the nuances of being a 1099 subcontractor versus a W-2 employee, the non-therapy duties that often come with traditional employment, and the hard-to-navigate waters of rates, negotiation, and setting up clear, beneficial contracts. They will touch upon the importance of establishing boundaries to prevent burnout and maintain a fulfilling career. Tune in to learn more! Listen now to learn the following objectives: Learners will identify the differences between contracting in a school and being a school employee Learners will understand the process for self-contracting and going through a staffing agency Learners will identify ways to find and negotiate a contract as a school-based therapist Guest Bio Elise Mitchell, M.S. CCC-SLP graduated from Missouri State University in 2013 and entered the world of school staffing by working for virtual staffing companies for six years as an SLP, school sales person, and provider manager.  Years later, Elise left the world of large staffing companies to focus on being an INTENTIONALLY small contractor, serving her state and setting her contract terms.  After falling in love with direct contracting, Elise founded The Therapist Support Network with the goal of making materials, support, and community available to all therapists who want to work with schools without working for them. Quotes “You can't be a contractor and suddenly, qualify a student outside of the parameters the state tells you to- you're still a school provider. You still have your governing body …and then, of course, IDEA.” -Elise Mitchell, M.S. CCC-SLP “ I called schools with a vacancy. I called a special education director, so don't call the HR department.” -Elise Mitchell, M.S. CCC-SLP “Don't sell to someone who has not consented to be sold to. We've all had those moments at car dealerships or walking across the mall or whatever where like someone just starts to sell to us and then it doesn't even matter. If they're selling me gold at for a cost of a penny, I'm not gonna listen to them because they, invaded my bubble and my boundaries.” -Elise Mitchell, M.S. CCC-SLP “Start hourly, and bill for all services, bill for evaluation write up, IEP write up, bill for everything….there are ways to get access to what schools have paid. That is public information.” -Elise Mitchell, M.S. CCC-SLP “If the district does have a salary schedule for the OTs, you can look at that. You've got to understand that that doesn't necessarily include health care costs. You’re going to have to take taxes out of that yourself…but I think that's another potential starting point to look at” -Jayson Davies, M.A, OTR/L Resources 👉 Elise - Instagram 👉 Facebook Group 👉 Elise’s School Contractor trainings and templates   (affiliate link) Don’t forget to use promo code JAYSON to save on your purchase. Episode Transcript Expand to view the full episode transcript. Jayson Davies     Welcome back school based OT practitioners for another insightful episode of the OT schoolhouse Podcast. Today we are exploring a slightly different side of school based OT, and that is the hiring and contracting side of it. OTPs PTS SLP is SLPA is everyone, even sometimes teachers have options when it comes to working in the schools. You can be a direct hire for a district or a school or maybe even a County Education Office, you can work for an agency that contracts with a district or as we'll discuss today, you can even contract yourself to a district rather than being a W two employee. There are pros and cons to each of these different dynamics. And that is why when I found Elise's website that therapy support network.com I knew I had to have her join the podcast to share her insights with you. Elise Mitchell is an SLP, who contracts herself as a practitioner with districts across the country. At the therapy support network, she now also helps others do the same OT practitioners included. So if you've ever thought about contracting yourself to work for a district, whether online or in person, this episode is for you. We also have a surprise at the very end of the episode for anyone who may want some support in making that happen. So sit back or you know, continue walking if that's what you're up to right now. And enjoy all the tips and tricks to landing your first contract when we return with the lease.    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's your host, Jayson Davies, class is officially in session.    Jayson Davies     Elise welcome to the OT schoolhouse podcast How you doing today?    Elise Mitchell     I am doing well. I'm so excited to be here. If you follow me, you know that I just am obsessed with the field of OT for so many reasons. Like as a mom as a professional that's collaborated. I love OTs. So I'm so excited. Yeah.      Jayson Davies     And you know, as I was just mentioning in the intro, you are actually an SLP. And it's it's rare that we have someone who is not an OT on this podcast. But it is a pleasure to have you on. So thank you so much for being here. And with that, I would love for you to share just a little bit about where you are in your speech language pathology career right now.    Elise Mitchell     Yeah. So I'm Elise, and I've been an SLP for Odin think this one through 11 years, I believe, maybe 10 years. I have to do the math later. But I was in sniff for a little bit and then I decided that was not for me. And so I started working with a staffing agency. I was promoted really quickly I was in sales, provider management, contract execution, etc, left that world. And then I professionally meandered for a while I have dubbed that term. I love a good little professional meander where you try a few things that doesn't work that doesn't work. And long story short, this opportunity presented itself in front of me to contract with a rural school. And I was like, Huh, well, I know about contracting with schools, because that's what I've done. For my professional career. I've managed school contracts, okay. But I always had that staffing company between me, it sounds like haha, I mean, I can contract directly with you, I have the skills, I have the tools, I do not want to be the school's employee because I'm in Missouri and Missouri SLPs are paid that work for the schools are paid lower than I could possibly afford. But I was like, hey, I can set a really competitive rate and contract with the school. So that ended my professional meandering, and I became a direct school contractor. After doing that, I realized that I had all of this education and experience with school sales, with school contracting with school provider management, that I wanted to do something to contribute to our field. And so I founded the therapist support network, with the goal of making accessible and affordable materials resources for SLPs, OTs and PTs who are interested in contracting with schools directly with schools as well. So I am I am now I am a direct school contractor. I work with rural Missouri schools virtually, and    Jayson Davies     I love it. That is awesome. And I love the professional Mandarin term. I love that. I think we all go through that at some point.    Elise Mitchell     Yeah, it's like you're like, do I put all of these things that I did in a short amount of time on a resume? Or does that look bad? Thankfully, I don't do resumes anymore. I do my bio, but like, when you're, you know, they never get my resume. They don't know what I do.    Jayson Davies     You know, it's so interesting. It's so interesting reading resumes, especially in the OT world, because you have a lot of like, I'm sure it's similar in speech. You've got people putting their level twos on resumes, and it's just like so random because they're applying for a school district. They have like this level two and acute care facility or, or maybe it's even just a recent experience just because they're changing from acute care to the schools, and their most recent job is like an acute care rehab facility. And it's just as funny like in other parts of the world in business, you don't see that right. Like people typically aren't going from working with adults to working with pediatrics.    Elise Mitchell     Right? yeah, yeah, I feel that way about my resume sometimes. Or even my bio. I'm like, I'm taking people for a ride, come on this journey with me.    Jayson Davies     Right, but it's all led you to where you are today. So that's cool. Yeah. All right. Well, we are going to talk deep into about contract therapy and contracting yourself with a district. But to start a little bit more broad. Take a step back, you mentioned a little or several of these, when you're talking about, you know, your meandering, there's a few different ways that one can work for and or with a district, can you outline some of those?    Elise Mitchell     Yeah, so the first is, as a school employee, this is, you know, some of our states here at a teacher pay scale, some of them may or not, but it is your standard school employee role, you are a W two employee with a school district, just like their English teacher, their math, teacher, etc. So that's one way. The other way is working either a subcontractor or an employee, because there's both a subcontractor or an employee of a staffing company. So we've all heard, especially in the virtual and the teletherapy. World, so there's these larger staffing companies that then you can work for, and you have a buffer between you and the school, that isn't the school. So often with this, you do get a little bit more flexibility, etc, because you're not that salary school employee that has to come in and out at every time, you know, but you have a middle person between you and the district. The third way, is directly contracting with the school. So in this circumstance, you take out that large staffing agency or like in our areas, the hospitals will or like, outpatient clinics, we'll call it, we'll put SLPs in there, you remove that middle person, and you are the direct contractor with school. So you find a school that is struggling to recruit that first category, which is the in house therapists, and you step in as a business as a sole proprietor depending on your state. And you step in or provide their therapy services, but you are a 1099, you are a contractor business owner, or however you want to word it.    Jayson Davies     Yeah, and I mean, I've done two of those, I've never done the one that you're doing though, I actually started as a contracted therapist through a third party that was with at the time, they were called my therapy company, they're now were bought up I believe, by stepping stones group look, conglomerate that is just huge. And eating everyone up, right. And then I and then I moved into a district employee role. And for me, at least out here in California, it was higher pay better benefits. And so that's why I moved into that role. I always considered the idea of potentially contracting directly with a therapist, but I a was a little scared, because you know, you you're on your own at that point. And I didn't know how to get started. I wish I would have known you about 10 years ago. But the reason I share that is because I think there's some benefits for each type. And I would love just to kind of ask you, obviously you are in the camp, being in rural Missouri, contracting as yourself with a district makes the most sense for you. But for those who are looking at all three options, what are just a few benefits for each of the three?    Elise Mitchell     Yeah, yeah, I always tell people like the benefits. They allied with your journey, you know, I'm never gonna roll out that like, by the time my kids are out of the house and things like that, that I won't go work for a school and get that retirement, you know, so I love this question because I'm like, it just depends on where you're at with your journey. But the first one working as a school employee, I would say number one, I just mentioned it is the benefits. If I needed health care, I think that I would have a lot more financial obstacles that I do. So healthcare in particular can be a really challenging gig for business owners, it just especially small business owners, so school employee, you know, access to that affordable health care is is really great. In some states, their school employees are a bit more protected. Like in Missouri, we don't have a caseload cap. So I just don't have and we're on the teacher pay scale like I don't have a state that's like oh yeah, school, but some some schools you are or some states who are a little bit more protected, where we do have caseload caps, etc. So employee will I argue, I'm gonna say that employee is the most stable.     Jayson Davies     Yeah, I agree.    Elise Mitchell     In regards. Yeah, salary schedule, you're an employee. It's significantly harder to fire an employee. Then just say, You know what, we're gonna let this call have tried to go, this isn't working out. So I do I do think that employees probably the most stable if you're someone that's like, I want to know, every month, what I'm gonna get paid employee is your is your jam. Yeah. So the next one is the staffing agency. I like this for someone who may be like me, that is like, I need some flexibility, because that's where I was at too is, you know, I need Tuesdays to take my kids to whatever appointments apparently we have appointments every week, it's our thing. You know, so I need my Tuesdays off, that's really difficult to find with a school employee role. You know. And so with a staffing agency, you get that a little bit more flexibility. And you don't have to worry about the sales process, which can be daunting for people I, I argue it's not as hard as we make it. But I'm biased. But you don't have to go through that sales and contracting process. And then let's talk about the con is you in return, give a portion of your pay to a staffing agency, and you hit the nail on the head, many of them, especially the ones that are larger, pay less than working for his school. And it's hourly, often. And so, you know, that can be tough, but they're great. If you want to get started with contracting with schools, or you're new to serving schools, that can be a great way to kind of dip your toe in as like, I'm not a school employee, but you're not, you know, jumping in.    Jayson Davies     Yeah, I often really quickly, I often get asked like, how do I get into the schools, and I've met people that have literally applied to 5, 6, 7, even more districts, and they can not get a job with a district, primarily because they all want three or five years of experience working in a school district. And my first word of advice to them usually is to look at the contracting agencies because they are always looking for people always. And they don't. To be fair, like it doesn't seem like the big ones, especially at least, they're not interested in how many years of experience you have. They're looking for the person that they can pay the least amount and get the most work out of if you want to add anything.     Elise Mitchell     Yeah, no, hit the nail on the head. There are some states where it's significantly harder to be an employee with schools. And in California is definitely one of those, New Jersey, New York, you have to like really show, Missouri is like, do you have, I mean, I was approached at a farm show, because I had on a speech therapist. It's the most Missouri story you've ever heard.    Jayson Davies     Like, you're not talking about pharmacy, right? You're talking like farmers and cows, right?    Elise Mitchell     Yeah. Yeah. Farm Show is like a huge like convention where there's all of these. It's like Asha, or do you guys have like an OTA? Yeah, a huge conference. But the vendors are all like they sell tractors or like if you want to buy a certain gene of cow like genetics. So I was at a farm show because we have a farm and a speech therapist shirt. And this like rural special education director came up to me it was like, Are you a speech therapist? I'm like, Well, yeah, but you don't know that I'm a good one.     Jayson Davies     They don't care.     Elise Mitchell     Yeah, no, not at all. So it's funny, because some states are like, Whatever do you have? Do you have the degree?     Jayson Davies     Yeah.    Elise Mitchell     like, we're desperate. But yeah, so, yes, staffing companies can be a really good entry to working with schools and there are some really cool ones that are like founded and run by therapists now that are paying, like some of the staffing companies are paying more than my direct rate in my state, like, you know, and so it's, I love that trend, but you are still getting part of the profit away, which may be worth it for you if you need that support. The last thing is direct contracting with schools. This is the out of the three this is the one that gives you the most autonomy if you set up your contract correctly. So this is where you say this is my caseload number like for me if you follow me you know that Tuesdays I'm off Tuesdays and Fridays are my no contract no coaching days when I'm being good, but you know you have that ability to set your terms so you have the most autonomy and then you should make that should be the highest earning I give a disclaimer of gross earning because there is that sticker shock that first time you pay your taxes so you know you want to ensure that you've priced yourself well and competitively to make it financially the benefit that it can't be but yeah, this is great for someone. and if you also have like that private practice edge, but you want the school schedule, because that's another thing. I love the school schedule. This is a really great way to be a private practice business owner but still not you know, you know, still have your No, no off.     Jayson Davies     Yeah, yeah, I completely agree. Like my family runs on the school district calendar, my wife is in the schools, I with OT school house basically run on the schools for the most degree. And you can't beat that like it is just nice having summers off. And two weeks in the winter, you can't beat that. So I want to ask you one more thing, because you mentioned working with a contracting company that sometimes I can look two different ways as an employee versus even actually contracting with the contractor, if we want to call it that, can you just really quickly share the differences between those two?    Elise Mitchell     Yeah, and it's important that we talk about this. So some companies bring on a 1099 subcontractor, you still in that sense, are treated as a quote unquote, business owner in the eyes of the IRS, which means you still have to pay your own taxes, you have to do everything that you would do as a direct contractor with a school except you didn't find that contract, right, you got rid of the sales and contract process. If that company is compliant, that's a whole other podcast. That's a whole other day. If that company is compliant, you still should have autonomy in that, like, I'm only working this day this day this day, as a subcontractor, and a lot of the staffing agencies do bring on providers as subcontractors, not as much in California, but in our other in our other states. The other one is w two. And in this case, you are an employee of the company, they pay your taxes, some of them provide health care, which is awesome. Some of them provide retirement. So most of them your hourly, still, but you are an employee, and still get that like I don't have to pay my taxes quarterly. You know, those those employee perks, and that one you should have, you may have less autonomy, you may have more managerial support. So that's nice. I love w two with a staffing company. If you are new to schools, I'd find one where your W two because they should equip you with a manager in support and training and those things that come from being an employee. But yeah, it's important for us to know the difference, because it's just so important to know what you're signing.    Jayson Davies     Yeah, yeah, absolutely. And now, before we get more into the idea of contracting directly with a district or school, is there any difference in the day to day, like we've we talked a little bit about, you know, the overarching benefits, you know, being on the school calendar, benefits and whatnot, but, you know, working directly with the kids, is there a difference between being an employee versus being contracted?    Elise Mitchell     Yes. So I think the biggest difference is, when you are an employee, they typically want you to do all the things employees do, which usually includes bus duty lunch duty, what are the other good ones like random and services about like, I don't know, math curriculum. I've had I've gotten weird face. Yeah, because you're an employee. And so they're going to build those things in because they want to really, I mean, you are on the UI on their salary, like they need to maximize the time you're being used. When you are a contractor, they do not want to pay you any more than they have to pay you. So you usually 99% of the time, you don't have that bus duty, you don't have that lunch duty, any unrelated task is removed from your plate, that does not mean that paperwork is removed from your plate, you absolutely should be paid for paperwork. Because that's I mean, you can't be a provider without paperwork. But the biggest thing with day to day is just again, those unrelated tasks. Also, when you're a contractor, like I don't start my day at 8am unless I have a student at 8am. Sundays, you know, like my, my Thursday starts at 915. So you just see more, you have that difference in like, I don't clock in and clock out. I see my students when they're on my schedule.     Jayson Davies     Yeah. Yeah, I mean, obviously, there's some differences. But what would you say are also some of the similarities, whether you're an employee or a contractor?    Elise Mitchell     that compliance piece, the state doesn't care if you're an employee or a contractor, you know, you, you still have to follow compliance. So this is something that I tell people, you can't be a contractor and suddenly, like, qualify a student outside of the parameters, the state tells you to quit, like you're still a school provider. So you still have your governing body have that that state, the state governing body, and then of course, IDA, so the similar the similarities, you're still a school provider, you still have to provide progress notes, unless for some reason you're just doing therapy and they have a different provider doing those notes. You know, you still see the students for like, a set number of times. You are it's it's still very similar.     Jayson Davies     Yeah, still got to do your notes.     Elise Mitchell     Yeah, you still have compliance. You still have to I mean, you have to evaluate the kids every year like, you know, that part, that part doesn't change, which I'm glad you brought that up. Because sometimes particularly with like in Missouri, OT and sensory, Missouri doesn't love like standalone sensory with OT, asked me how I know my youngest is a little sensory baby. And they were like, we can't touch this. Like, they don't like that stay at a load. And so even if you're a contract OT, you're not going to suddenly can't, you know, qualify them with that, like you still have those parameters. And sometimes people get bummed with that. And if you're bumped by that go into private practice, like, there's a space for you.    Jayson Davies     Yeah, yeah. Quick question. As a contracted therapist, do you ever feel like you're not part of the crew? I mean, do you feel like you are on your own island. And I'm sure you have multiple stories that you can share from many angles. But what are your thoughts,     Elise Mitchell     I do more when I'm virtual than when I'm in person, when I'm in person, I don't feel that much. I mean, you do have to put yourself out there. And I really encourage people like when you are onboarding, get to know the teachers, like walk around, introduce yourself, if you're on site, launch there, if the school is comfortable with it, which the majority of them forget, you're a contractor, and you have to actually re remind them that you're a contractor. And so in person, I found it's not as challenging as virtual and honestly virtual. As with a staffing agency, I felt that same way as like I'm, I'm the person on the computer. And so I felt I have to work just a little bit harder, you know, emailing to get to know the team, ensure that you email the general education, teacher get their feedback, just put yourself out there a little bit more. But I do I do feel that like, there's a little bit of that lack of like, water, what do they call it water cooler talk?    Jayson Davies     To the staff lounge talk? Yeah,    Elise Mitchell     yeah, yeah, there you go. Yeah,     Jayson Davies     Yeah, I mean, it's funny, because you know that some of the things you said, I think apply to both whether you're a working as your own contractor, therapist with the district, or if you're a contractor through a company, or if you're even an employee, a lot of times, we're the only OT or SLP on campus, like we're the only OT or SLP, the staff there knows. And if we don't take that initiative to get to know them, they're not going to take the initiative to get to know us. So I kind of think it goes with kind of with the territory, it just being a related service provider in some degree. So the one thing that I noticed as being a contracted therapist with a third party company was that it was harder for me to do things outside of IEP mandated minutes. If I wanted to conduct an in service, or if I wanted to get into the classroom to do some MTSS or something like that. That was a little bit more cumbersome. But I think that was the primary difference for me as far as being an employee. They were kind of more Yeah, go ahead, do it and try it out. I mean, you've got your 40 hours a week, use it, basically. So yeah, that was just my experience.     Elise Mitchell     That makes sense. That makes sense. Yeah.     Jayson Davies     All right. Now let's dive into the idea of actually potentially looking for a district and potentially contracting yourself out, I'm going to kind of walk through the rest of this podcast with the assumption that someone already has some experience in the schools because I think it's very hard to jump into the schools first year as an independent contractor. But I do want to ask you, you know, if you are a school based OT a school based SLP, PT, whatever it might be, what might you look for to determine if a district might be willing to partner or even looking for an OT to partner with as an independent contractor?    Elise Mitchell     Yeah, yeah. So first, I'll mentioned like the lowest hanging fruit like the easiest to grab, and then I'll talk through like, yeah, if you don't have that beautiful sparkling fruit just taking right. So the first which is the lowest hanging fruit, and still the number one way that anyone that I've worked with, has has obtained their contracts, not myself, I'm a I've a cold caller to life. And I'll explain that more here in a minute. But um, has been a word of mouth situation, you put yourself out there, which is funny because sometimes people are nervous to like, tell the world and I get it like if you're not, if you haven't given your notice yet, Let's bypass this step and not disclose to your boss that you're looking for another gig. But the one of the best ways if you have if you have access to like your grad school cohort, or something is just sharing saying, Hey, I did want to let you guys know I am serving. I would like that, you know, I'm serving contracts for the 2425 school year. Do you guys know any schools that are really struggling to recruit OT? Why I like that and why it's the lowest hanging fruit is because schools in particular Like having people who know people, like I mean, I'm sure if we're all school, we're all familiar with schools, there's politics, there's cliques, there's, you know, it's schools.    Jayson Davies     Yeah. And to be honest, that's one of the benefits I think of contracting yourself with the district is you don't have to deal with all that necessarily.    Elise Mitchell     I know, I know. Um, but yeah, so you, there's schools really like knowing someone who knows someone the same as, like, if you put something on your social media, you never know. And I had, I actually spoke to someone, just yesterday that she went to her son's IEP meeting. And the person in the IEP meeting was like, while you're here, the school next door is looking for an SLP. And so she's like, our contract with them. Yeah, so the more that you put yourself out there, wear the shirt to the farm show, you know, let if you're an OT with SLP friends, I know, I always know schools in Missouri that are struggling to recruit OTs, like, you know, put yourself out there. So that's, that's the easiest, but let's say you're an introvert, or you know, they're the OT, you're rural, the OT pool is pretty small in your area, like not a lot of educator friends, what you do is you look for schools that have a vacancy, you can find us on the job boards, you know, and that doesn't mean they're willing to contract. But that lets you know, they're still hiring, and they're likely struggling to hire. So that's going to be the next way. And that's actually my number one way of getting sales before I got to the point where schools just referred. I mean, schools now will just refer other schools to me. So I don't call anymore. That that was the number one way that I identified schools with a need is I called I called schools with a vacancy a call the special education director. So don't not the HR department Say that again? Yes, you call the special education director don't call HR. They don't they handle employees, not the contractors. And they get very confused and put you through the application process, no matter how many times you say.     Jayson Davies     I'm glad you shared that because I was totally in my head thinking, call HR call HR? No.    Elise Mitchell     I've actually had people that apply and that they're like, wait, I'm interviewing and I was like, on board a board. But I'm like, Just tell them there was a confusion like we could, you can, you can cut back for that. But for the most part, you want to talk to the special education director or equivalent, if whatever your state calls them, and say, you know, Hey, I am I am a business owner. If you have a business name, go ahead and throw it out there. And I'm an OT, and I am accepting contracts. So 2425 school year, I saw you all had a vacancy listed. Are you guys struggling to recruit? If so I, you know, I'd love to help you out?     Jayson Davies     Yeah, that's awesome. You know, I kind of want to just use this as a storytime and see where we go with it. Because the last week or so, I have received several emails from a large staffing agency. In fact, I think from multiple large staffing agencies telling me that they have a vacancy for my local school district. Yeah, my local school district, if you're listening all the OTs in the local school district, I don't believe I am applying. But anyways, let's just assume that someone is getting that type of email. Is that kind of the situation you're talking about right here like, Hey, I know this district has an opening, I can either a go the route of contacting the recruiter that's emailing me or I can sidestep it and do what you're talking about.    Elise Mitchell     Yeah, yeah. Find a school I would not and I do recruiters in big staffing agencies, which I respect, they're, they're cracking down at this. I would not engage with a staffing company, if you have an intention of direct contracting. That's another misconception that I've heard like people think they get the staffing company can connect them and then they can just give the staffing company that mood. Most staffing companies have policies in place that protects them if you do that. So I would not go that route. Instead, I would say, Yeah, I see the school district, I'm going to not work with a staffing agency. I'm going to track down this school that they're talking about and call them.    Jayson Davies     Gotcha. And that is the special education director, not the HR person.     Elise Mitchell     Absolutely. Yes, yes. You get anything. That's your bullet point. That's the thing to write down if you get anything from this from this episode.    Jayson Davies     Awesome. Awesome. Yeah, no, I think that's kind of what we really wanted to gather from this episode. Most. It's just kind of that how to get started. And as you mentioned, right, like that can be the first step, you know, searching for what districts are looking for someone and then potentially going around or finding a way to that special education director. I do want to ask you, though, like, what should I be worried about? If I'm going to give, especially if I've never done this before, and I'm going to call up that special education director. I'm going to tell him my business name, Tom. I'm open for potential hiring. I mean, I'm going to be nervous. It's the first time I'm doing it. What should I be worried about?    Elise Mitchell     Usually that part doesn't come with as many because what, what I always recommend doing is saying like, so here's a caveat, and I won't get too much into it. But if you ever go through any sales training with me, I am such an advocate for don't sell to someone who has not consented to be sold to. And we've all had those moments at car dealerships are walking across the mall or whatever, like someone just starts to sell to us. And then it doesn't even matter if they're selling me gold at for cost of a penny, I'm not going to listen to them because they like invaded my bubble and my boundaries. So in that call, usually, your call to action is like wins the chance to meet and discuss this more if they're open to it. So that calls shouldn't come with too many things every now and then you're gonna get which is what I say, which is that follow up call, the thing I would be just cautious about is know your rate ahead of time and know like, plug it in, calculate it, estimate taxes. Because if you say your rate really quickly, and the school like 50% of the time is going to pretend to choke and like, you know, they like to their schools, they like to see if they can get you down, you just have to be really confident in your rate, do not charge what the staffing company was going to pay you because they have taken out their portion. So I would say that's like my number one is just know your rate and be confident in your rate. And know to walk away if the school is like, well, we don't pay over. Like if you're in Florida, this is a this is Florida staying, you know, we don't pay over $60 an hour, if you can't live off that when you take taxes out, then I wouldn't I wouldn't continue that conversation. So I would say that's my number one is like, you know what you're going to charge to be competent, saying that number.    Jayson Davies     Gotcha. Absolutely. And we don't have to go too deep into this. I'm sure it can. It gets very intricate, I'm sure. But when it comes to potentially pricing yourself, what are just one or two tips you have, like Where should people even start with deciding that amount?    Elise Mitchell     Yeah, so I recommend beginners start with an hourly amount, you will see flat rate out there like I charge this much per hour. But if you don't really know how much how long it takes you to write a balance you can get in sticky situations where you're actually doing it for like $20 an hour. So I'm gonna say start hourly, and Bill for all services bill for evaluation write up, IEP write up? Well, for everything, you can look. So there are ways to get access to what schools have paid, that is public information. You just have to do some digging. So it's been there's board minute notes that contain it. There are ways to do like request to get that information. I personally don't use that anymore, because staffing agencies in particular charge a lot less than I do. But they also tend to have staffing issues. So schools will pay more than what they've paid. But you can get a ballpark that way like am I coming in? Am I coming in hot? So those are some tips that I do. And then just remember that most schools are 36 weeks out of the year. So when you're calculating, getting that salary, and you're looking at like, okay, my hourly rate times, I'm going to do 30 hours a week, times 36 weeks a year, that's going to be my grow salary.    Jayson Davies     Yeah, and I think the only other thing that I would add to it is, if the district does have a salary schedule for the OTs, you know, you can look at that, of course, you've got to understand that that doesn't necessarily include health care costs, that doesn't, you're gonna have to take taxes out of that yourself and all that good stuff. But I think that's another potential starting point to look at. But yeah, all the interesting stuff. Alright, so once you figure out, you know, you've got this number that you want to do and you present that to the special education director. What are some other things that will need to be sorted out?    Elise Mitchell     Yeah, so that's when you kind of get in that contract phase. Some states like California, New Jersey, they like to present their contract I don't love it. I talk about this in a few different areas if you follow me on what to do with that, but it's funny California is like my exception for everything I talk, you notice that? like.     Jayson Davies     You have lots of rules out here. I'm sorry.    Elise Mitchell     Like unless you're in California. Florida, California, New Jersey, I talk about those states way too much.    Jayson Davies     And you're in Missouri of all places like, you have nothing to do with them.      I know, I know, Texas is coveted clutch Texas is flirting with something. But yeah, so I you engage in the contract process. The contract process is really where you outline those terms. That's going to be your Goldstein. dirt that guides you through this, putting in there, what you're going to build for. So with the schools like, Whoa, I did not realize we were going to pay for you to write up this evaluation, you can say, share it. And you guys signed this contract that it said, you know, so after that begins the contracting process, that's when you really need to hone in on. Are you an LLC or an S corp? Are you a PLLC? Depending on your state, that's when liability insurance will come up. Some that's in the contract like provider will maintain this liability insurance. That's what those other things which are your nuts and bolts, and I will say the number one thing. Number one, I don't say mistake, but like, misstep that I see with contractors, is they try to get those nuts and bolts before they call. But often you get a liability insurance, and then you go to contract with the school and find out they want you to have cyber and security as well. So this the nuts and bolts stage really happens after you have identified a district that most likely is going to use you.    Jayson Davies     Yeah, yeah. I mean, I help some people start their own business, I kind of tell him the same thing, right. Like, there's some things that you want to have done up front, like you were talking about know your number. But there's some things that you just, you kind of know that they need to be done. But you can't necessarily do it until you've gotten through a few steps. And at that point, you kind of worry about it. So yeah, absolutely. With something such as I'm going to or not going to attend IEPs, caseload numbers, workload numbers is that stuff that might be included?    Elise Mitchell     It can be, yeah, I think can, so, an example with me, I was with a high school and I put a caseload number in my contract, I did not realize this high school, most of the students were 15 minutes, because they were in the process of, you know, transitioning out of my services. So I ended up severely under estimating the contract because my caseload read as 65. But my hours were much lower because of 6515 minutes, you know, basically. So put things in there that you don't want to deviate from, if you're like, I don't want to deviate from, you know, 30 hours a week that goes in the contract. If it's, you know, so those things that you're like, Yeah, my caseload is not tapping 40 To put it in there. But just know, once it's in there, that if you do deviate from it, you will need to do like an addendum or an attachment or something to that extent. Yeah.    Jayson Davies     Yeah. You know, I'm just, this entire time we've been talking, I've noticed that you've talked a lot about boundaries and setting boundaries for yourself. And I just want to ask, where did that come from? And do you feel like that's important for everyone? Or Should someone kind of feel that out for themselves?    Elise Mitchell     Yeah, so I think for me, in my past life, when I was an executive, for a staffing company, I did not have boundaries. I talk a lot about that. Like, I mean, I was grind culture, which served to me at that time, you know, I did very well, I learned what I what I now know. But because of that I did get really burnt out. And so when I started contracting, I was like, listen, like, I'm not, I'm not going through this journey again. So in order for me to not go through this journey, I got to not start it. So that's where a, you know, and you have to go through that you have to decide like, what do I need, because most of people when they come to me, they're struggling with where they're at currently. Gotta identify what it is, is it the hours a week is that the mental load isn't the fact that you just aren't making enough like you don't mind the job, but your page peanuts, identify what it is that you are now trying to leave. And that is going to drive those boundaries you put in place as a business owner, because if it does it, you're gonna end up in the same boat, like, contracting is only a fix if you use it to fix whatever you're leaving.    Jayson Davies     Yeah, yeah. I mean, it's, it's, no one job is going to fix your burnout problem. There's a lot more to it than that. And you really got to look internally and decide, okay, well, what isn't it because even if you're employed, I mean, you could make changes to the way that you are working in your employed gig, to combat that burnout a little bit. But if you just keep the same mentality, but jump into a new job, may not may not quite change.     Elise Mitchell     Yeah, yeah.     Jayson Davies     All right. I've got a question here for you. And this actually comes from it's a scenario that someone gave me and it's something that I've heard several times regarding contracted therapist. I don't think I've heard it much as far as like contracting with the district but more of like a third party thing. And it's that the districts are worried that the therapist will over evaluate over service students because they're getting paid per hour per service, whatever it might be. In fact, it went so far as someone that who's in our OT school house Collaborative membership, Christina, she was saying that she's evaluating, but she is not allowed to also be the treating therapist unless the parent requests her. Because of that reason, they don't want her to evaluate and treat because they think that that's a conflict of interest as a contracted therapist. Have you experienced that? Do you hear of others experiencing something or pushback from a district and that way?     Elise Mitchell     Not to that level, um, my-I have had first I call it first invoice sticker shock, because that happened. I think it happens probably 30% of my customers when they get that first invoice, and they haven't done the math, and they're like, Whoa, this is more than a salary. And like, yeah, it is. I pay my own taxes. This. So I've experienced more of that. And I have had schools that take like meetings off my plates. And I've I've had to push back. I've had to say, in my State slippers are not allowed to represent speech in meetings. I ethically have to be there, because I'm the case manager. So I have had those circumstances where they try to shave what I bill that I think I've experienced significantly more than like, you you have a conflict. And also I mean, I'm sorry, Christina has to go through that. Because it's one of those things. It's like, we don't trust your code of ethics, or obligation. Yeah. So I have I do reference my code of ethics, I would say at least annually, I've had to have a school that I'm like, This is my ethical boundary. One thing that I've also experienced that isn't quite related, but is I do tend to get schools that look for me for the students who are likely to go to due process, because they want to buffer themselves a little bit and like they're like contractor figure this out. So that's another thing is I do have to have my ethics close by, you know, and-    Jayson Davies     I feel like out here, it's almost been the opposite with me, sorry to interrupt, but I feel like they want the district employee because they're scared that the contractor might do something. And I think that that distrust and whatnot. But you see, you've seen it the opposite.     Elise Mitchell     Yeah, yeah. Well, in New Jersey is very similar to California, where they're, they're just more litigious parents utilize due process more. And so New Jersey, similar, where they like to have a little bit more of that protection stance as employees. So yeah, this is what is really cool about contracting. And this is why I hope I'm not gonna get dementia, because I am using different like brain cells every day. But I do, like every state is so profoundly different. But I have, I am at a place now as a contractor where like that I had one school in particular, it's like, you're going to see this kid because the parents want you to see this kid. And I'm like, there's no possible ethical reason I can serve a student and pull them out of their, their educational environment, like their, you know, their, their normative data does not support that. But I am at a place as a contractor where I know that I can let those contracts go. And there will be another contract that needs me. But it took several years to get that. So I think if you're in a situation where with as a contractor, you're like, oh me, I This is worse than being a school employee. I have like nobody trusts me if it there's that's likely not an ideal customer. And there are others out there.    Jayson Davies     Point. Fantastic. Thank you. All right. I've got two more questions for you as we wrap this up. And the first is a best case. Worst case scenario. So if you know you're just getting your first contract out there, what might be the worst case? What might be the best case?     Elise Mitchell     Yeah, so we'll start with worst case. The worst case is it lapses, I haven't had this happen, especially being virtual where an on site person comes. And they they terminate contract. I did for the first two years of contracting, I actually kept security blanket jobs. I was PRN with so many large staffing agencies. And I probably burnt bridges because they never actually did work for them. But I had that security because I was worried about that. So but then I've like I said I've learned to trust the system. There are just so many schools right now. But that's worst case. Worst case is the contract drops. It's a contract. Hopefully you have protective terms in your contract where they do have to give like a certain amount of notice but if you went to court would that hold up? You know so that's that's worst case. I've only had it happen to a few contracts and like I said it wouldn't have happened if I was in person. It's just because I'm virtual and still so many schools see that as and I get it I if I lose a contract for that reason. I'm like, Hey, you totally get it glad your needs are met. So that's worst case. Best case is you know, you have you have the job you've wanted, you've set your boundaries, you are getting paid more your business owner and there's just such a beauty that comes from that and that autonomy piece which I leaned heavily into, and you serve a school that either has been using staffing companies that hasn't met their needs. Or you serve a school that, you know, maybe they have caseload overflow their OT in house just can't take it all, and you're helping them out. So that is more my experience is just that really positive, like I helped like one of my schools had for SLPs last year, because the staffing company just really struggled to retain their SLPs. And so they were behind was it 120 sessions. It was, you know, and so I stepped in and I helped and it was beautiful and harmonious. And I made good money in return in addition, so, so yeah, that's best case.     Jayson Davies     Awesome. And just really quickly, remind me, are you now actually bringing on your own employees and or subcontractors?     Elise Mitchell     Yes, I subcontract out. It's a lot in Missouri. I will say I was in management and in my past roles, it's not quite for me. I love talking about it. I love interviews, training, recruitment, but I myself, again, I lean into autonomy. And with management, you still you have people who need you when they need you. So but yes, I do subcontract. And because, Missouri, just in particular has.    Jayson Davies     Yeah, and I mean, it's a very different role, right, like you brought up the management side of things. Most OTs most SOPs, most PTS, I imagine go into our profession, because they want to be down on the floor with the kids on the swings at the desk in the classroom, not because of that management piece. But it is definitely a piece that can happen. Once you've got one great contract, once you've got two or three great contracts and your time is being pooled, there's different ways to go about it. I mean, if you want to keep doing the the therapy part, maybe you bring on someone to help with a managerial role. Or if you want to do the managerial role, then you step back from the treatment role and start to do take on the managerial role. But that's what's nice about owning a business. Like you get to make those decisions.    Elise Mitchell     Yeah, and I love apps. That's my favorite. Like, if I work with the school one year, I come back to them that next year, and I'm like, do you guys want me to serve all your SLP? OT, PT, social work? Like, do you guys want me to take this all in? And then you and your team? Are there together? And yes, you are their manager. But I mean, you guys are your your little business family. So it's really cool. And it is, I would say, I don't completely call it a passive form of income. I don't think anything in our field is a passive form of it. Like, don't believe the hype. There's not I don't think anything's passive anymore. But yeah, but I do is more passive. Like when I was on vacation, not all of my schools were closed. So I still had income coming in towards the business where I wasn't actually serving the students.    Jayson Davies     Yeah, I think that is totally I mean, even with me, though, to school house, completely virtual platform, all professional development resources for school based OT practitioners. It's not passive. I've put in more work here than I ever did while working at the school districts. And yeah, and same thing with money. Like a lot of people assume that it can be much more financially benefit. And I think in most cases, small businesses, yeah, it can be a little bit more, but you know, it's not going to be a quick million dollars. Like, that's just not the case. We're talking about here. Anytime we're working with education. We're kind of in that same field. So     Elise Mitchell     Yeah, yes, absolutely.     Jayson Davies     Alright, Elise, well, part of the reason I wanted to have you on today is because I knew you're so knowledgeable and the reason you are so knowledgeable about this is because you've done it you've put this together you have developed your own contracts you have cold called as you mentioned, you've looked at the ethics all that good stuff and I know that you know your stuff and I wanted to share that with everyone that's out there listening. Now for anyone out there who obviously hears how much you know how much you have been able to support yourself and others where can they learn more about you? Where's that best spot to go?     Elise Mitchell     Yeah, so if you go to my website that therapists support network.com I have a free checklist you can download just to get started and then find me on Instagram at the therapist support network I go live a good amount and then if you are on Facebook SLP OT and PT school contractors there is an Oxford comma in there and we that is a really great place I go like I actually am going live there here soon I go live and just try to free knowledge share to the best of my ability so yeah, you can you can find me in those places.    Jayson Davies     Awesome. And you do have a course right? or?    Elise Mitchell     I do I actually have two I have two separate so one is for beginning contractors the school contractor packet if you just are like just give me the contracts the lease I got this I'm gonna run. Give me the sale. script so I have a school contractor packet if school contractor packet and training those are for people who want to get started with contracting, if you have a private practice want to expand to schools, but I also have my newest baby that was born in January is the school staffing packet and training. And that is for providers that wants to hire or subcontracted out school contracts. So you talk about I don't love it, but it's I love teaching about it. So if you want to hire or bring on 1099 therapists underneath you to serve your school, if your school has, has too many needs for you to serve yourself, I trade on that.     Jayson Davies     Awesome.     Elise Mitchell     Yeah.    Jayson Davies     thank you so much, really appreciate having you on and we will be sure to link to all those various places. I know I found you through the Facebook page that popped up on my feed one day, I was like, Oh my gosh, I want to learn more. And so now I'm completely wrapped up in your atmosphere. So I appreciate it. Thank you so much for coming on and sharing all your knowledge and contracting directly with school districts. I am sure there will be a handful of therapists who will have you to think as part of their job in a year or two. So thank you appreciate it.     Elise Mitchell     Absolutely, Absolutely. Thank you for having me.    Jayson Davies     Thank you Elise. One more time for sharing all of that knowledge around contracting yourself in the schools. And as I mentioned at the top of the show, Elise and I have a special surprise for you today. After Elise and I finished recording she graciously reached out to me and shared that she would love to extend a discount code to you as an OT schoolhouse listener. So if you head over to the therapists support network.com The link is in the show notes. And you use code Jayson J A Y S O N, you will save on any of her courses or templates that make contracting yourself with a district possible. Thank you again so much for tuning in today. And if you decide to take the leap into self contracting after listening to this episode, please let me know reach out at Jayson@OTSchoolHouse.com . I would love to hear how you're doing and maybe what is going on with your business as an OT preneur. Thanks again and I will catch you next time on the OT schoolhouse podcast. Bye.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT school house.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

Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 150 of the OT Schoolhouse Podcast. Abe Saffer and Dr. Miranda Virone are here to dive into the roots of occupational therapy’s involvement in mental health, uncover current challenges, and explore practical strategies for integrating effective mental health interventions in schools. If you're looking to expand your impact and equip yourself with the necessary skills and knowledge to address these kinds of challenges, or are just curious about the evolution of school-based mental health strategies, this discussion is for you. Tune in to learn more! Listen now to learn the following objectives: Learners will identify strategies for advocating the role of OT in mental health Learners will be able to apply strategies for integrating mental health interventions into their practice Learners will be able to analyze the biopsychosocial approach Guests Bios Dr. Miranda Virone Dr. Miranda Virone, OTD, MS OTR/L, PhD(c) is an Assistant Professor of Occupational Therapy, Educational Consultant, and passionate advocate for youth mental health. She serves as the co-facilitator of the American Occupational Therapy Association (AOTA) School Mental Health Community of Practice, the AOTA representative for the National Center of School Mental Health Advisory Board and served as a co-author of the Pennsylvania Occupational Therapy Association School Based Guidelines. Dr. Virone educates and advocates for occupational therapy’s role in school mental health by presenting at the state and national level, conducting and mentoring research projects, and leading student fieldwork experiences in school mental health initiatives. Abe Saffer Abe Saffer has over 15 years working in policy and lobbying, political communication, political organizing, and campaign management. He has established, maintained, and led successful coalitions on local, state, and national levels to educate and advance issues. Abe possesses specialized skills in crafting comprehensive messaging and advocacy strategies tailored to ensure complex policies effectively resonate with a wide range of audiences. He has extensive experience in analyzing and drafting legislation. He has also been quoted in multiple publications, and has authored several articles and editorials. He has an ability to thrive in high paced and intense work environments. Abe is currently a federal lobbyist for the American Occupational Therapy Association, lobbying Congress and the Administration on a number of issues, including: special and general education, early intervention, workforce, diversity and equity, health, appropriations, mental health, Medicaid in schools, and general disability. Quotes “I really think that we need to inject mental health and just about to every session like we can't just ignore mental health, it is really a backbone of every single thing that a child does”  -Jayson Davies, M.A, OTR/L “OTs eligible in every single state as a mental health profession” -Abe Saffer “Our lens is so very different from everybody else's that if we can just build the courage to talk about it and feel comfortable and confident talking about it we can break down a lot of barriers.”  -Dr. Miranda Virone “It's usually not a federal barrier that is preventing you from doing something it is generally if anything, it might be a state law. But more often than not, it's just people who don't understand what OTs is. -Abe Saffer “The biggest barrier that we face is misconceptions that have solidified that schools are so risk averse” -Abe Saffer “You need to be able to convince the administrator” -Abe Saffer “You can't assume that your school administrators know anything about ESSA there's a very strong chance that they don't… it can open up a lot of doors, it can open up a lot of conversations too” -Dr. Miranda Virone Resources 👉 Every Moment Counts 👉 MHSP(grant department of health ) 👉 Safer Communities Act  👉 ESSA   👉 IDEA 👉 Abe Saffer Twitter/x  👉 Congressional Affairs AOTA 👉 Specialized Instructional Support Personnel 👉 SASISP Guidance Brief  👉 Episode 91 Of OT Schoolhouse with Abe Saffer 👉 Making the Shift: Caseload to Workload Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hello and welcome to another insightful episode of the OT schoolhouse Podcast. Today we're diving into the critical integration of mental health and occupational therapy in the school settings. I'm your host, Jayson Davies and OT practitioner based in Southern California. And I really appreciate you joining us today. For our 100 and 50th episode, I wanted to address a topic I know so many school based OT practitioners have questioned in their careers, you probably have as well, and that is are OT practitioners, mental health providers, and if so, what does that mean for our role as school based OT practitioners? That's why today I'm excited to be joined by two distinguished guest, Miranda Varun, an Assistant Professor of Occupational Therapy with a rich background in school based practice and mental health advocacy, and a returning guest to the show ape Saffer, a federal lobbyist for a OTA who focuses on school based work and pediatric initiatives. As you will soon find out Miranda and Ava are the perfect duo to be helping us out today with answering these questions, and they aren't afraid to tackle the tough questions that I throw at them. And this episode Miranda and Abe will help us to explore the historical roots of OT and addressing psychological components of trauma, the importance of using a bio psychosocial approach, and how we can effectively integrate mental health interventions into our everyday practice as school based OT practitioners. To go a little bit further, Miranda will share invaluable tactics for building rapport with teachers and obtaining the necessary buy in for implementing OT strategies within the classroom. While he will really dive into overcoming federal and local barriers to providing comprehensive mental health services and the schools, no matter your experience with implementing mental health services in the schools, this discussion will provide you with a deeper understanding of the challenges, opportunities and crucial roles that we play and fostering mental health in educational settings. Stay tuned as we unpack how you can support mental well being within occupational therapy. We'll be right back.    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's your host, Jayson Davies, class is officially in session.    Jayson Davies     Miranda and Abe. Welcome to the OTs schoolhouse podcast. How are you doing today?    Miranda Virone     I'm doing great. Thank you. It's sunny here in western PA. So I'm soaking that up a little bit. It's enjoyable.    Jayson Davies     Yeah, take advantage of it while you can. Right?  Yes, we're hopefully getting a little bit of what the West Coast experiences more often. So it's looking good out there. But yeah, I'm doing great. Thank you for having me. I'm proud and glad and excited to be here and pursuing good company with ape. So it's all good. Yeah, absolutely. And I'm pretty sure the way that I first learned about yourself Miranda is actually through Abe, and we have Abe joining us from the DC area. How are you doing today Abe?    Abe Saffer     Good. How are you all doing?     Jayson Davies     Doing pretty darn well excited to talk about mental health and what it should look like? What it is what it actually can be? And how we can kind of merge everything all together between mental health and school based occupational therapy. Sound good?     Miranda Virone     Yeah, let's do it.     Abe Saffer     I can't wait.     Jayson Davies     Well, to get us started for today, I want to give you both a quick minute or two to kind of share where you are in the world of occupational therapy, how you fit into that. And Abe if you want to quickly share your responsibility, if you want to call it that in the world of OT go for it.    Abe Saffer     Yeah, so I'm the biggest fan of OT that is not an OT practitioner. I've been working for AOTA now for about seven and a half years or so. And I am one of their federal lobbyists and handle all of their, all of the school based work essentially for for the association. So that's anything pediatric is sort of in my portfolio.    Jayson Davies     Awesome. And that's what we're going to talk about ESA, ESSA talk about mental health with you, especially from that DC level, and then even at the state level as well. Great. It's great to have you here. And Miranda, what about you? Where are you in the world of occupational therapy today.    Miranda Virone     So I am currently an Assistant Professor of Occupational Therapy and Occupational Therapy Dr. Program in western Pennsylvania. So that's where I spend the majority of my time but also do consulting on the side in public schools for OT, related and OT supported mental health programming using a tiered approach. I've been for about the past three to four years now. CO facilitator of the AOTA school mental health community of practice, we fall under the realm of the Mental Health special intersection and about two years ago I accepted a role on the advisory board of the National Center for School Mental Health out of the University of Maryland, a great group of individuals that are doing a lot of great work to advance comprehensive school mental health. And then at a state level, the Pennsylvania Occupational Therapy Association, we have a mental health task force that kind of encompasses the realm of school mental health as well, looking at state level legislation and advocacy efforts to kind of support this work in schools where we can on a state level. Oh, yeah.     Jayson Davies     Oh, wow. So you are ingrained into it both at the federal and the state side? And it also looks like or sounds like you're working with local districts, even with consulting or whatnot. So you're just kind of everywhere?     Miranda Virone     Yeah, I try to be just I, yeah, I caught myself mildly intrusive, fertilise stuff like because I, I kind of invite myself into those arenas, where I think that OTs should be and try to convince people why we should be there. So I find myself in some interesting meetings sometimes. But, you know, it's all part of the advocacy work that you have to do to get the word out and to take to take your profession to the places that it really should be.    Jayson Davies     Yeah, and, you know, to be honest, I think any good advocate would say that you're right on target with that, like, you kind of have to be intrusive to be an advocate a little bit, sometimes that shoot from the hip and ask questions later, mentality gets yourself into a meeting, and then you get to figure out what you're doing once you're in the meeting. So yeah, just thank you so much for joining us. And really quickly, I do actually want to give you Miranda, just a quick moment to actually talk a little bit about your previous experience with school based occupational therapy.     Miranda Virone     Yeah, I was a school based practitioner for about 10 years in the State of Pennsylvania, during that time, direct services I provided. And then I kind of advanced to the point where I was supervising a group of five employees, we had four different school districts, we were providing services to small rural school districts. So there were pretty tiny, but all of the services that we provided to the students at the time, and the very beginning was, you know, strictly through IDEA services students that were identified with an educational exceptionality, we were providing direct support direct services that were, you know, sometimes they were billable services, that we also had a times a handful of students with 504 service agreements that we were providing services for as well. So really kind of under that umbrella of IDEA in the beginning and about five years into it, my interest kind of peeked into, you know, the mental health component of what we were doing with kids, you know, after seeing a lot of, you know, a lot of mental health kind of creeping into their daily routines and education, whether be regulation issues, or some situational stress or kind of issues. I thought, gosh, you know, we need to address this, this as part of what we do. And at the time, and the schools that I was working in, there were really no other services with the exception of school counseling, to provide those types of interventions. And, you know, they were being done more on kind of the universal level, but not necessarily targeted, or intensive approaches. So, you know, I just started digging around seeing what was out there seeing what available supports or things that were already existing and practice and hooked up with Su basic, which, you know, is kind of notorious in the world of positive mental health and OT, right.     Jayson Davies     Yeah.    Miranda Virone     Just from there just took off and went running with the concept of yeah, this is what we do. And if anybody's ever talked to sue, she's incredibly empowering. She'll make you feel like you can ride a unicorn to the moon, So.    Jayson Davies     Yep, yep, definitely no, Sue. Well, she's been on the podcast. And she's actually speaking with our OT Schoolhouse collaborative membership very soon. So always excited to have Sue on and I don't think you can even talk about mental health and occupational therapy without bringing Sue into the conversation. Every moment counts, that entire organization is just fantastic. So we're very lucky to have someone like her in the profession.     Miranda Virone     Okay, great.     Jayson Davies     All right. Well, we are diving into the world of mental health and school based OT here. And I first want to kind of ask you both, and we can choose who takes this one on first. But you know, OT really started within the world of mental health over 100 years ago. And when I went to school, you know, a little over a decade ago, mental health was really disappearing as mostly phys does. We have school based OT, but we're starting to see that resurgence of mental health into the world of occupational therapy. And Miranda, you kind of started down the road a little bit. So maybe you can take this one first. But why is it so important for you to really bring OT and mental health together again, especially as a school based therapist?    Miranda Virone     Yeah, definitely. It is. You're right. Jason, it's our roots. It's who we are. It's the fiber of our, you know, our beginnings of, of OT back 100 years ago when we saw returning soldiers from World War One and at the time, you know, They were experiencing what we refer to as shell shock, which now we know is PTSD, right? So we were enabling these soldiers with occupations as a means of doing and being becoming right and putting some very famous OT practitioners out there. But we gave people a sense of purpose or use of their hands. And in that respect, where we were addressing the psychological components of what they were experiencing, by allowing them to feel meaning and purpose in the daily occupations of their lives, and it's no different today, we talk a lot about how we use our occupation based lens to provide supports and services and interventions to the people that we, you know, we serve, and you can't separate that, and we learn in school. It's a biopsychosocial approach, right? We are holistic practitioners. And that is the absolute truth. And, you know, deviating from that, over the last 100 years has really kind of been a source of kind of the, you know, I personally think it's like a socio political kind of impact, right. And aid can attest to that a little bit more. You know, we saw in the 60s and 70s, deinstitutionalization, they had people spread into into the community, but we had no means of supporting them at the time, it was kind of a disaster happening in the world of mental health. And we lost a lot of footing in that sector. And I think we're realizing with current trends and mental health that we need to return to our roots, we need to become part of that response in the workforce to the growing mental health needs, especially among our youth.     Jayson Davies     Yeah, absolutely. And I just posted on social media the other day that, you know, whenever you work on mental health with the student, I truly believe that you're working on every single IEP goal, and then some and so I absolutely believe that we need to focus more on mental health because, yeah, you know, a famous quote, right, like, and I'm gonna butcher this, but just because a student has increased fine motor skills doesn't mean that they are going to be able to handwrite just because they have increased, any sort of, you know, the those minor detail performance skills doesn't mean that they're actually going to be able to function in real life. But I think with mental health, right, like that is such a baseline that everyone needs mental well being in order to do all the things. And so I want to jump to you aid now. And why do you feel that OT is the right profession, especially within school based OT, that's what we're always talking about here on the podcast. But why is OT the right profession to address mental health.    Abe Saffer     So I'm going t o admit that I'm biased here, because, you know, obviously, my paycheck comes from AOTA. But that all being said, as I've mentioned before, I am the biggest fan of the profession. Mental health, for me is something really personal. I've had family members that I've dealt with my own self, I've dealt with mental health stuff in my life. And so for me, I don't feel like there's anything more important for children, especially as the father of a child was in middle school, like, the idea of a child having healthy being, you know, mentally healthy is just really important for so many different reasons. And OT has this magic where they can, practitioners can really address things more than one thing at once, which I love. And so you can say, I use myself as an example all the time, as someone who has ADHD with anxiety, if you're able to have someone come in and work with me, which they have, it's all been for free, because it's been folks that I have meetings with, and they sort of give me tips here and there that I've picked up over the years, but they helped me get organized, which lowers my anxiety. And it's so rare that you're able to get both of those things. And so whenever I see my son feeling anxious or nervous about being around friends, or not knowing, you know, being embarrassed if he can't, if he's not as good at soccer, or whatever, as someone else, like I can understand how that can impact his day to day life and how that can impact his growth and sort of the his trajectory. And OTs is, again, magical profession that can not only help someone participate in their life, but in a way that they feel good about it. And I just imagine if we hadn't just gone, you know, probably still somewhere in the middle of a, you know, dealing with this global pandemic, pre COVID We still had a mental health crisis. And if you can bring, if you can inject professionals into a problem that they can, you know, accomplish more goals than you even realize was possible. Like, I'm all for that. And it's only gotten, you know, gotten more intensive for me since since the pandemic.    Jayson Davies     Yeah, yeah, I know, we'd like to say, right, that we're in a mental health crisis now. But like you've said, you know, it's, it's extended before the pandemic, definitely. And so, yeah, I mean, we're very fortunate in the sense that ESA came around in 2015. I know we're gonna dive more into that. And ESA it's really about serving all students, not just those on an IEP. And I think that definitely plays into a role of what we're going to talk about. But before we get into the kind of how to address mental health as a school based OT, let's kind of talk about what it actually looks like to address mental health as a school based OT practitioner, and Miranda, I think this might be the perfect place for you to kind of come in and share what you've done and kind of what it can look like when a school based practitioners supporting mental health or either an individual student or maybe even a larger population.    Miranda Virone     Yeah, definitely, there are definitely ways that OT practitioners can provide those mental health interventions to students that are currently on their caseload Absolutely. And it is supported through IDA, because we understand that our kids with educational exceptionalities actually do experience a higher incidence of mental health disorders than compared to our regular ed population. So you know, that is built into the IDEA system, when we're working with kids on caseload, we can integrate mental health strategies into our goals and into our interventions. And that's something that we should never separate even we're working on collaborative goals, which is really what we're trying to strive for now, in school based practice, right? But we look at those social emotional skills that are happening within the classroom, we can collaborate together on those using some of our mental health intervention strategies that, you know, we're taught, and we're grounded in through our education and through our history. So it's absolutely we are capable of doing this work. Now with that kind of caseload approach that is happening a lot across the United States. So it is possible. But obviously, we want to shift when we can, and in some ways to making things you know, more workload based, ideally, there's a lot of talk of that going on right now in AOTA and across the nation, because our OTPs are just in school based practice there, they are overworked, we acknowledge that it is a real problem. And, you know, we're looking to AOTA to provide us some guidance with some ratios and numbers and caseload workload data in the future. So, you know, if we take that workload approach, we have the ability to really serve under both of those umbrellas, you know, we have the ability to serve under ide a, with our traditional approaches, because we have kids that have those needs, and we need to make sure we're addressing those, and we have the ability to put our ESA hat on and serve the general school population. I would love ideally, to see kind of like that 50/50 model where 50% of our time is spent working under the IDEA and 50% is spent under our ESA hat, where we can provide those tier one and tier two, universal and targeted support throughout our schools with some of these programs that are embedded into the natural environment. And that's so occupation based, right? Those programs that can happen at recess, during lunchtime in the cafeteria out on, you know, the playgrounds, wherever, wherever our kids are, together and engaging in, you know, all those aspects of occupation that happened at school social participation, you know, health management is happening at school, like leisure, it's all happening there. When we can't just single it out it only being education that's happening in the environment, because all of those things are what makes the education successful. Right. So I'd love to see the ability for us as OTPs in schools to wear both of those hats successfully. And to have the support, we need to do it effectively.     Jayson Davies     Yeah, and if I ask you really quickly, just in a quote unquote, ideal world, what might a tier one and tier two Mental Health Initiative look like?    Miranda Virone     Yeah, so those will be universal support. So those are school wide programming, programming or services that we can either provide ourselves or we can collaborate with, among other team members in their schools, such as the school counselors, or school social workers, if we're lucky enough to have those in our district, right? Even our school if we have some mental health counselors in our schools, which is just absolutely fabulous to see that happen. But it can be individual types of approaches where, you know, we as a loan profession are targeting some needs. And I love to start with like some mental health literacy programs or some emotional literacy programs for the real little ones, pre K, kindergarten, first grade kids. Those are great universal programs to start with. And then you know, moving up to tier two, we can get some targeted groups together or working on small groups within classrooms on some of those social emotional skills. We can also talk about I love talking about social inclusion. I think that's a really great tier one and tier two strategy, especially in small groups. We talked about how to include people, and how to be sure we're not intentionally or unintentionally exploiting people. So there's a lot of different ways that we can be involved in those tier one and tier two strategies through MTSS. You know, they're, they're wonderful. It's just finding that place to start Right.     Jayson Davies     Yeah.    Miranda Virone     that's always the challenge. How do you get started? And you know, I'd love to share some ideas about that with everybody today.    Jayson Davies     Yeah, I love that and excited to get into that, especially the idea of OT supporting inclusion from an RTI MTSS model, like, how often do we talk about inclusion within an IEP about a single student, but then we do nothing other than trying to push that student into a classroom to actually support that student in the classroom. Like, we need to be talking to the general classroom, the entire school, about how to support this student and all the other students in the included classrooms, as opposed to just like, send a one on one aid and with this one student, and just magically, everything's going to be better. So, before we move on, I do just want to ask you really quickly for the OT practitioners out there, they say, you know, I kind of addressed mental health, but I don't have a specific goal to address mental health, you know, for my students on an IEP. So from your perspective, what does it look like to actually support a student on an IEP via mental health type of services? Does there need to be a specific mental health goal? Or is it just kind of something you do every day?    Miranda Virone     Yeah, I think that incorporating mental health interventions and strategies is a natural pairing with any intervention strategy that we attempt that does address goals that students might have, whether they're collaborative goals, or freestanding goals. When we think about our interventions, we can choose from a wide array of things to address those goals. We are not pigeon holed into something very specific, like we can not just do handwriting, because we have a handwriting goal. So we can only address handwriting, if we want to address the mental health component that is associated with maybe the handwriting struggles, because that child can't keep up with the handwriting challenges in the classroom, they feel excluded, they feel isolated, they feel embarrassed, you know, turn that handwriting opportunity into a journaling opportunity where that child gets to express their feelings and emotions about those situations, turn it into some sort of an artistic expression activity where the child can draw or create something through your interventions that expresses what they're feeling, or what their world might look like, if everybody else understood a little bit better, or push into that classroom, and address some social emotional topics during a group handwriting activity in the classroom. There are so many different ways, we just have to be willing to think outside the box, push a few little buttons here and there and get some buy in, always look for that one person in your school that's willing to give you an opportunity. That's a great way to start establishing some buy in with your partners in the school setting.    Jayson Davies     Absolutely. Thanks for sharing that. Yeah, I really think that we need to inject mental health and just about to every session, like we can't just ignore mental health, like it is really a backbone of every single thing that a child does. And you know, if their handwriting impacts them in the classroom, then you can bet that there might feel a little self conscious about their handwriting. I know I did as a kid, and I'm sure there are others that feel the same way. Alright, Abe, coming back to you now, because we're going to talk a little bit about government affairs. You already talked a little bit about how the mental health crisis was here before the pandemic, but obviously, during the pandemic, like mental health was actually on the news much more often. What does that look like in DC? What are you seeing at the legislative level when it comes to mental health? It sounds like it's more of a buzzword in DC. Is that the case right now?    Abe Saffer     Definitely more of a buzz word on the Hill in Congress where things are very contentious. When you talk about mental health, it's one of those bipartisan issues where people on both sides will agree oh, we need to do something. And actually Congress in 2020, to pass the Safer Communities Act, which to show you how much of a bipartisan issue mental health is and how big of a priority it is. The Safer Communities Act was in response to the mass shooting at Uvalde, Texas, which was, you know, horrific. And Congress, in its way, Congress passed the largest, most expansive gun control legislation in 30 years. But on top of that, it also included a huge amount of money and funding and support for mental health in schools. And so it's so it's such a big deal that this is something that is uniting folks to do actually make a change and do something. On the mental health side. It's, you definitely see a lot more folks that are lobbying, talking about their role in mental health, but because we've been doing this and why we I mean, OT, AOTA and practitioners have been doing this for years prior. We sort of have a little bit more credibility on that and we can talk about it because we have that long history of mental health and the profession. You know, it was 2016 was one of the first times I don't, I can't confirm. But I think it's first time in a either a long time or ever that like federal legislation actually included, was included to or amended to include OT into it. So it was this behavioral health workforce program through HERSA. That actually added OT to it. And since then you just sort of the way because he works in policies, you just build on past successes until you can get to a place where, you know, hopefully you want to be and that's sort of the way it works. And so, you know, in the last now, it would have been eight years since 2016, where we've made a ton of progress. And since COVID, it's just been taking off, like we've been able to make leaps and bounds because first of all, there's just such a huge need. So even, you know, I hate to talk about like turf wars, but that was sort of a DC reality. But now it's like, there's just such a huge shortage of mental health professionals in general, and school folks in general, that when we do talk about this, there's not as much, you know, no, that's mine, or are you stick to yours, that sort of thing, it's if someone can help in a way that, you know, that they're trained to help, please come in and help, like, we need all of it that we can get. So it's definitely become one of those huge issues in DC, as well, you know, at the state level, and I know that schools are talking about it, as well. And I think over the next couple of years, we're gonna see a lot of change related to it. And we'll just, you know, hope to keep it going on a positive trajectory.    Jayson Davies     Awesome, awesome, man. And you mentioned that, you know, national shortage of mental health providers, and I've actually ran into some OT practitioners across the, across the spectrum, and they really aren't sure if they are a mental health provider. And I think that's not uncommon. I think a lot of us question, right, because like, we're an OT, we didn't necessarily get a lot of mental health training as a therapist and OT school, maybe we haven't gone to a lot of mental health trainings, do we still constitute as a mental health provider and who judges whether or not that's accurate or not.     Abe Saffer     So in the policy realm, there's a bunch of different judges, most of them will look to the states. And so I'll talk about one mental health grant that the Department of ED releases, so they released this every year, they announced that every year, it's called the mental health service professionals demonstration program, or MHSP. And it's one of the few if not the only, like specific workforce grant for mental health, that the Department of Education administers all the rest are usually done through other agencies. Okay, so it got supersized with the Safer Communities Act that I mentioned, and went from roughly 100 million dollars a year to 500 million on top of that 100 million in 2022. And so, in that grant, it specifies and sort of this is the common theme when I talk mental health in schools is the grants best four buckets of eligibility, and it's schools, school counselors, school psychologists, social workers. And then number four is sort of the catch all in any other profession that is eligible to provide sorry, allowed by state law to provide mental health services to children. And so while there's a, you know, a federal law, or, you know, definition of what mental health providers in school looks like, because they, you know, they look to, they include three professions specifically, and then this catch all, they want to make sure that they're getting as many folks as possible. And so, because of that, in 2022, we were able to get a couple prob, a number of programs to apply for this mental health grant. And two of them got it. And that represents the first two programs that have ever gotten any, like, mental health education funding from the Department of Ed, like specific for just mental health. And both grants totaled about over almost $10 million. One was in Texas at the University of Incarnate Word, and the other one was in Minnesota, with the College of St. Scholastica. And it's just been, it's just been incredible. And I shared with both of you just as we were starting up, but the Department of Ed actually released new guidance on this grant. And there's two or frequently asked questions and one of them is is OTs eligible? And they said, Yes, OTs can apply for this can be eligible for this, as long as their state law says this, and I had the pleasure and honor of going through every single state Practice Act that defines the scope and every single one of them includes either cognitive psychosocial or psychological. So we are and by we I try to be cool and put myself in the category of a practitioner, but OT is eligible in every single state as a mental health profession. And if anyone ever says well Why, you know, if OT should be included? Why not X, Y and Z, you can say, look a state law, like, if they say that they should be a mental health professional and their scope of practice is defined by the state law, like, then yeah, we need all the help we can get and let them bring them in. But if they don't, if they're not, if that's not included in their scope, like, that shouldn't be part of their their efforts.     Jayson Davies     Well.    Miranda Virone     I'd love to answer this from an educational perspective to Miranda, like, I would love to just jump right in because that, you know, acknowledging the government's view, right, and federal legislation and language, and then state level language that's in our, you know, our not only our practice acts, but also in state level legislation is so important, but it's empowering to hear that, right? You hear that and you like it's there, we have the language there to support this. And when we go to our educational standards, right are a code standards. You look at how many times psychosocial or mental health is mentioned, in our accreditation standards, it would blow your mind because our educational accrediting body acknowledges that this is a component of who we are, you're never going to separate this from physical, the physical health and well being of individuals, because there's parity between the two, psychological and physical health, and social health are all equally important across the board, because they're so interconnected. So the Educational Standards support that. Not only that, when you compare our educational standards to some of the other acknowledged providers of mental health services, we meet or exceed, and educational standards, what they are seeing. So it is there, we just have this fierce impostor syndrome, we truly do, we don't know where we belong, we don't know where we fit, especially in schools. We don't know what we can do, we don't want to step on toes. But our lens is so very different from everybody else's, that if we can just build the courage to talk about it, and feel comfortable and confident talking about it, we can break down a lot of barriers that way.     Jayson Davies     Yeah, and something that I see here in Southern California, and thank you for sharing about the imposter syndrome, I was gonna bring that up, but you went right into it. So awesome. But something I'm seeing here in Southern California, at least is that we are one of the more easily accessible mental health providers within the schools. Psychologists do a lot of testing, but they don't do a lot of therapy. Getting into a program for counseling or talking to a school psychologist is very difficult for some kids. I mean, you think it's hard to get into OT it's really hard to get, like in touch with a counselor. I mean, there's just, I think that because of that, that shortage, school districts have put up probably illegal barriers to kids getting those services, and at least they can get OT and we can be that quote unquote, Frontline, for lack of better and we're not really frontline and when I call it it, but I mean, compared to the others, were frontline mental health providers, per se. And I think that's important. And like you said, it's something that we do need to embrace ame shared exactly what our state practice x, x have proven it. And like you said, right, we need to get over that impostor syndrome and just kind of take it on. So thank you both. That was a great tag team applaud. All right. So Abe I want to come back to you, because there's something that you have mentioned to me, that has really has kind of like almost made me rethink everything I know. And I think other OT practitioners need to hear this as well, because we always want to kind of blame the laws blame the federal laws that don't allow us to do this or that when it comes to mental health. Are there laws either in place or that just don't exist? That are barriers or facilitators? And you kind of dove into this a minute ago, but just want to give you a second to talk about that?    Abe Saffer     Yeah, no, I appreciate that. Um, I get a lot of calls and emails from OTs and OTAs, from all over the country. And what I found is that the majority of them and I would say I use the, say 99 out of 100 of them. When people are complaining, I can't do whatever X, Y or Z and it could be anything. They sort of asked like what needs to be changed on the federal level. And I say probably nothing like it's usually not a federal barrier that is preventing you from doing something it is generally, if anything, it might be a state law, but more often than not, it's just people who don't understand what OTs is, what it does, what it's capable of, and what federal and state law allows by it. I can't tell you how many times I've heard and so much that it became my number one myth on my myth document. You know, OTs are not a lot of provides services to any student with an IEP, because they're paid entirely under IDEA part B, like, I'm gonna get that tattooed on my forehead, because I've heard it so much. And I would say to them, let's just assume for a fact that you are paid entirely under Part B, which RP accounts for about 3% of national education funding, so the chances of that being the case is very small. Even if that was the case, you're still allowed to provide spent use use about 15%, up to 15% of your IDEA funding for early intervening services, which is a multi tiered system of support services. So there are schools out there that just, you know, Miranda said that things could be different from district to district. And I would just one up her and say, I've seen things that are different from school to school that an OT or an OTA is going from multiple schools in the same district and are dealing with two different, you know, realities. So as, as I've talked about on this podcast, and everywhere else, even dinner with my family and noise them, but where I talk about is that it just it never had that implementation. And so people don't know what a specialized instructional support personnel means what that term is. And it's just the related, it's just the list under the general ed law as the Every Student Succeeds Act that is the exact same as under IDEA. And it just allows for multi tiered systems of support. It allows for OTs, and OTAs, to work in General Ed. And so someone told me, a longtime education advocate a while ago, that something that they said to me, I just I loved. And it was the biggest issue, the biggest barrier that we face is misconceptions that have solidified that schools are so risk averse, which they you know, they, for obvious reasons, and I don't begrudge them at all for being risk averse. Having both my parents be retired teachers, like, I, I'm glad that they are a little risk averse, sometimes. But I will say that there are, that there are things that they have always done. And when you try to change that, you have to provide them with just overwhelming evidence that it's allowed, it's that they're not gonna get in trouble for it, because their administrators are very nervous. So when it comes to the ability to be able to provide mental health services, or, you know, to be frank and anything other than handwritings support in a school, you need to be able to convince that administrator. And the issue is most school based practitioners, you know, I won't say all just because I'm sure there's a couple that are other fine, but probably all, are so busy, that they don't have the time to like, research this and look this up, you know, some of them know to call me and, you know, my hobby at this point is just like helping look up laws, because I'm a lobbyist, I'm confrontational, like I want to win a fight, but they don't have the time to look it up. And administrators are just again, risk averse, and they don't have the time to sort of like, explore something that they're not sure about. They always sort of do what has been acceptable in the past. And so one of my goals for this year, which our fiscal year ends at the end of June, but so it'll bleed over into 2025 is to just develop resources for practitioners, or at least start doing it, to be able to let them advocate and talk about, you know, explain what is OTs role in mental health, explain why they are allowed to provide services, like what Universal Supports, they could actually provide, you know, like, basically just the fact sheet version of Miranda to be able to walk around and say like, this is, folks like this is the this is what your goal should be like, you can go ahead and do that. So it's it's the most frustrating, but it's also the area of my job where I see the most room for progress, because I don't have to get Congress to do anything to change this. And if you haven't been paying attention, that's not the easiest thing to do, do these days is to get Congress to do something even more difficult than usual. So it's exciting. And I do feel like we're right at the cusp of just seismic change in the profession in terms of school base for, you know, practice if we can just harness it.    Miranda Virone     And our advocacy has to start on a micro level, right? I mean, Abe got us he's got us covered at that macro level. But you can't assume that your school administrators know anything about ESA, there's a very strong chance that they don't. So you going to them with this information, maybe the first time they're ever hearing of it, and it can open up a lot of doors. It can open up a lot of conversations too, which I think is fabulous. So don't be afraid to have a conversation. You're coming in with the best interests of your students in mind. That's all it's about. It's not about who's right, who's wrong. It's not about I want to do this and prove to you that I can do this. It's about This is what these kids need. They fundamentally need these programs, they need the skills to build these skills. So they can be successful in all areas of occupation, right, and they can, in turn someday be successful adults too. So don't be afraid to have those conversations again, mildly intrusive, it's okay. It's okay to be that way. It can open up a lot of doors for you. That's why I'm here today.    Abe Saffer     I'll build on it. Just Just one last pitch is that? is absolutely right. Like it does begin on that level. And my plea to everyone who is listening is don't keep it on that level. So if you do have that victory, if you do, you know, if you are able to convince an administrator, let me know, like, I would absolutely love to hear that. Because the more times that I hear about stuff like that happening on the local level, or a state that's doing something innovative, the easier it is, for me to be able to sell that nationwide, whether that's state to state or, you know, on the to the federal government. So please don't keep it a secret.    Jayson Davies     Yeah. And if you need Abe's contact information, he's all over Twitter. And we will definitely have it on the show notes. So or acts as I guess it's called now. But anyways, continuing on Miranda, we've already talked about some of the barriers, age definitely kind of brought it down, kind of put the onus on us a little bit at the micro level. But from your perspective, what you have seen both as a practitioner and in talking to, you know, current ongoing, school based OT practitioners, what are you seeing as the biggest barriers to kind of getting going with with supporting mental health?     Miranda Virone     Yeah, I mean, it's definitely starts with ridiculous case loads. I, I can't not say that, because I know that your listeners feel that pain. And that's the first pain that they feel in practice, you know, and the reality is, you know, the AOTA workforce survey tells us that 25% of our OT practitioners are in schools, they're operating and functioning in schools. So that's a huge component of our workforce. And I think I'm so glad that Aotea is listening to our call, and need to establish some guidelines, some parity in what we're doing, you know, in comparison to other professionals in schools. You know, it's hard, because, you know, how do you advocate for workload approach, you really have to do you know, we talked about time studies, how you can you do this within your school to show what it is that you're doing, and show the overall need of the students in the building, based upon the climate and culture of the school, based upon the increase in mental health demands that are happening in the schools? I mean, gosh, all you have to do is ask for truancy reports, ask for behavioral reports and incidents reports. There's the data right there on a school and district level, that data, right, there is very telling of what's happening within our schools, we do have the skills to support that and we don't have to go hiring another individual to do it, you know, completely, we just need some additional support, we need some additional time. So again, that comes down to that advocacy piece, what can we do to advocate for that workload approach? What can we do to advocate for more time, in our week to address some of these needs that are happening among the regular population, we have to feel comfortable in our own skin, addressing our administrators again, you know, join some of these communities that practice, educate yourself, be amongst the people that share your interests and values, because they're the ones that are going to support you. We've got lots and lots of people out there that are doing amazing things. And they will inspire you every time you meet with them, or surround yourself with them. Even in a virtual contexts. You can take that and use it as fuel for your energy. And also, as you know, collecting data on how to proceed with those things, then the last piece is really funding and he touched a bit on this too, you know, we're talking about either additional hours in a week to address these mental health programs, you know, under that umbrella of ESA, not every school receives any funding from ESA, right. Not every district receives funding from ESA, it's really based kind of on some other methodology. So, you know, ESA provides us with great language. And it provides us with legislation and great support, but it doesn't always necessarily provide us with funding. And in my experience is schools that do receive as a funding, have kind of already appropriated it elsewhere, to ask them to redirect those funds towards some of these OT initiatives might be a little bit of a challenge. So we had to look for other ways to find funding. You know, I think a might have touched on free free care role expansion through ma that's one way that we can talk about that on a state level. You know, we might be asked to find the money to support this. So we need to be creative. We need to practice our grant writing skills, we may need to get in touch with some community agencies and partnerships to help us do this work to and they're out there. I've seen it happen. There are community businesses and agencies that are willing to give money to schools to support these efforts because they appreciate the need and value of what's happening.    Jayson Davies     That's awesome. Yeah. And I know by time this episode gets published, a OTA is having a webinar on grants and how to potentially find grants and apply for grants. But that webinar is likely available on a replay as my guest. And if we can find it, we'll definitely link to it for everyone to watch it. That's a big thing. I do want to dive into so little bit, I don't think we've addressed s fully since episode 91, when he was last with us. We've talked a little bit about ESA already today. But if there was a quick overview of ESA, I don't know who wants to take this one. But just kind of a quick overview and how it applies to school based OT practitioners.    Abe Saffer     That's all AYP. So Essa, for those who don't know, Every Student Succeeds Act is actually the reauthorization that was passed of the Elementary and Secondary Education Act. So the SCA, as it's called, was created in start with first pass in 65. And it created the department of education and public education in the nation as we know it. And so, as with every other major piece of legislation, the Congress sets it up to be nice to be be authorized, you know, regularly, usually every five or 10 years just depending on or even shorter, just depending on what type of legislation it is. But if you're ever if you've ever heard of No Child Left Behind, that was a bill that was passed in early 2000s That reauthorize EFCA. That's a replay replace that. And so when ESA was being debated in Congress, and it was before my time at MCA, but there was a huge emphasis on sort of creating this continuum, this sort of continuum of care for students of services with IDA. And so that's where assist comes from the specialized instructional support personnel, the brand new term that was created in 2015, to be able to say that these folks, you know, OTs OTAs, should be able to provide services in the general ed space. Now, the way that the system works is that the process works is first Congress passes a major piece of legislation, then the relevant agency will develop regulations in order to let folks know how you know, fill in the blank, so to speak. So in 2015, the bill was passed 2016, Department of Ed rolled out new regulations around it. And then what normally happens next is that the agency will say, here are some documents that aren't law, but it's like us, trying to make it easier for you to understand what the law says, which is called our guidance documents. That would have happened in 2017. And at that point, it was a new administration that took over for the Obama administration. And they just weren't got, they just had even told us point blank as one of my first things meetings I had with the Department of Ed, in my role, they said, This is just not what we do. And so we're now seven years, eight years, almost no, sorry, nine years from when si was passed. And there's never been a guidance document released that says, This is what this brand new term is, and why it's such a huge deal. You know, most, most OTs and OTAs. And states are usually under the Office of Special Education. And if not, it's usually the office of Pupil services. And pupil services isn't a thing anymore. And it's just states haven't made that change and districts don't know. And so I am happy that I'm proud to be able to share and I'll make sure we can link this for your folks, Jason. But the National Alliance of specialized instructional support personnel, the Coalition of all the professional associations that represent all these professions, as well as the teachers unions and the principals and the special ed administrators and a lot of others, we came together and worked on guidance, because if the department isn't going to release something, we wanted to make sure that states had that, that they had that tool at their disposal. So we have that on an Asus website now. And folks can can share that as widely as they want. It's, it's hot off the presses. So that so to speak. But essay is here until it needs to get reauthorized, which could be could be any year, but it might have come and gone without anyone really knowing it. But the policies within it, I think are here to stay because they really were intended to allow for a lot of flexibility, making sure that schools and districts weren't told what to do meanwhile giving them options. And I think that a lot of districts when they find out about it, love that.    Jayson Davies     Yeah, yeah, I'm looking at that document that from NSSP that you just talked about, and I'm just looking at some of the titles, the subtitles, and we're talking about school climate, chronic absenteeism, bullying, discipline, mental and physical health. I mean, these are all I'm pretty sure there's been a topic or a podcast episode on the daily and many other the most popular podcasts out there on each of these topics because they are such a big thing right now, within schools. I mean, I know the daily just the other day had one. Absenteeism, like 28% of kids chronically absent. I mean, it's just amazing. So I love that the NASSISP, sorry, nassisp. Is that how you say it Abe?     Abe Saffer     It is, it's a great term, but it does not roll off the tongue very.    Jayson Davies     But yeah, I love how they're basically just correlating everything that is research based and hot right now, and saying, Hey, we've got all the people right here that can address those things. And here they are. They're all under this term. They're all under this umbrella. And they're available. So that is awesome. All right. In this episode, we have talked a lot about the problem. We've talked about the problem from many different angles. And I want to spend the last few minutes here talking about how we can be the solution we dipped in dabbled a little bit in that over over the last 45 minutes. But I really want to talk about starting from the ground level school based OT practitioners who are excited to say, Hey, I'm assist, I can work on mental health or I'm a related service provider, I can work on mental health and a one on one setting where they can get started with that. And so if we start with what I think is the potentially the most easy to understand the most palpable because I think we're all doing that is those one on one services, IDE related services. So maybe Miranda, if you want to take this? How can we just start to get into the world of mental health and working with our one on one students?    Miranda Virone     Well, think about it this way, right? We don't have to define where we're working with those one on one students what environment that's happening. And we know what's happening in the walls of the school, but it doesn't mean we have to take them out of the classroom, and take them into a therapy room or a hallway or a closet for some of us, right? It means that we can work with them in their natural environment, their natural environment, is the classroom. It is the cafeteria, it is the playground, all of those environments within natural environments for the students that we work with. So we can go into those environments. And again, as we talked about before, it doesn't necessarily mean that we are only addressing that particular student, we might be addressing the whole classroom, who responds to that student and interacts with that student, those one on one services are still reflective of that embedded approach where we can go into the classroom and address the needs of one student and inadvertently dress the address the needs of the entire classroom, right, which is really cool. And that's a way for us to show. Our educators and our faculty in schools are distinct value. And when you do that you get buy in. So if one classroom teacher sees what you can do and your capability, you know, when you're really focusing your efforts on one student, but every student benefits in the classroom, that's still an intense target an intense intervention, that's still tier three support, you're still working through ide a to provide that services, students still billable, you can still bill for that service, you are just choosing the context in which you're providing that service in. So think about it that way and your documentation, your documentation has to be reflective of that too, right and supporting why it's necessary to provide that in that environment. So that's definitely where to start. When we're talking about one on one services.     Jayson Davies     you will follow up really quickly. A lot of therapists I find get hung up on the idea that a goal must be academic ly relevant. And then we talk about services that are taking place outside of the classroom outside of the OT room, out on the playground, cafeteria and whatnot. How would you address that?    Miranda Virone     Yeah, definitely. So the purpose when you create goals where you collaborate on goals, it is the success of the student in the educational environment. That's what Id EA is looking for. So what contributes to that success, right? It's not just education, specific focus, it's also social focus. It's also leisure focus of play participation, all of those factors contribute to educational success of that student. So use your OT lens, use your occupations. If you can justify it in your documentation, then you've done what you need to do. And so just go back to making sure that you're justifying what you're doing. And you're supporting it using that holistic lens. That's, that is what we do. And ide a acknowledges that we are related service providers with a distinct set of skills. So that that's already in place. They know that you just have to document it as such.     Jayson Davies     Yeah, and then one more, if I may, because we talked a little bit about documentation. I think therapists are a little scared to use the word mental health or the phrase mental health within an IEP because they're told you're the fine motor. They don't want to use it anywhere other than maybe on those more internal treatment plan document or a soap note. So should therapists have permission to use mental health on an IEP to use that term? Or should they? Do they need permission? Or, like, how do we get over this fear of like, I can't use the word mental health?     Miranda Virone     Absolutely. Well, the reality is, you know, we are not died, we cannot diagnose, right, we cannot diagnose a child with a mental health disorder, we may not even have the kids that are on our caseload may not have an identified mental health disorder, but you may have symptoms, that we might be helping them manage their symptoms. So think about it that way. So when we see, you know, the mental health symptoms that we see externally, and sometimes they internalize them, too, right? Those are what we call psychosocial factors. Those are how they influence these are the mental health signs and symptoms that influence their ability to interact with their environment. So when we revert and use that language, that's very much within our scope of practice. And that supersedes all practice acts, all, you know, that's within all of our federal language. So if you use that language, it's very supportive of what we do in our profession, and then we're not encroaching upon any potentially questionable language use.    Jayson Davies     I love that. That was like the perfect answer. I think we all need to just internalize that and remember that we have all this language to fall back on to support ourselves. So great, thank you so much. All right. Now if we go a little bit more broad, and someone is thinking, You know what, all right, I got the I got the one on one sessions. Even in some group sessions, I'm addressing some psychosocial factors. Beyond that. Now, I want to start getting into the MTS s s around and supporting larger groups. How can I get started?    Miranda Virone     Yeah, so you've, you've done some push in, you've done some embeddable strategies with maybe one of your one on one students, you've created this great rapport with that classroom teacher, you build this relationship, you have wild that teacher with your abilities. That's your buy in, right. Yeah, that's your person. So now you say, Hey, would you mind if I came into your classroom and did just a little segment, 10 minutes on emotional literacy? What do you think about that we're going to identify emotions, we're going to talk about what emotions look like, what they feel like, how to manage these challenging emotions. I can't imagine too many educators that are going to say, No, emotions aren't a problem in our classroom. Right. So that's just a way to get that small by and start with the littles, right, your kindergarten, first grade, they love having people come in, you know, there's a lot of energy in those classrooms. So having even a 10 or 15 minute reprieve, by having somebody else come in to do some programming is usually fairly welcome. So that's a great way to start. And then work your way up, you know, work your way up through your intermediate schools. And then you see all these great things happening, you start collecting some data, right, just some easy simple data, using maybe an exit ticket with the teacher on the, you know, the climate of the room, once you leave, or maybe some changes that they see in the next couple of hours after you've left the classroom. Or if they see any strategies that kids are starting to use independently after you've taught them to the classroom. That is great evidence right there that what you have done is supportive and effective. And then you can present this information to the administration. Look what I've done. This is all the great stuff that is happening just in this one classroom. Imagine if I could do this in the entire school. Right?     Jayson Davies     Yeah, All right. There's gonna be some people if I don't ask you about exit ticket and how that worked.    Miranda Virone     Yeah, exit ticket is really just kind of a little survey that the classroom teacher would take, you give a couple of questions. So you're not collecting, you know, that's not research data. You're not collecting, you don't need an IRB to do that. Right? You're just collecting some survey data from that classroom teacher on how things went, what they liked, what we could do differently, and then maybe follow up a day later with another survey, asking, you know, some getting some qualitative information. What strategies did you observe your kids using after I left or the day after? What has what carryover has occurred since we met last, and that is great information that you can take to your administrator, you know, the proof is in the pudding. Right? Right there it shows you some great solid evidence that your efforts are working.    Jayson Davies     Yeah, and I personally, I've just found that once you get in with one teacher, you never know what's gonna take you. It's amazing, right? Like you really do meet that one teacher because you had one student in their classroom. And now because you know that one teacher now you know, the one administrator and because you know, the one administrator, you know, the one district level administrator and the next thing you know, they're asking you to do an entire presentation to all the kindergarten teachers on something because they've seen you kind of go through the ranks and just help everyone so absolutely. All right, I want to come back to a but really quickly and ask kind of your last minute thoughts at the end of this podcast on individual OT practitioners being able to advocate for themselves and to work their way up within the realm of mental health at individual school.    Abe Saffer     Yeah, I think it's a great, great way to sort of end it. But my colleague, Jill has a fantastic way of saying this, where she wants people to advocate up and out. And that is the way of saying, you know, there's advocacy is not just one thing, it's not just what I do, or what people do, you know, on a grassroots level, there's advocacy is trying to get laws changed, or, you know, on the federal or state level advocacy, is trying to get something changed in your school, to be able to say, I want to be able to do you know, this intervention. Advocacy is also about trying to convince a client or a parent of a student to accept your plan of care, like, those are all advocacy. And so as you're looking through this, and as you're looking through your day, I would say that efficacy is also telling people what occupational therapy is not just parents and teachers, but friends and family, because the more that people know about it, the more that people can understand it, even if they don't understand the full scope. And I will say, I do not have any OT training than an AMC for seven and a half years, I think I have, okay, understanding of the profession. But there's still things I learned constantly where I'm like, Oh, you can do that, too. That makes sense. So just being able to sort of share that with as many people as possible, because when you find people that understand occupational therapy and are pushing for it, then that's gonna lead to policies being created at the, you know, the building level or the federal level, that are working to try to make sure that OTs and OTs can do what they do. You know, Miranda talked about workload, and caseload, and that's something that is, you know, is extremely important. And we're trying to find a way to be able to sort of start to move in that direction of workload without, you know, just not dumping a ton of extra work on folks right now. But we're also worried about, we want to make sure that like, there's such a demand that that, that schools are willing to say, in order, while we're changing this, we're going to figure out a way to make it as easy as possible on you. And so advocate to everyone, you know, talk about it at the Thanksgiving table, talk about it, and you're in line to the grocery store, talk about it anywhere you can, I can tell you that there's been a few times where I've been able to advocate it not in an official capacity, but just like talking to my family and friends about this. And it's it's everyone, I think, who who graduates from a program understands how amazing their profession is, and share that with others, because you want to make sure that they it's not just being kept a secret. And that way, selfishly, it makes my job easier. So that's, you know, a lobbyist is kind of one of my defining traits, but like the idea of being able to go into a meeting and say, Are you familiar with occupational therapy, and then say, well, I've never had it, and I'm not only but like, my cousin down the street has it. And, you know, I know, three or four OTs that I'm friends with. And so they've talked about it. That is such a much different meeting for me than if I go into a meeting. And they're like, no relation to it at all. And I started talking about it, and then they say, oh, yeah, my grandmother got that. Or my, my son got that you're like, yes. So talk to everyone about it never stopped bragging. Like, it might feel weird for you. But it might be the difference between someone in your life getting access to OT and that, and it might be the x the difference between them having independence and success. And that, and I want to look at any case studies Look at me, like I view myself as the product of OT. And it just happened to be that that OT was my boss. So please, just advocate everywhere you can. And tell me about it, too.    Jayson Davies     Yeah, you know, and we as as especially a school based OT practitioners like to almost brag that our bosses know nothing about what we do. And that shouldn't be the case. And the onus is on us to explain to them what OT is. And you might have to do it three, four or five a dozen times before they really understand. But we also shouldn't shy away from making sure that they understand, especially when they're our own boss. I like to say that with one of my previous special education coordinators who oversaw occupational therapy, we had a love, hate respect Um, relationship, you know, like, by the time I was done there, I think she understood OT a little bit more than she did when I got there, she would often become frustrated by me because I would kind of point to research or I would point to Ida sections. But that also helped her to better understand OT. And to a point, eventually, she would just look to me and say, Jason, I know you have the answer to this because you kind of do your homework. And she understood what I knew and what my profession was at that point. And yeah, there was that there was definitely that that respect for one another, too. We butt heads occasionally. Yeah, because we were both advocating for what we knew was right for kids. And that's okay to butt heads a little bit. But we had that respect for one another. And I think that kind of that kind of goes hand in hand with advocacy, I think. And so as Miranda put, it, what was the term that we were going with for the podcast term? intrusively, mildly intrusive?    Miranda Virone     Yes, mildly intrusive, you gotta be mild it. And the last, I just can't say this enough. Find your people, right? Find your people, the school mental health, community of practices, a great way to find the support that you need to do these things, you know, ideas and language and law. It's all there in that group. So if that's something that you are passionate about, you know, find your people to help you pursue it. It's a really great community of practice. There's a lot of support there a lot of networking, that happens as well. So I would strongly encourage you to get involved that way.     Jayson Davies     Absolutely. All right, well, I think that is a great place for us to wrap up today. Eva, Miranda, I want to thank you so much for spending the last hour or so with me really appreciate it. And I know so many school based OT practitioners are going to listen to this and just feel a lot better about where they are in their schools and how to provide or get started with providing mental health services. So thank you so much. I really appreciate your time.    Abe Saffer     Thank you for the opportunity. Yeah, thank you for all you do.    Jayson Davies     Thank you appreciate it. All right, thank you one more time, Miranda and a for joining us and sharing your invaluable insights into the integration of mental health and school based occupational therapy, your expertise, your dedication to advocating for and advancing this crucial aspect within occupational therapy is truly inspiring, and we cannot thank you enough. To you our listener, I hope this episode has enlightened and equipped you with a new perspective on maybe just how mental health is so important within the realm of occupational therapy, especially in the setting that so many of us work in the educational setting. Remember, as OT practitioners, you're not just addressing tasks, you're addressing the student's entire ability to access their education, mental health included. If you found this discussion helpful and you wish you could get even more support. As a school based OT practitioner, I invite you to check out the OT School Health Collaborative at OTSchoolHouse.com slash collab. Inside the collaborative you can earn a certificate of completion for listening to this very episode, and access further resources and support related to today's important topic. Our collaborative community is tailored to help you succeed and thrive and your practice providing you with the tools and community you need. Earn see us review the research and receive mentorship all year long at OTSchoolHouse.com slash collab. Thank you again for tuning in to the OT schoolhouse podcast. We're grateful for your continued support and eagerness to grow in your OT practice. I look forward to having you join us again on our next engaging and educational journey. We'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 OT school house.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! 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Click on your preferred podcast player link to listen wherever you enjoy podcasts . Welcome to the show notes for Episode 151 of the OT Schoolhouse Podcast. Discover how the 3-to-1 service model can transform collaboration among OT, PT, and speech providers, streamline evaluations, and enhance communication with teachers and parents.  In this episode, we'll dig into the scheduling and IEP logistical concerns that come with this model and explore strategies for successfully implementing it, including writing services onto the IEP.  Stay tuned as we uncover the impact of the 3-to-1 model on IEPs and highlight the importance of flexibility and creativity in delivering effective school-based OT services. Listen now to learn the following objectives: Learners will be able to identify the differences between the 3-to-1 model and the traditional one-time-a-week direct service model. Learners will identify the key benefits of the 3-to-1 service model in enhancing collaboration among OT, PT, and speech providers. Learners will identify strategies to manage their caseload effectively during flex weeks. Guests Bio Kristina Geraghty is an Occupational Therapist whom has been working in schools in New York and New Jersey for 14 years. She also does private work at a sensory gym after school. In 2018, Kristina started an online education business, Therapy Advance Courses, with her co-worker Lauren Catalier, who is a speech language pathologist. They founded this company after trying to find graduate courses that enabled them to move on their salary guides at their full time school job and realizing there was a need for affordable courses that were relevant to school based therapists. Quotes “Bringing the IEP to life, you're able to really go in and implement those things that you suggest.”  — Kristina Geraghty, MS OTR/L “I think going to the therapist first and getting them on board with this model is going to be key to keeping it going and giving it that ammunition that it needs to get implemented in more and more schools.” — Kristina Geraghty,MS OTR/L  “The whole point of us doing this therapy is to get these skills to translate over into the classroom." — Kristina Geraghty,MS OTR/L  “Just being a little less afraid to ask questions and say, how can we get creative? We get creative in our therapy sessions every day. So, why not get creative a little bit in how we are creating these IEPs." — Jayson Davies, MA, OTR/L “I do it 2 to 2. I really like this one, because it allows me to get into the classroom a little bit more, but still allows me to have that individual session." — Jayson Davies, MA, OTR/L Resources 👉   3 to 1 Model -Free resource  👉 Other Free Resources 👉 Inspired Treehouse 👉 Dr. Bev Moskowitz Episode Transcript Expand to view the full episode transcript. Jayson Davies     Hello and welcome to another episode of the OT schoolhouse podcast. I'm your host Jayson Davies. And today we're discussing a common term in the world of school based OT. That often seems like a pie in the sky dream. You are likely familiar with the three to one model as a concept. But today we're talking to a therapist who works at a district actually implementing that three to one model. Kristina Geraghty is an experienced occupational therapist currently thriving in a collaborative district, where the entire OT and SLP team operate under the 321 model. That is exactly why I invited Kristina onto the podcast to share her insights on managing her caseload. While navigating the challenges and benefits of the three to one model. We'll explore how this unconventional service model can enhance collaboration among OT, PT, and speech providers, streamline evaluations, and even improved communication with teachers and parents. We'll also discuss the scheduling and IEP logistical concerns that sometimes arise with a three to one model, and how you might even write the services onto the IEP. So stay tuned as we uncover the strategies for successfully implementing the three to one model. Its impact on an IEP and the importance of flexibility and creativity in providing effective school based OT services. Let's jump right in. Here's Kristina.    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's your host, Jayson Davies. Class is officially in session.    Jayson Davies     Kristina, welcome to the OT, schoolhouse podcast. It's such a pleasure having you here today. How are you?     Kristina Geraghty     I'm good. Jayson, how are you?     Jayson Davies     Doing fantastic. You know, we're just talking about general location. You used to be here in Southern California like myself, but you are now in New York. How are things in in New York area?  are    Kristina Geraghty     Are pretty good. You know, we have a summer like day today, which is great. I grew up here. So I only lived out in Cali for a couple years. But my whole family's back here. So things aren't good in New York.     Jayson Davies     Yeah. And have you worked as a as in like, the pediatric school base realm in both states or more one versus the other?     Kristina Geraghty     Yeah, I was not an OT. When I lived in California, I was very young. I was in my early 20s. So I was still finding my way at that time. And I became Yeah, I became an OT. When I when I moved back here to New York.     Jayson Davies     Yeah, I just really love talking to people that have practice in like multiple areas, because you really get to see like the differences and especially within school based OT, you know, it's very different from state to state, even county to county, heck, the same schools, and or two different schools in the same district even be so different. So it's always interesting just to talk to people from different areas. I love it.     Kristina Geraghty     Yeah, that is true. Well, I've worked in New York, and I've worked in New Jersey, and even though we're right next to each other, very different.     Jayson Davies     Yeah, yeah, I hear you know, I'm definitely on the other side of the country. But the whole contracting versus district employed, I know is very interesting in that realm. And I think that's going to tie into a little bit about the three to one model, as we're going to talk about today. So we won't go too far into that. But yeah, I would love to just learn a little bit more about you and your school based occupational therapy and just your occupational therapy background in general as we dive into this, so please, where are you in your, in your OT world today?     Kristina Geraghty     So I'm in my 13th year of practice, and I have always been in school based practice. So I when I graduated school, I was pregnant. And so I had my first child, and started my new career all within a few months. So it was a little bit crazy. But I definitely wanted to go into school based practice. You know, being a new mom, the hours definitely appealed to me more. I come from a family of paediatric practitioners. My My sister was a pediatric physical therapist. And my other sister was is is a special educator here in New York. She does early intervention and what's called CPSE here, which is preschool. And then my stepson is a speech therapist. So, we have a big a big crowd of pediatric therapists and my family so we're always talking about therapy and talking about our kids and, and things like that. So I began working in New York as an independent contractor for a school district in Westchester. And then I got a job in New Jersey, also as an independent contractor and then I ended up moving to New Jersey. And I landed a job as a school employee. And so I've been there for about seven years.     Jayson Davies     Awesome. Congrats. And how's that thing going from being a contractor to being a district employee?     Kristina Geraghty     I, you know, I really like it, they both had their positives and negatives. You know, as an independent contractor, I had a little more flexibility with my hours, I didn't work five days a week, which was, you know, a big, big bonus, especially when my kids were little. So I had, you know, when my kids were really little, it was nice, I worked like three or four days a week. But I always knew that I wanted to get to become, you know, a school full time employee at some point. And, you know, enjoy all the benefits of that. And I definitely feel that as an employee, I have a lot more opportunity for collaboration with my team. As an independent contractor, I felt like I was just coming in and out of the schools, they had me at, you know, three or four different schools. You know, and I was I was able to communicate with some people. But, you know, I hardly even went to meetings with parents and things like that. But now, as a school employee, I feel very immersed with with my team and with my students and their families. So there's much more of a connection there. Absolutely. And I think that's definitely going to come back up here in a little bit, as we talked about the three to one model, because that communication aspect is just so important. When it comes to the three to one module, to be honest, any model within the schools, there's a lot of communication within school based OTs. So. Yes;    Jayson Davies     Yeah, yeah, we'll get into that. So let's just kind of start by talking a little bit about what the three to one model is in relationship to school based occupational therapy. I think a lot of people have heard of this is something that has been around now for a few years, but for anyone who either just hasn't heard of it, or, you know, hasn't refreshed their brain with this one explained the three to one model.     Kristina Geraghty     So the three to one model is a workload model. And it basically takes into account the entire scope of the related service providers duties. So it goes beyond just, you know, the direct sessions that they provide to students individually and in groups, and takes into account all of the meetings and the evaluations, the consultations, all those extra things that we do you know, each day that that add up very fast. So it really goes, you know, above and beyond just the road service delivery that the standard model does.     Jayson Davies     Yeah, and when we're talking about the three and the one, what are we kind of referring to in those.     Kristina Geraghty     So every month, we have three weeks where we follow our traditional Monday through Friday schedule. And then we have the fourth week, which we we call our flex week, or you know, our indirect service week. And that is where we have some more flexibility. So we schedule some meetings with parents and teachers, we can schedule some observations we can get into, you know, different classes, different types of classes, different environments that we normally can't, because we're so bound by our schedule each day. So if I have a student that I want to go observe in gym or recess, or, you know, during writers workshop, I can make arrangements to do that.    Jayson Davies     I was just going to add a little bit, you know, I think when it comes to an IEP, a lot of us are used to seeing four times a month on an IEP for a student service or maybe 30 times a year or once a week even and I think that doesn't quite fit into the three to one model necessarily correct me if I'm wrong, but is that kind of a little bit different from what you might see on an IEP within the three to one model?    Kristina Geraghty     Um, well, we we put on our IEP as we go weekly, so most of our students are seeing either once or twice a week, or they may have you know, a monthly consult or maybe five consults a year or 10. You know, whatever that child that child needs. What we do is we have something written in our IEP s and that can be found on our on our handout that people can download. But we have something specific written in our IEPs about this indirect service week, and the students are still seen so we make a point we make sure that every student is seen at least once during that week. It's just may look a little bit different. They may get seen in a larger group they may get they may get seen alone. They may normally be in a group. me wait We may want to pull them out and you know, focus on something that's a little bit more difficult with a lot of kids around. So they will still get seen, it just may be in a different context than you know what stated in the IEP, they may get seen in their classroom.     Jayson Davies     Gotcha. Yeah. And I think it's important to see kids in multiple settings, you know, there's some things that you can do better as an OT practitioner in one setting, as opposed to another setting. And sometimes you really do need to see them in the various settings to address those different things for you, when you are deciding, you know, what the service is going to look like? I guess, do you ever consider not using a three to one model, or specifically using a three to one model for this student? Based upon what your evaluation is telling you?    Kristina Geraghty     Yes, yes, there's definitely some that you know, just do much better with one to one service, you know, but that flexibility is there. So if I do just want to stick to my regular schedule, and see a student the way I normally do, I can do that. But usually, like, during that week, like my wheels start turning, and I'll start thinking like, oh, maybe I need to bring the Aiden with him for this session. And I can, you know, review his sensory strategies with her or oh, you know, we talked about doing this a few weeks ago, we can do that during the flex week. So usually, more often than not, there's there's always something to do. But yeah, I mean, I think I think almost every student can benefit from their therapists pushing into their classroom. I mean, more often than not, I always learn something new about them, I always find something that they may be struggling with that I didn't know before. And usually, you know, it's a lot of times, it's something I can help with. So.     Jayson Davies     Yeah. And you talked a little bit about that blurb that you put into an IEP. But I know for us out here, we have to get really specific with our services on the service grid, like we got to put where the service is taking place, is there going to take place in a classroom? Is it going to take place in? In the students classroom or a separate classroom? We got to talk about if it's going to be one on one, or if it's going to be group and whatnot. So is it a little bit different in New Jersey, are you allowed to be a little bit more flexible? Or is that just what that extra blurb allows kind of a caveat to this to the very fixed schedule on the IEP?    Kristina Geraghty     both, so we have the blurb there. And then we also we do have those same parameters in, but we have a choice called natural learning environment for where the therapy takes place. And that kind of covers everything that would cover coming to the OT room, that would cover the classroom that would cover pushing into lunch, if we wanted to push into lunch, it basically covers us for everything. And we pretty much put all of our kids under natural learning environment.    Jayson Davies     That's great. We used to have an option. It wasn't called natural learning environment, but it was called service provider location. And so as it sounds, wherever the service provider was, that's where it could take place. Right. But you know, 12 years ago, when I started, that was common practice. And then slowly, it kind of disappeared, they wanted us to get more specific. And so they asked us to get more specific. But that only forced us to get a little bit more creative. And I'm saying this because I wonder if you've had to get more creative as well, because we had to start delineating that three to one when I would do the three to one. So I'd have to have two different services on the IEP, I would have to have three times a month in a pullout setting. And then one time a month in the classroom setting. That's how I would dictate a three to one service on an IEP. But it sounds like you're able to get in and get away with that natural context.    Kristina Geraghty     Yeah, yeah, we just use that as like our umbrella term for pretty much every child. I mean, I don't think there's ever been a parent that had an issue with that, once we explain it to them. That, you know, yeah, most of his sessions are going to take place in the in the therapy room, but there are going to be some that take place in the classroom. You know, there are a few students where I, I will specifically, you know, delineate for me to be pushing in with them, you know, if I don't feel that they should be pulled out, you know, more than once or twice a week, or if they're getting pulled out for multiple services. And I specifically, you know, say I think it's best that I just push into the classroom during Writers Workshop, or whatever it is, and then I will put like, in class as my service location.     Jayson Davies     Yeah. It's very interesting. You know, there's a lot of, I want to say there's there's a lot of formalities that have been over time ingrained into IEPs. And some of them are just the way that services are inputted onto that service page and I think is OT practice. shinners mean, just as anyone working on an IEP, we kind of have to question why we're doing stuff, you know, why are we putting this specific option on that service page? And how what what changes if I decide to use the natural context setting instead of the separate classroom setting or whatnot, and right, you know, being being willing to go ask our manager and say, hey, if I do this, does that mean, I can do this? And, you know, the worst we're gonna get is usually a no. And so     Kristina Geraghty     Right,     Jayson Davies     just being a little less afraid to ask and question and say, How can we get creative, we get creative in our therapy sessions every day, so why not get creative a little bit and how we are creating these IEP. So that's awesome. They figured out a way to make it work.    Kristina Geraghty     Yeah, I'm very fortunate with the district I work in, it's a very small district, our supervisor gives us a lot of autonomy, you know, we can always go to her with things, but she, she does have a lot of faith in us that we're doing the right thing. And she's, she's really flexible with us. You know, it's always whatever whatever's best for the student.     Jayson Davies     Yeah.    Kristina Geraghty     You know, and as long as the parent is informed, I mean, we also have great parents at our district that, you know, are just super supportive and grateful for the services. And, you know, once we explain to them what we're doing in the in the classroom, I mean, we've had parents come in during the flex week, Lauren, our speech therapist, you know, had a parent come in and train her on AAC during the flex week. So you know, some of our parents really get to see the benefit of it.     Jayson Davies     That's awesome. So you just mentioned that the speech therapist is doing this, too. So it's not just the OT team.    Kristina Geraghty     No, it's the whole team, the whole team does it. So we were in a Regional District, with several schools, our physical therapist is employed by the region and not directly through our school districts. So she comes in maybe twice a week, some of our behaviorists are employed through the region. And the whole region follows the model set, or I think anybody that's in that is following the model in the region, there may be a few schools that aren't. But we all follow the same schedule. So we decided at the beginning of the year, what those flex weeks are going to be. And everybody follows the same schedule. So during that week, the PTE that's in twice a week, her and I are able to co treat we're able to, you know, have a console on a few students or, you know, if we have to do work on some seating together for a student, we're able to do that during that week, because we're all on the same schedule.     Jayson Davies     Wow. Yeah, that's really impressive. So have you been working with this district or the school since before they moved to the three to one? Or did you kind of come in and they were using this?    Kristina Geraghty     before, but only for maybe a year before? I think I was there for maybe a year or two, before we implemented it, our supervisor was actually the one that suggested it, she she had heard about it. And she, she came to us about it, and you know, we're all for it, obviously. And then, you know, we just had to sell it to the rest of the staff, you know, at first glance, it looks like, Oh, they're getting a week off, you don't get, we don't get a week off. But once we, you know, explain to them what it what it was going to look like, then, you know, we're able to get buy in. And then now like as we as we use it, and as we push into the classrooms, more of the teachers are able to see like, oh, wow, this is, this is super useful, you know, because you're able to the My favorite part about it is that you can take those, you know, all those accommodations and modifications that you check off, you know, when you're filling out an IEP, I call it like bringing the IEP to life, like you're able to really go in and implement those things that you suggest. And I think it's a lot less daunting for the teachers, if I you know, just rather than like giving them a list of suggestions, or you know, one of those like generic things by going in there and just showing them how it's done in real time. It's it's so much easier to implement that way. Yeah,    Jayson Davies     I think a lot of times people just assume that because something gets marked on an IEP that the teacher, the staff in the classroom, we're just gonna know how to implement that accommodation. And obviously, that is not true.     Kristina Geraghty     And it's a lot of work for them.     Jayson Davies     Yeah, yeah, absolutely. And they need support. So I have a question, though, because you said that you were there before they kind of started this program and you helped to transition them. What would you say the ultimate goal was during that transition year, like, what why did people why did the supervisor and the rest of the team decide, You know what, it's going to be a good idea for us to go from this. You know, just one child or every child is getting that same service every week, week after week to switching it up to a three to one model.    Kristina Geraghty     I think we just wanted to be more efficient in the way we delivered our services. And this, this really allowed us to, and also we have a lot of meetings. So because we are a small district, we do go above and beyond with a lot of our families. And, you know, we go beyond just having that once a year IEP meeting, and, you know, some families, we're gonna have multiple meetings a year with them.     Jayson Davies     Yeah.     Kristina Geraghty     If it's if it's a really high needs student, or if the if the parent requests it. So this kind of allowed us a little more flexibility for having the meetings during that week, also, so that we weren't having to cancel our regular sessions to attend meetings during the other weeks. You know, it's not possible to schedule all of our meetings during this week, but we do try to schedule a lot of them.    Jayson Davies     That's what I was going to ask next. All right, so so a good majority of your IEP meetings you're able to put during that flex week, but not all of them? Yes, darn. I have tried to get creative with that I have tried to, I've tried to get creative about how we can do this, because it is a problem for everyone, teachers, oh T OT A's to some degree, even SLPs PTS everyone, we are always complaining about the time that we spend in meetings and how that is limiting us from being able to actually serve the students and right there's only so much time in a day. And there's even less time in a day re or after school to fit those meetings. And so they end up leading into the rest of the day. So help us to share how do those meetings look for you during that flex week? Does everyone try to squeeze them into that week? Are they during the day? Are they after the day?    Kristina Geraghty     during the day, we don't have them, we don't have meetings after school or before school, they're all there all during the school day between, you know, eight and three o'clock. You know, as far as the service providers, we are given a lot of flexibility with the meetings like I'll go in, and I'll just say I have a student to see at one o'clock and the case manager lets me, you know, go first, and then I can be excused. So we do have that flexibility. Because I mean, to sit in every meeting for the full meeting time would be impossible.    Jayson Davies     Yeah,     Kristina Geraghty     Never.    Jayson Davies     I, I go back and forth with it all the time. Like I want to sit in every meeting, I see how valuable it can be to sit in every meeting for the entire time. But then, like you just said, you know, we'd we'd be in meetings all day, every day. Yes,    Kristina Geraghty     then same. Like there are definitely some meetings that, you know, I want to hear what the teacher has to say. And I want to hear you know what the parent has to say, and I want to get, like, the big picture for that student. And it would be great, you know, if we could do it for all of them. But you got to kind of pick and choose which ones are are the big ones that you you really need to stay on for. You know, some of them. I'm in touch with the parents a lot throughout the year. So you know, I can slip in and out with just a quick update for them.    Jayson Davies     Yeah, so so as you were kind of making this shift, what did that process look like? Was it just an overnight hate? This year, we're using the three to one model, these are flex weeks, let's go or kind of walk us through that. Yeah. And and as you were making that transition Did you feel like you had to convince people at all and if so, was there any research or any articles that had helped or was it pretty, pretty easy for you all to just kind of this is what we're gonna do.     Kristina Geraghty     So we brought it up at a staff meeting, we had our supervisor there. So you know, that was key was that we had, you know, our supervisor was really advocating for it. We had the buy in from our principal, we had already spoken to her ahead of time. So when we we have staff meetings twice monthly. So when we had our staff meeting, basically our supervisor stood up and she explained, you know, what we're going to do and what it was going to look like, you know, she explained the verbiage that we're going to use in the IEPs. And we created a calendar and everybody everybody got the weeks that we were going to be doing this indirect service. You know, like I said, I'm sure some people were skeptical. But like as you know, as time has gone on, they have seen it, you know, because they'll bring something up, you know, something will come up in a meeting about you know, something that students struggling with and it's like, oh, I can go in on the flex week and check that out. You know, so it's very the parents hear about it. You know, the staff definitely gets to see the benefit of just us having a little bit of flexibility to come in and out of the classroom at different times of the day.  We did nothing I remember I think everyone was was pretty supportive. You know? And like I said, as time went on, we, you know, they just started to see the benefit of it, like we would communicate with them at the beginning of the week, or, you know, at the end of the week prior, and just, you know, give them a heads up and say, Hey, next week is the flex week, if there's any specific times that you feel would be useful for me to push in, let me know, if not, you know, I'd like to come in, during Writer's Workshop, you know, like, during the holidays, I would have, you know, a lot of teachers that had like, crafts planned out, and they would say, Oh, my God, we're doing we're doing his craft, and I just, I know, he's gonna need help. You know, can you come in at this time? Yep, sure, no problem. So, you know, once they see that kind of flexibility there, they're very grateful that we're able to come in there and help out. Yeah, the other thing they see, too, is, you know, a lot of times, like, I'll have multiple students in one class. So I'll plan like a whole class lesson. And I'll just come in, you know, for 4045 minutes, and I'll teach an entire lesson, you know, either on handwriting, or, you know, in second grade, I teach all the classes how to tie their shoes. So the teachers love that. So you know, that they see that benefit, too, that the the gen ed, population benefits from this too, from us pushing in? Sometimes they'll have, you know, a student like, oh, you know, what, since you're here, I wanted you to take a look, is there anything we can do to help him or like, I'll notice, you know, a child like, oh, you know, he could really use a seat cushion, you know, a wedge cushion to help with his posture. He's all over the place. So there's, you know, there's a lot of benefits that go beyond just servicing our students as well.    Jayson Davies     Yeah, yeah, definitely. And, and I know, there's been a lot of talking about the three to one model, we mentioned it up at the front, kind of, but when it comes to research, I, all the research that I've seen is more about like, this is a great idea. But it hasn't really been like compared to a direct pull out, you know, every week model, which would be great to see, I don't think that exists. If you know of anything, please let me know. But yeah, I, I love this idea of you calling it the flex week. And I'd love to kind of you've kind of teased a few things that you might do, you know, talking about accommodations, fitting in meetings, but what have you found to be the most beneficial part of that flex week, that's really allowed you to really just be more supportive for your students and your teachers.    Kristina Geraghty     I think it's just, it's it's creates, I think it creates that bridge for the student in that, you know, I pull him out, I pull him or her out of class, we work on these things in my room, and then they go back to class, and who knows, if they're actually using them or translating them. I mean, the whole point of us doing this therapy is to is to get these skills to translate over into the classroom. And I think sometimes with OT, they don't always see the connection. Right away. You know, when when you when you ask them, Why do you come to OT o because my handwriting sloppy, you know, but there's, there's so many other things that they're coming to OT for. And I think that when they see you in the classroom, and then you can say, oh, remember when we worked on this the other day, now's a good time to try this strategy. So like, a couple of weeks ago, you know, I was working with a student on on copying. And he you know, he was one of those kids that was looking at the spelling and like writing with it, looking at what he was writing and is writing was all over the place. And you know, I said oh, so let's let's do a little trick. You know, say it when you write it, say it when you read it. So I was teaching him to kind of chunk a few letters together, say it in his head, turn write it. And then literally, like two days later, I pushed into his classroom. And he he was working on a writing piece. And he had to copy and he was doing the same exact thing. And I was able to say, hey, remember when we were working on this in my room two days ago? And he was like, Oh, yeah. And you know, but then and then I was able to show it to the teacher and say, Hey, we were working on this and OTs a few days ago. Now I'm having him use it in the classroom. Now you know what to say to him? You know, say it when you write it, say it when you read it very simple. Now he's going to remember and I think like it just it creates that that bridge for the student, where, you know, they start to get like, why you're doing what you're doing in in OT.     Jayson Davies     Yeah,     Kristina Geraghty     I mean, that's like my most simple example. But um, and I think that when you're pushing in and they're able to see other kids that may struggle with the same things that They do, but aren't getting pulled out for services, I think that really helps with just, you know, the being neurodiverse friendly, you know, I'm promoting that inclusion, especially with my with my shoe tying, when I push in, to teach the second graders how to tie their shoes, I usually am working on it with my second grade students in OT, in preparation, because I want them to feel confident when I'm teaching it to the whole class, like, I've had some of my students be the one to teach the kids in their class, how to tie their shoes, because we've already worked on it. And they've already mastered it. And I think that, you know, for the students that we serve us, there's so many that that struggle with so many things throughout the day. And, you know, they're they're just they're, they feel less than and I think it's important for them to see that, you know, the football Jack also struggles with tying his shoes or something like that, you know, I think it's just, it's just good for them.     Jayson Davies     Yeah, absolutely. And I think the more we can get into to the classroom, the better. You know, we already talked about some kids really need it more, more than than just the one time a month. And you can do that. And, and some kids, like you mentioned, you know, they still need that pull up session for that fourth time, the the month during the flex week, and that's okay, this is designed to be flexible, and flex week. Right? What are some of the things that maybe you struggled with completing in your job as a school based OT that now you have that opportunity to do during the flex week? Does that make sense as a question?     Kristina Geraghty     Yeah, I would say probably evaluations, because some, some years are better than others. But sometimes, like my preps are only 30 minutes, I may have like a few, you know, two different 30 minute preps during the day. And I feel like you know, you get started on typing up an evaluation, and then you got to cut it off and go take a kid and come back to it later. I feel like it ends up taking you longer that way. So sometimes if I have something you know, really heavy that like I really want to be able to focus on first typing up in a vowel, I'll use that time to do it. So at least you can kind of like, set aside bigger chunks of time than you would during your normal schedule where you're just going by every 30 minutes. Same thing with pushing, you know, when I pushed into the classroom, now I can push in for a 45 minute lesson, and not just a 30 minute lesson. So I think just having those extra big chunks of time to to do things is is good.     Jayson Davies     Yeah. Yeah. Whether it be evaluations, I'm sure, sometimes it helps to have some time to catch up on documentation prep for an IEP. So there's so many different ways that you can use that. So awesome. Yes. You mentioned prep. Do you? Are you on the teacher contract, potentially and get a prep period? Is that what that is?    Kristina Geraghty     Yes, we got I think right now we have 270 minutes of prep a week.     Jayson Davies     I'm jealous. Like, you know, how many OTs are listening to this right now?     Kristina Geraghty     A lot of people are still in town. But yeah, we get we get the same amount of prep time as the teachers.    Jayson Davies     Yeah, I'm sure that comes with its own set of difficulties as well, though, right? Like we all we all want prep time. But we also all want a lot of different things in the schools, higher salaries, people to understand our job, and it's hard to find a district that has it all. And so we're always, you know, weighing pros and cons everywhere. So, yes, that's nice that you at least have some time to kind of.     Kristina Geraghty     Yes, it is it, it makes a world of difference. When I was an independent contractor, I did not get prep time. So I just, I had like just, you know, squished all my kids into a three or four day work schedule. And I went in and just, you know, banged it out. And having that prep time now, it makes a huge difference in just, you know, not having to bring work home, and things like that.     Jayson Davies     Yeah, yeah, definitely. So when it came to kind of making that shift over here, to the three to one model, what were some of the challenges, we've talked a lot about the good, but what what were some of the challenges that, you know, you kind of had to overcome a little bit. I'm sure there was at least a few, especially with, like you, I think you alluded to earlier, right? Some people might have just thought you're getting a week off, but, you know, you kind of had to shift that around a little bit.    Kristina Geraghty     Yeah. I mean, I guess when we were initially explaining it to parents, you know, some parents had never heard of it. You know, some parents were, you know, just had a lot of questions. So, I mean, that was a challenge figuring out you know, what the wording was going to be in the IEP, to cover us to make sure that, you know, we dotted all your I's and cross our T's with that. That was a challenge too. But other than that, it went pretty smooth. I think, also the scheduling, getting used to, you know, you're so used to being just bound to that schedule that you create at the beginning of the year. And, you know, basically, I would start my week out with like, a blank schedule. And then I just fill it in with pencil, as I figure out what I'm doing. So, you know, the first couple of times having to do that, and making sure that, you know, every kid was getting seen at least once, you know, making sure I just had all my bases covered, was was a bit of a challenge. Especially if, you know, I had a really busy week before the flex week and like, didn't have a lot of time to plan. You know, all of a sudden, it would be Friday. And, you know, Lauren, the speech therapist would be like, Oh, it's flex week, next week? And I'd be like, oh, yeah, you know, and I'd have to kinda like scramble it all, to start to start planning things, because you do have to plan ahead, you know, you got to email your teachers, you can't email them last minute. And, you know, say, When can I push in, like, you know, they've got plans to So yeah, just kind of getting getting into that mindset of knowing that that week is coming, and you got to plan for it ahead of time. It's just, it's just a different, you know, a different way of thinking that you'd have to get used to. Yes.     Jayson Davies     Now, you gotta have that scheduling conundrum. Every month, you got to figure out what you're doing for that week. So.  Yeah, yeah, I mean, we all complain right about having a build that schedule at the beginning of the year. But once you have adult at the beginning of the year, it's kind of nice, but you throw in this flex weeks, where everything is just now up in the air, and we have to reschedule everything and every, you know, fourth week or whatever, it is a little different.     Kristina Geraghty     Yes, and sometimes, you know, sometimes it works out that like, we don't have as much prep time, sometimes our flex weeks are busier than our regular weeks, just because, you know, there's meetings and, you know, every kid has to get seen or, you know, I plan to push into every second grade class to teach handwriting. So that's, you know, that takes up a big chunk of time where I'm pushing into every kindergarten class to do something. So, you know, there are some months where, you know, maybe I don't get that it's either 230, or I think it's 230, I can't remember, comes out to about like, 15 minutes a day of prep time. So yeah.    Jayson Davies     Do you ever feel like you still either Miss sessions, even when, because of the prep time? Does it actually make it sometimes more difficult to actually see every student? Or do you feel like it? I don't know, more difficult, easier, or just kind of the same?    Kristina Geraghty     Well, I guess it depends on my caseload that year, but my caseload basically stays around 40 Kids, which is pretty manageable in a five day week, with those prep periods, every, every so often, I'll get, you know, it kind of goes up up up, like towards the spring, and then you know, the meetings come and you start, you know, reducing some kids and your schedule comes back down. So yeah, there are some times that, you know, maybe I don't get all my prep time, and that's okay. I think, you know, we can get compensated for it if we if we don't take our prep. But I feel like sometimes I have an absence and I can't find another kid to poll or sometimes there's an assembly and none of my kids are available. So I feel like it all evens out in the end. So I never really looked to get compensated if I missed that, that prep time.     Jayson Davies     Yeah, do you? Do you build time into your prep for Miss sessions with absences? Is that kind of when you might make up some miss sessions? Or do you have time set aside during the rest of the week? Or does it all just kind of work out?     Kristina Geraghty     No, I would use my prep or I would call, maybe pull out like a bigger group and maybe kind of combine groups to get that makeup in. We are not required to make up every session that we missed, that would be impossible. You know, just because I mean, you know, if we take a personal day or a sick day, you know, we don't we don't have a sub. So it's just this but yeah, usually if you know if I have a student that you know, has been out a lot or if I've been out a lot, you know, if I if I was out sick or earlier this year, my dad passed away. So I was I was out for a couple of weeks. And then when I came back, I was kind of loading up my groups and skipping a lot of prep periods just to get a couple more sessions in. But you know, it ebbs and flows. So ya know, Oh, thank you. It's I know Overall, it's a good schedule. So,     Jayson Davies     Yeah, yeah, that's it's nice that it allows you to have some of that flexibility both within work. And then also a little personally, you have some flexibility as well to, to take on some of those things. Because I know that's why that in general, there's a lot of high burnout in education, not just OT, but just an education world. In general, there's a lot of burnout and a lot of people quitting within the first few years, just because of the time commitment and how much you have to do with such little resources. So that flexibility the flex week, and almost counteract that rigidness of every Monday at 9am. I know I'm gonna be seeing Johnny for the entire school year. Yeah, the 930 is gonna be this kid and this kid and,    Kristina Geraghty     Right, right, right. And we have like, right, now we have a substitute shortage by us. So we are always short on subs. So a lot of the teachers get called to sub in classes, during their prep periods. And you know, that that did create a bit of a challenge, because because we are IEP driven, we can't miss a session to sob. So we we were unable to really contribute to that. So, you know, they did ask us if, like, during the flex week, if if we would be available to sub so, you know, we said yes, but under the caveat that, you know, put us with our students, so, you know, as best we can. So if there if one of our students AIDS is out, you know, let us let us be with him.     Jayson Davies     Yeah.     Kristina Geraghty     And like, you know, we'll do a session with him, and then maybe go in the classroom and do a couple of things with him. So we make it into into a session. So that's how we we work our way around that is that, you know, usually if one of our special ed teachers are out or for the aides or someone like that, they'll just give it to our team. And we will rotate with that students. So the speech therapist will do a period with him, I'll do a period the behaviorist will do a period. So we work it out that way.    Jayson Davies     Oh, my goodness, that's like even going beyond the three to one model to be extra flexible. That's right.    Kristina Geraghty     Yeah. Yeah. It but it works for us. It works for us. And, and again, you know, sometimes it's it's going into a classroom at a time where I'm normally not in there. But I have students in there and you know, you just kind of get to look at them with a much wider lens. That way.    Jayson Davies     Yeah, I want to get into the topic of whether or not you monitor this program, or the district somehow monitors this program. But before I do, I want to kind of go back to a topic that we that we alluded to way up front, and I knew we'd come back to just the communication aspect and how important it is that not only the OT team is on the three to one flex model, but you know, the the PT kind of supporting in a way the speech therapists are on the three to one flex model as well, like, how has that really benefited the IEP teams?    Kristina Geraghty     Well, it definitely gives us some more time to communicate with one another. You know, like I said, especially with me in the PTE she's, you know, she's in and out of the building, I think maybe like two afternoons a week. So even just giving us like a 15 minute block of time to kind of just catch up on some students and, you know, collaborate a little has been amazing. Sometimes, you know, we'll just arrange like a co treatment session where we'll both work with the same student for you know, half an hour and you know, she RPT is really great. She she comes up with all sorts of great like behavioral and like motivational strategies. So I love you know, stealing her for keeping some of our more challenging kids motivated to complete their, their their therapy with me. So yeah, it's gives us gives us a really nice opportunity to to work together.    Jayson Davies     And so does your district allow you then to if you meet with a PT or you meet with the SLP, and the child is not present, under that IEP in the way that it's all written? Does that still count as a quote unquote, session for that student?    Kristina Geraghty     I would say yes, we, you're probably going to hate me again. But like, we don't have official like documentation that we have to do. We basically, in New Jersey, they do not require you to do any, like, session logging. Like there's no blanket.     Jayson Davies     Okay.     Kristina Geraghty     Yeah. So we do log our sessions through real time, which is our, you know, our IEP system. And but you're not, you're not required. So I guess it's kind of like a gray area. But, you know, like I said, what I do is I just have that blank schedule. And I fill it out in pencil everything that I did. And then I type it into a Google Doc, and then send it out to my supervisor and my principals. So, yeah, so they know everything I'm doing. And you know who I'm seeing. But I don't think like, I think if we did like a code treatment session, yes. But I think if it's just like a 15 minute console on a student, I would still be seeing that student that we would still be giving them some kind of direct service.    Jayson Davies     Okay. Yeah, I think that's where, for me, you know, being in California where I think we're a little bit more litigious, and everything's got to be like ran on IEP, that's where for me, I would write onto the IEP to separate service lines. And that first service line would be whatever the three weeks is out of the month, right that one time a week in the classroom, I'd probably write it a three times a month or around 30 times a year. And then I would add an additional service line that said, like 15 minute consults with IEP team members or something like that. And that would be my quote, unquote, flex. Okay, yeah. So just trying to think of creative ideas for someone out there who might be in a state where they got to, you know, figure out a way to put it on their IEP to make the three to one system work. So yeah,    Kristina Geraghty     right, like, maybe just putting that in for every student, but then, you know, it's, it's so hard, because like, not every student needs that 15 minute console per month, sometimes, you know, the PT and I are talking about the same student every month. Sometimes, you know, it's the same two or three students. But yeah, you know, once once you put it into that IEP, then you know, you're obligated to provide that service every single month.     Jayson Davies     Yeah, yeah. And I think that's, most of the districts out here have kind of gone to a 30 times a year on the IEP model, or three times a month. And even though we say 30 times a year, when there's really about 36 weeks, I believe of school, maybe 38, depending on how many holidays or whatnot. Or, or obviously, there's at least four weeks and every month, right? We still use that three times a month, or 30 times a year, because that kind of gives us that flexibility. We still put the student on our calendar every single week. But we have that flexibility, because we said 30 times a month. So it's you know, give yourself a little bit of buffer.     Kristina Geraghty     Yes.     Jayson Davies     And you're doing it on the right way, right? Like you're not saying I'm going to see four times a week and then only putting them on or sorry, four times a month, and then only putting on three times a month, right? You're going to Officer way, right? But that does give you a little buffer as long as you as long as you get your three times a month, then that fourth week can be a flex per se or something like that.     Kristina Geraghty     Yes, yes.     Jayson Davies     Anyways, all right. It is that I want to talk to you a little bit about progress monitoring at this program. And I don't know if you do or not, but I did just kind of want to open this door up to you and asked, you know, are your supervisors in some way trying to figure out if this model is working better than the previous model did? Or even from your perspective, are you seeing differences?    Kristina Geraghty     My supervisor now I don't, it's not really being monitored, per se. You know, we do seek out feedback from from the teachers and the other staff. And I think now it's just become such a natural part of our yearly schedule, that people don't really question it anymore. I feel like, you know, the actual effectiveness would would be really difficult to monitor as compared to, you know, four weeks of direct service. I think there definitely needs to be more research. Our download does include links to a few articles that have been put out recently some preliminary research, but you know, like everything else, there's always challenges in the in the research realm. And you know, finding really solid research behind it, but there definitely is some I know that I can't think of her name right now. She she does the Size Matters handwriting. Beverly, yeah, I know that she really pushes for this workload model. And she also has like a wealth of information about, you know, the research behind it and things like that. But as far as monitoring it now, I mean, I would suppose that, you know, you could send out surveys to the teachers, you know, a few times a year or something like that just to get to get feedback to get, you know, satisfaction levels. How satisfied are they with with This mode of service, they feel like it's helped they feel like it's kept things the same. You know, are they seeing the the direct benefits of using this model? So I would think something like that for a start would just be getting just be getting feedback from everybody.     Jayson Davies     Yeah, yeah, I'm just gonna throw this out there. There's anyone interested in a PhD, I would love to see like a program that potentially uses even you know, Christina's district and kind of compares it to a district that the OT team is using more of a, you know, traditional one time a week for every student, direct service. And I don't know you got, you'd have to get creative with the outcome measures and how you figure that out, maybe you're looking at the outcome measures of the teachers, the OTs or just the students, you have to get creative with it. But it would definitely be interesting to see just how things are different. I think that'd be great. So yeah,     Kristina Geraghty     Yeah, no, I think that would be a great idea.     Jayson Davies     Yeah,     Kristina Geraghty     To start looking into     Jayson Davies     One day, all right, we'll kind of get to the wrap up here. But I wanted to talk to you about one more other model that kind of falls in line with the 3 to 1 model, and something that I've used quite a bit in my past as a as an OT in the schools. And that's actually changing it from a three to one to a two to two model. And I do it two to two, I really liked this one, because it allows me to get into the classroom a little bit more, but still allows me to have that individual session. And so the way that I would often write this on an IEP would be either two times a month, or 15 times a year, pull out, and then same thing two times a month, or 15 times a year in the classroom. And that would allow me to either alternate every other week, right? In class, every class in class out of class, or I could make two pull outs, and then two portions, whatever. But yeah, have you ever used any model like that? And if so, your thoughts?    Kristina Geraghty     we haven't, but my first thought would just be how tricky that might be with scheduling. So being able to, you know, work your regular pullout schedule, and then schedule the right time to push into the classroom, I find that so challenging. And, you know, I've heard a lot of therapists say, like, you know, I tried to push into the classroom, but they're not doing anything relative to what we're working on. And I'm just standing there, and I feel like an aide. So, you know, I think that is really tricky, scheduling wise, just figuring out when you're going to be able to do that question and how it's going to work with all of your other sessions every month?     Jayson Davies     Yeah. And I'll take a little stab at that. Like, I think for me, it was just that not every student was on that two to two model versus I think what you're talking about with most kids are on the three to one models, not like half of your kids are on the three to one or 25%. Everyone is on that three to one. And so for me, those two to two, the kids that I had on a two to two model, were the ones that would go on my calendar first. And so I would, I would schedule their in class sessions. And then no matter what week it was, I always had them at the same time on my calendar. I just went in during that that in class session, I already figured out that that was a good time in the classroom. I hope that makes sense. Yeah. But again, that was because you know, maybe I had 10 kids on that, as opposed to every kid. And so I was able to find times where it made sense to go into the classroom for those 10 kids, but totally understand what you're saying. Right? If everyone on your on your caseload. Yeah, you got to figure out how to see everyone in a good time in their classroom, which is very hard to do.     Kristina Geraghty     Right right.     Jayson Davies     That makes me anxious just thinking about it. But yeah, so. So we talked a little bit about the or a lot about the three to one model. We talked about that two to two model idea, potentially. But looking ahead, do you see any potential developments or adaptations to the three to one model in response to the changing educational landscape and what has and has not been working for you?    Kristina Geraghty     I think that, you know, it's really still in its beginning stages. And I think that we are going to keep hearing more and more about it and the more schools that try it, hopefully the more research we will have to back it up. I think that, you know, as therapists and as you know, workshop presenters and educators, I think we can start by, you know, providing some more continuing ed, for therapists on you know, what they can do in the classroom or you know, how they can implement this model at school, what it looks like, what kind of activities can you do, and kind of giving them that toolkit to get started, I think is going to be really useful. I know that you know, the inspired Tree House has had a workshop for they've had it up for a couple of years. I took it a long time ago called pushing into the classroom, and they have some great ideas in there for, you know, lessons that you can do in like whole class lessons. And, you know, I just think that you know, the more workshops and courses we can offer, the more the word gets out, the more the therapist start to become open to this and start talking and seeing the benefit, and then start talking to their administrators. So, you know, I think, going going to the therapist first and getting getting them on board with this model is going to be key to keeping it going and, you know, giving it that ammunition that it needs to get implemented in more and more schools. I think also, you know, schools, a lot of schooling has become so academic heavy, and it's getting more and more difficult to pull students out of class, especially in middle school. I know, I don't see a lot of kids in my middle school, but I know, the speech therapist that we have at our middle school, she, she goes through it with her schedule, man. You know, just because they have such small windows through the day that they that they can afford to get pulled out of class. So I think you know, that, as far as like changing landscapes, you know, we're just we're becoming so much more academic heavy during the day. And you know, there's just less and less time to be pulling out for these services. And I think, you know, as the kids get older, they are more cognizant of getting pulled out of class, they don't want to get pulled out of class as much. So you know, we do have to start rethinking around, you know, pulling kids out of the class throughout the day.    Jayson Davies     Absolutely. And in heck, now, there's also schools that are going four days a week, which is going to make it even more interesting, and who knows where that'll go. But, yeah,  Yeah, yeah. I mean, even at the elementary schools, there's been some schools that I had been at where they're like, this is your block to get in, it's either got to be after lunch, or like, a certain block in the morning. And I'm like, I have six schools. I will try my best, like, we'll see how we do here. But yeah, you're right, scheduling is getting harder and harder every year. So yes, well, Christina, I want to say thank you so much for being here. Before I let you go, where can anyone go to learn more about yourself and the three to one model.    Kristina Geraghty     So the speech therapist that I work with, we actually own a business together called therapy advanced courses. And we have a website where we have links to a number of free downloads. So we have a link to a three to one download. And it basically explains, you know, how we implemented the model, it has a copy of the letter that we sent to our administrators, when we wanted to implement the model. It has links to different research articles, few different activity ideas, you know, and just how we how we go about organizing and implementing it. You know, as far as our business, we provide postgraduate courses for related service providers, so that they can move on their salary guide. So as you know, a lot of districts have a salary guide, where if you get if you take extra graduate courses, you get a bump and pay you move into that, you know, plus 15 lane or plus 30. So we create courses, specifically for OTs, PTs, speech therapists, social workers, school psychologists, guidance counselors, we are starting to branch out. We do have some teachers that are taking our courses, we have some special ed teachers that are taking our courses. So we are starting to branch out and create more generalized courses that you know, anybody any school employee can take. So most of our courses are three graduate credits. And they are all self paced and self study. So you complete the courses in your own time through our online learning platform. So,    Jayson Davies     Yeah, that could be a very helpful and actual useful way to move over on the PCL, because I know a lot of us look at the PayScale and we're like, I need 15 units, but I'm not gonna go get my doctorate. So what the heck am I going to? Like? Yeah, 10 units, So.     Kristina Geraghty     Yeah, well, that's that's really where it came from, was when I came to this district, I wanted to move up on my salary guide, and I had the hardest time finding courses that were really relevant to what I did. You know, I was able to take some like general courses on some of the teacher education websites, but they really weren't specialized. And as Lauren and I started talking, we thought, You know what, I wonder if we could just create our own I mean, unfortunately, I can't take my own course. But it turned into a real educational experience. And, you know, I learned so much now from creating these courses. And I, you know, I'm inspired every day in school because, you know, what do I what do I want to learn more about, you know, and how is it going to help me be a better school based practitioner? And that's really what the core of our courses are about is just, what do we need to know? What do we need to learn more about for our specific skill base position?     Jayson Davies     Awesome. Well, Kristina, thank you, again, so much for being here. It's been a pleasure. And we'll definitely keep in touch and see you next time.     Kristina Geraghty     All right. Thank you, Jayson.    Jayson Davies     Once again, thank you so much. So Kristina, for coming on and sharing her experiences with the three to one model. I hope after this episode, you're feeling like it's maybe a little bit more attainable to reach out to your administrators and your OT, or maybe even the SLP team as well, and say, hey, you know what, we can potentially implement this three to one model and just kind of start to paint a picture of what that can look like. And maybe what the transition might start to look like, it's really hard to make a shift overnight. But if you put that plan in place to start saying, hey, on our IEPs, we're going to start shifting our language just a little bit in this way on our services. And we're going to explain it in this way. And you know, that can really make that shift just, again, not overnight. But week by week, month, by month, you'll start to see it happening. And the next thing you know, two years later, yeah, I know it can take two years later, or take two years to get there. But all of a sudden, you will now be on a three to one model, you'll have time to complete those evaluations, you'll have more time to collaborate, you'll have more time to do all the things that you know that you should be doing, but just don't have the time to do right now. And all that while your services are likely just as efficient as they were when you were seeing a student every single week, not having time for anything else. So thank you again to Christina for sharing so much on the three to one model. Thank you for tuning in today. We really appreciate it. And again, don't forget that you can earn a certificate of completion for listening to this podcast as a member of the OT schoolhouse collaborative. If you'd like more information on the OT schoolhouse collaborative and how to join, you can do that over at OTSchoolHouse.com slash collab. I hope to see you in that community very soon. Thanks again for tuning in. We'll see you next time. Take care.    Amazing Narrator     Thank you for listening to the OT schoolhouse podcast. For more ways to help you and your students succeed right now. Head on over to OT school house.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