OTS 113: Finding Motivation in Transition-Aged Students: From Limitations to Success
- Jayson Davies
- Nov 15, 2022
- 42 min read
Updated: Nov 1, 2024
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Welcome to the show notes for Episode 113 of the OT Schoolhouse Podcast.
Have you ever thought about what it might look like working with transition-aged students? Even if you are currently working with them now, you may still question how to best use your skills to work with these older school-aged students effectively.
Today, we are speaking with Justin Lundstedt, OTR/L, where he will discuss many areas of TAS and executive functioning. Tune in to learn how you can help these students find motivation and success in their life outside of school.
Tune in to learn the following objectives:
Learners will identify what transition-aged students are
Learners will identify how OTPs can work with transition-aged students
Learners will identify how the domains of the OTPF-4 play a role in transition-aged students
Guest Bio
Justin Lundstedt, OTR/L
Justin Lundstedt is an occupational therapist of over 20 years. Over these two decades, Justin has worked primarily in pediatrics. He has spent time in physical rehabilitation, private clinic work, the special education field, and private therapy services. The majority of his professional career has been spent working in the special education field, where he has developed a strong interest in the development of executive function skills and how they are a key to so many of our student's ongoing struggles with regard to personal goal achievement. He specializes in the transition-age student because he believes this is an underutilized area for OT, and it has direct involvement with the success of our students transitioning from school to the community.
Justin has developed his own practice and Brand to focus on these specific areas. He currently owns Achieve Life OT & PT PLLC and has created a separate entity to focus on the education and development of other OTs in the executive Function World named: The Executive Function OT. He has created an evergreen course called OT and Executive Function of the Transition Age student, has recently participated in Jayson Davies Back to School OT conference, and has hosted multiple other webinars on this topic as well. He hopes to develop a niche that will help our profession as OTs develop in a way where we are seen for our knowledge and potential in the world of executive function.
Quotes
“We're so focused on getting our students to, you know, a certain academic level or demonstrating this certain skill, that we focus again on those proximal goals so much, and we forget about the distal” - Justin Lundstedt, OTR/L
“I do believe that we all have the capability, and motivation drives us, so if there's really that will to do, there's a way to find it” - Justin Lundstedt, OTR/L
“You are not a one-to-one aid when you push into a classroom, you're not a teacher, you are an OT, and you have the skill set of an OT working with those students” - Jayson Davies, MA, OTR/L
“What I'm really seeing at the older ages is, our expectations are high, where they may not have that development, and the development has changed” - Justin Lundstedt, OTR/L
Resources:
Episode Transcript
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Amazing Narrator
Hello and welcome to the OT school house podcast, your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host. Jayson Davies, class is officially in session.
Hey there. And welcome back to another episode of the OT school health podcast. Thank you so much for joining us today. My name is Jayson Davies, and I am an Occupational Therapist in Southern California. So excited for you to be here today. Now I want to start off this episode by admitting something. I've said it before, but I've never kind of framed it in this way. I've never just said, You know what? I admit it working in the high schools is tough. As an occupational therapist, I have done it for part of my career, and I remember that first time after working in the schools for several years or in the elementary schools for several years, I should say, having to move in to that high school realm, it was tough, and I really had to reframe my thinking. In the elementary schools, I had become accustomed to working on things like handwriting, working on fine motor skills, how to use scissors, how to facilitate interaction at recess. Honestly, it was a lot of handwriting, a lot of fine motor skills and some sensory processing skills as well. But as I transitioned into the high schools, I really had to reframe my own thinking, reframe my therapy, and really get back to remembering that we are occupational therapists, not just handwriting therapists or sensory motor therapists. And that really helped me to kind of get in the game at the high school level. I started to really talk to the teachers and really find out what was meaningful for these students. I also talked to the students to find out what was meaningful to them, right? What was important for them, not only to do, but also to perceive they didn't want to stand out. Like my second graders didn't care about if I was in the classroom. They were happy to see me in the classroom. High school is completely different, right? So I'm excited today to bring on our guest. His name is Justin lundstedt, and he has worked with high schoolers for a long time, and he's also worked with young adults, I guess I can call them after high school. So he has a very unique perspective on this, and I'm excited to bring him on. He's going to talk to us all about executive functioning and how to work with transition age students, those students that are in the realm of 14 to 22 Justin lens that we had the pleasure of hearing from him at the back to school conference, and I just loved everything that he had to say. So we're bringing him on for an episode of the podcast. I hope you enjoy this. We're talking about executive functioning, how to provide therapy in the high school setting and transition age students. Please help me to welcome to the OT school house podcast. Justin Lundstedt. Justin, welcome to the podcast. How you doing today?
Justin Lundstedt
I'm doing great. Jayson, how are you doing?
Fantastic. I am ready for fall. It is finally cooling down here in Southern California, and we got some fall weather.
Justin Lundstedt
Yeah, same here over in New York. The the leaves are actually at peak this week, so it's been sort of Awesome.
Awesome, man, I we don't get red, orange or yellow leaves here in California. It just doesn't have it just doesn't happen. I gotta go somewhere to find them.
Justin Lundstedt
But yeah, yeah, it's gorgeous over here right now. Awesome.
So let's dive into occupational therapy and Justin lundstedt, I mean, you are here to talk a little bit about executive functioning and the transition age student. We're going to dive all into that. But first, I want to give you an opportunity to share a little bit about where you are today in the world of occupational therapy. How'd you get here?
Justin Lundstedt
You know, long story short, I actually started off in a Gen, Ed School District, and then went into children's rehab, where I first really, you know, explored and discovered, really, the opportunities of occupational therapy, and from there, went to a special education school district, and really got my feet wet with regards to education, the academics. But you know, even more of our scope from ot working with a lot of transition age students, the older students, and focusing more on what happens when they leave school, which really became my love. So I've been doing this for about up to 22 years now, and love what I do. And have even, you know, developed my own stuff at this point, and have gone into some private practice and, you know, so that's where I am.
Awesome. You know what? I want to dive into that a little bit further, because you kind of hinted at that beyond public school, or beyond, you know, high school level. And so what does that look like? Where do I mean, to be honest, you know, what happens to students after they graduate high school? Like it's kind of that in public schools, we kind of stopped at that 18 or maybe 22 Yeah, exactly. But, but what do you see beyond that?
Justin Lundstedt
I mean, I see a lot of challenge, you know, so, like, one of the biggest things that I recognize is that under employment rate, that unemployment rate and the, you know, the want of students to be able to go into secondary education with, like, college, etc, but not having the pathway to do so. So a lot of my students who have a lot of significant impairments, you know, we work with them and really identify their goals. So it's really looking at what is their look at, as far as outcome after school, whether it be working at a job, full time, part time, living in a community based situation, independently, going to college, all of those things, but how they're going to work it, and how they're going to be successful at it,
Awesome. And so then you've worked at the high school level, but if I recall, you've also done your own thing outside beyond the high school level, right? So explain that a little bit. What have you done with that next age level?
Justin Lundstedt
So I actually had the opportunity to create some executive function curriculum for some community college students, and was an instructor. So I was out of my ot realm, but in an instructor realm, as far as educating them with regards to their own executive functioning skills and developing those because a lot of the times, you know, our students, especially those with intellectual disability or in you know, more of the special education setting, have been sort of led through school, I found, and don't have that real individualized outlook on what they want or where they want to go. So it's almost to the point of where we were recreating what is a goal and how to develop that, and how to build from that, and then find their, you know, find their why?
Wow. And I mean, sorry, questions are just coming to my mind. None of these questions were on our document, but I love that you're answering them. What happens to an IEP when a student graduates? I would imagine you might have some insight into that. After they turn 18 or 22 and they go to community college, they go get a new job, what happens to that IEP, if anything?
Justin Lundstedt
So there's not really an IEP anymore. It's really more self advocation for your disability, you know, more so from the individual. But obviously, if you have supports around you, those people you're working with, you know, admissions officers and accessibility and disability office, you know employers, with regards to how that, you know, assists them.
So they're not sorry, but there's not like a formal program the IEP doesn't continue. It's more of I need to seek out assistance from either my employer, or from my college, I need to go to them and try and figure out what's available?
Justin Lundstedt
Correct, correct. So usually, there's an office of accessibility and disability in a college that you would go to and work with them with regards to your disabilities, where they can help you and assist you with either finding academic advisors or assistants or working with accessibility and modifications, those types of things.
You know now that you say that, I remember I went to the University of Southern California, and I also went to a local junior college, Mount SAC and I remember they're popping up some like, get paid to take notes for a class that you're in, and it was coming directly from the school, and they even kind of said, you know, you're taking notes for someone that's in that class that needs support with that. And I never thought about that, really, until just now. And you said that that could be like a support another student in the classroom, right? Takes notes, and then they you provide those notes, you get paid, potentially, to take those notes, and then you give them to the to the school, who then passes them on to anyone who might have a learning disability or something like that in the classroom. Exactly. Wow. Cool. All right. Well, you know, that was a great intro, way more than I thought it was going to be. So let's go ahead and dive into the transition age student. Ta, yes, and let's just start kind of here with a working definition, because not everyone works in high school, middle schools, not everyone has the same experience you have. So what is a working definition for a transition age student? What does that refer to?
Justin Lundstedt
I mean, So a transition age student really references an individual between the ages of 14 and 24 you know, there you can argue the beginning and the end ages. Some people say 16 to 21 some people say 14 to 24 but that's really the age group that you're looking at, those students who are beginning to look at, you know, the independent life after school. And yes, it does start early, but it starts early so that they're able to get there. You know, while there's again, looking towards adulthood and that independent sustainability. So this is the age where we're looking at the development of skills that'll really allow these students, you know, the ability to survive in their environment post high school, whether it's college vocation or daily living.
Awesome. And, yeah, it's my understanding that that. Early, we have to start looking at a transition plan at 16. But some states are moving closer to that 14 age range. They're starting to say, hey, let's start earlier. Correct? Why do you think that is actually?
Justin Lundstedt
I think it's really so that there's more of a focus on what the student's goals are for post high school, you know, post school age, so that they can really get all of their ducks in a row, per se, you know, it's, it's really, so that they can identify the goals and start working towards them in a purposeful manner. Because otherwise, it's just, and this is my professional opinion, it's just redoing all of those daily living tasks, those pre vocational tasks, without true focus on what the students really looking for and moving towards. And again, as OTs, that's what we're looking at. We're looking at, you know, the client's perspective of their lifestyle.
Yeah, yeah, absolutely. So we're going to dive into kind of what maybe a transition plan looks like in a little bit. But first, I want to ask you about kind of the historical reference of transition age students. You know, ot has only been in public education for about 3040, years. And I would imagine that working directly with transition age students, whether an OT or someone else, is probably relatively new to schools. So can you just give us a little background of maybe where or when school started looking at transition age students?
Justin Lundstedt
I mean, it really started, if I remember correctly, back in the 70s, 70s and 80s. You know when the Office of Special Education and rehabilit Rehabilitative Services programs started looking at outcomes and recognizing that there was a need for, you know, increased assistance with students with intellectual disorder and special education needs in order to promote their independence and their lifestyles post high school. And then through there, you know, you you really developed in the idea, you know, the reauthorization of 1990 1997 really brought about the development of transition services to promote greater independent life outcomes for students with disabilities.
Yeah, again, you know, idea really brought about ot within special education, and I'm sure the same way it brought about understanding, hey, students aren't graduating. Those with disabilities aren't graduating. We need to do something. And with every passing or reauthorization of IDEA, I'm sure that's an area of interest, mostly because all the research, I think, is showing those with disabilities are less likely to graduate, get a job, live independently. And we know how much I hate to use this term, but that's what really the government looks at, is how expensive it is to take care of someone once they're no longer under the care of their parents. Absolutely. Yeah. So, so that's, you know, it's kind of one of those catch 22 like it's, it's hard to think that we need to look at this so much, but at the same time, it's great that we are looking at it so much. So I'm sure idea will continue to to look at transition age students, absolutely. All right, so let's talk a little bit about what you have seen in your own personal research discovery as well as just what you're seeing out there with OTs in general or other practitioners. What are OTs doing in relationship to to working with students with that are in that age range?
Justin Lundstedt
I mean, I'll be honest, I think there's, it's half and half. I think there's an awareness, but there's also an unawareness of what we're able to do with those students. You know, I think those that are in that field are really working towards developing the motor skills as well as the cognitive skills, which, you know, for me, that's sort of my my area of interest, utilizing those cognitive skills, the executive function skills, the goal directed skills, to really identify what you're trying to accomplish and how, and then from there, recognizing the strengths and weaknesses that you can use to get there. So it's really working with the student. You know, it's the traditional sort of definition of we're trying to modify, adapt or assist in developing those skills that the student needs in order to promote their adult lifestyle. So it could be anything, um, there's, there's a wide array. We can talk about academics, we can talk about vocation, we can talk about life skills, you know, we can even talk about social and leisure skills. Those are all things that impact our students lives. In secondary, you know, in high school, in middle school, and they actually are more focused in those grade levels, because now we're undergoing a lot more development and a lot more awareness and a lot more need. Needs to interact in order to get our own needs met.
Okay, cool. And then when you specifically have you had a chance to dive into the research at all. And you know, when we have a question about something, or when we want to look for something more about a particular topic, we often ask ourselves the question and look for the answer to that question, right? Have you found any answers to questions by looking at research? Or have you found that something's missing when you look at the research?
Justin Lundstedt
I've found a lot of information that states ot would be great at this, if we got more into it. You know, like with regards to even Transition Specialists, executive function, all of these areas. There's a lot of research out there that says we have great skills to assist with but there's not a lot out there that says we're implementing it at a regular rate.
I love that. That's like the everyday conundrum. It's so similar to the role that ot plays in RTI as well. There's a lot of work, or a lot of research out there that says, OTs say they want more information on RTI, but they're not actually doing it, but they would be great at it. But we need more research that says, hey, this is what you can do, right? There's RTI, or as being a transition, transition age or working with transition age students. So yeah, we need more research. That's the end of the day answer, absolutely. Alright, so let's talk a little bit about what we can do as therapists and the transition age student. I first want to talk about the plan, a transition plan, because I think that's kind of the overarching picture of what we need to kind of, it's like the IEP, right? Or it is part of the IEP. So can you share with us a little bit about that transition plan first?
Justin Lundstedt
So with regards to the transition plan in the IEP, you're really developing, and it should obviously be a collaborative process with your full IEP team, with honestly, the student heading it you're developing this plan in order to identify the expectations of the student for after high school, the you know, hopes, the goals for the student. I don't want to say hopes and dreams. I want to utilize the right terminology here, the goals for the student after high school and what skills or deficits they may have at that moment that are limiting them. So then we're promoting goals within that transition plan that are focusing on their exit. And this, you know, it comes about with utilization of evaluations and consulting with parents and teachers, you know, again, using the whole IEP team to collaborate, but focusing on the students what they really want in the future.
Jayson Davies
Yeah. And so, comparing it to an IEP, obviously, in an IEP, we have goals. What is the difference between a transition goal and an IEP goal? You just kind of mentioned, right? You're looking beyond.
Justin Lundstedt
Oh, absolutely so. And I'll tell you how we sort of do it. In my school, we take the transition goals and we create them as sort of this long term objective of what the student is seeking. And so let's say they want to go to college for computer design. Okay, so that's maybe their educational part of the goal. So then within the IEP, you're going to be looking at, you know, whether it be academic goals or motor still motor goals that are going to focus on that end transition goal. So you're actually taking the transition goals and then building it into those specific IEP goals as well.
Jayson Davies
I love that. That is a great example. I really like the idea of using I'm seeing this language more often distal and proximal goals. So you're creating a distal goal of that student going to college, that student getting a job, and then you're creating more proximal goals that you might fit into the IEP that are being addressed year after year, or are being measured, I should say year after year to lead to that distal goal. Absolutely love that. That's awesome. So I've got to share an experience. I have worked in a high school on and off a few years, not a ton. I have been a part of transition plans, because every kid in high school that has an IEP has a transition plan, but I must admit, they have been, for lack of a better term, fairly shoddy. These goals are for a student to attend a career fair. The goal is for a student to look into potential jobs. Yep. I mean, why do you think that is? And I'm at, like, a pretty, you know, a suburban upper end High School, that's kind of what's going on. Why do you think that's the case?
Justin Lundstedt
I think it's truly unfamiliarity with the process, you know. I think oftentimes we're so focused on getting our students to, you know, a certain, certain academic. Academic level or demonstrating this certain skill, that we focus again on those proximal goals so much, and we forget about the distal, you know, and something that I always say to I still work with one classroom of four and five year olds, and I actually just had a discussion with a parent the other day, and I said to them, the one thing I always state is think about them at 21 you know, whether it's behaviors or whether it's whatever you want to look at from your child, but think about what they're going to be if they stay how they are today at 21 and is that what you want? Because it's and again, I understand it's not about what the parent wants, but at that age, it is, you know, and we're really developing to a point where we want to focus on what the outcome is going to be, the long term outcome, and creating those short term goals in the sort of, you know, temporary time being. But when it comes down to it, we're so consistently looking at grade to grade that, you know, that 12th grade or that 21 years comes so quickly because we're so focused on all the other stuff involved. So I do agree with you. I've seen a lot of IEPs that are like, we'll go to a job fair, we'll, you know, search for a job in the community, and there's no, there's no meat to it, and then when they get to that later age group, it's like, okay, let's scramble. What are we going to do now?
Yeah, yeah, that's unfortunate. And you mentioned a little bit ago, I think you Gosh, what was the term you used? It might have been like the transition team leader or something like that. Like, I have not come across one of those here in our district. It was just kind of a collaborative effort, I guess you could call it, but it really was on the onus of the special education teacher. They were the ones the case carrier, that really led the charge. And if they didn't reach out to me about a transition plan, I didn't know about it until the IEP. So is that typical? Is it typically the case carrier, or are there other people working on this?
Justin Lundstedt
There It should be a collaboration. There's like so again, I'll give you my professional opinion. There should be a collaborative transitional team involved, because you're looking at all aspects of the child's life or the student's life, you know, most places. So a clinician may be the lead and a teacher may be the lead. It depends on the different districts. I know there's a lot of differences, you know, throughout my area, and then there are some districts that have a specific transition coordinator, but that, to me, is just starting to develop and become more popular because, again, it's another position put into place.
Jayson Davies
All right, cool. So I want to move into the actual side of the intervention. I think a great way to kind of transition over there would to be to ask you, we talked a little bit about shoddy goals, what are examples of maybe some good goals that might be put in place. And I know I'm putting putting you on the spot here a little bit, but what types of goals have you created that you think are halfway decent goals?
Justin Lundstedt
Um, none of them. No, I'm just kidding. I mean, from an academic perspective, I have created goals that really focus on so I can think of one student who really has, you know, some issues with dyscalculia, and really has difficulties organizing the math on paper, and actually wants to do more of engineering architecture, and is in that kind of a program right now, but is having difficulties with some of his math work. So one of his goals is to utilize, you know, specific, and I can't think of the goal off the top of my head, I apologize, but to utilize specific methods to perform the necessary concepts for his class work in math to, you know, promote and achieve the necessary grades that he needs to pass the class, because that is his goal, to their move forward and hopefully do more of that type of work. So that would be an academic type of goal. Does that make sense?
Jayson Davies
No, I like that, because you kind of shared the proximal and the distal side of it. The distal right is for him to eventually get into engineering, architecture, right? And then from there, you develop the more proximal goal that is the here and now, what he needs to do in his math class in order to work toward that long term goal. Great, love it. Thanks for sharing that.
Justin Lundstedt
No, no problem and and it's hard because, you know, we're trying to move towards those goals, where it's not just an OT isolated goal, but there is still a lot of that out there, you know, where we're creating our own goals and not working off of the full blown educational goals, which I think is typical in a lot of districts. But there's also a lot of districts starting to shift, and just everybody is focusing on those specific educational based goals.
Jayson Davies
Yeah, yeah, definitely. So we got completely way off topic. I'm going to try to bring us back here. I love it. I love where this conversation went. But now talking about that transition age student, we already talked, you know, 1421, 22 age range. When I think of, I don't want to use the word kids, you know, they're teens, they're young adults, when we think about that age range. We're talking a lot about social skills, emotional skills, obviously, cognitive growth in different areas. So now, in what ways can OTs really work in this age group? I get a lot of questions from OTs saying, I don't know what to do with high schoolers. Like, where do I even start?
Justin Lundstedt
Yeah, so I think my biggest way of identifying how to engage is really to either utilize something like the copm, the Canadian occupational performance measurement, or really doing a nice observation interaction with the student to identify their goals and their cognitive level. So yes, there's a lot of social stuff going on, and there's a lot of leisure based, you know, activity going on, mixed in with the academic and then you have the pre vocational. So it's really a conglomerate. And what I do is I break things down first of all, to see if they even have future goals. You know, because so often in the IEP, their goals are not theirs. And that's my first level. It's, it's the, you know, the old task analysis. I take it from, I'm looking at the client, and I want to break them down and task analyze them into each section, whether you know, from academic to vocational to ADLs and see where they're going. And like I said, there's so many of my students that don't have goals because they've been led through life rather than been asked what they want out of life. And so I'll ask students, what do you want to do? And they look at me like there's an after this. No, and it's, it's shocking. Well, it used to be shocking, and now I can sort of break it down and sort of prompt them with questions. So I use some coaching in there to prompt with questions. And then we together identify maybe somewhat of a plan, and then we work collaboratively as a team to develop that plan further.
Jayson Davies
Awesome. Awesome. Yeah, there have been some high schoolers that I'm working with that sometimes I think of the old, oh man, it wasn't, it was Allen Iverson that said, I'm just here so I don't, or it's just practice. I can't remember who it was that said I'm just here so I don't get fined. Like, it felt like the kids were just coming to OT because they had to. They didn't. I mean, there was no volition to be there. They didn't care what they worked on, and they even knew that the IEP team was often the decisions were being made by this IEP team that they didn't really have a say in. And so they're just like, I'm just here to work on the goals that you tell me to work on. Yeah, and I think that's a problem.
Justin Lundstedt
Yep. Oh, without a doubt. And that's where, and I get a lot of that too, especially with, you know, you're getting close to graduation. Oh, I'm here, what do you want me to do? And I'm like, I don't want you to do anything, you know? And that's where I first initiate that whole breakdown. Because they're like, Huh, you know. And they want to know, what am I supposed to be doing? And I ask them, you tell me, what are you supposed to be doing, and why are you doing it? Because if there's no why behind it and there's no motivation, you're not going to see any interest in success whatsoever. You're just going to have that student who's like, Okay, I'm here, you know. And sit, sit around and stare at you for 30 minutes, whereas, if there's a purpose for them and there's something that you could pull out of them that they really want to achieve, then you're going to have, you know that 30 minutes is going to feel like five.
Jayson Davies
Yeah, yeah, definitely. And I love that. You you tied in the copm, we'll be sure to link to that. It's pretty easy to find on Google, but for anyone who has any trouble, we'll link to that. So one thing that you did, and I love how you did this in a presentation at the back to school conference, is you broke down the domain of OT a little bit, and you broke it down to from occupations to client factors, performance, skills, and so we don't have to go through all of that. But if you had to look at occupations as a whole for this age range, what are maybe the two to three things that you're finding are most the biggest concerns, I guess, for the students, because obviously, an occupation can be anything, and the IEP team can come up with anything. But what are you seeing the the kids most focused or energized about?
Justin Lundstedt
So I think there's a there's a couple of things you could look at there. So I think one of them is really looking at the academic or the education area. So often we start to shed some of the academic expectations as they get older, because we're like, Okay, this is where they're going, and we sort of almost pre identify their their course, their path. For them where and like I said, this one student who I worked with with math, he wasn't even on the track to go into that kind of a course until a couple years ago, when we really identified that academics were of interest to him, you know. So it's really, again, pulling out their interest and identifying, hey, wait, there actually is more academics to be learned here. So that's one big area. I think way too often we pull back on that and focus on the life skills that they're going to need, but they may have those life skills, but where's the motivation to participate in whatever it is other than life skills that they want? Does that make sense?
Jayson Davies
Yeah, yeah. I can think of kids that I've had very similarly, right? Like, they just, I don't, I don't need academics. I'm gonna go start a business. Like, okay, well, well, what do you need to know to start a business? Yeah, right. And that can lead to some generation for them, or that motivation for some academic skills, right? Do you have the math that you're going to need. Oh, no, I just have a calculator on my phone. Okay, do you know how to use the calculator on your phone? Is your calculator a good enough calculator, like so many things, right?
Justin Lundstedt
Yeah, yeah. Can you do more than just access YouTube or the apps that you're looking for on that phone and you recognize it as a tool or just an entertainment center, you know? And that's huge. So from an academic perspective, there's that. And then, you know, pre vocational and leisure slash social are the other two big ones. You know, because number one, once you leave high school, you're on your own island, unless you're looking and finding what you need, or there's somebody finding it for you, which, yes, there's students that have a team that are helping them out, but then there's other students who are leaving and going into an abyss where they don't know what to do and how to access people and don't have transportation and they're at home.
Jayson Davies
Yeah, that's scary, scary to think about.
Justin Lundstedt
Yeah. And they rely on, you know, their video games to interact socially, which is great, but you're not getting that emotional attachment or that motivational attachment. It's just talking into a screen.
Jayson Davies
Yeah, you know, and this is off topic, but not completely off topic. Social media. I'm really surprised that OT, as far as I've seen, hasn't really gotten into social media. There's been, there's been aspects of people using virtual augmentative reality for therapy. But I don't even think we as a profession have acknowledged social media as a meaningful occupation, and I think it is almost necessary for it to be its own occupation, because it is part leisure, it is part education, it is part work. It is, I mean, there's so many pieces going into social media.
Justin Lundstedt
Yeah, no, I absolutely agree with you. And you know, fortunately, between myself, our speech therapist and our educators and our clinicians, it's, it's a nice collaborative where you have to be on top of that stuff too, because stuff goes on into the school that, you know, one student might be hurt by another student, and then there's students that are trying to get jobs and don't understand how to use the resume system on like indeed, or something like that. So, you know, there's so much from a social media perspective, to engage with and interact with.
Jayson Davies
Yeah, yeah, definitely. So we talked a little bit about some occupation at the higher end. We talked to me and about several we talked about academics, work, leisure, social media, if you want to call that an occupation, and then other areas of the domain. I'm just kind of kind of, you know what? Let's go down client factors. And you've already talked a little bit about this. I think this is, can be where the copm can really come into play. But that client factors, what do you tend to look for at that transition age range?
Justin Lundstedt
I mean, from client factors, I'm really looking at their first and foremost. You have to look at their environmental context, you know? I mean, you have to see where are they coming from, where are they living? What are they near? Who are they near? All of those things. Because, again, we're looking at how they're going to be able to engage. You know, another client factor is family wise. You know, do they have a strong knit family? Do they have that team around them that's going to be helping them build? Are they independent? Are they sort of on their own? Do they have many siblings that need care as well. You know, those factors, what are their values? What are their ethics? What do they really feel and believe about things moving forward? You know, what's what's meaningful to them? Do they have religion involved in their life? You know, all of these factors really participate in, you know, engage in their occupation.
Jayson Davies
Yeah, yeah, definitely. As OTs, you know, we all, we all have the access to the otpf for or at least we should, and so everyone needs to go through and look at the entire domain and how you work through each just kind of, it's almost like a chain, right? You just kind of move from the occupation, start large, and then move down. To figure out where you want to go. One last area within the domain that I do want to get your take on, because I think this is very unique to students of this age range. Is their roles, their habits and their routines. I think that they're very unique in the sense that, well, I mean, they're just in high school. High school is a whole beast of its own thing, and I think that high schoolers have a very unique set of roles and routines that sometimes we as adults think we know because we were there once upon a time, but obviously it's very different. So I'd love your take on that.
Justin Lundstedt
I mean, so before even saying anything, I have three teenagers in my house, you know. So I get sort of a cheat sheet there, because I see it on a daily basis. But it is so different from when I was a teenager, you know, just because, once again, you have social media, you have all of these constant sort of demands placed on the students, from a role perspective, they have to be a friend. They have to be responsible. There's definitely more responsibility placed on Gen, Ed, especially, I recognize more responsibility on what they're in charge of, what they need to take care of, you know, all of those things, from maintaining the school computer to, you know, looking on Google Classroom for their homework. It's not written down in class anymore. It's go check it on this, you know, web page, so it's carrying over all that information. So they have a lot more roles. They have a lot more responsibilities. From the fact that, you know, a lot of students are working at the younger ages. Still, they're getting jobs. But on top of that, now they have so many sports and so many after school activities, so they're bouncing from one thing to another. And our students in special education sometimes get lost in the shuffle in that, because they are brought to all of these activities. But then sometimes they lose those roles because they're just brought to them, rather than being engaged in leading themselves into them, and saying, This is what I want to do. So they may lose some of their roles, whereas other teenagers may be gaining multiple roles, if that makes sense.
Jayson Davies
Yeah. I mean, I think that even kind of encapsulate, encapsulates some of the changes in special education as a whole. You know that used to be a a clear goal, basically, of students to participate in everything, and I think that that goal is now changing to allowing students to choose what they want to participate in, right? It used to be, hey, you're in high school. You're going to go to all the classes that a typically developing peer would go to. So we're going to put you in a in a math class. We're going to put you in PE no matter whether you like it or not. And we're starting to see that change a little bit. And so we're giving them more power to make decisions on their own.
Justin Lundstedt
Now with that power, again, comes, you know that traditional saying, with power comes responsibility, right? Yeah. So with the responsibility we have to look at, and this is something that I think gets overlooked, often their cognitive level or their neurodevelopmental level, and that's where my sort of love for executive function comes in, because so many of our students, they are missing pockets of that cognition or of that executive function, and we just have expectations that they can do because they present as such. But then when you dig deeper, and as an OT this is where I task analyze, and I sort of figure out what's missing, what piece isn't happening, you recognize that, oh, man, they're not even you know aware of that, or they don't have the impulse control to even you know, be able to hold that in or the working memory to retain that information, you know? So those types of things are what I'm really seeing at the older ages, is our expectations are high where they may not have that development, and the development has changed. You know, there is definite research on that.
Jayson Davies
Yeah, yeah. And if you're listening right now and you're thinking of a particular student, you're not alone, so am I? So yeah, you know, that's what we do. Is over to use, right? Man, I could go in so many directions, but one thing that I have had only one student, even really this concept, come up with, and it's the student that I am thinking about is sports. And students that are in a more mod severe classroom, maybe they have, you know, they've got some skills, kind of like that kid that you're just talking about, right, that you can see that they've got a lot, but when you look underneath everything, you see the difficulties that they really have. Yeah, and kids should have the ability to participate in sports, participate in music, participate in all the extracurricular stuff. And so I'd love to get your take on on that. And if you've ever had the the ability to kind of work on those extracurriculars with a student.
Justin Lundstedt
I have not had like particular because I'm in a special ed school. We don't have all of those opportunities. What we do do is we make sure that if they have the interest, that they have the opportunity in their home district to go in and participate. I haven't had the opportunity to really have that kind of interaction, but I will say that my opinion is where there's a will, there's a way, you know, it's really finding that modification or that adaptation, or, you know, educating the other professionals as to the limitations that there may be in order to find other ways to be more inclusive. So it's really to me, I don't see any barriers or walls. I'm always that guy who's like, full steam ahead and trying to crash through. Because I do believe that we all have the capability and motivation drives us. So if there's really that will to do, there's a way to find it.
Jayson Davies
Yeah, absolutely. And, man, I can't remember where where it is, but I believe in idea. It does point out that idea includes extracurricular activities. So if you're in a position where, you know, you've got a student who wants to play baseball or whatever it might be, advocate for them now that may come with a little bit of a cost, you know, it's really hard. You might need to be the person that goes out to baseball with them as the OT, and you're going to have to try and make that work, you know, or is there someone else that can go out there isn't a higher during that time, or talk to the coach and, you know, try and work out some sort of system. But I do believe that there needs to be more done outside of the eight to three o'clock, whatever school hours is, you know, for kids who want to go out and beyond, definitely.
Justin Lundstedt
And I think that's another role that ot has, is to really interact and create more of that collaborative process, because we're able to recognize those adaptations and modifications and speak with those other parties that may not have the awareness.
Jayson Davies
Yeah, you don't realize how much of a specialty it is that you may be the only person actually thinking to go talk to someone. Yep. I mean, just the idea that you have, that you know the student, and just say, hey, why don't we go talk to the talk to the coach, like other people may not even think to do that. And as an OT when your task analysis, or do your task analysis, you might come to that conclusion and and go for it.
Justin Lundstedt
Yeah, absolutely, absolutely. And that's where I feel like ot as a whole is very unique, because we learn from that sort of task breakdown perspective.
Jayson Davies
Yeah, yeah. So I want to talk to you about two things that often come up. I'll start with this one, RTI, and that is because even myself, when I speak about RTI, I am often speaking at speaking about it from more of that elementary age level, starting young, so we can prevent evaluations, unnecessary evaluations, not all evaluations When a student gets older, but RTI can absolutely apply to all grade levels. And so I want to get your take on RTI as it relates to the high school.
Justin Lundstedt
I mean, from my perspective, utilizing RTI, you have your direct services, which are great, but there are ages. You know, there are students in those age groups that don't need necessarily direct treatment, but they need something, something more to help them. So those tier one, those tier twos, can be more utilized to promote some of that. So, you know, co teaching at a tier two. So if you look at RTI and you're looking at your tier two, co teaching is one of the possibilities. You know, working in a group with a teacher, that's something that I do in my own school. And I work in some of the English classes or the history class, and I work with a whole group of students, we work on a specific thing as far as locating some of the research and finding the answers. And how do we do this? And you know, both the visual perception as well as the cognitive awareness of what we're looking for. It works as a whole. It doesn't necessarily need to be direct treatment. It can be indirect. It can be co teaching. We can be using tier ones to create programs like those that you're speaking of, with regards to athletics or music. You know, we can be creating programs for bullying, and that's I think, even in the you know, best practice book through ot a discusses that developing programs is another way, because we have that awareness of our students needs and deficits, where we can incorporate it into a more inclusive environment.
Jayson Davies
I love those ideas, and now I'm going to push you, because I know someone listening right now is wondering, wait Justin, just said he goes into a classroom, he sits with a group of kids, helps them find research, helps them find answers. And they're thinking to themselves, because they they tell me, this is that's a one on one eight. And so I want to ask you, why, why are you not acting as a one on one aid. When you do that?
Justin Lundstedt
Because I'm using skill based intervention to recognize the deficits from a cognitive perspective, you know, I can as a one to one aid, yeah, I can sit there and I can feed them information, and I can tell them what to do, but I don't know their neurological development. I don't know, the breakdown of their perceptual skills versus their understanding of the question versus their ability to retrieve the information from, you know, previous classes, and you know, then I'll one up you on this that I'll get the why can't it be speech? I'm not saying it can't be speech, but that's where you have to work on your collaborative team and identify who's taking this role and why, you know, and it may come down to, well, they also have some motor issues with writing or taking the notes. So maybe that's more you Justin, you know, or maybe it's just a cognitive, expressive issue. So maybe that's more you speech, you know, that type of a thing, but I get the same questions all the time, and I responded to those types of questions on Facebook all the time, just because I want to be that guy that promotes ot but, yeah, I definitely recognize why people think you're just a one to one aide, but you've got to recognize you're using your skills that other people don't have.
Jayson Davies
100%, See, I'm not the only one who says that. Everyone listening. It's not just me. You are not a one to one aide. When you push into a classroom, you're not a teacher. You are an OT, and you have the skill set of an OT working with those students. Yes. Oh, right. Now, that's tier two going into the classroom. I gotta ask you about tier one at tier one. Have you either a developed any sort of program or B? Have you done in services for high school teachers? I'll have a follow up, but I'll let you answer that first.
Justin Lundstedt
I have done in services in the past for high school teachers, more focused on the vocational aspect of things and how we break down skills, from motor skills to cognitive skills to even emotional skills, why we're seeing some of the behaviors we see, you know, and that has really been effective, in my opinion, because it gives the staff, and now this is teachers and aides together, the awareness of really what we're looking at. So, you know, then you could say, now they've got some of those skills to see it, right? So maybe I don't need to provide that direct intervention, and we can go from there. So now we're not utilizing me as a direct intervention person, but we're utilizing me as an educator to promote so that they don't need me.
Jayson Davies
Yep, absolutely. My follow up was going to be what what courses or what development you've given to the teachers, but you kind of answered that, what is the most I don't know. Maybe you get requests or don't get requests. What have you had requests for when it comes to speaking to teachers, whether it be from teachers or maybe from admin? Are there any things that kind of continuously come up that they want you to present about?
Justin Lundstedt
More recently, it's become more about behavior, and so I put a flip on it, because I really recognize it more as executive function and goal directed skills. And a lot of times, our students don't have the self awareness to be some of their behaviors are not goal directed, their their automatic reactions or learned reactions. So they're not utilizing their, you know, neurological skills to promote this behavior. They're usually utilizing a mix of trauma and, you know, a mix a mix of trauma and learned reactions, and getting that reaction from others to then sort of use those as a functional response. Yeah. Does that make sense?
Jayson Davies
Yeah. I think that's fair. I mean, again, coming back to you're an OT and you have the ability to look below or beyond the behavior and go to the next level, what is really the behavior? What the behavior is more of an outcome than it is a cause or reason for what you're seeing on the outside. And so by looking at the executive function, you're getting deeper.
Justin Lundstedt
Right? And you're you're able to sort of break it down in, then through breaking it down, create the relationship, and then sort of build back up.
Jayson Davies
Wonderful. All right, you know what we are getting close to wrapping up, but I want to do a few rapid fires.
Justin Lundstedt
Oh boy.
Jayson Davies
Yeah, rapid fires. And just for everyone listening, Justin has no idea what I'm about to come up with. So let's go handwriting and high schools. Handwriting intervention in high school.
Justin Lundstedt
it depends on the student, and it depends on their goal. I have students who still work on it at times, but not for you know, they're not writing essays. They're they're typing their essays, and if they really want to work on getting their handwriting down, they may write a couple of sentences from the board, but. But that's because that's their goal, that they want to be able to effectively do or signature, you know, that's another big one for people. But and those that still write out checks, you know, we still have some of that too. So I'm not saying it's obsolete once you're in high school, because it's not, there are things that can be utilized. It's also the student's goal, you know, it's, it's really what their what their focus is.
Jayson Davies
Perfect, perfect answer, in my opinion, at least well the next one I had, I had working on sleep for a student at the high school range.
Justin Lundstedt
I mean, this isn't something you hear often, but, and I haven't had a specific goal for it, so don't, don't, you know, think that I'm all into the sleep situation, but I do have goals with my students about identifying their schedules to promote their ability to function, because so often you have students who are, you know, sucked into social media and Video games until two or three o'clock in the morning, and then they're rolling out of bed at 530 and coming to school, and that's where, again, breaking it down, identifying what their goals are and seeing how to get there.
Jayson Davies
All right. See everyone listening. Knowledge consults only in high school.
Justin Lundstedt
No way. If Listen, yes, there are, there are situations where consult only is fine, but if you have a student who doesn't understand their own impairment, they need more than just a consult. They need to understand what's going on themselves. It's individualized, you know, and there might need to be some direct service in there so that you can work with the student to understand their own strengths and weaknesses. Again, I work with students, and I ask them, What are your strengths and what are your weaknesses? They can give me 10,000 strengths, but as soon as it comes to weaknesses, they don't know anything. There's, there's nothing wrong. I don't have any issues, you know? So it's, it's self awareness, you know, it's recognizing those deficits.
Great answer. All right, last one here, I got for you the most unique goal you've ever written, or a student on an IEP.
Justin Lundstedt
Oh gosh. All right, you're gonna have to deal with my processing skills for a minute. I don't know, there definitely been a couple of vocation based goals that people have looked at me sideways because they didn't think the student was able to do them, you know. And one of, I know one of them, and this was more of a middle schooler, but back a long time ago, was actually creating a musical track on the iPad, because his focus was music, and he loved to take music and recreate it. But nobody really sort of saw the that potential and how you could engage academically. So we actually used, I forget the what's the app called Garage Band, and he created this remix, and I have it somewhere still, because it was amazing, and had like, six different organized parts through the orchestra, and just created this whole thing together. But instead of just doing it as, like, this piecemeal thing where he was using his own mind. It was breaking it down into steps, and he was following the directions to do it, rather than just doing the creation part. And nobody understanding how it's created. Does that? Does that make sense?
Jayson Davies
Yeah, yeah. And it works on more than just music, too. I mean.
Justin Lundstedt
Right, Without a doubt, it was. It was more focused on completing multi step direction. You know, it was, it was being able to follow instruction rather than just impulsively create.
Jayson Davies
Yeah, yeah. I never did it, but I always figured that if I worked in high schools long enough, there would come a time that I would write a goal related to social media, in some way for a student to access, Instagram, Facebook, whatever it might be, because that's how they communicate. That's how students communicate in in high school. And so, yeah, if I were to stay there long enough, I'm sure, I'm sure something like that.
Justin Lundstedt
Well, and you've given me ideas, as far as you know, moving forward, because there's definitely that impact. And again, with the cognitive piece, there's a social breakdown too, because sometimes you don't understand what the other person's saying, and you respond back to and it doesn't make sense, and then they come back at you. It becomes, you know, just this sort of whirlwind of a breakdown.
Jayson Davies
Likewise, the implications of what you do send or don't send.
Justin Lundstedt
Exactly, exactly. And there's a lot of that sort of digital literacy and digital citizenship out there and understanding it, you know, because the kids are often taught it in different classes, but understanding and comprehending and really applying the knowledge is different.
Jayson Davies
Yeah, yeah, definitely, yeah. If you wouldn't say it to someone's face, you probably shouldn't send it in a text message.
Justin Lundstedt
Exactly.
Alrighty, Justin, I think that's going to wrap up the the bulk of what we got going on today. But I would love to ask you if there's anything else you'd like to share for for those OTs out there who are maybe in year one and working in a high school, or maybe they're in year five and they're just still not feeling super confident about it, just a little word of advice or words of wisdom.
Justin Lundstedt
I mean, my biggest word of advice is follow your gut. You know, not the outline that people have created. I think too often our profession has been sort of identified by other professions as to what we do. And I think that if we really look at our education and the breakdown of what we've learned and apply that there's so many more areas that we could be that we could impact with our students. So do not hesitate from following your gut. Do not hesitate from going off the beaten path and take that leap, because if you don't, you know somebody else is going to do it, that's great, but they may not have the same skill set that you have.
Jayson Davies
Yeah, 100% you know, other people do work on occupations, but we are occupational therapists, and we come at it from a very unique way. And there's definitely something to be said about the way that we that we support students, so go for it absolutely All right. Well, before we sign off today, I do want to give you the opportunity to share a little bit about what you have going on, because I know you have a course, and so I'd love for you to share what what you're working on.
Justin Lundstedt
I do have a course out there focused on executive function and transition for the occupational therapist. So for those that are interested in developing their skill set, it goes over in detail. You know, really what executive function is, how it relates to occupational therapy and then how we apply it with transition age students. Because, like you said, transition age and executive function is a real passion of mine. I think it's an area that is often forgotten about. So I also do have a group for those you know, newer grads or people that are wanting to learn more about executive function, executive function for the occupational therapist, and that's on Facebook. And I'm currently developing a couple of more courses that are really more for the occupational therapist right now, my focus is to educate the occupational therapist. So I do, do you know, some coaching with therapists? I do, like I said, I'm creating more coursework so you can find that stuff on the executive function OT, so that's where I'm at right now.
Jayson Davies
Awesome. Sounds great. We will, we'll tag the Facebook group, we'll tag your website. And yeah, anything else we can find about you, we will tag people or tag you so that people can find you over on the OT school house show notes. So head on over to the show notes. You'll get all that info. And yeah, one last time. Justin, thank you so much for joining us today on the OT school health podcast. It's been a pleasure.
Justin Lundstedt
Oh, thank you so much. It's been my pleasure as well.
Jayson Davies
All right, everyone, take care. All right. And there you have it. So much goodness on how to support our students in the high school setting. Really, remember, there is more to occupational therapy than handwriting and fine motor skills and sensory motor skills. We are occupational therapists. We have the power to look at the occupation of any person from zero to 118 whatever it might be, and support them. So the next time that you get, I guess, thrown in, or maybe you get told you have to work at the high school in your district, don't fret. You got this. There's so much that you can do with those high schoolers. So take advantage of it. Learn about them, learn about their perceptions, their occupations and what they would love your support with. Until next time, enjoy your week, enjoy your day, enjoy your gym workout. If that's where you're at right now, or hopefully if you're driving you're staying safe and not focusing too much on the podcast. But until next time, take care and yeah, just have a good one.
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.
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