Episode 109: From One Coffee Cart to an entire Community-Based Instruction Program
- Jayson Davies M.A. OTR/L
- Sep 11, 2022
- 41 min read
Updated: Nov 4, 2024

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Welcome to the show notes for Episode 109 of the OT Schoolhouse Podcast.
Did you know that transitional services can be implemented even before a student gets to high school?
In this episode, we talk about how community-based instruction (CBI) can be implemented in the elementary school setting and how these children benefit greatly from starting early. Debbie Schwind discusses how she developed a campus-based CBI program for the students with just a coffee cart and how the program grew with the help of supportive teachers, staff, and administrators.
Tune in to learn the following objectives:
Learners will identify what community-based instruction looks like in an elementary school setting
Learners will identify a model that can help with CBI program development
Learners will identify the benefits of a CBI program
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Guest Bio
Deborah Schwind, DHSc, OTR/L, BCP, SCSS

Deborah Schwind is an occupational therapist with 30 years of experience in various pediatric settings, with the past 17 years in the public-school setting. She completed her doctoral dissertation from Drexel University. Her research focused on developing job skills, work behaviors, social skills, and self-determination skills through a school-based Community Based Instruction (CBI) program for students with autism in elementary school. She has presented nationally on transition skills, community-based instruction, IADL intervention, accessible curriculum, and adapted art tools. She has also been published on these topics, including a co-author of a chapter in Best Practices in School-Based Occupational Therapy.
She graduated with an undergrad degree in OT from East Carolina University, where she completed internships at Duke University and Johns Hopkins University. She received her graduate degree from Old Dominion University in educational administration. She has worked in pediatric rehab, early intervention, home health, and inpatient (including NICU) as well as outpatient settings, most recently being in school-based practice. She is an active member of the AOTA Community of Practice Transition work group. She is Pediatric Board Certified through AOTA and has a School Specialty Certification. She recently received an Innovation in OT Award for the National Board for Certification of Occupational Therapy.
Resources
Episode Transcript
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Deborah Schwind
So community based instruction is an evidence based teaching strategy, and it allows students to take knowledge from the classroom and apply it to a community setting. And that community setting, typically is off campus, but the community setting can also be the school community, and it's very functional, it's very purposeful, it's very meaningful, it's authentic learning, it's applied knowledge, and it's really OT.
Jayson Davies
Hey everyone, welcome to another episode of the OT school house podcast. What you just heard was arguably My favorite quote from today's episode, today we have joining us, Dr Debbie Schwinn to talk all about community based instruction and how she uses CBI in elementary schools to support students in their long term outcomes. We're talking about their ability to live independently, to have a job, to go to college, even all those things we start talking about early and community based instruction is a way that we can help support those students. Dr Debbie Schwinn actually started with a coffee card as her initial community based instruction program, and it has just grown from there. And so you're going to hear all about that in this episode. So let me go ahead, queue up the intro music, and when we come back, we're going to head into our episode for the day. So stick around, enjoy the intro music, and I will catch up with you in just a sec.
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
All right, and welcome back. Thank you one more time. So much for being here, for listening, whether you're on your drive home, on your drive to work or at the gym. Thank you for listening in today. I'm excited for today's episode because we have had some some episodes about transition age students and how we need to start having goals that go beyond high school. But today we're taking it back to that early elementary age and starting on some of those functional skills way earlier than we've talked about previously. We're talking about starting at the elementary school age, supporting students with on campus, community based instruction. Now I don't know what comes to mind for you when you think of the term community based instruction, but today we're going to be talking about programs that can be implemented as early as elementary school, such as coffee carts or other classroom jobs or maybe organizing the staff lounge, things that students at all ability levels can both accomplish and learn from. So this is going to be a great learning experience. We have someone coming on. Her name is Dr Debbie Schwinn, and she knows all about this. She's been implementing a similar program for many years, and she's even done the research on it. So she's going to share with us a ton of information, but before we do get into that, this is a professional development opportunity, and you can earn a certificate of completion for listening to this podcast and going and taking a quiz a little bit later, maybe once you get home. But because we're doing that, we do have some learning objectives. So our three learning objectives for you today are that you will identify what community based instruction looks like at an elementary school setting. You'll also identify a model that can help CBI program development, and finally, you're also going to identify the benefits of a CBI program. Now I'm not here to pretend like I am a CBI expert. I have definitely gone on my share of community audience with our students in the high school level, but this whole CBI in elementary school, this is totally new to me, and because of that, I am super excited to introduce to you, Dr Deborah Schwinn, Debbie has 30 years of experience as an occupational therapist, including the past 17 years in the public school setting. Debbie completed her doctoral dissertation from Drexel University, and as you might have guessed, her research focused on developing job skills, work behaviors, social skills and self determination skills, through a school based, community based instruction program for students with autism in elementary school. So please help me to welcome to the OT school house podcast. Dr Deborah Schwind, Debbie, welcome to the show. How are you doing today?
Deborah Schwind
I'm doing great. How are you?
Jayson Davies
I'm wonderful, enjoying enjoying the weather, enjoying the end of summer. It's hot, but I know a lot of school based OTs are getting back to school. What about you? Are you heading back into the schools this upcoming fall?
Deborah Schwind
Next Wednesday is my first day back.
Jayson Davies
Awesome. And so actually share with us a little bit about that. Where, where are you in the world? What are you doing, as far as school based ot?
Deborah Schwind
so I am outside of DC in Northern Virginia, and I work for a fairly large suburban school district, and I am very fortunate in that I get to work with students preschool through age 22 and in part of a Project SEARCH program, which I'm really always excited about.
Jayson Davies
That's awesome. And you know, we're talking about community based instruction, and actually we're talking a lot about more in line with what most people would think happening in high school that transition period, but we're really going to flip that around, and we're going to talk a lot about actually elementary school today, which is which is unique. A lot of people are doing what you're doing, but at the high school level. And so I am excited to talk about community based instruction in the elementary schools with you. Before we do that, though, I was on LinkedIn, just browsing a little bit, and I saw that you've been with your district for quite a while. How has it been being in one place for so long? How have you been able to grow within your school based ot community?
Deborah Schwind
So I have been there for 17 years, and before that, I worked in early intervention, home health, inpatient, outpatient pediatric settings. Have taught at the college level in occupational therapy assistant programs, doing the pediatric courses and assistive technology courses. So I have a lot of years of experience, if you will, but have seen a lot of changes in school based practice these last 17 years, especially with ESSA and MTSS and our role as sis as well as our role as related service provider. So there have been a lot of changes, and it's been, those have been really good changes.
Jayson Davies
That's awesome. Yeah, and you just mentioned a lot of acronyms. I'm not going to get into all those. All of those have already been mentioned on the podcast before, and we'll be sure to throw them into the show notes, because school based OT is full of acronyms. It's just everywhere.
Deborah Schwind
Say that I have my undergrad in OT. That's how old I am. So I have my BS and OT from East Carolina University, and I designed my own graduate degree, taking half of my classes in healthcare administration and half of my classes in educational administration. And then I've recently, in 2018 received my doctorate of Health Sciences from Drexel.
Jayson Davies
Okay, I was wondering about that, because you have your doctor in health sciences, but you also have a master's in education, correct, right? I want to ask you about that, because I thought about getting my master's in education. What did you learn throughout that master's of education that helps you as a school based OT?
Deborah Schwind
So it's a master's in educational administration, so it was really leadership type classes, and talking about how to create a culture in a school, addressing the climate in a school, and really taking on a lot of Leadership type of coursework. So it's definitely been very beneficial in my role as an OT even though I'm not an official administrator, I do feel like I am a leader within my department.
Jayson Davies
Yeah, I mean, we're all leaders in one way or the other, even if we don't have that official title.
Deborah Schwind
So absolutely.
Jayson Davies
Yeah, awesome. All right, so we are here, really today to dive in to your article evaluating a novel approach to community based instruction, also known as CBI in elementary school for students with autism. So let's go ahead and jump into that and to kick things off, why don't you share with us how this research even came to be. Was this your doctoral Capstone? Were you just a curious clinician or or, how did this come to be?
Deborah Schwind
So I was working in my doctorate classes where you have to do a dissertation, and I had this passion for transition, and when I started reading about some of the outcomes for adults with disabilities. It was actually really shocking that the unemployment rates are so incredibly high. So I feel like our whole purpose and education is to prepare our students for life after school and to prepare students to be contributing members of society. And when I was reading this, I just felt like, you know, we're really failing our students with special needs and different abilities, and I felt like we really need to do better as OTs and I felt like OTs had really play a big role in this. And as I was doing my research. Search for my classes, and was kind of grappling with what to do my dissertation research on. I kept explaining this program that I had created to my advisor, and it was actually her idea to do a program evaluation on this program that I had created, and I had been doing it for five years, so it wasn't a brand new type of a program, but that's kind of how it It started out and came to be part of my dissertation, or my dissertation, I should say,
Jayson Davies
gotcha. And so what made you decide to go the route like I mentioned earlier, a lot of people think about transitions. They think with the high schoolers, what made you decide to start earlier with those younger kiddos?
Deborah Schwind
So in our school division, our elementary school students were doing CBI, but they were going off campus, which is traditionally what you think of with CBI, and it really was not working. These were kids in third through fifth grade, and I know every school district is very different with how they teach students with special needs. And in our division, our students go to their neighborhood schools, and if they really everyone is Gen Ed, unless for some reason, there are significant behaviors or modifications to the curriculum that would not be helpful for the student to be in that gen ed classroom. However, saying that all of our students do go into Gen Ed, they just may not be in there all day. Okay, and so the students that are in our self contained classrooms really have, you know, significant impacts. They all have FBA is VIPs. You know, many of them have AAC devices. They have significant modifications to the curriculum. There's a lot of behaviors. And we were taking them out into the community. And we were taking them to places like the grocery store, restaurants, chain stores, and these were places that they weren't even going with their own families, so they were very unfamiliar settings with unfamiliar people, and it was very overwhelming. And what ended up happening is it really became a loss of instructional time because they weren't able to really access that community atmosphere. But then when we came back to the building, we were still dealing with the ramifications of that outing, and so we lost even additional instructional time. At the end of the school year, I was supporting it. I was going out with a teacher every week. And it also was really causing a divide in the community, because it's, it was a very sensory, overwhelming environment, and it was, you know, not showing our students strengths and in the community. So I just went to the teacher and said, You know, I want to support the students. I want to support you, but let's come up with a different idea. And so what we talked about was adopting the school as our community and building routines and behaviors and habits in a familiar environment with familiar people, and that's how it kind of came to be.
Jayson Davies
That's great. I mean, first of all, I just have to say kudos to your your district, your area, for even starting that young. I mean, I know in the district that I live in and and have worked at community outings aren't even happening till oftentimes, high school, maybe middle school, so even just starting at that third to fifth grade is just quite amazing. But with that, I kind of understand where you're seeing that divide. We want to we want to show off the abilities of our students, and we want them to be successful, and if every time they're going out, they're not having great experience, and people aren't seeing them being able to have that great experience, I can see where it could cause some disconnect. So.
Deborah Schwind
Right. It was, yeah, it was causing a divide, if you will, and it wasn't promoting acceptance of our students. So yeah, it turned out to be something way more than I ever thought that it would be. And because of that, we really were able to introduce a lot of different tasks and activities and occupations in this familiar environment with the. Familiar people. So we really were able to build habits and roles and responsibilities and routines, which is what our students all really need. Yeah, so it is perfect. It was the perfect storm, actually.
Jayson Davies
Yeah, you know. And in the article, you have an entire little chart of several different activities that students can be a part of, as well as the time of year. Taught that they can do this. So just for instance, please, if you're listening, go and look at the article so you can see this chart. But you have things such as stocking the teacher's office, coffee supply, Bin, running an outdoor garden, a farmer's market, stacking chairs, feeding the birds, composting like there's so many things here. Please, everyone, if you're listening, go look at the article so you can see this. But were you focusing on one particular community based instruction for your article's purpose?
Deborah Schwind
You know it was the looking at the program in general. Because one of the other driving forces for me doing this research was that there was some hesitancy within the school division that, and it wasn't from administrators, but that parents may not be supportive of a program like this because of the seemingly approach to functional living skills that may not be so academically heavy, and so there was a concern that the parents may not be supportive of it, and why really needed to find out if that was true. Because if that was true, then I don't feel like the program was going to be successful or accepted or adopted, because parents are a crucial part of the team, and so that was another really big driving force as to why I wanted to do the research on this.
Jayson Davies
That's great. I'm just going to be a little meta here. You know, as part of the podcast, we love to pull out quotes from the podcast, and we post those on social media. And as you speak, I'm just hearing things that, really I know is going to resonate with those listening. Some of the things you know, making sure that parents are on board, they are an important part of the team, making sure that teachers are on board and making sure that we're meshing the community. Those are all very important things that sometimes go overlooked. So I'm so, so happy to hear that you know you took into account those things. You weren't operating in a vacuum per se. You You didn't just say, I know this will help the kids. I'm going to do it no matter what others think. You want to get that that valuable input from others. So kudos. I may have jumped a little bit ahead, and so I want to take a step back really quickly and community based instruction. A lot of people may have heard that term, but not be so familiar with it. So before we go much further, can we get just a working definition for community based instruction CBI?
Deborah Schwind
absolutely. So community based instruction is an evidence based teaching strategy, and it allows students to take knowledge from the classroom and apply it to a community setting. And that community setting, typically is off campus, but the community setting can also be the school community, and it's very functional. It's very purposeful, it's very meaningful. It's authentic learning, it's applied knowledge, and it's really ot it has so much purpose for the students. It's so relevant for the students. So if you're talking about counting in the classroom and learning one to one correspondence, well, let's do that in the garden when we are picking the sunflowers. And we can count the sunflowers. We can measure how long the sunflower stems are. We can estimate how many we grew. We can have a farmers market and do money skills. We can read directions on how to make bird seed wreaths or those sorts of things. So the important thing to remember is that it is academics. It's applying the academics in a functional way. So that's the really key piece of it, it's doing what you're already doing, but then taking it to the next level and applying it.
Jayson Davies
So interesting. You know, I once heard that a lot of the research for students in general education starts with research from special education, because we learn how some of our students in special education can learn, and as you're talking about, you know, the different things that you do outside with sunflowers and whatnot, what I'm hearing actually, is a lot of things that might sound like steam, steam learning, science, technology, engineering and math, right?
Deborah Schwind
And so, yeah, thanks to learning, it's. PbO, it's solving problems, day to day problems in a very functional way. Yeah, yeah,
Jayson Davies
it's quite a feat when you can use real life in education. And sometimes that doesn't happen, you know, you got to get away from the textbooks. You know, we learn you learn that skill, but then you got to apply that skill outside. And, yeah, use it. So that's awesome. All right, I really want to move forward further with the research. But I have to ask you this, because I know this is true in the article you talk about how individuals with autism are the costliest group to serve with vocational rehabilitation services. Explain that a little bit are either why or how that comes to be.
Deborah Schwind
So there's many reasons that our students, even those without autism, are unemployed, and we can look at the predictors of transition success. And when we don't have those predictors of success, they become barriers to success. So not having those skills is as detrimental to the student as not having these predictors of success. So having social skills and workplace behaviors are a huge predictor of success. Not having those is a huge barrier to success, and for many of our students with autism, even those who are going away to college, who are going to be getting, you know, undergraduate degrees, these workplace behaviors and social skills really interfere with their ability to be successful. So not being able to work as a team, not being able to work as a group, that would be maybe something for someone at the college level, not being able to resolve a roommate conflict, not being able to interact with a professor. And then for some of our students you may not be going to college, just you know, having good hygiene, keeping your hands to yourself, having consistent behaviors, knowing how to ask for help, all of those sorts of things, these social skills and workplace behaviors can interfere. But the other things that can interfere are not having independence with ADLs and ideals, and that also goes to the college level, not being able to navigate the college campus, not being able to take your medication independently, not knowing when to shower or how often to wash Your clothes or shade, all of those kinds of things are really what interferes with our students who have disabilities. And I think some of the other things that are really important to understand is that most of our research on autistic individuals are really geared towards the younger person. We don't have a lot of people in their 40s and 50s who have autism, so we don't have those to study. We're really just starting to get to the point where we have autistic individuals who are in their 20s and 30s. So we're really just starting to realize these really poor outcomes. So as far as more specific reasons, I think that that's going to be research that is going to be continuing to evolve. A lot of our research right now, I call it this slice and dice. It's looking at fine motor skills, behavior skills, social skills, communication skills, behavior, we're looking at all of these foundational skills. We don't really have a lot of studies looking at functional outcomes and the end all be all, if you will. So hopefully, you know that can change as we have more and more students graduating with autism, but most people with autism are still in the school system. So, you know, there's a lot of opportunities for research.
Jayson Davies
Yeah, yeah. And I think that, I mean, obviously there are people, there are autistic individuals, that are outside the school system, but those are hard to they're hard to find. They're not a population that you have readily available, because you know that they're in the schools. So when it comes to research, you know, for every research article, we need participants, and it's nice, because in the schools, you have participants, you can reach out to the school and you can find them fairly easily, but, yeah, I absolutely agree, though, it'll be nice to see compare students who maybe are in a program where they start CBI at such an early, young age, you know, third grade, and compare that to a school district that doesn't have that program, and see what some of those outcomes are for those students do more than. Go into the workforce. Do more of them go to a community college or a four year university? I think that would be a great follow up study for their next.
Deborah Schwind
I think the other question I always have is, we have so many OTs that aren't working in the high school or provide consultative services in high school, and what would the outcomes be if ot was more involved? And could co teach these ideal classes or functional living classes? Could that even alone alter some of the outcomes?
Jayson Davies
Absolutely, absolutely. All right, so we're going to dive into the next part of the article. But as we do that, this little transition piece, I guess you could call it, is to break down kind of your overall aim. What was your goal with this article? We've talked about some of the some of the barriers and some of the reasons, but what was your focus on why this article exists?
Deborah Schwind
So it was really to evaluate the program, we wanted to determine what kind of attitudes people had about the program and what kind of knowledge they had about the program, and we wanted to get that information from three different stakeholder groups, so We looked at staff members that were in this particular school, both gen ed and special ed. We looked at administrators that were within the school and within the central office who had observed and seen the program, and then we also really wanted to get input and feedback from the parents. And we did parents of students who were currently involved in the in this class. So when I was setting up the program, I used a logic model to kind of set up the program. And the nice thing is that the logic model kind of really goes into the same program evaluation type outcomes. So if anyone was interested in setting something like this up, I would say, start with a logic model and then go from there.
Jayson Davies
Okay, I have no idea what a logic model is. I'm just going to say that what's the logic model?
Deborah Schwind
So it kind of breaks down a program that you are thinking about trying to develop, and it talks about all the tools you're going to need, the materials you're going to need, the people who are going to be involved, what your short term outcomes are going to be, your midterm and long term outcomes will be. So it kind of is a plan, if you will, to develop a program.
Jayson Davies
Gotcha, okay, and then so you have this program. You've already been doing the program, and now you're actually going to evaluate said program. When you set out to actually evaluate and you kind of started down this road. So I want to go a little bit further. It sounds like you had kind of three program evaluation outcomes that you were looking at learning action and impact. Is that correct? And how would you break that down?
Deborah Schwind
Okay, so the learning impact and those are actually outcomes that you will be looking at as part of a program evaluation. So when you're looking at a program evaluation, you have short term outcomes, these intermediary outcomes, and then long term outcomes. And you usually don't look at all of those different level outcomes at the same time. So because this program had never been evaluated before, we wanted to start at those short term outcomes, which are the learning outcomes, and within those learning outcomes are knowledge and attitude, because if you don't have good knowledge and there aren't good attitudes, then you really probably should stop the program, and you don't need to look at your intermediary or long term. You need to fix these things at the first level before you can continue on. So.
Jayson Davies
Great. And then if we, if we start to kind of look at that methodology, how did this? How did you actually, how did you collect these perspectives? I mean, were you having interviews? Were you doing questionnaires? What did that look like?
Deborah Schwind
So we designed a survey, and when I say we, it was the research committee, the dissertation committee, so we designed a survey that was on a Likert scale, and then we also came up with focus group questions, so everyone who decided to voluntarily participate, took the survey, and then anyone else who was interested could volunteer to be part of a focus group.
Jayson Davies
Gotcha. Okay, so everyone started with a survey, and then they had the option to opt into a little bit further of that focus group, right? Okay? And so just out of curiosity, what did those do you have off the top of your head, kind of just the numbers how? I'm assuming it was relatively small, because you were doing this just with one program. But you obviously had some parents. You had some teachers. What did that look like?
Deborah Schwind
An administrator? So an administrator, I had 10 administrators, and again, they were within the school and from central office, so special ed supervisors, autism supervisors, principals, assistant principals, that sort of thing, Transition Specialists. Then I had eight parents of current students, and there was usually only eight to 10 students in the classroom. So that was really a good number. And then we had 56 staff members do the survey. So we had a total of 74 survey participants.
Jayson Davies
That's not small, no. And then, so that's everyone that completed the survey. Did you have a decent amount of people that opted in for for that next step of the focus group?
Deborah Schwind
Yes. So focus group was a little bit tricky in that we had to do it at the end of the school year because we needed to make sure everyone had time to, you know, be a part of the program, if you will. So we did it at the end of the school year, and just naturally at the end of the school year, it's just crazy and chaotic, lots of things to do. So I was worried that it was going to have a difficult time, and I really wanted to keep the focus groups less than 10 people, just because it gets to be too difficult to try to transcribe. And, you know, it gets too long and lengthy, the actual focus group itself. So I had six administrators, I had three parents. I actually had five who wanted to do it, but two of them had transportation issues that day, so I only had three and then I had eight staff members, but I actually had more staff members that expressed an interest, but I had to make sure I had fair representation of general ed, special ed teachers and TAs so we obviously have a lot more gen ed teachers in our classroom. So I had to kind of separate it out like that.
Jayson Davies
And so when you ran the focus groups, did you speak to each of those three subsets individually, or did you kind of mix them up a little bit?
Deborah Schwind
So I had a neutral facilitator so that it was not biased, because obviously all the teachers, administrators and parents know me, so we would did not want them to feel pressured to support the program if they didn't. So we had a neutral facilitator that came in, and she met with the groups homogeneously. So it was just administrators, just parents or just staff, and the reason for that is that we did not want the parents to feel pressure from the administrators. We didn't want staff to feel pressure from the parents or, you know, the life, so we separated them out, and actually worked out really, really well.
Jayson Davies
Awesome. So let's dive into some of some of those themes that that arise both from the survey and then also from those small group sessions.
Deborah Schwind
So the themes were really very eye opening. I think doing a mixed methods study like this was really, really beneficial, because the numbers came out very high in knowledge and very high in attitudes. So that alone didn't really give us a lot of information, except that there was good knowledge and good attitudes. But once we were able to transcribe the focus groups and really analyzed and provided coding and themes to the focus group transcripts, what came out of it was really eye opening and was very, very helpful. Some of the themes were that there was a positive attitude about the program. They gave great ideas for program expansion and program enhancements and expansion. They talked about the culture of inclusion that this program promoted inclusion and supported inclusion. They talked about self determination and self esteem through these new roles that the students were learning. They talked about how this program really promoted authentic skill development, which is really what CBI is supposed to be all about. And then the other theme was that it really increased the expectations of everybody, including the student, of what they could do and what their potential. Show was, and what everyone saw them doing that it showed their the child's strengths.
Jayson Davies
Wow, wow. So did you feel like each of these subgroups, the three groups, were giving you the same type of responses, they were all saying this, or was there any difference in difference in their types of response? Was there one group that was more supportive and one group that was a little less supportive? Or were they all generally on the same page?
Deborah Schwind
It was really everyone on the same page. I mean, the feedback that they gave was really incredible. And I would say what really separated out the three groups is that it was actually really interesting, because the administrator groups really took on the perspective of organizational change and climate and culture. The parents really took on their focus was really about their child, very personal. And he talked about how much hope they gained from seeing their child perform these skills. And then the staff members really talked about they had the lens of just the day to day operation of the program. So it was really interesting to see their different viewpoints come out in the focus group.
Jayson Davies
Wow, that's really amazing. It's it's high praise when people are already trying to figure out how to expand a program. I mean, the I just the idea that someone's coming to you and not only do they appreciate it, but they want you to expand it, especially with that coming from administrators. I know many of us as occupational therapists in the schools. I mean, we can't get administrative support to save our lives. And so by doing this study, you were able to you were able to share what you do with the administrators. They saw what you did. They learned that it was beneficial. They also learned that the parents enjoyed it, appreciated it, and the teachers appreciated it. So I can only imagine that your administrators are more supportive of you now, even if they were supportive of you before, they're probably even more supportive of you after this study.
Deborah Schwind
You know, the the parents perspective was so incredible. I don't think this research would have been nearly as robust if I we did not have their perspective. And the idea that they talked about how this gave them so much hope, and some of the parents even talked about, you know, I've always felt like the future is very bleak for my child, and when I can see that they can work in the garden and they can work on the coffee shop, it gives me so much hope for the future. It is just really eye opening. I have a little story, actually, that is not it was not part of the study, but one of the moms that was in this had told me this little story at the end of the school year, he was getting ready to transition, and she had seen a couple of things that he had done, but she said, You know, I trust you, but I just can't imagine my son doing all of these things. And I said, Well, would you like me to take a video of him and send it to you? So I did, and I didn't even think my finger was off the send button. And she replied back, and she said, I am crying. My friends always have things to post on Facebook about what their children do, and I never have anything to post, and now I do, and it's just it really shows you that they just want to see their child successful, and that may not Always be academics, and that's okay.
Jayson Davies
Yeah, I agree. I agree. I mean, there's a few things that I have honed in on since actually reading up on idea, and some of other, some other educational documents, and I think that there has been this conflict, especially within the OT world of everything needs to be academic versus what about functional life skills? And I know, over the course of my 10 years as an OT, I've gone back and forth on that, you know, I think about goal writing at IEPs. I'm like, Oh, it needs to be focused on academic. If I collaborate with the teacher, it's going to be academic. Because, if they're talking about Common Core State Standards, or state standards in general, and if I'm tagging on to that goal, it's going to be academic. But as you're alluding to, and well, not even more than alluding to, you know, there's other things you know, the ability to have. Have a job beyond camp or beyond school, and you need more than academic skills to hold on to that job. So, yeah, I just, I think this, everything is quite amazing. You mentioned this is mixed methods. We talked a little bit about that qualitative side. What I don't think we've discussed the quantitative side of things. Was there? How did you do that, or what did that entail?
Deborah Schwind
The quantitative was a Likert scale survey that the committee developed together my advisory committee. And I was very fortunate with my advisory committee, because I had one professor who her specialty was qualitative. She was actually from George Washington University. I had a professor whose expertise was quantitative, and then I had a professor whose expertise is program evaluation. So she has done many, many different types of surveys and looked at many different types of programs. So we came up with just a 10 question survey. They were mixed together in that I had five questions that really looked more at attitudes. They were kind of belief questions, I believe this, and then five questions that were knowledge questions that were very factual in nature. And then it was on a four point scale, so that nobody could be neutral. They had to pick a side. So.
Jayson Davies
I recommend I have a master's thesis groups, and yep, I always recommend that always have an even number, so that people can't split the middle. That's right,
Deborah Schwind
which I didn't think that wasn't even an issue at all any of my results, but I did not know that when I was preparing the survey. So yeah, you
Jayson Davies
know, I do want to ask this, because it does happen sometimes, and if you don't ask, you may not get the answer. Were there any outliers? Was anyone a parent, a single administrator, a teacher? Did they have an opposing view to the majority.
Deborah Schwind
We didn't have any outliers in the focus group or in the survey, but as part of the survey, I did have a comment section, and there was also a couple other questions in the survey about, how have you learned about this program? Newsletters, flyers, brochures, actually working on the job, being a customer, those sorts of things. But there was one person who commented about some of the jobs, and some of the comments were very true in that from this person's perspective, you know, the jobs were redundant, or the jobs were messy, but that's really what we want we do. The redundancy might get boring for the teacher or the professor or the assistant or whoever. I don't know who, who had these responses, but that's really what we want. We want consistency. We don't want to have new jobs every day. We want them to gain independence and do the job more independently. So when I saw that, to me, it just meant that I needed to do more education that that was more of an education piece on my part. So.
Jayson Davies
Yeah, that's an important thank you for important note. Thank you for sharing that. Because I get that even from occupational therapists, occupational therapists and OTs, they often will feel especially those that are newer to to a school based ot position, they feel like every week they need to do something that is very different, vastly different from what they did the week before. And oftentimes we have to remind ourselves, you know, I don't learn a skill in 130 minute session. I need to practice over and over and over again. And I think as OTs, we feel like we have to do something new. We have to do something interesting. And I think we have to take a step back and remember that for these kids, doing something twice, for them, it's actually exciting. They like to do the same thing over and over and over again, exactly, especially considering the first time they probably fail. I mean, I failed the first time I did many things in my life, and so we have to give them that opportunity to improve. And I think if you do use that same or a very similar type of project, or whatever it might be task, you can help them to become more confident and improve those skills. So I'm sure you've seen the same thing throughout this project.
Deborah Schwind
Yeah, and the other thing is just, you know, with our OT lens and our ability to task analyze and to, you know, scaffold tasks and break down tasks and adapt tasks, modify tasks, we can take one task and do it 100 different. Different ways, and we can also grow independence. So that is one thing that I have been able to see with some of the teachers, is that the way the program gets implemented is I teach the students in the classroom how to do the job, and we do it as a group, and I do it along with the SLP. And as after we do it for several weeks, if we feel like some of the students are ready to start doing it in the school community, then we start adding it to their visual schedule, or they we start adding it to their choice board, and they can decide if they want to do that job. And at that point, the teacher and the assistants are really doing the jobs with them in the school community, but then I will come back and observe them. And so that's where I can say, You know what, let's do this now. Let's add this step. Or, you know, maybe it's somebody who is, you know, working on writing, for example, and we're doing a backpack delivery service. I'll say, you know, he has a goal of writing now, so let's bring the dry erase board, and when he has to find backpack number 25 in the cart, let's have him write it first. Or let's have him trace it first. Or Let's have him, you know, find it on a board, or whatever. So I can kind of, you know, change and enhance the jobs as they become more independent. So that's that's also really nice.
Jayson Davies
Yeah, definitely. And so you kind of alluded to this a little bit in here, so I gonna dive into this, this program, it's going on even when the OT isn't necessarily doing it with them, right? This is really more of an OT design program, but is being carried out by the teachers and the paraprofessionals. Is that correct?
Deborah Schwind
That is exactly right.
Jayson Davies
Okay, okay, I've got so many questions, and I I'm trying to, I'm trying to organize them in the most efficient way possible. So first I'm going to finish up kind of the the article per se, or those, my goodness, my my brain is trying to go on to the whole focus on the on the actual project itself. But I want to ask you, did you take a look at any of the student perceptions? Or is that something you would like to do in the future, or wish you would have done?
Deborah Schwind
I would love to do that in the future. That was not something so I had to get the IRB to approve this at the university level and within my school district, and that was just not something that they were going to approve. So I could not do that. But I think getting the perspective of the students within this classroom as well as the perspective of the students that are in the building, because many of these jobs are, you know, whole school jobs, so we have a library job that the gen ed students are doing as well. So our students go with their Gen Ed peers and do the job. So it would be really fascinating to get the perceptions of their peers, and they the peers know all of these students. I mean, they High Five them in the hallway. They know their name. They are. I was trying to find a quote that one of the teachers stated in during one of my focus groups, but it was basically that these students are in the very fabric, and they're woven in the very fabric of our school. And sometimes when you hear about self contained programs, you hear about, you know, the classroom in the basement, or the classroom at the end of the hall, and the students are not included, and that's not the case with this, and I think the Jobs had a lot to do with that, and that's also been very eye opening and very heartwarming actually, to have our students so included and so accepted and so embraced.
Jayson Davies
Yeah, yeah. I'm reading some of those quotes as you speak, and you know, one, it benefits the kids in our school community, all the kids, all the students, who are benefited. They are developing empathy, compassion. They are helping. They're an integral part to our community, and that's from a staff member. So, yeah, that's just, that's, that's invaluable. I love it. Okay, at the end of the day, what can an OT practitioner and OT, or an OT a or maybe even a teacher that is listening right now that's read this article. What is your hope that they would take away from this.
Deborah Schwind
I think, kind of circumventing back to a comment that you had made about idea, and idea is certainly something that is very supportive. Academics, but it's also supporting functional living skills and vocations and leisure. And how are we supporting those areas for our students? Are we looking at vocational skills from a very early age? We know our students need a lot of repetition, and the goal really should be that at 16, our students should be going off and doing internships, volunteer work or paid work. So at 16 we can't really start just looking at transition. Some states require you to look at it at 14, but even then, it's too late. Our students have already established possibly poor habits, and we need to address it much earlier than that. So I would encourage OTs to collaborate with teachers to figure out how we can incorporate ADL ID else into the curriculum, how we can incorporate vocational opportunities from a very early age, even in preschool. You know, so many of our autistic students don't really do pretend to play. So how in the preschool can we incorporate pretend to play and play firefighter and play nail salon and and play chef and and play all of these things? That's where our students, really early on, start taking on that role of vocation, and it's a way for them to start building some interests and ideas. So I would say, definitely collaborate with your teachers. And it's not just the special ed teacher. So in the middle school, I support my students and their family and consumer science classes and their tech ed classes, because research also shows us that students who are more independent with IDL skills are more likely to be employed. So if they can, you know, do laundry, they might be able to work in a hospital and do laundry in a hospital. If they can make a sandwich they could work in a restaurant. So there's a lot of correlations between ideal skills and employment. So I go in and I work with the teachers. I modify the curriculum, I modify the tasks, and make sure our students can access that curriculum in middle school. And I would really encourage other OTs to do the same.
Jayson Davies
Yeah, wow, so much to digest, and so much goodness. All right, we're gonna wrap up the article. I know I keep saying that, but we're really gonna wrap it up here with one last question, and then I want to talk about actually how you got started with the program a little bit, because I know that actually came first. This was just evaluating the program. If there's an OT out there that wants to potentially expand on this, or even you yourself want to expand on this, what do you envision as kind of the next steps for maybe the next program evaluation that you want to do or or whatnot?
Deborah Schwind
Yeah. So I've actually thought quite a bit about that. I actually have just submitted a secondary analysis of the focus groups to a journal. I just submitted it last month, so I have not heard back from them, but when I went back through the focus group transcripts, there was a lot of information in there about what people saw as some of the barriers to the program, as far as actually setting it up. And what were some facilitators, you know, what did you really need to have in order to get this program started? And one of the things that kept coming out through staff, administrators and parents is that you have to have administrator support, and if you don't have that, it is a huge barrier to program success. So I'm hoping that that article is accepted and we can publish that because it doesn't just have implications for a CBI program. It's really for any program. If you don't have an administrator who understands inclusion, who supports inclusion, who embraces all students, then some of these programs are just not going to work.
Jayson Davies
Absolutely, great. Well, I'm just going to say this out loud, if anyone wants to potentially, you know, take this for a capstone and run with it. Recommend finding Debbie. She's on LinkedIn. You can find her there and just reach out to her and see if there's any way that you. Can help, because this is an amazing program. It's in her district, but maybe you are in a different area of the country, and maybe you can potentially help your school district potentially to develop a similar type of program. So reach out to Debbie. I'm sure she would, she would love to love, love the support.
Deborah Schwind
Awesome. I've had quite a few ot students that have reached out to me that I've been able to mentor. So that's been great.
Jayson Davies
Great. All right, we have about five minutes left, and so I want to go way back before, not too far back, but before the before this article came to be, and you've been practicing for 17 years. I know from my experience that the longer that you are in a district, more people get to know you, the administrators get to know you. You can do more just because you built those relationships a little bit. But how did this program even get started? Did you actually initiate it? Was it already going? I know earlier you kind of said that kids were going off campus, but now it's on campus. Share with us the beginnings.
Deborah Schwind
Yeah, so we were going off campus, and it just was not working for our students, and so collaborated with the classroom teacher, and we really kind of thought, how about if we adopt the school as the community. And really, you know, we scaffold tasks, and we scaffold, you know, how we sequence things and but we don't always think about scaffolding the environment. And that's really what we did. We took this big off campus community of parking lots and grocery stores and school busses and said, you know, what? If that is too big for them, what could we do that's smaller? And it was just natural for us to think about the school as the community, and for some of these students, you know, just walking down the hall in their school building was difficult and challenging. So how can we expect them to be able to go off campus to places they've never been before and be able to be successful? I mean, it's just a very sensory, overwhelming task that we were asking them to do, so we decided to really, let's make the community smaller for them, so it's not so overwhelming. And then the first thing that we did, I think we must have had the first coffee cart in the country. So we started a coffee cart, and that was really how it all got started. And it just kind of started blossoming from there. One thing kind of led to another. The coffee cart led into stocking the condiments in the teachers lounge, and teachers starting to interact with our students and getting to know the students and having very functional conversation and using their AAC devices in a functional way. And then we started talking about, well, if they can stock the sugars, then how about if we ask if they can do something in the cafeteria. So we started having them stock condiments in the cafeteria. And then my son was getting ready to do his Eagle Scout project, and he went to the school and asked if he could build a garden. So the garden started through his Eagle Scout project, and the garden just really took off as well, and just gave us a whole new area to expand in, because he started planting and watering and lots of problem solving in the garden. You know, the hose is kinked. What do we do? The water is not coming out. How do we solve this problem? And you know, initially the students might get really upset, like it's not working, and they might throw it down. And then we would just say, well, let, let's think about it. What could we do? What can we look at? How can we solve this. It's okay. And problem solving is a big issue on the job. It's one of the workplace behaviors that our students have a really difficult time doing. So from the garden, we could water, we picked the crops, we started a farmers market. They sold the items from the farmers market. We would make things. We've made herbs and dressings and sold those. We Valentine's Day will make chocolates and they sell. The chocolates will make heart shaped rice crispy treats and sell those. We from the garden. We talk about healthy eating. What's good for you, what's bad for you, what should we eat? A lot of, What should we eat a little of we plant four different color carrots. So we do white, orange, yellow and purple, and then we separate them out. We talk about greater than less than we count them. We do the same thing with potatoes. We do purple potatoes, red potatoes, yellow potatoes. So. So there's just so much function in it. And so we talk about how to take care of ourselves. We'll do yoga. We bring the school nurse in, and she brings all of her medical instruments in, and the students get to kind of play with those, if you will, listen to their heartbeat, put the blood pressure cuff on so that the doctor's office may not be quite as scary, but all of this started with CBI, and it just has blossomed and grown. And there's so many different little, you know, avenues you can take from the jobs.
Jayson Davies
Wow, yeah, I think we need to get some of those kids playing ot like we need to. We need to have an OT game to let them play. They could be the one training the kids and the other skills for CVI or something, I don't know, but wow. Okay, I have two more questions for you, and then we'll wrap today up. And that is one these kids. You brought them back on campus. Have you gotten to the point where maybe it's time to go back off campus, maybe when they're a little older, potentially. What are your thoughts on that?
Deborah Schwind
So our middle school students, so one of the other themes that kind of came out in the dissertation research was within, I shouldn't say, a theme, but this overarching concept that was embedded in all of the themes is this idea of a continuum, that our expectations are on a continuum, inclusion is on a continuum. And the community, inclusion is a great example of that, that we can start small and grow the community so that it's more of a continuum, if you will. And so that idea of a continuum was actually pretty profound, and because of that, the school system has really kept our third through fifth graders at the school, and then as they move to middle school, they start going off campus, so that we're slowly expanding the size of the community as part of a continuum.
Jayson Davies
Gotcha. Okay, cool. And then so there is that expansion. And then my final question that I really want to ask, and I love hearing the answers to these, is, if an OT is in a school. They're in an elementary school. What would be some advice that you might give them in potentially starting a community based instruction program similar to this one.
Deborah Schwind
I think the big thing is collaboration. You know, maybe jotting some ideas down, maybe even starting to fill out one of those logic models that I had talked about, which you can just go online, search it, and you can get one, and then taking that to the teacher, getting her feedback and her input, and if the teacher seems to be on board, then going to the administrator and really talking to the administrator about it. It definitely takes collaboration. It's not something that you can just completely do on your own.
Jayson Davies
Absolutely, yeah, and I was just second that, you know, start with one teacher, because you'll be amazed by how things spread after you get that one teacher and one administrator on board. You know, you have that list of 20 different activities, but you start with one activity, one teacher, one administrator, and you'll, you'll be amazed. You know, next year you do two activities and two teachers volunteer three activities, three teachers.
Deborah Schwind
That's exactly right. And the other thing is to pick, try to pick activities that the school has already, is already doing. So, for example, the library job at our school, we were already doing that, but the students in the self contained programs were not being asked to be a part of it. So look around your school and see what's already being done, and if you can kind of embed some of the OT within that program, or make it a more inclusive program and try to make it more of a CBI type of a program.
Jayson Davies
Great. Well, Debbie, it has been such a pleasure. Thank you so much for sharing all these. I just kept nodding with everything you said today. So I really appreciate you being here, and I'm definitely going to have to follow up with you when that next article gets approved and we get to read that one so.
Deborah Schwind
Well, I want to thank you so much for, you know, spotlighting this article and these students, because, again, it's the whole reason why we're in school is to make sure they're successful when they graduate, and It does have to start early, so I really appreciate you taking an interest in this research and having me on the program.
Jayson Davies
Absolutely. Thank you one last time, and enjoy the rest of your day. Take care.
Deborah Schwind
Thank you.
Jayson Davies
All right, one last time. Thank you so much to Dr Deborah Schwinn for coming. Coming on the podcast. Debbie, it was a real pleasure having you and thank you to everyone listening to this podcast. To you, you know, again, I like to tell people I know that we have the best occupational therapy practitioners within the OT school house community, because you are willing to listen to an hour long podcast on your drive home to better support your students, to better support the teachers you serve and everyone you work with. So thank you so much for being here. And you know what? You just could have earned an hour of professional development to do that, all you have to do is head on over to OT schoolhouse.com/pd and click on Episode 109, and you could be on your way to earning one hour of professional development for listening to this episode that may be good for both your NBC ot registration as well as your state licensure. So be sure to head on over ot schoolhouse.com/pd, click on Episode 109, and you could take a quiz to earn your certificate of completion. Thanks again for being here. Really appreciate it, and I will see you in episode 110 thanks again. Take care everyone. Bye.
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