OTS 09: Diving Into RTI With a School-Based OT Consultant: An Interview With Leah Hiller, OTR/L

Press play below to listen to the podcast

Or click on your preferred podcast player link!

Welcome to the show notes for Episode 9 of the OT Schoolhouse Podcast.

In this episode, guest Leah Hiller, OTR/L, and Jayson dive into Response to Intervention (RTI) a bit and discuss several ways OTs can have an impact on students without ever completing an evaluation. RTI is a growing model in schools and as OTs, it opens the door for us to help more students in less time. It also provides opportunities for OTs to provide in-services for teachers and recommend curriculums that will benefit the social and motor aspects of student roles.

Have a listen if you would like to hear how Leah and Jayson are providing RTI in schools.

Links to Show References:

Contact Leah Hiller, OTR/L at Hillertherapy.com

Learning Without Tears (LWTears.com):

Formally known as Handwriting Without Tears, LWT is a leader in developing handwriting and keyboarding curriculums. Want to hear from them on the podcast? Shoot them an email and let them know about us.

We Thinkers! from SocialThinking.com:

This program uses music and plays to teach early learners how to manage everyday social situations.

Personal Space Camp by Julia Cook

Use this Amazon affiliate link to check out the book used by Leah to help her young students understand personal space in the school.

AOTA's FAQ On Response To Intervention (RTI)

Use this link to view AOTA's description and understanding of what RTI is and how OT/COTA can use RTI in schools.

Freebies!

Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.

Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com

Well,

Thanks for visiting the podcast show notes! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts

Episode Transcript

Expand to view the full episode transcript.

Amazing Narrator   

Hello and welcome to the otschoolhouse podcast. Your source for the latest school based occupational therapy tips, interviews and research now to get the conversation started, here are your hosts, Jayson and Abby. Class is officially in session. 

Jayson Davies   

Hey there. And welcome to the otschoolhouse podcast, I hope you're all having a wonderful summer. Today, I wanted to let you in on a special announcement we have been working on here at the otschoolhouse  and that is that you can now earn professional development units by listening to our episodes and then visiting our website at otschoolhouse.com, forward slash P D. That's the letters p d, as in professional development. I won't go into all the details as I want to get into today's content, but there are currently three episodes that we're offering for units right now for professional development, and those are episode number three on smart eagles, episode six on the comparison between the bot two and the M fun assessment, and episode seven on mental health and mindfulness with Dr Rochelle Murphy, but for any of you wondering, the podcast will continue to be free. We're just adding extra value by giving you the ability to earn professional development for episodes that you've already listened to. So don't worry, the podcast isn't going anywhere. Everyone will still have access to it, and not every episode will be a potential professional development opportunity, but we'll let you know when something is a professional development opportunity. So today's episode is not a professional development opportunity. Leah made it very difficult for us to decide whether or not we should do it or should not do it. She provided a lot of value, but in the end, we just weren't sure that it was enough to provide professional development. So rest assured that there will be some that you can earn professional development and others that you will not be able to earn professional development for all right. So getting into today's content, I'm excited to introduce to you all our guests today. Her name is Leah Hiller, and Leah and I met a few months ago when we both were asked to sit on a panel at the University of Southern California to talk to OT students about ready to graduate with their masters in OT it was a great panel, and I'm so glad I was able to attend. Not only did I enjoy the experience sharing with students, but it also gave me a chance to meet Leah as well as a few other OTS. And that day, Leah shared with me, you know, she has a private practice that she actually runs out of her house. But more than that, she blew me away, because she actually consults with a private preschool once a week, and so that's what we wanted to key in on today a little bit. So you're going to hear a lot about how she works with not only kids, but also the teachers, the administration and even some of the parents. So with that, please have a listen to my interview with Leah right now of Hiller therapy, and remember to visit otschoolhouse com, forward slash episode nine for today's show notes. Hey, Leah, thanks for joining the otschoolhouse podcast. I just finished a short introduction to our listeners about you, but I wanted to give you a second to share about who you are with everyone, maybe share us your ot story about how you became an OT. 

Leah Hiller   

Yes. So thank you for having me. Occupational Therapy is actually my second career, because when I was in college, I don't think I'd actually ever heard of OT. Yeah. So when I studied history, I studied communication, and then I became an elementary school teacher, and I taught for about 10 years. And so I really loved it. It was great, but I always liked kind of those kids that didn't fit in the mold Exactly. And I found that when I was in the classroom, I didn't necessarily get that much time with them, right. If there was a kid who wasn't just sort of the middle of the road, I could either refer them out or get them support somewhere, or in my spare moments, I could work with them if I had time, but it just wasn't a focus. So I worked with some really good OTS who were in my classroom, helping those kids, and I just kind of realized that that was exactly what I wanted to be doing. So I taught for almost 10 years, and then I left the classroom and went back to school myself.  

Jayson Davies   

Wow, so you went back full time? You're just in school for the entire time, or were you able to teach and go to school at the same time? 

Leah Hiller   

So I think my last year teaching, I did all the prereqs at night, and that was just about the hardest thing I've ever done. It was harder than being a full time student or a full time teacher. So I did that because it had been so many years since I'd been in college, and that kind of got me warmed up, and I did it. And then, yeah, I basically it was actually funny. I basically joked around that I was retiring, like I stopped working. I, you know, said my goodbyes, had a cake and a send off. And then I think, like, a week later. I started at USC. 

Jayson Davies   

Wow, very cool. So you're in a very interesting, unique position, and it's kind of cool that you came from schools, because you're kind of back in school somewhat. But more so than being in schools, you run your own private practice right out of your house. So can you tell us a little about, a little bit about how that came to be. Why are you working in your house and not somewhere else? Or How'd that work out? 

Leah Hiller   

Yeah, so I most of my time is spent in private practice. So I'm seeing kids to one, one to one in my clinic, which my clinic is my backyard and then my back house, and I think that part of my job probably looks like a lot of other small pediatric practices, but I can, of course, tell you all the things that makes my practice and special and wonderful. It's definitely individual. I love doing it. My commute is amazing. But I actually think that the time I spend outside of my practice, which is in my school based role, is what makes me a good I think it makes me a better OT, basically, and that's what you and I started talking about, was that one or two mornings a week during the school year, I am at school. I'm a school based, ot based pretty much, and my role there is completely different. I'm in a small private preschool. I do 01 to one intervention, so it's completely different than what I do in my private practice. I basically spend time doing things that help everyone at the school. I yeah, I get to talk with administrators, teachers, parents, definitely kids, but every day is different. I love it. 

Jayson Davies   

Very cool. And so how did that come to be? How did you go from because you had the private practice first, correct? Yes. And so you do not work in the traditional sense for the school, yet you still work in the school. So how did that come to be? 

Leah Hiller   

So I'm considered a consultant by the school, so I don't, yeah, while I'm working for the school, I'm not like an employee of the school, and my, yeah, my private practice is my employer. So the way I got this job, it was completely an accident. But as you know, as part of my job as a private practice, OT is assessment. So I guess maybe because of my teaching background, or just because assessment involves observing a child, I always go into the school if the child's enrolled in school or camp or daycare, whatever it is. I make sure that part of my assessment includes that visit. I just don't it doesn't cut it for me to just see them in action in my clinic or just get a report from the teacher to be like, here's what I think is going on. So I'm in and out of these preschools and elementary schools all the time, and I always try to kind of check in with the director and say hello if they have a minute. And so one of those times I had a client at this particular preschool, I checked in with the director, and we had maybe a 10 minute conversation. Of course, we started talking about this child, but we just kind of the conversation expanded and expanded. And she said, Hey, why don't you do an in service for my teachers? So we talked about what that would look like we did. And then after the in service, she basically was, like, we really should have an OT. Like, come do it.  

Jayson Davies   

They did not have an OT or anything on campus. 

Leah Hiller   

So they did not have an OT on campus. They had in the past, and I think that they'd had more than one. They had different OTs, and I think that it was not necessarily like a negative relationship. It just was kind of seen as like a luxury upgrade, like when we have money in the budget, we might be able to have an OT here or. 

Jayson Davies   

Gotcha. 

Leah Hiller   

You know, it would be like a cool thing to have, and sometimes they did, and sometimes they didn't. But it just wasn't kind of like part of the fabric of the school, it was, like, it was like an extra like, oh, wouldn't it be cool if we had, like, you know, Spanish class for the kids on Tuesdays. Wouldn't it be cool if there was a gymnastics teacher here? Wouldn't it be nice if, like, an OT came and did whatever it is OTS do? So I think that that was sort of the my. Mindset, but based on our conversation, I worked really hard to shift that mindset. 

Jayson Davies   

So did they get the gymnast teacher first or you first? 

Leah Hiller   

They have a pretty awesome coach. She's great. 

Jayson Davies   

Well, just to make sure, to clarify for everyone out there you are working in a private setting, a private preschool in California. So with a whole with IDA, it's a little bit different because it's the private preschool. So you do have a different experience than most school based OTS. And I think you understand that, 

Leah Hiller   

yes, I spend some time, and I've spent some time in the public school in my area, which is LAUSD, so I do see what what they do in a public preschool setting versus what I do, and I'm also in and out of public and private schools. So this model is a little different, but it's a pretty common model. There's a lot of private preschools, and the way they're getting served is honestly just inconsistent. 

Jayson Davies   

Gotcha, okay. Well, that kind of leads us into, I think, the model you were just kind of referring to, which is RTI model Response to Instruction and Intervention, if I can say it correctly. So you were kind of introduced to it at LAUSD. How much of RTI Did you know, before you took on this opportunity at the private preschool, were you already exposed to that, or was that something you kind of had to research a little bit going into this. 

Leah Hiller   

So figuring out what exactly I would do was like one of the most interesting parts of the job I knew about RTI vaguely from my conversation and or from my time in LAUSD and from my graduate school time. And I knew that during the course of my conversation with this particular preschool director, I knew that's what we were talking about, right? I knew that's what I wanted to be talking about. I knew that she was saying, Oh, the OT can come in and make sure my kids don't need ot, or tell me if they do need ot, right? That was the model that she wanted, she expected the OT to do, and I think historically, the OT had done. But I knew in my head I wanted it to be RTI, so I kind of, I was asked to write up a proposal. That's just how this particular school hires consultants. So I saw that as my opportunity. So that became my research time. And I was like, pulling out my pediatrics textbook. I was I was actually the aota website had some helpful resources. And I also looked back at some materials I had from LAUSD about their classroom based interventions.  

Jayson Davies   

Okay. 

Leah Hiller   

And so I kind of looked at all these things, and I wrote up a really short proposal, like maybe a page and a half.  

Jayson Davies   

Oh, that is short.  

Leah Hiller   

And I said, this is my plan for ot support, and it will focus on prevention and universal early intervention, perfect. And I like underline universal, and I underline prevention. And that, of course, is very vague, but I wanted to make sure that I wasn't just thinking my role would be different, but like, this was out there, right? And so then in looking at it, I was like, these are nice words, but what does it really mean? So I actually made a checklist of what I would do with my time, because as a consultant, I bill hourly, and actually I think I bill to the like, 15 minutes or half hour now, like I'm very specific with how I use my time, because I know they have a tight budget, and I want to respect that, and I have a checklist. I say, here's what I'll do for parent education, here's how I'm going to help you with curriculum. Here's what I could do for classroom supplies. And it was just like, this list of everything I thought I could do for them as an OT and I brought it, and I was so excited. And she kind of like, looked at it and was like, okay, cool. And I was like, no, no, no. Like, we're gonna go through this list. We're gonna do these things. And she looked at the list, and she was like, You're you're here, like, four hours a week, three hours. This is a lot of things. So I said, Okay, you're right. These are the things we potentially could do. And that's just the director was like, I love it. You're gonna write, you're gonna do some parent education, you're going to do Teacher Education. You're going to educate me like this is going to be so much fun. So I really, I just had an ally, and I loved that I actually had it in writing. And I think I even showed her a diagram of what the RTI model looked like with each tier, so that she could so I could say. Like, here's what you think OTS should be doing, you know, the one to one intervention. And I said, but here is the level where I work with everyone, and that's where I'm gonna be spending my time.  

Jayson Davies   

I love that. 

Leah Hiller   

Yeah. So it was, it was great. It was, it was good, and and it's actually worked out really, really well. 

Jayson Davies   

Because I think a lot of well, not just OTs, but also, like you said, administrators, when you go into a school, they expect the one to one pull out. That's what teachers, administrators, many OTS certified ot assistants, even the aides, the parents, they all expect occupational therapy to be a one to one, pull out, maybe a small group pull out. They're never expecting and they're always shocked when I say, You know what? I'm not going to pull your kid out. I'm going to go into their classroom and I'm going to work with the teacher so that the teacher can better support your student for five days a week instead of one day for 30 minutes a week. And so that's awesome. So tell me more. How are you helping the teachers at that school? 

Leah Hiller   

So I love, I love that you mentioned that, um, that thing with like, Oh, is that what you're doing? Because I do get those questions, even from the teachers who I kind of said, like, Oh, I was a teacher. And so when I'm in the classrooms, you know, I've gotten comments like, oh, but you're in here more as a teacher right now, right? You're more like, teacher trainer, right? And I'm like, No, I am the OT who is like, I guess both of me, I can't separate those parts, but I really said, like, OTs are teachers too. Like we are, even if you don't have a teaching credential, like I do, I am. I am a teaching. I'm teaching. I'm modeling. Like everything I'm doing is as an OT 

Jayson Davies   

everyone that works with a kid as a teacher, whether you want to be a teacher or not, if you're working with a kid, you're a teacher. 

Leah Hiller   

Um, yeah. So how I spend my time. So again, every day is different, but I might start out doing a mini lesson in the transitional kindergarten classroom, which I made sure to visit. Every time I was on campus, I would spend time with them. We started there we noticed that there were some fine motor challenges. And at first the idea was, oh, maybe one or two kids need a referral to OT. And then it was like, Oh, wait, maybe, like, three or four kids need a referral to OT. Oh, wait, maybe the whole class should probably have some bilateral coordination and fine motor and all these activities just embedded as part of their school day. And so it was an easy sell to get them to start using Handwriting Without Tears. They actually had already purchased some of the materials in years gone by, and really weren't using them, or were using them for other purposes, like all those lines and curves were in a big bin, and they were using them to build things, but not necessarily Batman or letters.  

Jayson Davies   

Yeah.  

Leah Hiller   

So, yeah. So we so I started doing that, and I was always, I really tried to be explicit with the teachers that I'm here for 20 minutes right now. Sit with me during the lesson, jump in when you need and then you're going to choose a lesson to do. I can help you pick it, and you're going to do it sometime this week, and we'll talk about it when I come back next time, and I'll do another lesson. So we kind of went back and forth. The kids loved it, and I just felt like a lot of flexibility to sort of do what needed to get done. If the teacher, if I walked into a classroom and the teacher said, Oh my gosh, they're killing each other out on the yard, we have to do something. I could think about what, you know, maybe do an observation for a few minutes, watch the kids in action and say, oh, here are the elements that I think are at play. Let's figure out how to address that. So I had a lot of flexibility. 

Jayson Davies   

That's cool, because, I mean, that shows your value, though you're there for four hours a week, and this program handwriting, Handwriting Without Tears, going back to that, it's an evident, evidence based program, and without you taking the initiative to work with them, even though they had the program on campus, they would never have implemented it without you being there to kind of guide them along. And they could have hired a physical therapist, a psychologist, they could have hired a gym instructor, and that would never have came about. But because an OT, that's what they went with, an OT who also has previous experience as a teacher, which is awesome, but because you were there, they were able to implement a program now that's going to help kids. Far after you may or may not still be working at that school. 

Leah Hiller   

And I love it, and I liked how not all schools are this open, but this school was one with that culture of like, Yeah, show me. Like, let's do this together. I think it clearly came from a director who felt that way too, who absolutely said, Yeah, show me, let's do that like I'm willing to to learn how to do this, and the teachers were just absolutely the same way. But I said we adopted two new curriculums this year that I'm really proud that that was done, but I think their total buy in cost for those two curriculums was like $250 Handwriting Without Tears. They already had all the materials, and I had gone to a Handwriting Without Tears workshop in years gone by, and so they actually provide a lot of the handouts and things like that for you to go into your school and do you know, share what you learn. So I had things readily available, and they had everything already. We also adopted the social thinking curriculum that's called we thinkers for preschool aged children, and that was, I mean, a teacher's guide and a couple books. It was so accessible, and the teachers, a couple of the teachers, ran with it and decided to integrate it into their Conscious Discipline program that they've already been using and have been using for years. So they basically took that and said, Oh, we see where this ties in with something we're already doing. And I really, completely took a step back with that. It was, like, my suggestion, I did a few model lessons, but then those few teachers, like, just made it their own. 

Jayson Davies   

That's cool, because you have to get them to buy in, like, you can go and do a few courses, but unless they're taking it on for themselves, it's a waste of everybody's time honestly and faced the time and money, but that's cool that you were able to somehow. I mean, you say that they're so nice and ready to take on anything, but I'm sure there's something that you must have done to help them, because I know you as a Your personality is awesome. So somehow they they liked you, and they liked what you were recommending and the way that you were teaching it that made it easy for them to continue on, which is, it's hard to do sometimes. 

Leah Hiller   

Well, I That's really nice of you to say, and I think that it's not necessarily. Of course, I think I'm super nice and approachable, but I don't think, I think there's two things at play. One was I was aware of when I was a teacher of how sometimes specialists or experts or whoever could kind of come in my classroom and just tell me how it was going to be, and sometimes it felt like a burden, like I remember reading psychologist reports, and it would just be This random laundry list of like 25 recommendations that I had to implement for the kid yesterday, and they didn't necessarily, they felt copied and pasted. Yeah? And so it just was, instead of being like, excited as a teacher that I was getting all these tools and this was going to really help the kid, it often just felt like a burden. So I never wanted to feel like a burden. Of course, no one wants to feel like a burden, but that was kind of at the front of my mind when I show up at the school, I want to be like a friendly face. And if I walk into a classroom and a teacher looks like she has had it. And, you know, I can tell that the kids are having a hard time. I can either say, like, Hey, can I help? Can I take them outside and do this, you know, body awareness game with them really quick, or, Hey, can I back up slowly and come back and see you next week? Like, I really that is above all. My goal is to just not be seen as someone who's just adding to their workload. 

Jayson Davies   

Yeah, I mean, and that's what teachers really want. You're right, I mean, I have felt both ways going into the classroom, and that's why now I make it a point to go in there, and I'm not going to give recommendations without going in and really looking at the classroom, but you have to take in the entire dynamic. You know. You have to know the teacher as well as the students, as well as even the aides, because a lot of times, the aides have a huge influence. And even if you can get buy in from the teacher, if the aides don't buy into it, then it typically ends up failing. But no that getting that buy in, it's it can be tricky, and somehow you have mastered it. So thank you. Later.  

Leah Hiller   

Oh, I think one thing that's really important is, especially when you go into a school setting, like you said, there's a lot of people there that just that aren't just the lead teacher, and a lot of times, especially in person. Schools, the the assistants are often the ones working with those kids with individual challenges, or like they're often the ones who are going to be refereeing that, like, you know, sports activity, or helping kids solve a problem during free play like they're often the ones doing that, like they're your audience too. I find that the school secretary at this school like she knows everything that's going on. She knows, oh yeah, this, you know, if there's a kid who's having an unexpectedly difficult day, she knows, oh yeah, well, grandma's sick or so and so is out of town, or this, like, that's a person who has so much to offer, and so it's like you have to make, kind of make those relationships. And you and I had talked about whether this was kind of, like a, is this a scalable model, like, is this something you could do at 10 different schools? And I kind of have a hard time envisioning how I could possibly do this at 10 different schools, because it's so much based on the individual relationships and me getting the time to chat with these people and getting the and just keeping it all in the back of my mind. As much as I take notes and do all of those things, I kind of need to remember, like, oh, which teaching team are you on, and which kid's parent just had a new sibling? Or, you know, you kind of have to have that stuff. 

Jayson Davies   

Definitely. I mean, yeah. And I'm transitioning right now from a job where I was working nine schools plus home hospital kids, and you're right, so I know exactly what you're talking about, and I was never able to build the rapport. You know, there's a handful of teachers that those special day classrooms that I was in regularly. I had a great rapport with those teachers, if something came up, I was there and but that helped me, because they trusted me when I made recommendations for something, they trusted me. You know, even though they thought it was going to cause chaos in their in their classroom, they trusted me when I told them, hey, we need to talk with the aides and have them back off a little bit to not do the project for the kids. And so they trusted me and allowed me to come in and kind of work with the A's to bring them back a little bit, versus if I went into a lot of times, like a general ed classroom that I didn't see them once every five months, because out of nine different schools, it's hard to build that rapport unless you're there every day, at least at weekly. I mean, you gotta be on campus. Otherwise it's just, every time you go, you're spent just building rapport, rather than really focusing on the kids. Because OT and teaching, it's a very personal thing, like you have to have that trust, otherwise nothing's gonna work really so, but yeah, so we can move on to the next one. But yes, props to you, Leah, for being so awesome with your preschool. So Handwriting Without Tears. The What did you call it, the we thinkers program? Those are things that you put into the entire school at A and that would be kind of like an RTI level one type of thing you're helping the entire school doing like an RTI level two thing. Now this is a little bit more intimate. You're working on the classroom level, and I know you do implement the handwriting without tears and the we thinkers in individual classrooms. But is there something else that you can think of, maybe even an example of how you did something differently based upon the classroom? Maybe they were even the same level of class, but because the dynamics were slightly different. You may have changed it up a little bit. 

Leah Hiller   

With those individual classes all the time. Sometimes you would go in the basis of the social thinking adoption was really looking at again, like conflicts on the play yard. We are in the middle of Los Angeles, there is not a lot of space, and many of the schools in this area don't have a ton of space, right? So it's a commodity. And if you're at a play based school, these kids need space to play, and so sometimes when there isn't huge fields to run and jump and play like conflicts happen, although I'll say, even when there is a huge amount of space to play, conflicts still happen. But So I noticed, or I didn't notice, the teachers brought this very much to my attention, that it was a challenge. So we and they have an excellent discipline, or not a they call it something Conscious Discipline. They have an excellent program. I really enjoyed learning about it, and these conflicts were still happening. And the behaviorist and I were like brainstorming, thinking about it, and I decided, Okay. The behaviors has his approach. That's what they do, and it is tried and true. And I was like, what is the OT approach to a problem and or a or a activity? It's task analysis. So I really kind of thought about the task analysis like, that's what makes my training different, yes, so I kind of pitched that to the teachers, like, I can be the problem solver. Let's take this apart. It's not just kids who are banging into each other on the yard. It's not that they're just too rough, like, every few minutes someone's getting hurt, it seems. And of course, as a teacher, your job is to keep them safe, so we need a solution other than they can't go out on the yard right because they right. That doesn't work. So I used the task analysis, and I was like, Okay, we need to break apart what's happening. Let's all watch, not just me observing, but Let's all watch and see what happens. And we looked at play skills, and I really talked about like, okay, these are the play skills we're working towards. We're gonna watch how they enter play. Are these kids doing a good job of entering play functionally? How about body awareness? Are they physically banging into each other, and that's what's causing all these, like, bumps and bruises. Like, what is it? Are they having trouble, like, modulating the volume? Is it that they are, you know, just exhausted. They're getting to school to like, what is it that's going on? Like, what is it the basis? And honestly, what we found was all of the above, right? Of course, for some kids, it's body awareness. For some kids, it's grading force, right? They're using things. They're just, you know, playing too rough. And for other kids, it's not being sure how to enter play. It's running up to a group of kids and just bulldozing their way into it. So you have all these things going on at once. Of course, individually, these kids are all typical. It's fine. None of them would qualify for an OT referral. Nobody needs to go home and like nothing to write home about. This is typical preschool behavior. Yet we're having melees on the yard, so we kind of use that piece to say, Okay, now what are we going to do about it? So with a little group or with a class, we started using the we thinkers stories, and we used like personal space camp, which is a lovely little book, and we did these different activities for everybody to learn about personal space, and we did different games where we learned about how hard you squeezing, too hard, squeezing too rough. We kind of did all these little mini lessons with the kids, and a lot of them were just kind of planning the seeds with the teachers. And I could hear it later. It was like, later on, like, Oh, he's, you know, he's just having trouble entering the group. And so it became the teachers, kind of were labeling their own problem, their own things, and kind of coming up with their own solutions. And now they have a curriculum, but they also kind of looked at challenges, or it was my goal for us to kind of like look at challenges as maybe with their component parts. 

Jayson Davies   

yeah, I mean, and you gave them basically a frame to look at these quote, unquote behaviors that were occurring, because they might look at it without your help and just see chaos. And you were able to come and kind of task analysis this entire system that is a classroom on the playground, and kind of break it down into different areas. These group of kids are one or seeking something. These groups of kids need more, maybe even social skills. Or these kids need to know how to ask, Can I play? And so you're able to come in there, and now it's analysis. Wow, I can't talk analyze. You're able to come in there and analyze an entire classroom and kind of break it down to where the where the teachers now feel that they can do it, which is even cool, like, even cooler, because you just not only helped the classroom, but you helped the teachers as well. So I don't know, I love everything you say. 

Leah Hiller   

I like it. And what I'll say is by no means did we quote, solve the problem like it is not perfect. It is far from perfect. Every preschool class has this typical behavior. What was exciting to see was sort of like a shift in how we talked about it. Yes, it was no longer like, oh, the kid, they're just, you know, battling each other on the yard. It became like it just was sort of a different lens to look at what was happening. And I really feel strongly that that's sort of step one in helping them, helping the kids and the parents and teachers, like how. Going to address it, like, once we kind of look at it a little differently, like, maybe we can approach it a little differently and also just like, see that it is approachable. It's not just like, Oh, why are they doing that? It's like, oh, here, here are the tools we have to help. 

Jayson Davies   

Yeah, and I think sometimes adults, teachers, aides, even OTs and everyone you know, sometimes we get stuck on seeing one kid doing one thing, and we forget to kind of take a step back and see that that kid's in a context, and that kid is not only acting on the playground, but they're also reacting to everything going around them. And so you really have to step back and see a whole picture thing. You can't see just one kid seeing what that kid's doing in a moment of time, because you don't know what happened to that kid 10 minutes ago, five minutes ago, or two hours ago, or what they're thinking about. But sometimes, when you take a step back and look at the entire play from all 20 kids that are out there, you kind of get a better dynamic, a better feel for how that play is flowing, and how you can adjust that a little bit so. 

Leah Hiller   

And I tried really hard to like, again, my job is to help the teachers like I am, like they are the experts. Yes, they are the experts in these kids. And I will tell you I said, my like, I'm here as part of a guess and check system. And I tried to be as transparent as possible. I would go in and be like, Okay, we've got this problem. Here are four things we're going to do about it. And I would check back in two weeks later. And the teachers would be like, those were some terrible ideas you have there. Or, like, those ideas did fourth, you know, here are the four consequences of those ideas or so it I was by no means like, this was not perfect, but the teachers were so willing to, like, go on the journey with me, like, we're gonna try this. And they would say to like, there isn't, there's no problem being like, Yeah, that does not work, and it does, you know, it doesn't always work and again, like they are the experts, and but it was, like, really exciting, just that we were really we were able to try stuff, like we had the space to try. And, yeah, it was great. 

Jayson Davies   

Alright, so getting on to again, we kind of started off big picture in service. We kind of narrowed it down a little bit now to one class at a time. What about groups? Are you doing any small groups? Kind of that tier two, kind of on the verge of tier three, ish, small group interactions in class? 

Leah Hiller   

So I do. I got to go into the classrooms, and I could kind of come up with some of these ideas that either the teachers were already doing. They often have little groups running in the classroom, so sometimes I could go in and just lead that group. They're already doing an activity. These teachers are awesome. So they're already doing an activity where the kids are making their own putty, and then another station they're like, getting to cut the putty up or build things with the putty, or, you know, all these different things that it's like, oh, if I had made a list of what I would love to see in a preschool, it's really already happening. So sometimes I would just get to be there to offer up cues for grass. Like, maybe we would help with grass. So maybe I would join a station where the kids are already cutting and doing all these things, and I would just kind of go in and, like, add a layer of support to it. Maybe I would try to grade the activity. If I see a kid who's already able to cut all the little snakes he rolled into all these little beads, then maybe we figure out how to punch holes and string those beads onto something like, maybe there's different levels, like, we can expand it in different in different ways. Other times, I came in with my own thing, and those mini lessons were a really good opportunity for me to follow up on some of the social thinking activities, or let the kids, like, build their own Matt man and play around with wet dry try in making letters. It was really kind of that opportunity to just expand whatever things we've introduced. 

Jayson Davies   

I can just imagine myself when I'm working in in a small group or in a class with a kid a lot of times, and you kind of referenced through this earlier is parents and or teachers wanting more services. So you made it very clear in your proposal. You know you're not there to really do one on one services. So what do you do when someone comes up and says, Hey, I think Little Jimmy over here could benefit from going to your clinic on Friday afternoons for some ot service. 

Leah Hiller   

Right? So that. One of those interesting fine lines that I am trying so hard to, like, you know, just walk the line, make sure that I don't cross those barriers. Because, of course, I do have private practice clients that are at the school. Like that was my introduction to the school, was that I saw clients there, and I continue to do so, and so I have to be careful. At times, I had even been able to see a client in my private practice at the school. So that's always an interesting thing. And sometimes I'll have to, you know, the teacher, of course, will know I'm here working with this particular kid. But obviously I blend in. The teachers are used to being able to grab me and ask questions here and there, so sometimes I have to say, like, Oh, I'm going to check in with you later on today, when I'm available for that. I have to be careful with confidentiality. I can't say I'm working with this individual because that's not another teacher in another class. Doesn't need to know that, so I do have to be careful on that, and I have to make sure that I honor my time in both ways, but yes, in general, it is my hope that by my being at the school, it will actually lead to fewer inappropriate referrals, and maybe, yeah, and maybe even fewer referrals in general, right? If we can get into the schools and manage and recognize some of the challenges and then address them in a class wide way or in a small group way, then maybe they'll not need to come my way at the and I think the other part of what I get to do is a lot of times parents or teachers will come in with exactly that question, hey, my kid needs to come to OT or the teacher will say, Oh, so and so definitely needs to come to OT so we put in place a process for that, and that was a conversation with the director. Also, again, the school has a behaviorist who's so knowledgeable, and is there more than I am, and so he really kind of knows the way things work. And so we really tried to be thoughtful about this process. So if a teacher suggests a challenge, I think this kid would benefit from ot I have them because they are the connection to the parent. I say, Okay, well, let's chat with the director. Let's see what what they think, and then let's ask the parent. They need to know what's happening. It makes I recognize that I have little kids. I as a parent, I don't want just to think that like there's some professional, like Lurker, right? Keeping it, keeping track of my child without my knowledge. So if there is a concern, the teacher needs to go to that parent and say, hey, here that I'm concerned. And I'm thinking, Leah should come in and observe this child like I think that they should come in. And so I'll help the teacher kind of frame it in a way that's based on skills, like we can kind of hash out, like, what is it you're seeing? I really encourage teachers. I emphasize the fact, like, I'm an OT I'm not a diagnostician, you're a teacher, you're not a diagnostician. Let's be objective. Let's leave this objective up, like, let's put that away. Yeah, tell let's talk about what you're seeing, and then share that with the parent. And of course, it can go one of two ways. Sometimes the parents like, oh my gosh, yeah, I see that too. What is going on with that? Or sometimes parents will say, Oh, that's not just typical four year old. Oh, okay. Then Then let's look into it. And other times parents will say, No, that's not something I'm comfortable with, and that is their prerogative. And then a lot of times parents will say, I said it would go one of two ways. This is way more many, many ways. But sometimes parents will say, You know what, let me talk to the OT. And so I'm also available if a parent wants to give me a call, and I can tell them, of course, at this point, I haven't screened their child, but I can talk to them just generally about what I do as an OT and what a what these little observations look like. And so then I'll go in. I'll set a time with the teacher. Usually, I try to peek in at a time where they're inside the classroom, a time where they are outside, a time where they are maybe having snack or lunch, I kind of just peek in. I do a what I consider like an initial screening, and I do mind. Notes as objectively as possible. I say what I see, and then I kind of put down, oh, we saw this. It could be related to fine motor challenges, or it could be related to core strength. And of course, I say, like, we don't know this. This is just a screening. We might want to look more into this. And sometimes, for some things, I'll just give general strategies, like, sometimes I get a call, Hey, my kids, there's a kid who's drooling, there's a kid who's W sitting, there's a kid who's doing this, you know, these very specific things. And I have just some kind of general strategies that we can sort of implement at home and at school. Here's here are the next steps. So I offer all that, and then again, the teacher is the one to share that information. They have my notes, but they are the one who can have that thoughtful conversation with a parent. 

Jayson Davies   

I think that's the right way to do that, because, like you said, you don't I wouldn't want to get a call about my kid from, I mean, I don't have kids yet, but I wouldn't want to get a call about my kid from an OT that I didn't even know knew my kid like that's not how the system is designed to work. You have your, you know your routes of communication, so that's good. All right, you touched briefly upon parents just there. How do you help parents other than you know, helping their kids often in the classroom through RTI, but you said earlier, I think too, that you might provide some training or something, or how do you get your word out to parents at a more general knowledge base. 

Leah Hiller   

So this school is already set up. They have a weekly email, a newsletter that goes out to the families and I could kind of just slide into place like the every once in a while, the behaviorist will write a little article about what's going on and offer some strategies. It's like these wonderful just little tidbits that are there for the parents. Sometimes the coach will present some ideas about promoting play. There's all these different people in the community and in the school that already are set up. So that's really my forum right now, is that couple times a year I get to write a little blurb about, here's what I do, and then I think this year I got to I wrote a little something about travel over spring break. A lot of the OTS over winter break, a lot of the families were going to go away. And so I got to write some strategies for making trips, car trips, maybe making those a little more engaging for the family. I gave some executive functioning strategies, little things here and there. And I kind of just try to pop those in in a way where hopefully parents will read that the other way, I didn't necessarily do a formal teacher educate or parent education program, because, again, I'm the background, yeah, I want the teachers to do that. So basically, I went to a parent meeting, which is again, a forum the school already has set up, but I can introduce myself say, kind of what my role is at the school. And also, the biggest thing is that I'm around. I'm there once a week, that parents know when I'm there. And occasionally one will stop me in the hall and say, Hey, I'm concerned about this. Is this a thing like, Should I, should I ask the teacher about my child's pencil grasp? Or should I worry about which shoes my kid is wearing if they're falling down a lot? So again, these are really easy questions that I can quickly give a general response, or I can say, you know, that's a more involved question. Here's the process, like, go ask your teacher. They can find me if they think it's a concern. And I'm also available to the director too. If there's like, something kind of going on at times, she'll just sort of pull me in and say, What do you think? How could we help in this particular way? And so I can kind of be like a sounding board for that. 

Jayson Davies   

Great, cool All right? Well, I don't want to take up too much of your time. I know we could probably talk all night long, but I do want to give you a chance to let people know where they can get a hold of you, where they can reach out to you, because I know on your website you have a few things. You have your research article that you did on there, or at least a link to that, and it also gives a little bit about your your clinic that you run from home. So go ahead and give a shout out to yourself. I guess, where people can get a hold of you from? 

Leah Hiller   

I will give. A shout out to myself. So I'm Leah Hiller and my clinic is Hiller therapy. Hillertherapy.com is my website, and yeah, they can absolutely you can reach me through there, if OTS are preparing in services, if you're looking to do these kinds of things with schools in your community, I'm happy to talk more about it. I know for me, the process of becoming a school consultant has been such a fun learning experience, and I really feel like I'm making a big difference. My private practice is small, and I really feel like I'm helping those kids and their families at the same time. When I'm at the school, it's so many kids and families that I get to interact with, and so I think it's great. I really enjoy it, and I hope other people will maybe see it as an avenue that they can pursue too. 

Jayson Davies   

Great. Sounds good? Well, thank you again for coming on. I enjoyed even more talking to you today than I did. We were kind of preparing this a few weeks or a week ago or whatever, but that's really cool. I'm so glad I had had an opportunity to meet you a few weeks ago and that you're able to come on and share your experience with us. So thank you. 

Leah Hiller   

Thank you so much. 

Jayson Davies   

Definitely take care. I'll talk to you later. 

Leah Hiller   

All right, bye, bye. 

Jayson Davies   

All right. Well, that was Leah Hiller of Hiller therapy. I once more, want to say thank you to everyone listening to the otschoolhouse com podcast, and, of course, a huge thank you to Leah from all of us for joining today on the podcast. It was sure great having her on. So be sure to check out otschoolhouse com, forward slash episode nine for today's show notes and the links to Leah's website. Have a great day and enjoy the rest of your summer. Bye, bye. 

Amazing Narrator   

 Thank you for listening to the otschoolhouse podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed. 

Click on the file below to download the transcript to your device.

OTS 09_ Diving Into RTI With a School-Based OT Consultant_ An Interview With Leah Hiller, .

Download • 135KB

Click here to view more episodes of the

OT Schoolhouse Podcast