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OTS 197: Bridging Sensory Integration and Academic Standards in School-Based OT

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  • 40 min read

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Welcome to the show notes for Episode 197 of the OT Schoolhouse Podcast.


In this episode of the OT Schoolhouse Podcast, host Jayson Davies is joined by Aimee Piller and Dr. Sultan Alfawaz to explore a powerful shift in school-based occupational therapy practice. Together, they break down how aligning OT services with academic standards can transform both student outcomes and how practitioners advocate for their role in schools.


You’ll learn practical strategies for linking evaluation data and sensory processing patterns to educational goals, including how to connect assessments like the EASI, SOCM, and BOT-3 to specific academic standards. The episode also unpacks proximal vs. distal outcomes and helps you confidently determine when to use Ayres Sensory Integration® versus sensory-based interventions in school settings.


Whether you're looking to strengthen your evaluations, improve collaboration with teachers, or better justify your services in IEP meetings, this episode provides a clear, actionable framework you can start using right away.


🎧 Listen now to learn how to connect your OT services to what matters most in schools—student participation and academic success.



Learning Objectives

— Learners will identify how to link occupational therapy interventions to academic or state standards to improve educational relevance and advocacy in school settings.


— Learners will differentiate between proximal (sensory processing) and distal (participation/academic) outcomes to strengthen clinical reasoning and goal writing.


— Learners will identify how to integrate state standards into the referral and evaluation process



Guest Bio



A pioneer in his field, Dr. Alfawaz was the first Saudi occupational therapist to earn a doctoral degree and receive certification from the American Board in Occupational Therapy. His groundbreaking contributions to sensory integration have earned acclaim from the global OT community. He served as President of the International Council for Education in Ayres Sensory Integration and formerly held a leadership role at the American Occupational Therapy Association.




Aimee Piller, PhD, OTR/L, BCP, FAOTA, is the owner and director of Piller Child Development, a multi-site outpatient pediatric therapy practice in the greater Phoenix area. She specializes in sensory integration and feeding therapy. Her scholarly interests include knowledge translation and the development of evidence-based treatment protocols to enhance clinical practice. She has numerous peer-reviewed publications, book chapters, international presentations, webinars/podcasts, and is the author of Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs.



Quotes


“We are the minority in schools—we must speak their language.”

— Dr. Alfawaz


“We don’t need to memorize standards—we just need to access them.”

— Dr. Piller


“We’re not fixing sensory issues—we’re enabling academic success.”

— Dr. Alfawaz


“We don’t have to guess—we can assess.”

— Dr. Piller


“Meaningful evaluations lead to meaningful OT services.”

— Jayson Davies, M.A, OTR/L



Resources




Assessment Tools:


Publications & Articles:

Organizations & Programs:

Standards & Frameworks:

Upcoming Presentations:

Other Resources:



Episode Transcript


Expand to view episode transcript

Jayson Davies   

Hello and welcome to episode 197 of the OT school house podcast. We are getting close to Episode 200 I'm excited for that, but yeah, today 197 I am Jayson Davies, your host, and today we're addressing how we better connect our OT services and IEP goals to the educational curriculum. I really feel like this is something that can better ingrain us into the educational system. You know, we often feel like we are on the outside looking in in school based OT, and this is important, and we're going to discuss that today. Joining me, are two leaders in the world of sensory integration to help with that. Dr Amy piller, author of implementing sensory based occupational therapy services a multi tiered approach to sensory processing needs. She was also with us in Episode 192 and joining Amy today is Dr Sultan alfarez, a past president of the International Council education of air sensory integration, and he's been pioneering this work, especially with integrating sensory integration with common core standards, since his doctoral studies at USC, and it's a special honor to have Sultan on the show. Since we studied together back at USC in Gosh, 2010 to 2012 or so together, Amy and Sultan have been researching and sharing how we can connect what we do as school based ot practitioners to the Common Core State Standards, or your state standards. Not only is this about justifying services to administrators, it's also about transforming how we think about evaluations, intervention, planning and even the language that we use in the school setting. We'll walk through the entire process, from referral to report writing, discuss the difference between proximal and distal outcomes, and even briefly explore how AI tools can help streamline this framework. If you've ever sat in an IEP meeting wishing that educators and the teachers and the administrators better understood how and why occupational therapy and sensory processing matter for academic success. This episode is for you. Let's dive in. 

 

Amazing Narrator   

Hello and welcome to the OT school house podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies, CLASI is officially in session. 

 

Jayson Davies   

Amy, welcome back to the OT school house podcast. Sultan. Welcome for the very first time. Aimee, you were just recently on the show, like, I don't know, five episodes ago, Episode 192, but Sultan, this is your first time. So thank you so much for joining us today. Yeah. 

 

Dr. Sultan Alfawaz   

I'm so excited and honored and humbled, 

 

Jayson Davies   

yeah, and we are very excited to have you and very thankful to have you because you are on the opposite side of the world, 10 hours away. I would love for you just to quickly share kind of where you are in the world of OT and even just where you are in the world. 

 

Dr. Sultan Alfawaz   

I'm in a country called Saudi Arabia. I'm in Riyadh. Currently, we are actually celebrating and observing the month of Ramadan. So I'm in Saudi now with my family. So it's 10pm 10pm Saudi time, our Mecca time. I'm really, really excited to be with you, Jayson. So I've been lucky to be with Jayson when we did our master together back in 2011 right? 

 

Jayson Davies   

Yeah, yeah. I don't remember all that that's too long ago now I don't talk about that OTs, 

 

Dr. Sultan Alfawaz   

yeah, right. So yeah, to be you know, I spent most of my professional life actually in the US, but I'm glad to be able to serve my own countries as well and help them with the experience that they gained while I was in California. 

 

Jayson Davies   

Awesome, perfect. Well, thank you so much for being here, and let's go ahead and dive into it here, because, as you mentioned, you know, you've been doing this for a long time, and for the past three years or so, the two of you have really teamed up to address this, this concept that really hasn't been addressed, and that is kind of pairing occupational therapy services with the idea of Common Core State Standards. Or in some states, they're not common core, they're just state standards. And so my first question is, what inspired you to kind of team up and tackle this, or, like, what even made you think, hey, we need to start pairing ot with state standards. 

 

Dr. Aimee Piller   

Well, Jayson, it's funny, because Sultan and I, when we were preparing for this podcast, we had a we're like, how did we actually get this rolling? Because I'll let Sultan talk in a minute about how this was his doctoral work. But we, we decided we met and Calif really got it going in California at the International sensory integration Congress is when we kind of really started thinking, maybe we could do something together, like you have some very similar interests in the school system as do I, as we had from the previous podcast. And sensory of course, is something that we're both experts in. And so we just started talking and decided, well, maybe we could get. Something together with Sultan's doctoral work, and then some of the work that I do with schools on sensory so Sultan, do you want to talk about your doctoral work? 

 

Dr. Sultan Alfawaz   

Maybe, yeah. So even back in the days when I met Jayson, so I finished my master and I started on at USC, I did my doctoral studies, and it was during the time when Dr Erna Blanche was working on her data collection of Stasi SAS. So I took an elective course in school based with the amazing one of my amazing mentor, Dr Julie. Vessel, Hi Julie. Julie was working as at that time, she was the prime, I think, occupational therapist in Anaheim School District. Correct me if I'm wrong, Jayson. And she said, Oh my god, Susanne, you're doing really, really great work. Why didn't you link it to that education standard, right, the Common Core State Standard? And and I said, Oh my god, actually, that would be when I dived in more I was and I was already been an OT for five years, seven years, right, working in the UK, Saudi and recently, like the last three years, been in the US. And I was like, Yeah, we always, we never, ever, kind of answer that puzzle is like, how do we have the language of the administrators, right? And I was honestly as non California was like a new Californian in the market, right? I didn't know that it actually exists. You know, at that time, the Common Core by 2012 2013 I didn't even thought about it as an occupational therapy. There was a solely educational standards. But then when I dived in, I actually linked it to the soci M as a proposal. And then since then, I remember I was back to, I was working at PTN at that time, and I talked with, I talked to the one of my supervisor out there, and I shared her that even the table where I linked the SIP at that time to the Common Core State Standard for first grader, for one of my client, and she's like, Oh my god, style, if you work on this, this is going to be a game changer, because a lot of therapists, you Know, they stay in their clinical bubble, especially with languages, especially when they justify their services within an IEP meeting, that's perfect. 

 

Jayson Davies   

That's exactly kind of where I wanted to go, right here off the bat is, you know, like, why is that even important? Why is it important for occupational therapy practitioners to understand common core and then to start to say or ask ourselves, how does what we do impact Common Core? Why is that important? I think it's 

 

Dr. Sultan Alfawaz   

very helpful. I don't know if you don't mind. Amy, just adding a little bit on that is like we link our intervention to Common Core. Stay in there. We kind of validate our role, right? Why we are in this queue in the school setting rather than the clinic. We're not just fixing what they say, the sensory issues. We are directly supporting the student ability to read, write, do their math, function or actively participate in a PE class or in a social setting, right? So it changes the conversation from medical necessity to a more educational relevance. And I think it's a really, really key to secure services and even equipment, for example, for in any educational setting or school setting. And I always remind my students and remind myself, we are the minority there. We are the minority in the school district as an occupational therapist, so we cannot, like, pretend or just believe that they will understand our language. It's the other way around, where we speak their language in order to advocate for our service. I'm not sure if Amy, you want to add anything on that, yeah. 

 

Dr. Aimee Piller   

And I think one thing that's really important and that we focus on, it's our main goal as occupational therapist, is participation in whatever environment that client is in. And so, you know, in the case of the school setting, that's the educational goals and standards that the state sets for the students that the teachers are trying to implement, and we can be there to help support those and when we start, as Sultan said, to make our language match with the language that the teachers know, administrators know. And we can make those links between what we're doing and those common core, which is our participation goals, right then they do start to see the value and understand how important we are, as well as how we do support what they're already doing perfect. 

 

Jayson Davies   

And I think that's kind of what I wanted to actually address next. Because I think some people, and I've even had this internal discussion with myself, is like, is this simply trying, are we doing this just to appease the stakeholders, or is this actually going to make occupational therapy better in itself? And I kind of want to get your take on that. Like, is the whole purpose of doing this just so that administrators better understand how we fit into the schools? And even maybe even convincing ourselves how we better fit into the schools. Or do you think this is actually making occupational therapy in school based a actual better profession, because we're doing this 

 

Dr. Aimee Piller   

well, Jayson, I really appreciate the fact that as occupational therapists, we are often very adaptable, but we also really do want to focus on what's meaningful to the client, and in this case, that's what the school is doing. So yes, it we hope that it does justify our services to administrators, right? We want to make sure that we continue to be a part of the team and show ourselves that show others that we're relevant to the team, but it also is shows our unique ability to come in as that kind of support personnel occupational therapy can support what's already going on in the school setting. School setting. Maybe we have our own goals. Maybe we're just embedding within those schools, but we are the unique ones, and we understand how we can make this link between maybe sensory processing patterns and then reading or writing or physical education, as well as the other aspects that the kids often are referred to OT for in the school setting. 

 

Dr. Sultan Alfawaz   

Yeah, if I may add just to this, I think a lot of us, especially within the ASI work, or even in any other work, sometimes we have all these assessment data, and we are kind of struggling to how to convert it to everyday language and everyday participation struggles. So I always say it's very, very helpful for OTs to link these proximal outcomes Right? Which is, are the specific sensory factor we identify in our assessment? For example, He has hyperactivity or power Praxis or balances issues. These are the root causes, right? But the administrative or the stakeholders want to know, what are the distant outcomes, right? What are the participation challenges, the actual behaviors or academic circles that we see in the classroom, like a child hitting or or failing to sit still in a class, in his chair, on her chair? So the distinction matter, because schools care most about I don't know from my experience, through my time in California and even in London, about the distal outcome, participation. I'm not sure. Amy, do you circle? Do you see the same in Arizona, or do you Jayson in OT? But I see they always focus on the participation. So for us as an OT, we have to show that by treating these proximal outcomes or the cause or the sensory needs, we're kind of improving the distal outcome the academic success. I think linking that is how we justify the use of air sensory integration within this course setting. 

 

Jayson Davies   

Yeah, and you know, Sultan really quickly, if I can ask you, because I can't recall Amy, we might have touched upon this a little bit in Episode 192 but you use the terms distal and proximal outcomes a little bit, and I know that's very common now, especially in the sensory integration literature, but I don't think it's as common outside of the sensory integration literature. And so I wanted to just to kind of get, you know, a few sentences from you about what you're actually referring to when you talk about distal and proximal. 

 

Dr. Sultan Alfawaz   

I could answer it like so, for example, let's say, if we have a child with like, you know, he, we have a student to, you know, hits other when they get loud, right? This is a problem. This is more, more of an a problem, that the teacher comes to your door and they say we have this issues, right? So we do this assessment, we do the easy or we do them SPM to and we find that child has hyperactivity to the auditor, to the auditory input. So this is then the proximal, right? So this is the the proximal is the hyperactivity to the auditory where the distal is more hitting his peers or hitting his teachers around. So if we look at the Common Core State Standard, for example, social emotional learning or even classroom participation, these are standard about how to engage effectively in a collaborative discussion or following the rules for collegial discussion, right? So when you write and justifies for your intervention for that participation struggle, you could justify your treating these sensory auditory sensitivities by using ASI approach. So we are not just stopping the hitting, but we actually enabling the student to meet that standard of participation in a collaborative conversation with a diverse pattern. So we kind of frame the sensor intervention in a kind and a tool to unlock specific, I would say, academic standard, right? I don't know if Amy, you want to add anything on it, yeah. 

 

Dr. Aimee Piller   

Basically, in a nutshell, your proximal outcomes are your sensory processing patterns, and your distal outcomes. Are there participation goals that you have, in this case, a common core standards, as Sultan gave several examples of so that's just a great way, I think, for us as occupational therapists, to explain to those receiving our services, or those who might be supporting those receiving our services, as to, how does. Sensory processing as Sultan said, How does this child sensory processing patterns? What does that mean when he's hitting another kid, or he's not able to attend to the task, or he can't participate in the writing activity the way the other students are, and so this is the language that we use in the sensory world, because we have to link that sensory processing pattern to what's going on with this participation challenge. Perfect. 

 

Jayson Davies   

Thank you. Appreciate you both explaining that, because I know it's not something that we hear every day, unless we're, you know, reading articles several times a month or maybe even a week. But thank you 

 

Dr. Sultan Alfawaz   

and I could Jayson, if I could add one thing here as well, is I'm sure Amy as well when we teach Earth sensory integration to our participant. We always teach them, even within assessment, is how to develop your outcome measure, right, how to be proactive about it, and how to identify proximal versus distal outcome, right? And then when they go to the school practice, they're like, Oh, how can I link them. So by having this framework of having the education standards help school based occupational therapists to have a more, I would say, explicit framework to apply ASI framework within the school setting. 

 

Jayson Davies   

Yeah, and correct me if I'm wrong, but I in most cases, IEP goals tend to be that distal, that distal outcome and the proximal outcome might be something that you put on your treatment plan that you're kind of focused on, or something from the data that came out of the evaluation that sounded about right, yes, right, perfect. Yeah, all right. I wanted to dive into something because obviously you two are very much experts in the world of sensory integration. You know, Amy just wrote a book on MTSS and sensory processing. Sultan, you were the president for the International Council of Education. And ASI, obviously, you both know what you're talking about. And so I want to get from one or even both of you how you help under how you help under how you help therapists understand the difference between asi, asi and the SBI is the sensory based interventions. And so if I can get just, you know, a brief elevator speech on how you both kind of help OTs to understand that. 

 

Dr. Aimee Piller   

Well, Jayson, I think it is a really important concept, especially when we're describing different things to non OTs. So I feel like OTs, we can kind of like we use airs si sometimes along with sensory based interventions, and they maybe are using them together, but oftentimes we don't distinguish those and what their purpose is, and then also how they're the intervention is. And Sultan can also follow up on this as well, but with the arssi, we have some pretty clear fidelity criteria that we have to utilize. We're really working on internal adaptive processes. We're helping sensory integration happen in a different way, in a more adaptive way, versus sensory based interventions really are designed to help the child have a more regulated level of arousal or alertness in order to match the task at hand. So they're not necessarily designed to make lasting changes. They're really designed to modify the situation at hand, the child's arousal level or alertness level or the sensory environment so that the child can participate in the task at the moment. 

 

Jayson Davies   

That's a good way to frame it. Thanks. And Sultan, did you want to add? 

 

Dr. Sultan Alfawaz   

No, I think Amy has covered it all, and I don't know. I'm sure your audience knows about the two newly published systematic review where it showed that both sensor based intervention and error sensor integration are actually evidence based interventions. So actually, we live in the kind of I would say at that time, is a gold standard for air sensor integration, for sensory integration in general. So do you want to add anything about it? Amy, I think you are the co author, right? Your first author for both, yeah, 

 

Dr. Aimee Piller   

we did leave the team for those two systematic reviews. The one on air sensor integration is great. It really shows this a plethora of evidence that's come out in the last 10 years to support air SSI in many settings, including the school setting. So that's really exciting for us, I think, as practitioners, that now we can come and say oftentimes that air sensory integration has been thought of to be done outside of the schools, and maybe just due to access to equipment or space or training, but now that the evidence is coming around and showing that it's very effective, that's something and some part of the reason, you know Sultan and I do this work is to try to get that airs si into the school system, and to link the importance of it to what students are doing in school. So that systematic review was recently published in a OT, so if anyone wants to take a look at that one, and then our second systematic review was on sensory based interventions, and it had very a lot of them had some good evidence. Some had evidence that said they were not that great. And those, some of those are techniques that we use a lot in the schools. So being careful about what. Our outcome measures are, what are we trying to do? Is this right for this particular child? Is really important, and then other of the sensory based interventions had really strong evidence. So those are things that you probably want to make sure that you're embedding within your treatment in any setting, things like caregiver and teacher training was a big one. A lot with deep pressure, tactile input was big. And that systematic review is actually open access. So we're really excited about that, because we wanted not only occupational therapists to access that, but also, you know, psychologists school personnel, to be able to access that article. And so we're happy that that is also an open access article, so all practitioners can access that and have that evidence. 

 

Jayson Davies   

I always love when you can find an open access we appreciate that. Amy, but I had no idea that you actually were on both of those. I knew you were on the ASI one. I didn't realize you also participated as an author for the SBI one. So thank you for putting those together, Jayson, first author even, 

 

Dr. Aimee Piller   

yes, yeah, it was quite an ordeal to undertake, but we were happy when the with the finished product. So hopefully it will help all practitioners so that they can, yeah, better, you know, use better evidence based interventions, 

 

Jayson Davies   

yeah, and I'm familiar with Colleen whiting's recent works as well that are more specific to school based occupational therapy, which is fantastic, because for a long time there, everything was more clinic based, but now we're starting to see that roll out and expand, really, to the school setting, which is which is really awesome. 

 

Dr. Sultan Alfawaz   

Yeah, it was even Celine has done a great work Jayson and her recent article call for action was last year. I think March last year, I really encourage all your audience to read it. It's an amazing article. It helps you with the wording to advocate for ASI in school setting. 

 

Jayson Davies   

Yeah, and if I can ask one follow up to that, Amy, despite there being this, this body of research for both ASI as well as the sensory based interventions. In my communications with practitioners, especially in the schools, there tends to be a lean toward more the sensory based interventions. I think in some cases, just because those can be implemented in the school or in the classroom, directly in the classroom, and I think ASI there is that idea that it takes a lot more frequency to do and you have to do it in a pull out setting, maybe you call that more restrictive. But from your you know, obviously you've looked into this deeply. Why do you think there is that kind of push, especially within the school based world, to use sbis as opposed to asi? 

 

Dr. Aimee Piller   

Well, Jayson, you made a good point that, you know, the SBI is, can be used in the classroom, which is great. You don't have to take the kid out of the learning environment. You can implement those there, and sometimes that's what the child needs, right? Especially when we're looking at reactivity difficulties, or just general regulate, sensory regulation. SBI is, are really might be the best intervention for that child, but when we start to look at kids that have some more significant Praxis issues, or some really sensory discrimination issues that are impacting that participation, those are not going to be addressed by sensory based interventions, and that's when errors as I really becomes important. And some things that Sultan and I have presented on in the past is really trying to make that distinction, of you know, when is sensory based interventions, what this child needs to access education, and when are his the child's difficulties may be different, and they're not reactivity based. They're more sensory processing based, and that air sensory integration is the evidence based intervention to address those. And so when do we implement that in the right framework so that the child is able to and colleen's article really did a great job that it didn't take that long to show meaningful participation improvement. So yeah, maybe we have to quote, unquote, pull this kid out for some services, but then maybe it just is a few months and we can go back into the classroom and implement more sensory based interventions. So there's lots of research still yet to be done on that, but I think some of that early research shows that, yeah, maybe it's a lot right now, but it might be less in the long run. 

 

Jayson Davies   

Yeah, that's the hard part about school based too, really quickly. So that's the hard part about school base is that we often think in time frames of a year, but if we start to think two times a week for eight weeks, and then, you know, a break from occupational therapy, because those eight weeks were so impactful that's actually less services than one time a week for, you know, the entire school year. Sultan, did you want to add? 

 

Dr. Sultan Alfawaz   

No, I just want to mention that our friend Christy Tang and Amy and I are actually presenting, right? Amy, yes, and how to implement, exactly how to implement ASI in a tight budget, yeah. So that's something to look for in the upcoming AA, right? Amy. You that's coming up. 

 

Jayson Davies   

Yeah, a OTs coming up. In fact, this episode is coming out right about a month before, before a ot a Inspire. So if you're listening, there's still time. It's in Anaheim. Come visit Disneyland and get some CEUs at the same time. Come meet Amy and Sultan. It'd be awesome. And myself, it'd be fun to meet you. So let's take a quick break, and when we come back, we're going to really going to really dive into what this actually looks like for a school based ot practitioner in the schools. All right, we are back with Amy and Sultan, and I really want to dive into what this looks like, you know, for the school based ot practicing. And so I want to walk through this, and I want to ask you, at what point in your referral or evaluation process would you even begin to start thinking about the Common Core State Standards? Is this something that you know, right from the moment a teacher approaches you about Johnny, that you start thinking about this? Or is it during, you know, while you're doing the bot three or the SPM, or when does that start to come into play? 

 

Dr. Aimee Piller   

Well, Jayson, for me, it's really important to start thinking about it from the beginning, right? This are the, these are the participation challenges that we're going to see if our assessment data indicates that there might be reasons that this child's having needs, ot services. So just thinking about that aspect of what com what Common Core State Standards is this child struggling with, in addition to, maybe, like, some of the other reasons we get referrals for OT, which is oftentimes some behavioral or social emotional difficulty, as well as just but also the academic or other standards that we see. So that's important to me to think about from the beginning, because that's the participation side. And then, of course, the assessment pieces is critical to determine if they're, you know, sensory processing differences, or are lending themselves or preventing this child from participating to their potential to meet these common core state standards. Assessments really important for some all of what we do as OTs. I always tell my therapist, I'm like, we have wonderful assessments in our in our profession, very valid and reliable assessments, and we don't have to guess. We can just assess so it's easy to to implement that, to see those connections, and that's what we talk a little bit about, as we have this article coming out on how to make the link between those proximal outcomes that we identified in our evaluation process to that distal outcome of the Common Core State Standards, because that's really where we want to see the progress, right? That's where we're going to be looking at, monitoring and evaluating that progress is on that those common core standards, yeah. 

 

Jayson Davies   

And so I guess I'm thinking back to that referral, right? Like when we are first learning about a student. I can imagine. Well, I'll say right now, presently, a lot of times referrals come in and all they say is one word, handwriting, sensory, fine motor. And so I'm thinking like how beneficial it might be if, rather than a teacher telling me sensory or handwriting, instead they're giving me a checklist of a few standards that the kid is having difficulty, you know, completing. Does that make sense? Is that something that you've seen anyone, or maybe even yourselves, are kind of working toward doing more of 

 

Dr. Sultan Alfawaz   

Yeah, I don't know if Amy want to add anything to this, but for me, is like, just this is when we started, me and Amy, actually, the conversation is how to change the narratives, right? So the first things of the narrative, because I'm sure all the school OT or clinical OT, they get like crazy with all these referral with just like one things, and yeah, like all these teachers or administrator are diagnosing those kids with participation difficulties. And I think if we can't control the narratives, and I think kind of repositioning the wording more toward the education standards, I think we position ourselves as an occupational therapist in a better state, right within that IEP meeting and with other, I would say, with other professionals, I think it will add another value of why we are there, and the importance of occupational therapist, because we always need to remind ourselves students, when they are at school, this is their main occupation, from 9am to maybe 3pm right? Their main occupation is being a student meeting these education standards that were set by their state. So I think returning the changing the narratives to participation challenges which affect their meeting their education standards will help us a lot to link the outcome data to the distal outcome. 

 

Dr. Aimee Piller   

And Jayson, you made a great point of like, could that be part of that reason for referral? Do we create a little checklist that says, Well, how is this child doing with particular standards at that grade? Wouldn't that be valuable information? As we're doing our assessment, we would really know, like, are these linking together, or what we're seeing is that different? It's not just handwriting. There's other aspects that this child may be struggling with, and to have that data in the beginning from the teacher's perspective could be really invaluable. 

 

Jayson Davies   

Oh yeah, because especially the sensory run, right? We just get a referral that says sensory on it. And we know a lot about sensory, but the teachers don't necessarily. Maybe they've gone to some teacher based trainings and they understand sensory a little bit, but a lot of times they're writing sensory more as an idea, not as a definitive, you know, reason for the actual evaluation. That's what they perceive it as, and that's why we're coming in to test it further. I think it would help us greatly, if you know it. Rather than putting sensory they said, This child's having difficulty with ELA, 4.3 and whatever, math, 2.58 whatever. I don't know all the different ones, but then we could go about through our process, through the evaluation process, and kind of work, work through that. So yeah, if anyone out there is creating a referral process that includes this, please let us know, because I think that'd be be really cool to see. So let's imagine we do have that now, right? We have, you know, we've gone and we talked to the teacher, and the teacher says, Yeah, I'm having difficulty. Written language is difficult for this student, you know, this type of or this specific state standard. Amy, you started to talk a little bit more about the evaluation tools. Sultan, you talked a little bit about how we do have really good evaluation tools. I guess the this begs the question, where do we go from there, right? So if we know that a student's having difficulty in this particular standard, how do we begin to link that to the evaluation data?  

 

Dr. Aimee Piller   

Yeah. So when I think, if we just want to take a common example that's been mentioned, we said, you know, handwriting, right? We all get lots of referrals for that. So if we look at that from the ELA standard, you know, that's a written narratives, right? We have to write narratives. That's what kids do. There's predict different standards based on grades. So then you think about like, what are the OT skills that are, what are the OT relevant skills in that? Well, there's things like Visual motor fine motor sequencing, motor planning, those are aspects of that. And so then what assessment tools do we have that's going to look at those skills to see if this is a reason, from the sensory processing as well as motor standpoints, that this child may be having difficulties with this particular standard. So we talk about some different aspects, such as and Sultan and I have really focused in on kind of three main assessments. I think just because they're we feel that they're easily accessible and hit the things that we need from a sensory processing and sensory motor standpoint, the socm, the easy and the bot three, and hoping that therapists have access to at least one of those three tools, but there's many others out there. So some things that those tests would look at that would be relevant to that writing narratives would be things like ocular motor there's this praxis and following directions, visual Praxis on designs, there's ideation, proprioception, bilateral coordination. Are just some examples from subtests from those standardized assessments that we might use to identify if those kind of proximal outcomes are impeding that writing, narrative Common Core State Standard, Sultan, do you want to add to that? 

 

Dr. Sultan Alfawaz   

I think you covered it all, just like linking. And I think we're not just saying only these assessments are the only one linked to education standard, but when we go to the ASI world, these are the most commonly and acceptable gold standard assessment tool, right? Is the easier, right? And when go to motor proficiency, especially with the PE we will have bot three or bot two, right? So we're linking these sub tests just to help you to kind of road map your brain whenever I am doing this assessment. These are the education standards that are linked, or sub tests that are linked to these specific educational standards. 

 

Jayson Davies   

Okay, so, Sultan, you mentioned kind of using this assessment tool, right? We'll go with the bot or the easy. You know them very well, and can explain how you get there. And then you've got this physical education PE standard. I guess my question is, is this sounds to a degree really time consuming, because there's a lot of standards. Not that we can't go one by one and pull out, you know, all that, but it is very time consuming. So I guess my question is, is for the school based ot practitioner, right? How do we, how do we do this, like, I guess, in a realistic way, right? Like, I mean, I guess we just start with one kid first standard, and then start to make, like, our own internal bank of you know how this works? I know you guys have done some, but how do we make this feasible? 

 

Dr. Sultan Alfawaz   

So, for example, let's say balance. For example, right balance? We have a lot of kids coming to us with some issues with like, let's say balance and vestibular issues. We, you know, we always look at what is for example, for balance. For example, for first grader, piece standard requires student to balance oneself, demonstrating momentary stillness. So for an OT perspective, we always look at what are the underlying skills needed for that? So we need what vestibular processing to detect head position, proprioception. So. For example, to know where the limbs are and our core strength. So if we use a test like, let's say so cm or bot three, and identify a deficit in vestibular processing, so we know that all these three tests will assess balance correct. We explain to them the student is failing PE or not doing good in PE because they are not trying. They're failing because their vestibular system is not processing gravity correctly. This wording for Nano T may not make a lot of sense until we link them to it to we link them to an education standard. So if, as if a teacher comes to me, let's say a PE teacher struggling or reporting that a student are having difficulty within a PE class, then we could look at our assessment data, what did it indicate, and link it to that education standard for that specific grade? 

 

Jayson Davies   

Yeah, yeah. And I mean to a degree we should be doing this anyways, right when we get a referral, we're supposed to be looking at that referral, deciding what observations we need to do because of the concern, what assessment tools we need to do because of the concern. We're just kind of adding in that, that added idea of the Common Core Standard, or the state standard, if you're in a state that's not using common core, kind of how that helps you guide where you go with the observation and the evaluation process. 

 

Dr. Sultan Alfawaz   

And I think it helps as well. Yeah, it kind of helps me as well, because, you know, some of us work in clinic and some of us work in school at the same times, or vice versa, right? So it kind of help you with even the wording, to know whenever I have any referral within that concerns, right with the concerns part how that concerns is affecting his education or her education standards within that specific I think once we try start doing this, that will help us a lot on justifying the services and linking the proximal outcome to The distant outcome. Yeah. 

 

Dr. Aimee Piller   

Amy, do you want to add? You know, it could seem to be a big, big chunk, right? Like we have enough, we have a lot to know as OTs, do? I have to also know these, these state standards, like, that's a little bit can be a little bit intimidating, maybe a little too much to think about. But we know our craft Well, right? We know what being an OT is. OTs gave examples of how we link these vestibular processing to maybe balance or coordination. We know that, right? Maybe I don't know the standard, but teachers know the standards, just like you had mentioned earlier. Do we ask them what they're having trouble with from a standard, or do I just take the concept that they're giving me? I can plug that into some tool, lots of tools we have available to us now this concept of this grade level, can you give me the standard for that? What standard will match what this child's having difficulty with? So I don't think that occupational therapists have to concern themselves with becoming super familiar with all the state standards. They just have to know how to access them, because we can easily, and we do that all the time in our evaluation process, make the link between where these challenges might be in sensory processing and participation. We just need someone to tell us which standard it's relevant to. And there's lots of tools out there that I think can help us with 

 

Dr. Sultan Alfawaz   

that, yeah, especially in AI world, it's simplify and helps you to save a lot of time of just linking, because all these standards are out there, are open for public, right? Yeah, just making yourself familiar with it. It's as simple as that, yeah? 

 

Jayson Davies   

And I mean, yes, it takes that extra step, but I also think that it can make our evaluations much better than if we're trying to complete an evaluation off of sensory or handwriting like as the referral. Reason, you know, getting that taking that minute to to email the teacher, or to send out a Google form that you have already built and and just try and get to understand a better concept of of what the teacher is really seeing as a struggle. And the common course kind of the standards kind of work nicely, because they're defined like a teacher can say yes or no. They don't have to try and put it in their own words, what the students having difficulty with? And that gives you so much information. So, yeah, I think that 

 

Dr. Sultan Alfawaz   

Jayson as well. It kind of validate the teacher concerns as well. Exactly, you know, it just kind of justify their concern because they're coming to you by saying he or she are having difficulties in meeting that education standards. So it's kind of justifying their concerns. And teachers 

 

Jayson Davies   

have a lot on their plate, right? Like it's hard for them to sit down and write a paragraph about what they're seeing in this child, but it's much easier just to go through a checklist of, you know, the common core standards for their grade level say, yep, Johnny's having difficulty with this one, this one, this one and this one doing good on 23 but difficulty with four or five. Let's see if the OT can support with those four or five. All right, let's move to the back end of the evaluation, because now we've got this data, right. We've gone through we've now linked the difficulty. That the student is having the strengths that they that they have, back to some standards now we have this information. I want to kind of go through. What do we use this information for? And do we actually embed this into our report? Is it more for our intervention plan? How do you both see an OT actually using this data on the back end of the evaluation? I guess. Amy, would you like to start with this one? 

 

Dr. Aimee Piller   

Yeah, two things I kind of think are important in this area is one, it's going to provide us with the information when we talked about earlier, is this child? Does this child need errors aside? Do they need sensory based interventions? If we know clearly what our data says from the evaluation process, we know where those participation challenges are, and now how they relate to Common Core State Standard. It's really easy to determine and justify if whether or not heirs SI is best for this child, or sensory based interventions are what this child needs for the state standard. So that's an important piece of that as well. And then the second of course is that intervention and treatment planning. What's our what are we working on? What's our goal? Is our goal? How do we write a goal that supports that Common Core Standard, or that state standard? Is our goal? Separate? Are we embedding depending on where you're at and what your IEP process looks like? So those two things are very important in the evaluation process. One, making sure you've got the right intervention for what you're trying to do, and then two, that your outcome measure that state standard is somehow embedded, either influencing your own ot goals, or that you're supporting particular goals that are there already. 

 

Jayson Davies   

Yeah, yeah, no, I couldn't agree more, and I think it does both sides of that, right. It helps us to better support the student, and also helps us to justify a little bit, which is what I think is also important. I don't want to jump into that yet, but I do want to say, because OTs like to have kind of this, we like to have this idea that we have this report right, and we have to do this report in an IEP, or we have to present this report in an IEP. Is this a place for us to actually input? You know, Johnny's having difficulty with these three standards, and below that is exactly how air sensory integration and occupational therapy can support the student. Is that something that that might be helpful? 

 

Dr. Aimee Piller   

To me, that makes it really, really clear that that's educationally relevant, right, which is so often what we get in the school setting. Oh, maybe it's not educationally relevant, or prove it's educationally relevant. So that makes it so clear, no one could probably even argue that, right, that it's right there. This is how it impacts it. If you've written that really good linking between those proximal and distal outcomes, then it's even though they don't speak the language of OTs, they can see that there's a link, right? So if this, if sensory processing and integration is impacting this, this child's performance, and the state standard, and I look and say, well, what's the intervention? What's the evidence based intervention for these difficulties, then that's the support that we need to either do errors outside of the school, or sensory based interventions or and sometimes it's something else completely. We determined it wasn't sensory it was something else this child needed. But now there's no question, I think, when we talk to administrators, parents, teachers, that when we have that clear link between the what's going on, sensory processing wise, and this state standard, why would they not support our intervention? That's the evidence based one for that area of difficulty we found in that evaluation process.  

 

Jayson Davies   

Yeah, I really appreciate how this entire process almost tells a story that gets us to this point because, you know, we're not just starting with a referral reason of sensory instead, we're starting with a referral reason that has a defined starting point, these three or four, however many standards. And because of those standards, we went through and we did this, we did an observation in the classroom, because that's what the standards that's where the standards occur, that the students having difficulty, or we went out to PE because those are the standards that the student was having difficulty. Then we use the assessment piece, because those standards told us, hey, there might be difficulty in these areas. So we assess those specific areas, and then we get to the end, where either a as Amy you're just kind of alluding to, right, we can very much define, yes, that sensory is the justification. On the flip side, it would be really simple, you know, for ot practitioners who maybe are looking to decrease or exit services, same type of thing. It could go back the other way and kind of say, look, I looked at these three standards based upon those. I thought this might be a concern. I evaluated not a concern. Maybe something else is needed. So I think that makes a nice picture. 

 

Dr. Sultan Alfawaz   

You really put it in a really, really clear way of explaining it. And this is why I I feel it's kind of bridge of our language to their language, you know, like, you know, maybe some of the audience have already tried it. I've already tried it. And once, I say, in the IEP, I remember when I first introduced it in 2014 15. And I feel like there is a silence and a pause in the IEP meeting. Oh, wow. You guys talk about education standards, you know, the education centers, right? It kind of changed the conversation a little bit, and it makes it more relevant, and it makes our work and our intervention, even our assessment, why we are using this particular assessment more relevant in education standards? 

 

Jayson Davies   

Yeah, yeah. All right. As we begin to wrap up here, I want to give you both the opportunity to share just a few other potential in your resources, ideas, research articles that you think that maybe anyone listening might want to look into you've already mentioned a few. We'll be sure to link to those in the show notes. But are there any other aside from the assessment tools that we've mentioned and some of the research that we've already mentioned, are there any specific tools or resources that you would recommend to a practitioner who wants to start implementing this framework? 

 

Dr. Aimee Piller   

Well, Sultan has done a lot of work already on some how to choose the right assessment for common core. So I think a lot of the work that he's done is there, and we've tried to put that together into some upcoming presentations that we have at a OT, a pre conference that we'll be doing on Wednesday. And we mentioned already that we've got one on how do you actually implement air sensory integration when you don't have a lot of money in the school system. We've got an OT practice article coming out that just briefly defines this thing. And Sultan and I continue to work on this because we think it's important for us as occupational therapists to really justify our services and speak the language of the people who are receiving our services or supporting our services, and then also knowing too, and I know you're going to link to, hopefully link to, the two systematic reviews that are coming out because there's still a lot of, I guess, not great information, or old information floating around about arssi and how it's not evidence based, but it has been recognized, but as an evidence based intervention, particularly for the autistic population. And as well as these new systematic reviews, and then there was also just a special issue in a j that came out that had a lot of resources on the evidence of sensory air sensory integration. And so as we maybe shift in thinking or discuss that shift in thinking as a profession does airs as I have a place in the school system. If it does, what does that look like? And I know we've talked about some different things coming out in relation to that. So I do know that there's even more information in the works on how to do airs, as I with good fidelity in the school system that's being worked on by some other organizations like CLASI. So some of those things are coming out, and I think it's a really exciting time for us as a profession, but we also have to make sure we're gathering those right, that good evidence for the setting that we're in. Sultan, do you have something resources? 

 

Dr. Sultan Alfawaz   

No, I you covered it all. But I would always, I would add to that, like even within this world that we are living now 2026 we are living in the world of AI, even using a customized AI tool, especially when someone will come to me and was like, Oh, my God, how I'm gonna remember all these educational standard right? You could build up this customized, customized chat bot within chat, GPT or Gemini, where you could upload all the educational standards, and we'll be able to say, Oh, what is the education standard for first grader that have difficulty with balance, you know, as an OT from your ASI training, where balance fallen right, proprioceptive and vestibular process, so you know you're proximal right. And then you link these participation challenges. And I think the more we utilize technologies as well with this new evidence. And I'm saying new evidence because it's it looks like more evidence is coming up. I see, like, every two months, we see a new evidence and new articles coming up. RCT, systematic review, which is the top tier in the pyramids, right? So I think we are living in a great time for ASI, and I hope, as much as we found now more evidence in in the clinical setting, we will find more evidence with within the school setting, and I think it takes a village all of us needs to do. The more we have clarity in our framework and our intervention and linking it to the school and educational standard, the more we'll be able to be more relevant within that setting. 

 

Jayson Davies   

I agree it is a very exciting time. Easy the CLASI and the easy as well as the star Institute, there's just so much going on right now from the sensory world coming together and focusing on school based, and that is just really exciting for a long time. Yeah, it was like, really clinic based, clinic based, clinic based, but we are starting to see that just kind of emerge into the school based ot realm. And that's exciting. I'm excited that we're able to do this podcast together to share a little bit about that and how we can link, you know, ot services to those proximal and distal goals and and. Standards, and I'm excited to see where you both go, because it's been fun, kind of following you over the last three years at a ot a and watching as like this continues to grow, and I'm excited to continue watching that. So I think it's super, super beneficial for ot practitioners, even if they can't do this, you know, with every single standard, every now and then, right, like, just, just kind of, as you're going through your evaluation process, think about it. How does it link? And maybe think about how you can even improve it next time to make your evaluations better. Because we all know that meaningful evaluations lead to meaningful ot services, and so the better our evaluations can be, the better that we can link school to occupational therapy. I think the better that the profession is going to be. So thank you so much. I really appreciate it, and congratulations again on your upcoming article. 

 

Dr. Aimee Piller   

Well, thank you, Jayson. 

 

Jayson Davies   

All right, and that wraps up this episode. Want to give a big thank you again to Amy and Sultan for joining me today and for the incredible work that they are both doing to bridge sensory integration and educational standards, this framework is truly helping school based ot practitioners speak the language of education while providing evidence based practices. I think the better that we can show exactly how what we do is having an impact on those state standards, the more that we can kind of just show the value that we provide to the students. Also, I think within that referral process, if we can better tease out what standards a student is having difficulty with, that is going to make our evaluations more powerful, which is then, of course, going to make our services more powerful. So to all of you listening, thank you so much. I hope this conversation gave you some practical ways to connect your ot services to the Common Core State Standards, or whatever your state standards are. Hopefully this helps you to link all your data to participation goals and justify the interventions that you are recommending in your meetings. If you want to dive deeper into topics like this and connect with other school based ot practitioners. I'd love to have you join the OT school house collaborative. There you'll get access to exclusive resources professional development and mentorship from myself and the OT School House team to help you grow in your practice. Head on over to OTs schoolhouse.com/collab, to learn more. Thanks so much for listening, and I'll catch you in the next episode of the OT schoolhouse podcast. 

 

Amazing Narrator   

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


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