OTS 36: Every Moment Counts Feat. Dr. Susan Bazyk, PhD, OTR/L, FAOTA
- Jayson Davies
- Aug 11, 2019
- 35 min read
Updated: May 13
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Welcome to the show notes for Episode 36 of the OT Schoolhouse Podcast.
In this episode, Jayson has a discussion with Dr. Sue Bazyk, OTR/L, FAOTA, about the changes in school-based OT over the past 40 years and how therapists can move forward to support ALL students.
Listen in to hear about:
How OT came to be ingrained in school-based Practice
How treatment models have changed over 40+ years in school-based OT
What LRE stands for and why inclusive and embedded/integrated services are vital to school-based OT
What the "Every Moment Counts" program is and where to learn more about it. (See below for links to several freebie Handouts)
Bio: Susan Bazyk, Ph.D., OTR/L, FAOTA is Professor Emerita of the Occupational Therapy Program at Cleveland State University where she taught for 34 years. Throughout her career, she has specialized in occupational therapy practice with children and youth in home, school, and community-based settings. Dr. Bazyk's research and publications have contributed to several areas of practice including parent-professional collaboration, understanding food refusal, occupation-based programming, and addressing the mental health needs of children. Since 2003, her scholarship has been guided by a commitment to exploring the needs of underserved populations – specifically, low-income urban youth.
In addition to authoring the book, Mental health promotion, prevention, and intervention with children and youth: A guiding framework (2011), Dr. Bazyk has authored 30 journal articles and several book chapters. She is the project director of Every Moment Counts: Promoting Mental Health Throughout the Day. She is nationally recognized for her leadership in building the capacity of occupational therapy practitioners to address the mental health needs of children and youth by embedding occupation-based mental health promotion strategies and model programs throughout the day to promote participation in school, home, and the community.
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I hope you enjoy this episode! Be sure to check out the resources below.
Links to Show References:
Quick reminder: Links to Amazon.com and other websites on this page may be affiliate links. Affiliate links benefit the OT School House at no additional cost to you. I appreciate your support by using these links.
The below references were mentioned throughout Episode 36 and generously shared by Dr. Bazyk.
This is the site to check out if you are interested in bringing the Every Moment Counts classroom, cafeteria, or Recess program to your school!
Every Moment Counts Info Sheet (below)
Refreshing Recess Info Sheet (below)
Comfortable Cafeteria Info Sheet (below)
Leisure Coaching Info Sheet
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,
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Episode Transcript
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Amazing Narrator
Hello and welcome to the OT school house podcast. Your source for school based occupational therapy tips, interviews and professional development now to get the conversation started, here is your host, Jayson Davies class is officially in session.
Jayson Davies
Hey everyone. And welcome to episode 36 of the OT school health podcast. My name is Jayson Davies and well, I'm just gonna put it out there. I am recording this intro on the day before I head back to school. Tomorrow is Wednesday, and I am heading back to school. It is the end of summer for me, or at least the end of summer vacation. Tomorrow we get to get back in and get a little training in and start to figure out our case loads a little bit and do all that good stuff. I'm sure some of you have probably already gone back. I think San Bernardino here in Southern California went back this week. But I know several of you back on the East Coast, it sounds like don't go back till till September, after Labor Day, I believe still on that kind of traditional labor day as the first weekend of or before going back to school. So everyone, I hope you're having a good finish to your summer or a good start to your school year. Hope that's going great for you. Before we get into our conversation today, that's going to be all about integrated services, a little bit about the history of school based OT and then we're going to talk about a very specific program with Dr Sue basic here, very special guest. I want to let you all in on a little thing going on here in California. I mentioned it before, but I want to give you a little more information. It's actually the Occupational Therapy Association of California. We are having our first annual school based occupational therapy symposium here in California. And OT is the one putting it on the theme this year is going to be promoting excellence and school based practice. And this is going to be held Friday, September 6 and seventh in Clovis, California. For those of you who don't know where Clovis is, it's kind of in the middle of California, near Fresno, off the 99 freeway. So it's kind of in the middle of California. Is trying to cater to, you know, everyone, both down in LA and in San Francisco. And we love to have as many people there as possible. I know some people can't always make it to the A, OT, a event. It's been kind of back east the last few years, their school based ot symposium, or conferences, you want to call it. So this one's going to be here on the West Coast, in California. You're all welcome to attend. Sessions will be led by California experts and school based ot on MTSS PBIS, assistive technology evaluations and much more. And you can earn up to 11 and a half PD use. For more information on that, you can visit the show notes at ot schoolhouse.com forward slash episode 36 or you can head over to OT online.org, OT is ot AC. I will be there helping to facilitate a few things going on. I'll also have some occupational sorry, ot school house stickers to give out. I'll be walking around. So if you see me, come say hi. We'd love to have you there. I believe it's under $200 right now for both days, but the price may be going up soon, so be sure to check it out ASAP. If you are interested. I know that's less than a month away, so be sure to check that out here shortly. All right, jumping into today's content. Like I said earlier today, we have on Dr Sue basic. Dr basic is a fellow of a OTA and a professor emerita at the OT program at Cleveland State University, where she was the director of the graduate certificate program in school based practice. Today she's here to talk about a little bit, a little bit about the history of school based, ot integrated services, as opposed to pull out services as well as her program, or the program She's the director of, which is called every moment counts. Some of you may have heard about that. We are going to really dive into that a little bit. She's going to tell us about the different programs that that are within that program. One of the things I love about it is that everything is free, so at every moment counts.org. There is three or four different programs. We're going to talk about it here in a moment, but they're all free for you to use. They talk about, I don't want to ruin it for everyone, but basically, we're going to talk a little bit about recess, cafeteria and in the classroom services, so be sure to stick around for that here just a moment, and all the links that we're going to talk about are going to be again at the show notes at ot schoolhouse.com, forward slash episode 36 as well as her full bio. I gave a very short bio, but that does not do it justice. Doctor basic has done so much for our profession. And, you know, I don't think this is actually in the podcast, but when we were on the phone together, she told me she never, she never meant to be a leader, you know, in the world of OT but just the way that she has gone about her professional career and how much she cares for the students and. And the practitioners alike, and helping the practitioners help the students, she has become a leader in our field. So I urge you to check out ot schoolhouse.com. Forward slash episode 36 to read her full bio and to check out what she's doing in her career still today. So with that, I'm going to welcome Dr Sue basic to the podcast. Hi, Dr basic, and welcome to the OT school house podcast. How are you doing this afternoon?
Susan Bazyk
Oh, great. Great to be here, and thank you for this opportunity.
Jayson Davies
Yeah, definitely. I'm really excited to have you here. I think, I think more people have heard about what we're going to talk about today, but may not know kind of the face behind it, the every moment Counts initiative, and so we're going to get into that a little bit. But first I want to let you kind of talk about yourself as an occupational therapist and how you became to be an OT and to where you are today.
Susan Bazyk
Okay, great. Well, I actually started out in a ot a program because I didn't know what I wanted to do, and fell in love with OT, and then went to Ohio State. So I really fell in love with OT. I was really going to go into art, but my father said you can't do that. You won't make a living. So anyway, I went to school. I've been at ot for 40 years, and I graduated from Ohio State University in 1978 so when I was in school, 1975 is one, the law was passed, yeah. And so I'm going to tell you a little bit historically of just my experience in seeing this evolve. So I got out of school, I really wanted to work with adults, and I decided to do my third field work in peds, just so I knew what this part of the my profession did. I did my last one at United Cerebral Palsy in Indianapolis, and fell in love with working with children, youth, families with disabilities. And I also went, I had to run the adult group with these adults with cerebral palsy, and it just amazed me that many of them never went to school because they didn't have the right to go to school, adults with appetite, CP, who were brilliant. So in my first job, I really saw the face of what not having the law did. And so then after that, I worked for UCP in Indiana, and then Florida. Fell in love with community based. Then I went into home based intervention. And I loved Birth to Three home based. And I started really involved through a OTA with family centered care. Because actually, when I started practice, I got criticized for talking too much to parents. It was before family centered care, and I really started, you know, thinking very much about advocacy for families. And in 1989 we know that the law added on the birth to three component and family centered care. So I was involved in a OT, a national initiative. We did trainings across the country a parent of a child with disability and an OT. We co taught conferences throughout the country. It was like 1989 about what family centered care is and what it should look like. And then I went into academia, and I taught all the peats courses, and every year I added more and more on school based practice, because that's where it was happening, yeah. So so I did develop, as a part of my role at Cleveland State University, a graduate certificate in school based practice for OTs and PTs that our students could take as an elective or they had to take elective courses. So I really see the need for more specialty education for entry level OTs, we do a lot at Cleveland State, but I hear of other programs that maybe have three classes.
Jayson Davies
Yeah, it's just tough. I agree with you on that. I mean, I don't feel like I came out of out of school ready to go into a school based position, and that said USC at the time, when I was there University of Southern California, they did have some sort of grant where people, they did, get more of that school based side. It was kind of that elective. I opted not to do that. I didn't think I was going to go into schools, honestly, and so I didn't do that. But looking back on it, one, I wish I did. And two, I realized how little information about schools I didn't get because I didn't do that very specific practice. So you're right. I think it's very cool that that you're that Cleveland is able to offer that option, and it is an option. So it sounds like people kind of have to know what direction they want to go, otherwise they're not going to get it necessarily right.
Susan Bazyk
And so just like you, I have Stu. Coming to me after they graduated, they started in skilled nursing facilities, but then they said, You know, I really love my practicum in schools, and I wish I did the school certificate. So that is an issue, but we do have a pretty heavy school based focus in our curriculum, but I think that's an issue nationally that I haven't been really involved in the Commission on education, but I do know through accreditation, there isn't a lot of specific criteria for school based practice.
Jayson Davies
All right, so you mentioned a little bit about the laws around 1975 I'm assuming you're referencing the Education for All Handicapped Children, Act also known as the EHA, as many people call it, given that you were going through school and just kind of starting out as an OT during that point. What did you see then? And what kind of shift Are you seeing over the years to the 2000s.
Susan Bazyk
Yeah, well, when I was in school, I might have had two classes on school based practice, and nothing was even in our books yet. I mean, there was very limited and what was there, I think OTs at the time. You know, the flood gates opened with this legislation that said, if children need ot to benefit from special ed, it has to be provided we were the small specialty, part of Pediatrics that was viewed as a small area. Now, 40 years later, school practice is the third largest practice area at 22% or higher. So I think we've evolved. But I think at the time we had hospital and clinic based OTs going into schools, really, not knowing about the educational context, they were freaking out about how to write an IEP. And I think they kind of translated their model of one on one service delivery like a clinic based type of service in a separate room down the hall, which still exists in some schools, unfortunately. So what's very interesting, I've been really involved with knowledge translation and how new knowledge enters practice, and it's estimated that it takes 17 years to translate knowledge to practice. And even with the law, I've heard people say we're still trying to make the law a reality. And so I do think OTs role is still evolving. I think it's I think it's really different. In different school systems, there isn't a lot of consistency, but I think that we're advancing in a number of ways, some of the shifts that I see, first, I think we're working to reflect LRE, the least restrictive environment with which the law states, by law, we should be providing services in natural context with the typical peers as much as possible, I think on a caseload model, we're still trying, trying to figure out how to do that. So it's a shift from clinic based model, where you're doing one on one in an isolated setting, to thinking about, how do I serve kids where they live, work and play and learn? So one of the things I wanted to mention too, so we are, are in the gen ed environment. Yeah, I presented at the World Federation of OT conference in 2018 in Africa. I had a poster on every moment counts, and there were OTs from all over the world coming up to me and almost drooling to say you're in the general schools. They call them regular schools or mainstream schools. And so we're talking about Canadian, New Zealand, Switzerland, Singapore in Europe. People want to be in mainstream or Gen Ed schools. They don't have a law that does that, so OTs have a very limited role in special schools. Yeah, and I came away from the World Federation with a much greater appreciation for what idea has done for us and how it has given us an opportunity to not only serve the kids with disabilities, but if we're integrating our services in natural context, we can impact all children and youth. And we all know that a lot of kids not on our caseloads can benefit from our services.
Jayson Davies
Absolutely. And so that whole shift kind of toward the general education that's relatively new with the reauthorization correct.
Susan Bazyk
Right in 1997 I think there was a real emphasis, too, that we should be providing services in the natural context. And so I know a lot of the OTs back then les. Lee Jayson was our pediatric coordinator at ot a and OT there was a lot of professional development around the need for OTs to understand the classroom context and curricula. So instead of just thinking of our little ot goals, we've got to think of really being educationally relevant. And so that's when even Barbara HAMP wrote a lot on consultation and collaboration. And so I would say that was like in the early two hundreds. So going back to some of the shifts, and some of this is a shift in how we practice as OTs. When I got out of school in the 80s, we were very focused on component, function, fine motor skills. NDT was big. I was NDT certified and si service certified. And it was doing the special stuff in these isolated settings doing pretend things that we call bottom up service provision, and the assumption that if you work on a pincer grasp, that that will automatically transfer to buttoning or pulling on your socks. So then, I think, in the 90s, things started changing because of theories of motor control and motor learning to function. And that really what we need to be doing is top down, working with people doing real things with real objects in the real environment. And then there was a revitalization of occupation based practice, and I think where we've gone from there, and even in OTs new vision, which I've been involved in, the focus now is participation for health and quality of life. Yes, and the function part is good, but I would always scratch my head and say, What about the kids who are so involved, who have very limited function. We can't just think about function. We have to think about health and quality of life. Is this person who's very involved in needs full support. How can we help them be healthy and happy? So in schools, I think the other thing that OTs and thinking of top down, really thinking about, how do we reflect our full scope of practice? So there's a lot of complaining about OTs do more than handwriting? Yes, absolutely, it is an important part of our role, but we shouldn't be teaching it. We should be teaching teachers and principals. We should be helping them identify the best handwriting curricula. But I think as a part of our role in education, we don't just focus on academic performance in the classroom. We still need to reflect our full scope of practice, which includes and includes social participation, play, leisure, meal times, bathroom and and so the law does state academic and non academic is what we should be addressing. But I think a lot of OTs somehow get the message that they should only be addressing classroom goals.
Jayson Davies
I think you're right sometimes, yeah, or, I mean, the classroom goals, slash IEP goals. And I also think when it comes to IEP goals, we've already had other podcasts about types of IEP goals, and a lot of people are still writing very specific ot goals, as opposed to more collaborative child based goal. Or, I guess you could say not child based, everything's child based, but kind of what you're talking about, kind of the health related goals, you know, not just about that, that pencil grass to use a pencil, but some way to functionally communicate.
Susan Bazyk
right? And well, the other thing is, you know, we address both. We address non academic goals. So if, when I started, and I've always worked very closely with OTs in the field, even as an academician, so part of my research philosophy is really doing research that matters. So having therapists tell me what they want to do in 1999 an OT Paula micheaux approached me, and she said, You know, I really want to do this integrated services. And she worked in two kindergarten classrooms, and she said, I want to integrate all of my work in these classrooms. And we did publish this. It was in a low income environment, and we looked at the emergent literacy and fine motor skills of both the kids on her IEP as well as the kids not on her IEP and the kids without disabilities also had a lot of delays, and so she integrated her services two days a week in these classrooms by modifying the class. This room, educating the teacher doing small group interventions during their little small group work. And lo and behold, after nine months, both groups made statistically significant changes in their performance. And so the principal who co authored the article with us said, I want to get the biggest bang out of my therapy buck. And so what we have to convince administrators and our supervisors is that when we integrate services, we can reach more children, and they're going to get more out of our therapy buck. So the struggle then is how to do that and within a caseload model, but the way that I'm seeing therapists do that is saying, if I'm in the natural context, I I need to be LRE, so if I'm doing a small group, I'm going to pull in some of the kids, not on an IEP, but that could benefit from my services. So small group interventions and beyond consultation, I think there's some new models that even Jay and K Smith wrote a lot about this before she passed away, she started really doing a lot related to co teaching. So the Right Start program that they developed is a co taught program in the classroom. The OT and the teacher, and I really got turned on to co teaching. I think I like the model, because instead of telling teachers do more and verbally telling them what to do, you're going to be in their context and doing with or taking some of the responsibility. So that's another shift.
Jayson Davies
I want to ask you a question, because you mentioned, I feel like some of the listeners might have this question, and you're saying that we can service kids who aren't necessarily on an IEP. And I feel like some people might ask, Well, what legal grounds do we have to do that? Because we are supposed to be within special education, per se. And so how does that work?
Susan Bazyk
The law again, going back to least restrictive environment, we shouldn't just, you know, we should be embedding our services in the classroom, in the lunch room. And I do think in their law, there is, there is a clause that talks about prevention. So when we think of models like RTI Response to Intervention and providing early intervening services, when we think of Positive Behavioral Interventions and Supports. I do think there are models in the school now that are thinking more about, how do we promote what we want in all the kids? How do we prevent what we don't want in the kids at risk or showing early signs? And then how do we intervene? But all of that should be occurring in natural context. And when we do that again, we have access to all kids.
Jayson Davies
So you're not suggesting at all that we're pulling these kids out, maybe some sort of RTI small group at the most, but for the most part, this is in the classroom. Maybe we're there to really focus on our kids that might be on our caseload, our workload, whatever you want to call it, but at the same time, we're able to access more than just those kids. Is that correct?
Susan Bazyk
Definitely, okay. And the reason we're doing that, it's because of LRE and it's because the law, yeah, and it's because of theories of motor learning and motor control. And the research indicates that children and people learn skills best in the natural environment, doing real things with real objects. So the other thing that the OT and I guess I'll get into this now with integrated services, because you did ask some questions. Have some questions about that. I do think this is a huge struggle for OTs how to do this. I think in some districts, they've been used to just pull it doing pull out therapy. And so one of my colleagues, Carol Conway, called me in 2011 and I happen to answer my phone in a in a big, suburban, wealthy district, and she said, I know what we're doing is not best practice. Could you help? And I said, Sure, because that, you know, I love working with therapists in the field. And she says, We're doing primarily pull out therapy, and I know that's not best practice, and these wealthy families want private therapy in the school, but that's kids go to school to receive their education and to participate, not to receive therapy. That's not school. So what we did is we started out and I we started thinking, how can we shift this big boat? I. And we started with an in service to OTs and PTs. With the they had to get permission from the head of Pupil personnel, special ed director to give them time off during the school day for this two hour in service. So I came and I kind of covered the law and best practice the research on integrated services and motor learning, and then we brainstormed what they could do. So they started with a time study looking at what they were doing already, and the head of Pupil personnel was very nervous about if parents heard that they were going to do more integrated and not pull out that they would fight that. So we decided as a group that we would take small baby steps, and we did develop a community of practice. We decided that everybody needed to be educated on why integrated services and not just springing this on teachers or other people. So we developed a community of practice, which is a group of people who agree to work together and learn together. We functioned for about only three to four months. We did the same in service to get buy in about why integrated services is best practice. And then they worked their time. Study in the beginning showed that they were only doing 20% of integrated services, and the rest was pull out within nine months, nine months to a year, they were providing 80% and so they were figuring out, how would I embed myself into art? How would I embed myself into language arts, the cafeteria and recess. And in terms of small groups in the cafeteria and recess, if an OT does a Lunch Bunch, for example, So Carol would do a Lunch Bunch, maybe with some of the children who are struggling socially on her caseload. And then she always ask the teacher, who else do you think would benefit from this? And the teacher would give names. You do not need parent permission to have them be a part of a Lunch Bunch during lunch and recess during times outside of academics. So that's really easy. Yeah, I did not know that. Yeah. So what I think is OTs can serve a lot more kids during small group interventions, and then also through universal services, which I will talk about with our cafeteria and recess programs.
Jayson Davies
Yeah. So I want to dive into that. I mean, we've talked a lot about really transitioning into that integrative model type of approach, and you did talk a little bit about how you made that shift. What would be your recommendation right now, real quick before we move on to every moment counts for any ot who's kind of in their job right now, they're kind of like, I understand. I'm doing the same thing. I'm 80% pull out, 20% push in. My colleagues are the same. Where should we start?
Susan Bazyk
Yeah, and usually when I present on this Carol, Conway presents with me, because she's lived it, and she's helped other districts to do that. But I think so people aren't overwhelmed. We had a mantra that said, look for the open doors. Which teacher thinks it would be a great idea. Introduced like she was friends with the counselor and they were starting to zones of regulation came out in 2011 and so they started in a special ed class resource room. They co taught a couple classes on zones of regulation. That was in 2011 it went over so well that now it's a part of their Gen Ed curriculum in this district. So co teaching again, going back to the open doors, starting small, picking one teacher, one classroom, finding out what the teacher's needs are, and you don't get buy in from a particular teacher. Don't let that stop you.
Jayson Davies
Yeah, I completely agree. Great. All right, so then I do want to transition kind of to every moment counts, and before we start diving into each individual program. Why don't you give us a little overview of how every moment counts came to be and what it is?
Susan Bazyk
Yeah. So, you know, I always worked with children and youth, always interested in I did a lot with feeding, and always interested in the psychosocial aspects of food refusal. That was an area of research for mine for a while, and then, so I was always connected at a OTA. And so in 1999 the Surgeon General came out with the very first report on mental health, and there was a separate report on children's mental health, and Barbara Hampton, Leslie Jackson, who were leaders in the field. They had. Held a think tank meeting at a OTA, which they must have had more money back then, 20 ot practitioners and researchers and academicians for two days to brainstorm and talk about our role in addressing mental health with children and youth. We had to read the whole Surgeon General report before we got there, and it was, it was really quite amazing, talking about the lack of what we were doing the Surgeon General really advocated for not just treating or intervening when someone has a diagnosis of a mental illness, but to really advocating for reduction of stigma and for prevention and promotion of positive mental health. So that was really a pivotal point in my career, and I kind of stepped up to the plate. One of the first things we decided as a group was to develop a practice guideline on addressing the psychosocial needs of children. And then, I think the second edition of that, I was asked to write a chapter on school mental health that was probably around 2006 and then I just got more and more involved in my mission was, how can we get OTs to translate our body of knowledge related to mental health into a school system practice or community practice. How can we articulate our role? Because some of the surveys that have been done by OTs have said OTs do address mental health, but it tends to be an underground practice under the auspices of holism, which doesn't mean anything to anybody. And so I started reading a lot about this public health approach to mental health, which was starting to be advocated for and written about in the late to like 2008 2009 and I had an opportunity to edit a book on applying this mental health promotion, prevention intervention framework to OT and so that was the book that came out in 2011 I spent a lot of time reading literature from outside the field and positive psychology and mental health promotion. And I said, This is who we are as OTs, this is who we are, and what I have found since writing the book. And I had several co authors of different chapters, we all got together, and we said we're applying this framework in each of the chapters. And so I was so excited to apply it to the OT process and come up with this whole idea of what can you do at the universal tier one level to promote positive mental health. What can you do at tier two to prevent mental illness? And what can we do at tier three for those identified with mental illness, and the problem there is because we're not licensed mental health providers at tier three for kids with just a mental illness. We're not always invited to the table, no to be a part of that, very rarely. But once we start talking about how what we do is different, that we can address mental health, but we do it, doing doing therapy, not doing talk therapy, that we can help diminish some symptoms associated with anxiety, we can help promote feelings of well being during activities. Then I don't think counselors are maybe as threatened, and they understand that what we're doing is different.
Jayson Davies
yeah. And so that led into EMC, every moment counts, correct.
Susan Bazyk
Right? So what happened after the book was published? I was so excited. It was pretty and I said, Well, who really cares if nobody that's it's not going to do anything. It was anticlimactic. So I went to a conference on Knowledge Translation in Canada, which was really another life altering kind of conference for me, because I realized that it's the researchers responsibility to work with practitioners to help translate knowledge in manageable pieces to practice and that, you know, a conference is not really the best way to do that, or randomized control trials, just reading research doesn't do that, that it takes coming together over time to read, reflect and dialog about this new knowledge and think about how to apply it. So I had this idea of this. I called it and I call it building capacity. I like building capacity because that's what we want to do. It's not evidence based practice. And so I couldn't even get funding. In 2011 I decided I'm going to do this small pilot study. I invited 14 OTs from diverse school districts, urban, suburban, alternative, rural. And I said, Will you join me for six months? I want you to read this whole book, two chapters at a time, and complete a discussion after every two chapters on how would you apply this? And then we met over three times, and I said, I got CEUs from our state association. And so it really didn't cost much, but one of the lessons there is, if you don't have get money, don't let that stop you, because nine months later, I met with a representative from the Department of Education. She oversaw related service providers. So in some states, there's a related service provider, person who should be advocating for us, and she told me about some funding. This was in January. We started our building capacity in like October, and I brought my group back, and I said, Now that you know this framework and what we should be doing as OTs, what? What do you envision? You know, I said, the sky's the limit. So it was really the 14 OTs and myself that envisioned every moment counts, I wrote the grant, and we were funded in May for 720,000 for three years. Wow. So this group has been a magical group of OTs, and we broke up in teams, and we had a cafeteria team. So when we were sitting there, we were saying, Well, part of OT scope of practice is meal times and social participation. Why aren't we? Why aren't we impacting the cafeteria, which tends to be a problematic time of day, and for kids with disabilities, they're in the cafeteria because it's LRH. What about we know about play and leisure? Why aren't we impacting recess? And then even with extracurricular participation, that's written into the law. We pulled up the law. We cover that whenever we present. Why aren't we impacting and it's number nine on the IEP in Ohio, it is, do you have an excurricular participation section?
Jayson Davies
I don't believe. So, not really. We kind of talk about a little bit like, it's one of the we talk about in the present level, the performance, a little bit about it, but I don't it's just kind of like social skills or something like that.
Susan Bazyk
Yeah, well, most of the time, people just check it off that if students need accommodations and supports to participate in extracurricular activities provided. So anyway, we got the funding, and that's when we broke up into teams and we pretty much developed model programs and embedded strategies. So the whole thing with every moment counts is not it can't be one class. It has to be a knowledgeable team of not only OTs, but all adults who kind of have an awareness of mental health, what positive mental health is, and how to embed interactions and strategies throughout the day to promote positive mental health. So for the classroom, we have on our website tier one, embedded strategies, all based on positive psychology research, and then a program called the calm moments cards. So three OTs, well, two ot ours and 1c OTA said there is so much stress in school, we want to develop something to help teachers and peer educators know how to recognize stress because they don't get coursework in that and then how to embed strategies. So we started with a literature review of evidence based practice, and came up with cognitive behavioral mindfulness and yoga, a lot of support and sensory based and we developed these cards surrounding 17 situational stressors. And so for each of the cards which is on our website, there's thinking strategies which are cognitive behavioral, what teachers can say to students. A lot of it is affirmations, positive affirmations, and then activities we have. We have mindfulness and yoga activities and resources and then sense reactivity. So and we did a study on the use of these cards, and showed some really positive results in teachers knowledge and confidence in embedding these strategies. So that's the classroom, the cafeteria and recess program. Them, so we had our teams, and we really thought about what would be realistic for OTs to do in the cafeteria and recess. We can't be there every day, but our role could be really to help prime the pump, so to say or shape those contexts by empowering the supervisors to know how to do their job and to empower the students to take responsibility for this time of the day. So we came up with, we did a literature review. We always start out with comprehensive literature review of what are best practices, but a lot of, for example, the cafeteria, a lot of literature was on just food, healthy eating, and not a whole lot on social context. So we developed a program six weeks, one day a week, the OT would embed some information, we have information sheets, and we had a theme for each week, so for both the cafeteria and recess that week two, the theme is how to be a good friend. And you know, I've done a lot with bully prevention, but one of the things I've realized is, if we don't teach children what we want them to be, then we're not going to get anywhere. We can't just teach them not to bully.
Jayson Davies
Yes, trying to be more preventative, rather than reactive. Or promotion, yeah, promotion.
Susan Bazyk
Learn some skills. Where are children learning how to be a good friend? And there actually isn't a whole lot of literature on that. Kelly Mahler, who wrote the Inner Inner reception, did write a little book on friendship. Week three. The theme is how to have a meal time conversation. And this is so much fun. I mean, some kids don't eat dinner with their families having a meal time conversation is a life skill. Week four is mix it up day, and it's practicing their conversation skills with someone new. And it's all about respecting differences and how to make new friends so they sit by someone new. And then another week is understanding the sensations of the cafeteria and kind of respecting differences. So the cafeteria, there's usually a lot of issues with noise, and we embed strategies on helping the supervisor know how to handle noise and teaching children how to regulate volume. So a big part of the program is empowering supervisors. The recess program focuses on active play and teamwork, and we offer some structured play activities, a quiet play activity or an active play because the research shows kids with disabilities or and who struggle socially do better when there's a structured play activity, because there's an instant invitation to participate. So they're wildly successful programs. Principals love these programs because we found it cuts down office referrals, and it cuts down injuries during recess. And so OTs, if we implant ourselves and create this role in one of the districts, the OT is now invited to interview, when they when they interview new cafeteria or recess supervisors and orient them every fall. How hard would that be?
Jayson Davies
Not hard at all. That's awesome. Because part of the reason that I knew I had to have you on here is because, in my experience, I worked in a toxic cafeteria, or one of my schools had a toxic cafeteria. And I mean, this is I've worked at enough schools now that I can kind of talk a little freely without everyone knowing exactly where this was, but literally, the cafeteria age were putting chairs five feet apart in the middle of the cafeteria. And when some kid, random, you know, the one kid that got caught for being too loud when everyone's being too loud, had to be isolated, sitting in this chair in the middle of the cafeteria without their lunge and it was just terrible, and hearing them yell all the time. And I was like, What can we do about this? And so what I learned about your program, which was just this summer, I haven't had a chance to obviously, implement it yet, but I knew I had to have you on. And then learned about the recess program, and it's even more so
Susan Bazyk
what's been exciting is there are OTs that look at it, or we've had OTs who've been really successful implementing these too. They're real hands on, folks, and you could everything. Instead of writing manuals for these programs, we decided that we would put everything on our website. Because it was really grant. It was federal funds. Going through the state and and we couldn't sell this. Yeah, so everything is free. So the manual, in a sense, is all on the website. We have one link that says 10 steps to success. So what would you do to gear up for this program and then just do it the six weeks? There's a lesson plan for each week. And so some therapists might be overwhelmed by it. We say, this is a flexible program. We had one therapist say, well, the cafeteria is too big, but she started with a classroom who happened to eat in their classroom, so that's a way to do it. But in one of our districts, nearby the OT who did it, the special ed director, was so impressed that now they're making it a district wide program.
Jayson Davies
Wow, that's awesome.
Susan Bazyk
There's so many creative ways to implement these programs. We're actually presenting at our state conference, ot a in the fall, and I'm gonna have a panel of OTs from different districts, talk about how they they did it, because it's, it's kind of different in every every district.
Jayson Davies
Yeah, that's great. So real quick, I want to jump back, because you did mention, in a way, the time commitment for the OT because a lot of the OTs right now, I can hear people, you know, it's all a great idea, but do I have time for it? And it sounds like the way that you guys designed it was for the OT to be more of that teacher, for the teachers, rather than a specific intervention, a list for the for the students.
Susan Bazyk
Is that correct for the cafeteria, recess or even the class? Yeah, any of them, I guess one of the other areas that we we looked at a lot is this whole concept of coaching, you know, so in the cafeteria and recess, we're demonstrating. There is more in the literature about the power of demonstration. So if the OTs implementing this program six weeks, one day a week, and some we always ask OTs, pull someone else in to CO, do the pro, you know, co implement like a speech pathologist, like a special ed teacher. And so the demonstration of simple themes, things like smiling, asking kids how they're doing, how is your weekend, all the pro social stuff, what we found is cafeteria supervisors, if they've if they've not been oriented to their job, they think their job is just to keep kids safe and to keep them quiet. That's reactive, instead of how to interact in ways that encourages friendship. And so our studies have shown that even in the six week program, we can change the culture of the cafeteria and recess, and it's really building capacity of those supervisors to think differently about their job and to challenge things like yelling at kids or having them eat in silence. So they're really fun programs, and what we see then, OTs tell me all the time is everybody in the school knows me now, kids run up to me and give me hugs in the hallway, and they're not even on my caseload. And that's the power of a universal service. And actually, at Cleveland State, we have a special topics course where our students are going into Cleveland schools and implementing both programs as a course, and they're learning to think in a bigger way what universal services mean, you're still serving the kids on your IEPs. So that gets back to the question of time. So you need to make a case that I have these three kids in this classroom during lunch who have a social participation goal, and this is how I'm addressing it. So it's really thinking smarter about utilization of time. And OTs, who are doing the study, they actually have more time because they're serving more kids at once. Yeah, the thing I know I remembered from before is we don't only just address our IEP goals, we can address more than what's on that goal. So if there's a handwriting goal, you can embed some strategies in practicing handwriting. If you're doing that that we know is promoting positive mental health, like acts of kindness is a strategy that helps us feel good emotionally. That's from research, and one ot told me he has kids write thank you notes when they practice handwriting that's embedding, teaching children how to be kind.
Jayson Davies
Yeah, I like that idea. That's awesome. Yeah, cool. So I think that's a really good overview of every moment counts. And again, everyone can access all that stuff at every moment counts.org. Correct, right. Awesome. I have one follow up question before I want, or not really follow up question. This is kind of an outside the box type of question that I wanted to ask you. And bigger. I mean, just thinking out 10 to 20 years, where do you see school based ot really kind of going. Where do you see this shift? Are we going to continue this integrated shift for the next 10 to 20 years? Or do you think there's going to be something, something else out there?
Susan Bazyk
Oh, I think we I think there's more of a demand for it. And we are being asked, we do do conferences all over the country, and I actually may be going to New Zealand in 2020 what's been exciting is OTs. I see more OTs who are speaking up, and I call them Mavericks, who are saying, mental health is a part of our business, and they're approaching departments of Ed and getting funding. We got funding in New Hampshire, an OT and a speech pathologist in Oklahoma, went to the related service person in the Department of Ed and said, We need to support and help build leadership in Oklahoma for related service providers, and they brought myself and Carolyn for a two day conference in May. It was all funded through the Department of Ed and the OTs and PTs and speech got to go for free. So what I'm excited about is that kind of leadership where people are saying, we need this. We need to do integrated services. More of these sessions were at a OTA this year. They were called contextualized practice. I like the term integrated. So what I hope happens is that as we do more of this integrated service, that we will be doing more universal types of programs that that help all children and youth be healthy, mentally, physically, and that we will be called in more like Nicole Furman, I will say in Mason City Schools in Ohio to be directors of programs that focus on mental wellness. That's where I think our strength lies. So we started out in the settlement houses back in 19 early 1900s those were centers in the middle of communities where we helped people adjust to the demands of living. I think schools are so exciting, and I think they're exciting because we get to work with children and youth and adults and families where they live, learn, play, and the other thing I didn't mention, we also have an initiative called Making leisure matter. And one of the OTs, Maria Lorena, who is just an amazing ot she and an ABA person and a speech pathologist developed connections their business, where they are offering groups in a rec center. They started out serving kids with autism, but now have, because of demand, have expanded to kids with other needs, and they involve typical peers. They started with cooking. Now they're making. They're doing a lot of how to make a lunch type, kind of group crafts, and I would love to see OTs in rec centers instead of clinics, because that's where families wanted to take their kids. And you don't have, you don't have overhead.
Jayson Davies
Yeah, no overhead, and even just the the mental health and you know, to some extent, stigma goes into that too. I mean, going to see an occupational therapist at a clinic is very different from going and getting naturally embedded services at a rec center, that it's not a clinic, it's more of just facilitation. So that's that's fantastic.
Susan Bazyk
Sir. Rec groups, just like anybody else offers a rec group, so they you can charge, but we have the knowledge to understand the sensory aspects they also offer, like adaptive part, like parties, who make maybe can't take their children to a restaurant or just need additional supports, yeah, so that's that's kind of where I'd like to see us go. But we schools, it will not that will not go away, and it's just exciting to see. How we're moving forward?
Jayson Davies
Yeah, absolutely. I just want to mention, real quick, I had a note that I took down while you're talking, and it was about a OTA, and I know nothing that we kind of talked about today was really like gun ho for a toa, a O T, A, and A O T, A has nothing to do with this podcast in general, but I do want to just kind of reach out and really encourage everyone listening to be an A OTA member. There's a lot of stuff going on, especially for school based stuff right now, whether it be the credentialing stuff, mental health, all that good stuff right now. So be sure, if you're not an A OTA member, give us some thought and potentially join a OTA as well as your state organization, because they really do help us out. So I just wanted to share that Ruth with everyone real quick.
Susan Bazyk
But yeah, I advocate for that. We have lobbyists on the Hill who are always advocating, if we were not written into idea as a related service provider, it could be very different. Would be very different. And also, there is a school mental health tool kit, if you just Google a OT, a school mental health tool kit that is free and downloadable. So there, for example, is an information sheet on depressed childhood depression, and how would that look in a classroom or in school, and what accommodations can you make and strategies. There's one on grief and loss kids who are grieving. There's one on obesity and the mental health risks associated with that. So check out those information sheets.
Jayson Davies
Great. Well, thank you sue for coming on to the podcast today. Are there any other resources, websites, any other way that you'd like to leave information out here.
Susan Bazyk
Well, the one last thing I've been involved in is a grant in North Dakota with Dr Susanne Nielson. And it was part of a SAMHSA grant, Substance Abuse Mental Health Administration grant. We were tagged on to it, and so what we've done is developed a five month kind of self paced capacity building program that interdisciplinary teams can go through. So we have five webinars. There's facilitation guides. So what my next step is, we'll be working with different OTs throughout the country to help them implement this. So it was just completely finished. It will be online and all for free, and you can get contact hours too through it.
Jayson Davies
Oh, awesome. And, yeah, is there a website for that one?
Susan Bazyk
I could share that with you. It's the Mountain Plains Technical Assistance Center. I haven't shared the link yet on the every moment counts website, but I will be doing that shortly.
Jayson Davies
All right. And as always, we'll try and put just about every link that we talked about today or something on the show notes at ot schoolhouse.com, forward slash episode 36 I believe it is, and, yeah, that'll be a good place to start. You'll have links to every moment counts, as well as some of the other resources we shared today. So thank you sue so much for coming on this show. I really appreciate it. All your hard work, and everything that you've done is making a big difference in OTs kids, teachers and all their lives. So thank you so much for everything.
Susan Bazyk
Thank you for this opportunity. It's been fun. Definitely take care. Okay, bye, bye.
Jayson Davies
Bye. All right, everyone. Well, thank you so much for listening in on today's Podcast, episode number 36 remember, everything that we talked about today can be seen or clicked on, on links and stuff at ot schoolhouse.com, forward slash episode 36 those are the show notes. Thank you so much to Dr basic for coming on today. Everything that she has done for our profession, like I said earlier, has just been amazing. Please check out every moment counts.org. Everything there, like just blew me away. When I looked at it, there's so many free resources. It can be a little bit overwhelming, I think because there is so much there. They really did put everything there for free. So definitely start off with one program like Dr basic was saying, start with one additional teacher that you know is on board, or maybe a speech therapist that can help you out a little bit. Start small. Work your way bigger as you see those successes. But whatever you do, just keep on getting better a little bit every day can go a long way. So take care everyone. We'll see you in episode 37 Have a great week and start your school year. Take care bye. Bye.
Amazing Narrator
Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now, head on over to otschoolhouse.com Until next time class is dismissed
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