OTS 52: Research Review: How Teachers & OTs Perceive School-Based OT
- Jayson Davies
- Jun 28, 2020
- 34 min read
Updated: Jun 24
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Have you ever felt unappreciated by the teachers at your school? Well, listen to this episode to learn what a small research study has to say about the way teachers and OTs perceive Occupational Therapy and therapists in the schools. Dr. Bolton and Jayson will talk about this and more in Episode 52 of the OT Schoolhouse Podcast!
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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. Welcome to episode number 52 of the OT school house podcast. My name is Jayson Davies, and if you're an occupational therapist that has ever felt like you're just not really appreciated in your school based ot job, you are in the right place. Today we have on a very special guest by the name of Tiffany Bolton. Tiffany recently had an article published in the Journal of Occupational therapy schools and early intervention, and the title of that article is occupational therapy role in school based practice perspectives from teachers and OTs. So we're going to get into that here in just a moment. But first, I want to ask for your help. Actually, this is coming out at the end of June, this podcast episode 52 and my birthday actually happens to be July 3. And so for this year, I thought that I would use this platform, the podcast and the OT school house, to reach out to all of you and ask for your help. I would like to set up a donation drive for the Big Brothers, Big Sisters of America organization and this organization, I did some homework before I donated myself and before I wanted to ask help from you. But the main reason that I want to support this organization, and I want to ask for your help in supporting this organization, is because I truly believe that education, whether it's about society, about academics, about social justice, social justice, if I can speak right, starts at such a young age. I think a school based occupational therapist and pediatric occupational therapist, we realize how much it matters to start young in educating our students or educating the children in our life, and whether or not you're a teacher, an occupational therapist, a parent, a babysitter, you absolutely have an influence on that child's life and who they come to be as an adult. And so especially when it comes to social justice and social equality, I truly believe that the younger we start, the bigger impact we can make, and that's part of the reason that I want to help support the Big Brothers and Big Sisters of America. And, you know, I did a little bit of homework, they have an A plus rating on charity watch, which basically means that they they do what they say they're going to do, and they are transparent. In fact, 91% of every dollar that is donated to them goes directly into their programs to support their program for big sisters, supporting little sisters, and Big Brothers, supporting little brothers. And so that's awesome. I did a little bit of research even on their CEO. I guess you could call her Pam yorio. She was the 2018 people's magazine, 25 women, women changing the world. She's been with the organization since 2014 as the CEO, and it looks like, actually, she might be stepping down soon. She's ready to move on, and they're looking for a new CEO. She's just a good leader. She even has a book about leadership. So please, if you're interested in supporting this cause, supporting me. If you've ever felt like that you wanted to give back to the OT school house, but didn't know how this is your chance. And not by supporting me, but by supporting Big Brothers and Big Sisters of america@bbs.org just go over there make a donation, and if you need even more of an incentive than that, go ahead and make a donation and send me a copy of your receipt or whatever. They email you back and I will give you $10 off your next purchase@otschoolhouse.com whether it be for a professional development course, podcast course, or for a future round of the A to Z school based ot course. All right, so again, that's bbs.org you can donate to your local chapter if you'd like, but note that that doesn't necessarily mean that the funds are going to go directly to that local chapter. So bbs.org Go ahead. Go there, make a donation. I would truly appreciate that, and let me know that you did share with me on social media, on Instagram, Facebook, at ot schoolhouse or shoot me an email. Jayson@otschoolhouse.com and when you do that, I will be sure to get you a little coupon code for $10 off your next ot school house purchase. And just like us, they are trying to figure out how to go digital too, so they understand some of our struggles. All right, so let's get into today's episode. Today's content, we are welcoming on Tiffany Bolton. She is a faculty member at the University of Missouri in the Occupational Therapy Program, and she has so much to share today. Okay, again, like I said earlier, one of the best conversations I've had in a while. Really appreciate her coming on, and we are going to talk about one of her research articles about the perceptions of OTs and teachers in school based ot so if you haven't had a chance to read this article, be sure to check out ot schoolhouse.com. Forward slash episode 52 for the links to the article as well as if you'd like to contact her. All right. So again, here is Tiffany Bolton. Please help me welcome her to the OT school house podcast. Hey Tiffany, welcome to the podcast. How are you doing this morning? I'm good. How are you doing very well. You know, as best as we can do right now, it is what the middle of June, and I think we're all still kind of stuck at home. How has quarantined life been for you?
Tiffany Bolton
I'm a little bit crazy. So I have seven year old twins that have been home with me this whole time and still don't have anywhere to go this summer. And my husband is also working from home, although I think he is returning to his office in the next couple of weeks. So I, on the other hand, am home until, I don't know when we're teaching hybrid this fall, so probably quite a while still.
Jayson Davies
Yeah, I know. I mean, we're talking about potentially in August, going back in some sort of blended model, where there'll be like two cohorts, and some kids will be at on campus, like Monday, Wednesday. Others will be Tuesday, Thursday, and then Friday will kind of be like a day for teachers check in with all of them at home. But yeah.
Tiffany Bolton
My kids are doing that for summer school, and I have a sneaking suspicion it's a trial run for the school year. So we're doing they're doing, like, two weeks on two weeks off in the month of July, kind of a similar setup, no Friday and at home work on the two weeks off, so we'll see.
Jayson Davies
Oh, so they're just so they're there four days a week or two weeks, and then after that, they have two weeks where they're still in school, but not at school, correct? Interesting, yeah, we'll see how that goes. Yeah, yeah. So tell us about your occupational therapy career, and where you're at now and how you got there. Sure,
Tiffany Bolton
I don't have a glamorous story about how I got there. I was raised in a very rural town, and I didn't even know what ot was I you know, I selected speech therapy because I was familiar with it, and I wanted to do something related to health care. I always wanted to work with children, and it was the only thing that I really knew what it was. So in college that put me in a intro to health professions class, which was the first time that I heard about OT and I got really excited about it, and really switched to it for that reason. So I can't there was no deep meaning behind it. And then, you know, like I said, I always wanted to do pediatrics in school, though, I was surprised by how much I liked adult therapy also. So I ended up in the neuro side of the world and so, so really, the majority of my background has been in kind of complex conditions in pediatrics, but I've done a decent amount of school based therapy in the past. Right now, I currently, I'm an associate clinical professor at the University of Missouri, and I teach in our pediatric curriculum, and we do. They're essentially, they're pro bono clinics, but we really use them for teaching clinics. They're built into our didactic curriculum, and I take students with me to a preschool. So that's really more of my current school setting is a preschool setting with ot students present with me, and then we do see some outpatients that are typically school aged children that sometimes don't qualify for services at school, and so we end up being kind of a good fit for them, that is where I'm at now. So, so I do some research, although I am not research faculty, so the research part of my job is more for fun and usually clinically related. So, oh,
Jayson Davies
that's cool. Well, I'm excited because we do get to talk about a little bit of your research. Today. We're going to get into that, but I actually want to ask, how was it getting into academia and transitioning from being a clinical ot into that more academic role.
Tiffany Bolton
Um, it's hard this. That's not an easy transition. Um, a co worker of mine is actually writing a book to sort of assist with that transition, which, you know, I think there's a necessary market for that. Yeah, I, um, I actually took the role of field work coordinator when I started. And so that was, maybe, I won't say easy, because that job is not by any means easy, but I was still able to use some of my clinical contacts, and, you know, be in touch with that world and doing site visits. And so it was maybe a nice bridge for me. But I also was teaching classes as I was the fieldwork coordinator, and I found that I really loved to be in the classroom. And so, you know, as soon as the opportunity presented itself, I moved into, you know, a clinical teaching role and out of that academic fieldwork coordinator role. But I think the hardest part is that there's really no manual. There's nobody to tell you what anything is. I i. I, you know, hadn't used power. There's just a lot of things that I hadn't done for a long time as a as a clinician, that I had to dive right back into. I don't even, you know, this is kind of embarrassing, but I didn't even, we didn't have rubrics when I was a student in OT school. And now rubrics are just like standard practice and so, but it helped to as soon as I really, as soon as I took this position, I also enrolled to get my doctorate. And so I think being in in school, you know, for my doctoral degree, really helped the transition. Gotcha, it's not easy. It's not an easy it's not a snap your fingers and make it happen. Kind of a thing.
Jayson Davies
Were you, were you doing the doctorate program in the same program that you were teaching.
Tiffany Bolton
No, I we actually are still developing our post professional doctoral program. So I got my post professional doctorate at the University of Kansas Medical Center. Gotcha
Jayson Davies
very cool. All right, so we are here again talking about your article yourself. And Lindy Platner. How? Before we get into it, I just want to give you a little opportunity to share how, what role does Lindy Platner have in this? Is she your colleague at the college or?
Tiffany Bolton
No, so Lindy was a student at the time, and she was not actually my student on this research project this she was a student in either one or two cohorts younger than the students that worked on this project with me, but Lindy had a strong interest in research, and we hired her on as a research assistant for two of us in our program that were clinical faculty. So research was not our primary role, but we both engage in research and need a little bit of help to write things up and to manage the data and our with a very supportive department chair. And so he allowed us to hire her on for a couple hours a week to help us finish up a few projects. So that's really Wendy's role. She kind of helped with literature review, organizing the data. She helped with some of the charts, and it was some of the writing, so it was nice to have a little assistance there.
Jayson Davies
Awesome. Well, shout out to Lindy, thanks for helping out. All right, so this article, it was published in the Journal of Occupational therapy schools and early intervention, and the title of that article is occupational therapy role and school based practice perspectives from teachers and OTs. I just want to say that I love that you kind of went outside of the just ot realm and did go out and talk to teachers as well or get surveys from teachers. So to get started with that, what made you decide to look at the perception of school based ot from both OTs and teachers.
Tiffany Bolton
Well, like I said, I do all of my research, you know, through the University of Missouri, and so it always includes students and I, I so I'm not obligated to do that. That's actually voluntary, since I'm not research faculty. That is not something that I have to do for my job. But I really like it for a couple of reasons. I think that it's really helpful for our students to work with faculty that are not that are not strictly research based, to look at clinical issues that are out there, to hear it from a perspective, that's from someone that's not research heavy, that you know, that struggles their way through the process and has to ask for help. That's me, you know. So I think that's an important reason. And the other thing is, what I really did with this particular student group was I gave them a population that I was interested in, and we just started a lit review process. So I have to say that this project really came from a really sort of true research methods perspective, where we really did start. We had this idea. We started with the literature review, identified a gap in the literature and went from there. So that's not always the case with student projects. You know, sometimes it's like, sorry, this is the data I'm collecting right now. You have to hop in. So this one really started from scratch, and to be perfectly honest, we were interested more in the transition from preschool to kindergarten. Like I said, I run some preschool programs, so and we asked questions that gathered information about that kindergarten year in the transition to school, but we as we also asked lots of other questions, and looking at the data, we thought we had a lot more to talk about than just The kindergarten piece, and so kind of shifted and reshaped as we Funny how that happens, right? Yeah, pulled data in, and we kind of dropped that focus on the kindergarten year so much. But that's really where we came from, was this. So there's, like, a lack of both federal and state standards for what preschool curriculum should look like. Yet there's sort of a unwritten rule about what kids should look like as they enter kindergarten, um. And then if you look at common core standards, um or or other standards for kindergarten, they're so vague and they say things like, um, would it like a you know, a five year old child will incorporate research into their. You're what you know. And so schools are coming up with their own way to to interpret that, and it's leading to, you know, really drastically different expectations, I think, from kindergarten all over the place. And so we, we wanted to explore, kind of what we were hearing anecdotally mixed with what we were looking up in the research. So we have kids come in and all the time, and, you know, parents feeling like, are my kids not keeping up? And I have no idea what's going on. OT and, you know, just, I'm like, we just, let's just dig a little deeper and find out what's happening, you know. And OTs would tell us, well, I would love to do that kind of therapy, but I can't, because of this reason. And so it's kind of just a big hodgepodge of all of those things.
Jayson Davies
Yeah. So it sounds like this was a master's thesis type of thing then.
Tiffany Bolton
Yeah, so their master's programs, and we call it like their synthe synthesis project, and so yes, it is essentially like a master's thesis.
Jayson Davies
Okay, I'm actually a thesis advisor at a local university over here, so I've been doing it. I've had three cohorts now, and so I kind of understand the process a little bit more. And you're right, it is a big transition, but it's a lot of fun, because you get to kind of take these students, and you're right, it is, I feel like the students are so much more involved when they start from the ground up, and you don't just tell them what to do, and when they have a hand in developing that whole process. They just get more involved, and they feel like they take more responsibility in it.
Tiffany Bolton
They do. They were so fired up about this topic, and actually none of the three of them have an interest in pediatrics long term, but they actually won the graduate synthesis Project Award for their year because, I think, just another passion, and I really think though, because it's due to the fact that we really just sort of followed the literature and kind of let guide us, and they were really immersed in it. So yeah, it was a good experience.
Jayson Davies
Awesome. So was it just one cohort that did this entire project, or did it go span over multiple cohorts?
Tiffany Bolton
It was one cohort that that developed and pushed out the initial survey. We have them for an entire year in our research sequence, the course of a year that we worked on it. And then really though, I spent a summer kind of looking at the data after they were finished, and then the next year, Lindy kind of jumped on the project with me, and it really took on a different shape. So those initial students were really involved in sort of the development of the survey, but not really the kind of the synthesis and, you know, the analyzing the data, yeah, analyzing and that, that publication is the end result. That was really kind of more after the fact.
Jayson Davies
Gotcha All right. So as you began to look into the perceptions of OTs in schools. What did you uncover in that literature review? That kind of moved this forward, and I'm sure that those students were very helpful in that literature review. What were they finding?
Tiffany Bolton
You know, they found it was that discrepancy between so this is, this is, this is a literature review in the sense that we also looked at more, you know, federally based school websites and things like that. So it wasn't just straight research, but we found that discrepancy in how schools were were interpreting Common Core standards, which is what everyone was using at that time. And we didn't cite a lot of those, because it would have involved citing a lot of individual schools. But you can get to the school website and they have drastically different goals, you know, correlated with the same Common Core Standard, and then you start to look at the preschools, and that information is really missing. And so that was, like I said, that's the gap we went after in terms of how we developed our survey, but we realized after the fact that those questions, that we had them, and that we had all the teachers answer, there was only one question that asked, How much, you know, how many kindergarten Well, if they were the OT, how many kids of their caseload comprised of kindergarteners, and how many teachers had kindergarten experience? And the rest of them were all just sort of general school based questions. And so we eventually, sort of, you know, looked at the data and and that's kind of how the paper took shape. So it's sort of twofold, like, really the and then, and then, you know, you always have to go back and backfill with literature. And so what we found is that, you know, the number one reason for referrals is handwriting. Yet our teachers reported on there that they don't see a lot of improvement. Our OTs said that they, you know, they feel like they have a role in all of these other areas. But yet, the literature says that we're not getting referred for that, so that became sort of our new GAP, if that makes sense. Yeah. And
Jayson Davies
I actually want to dive into that in a second. But first I want to ask, what did that survey look like for both OTs and for the teachers? Was it the same? Was it different?
Tiffany Bolton
No, it was different. So um, without getting too much into the nerdy applications of Qualtrics, um. You can develop a you basically, it's like a tree. So you have they start with one question, it branches off into other directions. So if they say yes, I'm a teacher that takes them to a whole new bank of questions. If they say no, I'm an OT it takes them to a new bank of questions. What we did try to do is, you know, if we asked OTs, do you feel like you have input in these certain areas, we would also ask the teachers, would you value OTs input in these same areas? So we tried to have questions where asked the OTs, do you have input? Do you think that you should have input? And then if the teachers would value that input is really tried to how we tried to match it up so that we asked questions about the same thing. But it then made that it made sense for each profession. Gotcha, we did that perfectly. But no,
Jayson Davies
that's exactly I mean, I actually used your article to create an Instagram post, and it's been one of my most popular Instagram posts. It was just to just a reminder to OTs that teachers really do value ot Yeah, and I think that was one of the main things that I took away from reading this article. And just because we often don't feel that love in the schools, partially because we're just at so many different schools that we don't have time to sometimes have those interactions.
Tiffany Bolton
Yes, exactly. I know that was, you know, and going back to your you know what the literature led us to, I think it was part of that too. So, so because we had developed the survey for slightly different reasons, we had sort of this pot of data that we were like, Whoa, this is more than we were expecting. So when we went back, was really, I think, highlighted that discrepancy between, oh my gosh, we're only getting referred for handwriting. Yet, the teachers think that we can do all of this, and we think we can do all of this, and this could look so much different. So I think that was really a big part of it, you know, as a second with kind of the secondary data set that we found, yeah,
Jayson Davies
and I know for anyone out there listening, it's hard to, I mean, we don't want to go into each individual question that's on the survey, but I highly recommend that if you have the ability to get access to the article definitely do that. They have some great charts on there that really just break it down into the teacher and the OT perception. But let's get into that actually a little bit. Yeah, it looks like you had about 92 OTs and teachers complete the survey. What was some key points that you already mentioned a few, but what are some other key points that you're able to derive from that data?
Tiffany Bolton
Yeah, um, well, surprisingly, and this is kind of what happens when you when you talk to, sort of your, your own network of teachers and OTs. You know, as we were developing the survey, we had several teachers, look at it, we had several OTs, look at it. We interviewed some teachers, so we wanted everybody's input on it. But then, you know, you put that out there to a larger group. And so sometimes it's interesting, because I felt like what we hear from a lot of the OTs that we work with in the school based settings, that they experience a lot of barriers to being able to provide more of a consultative service, or what we consider like an inclusive service, or push into the classroom type of service, but that's not what was reported on the survey, you know. So on the survey, really, the OT said that there were no barriers, but that they still didn't do it. Do? I think that that's representative, you know, I don't know. Like I said, my own network of OTs, I think would disagree with that somewhat. So I think some of that's just we pushed it on social media, and you, you know, you have to deal with with whoever answers it, and we have a breakdown of where they were located, by state, etc. But, yeah, it's just kind of interesting. So, so that was really interesting, though. Yeah, you know, I'm actually surprised me too. So if you just look at restraint perspective, about putting my Sway on it. What it says is that the OTs are not experiencing barriers to this, but yet still prefer a more direct you know that what we call the traditional pull out type of service, that's what it says. So, yeah, just trying to stay clear. That's what that so that one was really interesting to us because we were not expecting that. We were expecting to hear a lot about the barriers.
Jayson Davies
Yeah, that's interesting. And remind me again, where most of the OTs, because it was posted out on social media and the teachers, were most of them in the Missouri area, or was it pretty spread out nationally,
Tiffany Bolton
the majority of them were in the Missouri and Illinois area, but then we had representation in quite a few other states, so it was fairly spread out with us, with definitely a concentration in the Midwest, just because of the way we put the survey out. So that was an interesting find. I think the other, really, maybe the most compelling find, were those questions that I referenced earlier, where we asked, OTs, are you involved in things like instructional methods, the classroom environment, the classroom schedule, the lunchroom environment? And we asked a lot of that and and then we also asked if they felt like they should be and so I just a huge generalization. It was. Basically, no, we're not that involved. Yes, we think we should be in that the teachers also valued it. However, I will say the teachers did not rank very high in terms of the instructional methods, but I truly believe that that's more due to the fact that I don't know that most teachers would understand what kind of input OTs could have on instructional methods. And so I, I felt like that was more of almost an error in a survey where they really weren't set up to answer that question well, but for the most part, otherwise they they basically agreed with the OTs. Yes, we think you'd be very valuable, but it's not happening.
Jayson Davies
Yeah, and that's actually one thing that I teach in my A to Z school based ot course, is about how, or just what a OT, a even defines ot as in the schools. And you know, it doesn't say in their definition that we're handwriting and sensory processing specialists. It doesn't say that at all. It says that we are to help them, help students access their curriculum in all environments, lunchroom, recess in the classroom. And so I think as OTs, it's great to see that we value that, and that even some teachers value some of that. But it's not happening. I mean, to be honest, right?
Tiffany Bolton
It's really not, you know, and I know. I just want to put this out there for anyone who's listening in more progressive schools that have achieved some of this. I know that it is happening in some places, but I still think for the most part, what I see in here at conferences, and I'm on the children and youth special interest section in a ot a, what I'm hearing from most people is it is not happening. You know, we're still being referred as the handwriting specialists, and that is the bulk of what we're doing at school. And there's so much more, you know, that I think that that we could be addressing. And I I just have to say, I do. I think ot a has some great resources on school based practice out there.
Jayson Davies
That they've really stepped up their game. Their website is really good.
Tiffany Bolton
Of the website is phenomenal. And there's a excellent section on the caseload to workload transition that could be very helpful, I think, to a lot of school based therapists.
Jayson Davies
Yeah, you kind of mentioned how that the bulk of the surveys were kind of in your area, Missouri, Illinois, but I just it's something that I often say is, you know, we have people that listen to this podcast from all over the country and all over the entire world. I've had people from China reach out to me and say, Wow, thank you. But it's crazy how different ot can look from district to district, even though they're right next door, you're one district beyond workload. One district could be on caseload. One does RTI, one does absolutely no RTI. And the more spread out you go from state to state or state to across the country, it's even more different. And it's crazy how that is so different, even though teaching often looks pretty similar, but the OT profession looks so different.
Tiffany Bolton
Yeah, we actually some. We had a few places where people were able to write in some comments, and we had some comments come in about RTI. Interestingly though, the the teachers that we worked with in development of the survey, that was not common practice for them. So you know, like you just said, it's just really different. So we really attempted to try and stay as neutral as we could, so that the information, you know, could be could be used anywhere, while recognizing that, like you said, you know, it was Midwest centric. So I know that it doesn't represent everyone.
Jayson Davies
But hey, it's a good starting point, and the research is there for everyone to read it and just to take something away from that. So one of the other little data points you had was about referrals, both the reason for referrals and the timing of referrals throughout the school year. Were you surprised by what you found?
Tiffany Bolton
Not you know, not necessarily we, I can tell you that our, you know, I mean, I guess we had maybe a slight ulterior motive with asking that question, thinking that, depending on what the data said, we could recommend, oh my gosh, well, OTs could implement, you know, maybe more preventative to your one types of services at this time of year to be more effective. And maybe it still says that, but it really was heavily in the fall semester. And so, you know, that's not too surprising. You start off that year, and it becomes really apparent who looks different from from, you know, other kids. And so that wasn't too surprising, neither was the reason for referrals, because it just supported what we had found in the literature. Found in the literature, with handwriting, by far and large, being the most, you know, dominant referral. So, yeah, that's that wasn't too shocking, yeah.
Jayson Davies
So I have a question for you. Obviously, I've only worked in a few school districts here in California, and here, IEPs happen throughout the year. You can have an IEP on the first day of school. You can have an IEP on the last day of school, even though people hate that. But I've heard in some places, they try and put all the IEPs in one point of the year. Have you seen that? Is that something that you've come across?
Tiffany Bolton
I have not come across that specifically I see. More of the it seems to be based on, really, when that initial referral exactly right? Yeah. And it just stays on that, that rotating basis, um, so, no, I have not seen that so much. I guess I could sort of see the that'd be really stressful.
Jayson Davies
I know. I can't imagine being a case carrier and saying, Hey, all your IEPs are in the month of May, or all of them are going to be in September. Like, yeah, I don't want to hold 30 IEPs, I mean, or as an OT 100 IEPs, all in one month. But I know some schools do it. I just wondering if you if you had heard any of that based upon the feedback. No, okay, that's fine. All right. So, something that I've learned as a thesis advisor is that no matter how great a project can be. It's never perfect, and sometimes you get to a point where you're interpreting the data and you just wish you would have had the ability to ask one more question after concluding this survey. Do you feel that there's any questions that you wish you would have been able to add to that survey now.
Tiffany Bolton
yes, and this one will just burn my brain for the rest of my life. I cannot believe that we did not ask the OTs if they were contracted by the school or employed by the school district, because I think it makes a huge difference in the amount of time they're able to spend at the school. You know, the way that the their ability to provide tier one interventions, I think goes up dramatically if you were employed by the school district, and we did not ask that. So we have no way to separate out if our answers, you know, were like, we have no way to group them by OTs that are contracted versus employed by the school district. And, like I said, that will, that will, like, burn my soul for the rest of my life. I there's actually somebody I've connected with on the community. Board and children and youth. I'm blanking on her first name. I think the last name is Salazar. She is currently working on an additional survey, and she's used our survey heavily to build upon hers. So in terms of, like, looking for a next step, I believe that it's in the works. She's really done her homework in terms of having people look at the survey. And I told her that question, I'm like, don't forget to ask this important please ask this question. So yeah, she she's working on kind of I've read her survey, and it's excellent, and it really takes things to the next level. She didn't build it just upon her. She used about five different sort of resources that she built hers on pretty heavily, but it really takes, like the things that we ask, to the next step. So I'm excited to read it.
Jayson Davies
Awesome. She's finished it yet, but you're absolutely right. Though, just a few days ago, I had a contract therapist reach out to me. They're like, hey, I really want to do RTI, but I don't get paid to do any time after school. Yeah, and she's like, Well, what do I do? Like, I mean, it's almost kind of that thing where you have to show your worth by working for free at some point. And I mean, if you're going to do it like an in service, you almost have to volunteer your time to do that in service and hope that they see the value of it, and then ask for some time to do stuff like that. I mean, that's my only real recommendation when it comes to that.
Tiffany Bolton
No, I could not regret it more that we didn't ask that. But I hopefully that gives somebody else a jumping off point, you know, for another, another project, to take that sort of big missing piece, and it kind of lays out a second second project pretty nicely. So.
Jayson Davies
Absolutely. So you mentioned how someone else is taking it and running with it a little bit. Do you have any intentions on following the survey up with something?
Tiffany Bolton
So not directly this survey, I actually have a completely different research project that has become a life of its own, that, you know, I've had to call in. I've partnered up with research faculty on it, because at this point, it's kind of gone beyond what what I'm able to do in my my role at work. But we are looking specifically at measurements of handwriting in their preschool population, which most OTs are like, well, they shouldn't be able to write. I agree, but the world is expecting that of them, and at this point, I feel like as OTs, we need to, we can't keep saying that developmentally, they shouldn't be writing. So instead, what we have done is we wrote a screen, not a screen tool. It's we're actually working on standardizing a tool that looks at just functional writing, so when they're not penalized for letters, they don't know how to write. There is room for error in rating the letters, but it actually looks at letters and looks at names separately, because I think most OTs we recognize that that name becomes kind of a pattern, and they might be able to write Tiffany, but then you say, write an F, and they can't write an F. So we rate names separately, and we have a way to rate each letter. And our results have been really interesting. Our participant numbers have gotten up fairly high. And so like I said, I've partnered with research faculty because at this point it's it's getting outside my wheelhouse. We have a paper submitted right now that, and we're waiting to. Back on our initial sort of stages with this. The other interesting thing that we're measuring with this is we were measuring grasp because I know that my own personal philosophy as an OT is that grasp is not overly important. So I think that, you know, at some points it is worth, you know, attempting to correct or improve, but at some point it's okay if we have an adaptive type of grasp. And so far, no matter how many numbers we add to it, we are not seeing a correlation between accuracy of writing and grasp, which is not, was not really our initial goal, but it's been a fun result. Interesting. Yeah, I mean T shirts, but.
Jayson Davies
Yeah, I mean, every now and then I I just want to go. I just get this idea that I wish I could just go in and take a picture of every single student, handwriting grasp in, like one classroom.
Tiffany Bolton
Yes, Jason did this. We took picture. We have pictures of every, oh my gosh, of everyone that we evaluated. So you are sitting on my dream.
Jayson Davies
So wait, did you just do preschool with that?
Tiffany Bolton
Then we've just done preschool so far. We did shy away from naming our tool anything to do with preschool, because we feel like it could be something down the road with someone else's help, that we could standardize, especially for kids with delays that are older, because we really are focused on, like, functional writing. So, you know, as in, we're not looking at formation, we're looking at the end result. Can I read it? So when somebody hands me this paper, can I read it? And so we felt like that can be something really helpful for, you know, our kids with disabilities that are older than the preschool age. But yes, we have pictures of everyone's grasp at three, well, either two or three different test points, depending on what phase of the study they were in. And we have done some presentations where we paired up, we showed a sample, their matching sample of grasp to or, I'm sorry, their matching writing sample with their picture of grasp. And it's, I mean, you know, it's really like poignant when you see it visually, because some of the kids with the worst looking grasp have the best looking writing and whatnot. So we did a workshop that we actually passed out pictures, and it was like a contest for some different prizes, if people could match them up based on what they were seeing. And no one could. So that's a whole different research study we're just saving.
Jayson Davies
Oh, my goodness, you're gonna have to come back onto the podcast another another day. We're gonna have to do that. Yeah, no, I wasn't gonna ask you this, but I just want to what have you learned from going through the research process, just as an OT what have you like? What are you taking away from the research process?
Tiffany Bolton
Yeah, you know, when I was a clinician, I'll be really honest and say that what I did at that point in time probably wasn't very solid research, and I think that was just lack of understanding I didn't have a strong research base in my ot program, and so reading articles was really intimidating to me. I will say, you know, continuing my education really helped with that. But I think engaging in the research process in any way that you can helps it be less intimidating, and so you can take an article and dissect it a little bit more, and you don't have to be scared of, you know, the big words that are in there that you maybe don't understand. I'm just putting that out there. This is what I tell my students. I'm like, I want at the end of the day, if you don't learn anything about the actual research we did, but you feel like you could go into your job and you know, somebody says, Hey, we're collecting data on this. Would you like to be a part of his research? And you jump on that chance, then that's a win. And so I think that, you know, what I've really taken away from it is, don't shy away from it. There's a lot of people out there that are really willing to help. Heavy researchers are eccentric, amazing people, and they like to share what they know. And so pairing up with someone, or asking for somebody to help you understand what you're looking at can be really helpful. And you know, the other piece of it, I think, from the clinical side, is collecting data is absolutely imperative. And that can look like really simple tally sheets. It doesn't have to be really complicated. One of my focuses on anything that I do is that whatever we're collecting has to be fast, because I refuse to like change my clinical process like it has to, like the research. Sometimes, researchers that help me with my data. Sometimes cringe, because my data is can be a little messy. Sometimes, like, like, Well, what about this? I'm like, I don't know. We had 35 kids to evaluate in an hour, you know. Like, that's we had to get it done, you know. So, so coming up with clean ways to collect data, simple ways to collect data, because it really can back up what you're talking about. I, you know, questions come up a lot on the community board about, you know, I know this practice doesn't have a lot of evidence behind it, but I see it happening a lot in my clinic, and my question back almost 100% of the time is what. Kind of data are you collecting on it? You know? Can you? Can you show, without a doubt, that this, that this intervention is helping? So, yeah, I think my, my key, my key takeaways from the research process are, don't be intimidated by it. Yeah, don't, you know, like, don't hesitate to reach out for help from a university, anywhere that you are affiliated with. If you've taken a student from anywhere, reach out to them and say, Hey, could you guys help us with this? Or, you know, do, do do a journal club, anything like that, and then collect data? I mean, I think those are my biggest things.
Jayson Davies
Yeah, that's a good tip. Just reach out and, I mean, yeah, the worst you're going to get is a, sorry, no, we can't do it right now. And maybe you have another program that you have an affiliate affiliation with that you can ask. So, yeah, exactly.
Tiffany Bolton
And I you know on that note, a lot of the universities will provide you with a like complimentary access to their research database. So we can provide that at our university for interested people that take our students. We they can have access to our database, so they can have all those, you know, well, like this article we're talking about today is in a is not in an open access journal, but if you were affiliated with our university, you can jump right in and, you know, get the article requested through the library.
Jayson Davies
So yeah, I mean, even this the way that you and I got connected, as a perfect example, I just reached out to you because I couldn't get access to this article that I want. That I wanted to read. I was like, Hey, I'm just gonna email Tiffany and see if she has the ability to get access to it. So thank you for that, by the way. Yeah, no problem. But yeah, I think people do get overwhelmed. They just get bogged down. I think when they're reading an article, especially when you're looking at p is greater than or less than point 00, whatever, like, all these little numbers and things that just kind of make you confused. And unless you have taken a stats class, not just taking a stats class, but probably taken one recently, because that thing is the first thing that when you graduate, I feel like the stats is the first thing to leave your brain, for sure, but yeah so, but definitely, you know, you don't have to get bogged down by those. Look at what the interpretations say. Look at the lit review, and look at also the limitations, because any good article is going to have limitations, and if they don't have limitations, then you should be questioning that.
Tiffany Bolton
Probably, right, exactly. Yeah. And, I mean, you know, with just a little bit of help, I think you can learn to recognize, you know, how large of a study it is, you know, I mean, I think there's some little key points you can, you can use to really dissect an article quickly, yeah. And really, honestly, your ot students are good at this, so have your ot students help you, right, all right,
Jayson Davies
so let's go back to your article. Last question. I just want to wrap this up and ask, what is one key point that you think school based OTs should take away from the research that we talked about today?
Tiffany Bolton
I, you know, I think based on our findings, specifically, I think it is that the teachers do value our input. They're, you know, obviously there are OTs out there that do not feel like they experience barriers to to the type of OT that they would want to provide. And so I think keeping those things in mind, you are valued, the teachers, maybe and administrators need some more education about what all we can do in a school setting. I think that's maybe a big part of it. I think some of it really just comes really just comes from lack of knowing. And don't be stuck in that rut. You know, if you feel like this is what was happening before you were there, or what other therapists are doing, there is evidence out there, and, in fact, plentiful evidence out there to support you in changing that school based role. I think that's the biggest part. Don't be afraid to change your school based role. I always tell my students, I'm like, if you go into practice willing to question, you know, everything that you're seeing, then that's, you know, that's a big accomplishment. Ask questions and and make sure you understand what's happening. So, yeah, I think that's the biggest, the biggest one. I do have to say, we purposefully sought out this journal because it pop if you go to the ERIC database, so the education database, this journal pops up in there. And so we chose it on purpose, because even though it is an OT journal, it shows up in the educators database where administrators and teachers are reading. And so that was, I was fairly adamant about using that journal for that reason.
Jayson Davies
Tiffany, you are awesome. That is, that is great that you even went that far as to find a journal that does that. Because I haven't done this yet, but my dream is to present not at an OT conference, but at teachers conferences for that very reason, because people don't know what OT is in the schools, our admin don't know, and the only way they're going to find out is if we help them. I in services are a great way to start that process, because by providing in services, you are letting the teachers the admin know what you can do, and it's coming directly from your mouth. Mm. And so you can do that through in services. And in the same way, I feel like OTs need to get out into the educational world to share what we can do, because otherwise they're never going to find out. They're not going to go Google. What can ot do in schools?
Tiffany Bolton
Yeah, I would agree, and I would have to say too in this it's in the same journal some people that I know, well, Maria ball is another person. She's written an article about a way to change school based practice that I actually cited in this article. It's excellent. And Cynthia Cliff did the same. She did her PhD, and she has she did interviews with therapists, and both articles are in the same journal, and they're excellent in terms of giving you support if you're if you're wanting to make changes in your in your school that you're in.
Jayson Davies
Great. Well. Thank you so much. This has been a fantastic just a conversation. I enjoyed this conversation. Thank you so much. I want to give you a chance if you'd like to share, where people can potentially get a hold of you if they have specific questions or just want to learn more about your research.
Tiffany Bolton
Yeah, like I said, I work for the University of Missouri ot program. My email there is my it's my last name, so Bolton TL, so my first initial and my middle initial, Bolton tl@health.missouri.edu and if you're active at all on a OT, a you'll see my name really frequently. I have another year in the position as the communications coordinator, so I'm all over the community, children and youth board, and so you can, you can find me through there as well.
Jayson Davies
Oh, and no idea about that. So are you going to be in San Diego next year, assuming everything is so if they, if.
Tiffany Bolton
we're cleared to, you know, right, be around people again, Yep.
Jayson Davies
Yeah, I sure hope so. I'm looking forward to that one that's in my backyard, basically. So I haven't announced anything yet, and I haven't even started planning, but I'm hoping to do some ot school house type of meetup gig type of thing. So, yeah.
Tiffany Bolton
that's the plan I was supposed to present in Boston. So that was, you know, not, didn't happen, obviously. So, yep, that would be the plan, cool.
Jayson Davies
Well, hopefully I see you in San Diego then next year. And yeah, thank you so much again for coming on. Really appreciate it.
Tiffany Bolton
Yeah, no problem. Thank you. All right. Take care. Bye.
Jayson Davies
All right. Thank you everyone. So much for listening to this show. I hope that you found that refreshing and just a great way to kind of start July, I mean, just to remember that OTs and teachers, we work alongside of each other, we appreciate each other, and we do so much together. It's just great to see that people are working together and that teachers appreciate us. We appreciate them. Thank you so much to Tiffany Bolton for coming on the show. Really appreciate having her on. It was a great conversation. Just really appreciate it for all the show notes. Head on over to OT schoolhouse.com forward slash episode 52 and we'll see you next time on the podcast. Take care. 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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