OTS 58: Occupational Therapy in Preschool
- Jayson Davies
- Sep 27, 2020
- 42 min read
Updated: Jun 28
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Welcome to the show notes for the Episode 58 of the OT Schoolhouse Podcast.
In this episode of the OT Schoolhouse Podcast, I have a conversation with Amanda Speights, OTR/L about what occupational therapy looks like in a preschool. She works in a model preschool and I work in a preschool, not sure I would call it a model preschool =P
Anyways, in this episode, we talk about what the goal is for working with preschoolers, the referral and assessment process, and why we think it is important to collaborate with the preschool teachers to serve our students.
Links to Show References:
Visit Amanda's website at AmandaTheOT.com
Be sure to subscribe to the OT Schoolhouse email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.
Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com
Well,
Thanks for visiting the show notes for Episode 57! If you enjoyed this episode be sure to subscribe on Apple Podcasts, Google Podcast, Spotify, or wherever you listen to podcasts
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 58 of the OT school house podcast. Thank you so much for joining me. My name is Jayson Davies, and I am excited to be with you today. We are going to have a very short intro, and then we are going to start by jumping in with Amanda Speights, and we're going to talk about preschool and occupational therapy. She actually works in a quote, unquote model preschool down in Florida. And yeah, it's a great conversation. So I hope you will check out the entire thing. Also, real quick shout out to all my ot practitioners down in Florida. I don't know why, but there's so many OTPs down in Florida that really listen to the podcast. I really appreciate all the support from all of you down there, from everyone, but it just seems like lately I've been getting a lot of emails and whatnot from Florida. So thank you so much for for listening to the podcast, following the OT school house podcast, website, all that good stuff. Really appreciate that. All right, so real quick, before we do dive into preschools with Amanda spades, I want to invite you all to check out my Instagram, the OT school house Instagram page@instagram.com forward slash ot school house, all one word. I have actually figured out what reels are and how to use them, and I'm just really enjoying myself. Many of you, or at least few of you, might recall from the very early episodes when we kind of introduced who we were. I actually was considering being an animation major. I minored in film. And so the whole Tiktok reels craze has kind of gotten me back into that creative side of being, well, I mean, producing a little bit of film. I mean, the podcast does some I get to do some editing with the podcast, but I'm really enjoying the reels. I actually created one that's about a Pac Man tennis ball. I created another one about the zones of regulation. So I hope you'll head on over there. Check it out. Follow me, just for some general great school based OT. Content, all right, and with that, I'm just going to slide us on right into the interview. This is Amanda Speights, and she is a occupational therapist that works primarily in preschools down in Florida. I hope you enjoy the show. Hey, Amanda, welcome to the OT school house podcast. How are you doing this morning?
Amanda Speights
Great. Jayson, I'm so happy to be here.
Jayson Davies
Yeah, I'm excited to have you on why don't you go ahead and share us a little bit about your ot journey.
Amanda Speights
Okay, well, I went to Florida International University for my masters in OT, and I completed that in August of 2010 and immediately took a travel school job and moved to Virginia before I even took my boards.
Jayson Davies
Wow, that's a big before even officially being an OT, right?
Amanda Speights
So I worked on a temporary license, took my boards passed. Thank goodness that was a sigh of relief and and then worked in the schools in Portsmouth, Virginia for two years. Then I relocated to Atlanta, Georgia for about three years, before coming back down to South Florida, and I've been back home, but a little bit north of home, for about five years now.
Jayson Davies
You just couldn't stay away from Florida for too long, huh? No, I couldn't. So what settings were you in when you were moving around a little bit, primarily
Amanda Speights
school based, but then also some PRN jobs in the hospitals? Yeah,
Jayson Davies
I think we've all had a PRN job at some point. I worked in like a it wasn't exactly a sniff, but on the weekends, working in a little rehab area to work with some older, older clients. But yeah, I think we all kind of take that on, especially when we're younger and we're trying to pay off our student loans. It just helps a little bit. It helps a lot, right? So tell us, where are you now, and what does that job look like? Currently,
Amanda Speights
I work for Nova Southeastern University, and I'm in a preschool program that is accredited by the National Association for Education of Young Children, and our Prescott program is a model program for autistic children, and it's offered in partnership with Broward County
Jayson Davies
Gotcha. But that's not all. You're kind of sharing me that sharing with me that this is a very unique position, and how is that? So
Amanda Speights
it's unique because we're not just a school, we're a multidisciplinary demonstration and training center, so we train, and we serve as a model for a lot of schools to come and watch what we do, and we also conduct research and we train a lot of students. So currently, I actually have two level two fieldwork students with me who. Now, and that's
Jayson Davies
all on distance learning, right? Yes, it is. Oh my goodness, that's gotta be difficult. Yeah, I think I have a level two starting up in the near future. I think it's gonna be an occupational therapy assistant, but just like you, I think it's gonna be all distance learning, and I may never physically meet the student that I'm going to be working with. And that's kind of insane to think about.
Amanda Speights
It does it increases our time on Zoom, but I think that we've been able to have a pretty interesting experience and and they seem to be enjoying it. And one of my students said that she just thought that it was really relevant for the times, since it's obviously emerging practice, absolutely, it's a great thing to learn. Yeah,
Jayson Davies
and let's be honest here, even when the whole COVID 19 thing is over, things are never going to be back to completely the way they were before. I mean, Zoom is here to stay. Google meets is here to stay, teletherapy is here to stay. And so, yeah, you're right. It's, it's good that they're getting the practice now, and they're going to be better clinicians for it eventually. So definitely, yeah. So tell us a little bit more, because I know this, this unique area that you're in, you're actually at a university, right? Yes. Okay, and so how does the campus of the University, and how does a university work with a preschool? I mean, I've most occupational therapists, either A, we work directly for the district, or B, we're contracted for a third party, like a third party company or private entity that contracts therapist to a district and maybe, see you work for the county, or you work for a state, or like a we call them salpas Here in California, you kind of work for the county, and the county kind of contracts OTs out to the individual districts. But tell me how this dynamic works.
Amanda Speights
The University has a contract with the county to be an agency school, so that's how they provide the services. There's a couple of different other agency schools in the area that act as center based schools for kiddos that maybe need a little bit more of a restricted environment for their education. Okay?
Jayson Davies
And so this might be similar to a contract job, in the sense that you could be working for a private entity and working for the preschool, it just happens to be at a university. Yes, right? So
Amanda Speights
get all the benefits of being on the campus. You know, we have access to all of the great research and the professors are there. We have students that are are constantly being able to train and be on their level ones and level twos. And I've been fortunate enough to be able to guest lecture in the academic department as well.
Jayson Davies
Oh, nice. I was going to ask you, what, what academic sides do you get out of it? So you're guest lecturing every now and then,
Amanda Speights
every now and then, and I'm also working on my doctorate. Oh, wow,
Jayson Davies
congratulations on that. Maybe we ask what area you're kind of focusing in on right
Amanda Speights
now. I actually just got my practicum topic approved, and ta da telehealth.
Jayson Davies
Go figure. Yeah, nice. And so are your students coming from the same university that you work in? Then, yes, gotcha. That makes sense. All right. Well, let's kind of dive in a little bit further now into the actual practice. We know a little bit about Amanda. Now, how's distance learning going for you?
Amanda Speights
Honestly, it was a steep learning curve. It was, it's different. It was very different. I just, I really had to think about my coaching skills and and how I was going to explain what I do in layman's terms, to parents,
Jayson Davies
absolutely, I think communication has been something that we really had to focus on more so than we ever have had to, especially if you're working in a caseload with high needs where maybe your students aren't as verbal, and now you're Working with their adult parents, who are very verbal and are your your hands, your ears and your eyes. Working with that student, you really have to communicate with them. What do you think about that? Is that something that you're learning? Yes,
Amanda Speights
and I was really happy to receive an email from a family on my caseload in the spring who was working with a new therapist this fall, and we used blowing bubbles to teach breathing techniques for his self calming. And she was really excited to tell me that over the break, he actually began to use it independently. So I love that. I thought that that was a really difficult thing to translate, right? Because it's really abstract to teach him, but just through partnership, we were able to help him understand and he was able to grasp the technique. So, yeah, really happy.
Jayson Davies
That's awesome. Great job. So I gotta ask, because we're in the middle of a pandemic and everything, and I know people want, um. Resources, and just kind of to know what other occupational therapists are doing out there. So are you using zoom for your therapy sessions? Per se? Yes,
Amanda Speights
University has a professional contract with Zoom, gotcha,
Jayson Davies
and I know that's something that some school districts are weighing because of the price of the professional contract, and it's difficult. And even though I feel like zoom is the number one platform to be on, I understand that it's expensive, and so that may be a little bit of a perk of being at a university versus a public school that might not necessarily have the funding when they're already paying for Microsoft Teams and for Google meets, and it's just an extra expense for some of the public schools, but that that's great, right? So aside, you're on Zoom, what's going well and maybe what's not going so well with distance learning, what's been we talked a little bit about communication. But what else is going well or not going well?
Amanda Speights
I hope that my first evaluation is going well. I was assigned an evaluation to start. And since I did have access to the WPS online platform, I don't know if listeners are familiar with that platform, I was able to email mom, the SP MP, and correspond with her to clarify any trickier items. And the cool thing about that system is that it generates the reports for you, so it auto scores and generates reports. And since I have those students I mentioned, I was able to take it a step further and demonstrate the use of the quick tips to develop intervention reports. Nice and
Jayson Davies
is that the well, actually, you know what? I'm going to hold off on that question. We're going to get into some more evaluation questions a little bit later. But first, let's go ahead and dive into the role of an OT in the preschool system. I find that preschools are very unique for several reasons, the first being that there's no real mandated curriculum for preschools, at least not that I'm really aware of. The standards aren't really set. We're just trying to get them ready for kindergarten, and so I feel like a lot of options open up for teachers and providers with that. What type of occupations Do you feel like you focus on in the preschools?
Amanda Speights
Well, play, of course, naturally, right? Please. Preschool is really all about leveraging play for skill development, and it has to be fun. You can't be afraid to be animated, to be silly, if you want to be a preschool ot
Jayson Davies
i Yeah, second that, no doubt. But I think also at the same time right now, that's hard to do over, over this teletherapy platform, it's hard to get that engagement. What type of what type of population is your preschool? Do you have a wide variety of population, or is it all students with autism? Or what does
Amanda Speights
it look like? It is actually all students with autism? Okay? And so
Jayson Davies
my guess is a lot of times, and correct me, if I'm wrong, in California, a lot of times students don't get preschool paid for, or a free and appropriate education for preschool, unless they do have more involved difficulties with social skills, fine motor skills and whatnot, to be in that preschool for free. And is that kind of the case with you? Then, are these students a little bit more involved, have some more needs or higher needs?
Amanda Speights
Yes, my setting is considered intensive placement.
Jayson Davies
Gotcha. And so what can you get? Just paint us a picture of what the actual preschool looks like, not teletherapy wise, but just in general. What does it look like? How many kids, how many adults? What does it look look like? So
Amanda Speights
we have 145 preschoolers. Okay, so that's all children between the ages of three and five years old. And we have three OTs, three and a half because one of our speech therapist is part time. Speech language pathologists, two autism specialists, two behavior analysts and nurse. We have our director, our Associate Director, and 16 teachers. Oh, wow.
Jayson Davies
Okay, yes, okay. And so is you mentioned about 100 and what was it, 45 and are those students that all receive OT? Or is that all the preschoolers in general? Or are those numbers, those
Amanda Speights
are all the students that we have in the program in general? They don't all receive OT, but every classroom has an OT assigned that is acts as a consultant, so the teacher is receiving some ot education, some ot support. I
Jayson Davies
love that. Okay, and we're going to talk a little bit more about trainings and education a little bit later, but I want to continue on painting this picture. So the 140 550 kids or so, 16 teachers. We're talking about 10 kids per classroom or so. Uh, give or take, maybe a little request, give or take. Okay, and so you said that there's an OT kind of assigned to each classroom. That's awesome, yes. So how does that work? Then
Amanda Speights
that works because the OT we try to spread the kids out as far as when we're looking at placement in the classroom, so that not all of the kids that receive ot are just placed in in one class, and that way, when we're pushing in to service those kids, that's just kind of the push in model is that, you know, other kids benefit. And I think that's true, that even in in a less intensive setting, that that's that's what we would see in the gen ed population, that if there was a child that received ot in that classroom, just by way of the OT being there to service that child, we're going to notice something, and we're going to point it out, and we're going to educate the teacher so it really benefits all the kids in the classroom? Absolutely,
Jayson Davies
I agree. And so Are any of these classrooms, or any of them, like 5050, type of classrooms where there might be both students with autism as well as typical developing peers, or anything.
Amanda Speights
Or did, used to have a BPK program, but that we discontinued it. Okay?
Jayson Davies
You know what it's, it's, it's things that happen some places and don't happen in other places. And unfortunately, that's not something we have control of. But I just wanted to ask, because, like, what you just said, you know, ot can help all populations, and even if they're going in there, for the three students that are on the caseload, you're right, the other seven students, or however many students are in that classroom will absolutely benefit. So, yeah, all right, so we talked a little bit about the preschools that you work in and the populations that you work with. Another unique thing about preschools is that how students come to be referred for occupational therapy services. We have students that sometimes are almost in a way, sent into the preschool with ot because they had early intervention. We have some kids who are tested as soon as they're coming on because there might be concerns that the parent expresses. And then there's other students that we don't find until maybe they're four years old and they've already been in the program for a year or even older. You know, some kids we don't find out until they're in second grade, beyond preschool. But can you share with us a little bit about the referral process, how you find out about students? Maybe let's just start off with if a student's already in the program, and how might a referral look like
Amanda Speights
if they're already in the program, we proceed kind of with that RTI approach of implementing the whole group system, the small group, because, as I mentioned, the OT is already going into the classroom, probably for another student that has OT, yeah. And so we're educating the teacher, and we're giving suggestions and and we're making some modifications already and sometimes recommending specific individual strategies.
Jayson Davies
No, that's a great answer, and that's kind of what I'm doing right now, because I have a preschool similar setting. It's a public school, but it is. It's a classroom for students with moderate to severe autism, and so it's a one teacher, two other adults in the classroom, and right now, because it's the beginning of the year, there's only six or seven kids in there. I'm sure at some point during the year, might go up to nine or 10, but I kind of am in a similar situation, because just like you, I service three kids already in the classroom, and the teachers already asking for three more referrals to go through, and I'm doing an in class group. And so I'm trying to figure out at what point does it it's hard to ask this question, at what point do we do all these evaluations, or do we just kind of go the RTI route, where we just help everyone in the class and maybe not necessarily have an evaluation? And so have you ever had that kind of conversation with a teacher, maybe where they're trying to press a referral a little bit, and you're kind of like, well, we're already doing RTI. I'm already in the class a lot. Has that ever happened to you? And how do you kind of walk through it?
Amanda Speights
That has happened? Sometimes it seems as if the teacher just really wants ot to step in because they're nervous about addressing the skill, maybe they don't feel confident or competent to address the skill, and it can just be an educational opportunity for the teacher to show her you know how she really is doing this. Well, yeah, or and pointing out things. She is really doing well, or he is doing well. I think that sometimes the child just needs more exposure, yeah, explaining that, because especially in my setting, they're coming to me as their baby threes, they're just, yeah, they've just started school, so it's their first exposure to a formal educational setting. So that's something that I try to explain as well, is that they're they're really trying to adjust to, like, not missing mom and dad, right? So how can they focus on cutting or pre writing if they're just really wondering all day, where's Mommy?
Jayson Davies
Yeah, or even sitting in a chair for three minutes. I mean, right? A lot of times these kids haven't been asked to sit down for an extended period of time, and they've just been allowed to roam around the house or whatnot for the first three years of their life, and that's perfectly okay, but this is their first opportunity to be in school,
Amanda Speights
right? And that's the purpose of preschool, is to work on those skills of, can I sit down? Can I pay attention? Am I available for learning? Because as the child goes on, you the academics get more rigorous.
Jayson Davies
Absolutely, I like that. You brought that up because, again, like we've talked about, kind of a little bit earlier, things are so much different between preschool and once you get into kinder, first second grade, like you mentioned that it's really play based, and you're really focusing on that play to build the other skills. So I know we're getting a little bit off topic. We're on this referral topic, so I'm gonna drag myself back over here to this referral. We're gonna get a little bit more into occupations a little bit later, but so now you talked about how, and we've talked about how a student might be in the program, and you get that referral, you start with the RTI approach. At what point in that RTI approach do you say, okay, you know what? Let's go ahead with an evaluation.
Amanda Speights
I'm also looking to see in my setting. I'm looking to see like, the dynamics of the classroom and what's going on staff wise, and what's going on with the other kids, to see if you know this teacher really needs more support, that I really need to be physically present in the classroom more often.
Jayson Davies
Okay, okay, yeah, that makes sense. And whenever we do an evaluation, we should be taking into account those dynamics. How many adults are in there? What skills do those adults have, or what skills might they need? And again, I don't want to get ahead of myself. We're going to talk about evaluations. But what about child find? Do you participate in Child Find? Or is that something that you have to participate in, or is it really you're focusing on the kids once they're in that preschool?
Amanda Speights
I really focus on the kids once in a preschool, but some children do come to our program via Child Find, Okay,
Jayson Davies
fair enough. I know that's not an area that OTs really participate. There's there's another team that kind of, does that child find? And it's once they're in that preschool that we might really take on the roles. So right, understand that, I think that's kind of the extent of where referrals might come from. What about can you explain just a little bit about that process from an IFSP to an IEP? Just a little bit just an overview of what an IFSP might be, and bring that into an IEP. I know it's an individual family support plan, but how does that translate? Are you ever in those meetings that where a student is transitioning from an early intervention into a preschool setting, or does your or does the team have a specific team for that.
Amanda Speights
There's usually a specific team that sits in those transition meetings at times I might be called to what's called a staffing meeting when they've already been decided that they're going to be attending the program that I work at. Okay,
Jayson Davies
and even if a student has an IFSP, are they typically still evaluated even by the preschool OT, as they're transitioning from the IFSP to the preschool?
Amanda Speights
Yes, there's still a multidisciplinary team. Oddly enough, OT is not always included. I think sometimes, you know, someone has to raise a concern that they that's a red flag that ot needs to be included. But usually, when I see those multidisciplinary team evals that come through for the staffing, there is an OT included sometimes, well.
Jayson Davies
That's good. I know with our district, our preschools, the way that they decide whether or not ot should be included on that preschool evaluation, that initial evaluation is to look at the IFSP and see if ot was on there. If OT is on there, then yeah, they're going to go ahead with an evaluation for OT. But if it's not on there, then yeah, it really is up to either the team to look at documentation and if they see some, some. Delays within the activities of daily living, or fine motor skills to try and to basically ask for the OT evaluation. Or, really, I guess, the parent, and a lot of times, if this is a parent, say that their first, if this is their first student with a disability, they don't know what occupational therapy is, yeah, they're only three years into having this student that might have delays, and even then, maybe it's only been a year and a half that they've really understood that their student might have some delays or less time than that, and so I don't think they know to ask for OT, right, yeah, all right, so you talked a little bit just there about the multi team disciplinary evaluations, who all is on that team, and what are their roles and responsibilities on that team?
Amanda Speights
A lot of times, school psych and speech are kind of the default evaluators on that team, and then I'll see ot on there. If, like you said, ot was on the IFSP, or if the parents asked, yeah.
Jayson Davies
And you talked a little bit about having behavioral analysis or behavioral professionals on the team, I think earlier. Do they ever? Do you ever see them on that initial evaluation? Or is that more for a student that's been in the program and has shown some behavior difficulties.
Amanda Speights
It's usually for students that have been in the program and they might have a pbip when I would see your intervention program.
Jayson Davies
Yeah, gotcha. Okay, all right, so that's kind of a little bit about that referral process. Let's, let's dive into actually the evaluation. You know, what do you find to be the most common reason for an evaluation? Why are students being referred either right as they're coming in or by the teacher?
Amanda Speights
A lot of the times in preschool, I'm seeing pre writing, scissor skills and self regulation, for sure, because, like we were saying earlier, being able to sit down in a chair for three minutes can be hard our kiddos, and then specifically sensory related behaviors for my autistic kiddos.
Jayson Davies
Okay, and are you talking like related to stimming or hitting their head against something or I mean, I guess that kind of goes hand in hand with the self regulation.
Amanda Speights
Yeah, right, yeah. So some of it is some self stimulatory behavior, okay. And
Jayson Davies
you did talk about doing the SPM earlier, but what other tools are you using? And now I'm going to preface this with, obviously, things are completely different right now. Some tools are very difficult to use right now because we're on teletherapy. So let's go ahead and just imagine that things are back to normal. What evaluation tools do you typically use in your preschool assessments?
Amanda Speights
Well, for my county, we have a structured observation form. It's pretty lengthy and provides a pretty good deal of information. There's some yes, no questions, and there's some some rating of whether or not we think it's functional or emerging or or not present a specific skill. But what if I was looking to add a standardized assessment? I'm really loving the M fund right now,
Jayson Davies
the M fund as well, and I think it's great for the preschool populations, although I actually, when I was using the M fund, I was using it more with the K through two or K through three. It doesn't go up too high. So I didn't do the preschool part of the M Fund, which is a separate test in itself, right? There's the two books, yeah, exactly. So you have the book for preschool and then the book for K up explain what the M fund looks like for the preschoolers.
Amanda Speights
For the preschoolers, it has, you know, the same areas, and it comes with those observation checklists that I like for the classroom and the home. And then it goes through the neurological foundations reporting feature that shows all the different areas that really helps for intervention planning. And whenever I'm writing up my plans of care,
Jayson Davies
uh huh. And what are some of the actual tasks that that it asked the student to do? In them fun,
Amanda Speights
there's some folding tasks, there's some cutting there's like, balancing the ball on the spoon. I think that one's really fun and cool to try. And even some just like jumping and hopping in the gross motor section, yeah. And there's even some really cool, like the snack time game is really appropriate for preschool, because it's just going through having them, you know, try to open a water bottle and pour it out and pouring some crackers onto a napkin and seeing if they can manage it without spilling everywhere.
Jayson Davies
I'm not gonna lie, I always enjoyed the infant just because I got to eat some some goldfish. Yeah, but I. Um, no, I really liked, does the preschool version have, like, the little mazes that the older one does? It's like a little maze.
Amanda Speights
It does, but they're just very simplified, yeah, yeah.
Jayson Davies
And then I remember there was also some visual perceptual activities, like find the dog or find the airplane. I think that one's in there too, yeah, yeah, yes. So it's a very functional evaluation. That's what I really like it, is it? It's very much based on skills that the student is doing in the classroom. And so I really like that. A lot of like you've said, even that snack time, I feel like every time I go into my preschool classroom, they're always in snack time. I don't know why, but they're always eating. I feel like it's either eating or singing, yes, but you mentioned the neurological foundations part of the M fund. Can you explain that? Just a little bit more in detail, the neurological evaluation or foundations part of that,
Amanda Speights
right? So the M fund has three different things. It looks at it looks at. It looks at performance, it looks at participation. And like you said, the neurological foundations and the ones that I'm usually looking at are like the hand function, postural abilities, executive functions are really good ones, because we're looking at sustained attention. That's something that kiddos need to be able to be available for learning, like we talked about, and participation, and then even that non motor visual perception for, you know, scanning to find the dog or the bunny on that page.
Jayson Davies
Yeah. And can you briefly explain, like, how you go from looking at a child's work? How does the infant work? Where it goes from you have, you have the booklet that the child actually completed. They did the maze, they found the dog. How do you go from that over to the neurological foundations? If you can explain that briefly, well,
Amanda Speights
it just tells you that there's some different ways to score it by how many times they may have gone outside the boundaries of the maze, or if they touched a cat when they should have touched the dog, just to tell you that when they were supposed to be looking and scanning for the dog on the page, or even if they're supposed to be copying something, how many errors they made similar to any other test. It's just that the way it interprets it is by giving us an indication that a specific skill might be at risk. Yeah,
Jayson Davies
as I asked that question, I realized how difficult that is to answer, right?
Amanda Speights
It Yeah, it kind of it doesn't translate into a number. It translates it into an interpretation.
Jayson Davies
Yeah, because, as I'm thinking about it, it really you do get a score, or a standardized score, but that goes on the front page, and then you turn the booklet, and then you have this neurological foundations page, right? And it's really based upon kind of the individual score per task, right? Yeah. So if they got a zero, I think, or something or one. Then you go through this chart and you circle task number six, they scored a one on and task number six just happens to fall under the using appropriate pencil grasp or something like that, right,
Amanda Speights
right? Or bilateral integration, or sustained attention, or Yeah,
Jayson Davies
and that's what I really like about that evaluation, because it doesn't just give you a this student's performing at a 3.4 level, three years, four months level, but it actually tells you why they're performing at a 3.4 month level. It's because they scored low on that bilateral coordination specific activity, or they scored low on that fine motor pencil grasp activity or whatnot. And so that's why I find it really helpful. Do you have any other like things that you just really like about the M fund? I
Amanda Speights
think just those forms that I said about that, the observation forms for the classroom and home. Oh yeah. I like getting a good I like getting a good picture of what's going on across settings, because then I can know, is it really the skill, or is it the context? It could be the environment.
Jayson Davies
Yeah. And so you're kind of talking about all those different areas. So I'm going to ask you this question, then, is just paint us a picture of what your evaluation looks like. And I understand, again, things are completely different right now, but let's go based upon back to regular life. How are you What does your evaluation include, and what does it look like?
Amanda Speights
Our evaluations have different domains that we look at. So I know
Jayson Davies
you mentioned the you said that your county has some form of, like a checklist or structured observations that you go through, and then where do you move on? Is that the first thing you do? Or is there something you do before that? Or
Amanda Speights
that's where I start. I start with. I start. With what the county gives me to look at. So, looking at their learning environment, looking at self help skills, fine and visual motor, sensory processing, some, you know, gross motor and school related ADLs
Jayson Davies
and then. So from there, where do you go? After you've got that standardized or not standardized, sorry, that structured observations done. Where do you go from there?
Amanda Speights
Then I would look for an appropriate standardized evaluation. Since, as we talked about, my students can be a little bit more involved and and require a little bit more support, it's it might not always be appropriate to use that standardized test. Okay, so that's why the SPM, or sensory profile is is really good, since a lot of my kids do have sensory needs,
Jayson Davies
yes, and that is something obviously that the adults are able to do so just about any that's one that you can use on almost any student, because it's not actually the student completing it, it's the adult in the life of the of the child. Do you use both the classroom and the home form? Or do you tend to use just the classroom form?
Amanda Speights
I tend to use just the classroom form unless there is really a concern with it being very different. If the parents have reported something different, then I'd want to get more information and use the home form. And then, of course, right now, we can't use the school form exactly. You have to use the home form
Jayson Davies
exactly. Yeah, and I'm right there with you. I usually do the classroom form, but right now, obviously, we can't really do the classroom form, and so I'm only using the home form. So we talked about the SPM, the sensory profile, one of the other usually, and we talked about a little bit, the M fun. Are there other assessment tools that you might use?
Amanda Speights
I have used the VMI sometimes. That's a hard one with the preschoolers. That can be a hard one, but that's if I'm really looking like at a purely visual motor. And that's it like that. That's the only thing that the kiddo is really presenting difficulty with. Then I'll use the BMI.
Jayson Davies
Are you typically just doing the motor aspect of it, or do you also use the visual, visual perceptual part.
Amanda Speights
of it both? Yeah,
Jayson Davies
yeah. Do you do the motor coordination one as well. I think that's the is that the tan one where they have to stay within the lines.
Amanda Speights
Yeah, but those are usually really hard.
Jayson Davies
Agreed, agreed. The only other assessment that I know a lot of OTs that that work in that setting and the preschool setting, use might be as the Peabody. Do you ever use the Peabody?
Amanda Speights
I haven't, actually, I, I don't know. I think I just, I kind of got over the Peabody, and maybe that's why I liked I was really excited about the M fund when I found it, because it seems simple enough, like you said, there's the two books and and the younger book is much simpler than the older book. I actually do notice there's actually a pretty big jump in skills needed to complete, yeah, the older book than the younger book. So if I can definitely catch them when they're within the range for that younger book, it's a really great assessment for me.
Jayson Davies
Yeah, I think I'm gonna have to advocate for our district getting the M fund, because we use the Peabody for the most part for our preschool evaluations. And you know, don't get me wrong, the Peabody is a great tool, and I think they're working on the newest version of it. Don't quote me on that, but it's very much. I mean, yeah, it looks at skills that you need, such as crumbling paper, cutting across a page, staying on a line, but it's hard to administer just the way that it's broken up. I find it difficult to administer, and I don't find it very purposeful for the student. Versus the M fund looks like a coloring book. It looks like this nice, fun activity, and the student is just so much more engaged. I feel like there's more flow to it.
Amanda Speights
It's those isolated motor tasks. Yes, right? That's true too. Yeah, it doesn't make sense. It's like, here, do this, here, do this, here, do this. Like, why?
Jayson Davies
Yeah, why are we cutting a line? Like, versus in the M fun, it might be cut out this line to make a fish or something like that.
Amanda Speights
So folding the folding with the owl, you fold it to make the puppy for the Yeah, the puppy and the owl for the older one.
Jayson Davies
Okay, oh man, yeah, bringing back memories. Okay. So yeah, no, that's why I really, actually, I like the M fun. I mean, it's called functional. I mean, it has the word functional in the actual assessment title. And I really think that it absolutely is functional. So I really do like the M fund. All right, so we talked about the SPM, just review. Recap, real quick, SPM, sensory profile. We didn't really go over. Those too much. I don't think we need to go over those that much. They're both questionnaires that look at sensory perceptions from the adults perception, either or the adults observation, either the teacher or the parent. We talked about the M fund, talked about the Peabody, and touched upon the VMI as well, although at the same time as we were going over this, it sounded like you may not always use standardized assessments. Is that true? That's
Amanda Speights
true. All right, I don't have to use a standardized assessment, but it's, it's just my preference, at times, to get more information and just justify, you know, the need for services. I think it's really helpful.
Jayson Davies
Yeah, I agree. I mean, I don't know. I feel like there's almost like this split between occupational therapists. There's like, you have the 50% of occupational therapist, I don't know. I'm just making out numbers here. But you have OTs who feel like, yes, every assessment needs a standardized evaluation. And then you have the other subset of OTs who say, No, functional assessments are good. We don't need standardized evaluations. And I'm not here to argue one way or the other. But what would you say like during your evaluation process? What kind of goes through your head as to whether or not you feel like you need that standardized assessment? Right?
Amanda Speights
If there's a question on the team, if maybe, you know, the evaluation was was requested by a specific team member, and maybe other members on the team are not so sure. I think the evaluation helped. Those standardized evaluations help to give a better picture of, oh, actually, they are performing more on level than we thought, or because I think that there's, there's just an increase in expectations, even at the preschool level. It's just, I don't know if there, there's an expectation that they should be writing sentences or something by the time they're in preschool, but it's a little much at times, so I think that it backs me up as an OT to have my standardized assessment Absolutely.
Jayson Davies
And I think that is, I don't think it's a conscious decision that we make, but you're right. It helps. And I think when you've had that standardized evaluation, and you walk in and you have that data, then numbers sometimes speak louder than several paragraphs of narrative or a chart that says a student can do this or can't do that. I think that that number that says your student is in the average range, or your student is not in the average range, it just is easy to comprehend for people that may not be able to have the same lens that we have, right? And I think it's easier for others to understand the numbers or average, not average. So yeah, all right, I want to wrap up evaluations here. We talked about structured observations. We talked about standardized assessments. Is there anything else that you're doing? I'm sure you're doing interviews and whatnot. But after you wrap up your standardized assessments, is there anything else you really do, or you're writing up the report, obviously, right, right?
Amanda Speights
And then we're inserting that report into the IEP, usually under one of the four domains of our IEP,
Jayson Davies
under one of the four domains explain that, right?
Amanda Speights
So our IEP formats are curriculum and instruction, social, emotional and behavior, independent functioning and communication and oftentimes, ot will be found under that independent functioning section.
Jayson Davies
Gotcha, okay, independent functioning, that's a good place to for it to be, of course. All right, so that's interesting. I don't think every I don't think every IEP is laid out like that, and so that's interesting to see how exactly yours is set up. Okay, so then let's talk about, after you got this evaluation, you think that a student qualifies, what are some of the most common types of goals that you're writing you talked earlier about play. What type of goals are you writing for these students in preschool?
Amanda Speights
A lot of times we're we're trying to help them access their school environment. So it could be goals for self help skills and being able to be more independent with a functional routine, like arrival routines, or even the bathroom or the hand washing routines. I'll be writing goals, or being tagged on goals, because we try to really make it a collaborative thing that I've really been working on that like not going in and not writing the goal like really having my teacher tell me, okay, what is it that you need your student to do in order to participate in class? And I'm going to help you shape it into a goal that makes sense for you to take data on, because ultimately they're going to be taking the most data on that goal. And it needs to make sense for them.
Jayson Davies
Absolutely. I really like that you brought that up that was actually going to be my next question is whether or not you're writing ot specific goals or more collaborative type of goals. And I think that is so important to be writing collaborative goals, because almost like what we were talking about with the Peabody versus the M fund. Does it really matter if we can hand a student a piece of paper and, say, cut this paper across the line, or does it matter when we can give them a picture to cut out and they're actually able to cut out that picture and then paste it and color it? I mean, that's what we're really looking for, right? That functional skills. And we don't want to have just an isolated skill per se, we want them functioning in the classroom. So how does that work? Then, when you say, You know what, we need a collaborative goal, how do you go about that communication process to make it happen?
Amanda Speights
Luckily, I've had a lot of success. I'm not going to not going to lie. I've had a lot of success in this area, my teachers are really great, and they're really, really open to learning, and they really want to learn, to write better goals and to serve their students better. I think it's probably that being on that university campus, a lot of our staff might be students themselves. Maybe they're they're thinking about going into ot school or going to school to be a speech therapist or behavior analyst. Gotcha. So they are definitely very motivated to do that. And we'll just sit down and talk about, okay, well, what? What is the student doing for you in the classroom? What are they able to perform and demonstrate for me in an assessment or in an OT session? And how can we get those to match up? Yeah, absolutely.
Jayson Davies
All right. And so once we have our goals, then we OT, we obviously have to start with our services. And so we'll get into maybe a few of the specifics about types of services that you provide. But first, just give us an overview of what services you might put on an IEP and or provide for a preschool student.
Amanda Speights
It would just on the IEP, it would look probably similar to any other IEP where it just it says occupational therapy, you know, a certain number of minutes, one to two times per week.
Jayson Davies
Do you have to break it down to say whether or not those services will be individual or group?
Amanda Speights
Usually, I think we're able to indicate that on our plan of care if it will be individual group or a combination of both. Typically, I choose a combination of both because I provide push in and pull out services depending on the student's needs.
Jayson Davies
Yeah, and that's great. I only ask because, again, IEPs are different in every single state. Every single district does it slightly different, especially County and I know some districts, some states, they don't want you to put individual or group. They want you to put one of the other. And if you want to do individual and group, then you need to have two different services, one to say individual, one to say group. And so that's why I asked, just because it is different depending on where you are. So yeah, I know it's, it's something that I've learned specifically only because of this podcast and talking to OTs in areas across the world there. I mean, yeah, everyone does it a little bit different. So you do both individual and and groups. When you're doing groups, are these pull out groups or, well, again, trying to get away from this zoom idea right now, typically, if you're doing an individual, are you going into the classroom or pull out? And same thing with groups. Are you doing like centers in the classroom, whole groups in the classroom, or are you pulling a few students out?
Amanda Speights
I'm usually doing centers in the classroom, or I'm going on the playground. I'm pushing into gym class or music wherever I can figure out that I can get in there and work on one of those goals that I'm attached to?
Jayson Davies
Yeah, definitely. And so I want to challenge you just a little bit here is what planning goes into making that actually work. Because I know, and I think most OTs know, if you work in a school, you can't just pop into a classroom and things are just going to go great. It takes a little bit of planning. So
Amanda Speights
how does take it? Does take a lot of planning. Well, yeah, I have to coordinate with the teacher to see if, if, if we're going to co teach, or if I'm just going to be, I'm just going to be the support, you know, while she's teaching, and I'm just going to be, you know, trying to keep everybody in the area and trying to keep everybody on task. Or am I going to be teaching and the staff is going to be keeping everybody on task? Yeah, and so, and then helping to design the activity, especially for gym, oh, for Jim,
Jayson Davies
you go, you get some sensory. I love Jim. I love I don't know if you guys have a PE teachers. We have adaptive physical education teachers. They are my best friend. I've worked
Amanda Speights
with some great ones in the past, but we don't currently have them, so it's almost like we're it. Yeah,
Jayson Davies
no, I love it, because they do so much bilateral coordination, and they don't even know it. They do so much sensory stuff, as far as, like, motor planning and whatnot, and they don't even necessarily know it until we tell them, like, everything you're doing is sensory integration in a way, like they're doing so much crossing midline, using both sides of their body. It's just amazing how much work that they do that isn't just going to help the students physical activity, but also going to help them in the classroom. So I really, I really appreciate AP teachers, but that's cool. You get to do some of that a little bit. Then during gym, yeah, I get to do a little bit. And so when you're planning for centers, do you come in with your own activity? Do you just try and figure out what the theme of the week is? Are you taking a teacher's activity and modifying it? And how do you typically do your centers? Our
Amanda Speights
school is fairly structured, and I think that that's just the nature of our program. Because of the nature of, you know, the students that we serve. A lot of things are very structured. So we actually have a full calendar of what's the letter of the week? What's the core Word of the Week? Like it's planned out and our teachers, the OTs, direct the Handwriting Without Tears program. So that's one of the trainings that we provide to teachers, is on pre writing activities and incorporating Handwriting Without Tears, and they just follow a schedule that we give them for the whole year where they start with big line, then little line, and they might even repeat a couple throughout the but they follow a certain sequence that we've given them. Wait,
Jayson Davies
you said that We given them, yeah? Like they're following your guidelines for using the handwriting without tears, curriculum, yes, oh my gosh, that's amazing. I love that. I love that. And, you know, I think I want to pause, I want to talk about that, because that is not something that happens overnight, that is not something that's something that
Amanda Speights
has been built into the program, and it's, and that's why we're a model program, is that we try to show that okay, this is how it can be done, or how we how we would like it to be done, so in a way that we think is evidence based and effective.
Jayson Davies
Yeah, so you've been at the How long have you been with the current
Amanda Speights
program? Yeah, like four years, six months. Yeah, almost five years has,
Jayson Davies
has the Handwriting Without Tears program been there since you got there? Yes, okay, so you didn't go through the whole process of it being implemented. Have you by chance, like, just heard any stories about, like, how Handwriting Without Tears got implemented? Or was it in there from day one that you know of or you're unsure.
Amanda Speights
I'm unsure if it was in there from day one, but I know it has been in the program for quite some time. There's an OT that that's been with the program for 10 years, and she said that it's been there, always been there. It's always been there. Okay,
Jayson Davies
I just wonder, because, like I said, that's not something that happens overnight, and it's, I think it's difficult sometimes for OTs to implement some things like that. There's so many different barriers in place, whether it's because you're at a school for two years and then your district decides to move you to another school site, and you just don't have the time to build that rapport with teachers or whatnot, or the cost,
Amanda Speights
yeah, or the cost, because we end up being so. Part of us administering and directing this program is we have to manage the materials. We have to make sure. We have to go into the classroom and make sure that all the big lines and little lines and all the materials are there. We need to take inventory if, if something's missing, we need to report that to administration to be purchased. We need to wait to see what the budget looks like, to see if we can purchase it. So it does take quite a bit of coordination, and
Jayson Davies
not to mention just time in general, because a lot of districts are still working on this. I just the word coming to my head is arcade, archaic, like this old prehistoric version of a caseload where they just wanted to see students individually from 830 to 330 and that doesn't give you time to do something like this. You don't have the time to put a plan together. You don't have time to put an order together. You don't have time to get into a classroom without the purpose to work specifically with one student, and that is something that needs to be built into our time, right?
Amanda Speights
It's that workload approach that has been talked about so much. Yeah, yeah.
Jayson Davies
We're gonna have to talk more about workload in the future. There's a lot of there's actually a new article that just came out, and so I'll probably have to talk a little. Bit more about that in the future. All right, so I was actually going to ask you if you do trainings or in services, but you kind of already alluded to that, that you do, so share with us maybe just some of the in services you you provided and who you're providing those to.
Amanda Speights
Yes. So as I mentioned, we provided training on pre writing, including the use of Handwriting Without Tears. We talk about school related ADLs, and when we discuss sensory processing, we actually had teachers complete adult sensory profiles to kind of reinforce that the sensory differences are part of human experience. So that was really cool. I try to get I've been trying to get more creative in my trainings and use some different ways to help the information be relatable to the audience, because it can kind of come off as a bunch of OT jargon, right? And they think it's just ot magic like and that's why I think sometimes we might have some resistance on completing those evaluations or making sure that a child gets ot services. It's because it's still so mystical and magical to some people. What we do? Yes,
Jayson Davies
we're just gonna come in and that student is now just gonna sit for 10 minutes without Right? Any any supports. You know that students just gonna
Amanda Speights
be great, right? And that's probably what contributes to the insane caseloads. If we got it across to districts and teachers, that some of this stuff can be done by teachers, and it's just with our support, with our consultation with us as a coach, instead of us needing to be in the classroom every week for 30 minutes or 60 minutes, yeah, yeah.
Jayson Davies
And I think that is something that, you know, we provide a lot of in services to to teachers. But I think the other aspect is also in services, you know, we need to make sure that we invite our administrators and make sure that they're there as well. Have try and just invite them and hopefully they'll show up. Because I think they, while teachers may not completely understand OT, I don't think all the administrators do either. In fact, I've had an administrator tell me that OT is the hardest part of their job to, like, manage, because they don't truly understand OT. And I'm like, well, please just come talk to me about it. Like, come to my in services, like, I'm willing to let you know, and I'm willing to help you out understanding OT. So I think, I
Amanda Speights
think a ot a has some resources on that. On, yeah, on the website, there is, like, some
Jayson Davies
kind of manage OTs or something like that. Yeah,
Amanda Speights
there's an info sheet for school administrators. So maybe, like printing that out and flipping it in their mailbox or printing it out and when the next time you meet with them, when they do come to talk to you about it, you could just give that to them as a reminder to reference I just
Jayson Davies
got the idea of creating, like an anonymous email and just sending it to them from an anonymous email. Anyways, all right, so anything else about in services, or do you ever provide trainings for parents? Or is it primarily for employees? Yes,
Amanda Speights
actually, and we did through this whole kind of pandemic and the zoom, we were able to set up something for the parents in the spring as a service, we were providing support group for parents. Oh, wow, the OTs. We did a couple of in services on, I think we went over fine motor sensory sleep. Sleep was one that I was really interested in, and I thought that was really relevant for the time. So I got with one of the professors from the academic department and got some resources together, and we talked about sleep for one of our support groups.
Jayson Davies
That's really cool. I just want to highlight that aspect of your job, because you're working for a university, the aspect that you can kind of collaborate, not just with people who work in clinical practice, but also the academia side of it, and being able to work with them, that's really cool. I like that, all right. So let's finish up here. I want to talk about one last thing, and that is that transition from preschool to kindergarten. And I want to first ask you about where, what? What are the teachers expectations for preschoolers, or what is society's expectations you feel like for preschoolers? Where do preschoolers need to be when they're transitioning?
Amanda Speights
I think they're expecting them to be able to sit and attend for 20 minutes. That's a long time. It's long time. I don't I don't know if I always agree. I'm a fan of dynamic seating. I'm a fan of movement, infusing movement into the classroom and more interactive lessons. Instead of sitting down, as a society, we probably sit too much. Much. I think I've been sitting quite a bit now. I've been working from home, and I don't know why we're in a in a rush to make our kids sit down, like, let's keep them active for as long as we can. Yeah, no
Jayson Davies
joke. And then so let's just go over two areas. You mentioned earlier that the three main areas of referral were that self regulation, being able to kind of attend activities. And then you also mentioned writing and cutting. And so let's just cover writing and cutting real quick. Where do you think your preschool teachers or kindergarten teachers, as they're coming into kindergarten, are expecting these students to be at with writing.
Amanda Speights
They're expecting? I know, I know, by the end of kindergarten, they're wanting at least a sentence to be written. Wow. So going into coming out of preschool, they're wanting at least that name. They're wanting the kid to be but what if you have a really long last name? Really challenging. for kids, those poor kids, so and then with cutting, I think they're wanting them to cut out shapes, or they're wanting them to be able to cut, to do craft, so to be cutting out multiple, you know, irregular shapes. But that that might not be realistic, especially sometimes they're just handing them those thin floppy pieces of paper, right? And it's huge, the huge, thin floppy paper. And I'm like, oh my goodness, the largest
Jayson Davies
piece of construction paper they can find. Yeah, yeah, I get it. All right. So that's kind of the three areas. I think you're right about that. All right. So last thing, how does the transition work? For you guys, when a student is ready to go from preschool to kindergarten.
Amanda Speights
We're not required to evaluate, even though some students may be going through that process of, yeah, they might need an evaluation if they came in as developmental delay, right? And they're they're nearing that time where they're needing to kind of figure out a different eligibility, right, once that's more appropriate or more specific to what's actually going on. So school psych might be called in to do that, and sometimes, on a case by case basis, I've been asked just at the request of the parents for the purpose of educational planning. Maybe they really want, they really want those numbers, like we talked about earlier, that they just it's easier for them to understand the numbers sometimes. And if, and if it's such a hard time for parents, I feel like so it's a big transition, they're already just very nervous and and why not go ahead and and help them out, if we can. Yeah.
Jayson Davies
And so you mentioned earlier that this is like a model preschool program. When the kids are transitioning into kindergarten, are they going to a whole new school, or does the program that you're in also have that kindergarten program.
Amanda Speights
They are going to a whole new school? So yeah. So then there really can run high,
Jayson Davies
okay? And so that makes it difficult for you guys to even collaborate with maybe the kindergarten OT or the kindergarten teachers, because it's a whole new system,
Amanda Speights
right? We usually write some transition summaries, and we're responsible for letting the county know any equipment. So if we have any equipment on our plan of care, anything that we've recommended, anything that we've been using with the child, we're responsible for communicating that to the county so that they know to order that. And usually we've been told that it works out that they usually do have the items ready if we put it in because it's, it's at the end of the school year. Yeah, so they've had, they usually have the whole summer to get everything together. Hey, you
Jayson Davies
know, some districts are on it. Others not so much. So that's good to hear that the district is on it. Good to know. So, Alrighty, well, I think that's gonna wrap up today. Do you have any contact information or any if someone wants to reach out to you, or would you like to share your email or any information? Sure
Amanda Speights
you can actually find me at Amanda the OT com, and that's probably where you could find all the different links to like my LinkedIn and all of that good stuff. If you want to contact me and or email me something
Jayson Davies
great, Amanda the OT. And that is Amanda Speights, right? Did I say that last name correctly? You did awesome. Amanda spades, and she is at Amanda the ot.com check it out. And yeah, if you do have any questions for her, I'm sure there is a contact page over there or whatnot. So thank you so much, Amanda for coming on the show. Really appreciate you being here, and thank you for talking preschool with us. Great. Thank you for having me. Thank you so much. Bye bye, bye bye. All right. Well, that's gonna wrap up episode 58 again. A huge thank you to Amanda for coming on the show. From Amanda the ot.com I really appreciated what. Was talking about, as far as the evaluations go, and then how they just have this area where occupational therapy just fits right in one of those four areas that focuses on independence within the IEP. Super cool. I like how that just turns into having collaborative goals and then collaborative services. One last thing before I let you go, remember Check out my instagram at ot school house on Instagram for some fun content, some reels, some other posts and some treatment ideas. All right, until next time, my name is Jayson Davies. I will see you later. 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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