Top Tips For New School-Based OTs From the OT School House Community

The world of school-based occupational therapy is unique and different than any other setting. We are medical professionals in a world of education. You could say that we are “the odd man out”. As occupational therapists, we are educated to support a medical model. However, when we cross over to school-based therapy, our framework and foundation must shift to an education model. Because of this, I feel like school-based OTs spend an insane amount of time educating parents, faculty, and staff about our role in the school system.

Since we are initially trained in the medical model, if a therapist is just starting in the school system as a brand new graduate, or if an OT practitioner is transitioning into the schools after 20 years in inpatient rehab, the simple idea of starting in a school-based model can be daunting and terrifying all at the same time. So, when Jayson prompted the community to share a tip for new practitioners on Instagram, there were almost a hundred helpful comments from experienced school-based OT practitioners. Clearly, therapists are more than willing to give advice, especially related to areas and situations where they wish someone would have told them how to (you can fill in the blank).

As we dove into the comments more, several themes surfaced and we wanted to take some time to share and expand on these words of wisdom.

Tip #1: Build relationships with everyone on campus

  • “Make friends with the custodian! You never know when you’ll need to borrow tools/hardware or have them rig something up for you!” @Theeverydayot (Sarah)​

  • “In addition to making friends with the building secretaries and janitor, befriend the gym teacher…Also, don’t forget to provide support to the ‘specials’ teachers (art, gym, music, and computer). These teachers a lot of time get little support and aren’t quite sure how to meet students’ needs. Art and gym are often great classes to push in to for OTs.” - @Raejean84 (Raejean)

Each school you walk into is a family. Each member has its role and place, and no one wants to be left out. In all the years I have been in the schools, I cannot count the number of times I have borrowed the janitor’s hammer to “fix-up” a student’s locker to increase accessibility, or the number of adapted scissors (usually the loop scissors) I have given to art teachers for our students in special education classrooms to use while in their classroom. These are all things that can help build relationships within each of your campuses. No one is too great or too small to be involved. When you ask for that hammer, be genuine while you ask how their day is going. Take a second to see what the cafeteria monitor’s favorite TV show is. When you take the time to build these relationships across the entire campus, you can bet that they are going to reciprocate that relationship and take an interest in you.

Tip #2: Take time to build rapport

  • “Always start with building rapport with your clients, you’ll be able to more effectively meet your goals once your students have a solid trust in you and your relationship!” - @Kidscopinglab (Dr. Meryl & Shae)

The phrase “It takes a village to raise a child” can definitely apply here. Taking some time to build rapport with each of those individuals can help bring the entire team together. It can be simple things, like asking about their day, or offering to check supplies of adapted paper so they never run out. It could mean taking some time to sit in on the IEP meeting they told you about last minute, or adapting and integrating parent strategies into the classroom setting. Once you take this time to build rapport with the team, it becomes easier for them to help you as well if you get into a difficult situation.

Tip #3: Do not be afraid to ask questions

  • “Ask questions! Ask where the bathroom/gym/nurse’s office is rather than wandering around until you find it…Ask for help, Ask what people mean by acronyms- you get smarter and better at your job when you ask clarifying questions than when you pretend to know what people are talking about” @Michellemarie5 (Michelle)

This is where the previous rapport building and building relationships can come in handy. If you have taken the time to build rapport and relationships on your campuses, they are going to be more likely to help you. It can be embarrassing to ask simple questions about the location of the bathroom or where room 204 is. If you take time to build relationships, the teachers and staff are going to be more than willing to help you. They know you care.

Tip #4: Reach out for training and in turn, train others

  • “Do a lot of training. Train those teachers, push in, and present, present, present. You have too many kids to see all alone so instill help in the staff. Collaborate constantly.” - @Kidsviewtherapy (Theresa)

  • “Collaborate and create alliances with your case carriers and specialized academic instruction teachers, They will be your eyes and ears for your students everyday even if you physically can’t be on the school campus.” @Mamawells329 (Christine)

  • “Push in to the classroom, let the teachers see you working with the students. It will help create rapport with the teachers and buy-in for interventions you want to implement. Also makes sure what you might be working on in a pull out session transfer into their everyday environment” @Ashmenzies (Ashley)

Take a second to think back to your entry-level OT curriculum. What was one of the tools your professors or instructors would use to help teach concepts? Teaching others! Once you have received some training or some correction, take the time to turn around and apply it. This could be through training a teacher on a strategy you are using with a student or discussing a new strategy with a coworker or colleague. This can also help you build collaborative teams and alliances within your different campuses. If you have access to other OTs, maybe see if they can come and observe you or sit with you through your first IEP meeting. They can help you point out things about yourself that you may not pick up on. It could be little things like “your posture appeared very closed and uninviting” to “when you are talking with the parent, a different way to phrase that would be…”. Do not look at it as a colleague trying to pick apart everything little thing you do, but as an opportunity to grow and learn as a therapist.


Listen to Episode 45 of the OT School House Podcast for even more tips!


Tip #5: Find your own organization strategy so you can be flexible

  • “1. Using electronic documentation as much as possible and find some sort of way to keep track of IEP dates. 2. Try to avoid bouncing back and forth between schools.” - @Yoursch00lot (Amanda)

  • “I recommend making yourself a checklist of all the things that need to be completed before/after IEPs (data collection, teacher consult, scoring goals, drafting goals, documentation, etc.).” - @Sarahbeeot (Sarah)