mOTivated: the school-based OT

“School-based occupational therapy practitioners support academic achievement and social participation by promoting occupation within all school routines, including recess, classroom, and cafeteria time. They help children fulfill their role as students and prepare them for college, career, and community integration. They utilize prevention, promotion, and intervention strategies for mental and physical health and well-being. “

-AOTA

In my previous post OT: the art and science therapy,

we learned that   o c c u p a t i o n s   are used by occupational therapists as a therapeutic means to enhance quality of life, improve occupational participation, and promote physical and mental well-being. Well this same concept is utilized by school-based OTs with a primary focus on academics, social participation, leisure and play, as well as transitioning to work skills. In this setting, an occupational therapist may use her (or his) expertise to reduce barriers to participation within the classroom through environmental analysis and modifications among many other things.

  • Related service professionals—> occupational therapists are apart of a team of specialized instructional support personnel that are under Individuals with Disabilities Education Act (IDEA) as well as Section 504 of the Rehabilitation Act of 1973
  • It takes a village—> OT doesn’t work unless the parents, teachers, and other school staff are on board. It takes a team to promote occupational participation in these kiddo in order to support the child’s academic and behavioral needs as well as their functional performance

When it comes down to it, occupational therapy is anywhere and everywhere. Regardless of setting, OT helps

shanclients of all abilities and backgrounds to participate in their most meaningful occupations that are necessary or apart of their daily life routine.

 

Picture this.

In an ideal world, school-based OT would always occur inside the classroom with peer supports.

Imagine having two groups of six children at a table-a teacher at one table; the OT at the other table. Four of the children at the table with the OT have some type of developmental delay, high tone, and maybe just take a little more time to grasp academic concepts; these children qualify for OT services. Instead of removing the four children from the classroom, the eight other children participate in the intervention (with their four classmates) and become peer models. The OT may teach the teacher certain strategies to inhibit tone and increase the children’s attention span. To most people, the games or objectives of the intervention session may look like playtime… but in actuality the skilled occupational therapy practitioner  will use these “games” or activities to address a student’s physical, cognitive, social, emotional and sensory aspects of performance. 

***note: Don’t be a rude OT and pretend like you know the students better than the teacher who is with them all week. Teachers are invaluable to the success of the child; without them there would not be OT services provided in this setting. Thus, collaboration is key to benefit the student’s needs.***

However, sometimes it is necessary for the OT to pull the child out of the classroom environment to a smaller room. For instance, if the child has poor body awareness or is easily distracted by his classmates or by the classroom itself (yes, teachers are very creative and spend their money and time on classroom décor…. but for some kiddos, it is overstimulating!!) then the OT may arrange with the teacher a time for that student to receive therapy in a different environment…in addition to perhaps respectfully educating the teacher on why for some kids a crazy, beautiful, sparkly, multitextured room may spark some behavioral issues…

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Now before we dive deeper into school-based OT, I want to share a fine motor craft that another classmate and I created for our fieldwork Level 1 site (just think of this like a clinical rotation) at an all special needs school.

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The finished product

 

 

For this group session, six children of various cognitive and physical abilities and diagnoses sat at a rectangular table. As our warm up activity, we went around in a circle and introduced ourselves and said our favorite color. While this may seem very simple to you, for some of these children it is difficult due to oral motor impairments or recall limitations to recite their name and a color of their choice.

After the introductions, we showed an example of the final product. Each child received one paper rainbow and if cognitively capable chose the first color (red) out of the crayon box. For some children, it was necessary to limit the color choice down to two or three colors in order to help eliminate some of the wrong colors. This process was repeated until the rainbow was fully colored to the best of each individual student’s ability.

If strength and the ability to apply just enough force was not an issue than the kiddos were asked to break their fruit loops into halves. Each fruit loop half was matched to the colored rainbow stripe and glued piece by piece.

This activity was very challenging for some of the students due to their difficulty to attend to the task, low tone or high tone, grasp requirements, and more…

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Palmar Supinate Grasp-appropriate for 1-2 year olds

 

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Dynamic Tripod Pencil Grasp-mature prehension grasp pattern

 

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Pincer Grasp
  • Supplies needed for this craft include: rainbow stencils, crayons, fruit loops, and glue

  • Rationale: work on dynamic tripod grasp, pincer grip, color recognition, improve manual dexterity, in-hand manipulation, pressure modulation, visual perception, visual discrimination, and ability to follow directions

  • Grade down: to make this process easier set out only one item at a time until each step is completed, give verbal and tactile cues as needed

 

 

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Back to why OT in schools is fundamental and needed…

Occupational therapists in the school-based setting are pretty awesome and unique in the therapy world. According to the American Occupational Therapy Association (AOTA), some of the things an OT who works in schools may do in hopes to support participation includes the following:

  • Adapting activities and environments
    • Ex: modify playground equipment so that it is accessible for kiddos of all abilities; recommend that elementary students sit in weekly lunch groups to facilitate social interaction and communication
  • Collaborating with school staff
    • Ex: advocate for recess-kids need recess for their physical and mental health; teach Handwriting Without Tears
  • Increasing independence in daily living skills
    • Ex: promote organizational skills; address self care needs such as toileting or dressing-changing into gym attire
  • Supporting transition
    • Ex: kids aren’t kids forever-OTs help them transition to employment or assist them in community integration
  • Recommending assistive technology
    • Ex: recommending specific pencil grips to improve a child’s handwriting; recommending computer software specific to meet the child’s participation skills
  • Promoting positive behavior
    • Ex: this one is pretty simple-your child is more inclined to do well in school if he or she feels confident in his or her abilities; facilitate a positive learning environment to increase positive interactions
  • Supporting school mental health
    • Ex: initiate anti-bullying seminars; provide education to school staff on coping and calming strategies
  • Increasing attention
    • Ex: educate teacher on alerting activities for low tone children; recommend motor breaks
  • Addressing sensory, cognitive, motor needs
    • Ex: I don’t even know how to begin attempting to explain this one

 

Wait, I can’t afford occupational therapy services for my child.

Good news, occupational therapy is provided for freeeeeeeee in the school setting when determined educationally necessary. In public schools, federal, state, and local funding are used to cover the cost of skilled therapy intervention. There is this document called an individualized education program (IEP) for each student; the IEP team is the group that decides if a child qualifies for OT services.

As required by the Individuals with Disabilities Education Act (IDEA), parents can view their child’s performances and progress rate of their IEP goals which includes the occupational therapist’s goals for the child.

There is so much to learn about OT and I hope this post broadens your horizons on just one of the many settings you can find the art and science therapists!!

stay mOTivated,

SHANNEN M.