There is often confusion or lack of clarity as to the difference between school-based and community-based occupational and physical therapy services. Parents, administrators, physicians, school personnel, and even therapists may benefit from clarification of these two different roles. Knowledge of the responsibilities of therapists in each setting can help guide decision making, help determine what therapies are needed in which setting, and help determine how to effectively meet the unique needs of the student.
Occupational therapy & physical therapy in the school setting are considered a related service and are required to assist a child with a disability to benefit from special education. Practice in this area is governed by state and federal laws (i.e. IDEA 04, Section 504). In order for a student to be eligible for services in the public school setting there must be the presence of an eligible disability, and this disability must interfere with the student’s participation in school activities relative to other students in the same environment, situation, and curriculum. School-based therapists focus on removing barriers from students’ ability to learn, helping students develop skills which increase their independence in the school environment, and educating school personnel about the different considerations required for students with disabilities. Everything the therapist does with students in the school must be educationally relevant
Several agencies and organizations in the state of Wisconsin have collaborated in development of a pamphlet which helps to explain the differences between the provision of OT and PT in the school setting and the community setting and how each offers unique services for children. This document can be found at the Wisconsin Department of Public Instruction site by following the links to page 1 and page 2 of the School-Based and Community Based Therapy Services-Brochure. It is well worth reviewing.
Are you looking for current curriculum based data on handwriting? Check out AIMSWeb® Growth Table for Total Words Written. This source provides multi-year aggregate data with norms for grades 1 through 8 at fall, winter, and spring assessment periods. Students are asked to write spontaneously for 3 minutes. The student’s score is determined by the total number of words written within the 3 minute time frame. A “word” is considered any letter or group of letters separated by a space even if the word is misspelled or is a nonsense word.
This may serve as an appropriate curriculum based measure for assessing a student’s handwriting speed without compounding factors such as spelling, grammar, punctuation, capitalization, or content. The data does not, however, examine legibility factors such as alignment, letter formation, letter size and proportion, or slant which should be considered if legibility is an area of specific concern. This measure does not differentiate between cursive and manuscript writing styles, but certainly can provide information regarding basic student handwriting performance in relation to nationally normed grade level expectations.
While following a trail of blog links I came across an article posted on the AOTA website entitled “Everything You Should Know About Ergonomics and Youths, But Were Afraid to Ask“. Most of us think of ergonomics as an area addressing injury prevention in the workplace; “designing the work environment or conditions to prevent injury and promote health, safety, productivity, and comfort”. Typically, we think of this area as pertaining to adults and fail to consider the implications with respect to students and the work (occupation) of youths. The authors present compelling statistics relating to several challenge or potential problem areas as well as tips to prevent potential injury in our youth.
The challenge areas include:
- backpacks
- school workspace
- handwriting
- school computer workstation
- homework space
- home computer workstation
- laptop computers
- video games and television
- fitness
- sports and performing arts
Who would have ever thought there were so many areas of potential hazard in the lives of our nation’s youth and so many ways in which we can attempt to eliminate or minimize the impact of these potential problems? This article is well worth the read and worthy of consideration for sharing with school personnel and parents. Happy trails!
After several hours spent searching for other blogs written by OT’s or about occupational therapy I had given up all hope of finding anything remotely related. I thought that my goal of finding something out there addressing school-based OT practice was truly a lost cause. I then, coincidentally, read an article in the January 2007 edition of OT Practice magazine entitled “Surfing or Searching the Internet” by Mary Binderman and Mindy Hecker. They report running a simple Google search using the words autism and association which yielded 6,660,000 hits! They validate the excitement, challenge, and potential exhaustion inherent in surfing and searching the web for specific information and offer strategies including the use of fee-based databases. That didn’t help with my personal blog search, but it did validate my frustration. They close by recommending that “sometimes you just have to ‘jump in’ with both feet and enjoy the ride”. The problem is, sometimes I just don’t have the time to go for a ride.
This brings me back to my mission. I eventually gave up on my directed search efforts and decided to spend some time simply enjoying reading blogs that my school colleagues have written as part of a blogging workshop we’re taking. BINGO! There it was, hidden in plain sight…exactly what I was looking for! I discovered a link to Thriving in School, a fabulous blog written by OT’s at the Hosmer School in Watertown, MA. What this has taught me is that by following sources of particular interest, the digital “word of mouth”, you will likely discover what you were hoping to find all along. Thanks, coffeetalk!
While reading through the August 2006 issue of “S.I.Focus” magazine I happened across a fascinating column written by an 18 year old young man who lives in the Chicago area. He has high-functioning autism and writes in response to questions posed to him by readers. This particular question related to his experiences with sensory processing and whether any difficulties resolved on their own, with therapy, or whether they still persist.
He responds by touching upon five sensory channels that were problematic for him. His descriptions of his unique sensory challenges and the coping strategies that were effective for him are fascinating and so powerful:
~breathing through the mouth or holding his breath to avoid smelling noxious odors
~feeling “electrocuted” by sudden, sharp noises likd fire alarms or dogs barking. Advance knowledge and time to prepare for the event helped, but even with auditory integration therapy this sense is the one that has not steadily improved.
~taste issues went away over time, but his mother presented new foods one at a time for at least two weeks so that the new food became more familiar and “not so terrifying”. He also shares that he has an allergy to gluten and experiences severe headaches, chills, sore throat or fever if he eats food containing gluten.
~visually he used to be bothered by flashbulbs, but doesn’t experience that any longer. Interestingly, he shares that sight problem occurred the most when he was eating. Certain foods just looked bad and just the sight of them could trigger a gag. His mother put several cereal boxes around his place at the table so he wouldn’t have to see anyone else’s food.
~tactile sensitivities caused problems with haircuts and dressing. An electric razor was less painful than scissors which made him feel as though his hair was being pulled. Certain fabrics felt scratchy and the feel of air on his legs and arms was so annoying that he never wears shorts and rarely wears short sleeved shirts even in the heat of the summer.
James continues to describe how exposure to the irritating stimulus does not help the problem…..and that exposing a sensitive child to a noxious stimulus more often than necessary is like “unnecessary torture” causing more anxiety and fear of the stimulus than before. He does, however, mention that exceptions to this would be situations such as A.I.T. or if the child intiates and controls the stimulus. He briefly touches on the idea that self-stimulatory behaviors, like flicking lights on and off, are things that autistic kids like to do because they are trying to stimulate their eyes.
We have such limited opportunities to know how each of our student’s with autism experience their world. James’s unique perspective should help us all to honor individual differences in sensory processing and do what we can to help make their world a safer place to be.
James Williams can be contacted with questions at: AskJames@SIfocus.com
Personally, I can’t wait to read more of his work! Thanks James
Hello to everyone in the blogosphere! I’ve finally mustered the courage to take my first step into this new arena. My hope is that this format will provide the opportunity to share thoughts related to the practice of school based Occupational Therapy with colleagues and any other interested individual. I have a lot to learn about how to optimize this space, but I suppose that the first step is just a short journey in the right direction.
A few resources that I have found really helpful:
www.otexchange.com is a wonderful website that allows therapists to exchange ideas and provides a resource for other professionals and parents who support children with special needs. Features include free membership, downloadable documents, message boards and a chat room, links, and pertinent news postings.
For those of you out there who are particularly interested in sensory processing disorders, you can find some great information at http://www.spdnetwork.org/aboutspd/defining.html
That’s all for now, but more to come!
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