MAKING A BIG IMPACT THROUGH

COLLABORATIONDenise O. Alford OTR, MS

Lynn Wilde COTA

Learning Objectives■ The learner will understand the role of occupational therapy within the

school setting and be able to identify the differences between school-

based and medical models of occupational therapy.

■ The learner will understand the relationship between COTA and OTR in

the school setting.

■ The learner will understand the importance of collaboration with

teachers and para professionals to make a difference in the student’s

ability to participate in their curriculum.

■ The learner will be able to identify examples of ways that occupational

therapists support the staff and student to improve the student’s school

performance.

Medical Based OT

■ Requires doctor’s orders/prescription

■ Clients seen in facility

■ Reimbursement/insurance driven

■ Services paid for insurance or individual

■ Evaluations completed on insurance’s time line

■ Goals vary in duration

■ OT can be a stand alone service and have own goals

■ Direct service provided to the patient

School Based OT

■ OT typically provides services through Individuals with Disabilities

Education Act (IDEA) and special education

■ OT is a related service based on educational need

■ IEP team determines if OT testing is needed

■ Goals should be integrated with other professionals and are for a

year at a time

■ Revaluations typically completed every 3 years

■ State and federally funded

AOTA (2016) and AOTA (2013)

Possible Disability Designations in SPED

■ Specific learning disability

■ Other health impairment

■ Autism spectrum disorder

■ Emotional disturbance

■ Speech or language

impairment

■ Visual Impairment, including

blindness

■ Deafness

■ Hearing impairment

■ Orthopedic impairment

■ Intellectual disability

■ Traumatic brain injury

■ Multiple disabilities

The Process of Determining Special Education Eligibility

■ Child referred by parent or teacher

■ Special education team meeting- determine if testing is necessary

■ Signed consent for testing

■ Testing in all areas of suspected disability

■ IEP team determines if student qualifies and what area of disability

■ If student qualifies, determine services

■ Goals determined and who implements

OT Evaluation in School Setting■ Focuses on student’s ability to access the school,

curriculum, and any barriers

■ Informal observation

■ Interviews with parent(s), teachers, and student

■ Formal assessment

■ Written report is completed and is included in the IEP

Adapted from Occupational Therapy Essentials for Clinical Competence

OT’s Role in the School System■ Focus is on academics, play/leisure, social participation, self-care skills,

and transition/work skills

■ Educate staff and families to encourage student participation and

independence while at school

■ Modify or adapt areas that may be barriers to participation

■ Advocate for the student

■ Provide information regarding disabilities, disorders/syndromes,

precautions, and positioning.

AOTA 2016

Definition of Collaboration

■ Collaboration in the school setting is personnel

working together and sharing expertise to benefit

the needs of a child. Can be formal or informal

planning, development and monitoring of

interdisciplinary interventions.

Barnes and Turner 2000

OT/ COTA Relationship■ Supervision is always provided for the OTA by the OT

■ Supervision may be through email, text messages, phone,

face to face, and direct interactive supervision

■ OTA keeps the OT informed of any changes to the students

program and performance

■ To have a successful OT/OTA relationship there needs to be

respect and effective communication

People OT May Interact with (IEP Team)

■ Student

■ Parents/Caregivers

■ General education teacher

■ Administration

■ School diagnostician

■ OT/COTA partners

■ Special education teacher

■ Speech Pathologist

■ Physical Therapist

■ Music Therapist

■ School Psychologist

■ Vision Specialist

■ Orientation and Mobility

■ Auditory Impairment Teacher

■ Assistive technology specialist

■ Adaptive P.E. teacher

■ Behavioral Specialist

People OT May Interact with continued

■ School nurse

■ School Counselor

■ Art, Music, and P.E. teacher

■ Para professional

■ Librarian

■ Secretary/ person at front

desk

■ Cafeteria staff

■ Janitor

■ Bus driver

■ Lawyers

■ Advocates

■ Outside therapists

Delivery Methods■ Consult/ indirect

■ Pull out/direct

■ Combination of direct and indirect

■ In class support – Integrative/ collaborative– Authentic environment– Individual, small group or large group

Occupational Therapy Essentials for Clinical Competence, and Dunn 1996, AOTA (2013)

Benefits of Collaboration

▪ Increase positive outcomes

▪ Creates mutual respect

▪ Increases staff retention

▪ Increases knowledge for all involved

▪ Reduces teacher/therapist isolation

Adapted from Loy, Micheff, Nguyen, and B’Brien

Barriers to Collaboration

▪ Time constraints

▪ Lack of interprofessional knowledge

▪ Clash of professional knowledge

▪ Personality factors

▪ Complex and requires effort for all involved

Adapted from Barnes and Turner 2001

What Teachers Want You to Know ???

Creating Successful Relationships

■ Keeping the child’s needs as a priority

■ Authentic praise

■ Educating others regarding the role of OT

■ Having an open mind and listen to others

■ Identify norms

Adapted from Barner and Turner

Strategies to Increase Collaboration

■ Formal/ informal meetings

■ Follow up with written recommendations

■ Share strategies, activities, etc. that relate to the goals that OT supports

■ Consult on a regular basis with staff to monitor student progress/ staff needs

Handling Difficult Collaborative Situations

■ Provide achievable strategies- less is more

■ Offer to train the staff and demonstrate use of proposed

strategies, materials, and interventions

■ Consult with other team members or administration

Neil’s Story

Sometimes we even collaborate with

Santa

Resources ■ AOTA website- aota.org source of information/ fact sheets for parents,

teachers and therapist

■ Executive Council of Physical and Occupational Therapy Examiners-

PTOT.Texas.gov

■ TxSpot- txspot.org source for those that want to know about school-

based Occupational Therapy and Physical Therapy in Texas

■ TEA.Texas.gov/curriculum/TEKS- Texas Essential Knowledge and Skills

■ tea.texas.gov/About_TEA/Glossary_of_Acronyms

Bibliography■ Barnes, Karin J. and Turner, Keith D. (2001). Team Collaborative Practices Between Teachers and

Occupational Therapists. American Journal of Occupational Therapy, 55 (1), 83-89.

■ L. Davis (2018) Teacher Collaboration: How to Approach it in 2018. Schoology Exchange, February 7, 2018.

■ Kemmis, Barbara L. and Dunn, Winnie (1996). Collaborative Consultation: The Efficacy of Remedial and Compensatory Interventions in School Context. American Journal of Occupational Therapy, 50 (9), 709-717.

■ K. Jacobs and N. MacRae (2017)Occupational Therapy Essentials for Clinical Competence, Slack Inc.

■ M. M. Caskey and J . Carpenter (2014) Building Teacher Collaboration School-wide: Models for techer collaboration are ineffective without true participations AMLE Magazine. October 2014

■ What is the Role of the School-Based Occupational Therapy Practioner? Questions and Answers for Parents. AOTA 2013

■ Occupational Therapy in the School Settings Fact Sheet. AOTA 2016