Happy blogmas day 7! We are officially halfway through blogmas, and I hope you are enjoying it as much as I am. Today I am sharing a few things that I learned during my level II fieldwork experience in school-based practice. I am currently wrapping up my fieldwork placement (3 days left!) and I have learned so much. During this placement, I have been at a public elementary, middle, and high school in MA. Some things that I have experienced may differ depending on the school, town, or state you are in. Here are my main takeaways:
The Role of OT
Coming from an outpatient pediatrics setting prior to the school system, I really had to pivot my thinking and find myself/my style as a future OT again. I have a deep appreciation for both settings, and I think that each one has a strong value in pediatric occupational therapy. In the schools, my experience is that the role of the OT is to support students in accessing the curriculum. At the elementary level, this looked like a lot of handwriting and keyboarding practice, as well as ADLs among our students with more severe needs. At the middle school level, this looked like keyboarding practice, push-in support in the classroom, and working on ADLs/iADLs in the sub-separate classroom. At the high school level, this looked like lots of work on vocational skills, ADLs, and iADLs among students with varying needs.
In the school system, an OT may not work with other OTs directly. Instead, they may work with an interprofessional team including a SLP, PT, BCBA, school psychologist, special educators, instructional assistants, ABA tutors, administrators, general education teachers, etc. It is really important to be able to describe and advocate for the role of OT within the school system and in each student’s individual education. Each person on the team will be addressing certain goal areas for each student, so the team should work together to make sure that all goal areas are being addressed and that the support is consistent. For example, while OT can work on emotional regulation strategies, this may be tackled by the school psychologist while the OT works on other goal areas such as handwriting. This was hard for me to wrap my head around at first!
“It’s a marathon, not a sprint”
I really liked this quote from my CI, and it stuck with me throughout the duration of my fieldwork experience. In the school system, a student will work on the same goals for an entire calendar year or “IEP period.” This is different from an outpatient setting, where insurance may only grant a child 16 visits to accomplish their goals. In the schools, you have time to make progress and generalize it across the curriculum. You also have the ability to continue to see progress over many years depending on the student’s needs and goals that are updated yearly.
Data Collection, Efficacy, & EBP
Data collection was really important in this setting, and my CI had an organized method to collect and track data using spreadsheets. In the schools, we don’t write daily notes. Instead, we write progress notes a few times a year. In order to write progress notes and track progress on goals, we have to collect data to track progress throughout the year. This also allows us to assess the efficacy of our interventions and modify the treatment plan as needed.
Keep it Functional
My CI’s advice was to make sure that your goals are functional and that you are working on functional tasks during your OT sessions. For example, rather than having a goal on fine motor strengthening or coordination, write a goal about what you want the student to be able to do (e.g. handwriting). During our sessions, we didn’t simply play with putty or do fine motor exercises, but we practiced the functional tasks needed to be successful in the classroom.
Make it Fun
I’m not going to lie, just working on handwriting isn’t the most fun for the students. As I got to know them, I was able to make our OT sessions more fun by including activities that were motivating and engaging for them. Some things that we’ve been doing are GoNoodle, crafts, reading books, and singing songs.
Time Management & Organization
An OT’s caseload in the school system can be quite large and across multiple schools. It is imperative that as a school-based OT you are organized and are able to manage your time effectively. For example, when you get consent for an evaluation, make a to-do list of all the things that you need to do by the 30-day date. There are lots of dates, timelines, and laws/rules to abide by in the school system, so having an organized way to keep track of all of them will make your job so much easier!
School-based OTs — what other advice would you give to anyone interested in school-based practice?