Tuesday, April 21, 2015

A Day in the Life | School-based OT, Part 2

It's day two of getting a peak into the life of a school-based occupational therapist! Today, please welcome Heather Brohm! Heather's caseload is unique in that she works with students of all ages, ranging from kindergarten through high school. Read on to see what a typical day is like for Heather!

I am an occupational therapist, working in the public school setting. In public schools, occupational therapy is provided to children who are benefiting from IEPs, or Individualized Education Plans, or, in some instances, 504 Agreements, which refer to the Americans with Disabilities Act. OT falls under the category “Related Services” and, along with physical therapy, speech and language therapy, visual or hearing therapies, is focused on increasing independence and participation in the child’s role as a student. However, the students are not my only client in the schools. I work with adults in the schools as well, including paraprofessionals, nursing staff, other therapists, and teachers, including regular, special education, and special subjects (art, music, etc). 

My days are busy and long! I work with both secondary students – grades 9 to post-graduate, and elementary – Kindergarten to 5th. I can see both 5 year olds and 21 year olds in the same morning. In both of my schools, I see students in the Life Skills classroom, a self-contained room for children who have moderate to severe disabilities. I also see students who benefit from Learning Support, who need less intensive supports and may be included in regular education for all or part of the day. A typical day for me looks something like this:

7:30 – A whole class group with a Life Skills classroom at the secondary level. We do yoga together 1-2 times a month. I have observed benefits in self-care skills – donning and doffing shoes, vocational skills – wiping down mats, moving furniture, relaxation and self regulation, following directions, as well as the opportunities to stretch and move functionally.
8:00 – Pack up my stuff and move on to the elementary school, as I have an IEP meeting at 8:20. The student’s mother is attendance, as well as the special education and regular education teachers, principal, and speech and language therapist. We review the student’s progress made since the previous meeting, and discuss any concerns, changes in programming/placement, and new goals.
9:00 – An individual session with an older elementary student. We practice a strategy to support self-regulation and self- control, and trial a new, simplified method for recording homework assignments, to increase his self-efficacy and independence.
9:30 – Another older elementary student, this time working on keyboarding and improving his knowledge of basic computer skills.
10:00 – A group of younger elementary students – working on bilateral coordination, visual perception, and visual motor coordination. Today we practice tying shoe laces – what a way to address all 3!
10:30 – A pair of older students from the Life Skills classroom. They are making great progress in OT this year, improving self care skills to button small buttons independently.
11:00 – A younger student from the same classroom. He attends with his 1:1 aide, and we work on his emerging skills – zipping a jacket, writing his name, with lots of positive reinforcement and yoga poses in between.
11:30 – Kindergartner this time – addressing motor planning and bilateral coordination difficulties that impact his independence opening lunch containers.
12:00 – Making sure that I am incorporating suggestions from the vision therapist when designing this second grader’s therapy activities.
12:30 – I grab a quick snack while I finally jump on email. I may have invitations for IEP meetings, notifications of evaluations/permissions returned, questions from parents or teachers, or all of the above.
1:00 – I pop into another student’s speech and language session to check in. She uses AAC (Augmentative and Alternative Communication) and I use this opportunity to consult with her support staff and problem solve as necessary.
1:15 – I run down the hall to consult and check in on other students in Learning Support classrooms.
1:30 – I pick up another student from the Life Skills classroom – beginning our session with sensory input, moving on to practicing clothing fasteners and prewriting practice.
2:00 – Another short break – this time I’m writing my weekly notes home for the children in the self-contained classroom.
2:30 – Another pair of students and a classroom aide from Life Skills for yoga poses and finger plays!
3:00 – Last kiddo of the day, and we are working on a “How to Draw” activity of a popular cartoon to support motor planning, and fine and visual motor skills.
3:30 – I don’t have another IEP this afternoon, so I pack up and wipe down the table and mats. Some weeks I check in with the teachers I work with to see if there is anything they need or if there are successes to share.

It’s a long day, but full of little accomplishments and successes. I usually spend time each night, or on a lighter day, writing notes, IEPs, progress reports, and evaluations. I really enjoy being able to see my students take pride in their work and gain confidence, and working with such a wide range of students, in both ages and abilities, helps keep me on my toes and the big picture in mind. I love OT because it lets me be creative and a problem solver.

About Heather:
Heather Brohm, OTR/L, has been an occupational therapist for 6 year, working in the school setting with children from ages 4 to 21. She creates products for school OTs in her Teachers Pay Teachers store, The Organizing OT. Heather is interested in furthering the occupational therapy profession through a strong evidence base, and is the founder of AValidOccupation.org, a website designed just for occupational therapists. A Valid Occupation is a database of OT resources and references, enhanced with a professional social network of therapists from around the world.

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