Jayson Davies -OT

Fri, Oct 07, 2022 12:27PM 57:29 SUMMARY KEYWORDS student, rti, tier, special education, ot, parent, question, evaluation, teachers, sensory, support, iep team, school, classroom, child, occupational therapist, occupational therapy, iep, people, district

00:00 Ricoh. Also, I'm gonna, I'll do the intro and outro once we're done, yeah. So don't worry about that. All right, so here we go. Welcome. I'm so happy to have our conversation today. And I'd love to jump in and for you just to start telling me about yourself and why you're a special edstrategist, in terms of helping our students. Yeah. Good 00:28 morning. Thank you so much for having me, Wendy. It's a pleasure to be here. My name is Jason and I am a school based occupational therapy practitioner. And I have been for about 10 years now actually graduated from from USC, Southern California in 2012. So I think this marks right about 10 years right now. So yeah, I've been a school based ot for about 10 years. And now I also have a website where I support other school based occupational therapypractitioners through a podcast courses and a conference. So it's been a real, it's been a real journey the last 10 years. But I'm excited to be here. 01:04 Thank you so much for joining us. And we will link to all your information at the end and in our show notes. So people know where to find you on how to reach out. So Jason, as a school based, OT or occupational therapist, you see a lot a lot of students that you're working withdirectly, but you also see students that are struggling. And there's a term that's been floatingaround, I hope you could help kind of identify that and explain to us what that means. So what does the response to intervention strategy mean? 01:37 Yeah, so RTI as it's commonly referred to, some people also use the term MTS s multi tiered support systems. They're very, very similar, with slight differences. But what RTI really bringsinto education and it's kind of a relatively new concept, since kind of the No Child Left Behindback in 2004, is when it really started to show its light within schools. But it's kind of replacing what used to be a wait to fail model. And it used to be where students wouldn't get the supportthey needed until they're basically in special education. So they got evaluated by a psychologist, a special education teacher, maybe an OT, PT, speech. So now with the RTI, it's a tiered intervention, there's three tiers and is designed to provide the supports that a studentneeds before they necessarily need to be in special education. As we know, there's a wide range of needs that children have. And just because they don't have a disability doesn't meanthat they're not potentially struggling. But so yeah, RTI is designed to help students whether ornot they have a disability, at whatever level they are at. And I think we'll dive into that a little bit future. So don't jump ahead of myself.

02:55 Well, who is responsible for identifying students who are struggling, whether it's behaviorally oracademically at the school level? 03:03 Great question. I mean, the answer, you know, the, quote, unquote, correct answer, I guess youcould say is the entire school, right, everyone's responsible, as a teacher, they really do playthe primary role. And that's simply because they see the child every single day, as anoccupational therapist, I'm not in a classroom every single day. So I might not see the students that needs the support. And so it really is up to the teacher, maybe the administrators a littlebit as well as to, you know, identifying what students may need a little bit more support. Now, there's oftentimes that I'll get kind of stopped in the hallway by a teacher. And they might say,Hey, I have this student who has difficulties with writing or has a student who can't sit still. And so they'll come up to me and they'll stop me for a little bit. And that's when I kind of prompt them. All right, how can we go through the RTI process to support not only this student, but allof your students? 04:01 Thank you. So is RTI, part of special education? 04:05 Technically, no, RTI is not a part of special education. I will say that it kind of varies from stateto state, county to county, even district to district when you get to the third tier, and we'll talkabout that some districts will call the third tier of RTI, special education. And that is because tier three is more individualized. And so there are some places that will call that a specialeducation, evaluation and services. However, from my point of view, I think that we can participate. And when I say we, I mean the entire educational team can participate in all threetiers of RTI, before it gets to the special education realm. So your question about is it specialeducation or is it general education? Technically, it's general education, but it really should becollaborative, because those special education providers or the people that are typicallydeemed as special education providers like myself, OTs speech therapist, we can providesupport to the General Education team, even though we are primarily funded by specialeducation, and are often pressed to stay within our special education bubble.

05:15

But everybody wants to pick your brain. I have quite a few everyone on the staff, I'm sure ifthey have a concern or a question, I, you know, you just flashback to when I was in a schoolbuilding, and you do get stopped often in the hallway for for questions. So that does make sense. Let me ask you. So I want to before we kind of get into RTI and the teams and thestrategies and the tiers, if we could just talk a little bit about the law a second and maybe kindof shed some light for folks that are listening in terms of really the federal law, I mean, it likeyou said districts and states kind of have their own interpretation sometimes and they havetheir own subset, but talking about Ida, our federal guidance of this, someone that's identifiedwith needing RTI, can they still start the special education evaluation process? 06:11 Oh, yeah, absolutely. I mean, districts can not put in place systems that prevent a student fromgetting special education. And so while you can implement RTI at a school level, or at a districtlevel, you can't, as a district, say, sorry, we're not going to evaluate your student because wehave RTI. If a parent puts in that request, or if there is a suspected disability that would preventthe student from accessing their education, then my belief and what I, I do look at Ida, also lookat Every Student Succeeds Act of 2015. My perception is yes, you need to do that evaluation.Now, that's not to say the RTI can't happen at the same time as a special education, evaluationor processes going on. Just because a student is in a special education classroom doesn't meanthat they can't receive the benefits from RTI. So they can happen simultaneously. But yeah, you can't use RTI as an excuse to not move a student into special education. I hope that answers your question. 07:22 Yeah, it does. Let me follow up with that. So then how long should a student receive regularinterventions before a school kind of initiates an IDA evaluation? 07:34 I mean, it really varies. I think it also varies who is coming up with the idea for an evaluation.Typically, I have seen the tears like people will put a student in a tear for about eight weeksand gather some data during eight weeks, and they end that might be tier one. And then they move to tier two for another eight weeks. And so they kind of go up that through that eight week system. However, I would argue, because Ida is pretty clear that if a parent is requestingany evaluation, then as a district personnel, I would be pressed to not say, Let's sorry, parent,no, we're gonna go through this eight weeks, the next eight weeks in the next eight weeksbefore we do your evaluation, simply because Ida states that if a parent comes to us with aconcern and an evaluation request, we need to a help them put it in writing, and then behelped them actually get through that evaluation process. 08:35

So is the child find obligation triggered if a child moves through tiers of intervention with someimprovement, right? So like you said, kind of before a parent, ask or request for thatevaluation? If they're moving through, you know, tier one, which we're going to talk about here,but they move through it, you've collected data, we're gonna move them into tier two, they'reshowing improvement, but they also continue to show deficits and achievement. 09:03 What does that look like? Who's responsible for 09:09 starting an evaluation process at a school level? 09:13 Gotcha. Okay. So 09:17 let me answer that in two ways. I guess the first question, right, you're going through, you'regoing through the tiers, the first thing I would say is that students, their their progress shouldbe measured in all areas of concern, right? We can't just pick one specific area and measurethat. You'll often see that schools break down RTI or MTSS. Sometimes it'll be called RTI, a or MTS S A for academics and then MTS s be for behavior. But even that can be further broken down, right academics is more than just academics. You have math, ela writing and all that good stuff. And so we need to make sure that we're measuring all the various areas of need forthat student. Typically it does fall, unfortunately, upon the teacher. So it's because again, like I said earlier, they're the ones that are seeing the student every day. Sometimes schools will have some sort of MTSS or RTI coordinator that does that. But yeah, so that's to kind of fall upon. That being said, to answer kind of your second question, and there is who makes thatevaluation. Typically, it's whoever is making that data or taking that data. But oftentimes, it'll come from a team. And so especially once a student gets into level two, especially in levelthree, they're being followed already by a team, even though it's not your traditional IEP team,which is, you know, very large, very formal, or it can be large, it's always very formal. A student might have a 504 plan or student study team, where it is the teacher, the administrator, theparent, and maybe the RTI, whoever is in charge of our RTI, the RTI, a RTI be leader. And so those people can meet, and they can make a decision, you know, what, hey, Johnny's makingsome great progress here. But we're still struggling, the doctor has kind of told us maybethere's some sensory processing difficulties, let's go ahead and refer the student for a specialeducation evaluation. And let the parent know what that means. That means we are going tohand this over to our school psychologists and our specialized academic instruction teacher,and they're going to do an evaluation to determine if something if a learning disability ofautism is whatever it might be, is preventing your student from accessing their education.

11:46 So you mentioned our TI B for behavior. How do you define that? You know, I think academics ispretty well known, but how would you define the elements of breaking down? The B forbehavior? 12:01 Oh, gosh, I've never had to actually directly answer a question like this. I like it. Um, you know,coming from an occupational therapy standpoint, I see behavior as communication. I don't necessarily see behavior always as a choice, it is more of a reaction from kids. And so I guesswhen when you're looking at the behavior, I like to just kind of see what is the student trying tosay, with their behavior? What are they telling us? Are they telling us that they're havingdifficulty with social interactions? Are they telling us that, uh, that his particular academic skillis tough for them? And, you know, I basically they're saying, I can't do this, I want to give up.And so that's the perspective I come from, you know, you also have behavioral intervention itinterventionist who will often use the ABC data, antecedent behavior consequence data. And I think that is a good way to measure behavior, because you can see, okay, the student wasstruggling with a math test or math assignment, which led to a behavior. And then what was that consequence, we have to remember that a consequence isn't always a quote, unquote,bad thing, a consequence can be providing the student support that could be a consequence, per se. But yeah, I really come from the idea that behavior is communication. And so when I'm looking at RTI, B, Mt. SSB, I'm really trying to figure out what is the student trying to tell us andoftentimes those students that are coming from the NTSB side of things are the kids that are inthe office every other day or every day. And so that's how the referrals might come through. 13:53 Let's dive in then. So what are the levels of RTI? We've kind of hinted about this? Yep. So what are the levels? And what do they mean, whether it's RTI or MCSS? 14:04 Perfect, so yeah, either way, they're both tiered interventions. And they there are three tiers. In most cases, I have seen some models that add a fourth tier, but I'll just go over the three tiers.Tier one is really all about first best instruction is what is often called. And basically that's thatmeans making sure that the teachers are well equipped with the knowledge that they need toprovide the first best instruction for our students. So Tier one is really education based for theteachers, making sure that teachers have been to professional development not only fromother teachers, but from speech therapists from OTS so that they've learned a little bit aboutsensory processing so they learned a little bit about developmental communication so thatthey've learned a little bit about ABC data and, and how to prevent outbursts, you know,teachers, again, they are with the students Six hours a day, every single day. And so making sure that they have the best strategies in place. As an occupational therapist, what I like to tellother OTs, as far as Tier one is to, first of all, get into the classroom and find out what theteachers need help with. Just ask them, you know, they are more than willing to tell you Yeah,you know, this year, I have a lot of students that just can't sit still, or this year, I have a lot ofstudents that are for some reason struggling with one digit math or this year, I have a lot of students that are struggling with a particular letter in the alphabet, they just for whateverreason, they can't find that letter. And so from there, I don't look at one particular student, I tryto figure out a way that I can support that teacher as a whole. And so I might meet with thekindergarten team, the three kindergarten teachers and provide some strategies that way, orkind of do like a q&a session with them, per se. You know, what, what questions do you have?How can I provide support? So I think of tier one more as classroom interventions as a whole?Does that make sense?

16:05 It does. And I like how you said classroom interventions as a whole, because when youmentioned, tier one, equating to first best instruction, as a parent, I would think, well, aren't I toexpect that my classroom teacher and my child is going to have that knowledge. But I think reframing it as you know, what can we do as a classroom as a whole, to support all the differentlearners within that makes more sense to me and to bring in experts that are more qualified toidentify specific needs whether like you said sensory or, you know, attention, engagement, allof those fun things? 16:48 Yeah. And sensory is a great example, right? I mean, obviously sensory is a buzzword. Sensoryfidgets is like the hot item that target will sell to you and Amazon will show you on yourAmazon shopping list, right? Hey by these sensory fidgets. But what's the difference between a sensory fidget and a toy, that is definitely something that an occupational therapist can supportteachers in and letting them know a what's the difference between a sensory fidget and a toyand be when is the time to use a sensory fidget? You should you just give every student fiveminutes at the beginning of the day, time to play with a sensory fidget. Or if you do that, are you basically just turning it into a toy. And so that's a great example where OTS can come inand provide that support for the teachers to let them know, you know, alright, here's thesensory fidget, the times of day that maybe you want to use, these are when students aregetting a little drowsy, and they need a little pick me up past the time you want to use this. Or maybe here's a calm down video from YouTube, you know what, that'd be a great time to useright after recess when you're trying to bring them down. And that's how an OT can support teachers and students. 17:59 And I love that you gave some low hanging fruit of what a sensory fidget is and how we couldreally implement it, because honestly, we could have a whole podcast just on that conversationalone. But I don't want to leave people hanging with our tier two and tier three intervention. So thanks for kind of giving us a little information on sense. 18:22 Yeah, so So tier two, we can dive right into it. Tier one is all about the entire classroom. Tier Two is when you break that down into some smaller groups. For occupational therapy. Again, what I teach fellow OTS that I work with is to think of OT or sorry, think of tier two, as going into what I teach fellow OTS that I work with is to think of OT or sorry, think of tier two, as going into the classroom and maybe leaving a center. Or if you're at a very, maybe a smaller school. And maybe there's one or two kids from this classroom that need some help. Maybe there's one or two kids from this first grade classroom that need some help. Maybe you meet with those four kids in a pod. And you're providing specific intervention related to handwriting, because the tierone handwriting program hasn't helped them enough. So going from tier one, which is whole classroom, tier two tends to be a smaller group. There are other instances where it's, it's kind of a gray area between tier one and tier two, where an OT and a teacher can collaborate togetherto co teach a specific lesson. And maybe again, just for some quick examples. Maybe theteacher and the OT are collaborating to provide a weekly handwriting program instruction inthe classroom. And then or another idea, again, it could be sensory, it could be a multitude ofthings, mental health, whatever we want to go with, but that would that's kind of a gray areabetween one and two, because you're really you're still working on the classroom, but you're alittle bit more involved and you're collaborating with that teacher with the students.

19:59 Yeah, Where Where would a special educator fall in that tier two, do special educators fallwithin that because you're talking about they you as an OT come in. And you can provide thattier two intervention, whether it's collaborative, collaboratively with kind of a co teaching kindof model with the classroom teacher, or doing more of a small group. I guess I have two questions here. So where does the special ed teacher fall within that? And then if you're doing asmall group, is that considered a pullout model? And then do you need approval from a parent? 20:35 Yes. So we'll answer the first question first, the sai teacher, the RSP, teachers, specialeducation teacher, they can do similar things as far as they have specialized knowledge. It's funny, because a lot of the a lot of the things that we do in general education today actuallycame out of special education research. And so those special educators, they have a lot ofwonderful knowledge that they can share with those teachers through tier one, or even throughtier two. Now to go, and that leads directly into your second question, right is when does itbecome special education or not? Yeah, it can be tricky when you're talking about those smallgroups, if you are pulling them to a pod, and I am hesitant to do that without getting some sortof parent permission. Now, the difference between me seeing a student in a small group orindividually under an IEP is that I have evaluated that student thoroughly. The psychologist has evaluated that student thoroughly. They are they have specific goals that we are working on.When it comes to these, this other This RtI group, we are using more general strategies that weassume will work for all students. And they're not specific goal oriented. They're well, I shouldn't say that a goal oriented, we're working on a specific goal. But we're using more of a program approach, not an individualized approach. Does that make sense? So we might use aspecific program such as the size matters handwriting program, where we might use the zonesof regulation program, and we're using that kind of to its tee, as opposed to reallyindividualizing it for a student based upon their evaluation results. 22:23 And I appreciate that input. Because I think as, as professionals, I mean, I feel like this is such a great discussion that we're having because I think parents that are listening and shine some great discussion that we re having, because I think parents that are listening and shine some light on kind of what's, what is what can the school offer. And then as a professional, kind ofreally shining light on where their role may be, and where they could seek more information forthat. So we said Tier one is your first best instruction. And then tier two is that small group ofstudents that are still within that classroom setting that are still identified in the generaleducation, and as just needing additional support to hopefully get them over this hump, andreally help let's level the playing field for them within the classroom setting. Is that right? So far?

23:11 Yep. Yep, sounds good. Okay, and then now, where do we go from here? 23:16 Yeah. And so that leads into tier three, which is the muddy tier of all of them, it doesn't matterif you're reading a blog post research, whatever it might be tier three, always looks a littlemuddy always is a little complicated. My take is that tier three is when a student is kind of onwhat we call an SST team, a student study team. Different places call them different things. But really, it's not an IEP, but it is, you know, we are closely monitoring this child as a team todetermine if they need an IEP potentially. And as an occupational therapist, as a specialeducation provider, I feel that our role on or for a tier three student is really sitting on that SSTteam, and providing still technically general strategies, because we haven't, because wehaven't evaluated the student. But at the same time, we're learning a little bit more about the student from this team. And we're providing strategies for the team to try. And so we can we can give the teacher or whoever else is working with the student directly, give them ideas andgive them ways to measure the progress or lack of progress when we implement those ideas orthose strategies. And then I think from from that tier three model, I think you're quickly goingto find out whether or not it's time to move a student up to an IEP. Or say, you know, what,what we put in place, it really worked really quickly, they can go back down to tier two. I don't think that students should be in tier three for very long because if they're in tier three, we'rereally saying saying, hey, this kid needs help. And we either need to get them the help thatthey that they need or see that very rapid progress, where hopefully they're moving back downto tier two, or tier one. 25:13 Where are the parents fall within this? Meaning when are parents notified that their child isgoing to be receiving the support? 25:24 That's a good question. I think that varies for for every school district, obviously, I know in myexperience, it's right around that tier three, that they're really being notified because they'rebecoming part of the team. I believe my my wife is actually an assistant principal. And I actually think that even if they're doing tier two, they are actually sending home a permission slip for Tier Two out of class intervention, because like we talked about earlier, tier two could bethat pullout, so even though they're not receiving special education, they are missing classtime. And so they would have some sort of form that says, you know, what, here are thebenefits? Here's why we're doing this, do you agree to have you near student pulled out forhowever much time it is a day to really hit these, these core strategies that we feel isnecessary in tier two?

26:22 In your experience, have you seen students, like you said, move up to tier three, and then dropback down that they've just needed kind of this little push or systematic kind of instruction toget them over a hump? And then have been able to kind of keep moving? Or do you more seethat as the student progresses? tier one, tier two, tier three, and now they're on the monitor,it's like, you know, what, I think they really would qualify, and let's start that process forspecialized instruction. 26:53 Yeah, I think it does happen both ways. I think when it comes to my personal experience, as anoccupational therapist, I think the kids that I typically become part of that program with are thestudents that tend to eventually need that evaluation. If I'm really getting involved at the tierthree level, I feel like those students are the ones that are diagnosed with something. They're often diagnosed with a learning disability of some sort with autism. And so we end up typically, typically doing that evaluation of some kind. I'm sure there are many students that get to tiertwo, tier three and then work their way backwards. But I think when you're bringing in the OT,at that level, we're getting to a point where people are losing their they're losing strategies,they're running out of strategies, like just say, not losing, they're running out of strategies,they've tried a lot, right, they've come to the tee for ideas that come to the speech and theBCBA for for ideas, and they're just running out and by time you get to tier three, you need thatmore individualized evaluation from the school psychologist from the OT and whoever it mightbe to figure out how we can really support the child. 28:05 Do all schools have RTI teams and strategies? 28:09 Oh, gosh, no. 28:12 As I mentioned earlier, RTI is relatively new when you look at education, right? It's only beenaround for about 20 years. And even then, it really wasn't started to roll out until probably 2014 ish. I remember I started in the schools in 2012. And RTI wasn't really a term that was thrown around like it is now. And so I think RTI is definitely relatively new. And I've worked in three different school districts. And a, it looks different RTI looks different in all three school districts. And B, some districts have a better program than others. You know, schools are underfunded, and they have to figure out where to put their funds. And so I've seen some schools that onlyhave an RTI program for behavior, and other schools that only have an RTI program foracademics. And that's because that's an area of focus. It's hard to change or make tons of change in one year. And so you can have to, over time, you know, with with collaboration withyour community, your team being everyone on the campus, trying to decide what are ourpriorities, where are we going to focus? It's, I mean, it's hard to say but you know, you mightwant to focus on academics this year. And for the students that have behavioral concerns, maybe we don't have an RTI program for those students right now. But even if we don't have the RTI program, we can still refer them to the OT to the BCBA to do an evaluation even if thatRTI program is established yet.

29:50 What a better RTI program look like if I was an outsider, how would I kind of in your experience,because yeah, I've seen it different ways. 30:00 Yeah, I mean, 30:03 I would say that you need to put structure in place. So if you're say you're at a school andyou're like, wait, we don't have an RTI program, I would say start with tier one and move upfrom there, get a structured tier one in place, and then move on to tier two, get a structuredtier two in place, and then move on to tier three. Tier one is going to help 97 I think is kind ofwhat they say 97% of students are going to get support from tier one. And then a slightly smaller percentage is going to get help from tier two. So let's start at tier one, supportingeveryone making sure that our teachers are very well educated, making sure that our specialeducation providers know that they can support the general education teachers, and thenmove up from there. Once you have that tier one established, and you start to figure out whothat maybe it's 10% of kids or so that need some tier two support, then you can figure out asystem for tier two and what that's going to look at. But I would definitely recommend starting with that tier one, and then moving up from there. 31:10 You mentioned something that made me think of data, and I'm gonna ask a database question.But before I kind of asked that question, how are we identifying with data students for thedifferent tiers? I'm assuming it has to be data driven, right? It can't just be one teachers like,that looks like they need some help. I mean, I'm sure there's an involved, but I know it has to be backed by some sort of data.

31:37 Yeah, you know, and onto this two different ways. First of all, data doesn't need to be hard to collect, it doesn't need to be some pie in the sky thing. We don't need to use a standardized evaluation tool with every single student in first grade to determine if we need to dointervention. For Tier One, there's not really a lot of data going on, because your I guess thereis the data for tier one really is coming at the district level, because that you do your districtassessments, right, and you're trying to determine what teachers are supporting students inwhat way, a lot of times, the teachers will get some of that feedback. But other people aren't getting some of that feedback. Maybe they should be maybe OTs and speech therapists shouldbe getting some of that feedback as well. But I like to use the example of a vision screening for collecting data. Because a lot of people think that a screening, especially when it comes from aprofessional, a special education professional should be like a one to one screening todetermine if the student needs RTI services. And I don't think that's correct in. In most states, I believe we have vision screenings at some grade levels, some intervals, maybe it's first, fourthand sixth grade. But when you do a vision screening, every student gets looked at, it's only afive minute little test, right? It's this cover your right eye cover your left, I read the letters,that's all it is, but every student gets looked at. And I think the same thing holds true when itcomes to RTI, whether it's level one, level two, level three, you get a little bit moreindividualized, but at least for those first two levels, it's just making sure we're looking at everystudent, at least in a single classroom, if not an entire grade level. So what I might suggest is I keep going back to I'm trying to think of a different example. But maybe it's let's go with sensory processing. And all the students are having difficulty in class, they're having difficulty sitting still. So the OT might come in, and it could be a somewhat informal observation, butthey are keeping track of timeframes that students are sitting down for timeframes, thatstudents are standing up timeframes that some students are standing up, and some studentsare sitting down timeframes that some students are kicking their legs, under the desk,whatever it might be, but their observations that they can take, that is something that can thenbe repeated eight weeks later, after some intervention has been put in place. And they can take that same observation data. It doesn't need to be a specific test or anything. It can be more observational, as long as you're, as long as you're looking at the same things from weekone to week eight, right? You can't change the change the measuring stick, you got to use thesame tool. 34:27 When I liked that you said that because I know, as an educator listening, they may think, Oh,this is one more thing, but I think we can make it simple, right in terms of how we're doing it, aslong as it's consistent. To not add to an educators plate. We all know that their plate isoverflowing especially now so we don't want to add more to it. So I think simplicity is really the best and a lot of ways to do this. Assume that I'm a parent and my child is receiving RTI Is theresomebody they should reach out to at the school level to get specific information on theirprocess or progress or any of that? 35:09 I was for RTI, I would definitely start with a general education teacher, your students teacher,there may or may not be like a, I think I spoke about earlier, a RTI counselor or an RTIpersonnel if the district or if that school has specific funds that they've designated they might

personnel if the district or if that school has specific funds that they ve designated, they might have an MTS s, a or RTI a counselor. So that person might be who you would reach out to. But I would say definitely, you're starting with that classroom teacher. 35:40 We've talked a lot about RTI, and what that means and what that can look like you are anoccupational therapist. So I'd love to know kind of what is your role as a school based occupational therapist? 35:54 Yeah, so excuse me, my role is what we talked a lot about RTI, I do play a role within RTI andsupporting students there, but primarily occupational therapy, we are a special educationrelated service provider. And so typically, we are supporting students who are on an IEP thathave difficulty with fine motor skills, visual motor skills, sensory processing skills that relate totheir functional output in school. So if a student has a fine motor deficit, then we need to look to see how that fine motor deficit is impacting their educational curriculum, their educationalcareer, kind of going a little bit further than that, if a student has a fine motor deficit, I can asan occupational therapist, or we all can, we can come at it from a to or from a few different ways. We can say, alright, let's support that student and increasing their fine motor skills sothat they can hold a pencil, or we can come at it from more of an accommodative point of viewand say, you know, what, we've been working on fine motor skills for a while, they haven'tgotten better, what accommodations can we put in place to replace the need for that particularfine motor skill. And you might end up saying, Okay, let's try speech to text. Or let's try usingan adaptive keyboard so that the student doesn't have to use their left hand when typing orsomething like that. So that's kind of a nutshell of occupational therapy, but there's two mainkeys that you really have to hone in on is that they have a deficit. And that deficit is impactingthe education, they can have a deficit and not be impacting their education. And, you know,that might be the realm for someon e else to or sorry, let me make sure I'm getting this theright way, they could have a deficit, and it could not be impacting their education. If that's the case, then we might not qualify or not qualify, we might not recommend services for thatstudent, because their deficit is not preventing them from accessing their education. And that instance, I might recommend to a parent or not recommend, but mentioned to them that thereare other avenues for occupational therapy services, like through insurance and whatnotoutside of school. And that might suggest that the parent talked to their primary care physicianor doctor, whoever they go to, and ask them about occupational therapy, we have to rememberthat everything related to school based ot has to be present on school, or looking at schoolfunction, not at home function. So there's at home concerns, I would suggest talking to their to their doctor. Now, on the flip side, sorry, making a long answer here. On the flip side, theycould not have fine motor deficits, but they are having functional difficulties in the classroom.And that's where it gets a little tricky, because we have to weed out what is causing thosefunctional deficits. Now, let's go back to the behavior example. Because behavior difficulties could be caused, we talked a lot about communication, but it can be broken down further than that. Are they trying to communicate because of sensory preferences that they'reexperiencing? If so, then maybe the OT is the right person to address that? Are they havingbehavioral concerns because they can't communicate their needs and wants, that may be moreof a speech therapists perspective. And so I might have to weed out in my evaluation and say, Hey, this is an OT thing, I can address it. Or as a professional, I also have to know what isbeyond my realm and say, You know what, I think this might be more of a speech concern. Let me refer you over to the speech therapist or an evaluation.

39:45 That's a lot of information for parents. I think, you know, because you're trying as a parent,you're coming from this pace, place of fear and love and you're trying to navigate a systemthat's so uncertain as a parent because it's a set of roles that are very different than yourknowledge bases. And I say that as a parent that has a child with medical needs, and I evenhave the special ed background. So I feel like it becomes tricky. So let me ask you, youmentioned, you know, private OT, and school based OT, and often all related services, whetherit's speech language, physical therapy, occupational therapy, when you talk about the private,and then you talk about school based, they really operate in different silos, like that medicalmodel is very different than a school based model. And I think that then gets confusing for aparent of what they see as impeding the progress of their baby, their student, versus what theschool is able to offer. Can you talk a little bit more about that to maybe provide some answersor clarity for a parent that they say, Okay, well, I'm going to my private OT, and they're saying,I should really work on this with my guy, my person, and then I go to the school and the schoolis like, that's not really a deficit that's impacting the education that your child is receiving, andhow do you kind of come together as a partnership at that, as a team, as an IEP team as aparent coming to their to say, Alright, how do we kind of clear this water and, and really workas a partnership between this medical model and school based model? 41:29 Yeah, that's, that's a million dollar question. Yeah, right. You know, I, there are times where I just wish that there wasn't that difference between medical model and in the school model.Because we really are doing similar things. I mean, it's not like you're going to see a pediatricot at the clinic, it's going to look similar to what the school based OT is doing in school. What I love about school based OT is that we get to see the student in their natural environment. And one of my favorite models within OT is called the pe o model is the person environment andoccupation, model, occupation, meaning an activity. And all of those three things have to worktogether, the person and their skills, the environment and the occupation auto sync, to to helpa student to help anyone, we all need to be in the right place, doing the right thing at the righttime. But yeah, I think that we really are doing similar things, as you mentioned, that in theschools, we have to look at something that's education based, if you come to an IEP as aparent, and you're saying, I'm having concerns with dressing at home with my student, then I'mgoing to say, well, that's not something that we necessarily work on at school, unless your kidis in the middle school or high school, and they're having to change out for physical education.At that point, then it's absolutely relevant to education. And so it is hard to figure out when tosomething become relevant within the educational field, as opposed to being more of anoutpatient. And that's why it's so important for many people to communicate. A lot of times I see OTs, they might recommend that a student not need services, but then they findsomething, some new information at the IEP where they just recommended I didn't where theyjust recommended, the student doesn't need ot services. And so it's very important that the entire team talk to each other. That's, that's a right, we need to make sure that all the concerns are out on the table. And then if a student does receive OT, or even if they don't, but you're going through an evaluation, let your school ot know, if your student receives outside ot yourschool ot can get some paperwork signed by yourself, and they can reach out to your privateOT and kind of figure out what's going on that way. And so in a way, you're expanding that IEPteam you're letting the OT and the School Talk to though Tiana the school and a lot morecollaboration can happen that way. And OTS have their own lingo, right? And so sometimes thatthat helps out with whether or not a student needs OT or not, when it comes down to theevaluation.

44:24 I like that you gave that example, in terms of expanding that IEP team out. Because oftentimes you talk about partnerships and parents being a partner at the IEP table. And that can be challenging for a parent because they think it's me against them. And so really thatcommunication is key and really bringing in members working with that child outside of aschool setting, as well as inside the school setting to have that constant communication to kindof make sure everybody's on the same page. 45:00 Yeah, definitely. 45:01 Have you seen other ways where that has worked? Well, in terms of forming that partnership?Oh, yeah. 45:09 A partnership is key relationship building is key building rapport, not only with a student, butalso with a family is 100% key. We used to tell people in a district that I worked for, that if youhave myself and a specific school school psychologist, on your IEP team, you should never needto feel like you need an advocate because we are going to be your students biggest advocate,and we're going to answer the phone, when you call, we're going to answer your emails,anything you have, we are here for you. And we really were student centered. But I've also been on IEP teams where I'm questioning what the program specialist from the district issaying. And I, I mean, I can give you horror stories, but there are times that people or thedistrict puts in place barriers, and it is totally unfair. And I completely disagree with it. And it leads to difficult conversations, and it leads to frustration. And again, it is a parent's right tohave an advocate is that a parent's right to have a lawyer. And there are times as a district employee, I'm not going to tell you go get an advocate. But there, I don't feel bad when a parent brings an advocate to a meeting. Because I know what that means. It typically meansthat there has been a lack of communication between the district and the parent. And that's just not cool. We need to open up the communication lines for everyone. And yeah, I know it's costly for a district it is I get it, and it's hard. But I think it's absolutely necessary, not only forthe student benefit, but also just for the the the IEP team working together, you know, that'simportant.

46:54 I love that, 46:55 you know, you can lead that conversation with if I'm part of your team, things are going to beokay. It's just very comforting for a parent. So kind of as I'm winding down some questionsabout occupational therapy, do you have a piece of like a golden nugget that you could sharewith a parent in terms of occupational therapy at school, whether it's tracking IEP goals,whether it's progress monitoring, whether it's asking questions, when they're not for what toask, is there some sort of theme that you have seen over your years of sitting at IEP tables andthings? I wish every parent 47:33 knew that? 47:36 Yeah, I'll give you two. One is a really hot topic. The other one is just something that everyone needs to know. And I'll start with the evaluations, because you need to make sure and youshould expect your occupational therapist or any related service provider to have a thoroughevaluation. And in my opinion, evaluations should be more than one to three pages, they needto be more extensive, and they need to be explained to you. So I would look for any evaluationwhere the therapist has done observations in the classroom that sometimes gets missed. You want to see that this that the therapist actually went in and observed your student in thenatural context, you want to see that they've done some form of evaluation. And sometimes it's not a formal evaluation, but you want to see, or sorry, an assessment. You want to make sure that you're seeing an assessment, basically, you're seeing data, what are they scoring and finemotor? What are they scoring and sensory processing? You want to see that part? And then thelast piece that sometimes goes unmixed is the synthesis. How are they tying that all together?What do the observations plus the data actually equate to? Not just a summary, some peoplewill just give you a summary about your student, you want to see an actual breakdown? Whatdoes? What does it mean that they scored low on this test? What does it mean that theyweren't able to form diagonal lines, so you want to see that, that synthesis within the report.The other one that I'll give you really quickly is sensory diets. I know that's a hot topic. And so I personally, I personally don't like the term sensory diet, because I see it as very prescriptive, aslike your student needs five minutes of swing at 10am 10 minutes of sensory fidget at 11am, soforth and so on. Right? I prefer more of a sensory preference sheet and what I will do and feelfree to, you know, ask your ot for something more like this, if if this equates to your student issomething where they look at your student identify some common behaviors that would eithershow that they are under responsive to whatever is going on in the classroom, or maybethey're over responding. And if that is the case, what are some sensory ideas that can beprovided based upon the over responsiveness or under responsiveness? going on in theclassroom, as opposed again to that at ADM, they need this at 10pm. They need this.

50:07 That's fantastic. It really is fantastic. And the folks can't see me. But I'm certainly shaking my head about the evaluation component and observations. And the center synthesis part 50:19 is critical. Critical. Yep. Especially if 50:23 you're going to be developing some sort of individualized systematic plan based on that youreally need to have that synthesis, pulling all together. What's your favorite productivity tool or resource that you're using lately? productivity tool. Oh, god. Yeah. I'm just kind of wrapping up some questions and given you some final thoughts. 50:45 Are you product I mean, oh, gosh, productivity tools. 50:51 It could be for data collection, it could be for what is something that's helping you be a betterversion of you, with the students that you support? Yeah. So 51:04 one thing that I use as an occupational therapist, it's a website. It's called tools to grow. And it's a subscription models, I think it's about $80 a year. And it basically has a ton of resources for school based FTEs. Some of them are printable worksheets. Some of them are more extensive, like handouts for teachers or handouts for parents, or sometimes it's like an entire, like 180Day agenda that you can print out and binds, right. So that's helpful. The other thing that Iknow all school based OTS are always looking for is a way to quicken up their notes. And so a tool that I've been looking more into is called sped note SPE, G and ote. And it's basically a toolthat it's just designed to help Quicken up that that five minute note taking process, becausefive minutes 12 to 16 times a day really adds up. And so trying to speed that time up. So yeah, those are two tools. 52:03 It says, and I should apologize, I did throw that question out with preference, preference andgiving you the the heads up that this was what was coming. So kind of as we are wrapping up, ht h ld Ih kd th tIdid 't k ht k?

what should I have asked you that I didn't know enough to ask? 52:19 Oh, you were pretty good. You asked? You asked most the questions. But really I love this question. Because I asked this question every time I buy a car. Anytime I'm buying something, I always ask the same exact question. Like to the car dealership? What am I not asking you that Ishould be asking you? So I love your question, but I've never been asked it. 52:37 But so funny, I usually will say to somebody similar in that same vein, if I'm, you know, gettingsome sort of advice, I'll say, what would you tell your sister? And then I always follow upassuming that you you know, you adore your sister, or your mother or something of thatnature? 52:53 Yes, with with love, what would you tell them? Right? Um, one thing what I tell and mostly forparents and special education teachers, you know, I would just remind everyone that the IEPteam is not a formality, it is a meaningful piece of the team. And same thing with evaluations,you know, OTs cannot do evaluations just for the sole process of saying a student needs OT ordoesn't need ot, that evaluation leads to so much more. And that's why that synthesis is so important. And so I would just say, go into that IEP team meeting, and, you know, be open, butalso expect professionalism from your team and expect everything that you want from yourteam, because they are getting paid to be there very, pretty well, for the most part to be onthis team. And you deserve to have their opinions expressed in a timely way. I should say in atimely way, in a in a way that basically answers your questions in a timely way, right, they needto get their information out to you. And so just just be open, but expect Don't, Don't lower yourexpectations for an IEP team because they really are there to help you better understand yourstudent at the end of the day, you know your student best, but they're there to provide somecolor for your student. 54:26 That's fantastic. So if you could, what would it be and why? If you could have a billboard withone tip for parents? 54:35 Oh gosh. 54:39 A billboard with one tip for parents related to education

A billboard with one tip for parents related to education. 54:43 It's gonna be anything really. 54:48 Um, 54:49 oh gosh. 54:51 Maybe I'll go with this. Get into the classroom. If you can figure out a way. I know it's hard with work and whatnot. But if you can take even one day off a month to, to volunteer at your child's school. I know sometimes, you know, it all depends on what their regulations are on this, butjust just be a part of your child's school life. And some ways you can get get into the campus.Get to know the teachers that are there through volunteering, or whatever it might be, I don'tthink you can build enough rapport with the people that are seeing your child every single day. 55:28 That's beautiful. It is beautiful. And like you said, you know, just try to, even if you can justcarve out a short amount of time, monthly bi monthly just to build that rapport with the folksthat are supporting your child. And also it goes a long way with your babies, your personalbabies, you know that they see you in the building, and that you've kind of paused on work, lifeis so crazy and hectic. And people are on their device and running around and doing soccer and all that stuff. So I think it means a lot to both the staff at the school that you're in the building,trying to make time to support the students and for your personal child, that you're coming inand helping out in the classroom. I think they really appreciate that, whether they say that or not, you know, your own kids 56:12 love that. Yeah, and I think relationships can can overcome a lot of deficits. I think having agood relationship with your child, or even a good relationship with their teacher oradministrators can overcome some of the some of the difficulties that any of them might behaving be having. So 56:29

56:29 yeah, incredible. So powerful. Jason, really, it is powerful. And I appreciate you providingtremendous information and value to not only the parents that are listening, but toprofessionals as well. Where can folks find you? I know you mentioned in the beginning, butlet's make sure that they can reach out and find you if they have other questions or want tocheck out all the fantastic stuff that you've got going on. 56:52 Yeah, ot school house.com Is my home base. That's where I would definitely start and you can find everything there. You can get linked to our social media pages from there. If you want, you can also use the contact form at the bottom of the page. If you have any questions for me. That Contact Form will come directly to me. So ot schoolhouse.com 57:11 Incredible. I'm so pleased that you're able to join us today for this back and forth and answeringquestions and hopefully clearing up some misinformation that people may have. So I appreciate your time. Thank you so so much. 57:25 Thank you, Andy. It's been a pleasure. Take care you back