Announcer (00:01): Highlighting the amazing stories from inside the North Clackamas School District, this is the Proud To Be NCSD podcast hosted by longtime principal and current community relations director, Curtis Long.

Curtis Long (00:14): It's just after lunch recess at Bilquist Elementary and moments after second grader Jace has caught his breath from skidding down slides and persistently pacing around the playground, this energetic eight year old now finds himself carefully clenching his pencil and concentrating on printing perfect penmanship on his paper.

Teacher (00:31): Okay what letters next?

2nd Grade Jace (00:38): W...

Teacher (00:38): You're right, you slide down. Slide up. Can you make a W over here? Good job

Curtis Long (00:51): Though the catchy self-imposed sound effects might say otherwise, this is not an easy task for Jace who earlier this year struggled with having enough finger strength to hold a pencil. So much so that anything he put on paper was barely visible.

Teacher (01:05): Oh easy peasy when you do it like that, right?

2nd Grade Jace (01:08): Easy Peasy.

Curtis Long (01:08): As you can probably tell, Jace loves the positive feedback he receives from Ms. Rose. So much so that he always does his best to dot all his I and cross all his T's.

Teacher (01:19): Okay let's do T. What do we do first?

2nd Grade Jace (01:21): Start at the top...

Teacher (01:22): And then you slide down and cross slide down and across.

Curtis Long (01:27): Ms. Rose, however is not Jace's second grade teacher in room seven, she's one of the North Clackamas School District's nine occupational and physical therapists who spend their days crisscrossing from school to school. Making sure students with physical challenges like Jace can be just as successful in school as all of their classmates. As we'll hear in this week's, Proud To Be NCSD podcast, those physical challenges can range from fine motor finger strength, like Jace.

Teacher (01:52): Good you are so focused.

Curtis Long (01:53): To kids trying to maintain their balance, navigating playground equipment.

Curtis Long (01:59): These are the North Clackamas staff members who help remove barriers for students who physically just might need a little extra boost. Who are these licensed occupational and physical therapists in N C S D? How do they consult with families and staff members? And most importantly, how do they make such lasting connections with NCSD kids? And joining us today on this lively edition of the Proud To Be NCSD podcast are members of the NCSD Motor Team. Gotta like that term, they're gonna explain it for you. That's Rose Brenner Nicole Nix, Morgan Garner, and Lisa Klein. Rose, Nicole, Morgan, Lisa, such a pleasure to have all of you taking time out of your busy schedules today. Thanks so much for joining us.

Morgan Garner (02:36): Thank you for having us. Yeah. This is Morgan Garner. I am the occupational therapist that serves the Milwaukie feeder here in our district. It's my second year in our district. Before this, I was an occupational therapist doing skilled and outpatient rehab with older adults.

Curtis Long (02:53): So I can tell that some of you have listened to our podcast before because you know what's coming. I'm going to ask each of you to introduce yourselves. And Morgan already jumped the gun on that <laugh>. So let's have each one of you introduce yourselves and explain kind of what you do in North Clackamas and maybe how you arrived in North Clackamas just as Morgan modeled for you there right off the top

Rose Brenner (03:11): I'm Rose Brenner, I'm another occupational therapist at North Clackamas and I work with the Rex Putnam feeder system. So I think all of us OTs are responsible for around six or eight schools that those are the ones I'm in charge of.

Curtis Long (03:25): And you were Ms. Rose there at the beginning of the podcast working with little Jace there? Mm-hmm.

Rose Brenner (03:30): <affirmative>? Yep.

Nicole Nix (03:30): I'm Nicole Nix, I'm the physical therapist assistant for the whole district, <laugh>, and I'm half of the physical therapy team. And Craig Anderson is our pt, so I'm sure you guys have seen him around. I have been in the district for almost 19 years and before that I was in school nursing.

Lisa Klein (03:48): Hi. That was leaves me. I'm Lisa Klein. I'm um, the COTA certified occupational therapy assistant for North Clackamas School District. I've been a COTA for 32 years. Uh, that means I'm the eldest of the group

Nicole Nix (04:00): <laugh>, but I've been here the longest

Lisa Klein (04:01): <laugh>. That's true. And um, I've graduated from COTA School and went right into working in schools. I worked for Clackamas E S D for 20 years before I came to North Clackamas. They sort of, I was contracted with North Clackamas and then they hired us all as employees in 2009 and I actually work in all the different feeder systems and support all the other four OTs and I really love working with kids.

Curtis Long (04:23): Well we're so glad to have all of you here today. And as you mentioned, we're missing a few from your team. You've mentioned a couple of names and feel free to make sure we recognize those names throughout the podcast. So interestingly, let's start from the beginning and maybe the most basic we can for some of our listeners. And we've heard the terms occupational therapy and physical therapy. Let's take those apart. What's the difference between occupational therapy and physical therapy, especially when it comes to a school setting?

Nicole Nix (04:48): So physical therapy, we work on the big motor movements, jumping, hopping, skipping how they access the school, whether it's in a wheelchair, crutches or how they run out to recess.

Morgan Garner (05:02): And a occupational therapist works with someone on their occupations. And in this case that would be a student's occupations, which would be anything they do in school. So their academics or how they're participating at recess or lunch or specials.

Rose Brenner (05:19): Yeah, I think that's totally right. I think in the past how it was thought of is only fine motor skills and only handwriting. And really what we're able to do given our license and our education is a lot more than that depending on what our caseload needs.

Curtis Long (05:36): So we're thinking occupational therapy, you think of it as an occupation and a student's occupation then is to be able to participate in school. Mm-hmm. <affirmative> the same way as all of his or her peers can participate in school. So that's what rose, you were doing occupational therapy then with Jace there at the beginning. Mm-hmm. <affirmative> on gripping his pencil. And I know you had explained to me he come quite a long ways from the beginning of the year to where he is now.

Rose Brenner (05:58): Yeah, he has, he's come a long way with his hand strength and his just fine motor control. But also he's getting a lot better at just regulating his nervous system at learning different strategies to calm his body down. Uh, like breathing strategies and other strategies and things like that. And I think his teachers and the people who support him every day have learned a lot about how to best support him in the classroom.

Lisa Klein (06:22): That's the one thing I like about occupational therapy is that we, we kind of look at the whole student and see what barriers they are having during their school day that keep them from being independent and being able to do everything that, uh, their peers can do. And so every student is an individual and we take a look at what barriers are impacting their day. And it might be sensory strategies. We do a lot of collaboration with teachers as well as working directly with students. And we try and teach them as much independence as possible. Cuz with occupational therapy, that's the key is we want people in general able to be independent, be able to access and do everything that they wanna be able to do in their day and be successful and happy kids people just all around.

Morgan Garner (07:03): I think our national Organization of Occupational Therapy, the, the motto is living life to the fullest. So that's our goal is to allow the students to do the best that they possibly can in school.

Nicole Nix (07:15): We look at how they function in their school environment and kind of overlap with occupational therapy and access and breaking down those barriers.

Curtis Long (07:23): So how do you come across these kids? Do they qualify? Are they identified early on, maybe even before they arrive in kindergarten? Do they have to qualify for your services? And if so, how do they do that?

Rose Brenner (07:35): Yes. So we support students who are on IEPs. Mm-hmm. <affirmative> or individualized education plans. Yeah. And in order to have an occupational therapist support an individual student, that student would need to have an OT evaluation. And they would access that by their teacher or other school members. Really flagging that student as we have some concerns about this student in the areas of fine motor or in the case of physical therapy, maybe it's gross motor skills or safety concerns or sensory concerns, anything like that. And after that, they may try some strategies to see can we address this problem without an OT or a pt? And if not, they would get evaluated and we would decide based off of that evaluation as a team, whether or not a licensed physical or occupational therapist is necessary for that student to achieve their individualized goals.

Nicole Nix (08:29): But they also, a lot of those kids do come in from the early intervention mm-hmm. <affirmative> ECSE program. So when they come to kindergarten, they've already had transition meetings with their previous PTs and OTs and their upcoming PTs and OTs here in our district. And then they come up with the collaborative school-based schools.

Curtis Long (08:48): So if a teacher has concerns or a school team has concerns, I imagine they contact you right away and you're a part of that evaluation process then, right?

Morgan Garner (08:55): We can be, it often depends. Would you like me to walk you through our referral process?

Curtis Long (09:00): For sure. Let's walk through that. Now remember we have listeners that are just kind of figuring this out or finding this out for the first time. So for someone like me who's been a part of a school for a long time, or all of us, it's a little bit different than someone who hasn't been through this before. So let's walk through the process. All right. How would that work, Morgan?

Morgan Garner (09:15): So we're gonna have our, our fictitious student, Johnny. All right. Johnny who's having a hard time holding a pencil and uh, Johnny's in kindergarten and his teacher has concerns that he can't hold a pencil. Mm-hmm. <affirmative>. And so his teacher might reach out to us and say, Hey, I really think Johnny needs occupational therapy. So then we would look at our referral process and say, one is Johnny already on an I E P? Okay. If he is, then we're gonna send our, what we call our pre-referral strategies, which would be some like basic things for the teacher to try that might fix the problem without him actually needing occupational therapy. So like, oh, have you tried teaching him the pinch flip trick for holding a pencil? And we actually, I should back up a little bit. We actually don't even really wanna know Johnny's name at this time. Okay. We just wanna know and pretend we

Curtis Long (09:59): Don't know who Johnny is...

Morgan Garner (10:00): Yes. Okay. That this teacher has a student that she needs help with. Gotcha. And, and the reason we don't wanna know Johnny's name at this point is because we haven't gotten parent consent to observe him or provide any specific recommendations. Where does kind of,

Curtis Long (10:12): So before you do that, you would consult with the parents?

Morgan Garner (10:15): Yeah so that's part of the referral process is we do have to get consent. So we say, Hey, try these these strategies for four to six weeks, let us know how they work out. And then if you still have concerns and you feel like occupational therapy is needed to address these concerns, then we will get parent consent for an evaluation. We'll evaluate the student, the I E P team will all meet and we'll determine what type of OT service is needed. Do we need consultation or direct services? If we are gonna have direct services, we usually wanna have a collaborative goal with the learning specialist. So that might be a writing goal where we say, okay, these are the objectives that we can work on together that we feel like would be helpful for Johnny if it's a consultation model. One more just providing some strategies. Mm-hmm. <affirmative> and I'm sure we'll go into this more later. Yeah.

Lisa Klein (11:00): I mean sometimes kids go through the evaluation process and they are determined that they don't really need occupational therapy. But you know, that's just team decision. Just like any I E P determination would be. So it might just be that, and our level of service also depends on the team.

Curtis Long (11:14): And Morgan, I think you mentioned before, if a student is already on an I E P, we've heard that term before, Rose mentioned that too. So I E P means that they're receiving special education services within their school. What if kids aren't, what happens then?

Morgan Garner (11:26): That's an excellent question. So if they don't already have special education services and the teacher says, Hey, I think this student would benefit from occupational therapy, then we would get the case manager involved and say, Hey, is this a A student who's on your radar? Are you thinking of doing some testing and maybe bringing them into special education? Because then would would be an initial evaluation. And so your original question had be, would we be part of that initial evaluation? Mm-hmm. And sometimes we are, sometimes the teacher says, Hey, I've already tried all these strategies. Mm-hmm. <affirmative>, none of them have worked. I think he still really needs help. And then we would be in from the very beginning.

Curtis Long (12:04): So we've talked a little bit about the referral process and I think some people will think, especially parents in our district, Hey, my child is struggling with this. Why is this referral process so arduous? Why is it taking so long? And I'm sure you have answers to that. There are rules we have to follow and procedures we have to follow.

Rose Brenner (12:22): Yeah, you're right. A lot of it is because of the legal rules that are coming from the state and even the nationwide rules from I D E A, which is the individuals, uh, with Disabilities Education Act. You're testing me here. <laugh>.

Curtis Long (12:37): Very good.

Rose Brenner (12:38): Uh, so we do have to follow all of the laws. That's maybe thing number one. And thing number two is just, it's about making sure that our license services are spread kind of fairly for the students who do have that most need for a licensed kind of more medical professional to support them. Or can we more quickly help their teacher with a strategy that they could use, not just with that one student but with multiple students in their classroom or with maybe all future students who, who are having that same type of more common problem. Or like in the case of the pandemic, is this truly a disability that is causing this issue, this access issue? Or is it the fact that many kids are having the same type of problem because of the pandemic? Mm-hmm. <affirmative> and the results of that on all kids. I would love to believe that any student could benefit from time with an occupational therapist, but at the end of the day, they're here to learn and to be with their class and to participate in their kind of school or classroom community, not to go to therapy. And the therapy, whether it's occupational or physical, is only there if that student is unable to access their education without it. And that's the key.

Curtis Long (13:50): How about for students who maybe have an accident, they have a cast on their arm or they're temporarily uh, have a cast on their leg. Are they eligible for occupational or physical therapy? Mm-hmm. Based on a, something that's gonna be temporary for them.

Nicole Nix (14:02): That usually falls under a 5 0 4 mm. Okay. Um, and that depending on the age level, so I think elementary school is usually run by the principal or counselor.

Curtis Long (14:11): Sure is. I know those <laugh>. Yeah. I know how to do 5 0 4 s.

Nicole Nix (14:14): Mm-hmm. <affirmative> and the middle school and high schools are usually counselors, I believe. Mm-hmm. <affirmative>. And they will reach out to us and say, Johnny broke his leg. We need some support on how to get him to a toilet. And unfortunately <laugh> Yeah, we spend a lot of time in bathrooms. Sure. Teaching transfers. But Craig would go in and evaluate how Johnny transfers. We of course need the medical information from the doctors of what the surgery was. So we know how much support to give.

Curtis Long (14:41): And I think that's a good illustration of things that people don't think about. So you have a seven year old student who all of a sudden has a full leg cast. They're gonna need some support, especially in the restroom or anything else around mm-hmm. <affirmative>, how to get their lunch tray and things like that. Mm-hmm. <affirmative>. So those are things that you're helping with and helping brainstorm ideas or directly supporting the kids with that. Mm-hmm. <affirmative>.

Lisa Klein (14:59): Mm-hmm. <affirmative> out at recess and everything. Recess.

Nicole Nix (15:01): Come up with some alternate

Lisa Klein (15:03): Carrying their tray and you know, in the cafeteria, just all sorts of...

Nicole Nix (15:06): PE's a big one.

Curtis Long (15:07): Yeah. PE would be a big one. Mm-hmm. <affirmative>. Okay.

Lisa Klein (15:08): Especially some of our gyms are really busy, so there's lots of chaotic kids running around. <laugh>, they could knock Johnny off his crutches.

Curtis Long (15:15): For sure. Poor Johnny. Poor Johnny can't hold his pencil. And now we've got him with a broken leg and he needs help getting to the rest of the room.

Lisa Klein (15:21): There are some Sallys out there too though.

Curtis Long (15:23): Okay. Of course there are. Of course there are. So Johnny has qualified. So then how do you guys figure out, how often do I get to see Johnny or how is that going to work? Do I provide some recommendations to the teacher or do I see Johnny directly? And if so, how often? How does all that work?

Lisa Klein (15:38): Team decision? Okay. At the IEP team.

Curtis Long (15:41): So they, the team comes together, which you guys would be a part of, and then you make those decisions. So Rose, you're getting ready to, to explain it. We, we still got Johnny on the mind.

Rose Brenner (15:50): Yeah. So I think the biggest thing to think about is what is the team, including the parent mm-hmm. <affirmative> and the teacher and their special education teacher. What's the team's biggest goals for the student? And based off of that, how much would we need in OT or a PT to be able to support that team in order to achieve that goal? So it really does depend a lot on what the students goals are, what the, their priorities are for the year. Because there might be a thousand goals we could make sure, but we have to decide on what are the most important ones and who is needed in order to support those goals. And it could even depend on what are the skills of those individual teachers. There might be a teacher who's like, I've been through this, I've done it, I know what to do. And they might need less support than a newer teacher or a newer special ed teacher. So it just depends.

Nicole Nix (16:38): And we also want Johnny to be part of those goals too. For sure. Yeah. Because we have, especially as the success kid gets older, especially success, the kid is motivated to

Rose Brenner (16:46): Yeah. There's a lot of factors that go into it. It couldn't even include as you know, is a fifth grader likely to care about this skill and be motivated to change <laugh>?

Lisa Klein (16:56): Yeah. Does he? Does he wanna modify his pencil grip right. At fifth grade? Probably not.

Curtis Long (17:01): We heard from Jace at the beginning, if he were in fifth or sixth grade, would he be as enthusiastic about making those sound effects, making his Ws?

Lisa Klein (17:08): No. And that's the thing we look at, you know, with older kids, we look at, uh, maybe they're not doing as much writing with, you know, a pencil. And so these days we use, we teach a lot of kids speech to text and typing Sure. Strategies for their written output. And cuz a lot of kids in fifth grade or later, they don't wanna laboriously work on writing their letters perfectly. And so I don't blame them

Rose Brenner (17:28): And they need to move on to higher level thinking skills. Mm-hmm. <affirmative>. And they need to be spending their time in school on, on other goals at that age. Mm-hmm. <affirmative> besides just focusing for years and years and years on handwriting. For a student who has underlying motor impairments that may never go away in their life, there's so many other strengths that that student might have and ways that they can build their skills, whether it's writing or something else.

Nicole Nix (17:52): Kind of on the PT side of it, as I think through some of our kids since I've been here so long, like in the early elementary, a lot of our goals are surrounding how do they get down for circle time and how do they sit and tolerate sitting unsupported at circle time. And as a fifth grader and moving forward, they're not getting down onto the ground. Right. So our goals change mm-hmm. <affirmative> mm-hmm. <affirmative> and adapt towards what they are doing in their school day.

Curtis Long (18:17): Do you find that, and based on what we've talked about so far, that most of the referrals and your early consultations about kids are at the elementary level most

Nicole Nix (18:25): Of the time.

Curtis Long (18:25): Okay. Mm-hmm. <affirmative>. Like what would be an example when we, when we have a middle school kid or a high school kid getting occupational therapy or physical therapy for the first time?

Nicole Nix (18:33): A big example would be a student that has a traumatic injury, like a spinal cord injury. Okay. And their whole life has changed. Yeah. Overnight. That's probably the most drastic example I can think of.

Rose Brenner (18:44): We have a few students in the district that have degenerative conditions as well, which means their condition worsens over time. Mm-hmm. <affirmative>. So they might have an increasing need for services as they get older. And it still might be more of a consultation kind of model because at that point you can really talk to the student about, Hey, what's the most challenging part of your day? And how can we make this better? And how can we help you learn to advocate for yourself rather than a kindergarten student is

Lisa Klein (19:12): Mm-hmm. <affirmative>

Rose Brenner (19:14): Look different.

Lisa Klein (19:14): I find too that the older the child is a student is the more they are learning. Our focus is a little different in what they, you know, wanna be able to do independently. Like I work a lot in the middle school and the high school kids and instead of working on handwriting, a lot of 'em, they wanna be able to get into their locker independently. Mm-hmm. <affirmative>, they want to be able to be organized with their classwork and be able to turn their, you know, work in on time. And so we work a lot on more executive functioning skills, how to get your assignments done in a timely manner. How to, what are your barriers keeping you from being success? A successful student in middle and high school. And so the focus really does change as they get older. It's not just on handwriting per se, it's sort of always evolving as they get older.

Curtis Long (19:53): So just like occupational therapy needs have evolved for kids from primary pencil placement to pivoting padlocks, this discussion with NCSD OTs and PTs continues to evolve as well. So far we've taken a closer look at how students qualify for these important extra services. But what if a student's need for a little extra support isn't physical at all?

Morgan Garner (20:13): I've been getting a lot of referrals for students with sensory processing difficulties. Okay. So they're just having a hard time regulating their emotions, regulating their bodies.

Curtis Long (20:23): And what's the best part about being an occupational or physical therapist for North Clackamas District students?

Nicole Nix (20:29): I love that I get to go to recess all day and PE and just knowing that we are making a difference for these kids and advocating for them to be included rather than sitting on the sidelines.

Curtis Long (20:43): The second half of the Proud To Be NCSD podcast is up next. Right after this short recess.

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Curtis Long (21:43): And Lisa, that was gonna lead right to my next question because I think people are probably interested in, is there a most common thing that you see kids for? I'm sure it's a wide variety, but we've talked about pencil grip at the younger kids level. I didn't think of navigating a locker. That would be something for sure. Shoe time. What are some of the mo Oh, shoe tieing. That's a good one too. So that's what I was gonna get into. What are the things that you see most commonly that maybe our listeners wouldn't think of? Oh yeah. I could see how a child would have trouble with that and that's why you guys are a part of our district. So what are some things that you deal with on a daily basis or weekly basis?

Morgan Garner (22:14): I think that fine motor skills used to kind of be the bread and butter of our OT team. Mm-hmm. <affirmative>. But over the last couple years, I think especially post covid, I've been getting a lot of referrals for students with sensory processing difficulties. So they're just having a hard time regulating their emotions, regulating their bodies and you know, sometimes it's behavior issues. Sometimes it's leading to they're just having difficulty participating because they're overwhelmed by their environment or they're having a hard time participating because they're seeking some sort of sensory input that helps 'em feel regulated but makes it so they can't do their schoolwork. And so the team calls us in cuz we're kind of considered the sensory experts to do a sensory evaluation, which usually involves a questionnaire that goes to the teacher that then we analyze and it helps us say yes they are avoiding auditory stimuli. True. And they're seeking, um, movement based stimuli.

Curtis Long (23:08): So you guys are kind of like the detectives trying to figure out what is causing the student to act the way he or she is. And it's usually in response to, and I didn't even think of that. You think of physical therapy or physical things that the kid does, but there's a lot of emotional regulation that you're trying to uncover and help a child through. And rose, I remember at the, when we visited Jace earlier in the podcast, we didn't put this part on the recording, but you did some deep breaths with him at the beginning and he did a, a couple of pushes against the wall to kind of get himself centered. So that's something that you guys are working on quite a bit too, that I think our listeners maybe don't realize that our OTs and PTs are also helping kids with emotional regulation as well.

Lisa Klein (23:45): Yeah I think that's part of it. We share the strategies with teachers and support staff that they can do those stretches or those, you know, movements to help build those strengthening, you know, the skills on a daily basis cuz we're not there every day at that particular school. And I, I also wanna add to what Morgan said about post covid that I seem to be seeing a lot more just weak, I dunno, trunk strength...

Curtis Long (24:05): Weak core muscles?

Lisa Klein (24:06): Core muscles. Yeah. Like kids were stuck in the house for a while during covid and they're not out playing on the playgrounds and running around and building their hands and Johnny's falling out of his chair. Right. You know, kind of thing. Poor Johnny. Yeah.

Curtis Long (24:17): Johnny's had a rough time during this podcast,

Lisa Klein (24:19): You know, is it, is it because Johnny wants to fall out of his chair cuz he's, you know, or is it because his core strength is weak? You know, so we have to kind of go in and yes, detectives is kind of what we all are here. It's figuring out what's going on with this student then what are the barriers going on and how can we help?

Morgan Garner (24:33): We've also noticed with the whole post covid thing, weaker hand muscles. Mm-hmm. <affirmative> because there's a lot of time spent on Chromebooks where you're not really using your hands the way that you would be if you were in school holding a pencil or even coloring. Um Yeah, doing crafts, playing video games, doing things on the computer doesn't build hand strength.

Curtis Long (24:54): So I'd imagine kids are having trouble maybe with using scissors for the first time. Mm-hmm. <affirmative> or opening containers or the glue sticks that you have to roll mm-hmm <affirmative> to, to get the glue to come out of a lot of things that we just don't think about. They just didn't have that practice here

Lisa Klein (25:07): In an OT school. I, that's kind of what we do. Like, you know, we do a lot of task analysis for things, figuring out what strengths or what skills are needed to do bilateral tasks like opening a glue stick or a marker and getting, having the strength to be able to mm-hmm. <affirmative> work with both hands together. So breaking down tasks, figuring out what's the block that's keeping that student to being successful.

Morgan Garner (25:26): And you mentioned opening containers. That is something else that we will sometimes address is self-care skills. Okay. So if we have a student who is having a hard time zipping or un zipping their coat mm-hmm. <affirmative> or um, opening their lunch containers or doing buttons, those would be kind of the functional skills that they need on a daily basis but maybe isn't directly tied to their academics.

Nicole Nix (25:49): And from a PT standpoint, it's a little different. We do a lot of transfers. We've noticed the kids have less endurance for activities, which is probably why they're falling out of their chair

Curtis Long (25:59): <laugh>. Okay. So transfers, help me understand what transfers are. So this is from one location to another maybe? Yeah. Okay.

Nicole Nix (26:06): A transfer could be how they're walking from their classroom. Okay. To the playground or a transfer could be how they're getting from their wheelchair to their classroom chair. Mm-hmm <affirmative> or to the lunch table so that they can sit with their friends. A lot of our kids in wheelchairs tend to be off to the side. Sure. And our job is to get them in the middle and so that they can access the lunchroom, the playgrounds, the restrooms ke And so we've definitely seen an increase of balance issues and endurance. Yeah.

Curtis Long (26:34): So we have kids who are in wheelchairs but can get themselves to the cafeteria and maybe transfer to a cafeteria seat mm-hmm. <affirmative> so they can sit with their friends. Yeah, sure. Or same thing going to music class or somewhere else. Okay.

Nicole Nix (26:45): Right. Yep. And we, we work with a lot of different types of adaptive equipment. Okay. And so some of our higher need kids might have a standard that you see and we're, we have them standing during music class. Hmm. We found that super beneficial, especially for our high school kids that are in choir. Okay. Standing upright to sing is a lot easier than when you're sitting hunched in your wheelchair and helping the staff.

Curtis Long (27:06): Sure, OK...

Nicole Nix (27:06): Ways to protect the student and the staff member cuz most of our kids in wheelchairs need support to transfer.

Curtis Long (27:13): And I would imagine that with North Clackamas staff members, you get a lot of help from them. I'm sure they want to do what's best for their kid and mm-hmm. <affirmative>, there are probably lots of staff members who don't get the recognition they probably deserve for going out of their way to make students in their classroom feel even more included.

Nicole Nix (27:29): That's a thousand percent correct. I think the most success we have is when we have the team members that are with the kids every single day and they're working on the tasks that the kids need and want to succeed.

Lisa Klein (27:42): And North Clackamas has fantastic staff.

Curtis Long (27:43): They sure do.

Nicole Nix (27:45): Espcecially, I'm gonna shout out the para-educators because Uhhuh <affirmative>, they have the hardest job in the district. Mm-hmm

Curtis Long (27:49): <affirmative> and it's things that they would've never thought was part of their job description. Absolutely...

Nicole Nix (27:53): And they take it like a champ <laugh>.

Curtis Long (27:55): So we have some students that maybe have a certain para educator that's assigned to them most of the day or a one-on-one assistant. Is that the case or are these It kind depends. Okay. A rotating group of para educators usually

Lisa Klein (28:07): Rotating.

Nicole Nix (28:07): Okay. Because the students are in an S LCA classroom. Right. Or a TLC. There's multiple staff members that work with them. We do have some kids that are in general education and they just have one staff member that works with them. Mm-hmm <affirmative> for their transfers. Mm-hmm <affirmative> or if they need more than one person.

Curtis Long (28:24): You mentioned something very quickly, Morgan. The push in model and for our listeners who don't know what that is, that basically means that you are pushing into the classroom rather than pulling a student out for services. Like we heard at the beginning where Rose was working with Jace in a separate area. There were probably times when Rose goes into that classroom and works with Jace directly. So let's talk about the different models that you use to help kids with O T or PT.

Nicole Nix (28:45): So thinking back over the a million years I've been here, we used to do only pullout. Mm-hmm <affirmative>. We used to pull the kids outta class, work on a couple skills, balance how they're sitting in their chair and then say, okay, go back to class and there was no carryover. Mm-hmm <affirmative>, the staff didn't see what we were doing. The student couldn't take what we were working on in that small little space and bring it back to their classroom and utilize it. So over the years we have worked diligently with the teams of like, let us come into the classroom, watch how we're putting Johnny in the standard and then you can do it every day. Or let's go to PE and see how they're catching a ball. And then the para-educators can then help support that on the days that we're not in PE with Johnny. So there was just so much more carryover and more success when the teams knew what we were doing.

Rose Brenner (29:34): And that's what the research is showing more and more now too, is the more that we can get into those classrooms and and model what we would do with a student and collaborate with our fellow teachers or special education teachers or paraprofessionals, the better results that the student ends up getting.

Curtis Long (29:54): And how rewarding is it for all of you to visit that classroom again and see what you had worked on or what you had tutored the para-educator or the teacher with. And to see that in action and and smiles on kids' faces because they're participating, that's gotta be very rewarding for you.

Lisa Klein (30:09): I think that's what keeps us all coming back <laugh>, is when I see kids in ATP and they're like, Hey Miss Lisa, I remember you from when I was in elementary school. You taught me how to do this or that and I can do it myself now.

Nicole Nix (30:22): And I'm thinking too when we did the pullout model, things that we thought were like the best ideas ever and then we expect staff to do it in the classroom and it just would not work. Yeah. Whatever the reason, whether it was all the kids around or the space or whatever, it's really important to be able to collaborate with the teachers and from all different areas, whether it's music or the classroom teacher or the para-educators or the playground teachers to like make sure that we're all on the same page. Mm-hmm.

Rose Brenner (30:50): <affirmative>. I think now what we do a lot is a combination. So for example, I might pull Jace once a month to work with him directly and that's when I get to really see how are you doing on these skills when you're in a distraction free environment one-on-one and what strategies can I use that you easily pick up on and that you might be able to be independent with in the classroom. And then the other times that I see him during the month, I'm either with his small group that he sees every day or in his regular education classroom and that's when I get to, to share those ideas and strategies. And he already has seen that activity before. He kind of knows how to do it. And that's where we can really work on transferring it to the everyday environment.

Curtis Long (31:33): As I've said many times during interviews on this podcast, I am a sucker for success stories. And Lisa, you mentioned a little bit about this because you've seen students now in the ATP program that you had way back in elementary school. Now I don't want any of you to mention any names, but I would love to hear any stories you might have of students you met maybe at an early age. You've worked with him for a few years and now you're just amazed at what they're accomplishing now. I'd love to hear any stories like that. Do you have any of those?

Nicole Nix (31:58): I have a handful. Someone that came to mind who is no longer in the district. He is, I believe a lawyer. He had a pretty severe diagnosis with a lot of medical complications, but he made it from kindergarten through 18 here and went on to college and, you know, was,

Curtis Long (32:16): Did you meet him as a kindergartner and follow him through?

Nicole Nix (32:19): He was second grade, I believe. Mm-hmm.

Curtis Long (32:21): <affirmative> when you met him? School actually. Okay.

Nicole Nix (32:24): When I met him and yeah, now he was out being a adult.

Curtis Long (32:29): What do you mean? North Clackamas kids grow to be adults and do adult things?

Nicole Nix (32:33): Yeah. So I haven't seen him in about two years, but the last time I did he was finishing his undergrad and choosing which law school he wanted to attend.

Curtis Long (32:42): Wow. Fantastic.

Lisa Klein (32:43): Yeah. I met a girl that I had started with in third grade and uh, I actually met her, she was at the New Seasons out here in Happy Valley and she came up to me, I didn't even recognize her course and she of course said, Hey Miss Lisa, guess what? And I said, I, I was like, ugh, <laugh>, I forgot her name but yep. She remembered mine. And um, I said, what? And she said, I just graduated from high school and I'm, I'm moving in with my friend and uh, we're gonna get an apartment together and go to college over at, at Clackamas Community College. And I mean, I was amazed cuz she, you know, has come so far. Sure. And now she was excited to tell me about how she was moving out and being independent. I mean, I think that's what we all want with our kids is to be, have a successful school experience and then move on and become independent adults. So mm-hmm. <affirmative>, that's our long-term goal.

Nicole Nix (33:28): And I think the only way it happens is having the collaboration between what we do as this weird job as people don't know what we do a lot.

Curtis Long (33:37): That's why you're here <laugh>.

Nicole Nix (33:39): And working with all the teachers and staff from kindergarten through 21,

Lisa Klein (33:45): I think occupational therapists have kind of an issue. You know, no matter what age we work with, cuz people, they don't know what occupational therapy is. And so they always look at us and say, what? Like what do you do? What are, are you trying to give my child a job? <laugh>. I mean the cool thing about occupational therapy and physical therapy is we have such a great job because we touch an every area of a student's life and we can make a lot of difference in somebody having a successful, positive independent life. And so I think that's what drew me to occupational therapy from the get-go, from

Nicole Nix (34:17): The PT side, we always get called the OTs. People just don't know we exist. But the best part for me is knowing that some of these kids I've gotten to be with since kindergarten, you know, most teachers have their students for a year or two

Curtis Long (34:30): Right. For one year. Yep.

Nicole Nix (34:32): And the kids move on. But just watching some of these kids, we have a group of boys right now that are at ATP that when they were in kindergarten, they were <laugh>, they were a handful. Yeah. But they're doing awesome now.

Morgan Garner (34:44): Nicole, if it makes you feel any better, I get mistaken for a PT frequently. Oh yeah. Good to know. People say, who are you again? You're, you're a PT, right? Mm-hmm. <affirmative> like no OT <laugh>.

Lisa Klein (34:53): We like to tease the PTs. They spend a lot of time in the bathrooms, especially Nicole.

Curtis Long (34:58): So that's part of the job...

Lisa Klein (34:58): We call her the bathroom queen

Curtis Long (34:59): That's part of the job. Well that was the goal of this podcast is to educate people on the wonderful things that you do throughout our district and the difference between occupational therapy and physical therapy. And we've touched on that a little bit here too as we start to run out of time. One simple way to end this, tell me the best part about being a school-based occupational therapist or a physical therapist. And some of you have touched on this already, is to see the, see kids succeed. So what is the best part of your job? What do you see as the best part of the job that you do? That sometimes gets overlooked in our district. And that's the purpose of this podcast, is to make sure it doesn't get overlooked.

Rose Brenner (35:30): I just really like being part of the school community and really contributing towards the overall goals the district has.

Morgan Garner (35:36): Well I made the switch from working with older adults to working with kids and I just, I feel that there's so much hope and promise for these students, you know, that they're beginning of their lives, they have so much ahead of them. So it was very refreshing for me, you know, working with people who were sometimes on hospice or, you know, very close to the end of their life, to suddenly working with kids where I felt like this is the future.

Lisa Klein (36:04): And I just love working with all the special ed staff and the staff and the schools. Cause I think North Clackamas has a fantastic group of teachers and I just really enjoy working with the kids because kids don't really know they're getting therapy. They just think we're having fun mm-hmm. <affirmative> and having a good time. And we're actually strengthening skills. So it's kind of a great all around. I get paid to play the kids <laugh> situation.

Nicole Nix (36:25): I'm similar. I love that I get to go to recess all day and pe and just knowing that we are making a difference for these kids and advocating for them to be included rather than sitting on the sidelines. There's a little bit of a passionate side that Craig and I are working on right now is making these playgrounds more inclusive mm-hmm. <affirmative> so that our kids can play with their friends.

Morgan Garner (36:49): I will just mention, uh, the rest of our team members who are not here. So as we mentioned, we're in feeder system, so we're each kind of in charge of, uh, some elementary schools, middle school and high school. So not present today we have Anya who is with the

Lisa Klein (37:04): Nelson

Morgan Garner (37:05): Nelson feeder system. Thank you. And then we have Annie who is with the Clackamas feeder system. And then Melanie, who this year is in a new role, she is supporting us with evaluations. So she kind of travels the whole district helping out with evaluations. And then she also works at the Early Childhood Evaluations Center. Mm-hmm. <affirmative>. And then of course Craig, our physical therapist who is over the whole district as well.

Nicole Nix (37:32): Yep one and only physical therapist, one and only Craig

Lisa Klein (37:34): <laugh>. And we can't forget Melissa, she's a, a COTA, another COTA. She works one day a week on Fridays and she supports ald Milwaukee High School and Oregon Trail Elementary.

Curtis Long (37:45): Well the purpose of this podcast on the Proud To Be NCSD podcast is to try to recognize all of the amazing staff members we have within our North Clackamas school district. And I think we've really found some gems with this one and our people that are often overlooked. Our occupational therapists and physical therapists who work a lot of times behind the scenes to make sure our kids are successful. But you ask any elementary school kid or middle or high school kid who receives services from any of these people here and you'll see nothing but smiles and I'm sure gratitude from them and all of you here today. So Lisa and Nicole and Rose and Morgan, you truly make us Proud To Be NCSD. So thanks so much for being here. I'm glad we've got a chance to get to know all of you and hopefully people now have a better understanding of what you do on your job and how you help kids become successful in our school district. Thanks again for being here.

Whole Group (38:35): Thanks for having having us. Thank You. Thank you.

Curtis Long (38:37): Thanks for listening to The Proud To Be NCSD podcast. In North Clackamas, we know that education is a community effort and we're so thankful that you and your family are a part of our community. Until next time, remember, there are always great things to see wherever you go in N C S D.