MAKING A BIG IMPACT THROUGH
COLLABORATIONDenise O. Alford OTR, MS
Lynn Wilde COTA
Learning Objectives■ The learner will understand the role of occupational therapy within the
school setting and be able to identify the differences between school-
based and medical models of occupational therapy.
■ The learner will understand the relationship between COTA and OTR in
the school setting.
■ The learner will understand the importance of collaboration with
teachers and para professionals to make a difference in the student’s
ability to participate in their curriculum.
■ The learner will be able to identify examples of ways that occupational
therapists support the staff and student to improve the student’s school
performance.
Medical Based OT
■ Requires doctor’s orders/prescription
■ Clients seen in facility
■ Reimbursement/insurance driven
■ Services paid for insurance or individual
■ Evaluations completed on insurance’s time line
■ Goals vary in duration
■ OT can be a stand alone service and have own goals
■ Direct service provided to the patient
School Based OT
■ OT typically provides services through Individuals with Disabilities
Education Act (IDEA) and special education
■ OT is a related service based on educational need
■ IEP team determines if OT testing is needed
■ Goals should be integrated with other professionals and are for a
year at a time
■ Revaluations typically completed every 3 years
■ State and federally funded
AOTA (2016) and AOTA (2013)
Possible Disability Designations in SPED
■ Specific learning disability
■ Other health impairment
■ Autism spectrum disorder
■ Emotional disturbance
■ Speech or language
impairment
■ Visual Impairment, including
blindness
■ Deafness
■ Hearing impairment
■ Orthopedic impairment
■ Intellectual disability
■ Traumatic brain injury
■ Multiple disabilities
The Process of Determining Special Education Eligibility
■ Child referred by parent or teacher
■ Special education team meeting- determine if testing is necessary
■ Signed consent for testing
■ Testing in all areas of suspected disability
■ IEP team determines if student qualifies and what area of disability
■ If student qualifies, determine services
■ Goals determined and who implements
OT Evaluation in School Setting■ Focuses on student’s ability to access the school,
curriculum, and any barriers
■ Informal observation
■ Interviews with parent(s), teachers, and student
■ Formal assessment
■ Written report is completed and is included in the IEP
Adapted from Occupational Therapy Essentials for Clinical Competence
OT’s Role in the School System■ Focus is on academics, play/leisure, social participation, self-care skills,
and transition/work skills
■ Educate staff and families to encourage student participation and
independence while at school
■ Modify or adapt areas that may be barriers to participation
■ Advocate for the student
■ Provide information regarding disabilities, disorders/syndromes,
precautions, and positioning.
AOTA 2016
Definition of Collaboration
■ Collaboration in the school setting is personnel
working together and sharing expertise to benefit
the needs of a child. Can be formal or informal
planning, development and monitoring of
interdisciplinary interventions.
Barnes and Turner 2000
OT/ COTA Relationship■ Supervision is always provided for the OTA by the OT
■ Supervision may be through email, text messages, phone,
face to face, and direct interactive supervision
■ OTA keeps the OT informed of any changes to the students
program and performance
■ To have a successful OT/OTA relationship there needs to be
respect and effective communication
People OT May Interact with (IEP Team)
■ Student
■ Parents/Caregivers
■ General education teacher
■ Administration
■ School diagnostician
■ OT/COTA partners
■ Special education teacher
■ Speech Pathologist
■ Physical Therapist
■ Music Therapist
■ School Psychologist
■ Vision Specialist
■ Orientation and Mobility
■ Auditory Impairment Teacher
■ Assistive technology specialist
■ Adaptive P.E. teacher
■ Behavioral Specialist
People OT May Interact with continued
■ School nurse
■ School Counselor
■ Art, Music, and P.E. teacher
■ Para professional
■ Librarian
■ Secretary/ person at front
desk
■ Cafeteria staff
■ Janitor
■ Bus driver
■ Lawyers
■ Advocates
■ Outside therapists
Delivery Methods■ Consult/ indirect
■ Pull out/direct
■ Combination of direct and indirect
■ In class support – Integrative/ collaborative– Authentic environment– Individual, small group or large group
Occupational Therapy Essentials for Clinical Competence, and Dunn 1996, AOTA (2013)
Benefits of Collaboration
▪ Increase positive outcomes
▪ Creates mutual respect
▪ Increases staff retention
▪ Increases knowledge for all involved
▪ Reduces teacher/therapist isolation
Adapted from Loy, Micheff, Nguyen, and B’Brien
Barriers to Collaboration
▪ Time constraints
▪ Lack of interprofessional knowledge
▪ Clash of professional knowledge
▪ Personality factors
▪ Complex and requires effort for all involved
Adapted from Barnes and Turner 2001
What Teachers Want You to Know ???
Creating Successful Relationships
■ Keeping the child’s needs as a priority
■ Authentic praise
■ Educating others regarding the role of OT
■ Having an open mind and listen to others
■ Identify norms
Adapted from Barner and Turner
Strategies to Increase Collaboration
■ Formal/ informal meetings
■ Follow up with written recommendations
■ Share strategies, activities, etc. that relate to the goals that OT supports
■ Consult on a regular basis with staff to monitor student progress/ staff needs
Handling Difficult Collaborative Situations
■ Provide achievable strategies- less is more
■ Offer to train the staff and demonstrate use of proposed
strategies, materials, and interventions
■ Consult with other team members or administration
Neil’s Story
Sometimes we even collaborate with
Santa
Resources ■ AOTA website- aota.org source of information/ fact sheets for parents,
teachers and therapist
■ Executive Council of Physical and Occupational Therapy Examiners-
PTOT.Texas.gov
■ TxSpot- txspot.org source for those that want to know about school-
based Occupational Therapy and Physical Therapy in Texas
■ TEA.Texas.gov/curriculum/TEKS- Texas Essential Knowledge and Skills
■ tea.texas.gov/About_TEA/Glossary_of_Acronyms
Bibliography■ Barnes, Karin J. and Turner, Keith D. (2001). Team Collaborative Practices Between Teachers and
Occupational Therapists. American Journal of Occupational Therapy, 55 (1), 83-89.
■ L. Davis (2018) Teacher Collaboration: How to Approach it in 2018. Schoology Exchange, February 7, 2018.
■ Kemmis, Barbara L. and Dunn, Winnie (1996). Collaborative Consultation: The Efficacy of Remedial and Compensatory Interventions in School Context. American Journal of Occupational Therapy, 50 (9), 709-717.
■ K. Jacobs and N. MacRae (2017)Occupational Therapy Essentials for Clinical Competence, Slack Inc.
■ M. M. Caskey and J . Carpenter (2014) Building Teacher Collaboration School-wide: Models for techer collaboration are ineffective without true participations AMLE Magazine. October 2014
■ What is the Role of the School-Based Occupational Therapy Practioner? Questions and Answers for Parents. AOTA 2013
■ Occupational Therapy in the School Settings Fact Sheet. AOTA 2016