E91: Occupational Therapist (OT) [IEP Team BONUS Series]
In this IEP Team Bonus Series we are talking about occupational therapists, my own profession! It's a little bit more in depth than you likely need...but then again...OTs are one of those professions that can cover a LOT when it comes to supporting your child!
In this IEP Team Bonus Series we are talking about occupational therapists, my own profession! It’s a little bit more in depth than you likely need…but then again…OTs are one of those professions that can cover a LOT when it comes to supporting your child!
In this episode we discuss:
1) What requirements an OT needs to practice in the schools
2) What an OT actually can DO for your child
3) Some school cultural barriers to advocating directly for “more OT” for your child
Download the FREE IEP Process Step-By-Step Guide
E91: Occupational Therapist
[00:00:00] On this week’s IEP team bonus series. We are talking about occupational therapy, my own profession. We will go into the qualifications of an occupational therapist and also what ots do in the schools to help support your child which is incredibly vague and incredibly hard to explain but i’m going to give it my best shot stay tuned for this extra special episode all about occupational therapists on the podcast
You are listening to the parent IEP lab, the podcast that helps you get an effective IEP plan for your child so that you can get them supported and learning in school. I’m Beth LEAs and Feld occupational therapist, who started to notice trends in parents who got effective IEP for their kids without having to fight with the school.
My mission is to help you turn insider knowledge from the school side into effective parent advocacy for your child. The parent IEP lab is all about the most important thing. Parent input into IEP. And also helping you prep for upcoming meetings without the stress. And also we talk about commonly missed opportunities for parents to get an [00:01:00] effective IEP outside of the IEP meeting too. So let’s dive into today’s episode and think about what we can change and tweak to get the right formula for success for your child to learn and grow in school.
Welcome to the lab.
If you have a meeting coming up in the next few months, or maybe in 12 months, do not wait to snag my new freebie, the IEP process step-by-step guide it breaks down the IEP annual review process and includes what, and when you should share your parent input. So you can actually feel heard at your next IEP meeting. Download your free copy at www.theieplab.com/iep. Or the link is below this podcast in your podcast player. Now let’s get into the episode
I’m going to be very honest. I am really nervous to talk about my own profession on the podcast. I think I have fun talking about other roles because I observe it so much, but we’re talking from my own experience. And of course all the other OTs that I’ve worked with, but it’s not like I [00:02:00] don’t know what I’m talking about, but it just feels like I’m going to forget something important, especially with a profession that is notoriously vague.
And hard to explain. So it’s also because occupational therapists are the flexible Jack of all trades people and the IEP team. And within every environment that we work, whether it’s like home health or in hospitals, because one of my internships was actually in the medical ICU.
We work in. Inpatient mental health systems. We do pediatric work in the homes. We do outpatient, we do schools, we do a lot of different things. And so I feel like I could talk about this for hours, but I’m going to make it as quick as I possibly can around 20 minutes, because that’s what I shoot for for every episode, because I know you guys are busy, right?
So first things first, let’s kind of ease into it. If you are new to the IEP team bonus series, we are about six weeks in. So, if you would like to scroll through and look for a special education teacher or a school psychologist, then all you have to do is [00:03:00] scroll back in your podcast player to find them they’re dropped every Thursday. So this week we are talking about occupational therapy or OTs. We will go through OTs qualifications a little bit about OT versus Coda, which is an, a certified occupational therapy assistant, um, because they are still present in schools and then we’ll get into what they actually do on an IEP team to help your child.
Access their education and that’s where it gets tricky and interesting and eye opening. I hope for you too. So first qualification, so this list that I’m going to read off of is the color of state qualifications in order to have an educational OT license, which is in addition to our state license. So we actually have like three different licenses that we have, um, to be able to work in schools. And so as some of, you know, from listening to other podcasts, I love examples. So I frequently pull Colorado standards to give you an example, but if you need help finding your own state’s qualifications or standards, just hop into the Facebook group to ask for help [00:04:00] the link to join.
It is below this podcast in your podcast player. So the first qualification. We’re already going to have a discussion about, because it says a bachelor’s or higher degree from a regionally accredited institution. It has not been possible to get just a bachelor’s in OT and be able to practice as an OT, since I think 1993 or maybe 1995, I might be off on that date a little bit. So it used to be
an entry-level bachelor’s so you could go to school and get a four-year degree and become an OT after you pass the board exam. So you still have OTs working in the schools that have a bachelor’s degree and don’t have a master’s degree. That’s totally possible.
I was actually working with one of the four OTs that I worked with. Still had her bachelors and did not go on to get her master’s I think she’s actually going back now, um, which is kind of cool. I’m going to be honest. Um, when I worked underneath an OT, when I was a paraprofessional in Douglas county schools, which is a humongous district south [00:05:00] of Denver, she actually went on to get her master’s, but she did it to get her principal’s license.
And then she moved from an OT to be an assistant principal and managing behavior. And I think that’s an amazing role for us. I think it’s incredible. Double. But now that we have an entry level masters, we have less of those options to, you know, go ahead and get your master’s and then move into another role in the schools because we have, we have an OT master’s and that already costs a lot of money.
Uh, to be able to get an a master’s degree in occupational therapy as well. So, Again, you might see. Um, some OTs still have bachelor degrees and that’s totally fine. And then you’ll see some with master’s and you will also see, I think it was maybe three years ago. Where there are some programs who are doing an OT D which is an OT doctorate.
And this had thing is I have my masters and all they had to do to change my program [00:06:00] from a master’s to a doctorate level degree was add one class and four more weeks of field work. Or internship. And so that’s it. So it doesn’t mean that they have a PhD, um, which is like a research or like a doctor doctorate. Um, it’s more like a, a specialized OT doctorate degree. So just know that those three things are out there. It doesn’t really matter to be honest.
Um, it just has to do with how you got your license . And when you got your license. So the second thing is completion of an American occupational therapy association, accredited college or university program in occupational therapy. So, um, you have to go through those particular programs and then completion of a practicum or internship
as required by the school of occupational therapy attended, which may be held in a variety of settings. So also, you know, I think I’ve mentioned this on the podcast before, but my particular program, I graduated from the university of North Dakota. They had a Casper Wyoming campus, which,[00:07:00] was basically like going to the university of North Dakota.
And what happened was we are very, very focused on mental health, which is our roots. We’re going to talk about that in a little bit. But I did a field work in physical disabilities and a field work in mental health. And I could not add pediatrics, which is kids. I could not add a pediatric field work or internship unless I added a third one and that was optional and I had to pay more for it.
Um, so what happened was I did an inpatient and outpatient mental health facility. And then I did the medical ICU at UC health in and shoots campus. If you’re familiar with Denver, that’s like a really big original campus right next to children’s hospital. And then I wanted to set up a third field work in schools.
But my field work educator got all messed up and so it was going to be an hour commute one way. To get to my field work. So I ended up canceling because I didn’t actually need it. The cool thing is when I [00:08:00] got into pediatrics, I was like, oh, I use these two things. I use physical disabilities. So like transfers and wheelchair management and those kinds of things. And then I also use the mental health piece as well. So.
Um, different schools though are different. Like Colorado state university has a really highly ranked occupational therapy program and there’s, they are required to do a pediatrics rotation. So those rotations can look different. Um, so you just have different different requirements for different settings, which I think is very interesting.
The next one is a valid occupational therapy license issued by the Colorado department of regulatory agencies. So this is our state license. We have to be licensed by the state first, before we can get our license to be in the schools. And then also passage of the occupational therapy, national registration examination administered by the national board for certification in occupational therapy.
So that is the NBC. Oh T and we all have to pass that board exam. So I don’t even know why they put that on there [00:09:00] because we have to pass our board in order to have our state license. And so it’s. A little bit redundant in there, but I guess it all makes sense to them. So that’s okay. Okay. So let’s get into the fun part, which is what OTs actually do. And I have.
Just kind of a little bit of a story. I found OT because I was first an adaptive horseback riding instructor and I also fell into this job with managing the horse program for a camp, which catered to kids with ADHD learning disabilities. And it was called Asperger’s at the time, but autistic individuals.
And then I transferred in that same company. They also had an accredited high school that was wilderness based. So. So I have been all over the country and a lot of national parks and I have helped kids with homework in like the Havasupai falls of Arizona and in the grand canyon. So I was kind of a paraeducator in a way. I wasn’t a certified teacher for them, but they would bring packets of their schoolwork and I would [00:10:00] help them with their schoolwork while we were.
Doing adventurous things on the road for two weeks at a time. Super interesting. A lot of help with kids with mental illness. Um, and living with them 24 hours a day and also, behavioral disorders and odd type things and, um, kind of living with them. So that was really cool. I had one other person who was with me.
Um, doing that on the road. And then I think we had five boys, five teenage boys. So fast forward to when I was doing some more adaptive riding work, I had an OT that was do consults with us. Um, because she worked at the residential school that was right next door. And I was like, wait a minute.
You’re an OT. Like what, what is that again? And she told me what it was and I was like, oh, that’s me. That’s what I want to do. Like, I’ve been looking for just this thing and I didn’t know, it existed. So, let me kind of explain as clearly as I can, the definition of it and we’ll go from there. So
and the occupation itself is something that a [00:11:00] person needs or wants to do. So we are a profession of doing, being, and becoming a, which just means that we are really looking at the person as a whole. And we’re looking at any barriers that that person is experiencing because of their disability, whatever that disability is.
Whether that’s mental health or it’s a physical disability or combination of both. And then we are going to figure out a way around their disability or through their disability to help them participate in the things that they want or need to do. There are kind of two ways. I like to explain our profession. The first way is we are practical problem solvers. So some of us are wildly creative as far as like crafts go. That is not me. That is something I struggled with in.
The schools and in pediatrics in general, but I am incredibly playful when I’m with kids. And so I love being creative and playful with like the things that we got in front of us. And then others are like me in that we are practical problem solvers. So I love [00:12:00] things that like, um, okay. We need to figure this out. Like, is there a person or is there a thing, or is there a system technology tool that I can figure out.
To help this person do what they need to do with less assistance from a person or with more autonomy or more independence. The second way. I like to explain us as we are also functional neurologists. So we’re not actual neurologists, we’re not doctors, but we take neuroscience in school and we study the brain. And what that means as far as like function and what that person
is feeling and doing, we are very, very incredibly empathetic. We start by trying to take the perspective of that person, really listening to what that person is telling us or showing us if they are non-speaking. And so we really start at the heart of what that person really wants to be able to do or what they need to be able to do. And we start there with, um, making some gains and figuring out how to give that person more independence or more autonomy, which [00:13:00] is just choice over
what they do, right? Um, we started as a profession by helping world war one veterans find meaning in their life. Again. By being involved in doing things. So we kind of come from that crafting woodworking movement. And so we have really strong mental health training as well as physical, you know, training as well, like activities of daily living, going to the bathroom, showering, that kind of thing.
So when it comes to the state, which is very comical to me, when it comes to the state of Colorado, we are classified as motor therapists. So isn’t that funny that I just like tell you all about like all the things that we do, and then we’re, we’re classified as motor therapists. So PT, so physical therapy and occupational therapy in the state of Colorado are both under the motor category.
And so when it comes to sensory, like. When we check that box of the permission to test. It’s like, oh yeah, motor therapists, but we’re also looking at sensory, but we’re also looking at this. And so if we kind of have to write a [00:14:00] paragraph on what we’re going to look at, um, but yeah, so other systems and supports kind of limit what we do. And so this transitions nicely into talking about schools.
So in schools, the parts where we really stand out and step in most often are helping children with handwriting and that’s like a brain and body connection. Right. Hopefully that makes more sense now. And we help with sensory regulation and emotional regulation, strategies, tools, and supports. We help a lot with functional daily living skills.
We are also highly involved in accommodations and assistive technology. We also our profession who is explicitly trained in what’s called activity analysis, which just means that we can break down a skill. Like let’s take writing a sentence. Okay. As your skill. Um, and so we can break that down into, oh, well you have to think about what you want to write. Oh, you have to know your letters. Oh, you have to be able to grip the pencil. Oh, you have to be able to see the paper. You have to be able to see the lines.
You have to be able to coordinate your [00:15:00] eyes and your hands to be able to write on the letter. Like we can break down things. So so far. And I remember doing those projects in school too. And like the other example is like putting on a pair of pants. Like you don’t realize how complicated it is to teach somebody how to put on a pair of pants until you have a two year old. Right. Or you have somebody with a disability who, you know, don’t, doesn’t have grip strength of their hands.
Okay. Well, how are we going to get around that? So we look and break down these activities that really, you know, putting on your pair of pants. Like if you can’t do that yourself, and you’re an older adult, Like, that’s a piece of your identity that you want to hold on to, right. That you can dress yourself. That’s a big deal. So, um, we are specialized in kind of breaking that down and then problem-solving.
What’s the barrier that’s getting in the way. And then problem solving or teaching strategies to teach the skill or alter the skill or change the demands of this skill, um, to get it done as well. So, We are both skilled in teaching a person to skill and [00:16:00] decreasing assistance so that they can do it more independently and autonomous tenaciously. I’ve talked about that before, so maybe.
Take that out. And then, you know, to apply that to schools. When I was first in schools, I had a really hard time learning what my role is. Not just in the school setting because we’re related service providers. So that means that we can’t. Case manage. There’s a couple exceptions, like Washington state, New York city, those kinds of things, but we can’t case manage. So we have to add on to somebody else, like the special education teacher or the school or the speech language pathologist.
In order to have that child on the caseload and everything has to be educationally relevant somehow. And we can be pretty creative and justifying that. But we also just overlap in areas already covered by roles that are quote unquote, like more important or prioritize more than us. So, you know, if I’m covering 10 schools,
And that special education teacher in one of those schools is like really, really [00:17:00] into activities of daily living and has been teaching it for 20 years. Well, that teacher doesn’t need me to come in and teach activities of daily living. We might consult with each other. She might need me to help brainstorm, or maybe it’s a disability that she hasn’t seen before.
And she needs help, really breaking down. Okay. This is this genetic condition and I’m not sure. How to address it and do we compensate for it or can she get better at doing this? And that’s when we can come in and really help, because we know that that disability progression, because we understand the human body.
And we understand disability. So, so deeply compared to other people, but you know, one team, you know, would have a teacher who really likes activities of daily living. And so they didn’t need me in that role, but then another elementary school. The school psychologist would love sensory supports and has taken extra classes.
In sensory supports. And so that school psychologist would take out a lot of that, of my caseload and really fill in that gap in that school. So I was needed [00:18:00] in other parts of the IEP where she wasn’t involved, or, you know, maybe it was more of a handwriting role in that school, but you know, another person would pick that up. That was there more frequently in that building than I was. So our role is always different, which is really cool for us in a way, but really confusing for parents to understand too.
So that’s why I keep telling you guys. You know, when you form your ass, like don’t ever go in and say, my kid needs more OT. Start with like the problem that you want supported and really justify that ask. And we talk about that a lot in the prep course, which is like, how do you structure your ask to get the yes. And so one of those things is really stating the problem.
Instead of stating the profession because as you can kind of now see, when I paint this picture, The best support for your kid might not actually be the OT. You might want that special education teacher who is there every single day, who loves activities of daily living to be able to do that every single day. And why would you.
I want OT to come in and take your [00:19:00] kid away from that teacher for some time to work on the same thing. If that teacher is covering it and covering it really well and really consistently, right. So it just depends. Um, You know, we do have a kind of stigma that we get classified as handwriting teachers, quote unquote. And I would say most OTs are like, I’m not, I’m not a, no, I’m not a handwriting teacher. I might specialize in that.
But please don’t call me that. But then there is some therapists who really that’s the only thing that they want to do is handwriting. And that’s what they see their role is. And so they’re, they’re kind of self-limiting in that way. And so we’re working on that barrier as well. So it just depends on the OT. It depends on the administration, because if they’ve always had OTs who really liked that handwriting role, and haven’t really kind of pushed the boundaries, then maybe they’re stuck there.
And of course the state and district guidelines as well. So us being classified as motor therapists, Really kind of, I mean, it sets the stage for what the state expects us to work on. Right. [00:20:00] So just to kind of wrap up and end on an example, I’ll talk about my last caseload that I had in my last position in the district. And I served two elementary schools. One was an.
An international baccalaureate school. So they were talking about different cultures. Then they had more project-based learning, which I really like, and they didn’t really have, uh, a program. They didn’t have like, um, an autism program or. A social, emotional program or anything like that. And so, and they also didn’t have any preschools there either. They were a school that was busting at the seams. And so people got kicked out.
AKA preschools into different buildings, um, because they shortly ran out of room there. So the other elementary school that I had was where the autism program was housed. And so I served that program. I served the rest of the K through five population. So a lot of learning disabilities, a lot of, um, you know, assistive technology there as well. And then also two preschool rooms there as well. So I spent like two days at [00:21:00] that school with the autism program and the preschools in addition to K through five and then one day a week.
And it wasn’t even like a full day. I would, I would like. Do most of the day at that school. And then also have a chunk of time where if I had to go to another school for. For testing a kid like at the middle school or go to the other elementary school to test or test at that particular school that I had a block of time to catch up on paperwork.
And, um, to go and do those assessments without missing any other kids from my caseload while doing that. And then I also covered the middle school and the middle school had, um, not necessarily an autism program per se, but it had this significant support needs program. And I also supported, kids with learning disabilities made sure that they had their assistive technology,
things like that. So there was, I think, four special education teachers that I supported. Within the middle school. Um, but obviously like my caseload was pretty like light and comparison. As far as minutes go. Compared to like the preschools and the elementary [00:22:00] schools. So I would spend one day a week at the middle school covering the whole middle school in that as well. And then.
Oh, also like over the years I supervised a codess, which is a certified occupational therapy assistant and just really quick, cause we’re going to talk about them later, but. I’m certified occupational therapy assistance. I have their own state license, but then they operated under my license for working in the schools. So they didn’t have like a separate school license like we do as an OT, our registered occupational therapist did.
Um, they have an associates degree and then also pass a board exam. And so they are very, very skilled in the intervention part. They do not do any of the real assessment. They’re not really supposed to, they’re supposed to contribute to the assessment. Um, with observations they’re supposed to contribute to goal writing, but all of that treatment planning comes to the OT. So.
Once every month I would rotate around and I would [00:23:00] observe her with the students and we’d problem solve, like, okay, what’s working, what’s not working. And is the school right? Or, you know, this IEP is coming up. Can I get a summary of what you’ve been doing? What the progress is and that kind of thing.
Um, so that’s just really quickly when it, what a Coda is and you’ll see, see them still in the schools. It feels like they’re being processed out a bit, but that really depends on the district and what’s going on in the district as well. Um, and then I also started our brain injury team. So we have a really cool traumatic brain injury team. As far as the state of Colorado goes, it’s actually modeled after the program in Pennsylvania, which is an amazing program. And so I got to start the brain steps team for our district. I was kind of looking for some leadership because I don’t, you know, I don’t run IEP or anything.
So I was looking for some leadership and was asked by our administration to start the brain injury team, which is really. Really fun. Um, so I would have preschoolers to eighth grade. I also, you know, in, in former years I [00:24:00] covered the 18 to 21 program, the high school, the charter school. Um, I kind of covered every building, but I think two in the district. And so I was just moved around a lot because we were growing so much. So I would have, you know, preschoolers to eighth grade this last year that I worked there, a variety of handwriting goals, self-advocacy goals, assistive technology, evaluations, and support.
A little bit of executive functioning work, too. Like organization things normally fell to me as well. Um, but the school psychologists and the special education teachers could support with that as well. And then of course I was a big supporter of the sensory supports needed, especially in that autism program as well. So, um, it was really fun, but it was also really tiring. Every day was super different. And so.
Um, yeah, so I had a caseload of about, I think I had 45. 45 to 50 direct kids every single week. So I’m going to see about 10 to 12 kids in a day. And then on top of that, do all [00:25:00] of my evaluations, all of my paperwork, all of my assessments, that kind of thing too. So, um, that is occupational therapy. Hopefully I did a good job. Hopefully if there’s an OT, listening to this, you feel like I did a good job representing our
profession. And I just, I love our profession. It’s really amazing, but I wish that it wasn’t so vague sometimes to explain, but hopefully it did a good job. Of course, if you have any other further questions about occupational therapy, I would love to go on and on about it our Facebook group.
So click the link below this episode to join the Facebook group. If you aren’t there already and ask the way about any team member role, but of course I would love to. Help you with understanding OT a little bit more. As we are incredibly vague and don’t forget as well as the link below this podcast in your podcast player is there for the new freebie, which is the IEP process step-by-step guide as well. So thank you so much for listening and I’ll see you. Same time, same place next week. Thanks so much.