“Related services” is the term for a whole range of therapeutic specialties within special education, including occupational therapy and physical therapy. And although schools are closed, the professionals providing these services are working as hard as ever to ensure that students are receiving therapeutic support. Three of our staff members, Monica Friedman-Diaz, OTR, Beth Kaplan, COTA and Mary Kate O’Callaghan, PT, recently shared how they’re adapting to a virtual environment.
How many students do you each serve, in total?
Friedman-Diaz: “This year, I provide occupational therapy services for 35 third, fourth, and fifth grade students at Cottage Lane Elementary School. I, along with Beth Kaplan, share the responsibility of working with students in every building during the Initial Evaluation Process.”
O’Callaghan: “I provide direct physical therapy services with 29 students and consult for an additional four. The students I support range in age from kindergarten to 11th grade, so I travel to each school multiple times over the course of each week. This year, I also supported an out-of-district student due to their individual needs.”
“Kaplan: “I provide occupational therapy for 38 students in kindergarten, first and second grade. I also provide consultation, through the building-level Response to Intervention (RTI) process, to teachers and other staff members. This year, I also had the opportunity to ‘push-in’ to Art Teacher Elizabeth Piteo’s classes.”
How did you prepare yourselves and/or your students for distance learning?
Friedman-Diaz: “I realized pretty early on that providing occupational therapy services through Distance Learning, was not going to be something that should be handled alone. Collaboration with my fellow OT service providers on new and varied approaches has been super helpful. Equally important, became the Related Service partnership at Cottage Lane, which encompasses PT, OT and speech-language. By working so closely together, our hope was to provide the most support to our students and families, in whichever way best suited the individual, with the least amount of pressure and angst. This meant that our own individualized, Related Services Google Classrooms, in conjunction with e-mails, phone calls, and text messages, would be offered as methods of communication. Partnering with teachers to gain access to student work in their classrooms has been another important piece for communication and planning. Establishing a remote work space, and all the technological and therapeutic-based materials, was also an important piece of the puzzle, bringing to life the reality of ‘outside the box’ thinking while staying inside.”
O’Callaghan: “The nature of physical therapy is hands-on, with direct person-to-person interaction. I needed to adjust my thinking and learn different technology platforms in order to contact my students and not overwhelm families. I collaborated with other related service providers in the various buildings to establish google classrooms. The Google Classrooms look different in each building, as the needs of the students and their level of independence differs. Within the Google Classrooms are therapeutic activities based on the age level of the students and each particular student’s needs. This provides the students and families a resource of gross motor tasks to perform as their schedule allows.”
Kaplan: “The collaboration between related service providers, teachers and administration, has been the key to making this a successful transition. The first step was to become familiar with various online resources, including Zoom and Google Classroom. Speech-Language Pathologist Melissa Jacob, RTI Teacher Lauren Maurer and I practiced setting up Zoom sessions, posting on our specific Google Classroom pages and modifying documents for online classes. Parent consultation has also been probably the most important. Working with families, we set up workspaces, activities for self-regulation and taught our K-2 students how to use a mouse, to write and color on the Zoom screen and online etiquette.”
What, if any, are some of the unique challenges you’ve encountered with distance learning so far?
Friedman-Diaz: “I think that the biggest challenge for me was not necessarily the nuances of the technology itself, but more of the time management of working from home alongside my husband, also a teacher, and my new ‘student teachers’ (my two-year-old son and four-year-old daughter). It was pretty obvious that the introduction of my own children on staff, parent and student Zoom sessions was bound to happen. The shouts of excitement from a potty-training child achieving a sticker and slamming open the door to yell for me just as I UNMUTED to present my part at a meeting…a little more unexpected (all the while, lightening the mood of the awkwardness of our first Zoom meetings).”
O’Callaghan: “The biggest challenge for me has been learning the technology. Physical therapy is very hands on and I use verbal and visual cues, along with hand-over-hand assistance, to help students learn physical tasks. Using platforms like Google Classroom and Zoom have made me reassess and modify activities and tasks that I have been using in practice for years to best help my students.”
Kaplan: “The most challenging and rewarding experience has been learning how to effectively use the technology to engage students so that they could achieve their goals. Although teletherapy has been utilized by many health care providers around the world, we have always provided occupational therapy services face-to-face in an amazing therapy room. Now we’re learning to be creative at home, including animal yoga poses and fun movement break exercises, to improve self-regulation and endurance needed to participate in school.”
How are you partnering with families to support their children at home?
Friedman-Diaz: “I understood early on that it was most important to really listen and follow the lead of our families and the level of support they were looking for. Initially, parents were so kind and thankful for our support, but simply learning the technology and focusing on classroom work were at the forefront of distance learning. To respect the intricacies of ‘the new normal,’ over time, we came up with additional plans, such as offering to work on goals while completing classroom assignments (adding an OT spin to what the students were already required to do) or maximizing time due to schedule or technology conflicts by collaborating and treating a student, simultaneously, with another service provider. While I feel it is important to keep the connection and support going with my students, it continues to be, just as important to reassure parents and caregivers that ‘OT is all around us.’ The family yard work sessions (core/upper body strengthening); slime-making, bike rides, and trampoline breaks (for sensory input); time spent cooking with the kiddies (for executive functioning/fine motor skills); couch cushion tent sessions (for self-regulation/mindfulness); and of course, the “extra keyboarding practice” that is hand-in-hand with distance learning, are all excellent methods of getting in a little extra OT, in the natural every day environment. We are all in this together and it all counts.”
O’Callaghan: “Initially, it was important to contact all families to make sure they were healthy and determine if they were in need of assistance. Each family was called and/or emailed in order to establish the best means of communication. After creating the Google Classrooms, all families were again contacted to ensure the students were able to access the activities. Some families stated that their children were enjoying the activities. Others said they were too overwhelmed to participate and were reassured to do the best they can, in these uncertain times. I have also delivered equipment that was left at school to a few students so they can continue toward progress with their gross motor goals.”
Kaplan: “The partnership with parents has been the most important piece of the puzzle. Many of the parents have never attended an occupational therapy session with their child. Working with the parents and children in their home environment enables me to explain the rationale behind the activities. Many foundation skills are key to achieving the actual goals. For example, exercises to improve finger and hand strength actually help improve handwriting skills. I love that I have the ability to consult weekly with the parents and explain the importance of these skills. We are learning together how to effectively use technology to support the children.”
What are key things that you’ve learned through this process so far? How, if at all, has it impacted your thinking about your own professional practice?
Friedman-Diaz: “All in all, I feel like this process has reminded me, more than ever, of the importance of ‘sharing what you know, in order to reap the rewards of all the incredible amount of things out there that you don’t know.’ The collaboration between myself and others in the OT community around the world has provided me with a huge platform for shared resources, ultimately enhancing my box of OT tricks for students and teachers alike. While not under the best of circumstances, I feel like distance learning has really challenged me to step outside of my 16 years of practice, ultimately providing me with technology I can use, in my role as a school-based occupational therapist.”
O’Callaghan: “I’ll continue to use Google Classroom, in some form, as a resource for my students and their families. It’s a great way to have various resources at their fingertips and an easy way to keep lines of communication open, particularly for students and families who want to carry-over skills and strategies at home.”
Kaplan: “I always prided myself in being flexible, but I have a new appreciation for what that means and have learned to adjust expectations. Every day, I’m learning new ways to improve the sessions. Students are enjoying utilizing both traditional worksheets and/or technology. OT’s role in school has always been to help the student access the curriculum. Now, the way they learn has shifted; OT has had to also adjust. The classroom is now located within the child’s home and we have the opportunity to work with the students in their environment. Parents have always been an integral part of the team, but we generally only meet a few times a year. This has been a wonderful experience working collaboratively with families on a daily basis.”