7School Based Disorders and Strategies for Interventions Occupational Therapy in the school setting is defined as an intervention service to help the child achieve their educational goals.
8Primary difficulties seen in children in a school based setting Autistic Spectrum DisorderPervasive Developmental Disorder (PDD)Sensory Integration DeficitsGeneral Developmental DelaysOther various genetic disabilities and syndromes (cerebral palsy, muscular dystrophy)
9Variety of strategies to help school aged children become functional Fine Motor – eye-hand and arm skillsHandwriting and pre-handwriting skillsVisual Motor skillsSelf-Help skillsSensory Processing skills (as relates to functional school based activities)
11What is school-based Physical Therapy? IDEA Part B defines physical therapy as, services provided by a qualified physical therapist. These RELATED services are implemented to optimize a child’s function and facilitate a child’s ability to benefit from their educational program.
12School Environment Bus Classroom Hallway Bathroom Cafeteria Doors Gym StairsPlayground
13Considerations for Physical Therapy Qualifications Impact of clinical findings on student’s safety and function in schoolDecreased sitting balanceStability of student’s condition in relation to function in schoolSeizure disorderSeverity of student’s current conditionAbility to communicate pain or discomfortDevelopmental expectations in relation to function in schoolBased on current research in child’s disability
14Considerations for Physical Therapy Qualifications Priorities of student, parents, staffChild may lose interest in gross motor activities, skills may plateauCurrent abilities and needs of child in relation to function in the school environmentHelp or hinder child’s achievements in educational program (less is more?)Physical environment in relation to student’s functionNeed to negotiate stairs, distance between classes, mobility within classroom, etc.
15Physical Therapy Interventions in the School-Based Environment therapeutic exerciseBalance, coordination, gait, and mobility training;Aerobic endurance activities; strengthening exercises
16Physical Therapy Interventions in the School-Based Environment functional training in schoolactivitiesUp and down the stairs, getting up and downfrom chair, negotiating playground equipment
17Physical Therapy Interventions in the School-Based Environment prescription, training and use of adaptive equipmentAssistive devices: crutches, canes, walkers, wheelchairsPower devices: motorized wheelchairsAdaptive devices: seating systems, raised toilet seats, grab bars; supine, prone, or dynamic standersOrthotic devices: braces, shoe insertsProtective devices: cushions, helmetsSupportive devices: compression garments, collars
18Physical Therapy Interventions in the School-Based Environment respiratory/rib cage exercisesBreathing strategies, positioning, movement, andexercises to improve function
19Physical Therapy Interventions in the School-Based Environment manual therapyHands-on techniques for joint and soft tissuemobilization
20Physical Therapy Interventions in the School-Based Environment motor learning in the outside environmentAmbulating on sidewalk
21Physical Therapy Interventions in the School-Based Environment compensation/ adaptationEnergy conservation techniques for the day or specific task
22Physical Therapy Interventions in the School-Based Environment preventing further disabilityEducation of student, family, and staff on specific helpful exercises or stretches
23Physical Therapy Interventions in the School-Based Environment promoting healthThe education of a student, family, and staff in the impact of daily routines on a student’s ability to be successful in educational program. For example: nutrition and sleep
26Teacher of the DeafA qualified teacher with the skills and knowledge required to provide quality teaching to students that are deaf/hard of hearing in the general education classroom.
27Educate and train staff regarding hearing loss, modifications and accommodations. Use of equipment (personal FM and soundfield system)ImportanceFunctionCareDaily check on hearing aids/cochlear implants
28Two main types of services ConsultationProvide information to staffInstructional techniques to useWays to improve noise ratios in the classroomProviding information to the student’s classmates on hearing loss or devicesParticipation in IEPObservation of the student in class and other school environmentsHelping the student to advocate for his/her needs within the school/environmentMonitor hearing aid/cochlear implants, both visually and listening to themAssist in the appropriate placement of studentsMeet regularly with general education teacher to discuss areas of concern and to ensure communication is effective
29Direct InstructionAssistance with language and auditory skills are provided within the classroom environment or the student is pulled out into a quiet environment.Daily, weekly consultInstruction in the use and care of hearing aids, cochlear implants and FM systemsIndividual instruction in and out of the regular classroomLanguage developmentAuditory trainingSocial and emotional support.29
30Working with students who are deaf/hard of hearing requires a team approach to determine the individual needs and to develop an appropriate educational plan.The ultimate goal is teaching the students to self advocate and to become independent learners.
32The Individuals With Disabilities Education Act (IDEA) Provides Speech-Language Services For: School-age children with communication disorders that adversely affect children’s educational performance
33Good Communication Skills Lead to Successful: • Speaking• Thinking• Reading• Writing• Learning
34Poor Communication Skills Lead to Problems: Understanding classroom instructionParticipating in classroom instructionDeveloping and maintainingrelationships
35SLPs Work With Children Who Have a Variety of Disabilities • LanguageVoiceFluency or stutteringArticulationSwallowing , alsocalled dysphagia
36Language Disabilities Include: Slow development of vocabulary, concepts or grammarInability to use different communication styles for different situationsPoor building blocks of understanding/expressing ideas, social development, learning, reading, andwriting
37SLPs Have Many Roles in Schools Prevention of communication disordersIdentification of students at risk for later problemsAssessment of students’ communication skillsEvaluation of the results of comprehensive assessmentsDevelopment and implementation of IEPs
38SLPs Have Many Roles in Schools (continued) Documentation of outcomesCollaboration with teachers and other professionalsAdvocacy for teaching practicesParticipation in research projects
39SLPs Work With Children in a Variety of Ways Combine communication goals with academic andsocial goalsIntegrate classroom objectivesHelp students understand and use basic languageconceptsSupport reading and writingIncrease students’ understanding of textsand lessons
40SLPs Work With Children in a Variety of Ways (continued) Services can vary depending on students’needsMonitoring or periodic screeningCollaborating and consultingClassroom based servicesSmall group or individual sessionsSpeech classrooms
41Signs of Communication Disorders (continued) Problems understanding others and following directionsDoesn’t get along with othersProblems taking tests
42How to Get HelpMeet with classroom teacherRequest a screening
44School-Based Counseling provides support to our students in areas such as: Friendship/Social SkillEnhancing Self-EsteemChanging Families (Loss/Divorce)Managing Anger and StressCoping and AnxietySchool PerformanceResponsibility and Making Good ChoicesCounseling services are offered through individual sessions and/or small groups
48Work With Students to:provide counseling, instruction, and mentoring for those struggling with social, emotional, and behavioral problemsincrease achievement by assessing barriers to learning and determining the best instructional strategies to improve learningpromote wellness and resilience by reinforcing communication and social skills, problem solving, anger management, self-regulation, self-determination, and optimismenhance understanding and acceptance of diverse cultures and backgrounds.
49Work With Students and Their Families to: identify and address learning and behavior problems that interfere with school successevaluate eligibility for special education services (within a multidisciplinary team)support students' social, emotional, and behavioral healthteach parenting skills and enhance home–school collaborationmake referrals and help coordinate community support services.
50Work With Teachers to:Identify and resolve academic barriers to learningDesign and implement student progress monitoring systemsDesign and implement academic and behavioral interventionsSupport effective individualized instructionCreate positive classroom environmentsMotivate all students to engage in learning