SCHOOL BASED RELATED SERVICES

OCCUPATIONAL THERAPY

School-Based Occupational Therapy What is School Based Occupational Therapy?   What is the purpose of OT in a School Setting?

Indicators of Eligibility Task Behavior  Pre-Handwriting/Handwriting  Fine Motor  Sensory Motor Sensory Integration

Indications of Possible Sensory Deficits VESTIBULAR  TACTILE – Hyper-sensitivity (over sensitive to tactile experiences)  TACTILE – Hypo-sensitivity (under sensitive to tactile experiences) PROPRIOCEPTIVE  VISUAL

Types of Sensory Integrative Activities VESTIBULAR ACTIVITIES  TACTILE ACTIVITIES  PROPRIOCEPTIVE ACTIVITIES  VISUAL ACTIVITIES

School 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.

Primary difficulties seen in children in a school based setting Autistic Spectrum Disorder Pervasive Developmental Disorder (PDD) Sensory Integration Deficits General Developmental Delays Other various genetic disabilities and syndromes (cerebral palsy, muscular dystrophy)

Variety of strategies to help school aged children become functional Fine Motor – eye-hand and arm skills Handwriting and pre-handwriting skills Visual Motor skills Self-Help skills Sensory Processing skills (as relates to functional school based activities)

PHYSICAL THERAPY

What 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.

School Environment Bus Classroom Hallway Bathroom Cafeteria Doors Gym Stairs Playground

Considerations for Physical Therapy Qualifications Impact of clinical findings on student’s safety and function in school Decreased sitting balance Stability of student’s condition in relation to function in school Seizure disorder Severity of student’s current condition Ability to communicate pain or discomfort Developmental expectations in relation to function in school Based on current research in child’s disability

Considerations for Physical Therapy Qualifications Priorities of student, parents, staff Child may lose interest in gross motor activities, skills may plateau Current abilities and needs of child in relation to function in the school environment Help or hinder child’s achievements in educational program (less is more?) Physical environment in relation to student’s function Need to negotiate stairs, distance between classes, mobility within classroom, etc.

Physical Therapy Interventions in the School-Based Environment therapeutic exercise Balance, coordination, gait, and mobility training; Aerobic endurance activities; strengthening exercises

Physical Therapy Interventions in the School-Based Environment functional training in school activities Up and down the stairs, getting up and down from chair, negotiating playground equipment

Physical Therapy Interventions in the School-Based Environment prescription, training and use of adaptive equipment Assistive devices: crutches, canes, walkers, wheelchairs Power devices: motorized wheelchairs Adaptive devices: seating systems, raised toilet seats, grab bars; supine, prone, or dynamic standers Orthotic devices: braces, shoe inserts Protective devices: cushions, helmets Supportive devices: compression garments, collars

Physical Therapy Interventions in the School-Based Environment respiratory/rib cage exercises Breathing strategies, positioning, movement, and exercises to improve function

Physical Therapy Interventions in the School-Based Environment manual therapy Hands-on techniques for joint and soft tissue mobilization

Physical Therapy Interventions in the School-Based Environment motor learning in the outside environment Ambulating on sidewalk

Physical Therapy Interventions in the School-Based Environment compensation/ adaptation Energy conservation techniques for the day or specific task

Physical Therapy Interventions in the School-Based Environment preventing further disability Education of student, family, and staff on specific helpful exercises or stretches

Physical Therapy Interventions in the School-Based Environment promoting health The 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

References http://www.pediatricapta.org/consumer-patient-information/pdfs/09%20ABCs%20of%20Ped%20PT.pdf http://www.pediatricapta.org/consumer-patient-information/pdfs/Evidence-based%20Practice%20Fact%20Sheet.pdf www.apta.org http://dpi.wi.gov/sped/pdf/ot-pt-guide-2nd-edition.pdf http://www.sde.ct.gov/sde/lib/sde/PDF/DEPS/Special/PTGuidelines.pdf

TEACHER OF THE DEAF

Teacher of the Deaf A 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.

Educate and train staff regarding hearing loss, modifications and accommodations. Use of equipment (personal FM and soundfield system) Importance Function Care Daily check on hearing aids/cochlear implants

Two main types of services Consultation Provide information to staff Instructional techniques to use Ways to improve noise ratios in the classroom Providing information to the student’s classmates on hearing loss or devices Participation in IEP Observation of the student in class and other school environments Helping the student to advocate for his/her needs within the school/environment Monitor hearing aid/cochlear implants, both visually and listening to them Assist in the appropriate placement of students Meet regularly with general education teacher to discuss areas of concern and to ensure communication is effective

Direct Instruction Assistance with language and auditory skills are provided within the classroom environment or the student is pulled out into a quiet environment. Daily, weekly consult Instruction in the use and care of hearing aids, cochlear implants and FM systems Individual instruction in and out of the regular classroom Language development Auditory training Social and emotional support. 29

Working 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.

SPEECH-LANGUAGE

The Individuals With Disabilities Education Act (IDEA) Provides Speech-Language Services For: School-age children with communication disorders that adversely affect children’s educational performance

Good Communication Skills Lead to Successful: • Speaking • Thinking • Reading • Writing • Learning

Poor Communication Skills Lead to Problems: Understanding classroom instruction Participating in classroom instruction Developing and maintaining relationships

SLPs Work With Children Who Have a Variety of Disabilities • Language Voice Fluency or stuttering Articulation Swallowing , also called dysphagia

Language Disabilities Include: Slow development of vocabulary, concepts or grammar Inability to use different communication styles for different situations Poor building blocks of understanding/expressing ideas, social development, learning, reading, and writing

SLPs Have Many Roles in Schools Prevention of communication disorders Identification of students at risk for later problems Assessment of students’ communication skills Evaluation of the results of comprehensive assessments Development and implementation of IEPs

SLPs Have Many Roles in Schools (continued) Documentation of outcomes Collaboration with teachers and other professionals Advocacy for teaching practices Participation in research projects

SLPs Work With Children in a Variety of Ways Combine communication goals with academic and social goals Integrate classroom objectives Help students understand and use basic language concepts Support reading and writing Increase students’ understanding of texts and lessons

SLPs Work With Children in a Variety of Ways (continued) Services can vary depending on students’ needs Monitoring or periodic screening Collaborating and consulting Classroom based services Small group or individual sessions Speech classrooms

Signs of Communication Disorders (continued) Problems understanding others and following directions Doesn’t get along with others Problems taking tests

How to Get Help Meet with classroom teacher Request a screening

Guidance Counseling

School-Based Counseling provides support to our students in areas such as: Friendship/Social Skill Enhancing Self-Esteem Changing Families (Loss/Divorce) Managing Anger and Stress Coping and Anxiety School Performance Responsibility and Making Good Choices Counseling services are offered through individual sessions and/or small groups

SCHOOL PSYCHOLOGY

What do School Psychologists do?

Whatever it Takes!

Work With Students to: provide counseling, instruction, and mentoring for those struggling with social, emotional, and behavioral problems increase achievement by assessing barriers to learning and determining the best instructional strategies to improve learning promote wellness and resilience by reinforcing communication and social skills, problem solving, anger management, self-regulation, self-determination, and optimism enhance understanding and acceptance of diverse cultures and backgrounds.

Work With Students and Their Families to: identify and address learning and behavior problems that interfere with school success evaluate eligibility for special education services (within a multidisciplinary team) support students' social, emotional, and behavioral health teach parenting skills and enhance home–school collaboration make referrals and help coordinate community support services.

Work With Teachers to: Identify and resolve academic barriers to learning Design and implement student progress monitoring systems Design and implement academic and behavioral interventions Support effective individualized instruction Create positive classroom environments Motivate all students to engage in learning