OT Tonya talks about working in the school systems

Tonya, an OTR in a CA school system with a GREAT website at http://www.therapyfunzone.com that I plan to stalk, very kindly answered some questions I had about working in the school system.

1) If I know the basic IDEA laws and basic Section 504, is there anything else really in-depth that a school OT needs to be aware of? IE that might get asked in an interview or by a parent or something? 

One thing that you will be asked is if you are familiar with sensory processing and if you are familiar with sensory diets.  As a school therapist, you are there to provide services for the child to be able to access his curriculum and to function in school.  We don’t really provide sensory integration therapy, but we do provide sensory strategies to help the student be successful and make it through his day.  Therefore, it is not necessary to be an SI therapist, but to have a knowledge of sensory strategies and techniques.

2) What grades do you work with and what are your main evaluation tools? Peabody? BOT? SFA? How much training in these evaluation tools is common before doing them alone?

I do Kindergarten through Middle School.  Another therapist covers High school, and a different therapist does preschool.  Evaluations that I use are the BOT, DTVP (developmental test for visual perception), I have used the ETCH for handwriting, and the THS-R (test for handwriting skills – revised) for handwriting, though I really don’t like standardized handwriting tests.  In fact, I rarely use a standardized test for anything because I feel like I get more information when I use my data collection form that I made up (http://therapyfunzone.com/blog/wp-content/uploads/2010/09/Microsoft-Word-OT-school-skills-assessment.pdf).  I usually test fine motor and handwriting and then I do the math and work out what percentage the student was able to write correctly regarding legibility, line placement and spacing.  I don’t believe in handwriting perfection, I believe in legibility, because many doctors would fail the legibility, but do not need OT.


Before I did any of these evaluations, I got no training.  You read the manual and do it.  It takes more time scoring them though, and you really need the manuals for scoring.

3) How much documentation do you do on a daily basis and can you briefly mention what it entails.

We keep a log for each student and write in the amount of time seen.  Then we write a note each day we see them (it can be very short, and is basically so that we can look back and see their progress when it comes time to do a re-eval or IEP.  I like to send a note home periodically also.  We have to update goals on the computer at grade times to see if the student is making progress each trimester or quarter. 


An IEP is held each year for our students and it seems to work out that I have an IEP a week, but it can vary.  For the IEP you need to write up a short blurb on what they are doing, progress made toward goals, and write new goals.

4) What's a typical day like for you?

I love the days when all that I do is treat kids, but that is not usually the case.  I average going to about 2 schools a day, one in the morning and one in the afternoon, but sometimes go to 3 or 4.  Once a week there will probably be an IEP after school usually scheduled around 2:30, but can be later depending on the school.  I do some handwriting work, visual motor activities, strengthening activities, etc, and lots of consulting with teachers.

5) What do you think are a few important things OTs should know before considering a school OT job?

The most stressful part is when they forget to tell you about an IEP that you needed to evaluate the child for, and the meeting is in 2 days, so you have to drop everything and get that child evaluated and write it up and be ready for the IEP. 


I don’t like stress, and like to have everything done and ready well in advance, so I hate it when I am thrown a curve ball.  But flexibility is required.


You have to be on top of getting the evaluations done because the IEP schedule is not very forgiving. 


Visual perceptual is a huge part of OT because it ties in so much to handwriting and ability to complete tasks in the classroom.

6) How much interaction do you have with other school OTs, and/or PTs, SPED teachers, etc?

We actually have a therapy office (didn’t have one at the last school district I was at), and we run into each other at least once a week.  There are 3 OTRs and 2 COTAs at the district that I am at.  I share a couple of schools with the COTAs, so we work together with the kids.  It is great to be working with people again.  I never saw other OTs at the last school district I was at, and I really missed it.  You do really get to know the spec ed teachers, and work closely with them.  Often you work in their class during class time.

7) Are the IEPs really difficult and can you talk a little about how a typical IEP is formed?

I don’t think that IEPs are difficult.  Paperwork wise, you just have to remember all of the parts that need to be filled in by OT, but the actual meeting is sometimes a nice break from treating.  It is also a good time to get to know the parent, give them a home program, and discuss what you are doing in OT.  Every once in a while, a parent will have unreasonable expectations, but I find that that is not the norm.  Most of the time we are all working together to get the best situation for the student.

8) So let's say a kid is targeted by his teacher as possibly needing some extra services. Then what? The OT evals him and then writes up IEP goals, or the educational team evals him including an OT and based on their evals they write up a IEP or what? This got me a little confused, the sequence of evals/IEPs etc…

In California, where I work, OT is not a stand alone service, so we can not do an evaluation until the student is deemed eligible for special ed (usually, but there can be odd circumstances).  So, usually a teacher will think that “Johnny” is having trouble with writing or fine motor problems or whatever.  They will fill out a referral form and send it to the therapy office.  We will then generate a form for the parent to sign to give us permission to evaluate (sometimes it gets out of order, but this is how it is supposed to go).  Once we have the parent’s permission, we will evaluate.  Then we need to hold another IEP meeting in order to add OT onto their IEP.  It can usually be a shortened meeting depending on if anyone else did extra evals too.  There can be multiple IEP meetings a year for one child, depending on what needs to be done.  So really, it can go in any order.  They do try to coordinate the evals if they know ahead of time, and try not to have to schedule too many because scheduling them can be a pain in the booty.

9) Do you think a new grad can go into the school system successfully? What about a semi-experienced therapist but without school experience?

I think that it would be difficult for a new grad to do the school system because of the lack of interaction with other OTs.  It would be easier in a really big school district, and also easier at a preschool because you would be in one place rather that traveling to 8 different schools in a week.  A semi experienced therapist could do it though.  It would be best to have other therapists to bounce things off of, and again mostly because you can feel very isolated, which is hard if you don’t have too much experience. 

10) What workshops do you recommend? Handwriting without Tears? Interactive Metronome? Therapeutic Listening? Etc  

Handwriting without tears is a good one.  I took a workshop on putting together the handwriting puzzle.  Autism classes and sensory classes are important to take as well.

11) Anything else you want to say? 😉

Organization is really important when working school district.  You have so many schools and it is hard to keep track of what you are doing for who at what school.  One pain about working in the school district is that it takes over your car.  No one can sit in the front seat of my car during the week because that is where I keep my papers and files.  I can’t go to Costco after work because there is no room in the back of my car for bulk items as it is full of toys, activities and other OT related stuff.


I hope that this was helpful.  I felt like when I started school district that I had no resources and it was really frustrating.  That is one reason that I started Therapy fun zone.  I felt like I was re-inventing the wheel by having to make eval write up templates etc.  

Jan 24, 2011 | Category: Occupational Therapy | Comments: 1