An “Old O.T.’s” Advice for other “School O.T.s”

Forward from Miss Jaime, O.T.:  When I first graduated from OT school, I got a job working as a contract therapist in a public school.  I had no supervisor, no mentor, and no one to ask questions.

Thank goodness, I ended up placed in a school with such a large caseload that there was also another (more experienced) OT.   She took me under her wing and offered me informal mentorship and much invaluable advice as a colleague and friend.

I left that agency very soon to get a district job, but I am forever grateful to my first mentor, Diane Fine, Occupational Therapy Extraordinaire.  Twenty years later, Diane still works for that agency in that building and has generously offered to share her experiences and advice to new school OTs in the field.

I am an old OT.  I don’t know when that happened.  I mean, I don’t feel like an old OT and I don’t look the way I think old OTs are supposed to look.  Certainly not like the old OT that was supervisor on my first clinical affiliation. Now that was an old OT (although she was most likely younger than I am today).  She was cranky and mean and told me I would never contribute much to our profession. She knew “my kind,” she said.

Young, pretty, newly married to a doctor. “You won’t work much,” she said.

 Well, here I am today. No longer young and pretty and certainly no longer married to that doctor.

But I have been a working O.T. for 39 years and counting.

So being an “old OT”, I have the ability to reflect on my past experiences as well as my present practice with a certain degree of wisdom that can only come from years and years of work in this field.  

For the past 22 years, I have been a contracting occupational therapist in a public school district on Long Island.  I came to this purely by accident. I had been working in adult rehab in an outpatient clinic. The hours were long and the vacations few.  I had three children. My youngest was three. I wanted the opportunity to choose my days and hours and have off when my kids’ schools were closed.  So I answered an ad in the newspaper (see how old I am? No internet search) and thus began my life as a contract therapist.

I came from a medical model.  As far as I was concerned, I was bringing this frame of reference into the schools.  I had no idea how my “treatments” were going to enhance the student’s academic success. Over the years, with the help of some wonderful teachers I’ve had the pleasure of working with, I began to learn how to combine my knowledge of neurodevelopment with the goals of the education model.   Classroom teachers and I would talk briefly between sessions or in the hallways. They would tell me about their student’s difficulties, such as their behaviors in class. I would share with them possible explanations and solutions. This became a collaborative effort that benefitted the classroom teachers and more importantly, their students.  

Being a contractor for over two decades was not my initial intention. The years sort of snuck up on me.  I enjoyed the independence. I determined my treatment plans and techniques. No one was looking over my shoulder in that area.  I’ve had the pleasure of working with some very talented OTs and PTs over the years. I like to think they were able to learn from my expertise as I know I have from theirs.  Many times there was just me. No department, no union, no peers. I have spent 22 years in one district – mostly in one school. Now that I am nearing retirement, I have no pension.  I am still getting almost the exact same fee for service I got in 1997. I knew about this all along and still decided to stay, but I would not advise this as a model to follow. I often tell my younger peers not to stay with the agency for too long.  “Get out while you can”, I half joke.

So what happens as a result?  A lot of unpaid time I spend tending to these student’s needs. I’m in a difficult position. I want to collaborate with the teachers and ultimately help these kids learn. But my time as an experienced professional is worth something.  

 As an aside, this year the principal decided to place every teacher and teacher assistant’s photo outside their classroom.  The other OT, PT and I were never photographed.

The theme book for the school year is “The Dot”. A lovely story about the creativity in all of us and how we can make a mark on this world.  A colored dot was hung up with the names of every student, teacher, aide, and custodian. In short, every human being in the building – except the OTs and PT. When I questioned this, the response was “Oh, you’re not on the list.”  

Exactly! We are not on “the list”, or the email chain or in the secret santa group or the super bowl pool. Even though I have been at that school longer than almost every other staff member.

Now if I can be this detached after 22 years in one school,  imagine how a contracting therapist traveling to multiple schools in multiple districts feels.  

(“Actually, I’m not even in the staff photo” reports Diane Fine, Long Island contract therapist in the same building for 22 years)

More important than feelings, however, is the difficulty this poses for those therapists that need to collaborate with the educational team. 

Public schools today are filled with students who have varying degrees of learning and physical disabilities. OTs are the unique professionals who have the educational background to help teachers understand and approach these challenges in a way that can help kids do their job – get educated.  It has taken me over 20 years of sharing my knowledge and clinical expertise with the educators in my school. I know I am respected and trusted by the teachers I work with.

However, I know that as a contractor who is not employed by the district, I am considered an outsider in many ways.  I have to ask to be invited to team meetings concerning student’s IEPs.  I’m expected to put forth work without being compensated  – It’s part of the territory when navigating this position.  

I’m not ready to quit yet. This old OT may have a few more years in her. But it’s up to you younger therapists to continue to educate the educators and administrators so that they understand the vital role we play in the successes of our students.

Miss Jaime, O.T.:  I am so honored that Diane, my first mentor, shared her wisdom and experience with my readers.  I have been advocating for equal rights for Occupational Therapists within New York state.  Because what’s been going on for so long JUST ISN’T right.  If you’d like to learn more about advocating for OTs, click here! 


About the Author:

Diane Fine is an occupational therapist with 38 years experience as a clinician.  She is a graduate of New York University.  Diane began her professional career in inpatient adult rehabilitation with rotations on stroke, spinal cord, and cardiac units.  She then worked in a private physiatrist practice specializing in hand injuries.  Following this, Mrs. Fine worked in an outpatient adult rehabilitation center where she was the student clinical coordinator.  For the past two decades, she has been working in the public school setting as a contracting therapist in Long Island, NY.

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“Cookie Cutter Therapy”- Why it’s OK with me….

The other day I did an autumn arts and crafts project with all of the students on my caseload.

Every. Single. One.

Kindergartners as well as fourth graders.

Very often we hear about the problem of a “cookie cutter therapist”.

Meaning – a therapist that does one thing with every single student regardless of their goals or deficit areas.

A lot of people have a problem with this and so do I – sometimes.

I might sound like I’m contradicting myself because I said I’m OK with doing the same activity with every single student but here’s the thing:

One of an occupational therapist’s best and greatest qualities is creativity and flexibility. Teachers have this gift, too!

Every single child has different goals – so tweak that activity to work for them!

Change it Up!

Here are some ways to tweak this simple fall craft.

  • For really weak fine motor skills, take one piece of tissue paper in each hand. Hold the student’s hands up in the air like a “Y”. Crunch the tissues into little balls without using his other hand or his chin or even his belly to help with the crunching.
  • To work on mid crossing midline; place the paper to the other side of the student’s body.  Put the helping hand on vacation (meaning behind his back). His dominant hand has to crossover in order to glue on the leaves of the tree.
  • My student with weak grip strength had to use a clothespin to pick up each tissue ball and place it on the tree.
  • My student with really poor scissor skills had to cut the tissue before he crunched. He also cut a piece of green construction paper to make grass for the bottom of his picture.

So – if you were a random person standing at the door of my occupational therapy room, you’d see every student come out with a picture of a tree with different colored fall leaves on it.

It might look like I’m doing cookie cutter therapy but I’m not.

It’s ok to re-use an Idea

My point is – give yourself a break! It’s OK to do the same or similar activity with different students.

Just use your creative mind to tweak it to work for that student and the needs of that student.

For teachers, this may mean creating groups of students who will complete the task in a different way. For example, the red table will use clothespins to pick up the leaves and the blue table has to crunch with two hands in the air in the shape of a Y.

Once you give yourself permission to do one activity with all the kids; you’ll see how easy it is to change it up.

Need an AMAZING Activity to do with your kids this week?

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The Hidden Benefits of Flexible Seating

An exciting guest post from 4th-grade teacher, Jennifer O’Brien about the Hidden Benefits of Flexible Seating!

*This post contains affilaite links

Prior to implementing flexible seating in my classroom, I did A LOT of research. A flexible seating transformation is so much more than just buying new furniture. There are rules and expectations that must be clearly communicated to the students to ensure an easy transition. While I prepared myself for this change, I learned about some of the benefits of flexible seating: 

  • Comfort: Students are more comfortable, allowing them to focus for longer periods of time. This leads to higher academic achievement. 
  • Differentiated Seating: Flexible seating is essentially “differentiated” seating. There are many different choices, some options giving children the sensory input that they need.  
  • Improved Behavior: Students are less disruptive and are able to burn off energy throughout the day. 

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The “hidden benefits”

When I made this commitment, I never would’ve thought that I’d see such positive changes (so quickly, too!) within my classroom.  

  • New Friendships

    With flexible seating, students aren’t tied down to one desk or seating arrangement. Throughout the day, they are sitting with different children. I have seen new friendships grow from this and I feel like it has only brought my students, and my class as a whole, closer.   

  •  Collaboration

    Tables replaced the desks that were removed from my classroom during this transformation. I’ll admit- I was nervous that this would lead to a much noisier room, but that did not happen. Instead, I found that there was more productive chatter around the classroom. Tables foster a much more collaborative learning environment. I feel that this has also led to the development of stronger social skills in many of my students. 

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    FREEBIE: Choosing the Right Alternative Seating Option

  • Improved Self-Monitoring Skills

    The purpose of flexible seating is to give students the power of choice. They should be comfortable and ready to learn. This has been one of the more challenging skills to master but it has helped my students develop a necessary awareness throughout the school day. When I ask students to choose a “smart spot”, they know what is expected of them. It has been amazing to see them mature with this concept, understanding what both concentration and productivity should look like. When students feel like they cannot focus or that need to move, they may do so.   

  • Stronger Classroom Management

     Since I was rolling out this transformation mid-year, I knew that my classroom management had to be strong. Clear rules and expectations are critical and must remain consistent. Seeing my students understand the daily routine and take responsibility for their learning has been incredible.  I’ve learned so much through this experience, and I believe it has made me a stronger, more effective teacher.  Stronger classroom management is definitely a hidden benefit of flexible seating!

Interested in learning more about Alternative Seating?  Check out:

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The Hidden Benefits of Flexible Seating

Jennifer O’Brien has a Master’s degree in Literacy from St. Joseph’s College in Patchogue, N.Y.. She is General Education and Special Education certified birth-6th grade. Jennifer has been a public school teacher on Long Island for 3 years. In her spare time, she enjoys creating supplemental resources for her students to use as well as reading and going to the beach!  Check out Jennifer’s Teachers Pay Teachers Store.



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How to Determine the Frequency and Duration of School-based Occupational Therapy Services

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“I just don’t know what to do!”

The Occupational Therapist was upset and frustrated.  Her desk was covered in papers, folders, and notebooks.   She ran her fingers through her unkempt hair and sighed.  I understood. I’d been there, too.

“This child’s scores OT scores are really low, but the teacher doesn’t see any functional difficulties in the classroom.  I can’t recommend OT if there’s nothing functional to work on!”

Occupational Therapists and Committees on Special Education (CSEs) are often in a dilemma when it comes to determining the amount of services to recommend for a child.

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Spring is in the air!

That means nice weather, flowers blooming, and best of all, fun new stuff at the Dollar Store!

By this time of the year, I’m a little sick of all my toys and games. I’m ready for something different and fresh to keep my kids focused and having fun during therapy. BUT – I already spent my OT budget, so I need to keep the costs down.

Like a true budget diva, I head straight to the Dollar Store. Spring is a great time to stock up on cheap supplies that are only available at this time of the year, BUT, you can use them all year long.

I’ve made a quick list for you – along with ideas to for how to use them!

9 Best Springtime Dollar Store Supplies FOR OTs

1). Pool noodles – super cheap and easy to cut to different sizes. You can turn your pool noodle into a bat to hit balloons, use it to help position a child, or use it as a resistive material to stick buttons in. Now is the time to stock up!ot, dollar store supplies, classroom pool noodles, best springtime dollar store supplies

2) Buttons – speaking of buttons, my dollar store (dollar tree) has lots of cute buttons in spring colors. These are perfect for working on manipulation, categorizing by size or sorting by color, and of course, buttoning!

3) Garden “Kneeling pads” – these are great to use as markers for “where” kids should sit during circle time. You can also use them as a visual cue during yoga or core strength activities. My #1 favorite way to use them is to actually have kids kneel. This makes working on a vertical surface fun, or can be a fun “alternative” writing position. You can also use them as a resistive material to stick things (golf tees?) in. They are pretty big, so they last a while.

4) Balloons – Balloons are available all year long, but by now I’ve always run out. Balloons can be used with tennis rackets, pool noodle bats, or hanging on a string from the ceiling. Put your child on a therapy ball and have them cross midline to “swat the balloon”. Use them with the whole class by playing “keep it up” until the music stops. Then have the children hold their balloon and write a spelling word on it with a sharpie.

5) Ping pong balls – Where do I start? Use kitchen tongs to pick them up and cross midline to put them in a bowl. Write words on them and have the children read the words as they “grab” the ball with their tongs. Sort them in an egg carton using word families.

6) Plastic eggs – I love to write on my plastic eggs with a sharpie. Then I can work on rhyming, writing, or matching. Write a capital on one side and lowercase on the other. Putting them together and taking them apart is great for bilateral coordination, visual attention, and motor planning!

7) Jump rope- jumping rope is such a hard skill for some kids. You can also use jump ropes to teach shoe-tying to a whole class. Use them for group games, to make circles for jumping in and out, etc. Teach knot tying and untying. These are daily living skills that are really hard for some kids.

8) Egg dying kits – I love the little different colored baskets that come in the dollar store kit- I have the kids sort spring colored pom poms into the same color basket with clothespins.  The powdered dye can be used to color homemade play dough or to dye pasta for sensory activities.

9) Craft stuff – Check the craft section for all the spring colored pom poms, crafts sticks, buttons, pipe cleaners, and beads. These are perfect for Mother’s Day crafts!

I hope you found this list helpful! So tell me, what’s your favorite dollar store find?

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Understanding Your Child’s Annual Review Test Scores

Learn more about Sensory Processing in this FREE webinar!

Annual review time can be stressful for parents and teachers.

Unfortunately, sometimes the child simply doesn’t qualify for what a parent is asking for.  It’s very important to understand your child’s test scores and to know the special education process.

Understanding Your Child’s Standardized Test Scores

The district will only provide special education services to a child who is significantly behind his peers. A child who is “Below Average” is NOT significantly delayed.

Parents are often unhappy with “Below Average” or “Low Average”, but those terms are still within the Average range.

First, a child meets eligibility criteria to be classified as a child who needs specialized instruction in order to access their curriculum. Then, the Committee on Special Education or the Committee on Preschool Special Education will classify that child into one of 13 different categories.  They will develop an IEP  (Individualized Education Program).

The classification DOES NOT determine the level of services a child will receive. For example, a classification of Autism does not automatically mean the child will receive more services.

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