Research has shown that collaboration and an integrated therapy model are best practice in school based therapies.
Students have the opportunity to practice their emerging skills in all areas of their school day when this occurs. They are not limited to the direct service sessions. Goals should be written with a team approach so data can be collected across all settings.
Despite the knowledge of this best practice, therapists still report barriers to collaboration. Barriers include time to meet, role release, flexibility of scheduling and team cooperation.
This challenge is especially evident in the public school model where therapists are at multiple schools, working with a variety of teams of therapists and staff who rarely overlap in the same place. Often therapists change from year to year, further disrupting the team. Additional planning and collaboration time is not often worked into overflowing schedules. Therapists tend to write their goals in isolation based on a traditional model of therapy. If a child is disruptive in class, the teacher may want a break from the student, and some therapists prefer the older pull-out model of service.
The benefits of collaboration range from extra physical support in the classroom to building awareness of issues and allowing for creative problem solving. It allows for an OT to see where they can support a student’s mobility or a PT to see how to model on AAC. Offering movement opportunities within the classroom can support the whole class even if only a few students receive direct service. Typical peers can serve as role models in the classroom as well as in PE and at recess.
What can we do to support collaboration in public schools?
1. Educate teachers, families and special education supervisors on the benefits of using this established best practice.
- Students who work on their goals throughout the day achieve them faster and demonstrate generalization of skills in a variety of environments.
- Using the integrated/collaborative model reduces the need for direct services over time.
2. Build relationships with our therapy peers and classroom teachers.
-
- Meet with your team- on zoom if needed. Discuss goals for the students to see where there is overlap
- Is a lack of joint attention impacting all of your goals? How can we address it across all settings?
- Are classroom staff over-prompting? Let’s collect data to see if staff need to be educated on the prompt hierarchy and processing speeds.
-
- Can we support the classroom with movement breaks, shoe tying groups or regulation strategies? What helps one student may help many and may help with classroom management.
- Set clear expectations about how all staff are expected to support the goals.
3. Communicate with our therapy peers and classroom teachers.
- Let the team know what you are seeing:
- Johnny is being helped to stand up by his 1:1. I thought we agreed to give him 10 seconds to process the request?
- I noticed Bobby’s AAC has not been charged. How can we ensure this is addressed
- Mary is working on donning and doffing her coat. I noticed she is losing her balance when she does this. Let’s encourage her to hold onto the cubbies with one hand when she is working on this skill rather than doing it for her.
- Provide data collection sheets in opportune places as reminders of goals/objectives and to get a clear picture of what happens during the day.
- Next to the cubbies: data for doffing jacket and hanging up bag
- Next to the bathroom: data for transfers or balance for clothing management
4. Ensure Specially Designed Instructions are thoughtful and support goal work throughout the day- examples:
- Mary will have daily opportunities to don and doff her coat.
- Susie will be given 5 full seconds to process instructions following a verbal prompt before introducing a tactile or gestural prompt to accommodate her processing speed.
- Bobby’s AAC will be charged and within arms reach throughout the day. When technology cannot be accessed, Bobby will be presented with a low tech board to allow for consistent communication.
Integrating into the classroom and collaborating with therapy peers takes time and practice, but the positive outcomes have been proven. It supports the least restrictive environment which is our collective goal. 2 It takes a concerted effort from all parties but can be started with an email and a team meeting. If your school’s administration is not aware of the benefits, it is our job as related services to educate them and to provide evidenced based therapy.
Author: Amy Wolstenholme, PT, DPT
