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Susan Skees Hermes, OTR/L, OTD, BCP

FOTA Annual Conference

October 26, 2018

Pick your Partners:

Teacher, PT, and OT

Collaboration in Schools

Learning Objectives:

1. At the conclusion of this session, participants will be able

to identify the fundamental principles of successful

interdisciplinary collaboration from the literature.

2. At the conclusion of this session, participants will be able

to identify their own strength and challenges for teamwork

3. At the conclusion of this session, participants will be able

to identify 3 methods to collaborate across disciplines in a

medically complex classroom program.

Key Points

➢ Educational law and evidence supports

collaboration and teaming to provide prevention,

detection, and early intervention for students at

risk as well as those formally identified as

eligible for special education services.

Key Points

➢ Both as a professional development tool and a

front line initiative in promotion of community

level therapy outcomes, collaboration in the

school setting is an effective investment of

school-based clinician’s time.

Key Points

➢ Occupational and Physical therapy have been

growing in their role on the school based teams

and processes that address individual special

education students, classrooms, and tier 1 and 2

response to intervention and MTSS.

“when multiple health workers from different

professional backgrounds work together with patients,

families, [careers], and communities to deliver the

highest quality of care.”

Interprofessional Collaborative Practice

- WHO, 2010

Interprofessional collaboration competency domains

Fundamental Principles

1. Values/ Ethics for Interprofessional Practice

2. Roles/ Responsibilities

3. Interprofessional Communication

4. Team/ Teamwork

IPEC, 2016, Karmali, 2018

- IPEC Core Competencies for Interprofessional Collaborative Practice, 2016

Synthesis of the research

Karmali, 2018

❖ Leadership theories

➢ Path Goal theory (Mitchell & House, 1975)

➢ Theory U (Scharmer, 2015)

❖ Interprofessional communication improvements

❖ Regular involvement in the problem-solving process

Synthesis of the research

Gaylord, 2016

❖ Survey results

➢ Highest uses of EBP

➢ Users of remedial interventions

➢ Self rated “well-prepared” to deliver contextual

services

Synthesis of the research

Orentlicher, et al, 2014

❖ Consider the routines & schedules within the school

❖ Interactive team process

❖ In all stages of service provision

Rosas & Camarihna-Matos, 2008

❖ Hard factors (competency matching + preparedness)

❖ Soft factors (character, willingness, empathy/ affinity)

Summary of Positive Outcomes

➢ Improved communication skills for all on collaborative team

➢ Cultural competencies for all on collaborative team

➢ More support to meet children’s needs

➢ Increased opportunities for children’s interactions in various

environments

➢ Inclusion of children with disabilities in the least restrictive

environment

Strengths and

Challenges for

Teamwork

➢ Systemic

○ Paperwork

○ Time

➢ Interpersonal

○ Lack of access

➢ Personal

○ Restrictive beliefs

○ Limited communication

➢ Systemic

○ Caseload vs workload

○ Time allowed

➢ Interpersonal

○ Shared assignments

➢ Personal

○ Shared beliefs

○ Dynamic communication

Strengths (Supports) Challenges (Barriers)

Definitions

Teaming Styles:

● Interdisciplinary/ Interprofessional

● Multidisciplinary

● Trans-disciplinary

Self-Assessment on Collaboration

1. Your own readiness?

2. Your own strength/ challenges for teamwork?

3. Individual students on your caseload?

4. Teachers/ PT/ ST or others go fit?

5. Is there school environment support ?

Common Ground

Finding Common Goals

➢ Student meets their IEP goals quicker

➢ Student can generalize skills across providers and

context/ settings

➢ Disciplines can address team determined service

minutes more efficiently

Evolving Legislation Implications

➢ IDEA (1985, 2004) - Mandates collaboration

➢ ESSA (2015) - Planning to policy

➢ ADA (1990) - Interpretation & application

variances

➢ AHCA/ Medicaid - Funding & eligibility

changes

Collaboration Indicators for Partners

➢ Flexibility

➢ Approachable

➢ Team focused

Collaboration Indicators for Situations

➢ Multiple related services on IEP

➢ PDP across Disciplines

➢ COTA/L + OT/L/ LPTA + LPT

Collaboration Indicators for Environments

➢ Shared space

➢ Common time at school in schedule

➢ Shared materials

Methods and

Activities

Discussion

Methods Activities

● Consultations with teachers/

IEP& MDT meetings

● Shared sessions

● Circle time

● School morning meetings

● Parent involvement days

● Staff trainings

● Classroom trainings

● Obstacle course

● Sharing materials for common

resources

● Pinterest/ Blogs

Examples of School-based Collaboration

● Individual student’s IEP (PT, OT, teacher) co-

session evolves into classroom strategies

● Classwide (weekly obstacle course + learning boxes)

● Teacher PDP

● Schoolwide (Self-regulation approach involving PT,

OT, adapted PE, Special Education teachers &

general education PE)

Collaboration Example in a

Medically Complex Classroom

Focus: ○ Safety

○ Social skills

○ Motor

development

○ Language &

communication

○ Choice making

Methods: ○ IEP/ MDT

meetings

○ Consultations with

teachers

○ Shared therapy

sessions

○ Circle time

Collaboration Across Disciplines

What does it look like?

❏ Intact body functions

❏ Sensory patterns

❏ IEP Goals

Collaboration Across Disciplines

What does it look like?

❏ Student

❏ Classroom

❏ Special Ed classes

❏ Adapted PE in

inclusionary gen ed

Lessons Learned

The IEP plan and time frame are important consideration

(How can I help you to get these done?)

We have more opportunities to support consistency

(What are the things we all need to do/ say?)

Our efforts can be built upon in successive months/ years

(When do we want to see the benefits?)

Key Points➢ Educational law and evidence supports collaboration and teaming to provide

prevention, detection, and early intervention for students at risk as well as those

formally identified as eligible for special education services.

➢ Both as a professional development tool and a front line initiative in promotion

of community level therapy outcomes, collaboration in the school setting is an

effective investment of school-based clinician’s time.

➢ Occupational and Physical therapy have been growing in their role on the

school based teams and processes that address individual special education

students, classrooms, and tier 1 and 2 response to intervention and MTSS.

Questions

BIG THANKS TO:

Rachael Nordlinder, COTA

Phoebi Lei, PT, DPT

Vicki Shook, MAk, MS

References ● Bergstrom, M. K. (2008). Professional development in response to intervention:

Implementation of a model in rural region. Rural Special Education Quarterly. 27

(4).

● Cahill, S. (2017). Serving all students:Integrating OT and PT into multi-tiered

systems of support. Presentation 11/19/17 for NOTA/ CCSD workshop.

● Gaylord, H. C. (2016). Factors associated with school based occupational therapy

service delivery. (Unpublished doctoral advanced practice project).

● Johnson, C. E. (2017). Understanding interprofessional collaboration: An essential

skill for all practitioners. OT Practice, 22(11), C 1-8.

● Karmali, S. (2018). Using leadership theories to improve interprofessional

communication and patient outcomes. AOTA SIS Quarterly Practice Connections,

3(1), 18 - 20.

References ● Laverdure, P., Cosbey, J., Gaylord, H., & LeCompte, B. (2017). Providing

collaborative and contextual service in school contexts and environments. OT

Practice, 22(15).C 1-8.

● Ohl, A. M., Graze, H., Weber, K., Kenny, S., Salvatore, C., & Wagreich, S. (2013).

Effectiveness of a 10-week tier-1 response to intervention program in improving fine

motor and visual-motor skills in general education kindergarten students. American

Journal of Occupational Therapy, 67(5), 507-514.

● Orentlicher, M. L., Handley More, D., Ehrenberg, R., Frenkel, M., & Markowitz, L.

(2014). Interprofessional collaboration in schools: A review of current evidence.

AOTA SIS Quarterly Practice Connections - EISSI, 21(2), 1 - 3.

● Rosas, J., & Camarihna-Matos, L. (2008). A collaboration readiness assessment

approach. In A. Azevedo, ed., Innovation in Manufacturing Networks, 266, 77 -86.