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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.
