This is the second of a 6 part series dedicated to inspiring leadership on transition teams through the use of resources including evidence, tools and models for high school based practice. Feel free to contribute your own comments about experiences, tools and resources you use that are not mentioned here. Please note, in an effort to keep the information in the more casual form of a blog, a reference list is available via email to the author at heather@newviewot.com.
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"Thee lift me and
I'll lift thee and we'll ascend together." Quaker Proverb
Becoming Aware
Before we dive into evidence-based activities you can use in transition
I wanted to share with you some OT literature that might give you some
validation; there are many shared barriers to providing transition services in
school based practice.
If we can have a better awareness of what is and is not working, what
others are experiencing and what impacts practice we can develop a better
action plan for change.
Awareness of the status of
practice =
The first step in
addressing priorities of change
R.D. Laing said (found in The 8th Habit, by Steven Covey, p. 43):
“The range of what we
think and do is limited by what we fail to notice. And because we fail to
notice that we fail to notice, there is little we can do to change: until we
notice how failing to notice shapes our thoughts and deeds”
So, in an effort to create change and help our students have successful
outcomes after high school, let's take note of what some (if not all) of us are experiencing. Shall we?
What the OT Literature is Saying About OT in Transition
Kardos and White (2005)
These researchers investigated school-based OTs degree of knowledge
regarding transition services and their amount of participation in them and the
results, though not entirely surprising based on my practice experience, they
do reflect a continued disconnect between OT as a related service on the IEP
and transition evaluation and services.
Highlights:
*30% (n=80) of OTs indicated they participated in transition services in
such a way that their skills were maximized
* Half of the OTs reported contributions to the evaluative process that
led to drafting of goals and objectives related to transitioning
*30% of OTs reported participating in the post-secondary employment
assessment process
*74% indicated transition services were the responsibility of another
discipline
The authors concluded:
“Occupational therapists
in the public schools are well-placed and trained to address these areas, and
should be exploring ways in which they can collaborate with special education
transition teams to augment services that have been well documented nationally
as needing improvement,” (Kardos & White, 2005, p. 178).
Gangl, Neufield and Berg (2011)
They investigated occupational therapy’s role in high school transition
in the Midwest using a qualitative survey method.
The background on this study:
*Survey participants included six OTs and five non-OTs
*Three main themes were revealed after the data analysis was complete:
1. Non-OTs perceived OTs as not having a role in transition
2. OTs saw their role in transition but were not involved unless a
student received direct services
3. OT is not seen as an important part of transition services
Most thought provoking were the critical barriers OTs identified:
1. Many parents were unaware of the benefit OT
intervention could have in the transition from high school to young adulthood
2. The rate of referrals for OT services
dramatically declined after 6th grade
3. The school personnel did not view OT as a
vital or priority in the transition evaluation process and OTs were not sure
his or her participation in the transition process should be considered as a
typical part of school-based OT intervention
4. OTs believed they did not have enough time to
“build collaborative relationships with teachers, parents and staff; to expand
their practice to include more transitional activities; and to develop new
programs outside of their service minutes” (p. 161).
Quite appropriately, the authors draw the link between successful
student outcomes in post-secondary life and OT:
“If a state’s education
goal is for students with disabilities to be employed or enrolled in continued
education 1 year after graduation, there are clear roles for occupational
therapy services” (Gangl, Neufield and Berg, 2011, p. 165).
Moll, Huff and Detwiler (2003)
These authors identified the strengths of OT and its parallel nature to
the employment transition process:
1. Value of meaningful occupation
2. Patient-centered approach
3. Goals based on individual preferences
4. Job placement based on function and skill
level
5. Identification of job modifications that
promote successful outcomes
6. Expertise in environmental assessment and fit
between person, environment, and occupation
7. Understanding and advocacy of the Americans
with Disabilities Act
Though these areas might seem obvious to us, it is clear, based on the
studies summarized above, that many OTs are not using these unique and valid
skills in their contribution to the IEP and transition plan at the high school
level.
Why should we care about these studies?
Well, first, we have to know where we are to establish where we want to
go.
Second, it helps to have commonly shared feelings exposed for those of
us in high-school based practice. It gives us a community of shared
experiences.
While we nod our heads in agreement we likely spark thought and inspire
a desire to create change.
Lastly, I propose a challenge led by these results:
Choose one barrier above that resonates with you most and think of 2-3
simple, concrete ways you might start chipping away at it.
This call to action doesn’t need fireworks: we can each start with one
student or one supervisor with casual discussions.
Want Examples?
*Schedule an informal meeting with your immediate supervisor to share
these studies to highlight those you see in your program
*Meet with the transition specialist at your school to discuss
collaboration with one student who might have an upcoming IEP meeting
*Ask the transition specialist and/or special education coordinator what
role they see OT having in transition
* Ask your supervisor what he or she feels is the role of OT in
transition and their perceived barriers in your school. Share the findings of
the studies above.
Please share some successful steps you have taken in the past to chip
away at a barrier or, if you feel you are well used as an OT in a transition
plan, please share how this came about for others to benefit too!
This is the first of a 6 part series dedicated
to inspiring leadership on transition teams through the use of resources
including evidence, tools and models for high school based practice. Feel free
to contribute your own comments about tools and resources you use that are not
mentioned here! Please note, in an effort to keep the information in the more
casual form of a blog, a reference list is available via email to the author at
heatherj@newviewot.com.
"We immediately become more effective when we decide to change ourselves rather than asking things to change for us." Steven Covey
The Centennial
Vision isn't just for the leaders of the profession to follow. It calls for all
OT practitioners to be leaders of the profession. Leadership isn't a position
but a choice (Covey, 2004) and we must all choose to take a leadership role
within our school-based practice in order to advocate not only for OT but also,
more importantly, for the needs of our students.
Recent survey
research shows OTs are not well integrated into high school transition teams.
Spencer, Emery,
and Schneck (2003) conducted a survey on special education directors and their
perceptions of the role of occupational therapy in transition.
Overall, special
education directors felt that OTs were needed in job assessment, job
performance and other employment skill areas but were most widely used in domestic skills, meal preparation, leisure
exploration, assistive technology, modifying the task environment, IEP planning
and staff education.
Most concerning
was the directors' indication that OTs provided only 5-8% of any
community-based transition service.
5-8% of any community-based
transition service!
Kardos and White
(2005) investigated school-based OTs degree of knowledge regarding transition
services and their amount of participation in them.
Though there
were many revelations in this study that will be discussed in later posts,
there were many barriers identified as impacting OT practice in high school
transition that are likely felt by many OTs.
Barriers
included:
* Lack of
understanding of the OTs role by other disciplines
* Lack of
knowledge regarding assessment tools to evaluate in the area of transition
* Transition
services not being taught in respective OT programs
* Lack of
knowledge of their role as an occupational therapist in transition services
Studies like
these create lots of thoughts and questions.
* How do we become
leaders on transition teams?
* How can we
become part of the transition team rather than in a box providing handwriting
or no services at all to high school students?
* How do we get
out into the functional environment to address the areas of occupation our
students need us in?
* How do we create
change when our caseloads are full, our days are packed and our supervisors
aren't interested?
One place to
start in our leadership on these teams might be with evidence and a better
awareness of the tools, models and resources available both within the OT
profession and from other professions.
Change can't
happen overnight, however with the employment of small steps, starting one
student at a time, change through leadership is possible in the long run.
Are you ready?!