lifeskillsOT

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 6^th 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!