This is a blog shared by a team of therapists around the country who care about transitions, occupational therapy, and services for individuals with autism. The bloggers include therapists from California, Maryland, as well as a professor from Towson University, and the AOTA pediatric coordinator. We welcome your comments and suggestions.
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?!
Personally, I think we need to have a divide and conquer approach. My viewpoint is only limited in regards to autism, however. So, people who know other disabilities that might benefit from this can chime in here.
1. We need to teach autism self-advocates about the possibilities of what we are all about and what we can do. They could very well be the ones who can relay to the message to caregivers, which are the ultimate catalysts to get OT to play a bigger role in transitioning for their kids.
2. There could be those among our OT community where we could have personal experiences with one of the diagnosis that could be addressed by high school transition teams- whether as a person with the diagnosis or a loved one he/she knows has the diagnosis.. These are the people who could really help the OT profession in educating the rest of the OT community about being leaders in this area. Better yet, these people could be leaders themselves. I know I am doing my part in regards to autism. The OT profession needs more students/practitioners who can step up and play this kind of role.
3. I think students could really benefit from hearing lived experiences of people with different diagnosis. The reason I am sharing a bit of my lived experience on here is to help OT professionals and students to become better practitioners to see what autism is like from the inside. As a student who is still doing my level 2 FW, I learned a lot from people's lived experiences when they come to share with my class. So, I hope OT and OTA school educators can contact me and I will be glad to speak about Asperger's (or autism) from my perspective- whether it's in person or through video chat. I am not going to be boasting about myself. But, there are not many on the autism spectrum who can explain autism in the OT context.
First, let me say congratulations on bringing up this tremendously neglected and gravely needed area of OT. The reason it is neglected is because it is difficult to do. And it takes us out of the comfort zone of our closet, hallway or any small space that we are relegated to in the schools. Off my soapbox, now, let me say next that when I was working in my first school-based position, it took me to the outreaches of Maine to a wonderful community with 4 elementary schools, 1 middle school and 1 high school. Yikes, the high school wasn't pediatrics to me. I had previously been a middle/high school teacher and so I knew that they were adults! So, I approached it by reaching out to the community, getting out into the community and getting a feel for what they wanted for their adults with special needs. I met with parents, went to students' homes and joined groups. I joined a group called Bridges that was a community-based group that was designed to address the transition needs of high school students and became actively involved in making suggestions, seeking information, and attempting the place my high school students into positions that will train them to transition into the community after graduation. I was the only school-based member, the only OT, and they took me in with open arms! Exciting! But, a lot of what I did with Bridges was on my own time at first. Later, my supervisor allowed me to attend meetings, etc, on "company time."
Again, thanks for giving me an opportunity to share this information and for bringing this important issue to the forefront!
Bill, you bring up a great point and very unique perspective for OTs. Your point about sharing life experiences is valid and important, especially because people remember better when they have an emotional attachment to an idea or experience. Have you ever considered starting a blog?
You also mentioned about being self-advocates and that is part of what OT should be doing, too, on transition teams: giving students the tools to be their own advocates of their strengths and ability to contribute to the community.
Kathreine, your story is exactly what OTs practicing in this area need to hear! It is the best to hear about real life "take charge" experiences and how they ended up. I think we often become too focused on what is right in front of us and if we took one step outside of our comfort zone and thing about one thing we can do to make a change (just as you did) I think we would find the doors would open wide to opportunities for our students and OT practice.
I think OTs need to really consider how important this transition from high school to young adulthood is: we have the ability to set a students course for many years once they leave! This includes how they handle themselves and communicate their needs in the workplace and community. High school is where they will learn it first and we need to be major player because of the focus that is inherently transition and OT: occupation!
I think you will find the next posts over the coming weeks helpful if you are still working in school-based practice!
Thank you both for your thought-provoking and thoughtful comments!
Actually, I already have on OTConnections. It's called Conversations with Aspies. It's something I have started since early last year. I am a frequent blogger, so check that out. I have been doing my best to try to explain autism from how I see it and translate it into OT context.
The "self-advocate" term- I actually got it from some of the fellow speakers at the Autism West conference recently. Their jaws actually dropped when I told them that I am also in the OT community as well. But, yes, there are many adult self-advocates out there. Unfortunately, probably most of them don't understand what OT does and/or the possibilities that it could bring as well as I do (since I already did 2 years of OT school and have been to numerous OT conferences).
I believe that as I get further along in my career, my name should become a hot commodity in autism in OT, whether it's in leadership positions or for autism-related presentations. I might be wrong on this... but there is not a lot of people in OT who also is in the autism spectrum out there. So, the more involved I am in autism in OT, the more I think it will raise awareness of OT in the autism community!