Service Delivery Flashcards
workload vs caseload
Workloadrefers to all activities in which a school-based practitioner engages in that support students directly and indirectly,
andcaseloadrefers to the number of clients the practitioner treats
Range of Service Delivery
Indirect
On behalf of the child
Program supports
School-wide committees
Response to Intervention (RtI)/Multi-tiered Systems of Support (MTSS)
Positive Behavioral Intervention Supports (PBIS)
Direct-
Individual
Small group
Large group (classroom)
Variety of settings- where?
purpose of push in services
Service Quality
Efficiency
Service cohesiveness
Increased effectiveness
Better meet child’s needs
Generalization of skill
Most natural environment
Least-Restrictive
Why do pull out services
Better for kids who havea
signifigant Skill deficit
for kids with Sensory regulation
more discrete Handwriting instruction
discrete Self-care
If there are behaviors or sensory needs where the child has an Inability to work in group
Making push in sessions work
Make the teacher part of your planning
Assist the child/children in teacher lessons
Periodically present an activity the whole class can participate in- collaborate using curriculum
Find an area of the room to use if your “in class” activity with the child is likely to distract other children
Integrate classroom curriculum into your therapy plans
“Blend” into the instruction
Keep data- this is Response to Intervention!
How do I decide OT services for a child?
Child-centered Decision Making
The child:
- the environment(s),
- identifying problems through evaluation,
- teacher
- schedule
first step in documentation is
referral
Occupational Therapy Referral form:
The teacher must complete the form, talk with parents regarding the referral and have the building principal sign the form. It can then be sent to OT.
The teacher/ referring person should already be in contact with the parents
Documentation Process
Referral
Written Parental Consent
Observation- Classroom/ environment
Evaluation- at least 2 relevant assessments
Reports
Evaluation with goals
Intervention Plan
Type of Service Provision
IEP/504
RtI
Session Notes
Data Collection
Progress Monitoring
Annual Review/Re-evaluation (every 3 years)
Discharge
what is the best practice for evaluations
2 standardized and then informal
best practice for writing notes is to write them using medicaid billable T or F
True
You should be writing notes how often?
every session
School documentation uses medaid standards
Daily/every session
Contemporaneous- as soon as possible following the session
- Group v. Individual (and # in group)
- Length of session
- What did you work on (goals and objectives)?
- How did you address this (activity and educational applicability)?
- Progress noted and how was this measured (using what criteria)? (Level of assistance? Prompts? Redirection needed?)
- How long did the session last and was the child engaged for the majority?
- General plan for the next session
School Documentation for Medicaid
Daily/every session
Contemporaneous- as soon as possible following the session
Group v. Individual (and # in group)
Length of session
What did you work on (goals and objectives)?
How did you address this (activity and educational applicability)?
Progress noted and how was this measured (using what criteria)? (Level of assistance? Prompts? Redirection needed?)
How long did the session last and was the child engaged for the majority?
General plan for the next session
Discharge considerations
Based on the student outcomes after intervention occurs in the above performance areas, each of the following criteria should be considered to determine if the student no longer requires therapy.
- If The expected therapy outcomes have been met and no additional outcomes are appropriate, what’s next?
Discharge
What if The potential for further progress as a result of therapy appears unlikely.
Discharge
What if The identified limitation(s) no longer require(s) the unique expertise of the therapist.
Discharge
What if The problem ceases to be educationally relevant.
Discharge
What if Therapy is contraindicated due to change in medical or physical status, and psychological and/or social complications.
Discharge
Guiding Legislation
IDEA 2004
-Provide early intervening services (EIS) for students at risk
Use of evidence-based instruction and intervention prior to classification of Specific Learning Disability (SLD)
Up to 15% of amount received for Special Education in LEA toward EIS
Response to Intervention (RtI)
multi-tiered early prevention and intervention system.
main goal is to close gaps to all students.
catch them soon, provide tier 2 or tier 3
Tier 1 in RtI
All students. 80-90% of academics and /or behavior - All students all settings. Regular core curriculum
Tier 2 in RTI
more targeted group interventions. 5-15%. Give the teacher a list of strategies to try with data checklists. 8-10 weeks
Tier 3 in RTI
1-5% of students will need Tier 3 after they have received Tier 2. 1 on 1 with out an IEP. They would need direct instruction in handwriting, for example. Suppossed to be for 8-10 weeks in each tier.
Best Practice- Intervention
RtI is the pre-referral to Special Education (Clark and Miller, 1996)
Problem solving prior to placing a child in special education (Clark and Miller, 1996)
OT Intervention- collect evidence
Assessments- what are we using- needs to be a pre-post- measure
Progress monitoring
Education for OTs on RtI
Progress Monitoring
“Ecological view of the student’s functioning” (Clark and Miller, 1996, p. 705)
Describe behavior as outcome (specific, observable, measurable)
What from this, what do we as OTs want to address as a problem contributing to this?
Present level of performance (PLEP) - where are they at baseline?
Data collection (who, what, where and when/how often)
Current evidence
Effectiveness of a 10-week tier 1 Response to Intervention program in improving fine motor and visual-motor skills in general education kindergarten students (Ohl et al., 2013)
Response to Intervention (RtI) model: Using the Print Tool to develop a collaborative plan (Clark et al., 2008)
Integrating Occupational therapy services in a kindergarten curriculum: A look at the outcomes (Bazyk et al., 2009)
Occupational therapy effects on visual-motor skills in preschool children (Dankert et al., 2003)
A short-term graphomotor program for improving writing readiness skills of first-grade students (Ratzon et al., 2007)
RTI is not a billable service so we need to
know the administration, the legislation.
how to be a change agent in schools
Understand the system
Know the legislation and be an advocate for OT!!
Understand the organizational structure—schools are top down (administration makes decisions, based on many factors)
Scan the environment for things that may need to change- how can you assist?
Have a vision- betterment of all with little effort
Remember the responsibility to the community
A common caring is needed for a shared vision
