Tag: Education

Posted in Eleanor Cawley, M.S., OT

So Why Should Occupational Therapists Bother to Write Rubrics?

Posted on by Eleanor Cawley

Mostly, therapists read my posts on social media and then move on. Some comment positively and others, not at all. But then there are those times when there  is that one person who challenges you. I must say, that one person tends to get my fight on! I feel that I have to prove my work all over again. But I really love the debate. To those of you who feel that rubrics are not necessary, that’s okay. However, I feel they are.
Rubrics have been around for a very long time. During my research for my book, “Using Rubrics to Monitor Outcomes in Occupational Therapy“I found that rubrics actually began not in the educational field but in the medical field, decades ago. I feel that rubrics were lost in the shuffle in part due to the changes in the provider/client relationship, moving from power over to power with and ultimately to power through our clients. Now that we are searching for ways to become more ‘client-centered’ as a profession, I feel that transparent, understandable documentation is the key.

It has always been our premise, as occupational therapists, to have our clients engaged in purposeful activity. With the increasing intrusion of third-party payment systems into what we do with our clients and the struggle to become ‘client-centered’ having a method of recording progress becomes increasingly important. Yes, of course, we need to get paid for our work but we also have an obligation to our clients, any one receiving our services.

We all have those people, who question what we do.  I am sure that each and every one of us has had this experience.  Sometimes we can explain what is going on, through statements based on clinical knowledge, but then there are other times that we need real data.  Some challengers will accept the “+” or “-” system of data collection [“+” yes the client was able to perform the task or “-” no the client was not able to perform the task]  while

 

My Book Cover2
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others want more information.

So rubrics offer us a method of documenting some of our thought processing with regard to critical thinking, clinical reasoning and judgment. Sharing rubrics with clients and caregivers provides them with a tool to engage them in the treatment process in a way that is greater than just sharing goals.  By encouraging clients to monitor their own progress they become more vested, more engaged and more accountable to themselves and to us, their service providers, ultimately leading to greater gains.

Rubrics may be initially time-consuming to learn and to write, just like any other skill, the experienced therapist will soon be developing rubrics a lightening speed and have at their disposal a wealth of data and documentation supporting our services.  In my humble opinion, if a therapist chooses to use or not to use rubrics, it is okay, it’s their decision.  I choose to use rubrics, engage my clients in progress monitoring, and have data specifically highlighting the client’s progress.  In my opinion, how can I expect my clients to make the best progress if I do not share my expectations with them. I feel that I empower my clients through the use of rubrics, because I want to, not because I have to.

 

 

Posted in Eleanor Cawley, M.S., OT

Revisiting The Student Interview

Posted on by Eleanor Cawley

The Student Interview CoverAI have worked with middle and high school students most often.  At this age, a student’s frustrations increase proportionally to the workload.  They are aware of what works and what does not work for them.  When frustrations run so high and parents begin to panic, it is at this time other professionals, advocate and lawyers, become involved.

The Student Interview was developed because of a number of school-based cases that I had been involved in were quite intense.  Every small detail of the case was explored in depth.  I felt that it was imperative that the student have a voice and that I had a document that asked all the right questions. While it is very sad to see the state of the educational system, as it is right now, I feel that the educational system is in transition.  There are always ups and downs when experiencing a transition.

Over the last few years, I have used this interview with many students.  Since this is a form to complete, it is good experience for a student in the transition process.  There is a variety of questions, relevant to the student’s educational, vocational and self-care needs.  Some questions require a yes or no response, while others are open-ended and call for more detail.  The Student Interview serves its intended purpose quite nicely. Since using The Student Interview, I have not had that “uh oh” moment when something comes up that I should be aware of.  At least nothing that I have not at least asked and have a response to.

I really love a student’s surprise when he or she is asked to complete the satisfaction survey.  This is often the very first time a student is asked for his or her opinion on services.  I, now, provide each student with this interview.  I find it an invaluable tool not only as written documentation but also as a basis for a deeper conversation regarding a student’s skills, and their perceptions of themselves.

 

Using Microsoft OneNote for Homework Assignments for Students with Special Needs

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As you may or may not know by now, I love using Microsoft OneNote with all my students.  There is an iPad app for OneNote  as well as computer applications.  As of this date, the app is free.  Since there is an iPad app, iPads do not need to be sent home with students.  Parents can access the app for their own iPad.  With the Notebook stored on Windows Live, the parent, the student and the teacher can access the notebook.  OneNote comes with any Microsoft Office Suite.  It is more cost effective to buy the suite than just OneNote alone as you then have access to other programs.  If you click on the image, you can enlarge it to see all the notes that I have written.  If this assignment is going to a number of students, you can e-mail the page so that it can be opened in each student’s notebook.  This is my notetaking program of choice for all my students.

Posted in Eleanor Cawley, M.S., OT

School-Based Professionals Using Microsoft OneNote

Posted on by Eleanor Cawley

As I have always said, Microsoft OneNote far out shines its free counterpart, Evernote.  I use OneNote for all my documentation needs. In fact, I wrote about it in my book, ‘Using Rubrics to Monitor Outcomes in Occupational Therapy.’  OneNote acts as a notebook or file folder.  Each notebook can have an infinite number of tabs [sections] and pages.  The best thing is that you can carry all your files, well organized, on a thumb drive [USB Drive].  Student work samples can be scanned into OneNote and other work samples can be printed into OneNote.  I can enter a page from any program or website. For me, the best feature of OneNote, and the one that makes it so much more flexible than Evernote, is the ability to create templates that can be used in every notebook.  Templates are universal.  That saves much needed time, as I do not have to redo the template for each of my students. OneNote conserves your energy since you never have to take large files or notebooks home.

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Posted in Eleanor Cawley, M.S., OT

Annual Review will be here before you know it–Create Balanced Assessments!

Posted on by Eleanor Cawley

That’s right!  Annual review season will be here in just a few months.  You should start writing your annual reviews shortly.  During annual review, it is prudent to get a student’s feedback on what is working and what is not working.  Make sure that you have a way to gain that additional information.  An interview is always helpful to provide insight on a student’s ability to function not only in the classroom but also at home.  Parents so often paint a different picture of a student’s abilities at home.  Students can behave differently at home.

This is the time to put all your ‘ducks in a row.’  When assessing your students, make sure to have a balanced assessment with some type of real-life [authentic] assessment.  This often means having a rubric to demonstrate how a student’s progress has been judged and the data that supports the student’s progress.

Think about interviewing your student to learn about his or her insights into their skills. Did you ever think about providing your student with a satisfaction survey?  This is quite eye opening.  By developing a rapport with your students, you have the opportunity to create a report that is quite inclusive of all their skills and their opinions.  Listening to and including your student’s opinions leads to better goal development, better outcomes and improved compliance with recommended strategies.

Engage your students in every way possible to participate in collecting data and the development of their IEP.  You will go a long way in developing the respect and the trust of your students.

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Posted in Eleanor Cawley, M.S., OT

Does Backpack Safety Awareness go far Enough?

Posted on by Eleanor Cawley

ImageDoes your child come home like this?  Does your child complain of back pain?  Do you think that your child’s backpack is too heavy?  Well, it probably is.  The American Occupational Therapy Association has done an admirable job at promoting backpack safety awareness  and offers additional suggestions for parents and students. 

Most schools provide a double set of books to each child-one for school and one for home.  This is a good option but it does not go far enough.  There are some students who carry an overstuffed backpack because they do not know how to organize, others because they don’t want to be caught without an assignment.  When the time comes, though, the assignment is nowhere to be found.  There are other options.

Have you ever heard of a flipped classroom?  A flipped classroom provides supportive learning activities in the classroom [homework done in class not at home] while providing lectures through other media at home.  What about doing this with handouts, notes and other backpack materials.

Suppose handouts and lectures were viewed at home with a parent.  The parent would be learning the same material as the student, in the same way that it is taught in the classroom.  Handouts and paperwork could be viewed at home, while the actual labs and other materials were viewed in school.  This would then provide a significant measure of consistency between home and school.

In order to improve backpack safety and reduce pain and injury, I propose the following:

  • Parents access the handouts on a weekly basis either through e-mail or downloaded from a school server or even Google Drive.
  • Parents will review the handouts with their child prior to going to class [part of good note-taking-preview the material first]
  • Students will engage in activities based on the handouts and be scored on their knowledge using rubrics
  • Students will engage in class lectures in other media at home, with parent involvement [can be previewed or reviewed at any time]
  • Lectures can be provided daily or weekly and need not be long- Facts and a few examples provided with leading questions for thought to be addressed during the school day.  Class time is then spent on implementation of the lecture material to real life situations fostering critical thinking.
  • Engagement in after school team sport’s can be considered physical education–criteria can be scored and met with supervision of the physical education department–providing more class time
  • Parents can review a student’s progress at any time via a parent portal-[teacher needs to upload activity results daily or even weekly]

In my opinion, this can also increase educational time without having to increase the length of the school day or the length of the school year.  This may be a simplistic view, but in order to maximize parental involvement, educational exposure and decrease injury due to a lack of knowledge or follow through on backpack safety, this is an option.  Backpacks would be significantly lighter since little paper work goes between home and school.  Handouts and other paperwork is stored on a server so that it is never misplaced.  In addition, technology would then become a learning tool and not just for play.  Teachers could recommend apps and programs to support learning targeted skills turning gaming into learning.

The Common Core is probably here to stay since it’s goal is to develop and to reinforce critical thinking.  There may be modifications along the way, but the concepts will remain.  Critical and computational thinking are the skills that will bring our children into the future, the basis of STEM Programming and problem solving.  No backpacks will be required in the near future.

 

Posted in Eleanor Cawley, M.S., OT

-Daily Task Worksheets

Posted on by Eleanor Cawley

When working in schools, there is a constant need to collect and analyze data.  In doing so, I also feel the need to constantly evaluate my students’ skills in other areas as well.  I always try to assess or reassess skill(s) during each session.  I began creating Daily Task Worksheets.  I typically work with an older population [middle and high school] so that vocational skills also enter into the therapy session.  My thought was to get my students used to using and finishing a checklist in a timely fashion.  I now keep my forms in Microsoft OneNote so that my students’ work was organized and they can use technology while completing a number of tasks assigned on any given day.  Students were assigned to one of my computers [they all had names] and asked to open their own notebook.  Since many of my students are seen in groups at this age, it is important to create an individualized plan for each student that encompasses their goals and promotes a sense of independence.  My students love working on daily task worksheets.

Daily Task Worksheet 5

Daily Task Worksheet 5 pg2

My students were able to complete tasks independently or with very little assistance.  At the same time, I would be assessing activities of daily living [tie your left shoe], left-right discrimination, handwriting, following written directions, and any other number of skills.  Since each of the worksheets were created for individual students, I could easily include activities that would measure goal progress and, of course, explore daily progress on anything related to those darn standardized assessments.  If the worksheet is completed on a tablet, a stylus is offered to the student for handwriting.  Sometimes that portion of the worksheet was printed so that the student could complete it on paper.  I always worked on a student’s signature, whether or not is was a goal and had them sign in daily [this just supported my billing].  It was the very first part of the therapy session.  Students were required to keep an agenda for school, so I used that agenda to further increase their independence by applying a label for OT, which they applied to the correct date and added a period #.  I found that students with transition issues were able to get so much more work accomplished than when they did not have a worksheet.

 

Posted in Eleanor Cawley, M.S., OT

-Using OneNote for Daily Tasks in an Alternately Assessed Classroom

Posted on by Eleanor Cawley

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One of the daily tasks that a student in an alternately assessed class can do is to take attendance.  Many students can recognize classmates names, even though he or she is unable to read.  By using OneNote, the daily attendance can become an activity that is easily mastered in a short period of time.

In the screen shot above, I have added a number of fictitious names with a check box next to each name.  I have enlarged the font making the requisite eye hand coordination a bit easier.  The student in charge of attendance merely needs to either click on the box, or if using a tablet, tap it to check the box to indicate that the student was in attendance.  You can make the template a bit more challenging by adding additional responses, such, absent, and even add related services, i.e., OT, PT, Speech, etc.

The Attendance form is saved as a template so that there is no need to recreate the form each time.  The form is easily modified to add or subtract additional students.  A space for a student to sign can also be added and completed with with a pen tablet on a PC or with a stylus on the iPad or tablet.

Attendance 2

This is another, more advanced version of taking attendance.  The template saved on OneNote can be modified as your students abilities improve.  The student responsible for taking attendance will need to interact with each student in the room to obtain his or her initials on the form.  This can be accomplished using a pen tablet with a PC or a stylus using an iPad.  Learning how to write initials is another skill that will become useful in vocational training.

Posted in Occupational Therapy

-Using Rubrics to Measure Patient Progress in All Practice Areas

Posted on by Eleanor Cawley
Taken from the handout "Putting on Socks with One Hand" from Ohio State's Wexner Medical Center
Taken from the handout “Putting on Socks with One Hand” from Ohio State’s Wexner Medical Center

The following example of using a rubric in a rehab setting was developed from the handout “Putting on Socks with One Hand” available on Ohio State’s Wexner Medical Center site.   The rubric contained in this post was developed from this handout so that the directions that are provided to the patient match the expectations of the therapist as set forth in the assessment rubric.  If you have read my book, “Using Rubrics to Monitor Outcomes in Occupational Therapy”,  you would know:

 “Various dictionaries define a rubric as a set of rules.  In this case, rules that are used to make a judgment regarding a student’s level of performance.  Rubrics identify the standard of performance.  It is a way of communicating what is expected, describing a level of performance and the associated quality.”

So now we can see how the handout becomes a rubric and how a rubric is more clear and more transparent as a method of documenting patient progress than any other.

The rubric contains not only the steps to follow [listed as criteria] but also contains descriptors [as a graded judgment of attainment].  In this example, level of attainment or goal progress is assessed through the number of trials [red].  This method of documenting goal progress can be monitored and judged by any other therapist working with the patient when the primary therapist is not present.  The criteria is measurable and can be measured.  This meets the IDEA criteria.  By outlining the rules for judgement, consistency between raters [therapists] is possible.  Does each therapist [measuring progress] find the same areas of deficit?  More than likely, yes.  The potential for inconsistency can come from the therapeutic activities conducted prior to the task.  For example, did the primary therapist apply heat, but the covering therapist did not?  Did the primary therapist perform stretching exercises differently than the covering therapist?  While there are many variables between therapists, a consensus in deficit areas should be judged to be similar.  Please keep in mind that the rubric contained in this post is an assessment rubric [a standard based on the handout provided to the patient].  Once the patient’s deficits or limitations have been identified, the rubric will need to be modified to meet the individual needs of the patient.  Initially, developing a rubric can be time consuming.  However, once you have developed your rubric and saved it to use again, it can easily be modified for each individual patient.

If you would like a copy of this assessment rubric, please follow my blog and send your e-mail address to eleanorot@gmail.com

One Hand Sock Data Sheet

Posted in Assistive Technology

-Using OneNote to take Notes in Secondary Schools and College

Posted on by Eleanor Cawley

Another of my favorite therapy areas is teaching students how to take notes.  Taking notes is not easy.  Students must be able to respond to auditory cues with a pen/pencil or a keyboard.  Some students feel the need to take down every word, while others can take down the highlights.  Since I am an occupational therapist, my job is to teach students how to respond to environmental cues with movement.  So I would like to talk about taking notes in my favorite note-taking program, OneNote.

There are a number of reasons to set up note – taking templates or forms in OneNote.  For example, this T-Chart can be used for a number of different classes and discussions within a class.  Prompts that may indicate that a T-Chart should be used are:  Compare/Contrast; Conversely; Vocabulary Words/Definitions; Pros/Cons, etc.  This note-taking template can also be used for pre-algebra/algebra or anywhere where there is a rule and a sample.  The Cornell style of note-taking also uses a asymmetrical T-Chart for cues and notes.

Simple T-Chart created from a table and saved as a template
Simple T-Chart created from a table and saved as a template

Much of the job is already done for the student.  The page is already formatted for the student.  I find that formatting is often part of the delay and disorganization in taking notes.  If you click on the date, a little calendar appears and the date can be easily changed (calendar will indicate the correct date).  The same can be done for the time. Rows can easily be added to the table by clicking on the appropriate icon in the ribbon at the top of the screen or by right-click and then click on Table.  The color of the page and print can also be changed to address any visual concerns.

The real trick is learning the verbal prompts so that the appropriate form can be identified and opened.  The great part of this system is that this is an auto-save program!  If the student closes the program before saving, the work will still be there.  Another factor to consider is keyboarding speed and accuracy.  Figure out if the student can take dictation on the keyboard accurately before recommending this method to any student.

Posted in Eleanor Cawley, M.S., OT, Occupational Therapy

Working on a New Book

Posted on by Eleanor Cawley

I am currently working on a new book called “Mom, Do I Have to Take Notes?”  This will be a humorous look at note-taking skills for students in grades 4 through college.

 

You are not required to complete the contact information to answer this poll.  The purpose of the contact form is for you to acquire additional information, if you chose.

Posted in Eleanor Cawley, M.S., OT, New Beginings, Occupational Therapy

Should Middle and High School Students Participate in the Evaluation and Annual Review Process?

Posted on by Eleanor Cawley

Should Students Have a Voice?

Absolutely!  Most students at the middle and high school level are looking for a sense of independence.  Students of this age are often at a point where they want to know why they should continue therapy, and if they continue, why they can’t decide what they need to work on.  In a school setting, the goals need to relate to a student’s educational and/or vocational needs.  There is so much more information that a therapist needs to know to determine a student’s perception of his or her abilities and further determines whether or not a student really needs to continue.  Standardized test scores, although important, are only a snap shot of the student’s abilities at the time the student participated in the assessment.  It is not a clear and thorough picture of the student’s ability to function in a classroom.

I have often found that a student will provide more information if the questions are presented in a written format, particularly with sensitive areas, like activities of daily living, presented in checklist format.  Students will review the document, quickly at first, check an answer [which the therapist or teacher can expand on later] and then move on.  The written format provides a canvas, if you will, to create a dialogue with the student.  For example, let’s say that the student checks off that he or she can make a sandwich, ask the student how he or she makes that sandwich and you will get a better idea if he or she really is capable of making that sandwich.

I have developed a written interview, which I began using with some of my students over the last few years.  I was able to better assess a student’s abilities and perceptions of being able to care for him or herself and support classroom skills.  It prevents that ‘oh no’ moment when something is revealed in a CSE meeting that you should know but don’t surfaces.  When interviewing a student verbally, many of those items are glossed over and the interview proceeds.  A written document is a bit impersonal and the student may just answer more truthfully and feel more comfortable in doing so.

Let’s go back to that sandwich; a student checks off that he is able to make a sandwich.  Later, when reviewing the interview with the student, you ask, “How do you make that sandwich?”  The student lists all the items that he needs for the sandwich but is unable to describe how to actually make that sandwich.  This may indicate that a student has a form of dyspraxia or apraxia that has been addressed in other areas through years of therapy, but not yet in the area of self-care.  In very basic terms dyspraxia (problems with) or apraxia (unable to) refer to sequencing the steps to perform a skill.

This is enlightening and indicates other areas need to be explored.  When evaluating a student, all methods of gathering information should be used.  Standardized and non-standardized testing is important but so is the interview of the student and the teacher and authentic assessments, such as a rubric, to provide a balanced assessment of the student’s abilities.

A school-based assessment includes a reason for the referral [the problems that the student is having in the classroom], and his or her motivation for educational activities.  In my opinion, motivation can be broken down in to at least two components:  skill and desire.  If a student has limited or no skill in a particular area, there will be no desire to engage in the activity.

Motivation becomes a particularly important factor in the middle and high school years.  In order to encourage participation in therapy, students need to participate in and feel part of the evaluation process.  For one reason or another, a student may become disillusioned with therapy.  Comments may be made by peers, making the student uncomfortable with being pulled out of class.  Pushing into the class may not be an option either and may further target the student for comments and potential bullying.  At this point, if the student is so resistant to the therapeutic environment, consults may be the only option other than discharge.

Bibliography

Cawley, M.S., OTR/L, E. (2013). Using Rubrics to Monitor Outcomes in Occupational Therapy. Huntington Station: Eleanor Cawley, M.S., OTR/L.

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, New Beginings

Assistive Technology Assessment

Posted on by Eleanor Cawley

Thinking in Terms of Developing Skill Sets Rather Than Compensating for a Disability

There are many types of assistive technology evaluations including:  mobility, seating/positioning, communication, computer access, switch-access, and aids for daily living, work-site modification, home modification, and recreational assessments.  While assistive technology should be considered in the typical ways; it should also be considered in other ways, i.e., development of skill sets.

From the use of smart phones to navigating the community, developing visual picture schedules to support a cooking or grooming task to the use of laptops and desk top computers for literacy programming, assistive technology supports the development of skills or skill sets.  [Assistive] Technology is here to stay.

Students who are unable to develop skills similar to their peers may very well be more capable with the use of technology.  The Cloud, iPads, iPhones and tablets make taking notes and organizing those notes much easier [with training] increasing a student’s ability to be independent.  Using literacy programming may actually provide a student a voice where he or she did not have one before.  Using technology successfully has the potential to help a student develop confidence and self-esteem.

What makes the addition of developing a skill set different from the typical assistive technology evaluation?  First the referral is targeted toward a specific reason for that referral.  All of the same criteria for that typical evaluation are assessed.  The same programming and devices are explored as is the student’s responses.  Each teacher working with this student is provided with a questionnaire and interviewed based on those responses.  This then gives the evaluator a picture of the student and the skills required to meet the demands in each core class.  A clearer picture of the student’s abilities to achieve the desired skill set is then established.

Based on the demands of that particular skill set, the student is observed discreetly in a core class.  For example, if the desired skill set is to take notes, the following skills will be explored and data collected:  responses to sight and sound, orientation to the teacher, motor response to cue words, quality of the notes taken (content, legibility and organization), etc.  Based on the data collected, recommendations are then made to help the student reach the goal of the desired skill set.  This may be almost a full day of assessment for a particular student.

Once recommendations have been made, and the report has been submitted to the district, the real work begins.  It is important for the evaluator to be in contact with the district’s technology team.  Together with the technology team, a device can be prepared to meet the student’s needs in each of his or her classes.  In the case of note taking, it may mean that a device must be in sync with the Smart Board in class so that the student can save the lecture notes.  Different programs, based on teacher preference, may also need to be learned by the student to ensure that the notes are recorded.

So after a full day of evaluation, and further consult with the technology department, it is prudent to set up additional consult sessions to train the student and the staff in the use of the device, develop future goals and assess whether or not this plan of action will be successful for the student.  In order for assistive technology to meet the needs of the student, it must be constantly assessed and re-assessed, with additional support to the student.

In a different scenario, a student may be recommended for an assistive technology evaluation to address poor handwriting skills.  In addition to the typical assistive technology evaluation where the student’s keyboarding ability is assessed, he or she may need additional support in keyboarding using a touch typing method to improve speed and accuracy.  Often a student with poor handwriting skills has been provided with a computer as needed but he or she has not learned the correct method of keyboarding.  This leads to greater frustration and disenchantment, with any device provided, due to a higher error rate.

A traditional assistive technology evaluation may be requested if the student has reading difficulties, for example, Dyslexia.  Options for assistive technology include text to speech programming-having text from a computer read to the student in a computer voice.  Once the student has been approved for assistive technology, depending on the programming chosen by the district, the voice in the test to speech program can be somewhat pleasing or definitely irritating.  It is difficult to train a student to to modify and use this type of programming during the initial evaluation.  Digital book sharing services require that the student have an account.  This account needs to have a completed application, parent consent and a sign-off by a professional to indicate a visual print disability.  It can take a day or two for the company to approve the application.  Upon approval, a Welcome e-mail is sent to access the account.  Often, an additional program needs to be downloaded before the student or parent can download books to read.

There is a significant delay in the student accessing and using this programming.  If the teacher has not had access to digital book sharing prior to this student, he or she also needs to learn how to use the programming.  So in addition to the evaluation and initial training, follow up and ongoing training is necessary.  This training can be done by the evaluator or district personnel knowledgeable in this area.

In general, assistive technology can only be considered successful if the student is using it to function within his school and home environments and is able to perform the activities with an increased level of independence.  This brings attention to another issue that arises with the use of assistive technology, which is caregiver training.  Frequently, in this training loop, the parent [or caregiver] is left out.  It is important to have the parent participate in at least one training session, once the technology, approved by the district, is in place.

It is ny goal to ensure that every student receiving assistive technology, either through the district or through private funding, receive the training that he or she needs to gain independence.  Once again, if the student is not comfortable with the technology or does not fully understand how to use it, the technology is wasted as is the money spent or the evaluation, purchase and training.  We must also be very careful in not allowing the assistive technology provided being considered another failure.  This can further undermine a student’s self-confidence and self-esteem.