Posted in Eleanor Cawley

Pushing the Birds out of the Nest

Leaving the nest copyThese opinions are my own based on my personal school-based experiences and recent postings from other therapists on social media 

When is it time to discharge?

This is always one of the biggest questions when it comes down to CSE Meetings and whether or not to recommend services for students next year. Of course, in a school-based setting, the big ‘money makers’ are handwriting and now keyboarding. Before making that decision, I think that it is important to look at the student’s level of function in a particular environment. I feel that when we report progress a rubric is very important but so is the environment or context in which the skill is performed. When I look at either handwriting or keyboarding I look at the following:

  1. Can the student perform the task automatically with my assistance in a therapy room?
  2. Can the student perform the task automatically in the therapy room without my assistance?
  3. Can the student perform the task automatically in a classroom with my assistance?
  4. Can the student perform the task automatically in a classroom without my assistance?

This is an important factor that is left out of documentation on goal progress. Anyone that knows about me, knows that I love to use rubrics. I love documentation to be clear and concise, understood without my being there to explain. So I often base my documentation on the level of self-sufficiency-does the student have the power to perform the task over a wide range of activities and settings. In other words, is the handwriting or keyboarding at the level of being automatic? The DeCoste Writing Protocol is an evidence-based tool with some very good research supporting its development. Based on this research, both handwriting and keyboarding should be at the level of automaticity. If these skills are not automatic, then the focus in on the motor components of the task and therefore the student cannot meet the cognitive demands of the writing task. Basically, we will not know what the student has absorbed because he or she cannot get it on paper.

I remember hearing somewhere that in order to do your best on a test, you should take the test in the same location that the teaching or learning took place. Could that mean that a student may hand write better if he or she is in the room where they actually learned the skill? It is certainly an interesting point and possibly one for a good research study. Our goal is to have the student generalize the skills to all handwriting or keyboarding tasks-to become proficient. The Written Language Production Standards provides us with what is expected of a student with regard to handwriting and keyboarding at a particular grade level. Does your student meet those standards? Do you think that your student is capable of meeting those standards? Why or why not? Is the student capable of meeting those standards in a variety of settings without your support? Why or why not? I feel that I am not doing my job well, if I can’t answer these questions, my student is not performing as expected within the classroom and I have not offered alternatives.

There is also something else to consider and that is the student’s expectations and preferences. Is this student so overwhelmed with handwriting or keyboarding that they have just given up? I use The Student Interview to explore the student’s preferences and understanding of their own skills, i.e., what the student thinks they can do to what the parent thinks they can to and compare that to what I and the teacher see them do. The level of anxiety and frustration that a student experiences with not being able to express themselves on paper should be considered.

So while I would always like to think that OT RULES and I have all the answers, I don’t. What I do know is this, keep the student involved with determining goal progress, assess the skill across settings and keep the student in mind when determining where to go next, if anywhere. If you think that you can discharge a student when they can type 10 words a minute and they are in the 4th grade or above, think again. That student is not ready to handle the keyboard in the classroom.

Posted in Eleanor Cawley, M.S., OTR/L

Revisiting The Student Interview

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.


Posted in Eleanor Cawley, M.S., OTR/L

Using Rubrics to Monitor Outcomes in Occupational Therapy

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My Book Cover2

Using Rubrics to Monitor Outcomes in Occupational Therapy

Every practice setting that an occupational therapist, or any other health care provider, works in is demanding accountability and transparency. School-based practice is not immune, gone are the days of a teacher’s or therapist’s opinion. Reports are now required to be a balanced assessment of a student’s abilities, strengths and weakness including both formative and summative data. Occupational therapists need to know how to meet the demands of today’s data driven environment. As a research emergent profession, we are called upon to take data systematically. In an educational environment, occupational therapists should be aligning their data collectionmethods and documentation style with teachers. By aligning our documentation style and data collection methods, a more cohesive picture of the student emerges. This allows for more concise development of the IEP and goals targeted toward the student’s individual needs. Data collection need not be difficult. With a little preparation and smart organization planning, data collection becomes easy. When annual review time comes around, goal progress is also easy to report. This allows better planning for the coming year by the Committee on Special Education. Students also benefit by using rubrics in an occupational therapy setting. Some students cannot see or understand the “hidden curriculum.” These students need the guidelines for achievement that others may not. In using a rubric, you are defining the rules by which you consider a goal achieved. This can potentially improve goal progress and decrease the student’s anxiety about being pulled out or having a therapist in the classroom. For some students, a rubric provides the light at the end of the tunnel. With systematic data collection through the use of rubrics, occupational therapists have a unique opportunity to review and interpret the data collected from his or her students to create pilot or ex post facto studies. This can potentially lead to further research. Rubrics can be a win-win situation.


Topics Included in this book:

About the Author




Why Should Occupational Therapists Use Rubrics?

Critical Thinking, Clinical Reasoning and Clinical Judgment

Thinking like a Researcher

What is a Rubric?

Advantages and Disadvantages of Using Rubrics for an Assessment

Tips for Rubric Development

How Do Rubrics Relate to the IEP?

Types of Rubrics

Just a Word on Organization

Occupational Therapy Assessment

A Balance between Standardized and Non-Standardized Assessments

A More Complete Picture


Clinical Observations

Components of a Rubric


Scoring/Rating Scales




Individual Skill Rubric

Analytic Rubric

Holistic Rubric

Chapter Five

Why are Other Staff Members Taking Data on my Goals?

Making Goals Measurable

What does Measurable Mean?

Goal Development Chart

Collecting Relevant Data

Formative Data

Summative Data

Data Collection


Case Studies


Task:  Shoe Tying

Plan:  Assessment

Questions & Answers

Results & Follow Up


Task:  Keyboarding

Plan: Assessment

Questions & Answers

Results & Follow Up



Table 1:  Types of Rubrics

Table 2:  This is an example of a Individual skill rubric with benchmarks for a cutting with scissors goal

Table 3:  Sample of Staff Log-In Sheet

Table 4:  Methods of Assessment

Table 5:  Descriptive Terms to Rate Student’s Performance

Table 6:  Sample Holistic Rubric

Table 7:  Sample Measurable Goals  for IEP

Table 8:  Goal Development Chart

Table 9:  Types of Data

Table 10:  Interpreting Data Worksheet

Table 11:  Double Loop Shoe Tying Assessment Rubric

Table 12:  Double Loop Shoe Tying Assessment Data Sheet

Table 13:  Adapted Double Loop Shoe Tying Rubric

Table 14:  Adapted Double Loop Shoe Tying Assessment Rubric Data Collection Sheet

Table 15: One Hand Keyboarding Assessment

Table 16:  Graphic Representation of Data Collected

Table 17: Keyboarding Assessment Rubric

Table 18:  Assessment Rubric: Putting on Socks with One Hand

Table 19:  Data Collection: Putting on Socks with One Hand

Table 20:  Assessment Rubric:  Packaging Utensils