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

Creating Digital Notebooks

Reduce frustration for you and your child

Organization Group NewsIt is difficult for some students to get through school well organized.  Parents, teacher and even students become frustrated with missing homework assignments, notes out of order torn or even missing altogether.  When frustration ensues, it is easy to become argumentative, which is counter-productive to getting work done.

It is my goal to support your efforts to help your child by taking that task over. Creating digital notebooks with your child, there is little worry about losing important work.

Children with Executive Function Disorder have difficulty performing “activities such as planning, organizing, strategizing, paying attention to and remembering details, and managing time and space. ”

Using technology I can help your child manage all that paperwork and not feel so frustrated.  Just think, once a document is loaded into the correct digital notebook, it will never be lost.  If your child loses a paper document that has been uploaded, all he or she needs to do is print out the document.

When teachers request that the student present a notebook, the notebook can be e-mailed to the teacher.  If the teacher will not accept a digital form of this notebook, the notebook can be printed.

Notebooks will be available, in real-time, on the web allowing access in any location with an internet connection by simply using a log-on and password.

Less frustration for all makes home and school life smoother. Please feel free to call for further information.  631-629-4699

 

Posted in Occupational Therapy

To all the Lefties Out There! Yes, Our President is a Lefty!

Check out the President's position.  His paper is set up for a right-handed writer.
Check out the President’s position. His paper is set up for a right-handed writer.

 

Recently we celebrated Left-Handers Day.  There were a number of articles written about those who write with their left hand.  Some articles talked about the psychological differences between lefties and righties.  Other articles discussed the statistics of lefties vs. righties. BUT what about the functional aspects of handwriting for lefties?  This is really a world made for righties!  Just look at notebooks and binders.  The rings of a binder and the spiral of a notebook are all on the left side of the book.  The left handed writer must learn to navigate around and through these obstacles.  Do you see how this young woman is attempting to write in a binder awkwardly navigating her hand through the rings of the binder?

Lefty with binder

There are a few ways to solve this problem without having to torture your students:

  • Flip the binder around so that the rings are on the right side (upside down to a righty).  You will be writing on the backside of the righty page (front side for a lefty).
  • OR Take a page or two out of the binder to write on then replace them when you are done.  Some times it helps the quality of the handwriting by having a page or two under the one that you are writing on.
  • OR Use a loose-leaf pad for notes and (easier to carry than a binder) then place the notes in the binder at the end of the day.

If you must use a notebook, you can use the following tips:

  • Start at the back of the notebook instead of the front.  Particularly if you use one of those wire spiral bound notebooks.
  • Use a notebook that has the spiral at the top instead of down the side.

Spiral on the top Notebook

 

Stay organized.  Keep your binder neat and tidy so that you can use it as a slant board.  A slant board will help extend that wrist a bit.  By extending that wrist, you can prevent smudges and fatigue from that lefty flexed wrist.

lefty on a slant board

 

Lastly, if you are a lefty, elevate the corner of that paper.  This may also help you extend that wrist a bit.

Lefty paper position

 

Happy Belated Left-Hander’s Day!

 

Posted in Occupational Therapy

-Using Rubrics to Measure Patient Progress in All Practice Areas

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 Eleanor Cawley, M.S., OTR/L, New Beginings, Occupational Therapy

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

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.