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

Imagine the Life of a Student with an Executive Function Disorder…..

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If you click on the photo above, you can read the infographic on a student, named Josh, who happens to have an executive function disorder.  This is all too common for many parents and teachers–the student unintentionally comes to school without ……. Homework is one of those things that is typically forgotten. Imagine how the student feels when the teacher asks for the homework and it’s not there.  There has to be a solution and there is.  There are a number of ways that the forgotten homework problem can be resolved through technology.

A great way to resolve this problem is by using Microsoft OneNote.  Microsoft OneNote comes with all Microsoft Office Suites–from the least expensive to the most expensive suite.  If you have purchased Microsoft Office then you have OneNote.  Most school districts use Microsoft Office so that they already have it as well.  A student’s homework notebook can be stored in a number of ways:  1.  The school district may allow access to the district server with a student log in from home.  2.  The district can allow access to a Windows Live account from a school computer or iPad.  The OneNote iPad app is free!

So now, the student, through whatever means, is able to access his or her homework assignment in their OneNote notebook.  As soon as the student enters any response to the assignment, it is instantaneously updated on any device that the student or teacher has access to.  So that means when the teacher says, “Josh do you have your homework?” Josh can say yes I do!  If it is not the paper version [easily printed from OneNote], at least Josh would be able to retrieve his assignment from OneNote.  This problem is then eliminated thus helping Josh feel more secure in his abilities.

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Remember that this is only a very basic rubric and will need to be modified to meet the individual needs of each student

It is very helpful to use rubrics to help a student see progress.  This rubric can be saved as a template within OneNote and be completed immediately after the homework is complete.  An additional rubric can be used to demonstrate Josh’s progress in locating his homework at school. In my opinion, we have to stop sweating the small stuff and find ways to help students with Executive Function Disorder be more successful in school.  If we can eliminate minor problems by using technology then that’s what we need to do.

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., OTR/L

School-Based Professionals Using Microsoft OneNote

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.

 

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

-Taking Notes from an Occupational Therapist’s Perspective

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http://1stopbrainshop.com/study-skills/making-notes-on-books-or-handouts/951/

Taking notes is a very complex skill rooted in abilities developed in infancy.  While sitting in a classroom, a student is expected to have appropriate cognitive and motor responses to the teacher providing the lecture.  That is easier said than done!

As an infant, we are supposed to alert to a sound, respond to that sound with head turning in that direction, differentiate pleasant sounds from unpleasant sound and learn to express pleasure or displeasure.  Visually, we are expected to respond in a similar way: alert to a visual stimulus, respond by following that stimulus by turning our head to follow it, differentiate pleasurable from displeasing.  Infants are expected to demonstrate a motor response to the stimulus, i.e., eye opening, finger splaying, and activation of limbs.

Just as an infant is expected to display a motor response to stimuli, a student is also expected to respond motorically to stimuli provided by the teacher.  Students learn to respond to certain cues, i.e., “This is important,” “Conversely,” repetition of the information, etc.  It is very difficult for student to respond if he or she lacks the prerequisite skills.  Alternatives for taking notes should be offered to the student.  The least invasive is to have the student copy notes from the board (far point).  Some students have difficulty with visual skills such as pursuits and saccades (visual tracking and changing fixation from one target to another) making this difficult.  First a slant board (often a binder) can be used to address this issue.  If that doesn’t work then maybe copying from near point will work.

The next more invasive intervention might be providing the student with some form of prepared notes, i.e., Cloze Notes.  Cloze notes are fill-in the blank notes.  Students are only required to add one or two words to a statement rather than copy the entire statement.  The next level might be providing the student with a copy of teacher generated notes prior to the class for the student to highlight during class.  The next level might be having the student attempt whatever he or she is able then giving a copy of notes to the student, usually a copy from another student who takes very good notes.

Another strategy is to use on-line notes for a site like www.studyblue.com.  You may be lucky enough to find course notes similar to class notes with flash cards.  Kno.com is a site where you can buy electronic textbooks (usually at a reduced cost), this site also provides lecture (from the book), study materials and social networking for studying.  Kno.com is iPad friendly.  Along with programs like Evernote with Penultimate, this maybe all the student needs to be in class.  A student could photograph handouts and never have to carry another piece of paper.  Assignments could be entered into Everstudent (a digital assignment book/agenda).

One of the last options would be to type notes on a laptop or a computer.  If the student lacks the prerequisite skills for note taking, they cannot be expected to be successful if you give them something to type on even though they can type at a good speed with good accuracy.  A sixth grader is expected to type at a speed of 25-30 words per minute with 93% accuracy.  If a student has only handwriting concerns, is able to meet all the prerequisite skills for note taking, can type 25-30 words per minute with 93% accuracy then maybe the option for using a keyboard or laptop is the answer.

Posted in New Beginings

Civility

Parents, Advocates and Lawyers, Oh My!

I am not sure why the CSE Meeting or the IEP have become such a battle ground for parents and school district administrators but something needs to change.  I have absolutely no doubt that parents, teachers, therapists and administrators have the best interests of the student at heart.  Everyone working with the student wants this child to succeed to the best of his or her ability.  What I don’t really understand is the lack of real communication between parents and school district staff.  

I do not know one teacher or therapist who would not try to incorporate the parents’ requests in a student’s educational plan.  Sometimes, for whatever reason, a second evaluation needs to be done.  Maybe the first one was conducted on a bad day for the student or even the evaluator and/or did not provide enough recommendations.  So the evaluation is performed again by a different evaluator.  It is not an insult to anyone.  It is just done.

I would assume that parents and district staff take notes during conversations and meetings-it helps us to remember what occurred during a meeting.  But we all need to follow the law about what is recommended and how it is recommended.  There is a referral process and a procedure that needs to be followed.  There are activities that can be performed based on the student’s educational placement.  For example: community integration and travel may occur at the alternate assessment level but not at the inclusion or resource room level.  

Activities of daily living that include self-care, should be done within the home unless the school is set up and approved to do this type of training [most, if not all, public schools are not].  As a therapist, I can provide some structure to the activities at home by picture prompts [showering, for example], task analysis and rubrics so that together we can get the job done-school staff and parents working together.  

The most important thing is that we need to listen to the student.  Sometimes the student says, “Enough, no more therapy.”  At that point we need to go into consult mode, reduce the therapy sessions to a very low frequency or discontinue therapy.  We must respect the student!

The most important thing that I hope anyone reading this blog takes away, is that we all need to communicate with each other with the student’s future in mind.  We all need to be able to ask questions and answer them, civilly, without threat of legal ramifications.  Unless the situation has degenerated to a point where no communication is occurring, parents and school staff should be able to address all the student’s needs through effective meeting strategies.  

We should be able to:

1.  Start any meeting in a timely manner [some might be a bit late for whatever reason-participation is the import thing]

2.  Set the ground rules.  This is often done with a parent receiving a handout of rights and responsibilities.  I think that this should go further and an agenda be provided prior to any meeting.

3.  Follow that agenda.  Agenda should be developed with the parent and possibly the student [if old enough and able] to ensure that all their concerns are addressed.  

4.  Monitor time spent.  Respect the time of the parent, the student and professional staff at the meeting.  There is generally another meeting that follows right after.

5.  Encourage participation of all those involved, including the student.  Both parents and staff should enable the student’s participation by either a portfolio or statement to be read.

6.  Approve any new follow-up assessments or actions by both parents and district staff.  Referrals need to provide good information about the reason for referral so that all the questions are answered in the report.

7.  Read a summary of the minutes taken before the meeting adjourns for clarity.  

8.  Minutes should be provided to all parties-all district staff and related service providers involved and parents, after the meeting in a timely manner.

 

The thing that I find that does not occur and should is an agenda.  The agenda provides a structure to the meeting and makes sure that all concerns listed are heard and addressed.  It limits the potential for disagreement during the meeting.  A new meeting can always be scheduled to address any new concerns.  It limits the “Uh Oh!” moments for both the parents and the staff.  

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.

Posted in Assistive Technology, Eleanor Cawley, M.S., OTR/L, New Beginings, Occupational Therapy

When Is It The Time To Recommend Assistive Technology For Note-Taking?

I must state, before anyone reads this, that I am a HUGE fan of using assistive technology.

I recently read a comment about a piece of technology not being “cool.”  I realize that there are students who will never feel “cool” when using assistive technology.   I also feel that students must be taught touch typing and the basics of functional programing before being asked to take notes using assistive technology.  It always boggles my mind when some recommends a piece of assistive technology, such as an Alpha Smart, without ever considering if it will really work for the student.  Many students consider an Alpha Smart to be ‘uncool’ for the following reasons:

  1. Looking different from peers
  2. Not knowing how to use the device
  3. Still not being able to keep up
  4. Fumbling with the technology in front of others

In my humble opinion, students need time to learn how to use such a piece of equipment or a program.  One of the reasons that a student might need the technology is due to an inability to handwrite legibly.  Another might be difficulty organizing thoughts and motor movements.   Assistive technology needs to be worked on privately with the student or in a very small group with other students using similar technology.  Every aspect of using that device and the skill that it is supposed to support needs to be worked on prior to giving this device/technology to the student to use in the real world.  For example, when providing an alternative keyboard to a student to use to take notes the following needs to be explored:

  1. Can the student take notes without the device even though his or her handwriting may be illegible to others?
  2. Does the student know the verbal cues that would trigger him or her to start taking notes?
  3. Is the student capable of taking dictation either written or using a keyboard?
  4. Can the student use those verbal cues to format notes?  If a student hears the terms “Pros and Cons” or the word “conversely” does the student know that this may be a great time to use a T-Chart style of notes?
  5. Can the student attend to the instructor long enough to follow the lecture?
  6. Is the student familiar enough with the keyboard to type at least 30 words per minute over the length of the class for note taking?
  7. Can the student use punctuation to help the notes make sense with any degree of success?
  8. Is the student comfortable enough with keyboarding in a room full of other students, who are not using a keyboard, to be successful?

Obviously, I could ramble on and on.  We need to think, “When is an alternative device or program better than the low-tech copy of notes provided to the student?  The technology that we supply is only as good as the support that we give to the student.  If we jump to provide assistive technology to a student without looking at the student’s overall ability to succeed without the device, then are we sabotaging the student to dump the device or program and throw in the towel?

I feel that note-taking should be a skill taught in every school, to every student.   A task analysis of note-taking skills needs to be completed and the student assessed using that analysis before providing a device.  The organization of the page should come before the thought of using an assistive technology device or program.  The language that we use in the classroom should trigger a particular format of notes.

There is so much learning that needs to be done by each and every student.  Students are getting frustrated and need to have a place, a structure to go back to.  At that point, once the structure has been taught and reinforced and the student is not yet successful, then and only then should a device or program be considered for taking notes.

I know that every teacher that I come in contact with is working day and night to help all the students learn everything they need to.  I know that many provide notes, study guides and review materials to students, hoping that somewhere, sometime, something will work at some point.  I think that those of us working with students need the structure, the organizational hierarchy, to assess a student’s abilities just like our students need to learn.