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

So Why Should Occupational Therapists Bother to Write Rubrics?

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., 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

-Daily Task Worksheets

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., 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.