Providing Related Services to Homebound Students Survey Results

Providing Related Services to Homebound Students Survey Results

During the last quarter of 2017, Your Therapy Source posted a survey on providing related services to homebound students.  A school-based therapist submitted a question regarding how other districts were providing related services to students who remain at home, therefore a survey was created to see how other districts service homebound students.  It was requested to only answer the survey if you are a related service provider working in a school district (preschool or K-12). The survey received 238 responses.

Results of Providing Related Services to Homebound Students Survey:

Question 1:  What is your job title?

• 61.2% were OT/COTAs
• 37.9% were PT/PTAs
• the remaining responders were 1 SLP and 1 APE teacher

Question #2: Do the majority of your school district’s homebound students receive physical, occupational or speech therapy as direct or consult services?

• 54% received direct services
• 30.2% received consult services
• 3% do not provide services to homebound students

Question #4:  Can any therapist have homebound students on his/her caseload, or is one therapist designated for homebound services?

• 84.9% any therapist
• 6% one therapist is designated

Question #5:  Do the majority of your homebound students receive services due to temporary circumstance (e.g., student gets surgery and is homebound for 6 weeks, then returns to school) or all school year (medically fragile children who will not attend school all year)?

• 67.1% homebound students receive related services all school year
• 20.5% are temporary circumstances

Question #6:  Does your school district have a formal policy regarding related services for homebound students?

• 28.2% do have a formal policy regarding related services for homebound students
• 56.8% do not have a formal policy regarding related services for homebound students

Question #7:  As a related service provider, what would you change about your school’s practices regarding providing related services to homebound students?

Short Answer Responses:

• Nothing (11)
• consistency (2)
• hire outside contractor to complete these services
• Better define the need for homebound status and have one therapist cover the district instead of different therapists.
• Increased parent and homebound special education teacher knowledge
• Have the student come to public place if medically possible vs. therapist in homes.
• I don’t think there is really anything to change. We typically go out with the teacher and provide support in the area of seating and positioning and/or mobility, typically an hour a month. So far that has worked well.
• I would have a policy in place for therapists to refer to.
• Decrease the reliance on related services without having adequate academic tutoring in place.
• if provided at home needs to be in an effort to relate services to school so that the student can return to school unless the child is medically fragile
• I currently do not have a homebound student. I think criteria for services needs to be clearly stated in a related service policy
• Need to concentrate the number of IEP goals for homebound students and who will implement them.
• OT is related in the school setting. I find that a medical model service is provided in homebound more than accommodations, etc. that might take place in a school setting.
• A policy regarding related services and homebound children is a good idea.
• I would like to see therapists allowed to see the student after the school day and be paid hourly for that service. It is too hard to fit homebound students into an already tight schedule, especially if the service is only going to be temporary.
• There is no one option. Each case is handled individually.
• I would change our practice from direct services (1 or 2x week) to consultation in the home, as many times the student is either too sick for therapies or isn’t motivated to work.
• I would prefer more communication among therapists. This doesn’t happen at all.
• I would formulate a policy about service time and expectations so that they were consistent for all homebound students
• Allow therapist adequate time to add homebound kids to their schedule.
• Have a clear procedure and maybe even a specific team designated to do so
• have a formal policy and more communication with homebound teacher and family about how to hel the student more while homebound.
• Increased communication between parents and staff members as well as clearer guidelines in determining when to put students to home bound status
• remembering to include in IEP meetings
• I would make any homebound student PT consult only.
• compensation should be higher
• improve the efficiency of the process, takes too long to get homebound started
• the teachers who service the homebound students go after school hours for extra pay. Related service providers must go during the school day. It is very difficult to work together.
• Need more formal policies in place, including criteria for discharge/change in service delivery (consult).
• having a policy- reassessing the situation as caseloads change to see if the service would be better outsourced
• The students on homebound have Dr. orders they are medically fragile because the parents wanted it for their children but they would be MUCH BETTER in school with a day full of sensory stimulation and interaction with other students.
• Currently, I only have one on my caseload and she is often too ill for therapies. It is working the way we do it right now.
• our homebound department is totally contracted to teachers after the school day, and most of them are general education teachers, who have no background in working with special needs, cognitively impaired, medically fragile students. Because the teachers are not there until after contracted time, it makes it difficult to interact with them. I would reinstitute teaching positions for these students. The 3-5 year old students do receive services within the school day.
• I think the way we do it works. We assess students and determine if educationally related services are needed based on the student’s needs and what the teacher will be responsible for.
• Some homes/neighborhoods are not safe. It would be great to have a central location for therapy, but there are many variables for this to be successful.
• Would like them to have a set policy rather than set it individually, often based on pushiness of parents and not necessarily on needs of the students
• That the student would have to try to come to school on a shortened day/week after a year of homebound. Most of the homebound students are not that medically fragile and are going on outings with their parents when they are home during the day.
• To have a policy regarding the necessity of school-based related services as part of the homebound instruction. Specifically, how does homebound school-based PT look different than home-care PT services?
• We should not be expected to go into homes that are not safe or are extremely unclean. Our district should come up with another option in those special circumstances.
• There needs to be a clear description and explanation to parents of school-based vs habilitative services.
• I feel that services should be monthly/yearly and primarily consultative because we usually end up delivering services that are more clinically based.
• We have a small percentage of students that receive related services on Homebound.
• We rarely have students that are served in this capacity and usually if they are it is medically fragile children. I do hate that sometimes kids wind up on homebound due to limited communication between doctors and school. In those cases, I wish the doctors would come to meetings or participate by phone.
• No changes, they are a very minimal part of our caseload.
• More consult, less direct. The 2 medically fragile homebound students on my caseload have full-time nurses that know more about them than I ever will. I am not providing skilled service. It is mostly passive range of motion for maintenance which can be taught to caregivers.
• would like to have a formal policy in writing
• Provide more equipment
• Develop consistent guidelines for service type and frequency, discuss equipment, discuss goals, discuss how to best be integrated with teachers versus being more of a medical model
• More defined policy for determining homebound related service provision
• better communication between staff and families on plan of care and progress monitoring
• Should be consultative when going homebound.
• written policy
• Making sure that the IEP is educationally relevant instead of therapy oriented even though the student is receiving services at home.
• Nothing. We take it case by case. We have a general policy, but it can change based on the needs of the student.
• a clearer delineation between medical and educational OT services
• Make more clear-cut guidelines
• Would like more autonomy with goals to reflect the unique needs of a homebound student’s learning needs in their home environment.
• Protocol for frequency of homebound PT services
• Follow the same policy as we have for students who attend school – educational relevance and impact.
• clear guidelines on medical vs. school model
• To have designated therapists service homebound students versus homeschool therapists servicing them, particularly year round.
• have more materials provided
• Teaching staff pay increase. We have many related service providers but not enough teachers for homebound students.
• I think because it is so specific to each student, it works out fairly well. Only issue is sometimes being available so student with primary teacher (ex. if they provide services after school hours).
• When homebound is not for a medical reason but more of a parent preference, district does not push the issue of coming to school
• To not let parents dictate what the student needs, but to let the team as a whole determine what is necessary for the student to benefit from their special education curriculum
• It seems a consultation model would be more appropriate
• They are great using parapros for a monthly home visit instead of sending out professionals for educational tasks
• Improve communication.
• make related services times correlate with instructional time i.e. not give 1 hour of OT if only getting 5 of instruction.
• Have a formal policy regarding related services for homebound students
• district therapists provide services, not contracted therapists
• If the number of homebound students receiving Services Exceed 2, look at the viability of having another therapist provide services for any additional children
• We do have some issues with wanting two staff to go into the home for safety/legal reasons and this is not always approved by administration.
• Add more hours to our schedule to complete homebound services, since it involves more time (driving there and back and the actual service hours) and we both work part time.
• services must be related to the current educational setting. IE home. If the child is able to navigate home environment then PT should be very limited or consult only.
• Improving correlation between homebound therapy and the educational demands as a homebound student.
• if they are medically fragile or unable to attend school then the school-based OT or PT should not be servicing them.
• More consistency in the provision of services
• Have a specific Homebound PT providing the services
• I would like more safety procedures. The school has no idea when or where I go. In today’s world going some places are not safe. It’s also hard when you have a full school day and then go to someone’s house after work hours.
• I am ok with how we do it in my district. I am allowed flexibility to set my schedule and adapt service minutes to best serve the student.
• Our district is doing a good job with it
• Difficulty in scheduling, need to know when school starts
• Clarify policy
• Speed up the process.
• I don’t believe it is appropriate to treat homebound kiddos if the therapist is a school therapist. It should be medically based therapies only. When the kiddo can tolerate school days, then he should get school-based therapy services. We really need to keep the lines clearer.
• We discuss on a case by case basis and I am happy with that
• Make a policy on the appropriateness of serving these students and knowing when to dismiss them from services. Also, educate families and staff on medical vs educational relevance for medically fragile students.
• I think we need a formal policy regarding related services for homebound for medically fragile students that may receive services year long.
• Allow enough time or allow the therapist to do visit after school at contractor’s rate.
• More consistency as to who is eligible.
• It should be more consultative than direct and not just mirror what they would get in a traditional educational setting.

ANSWER OUR CURRENT SURVEY QUESTION

If you need forms and templates to increase communication between school and home check out, School and Home Communication Forms for Therapists.

Therapists, school staff, and parents are all so busy it can be hard to communicate. This collection of forms will save you loads of time. Therapists can review schedules, report on daily or weekly progress, track behavior, review IEP goals, track communication and more. It is suitable for all school-based therapists. Parents can request therapist to complete daily or weekly updates especially beneficial for non-verbal children.  FIND OUT MORE.

 

 

 

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Fine Motor and Executive Function Skills with a Winter Theme

Fine Motor and Executive Function Skills with a Winter Theme

Do you struggle to find the time to plan out therapy sessions?  These no-prep activities encourage fine motor and executive function skills with a Winter theme.  And… they are FREE!  The black and white pages are super easy to print off and start working with students right away.  This three-page free sample download is from the Winter Skill Builders packet, created by Thia Triggs, school-based Occupational Therapist.

DOWNLOAD YOUR FREE SAMPLE PAGES FOR FINE MOTOR AND EXECUTIVE FUNCTION SKILLS WITH A WINTER THEME

School-based Occupational Therapist, Thia Triggs, has designed this differentiated Winter Skill Builders digital download to: 
◦ Build fundamental fine motor and executive functioning skills for kindergarten-age kids.
◦ Target specific CCSS literacy and math skills in ways that interest and engage even the most reluctant children.
◦ Provide differentiated yet equivalent materials so you can easily provide the just-right level of difficulty and challenge for a group with diverse skills.

Winter Skill Builders Features:

•  Teacher’s Guide for each of the six units.
• Occupational Therapy tips and tricks for explicit instruction, developmental sequence, and breaking tasks into their smallest steps so all children can learn.
• Specific differentiation tools and support.
• Specific objectives for fine motor, visual motor, and executive function skill development.
• Detailed table of contents so you can easily find what you need at a moment’s notice.
• No-prep, print-and-use printables.
• 61 pages.
• Secular winter-themed worksheets.

FIND OUT MORE.

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January Digital Magazine for Pediatric OTs and PT

January Digital Magazine for Pediatric OTs and PTs

The January Digital Magazine for Pediatric Occupational and Physical Therapists has been posted.  When you sign up for our email newsletter you will get access to the FREE digital magazine.  You can sign up below to receive articles on:

ORTHOGRAPHIC PROCESSING AND HANDWRITING

POSTURAL STABILITY AND DYSLEXIA

TASK-ORIENTED TRAINING FOR CHILDREN WITH HEMIPLEGIA

KEYBOARDING VERSUS HANDWRITING SPEED AND LEARNING DISABILITIES

SLEEP, BEDTIME ROUTINES, ANXIETY, AND AUTISM

PRAXIS, MOTOR SKILLS AND AUTISM SPECTRUM DISORDER

TOE WALKING AND SEVERE AUTISM SPECTRUM DISORDER

SENSORY PROCESSING DISORDER, DAILY FUNCTIONING, AND ADHD

TOP 10 BLOG POSTS FROM 2017 AT YOUR THERAPY SOURCE

10 AWESOME IDEAS TO START THE NEW YEAR FOR PEDIATRIC THERAPISTS

LEAP INTO THE NEW YEAR ACTIVITY FOR 2018

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10 Awesome Ideas to Start the New Year for Pediatric Therapists

10 Awesome Ideas to Start the New Year for Pediatric Therapists

Do you like to start fresh in the new year?  Do you set goals for yourself to accomplish during this time of year? Being a school-based therapist is a wonderful job but one of the most difficult aspects of the job is managing crazy schedules in a very tight time frame.  It can be a struggle to fit in paperwork time on top of therapy sessions so setting goals to work smarter not harder can be amazingly helpful for pediatric therapists.  Here are 10 awesome ideas to start the new year for pediatric therapists:

5 Ways to Improve Productivity – read tips on how to work smarter not harder

School-Based Therapy Resolutions – read about past resolutions and how they went

Self Improvement to Help Achieve Goals:  this is a self-improvement worksheet to complete to establish what steps need to be taken to achieve a goal.

Helping Children to Establish Healthy Resolutions  – kids need new goals for overall health

5 Quick Fixes to Improve Therapy Sessions  – from room arrangement to timing these tips will help with each session

Integrate Therapy Goals into the Curriculum  – infuse therapy into the curriculum

How to Be a Successful Pediatric Therapist Coach – A huge benefit to coaching is providing parents and teachers the skills to support their child’s learning throughout daily routines, which can lead to an increase in the caregiver’s involvement and follow through.

5 Simple Tips to Help Children Reach Their Goals and 5 Tips on Tackling Big Goals:  easy suggestions to help the children reach their goals

What is a Growth Mindset? Learn how about self-perception and how it can help you succeed.

5 Reasons to Use Student Generated Data Collection – This method can help cut down on paperwork time and maximize goal achievement.

What do you hope to improve this school year?  Start out by finishing this statement – “This year I will…”

Need a laugh when you look back over the years as a pediatric therapist?  Play Have You Ever Therapist Style.

 

 

The post 10 Awesome Ideas to Start the New Year for Pediatric Therapists appeared first on Your Therapy Source.

Never Have I Ever Therapist Style

Never Have I Ever Therapist Style

I keep seeing all these point scales all over Facebook where you give yourself a score based on things that you have done.  I thought it would e fun to create a Never Have I Ever Therapist Style.  Give yourself one point for each statement that you have done during your career.  Here is my hypothesis – any pediatric therapist who gets a perfect score of 20 probably has at least 5 years of school-based therapy experience.  Would love to hear if you prove me wrong!

So here we go – one point for each statement, Never Have I Ever…

___ been locked out of a school
___ worked in a closet
___ unable to discharge because IEP team refused
___ been barfed on
___ worked with demanding parents
___ spent too much time in the toy aisle
___ repeatedly heard “fix this sensory issue”
___ had a ridiculously messy car
___ had my own kids take my work toys
___ ripped holes in the knees of my pants
___ disagreed with a lawyer
___ just finished scheduling caseload then student transfers in
___ written IEPs at home
___ completed and typed up an eval in under 2 hours
___ hurt your back on the job
___ stayed on schedule all day
___ provided carry over activities that no one followed through with
___ been called the OT/PT
___ cringed at the statement “babies don’t need to crawl”
___ fought to stop taking away recess as a punishment

TOTAL SCORE: ????

In all seriousness, the job of a school-based therapist can be overwhelming at times, to say the least.  At the end of the day, it is an amazing job where we get to work and play all day long.  As pediatric Occupational and Physical Therapist, we always need to remember that one of the most important, if not the MOST important, aspect of our job is to educate.  We need to let students, teachers, school staff and parents know what we do and why we do it.  Without buy-in from all team members, goals can not be reached.  In addition, in order for therapeutic activities to be carried out all day long we need to educate people how to make that happen.

Read more:

5 Reasons to Provide Hand Outs

How to Be a Successful Pediatric Therapist Coach

Educate Poster

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Top 10 Blog Posts from 2017 at Your Therapy Source

Top 10 Blog Posts from 2017 at Your Therapy Source

Ever wonder what people read the most here at Your Therapy Source?  Well, here is your answer from 2017.  Here are the top 10 blog posts from 2017:

10. Color, Cut, Glue Summer

9. Norms for Core Strength in Children

8.  26 Calming Strategies for the Classroom

7.  Writing SMART Goals for School-Based OTs and PTs

6.  Find and Color Christmas Doodle Find

5.  Practice Scissor Skills – Color, Cut, Glue Spring

4.  Five Tips to Help Children Develop Body Awareness

3.  Fifteen Free Visual Spatial Printables

2.  Self Regulation Activities

And the number ONE blog post from 2017 was…

 Ten Fun Games to Practice Self Regulation Skills

 

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Sensory Processing Disorder, Daily Functioning, and ADHD

Sensory Processing Disorder, Daily Functioning, and ADHD

The European Journal of Paediatric Neurology published research on sensory processing disorder, daily functioning, and ADHD.  The study included 77 children, ages 8-11 years old (37 with ADHD and 39 typical controls).  Each child was evaluated using the Conner’s Parent Rating Scale-Revised: Short Form (CPRS–R:S), the Short Sensory Profile (SSP) and the Children Activity Scale for Parents (ChAS-P).  These tests were used to assess ADHD symptoms, sensory processing symptoms, and difficulties in daily function.

The results indicated the following:

• the Short Sensory Profile total score of the ADHD group was significantly lower than that of the control group.
• 65.8% of the children with ADHD had an abnormal Short Sensory Profile score indicating sensory processing disorder.
• only 2.6% of the typical children control group had an abnormal Short Sensory Profile score.
• the daily function of children with ADHD was significantly lower than in typical controls as indicated by the Children Activity Scale for Parents scores with the largest differences found in activities that require executive function skills.
• children with ADHD and abnormal Short Sensory Profile scores, had a significantly lower daily functional ability than controls.
• children with ADHD but normal Short Sensory Profile scores had only marginally lower daily functional abilities than controls.
• males had lower mean ChAS-P scores than females, however,  these differences were statistically significant only among the children with ADHD.

The researchers concluded that sensory processing disorder may be a possible specifier of ADHD in children that is associated with functional consequences.

Reference:  Mimouni-Bloch, A., Offek, H., Rosenblum, S., Posener, E., Silman, Z., & Engel-Yeger, B. (2017). Association between sensory processing disorder and daily function of children with attention deficit/hyperactive disorder and controls. European Journal of Paediatric Neurology, 21, e171.

Do you need simple handouts to help explain sensory processing disorder and how it can affect function?  The What? Why? and How? series helps to explain different topics to students, parents, and teachers. Each hand out includes a definition of what the topic is, why it is important and how you can help.

Series 3 includes one page hand outs on the following topics:

• Sensory Processing
• Proprioception
• Vestibular System
• Tactile System
• Sensory Registration
• Sensory Modulation
• Sensory Defensiveness
• Sensory Diet
• Self Regulation
• Dyspraxia

FIND OUT MORE.

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