For the month of September, the Handwriting is Fun! Blog will be sharing insights about the role of Occupational Therapy in the classroom. In recent years, the role of OT, in general, has been changing with the waves of healthcare and education reforms. Despite a certain amount of turmoil and confusion where those changes may have thrown us a curve ball, most often they have provided us with an opportunity to make a difference in an area in which we’ve longed to see an improvement. For me, that has been handwriting mastery. For others, it has been the role of OT in the educational system as a whole. This second article in our “OT in the Classroom” series addresses the role of OT as an vehicle for guiding teachers, educational staff, and administrative leaders in striving for and achieving handwriting mastery for their students. Marie Toole, OTR/L, shares the amazing work that she and the OT staff in her district are doing to Advocate for Change.
An Advocate for Change
by Marie Toole, OTR/L
Many years ago, as a new school-based occupational therapist, I was ready to conquer the world. That first year was a blur of referrals and therapy and meetings and learning. The OT staff sat down at the end of that first school year and — after counting up how many referrals we got for handwriting — decided to do something different.
We had to figure out how to handle all these referrals and distinguish between those students who really needed occupational therapy intervention and those who would benefit from good instruction in handwriting from the teacher. We needed to be agents of change or we were going to be burned out.
Over the last 20 years we have seen a significant drop in our referrals for strictly handwriting. The referrals we get now are for a myriad of reasons and almost all of them end up with us servicing the child for direct OT interventions. How did we cut our referrals in half, meet the concerns of the classroom teachers and yet still make sure students have legible handwriting? Over the years we have employed a number of strategies. Let me share them with you.
Teachers told us they either did not feel comfortable teaching handwriting in the classroom or felt like they were not doing a good job. So we helped.
- We gave workshops to teachers, paraprofessionals, and parents about hand skills, handwriting, and posture. Building on our handwriting curriculum, we wrote out each letter description, which showed them how to form the letters and gave them the language and developmental order in which to teach letters. Everybody is now using the same language to teach in a consistent manner.
- Partnering with the physical therapist, we gave an inservice to local preschools on the typical development of the 2- to 6-year old. This helped those teachers to have realistic expectations for hand skill development.
- With our physical education teachers we developed Classroom Rechargers. These are 20 movement-based activities per grade level that teachers can perform right in their classroom with little-to-no equipment or space. We put together handwriting warm-ups, exercises, and activities to be done just prior to teaching letter instruction.
- We showed kindergarten teachers the importance of building the base of hand skills before adding on the challenge of handwriting.
- We continually give workshops once or twice per year on various topics. Information, tips, or skills teachers can use the next day in their classroom are the most valuable to them. We generally have a large audience.
- When new teachers join our buildings or teachers switch grades, we always make sure to touch base with them and help them navigate the teaching of the handwriting process. Checking in periodically to see how letter instruction is going is always helpful, too.
Seating and posture were important areas where teachers needed assistance.
- At the beginning of each school year, we go in and check the desk and chair height for every student on our caseload. We make sure students fit their work space.
- We send an email to remind staff how to check for proper desk and chair height and will help any teachers struggling with this. The custodian is our friend, helping us find the right furniture or to adjust desk height.
- We have also advocated for stand up desks and several of our classrooms now sport at least one stand up desk. We add sensory equipment — seat cushions, bicycle tubing around the chair legs, and hand tools — for those students who move and fidget. When students are comfortable and in a good place for learning, it makes handwriting instruction so much easier.
We use a pre-referral process to keep track of teacher requests and to address needs in a timely manner.
- Teachers must fill out a basic form telling us their concerns and what they have tried already.
- The pre-referral forms help us fine tune our classroom observations to an area in which the student may be having challenges, such as math, writing, or organization.
- We then tailor our classroom observation to those specific areas.
Planning and coordination are important first steps.
- At the beginning of each school year we discuss with the classroom teacher and special educator the most convenient time when writing is being taught and we plan our schedules around it. Most of our teachers have been with us long enough to understand the limitations in our schedule and will cooperate to make this work. When we show up for our therapy time, the teachers welcome the extra pair of hands to help with letter instruction, the writing process, typing on Google Docs, or writing poetry.
- We know the curriculum. The students do not get pulled from instruction and we get to work in the moment with the students on meaningful work. We also get to put our eyes on all the students in that classroom and may help other struggling writers as well.
- We co-teach cursive letter instruction in most of our third grade classrooms as part of our third-graders’ therapy time. It gives us in-class time and we get to work with the whole class by showing them some multisensory ways to learn letters using sand, chalkboards, or kin-tac cards.
- We are lucky that we are district employees and have the luxury of having an occasional block of time to observe students in class, on the playground, or in the gym. We also use our therapy time to work in the classrooms with students on their OT goals.
Early Intervention and Response to Intervention (RtI):
In our district we are lucky to have an administration that support us.
- This allows us to go into each kindergarten classroom under regular education for one half hour per week to “SPOT” children who might need help with hand skills.
- SPOT stands for Speech and OT. Our “SPOT” time is available to assist the teacher with activities that may be challenging for 5- and 6-year olds. In our OT sessions we might be working on scissor skills, gluing, coloring, and eventually, after months of hand skills training, handwriting.
- As the year progresses we generally have a small group of students that we focus on during SPOT. We do the same activity that the whole class is doing but those students may need more assistance. These students become our “watch” students in first grade and then we have our entry into the first grade classrooms under RtI.
- This took many years of “selling” to our principal. We argued that we could ward off some referrals by giving a little help early rather than a lot of help later. The administration agreed to a trial. After seeing the results, the program stuck.
- One way we have cemented that progress in our administrators’ minds is to have them conduct their yearly observations of us when we work in the classrooms. We love to have them come observe us working with a group in the fall, again in January, and later in May. To see that transformation is like gold in the bank.
Winning over skeptics
Patience and respect guide us in the classroom.
- It is not always easy and there are some teachers who do not appreciate us coming into their classrooms. In those cases, we take it slow and become a guest in that teacher’s classroom. When they see the intrinsic value that we bring to the table as occupational therapists, most teachers come around.
- Generally we have found that teachers can’t wait for us to work in their classroom and are bummed when they do not have students who receive OT in their classroom that year. It takes time, sometimes lots of years of trying. But working together as a team shows the student that everyone is on the same page and you have the same expectations for him or her.
Having a strong special education team is helpful as well.
- Working with the classroom teacher, special educator, and the rest of the special education team has helped us to fine tune our occupational therapy process.
- Often it is the special education teacher who brings concerns or referrals to the occupational therapy staff.
Advocating at the administrative level
Becoming visible is essential.
- We knew we needed to get good at this or we would continue to struggle year after year. Our principal, assistant principal, and even the superintendent know who we are.
- We consistently advocate for what is right for children. In our 20 plus years, there have been many principals and superintendents at the helm. We had to get to know them, their goals, and how they liked to work.
- We asked for OT be represented on the curriculum committee for language arts when administrators revised it many years ago. We ended up putting a handwriting strand into the curriculum with expectations developmentally appropriate for kindergarten through fourth grade.
- When the district was thinking of cutting out cursive instruction, we took this on as our mission to research it and make informed decisions. We took our time, and over the course of three years, we read many research articles and spoke with many other local districts to see what they were doing. We ultimately decided to keep cursive instruction as an integral part of our third grade curriculum.
- When advocating for the SPOT time in kindergarten, we came armed with data to show that it was beneficial. We constantly print out articles about teaching handwriting and give them to our principal.
- Being relentless in the pursuit of continually advocating for what is right for children can be tiring. It is not something that happens overnight. Looking ahead and looking towards the big picture has helped us to maintain our vision. Continually putting it in front of administrators keeps it fresh and does not allow stagnation or somebody to forget how important handwriting is in the curriculum.
An important point to remember:
- We cannot become the “handwriting teacher.” That’s the job of the classroom teacher. We are occupational therapists who look at functional skills and participation in the school curriculum and environment.
- By empowering teachers to actually teach handwriting before they expect children to write, we advocate for what our students need. Ongoing support and advocacy will encourage teachers to keep teaching proper letter formation. This in turn will allow our OT interventions to remain focused on the functional skills students need to navigate the complex world of school.
Marie L. Toole, MS, OTR/ L, is a pediatric occupational therapist with 28 years experience in NICU, Early Intervention, and private practice with the last 20 years spent working in public schools. She is NBCOT and SIPT certified as well as a member of AOTA and NHOTA. She lives in southern New Hampshire and can be reached at email@example.com. Follow her on Twitter @MarieTooleOTNH, on Pinterest marietooleNHOT, and on School Tools for Pediatric Occupational Therapists where she tweets, pins, and posts about OT, education, autism, and sensory integration, as well as other school related topics.
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