As I listened to Cindy Perkins, the insightful school counselor from Maine who presented on P.L.A.C.E. at the ATTACh conference last week, it occurred to me – many Occupational Therapists are clueless.
Ok, perhaps they are not clueless…but as Cindy detailed the interventions and tools that she uses and encourages the classroom teachers to use for children exhibiting behavior problems (often a result of their trauma and anxiety), most were sensory-related.
Cindy’s school actually has an OT Room – a place where occupational therapy is done with mini-trampolines, swings and other sensory toys. As she explained this, there was a murmur around the room about how this was the exception and not the rule in most schools. Cindy works with many students who aren’t in the special ed system (no IEP), yet are still allowed to use the OT Room if breaks are needed for them to compose themselves and return to the classroom ready to learn.
I gotta say that this has NOT been my experience, or the experience of most parents who contact me about school issues. Even the children with IEPs rarely get the sensory processing therapist that could truly help them. In the “evil empire” school system that I just came from, after years of barely not qualifying for OT services, according to their internal evaluations, when LuLu did qualify, she was granted 60 minutes a month of “consultative services”. That is not a lot of time to teach a classroom teacher all the tricks that can be used to help a child learn to self-regulate through sensory input.
But the problem is not with the Occupational Therapists themselves, but, as usual, with the system. School systems are doing all they can to limit what they’re responsible for providing (it’s a money thing). Training occupational therapists in sensory integration therapy is expensive, as it is not yet a part of their basic curriculum. And because special education law does not dictate what OT services are to be provided to those students for whom OT is found necessary, in many districts sensory integration therapies are not provided by the school systems. The general argument against providing sensory integration therapy is that the sensory deficits do not impact the child’s ability to learn.
Oh how wrong can “the system” be! As Cindy so clearly explained in her presentation, for children with anxiety disorders (PTSD, OCD, GAD, etc.), being able to use a sensory-based intervention helps them to be able to regulate themselves. And there’s no life skill more important to a child who easily dysregulates than to teach them self-regulation!
Cindy reported that if she could recognize and intervene at the first sign that a traumatized child was becoming dysregulated, she could very often help the child to avoid escalating to a meltdown. She recommended using a variety of tools including movement (trampolines and swings), music (wearing ipods), and sensory satisfying (gum chewing and holding weighted objects) to give the child an opportunity for self-regulation.
And this led me to my sad realization that OTs either don’t understand the importance of what they can do for children through sensory integration therapy, or, because they work for “the system” they don’t care enough to rock the boat and change things. I suspect there are several hundred OTs in school systems across the nation who understand all this and beat their heads against the wall daily.
Yet, it’s been my experience that there are others who are comfortable in their jobs and satisfied to just keep doing whatever it is they are doing, without fully recognizing the impact they could make on so many children’s lives with these simple interventions.
Sensory Integration Therapy Leading Districts to Handle more OT Requests
Sensory Integration Dysfunction