By: Laura Petix, MS OTR/LEPISODE 69


It’s Occupational Therapy month and we are celebrating by highlighting some of the ways you can get OT support for your children. Today we’re talking about OT support through the public school system, specifically in the United States. This episode covers basic information about IEP services and 504 plans, how they differ and how to effectively create a support team that has your child’s best interests in mind.

Casey Waugh, MS OTR/L

Casey Waugh is a pediatric occupational therapist with 11 years of experience in outpatient, early intervention, and school settings. Casey’s passion is to elevate parent confidence through education and advocacy.  Her social media channel OT Time with Casey was created in response to a desire to help fill gaps between professional knowledge and parental knowledge.  Casey has focused her effort on learning and training in the areas of feeding, sensory processing, and special education processes, particularly in regard to ADHD and OT in schools. On a personal note, she is a mom of two active and sweet little boys, and the idea of a perfect date night with her hubs is a night on the couch watching The Office with their cats Frank and Beans.

In this episode, you’ll learn: 

Episode Links

The Role of OT in a School-Based Setting: Unpacking IEPs and 504 Plans
Casey (00:00):Okay, now I think it's important to note that there's a difference in a medical diagnosis and what's considered a disability in education law because you could go to your pediatrician and get an A D H D diagnosis, or maybe you go to a psychologist and get or a psychiatrist and get an...

Casey (00:00):Okay, now I think it’s important to note that there’s a difference in a medical diagnosis and what’s considered a disability in education law because you could go to your pediatrician and get an A D H D diagnosis, or maybe you go to a psychologist and get or a psychiatrist and get an autism diagnosis that doesn’t just give you a ticket to take to the school and get an I E P. They do their own evaluations and they have a list of disability categories. The school does not diagnose anyone with a medical disability.Speaker 2 (00:39):Welcome to the Sensory Wise Solutions podcast for parents where parents can get real actionable strategies to support kids with sensory processing disorder. I’m Laura, OT and mom to Liliana, a sensory sensitive kid who inherited my anxiety and my love for all things Disney. Consider me your new OT mom. Bestie. I know my stuff, but I also know what it’s really like in the trenches of parenting a child with sensory processing disorder.Speaker 3 (01:09):Okay, mom, enough about me. Let’s start the podcast.Laura (01:17):Happy Occupational Therapy Month in the United States, everybody who’s listening, thank you for being here. Welcome to another episode. April is OT month and this month I’m going to be highlighting a lot of the different ways that OT can help your child. I’m going to give you a lot of tips and tricks to advocate for your child to get OT services. My hope is that one of the episodes or one of the social media posts or one of the emails this month gives you the exact thing that you need to hear right now and also gives you some tips either to start supporting your child at home if you can’t access OT, or maybe gives you some ideas and ways to better advocate so that your child can get OT services, however that might look. So today we are talking about I E P and 5 0 4 services through the school system.(02:13):If you are not in the United States, you might not know what these mean, but I still encourage you to listen and maybe you could find similar services or at least know the questions to ask in your community wherever you’re located. So today I’m interviewing Casey Wall. She is a pediatric occupational therapist with 11 years of experience in outpatient early intervention and school settings. Casey’s passion is to elevate parent confidence through education and advocacy. Her social media channel OT time with Casey was created in response to DESI to a desire to help fill gaps between professional knowledge and parent knowledge. Casey has focused her effort on learning and training in the areas of feeding, sensory, processing and special education processes, particularly in regard to ADHD and OT in schools. On a personal note, she is the mom of two active and sweet little boys, and the idea of a perfect date night with her hubs is a night on the couch watching the office with their cats, frank and beans.(03:12):Oh my goodness. I love that. I love all of that. All right, let’s get into the interview. Casey, it’s so good to have you on the podcast. This is a long time coming. You and I have connected a lot over social media and I have sent so many parents your way that I’m excited to have you now on the podcast to talk about a topic that right now apparently is a national holiday, sort of unofficial holiday in the United States. It is national i e p writing day if you’re in the United States the first Monday of April. So happy to have you on Casey. If you could just introduce yourself to us and tell us a little bit about yourself.This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 2 of 15Casey (03:51):Great. Thanks for having me. And you’re the first to tell me that there is a national i e P writing day, but I mean I’ll celebrate anything. So that works for me. My name is Casey and I am an OT in Pittsburgh, Pennsylvania. I graduated about 11 years ago and I quickly realized that I love OT and I try to do too many things at once. I see a lot of gaps in what currently exists as far as what OTs do in different settings, and I try my best to fill those gaps and it leaves me spread in a lot of different directions. So I recently started working in a school about three years ago. I started working at an approved private school. So the children who come to my school, their school districts said they cannot provide the education that they need, so they pay for the kids to come to my school. Every student at my school has an I e P and Wow,(04:51):Wonderful school. Yes, everyone has one from preschool all the way up through the end. Everyone has an I e P. So I was starting to attend a lot of meetings just by nature of seeing these kids and even in this really, really wonderful school that I work at where the teachers are very involved, the administration is wonderful. I still felt like parents who have this support system still were not understanding all of the different aspects of special education and eventually our students transitioned back to their public schools. That’s the goal. So I was like, our parents need to know about these things. We’ll help them advocate for their child in the future. So that’s kind of what led me down understanding IEPs better and doing a lot of my own learning and research and reading the laws and buying all these books because I wanted to help fill that gap to help parents understand their role and also of course, advocate for OT and how important it is in schools. So that’s a long-winded answer of how we got to IEPs and ot.Laura (05:58):I love that. I did not realize that there were schools. I think there’s something similar to that in California where I’ve heard of the public school not being able to meet those needs, and so they will pay for private OT or a separate or private school. But I didn’t realize that there was schools dedicated where they put all of those kids together. That’s not considered a special education. Is it called something specific when you think of those schools and is it that an exception? They don’t have those everywhere. I’ve never heard of that. SoCasey (06:31):They’re called approved private schools. A p s is the abbreviation. Okay. Are so many abbreviations in special ed? Yeah, there may. There are several in Pittsburgh. Some are for kids who have multiple disabilities that have a lot of medical needs. There may be some that are only for children who experience certain levels of autism or the school I work at is for kids who are deaf and hard of hearing. So they have cochlear implants or hearing aids. So we are a specialized school that has teachers of the deaf. We have all of that to support those kids, to get them ready to listen and learn and then they transition back. So we are kind of like their preparation. They come to us very young and some of our kids transition out by kindergarten. Some are back to their home districts by second or third grade, some stay longer. It really depends on their individual needs. But the approved private school is something that is nationwide. They just may not be as spec. They have a specific need that they are filling. There has to be a reason why the district would pay the money to bust them.Laura (07:42):This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 3 of 15Yeah. So I want to give everyone a little background of why this topic is important, why it keeps coming up for me. So I always joke that I could never work for, I think the school district would not like me. I always say that because I am always advocating for more OT and I, I’m not making everything an OT thing, but sensory is involved in all aspects of learning and behavior. So it’s so hard for me to believe or hear when a certain child who doesn’t have a clear limitation to accessing academic impact, but they have very clear sensory needs at home or in the clinic and hearing that that does not qualify them for services. And I feel like the school district would not really like me and the same thing with insurance companies. So I could never work in a clinic that had to have all of these parameters dictated by people who don’t even understand what sensory needs are.(08:39):So I’ve found myself in this nice little niche where I can help parents understand it themselves and take that and advocate for their kids. And one aspect of that a lot is the school. And I also have told parents I’ve never worked in the schools. I’ve never been a school-based ot. I’ve always been a private OT who sometimes goes into the classroom and observes and helps provide specialized support relating to sensory because not a lot of school OTs are trained in sensory, but I’ve never had to deal with the red tape and the politics. That sounds so overwhelming as an OT and I can only imagine as a parent. So I want to take this episode to set the record straight to help parents understand a school-based OTs role. And I also want therapists who are listening to this to be open to understanding where parents are coming from and hope that we can get closer together and keep remembering that it’s all in support of the child and just think of different ways to move forward, whether on the parent side or the therapist side. So I want to start out Casey, by asking you, I just to define to anyone who’s listening who might not be in the states or is new to all of this, what exactly is an I E P and then also how that differs from other special education services that a child might have in the United States public system?Casey (10:14):So I e stands for an individualized education plan and it is a plan that is put together that provides specialized instruction in whatever area that child needs. And the goal of any I E P is to help a child move towards independent living, further education or future employment. Those are the three things that are written in the law. That is what an I E P is for, to get a child ready for that. So we provide specialized education through an I E P in a lot of different ways, but there has to be a documented and a very real way that the disability is impacting learning and how they’re accessing their environments. So IEPs are governed under a law called ID ea, which is the education law, and it provides a lot of protections for parents and for students who have a disability. Now, I think it’s important to note that there’s a difference in a medical diagnosis and what’s considered a disability in education law because you could go to your pediatrician and get an A D H D diagnosis or maybe you go to a psychologist and get or a psychiatrist and get an autism diagnosis that doesn’t just give you a ticket to take to the school and get an I E P.(11:45):They do their own evaluations and they have a list of disability categories. The school does not diagnose anyone with a medical disability. They cannot do that. The school cannot say a child is autistic. They don’t test them for that. That’s not their role. But they could categorize someone into a description that says you have similarities to people with autism, so we’re going to put you under this disability category, not the same as a medical diagnosis. And all that to say that OTs role in all of this is also kind of varied because you can’t have only OT on an I E P. There has to be something that’s impacting academic learning and that’s where this could go on a whole other big tangent.This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 4 of 15Laura (12:36):I’m like, I have so many questions already.Casey (12:38):I know. And it comes down, it always, and this is the very part sucks, but everything comes down to money. Everything comes to council money. And it is so frustrating because we know it should be in the child’s best interest, but special education is expensive. And having a team really look at the whole child and recognize, yes, sensory is important, but that’s alone. Alone. We know that it’s not only sensory, but that by itself is not something that would fall under neatly in one of those disability categories. So I just talked, I tend to ramble. So let’s see. Are there questions in there about anything before I talk about 5 0 4 s?Laura (13:22):I have a lot, but I also want to hold onto them because it’s going to be a bigger part of the conversation. Okay. So I’m going to hold onto them now since we’re just set identifying what an I E P is. Okay. So just to summarize, I’m making sure I’m understanding correctly and anyone is listening. So i e P services are specialized. Would you say interventions or plans specifically targeting areas of need that a child would have in order to access the academic content like differently or in a specialized way compared to how they normally would teach the content? It’s very specific to the content related to the academics that they’re learning in that school.Casey (14:04):Yes. And also, I mean it does include you can have goals and areas of need that are behavioral and emotional and academic. It’s not just like math and reading. It can include other things as well. But the biggest thing is the child needs specialized, specially designed instruction. That’s another catch.Laura (14:28):Specialized, specially designed instruction. I have not heard of that one either. Yeah. So the child, and then what you were saying is if they are not receiving any of the other services, which are, can we list out quickly, is it speech and somethingCasey (14:47):Specific? Yeah, it’s like a special ed teacher and you can’t have a speech only i eLaura (14:54):Ping,Casey (14:54):But you can’t haveLaura (14:55):But not ot. So you have to kind of qualify for those bigger things first. And then if they’re like, oh yeah, you could also benefit from ot. Yes. You think you would not have a child who has an OT only I E P. And that’s across the board at every state. FromThis transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 5 of 15Casey (15:09):My understanding. There may be some states who have different laws around that, but it is not as far as I know, there are no states currently OT is trying to advocate for that. But that comes down, those are laws that will be left years from now. SoLaura (15:27):Right now, and so yeah. And then these IEPs involve another professional coming in to do that specialized instruction that’s aside from the teacher. So either a speech therapist or an OT or some specialized behavior professional. Is that right? ThereCasey (15:43):Is some level of special education involvement, whether it is, could be even just small group time with a special ed teacher. Maybe they come into the general ed classroom that it doesn’t necessarily have to be pulling out and going to an entire different room. But there’s some sort of specially designed instruction that makes different than the common standards of that grade level, which I think is a good lead to 5 0 4 s.Laura (16:14):Yes, the difference between an IEP and a 5 0 4 plan.Casey (16:18):So a 5 0 4 plan is something that provides only accommodations or changes to the environment or the way things are set up. They’re not touching. Curriculum 5 0 4 doesn’t make any changes to what the child is being taught. Words are still the same. They are still learning their grade level math or they’re still in this reading class. They just might have changes to maybe how they are getting that information. Maybe they get it written as well as read to them. Maybe they get less homework or something that is changing the way that they engage in the environment, but it is not touching the curriculum. And those are the big differences. I e p, specialty design instruction, A 5 0 4 is just accommodations to the environment to help that child learn. And it’s different laws. Technically a 5 0 4 isn’t even a special education plan. It’s just a thing that we put in place when we were like, oh, there are kids who don’t nicely fit into an I E P but still need help. And I think the easiest example is if a child uses a wheelchair and they have to go to certain classes, then they came up with a plan to S to say, you can’t say this kid can’t come to school here. It’s really a civil rights kind of thing to protect a child from being discriminated against. So those are the big differences there.Laura (17:50):And so to help parents separate the two again also on qualification level, is it easier to qualify and to get a 5 0 4 plan than it would be an I E PCasey (18:06):Kind of. I think that 5 0 4 plans can be, but really the process is not as clear cut as I, because there is not that background law that says this is how you have to do it. So some schools may have a really in-depth evaluation that they also do and they may do all of these different types of things and ask for documentation. I’ve also heard of some schools saying, we have something from your doctor that says you have diabetes, for example, we’ll give you a 5 0 4. So it varies because those protections from the This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 6 of 15law, it’s not an education law, it is from a civil rights law that’s being applied to schools. So schools have different ways that they can and do go about putting that in place. But is if you have a disability or even are suspected of having a disability that impacts your life and they have different areas of life they think about, it’s like, I don’t know all of them off the top of my head. It’s like cognitive daily life, social, things like that. If it impacts that in a significant way, then you can potentially have a 5 0 4 plan. So yes, it’s easier, but it’s also not because some schools might be like, I don’t know, they don’t have a very clear path that they have to go, which an I E P does. It is written in the law what you’re supposed to do. And so there’s not that protection with 5 0 4 sLaura (19:39):And where I feel like a lot of my parents that I work with, the majority of the audience here are those kids with the not quite fitting in a certain box, like you said, who just have sensory. We’re putting that in quotes, strong air quotes around just sensory because usually it bleeds into so many aspects. So that’s where a lot of my parents end up falling into where they have strong sensory needs that are impacting their ability to participate fully or at least have some sense of quality of life around school. They’re hating school or it’s too hard. They’re able to make it through, but they’re masking so much that they’re not actually remembering the content or they are like my daughter, I almost did a 5 0 4 plan because she was having quick for a short period of time, school refusal because of clothing. And so we were late to school a couple times and I was like, do I need to have support around getting to school on time? All of those things. And so parents end up going that route. Are you seeing that as well, that a lot of the kids, you could have your sensory needs being met, if not by an I E P, then writing them into an accommodation support plan through a 5 0 4 plan. Does that happen a lot? As much as I can in my head, I think it doesCasey (21:00):Happen. But I think that the issue becomes, again, down to money. There is no funding that is provided for 5 0 4 s. So a school may put a 5 0 4 plan in place and give it to a teacher and then the teacher is kind of on their own putting PuttingLaura (21:22):It together. Yeah. The difference is there’s not a professional helping the what’s the plan is written, which I assume comes from feedback from if an ot, is there an OT on the team to help write the plan.Casey (21:37):There can be. I know there’s a lot of maybe if, but yeah. And the ot, some school districts will have money that they set aside and say, yes, an ot, we will give you services through a 5 0 4, but they do not have to. If you have a 5 0 4 plan, you do need automatically. They don’t have to provide any related services. So this is where it gets very tricky when you have a district who says you don’t qualify for an I E P, we’ll give you a 5 0 4, but that’s just accommodations that the teacher’s going to do in the classroom. And I think a well-written 5 0 4 can really help a child. But it comes down to what support that teacher is getting. Is the special ed teacher helping them? Are they checking in who’s holding them accountable? There don’t even necessarily have to be goals written into it.(22:26):So there to be, and it’s, as a parent, if you go into it with the expectation that we are going to write goals as a team, and maybe that means that I will have to call as the parent once a month to see how things This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 7 of 15are going. Or maybe we can say, is it possible to have the ot? They are allowed to say no. Whereas in an I E P, if you qualify for something, they can’t tell you that you don’t get it. Yeah, I think they can be really helpful as when a team is well supported, when a teacher team is well supported, when the OT is respected and is able to provide even in services that help all of the teachers,Laura (23:08):That would be lovely.Casey (23:09):Many kids that could benefit from these things. So a well supported team can write a very great 5 0 4 and it can help a lot. But there’s a lot of things that have to go in to making sure that that child gets what they need. And that’sLaura (23:25):Hard because again, parents need to know to ask for it. Or the question I get from parents is like, okay, I know my child needs help, but I don’t even know what to ask for. What are my options? I need a menu of options to ask for. Oh yeah, that would help my child. They just don’t know, which makes sense. They wouldn’t think that way. And if the school says, okay, we’ll give you a 5 0 4 plan, what do you want on it? And they don’t have an ot. It’s like we’re both, we’re at the table and we’re have nothing to put on the plan. So if a parent is working with an OT outside of the school, either they’re consulting me, consulting you, or they have some private OT they work with or they just have a really good understanding of what their child needs. Would you say that there’s any benefit, is there a difference or what are the main differences between just communicating that directly to the teacher and just saying, Hey, my child could benefit from this in a written document, an email, or going through the official 5 0 4 plan route. Is there pros and cons to each that you can think of?Casey (24:27):Yes. I always care on the side of getting things documented. If it’s not written down then it didn’t happen kind of thing. Especially in what if you have a great teacher in first grade who is like, yes, I will do this. They are on it. They are willing to try everything and you get to second grade and that teacher’s like, no, I don’t. Okay, I follow this behavior plan. And they will sit and has that kind of approach. If there’s not something documented with the school, even if it is a 5 0 4 plan and not an I E p, then they can say I don’t have to do that. And I’m not trying to say that the 5 0 4 that is written doesn’t have to be followed because it does. I’m just kind of getting at what support the teacher is having and who is coming up with the plan. That does happen a lot. Like you said, they ask the parents, what do you want on it? They’re like,Laura (25:20):I dunno.Casey (25:22):Yeah. If you have an outside ot, having them even signing consents, like say, Hey, you can call my kids’ teacher and let’s know, I gave them permission to talk to you. They can have a conversation because maybe there are things that you can pull yourself out of being the middleman. But definitely the thing I take away from all of that is having open communication from the beginning and build a sense of a This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 8 of 15team. If you go in one way or the other saying, I want this, I need this. And give them a list of a hundred things that you expect, they’re probably going to be what Also, if you go in the first time you talk to the kids’ teachers because there’s all these issues going on, we have a responsibility to build that team approach. And it can be hard, and it doesn’t mean you have to be best friends with everybody, but having that professional, almost like businesslike approach to these things builds up the team and it lets them know that you are looking for and expecting a level of communication. But I definitely think to come down to it, having a documented plan that is written in on file with the school is going to be more helpful throughout the childlike schooling in general. Then having that email to the one teacher. Cause maybe then the art teacher doesn’t get it or the music teacher,Laura (26:51):Oh gosh, the different teachers I was not prepared for as in kindergarten, what my daughter, I’m like thank thankfully she’s great at school. But I’m like, I couldn’t imagine having to have individual accommodations and talking to the PE teacher, the art teacher, the social emotional teacher, the reading special. I was not prepared for that. So I want to, because I also get a lot of teachers here listening. And I remember the 10th awkward, I don’t know the right word for it, as an outsider OT who did not work within the school district. Whenever I was paid by a client to go into this school, especially when it was a public school, I always felt this awkward tension. I was the bad guy who was going to tell the teacher things they’re doing wrong. So I always went into it with that mindset to no, I want to work with the teacher, I want to help them.(27:50):But because I wasn’t in the classroom and I’m not used to working with that many kids, I’m sure a lot of the recommendations I put the teachers were probably, there’s no way I’m doing that. I cannot do that. But then also knowing on my end, I’m like, I can’t still not recommend it because that’s still the best. But also knowing what are the chances this is going to happen As an ot, I’m curious, you’re closer to the teachers and have heard that what is that climate and what are you hearing from them and what S should parents or OTs get from this if they’re trying to make the teachers bees as successful as possible with this student?Casey (28:35):I think that the biggest thing going into it as the OT is making sure that any recommendation that you give is created with the teacher right there, talking through it with them. Because you don’t want to provide just a checklist of all these things they have to do when it’s one in 20 kits that they have in their classroom. And I think it also comes down to again, how much support that teachers have. We know that right now in this country, there are a lot of teachers who are burnout and have maybe 18 out of 20 kids have various centuries. It’s wild. And I know that covid, everything that happened when kids were out of school, that has really impacted particularly second graders, third graders right now. So I think that the biggest thing that I wish OTs could do and were respected enough to do in the district as a whole is provide support to teachers across the board. Because we might have certain kids identified, but literally all kids could benefit from some level of sensory input.Laura (29:52):Yes.Casey (29:53):This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 9 of 15So it comes from above. And so we can do what we can do in the classroom with these kids that are on our caseload, but if it’s not a cultural accepting this thing that just, it’s real life. These kids have sensory needs and giving them a fidget isn’t going to fix that. And I think also educating from an OT as well as all of the other people who have expertise in the differences between sensory needs and D H D and trauma and how that can all look. We might see similar outward behaviors, but a sensory diet is not going to help a kid with a D H ADHD in the same way as it would a child who really has different sensory needs in and of itself. If so, I get a lot of questions from teachers for kids who have A D H D and I’m like, I can give you some suggestions on how to help them, but my sensory tools are not going to help him sit for 20 minutes because it’s just I cannotLaura (30:57):Do that when there’s a D H D involved. Yeah, yeah.Casey (31:00):It’s different. So I think that the OTs role when possible is to provide education. I know you, if you’re an OT listening, maybe public speaking is not your thing, but finding some way to have somebody to come do an in-service on one of those days that all the teachers are there. It would be invaluable because I think teachers are told, try this or do that. And you can use the tools and maybe they’ll help some kids, but if you don’t have the understanding of why they are needed and you don’t have the support to do it, it becomes really challenging. So I forget what the original question was, but I think ILaura (31:43):No, but that’s all that. No, that’s great. And it did make me think something that I remember, I’m not really in the school-based OT forms anymore, but I used to be on a lot of school-based ot, like Facebook groups and stuff. And I was hearing a lot of chatter from school-based OTs, frustrated, burnt out of course, overwhelmed by how many referrals they were getting for sensory. There’s this uptick in teachers identifying it’s a sensory needed, it’s a sensory. And they were saying sensory is this buzzword now. And they’re saying everything is sensory. I’m on the outside. I’m again reading these and I’m like an outside OT who is specialized in sensory. I was like, I would much rather them over-report sensory and assume it’s that rather than saying it’s they’re a bad kid. Cause I have had some experiences where teachers who looked at me and were like, sensory is not real. This kid just needs better this, better that. And I, that was harder for me to hear. Help me understand if you know what I’m talking about. If you’ve heard that kind of chatter too, help me understand where that’s coming from and how you would set the record or how you would respond as an ot if a teacher was maybe identifying a bunch of sensory needs all over the place and you maybe didn’t have the resources to properly address that. Give me more insight into unpacking that debate sort of.Casey (33:02):Yeah. And I think that mean, again, this could kind of be a whole tangent in and of itself. Their kids are learning differently now than they did 10 years ago, 20 years ago. Our expectation of what we ask kids to do, the expectations get higher and higher. I mean, you have a kindergartner too. So do the things that they are learning in kindergarten right now we’re learning our letters in kindergarten and now they are reading, they are writing sentences, they’re telling time. It’s crazy. So the things that they learn are becoming more advanced. Their bodies as infants, toddlers, preschoolers maybe did not have much of as much opportunity. This isn’t across the board, but something to think about. We don’t have as much This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 10 of 15opportunity to spend time outside or maybe we’re not doing all of that sensory play when we’re little or play-based preschools, things like that are not as common now.(34:00):So that plays into development in school age. So all that to say, kids are learning differently and I think that impacts kids in different ways. But the easiest thing to see is the outward expression of that which comes from, they’re not sitting, they’re not paying attention, they can’t focus. They want to reward for everything. If it’s not super exciting, they’re not going to do it. And maybe that’s true. Maybe there is something that is going on and our job is to try to figure out why. And it can be really complicated. So I think that as an OT, we can provide, again, some support for that teacher to recognize you have sensory needs or you’re seeing this not even labeling it right off the bat, but you’re seeing a lot of different things. So being clear about what your role is as an ot, you say, I’m an expert in these areas, which could be how they’re using their hands or how they’re writing the observable things that you could see.(35:07):You can talk about any training you have in sensory processing, but also recognizing like, hey, have we talked to the rest of the team? Who’s our behavior specialist that we can also bring in, again, building on that team approach. At my school we have a behavior specialist. So we work together all the time to come up with solutions for kids. We are just constantly in communication, trying things and saying, if the teacher says this isn’t working, and then we say we have to try something different. We may not find the perfect fidget or the perfect sensory tool for each child, but we can educate on the importance of movement for everyone. We can educate on the importance of chunking activities and not expecting them to sit. All of those things come down to kids learn differently. So we have to adapt. And that’s not that we have to lower our expectations, but we to have to let go of the expectation that we’re going to sit for an hour.(36:08):I don’t, especially in the younger grades. So that’s kind of again, pulling off of the team, making sure that there’s someone who can answer questions about behavior from a behavior specialist expertise. You have the OT who can answer questions about the sensory needs and also just recognizing that the teacher, her points are valid and yeah, it’s hard. So what can we do to make her job easier? Now maybe you have some suggestions there. And then working down to individual kids or identifying who actually needs ot because the referrals can be pretty high because sensory is kind of a buzzword. It is,Laura (36:57):And I think parents don’t all understand this right away, is that when we graduate from OT school, we don’t have specialties in med school. Some OTs will let you have electives where you learn more about it like an interest topic, but you don’t graduate as a pediatric ot, you graduate as an occupational therapist and you go to your internships where you’re placed and you still don’t even get to choose that. And then you take a general test and then you go into whatever you want. Some field will require a specialization in hand therapy and things like that. But for school-based OT and even for a sensory-based clinic, you can just start with whatever training you have from grad school, which is not a lot on sensory. I learned 95% of what I know from my field work, which was in a pediatric sensory clinic. And then after that, once I started making money, I had to pay for my own professional development right in it.(37:55):So that’s the same for schools. And then in school-based ot, if you don’t have enough sensory-based training and you don’t seek that out because your school maybe doesn’t even offer that they don’t have a sensory room, why would you spend your extra time learning about something that you’re not going This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 11 of 15to get practice with to support in your caseload? Because there’s less just sensory it. And then if you don’t have enough mentorship, I could see how it down the line, they get less and less training or confidence in the sensory piece and it feels very surface level. So what I always tell parents is that if your child has true sensory processing challenges and OT at the school will help come up with accommodations and modifications to make them be successful, but they’re not really going to target sensory processing skills and a building skills type thing.(38:47):You really need to go to a spec to an ot. But what I heard, which I don’t know if it was a rumor or depend on who told me was that legally or you’re not supposed to as the school-based ot, if you see this family talking to you and saying, yeah, but my child needs support, his proprioception about his body awareness is terrible and modifying this will help, but we need more and the school can’t provide it. I heard that school OTs or someone on the school cannot say you should go to a private OT or else the school is responsible for it. And that blew my mind.Casey (39:21):Yeah, I think that that is something, for example, if we feel a child needs an A D H D evaluation, we can’t, especially in our, the private school that I work at, we can’t just say, go to this person and they will evaluate you. Because when we recommend that, yes, then the school district has to pay for it. You can have conversations about it and kind of say, this is what we’re sharing and maybe other families have done this, but we can’t necessarily make specific recommendations and say, because then it could be turned around. I’m not saying that those parents would do that, but if they said, well your school OT said we had to do this in order to be successful in school, then that is saying we can’t provide them with what they needLaura (40:10):To be. So you have to say it in a very sneaky way almost. I know. And what ICasey (40:16):Think, yeah,Laura (40:17):What I feel like I’ve been hearing, maybe it’s different now, but in the past when I had this conversation years ago was either O OTs just feel awkward saying it so they don’t say it at all. But then parents don’t even really know what OT is like don’t even know there’s an option out there to look for it. And then that’s where I get frustrated where I’m like, well how come the school, it’s like I feel like it should be okay to say your child needs to, there’s like there’s specialties out there and this is not within my scope of practice, but yes, I think your child could benefit for your home life or something outside. But yeah, ICasey (40:51):Mean I’ve had conversations with parents who have there, I mean every kid at my school essentially has sensory needs if they’re deaf or hard of hearing, it impacts a lot of things. So of course, again, I’m kind of in a very different setting. I’m not in a public school, but I have had conversations with parents explaining what I will do from a sensory perspective. And this one parent I’m thinking in particular already had an outside ot. So I was saying I was able to say, your outpatient OT can do all of these things. My goal is to help your children be successful at school. So it wasn’t like you need to seek that This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 12 of 15out. I was just helping her because she would say, well they don’t do that there and you’re doing something different. And so it’s just helpful to explain we are both OTs and we just have different goals because it’s a different setting and I am not going to be getting into the nitty gritty of helping their sensory processing system change from all of that rewiring that takes intensive outpatient clinic work. That’s not what I’m going to do. I can help them from a sensory perspective in these ways, but I am not going to do this. So I’ve had those conversations not necessarily saying, you need to go get that.Laura (42:10):Yeah,Casey (42:11):Personally haven’t had to do that, but I know what you’re saying. Yeah, there’s difference in what we do in different settings. That’s just the nature of ot.Laura (42:20):So or how do you advise a parent to start, let’s say they started the I E P process. They’ve requested that their child has been assessed and they are told that their child does not qualify for ot. But let’s say this family knows specifically whether their child has a medical diagnosis of autism or has been identified to have sensory needs in some way. This parent knows their child needs help with sensory from however they know it, they know it. What do you advise their next step in terms of what to do when you disagree with that? And then things that they can do to maybe get any support for sensory at all?Casey (43:00):So if you’ve already had the evaluation, let’s say the OT did an evaluation, I would ask for to specifically see what tools they used, what tests they used, whether they did a sensory profile or whatever they actually did to ask for copies of that. And then also ask for the scores from whatever motor assessment they did. And if in that question you find out they didn’t do a sensory questionnaire or they didn’t do a motor assessment, then you can request that and you can have the same OT do that. But if you feel like the school did not do a comprehensive evaluation and look at all of the areas of need, which to kind of give a side note, make sure that you communicate all of those things that you want to be assessed from the beginning listing out, I want their sensory processing and their motor systems as well to be assessed.(43:58):Make sure that that’s known. It should be. But just to make sure, again, it’s in writing and if you feel like they didn’t do a comprehensive evaluation, then you do have an option of having an independent evaluation done. There are legal avenues to have the school pay for that, but it ultimately, even if you do and you say this school OT evaluation was not sufficient, we had the independent evaluation, the school can still technically say we, it took it under consideration, but we do not need to accept it. However, I feel like again, it goes back to making sure you are communicating what you expect and then asking for documentation, looking at it, getting the independent evaluation if you need to. And then there are legal avenues that you can go up. You can go through some process called due process and sometimes it’s just mediating with a third party. Sometimes it go does go to court. So there are very specific ways that you do that. But hopefully it doesn’t get to that one other document that if they say no, you don’t qualify, it’s called A P W N, which is a prior written notice and that will have to document why they are saying no. So it will clearly date. SoThis transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 13 of 15Laura (45:20):The parent would have to ask for this,Casey (45:22):You’re supposed to get it, you shouldn’t have to ask for it. But if you don’t get it or you don’t get something that’s called a prior written notice, P W N, then you can ask for it. And they have to write what they did, the evaluation they did, the options they considered and why they chose what they did. So that can be helpful too. Got it. To see their training.Laura (45:45):But so if parents are listening to be considered a comprehensive evaluation in regards to sensory, most schools, if not all, will provide either a sensory processing measure or a sensory profile. Is that correct? At the very least.Casey (45:59):I mean, I would hope so. I would hope so because those would have the option of doing the teacher report. Yeah. I have some observation. They should send one home too as well. They need to consider parent input.Laura (46:13):Yeah. So my question is that for parents like me where I know from a, because I understand sensory, I know her behavior at home can be directly linked to things at school. So is it fair of me to, even though her teacher’s not seeing it, is it fair of me to ask the teacher, it would really help her have be more regulated after school so we can practice more reading and homework or whatever it is. If at the end of the day you let her have five minutes out something where there needs to be no modification, even though you’re not seeing it at school, it’s still impacting her ability to learn at home, academic content or something else. Is that something that has ever been brought up or talked about?Casey (46:57):Yeah, for sure. And I think that you have to think a child is not a vacuum, there are not one person at school. They might have different behaviors or things that you’re seeing, but yes, it is important to share. I think sometimes parents, maybe you’ve, you feel like you don’t want to share with the teacher or somebody on your team about what is really happening at home or maybe you feel embarrassed or something. But really sharing a full picture of your child with your teacher hopefully can help them see them as a whole person. And you can open that conversation about this is what works for us. And talking about how maybe it’s hard getting to school and how that can impact the rest of and getting home. And we are not, especially as children, very good at compartmentalizing. Once we’re home with our safe people, it all comes out.(47:56):And I think that’s important for teachers to know. So definitely having those conversations and trying to get something in place. And I hope that taking from what I was saying, that this doesn’t sound like super depressing and feeling like there’s no end in sight. It might be an uphill road, but the biggest takeaways are to be open with communication, start talking with your child’s teacher and trying to work together. Everybody has expertise to bring to the table, especially as the parent, but taking what the teacher has to say as well and trying to work together to come up with a plan, whether that comes down to a 5 0 4 This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 14 of 15that is well written and has oversight and goals or getting an I E P that can provide more support. It can happen. It just might take a little bit more work now. But the outcome of that I think is we are showing our kids that we are advocating for them so that then they can advocate for themselves in the future.(49:01):And it can be hard and it can be, I don’t know, it can be challenging, but knowing that you’re not alone. There are so many parents who also have this same experience and there are other people who, whether it’s finding communities online or local groups on Facebook, there are other people who can talk with you and share insight even about your school district. Find those mom groups that you can talk to and share what’s going on because somebody’s been down that road before and someone will help you figure out like, oh, this teacher said this and this teacher, you need to really do this. I really think that sharing with the community you feel safe in is going to be really helpful. And finding those support people, whether it’s your family or sometimes it’s not. Maybe it’s friends and maybe it’s people across the country, but there are other people who have experienced it and there’s the community out there. We just have to get you connected with it, I guess.Laura (50:02):Yes. Wow. Such a good takeaway summary that you did for me. Thank you for doing that. That’s like a perfect way to edit. You summarize all the good takeaways you reminded them about to find their village. I love it. This is perfect Casey. So can you please let everybody know who might want to learn more from you where they could find more of you online, any resources you might have, let us know where we could find you.Casey (50:25):Sure. So I am on Instagram and TikTok and very old videos on YouTube that are two years old, but they’re still applicable cause they talk about IEPs and 5 0 4 s and things like that. But my handle is OT time with Casey, so you can find me on those channels there. I do have a website and I am offering, I can do consults, but I will forewarn you that my schedule is not as broad as someone who has, I have a full￾time job and I’ve got two kids, so I do one-on-one consults to even just talk through for 20 minutes. Here’s going on, what can we do next? And just giving next steps, do that. Okay. I can also do ongoing support, but again, my schedule is not super open, especially in the school year. Summer’s a little bit different, but my website is also OT time with Casey, so you can find that there. Yeah, so I also, you can email me, you can find me on Instagram. I’m pretty responsive in dms. Maybe not the same day, maybe the next day, but I’ll get back to you. Promise.Laura (51:33):I will put all of those links in the show notes. Thank you for offering those resources for parents. It’s a perfect gap that you are filling how we talked in. Again, this is one of a major gaps that need to be filled right now, and social media has so many pros and cons, but one of the pros is that you’re able to build these communities for parents and find the village that they’re looking for. So thank you for offering that for parents. Thank you for your time today. I hope everyone found something helpful, whether it’s something new to try or just the encouragement that you’re already doing the right thing. That’s my goal for every episode. Thanks for your time, Casey.Casey (52:08):Yeah, thanks for having me.This transcript was exported on Mar 29, 2023 – view latest version here.CaseyWaugh_Episode69 (Completed 03/22/23)Transcript by Rev.comPage 15 of 15Speaker 2 (52:12):If you enjoyed this podcast, please consider rating it and leaving a review, which helps other parents find me as well. Want to learn more from me. I share tons more over on Instagram at the OT butterfly. See you next time.




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Laura Petix, MS OTR/L

I’m an enneagram 6, so my brain is constantly moving. My OT lenses never turn off and I can’t “un-see” the sensory and other developmental skills that go in to literally every activity. I love taking what I see and breaking it down into simple terms so parents can understand what goes into their child’s behavior and skills.

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