Teacher Experts - Haggart on Integrated Therapies (Archives)

Ann G. Haggart, Ed.M.
Topic: Integrated Therapies (Archives)

I'm a PT who thinks that it's ridiculous to have teachers or aides ranging children -- that's my job! How can I convince my sped director?

My child care center has enrolled several children who have disabilities. We have a couple of different therapists coming in and out during the week. Shouldn't I know what they're doing? Aren't there some things we should be doing for these children?

What is block scheduling?

Q. What is an "ecological assessment"?

A. Ecological assessment is a really important tool in the integrated therapy model. It uses structured observations for two purposes:
(1)to interpret clinical data within the context of a child's natural setting. This allows the evaluator to focus findings on functionally relevant tasks/skills rather than addressing each clinical finding as equally important to the child's independence and participation in age appropriate routines;
(2) to identify activities in the routines of the natural setting which already address skills which the child needs to be working on. For example, if the child is working on bi-lateral coordination, are there naturally occurring routines within which this skill could be addressed (such as opening a milk carton with 2 hands, stabilizing paper on a desk, walking with alternating steps down the school bus stairs.) This type of "task analysis" is important because it helps teachers and parents have a better understanding of how therapeutic needs can be addressed without pulling children out of classrooms. It also relieves teachers to realize that they are already doing many of the things the child needs. They may simply need to be more intentional when they address these skills with a child on an IEP.
Ecological assessment can also be used to identify the types of accommodations the child may need to access naturally occurring routines. The focus is on the environment and creating multiple opportunities for children to participate in what's going on there, rather that focusing the therapist's attention on child specific skills without consideration of the environment.

Q. I'm a PT who thinks that it's ridiculous to have teachers or aides ranging children -- that's my job! How can I convince my sped director?

A. As a physical therapist you have special skills and knowledge that teachers and aides do not have. If a child needs to be ranged then that child probably needs to be ranged at least daily. It's not necessary for a physical therapist to do the actual ranging, as non-therapists are capable of doing this under your guidance, direction, and monitoring. Schools need you to be using your special skills and knowledge to support children's access to that environment and to work with others to create and implement accommodations, not having you do activities (such as daily ranging) which can and probably should be done by someone else.

Q. My child care center has enrolled several children who have disabilities. We have a couple of different therapists coming in and out during the week. Shouldn't I know what they're doing? Aren't there some things we should be doing for these children?

A. The IDEA-97 amendments have made it clear that early intervention programs need to support children and families in "natural environments". A child care center would be considered a natural environment. It's good that the EI therapists are coming to your center; however, you have raised important issues. You absolutely need to know what they are doing -- they are in your center! In my experience I've found that the therapists also want you to know what they are doing and they want to have you doing some carry-over activities through-out the day. But they are often rushed and often don't know how to go about starting this conversation. Find out who the director of the early intervention program is and invite him/her to your center. Sit down together with a list of questions you want to discuss and create a plan that will work for both of you. Good communication is the key.

Q. What is block scheduling?

A. Block scheduling is a way for school-based therapists to schedule their time. Rather that schedule 2x30 clinical treatment units, a therapist looks at all the tasks which must be done (evals, consultation, direct service, team meetings, etc.) and designates blocks of time to do these things. In the integrated therapy model a therapist's schedule usually changes each week to more accurately reflect the very current needs of the teachers and students s/he works with.