This is thinking cluesive I'm Tim Vegas. Okay, I want to talk to all the teachers listening, especially special education teachers. How many of you work with occupational therapists in your school? Or in your classroom? Let's just get a show of hands. Just raise your hand or give me a nod. Great. Great. Thank you. I see you in your car. You taking a walk and you drinking your coffee? Aren't OTS? Wonderful. Let's all give it up for OTS. There we go. You know, April is ot month. I know right. Now, how many of you can explain what an OT does? If you said fine motor or independent feeding skills? This episode is going to blow your mind. This week's guest Savita Sundar, she gives the best explanation of the role of occupational therapists I have ever heard. And you're going to hear it right after this short break. Stick around. We'll be right back.
Sarita Sundar is an occupational therapist and PhD candidate who specializes in inclusive practices for students with extensive support needs. With over 15 years in public schools. She's a champion for Inclusive Education, leveraging her ot experience to foster access and participation at Texas Women's University. She mentors future OTs, and teaches as an adjunct faculty member, Savita also serves as the partnerships officer at changing perspectives, promoting social emotional learning. She also hosts the podcast inclusive occupations, inspiring the creation of Inclusive Communities for Children and youth with disabilities. In this episode of thick, inclusive Sabetha and I delve into the nuances of including students with extensive support needs into general education. So Vita unpacks her transition from a traditional understanding of educational practices to pioneering inclusive education methodologies. Her commitment in nurturing social contexts that facilitate the engagement and growth of children with disabilities shines through as she retells experiences that reshaped her professional trajectory. Leveraging her background as an occupational therapist saveetha passionately argues for a system wide approach, where therapists go beyond addressing motor skills to facilitate comprehensive participation and inclusion within educational settings, making her a vital voice in the call for an educational paradigm shift. Before we dive into our conversation with the Vita, I want to share a word from this week's sponsor, with one in 36 children diagnosed with autism. The Autism Society of America is dedicated to creating connections, empowering everyone in the autism community with the resources needed to live fully as the nation's oldest leading grassroots autism organization, the Autism Society and its approximately 70 affiliates serve over half a million people each year. By championing initiatives that advance equitable opportunities in health care, education, employment, safety and public policy. The organization executes a national reach with meaningful local impact through education, advocacy, support and community programming. The Autism Society works toward a world in which everyone is connected to the support they need when they need it. For more information, go to autism society.org. The connection is you and now my conversation with Savita Sundar
Savita Sunder. Welcome to the thing inclusive podcast.
Thank you, Tim. Thanks for having me.
Yeah, of course, of course. How long have we known each other? Sabetha? It's been it's been a while. Yeah. Yeah, yeah. And I want to say right off the bat that saveetha has a wonderful podcast called inclusive occupations got to get it, right. Yeah. That's No, no, it says right off the top my head. And so, after you listen to this episode, go ahead and subscribe, wherever you get your podcasts, to submit those because she has some great guests. And to start us off, I'd love to know, you know, everyone, everyone kind of gets on the road to inclusive education a little differently. So what started you on the road? To inclusive education?
Sure, yeah. So I am an Occupational Therapist, by trade. And I've been an OT since 2001. Again, so it's been long time. And I always wanted to work in, in pediatric practice with children. So I sort of took all courses in that space and took up a job and pediatrics and school based practice in Arkansas, and then moved around and ended up in California in 2008, when I started working in the school system, and I was hired by the Santa Clara County Office of Education, and I worked with them for 13 years. And during the course of my practice, as an OT in the school, so the county office of education, as well as I should say they they helped me grow my roots in this space. And I work predominantly with students with extensive support needs, should say exclusively with students with extensive support needs, and this is way back many years ago. When so that the the way the schools were set up in the Bay Area, California in Santa Clara County, which is the Silicon Valley is that the school districts are many school districts are very tiny. Some are big, some are tiny, but when they are unable to provide FAPE for an appropriate public public education, they would seek help from the county, which was like a third party organization that would combine students from a bunch of different districts and open up a classroom within one of those school districts, one of those public schools that we were but the school the classroom was a county program. So we were still within a school campus, a public school campus, but we weren't usually did not belong to that particular school district. We had students from other school districts and we also had site based centers or centers exclusively for students. You know, with autism diagnoses or students with orthopedic impairments, so there are some sites that are specific to their disability categories, medically fragile programs. So I you know, I worked there for five years in the beginning, you know, traditional ot practice going from different schools helping students in that classroom meet their IEP goals. But there were many incidences I should say that sort of set a light bulb going for me. I teachers would have some of the teachers would have this inclusion time where they would have kids from Gen Ed come into our classrooms and, you know, hang out with our kiddos. And we would have these inclusion days and inclusion times inclusion activities. Oh, it's inclusion time for this kid, they have to be taken to that particular PE session, whatever and brought back. So once one, one interesting story that I like to share is when one of the teachers would invite kids from fourth and fifth grade come into our cater to self contained. We call them as DCS or special day class in California to come into our classrooms and the kids hung out with our little kids with disabilities. And there was one student who was just enamored by these girls who would come in from fourth grade and he would follow them and he just loved interacting with these kids who were sort of giving him a lot of attention and noticed enjoying their company. And we'll be working with a student I'd been I had been serving the student for a long time from all the way from preschool and he had come a long way from not wanting to touch anything to You know, not even walking at that point, when he started with us. And he had come a long way, there was one thing we still were struggling with helping him to feed himself, he just refused to feed himself. There really wasn't any physical, you know, limitation with feeding himself, but he just waited for somebody to feed them. So one day, these kids, these girls from fourth grade came in and sat with him and looked at him and like, Hey, Jimmy, his name is not Jimmy, I'm just saying, Jimmy, I have yogurt, too. Let's eat. And so and he was like, oh, yeah, let's see that he sits with with these girls and starts feeding himself, like he's been doing it forever, was like, Oh, my gosh, all it took was that social context for him to be with his peers, to to just start feeding himself, he just wanted to impress them, or I suppose I just wanted to feel he was part of, of that group. So that really opened my eyes. And after that incident, I should say that I started noticing this more and more and more, there were times when in the presence of their peers, our kiddos did so much better or seem so much more engaged in activities. And so I started looking into involving kids without disabilities in my session, in my ot session, and I really didn't know a lot about inclusion at that at that point. But sort of organically, I realized that this is so much more impactful than any other traditional ot approaches that I have been using in the past, just having that peer support peer relationships can make a huge difference for my students. So that sort of became my focus. And I started doing programs within the Middle School campus where that's when the segregation sort of becomes wider, and our kids hardly ever had any time with their peers. So I collaborated with the Gen Ed Leadership, the elective teacher, and we had ongoing programs where the kids would come to our program, and we would have gardening activities going on. And, you know, a lot of things. So our team and the agenda team collaborated and did stuff, and it was probably the most fulfilling part of my job was beyond working on, you know, traditional therapy, this just made so much more impact, and it's so truly represented who I am as an occupational therapist. So I felt this is where I want to focus my attention on and I just became obsessed with that space, I should say. And at that point, I only thought about social inclusion. And I said, Okay, I want to go explore further, I want to investigate the space more and started my PhD journey in occupational therapy at Texas Woman's University, only to find out that our literature is so limited in the space in an inclusive participation. And so I really had to jump into the education literature to enhance my knowledge. And starting off with social inclusion, I evolved, I should say, very soon to understand that you cannot separate social and academic inclusion, even the very definition of social inclusion involves interpersonal relationships and community participation, and what is community participation in school, being able to access all that students without disabilities are able to access as well, right. So they just cannot be separated. So that that sort of set me on this path of exploring inclusion and making that happen in the lives of the students that we serve in schools.
And you were working in this county setting you said for five years, for 13
years. So the first five years are sort of where I, I think, realized that this is important. Five years, I should say the next eight years was all about me trying to make that more of a focus for in my practice.
Gotcha. Yeah. I, I am familiar with the County, the county programs work in California. Because I taught in Pasadena Unified in California, and we had a very similar system of the county, like Los Angeles County Office of Education that would have classrooms, in schools that were in the vicinity of or within the perimeter of the the county. And then there were County Schools. Like you said, like it was special schools and I I don't think I've ever told you this. But when I was going to Cal State Fullerton for my teacher ed program, we went to a quote unquote inclusive school. This was like the best in the area, essentially it I don't even remember the name of the school. But I mean, it was it was fully inclusive. Okay, it was. But then I don't know who asked, I might have asked, somebody else might have asked, I don't remember and be like, Where are the kids with and we didn't have this, we didn't have extensive support needs. Like, that wasn't the language, we use something else? We're like, where are those? Where are the other kids? They're like, Oh, they don't go here. Yeah, they go somewhere else. And it's like, okay.
Exactly. And it was interesting, because I had never worked in any other set. While I did sort of work a little bit in the district before I started with the county. But for the longest time, I only served kids with the most significant support needs that I didn't know how else. And then the county office had an inclusion collaborative department that supported districts in enabling inclusive setting for which was sort of, you know, ironic that we had our own exclusive programs when we were supporting inclusion in the districts. So while completely turning a blind eye, to this population of students we had in 500, school sites, 500 classrooms, who just had absolutely no inclusion time, or very minimal inclusion time. And what people perceive as inclusion was also very different from school to school and person to person. And I mean, personally, I would have answered differently if you had asked me that whether your school is inclusive or not, if you're asked me like 13 years, of course, we're very inclusive, we have all these programs where we facilitate inclusion of our students. So I know, I know better now. I have to do better now. So yeah, yeah. And the literature just like, why aren't we doing this, if this was so clear, and it's been around for 30 years, more than 30 years that kids do academically, socially, and in you know, long term outcome wise, better when they are in inclusive settings. And the limitation has nothing to do with student needs, the barrier has nothing to do with student needs. It's more to do with our mindset and capacity factors. So that's where we need to be focusing our attention on.
Yeah,
yeah.
What so what's the thing that really changed your mind? Because you, you're you, cuz you mentioned at the beginning that the story of the of, including Jimmy, right, or, or having Jimmy be in a place where he was with typically developing peers, and then in seeing so clearly the benefit of that? Was there like in, in your definition of inclusion and how you would describe inclusion or inclusive education now? Where was there a moment where it all kind of clicked for you like your understanding of it, of how you would describe it now.
I have to say it evolved slowly, it didn't click. Clicking moments, I think it was like, oh, with peers, kids do so much better. And next is like, oh, we have to intentionally facilitate that it cannot, you know, we can't just throw kids in Gen Ed and say, Here we are, or we have in terms of recess, we have inclusive assemblies, that's not inclusive, that's just physical space sharing. Inclusion takes intentional effort. So we have to facilitate that and make it happen. And then I also felt like, oh, it's not realistic. It's not very sensible to have kids with such significant cognitive differences to be educated in the general education classroom, it doesn't make very much sense to like, of course, compared to being in a self contained to general education setting. They're learning a lot. We're just measuring different things. Right. So if we were to measure what's more important for our students in 21st century, we obviously will find that kids gain a lot in a general education classroom, regardless of the nature of their disabilities. Just so many of those with readings with listening to your podcast and you know, delving into the literature and, you know, brooding over these questions and having conversations with people or in the space, I think that I have had several eye opening moments and I have to say that at this point, where I am in my PhD program. I'm a PhD candidate now waiting to mean, I'm just about to get my dissertation started. I feel like things have come together. And I feel like I'm in a place at this time, where I'm clear that my focus going forward is to, to ensure that my profession and school plays a powerful role in enabling inclusive participation for students with disabilities, especially students with extensive support needs. And you know, it's kind of so true over the course of my my PhD program, I did two studies. The first study was, like I said, I started off with social inclusion, right? So I wanted to find out what is what will schools do to facilitate social inclusion since there's absolutely zero literature and OT on social inclusion for students with extensive support needs, I want to look at what schools do to facilitate social inclusion for students with excellence. So I looked into the literature, I did a scoping review. And I found that so I specifically looked at studies that addressed social element of inclusion. So I found that the number one was pure mediated interventions, the number one intervention used is peer mediated interventions, and then then comes to school wide, comprehensive efforts.
And then collaboration, could you I'm sorry, for interrupting. Could you explain what that what that means or looks like it just in case somebody hears peer mediated interventions and doesn't know, doesn't know what that means.
So peer mediated interventions is where we involve peers without disabilities, to to enable inclusion to be agents of inclusion for students with extensive support needs. So there are different types of peer mediators, interventions. And I think if you go to Dr. Carter's website, you can find a lot of resources. And also the Thai Center has some really great resources on peer mediator intervention. So we help peer support programs, peer partner programs and peer network intervention. So they're like slightly different peer support is where you have a student with a disability and a student with a disability, specifically working on certain goals addressing certain goals, whereas peer networks is creating a community for, for for, for a student who has significant support needs with other peers who can sort of help them integrate into the the school, I would say in school. The school is social spaces, that will be peer network. And they do activities outside. Again, peer partner programs are programs where again, they partner with peers, and they have programs like Best Buddies, I think, come under peer programs. So all of these are our efforts that we're making, although it's not the whole thing, they're little efforts that we're making to invite students with disabilities who have historically been outside or on the margins of our society into the, into our spaces. But that's not enough. That's not it. That's not inclusion itself is just a pathway towards getting there because our systems have been this way forever. So to change that it takes time. But we never should be satisfied and say like, Oh, we've burned clothes over there. No, it's a journey inclusion as a journey. And and I also have come to understand, so I have inclusion, there's like authentic inclusion, right? So authentic inclusion takes it takes active effort to combat exclusion. That's what include authentic inclusion is it is beyond physical placement. It takes intentional effort. And it addresses all three dimensions of inclusion, which is the physical, academic and the social dimension. So an authentic inclusion is a journey forever, always trying to combat exclusion.
Yeah, yeah, I know, some people don't like to hear that. You know, like, they don't like to hear that it takes time. Because they want it now and I get it, I get that I get that we want it now. And I also I also get that, you know, Best Buddies. And then, you know, put whatever sort of synonym to Best Buddies. So there's lots of different kinds of programs out there that that facilitate, hopefully authentic friendships. That that that isn't inclusion. I think it's difficult because, you know, for people who have been advocating for authentic was inclusive education for so long and then seeing programs highlighted in a positive note, either in the middIe media or someone just talking to you, you don't want to completely be like, well, that's not inclusion, you know, like, like, have this attitude of this attitude of like that that isn't real, you know, because the thing is, is like it's real for, like, it's real for the kids that are involved with the friendships, you know what I mean, even though it may not be perfect, right?
Exactly. And I think we, we should never become paralyzed by this analysis of like, what is the right thing to do? And then we never do anything.
Exactly what is worse
than doing something wrong? I think at some times, I mean, there are no logical absolutes anywhere. So when we have the intention of creating better engagement and participation for our students, then we take efforts and when we take efforts we learn as we grow like, this is good. But of course, I want to do even better. So we never get to doing something that we think is right. We'll never learn to do to get that make that better. Right.
So yeah, yeah, exactly, exactly.
I think the intention is very important. And with the intention, the effort to do the right thing, and being open to learn and grow along the way is key.
I love the lens that you're looking at this with, specifically occupational therapy. I've worked in public schools for a while. And I've known lots of occupational therapists. And I have always felt that OTS have, I don't know, they were like, the easiest to get on board with. Like, thinking inclusively, you know, like SLPs are wonderful, like speech language pathologists are wonderful people. And I'm so glad that they're part of the school system, and that they're part of like related services, you know, but for some reason, occupational therapists, I could always be like, Hey, I've got this wild idea. What if we, and then you know, and they're always like, Yeah, let's do it. So I'm like, Why do you think that is? Because we
were born to do that. We were, we were trained and design. We were manufactured to do that. Okay, so, you know, it's so another aha moment for me was, we always have a difficulty articulating what we do, right? We, that's the nature it's both the the boon and the bane of our profession, I should say that occupational therapy cannot be put into isolated into step into our account be boxed into these specific roles. Because we are, the way occupational therapy is defined us, it is defined as the therapeutic use of everyday life activities, to to enhance participation, enhance or enable participation. So something as broad as that you cannot. It's an it's an it's an administrative nightmare to use somebody with such a broad scope of practice, right? And even for us to explain what do you do? We enable participation and lights, occupations, and I'd be like, What do you mean and so we're constantly being misunderstood and misrepresented all over the place. And so we are siloed into these Okay, ot Here you go, work on fine and gross motor section. Here you go work on sensory areas. But that's not all we do. We our background was never we never had handwriting training in school, like zero. And like 90% of our referrals are for handwriting and most schools. We didn't we had I mean sensory is an age sensory integration is an area that an occupational therapist heavily researched in. And so that's sort of become a big element of our of our scope or over over many tools that we use, but that's just another tool we use to in to increase participation in lights, occupations and in school based practice. Education is the main occupation of a student and an education comes all the other occupations that are integral to a success to the success of a student that is self care. As an occupation, social participation as an occupation, all of these occupations are, are integral to playing the role of the student effectively. Right? So that is our, our scope. So in given that always frustrates us occupational therapists, like we're not handwriting teachers, we're not sensory therapists. We're not like motor therapists. Who are you then. And I think the best definition is that I can think of the best rule that we can embrace in school is inclusion therapists, right inclusion specialists, that is just so representative of who we are as best as it can be representative of who we are, because we're going to enable participation in the least restrictive environment, right. So again, that's another so that's one thing. So occupational therapy we are training is basically in enabling participation and participation we see as involving these three main dimensions. One is the person who's participating, the context of the environment in which they are participating, and the occupation or the activity that they're doing. So these three are like the main competence for successful participation. Okay, so an AR training is an understanding the person all different aspects, the physical, the psychosocial elements of a person. And then we understand the context, the physical context and the physical environment and the social environment, then we study occupations in depth, we understand how we can break down activities and, and understand it in depth. So with all of this training and the dynamic relationship between these three components, I think we have some pretty great perspectives about how we can meaningfully enable inclusion in schools. So right, we know that if you have a student with, with extensive support needs in a general education classroom without making any accommodations or making any modifications to the physical or the social environment, you're not really doing inclusion there, you're actually you're actually facilitating exclusion in some way. Like, why do i Why do I want to be here, if nobody wants me here, nobody's doing anything to make it accessible for me. So you need to bring in an OT here to make it accessible for the student. Right? So it takes a team effort and OTs can be very powerful support in that space. I doubt administrators know that. This is what OTS do, this is what we are trained in.
Yeah, sounds like it sounds like districts need to utilize OTS more in this, like inclusion facilitator role. You know, I mean, some districts have a role called an inclusion facilitator. And they're mostly like, you know, teachers on special assignment where they don't have a classroom, but they're still, like, technically a teacher, like on paper. And then they help facilitate, or they have some sort of administrative credential. And they, you know, they help with planning and they help with collaboration. But, yeah, it's really interesting. And also, your your comment about, you know, OTs mostly being used as handwriting like, I know that. I don't want to be too cynical, but I feel like that is that is right on point. With how teas are typically used, right? And handwriting is such a, I mean, that's a whole other topic, whether or not we should be working on handwriting, handwriting anyways, with technology and everything. But you know, anyways, we don't have to talk about that.
I mean, it's 21st century, and we have very many concerns. And I think they want ot services for a student. And the only way they believe they can get ot services for a student is to find an area of deficit. And handwriting stands as an area of functional deficit. And then therefore gets referred, or writing is a big area that OTS are called to support and unconscious handwriting, you know, you're working on technology for expressive communication, all that sort of falls under that, but that's not the only thing. That's not the only thing there's much more to it. Yeah,
I mean, like I just the feeding to, you know, the feeding and the the self care that that takes up a lot of a lot of minutes on IEPs. And so I'm wondering though, like, let's say I'm an administrator, and I'm having an aha moment and the light bulbs are going off and I'm like, oh my goodness, I can utilize my OTS differently What does that even look like in the IEP? Like? How would? How would us? How would a team describe or characterize a service? Like that? You know, given given some new information about, like what OTS do.
To him? I think that's a very, very good question and a very important question. And it's does not have an easy answer. One thing I do want to bring to attention is we have this very clear statement that a student can be removed from general education, if and only if, with the use of supplementary aids and services the student is unable to benefit from or unable to learn in the general education environment, can a student be moved to a outside the narrow education environment, right? So what are supplementary aids and services. So they are supporting services that enable a child to access general education environments, that's what supplementary aids and services are. an IDE does not specify what those services are, it's a list a never ending list of services and AIDS. So OTS can be used as supplementary services, we don't have to be used only as related services where we are in the IPs that many number of minutes, but we can be listed as supplementary services to enable to, to help with accessing, say science science lessons. So in addition to the special educator, and there is an OT coming in and helping the teacher adapt science lessons in a way that's meaningful in for that student, and oftentimes for the whole classroom, for the students with a range of abilities to maximize their learning, what a powerful in the genus resource you have in your school, if you put ot as a supplementary service there, right. And, and also you can, when you write your goals, of course, every school is has different customary practices of how they write goals. You don't have to delegate ot goals, the team sits together and makes these goals. And the framework from which you see the students goals is if you're looking at the goals, as a as a way to enable access in general education environments, like you're putting goals where the student will learn, say math concepts of fractions in the general education setting, then the OT can be added on in that goal, the speech therapists can be added on so the oh, they can support multiple goals. And the service, the intervention that an OT provides does not have to be a one on one pullout service. Right? The service can be provided over a spectrum of individual group consultation, all of those things that can help this child maximize their learning to meet those IEP goals. So I think it's a mindset change for administrators, and OTs and teachers to view the services as very helpful in making access to general education possible. With that mindset, you can creatively rewrite the service delivery language, how do you articulate the services? So again, it varies from state to state and California, people specify this many number of minutes in such a specific place, we either individually or in a group setting. But you want to look further and see, is this a legal mandate? Was this the customary practice in your school? Oh, yeah, that's, yeah, that's something to look into. Because it's not the federal law does not require you to specify whether it's individual or group requires you to specify the location of services. In Texas, though, in one of this in one of the school districts, they always wrote, it would be provided over on so many minutes a year, over a period of, you know, like so many minutes, a quarter or so many minutes a month, depending on that student and our team, but with with the possibility of providing either individual group or consultation over a spectrum on whatever is necessary for the student.
Right, right. Oh, my goodness. Yeah. I just remember like being an IEP meetings and it's like, okay, this student is getting 60 minutes per month of OT consultation, but that OT is like in my classroom, like to twice a week, you know, so they're essentially getting more are, you know, but you know, the way that you're putting it on paper is, it's just so confusing. It's just, it's so confusing. And then the other thing, I don't know if they have this in Texas. But when I taught in Georgia, this is the way that it was they had a rubric about. And based on how many years of service the student received, like, let's say, if the student received five, you know, years of OT service, then the team could possibly say, well, we've been providing this level of service for X amount of years. So providing service at the same level is not providing benefit. So therefore, we're reducing the amount of service, it was wild.
Yeah, it happens in many places. So the justification for service delivery is also so like, weird, because Oh, the kid has not made progress, and therefore no tea is needed. Or the kid really needs to make progress. And therefore we do more ot services. So the same, the reason is used to justify both removing service and adding on service. And let's say that I think if an OT does not end, like if you're only working on handwriting and say, okay, the kid hasn't, we've tried to five years, we've tried to write his name, and he hasn't learned to write his name. And therefore now we're going to dismiss ot services. So that just reinforces to the team that OTS only work on handwriting. Right? Right. Right, if you if you were to say, Okay, if the OT scope is to enable maximize participation in a lesser restrictive environment, then it opens up a whole big scope for an OT to support to stay in the system and to stay within the IEP team in creative ways. One example, is just making resources accessible for students. Not just physically but socially accessible, it takes it takes somebody designing games that would work for, for students with and without disabilities to play together. Take cafeteria, if you want to make cafeteria accessible for our students, how can you not have just kids from self contained sitting in one corner of the room? How can you have kids mingle? How can you creatively design, you know, eating activities, you know, oh, let's do food tasting today. So once a week, and it's not just kids with kids with disabilities, kids with autism are always pointed out as saying, Oh, they're very sensitive to foods. But there are a lot of kids who do not have a diagnosis of autism, who have very limited food choices. So that can be a great opportunity. Like we're going to work on improving our food, you know, healthy food choices, and then have kids taste foods that creates room for inclusion, you can know all the idiosyncrasies of our kiddos will come out and, and facilitate engagement and participation. Same with you know, you could just teach fraction with an apple in the class, creatively design a lesson with an OT and a teacher can work together to creatively design a lesson where our kids can have more ambitious goals in their IEP
goals. School is a great example. Yes. Great examples. And yeah, I hope I hope people that are listening, you can start to think creatively about how to use OTs, or at least have a conversation with the OT, that that, you know, is that their school or you know, is supporting? Because, again, going back to my comment about OTs, we're we're always the ones who were open had an open mind with how to include learners. And so appreciate I so appreciate that about about them. And from talking with you. It seems like you know, it is part of the training, you know, is part of the training and in being an OT, and no one's ever explained. Occupational therapists or therapy the way that you have to me so I am learning a lot. Oh,
and I was talking about the two studies I did in my Oh, yeah, we HD the one was the scoping review. And again, the scoping. We had no mention of any OT or any SOP involved in that inclusion process, but that's something else. The other study I did was a survey of OTs and special ed teachers who work with students with extensive support needs. And I want to know what percentage of the Northeast caseload involves students with extensive support needs. We don't have that data, right? Yeah, so students are extensive sport needs are probably 1% of the school student population. Right about one to 2% a student population. So looking at an OTS caseload, so I first did an interest survey on Facebook, I just been to a bunch of Facebook school based ot Facebook groups. And I said, I just want to know what percentage of your caseload involves students with extensive support needs was a one question survey very easy for people to fill. And I got 186 responses in three days. And that's good. Yeah. And The finding was, at least more than 50% of OTS said that at least 40% of their caseload involve students with extensive support needs. Wow. Wow, when I did a, you know, an IRB approved formal survey, and I had about 100 and 130. responses from OTS are eliminated some of them but the same exact same result was there to achieve 50% of OTS said that, I mean, more than 50% ot said that at least 40% of their caseload involved students with extensive support needs. And every time I do a presentation and conferences are of curiosity, I put that question out there, and I keep getting the same result. So I mean, we're OTS work in different school districts. And sometimes the justification is, oh, they're too severe to benefit from ot services, or others. In other settings. It's like, oh, they really need ot services. So the reasoning is so different. However, it sounds like majority of us support a significant number of students with extensive support needs. And the next question was, what do you work on with these students? And of course, the responses was handwriting, self care, sensory regulation, fine motor skills, the typical one, how do they lead to inclusion as an outcome, like what is the purpose of working on handwriting for many years, or working on buttoning your shirt for many years, that does not take the expertise of a doctoral level? You know, right now, the majority of Moti programs are entry level doctorate, so students finish their bachelor's go to a three year doctoral program, and they come with so much passion. So I have been teaching for the past three years in, you know, in my in the, in Texas Women's University, and the students are amazing, the amount of passion they come with to change the world, and will make an impact in the society you know, and to take all of these human this human potential and reduce it down to like, you know, playing whack a mole and in schools knocking off IEP mandates, you know, oh, here's an eval, put that down. Here's another eval, put that down. And that's not what we went to school for, you can they can do a lot more,
oh, my goodness, I get this, oh, this is so good. Well, I need a second. I'm just so I'm just, I'm like literally replaying all of the OTS in like IEPs I've ever had. And every time it has been in my classroom going, and all the training and and effort and the in the passion, like you said, and then being relegated to certain kinds of activities and like being pigeonholed essentially, you know,
so to do buttons, you don't do buttons, you don't need a lot of OT support time, right? So you can always justify reducing ot time because you're only working on buttoning, and you know, the school, the classroom can do that. You're just working on self feeding, and it cannot be taught in one session. It has to be done every single day. And I've already trained the staff. So ot services are dismissed for the student. Right? Oh, handwriting trading off, it's not at his level anymore.
So saveetha What the like, What should it look like going forward? Like if you had a magic wand and you could change, like how OTS are utilized either in school or how, you know, maybe just how people view it is like, what is your vision going forward?
I had a magic one lower. Part of me wants to say I think the admins have to take a stand that OTS will stop addressing handwriting skills in schools that are actually it's not that they should not I know they have a lot of expertise, but I think putting them in that fine motor box and relegating them to that role is very severely limiting. And I think ot should be Given a time outside of IEP mandated services, so if the student if a therapist has 30 students or 60 students and their caseload then the the, the time of their work, their work time is calculated based on how many students they support, we must allocate a considerable amount of time in an OTS workload to support systems to support schools to support classrooms, and that will significantly reduce the number of unnecessary referrals, you wouldn't have handwriting referrals, if, if the therapist in the teacher has, has had a discussion, and the teacher has been taught some techniques and say, Okay, these are some things that you can universally use with all students, there are programs out there that you can avail. And, you know, use it for all of your client. There's no systematic handwriting instruction going on in many schools, because it is not perceived as something important, but for a kid who has a disability is already struggling with several, you know, challenges your micro focusing on another area of challenge and forcing the kid and showing them over and over again, what they're not good at, is I think detrimental to a student's learning. Instead, if you can make, you can help you can use an OT to create UDL in the class, like, you know, How can kids either speak out their answers, or use a partner assisted way of expressing their learning, you know, have all these options available for all students, then I think, you know, you're using your ot better and the system and use them as supplementary services and also related services. So that also opens up give them a lot of time, to provide universal supports for the classrooms, the schools they serve. And use OTS also, to write goals in the IEP, that will enable a student have access to more general education environments. If the student is only doing assembly, you can start off with even just assembly, but the OTS intervention goes into making the assembly accessible and meaningful for for the student. So that way, you're helping a whole variety of students. You cannot support a student by just directly working with the student to support the student by working on the activity and the environment, along with the students.
This is fantastic. Sabetha thank you so much for sharing your vision. Do you have any final thoughts to to share with our listeners, educators, principals, parents, whoever, what's what's on your mind for the last few minutes.
I think I shared most of that, but just a cell summarize. As a takeaway. I just want to say that schools you have some very, very resourceful in the genus supports in OTs and your school to take advantage of them and remove and stop viewing OTS as these motor specialists or, or handwriting specialists and view them more as participation specialists and then that would help you use their expertise in more meaningful ways that's more relevant to 21st century needs. And OTS are also mental health professionals. So that's a huge area. So we I think what's unique about OT is we understand the body mind relationship more, more than most other professionals because that's where our training is, you know, we've had intense training in anatomy and physiology and development and Medic medicine and this and, you know, pathology and all of those things that we have a sound knowledge and that we also understand psychiatric, we understand mental health and depth and all with the outcome of how can we integrate it to enable access and participation. So if you understand that, then I think you definitely can use OTS in very creative ways and your systems.
I like that participation specialists. That's good.
Participation specialists, inclusion specialist accessibility specialist, but not motor specialists or sensory specialists. That's just one of the many tools we use to enable participation
when we return the mystery question.
All right, mystery Question time. Let's see if it's a good one. Okay. What do you feel people complain too much about these days?
What do people like? And
what if people can plain? Yeah, that might be you know, what, do you complain about too much these days?
It's just not enough time. You know, I think I see that a lot and hear people say there's just not enough time to do all that I want to do or to do, or that I need to do.
That's relatable. That is relatable. Yeah, you know, I was thinking this is this is so basic, but I went to the grocery store the other day for we are making. We're making Cuban sandwiches. Okay, so like, yeah, this Cuban sandwich recipe, like slow roast the pork and stuff. It's like, so good, right. But we needed chips. So I went to the store to get chips. Oh my gosh, my wife does the grocery shopping. So like, I don't always see how much things are. But I'm like, Are you kidding me? Like it seems such like a silly thing to complain about, you know, especially in this like climate in our country where everyone is complaining about inflation, but like, I definitely was like complaining about it. In my mind, at least I'm like, I cannot believe I'm paying this much for potato chips. But
I hear you I you know, I It's so funny. I just just think about the time when I was a student I when I came from India in 2001, as a student, you can cut it off with business. I came as a student, you know, things are very different. Now, you know, the world is more, much closer than it was back then. And, and my roommates and I would go shopping and everything we would multiply by 50. And like a yogurt cost like 1.5 dollars. And that times 5075 rupees for a box of yogurt. We don't need to eat yogurt. And we go on to the next item. And we will for the first two weeks we were here we were like oh my gosh, this is unbelievable. There's no way we're going to be spending so much basic essentials. I know
right? For
our lives. And then now the whole idea of like money, it's just become too far. And you know, I don't know, I just I Quit bothering about how things are like so outrageous.
Ya know, and I like I don't even live in California anymore. Like when we go back home to visit the you know, gas prices and then just like going out to eat or you know, the grocery store. It's just a it's like, it's mind boggling. So anyways, uh, you know, and this this is like a completely like, value. Free conversation. Like, I don't have like the I don't have any axe to grind. Like with any particular group or person. It's just, it just is what it is. saveetha Sundar, thank you so much for being on the thing that was in podcast. We appreciate it.
Thank you so much, Tim. This is fun.
That chime means it's free time. And this week, it's time to dip into the mailbag. Okay, it's just the email inbox, but it sounds cooler if you think of it as a bag. Here we go. This message is from Karen, thanks for your article about what inclusion is not. What is your view on kids with disabilities attending Special Olympics? Oh, wow. Thanks for asking Karen. I do have some thoughts about Special Olympics. And if you want to read the article she is referring to we will link it in the show notes. To put it very simply, I don't love it. I put Special Olympics in the same category as programs like helping hands and Best Buddies which, in my opinion, aren't shining examples of authentic inclusion. I think it probably depends on the program, but is very easy for a helper help ie dynamic to be present. And I don't think that moves us closer to what we want. Ultimately, we We have to ask ourselves, are these types of programs going to change schools to be more inclusive at the system level? And I'm just not sure that they are. But I am going to throw a slight wrinkle in for all of us to think about. While I'm not a huge fan of programs like Special Olympics unified sports, Best Buddies, the sparkle effect and other programs that bring people with and without disabilities together. I cannot deny that many disabled people love them. Partly because there are so few places for them to feel included. So are these programs perfect? No. Are they beneficial? I think they are. But do they move us forward to fully inclusive schools? I haven't seen that they do. Not yet. Anyways
that's it for this episode of thinking cluesive I'd love to know what you thought about this episode or any episode. Feel free to email me at T V vegas@mcie.org. That's TVILLEG a s at MCIE dot o RG or find us on the socials at think underscore inclusive we are at that handle pretty much everywhere. Think inclusive is written, edited, designed and mixed and mastered by me to Vegas, and is a production of the Maryland Coalition for Inclusive Education. Learn more about who we are, what we do and how you can become a partner@mcie.org Thanks to the Autism Society for being our sponsor this week. Learn more at Autism Society dot o RG Original Music by miles credit. Additional music from melody that's me, l o. D IE. Thanks for your time and attention. And remember, inclusion always works.
When I was preparing to send you questions, I was like, Where are the notes and I couldn't find them. So this is the best that I could off the top of my head. That's
okay, we'll we'll just chat and we'll see where I don't have anything sort of clearly outlined either, so I'm just gonna speak from
Yeah, it'll be fine. It'll be fine. Okay, so are you ready? And we'll just jump in. Sure. All right. MCIE
