QUESTION:

I am an occupational therapist working in a primary school in Vermont. We have many students with a history of trauma who have difficulty with behavior in the school setting. However, they are not on our OT caseload. Teachers are at their wit’s end trying to accommodate these students’ needs. Our administrator recently asked if I would present sensory modalities that teachers that could use without OT monitoring. I am struggling to find information with definitive answers. Our district purchased your Multi-User Brain Works program, and I use it frequently for students on my caseload, so I plan to demonstrate how it can be used in the classroom. Do you have any other information on this topic?

GWEN’S ANSWER:

Thank you for using BrainWorks and recommending it to your staff!

Your problem is a common one. When I think back to 1995 when I began working in pediatrics, I remember a caseload of kids with CP, Down Syndrome, cognitive impairment, and autism. Today, in the clinic where I work very part-time, our clients are 80% behavior/trauma issues and only about 20% of the diagnoses previously listed. That’s such a drastic change! It’s exciting, though, that administrators are beginning to recognize our role with kids experiencing these issues.

Sensory Needs

As for meeting the needs of these kids in the classroom without an OT consulting, I feel like these are the best strategies:

  • Brain breaks and sensory breaks: You may want to provide in-service training to teachers to help them understand the purpose, frequency, and recommended duration of these breaks. In a nutshell:
    • Brain breaks should be short (30–60 seconds) but frequent (every 15 minutes in kindergarten increasing to every 50 minutes by middle school)
    • Sensory breaks should be longer (10 minutes) but less frequent (every hour in kindergarten increasing to every 2 hours by fourth grade).
    • For additional guidance on movement breaks in the classroom, I recommend my webinar titled Meeting Sensory Needs in the General Education Classroom based on our research study.
  • Modifications and adaptations: You could also include basic recommendations in the same in-service training. I typically recommend things that could benefit almost all kids (peaceful music, white noise, study carrels, and minimal use of fluorescent lighting). Also consider visual boundaries (duct tape around a student’s work area, flexible seating options like being allowed to work on the floor or straddling their desk chairs).

Equipment Needs

As far as any type of equipment goes, I do feel strongly that it needs to be overseen by a therapist or a teacher with advanced training. Here are some reasons:

  • Minimize unneeded expenses: If teachers start handing out weighted vests to every kid who ever misbehaves, a lot of money may be invested in a strategy that may only be appropriate for a few of those kids.
  • Safety: Putting a weighted vest on a child with low muscle tone could cause ergonomic issues and further impair normal development.
  • Behavior: Without a proper understanding of its use, kids are often given sensory equipment after they act up. This can inadvertently reinforce maladaptive behavior.

These are just a few examples. The best answer is probably hiring more OTs to help meet the need of these kids. However, I know that can be a hard sell. Still, I do think it’s very important that an OT or PT at least monitors the use of equipment. It’s the district’s responsibility to make sure that happens, whatever it takes. For now, I would help teachers see the benefits of increasing movement in the classrooms and hope that will alleviate the issues of most of the kids, so the ones who need a therapist will have access to one.

I hope that helps! Please let me know if I can be of further assistance.

Best Wishes,
Gwen