A Day in the Life of a School-Based Occupational Therapist
We’re really excited to feature this article written by school-based occupational therapist Devon Breithart, OTR/L. In the article, Devon shares what a day in the life is like working in the school system.
When I first started OT school, I had a lot of questions. But the most persistent one that stuck with me was “What does being an occupational therapist actually look like?”
I knew I wanted to help people, but except for a few days shadowing in a Skilled Nursing Facility (SNF) before starting school, I really had no idea what the day-to-day was like. What did a treatment session look like? An evaluation? How did you know what activities to pick, and how did you know if they were working?
That’s why I wanted to share a little bit about my work as a school-based occupational therapist.
Whether you’re a seasoned OT looking to change settings, a new grad, or maybe even an undergraduate student trying to learn more about occupational therapy, I hope this information helps you picture a day in the life as an OT in the school system!
8:00 – 8:30 AM:
I arrive at my first school and sign in. I don’t have any office space here, but it’s always easy to find a spot to fire up my computer in the staff lounge. I check my email and respond to a few IEP meeting invitations, a question one of my teachers has, a screening request. I review my calendar and make sure there isn’t anything last-minute I need to do for any of my treatment sessions or meetings this afternoon. I double-check my bag for the things I need for my first group.
8:30 – 8:45 AM:
At this point I’m at my first classroom. It’s what’s called a moderate-severe Special Day Class (SDC) which means it’s a self-contained classroom for students with disabilities like autism, intellectual disability, orthopedic impairments, etc. This particular one is K-2, so I work with them on a lot of fine and visual motor skills. Except for two students in the class who show up later in the school day and need more individual support, I work with all of the students in a group.
I usually try to plan something that will last around 30 minutes with rest breaks given for the students who need them. I always try to plan something that I can easily modify or accommodate on the fly, especially since I’m working with kids with varying ability levels.
Today I brought a simple craft – an animal dot-to-dot that I plan to have the students trace, cut out, and paste on a piece of construction paper. I also brought a fun activity for the kids to do for the second part of the group – a tub full of water beads.
To start the craft, I go around to each student and present them with two options of color of paper and animals, having them verbally indicate, use a sign, or their AAC device to make a choice (supporting speech and language goals as well!).
Since I’m seeing all of the students, I’m lucky to have the support of the paraprofessionals and the teacher as well, which I like since it helps them carry over strategies when I’m not there. For the rest of the group, I spend my time adjusting grasps as needed, trialing what adaptive scissors may work well with certain students, and training the paraprofessionals on the most effective way to cue the students.
Once everyone has finished their craft, we all play with the water beads. The kids enjoy it, and since I’ve also brought tweezers, eye droppers, and scoop scissors, it has the added benefit of continuing to address fine motor skills. During this time, I quickly jot down some notes on my computer about each of the students’ performance – later I will go back and refine this into a short daily note.
My group has finished and one of my other students has arrived to class. I see this student on a more consultative basis, so I spend time talking with her teacher and asking how previous strategies have worked and what they need for the future. The student has recently received an iPad, so I work with the teacher on finding the ideal spot to place the stand for optimal visual and motor engagement.
I give the team some strategies for protecting their backs when they transfer the student out of her wheelchair, and make myself a note on my to-do list to order some u-cuff bands for her.
I spend the rest of the morning pushing into gen ed classrooms for the other students on my caseload at this school. I always try to push in if possible, because I believe it’s integral to carryover of strategies both for the student and the teacher.
Most of my students have decreased fine and visual motor skills that affect their handwriting, so we work directly on that. I generally use a combination of strategies I’ve learned from Size Matters Handwriting Program, Handwriting without Tears, and just little things I’ve picked up through experience.
I always try to check in with the teacher before I leave, but if they’re busy, I’ll send an email instead.
Around 11:30 AM:
I’ll sit down and eat some lunch. I try to actually take a break, but if I’m feeling busy, I’m guilty of using this time to finish up some notes or check my email again. I try to be as responsive to email as possible because I feel like my most important role in the school system is to be a resource to my teachers. I also try to eat lunch in the staff lounge, that way if anyone might have a question for me I can be available to them.
I have another school I have to get to today, so I go ahead and make the drive over. I’m lucky that my schools are all pretty close together, so it takes less than 10 minutes. When I get to this school, I make sure to grab the testing kit that I had grabbed from the main office yesterday.
I sign in and ask the secretary if I could use some space to test a student; she sets me up in a small room off the main office that has everything I need – table, chairs, and good lighting. I get out the assessment protocol and paperwork so that my student doesn’t have to wait once he gets here.
I go retrieve my student from his classroom and chat quickly with his teacher. This is a happy day of testing, because this student has met his goals and likely no longer requires occupational therapy to access his educational program.
From reviewing his writing samples and discussing with his teacher, I feel comfortable exiting him, but my district requires a full evaluation in order to do so. A standardized test isn’t technically required, but it will help it be a stronger evaluation, and, I may catch something that the student is still struggling with.
I give him portions of the BOT-2, which is a test of motor skills. We focus on the fine and visual motor sections which involve a lot of pencil and paper tasks as well as cutting and in-hand manipulation. He does well with everything except a folding task, which I chalk up to lack of exposure.
I won’t know his actual score until I reference the manual later, but I can tell from experience he’s scoring in the average range for his age. He’s a fun kid and jokes around with me a lot during the test, and I know I will miss working with him.
We return to class, and I check in one more time with his teacher. This student had been mainly struggling with handwriting, but I check for any other fine motor concerns – opening containers at lunch, zipping up a jacket, etc – as well as other deficits that may limit his participation as a student like attention or ability to follow directions. I’m happy to hear he’s doing well all around and doing a great job on his football team too.
I unfortunately had to cancel another student’s session in this class to have time for testing, so I check in about him too and review his writing from that afternoon. He definitely still needs some help, so I give the teacher some quick strategies and schedule a make-up session for next week.
I leave to travel to an IEP meeting at another school. I bring a printout of goal progress to add to the IEP, but otherwise work off of my computer in an effort to save paper. This IEP meeting is just an annual review, and it’s pretty cut and dry. All of the professionals on the case – gen ed teacher, special ed teacher, speech-language pathologist, and me – take turns presenting how the student has been doing.
I make sure to tell the family what I love about their student – they often don’t hear enough about their strengths.
The team proposes new goals and recommends the services the student needs to meet these goals. The student is progressing well and family is in agreement, so it’s a relatively quick meeting.
By 3:30 PM:
I’m back in my office at the district’s special education headquarters. I do some quick treatment planning for a group I’m running tomorrow, and put some finishing touches on my daily notes. I don’t touch the test results from earlier, but I do make sure I have the due date on my calendar so I can find time to work on it.
I have a strict no-taking-work-home policy, especially since I’m a travel therapist and am paid hourly. By about 4:00, I’m on my way out the door. I make sure to grab any materials I need for tomorrow and call it a day.
Some days are harder than this (and some are easier!) but this is a pretty accurate picture of what a typical day looks like for me. Sometimes I won’t have an IEP meeting, and sometimes I’ll have three that I have to juggle my time between. I think one of the key things in this job (and most OT jobs, to be honest) is the ability to be flexible.
There are definitely times when everything hits at once and it becomes stressful, but it’s all worth it for the best days when I can make a struggling student feel successful, a teacher more empowered, or a parent proud.
I will always be grateful for this experience, and I hope hearing about it has helped de-shroud some of the mystery.
We hoped you enjoyed this look into the life of a school-based occupational therapist!
What other specialties within occupational therapy would you like to know more about? Please let us know in the comments below.